MOUNT DESERT ISLAND HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MOUNT DESERT ISLAND HOSPITAL (EIN 01-0211797)
Tax period
2011-05-01 to 2012-04-30
Filed
2013-03-15
IRS object ID
201330749349300118
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-03-15T12:50:27-07:00Timestamp
Tax Period End Date2012-04-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN010211797EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MOUNT DESERT ISLAND HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMOUNNameControl
Phone2072885081Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 8AddressLine1
Address Line210 Wayman LaneAddressLine2
CityBar HarborCity
StateMEState
ZIP Code046090008ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameChristina HardingName
TitleCFOTitle
Phone2072885082Phone
Date Signed2013-03-15DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonArthur BlankNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line110 Wayman LaneAddressLine1
Address Line2PO Box 8AddressLine2
CityBar HarborCity
StateMEState
ZIP Code046090008ZIPCode
FieldValueIRS element (for citing)
Gross Receipts54021105GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.mdihospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1897YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionMount Desert Island Hospital's mission is to provide compassionate care and strengthen the health of our community by embracing tomorrow's methods and respecting time-honored values.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees526TotalNbrEmployees
Total Nbr Volunteers290TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1540806ContributionsGrantsPriorYear
Contributions Grants Current Year2017517ContributionsGrantsCurrentYear
Program Service Revenue Prior Year49496610ProgramServiceRevenuePriorYear
Program Service Revenue CY50482649ProgramServiceRevenueCY
Investment Income Prior Year28647InvestmentIncomePriorYear
Investment Income Current Year591026InvestmentIncomeCurrentYear
Other Revenue Prior Year801092OtherRevenuePriorYear
Other Revenue Current Year926297OtherRevenueCurrentYear
Total Revenue Prior Year51867155TotalRevenuePriorYear
Total Revenue Current Year54017489TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year30191177SalariesEtcPriorYear
Salaries Etc Current Year32391277SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year217804TotalFundrsngExpCurrentYear
Other Expense Prior Year21299884OtherExpensePriorYear
Other Expenses Current Year22644074OtherExpensesCurrentYear
Total Expenses Prior Year51491061TotalExpensesPriorYear
Total Expenses Current Year55035351TotalExpensesCurrentYear
Revenues Less Expenses Prior Year376094RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1017862RevenuesLessExpensesCY
Total Assets BOY52909124TotalAssetsBOY
Total Assets EOY52560561TotalAssetsEOY
Total Liabilities BOY30019700TotalLiabilitiesBOY
Total Liabilities EOY31815380TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY22889424NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY20745181NetAssetsOrFundBalancesEOY
Mission DescriptionMount Desert Island Hospital's mission is to provide compassionate care and strengthen the health of our community by embracing tomorrow's methods and respecting time-honored values.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense41889300Expense
Grants0Grants
Revenue51408946Revenue
DescriptionPatient Care: Mount Desert Island Hospital's mission statement is described in Part II, Line 1 above. In Fiscal Year 2012, MDI Hospital provided $863,130 in services for which no compensation was expected or received. Policies exist to provide relief for those who cannot pay for medical care. MDI Hospital provides care to persons covered by governmental programs including Medicare, Medicaid and Champus. The unreimbursed value for providing care to these patients approximates $12,750,000. The Hospital provides a number of health services and preventative health programs to the community. Most of these programs are either covered by insurance, are offered at very low costs or are free to the community. Available programs include: cardiac pulmonary rehabilitation, wellness programs, diabetes education, nutrition counseling, parenting, pregnancy and sibling classes and physical and occupational therapy programs. Throughout the year, staff from the hospital make presentations to area school children regarding smoking cessation and health nutrition. Additionally, community groups such as Alcoholics Anonymous use the hospital's conference rooms for their meetings.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense41889300TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109661NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees526NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMEStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonArthur BlankNamePerson
Telephone Number2072885081TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110 Wayman LaneAddressLine1
CityBar HarborCity
StateMEState
ZIP Code046090008ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
Arthur J Blank
President and CEO40XX284722042502
John Adams MD
Board Member1X000
John Benson MD
Boardmember1X000
Michael Bonsey
Chairman5XX000
Stewart Brecher
Board Member1X000
Mary Dudzik MD
Board Member and Family Physician40X182833026939
David Einhorn Esq
Board Member1X000
Kathleen Field
Board Member1X000
Julius Krevans MD
Board Member1X000
Julian Kuffler MD
2nd Vice Chair & Family Physician40X220958027208
Dean Read
Board Member1X000
Mickey Shattow
Board Member1X000
Patricia Hand PhD
Board Member1X000
Elsie Flemings
Board Member1X000
Noelle Wolf
Board Member1X000
Vince Messer
1st Vice Chair3XX000
James Bright
Board member1X000
David Painter
Board Member and Family Physician40X144795029600
Christina M Harding
CFO/VP of Finance40X4658408612
Bradley Perkins
CFO/VP of Finance40X116052010389
Audrey Reed
Secretary40X48755023678
Brian Caine
Family Physician4021898405262X
Michael Heniser
Family Physician40300837019799X
Ronald Prokopius
Internal medicine Physician40299117033096X
Edward White
Orthopedic Surgeon40330069041996X
Stuart Davidson
Orthopedic Surgeon40427848041112X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2621554TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation310193TotalOtherCompensation
Number Individuals GT100 K41NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensationAddress Line2AddressOfContractor/AddressUS/AddressLine2
Bay View Physical Therapy
125 Oak StreetEllsworthME04605Physical Therapy642147
NEHE MRI LLC
PO Box 415220BostonMA022415220medical testing MRI411205
J&D Imaging
PO Box 213Bar HarborME04609Imaging test reading357145
Rao Surapememi P Ramanadha MD
50 358 Broad stBangorME04401Urologist357000suite 207
Dahl Chase Diagnostic Services
417 State StreetBangorME04401pathology services161954Suite 441
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants15281GovernmentGrants
All Other Contributions2002236AllOtherContributions
Noncash Contributions549196NoncashContributions
Total Contributions2017517TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Patient Service Revenue90009928394834283948340$0
Medicare/Medicaid payments90009922087815220878150$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue50482649TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column274589TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$274,589ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column3616TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,616ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities316437Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3616Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities312821Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column312821TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$312,821ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Cafeteria Sales9000991990211990210$0
Miscellaneous Income-Eden90009988119881190$0
Misc income - HC Admin9000991517571517570$0

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column487400TotalRevenueColumn
Related Or Exempt Function Income487400RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue926297TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column54017489TotalRevenueColumn
Related Or Exempt Function Income51408946RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$591,026ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total868576Total
Program Services0ProgramServices
Management And General868576ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total22850497Total
Program Services17154841ProgramServices
Management And General5570656ManagementAndGeneral
Fundraising125000Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total628862Total
Program Services454825ProgramServices
Management And General170723ManagementAndGeneral
Fundraising3314Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6452865Total
Program Services4667107ProgramServices
Management And General1751843ManagementAndGeneral
Fundraising33915Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1590477Total
Program Services1150314ProgramServices
Management And General431781ManagementAndGeneral
Fundraising8382Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total105150Total
Program Services0ProgramServices
Management And General105150ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total85487Total
Program Services0ProgramServices
Management And General85487ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total-41848Total
Program Services0ProgramServices
Management And General-41848ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total90218Total
Program Services0ProgramServices
Management And General90218ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4752857Total
Program Services4627244ProgramServices
Management And General125613ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total836689Total
Program Services669351ProgramServices
Management And General167338ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total44257Total
Program Services30261ProgramServices
Management And General13996ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total262178Total
Program Services130101ProgramServices
Management And General132077ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total804178Total
Program Services644410ProgramServices
Management And General159768ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2170997Total
Program Services1736798ProgramServices
Management And General434199ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total921374Total
Program Services831530ProgramServices
Management And General89844ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Purchased Services5746697398315717635400
Bad debt expense3091286309128600
Physician fees13577141332714250000
Hospital provider tax87162087162000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1545220Total
Program Services513741ProgramServices
Management And General984286ManagementAndGeneral
Fundraising47193Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total55035351Total
Program Services41889300ProgramServices
Management And General12928247ManagementAndGeneral
Fundraising217804Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY34647BOY
EOY45798EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY2976580BOY
EOY2768971EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4988287BOY
EOY5020765EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY515042BOY
EOY533456EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY148458BOY
EOY172391EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis44796979LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec21454862LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY24091510BOY
EOY23342117EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY13875549BOY
EOY12789380EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6279051BOY
EOY7887683EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY52909124BOY
EOY52560561EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY11945764BOY
EOY13236501EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY38837EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY5382336BOY
EOY4784067EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY10252880BOY
EOY9806150EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2438720BOY
EOY3949825EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY30019700BOY
EOY31815380EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY15829167BOY
EOY13622451EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5051084BOY
EOY5222565EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2009173BOY
EOY1900165EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY22889424BOY
EOY20745181EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY52909124BOY
EOY52560561EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1017862ReconcilationRevenueExpenses
Reconcilation Other Changes-1126381ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$1,797OtherActivitiesAmount
Total Lobbying Expenditures IIB1797TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSchC_P2B_S00_L01Identifier
Return ReferenceSchedule C, Part II-B, Line 1ReturnReference
ExplanationThis amount represents a portion of dues determined expended for specific lobbying purposes. These expenditures are defined as direct communications with certain members of federal, state or local government to influcence legislation. These dues support the organizations advocacy and representation in its broadest sense, activites that are well beyond the scope of defined lobbying activities. For the Maine Hospital Association, total dues are 11,593, of which 15.5% are lobbying expenses or $1,797. total lobbying expnses included in dues is $1,797.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance8117020BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses-421691InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures1366000OtherExpenditures
Administrative Expenses28848AdministrativeExpenses
End Of Year Balance6300481EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance6997367BeginningOfYearBalance
Contributions17162Contributions
Investment Earnings Or Losses1180156InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures46000OtherExpenditures
Administrative Expenses31665AdministrativeExpenses
End Of Year Balance8117020EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3938882BeginningOfYearBalance
Contributions1801964Contributions
Investment Earnings Or Losses1284232InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures7570OtherExpenditures
Administrative Expenses20141AdministrativeExpenses
End Of Year Balance6997367EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance0BeginningOfYearBalance
Contributions5077190Contributions
Investment Earnings Or Losses-974551InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures150000OtherExpenditures
Administrative Expenses13757AdministrativeExpenses
End Of Year Balance3938882EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0PermanentEndowmentEOYBalance
Term Endowment EOY Balance0TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis3322148OtherCostOrOtherBasis
Book Value3322148BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis21801737OtherCostOrOtherBasis
Depreciation10950594Depreciation
Book Value10851143BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis235558OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value235558BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis14458724OtherCostOrOtherBasis
Depreciation10504268Depreciation
Book Value3954456BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis4978812OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value4978812BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings23342117TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
Due from affiliates4568187
Deferred financing costs86894
Estimated third party payor settlements3040009
Deposits held in escrow98000
Other miscellaneous receivables94593
FieldValueIRS element (for citing)
Total Book Value Other Assets7887683TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Deferred compensation$1,420,011
Estimated 3rd party payor settlements$2,220,007
Due to affiliate$309,807
FieldValueIRS element (for citing)
Total Of Amounts3949825TotalOfAmounts
Total Revenue54017489TotalRevenue
Total Expenses55035351TotalExpenses
Excess Or Deficit For Year-1017862ExcessOrDeficitForYear
Net Unrealized GL On Investments811947NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other$1,318,559OtherAmount
Total Adjustments2130506TotalAdjustments
Excess Or Deficit Per FS1112644ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt52497411TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues-1520078OtherRevenues
Revenue Not Rptd F990-1520078RevenueNotRptdF990
Revenue Subtotal54017489RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99054017489TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt54741458TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included-293893OtherExpensesIncluded
Expenses Not Rptd F990-293893ExpensesNotRptdF990
Expenses Subtotal55035351ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99055035351TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchD_P05_S00_L04Schedule D, Part V, Line 4The quasi endowment funds are held for Hospital use and restricted by the Board of Directors. Interest may be used to fund operational expenses at the discretion of the Board of Directors. Principal funds are to be held in the quasi endowment to fund future liabilities including Eartned Time Liabilities and Lines of Credit funding.
SchD_P11_S00_L08Schedule D, Part XI, Line 8Changes in pledges receivable 1,318,559
SchD_P12_S00_L02dSchedule D, Part XII, Line 2dTotal of 1,520,010 represents items recorded as revenue below "Loss from operations" on audited financial statements: net assets released (941,578) Gifts and bequests (683,677) Interest income on investments (249,356) Investment management fees-now inc w/expenses 41,848 Other revenue (loss) below operating gain 312,821
SchD_P13_S00_L02dSchedule D, Part XIII, Line 2dFundraising expenses and Investment management fees recorded ont he audited financial statements as other income (expense) Fundraising expenses 217,804 Other 34,242 Investment fees 41,848

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense624918TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense624918NetCommunityBenefitExpense
Percent Of Total Expense0.0114PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense5656636TotalCommunityBenefitExpense
Direct Offsetting Revenue5193842DirectOffsettingRevenue
Net Community Benefit Expense462794NetCommunityBenefitExpense
Percent Of Total Expense0.0084PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense6281554TotalCommunityBenefitExpense
Direct Offsetting Revenue5193842DirectOffsettingRevenue
Net Community Benefit Expense1087712NetCommunityBenefitExpense
Percent Of Total Expense0.0198PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense12126115TotalCommunityBenefitExpense
Direct Offsetting Revenue8126050DirectOffsettingRevenue
Net Community Benefit Expense4000065NetCommunityBenefitExpense
Percent Of Total Expense0.0727PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense12126115TotalCommunityBenefitExpense
Direct Offsetting Revenue8126050DirectOffsettingRevenue
Net Community Benefit Expense4000065NetCommunityBenefitExpense
Percent Of Total Expense0.0727PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense18407669TotalCommunityBenefitExpense
Direct Offsetting Revenue13319892DirectOffsettingRevenue
Net Community Benefit Expense5087777NetCommunityBenefitExpense
Percent Of Total Expense0.0925PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$3,091,286BadDebtExpenseAmount
Amount Attributable To2238133AmountAttributableTo
Amount Reimbursed By Medicare15280621AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare18518945CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-3238324MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities11NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (11 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1Address Line2Address/AddressLine2CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalCritical Access HospitalCriticalAccessHospitalEr24 HoursEr24HoursOtherOther
Mount Desert Island Hospital
110 Wayman LanePO Box 8Bar HarborME046090008XXXX
Cadillac Family Practice and Behavioral Health Center
2322 Main StreetBar HarborME04609Outpatient clinic
Cooper Gilmore Health Center
317 Hancock RoadBar HarborME04609Outpatient clinic
Trenton Health Center
4394 Bar Harbor RoadTrentonME04605Outpatient clinic
Community Health Center
516 Community LaneSouthwest HarborME04679Outpatient clinic
Family Health Center
69 Hancock RoadBar HarborME04609Outpatient Clinic
Women's Health Center
78 Wayman LaneBar HarborME04609Outpatient clinic
Northeast Harbor Clinic
8Kimball RoadNortheast HarborME04679Outpatient clinic
MDI Orthopedic clinic
910 Wayman LaneBar HarborME04609Outpatient Clinic
MDI Dermatology Clinic
10322 Main StreetBar HarborME04609Outpatient Clinic
MDI Urology Clinic
11322 Main StreetBar HarborME04609Outpatient Clinic

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (11 entries)

Hospital Facility NumberHospitalFacilityNumberCHNA ConductedCHNAConductedCommunity DefinitionCommunityDefinitionCommunity DemographicsCommunityDemographicsExisting ResourcesExistingResourcesHow Data ObtainedHowDataObtainedCommunity Health NeedsCommunityHealthNeedsOther Health IssuesOtherHealthIssuesIdentifying ProcessIdentifyingProcessConsulting ProcessConsultingProcessNeeds Assessment ConductedNeedsAssessmentConductedTake Into AccountTakeIntoAccountOther FacilitiesOtherFacilitiesCHNA Widely AvailableCHNAWidelyAvailableOwn WebsiteOwnWebsiteOn RequestOnRequestAdopt Implement StrategyAdoptImplementStrategyExecute Implement StrategyExecuteImplementStrategyDevelop Community PlanDevelopCommunityPlanParticipate Community PlanParticipateCommunityPlanInclude Operational PlansIncludeOperationalPlansPrioritize Health NeedsPrioritizeHealthNeedsPrioritize ServicesPrioritizeServicesAll Needs AddressedAllNeedsAddressedEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareState RegulationStateRegulationExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsitePosted In Emergency RoomPostedInEmergencyRoomPosted In Admission OfficePostedInAdmissionOfficeProvided On AdmissionProvidedOnAdmissionAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentPermit Report To Credit AgencyPermitReportToCreditAgencyPermit Lien On ResidencePermitLienOnResidenceCollection ActivitiesCollectionActivitiesNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyMedicare RateMedicareRateAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossChargesOther MethodOtherMethod
Mount Desert Island Hospital
11XXXXXXXX11101XXXXXXXXX01115012501XXXXXXX11XXXXX1XX0XX1X00
Cadillac Family Practice and Behavioral Health Center
21XXXXXXXX11101XXXXXXXXX01115012501XXXXXXX11XXXXX1XX0XX1X00X
Cooper Gilmore Health Center
31XXXXXXXX11101XXXXXXXXX01115012501XXXXXXX11XXXXX1XX0XX1X00X
Trenton Health Center
41XXXXXXXX11101XXXXXXXXX01115012501XXXXXXX11XXXXX1XX0XX1X00X
Community Health Center
51XXXXXXXX11101XXXXXXXXX01115012501XXXXXXX11XXXXX1XX0XX1X00X
Family Health Center
61XXXXXXXX11101XXXXXXXXX01115012501XXXXXXX11XXXXX1XX0XX1X00X
Women's Health Center
71XXXXXXXX11101XXXXXXXXX01115012501XXXXXXX11XXXXX1XX0XX1X00X
Northeast Harbor Clinic
81XXXXXXXX11101XXXXXXXXX01115012501XXXXXXX11XXXXX1XX0XX1X00X
MDI Orthopedic clinic
91XXXXXXXX11101XXXXXXXXX01115012501XXXXXXX11XXXXX1XX0XX1X00X
MDI Dermatology Clinic
101XXXXXXXX11101XXXXXXXXX01115012501XXXXXXX11XXXXX1XX0XX1X00X
MDI Urology Clinic
111XXXXXXXX11101XXXXXXXXX01115012501XXXXXXX11XXXXX1XX0XX1X00X

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchH_P01_S00_L06aSchedule H, Part I, Line 6aThe Mount Desert Island Hospital process was a partnership with Healthy Acadia, a comprehensive community health coalition that was formed in 2001 with the public health funding provided by the Maine Center for Disease Control and Prevention.
SchH_P01_S00_L07Schedule H, Part I, Line 7Costing methodology utilized for this table were derived from Worksheet 2, Ratio of patient care cost to charges with data from our fiscal year 2012 filed cost reports.
SchH_P01_S00_L07gSchedule H, Part I, Line 7gIRS 990H Worksheet 6--Subsidized health Services--(The supporting schedule for part I, Line 7g) We did not utilize the Worksheet 2 percentage when determining the profit/loss of each of our provider based clinics. In addition, when we were compiling the subsidized provder based clinics listed in 1C above, we utilized the actual estimated costs on the Medicare cost report we prepared instead of applying towrksheet 2 cost to charge percentage.
SchH_P03_S0A_L04Schedule H, Part III, Section A, Line 4Audit Footnote#2. 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. The bad debt expense has been calculated utilizing data from our fiscal year 2012 filed cost report to produce the cost to charge ratio for Worksheet 2 Ratio of Patient Care Cost to Charges. Bad Debt expense per audited financial statements is $3,091,286. Bad debts are a community benefit as services are provided regardless of the patient's ability to pay.
SchH_P03_S0B_L08Schedule H, Part III, Section B, Line 8The Medicare shortfall would be considered as a community benefit as it is the cost of providing quality acute and primary care services while maintaining careful stewardshipp of resources with a commitment to service excellence. This was calculated utilizing Medicare net patient revenue with associated Medicare costs per the filed fiscal year 2012 cost report.
SchH_P03_S0C_L09bSchedule H, Part III, Section C, Line 9bCollection practices follow the free care policy of ensuring those patients who are eligible for federal or state medical assistance programs are covered. If not eligible for these programs, charity care eligibility is determined. The cost share plan guidelines of the free care policy are clearly stated to ensure proper collection policy and practice.
SchH_P05_S0B_L05Schedule H, Part V, Section B, Line 5The Community Health Needs Assessment is available to our community members through our problic website and the ongoing implementation and work plan is documented by our Planning and Board committees.
SchH_P05_S0B_L07Schedule H, Part V, Section B, Line 7The Mount Desert Island Hospital's Community Health Needs Assessment provides an opportunity to gain insight into the needs and assets that are served, it also provides a measure to identify and address the needs of the vulnerable populations with our community. The Mount Desert Island Hospital process was a partnership with Health Acadia, a comprehensive community health coalition that was formed in 2001 with the public health funding provided by the Maine Center for Disease Control and Prevention. The Community Health Improvement Plan and Health Needs Assessment were performed using the Mobilizing for Action through Planning and Partnerships (MAPP) process utilizing a broad cross section of our demographic and service area. This process delivered the basis for the assessment which demonstrated the strengths and opportunities for our plan. This process involved gather of two types of data, quantitative (demographics, health indicators, local statistics, etc.) and qualitative (Public Surveys, Focus Groups and Community Stakeholders). The data helps support short-term and long-term decisions about allocation of community human and capital resources. Participants included members of the Hospital's medical staff, nursing staff, board of trustees' and administration. Focus groups were used to gain feedback from diverse and remote populations, as an institution that serves the rural and coastal community of Mount Desert Island and the other islands off the Coast of Hancock County, this feedback was essential to continue to develop strategies to meet the needs of our residents. This collaborative effort developed the eight themes for strategic initiatives and goals. 1.) How can we ensure that all community members have access to affordable high quality health care? 2.) How can we ensure that all community members have access to health affordable food? 3.) How can we increase physical activity and health transportation in our region? 4.) How can we reduce and prevent substance abuse in our community? 5.) How can we ensure that the children and youth in our region have the best opportunities to grow and thrive? 6.) How can we promote healthy aging for all members of our community? 7.) How do we build an environment that is healthy, free from toxins, and protected for current and future generations? 8.) How can we increase economic opportunities and decrease economic disparities in our region? Mount Desert Island Hospital has reviewed and identified the key strategies of this plan by developing a dimplementation and mapping of current and future strategies. The plan has been vetted through the Board of Trustees of the Hospital and is resourced to the Plannign Committee of the Board of Trustees for continued review and prioritization. The key elements of the Community Health needs Assessment that were not in full alignment with the Hospital's mission and assets were Strategy 2. Although we promote healthy food options, our organization does not have a mechanism in place to distribute or provide food options to our community outside of our cafeteria.
SchH_P06_S00_L02Schedule H, Part VI, Line 2Mount Desert Island Hospital assesses the health needs of the community through the use of a collaborative Community Health Needs Assessment. As a key participant in the CHNA process our institution is able to further address and identify those areas of most concern and need in our community. A community needs assessment is a point in time effort to measure the health and well being of the community. It serves as a constructive tool to and basis for Mount Desert Island Hospital's strategic and subsequent action planning to develop Health Policy Advocacy, allocate resources, improve or expand existing services, implement new programs and collaborate with other community health care providers. A community health needs assessment also serves as a benchmark for future assessment of measured progress toward established community health objectives.
SchH_P06_S00_L03Schedule H, Part VI, Line 3MDIH is committed to: -Providing access to quality healthcare services with compassion, dignity and respect for those we serve, particularly the poor, indigent, and underserved in our communities. -Caring for all members of our communities or persons needed care, regardless of their ability to pay for services. - Assisting our patients who cannot afford to pay for part or all of the services received by working with our community to address those in need and aid in finding the financial resources available. In accordance with the American Hospital Association Recommendations, MDIH has adopted guiding principles when handling the billing, collections and financial support functions for our patients. - Provide effective communications with patients regarding hospital bills - Make affirmative efforts to help patients apply for public and private financial support programs -Offer financial support to patients with limited means -Implement policies and procedures for assisting low-income patients in a consistent manner -Implement fair and consistent billing and collection practices for all patients with patient payment obligations Communicate effectively and timely with our patients regarding patient payment obligation. Noting that a patient financial representative is available to assist with triaging patient needs and working with our patients to align resources. This representative is available to explain and review patient payment obligations as well we have a patient advocate to facilitate issues that arise in the course of this process. Information about hospital based financial support polices and external support programs that provide coverage for services are made available to patients during the pre-registration and registration processes and/or through communications with patients seeking financial assistance. MDIH offers financial support to patients with limited means. This support is available to uninsured and underinsured patients who do not qualify for public programs or other means of assistance. Notification about financial assistance programs at MDIH, including contact information, is available through messaging included on patient bills, physician offices, public areas, care management staff, registration areas, billing support staff and reception in the hospital, and clinics. Patient brochures describing the financial counseling and assistance services are available in these areas as well as on our public website, mdihospital.org.
SchH_P06_S00_L04Schedule H, Part VI, Line 4MDI Hospital provides services to Mount Desert Island and coastal Maine designated as a Critical Access Hospital, in hancock County, southeastern Maine. Mount Desert Island is comprised of 108 square miles and is the 6th largest island in the continental United States and second largest island (Long Island, NY being the largest) on the eastern seaboard. The primary geographic area serviced consists of Mount Desert Island along with the outer islands of Swans, Frenchboro, and Cranberry Isles, with a total permanent year-round population of approximately 10,000. Mount Desert Island is a destination for tourists from all over the world. Cruise ships are in the harbor from May through October and most often in September. The summer residents increase the island population by at least 30,000. Also, many thousands of tourists visit the island annually. It is reported that as many as 2.5 million people visit Acadian National Park on Mount Desert Island annually, many of whom will reside on island during their visit. This population swelling results in a significant increase in medical services provided by Mount Desert Island Hospital and its health centers located throughout the communtiy, While tourism continues to be one of the largest industries, the Jackson Laboratory, boat building, fishing and aquaculture are also a large part of the conomy on MDI. Based on demographic data, approximately 9 percent of the permanent population is below the poverty line. The demographics support an aging population as demonstrated by the 44 percent Medicare utilization at MDI Hospital. Mainecare, the state government program, accounted for 10 percent of the Hospitals gross patient service revenue for the fiscal year. While additional workers are needed to service the significant seasonal influx, the majority is under and or uninsured resulting in increased charity care and bad debts. Although the majority of Mount Desert Isalnds permanent popultion is Caucasian the additional tourists seasonal worksers and summer residents are a very diverse population.
SchH_P06_S00_L05Schedule H, Part VI, Line 5The governing Board and committe members of MDI Hospital are all local residents of the community serviced by the Hospital. The Hospital's Board is part of the tapestry of the community. They are people who understand the history and culture of the community all helping the Hospital keep pace accessing the needs of their friends and neighbors. The array of community members helps MDI Hospital's Board balance its need for financial stewardship with its caring mission. As the board is comprised of people who live and work on the Island, it also ensures that MDI Hospital maintains its uniquely personal connection and intimacy to the communities it serves. Medical staff privileges are extended to all qualified physicians in the community. As MDI Hospital is located on an Island, additional specialty services are made available on the island by medical staff from the mainland, thus providing many specialty services which would otherwise be unavilable in the community. Patients would still have access to these specialties; they woudl have to travel off the island to other communities or cities to receive these services. The organization applies surplus funds to patient care improvements through its capital expenditure program, employee and medical staff education, community benefits programs, to remain viable and technologically current. Advocacy initiatives for promoting community wide, state or nataioanl efforts work to improve health of the population and increase access. Community involvement is key as MDI Hospitals ability to provide high quality health care is directly affected by the policies that are adopted in Augusta and Washington. As competing interests are at work in these venues it is necessary for the community toa dvocate for the Hospital to ensure its health which is essential to the quality of life in the community. MDI Hospital is a community hospital designated as a creitcal access hospital which participates in all federal, state and local governement programs including Medicare, MaineCare (Medicaid), and Champus. MDI Hospital provides acute and primary care services, including a 24 hour emergency room, serving all patients regardless of their ability o pay. patients are informed of Federal, State and local government benefits as well as the Hospitals financial assistance and sliding scale discounts. Information is also available to patients in various areas of the Hospital as well as written on the back of their bill. While MDI Hospital may not be directly involved in clinical research, the Jackson Laboratory, an independent non-profit organization and leading genetics research laboratory focusing on mammalian genetics research with a strong research program investigating cancer and other gneetic diseases, is a vital member of the Mount Desert Island community as well as its largest employer.
SchH_P06_S00_L07Schedule H, Part VI, Line 7Maine

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Arthur J Blank
278657060650001650002600203272240165000
Mary Dudzik MD
15804702478600058500210890209772000
Julian Kuffler MD
2209580000000272080248166000
David Painter
121810022985000161200134800174395000
Brian Caine
1725000464840000052620224246000
Michael Heniser
28898001185700000197990320636000
Ronald Prokopius
26639603272100000330960332213000
Stuart Davidson
42784800000165000246120468960000
Edward White
33006900000160730259230372065000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchJ_P01_S00_L01aSchedule J, Part I, Line 1aThe Hospital provides the CEO's fitness membership, which is approximately $399 per year. MDI Hospital reimburses all other benefited employees up to $100 per year towards the YMCA or other health club membership with appropriate supporting documentation.
SchJ_P01_S00_L07Schedule J, Part I, Line 7The Hospital provides a performance incentive system for Division Directors and Vice Presidents who are employees in good standing during the entire fiscal year. The program is based on the organization maintaining top 12 status in overall patient satisfaction, meeting its financial target, as well as individual financial performance and quality improvement objectives.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Date IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MHHEFA 92 Bond
1992-07-011300000Contruction and renovation of hospital departments000
MHHEFA 2006F Bond
2005-07-03707200Replacement of central chiller000
MHHEFA 2007B Bond
2007-07-034427988Clinic construction, office and clinic space000
MHEFFA 2010 Bond
2010-07-011200000Refinancing of 98A Bond for renovation of outpatient service area000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Amount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
00130000000000013000000019930011
007072000000007072000020080011
00442798800000044279880020090011
00120000000000000019991011

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00000001
00000001
00000001
00000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000000
000000
000000
000000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1John Benson MD -- J and D ImagingBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipBoard MemberRelationship
Amount Of Transaction353865AmountOfTransaction
Description Of TransactionEquipment leasing and radiology servicesDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierSchL_P04_S00_L00Identifier
Return ReferenceSchedule L, Part IVReturnReference
ExplanationJohn Benson, MD is the proprietor of J&D Imaging Co. J&D Imaging does consulting for MDI Hospital in the form of radiology services performed by Dr. John Benson. MDI Hospital also leases radiology equipment from J&D Imaging. Although Dr. Benson is a member of the Board of Directors of MDI Hospital, he abstains from any situation which may be deemed a conflict of interest, and duly reports and completes on required disclosures.Explanation

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions7NumberOfContributions
Noncash Contribs Rptd F990549196NoncashContribsRptdF990
Method Of Determining RevenuesFair Market ValueMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used1ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierSchM_P01_S00_L32bIdentifier
Return ReferenceSchedule M, Part I, Line 32bReturnReference
ExplanationThe hospital policy requires that stock donations are immediately sold by the Advisors Account to which they are received.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bThe inital review of the Form 990 is performed by the Finance Sub-Committee of the Board of Director's of the hospital. The members are provided with an electronic copy of the Form 990 and all supporting schedules (printed versions are also availbe upon request). Once reviewed by the Finance Sub-Committee, all Board of Trustees are provided with a copy of the Form 990 and supporting schedules for review. The Form is provided thirty days in advance of filing giving the Board Members opportunity to comment and review, both the CEO, President and CFO, Vice President are availabe to answer any inquiries. Board Members are also given the opportunity to receive the final copy via an electronic format or a printed copy.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cPer the conflict of interest policy, the organization monitors and enforces disclosure compliance of interests that could give rise to conflicts by officers, directors, or trustees, and key employees. Disclosures are completed and submitted to the CEO. Board members will abstain from discussions or approval if there is even an appearance of possible conflict of interest during meetings.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15The compensation for CEO, other Officers and Key Employees of MDI Hospital is reviewed and approved by the governing body. Utilization of data as to comparable compensation for similarly qualified persons in functionally comparable positions at similarly situated organizations is gathered and analyzed to determine compensation for these positions.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19The annual report and form 990, including financial information, is available to the public through our website at mdihospital.org. Additional financial information is available on federal and state governmental websites for required reporting. Governing documents, conflict of interest policy are availabe upon request, as are audited financial statements.
F990_P11_S00_L05Form 990, Part XI, Line 5This is made up of Gifts and bequests, interest income on investments, realized gain on sale of investments and other miscellaneous expense.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Birch Bay Village Retirement CommunityBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110 Wayman LaneAddressLine1
CityBar HarborCity
StateMEState
ZIP Code04609ZIPCode
FieldValueIRS element (for citing)
EIN010481696EIN
Primary ActivitiesRetirement CommunityPrimaryActivities
Legal Domicile StateMELegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status170(b)(1)(A)(iii)PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Mount Desert Island HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Controlled Org0ControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Mount Desert Management CompanyBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 8AddressLine1
Address Line210 Wayman LaneAddressLine2
CityBar HarborCity
StateMEState
ZIP Code04609ZIPCode
FieldValueIRS element (for citing)
EIN010538776EIN
Primary ActivityReal Estate DevelopmentPrimaryActivity
Legal Domicile StateMELegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Birch Bay Village Retirement CommunityBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Share Of Total Income37917ShareOfTotalIncome
Share Of EOY Assets1047580ShareOfEOYAssets
Percentage Ownership1PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Birch Bay Village Retirement CommunityBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeqTransactionType
Amount Involved405259AmountInvolved
Method Of Amt DeterminationReceivable account - a receivable account is maintained on the general ledger of MDI Hospital, as well as an accounts payable account on the general ledger of Birch Bay Village Retirement Community. Transfers to the Birch Bay Village Retirement Community account are recorded as receivables at the time of transfer. A detail of this account is maintained in order to provide this information.MethodOfAmtDetermination

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationThis return was filed on 03/15/2013. Extensions were requested and granted, moving the due date for this return to 3/15/2013.Explanation

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