2013-08-07T09:53:58-05:00 2012-12-31 020383073 WILLIAM STEELE & ASSOCIATES PC 40 STARK STREET MANCHESTER NH 03101 990 2012-01-01 010342399 ST ANDRE HEALTH CARE FACILITY STAN 2072825171 407 POOL STREET BIDDEFORD ME 04005 ANDREA OTIS-HIGGINS 2072825171 2013-08-05 1 WILLIAM G STEELE JR CPA P00233103 6036228881 2012 2016-02-24 21:20:13Z ANDREA OTIS-HIGGINS 407 POOL STREET BIDDEFORD ME 04005 7961249 0 X STANDRE.ORG X 1946 ME ST. ANDRE HEALTH CARE FACILITY ANSWERS GOD'S CALL TO PROMOTE A HIGH QUALITY, COMPASSIONATE HEALTH CARE COMMUNITY WHERE ALL PEOPLE FLOURISH. 9 8 232 0 0 0 6481 8239 8002979 7916129 17286 28073 7377 8808 8034123 7961249 0 0 0 0 4106705 4651948 0 0 0 3710866 3369071 7817571 8021019 216552 -59770 5300854 5182711 2418789 1829962 2882065 3352749 ST ANDRE HEALTH CARE FACILITY ANSWERS GOD'S CALL TO PROMOTE A HIGH QUALITY,COMPASSIONATE HEALTH CARE COMMUNITY WHERE ALL PEOPLE FLOURISH. 0 0 7897780 7924937 ST ANDRE HEALTH CARE FACILITY PROVIDED 33,129 SKILLED NURSING CARE DAYS OF SERVICE OF WHICH 25,674 DAYS WERE REIMBURSED BY MEDICAID AT WELL BELOW COST. 7897780 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 20 0 1 232 1 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 ME X X ANDREA OTIS-HIGGINS 2072825171 407 POOL STREET BIDDEFORD ME 04005 SR PRISCILLE ROY 1.00 X 0 0 0 ANDREA OTIS-HIGGINS 40.00 X X 148547 0 784 RENEE O'NEIL 1.00 X 0 0 0 PAT CAMIRE 1.00 X X 0 0 0 KENNETH FARLEY 1.00 X X 0 0 0 MARILYN GUGLIUCCI 1.00 X 0 0 0 ROLAND CRONKHITE JR 1.00 X X 0 0 0 NANCY DRAPEAU 1.00 X X 0 0 0 HELENE GIRARD KENNEDY 1.00 X 0 0 0 148547 0 784 1 0 0 0 REHABCARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 PATIENT REHABILIATION SERVICES 697723 ANTHEM BLUE CROSS BLUE SHIELD PO BOX 591 LEWISTON ME 04243 HEALTH INSURANCE 388123 OMNICARE INC PO BOX 715268 ST LOUIS MO 63150 PHARMACY 237774 US FOODSERVICE PO BOX 3155 BOSTON MA 02241 PATIENT FOOD 205416 COVENANT HEALTH SYSTEMS INC 100 AMES POND DRIVE TEWKSBURY MA 01876 MANAGEMENT SERVICES 157089 6 8239 8239 PATIENT SERVICE REVENU 623000 7916129 7916129 7916129 28073 28073 CAFETERIA SALES 623000 8808 8808 8808 7961249 7924937 0 28073 148547 148547 3812664 3812664 7539 7539 390473 390473 292725 292725 101024 101024 28750 28750 22215 22215 115306 115306 219786 219786 18020 18020 67926 67926 301960 301960 67668 67668 PATIENT CARE PURCH SERV 1165755 1165755 MEDICAL & OTHER SUPPLIE 630385 630385 MEDICAID USER FEE 487211 487211 OTHER PATIENT CARE EXPE 143065 143065 8021019 7897780 123239 0 256488 158205 15910 16123 828793 848788 13134 14427 76534 61409 7207879 4486925 2816807 2720954 1182309 1322195 110879 40610 5300854 5182711 771575 832428 1085982 971408 49500 0 511732 26126 2418789 1829962 X 2882065 3352749 2882065 3352749 5300854 5182711 X -59770 112026 418428 X 0 1 X 1 0 X 49692 27499 16355 6481 8239 108266 7396408 7903490 7789128 8010356 7924937 39024319 7446100 7930989 7805483 8016837 7933176 39132585 0 0 0 39132585 3610 33103 30157 17286 28073 112229 3610 33103 30157 17286 28073 112229 7449710 7964092 7835640 8034123 7961249 39244814 0.99710 0.99320 0.00290 0.00680 X 1268 1268 3435999 2119623 1316376 3551707 2367302 1184405 218905 218905 2720954 RESIDENT PERSONAL FUNDS 26126 26126 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS IS THE FOLLOWING, "THE SYSTEM HAS EVALUATED THE POSITIONS TAKEN ON ITS FILED TAX RETURNS. THE SYSTEM HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT DECEMBER 31, 2012." FORM 990, PART VI, SECTION A, LINE 6 COVENANT HEALTH SYSTEMS, INC. IS THE SOLE MEMBER OF ST. ANDRE AND AS SUCH HAS CERTAIN RESERVED RIGHTS. FORM 990, PART VI, SECTION A, LINE 7A COVENANT HEALTH SYSTEMS, INC. IS THE SOLE MEMBER OF ST ANDRE AND AS SUCH HAS CERTAIN RESERVED RIGHTS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO IT'S BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C ST ANDRE HELATH CARE FACILITY HAS A FORMAL, WRITTEN ORGANIZATIONAL INTEGRITY POLICY ADMINISTERED BY A FULL-TIME ORGANIZATIONAL INTEGRITY OFFICER. FORM 990, PART VI, SECTION B, LINE 15 EVERY 2 TO 3 YEARS THE COMPENSATION COMMITTEE OF THE COVENANT HEALTH SYSTEMS BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS USED TO DEVELOP RECOMMENDATIONS FOR CHANGES TO THE COMPENSATION PROGRAM. SINCE 2003, THE COMPENSATION COMMITTEE HAS ENGAGED MERCER HUMAN RESOURCES CONSULTING TO CONDUCT THIS ANALYSIS. OBJECTIVES ARE TO ASSESS THE COMPOSITENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS OF THE SENIOR LEADERSHIP TEAM; DEVELOP MARKET BASED COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF THERE ARE ANY, ARE COMPETITIVE AND REASONABLE. FORM 990, PART VI, SECTION C, LINE 19 ST ANDRE HEALTH CARE FACILITY MAKES IT'S GOVERNING BODY DOCUMENTS AND POLICIES AVAILABLE TO INTERESTED PARTIES UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: TRANSFER AMONG AFFILIATES 418,428. COVENANT HEALTH SYSTEMS INC 100 AMES POND DRIVE TEWKSBURY MA 01876 222484505 MANAGEMENT MA 501(C)3 509A2 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 COVENANT HEALTH SYSTEMS INC M 148224 ACTUAL COST COVENANT HEALTH SYSTEMS INC C 418428 ACTUAL COST