2013-02-04T12:49:56-06:00 2012-06-30 010391345 Berry Dunn McNeil & Parker LLC 36 Pleasant Street Bangor ME 04401 990 2011-07-01 510172239 Island Nursing Home ISLA 2073482351 587 North Deer Isle Road Deer Isle ME 04627 Marc Plourde 2073482351 2013-01-31 1 Barbara J McGuan CPA P00219457 2079421600 2013-01-31 2011 2016-02-25 16:41:14Z Marc Plourde 587 North Deer Isle Road Deer Isle ME 04627 4136132 0 X n/a X 1975 ME To provide nursing care and adult day care 11 11 134 32 0 0 94326 133237 3995804 3972672 23343 25845 50 0 4113523 4131754 2310 2750 0 0 2576922 2628091 0 0 0 1308224 1330929 3887456 3961770 226067 169984 3561185 3800178 1842234 1896372 1718951 1903806 X The mission of Island Nursing Home, Deer Isle, Maine, a non-profit facility, is to incorporate the values of dignity, compassion, professionalism and community in providing life-care services or resources to individuals and families in need; to instill purpose and hope; and to support all stages of living and dying.The Island Nursing Home is committed to a primary obligation to serve residents of the communities of Deer Isle, Stonington, Isle au Haut, Brooksville, Brooklin, Sedgwick and Blue Hill. 0 0 3519605 2750 3972672 Nursing Home Care - Seventy-bed long term care facility offering skilled nursing, residential and ancillary services to medically needy residents. 3519605 1 1 0 1 0 0 0 0 0 1 1 0 0 0 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 0 0 0 0 0 0 1 11 0 1 134 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 ME X Marc Plourde 2073482351 587 North Deer Isle Rd Deer Isle ME 04627 Pamela N Siewers 1.00 X X 0 0 0 Claudette O Kydd 1.00 X 0 0 0 Don Holmes 1.00 X 0 0 0 Robert Lasky 1.00 X X 0 0 0 Kathleen Billings-Pezaris 1.00 X 0 0 0 John P Eysenbach 1.00 X 0 0 0 Deborah DeWitt 1.00 X 0 0 0 Kathleen Hayward 1.00 X 0 0 0 Joe Perkins 1.00 X 0 0 0 Marilyn Verhey 1.00 X 0 0 0 Joan Freeman 1.00 X 0 0 0 Marc Plourde 40.00 X 112230 0 2587 112230 0 2587 1 0 0 0 Synertx 7540 North 19th Av Suite 200 Phoenix AZ 85021 Phys & Occup Therapy 127983 1 8053 125184 133237 Medicare/medicaid Rev 623000 5750609 5750609 Pvt. Pay Nursing Care 623000 721766 721766 Miscellaneous Revenue 623000 1102 1102 Contractual Adjustment 623000 -2500805 -2500805 3972672 28326 28326 1000 3481 -2481 -2481 -2481 897 8053 897 0 4131754 3972672 0 25845 2750 2750 114817 114817 1924631 1785112 139519 370854 305657 65197 217789 204612 13177 3291 3291 35463 35463 11135 11135 28230 28230 227593 221932 5661 120443 120443 10566 10566 50889 50889 174259 174259 81921 81921 Provider tax expense 223729 223729 Food 133088 133088 Therapy services 120325 120325 Data processing costs 25030 25030 84967 44957 40010 3961770 3519605 442165 0 2663 3439 352226 440535 376644 414273 54312 59600 68662 57676 4477834 3055478 1446807 1422356 1258182 1400862 1689 1437 3561185 3800178 787689 915815 1013848 915350 40697 65207 1842234 1896372 X 1669080 1841673 5864 18126 44007 44007 1718951 1903806 3561185 3800178 X 169984 14871 X X 0 1 1 X 0 X 192198 25861 26212 94326 133237 471834 3962082 3823024 3812146 3995804 3972672 19565728 1564 897 2461 4154280 3848885 3838358 4091694 4106806 20040023 3233 1675 5350 6860 8500 25618 0 3233 1675 5350 6860 8500 25618 20014405 29285 21838 20134 23854 28326 123437 29285 21838 20134 23854 28326 123437 4183565 3870723 3858492 4115548 4135132 20163460 0.99260 0.99250 0.00610 0.00650 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1093 1093 0 Explanation of Lobbying Activities: Part II-B, Line 1: 29.80% of dues paid to Maine Health Care Association were attributable to lobbying. 1295208 146678 42680 16161 1468405 721890 475923 130404 33009 1295208 435937 254946 37015 6008 721890 548983 25861 -58999 79908 435937 0.95770 0.03000 0.01230 0 0 55290 55290 2755291 1872193 883098 1187750 877457 310293 479503 305828 173675 1422356 Estimated third party payor settlement 65207 65207 4131754 3961770 169984 14871 14871 184855 4146625 14871 14871 4131754 0 4131754 3961770 0 3961770 0 3961770 Description of Intended Use of Endowment Funds: Part V, Line 4: The intended uses of the endowment funds include funding for scholarships and other activities of the nursing home. Form 990, Part VI, Section B, line 11 Form 990 was provided to the governing body by email. It was reviewed by the Chair of the Finance Committee and the President of the Board of Directors. Form 990, Part VI, Section B, line 12c Each director, principal officer and member of a committee with governing board-delegated powers shall annually sign a statement, which affirms such person: (a) has received a copy of the conflict of interest policy, (b) has read and understands the policy, (c) has agreed to comply with the policy and (d) understands the Island Nursing Home is charitable and in order to maintain its federal exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. After disclosure of the financial interest and all material facts, and after any discussion with the interested person, he/she shall leave the governing board or committee meeting while the determination of a conflict of interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest transaction shall be approved or ratified. Form 990, Part VI, Section B, line 15a The process for determining the administrator's compensation includes a compensation committee, compensation survey or study and approval by the board or compensation committee. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 14,871. Oversight of Audit Form 990, Part XII, Line 2c The audit process has not changed from the prior year.