HENRIETTA D GOODALL HOSPITAL INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- HENRIETTA D GOODALL HOSPITAL INC (EIN 01-0078060)
- Tax period
- 2010-06-01 to 2011-05-31
- Filed
- 2012-04-09
- IRS object ID
- 201201009349300905
- Schema version
- 2010v3.4
- 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 K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-04-09T13:28:16-05:00 | Timestamp |
| Tax Period End Date | 2011-05-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FEELEY & DRISCOLL PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 PORTLAND STREET | AddressLine1 |
| City | BOSTON | City |
| State | MA | State |
| ZIP Code | 02114 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-06-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010078060 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRIETTA D GOODALL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HENR | NameControl |
| Phone | 2074907337 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 JUNE STREET | AddressLine1 |
| City | SANFORD | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PATRICIA APRILE | Name |
| Title | CEO/PRESIDENT | Title |
| Phone | 2074907337 | Phone |
| Date Signed | 2012-03-19 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEFFREY T ROGERS | Name |
| Phone | 6177427788 | Phone |
| Date Prepared | 2012-03-19 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | PATRICIA APRILE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 JUNE STREET | AddressLine1 |
| City | SANFORD | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 89034399 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.GOODALLHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1927 | YearFormation |
| State Legal Domicile | ME | StateLegalDomicile |
| Activity Or Mission Description | HENRIETTA D. GOODALL HOSPITAL, INC.'S MISSION IS TO SERVE AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF ITS COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1052 | TotalNbrEmployees |
| Total Nbr Volunteers | 83 | TotalNbrVolunteers |
| Total Gross UBI | 637980 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 44607 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1551088 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 886119 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 78388437 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 84756137 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 505858 | InvestmentIncomePriorYear |
| Investment Income Current Year | 392370 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 935761 | OtherRevenuePriorYear |
| Other Revenue Current Year | 480981 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 81381144 | TotalRevenuePriorYear |
| Total Revenue Current Year | 86515607 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 44020030 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 48293479 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 44466 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 36806772 | OtherExpensePriorYear |
| Other Expenses Current Year | 38067590 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 80826802 | TotalExpensesPriorYear |
| Total Expenses Current Year | 86361069 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 554342 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 154538 | RevenuesLessExpensesCY |
| Total Assets BOY | 84336393 | TotalAssetsBOY |
| Total Assets EOY | 87795787 | TotalAssetsEOY |
| Total Liabilities BOY | 37018987 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 37442858 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 47317406 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 50352929 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | HENRIETTA D. GOODALL HOSPITAL, INC. OWNS AND OPERATES H. D. GOODALL HOSPITAL, INC. (ACUTE CARE HOSPITAL), GOODALL HEALTH PARTNERS (A MULTI-SPECIALTY PHYSICIAN AND SURGEON GROUP), THE MEDICAL GROUP (A MULTI-SPECIALTY PHYSICIAN AND SURGEON GROUP), GOODALL OUTPATIENT CLINIC (A FACILITY WHERE A VARIETY OF OUTPATIENT SERVICES ARE PERFORMED), GOODALL OUTPATIENT SERVICES-WATERBORO AND GOODALL ELDERCARE SERVICES (A LONG TERM CARE FACILITY) IN YORK COUNTY. YORK COUNTY CONSISTS OF 18 TOWNS AND CITIES LOCATED ON THE SOUTHERN MAINE COAST WITH A POPULATION OF OVER 200,000. HENRIETTA D. GOODALL HOSPITAL, INC FURTHERS ITS MISSION AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITY AND PROVIDES ACCESS TO NEEDED HEALTH CARE SERVICES 365 DAYS A YEAR, 24 HOURS A DAY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 52959453 | Expense |
| Revenue | 63567757 | Revenue |
| Description | GOODALL HOSPITAL IS A 58 BED HOSPITAL WHICH STRIVES TO MEET THE HEALTH CARE NEEDS OF INDIVIDUALS AND FAMILIES THROUGHOUT YORK COUNTY. GOODALL HOSPITAL OFFERS A BROAD RANGE OF MEDICAL, SURGICAL, DIAGNOSTIC, CLINICAL AND REHABILITATION SERVICES, WELLNESS EDUCATION, SUPPORT GROUPS AND OTHER COMMUNITY OUTREACH PROGRAMS. GOODALL HOSPITAL HAS HAD 21,684 EMERGENCY ROOM VISITS, 48,669 RADIOLOGY PROCEDURES, 389,153 LABORATORY PROCEDURES, 67,687 THERAPY PROCEDURES, 190 INFANTS BORN AND 2,585 SURGERY CASES. GOODALL HOSPITAL PROVIDED $1,457,760 IN CHARITY CARE TO THE COMMUNITY. THIS INCLUDES PATIENTS WHO ARE UNDERINSURED OR THOSE WITHOUT ANY INSURANCE. IN ADDITION TO THE CHARITABLE CARE SERVICES, WE ARE CONTINUALLY ABSORBING ALL THE COSTS ASSOCIATED WITH PROVIDING THE COMMUNITY A VARIETY OF SPECIAL COMPLIMENTARY EDUCATIONAL AND INFORMATIONAL SERVICES. GOODALL PROUDLY SPONSORS COMMUNITY ORGANIZATIONS, SCHOOL GROUPS, CIVIC ORGANIZATIONS AND SPECIAL EVENTS (LIKE THE LOCAL BASEBALL TEAM). GOODALL HOSPITAL SPONSORS TWO TO FOUR FREE EDUCATION EVENTS EACH MONTH OF THE YEAR ALONG WITH DOZENS OF SUPPORT GROUPS. GOODALL HOSPITAL ALSO ROUTINELY PARTICIPATES IN HEALTH FAIRS AND BUSINESS EVENTS, PERFORMING BLOOD PRESSURE CHECKS, CHOLESTEROL SCREENINGS AND CPR TRAINING. GOODALL HOSPITAL'S SENIOR ADVOCATE PROVIDES FREE ADVICE AND SERVICES TO ELDERLY MEMBERS OF THE COMMUNITY. SERVICES INCLUDE HELP WITH INSURANCE AND MEDICAL ISSUES, AS WELL AS PERSONAL ISSUES INCLUDING TAX INFORMATION, FINANCES AND HOME NEEDS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 8360604 | Expense |
| Revenue | 8382439 | Revenue |
| Description | GOODALL HEALTH PARTNERS CONSIST OF MANY PHYSICIANS WITH MULTI-SPECIALTY SERVICES IN DIFFERENT LOCATIONS THROUGHOUT YORK COUNTY. THESE PHYSICIANS COMPLIMENT THE HOSPITAL IN MAINTAINING ITS MISSION TO SERVE AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITY BY SERVING THE POPULOUS. THESE SPECIALTIES INCLUDE (BUT ARE NOT LIMITED TO) CARDIOLOGY, ENT, FAMILY PRACTICES, WOMEN' HEALTH, INTERNAL MEDICINE, PEDIATRICS, ORTHO AND GENERAL SURGERY. THE NUMBER OF PATIENTS SEEN WERE 14,709 FOR A TOTAL NUMBER OF VISITS OF 54,019. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6550394 | Expense |
| Revenue | 7957160 | Revenue |
| Description | GOODALL HOSPITAL ELDERCARE SERVICES PROVIDE LONG-TERM CARE, MEDICAL SERVICES AND DAYCARE TO OUR SENIOR CITIZENS. ELDERCARE HAD ADMITTED 303 RESIDENTS FOR A TOTAL OF 39,025 PATIENT DAYS. WE CONTINUE TO GROW AND ADAPT TO THE NEEDS OF OUR COMMUNITY WITH THIS SERVICE. GOODALL HOSPITAL ELDERCARE PRIDES THEMSELVES BY CREATING A HOME-LIKE, COMFORTABLE ENVIRONMENT FOR THE RESIDENTS AND STAFF. THE NEWTON CENTER FOR REHABILITATION AND NURSING CARE PROMOTES HIGH QUALITY CARE; WITH DEDICATED STAFF FAMILY EDUCATIONAL AND INVOLVEMENT MAKE THIS PROGRAM SPECIAL. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6642193 | Expense |
| Revenue | 5434037 | Revenue |
| Description | THE MEDICAL GROUP CONSISTS OF MANY PHYSICIANS WITH MULTI-SPECIALTY SERVICES THAT EXTEND GOODALL HOSPITAL'S EXISTING SERVICES TO KENNEBUNK, ME. THESE PHYSICIANS COMPLEMENT THE HOSPITAL IN MAINTAINING ITS MISSION TO SERVE AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITY. THESE SERVICES INCLUDE (BUT ARE NOT LIMITED TO) FULL SERVICE PRIMARY CARE, WOMENS'S HEALTH, GASTROENTEROLGY, PULMONARY MEDICINE, ORTHOPEDICS AND PAIN MANAGEMENT. THE NUMBER OF PATIENTS SEEN WERE 9,179 FOR A TOTAL NUMBER OF VISITS OF 35,315. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 6642193 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 5434037 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 74512644 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 64 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1052 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Taxable Distributions | 0 | TaxableDistributions |
| Distribution To Donor | 0 | DistributionToDonor |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 1 | OfficerMailingAddress |
| Local Chapters | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | 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 | DANIEL FORGUES CFO | NamePerson |
| Telephone Number | 2074907327 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 JUNE STREET | AddressLine1 |
| City | SANFORD | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (30 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| LORI ANN BLACK | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| ANN M BROOKS MD | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| GEORGE E HISSONG JR | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| MARK MICKERIZ | |||||||||
| CHAIR | 2.00 | X | 0 | 0 | 0 | X | |||
| DAVID C NICKERSON | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| MERILEE MAPES PERKINS | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| MICHAEL L RALSTON | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| ROBERT REINKEN | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| SUSAN T ROBERTS | |||||||||
| SECRETARY/CHAIR OF PATIENT CARE | 2.00 | X | 0 | 0 | 0 | ||||
| WILLIAM FRANK | |||||||||
| VICE CHAIR/CHAIR OF FINANCE | 2.00 | X | 18675 | 0 | 0 | X | |||
| DARLENE STROMSTAD | |||||||||
| PRESIDENT THROUGH 5/31/11 | 40.00 | X | 416547 | 0 | 13635 | X | |||
| PATRICIA APRILE | |||||||||
| VP OF OPERATIONS | 40.00 | X | 200487 | 0 | 19034 | X | |||
| RONALD BRYANT | |||||||||
| CFO THROUGH 9/30/10 | 40.00 | X | 123130 | 0 | 15000 | X | |||
| CHARLES CARUSO | |||||||||
| CHIEF INFORMATION OFFICER | 40.00 | X | 161469 | 0 | 22052 | X | |||
| DANIEL FORGUES | |||||||||
| CFO EFFECTIVE 1/1/11 | 40.00 | X | 0 | 0 | 0 | X | |||
| KATHLEEN MORRIS MD | |||||||||
| PRESIDENT OF THE MEDICAL STAFF | 2.00 | X | 197940 | 0 | 12813 | X | |||
| DAVID EAGLESON | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| BECKY BRINK | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| MUKESH BHARGAVA MD | |||||||||
| VP OF MEDICAL AFFAIRS | 16.00 | X | 150127 | 0 | 0 | X | |||
| ADAM SCHLAGER | |||||||||
| VP OF PHYSCIANS SERVICES | 40.00 | X | 19539 | 0 | 101 | X | |||
| FRANK GOUDREAU | |||||||||
| PHYSICIAN | 40.00 | 444944 | 0 | 26816 | X | ||||
| JOHNATHAN SHILL | |||||||||
| PHYSICIAN | 40.00 | 293871 | 0 | 13774 | X | ||||
| KENT HALL | |||||||||
| PHYSICIAN | 40.00 | 347140 | 0 | 20655 | X | ||||
| NINA SHERVIN | |||||||||
| PHYSICIAN | 40.00 | 396205 | 0 | 16296 | X | ||||
| JOHN THOMPSON | |||||||||
| PHYSICIAN | 40.00 | 413702 | 0 | 26010 | X | ||||
| LORRAINE D MASURE | |||||||||
| FORMER SECRETARY | 2.00 | 0 | 0 | 0 | X | ||||
| MARK RAUTENBERG MD | |||||||||
| FORMER TRUSTEE | 2.00 | 0 | 0 | 0 | X | ||||
| WEBER SHILL | |||||||||
| FORMER VP OF PHYSICIAN PRACTICES | 40.00 | 0 | 0 | 0 | X | ||||
| DAVID HAMLIN | |||||||||
| FORMER VP OF PATIENT CARE | 40.00 | 0 | 0 | 0 | X | ||||
| ROBERT I HARDISON | |||||||||
| FORMER TRUSTEE | 2.00 | 0 | 0 | 0 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3183776 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 186186 | TotalOtherCompensation |
| Number Individuals GT100 K | 48 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MAK ANESTHESIA INC | |||||
| 156 COUNTRY CLUB ROAD | SANFORD | ME | 04073 | ANESTHESIA SERVICES PROVIDED TO HENRIETT | 574527 |
| LEONID TEMKIN MD PA | |||||
| 239 ARUNDEL ROAD | KENNEBUNK | ME | 04046 | ANESTHESIA SERVICES PROVIDED TO HENRIETT | 521309 |
| THOMAS MOORE MD | |||||
| 17 MERRILL BROOK DR | SCARBOTOURHG | ME | 04074 | PHYSICIAN SERVICES PROVIDED TO HENRIETTA | 287302 |
| MARK RAUTENBERG MD | |||||
| 300 SLIGO ROAD | ROLLINGSFORD | NH | 03869 | PHYSICIAN SERVICES PROVIDED TO HENRIETTA | 266131 |
| EDWARD BURZON PC | |||||
| 1 SARAH PAUL HILL | MADBURY | NH | 03823 | PHYSICIAN SERVICES PROVIDED TO HENRIETTA | 263900 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 12 | NumberOfContractorsGT100K |
| Government Grants | 697353 | GovernmentGrants |
| All Other Contributions | 188766 | AllOtherContributions |
| Total Contributions | 886119 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE RE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 84756137 | TotalRevenueColumn |
| Related Or Exempt Function Income | 84119202 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 636935 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 84756137 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 565661 | TotalRevenueColumn |
| Exclusion | $565,661 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 714880 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1255642 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -540762 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -540762 | TotalRevenueColumn |
| Related Or Exempt Function Income | -540762 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1082611 | Securities |
| Other | 7248 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1241441 | Securities |
| Other | 21709 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -158830 | Securities |
| Other | -14461 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -173291 | TotalRevenueColumn |
| Exclusion | -$173,291 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| REBATE REVENUE | 900099 | 426703 | 426703 |
| CAFETERIA REVENUE | 900099 | 252318 | 252318 |
| MISCELLANEOUS REVENUE | 900099 | 243996 | 243996 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 98726 | TotalRevenueColumn |
| Related Or Exempt Function Income | 97681 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1045 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1021743 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 86515607 | TotalRevenueColumn |
| Related Or Exempt Function Income | 84599138 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 637980 | UnrelatedBusinessRevenue |
| Exclusion | $392,370 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 933651 | Total |
| Management And General | 933651 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38715513 | Total |
| Program Services | 33647710 | ProgramServices |
| Management And General | 5033017 | ManagementAndGeneral |
| Fundraising | 34786 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5902283 | Total |
| Program Services | 5130671 | ProgramServices |
| Management And General | 767297 | ManagementAndGeneral |
| Fundraising | 4315 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2742032 | Total |
| Program Services | 2382302 | ProgramServices |
| Management And General | 356464 | ManagementAndGeneral |
| Fundraising | 3266 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 119192 | Total |
| Management And General | 119192 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121676 | Total |
| Management And General | 121676 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 126000 | Total |
| Management And General | 126000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6020446 | Total |
| Program Services | 4551148 | ProgramServices |
| Management And General | 1469298 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 96874 | Total |
| Management And General | 96874 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102814 | Total |
| Program Services | 86681 | ProgramServices |
| Management And General | 16101 | ManagementAndGeneral |
| Fundraising | 32 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 506835 | Total |
| Program Services | 119587 | ProgramServices |
| Management And General | 387248 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1589071 | Total |
| Program Services | 588086 | ProgramServices |
| Management And General | 1000985 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18306 | Total |
| Program Services | 14711 | ProgramServices |
| Management And General | 3595 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148307 | Total |
| Program Services | 119751 | ProgramServices |
| Management And General | 28192 | ManagementAndGeneral |
| Fundraising | 364 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 846629 | Total |
| Program Services | 771891 | ProgramServices |
| Management And General | 74738 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3647794 | Total |
| Program Services | 3283015 | ProgramServices |
| Management And General | 364779 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1059414 | Total |
| Program Services | 969785 | ProgramServices |
| Management And General | 89629 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| GENERAL HOSPITAL SUPPLI | 8045030 | 7925434 | 119478 | 118 |
| PROVISION FOR DOUBTFUL | 5914783 | 5914783 | ||
| MISCELLANEOUS | 3937510 | 3240180 | 695745 | 1585 |
| PHYSICIAN FEES | 3911984 | 3911984 | ||
| HEALTHCARE PROVIDER TAX | 1854925 | 1854925 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 86361069 | Total |
| Program Services | 74512644 | ProgramServices |
| Management And General | 11803959 | ManagementAndGeneral |
| Fundraising | 44466 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5185 | BOY |
| EOY | 5575 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5414641 | BOY |
| EOY | 3451617 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7753284 | BOY |
| EOY | 9577350 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 851677 | BOY |
| EOY | 851677 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1535788 | BOY |
| EOY | 1481101 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2094494 | BOY |
| EOY | 1548569 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 73409727 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 39582301 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34628970 | BOY |
| EOY | 33827426 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8087521 | BOY |
| EOY | 12582059 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12710758 | BOY |
| EOY | 14607527 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11254075 | BOY |
| EOY | 9862886 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 84336393 | BOY |
| EOY | 87795787 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12651004 | BOY |
| EOY | 13116998 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11814439 | BOY |
| EOY | 10610766 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12061491 | BOY |
| EOY | 12924027 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 492053 | BOY |
| EOY | 791067 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37018987 | BOY |
| EOY | 37442858 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36953692 | BOY |
| EOY | 38397945 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1451392 | BOY |
| EOY | 1572577 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8912322 | BOY |
| EOY | 10382407 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47317406 | BOY |
| EOY | 50352929 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 84336393 | BOY |
| EOY | 87795787 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 154538 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 2880986 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $135,858 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 135858 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | HENRIETTA D. GOODALL HOSPITAL, INC. HAS A CONTRACT FOR GOVERNMENT RELATIONS SERVICES WITH THE GRINNELL ASSOCIATES TO IDENTIFY, RESEARCH AND CHAMPION EFFORTS FOR APPROPRIATION FUNDING OPPORTUNITIES TO MEET THE HOSPITAL'S GOALS AND OBJECTIVES, INCLUDING FACILITY DEVELOPMENT, SYSTEM TECHNOLOGY ENHANCEMENTS, EQUIPMENT ACQUISITION, WELLNESS AND COMMUNITY HEALTH AND EMERGENCY PREPAREDNESS. INCLUDED IS AMOUNTS PAID AS PART OF DUES TO MHA/AHA FOR LOBBYIST ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 17085103 | BeginningOfYearBalance |
| Contributions | 1898375 | Contributions |
| Investment Earnings Or Losses | 2691423 | InvestmentEarningsOrLosses |
| Other Expenditures | 7000 | OtherExpenditures |
| End Of Year Balance | 21667901 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 14720200 | BeginningOfYearBalance |
| Contributions | 642735 | Contributions |
| Investment Earnings Or Losses | 1962857 | InvestmentEarningsOrLosses |
| Other Expenditures | 240689 | OtherExpenditures |
| End Of Year Balance | 17085103 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.52000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.48000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2728106 | OtherCostOrOtherBasis |
| Book Value | 2728106 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 43978411 | OtherCostOrOtherBasis |
| Depreciation | 21815780 | Depreciation |
| Book Value | 22162631 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4521887 | OtherCostOrOtherBasis |
| Depreciation | 1649985 | Depreciation |
| Book Value | 2871902 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 18902264 | OtherCostOrOtherBasis |
| Depreciation | 14948138 | Depreciation |
| Book Value | 3954126 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3279059 | OtherCostOrOtherBasis |
| Depreciation | 1168398 | Depreciation |
| Book Value | 2110661 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 33827426 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| ALTERNATIVE INVESTMENTS | 2992034 | F |
| BENEFICIAL INTEREST IN PERPETUAL TRUSTS | 9468845 | F |
| INVESTMENT IN REAL PROPERTY | 2146648 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 14607527 | TotalOfBookValueSecurities |
Other Assets OtherAssets (11 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INVESTMENTS IN SUBSIDIARIES & JOINT VENTURES | 493126 |
| DEFERRED FINANCING COSTS | 171184 |
| DUE FROM AFFILIATES | 1671001 |
| TRUSTEE HELD FUNDS (BOND FUNDS) | 1327303 |
| SYNERNET WORKERS' COMPENSATION CAPITAL CONTRIBUTION | 39633 |
| CONTRIBUTION RECEIVABLE FROM REMAINDER TRUST | 32933 |
| ESTIMATED SETTLEMENTS WITH MAINECARE | 4688424 |
| INTANGIBLE ASSET - TMG GOODWILL | 1347958 |
| INTANGIBLE ASSET - ORTHO MEDICAL RECORDS | 17892 |
| HDG DUE FROM TEMP NET ASSETS | 4344 |
| HDG CAPITAL RESERVE CASH | 69088 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 9862886 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ESTIMATED SETTLEMENTS DUE TO THIRD-PARTY PAYORS | Description |
| Amount | $791,067 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 791067 | TotalOfAmounts |
| Total Revenue | 86515607 | TotalRevenue |
| Total Expenses | 86361069 | TotalExpenses |
| Excess Or Deficit For Year | 154538 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 102480 | NetUnrealizedGLOnInvestments |
| Other | $2,778,506 | OtherAmount |
| Total Adjustments | 2880986 | TotalAdjustments |
| Excess Or Deficit Per FS | 3035524 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 87805322 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 1289715 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 1289715 | RevenueNotRptdF990 |
| Revenue Subtotal | 86515607 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 86515607 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 86361069 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 86361069 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 86361069 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | UNDER THE POLICY OF THE ORGANIZATION, THE ENDOWMENT ASSETS ARE INVESTED CONSERVATIVELY WITH THE INTENT OF PROVIDING A PREDICTABLE STREAM OF FUNDING TO THE ORGANIZATION FOR PURCHASES OF CAPITAL, EXPANSION PROJECTS AND TO SUPPLEMENT GENERAL OPERATIONS. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES FOOTNOTE PER THE HENRIETTA D. GOODALL HOSPITAL, INC. AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS: IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, THE ORGANIZATION ANNUALLY EVALUATES ITS TAX STATUS AND TAX POSITIONS TAKEN WITH RESPECT TO ITS OPERATIONS AND FINANCIAL POSITION. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | RELEASES FROM TEMPORARILY RESTRICTED NET ASSETS -20,379. INCREASE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS 1,464,292. UNREALIZED GAIN ON SECURITIES 1,289,715. OTHER CHANGES IN NET ASSETS -3,686. RESTRICTED CONTRIBUTIONS 48,564. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4858211 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4858211 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05630 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16033775 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11097345 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4936430 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05720 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 20891986 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11097345 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9794641 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.11350 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1046016 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 841847 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 204169 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1046016 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 841847 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 204169 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21938002 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11939192 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9998810 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.11590 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 99204 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 87947 | DirectOffsettingRevenue |
| Net Community Building Expense | 11257 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 62002 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 54967 | DirectOffsettingRevenue |
| Net Community Building Expense | 7035 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 31001 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 27483 | DirectOffsettingRevenue |
| Net Community Building Expense | 3518 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 102304 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 90695 | DirectOffsettingRevenue |
| Net Community Building Expense | 11609 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 15501 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 13742 | DirectOffsettingRevenue |
| Net Community Building Expense | 1759 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 310012 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 274834 | DirectOffsettingRevenue |
| Net Community Building Expense | 35178 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,469,304 | BadDebtExpenseAmount |
| Amount Attributable To | 710475 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 12992147 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 14010714 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1018567 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (6 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| 1 CANCER CARE CENTER OF YORK COUNTY | |||
| SUPPORT AND PERFORM MEDICAL PROCEEDURES FOR CANCER PATIENTS | 0.33330 | 0.00000 | 0.00000 |
| 2 GSM REALTOR INC | |||
| REAL ESTATE HOLDING COMPANY | 0.33330 | 0.00000 | 0.00000 |
| 3 GOODALL HOSPITAL REAL ESTATE HOLDING CO LLC | |||
| REAL ESTATE HOLDING COMPANY | 1.00000 | 0.00000 | 0.00000 |
| 4 WATERBORO MEDICAL OFFICE BUILDING LLC | |||
| REAL ESTATE HOLDING COMPANY | 1.00000 | 0.00000 | 0.00000 |
| 5 GOODALL HOSPITAL MEDICAL OFFICE BUILDING LLC | |||
| REAL ESTATE HOLDING COMPANY | 1.00000 | 0.00000 | 0.00000 |
| 6 PINE TREE INSURANCE A RECIPROCAL RISK RETENTION GROUP | |||
| PROVIDE MALPRACTICE INSURANCE FOR A GROUP OF HEALTH CARE PROVIDERS | 0.25860 | 0.00000 | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 10 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (10 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|
| HENRIETTA D GOODALL HOSPITAL INC | ||||||||
| 1 | 25 JUNE STREET | SANFORD | ME | 04073 | X | X | X | |
| NEWTON CENTER (ELDER CARE) | ||||||||
| 2 | 35 JULY STREET | SANFORD | ME | 04073 | NURSING HOME | |||
| GOODALL HEALTH PARTNERS | ||||||||
| 3 | 25 JUNE STREET | SANFORD | ME | 04073 | PHYSICIAN PRACTICES | |||
| WELLNESS CENTER | ||||||||
| 4 | 13 JULY STREET | SANFORD | ME | 04073 | CLINIC | |||
| GOODALL HEALTH PARTNERS | ||||||||
| 5 | 10 GOODALL DRIVE | EAST WATERBORO | ME | 04070 | PHYSICIAN PRACTICES | |||
| GOODALL HEALTH PARTNERS | ||||||||
| 6 | 272 COTTAGE STREET | SANFORD | ME | 04073 | PHYSICIAN PRACTICES | |||
| THE MEDICAL GROUP | ||||||||
| 7 | 2 LIVEWELL DRIVE | KENNEBUNK | ME | 04043 | PHYSICIAN PRACTICES | |||
| COMMUNITY SERVICES | ||||||||
| 8 | 15 DAIGLE STREET | SANFORD | ME | 04073 | COMMUNITY PROGRAMS | |||
| OCCUPATIONAL HEALTH SERVICES | ||||||||
| 9 | 2 LIVEWELL DRIVE | KENNEBUNK | ME | 04043 | PHYSICIAN PRACTICES | |||
| GOODALL HEALTH CLINICS | ||||||||
| 10 | 2 LIVEWELL DRIVE | KENNEBUNK | ME | 04043 | CLINIC | |||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRIETTA D GOODALL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | Return ReferenceReturnReference | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 6A: PARTNERS FOR HEALTHIER COMMUNITIES HAS COLLABORATED WITH YORK DISTRICT HEALTHY MAINE PARTNERSHIPS, THE GREATER YORK COUNTY UNITED WAY, YORK COUNTY HEAD START, AND THE GREATER YORK COUNTY YMCA TO GUIDE A COUNTY-WIDE COMMUNITY NEEDS ASSESSMENT PROCESS UTILIZING MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP). THE ASSESSMENT REPORTS WERE SHARED AT VARIOUS COMMUNITY FORUMS. | ||
| PART I, LINE 7: GOODALL HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO ASSISTS AND EDUCATES PATIENTS AND THEIR FAMILIES ON FINANCIAL MATTERS CONCERNING THE HOSPITAL CHARITY CARE POLICY AND ELIGIBILITY FOR STATE AND FEDERAL PROGRAMS. THIS ASSISTANCE CAN BE AS SPECIFIC AS ASSISTING THE PATIENT AND/OR FAMILIES IN COMPLETING THE VARIOUS FORMS REQUIRED BY MEDICAID AND MEDICARE. THE HOSPITAL'S SENIOR ADVOCATE PROGRAM PROVIDES FREE ADVICE AND SERVICES TO ELDERLY MEMBERS OF THE COMMUNITY. THESE SERVICES INCLUDE ASSISTANCE WITH INSURANCE AND MEDICAL ISSUES, TAX INFORMATION, PERSONAL FINANCES AND HOME NEEDS. THE SENIOR ADVOCATE HAS EXTENSIVE KNOWLEDGE OF THE ISSUES FACING SENIORS AND CAN HELP WITH ASSESSMENT OF CURRENT NEEDS AND PROVIDE REFERRALS TO EXISTING SERVICES.GOODALL HOSPITAL ALSO PROVIDES A PRESCRIPTION ASSISTANCE PROGRAM CALLED RX ASSIST. THE PROGRAM IS DESIGNED TO ASSIST THOSE WHO DO NOT QUALIFY FOR TRADITIONAL ASSISTANCE PROGRAMS SUCH AS MEDICARE D OR MAINECARE. | ||
| COMMUNITY SUPPORT WAS ACHIEVED BY THE DIRECTOR OF PARTNERS FOR HEALTHIER COMMUNITIES CO-CHAIRING AND PARTICIPATING ON NUMEROUS WORKGROUPS/COMMITTEES WITHIN THE YORK COUNTY. THESE COMMITTEES WORKED WITH PARTICIPATION IN MANY EDUCATION SESSIONS WITHIN THE COMMUNITY BY PROVIDING CONFIDENTIALLY FOR INDIVIDUALS PARTICIPATING IN HEALTH RELATED PROMOTIONS. ALSO, PHC HAS BEEN ACTIVE IN ACTING AS A SPOKESPERSON FOR THE CONTINUED SUPPORT OF THE 211 PROGRAM AS IT PURSUES EXPANSION WITH ON-LINE ASSESSMENT. PHC HAS CONDUCTED ASSESSMENT OF GAPS IN SUPPORT GROUP RESOURCES AND WORKED WITH 211 TO UPDATE THE DATABASE. STROKE HAS BEEN IDENTIFIED AS A GAP TO ADDRESS. | PART 2 LINE 3: | |
| ENVIRONMENTAL IMPROVEMENTS ARE A VERY IMPORTANT ASPECT OF THE WORKINGS OF PARTNERS FOR HEALTHIER COMMUNITIES THROUGH THE LEAD POISONING PREVENTION SUPPLIES/EDUCATION THAT THE ORGANIZATION OFFERS AND ITS PARTICIPATION IN COMMUNITY EFFORTS. PHC CONTRIBUTED TO THE IMPLEMENTATION OF "MOOSE TRAILS" ON SIDEWALKS IN DOWNTOWN SANFORD TO PROMOTE SAFE PATHS FOR WALKING AS WELL AS BIKING TO SCHOOL. PHC PARTNERED WITH THE SANFORD YMCA TO LAUNCH AN INDOOR WALKING LOOP AT WAL-MART AS WELL AS APPLICABLE EDUCATION. PHC EDUCATED 300 BUSINESSES AND 11 RESTAURANTS ON THE NEW TOBACCO LAWS. PHC PROVIDED ASSISTANCE ON MAKING NECESSARY POLICY AND ENVIRONMENTAL CHANGES TO SUPPORT NEW REQUIREMENTS. | PART 2 LINE 4: | |
| PARTNERS FOR HEALTHIER COMMUNITIES WORKED WITH COMMUNITY ADVISORS TO CREATE A VISION FOR MOBILIZING AN ELEVEN TOWN SERVICE AREA. BASED ON THIS CONVERSATION, PHC HAS WORKED TO MOBILIZE OR PARTNER WITH EXISTING TASKFORCES IN 3 REGIONS OF THE SERVICE AREA. RECENT MONTHS HAVE BEEN SPENT RECRUITING ADVISORY BOARD MEMBERS.PARTNERS FOR HEALTHIER COMMUNITIES HAS COLLABORATED WITH YORK DISTRICT HEALTHY MAINE PARTNERSHIPS, THE GREATER YORK COUNTY UNITED WAY, YORK COUNTY HEAD START, AND THE GREATER YORK COUNTY YMCA TO GUIDE A COUNTY-WIDE COMMUNITY NEEDS ASSESSMENT PROCESS UTILIZING MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP). THE ASSESSMENT REPORTS WERE SHARED AT VARIOUS COMMUNITY FORUMS. PARTNERS FOR HEALTHIER COMMUNITIES HAVE FACILITATED STRATEGIC PLANNING PROCESSES IN THE SANFORD, WATERBORO, AND SACOPEE VALLEY COMMUNITIES. THE HMP DIRECTOR HAS DEDICATED 40 HOURS TO THIS COMPONENT OF THE COMMUNITY NEEDS PROCESS. THE COMMUNITIES ARE CURRENTLY IN THE ACTION PLANNING PHASE.PARTNERS FOR HEALTHIER COMMUNITIES IS COLLABORATING WITH THE TOWN OF SANFORD AND SAFE SCHOOLS HEALTHY SANFORD TO MOBILIZE THE SAFE AND HEALTHY SANFORD COALITION. AS A RESULT, THE TOWN WAS AWARDED A DRUG FREE COMMUNITIES GRANT OF $625,000 OVER A 5 YEAR PERIOD TO ADDRESS YOUTH SUBSTANCE ABUSE PREVENTION EFFORTS. PHC PARTICIPATED IN 8 PARENTAL/STUDENT INFORMATION NIGHTS RELATED TO SUBSTANCE ABUSE PREVENTION. THE HMP PREVENTION COORDINATOR HAS CONTRIBUTED 32 HOURS TO GRANT WRITING AND PLANNING IN THE SANFORD COMMUNITY AS WELL AS SERVING AS A LEADER IN SECURING THE DRUG FREE COMMUNITIES GRANT.PARTNERS FOR HEALTHIER COMMUNITIES HAS CONDUCTED ASSESSMENT OF GAPS IN SUPPORT GROUP RESOURCES AND WORKED WITH 211 TO UPDATE DATABASE. STROKE HAS BEEN IDENTIFIED AS A GAP TO ADDRESS. | PART II LINE 6: | |
| COMMUNITY HEALTH IMPROVEMENTS HAVE LEAD GOODALL TO PARTNER WITH YORK DISTRICT HEALTHY MAINE PARTNERSHIPS AND YORK COUNTY COMMUNITY ACTION TO COORDINATE TRAINING OF ALL YORK COUNTY HEAD START SITES ON THE 5-2-1-0 PHYSICAL ACTIVITY AND NUTRITION MODEL. GOODALL CONTINUED TO PROVIDE TECHNICAL ASSISTANCE TO SITES WITHIN THE SERVICE AREA. COMMUNITY HEALTH IMPROVEMENTS WILL LEAD GOODALL IN THE PURSUIT OF WORKING WITH YORK DISTRICT ENGAGED 40 YOUTH IN THE ANNUAL STICKER SHOCK CAMPAIGN TO AFFIX 25,000 STICKERS AT 36 STORES THROUGHOUT THE COMMUNITY TO INFORM ADULTS OF THE CONSEQUENCES ASSOCIATED WITH PURCHASING ALCOHOL FOR MINORS.PARTNERS FOR HEALTHIER COMMUNITIES FUNDED 2 $250 MINI-GRANTS TO AREA YOUTH GROUPS TO WORK ON ANTI-TOBACCO MESSAGING AND ADVOCACY PROJECTS. PHC STAFF WORKED WITH THE GROUPS TO DETERMINE PROJECT AND PROVIDED EDUCATION AND RESOURCES.PHC COORDINATED PRESENTATION BY DISTRICT TOBACCO COORDINATOR FOR 4 YOUTH GROUPS IN THE SANFORD SCHOOL DISTRICT. COORDINATED 8 CLASSES AT NO CHARGE FOR A TOBACCO CESSATION PROGRAM FOR THE COMMUNITY WITH 24 INDIVIDUALS COMPLETING.THE HMP DIRECTOR CONTRIBUTED TO EDUCATING PHYSICIAN PRACTICES AND/OR PATIENTS ON HEALTHY WEIGHT AWARENESS RESOURCES.THE HMP DIRECTOR CONDUCTED 1 COMMUNITY PRESENTATION RELATED TO SIGNS AND SYMPTOMS OF HEART ATTACK AND STROKE.AS A LET'S GO 5-2-1-0 DISSEMINATION PARTNER, PHC HAS PROVIDED LET'S GO CHILDCARE TOOLKITS TO DAYCARE PROVIDERS AND PEDIATRIC OFFICES, PHC HAS ALSO CONDUCTED 3 TRAININGS FOR CHILDCARE PROVIDERS, ATTENDED QUARTERLY STAKEHOLDERS MEETINGS, ENGAGED SANFORD SCHOOL DISTRICT IN REGISTERING AS "READY" 2 SITES FOR THE UPCOMING SCHOOL YEAR.PHC PARTNERED WITH SANFORD DOWNTOWN LEGACY TO LAUNCH DOUBLE YOUR EBT VALUE FOR FRUIT AND VEGGIE PURCHASES. PHC COLLABORATED WITH YORK DISTRICT PUBLIC HEALTH COUNCIL AND YORK COUNTY EMERGENCY MANAGEMENT TO LAUNCH WELL CHECK REGISTRY.PHC COORDINATED AN OUTREACH PRESENTATION TO YORK DISTRICT SUPERINTENDENTS. AS A RESULT, EACH HEALTHY MAINE PARTNERSHIP WILL BE MEETING ONE-ON-ONE WITH SCHOOL DISTRICTS TO DETERMINE HOW TO BEST COORDINATE PREVENTION EFFORTS ACROSS ALL SCHOOLS IN THE COUNTY. PHC WORKED WITH AN AREA FOOD PANTRY TO CREATE HEALTH RELATED INFORMATION PACKETS FOR CLIENTS AND ALSO ASSISTED WITH PLANNING A COMMUNITY OPEN HOUSE.THE HEALTH PREVENTION COORDINATOR CONTRIBUTED 40 HOURS TO COORDINATING THE DEVELOPMENT OF BRIDGE TO HOME HEALTH LITERACY PROGRAM WITH ROTARY, GOODALL HOSPITAL, AND LITERACY VOLUNTEERS. THE HEALTH PREVENTION COORDINATOR COORDINATED AND/OR PARTICIPATED IN THE MANY PARENTAL INFORMATION NIGHTS RELATED TO SUBSTANCE ABUSE PREVENTION INCLUDING IN PARTNERING WITH THE SANFORD AND YORK COUNTY SHERIFF DEPARTMENT IN CONDUCTING COMPLIANCES WITH ALCOHOL SALES. | PART II LINE 7: | |
| PARTNERS FOR HEALTHIER COMMUNITIES PROVIDED WORKSITE WELLNESS TRAINING WITH THE WABAN ORGANIZATION AS WELL AS HOSTED "SAFE AND RESPONSIBLE BEVERAGE SELLER / SERVER TRAINING" PROGRAMS THROUGHOUT THE YEAR. | PART II LINE 8: | |
| PART III, LINE 4: FOOTNOTE CONCERNING BAD DEBTS: MANAGEMENT MONITORS AND EVALUATES ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS TO ENSURE THAT RECEIVABLES ARE STATED AT THEIR NET REALIZABLE VALUE. THE COSTING METHODOLOGY CONSISTS OF APPLYING A COST TO CHARGE RATIO TO THE RECORDED PROVISION FOR BAD DEBT (REPRESENTING UNCOLLECTED CHARGES) AND CHARITY CARE REVENUES BASED ON COST REPORT. | ||
| PART III, LINE 8: THE COSTING METHODOLOGY CONSISTS OF APPLYING A COST TO CHARGE RATIO TO INPATIENT AND OUTPATIENT REVENUES BASED ON MEDICARE COST REPORT.THE COMPUTED SHORTFALL HAS NOT BEEN INCLUDED IN COMMUNITY BENEFIT. | ||
| PART VI, LINE 2: GOODALL HOSPITAL'S BOARD OF TRUSTEES IS COMPRISED OF A DIVERSE GROUP OF COMMUNITY MEMBERS. THE BOARD OF TRUSTEES PROVIDES INSIGHT AND DIRECTION TO THE HOSPITAL. PARTNERS FOR HEALTHIER COMMUNITIES HAVE FACILITATED STRATEGIC PLANNING PROCESSES IN THE SANFORD, WATERBORO, AND SACOPEE VALLEY COMMUNITIES. THE HMP DIRECTOR HAS DEDICATED 40 HOURS TO THIS COMPONENT OF THE COMMUNITY NEEDS PROCESS. THE HMP PREVENTION COORDINATOR HAS DEDICATED 12 HOURS TO THE PROCESS. THE HMP HEALTH PROMOTION COORDINATOR HAS DEDICATED 12 HOURS TO THE PROCESS. THE COMMUNITIES ARE CURRENTLY IN THE ACTION PLANNING PHASE.PHC HAS WORKED WITH COMMUNITY ADVISORS TO CREATE A VISION FOR MOBILIZING AN ELEVEN TOWN SERVICE AREA. BASED ON THIS CONVERSATION, PHC HAS WORKED TO MOBILIZE OR PARTNER WITH EXISTING TASKFORCES IN 3 REGIONS OF THE SERVICE AREA. RECENT MONTHS HAVE BEEN SPENT RECRUITING ADVISORY BOARD MEMBERS.PHC IS COLLABORATING WITH THE TOWN OF SANFORD AND SAFE SCHOOLS HEALTHY SANFORD TO MOBILIZE THE SAFE AND HEALTHY SANFORD COALITION. AS A RESULT, THE TOWN WAS AWARDED A DRUG FREE COMMUNITIES GRANT OF $625,000 OVER A 5 YEAR PERIOD TO ADDRESS YOUTH SUBSTANCE ABUSE PREVENTION EFFORTS.THE HMP PREVENTION COORDINATOR HAS CONTRIBUTED 32 HOURS TO GRANT WRITING AND PLANNING IN THE SANFORD COMMUNITY AND ALSO SERVED AS A LEADER IN SECURING THE DRUG FREE COMMUNITIES GRANT.PHC CONDUCTED AN ASSESSMENT OF GAPS IN SUPPORT GROUP RESOURCES AND WORKED WITH 211 TO UPDATE THE DATABASE. STROKE HAS BEEN IDENTIFIED AS A GAP TO ADDRESS. | ||
| PART VI, LINE 3: GOODALL HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO ASSISTS AND EDUCATES PATIENTS AND THEIR FAMILIES ON FINANCIAL MATTERS CONCERNING THE HOSPITAL CHARITY CARE POLICY AND ELIGIBILITY FOR STATE AND FEDERAL PROGRAMS. THIS ASSISTANCE CAN BE AS SPECIFIC AS ASSISTING THE PATIENT AND/OR FAMILIES IN COMPLETING THE VARIOUS FORMS REQUIRED BY MEDICAID AND MEDICARE. THE HOSPITAL'S SENIOR ADVOCATE PROGRAM PROVIDES FREE ADVICE AND SERVICES TO ELDERLY MEMBERS OF THE COMMUNITY. THESE SERVICES INCLUDE ASSISTANCE WITH INSURANCE AND MEDICAL ISSUES, TAX INFORMATION, PERSONAL FINANCES AND HOME NEEDS. THE SENIOR ADVOCATE HAS EXTENSIVE KNOWLEDGE OF THE ISSUES FACING SENIORS AND CAN HELP WITH ASSESSMENT OF CURRENT NEEDS AND PROVIDE REFERRALS TO EXISTING SERVICES. COMMON TYPES OF ASSISTANCE, IN ADDITION TO ADVOCACY, MAY INCLUDE: MEDICARE D ENROLLMENT; ADVANCE DIRECTIVE PLANNING; ASSISTANCE AND EDUCATION IN PREVENTING FRAUD, EXPLOITATION, AND ABUSE; CONNECTION TO RESOURCES FOR TRANSPORTATION, HOME HEALTH CARE, MEALS, ETC. THE SENIOR ADVOCATE PROGRAM RECEIVED 2,232 INQUIRIES FOR ASSISTANCE THROUGHOUT THE YEAR WITH THE FOLLOWING BREAKDOWN BY CONCERN TYPE (MEDICARE D 20%, INSURANCE 20%, FINANCE ASSIST 15%, OTHER 45%). THE OTHER CONCERN TYPES INCLUDE THE FOLLOWING SUBJECT AREAS (POA/GUARDIANSHIP, FUEL ASSISTANCE, DENTAL, VISION, VA BENEFITS, TRANSPORTATION, HOUSING, SOCIAL SECURITY, DISABILITY, PAPERWORK, DME AND MEDICAL SUPPLIES, SNOW REMOVAL, PLACEMENT, HOME CARE, HOME REPAIR, FOOD RESOURCES, ADV. DIRECTIVES, ETC.). 107 FAMILIES WERE PROVIDED INFORMATION BY THE MAINE FAMILIES PROGRAM ON 144 COMMUNITY EVENTS AND AREA RESOURCES FOR A TOTAL OF 529 REFERRALS.MFYC HELD THE FOLLOWING EVENTS TO HELP LINK FAMILIES WITH OTHER FAMILIES THAT ARE EXPERIENCING SIMILAR LIFE CIRCUMSTANCES WITH RAISING CHILDREN. BREASTFEEDING SUPPORT, NUTRITION, SHAKEN BABY SYNDROME PREVENTION, HOME SAFETY AND LEAD POISONING RISK. THIS PROGRAM PROVIDED 1,377 VISITS WITH 129 FAMILIES IN THE COMMUNITY HEALTH IMPROVEMENT SERVICES, AND SERVES TO CREATE A NATURAL SUPPORT SYSTEM FOR YOUNG FAMILIES.RXASSIST PROGRAM - THE PRESCRIPTION ASSISTANCE PROGRAM PROVIDES HELP TO THOSE WHO CURRENTLY DO NOT HAVE PRESCRIPTION COVERAGE AND HAVE DIFFICULTY AFFORDING THEIR MEDICINES. THE PROGRAM IS DESIGNED TO ASSIST THOSE WHO DO NOT QUALIFY FOR OTHER TRADITIONAL ASSISTANCE PROGRAMS SUCH AS MEDICARE D OR MAINE CARE, BUT WHOSE FINANCIAL SITUATION QUALIFIES THEM TO RECEIVE SUPPORT. FREE OR LOW-COST PRESCRIPTION DRUGS CAN BE OBTAINED DIRECTLY FROM PHARMACEUTICAL COMPANIES IF ELIGIBILITY GUIDELINES ARE MET. THE HOSPITAL RECEIVED 214 APPLICATION REQUESTS FOR SUBMISSION TO THE APPROPRIATE PHARMACEUTICAL PRESCRIPTION ASSISTANCE PROGRAMS, COMPLETED 824 CLIENT CONTACTS, PROCESSED 1645 PRESCRIPTIONS, AND SAVED $836,513 FOR CLIENTS SERVED THROUGH THIS PROGRAM, DURING THE YEAR. | ||
| PART VI, LINE 4: GOODALL HOSPITAL SERVES THE POPULATION OF WESTERN YORK COUNTY, MAINE. SANFORD IS THE TOWN WITH THE LARGEST POPULATION IN THE HOSPITAL'S SERVICE AREA, WITH A POPULATION OF APPROXIMATELY 21,000 WITH AN ELDERLY POPULATION RATE OF 15% AND FAMILIES REPRESENTING 64% OF THIS POPULATION, WITH 93% BEING WHITE CAUCASIAN.THE HOSPITAL'S MEDICAID VOLUME IS 24% AND IS AMONGST THE HIGHEST IN THE STATE AND REFLECTS THE HIGH PERCENTAGE OF FAMILIES WITH THE INCOME LESS THAN 100% OF THE FEDERAL POVERTY LEVEL. SANFORD'S POVERTY RATE IS 17%, WHILE THE STATE OF MAINE IS AT 12%. 72% OF SANFORD'S ELEMENTARY SCHOOL CHILDREN ARE ELIGIBLE TO RECEIVE FREE OR SUBSIDIZED MEALS.SANFORD'S UNEMPLOYMENT RATE OF 10% EXCEEDS THE STATE'S OVERALL UNEMPLOYMENT RATE OF 8%. SANFORD HAS BEEN DESIGNATED AS A MEDICALLY UNDERSERVICED AREA. | ||
| PART VI, LINE 6: GOODALL HOSPITAL PROVIDES NUMEROUS EDUCATIONAL CLASSES FOR THE COMMUNITIES IT SERVICES. THE ORGANIZATION PREPARES A QUARTERLY FLYER CALLED THE "COMMUNITY EDUCATION CALENDAR". THIS LISTING PROVIDES THE EDUCATIONAL SEMINARS THAT ARE OPEN FOR FREE PUBLIC PARTICIPATION. THESE SEMINARS ARE HELD ON MOST EVENINGS (FOR EASE OF COMMUNITY PARTICIPATION) AND ARE TYPICALLY 1 1/2 HOURS IN DURATION. THE SEMINARS ARE LED BY KNOWLEDGEABLE GOODALL PROFESSIONALS WHO ARE TRAINED AND EDUCATED IN THE SPECIFIC AREAS. THE EVENTS INCLUDE THE FOLLOWING AREAS: SPORTS MEDICINE, ALCOHOL AWARENESS, FUN WITH FRUITS & VEGGIES, WATER AEROBICS, WEIGHT MANAGEMENT, MEDICATION REVIEWS, DIABETES, BLOOD PRESSURE CHECKS AND MANY MORE. | ||
| PART VI, LINE 7: N/A | ||
| ME | PART VI, LINE 7 | REPORTS FILED WITH STATES |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DARLENE STROMSTAD | |||||||||||||
| 356547 | 0 | 60000 | 0 | 0 | 0 | 2278 | 0 | 11357 | 0 | 430182 | 0 | 0 | 0 |
| PATRICIA APRILE | |||||||||||||
| 197138 | 0 | 3349 | 0 | 0 | 0 | 1216 | 0 | 17818 | 0 | 219521 | 0 | 0 | 0 |
| RONALD BRYANT | |||||||||||||
| CHARLES CARUSO | |||||||||||||
| 161469 | 0 | 0 | 0 | 0 | 0 | 861 | 0 | 21191 | 0 | 183521 | 0 | 0 | 0 |
| DANIEL FORGUES | |||||||||||||
| KATHLEEN MORRIS MD | |||||||||||||
| 197940 | 0 | 0 | 0 | 0 | 0 | 2460 | 0 | 10353 | 0 | 210753 | 0 | 0 | 0 |
| MUKESH BHARGAVA MD | |||||||||||||
| 150127 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 150127 | 0 | 0 | 0 |
| ADAM SCHLAGER | |||||||||||||
| FRANK GOUDREAU | |||||||||||||
| 444944 | 0 | 0 | 0 | 0 | 0 | 2209 | 0 | 24607 | 0 | 471760 | 0 | 0 | 0 |
| JOHNATHAN SHILL | |||||||||||||
| 287328 | 0 | 6543 | 0 | 0 | 0 | 2530 | 0 | 11244 | 0 | 307645 | 0 | 0 | 0 |
| KENT HALL | |||||||||||||
| 254627 | 0 | 92513 | 0 | 0 | 0 | 1873 | 0 | 18782 | 0 | 367795 | 0 | 0 | 0 |
| NINA SHERVIN | |||||||||||||
| 371205 | 0 | 25000 | 0 | 0 | 0 | 288 | 0 | 16008 | 0 | 412501 | 0 | 0 | 0 |
| JOHN THOMPSON | |||||||||||||
| 413702 | 0 | 0 | 0 | 0 | 0 | 2160 | 0 | 23850 | 0 | 439712 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| MAINE HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 010314384 | 560425D49 | 2006-09-07 | 6020317 | RENOVATE HOSPITAL AND PURCHASE EQUIPMENT | 0 | 0 | 0 |
| MAINE HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 010314385 | 560425H37 | 2007-07-18 | 5108908 | REFINANCE MHHEFA REVENUE BOND 1996A | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Amount UnspentAmountUnspent | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|
| 6470000 | 522453 | 82639 | 5836740 | 293000 | 2007 | 0 | 0 | 1 | 1 |
| 78484 | 451093 | 78484 | 0 | 1 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | PETER G BOOTH | NamePerson |
| Purpose Of Loan | TO PROVIDE RETIREMENT FUNDS VIA A SPLIT DOLLAR LIFE INSURANCE POLICY | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $851,677 | OriginalPrincipalAmount |
| Balance Due | 851677 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 851677 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| MARK MICKERIZ | |||
| CHAIR OF GOODALL'S BOARD AND PRESIDENT OF SANFORD INSTITUTE FOR SAVINGS | 4623278 | SANFORD INSTITUTE FOR SAVINGS (SIS) HAS THREE OUTSTANDING LOANS WITH HENRIETTA D. GOODALL HOSPITAL, INC. THE ORIGINAL AMOUNT OF THE LOAN WAS $7,330,000 AND AS OF MAY 31, 2011, THE REMAINING BALANCE ON THE LOANS WERE $4,623,278. | 0 |
| WEBER SHILL | |||
| FORMER OWNER OF TMG | 1405483 | WEBER SHILL HAS ONE OUTSTANDING LOAN WITH HENRIETTA D. GOODALL HOSPITAL INC. FOR THE PURCHASE OF THE MEDICAL GROUP. THE ORIGINAL AMOUNT OF THE LOAN WAS $1,835,248 AND AS OF MAY 31, 2011, THE REMAINING BALANCE OF THE LOAN WAS $1,405,483. | 0 |
| WILLIAM FRANK | |||
| CHAIR OF THE FINANCE COMMITTEE | 18675 | GOODALL HOSPITAL CONTRACTS WITH DR. FRANK TO PERFORM VARIOUS DUTIES AT THE HOSPITAL, SUCH AS ON CALL, IMPACT COVERAGE, AND SOME COMMITTEES. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | MANAGEMENT REVIEWS THE 990 WITH ITS EXTERNAL AUDITORS PRIOR TO SUBMISSION. MANAGEMENT WILL MAKE THE 990 AVAILABLE FOR BOARD REVIEW PRIOR TO SIGNATURE AND SUBMISSION OF THE RETURN. DARLENE STROMSTAD CAN BE REACHED AT 377 THREE MILE HILL ROAD, MIDDLEBURY, CT 06762 AND RON BRYAN CAN BE REACHED AT 59 STONE ROAD, KENNEBUNKPORT, ME 04046, (207) 967-2383 | |
| THE HOSPITAL ENSURES THAT THE CONFLICT OF INTEREST POLICY IS ENFORCED BY REQUIRING BOARD MEMBERS TO SIGN CONFLICT OF INTEREST DOCUMENTS ON A YEARLY BASIS. THESE DOCUMENTS ARE REVIEWED ANNUALLY BY MANAGEMENT TO IDENTIFY ANY CONFLICTS, ACTUAL OR PERCEIVED, AND TO DEVELOP NECESSARY RESOLUTIONS FOR ANY INDENTIFIED CONFLICTS. | FORM 990, PART VI, SECTION B, LINE 12C | |
| 15A: THE BOARD OF DIRECTORS APPROVES THE COMPENSATION FOR THE CEO AFTER CAREFUL REVIEW OF INDUSTRY SALARY COMPENSATION INFORMATION (COMPENSATION STUDY) WITH AN OUTSIDE COMPENSATION CONSULTANT. 15B: UNDER THE GUIDANCE OF PROFESSIONAL COMPENSATION CONSULTANTS, THE HR DIRECTOR REVIEWS THE PAY MODEL WITH THE CEO AND COO TO ENSURE THAT THE ORGANIZATION IS ABLE TO RECRUIT AND RETAIN A HIGHLY QUALIFIED WORKFORCE, WHILE PROVIDING THE NECESSARY STRUCTURE TO EFFECTIVELY MANAGE THE COMPETITIVE ADVANTAGE OF PRODUCTIVITY, TOTAL QUALITY, CUSTOMER SERVICE AND COSTS. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE ORGANIZATION WILL PROVIDE ITS FORMS 1023, 990 AND 990-T UPON WRITTEN REQUEST. IT EVALUATES THE REASON FOR THE REQUEST AND DEEMS WHETHER IT WILL OFFER THESE DOCUMENTS BASED ON THE INTENT AND PURPOSE OF THE REQUEST. | FORM 990, PART VI, SECTION C, LINE 18 | |
| THE HOSPITAL WILL PROVIDE ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY UPON WRITTEN REQUEST. IT EVALUATES THE REASON FOR THE REQUEST AND DEEMS WHETHER IT WILL OFFER THESE DOCUMENTS BASED ON THE INTENT AND PURPOSE OF THE REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| DESCRIPTION OF BOND ISSUE PRICE | AMOUNTS LISTED AS BOND ISSUE PRICE DO NOT MATCH IRS FORM 8038, PART III, LINE 21(B), AS THE HOSPITAL WAS A PART OF A GROUP OF ORGANIZATIONS PARTICIPATING IN THE REVENUE BONDS ISSUANCE. THUS, THE AMOUNT LISTED IS THE HOSPITAL'S PORTION OF THE TOTAL BOND ISSUE PRICE. | SCHEDULE K, PART I, COLUMN E |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 102,480. RELEASES FROM TEMPORARILY RESTRICTED NET ASSETS -20,379. INCREASE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS 1,464,292. UNREALIZED GAIN ON SECURITIES 1,289,715. OTHER CHANGES IN NET ASSETS -3,686. RESTRICTED CONTRIBUTIONS 48,564. TOTAL TO FORM 990, PART XI, LINE 5: 2,880,986. | FORM 990, PART XI, LINE 5: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|
| GOODALL HOSPITAL REAL ESTATE HOLDING COMPANY LLC | |||||||
| 25 JUNE STREET | SANFORD | ME | 04073 | 010078060 | REAL ESTATE HOLDING COMPANY | ME | HENRIETTA D GOODALL HOSPITAL INC |
| WATERBORO MEDICAL OFFICE BUILDING LLC | |||||||
| 25 JUNE STREET | SANFORD | ME | 04073 | 010078060 | REAL ESTATE HOLDING COMPANY | ME | HENRIETTA D GOODALL HOSPITAL INC |
| GOODALL HOSPITAL MEDICAL OFFICE BUILDING LLC | |||||||
| 25 JUNE STREET | SANFORD | ME | 04073 | 010078060 | REAL ESTATE HOLDING COMPANY | ME | HENRIETTA D GOODALL HOSPITAL INC |
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MANOR AT PHILLIPSTOWN PLACE INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 JUNE STREET | AddressLine1 |
| City | SANFORD | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010473857 | EIN |
| Primary Activities | PROVIDE CARE TO THE ELDERLY | PrimaryActivities |
| Legal Domicile State | ME | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 9 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRIETTA D GOODALL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JUNE STREET PHARMACY LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 JUNE STREET | AddressLine1 |
| City | SANFORD | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020765952 | EIN |
| Primary Activity | PROVIDE PHARMACY SERVICES TO THE COMMUNITY. | PrimaryActivity |
| Legal Domicile State | ME | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRIETTA D GOODALL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 159515 | ShareOfTotalIncome |
| Share Of EOY Assets | 860011 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| JUNE STREET PHARMACY LLC | ||
| A | 55388 | ACTUAL INTEREST CHARGED |
| JUNE STREET PHARMACY LLC | ||
| I | 934673 | ACTUAL COSTS INCURRED |
| MANOR AT PHILLIPSTOWN PLACE INC | ||
| P | 311620 | ACTUAL COSTS INCURRED |
| JUNE STREET PHARMACY LLC | ||
| N | 18000 | ACTUAL COSTS INCURRED |
| MANOR AT PHILLIPSTOWN PLACE INC | ||
| N | 36000 | ACTUAL COSTS INCURRED |
| JUNE STREET PHARMACY LLC | ||
| E | 424708 | ACTUAL PRINCIPAL DUE |
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