2012-08-10T11:00:33-05:00 2011-12-31 020383073 WILLIAM STEELE & ASSOCIATES PC 40 STARK STREET MANCHESTER NH 03101 990 2011-01-01 010342399 ST ANDRE HEALTH CARE FACILITY STAN 2072825171 407 POOL STREET BIDDEFORD ME 04005 ANDREA OTIS-HIGGINS 2072825171 2012-08-07 1 MICHAEL A BARBARITA CPA P00801253 6036228881 2011 2016-02-24 21:20:13Z ANDREA OTIS-HIGGINS 407 POOL STREET BIDDEFORD ME 04005 8034123 0 0928 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. 11 10 226 0 0 0 13647 6481 7786228 8002979 30157 17286 5608 7377 7835640 8034123 0 0 0 0 4333630 4106705 0 0 0 3668127 3710866 8001757 7817571 -166117 216552 5645951 5300854 2962022 2418789 2683929 2882065 ST ANDRE HEALTH CARE FACILITY ANSWERS GOD'S CALL TO PROMOTE A HIGH QUALITY,COMPASSIONATE HEALTH CARE COMMUNITY WHERE ALL PEOPLE FLOURISH. 0 0 7711391 8010356 ST ANDRE HEALTH CARE FACILITY PROVIDED 31,129 SKILLED NURSING CARE DAYS OF SERVICE OF WHICH 22,295 DAYS WERE REIMBURSED BY MEDICAID AT WELL BELOW COST. 7711391 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 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 0 1 20 0 1 226 1 0 0 0 0 0 0 0 0 0 0 X 11 10 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 114086 0 2836 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 ROLAND GAGNE 1.00 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 KIM DENNIS 1.00 X 0 0 0 114086 0 2836 1 0 0 0 REHABCARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 PATIENT REHABILIATION SERVICES 539799 ANTHEM BLUE CROSS BLUE SHIELD PO BOX 591 LEWISTON ME 04243 HEALTH INSURANCE 387686 MAINLAND STRUCTURES CORP 11A BARTLETT RD GORHAM ME 04038 CONSTRUCTION 343444 OMNICARE INC PO BOX 715268 ST LOUIS MO 63150 PHARMACY 217245 US FOODSERVICE PO BOX 3155 BOSTON MA 02241 PATIENT FOOD 172508 8 6481 6481 PATIENT SERVICE REVENU 623000 8002979 8002979 8002979 17286 17286 CAFETERIA SALES 623000 7377 7377 7377 8034123 8010356 0 17286 114086 114086 3663200 3663200 8828 8828 53867 53867 266724 266724 80592 80592 16728 16728 25588 25588 70143 70143 209269 209269 7997 7997 78274 78274 269775 269775 424434 424434 PATIENT CARE PURCH SERV 1111429 1111429 MEDICAL & OTHER SUPPLIE 630177 630177 MEDICAID USER FEE 449281 449281 BAD DEBT EXPENSE 174369 174369 162810 162810 7817571 7711391 106180 0 139685 256488 14219 15910 1192956 828793 12896 13134 88118 76534 7001772 4184965 2356315 2816807 1181243 1182309 660519 110879 5645951 5300854 946400 771575 1244216 1085982 150000 49500 621406 511732 2962022 2418789 X 2683929 2882065 2683929 2882065 5645951 5300854 X 216552 -18416 X 0 1 1 X 0 X 16619 49692 27499 16355 6481 116646 7113549 7396408 7903490 7789128 8010356 38212931 7130168 7446100 7930989 7805483 8016837 38329577 0 0 0 38329577 179835 3610 33103 30157 17286 263991 179835 3610 33103 30157 17286 263991 7310003 7449710 7964092 7835640 8034123 38593568 0.99320 0.98930 0.00680 0.01070 X 1268 1268 2774199 1999274 774925 2969655 2185691 783964 1256650 1256650 2816807 DUE TO AFFILIATE 2400 OTHER NOTES PAYABLE 488202 RESIDENT PERSONAL FUNDS 21130 511732 8034123 7817571 216552 -18416 -18416 198136 8015705 -18418 -18418 8034123 0 8034123 7817571 0 7817571 0 7817571 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 5: NET UNREALIZED LOSSES ON INVESTMENTS: -18,416. COVENANT HEALTH SYSTEMS INC 100 AMES POND DRIVE TEWKSBURY MA 01876 222484505 MANAGEMENT MA 501(C)3 509A2 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 COVENANT HEALTH SYSTEMS INC L 155309 ACTUAL COST