MAINE BEHAVIORAL HEALTHCARE: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MAINE BEHAVIORAL HEALTHCARE (EIN 01-0524834)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-07-13
IRS object ID
201211959349300956
Schema version
2010v3.7
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-07-13T14:28:21-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MAINEHEALTHBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1110 FREE STAddressLine1
CityPORTLANDCity
StateMEState
ZIP Code041013908ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN010524834EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SPRING HARBOR HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSPRINameControl
Phone2077612200Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1123 ANDOVER ROADAddressLine1
CityWESTBROOKCity
StateMEState
ZIP Code04092ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGREG BOWERSName
TitleEXECUTIVE VP & TREASURERTitle
Phone2077612200Phone
Date Signed2012-07-12DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Date Prepared2012-07-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDENNIS P KINGNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1123 ANDOVER ROADAddressLine1
CityWESTBROOKCity
StateMEState
ZIP Code04092ZIPCode
FieldValueIRS element (for citing)
Gross Receipts32233478GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SPRINGHARBOR.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1999YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionSPRING HARBOR HOSPITAL OFFERS PEOPLE IN MENTAL HEALTH CRISIS HIGH-QUALITY, FOCUSED TREATMENT TO SUPPORT THEIR ONGOING RECOVERY.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees506TotalNbrEmployees
Total Nbr Volunteers13TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year512270ContributionsGrantsPriorYear
Contributions Grants Current Year413818ContributionsGrantsCurrentYear
Program Service Revenue Prior Year31372997ProgramServiceRevenuePriorYear
Program Service Revenue CY31742462ProgramServiceRevenueCY
Investment Income Prior Year71479InvestmentIncomePriorYear
Investment Income Current Year55003InvestmentIncomeCurrentYear
Other Revenue Current Year13104OtherRevenueCurrentYear
Total Revenue Prior Year31956746TotalRevenuePriorYear
Total Revenue Current Year32224387TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year21606624SalariesEtcPriorYear
Salaries Etc Current Year21316294SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year84868TotalFundrsngExpCurrentYear
Other Expense Prior Year9985886OtherExpensePriorYear
Other Expenses Current Year10228131OtherExpensesCurrentYear
Total Expenses Prior Year31592510TotalExpensesPriorYear
Total Expenses Current Year31544425TotalExpensesCurrentYear
Revenues Less Expenses Prior Year364236RevenuesLessExpensesPriorYear
Revenues Less Expenses CY679962RevenuesLessExpensesCY
Total Assets BOY33228255TotalAssetsBOY
Total Assets EOY37113459TotalAssetsEOY
Total Liabilities BOY25061476TotalLiabilitiesBOY
Total Liabilities EOY28293180TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8166779NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8820279NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSPRING HARBOR HOSPITAL OFFERS PEOPLE IN MENTAL HEALTH CRISIS HIGH-QUALITY, FOCUSED TREATMENT TO SUPPORT THEIR ONGOING RECOVERY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense13069550Expense
Revenue15127832Revenue
DescriptionADULT SERVICES - ADULT TREATMENT FOCUSES ON RAPID STABILIZATION OF SYMPTOMS AND APPROPRIATE AFTERCARE FOR EACH PATIENT. TREATMENT INCLUDES A COMPREHENSIVE EVALUATION OF PERTINENT PSYCHIATRIC, PSYCHOLOGICAL, DEVELOPMENTAL, AND MEDICAL FACTORS. THE TEAM DEVELOPS AND IMPLEMENTS INDIVIDUALIZED TREATMENT PLANS AND ENLISTS COMMUNITY SUPPORT TO ENSURE APPROPRIATE FOLLOW-UP CARE FOR EACH PATIENT. SEE ATTACHED COMMUNITY BENEFIT REPORT FOR MAINE MENTAL HEALTH PARTNERS & SUBSIDIARIES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense9333323Expense
Revenue10803198Revenue
DescriptionCHILD AND ADOLESCENT SERVICES -OUR 28 YOUTH BEDS SERVE CHILDREN AND ADOLESCENTS WHO REQUIRE ACUTE MENTAL HEALTHCARE AND SUBSTANCE ABUSE INTERVENTION. PROGRAMMING INCLUDES COMPREHENSIVE PSYCHIATRIC EVALUATION, INDIVIDUAL AND FAMILY THERAPY, RECREATIONAL AND GROUP THERAPY, MEDICATION MANAGEMENT, PARENT EDUCATION, AND ON-SITE ACADEMIC INSTRUCTION. THE UNITS SPECIALIZE IN THE TREATMENT OF DIAGNOSES COMMON TO YOUTH, INCLUDING ANXIETY,PSYCHOTIC OR DEPRESSIVE DISORDERS, OPPOSITIONAL/DEFIANT DISORDER, ATTENTION DEFICIT/HYPERACTIVITY DISORDER(ADD/ADHD), AND POST-TRAUMATIC STRESS DISORDER (PTSD).Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense4546604Expense
Revenue5262635Revenue
DescriptionDEVELOPMENTAL DISORDERS PROGRAM - THE STATE'S ONLY HOSPITAL PROGRAM FOR YOUTH WITH AUTISM AND MENTAL ILLNESS,THE DEVELOPMENTAL DISORDERS PROGRAM DELIVERS HIGH-QUALITY TREATMENT OUTCOMES THROUGH A COMBINATION OF EXPERT PROGRAMMING, SPECIALLY TRAINED CAREGIVERS, AND THE INDIVIDUAL POTENTIAL OF EACH PATIENT. THE PROGRAM OFFERS INTENSIVE TREATMENT FOR AGGRESSION, SELF-INJURY, IMPAIRMENT IN FUNCTIONING, AND MENTAL HEALTH CHALLENGES IN CHILDREN AGES 2 TO 21 WHO HAVE A DEVELOPMENTAL DISORDER AND CANNOT CURRENTLY FUNCTION SAFELY OUTSIDE THE HOSPITAL SETTING.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense474129Expense
Revenue548797Revenue
DescriptionOTHER PROGRAM SERVICES INCLUDE CAFETERIA AND VENDING UNITS SALES, OTHER REVENUE FROM MEDICAL RECORDS, RENT FROM A RELATED PARTY, AND EDUCATIONAL SERVICES.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp474129TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev548797TotalOfOtherProgramServiceRev
Total Program Service Expense27423606TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementstrueConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10969NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees506NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledMEStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMICHAEL ABBATIELLO CFONamePerson
Telephone Number2077612233TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line178 ATLANTIC PLACEAddressLine1
CitySOUTH PORTLANDCity
StateMEState
ZIP Code04106ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
RICHARD PETERSEN
PRES. & CEO1.00X097290067040
FRANCIS G MCGINTY
TREASURER1.00X061967942055X
DENNIS P KING
PRESIDENT/CE16.00X039706730312X
FRANK LAVOIE MD
TRUSTEE1.00X033416721264
DAVID LAKARI
CHAIR3.00X000X
SHERI BOULOS
TRUSTEE1.00X000
JANIS COHEN
TRUSTEE1.00X000
JAMES HARNAR
TRUSTEE1.00X000
NANCY HASENFUS MD
TRUSTEE1.00X000
TRACY HAWKINS
VICE CHAIR3.00X000X
LESTER W HODGDON
TRUSTEE1.00X000
LISA C HOOK
TRUSTEE1.00X000
NANCY POND
TRUSTEE1.00X000
ANNA H WELLS
SECRETARY3.00X000X
LESTER F WILKINSON JR
TRUSTEE1.00X000
JOHN SHOOS
TRUSTEE1.00X000
ROGER F WOODMAN JR
TRUSTEE1.00X000
GIRARD ROBINSON MD
CHIEF MEDICA12.00035441828489X
DONALD E QUIGLEY
ASST. SECRET1.00031209834569X
GREGORY BOWERS
EXEC. VP & T4.00017232319042X
RICHARD HANLEY
COO34.00017142719288X
MARY JANE KREBS
CCO & CNO22.00016944019281X
GAIL WILKERSON
CHF PLAN. &8.00011241917121X
MARK FULTON
ASSOCIATE MD40.00196666020046X
MATTHEW SIEGEL MD
PHYSICIAN40.00193099020019X
WILLIAM BRENNAN MD
PHYSICIAN40.00189992019720X
JOHN MURPHY MD
PHYSICIAN40.00187388020123X
DANIEL HOLLIDAY MD
PHYSICIAN40.00178780019028X
FieldValueIRS element (for citing)
Total Reportable Comp From Org945925TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3615938TotalReportableCompFrmRltdOrgs
Total Other Compensation397397TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Federated Campaigns201FederatedCampaigns
All Other Contributions413617AllOtherContributions
Total Contributions413818TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
ADULT SERVICES6230001512783215127832
CHILD & ADOLESCENT6230001080319810803198
DEVELOPMENTAL DISORDERS62300052626355262635
RENT INCOME531120276765276765
CAFETERIA722210227469227469

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column44563TotalRevenueColumn
Related Or Exempt Function Income44563RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue31742462TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column46075TotalRevenueColumn
Exclusion$46,075ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities8928Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities8928Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column8928TotalRevenueColumn
Related Or Exempt Function Income8928RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Income Fundraising Events22195GrossIncomeFundraisingEvents
Fundraising Direct Expenses9091FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column13104TotalRevenueColumn

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column32224387TotalRevenueColumn
Related Or Exempt Function Income31751390RelatedOrExemptFunctionIncome
Exclusion$46,075ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total568480Total
Program Services191620ProgramServices
Management And General376860ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total16329475Total
Program Services15989915ProgramServices
Management And General256592ManagementAndGeneral
Fundraising82968Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total440970Total
Program Services427741ProgramServices
Management And General13229ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2739493Total
Program Services2657308ProgramServices
Management And General82185ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1237876Total
Program Services1200740ProgramServices
Management And General37136ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total3157149Total
Management And General3157149ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total2537Total
Management And General2537ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total688367Total
Program Services685102ProgramServices
Management And General2097ManagementAndGeneral
Fundraising1168Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total9992Total
Program Services9692ProgramServices
Management And General300ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total375668Total
Program Services364988ProgramServices
Management And General10209ManagementAndGeneral
Fundraising471Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total25671Total
Program Services24901ProgramServices
Management And General770ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1882009Total
Program Services1825549ProgramServices
Management And General56460ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total37203Total
Program Services36684ProgramServices
Management And General455ManagementAndGeneral
Fundraising64Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total68805Total
Program Services66489ProgramServices
Management And General2141ManagementAndGeneral
Fundraising175Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1049934Total
Program Services1018436ProgramServices
Management And General31498ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total126928Total
Program Services123880ProgramServices
Management And General3048ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesFundraisingFundraisingManagement And GeneralManagementAndGeneral
HOSPITAL TAX770510770510
PHARMACY SERVICES671176671176
PROVISION FOR BAD DEBT666903666903
FOOD SERVICES43353043350822
MEMBERSHIP DUES1094941062093285

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total152255Total
Program Services152255ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total31544425Total
Program Services27423606ProgramServices
Management And General4035951ManagementAndGeneral
Fundraising84868Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1665BOY
EOY1665EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY9178192BOY
EOY14381993EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY9803BOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1955577BOY
EOY1139077EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY436797EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY249042BOY
EOY262936EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY112803BOY
EOY57792EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis28340027LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8379110LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY20863292BOY
EOY19960917EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY613192BOY
EOY638800EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY244689BOY
EOY233482EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY33228255BOY
EOY37113459EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2732554BOY
EOY2911701EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY22188897BOY
EOY21554118EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY140025BOY
EOY3827361EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY25061476BOY
EOY28293180EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY7753144BOY
EOY8309847EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY63635BOY
EOY160432EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY350000BOY
EOY350000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8166779BOY
EOY8820279EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY33228255BOY
EOY37113459EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses679962ReconcilationRevenueExpenses
Reconcilation Other Changes-26462ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
Form1120 Pol FiledfalseForm1120PolFiled
Form4720 FiledfalseForm4720Filed
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$6,187OtherActivitiesAmount
Total Lobbying Expenditures IIB6187TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax
Substantially All Dues NondeductfalseSubstantiallyAllDuesNondeduct
Only In House LobbyingfalseOnlyInHouseLobbying
Agree To Carryover Prior YearfalseAgreeToCarryoverPriorYear

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE C, PART II-B, LINE 1IReturnReference
ExplanationA PORTION OF MEMBERSHIP DUES PAID REPRESENTS LOBBYING ACTIVITIES. LOBBYING PORTION OF MAINE HOSPITAL ASSOCIATION DUES: 4,533 LOBBYING PORTION OF AMERICAN HOSPITAL ASSOCIATION DUES: 1,654 TOTAL DUES PAID REPRESENTING LOBBYING ACTIVITIES: 6,187Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Preservation Of Open SpaceXPreservationOfOpenSpace
Total Number Of Easements1TotalNumberOfEasements
Total Acreage54TotalAcreage
Nmbr States In Which Easements Held1NmbrStatesInWhichEasementsHeld
Written Policy MonitoringfalseWrittenPolicyMonitoring
Staff Hours Spent On Enforcement5StaffHoursSpentOnEnforcement
Expenses Incurred For Enforcement250ExpensesIncurredForEnforcement
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance350000BeginningOfYearBalance
Investment Earnings Or Losses2093InvestmentEarningsOrLosses
Other Expenditures2093OtherExpenditures
End Of Year Balance350000EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance350000BeginningOfYearBalance
Investment Earnings Or Losses33229InvestmentEarningsOrLosses
Other Expenditures33229OtherExpenditures
End Of Year Balance350000EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance350000BeginningOfYearBalance
Investment Earnings Or Losses7350InvestmentEarningsOrLosses
Other Expenditures7350OtherExpenditures
End Of Year Balance350000EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1212130OtherCostOrOtherBasis
Book Value1212130BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis23449433OtherCostOrOtherBasis
Depreciation5480863Depreciation
Book Value17968570BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis732069OtherCostOrOtherBasis
Depreciation455568Depreciation
Book Value276501BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2946395OtherCostOrOtherBasis
Depreciation2442679Depreciation
Book Value503716BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings19960917TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
AMOUNTS PAYABLE UNDER REIMB. REGS.$3,398,886
DUE TO AFFILIATES$428,475
FieldValueIRS element (for citing)
Total Of Amounts3827361TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ACCOUNTING FOR CONSERVATION EASEMENTSSCHEDULE D, PAGE 1, PART II, LINE 9IN 2002 SPRING HARBOR HOSPITAL ACQUIRED A 54-ACRE PARCEL OF LAND DESIGNATED AS A CONSERVATION EASEMENT WHICH WAS CONVEYED AS PART OF A LAND PURCHASE UPON WHICH THE HOSPITAL WAS BUILT.
INTENDED USES FOR ENDOWMENT FUNDSSCHEDULE D, PAGE 2, PART V, LINE 4THE INCOME FROM THIS PERMANENT ENDOWMENT IS INTENDED TO BE USED PRIMARILY FOR THE SERVICES PROVIDED BY SPRING HARBOR HOSPITAL'S CHILD AND ADOLESCENT PROGRAMS.
LIABILITY UNDER FIN 48 FOOTNOTESCHEDULE D, PAGE 3, PART XSPRING HARBOR HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1SIGNS OF HOPENameOfEvent1
Gross Receipts Event122195GrossReceiptsEvent1
Gross Revenue Event122195GrossRevenueEvent1
Entertainment Event17500EntertainmentEvent1
Other Direct Expenses Event11591OtherDirectExpensesEvent1
Gross Receipts Total22195GrossReceiptsTotal
Gross Revenue Total Events22195GrossRevenueTotalEvents
Entertainment Total Events7500EntertainmentTotalEvents
Other Direct Expenses Total Events1591OtherDirectExpensesTotalEvents
Direct Expense Summary Events9091DirectExpenseSummaryEvents
Net Income Summary13104NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage1.75000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3434384TotalCommunityBenefitExpense
Net Community Benefit Expense3434384NetCommunityBenefitExpense
Percent Of Total Expense0.10890PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense3434384TotalCommunityBenefitExpense
Net Community Benefit Expense3434384NetCommunityBenefitExpense
Percent Of Total Expense0.10890PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense98663TotalCommunityBenefitExpense
Net Community Benefit Expense98663NetCommunityBenefitExpense
Percent Of Total Expense0.00310PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense101235TotalCommunityBenefitExpense
Net Community Benefit Expense101235NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense6812TotalCommunityBenefitExpense
Net Community Benefit Expense6812NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense206710TotalCommunityBenefitExpense
Net Community Benefit Expense206710NetCommunityBenefitExpense
Percent Of Total Expense0.00660PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3641094TotalCommunityBenefitExpense
Net Community Benefit Expense3641094NetCommunityBenefitExpense
Percent Of Total Expense0.11540PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$404,143BadDebtExpenseAmount
Amount Reimbursed By Medicare3041631AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare3961889CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-920258MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1SPRING HARBOR HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1123 ANDOVER ROADAddressLine1
CityWESTBROOKCity
StateMEState
ZIP Code04092ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SPRING HARBOR HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OTHER TESTING METHODS FOR FREE OR DISCOUNTED CAREPART I LINE 3CSPRING HARBOR HOSPITAL DOES NOT PROVIDE DISCOUNTED CARE ONLY FREE CARE FOR WHICH THE FPG IS USED TO DETERMINE ELIGIBILITY
RELATED ORGANIZATION INFORMATIONPART I LINE 6ASPRING HARBORS ANNUAL COMMUNITY BENEFIT REPORT INFORMATION IS CONTAINED IN A REPORT PREPARED BY SPRING HARBORS PARENT ORGANIZATION MAINE MENTAL HEALTH PARTNERS
COSTING METHODOLOGY EXPLANATIONPART I LINE 7CHARITY CARE COST DATA PRESENTED IN THIS SECTION HAS BEEN CALCULATED BY ASSIGNING THE AVERAGE OVERALL SPRING HARBOR RATIO OF COST TO CHARGES TO THE ACTUAL GROSS AMOUNT OF CHARITY CARE CHARGES RECORDED BY THE HOSPITAL DURING THE PERIOD OTHER BENEFIT COST DATA HAS BEEN CALCULATED THROUGH THE USE OF A COMBINATION OF ACTUAL GENERAL LEDGER SPECIFIC COST DATA AND THE USE OF EMPLOYEE TIME STUDIES ALL OTHER BENEFIT COST DATA IN PART I LINE 7 MATCHES THE DATA PRESENTED FOR SPRING HARBOR HOSPITAL IN MAINE MENTAL HEALTH PARTERS ANNUAL COMMUNITY BENEFIT REPORT
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4SPRING HARBOR HOSPITAL DOES NOT HAVE A SPECIFIC FOOTNOTE IN THE FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE HOWEVER REFERENCE IS MADE WITHIN THE FOOTNOTES TO A BAD DEBT POLICY IN A COUPLE OF INSTANCES WITHIN THE FOOTNOTE DESCRIBING SIGNIFICANT ACCOUNTING POLICES IS THE SECTION TITLED ACCOUNTS RECEIVABLE WHERE THE FOLLOWING EXPLAINS THE BAD DEBT RESERVE THE RESERVE FOR UNCOLLECTIBLE ACCOUNTS IS PROVIDED BASED ON AN ANALYSIS BY MANAGEMENT OF THE COLLECTIBILITY OF OUTSTANDING BALANCES MANAGEMENT CONSIDERS THE AGE OF OUTSTANDING BALANCES AND PAST COLLECTION EFFORTS IN DETERMINING THE RESERVE FOR UNCOLLECTIBLE ACCOUNTS ACCOUNTS DEEMED UNCOLLECTIBLE ARE CHARGED OFF AGAINST THE ESTABLISHED RESERVE ALSO WITHIN THE SIGNIFICANT ACCOUNTING POLICIES IS THE SECTION TITLED CHARITY CARE AND BAD DEBTS WHERE THE FOLLOWING DESCRIBES THE BAD DEBT EXPENSE REVENUE FOR SERVICES RENDERED TO INDIVIDUALS FROM WHOM PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED IS WRITTEN OFF AND INCLUDED AS PART OF THE ALLOWANCE FOR BAD DEBTS THE AMOUNT OF EXPENSE ASSOCIATED WITH THE PROVISION OF SERVICES ULTIMATELY WRITTEN OFF AS BAD DEBT AT SPRING HARBOR HAS BEEN CALCULATED AT 404143 FOR THE CURRENT FISCAL YEAR THIS AMOUNT WAS CALCULATED BY ASSIGNING THE AVERAGE OVERALL SPRING HARBOR RATIO OF COST TO CHARGES TO THE GROSS AMOUNT OF CHARGES WRITTEN OFF AS BAD DEBT DURING THE FISCAL PERIOD BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES SPRING HARBOR HAS PROVIDED WITHOUT COMPENSATION AS A TAXEXEMPT HOSPITAL SPRING HARBOR PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENTS ABILITY TO PAY FOR THE SERVICES SPRING HARBOR CANNOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES RELATED TO A PORTION OF OUR COMMUNITY BASED PATIENT POPULATION THEIR MEDICAL BILLS OFTEN PLACE THESE INDIVIDUALS IN UNTENABLE POSITIONS WHERE THEY ARE NOT ABLE TO HANDLE THEIR PERSONAL DEBT AND THEN THEIR NEW MEDICAL DEBT HOWEVER BECAUSE OF THEIR INCOME LEVEL THEY DO NOT QUALIFY FOR FREE CARE BY PROVIDING NECESSARY HEALTHCARE SERVICES TO THOSE INDIVIDUALS EITHER WHO FAIL TO APPLY FOR FINANCIAL ASSISTANCE OR WHO ARE EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES SPRING HARBOR BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT
MEDICARE EXPLANATIONPART III LINE 8SPRING HARBOR HOSPITAL IS CURRENTLY REIMBURSED BY MEDICARE PART A FOR INPATIENT SERVICES THROUGH A PROSPECTIVE PAYMENT SYSTEM PPS DAY RATE METHODOLOGY WHILE MEDICARE PART B REIMBURSES THE HOSPITAL FOR PROFESSIONAL SERVICES RENDERED THROUGH A FEE SCHEDULE FOR EACH SERVICE PROVIDED IN BOTH CASES PART A AND PART B THE REIMBURSEMENT PROVIDED DOES NOT FULLY COVER THE HOSPITALS COSTS TO PROVIDE SERVICES TO MEDICARE BENEFICIARIES ACTUAL FY11 COSTS TO PROVIDE CARE FOR MEDICARE PATIENTS HAS BEEN CALCULATED AT 3961889 WHILE TOTAL ACTUAL MEDICARE REIMBURSEMENT PROVIDED TOTALED 3041631 THE COST CALCULATION WAS DETERMINED USING STANDARD MEDICARE PART A COST REPORTING METHODOLOGIES COST TO CHARGE RATIOS COUPLED WITH INHOUSE SPRING HARBOR ANALYSIS OF PART B COSTS THE DIFFERENCE BETWEEN ACTUAL COST AND MEDICARE REIMBURSEMENT OF 920258 REPRESENTS THE COST OF ACTUAL UNREIMBURSED CARE PROVIDED TO MEDICARE BENEFICIARIES SPRING HARBOR HOSPITAL BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE HOSPITAL HAS A CLEAR MISSION COMMITMENT TO SERVING ELDERLY PATIENTS AND ADULTS WITH DISABILITIES THROUGH THE PROVISION OF SPECIFIC SUBSIDIZED PROGRAMS DEVELOPED TO HELP IMPROVE THE HEALTH STATUS OF THESE PATIENTS IF THESE CRITICAL SUBSIDIZED PROGRAMS WERE NOT PROVIDED BY THE HOSPITAL THEY WOULD BECOME THE OBLIGATION OF THE FEDERAL GOVERNMENT
COLLECTION PRACTICES EXPLANATIONPART III LINE 9BSPRING HARBOR HOSPITAL OFFERS FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE NO MEANS TO PAY FOR THEIR CARE BY MAINTAINING CHARITYINDIGENT CARE PROGRAMS CHARITY CARE IS PROVIDED TO THOSE PATIENTS WHO COMPLETE AN APPLICATION AND WHO OFFER EVIDENCE THAT THEY MEET THE ELIGIBILITY REQUIREMENTS THOSE PATIENTS WHO REFUSE APPLICATION OR WHO FAIL TO MEET THE REQUIREMENTS FOR UNCOMPENSATED CARE ARE PURSUED FOR COLLECTION UNSUCCESSFUL ATTEMPTS AT COLLECTION MAY RESULT IN THE ACCOUNT BEING WRITTEN OFF AS BAD DEBT FOR THOSE PATIENTS THAT DO QUALIFY FOR CHARITY CARE ACCOUNT BALANCES ARE ADJUSTED ACCORDINGLY ONCE THEIR CHARITY CARE APPLICATION HAS BEEN APPROVED MORE DETAILS REGARDING THE CHARITY CARE PROCESS AT SPRING HARBOR ARE MAINTAINED IN THE HOSPITALS WRITTEN AND PUBLICLY AVAILABLE CHARITY CARE POLICY
NEEDS ASSESSMENTPART VISPRING HARBOR HOSPITAL IS A MEMBER OF MAINEHEALTH WHICH CONDUCTS A THOROUGH COMMUNITY NEEDS ASSESSMENT AND DIRECTS ITS MEMBER ORGANIZATIONS TO RESPOND TO THE NEEDS IDENTIFIED MAINEHEALTH MEMBERS ALSO PARTICIPATE IN VARIOUS INITIATIVES TO KEEP THOSE ASSESSMENTS UP TO DATE SOME OF THESE INITIATIVES INCLUDE CLINICAL STRATEGIC PLANNING FINANCIAL STRATEGIC PLANNING FACILITY PLANNING HUMAN RESOURCE PLANNING STAFF DEVELOPMENT PLANNING PHYSICIAN RECRUITMENT STRATEGIC PLANNING EMERGENCY PREPAREDNESS PLANNING IN ADDITION TO THESE INTERNAL ASSESSMENTS MAINEHEALTH MEMBER ORGANIZATIONS ALSO REVIEW AND ACT ON MANY OF THE RECOMMENDATIONS PROVIDED BY EXTERNAL GROUPS AND STATE HEALTH PLANNING INITIATIVES SUCH AS THE MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTHY MAINE 2010 AND AUTISM SPECTRUM DISORDERS REPORT THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION AND THE STATE HEALTH PLAN CREATED BY THE ADVISORY COMMITTEE FOR HEALTH SYSTEMS DEVELOPMENT
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VISPRING HARBOR HOSPITAL DISTRIBUTES A PATIENT FINANCIAL POLICIES BROCHURE TO EACH PATIENT UPON ADMISSION WHICH INCLUDES BUT IS NOT LIMITED TO INFORMATION ON HOW TO ACCESS AND APPLY FOR SPRING HARBOR HOSPITALS FINANCIAL ASSISTANCE PROGRAM FINANCIAL COUNSELING SERVICES MAINECARE MEDICARE AND SOCIAL SECURITY
COMMUNITY INFORMATIONPART VISPRING HARBOR HOSPITALS SERVICE REGION ENCOMPASSES THE SOUTHERNMOST 11 COUNTIES OF MAINE AND ITS APPROXIMATELY 960000 RESIDENTS THREE QUARTERS OF THE STATE POPULATION OF THIS NUMBER IT IS ESTIMATED THAT 7 OF CHILDREN AND 23 OF ADULTS HAVE A DIAGNOSABLE MENTAL ILLNESS THIS EQUATES TO A POTENTIAL POPULATION SERVED OF 190000 MAINE RESIDENTS
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VISPRING HARBOR HOSPITAL IN PARTNERSHIP WITH MAINEHEALTH DEVELOPED A PROGRAM TO IMPROVE PRIMARY CAREMENTAL HEALTH INTEGRATION AND HELPS PEOPLE WITH DEPRESSION AND THOSE WHO CARE FOR AND ABOUT THEM THE PROGRAM TRAINS PRIMARY CARE PROVIDERS ON THE DIAGNOSIS AND TREATMENT OF PATIENTS AND MANY PHYSICIANS USE AN ELECTRONIC REGISTRY TO TRACK OUTCOME MEASURES THE PROGRAM CONDUCTS A COLLABORATIVE LEARNING COMMUNITY EXPLORING THE EFFECTIVENESS EFFICIENCY AND COSTBENEFIT OF INTEGRATION WITH PRIMARY CAREMENTAL HEALTH PARTNERS
AFFILIATED HEALTH CARE INFORMATIONPART VISPRING HARBOR HOSPITAL IS A MEMBER OF MAINE MENTAL HEALTH PARTNERS MAINE MENTAL HEALTH PARTNERS MISSION IS TO FACILITATE PROMOTE AND MAINTAIN A HIGHQUALITY INTEGRATED SYSTEM OF MENTAL HEALTH SERVICES IN THE MAINEHEALTH REGION BY PROMOTING INDIVIDUALS SUCCESSFUL FUNCTIONING IN THE COMMUNITY IE RECOVERY SUPPORTING ACCESS TO SAFE HIGHQUALITY CARE DELIVERED AS CLOSE AS POSSIBLE TO AN INDIVIDUALS HOME AND AT THE BEST POSSIBLE COST DESIGNING DEVELOPING AND SUPPORTING A CONTINUUM OF CARE THAT FULFILLS EACH REGIONS MENTAL HEALTH NEEDS ADVOCATING LOCALLY STATEWIDE REGIONALLY AND NATIONALLY TO ENHANCE MENTAL HEALTH FOR MAINE PEOPLE CREATING A MODEL SYSTEM OF LEADERSHIP CLINICAL EXCELLENCE INNOVATION AND EXPERTISE
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILEDPART VIMAINE

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
RICHARD PETERSEN
60624314800021865752879141611039940
FRANCIS G MCGINTY
388950680001627292811113944661734
DENNIS P KING
2707184100085349221228190427379
FRANK LAVOIE MD
334167857512689355431
GIRARD ROBINSON MD
305760427335925211067383382907
DONALD E QUIGLEY
25213234000259662062513944346667
GREGORY BOWERS
15226920054536613676191365
RICHARD HANLEY
15842713000525914029190715
MARY JANE KREBS
14944020000530813973188721
MARK FULTON
196666602514021216712
MATTHEW SIEGEL MD
193099600014019213118
WILLIAM BRENNAN MD
189992578213938209712
JOHN MURPHY MD
187388583214291207511
DANIEL HOLLIDAY MD
178780550213526197808

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTSSCHEDULE J, PAGE 1, PART I, LINE 4RICHARD PETERSEN 0 207,285 0 FRANCIS G. MCGINTY 0 158,992 0 DENNIS P. KING 0 71,715 0 GIRARD ROBINSON, MD 0 2,272 0 DONALD E. QUIGLEY 0 19,046 0
OTHER ADDITIONAL INFORMATIONSCHEDULE J, PART IIITHE NONQUALIFIED PAYMENTS SHOWN ABOVE ARE FROM RELATED ORGANIZATIONS WHERE THE INDIVIDUALS ARE EMPLOYED. PART I, LINE 1A THE ORGANIZATION PAID DUES TO THE CUMBERLAND CLUB, A SOCIAL CLUB. THE CLUB IS USED TO CONDUCT BUSINESS MEETINGS. THE CLUB'S MEMBERSHIP RESTRICTIONS REQUIRE THAT THE MEMBERSHIP BE IN THE NAME OF AN INDIVIDUAL, NOT A BUSINESS. THEREFORE, THE MEMBERSHIP IS UNDER THE NAME OF THE CEO, DENNIS KING. NONE OF THESE DUES ARE TREATED AS A TAXABLE BENEFIT TO THE CEO.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ALL OTHER ACHIEVEMENTS DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4DOTHER PROGRAM SERVICES INCLUDE CAFETERIA AND VENDING UNITS SALES, OTHER REVENUE FROM MEDICAL RECORDS, RENT FROM A RELATED PARTY, AND EDUCATIONAL SERVICES.
SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTSFORM 990, PAGE 6, PART VI, LINE 4SPRING HARBOR HOSPITAL CHANGED THEIR BY-LAWS TO IMPLEMENT CHANGES TO THE SENIOR FINANCIAL MANAGEMENT STRUCTURE TO INCLUDE A CHIEF FINANCIAL OFFICER AND TREASURER AND TO APPOINT SUCH OFFICERS UPON THE AMENDMENT OF THE BY-LAWS.
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6MAINE MENTAL HEALTH PARTNERS (MMHP) IS THE SOLE MEMBER OF SPRING HARBOR HOSPITAL. MAINEHEALTH (EIN 01-0431680), AS THE SOLE MEMBER OF MMHP, HAS THE RIGHT TO APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BODY OF MMHP AND ITS SUBSIDIARIES.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ATHE SOLE MEMBER, MAINE MENTAL HEALTH PARTNERS MAY ELECT THE BOARD OF DIRECTORS FROM A SLATE OF NOMINEES SUBMITTED BY THE CORPORATION. THE OFFICERS ARE ELECTED BY THE BOARD OF TRUSTEES, EXCEPT THAT THE CFO, COO, CHIEF MEDICAL OFFICER AND CHIEF CLINICAL & NURSING OFFICER ARE APPOINTED BY THE BOARD OF TRUSTEES BASED UPON A RECOMMENDATION OF THE CEO.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BDECISIONS OF THE GOVERNING BODY SUCH AS BUDGETS, BUSINESS STRATEGIES, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION, AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE FULL BOARD PERFORMS A REVIEW OF THE FORM 990. A FINAL DETAILED REVIEW OF THE FORM 990 IS PERFORMED BY THE CHIEF FINANCIAL OFFICER BEFORE SIGNING AND PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE OBTAINED ANNUALLY. THE ORGANIZATION REVIEWS THE RESPONSES TO THESE DOCUMENTS AND ADDRESSES ANY ISSUES IMMEDIATELY.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ASPRING HARBOR HOSPITAL BOARD OF DIRECTORS ARE RESPONSIBLE FOR AN ANNUAL EVALUATION OF THE PRESIDENT/CEO AND THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. FOR THOSE KEY ADMINISTRATIVE EMPLOYEES THAT ARE SHARED WITH MMHP, COMPENSATION IS EVALUATED BY THE MMHP GOVERNANCE COMMITTEE AND APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS. IN ADDITION, THE ORGANIZATION UTILIZES THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTING FIRM, AND INDUSTRY SURVEY.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE MEMBER IS RESPONSIBLE FOR AN ANNUAL EVALUATION OF THE PRESIDENT/CEO AND THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. COMPENSATION IS EVALUATED BY THE COMPENSATION COMMITTEE APPOINTED BY THE MEMBER, AND THE ORGANIZATION'S BOARD OF TRUSTEES MUST APPROVE OF THE COMPENSATION. IN ADDITION, THE ORGANIZATION UTILIZES THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTING FIRM, AND INDUSTRY SURVEY.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST.
ADDITIONAL INFORMATIONFORM 990, PART VIICOLUMN B - AVERAGE HOURS WORKED AT RELATED ORGANIZATIONS RICHARD PETERSEN IS THE PRESIDENT & CEO OF MAINE MEDICAL CENTER, A RELATED ORGANIZATION. HE SPENDS THE MAJORITY OF HIS TIME IN THIS ROLE. DENNIS KING IS THE CEO OF MMHP AND DIVIDES HIS TIME BETWEEN ALL OF THE ENTITIES WITHIN MMHP. FRANCIS MCGINTY IS THE EXECUTIVE VP & TREASURER OF MAINEHEALTH, A RELATED ORGANIZATION. HE DIVIDES HIS TIME BETWEEN ALL OF THE ENTITIES WITHIN MAINEHEALTH. GIRARD ROBINSON IS THE CMO FOR BOTH SHH AND SPRING HARBOR COMMUNITY SERVICES AND THE VICE PRESIDENT OF MEDICAL AFFAIRS FOR MMHP. HE SPENDS APPROXIMATELY 4 HOURS A WEEK AS CMO OF SHCS AND 20 HOURS PER WEEK AS VP OF MEDICAL AFFAIRS FOR MMHP. DONALD QUIGLEY IS THE SENIOR VICE PRESIDENT & GENERAL COUNSEL FOR MAINEHEALTH AND DIVIDES HIS TIME BETWEEN ALL OF THE MAINEHEALTH ENTITIES. GREGORY BOWERS IS THE EXECUTIVE VICE PRESIDENT & TREASURER OF MMHP AND DIVIDES HIS TIME AMONG ALL OF THE MMHP ENTITIES. RICHARD HANLEY IS THE CHIEF OPERATING OFFICER OF MMHP AND ALSO DIVIDES HIS TIME AMONG THE MMHP ENTITIES. MARY JANE KREBS IS THE PRESIDENT & CEO OF COMMUNITY COUNSELING CENTER, A RELATED ORGANIZATION. SHE SPENDS APPROXIMATELY 20 HOURS PER WEEK DOING WORK FOR THAT ORGANIZATION. GAIL WILKERSON IS THE CHIEF OPERATING OFFICER AT SPRING HARBOR COMMUNITY SERVICES AND SPENDS APPROXIMATELY 24 HOURS PER WEEK IN THAT ROLE. SHE IS ALSO THE VP OF STRATEGY & SYSTEM DEVELOPMENT FOR MMHP AND SPENDS APPROXIMATELY 8 HOURS DOING WORK FOR THAT ORGANIZATION.
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5OTHER CHANGES TO NET ASSETS INCLUDE THE FOLLOWING: (12,634) - EQUITY TRANSFER TO RELATED ORGANIZATION 2,588 - EQUITY TRANSFER FROM RELATED ORGANIZATION (16,415) - UNREALIZED LOSS ON INVESTMENTS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
MAINEHEALTH
110 FREE STREETPORTLANDME04101010431680HEALTHCAREME501C311CNAfalse
MAINE MENTAL HEALTH PARTNERS
123 ANDOVER ROADWESTBROOKME04092263426990HEALTHCAREME501C311CMAINEHLTHfalse
SPRING HARBOR COMMUNITY SERVICES
123 ANDOVER ROADWESTBROOKME04092010524835HEALTHCAREME501C39MMHPfalse
COMMUNITY COUNSELING CENTER
165 LANCASTER STREETPORTLANDME04101010288362HEALTHCAREME501C37MMHPfalse
COUNSELING SERVICES INC
PO BOX 1010SACOME04072010315038HEALTHCAREME501C37MMHPfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1INTEGRATED BEHAVIORAL HEALTH INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1123 ANDOVER ROADAddressLine1
CityWESTBROOKCity
StateMEState
ZIP Code04092ZIPCode
FieldValueIRS element (for citing)
EIN208736290EIN
Primary ActivityHEALTHCAREPrimaryActivity
Legal Domicile StateMELegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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