LINCOLNHEALTH: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
LINCOLNHEALTH (EIN 01-0153960)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-09
IRS object ID
201212229349300046
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)
Timestamp2012-08-09T12:33:23-05:00Timestamp
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)
EIN010153960EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST ANDREWS HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTANNameControl
Phone2076338413Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line16 ST ANDREWS LANEAddressLine1
CityBOOTHBAY HARBORCity
StateMEState
ZIP Code04538ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWAYNE PRINTYName
TitleCFOTitle
Phone2076338413Phone
Date Signed2012-08-09DateSigned
Authorize Third PartyfalseAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Date Prepared2012-08-09DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonWAYNE PRINTY CFONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line135 MILES STREETAddressLine1
CityDARMARISCOTTACity
StateMEState
ZIP Code04543ZIPCode
FieldValueIRS element (for citing)
Gross Receipts20723142GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.STANDREWSHEALTHCARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1955YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission Description- TO ESTABLISH, OPERATE, & MAINTAIN FOR SCIENTIFIC, CHARITABLE, EDUCATIONAL & BENEVOLENT PURPOSES A PUBLIC HOSPITAL, CLINIC, INFIRMARY & RETIREMENT COMMUNITY FOR THE CARE & TREATMENT OF SICK, WOUNDED, INFIRM OR AGED PERSONS, A DOCTOR'S OFFICE BUILDING & A SCHOOL FOR THE EDUCATION & TRAINING OF NURSES, ALL WITHOUT DISCRIMINATION AS TO RACE, COLOR, CREED, NATIONAL ORIGIN, AGE, GENDER, SEXUAL ORIENTATION OR FINANCIAL STATUS. - TO BE OPERATED & MAINTAINED AS A CRITICAL ACCESS HOSPITAL IN ACCORDANCE WITH THE STANDARDS ESTABLISHED FROM TIME TO TIME FOR THE MEDICARE RURAL HOSPITAL FLEXIBILITY PROGRAM. - TO ENCOURAGE & CARRY ON EDUCATIONAL ACTIVITIES PURSUANT TO CONTINUALLY IMPROVING THE QUALITY OF CARE PROVIDED. - TO COOPERATE & PARTICIPATE WITH ALLIED AGENCIES IN ALL ACTIVITIES DESIGNED TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY IN THE AREAS SERVED BY THE HOSPITAL. - THIS CORPORATION SHALL NOT BE CONDUCTED FOR GAIN OR PROFIT, & NO PART OF THE NET EARNINGS SHALL INURE TO THE BENEFIT OF ANActivityOrMissionDescription
Nbr Voting Members Governing Body21NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees253TotalNbrEmployees
Total Nbr Volunteers76TotalNbrVolunteers
Total Gross UBI161371TotalGrossUBI
Net Unrelated Business Txbl Income-19854NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year873746ContributionsGrantsPriorYear
Contributions Grants Current Year354360ContributionsGrantsCurrentYear
Program Service Revenue Prior Year19204839ProgramServiceRevenuePriorYear
Program Service Revenue CY18482299ProgramServiceRevenueCY
Investment Income Prior Year39005InvestmentIncomePriorYear
Investment Income Current Year285969InvestmentIncomeCurrentYear
Other Revenue Prior Year695892OtherRevenuePriorYear
Other Revenue Current Year588128OtherRevenueCurrentYear
Total Revenue Prior Year20813482TotalRevenuePriorYear
Total Revenue Current Year19710756TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year8756523SalariesEtcPriorYear
Salaries Etc Current Year8620981SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year53345TotalFundrsngExpCurrentYear
Other Expense Prior Year11428874OtherExpensePriorYear
Other Expenses Current Year10250796OtherExpensesCurrentYear
Total Expenses Prior Year20185397TotalExpensesPriorYear
Total Expenses Current Year18871777TotalExpensesCurrentYear
Revenues Less Expenses Prior Year628085RevenuesLessExpensesPriorYear
Revenues Less Expenses CY838979RevenuesLessExpensesCY
Total Assets BOY31255498TotalAssetsBOY
Total Assets EOY29985446TotalAssetsEOY
Total Liabilities BOY17145091TotalLiabilitiesBOY
Total Liabilities EOY15489050TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY14110407NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY14496396NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission Description- TO ESTABLISH, OPERATE, & MAINTAIN FOR SCIENTIFIC, CHARITABLE, EDUCATIONAL & BENEVOLENT PURPOSES A PUBLIC HOSPITAL, CLINIC, INFIRMARY & RETIREMENT COMMUNITY FOR THE CARE & TREATMENT OF SICK, WOUNDED, INFIRM OR AGED PERSONS, A DOCTOR'S OFFICE BUILDING & A SCHOOL FOR THE EDUCATION & TRAINING OF NURSES, ALL WITHOUT DISCRIMINATION AS TO RACE, COLOR, CREED, NATIONAL ORIGIN, AGE, GENDER, SEXUAL ORIENTATION OR FINANCIAL STATUS. - TO BE OPERATED & MAINTAINED AS A CRITICAL ACCESS HOSPITAL IN ACCORDANCE WITH THE STANDARDS ESTABLISHED FROM TIME TO TIME FOR THE MEDICARE RURAL HOSPITAL FLEXIBILITY PROGRAM. - TO ENCOURAGE & CARRY ON EDUCATIONAL ACTIVITIES PURSUANT TO CONTINUALLY IMPROVING THE QUALITY OF CARE PROVIDED. - TO COOPERATE & PARTICIPATE WITH ALLIED AGENCIES IN ALL ACTIVITIES DESIGNED TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY IN THE AREAS SERVED BY THE HOSPITAL. - THIS CORPORATION SHALL NOT BE CONDUCTED FOR GAIN OR PROFIT, & NO PART OF THE NET EARNINGS SHALL INURE TO THE BENEFIT OF ANMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense11692421Expense
Revenue12786914Revenue
DescriptionST. ANDREWS HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL. THE HOSPITAL OPERATIONS PROVIDE BOTH ACUTE CARE AND REHABILITATIVE CARE IN ITS INPATIENT SETTING. OUTPATIENT SERVICES INCLUDE EMERGENCY CARE, GENERAL SURGERY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, CARDIOPULMONARY SERVICES, DIAGNOSTIC IMAGING, LABORATORY, AND PHARMACY. (CONTINUED ON SCHEDULE O) PATIENT DAYS: ADULT & CHILDREN:3,780 NURSING FACILITY: 10,721 DISCHARGES: 331 DEPARTMENT AMOUNT STATISTICS OPERATING ROOM 304 PROCEDURES LABORATORY 29,289 TESTS CARDIOPULMONARY 2,309 PROCEDURES CT SCANS 1,136 PROCEDURES RADIOLOGY 2,860 PROCEDURES REHABILITATION SERVICES 6,882 VISITS OUTPATIENT DEPARTMENT: EMERGENCY ROOM 3,695 VISITS PLEASE SEE ATTACHED COMMUNITY BENEFITS STATEMENTDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense4297926Expense
Revenue5363780Revenue
DescriptionST. ANDREWS HOSPITAL OFFERS LONG TERM CARE SERVICES AT ST. ANDREWS VILLAGE COMMUNITY. IT INCLUDES 13 ASSISTED LIVING UNITS, 28 INDEPENDENT LIVING APARTMENTS, 11 DEMENTIA CARE BEDS, ADULT DAY SERVICES, AND 30 LONG-TERM CARE BEDS. STATISTICS FOR THE YEAR: ASSISTED LIVING 4,231 DAYS, INDEPENDENT LIVING 7,904 DAYS, DEMENTIA CARE 3,787 DAYS, AND ADULT DAY SERVICES 462 HOURS.Description
FieldValueIRS element (for citing)
Total Program Service Expense15990347TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
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 ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
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 With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees253NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
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
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members21NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
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 PersonCHIEF FINANCIAL OFFICERNamePerson
Telephone Number2076338413TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16 ST ANDREWS LANEAddressLine1
CityBOOTHBAY HARBORCity
StateMEState
ZIP Code04538ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
GARTH MILLER MD
TRUSTEE0.40X045238923399
MARK FOURRE MD
TRUSTEE0.40X027317822968
ROBERT MCARTOR MD
TRUSTEE0.40X016619919048
DANIEL FRIEDLAND MD
TRUSTEE0.40X015982418695
STEVEN FEDER DO
TRUSTEE0.40X015801419016
ALAN BARKER MD
TRUSTEE0.40X01267185649
WILLIAM LOGAN
TRUSTEE0.40X000
PETER MUNDY
CHAIRMAN0.40X000
ROBERT CONN
TREASURER0.40X000
DANIEL PYKETT
SECRETARY0.40X000
BARBARA MITCHELL
TRUSTEE0.40X000
CATHERINE GREGG
TRUSTEE0.40X000
DAVID TRAHAN
TRUSTEE0.40X000
JANE G SMITH
TRUSTEE0.40X000
JANE HURD
TRUSTEE0.40X000
JEFFREY CURTIS
VICE-CHAIRMA0.40X000
JAMES HUNT
TRUSTEE0.40X000
NORMAN HOCHGRAF
TRUSTEE0.40X000
PATRICK LYDON
TRUSTEE0.40X000
REV DR MARY JO ZIMMERLI
TRUSTEE0.40X000
WILLIAM BUTLER
TRUSTEE0.40X000
JAMES DONOVAN
CEO LCH3.00028487222940X
WAYNE PRINTY
CFO3.00017734319051X
MARY DIMASCIO
VP CRITICAL50.00131179010444X
CHARLES KIRK
PHARMACIST50.00126442017418X
PATRICE CARTER
PHARMACIST50.00124194016637X
FieldValueIRS element (for citing)
Total Reportable Comp From Org381815TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1798537TotalReportableCompFrmRltdOrgs
Total Other Compensation195265TotalOtherCompensation
Number Individuals GT100 K3NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Government Grants24084GovernmentGrants
All Other Contributions330276AllOtherContributions
Total Contributions354360TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column18482299TotalRevenueColumn
Related Or Exempt Function Income18482299RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue18482299TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column118219TotalRevenueColumn
Exclusion$118,219ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real15508Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real15508Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column15508TotalRevenueColumn
Unrelated Business Revenue15508UnrelatedBusinessRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1180136Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1012386Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities167750Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column167750TotalRevenueColumn
Related Or Exempt Function Income167750RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
MISCELLANEOUS INCOME900099426757426757
COTTAGE SERVICES5313109220392203
MANAGEMENT FEES5313103342333423

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column20237TotalRevenueColumn
Unrelated Business Revenue20237UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue572620TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column19710756TotalRevenueColumn
Related Or Exempt Function Income19076806RelatedOrExemptFunctionIncome
Unrelated Business Revenue161371UnrelatedBusinessRevenue
Exclusion$118,219ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6442880Total
Program Services5753406ProgramServices
Management And General689474ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total159552Total
Program Services142001ProgramServices
Management And General17551ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1519338Total
Program Services1352211ProgramServices
Management And General167127ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total499211Total
Program Services444298ProgramServices
Management And General54913ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2000Total
Management And General2000ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total7682Total
Management And General7682ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4801169Total
Program Services3168138ProgramServices
Management And General1579686ManagementAndGeneral
Fundraising53345Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total28121Total
Program Services25869ProgramServices
Management And General2252ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1337227Total
Program Services1188633ProgramServices
Management And General148594ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total692745Total
Program Services679426ProgramServices
Management And General13319ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total23152Total
Program Services18117ProgramServices
Management And General5035ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total534382Total
Program Services534089ProgramServices
Management And General293ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1280210Total
Program Services1280210ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
HOSPITAL & PROVIDER TAXES522803522803
BAD DEBTS50045244296257490
FOOD3826203764666154
MISCELLANEOUS978055920338602
DUES & SUBSCRIPTIONS40428251537913

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total18871777Total
Program Services15990347ProgramServices
Management And General2828085ManagementAndGeneral
Fundraising53345Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1304876BOY
EOY443507EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY11271BOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY397489BOY
EOY152570EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2248141BOY
EOY2312264EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY258304BOY
EOY328267EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY101037BOY
EOY95607EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis34618123LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec16345309LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY18978746BOY
EOY18272814EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6475472BOY
EOY6136923EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1480162BOY
EOY2243494EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY31255498BOY
EOY29985446EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY913912BOY
EOY671280EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY331087BOY
EOY230590EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY7925457BOY
EOY7624212EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3837645BOY
EOY3671408EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4136990BOY
EOY3291560EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY17145091BOY
EOY15489050EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY12837313BOY
EOY13684336EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY616234BOY
EOY180801EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY656860BOY
EOY631259EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14110407BOY
EOY14496396EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY31255498BOY
EOY29985446EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses838979ReconcilationRevenueExpenses
Reconcilation Other Changes-452990ReconcilationOtherChanges
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$6,071OtherActivitiesAmount
Total Lobbying Expenditures IIB6071TotalLobbyingExpendituresIIB
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
ExplanationPORTION OF MEMBERSHIP DUES ATTRIBUTABLE TO LOBBYING ACTIVITIES: LOBBYING PORTION OF MAINE HOSPITAL ASSOCIATION DUES: 3,044 LOBBYING PORTION OF AMERICAN HOSPITAL ASSOCIATION DUES: 1,537 LOBBYING PORTION OF MAINE HEALTH CARE ASSOCIATION: 1,253 LOBBYING PORTION OF AMERICAN HEALTH CARE ASSOCIATION: 237Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance4402289BeginningOfYearBalance
Contributions70055Contributions
Investment Earnings Or Losses91209InvestmentEarningsOrLosses
Administrative Expenses-18534AdministrativeExpenses
End Of Year Balance4545019EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3797878BeginningOfYearBalance
Investment Earnings Or Losses585966InvestmentEarningsOrLosses
Other Expenditures34289OtherExpenditures
Administrative Expenses-15844AdministrativeExpenses
End Of Year Balance4402289EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3708727BeginningOfYearBalance
Contributions77640Contributions
Investment Earnings Or Losses87588InvestmentEarningsOrLosses
Other Expenditures-62499OtherExpenditures
Administrative Expenses-13578AdministrativeExpenses
End Of Year Balance3797878EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.89310BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.10690PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis646055OtherCostOrOtherBasis
Book Value646055BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis21303089OtherCostOrOtherBasis
Depreciation6583106Depreciation
Book Value14719983BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis10538014OtherCostOrOtherBasis
Depreciation8151284Depreciation
Book Value2386730BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2130965OtherCostOrOtherBasis
Depreciation1610919Depreciation
Book Value520046BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings18272814TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATE1887242
PATIENT AND OTHER DEPOSITS203125
DEFERRED FINANCING COSTS100236
OTHER ASSETS52891
FieldValueIRS element (for citing)
Total Book Value Other Assets2243494TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
AMOUNTS PAYABLE UNDER REIMB. REGS.$1,878,298
DUE TO AFFILIATE$1,069,342
DEPOSITS PAYABLE$203,122
MALPRATICE INSURANCE RESERVE$59,170
OTHER LIABILITIES$56,628
ASSET RETIREMENT OBLIGATIONS$25,000
FieldValueIRS element (for citing)
Total Of Amounts3291560TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierINTENDED USES FOR ENDOWMENT FUNDSIdentifier
Return ReferenceSCHEDULE D, PAGE 2, PART V, LINE 4ReturnReference
ExplanationENDOWMENT FUNDS CONSIST OF A BENEFICIAL INTEREST IN A PERPETUAL TRUST, BOARD DESIGNATED FUNDS, AND BEQUESTS THAT HAVE BEEN VOTED ON BY THE BOARD OF TRUSTEES TO BE UNRESTRICTED ENDOWMENT FUNDS.Explanation

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 CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage2.25000DiscountedOtherPercentage
FieldValueIRS element (for citing)
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 Expense308287TotalCommunityBenefitExpense
Net Community Benefit Expense308287NetCommunityBenefitExpense
Percent Of Total Expense0.01630PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense3188576TotalCommunityBenefitExpense
Direct Offsetting Revenue2208320DirectOffsettingRevenue
Net Community Benefit Expense980256NetCommunityBenefitExpense
Percent Of Total Expense0.05190PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense3496863TotalCommunityBenefitExpense
Direct Offsetting Revenue2208320DirectOffsettingRevenue
Net Community Benefit Expense1288543NetCommunityBenefitExpense
Percent Of Total Expense0.06830PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense6422TotalCommunityBenefitExpense
Net Community Benefit Expense6422NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense5900TotalCommunityBenefitExpense
Net Community Benefit Expense5900NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense8862TotalCommunityBenefitExpense
Net Community Benefit Expense8862NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense4659TotalCommunityBenefitExpense
Net Community Benefit Expense4659NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense25843TotalCommunityBenefitExpense
Net Community Benefit Expense25843NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3522706TotalCommunityBenefitExpense
Direct Offsetting Revenue2208320DirectOffsettingRevenue
Net Community Benefit Expense1314386NetCommunityBenefitExpense
Percent Of Total Expense0.06960PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense3756TotalCommunityBuildingExpense
Net Community Building Expense3756NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense5000TotalCommunityBuildingExpense
Net Community Building Expense5000NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense8756TotalCommunityBuildingExpense
Net Community Building Expense8756NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$355,336BadDebtExpenseAmount
Amount Reimbursed By Medicare6672344AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare6578726CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall93618MedicareSurplusOrShortfall

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 Line1ST ANDREWS HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line16 ST ANDREWS LANEAddressLine1
CityBOOTHBAY HARBORCity
StateMEState
ZIP Code04538ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Critical Access HospitalXCriticalAccessHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST ANDREWS HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST ANDREWS HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1DBA ST ANDREWS VILLAGEAddressLine1
Address Line2145 EMERY LANEAddressLine2
CityBOOTHBAY HARBORCity
StateMEState
ZIP Code04538ZIPCode
FieldValueIRS element (for citing)
Facility TypeLONG-TERM CARE FACILITYFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUBSIDIZED HEALTH SERVICES EXPLANATIONPART I LINE 7GSUBSIDIZED HEALTH SERVICES INCLUDE SCHOOL BASED HEALTH CENTERS WHERE LINCOLN COUNTY HEALTH CARE INC LCH AND ITS SUBSIDIARIES MILES MEMORIAL HOSPITAL MMH AND ST ANDREWS HOSPITAL SAH PROVIDE PHYSICIANS OR NURSE PRACTITIONERS TO CONSULT AND PROVIDE SERVICES WITHIN THE SCHOOL CLINICS ARE ALSO OFFERED THROUGHOUT THE YEAR TO PROVIDE SUBSIDIZED SERVICES SUCH AS MAMMOGRAPHY BLOOD PRESSURE SCREENINGS ETC TO ENCOURAGE ITS RESIDENTS TO OBTAIN THESE HEALTH SERVICES PHYSICIAN PRACTICES OFFERING SERVICES SUCH AS FAMILY MEDICINE INTERNAL MEDICINE AND PEDIATRICS OPERATE AT A LOSS IN ORDER TO ENSURE HEALTHCARE FOR ITS COMMUNITY MEMBERS REGARDLESS OF THEIR ABILITY TO PAY 8862 OF EXPENSES RELATED TO OUTPATIENT CLINICS ARE INCLUDED IN THE SUBSIDIZED HEALTH SERVICES TOTAL IN PART I LINE 7G
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSEPART I LINE 7 COLUMN FBAD DEBT EXPENSE OF 500452 WAS REMOVED FROM TOTAL EXPENSES WHEN CALCULATING THE PERCENT OF TOTAL EXPENSES IN COLUMN F
COSTING METHODOLOGY EXPLANATIONPART I LINE 7CHARITY CARE AND MEANSTESTED GOVERNMENT PROGRAMS UTILIZE A COST TO CHARGE RATIO IN DETERMINING THE COST OF THE ACTUAL CHARITY CARE WRITEOFF THE COST TO CHARGE RATIO IS DERIVED FROM THE ANNUAL COST REPORT SUBMISSIONS
COMMUNITY BUILDING ACTIVITIESPART IILINCOLN COUNTY HEALTHCARE INC AND ITS SUBSIDIARY HOSPITAL ORGANIZATIONS MILES MEMORIAL HOSPITAL AND ST ANDREWS HOSPITAL PARTNER WITH VARIOUS COMMUNITY GROUPS SUCH AS THE LINCOLN COUNTY ABUSE TASK FORCE AND THE DOMESTIC ABUSE PREVENTION COUNCIL TO IMPROVE AND PROTECT THE HEALTH OF ITS COMMUNITY MEMBERS MEALS ARE PREPARED BY ITS STAFF AS PART OF THE LOCAL MEALS ON WHEELS PROGRAMS WHICH DELIVERS MEALS TO THE ELDERLY POPULATION TO ASSIST WITH THEIR NUTRITIONAL NEEDS LCH PARTICIPATES IN THE COMMUNITY DISASTER TRAINING HELD ON A REGULAR BASIS THROUGHOUT THE COUNTY PART III LINE 4 BAD DEBT EXPLANATION FROM THE LCH AUDITED FINANCIAL STATEMENTS CHARITY CARE AND BAD DEBTS MMH AND SAH THE HOSPITALS ACCEPT ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO CERTAIN ESTABLISHED POLICIES OF THE HOSPITALS ESSENTIALLY THESE POLICIES DEFINE CHARITY CARE AS THOSE SERVICES FOR WHICH LIMITED OR NO PAYMENT IS ANTICIPATED IN ASSESSING A PATIENTS ABILITY TO PAY THE HOSPITALS UTILIZE GENERALLY RECOGNIZED POVERTY INCOME LEVELS CHARITY CARE IS MEASURED BASED ON THE HOSPITALS ESTABLISHED RATES THE HOSPITALS UTILIZE ANNUAL FEDERAL GUIDELINES AND ADJUST ACCOUNT FOR THOSE WHOSE INCOME IS 225 OF THE POVERTY LEVEL TAKING FAMILY SIZE INTO CONSIDERATION THE COSTS AND EXPENSES INCURRED IN PROVIDING THESE SERVICES ARE INCLUDED IN OPERATING EXPENSES REVENUE FOR SERVICES RENDERED TO INDIVIDUALS FROM WHO PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED IS WRITTEN OFF AND INCLUDED AS PART OF THE ALLOWANCE FOR BAD DEBTS THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON PART III LINE 2 AND 3 FOLLOW THE WORKSHEETS PROVIDED IN THE SCHEDULE H INSTRUCTIONS AND UTILIZES COSTS TO CHARGE INFORMATION DERIVED DIRECTLY OFF THE ANNUAL COST REPORTS BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES ST ANDREWS HOSPITAL HAS PROVIDED WITHOUT COMPENSATION AS A TAXEXEMPT HOSPITAL SAH PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENTS ABILITY TO PAY FOR THE SERVICES A PORTION OF SAH BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THAT FOR A VARIETY OF REASONS DO NOT COMPLETE THE FINANCIAL ASSISTANCE APPLICATION PROCESS SAH CANNOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE SAH FREE CARE POLICY IN ADDITION BAD DEBT EXPENSE ALSO INCLUDES AMOUNTS FOR SERVICES PROVIDED TO INDIVIDUALS EXPERIENCING 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 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 SAH BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT PART III LINE 8 MEDICARE EXPLANATION MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO THE HOSPITAL BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE MEDICAL CENTER 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 PART III LINE 9B COLLECTION PRACTICES EXPLANATION COLLECTION POLICY EXCERPT REGARDING SELFPAY ACCOUNTS FOR SELFPAY BALANCES PAYMENTS MUST BE ARRANGED BY THE FINANCIAL COUNSELOR OR PATIENT ACCOUNTS STAFF USING THE FOLLOWING CRITERIA BALANCES UNDER 100 25MONTH MINIMUM BALANCES L00500 50MONTH MINIMUM BALANCES OVER 500 100MONTH MINIMUM IF THE PATIENT CANNOT MEET THE GUIDELINES ABOVE THE FINANCIAL COUNSELOR OR PATIENT ACCOUNTS STAFF WILL REQUEST PROOF OF INCOME AND REASON WHY THEY CANNOT MAKE REGULAR PAYMENTS THE PATIENT WILL BE OFFERED FINANCIAL ASSISTANCE IF CRITERIA IS MET WITH FREE CARE GUIDELINES AND OTHER ASSISTANCE THAT IS AVAILABLE WHEN IT IS DETERMINED THAT THE GUARANTOR CANNOT REALISTICALLY MEET THE EXTENDED PAYMENT PLAN TERMS DUE TO INSUFFICIENT INCOME LIMITED OR NEGLIGIBLE ASSETS OR OTHER EXTENUATING CIRCUMSTANCES BEYOND THE GUARANTORS CONTROL THE HOSPITAL MAY REDUCE THE TOTAL INDEBTEDNESS THROUGH FREE CARE UNDER THE SUPERVISION OF THE DIRECTOR OF PATIENT ACCOUNTS THE FINANCIAL COUNSELORS WILL FOLLOW THE FREE CARE GUIDELINES FOR APPROVAL OF FREE CARE A FREE CARE WRITEOFF MAY BE UTILIZED ONLY AFTER ALL THIRD PARTY BENEFIT POSSIBILITIES HAVE BEEN EXHAUSTED AND WHEN IT IS DETERMINED THAT NO OTHER HOSPITAL ASSISTANCE PROGRAMS OR FUNDS ARE APPLICABLE OR AVAILABLE TO THE GUARANTOR ONCE APPROVED THE HOSPITAL WILL ALLOW FULL OR PARTIAL ADJUSTMENTS ON BALANCES UP TO 225 OF THE FREE CARE GUIDELINES SET BY THE STATE OF MAINE
NEEDS ASSESSMENTPART VITHE HEALTH NEEDS OF THE COMMUNITY ARE ASSESSED BY UTILIZING THE MAINE STATE HEALTH PLAN AND ASSESSMENT COMMUNITY FORUMS INVOLVEMENT IN COMMUNITY BASED HEALTH STATUS IMPROVEMENT PROGRAMS AND IN CONJUNCTION WITH MAINEHEALTH OUR HEALTH CARE SYSTEM MAINEHEALTH ALSO PARTICIPATES IN VARIOUS INITIATIVES TO HELP SUPPORT AND PROVIDE UPDATES TO COMMUNITY NEEDS ASSESSMENT PLANNING SOME OF THESE INITIATIVES INCLUDE CLINICAL STRATEGIC PLANNING FINANCIAL STRATEGIC PLANNING FACILITY PLANNING MANPOWER PLANNING PHYSICIAN RECRUITMENT STRATEGIC PLANNING EMERGENCY PREPAREDNESS PLANNING ALONG WITH THE INTERNAL ASSESSMENTS MOST MEMBER ORGANIZATIONS ALSO REVIEW AND ACT ON MANY OF THE RECOMMENDATIONS PROVIDED BY EXTERNAL GROUPS SUCH AS THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION AND THE STATE HEALTH PLAN CREATED BY THE ADVISORY COMMITTEE FOR HEALTH SYSTEMS DEVELOPMENT IN ADDITION MAINEHEALTH AND ITS PARTNERS IN THE ONEMAINE HEALTH COLLABORATIVE EASTERN MAINE HEALTH SYSTEM AND MAINEGENERAL HEALTH RELEASED THE ONEMAINE HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT REPORT IN 2011 THE REPORT IS A COMPREHENSIVE COMPILATION AND ANALYSIS CONTAINING PRIMARY AND SECONDARY HEALTH DATA SOURCES THE REPORT CONTAINS A HEALTH STATUS PROFILE FOR THE STATE AS A WHOLE AND FOR EACH OF MAINES SIXTEEN COUNTIES THE PRIMARY DATA SOURCE WAS A RANDOMIZED TELEPHONE SURVEY THE SAMPLING METHODOLOGY WAS DESIGNED TO PERMIT COMPARISONS AT THE COUNTY LEVEL SECONDARY DATA SOURCES INCLUDE NUMEROUS STATE AND FEDERAL SOURCES THIS REPORT PROVIDES BASELINE DATA ON HUNDREDS OF HEALTH INDICATORS THAT ARE RELEVANT TO HOSPITALS AND COMMUNITIES TO INFORM PLANNING AND EVALUATION ACTIVITIES PLANS CALL FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT TO BE REPLICATED EVERY THREE YEARS MAINEHEALTH HOLDS COMMUNITY FORUMS IN PARTNERSHIP WITH EACH MEMBER AND AFFILIATE HOSPITAL IN ORDER TO INCREASE UNDERSTANDING AND USE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND TO INFORM IDENTIFICATION AND ACTION ON LOCAL COMMUNITYBASED HEALTH PRIORITIES
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VIPATIENTS AND OTHER PERSONS WHO ARE BILLED FOR PATIENT CARE ARE INFORMED ABOUT ELIGIBILITY CRITERIA FOR FREE CARE GOVERNMENTAL ASSISTANCE IE MEDICAID AND OTHER ASSISTANCE PROGRAMS SUCH NOTIFICATION IS ACCOMPLISHED IN THE FOLLOWING WAYS ALL SELFPAY PATIENTS ARE PROVIDED A PACKET THAT DESCRIBES AVAILABLE PROGRAMS ELIGIBILITY AND THE APPLICATION PROCESS NOTIFICATIONS ARE POSTED AT NUMEROUS LOCATIONS THROUGHOUT THE HOSPITAL IN PATIENT CARE AREAS AS WELL AS THE HOSPITAL ENTRANCE INPATIENTS WITHOUT INSURANCE RECEIVE FINANCIAL COUNSELING AT WHICH TIME FINANCIAL ASSISTANCE OPPORTUNITIES ARE DISCUSSED HOSPITAL STAFF WILL ASSIST PATIENTS IN THE APPLICATION PROCESS PATIENT BILLS AND STATEMENTS PROVIDE A TELEPHONE NUMBER TO CALL FOR INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS AND HELP IN QUALIFYING FOR THEM
COMMUNITY INFORMATIONPART VIOUR SERVICE AREA IS LINCOLN COUNTY MAINE WHICH WAS INCORPORATED JUNE 19 1760 LINCOLN COUNTY CONTAINS 457 SQUARE MILES OF LAND 451 MILES OF COASTLINE AND SIX RIVERS MARINE INTERESTS SUCH AS COMMERCIAL FISHING LOBSTERING CLAMMING EELING BOAT BUILDING ALONG WITH FORESTRY AND AGRICULTURE CONSTITUTED THE MAJORITY OF OUR EARLY ECONOMIC BASE IN MORE RECENT TIMES SERVICE INDUSTRIES AND TOURISM ALSO SERVE AS OUR ECONOMIC BASE ACCORDING TO 20062008 AMERICAN COMMUNITY SURVEY OF THE US CENSUS BUREAU LINCOLN COUNTY HAS A TOTAL POPULATION OF 34730 THIS POPULATION ALMOST DOUBLES IN THE SUMMER AS WE ARE A VERY BUSY TOURIST DESTINATION ON THE COAST TEN PERCENT OF OUR RESIDENTS ARE BELOW THE POVERTY LEVEL MAINE HAS THE THIRD HIGHEST PERCENTAGE OF RESIDENTS OVER 65 156 VERSUS 129 NATIONALLY WITHIN MAINE LINCOLN COUNTY HAS THE HIGHEST PERCENTAGE OF RESIDENTS OVER 65 200 LINCOLN COUNTY ALSO HAS A HIGHER MEDIAN AGE 456 VS 367 THAN IN THE UNITED STATES AS COMPARED TO THE UNITED STATES 652 A SMALLER PERCENT OF RESIDENTS AT LEAST 16 YEARS OF AGE ARE IN THE LABOR FORCE 642 LINCOLN COUNTY IS AN ECONOMICALLY POOR COUNTY THE US DEPARTMENT OF LABOR REPORTS THAT THE WEEKLY WAGE IN LINCOLN COUNTY DURING THE THIRD QUARTER OF 2009 WAS ONLY 542 AS COMPARED TO THE AVERAGE WEEKLY WAGE OF 840 IN THE UNITED STATES IN FACT LINCOLN COUNTY HAS THE SECOND LOWEST WEEKLY WAGE OF ALL COUNTIES IN MAINE THESE POPULATION AND ECONOMIC DATA POINT OUT THE DEPENDENCE OF MILES MEMORIAL HOSPITAL ON MEDICARE AND MEDICAID AND EXPLAIN THE LARGE AMOUNT OF UNCOMPENSATED CARE PROVIDED ST ANDREWS HOSPITAL IS A CRITICAL ACCESS HOSPITAL LOCATED IN BOOTHBAY HARBOR IT IS THE ONLY OTHER HOSPITAL IN LINCOLN COUNTY THE PROVISION OF CARE TO LINCOLN COUNTY RESIDENTS IS COORDINATED BETWEEN MILES AND ST ANDREWS AND THEY SHARE COMMON GOVERNANCE MANAGEMENT AND ADMINISTRATIVE SERVICES IN A EFFORT TO CONTROL COSTS PORTIONS OF LINCOLN COUNTY HAVE BEEN DESIGNATED AS MEDICALLY UNDERSERVED
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VITHE TAX EXEMPT PURPOSE OF THE ORGANIZATION TO IMPROVE THE HEALTH OF THE COMMUNITY IS PROMOTED AND ENHANCED IN THE FOLLOWING WAYS THE MAJORITY OF THE GOVERNING BODY IS COMPOSED OF PERSONS LIVING WITHIN THE HOSPITAL SERVICE AREA THAT ARE NEITHER EMPLOYED BY NOR HAVE CONTRACTUAL RELATIONSHIPS WITH THE HOSPITAL OR ITS AFFILIATES MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SOLICITATION OF COMMUNITY INPUT IN THE STRATEGIC PLANNING PROCESS COMMON GOVERNANCE OF THE HOSPITALS LONGTERM CARE HOME HEALTH HOSPICE AND PHYSICIAN SERVICES PROVIDED IN THE COUNTY TO PROMOTE COMMON HEALTH CARE AND IMPROVEMENT PLANNING AND CONTROL COSTS VOLUNTARY CAP ON INCOME FROM OPERATIONS TO RESTRAIN PRICES AND TO FUND HEALTH CARE AND HEALTH IMPROVEMENT ACTIVITIES SURPLUS FUNDS ARE REINVESTED IN CAPITAL EQUIPMENT AND IMPROVEMENTS TO ENSURE HIGH QUALITY CARE EACH YEAR A PORTION OF RETAINED EARNINGS ARE DISTRIBUTED TO OUR PARENT MAINEHEALTH FOR THE SPECIFIC PURPOSE OF HEALTH STATUS IMPROVEMENT PROGRAMS THROUGHOUT THE MAINEHEALTH SERVICE AREA
AFFILIATED HEALTH CARE INFORMATIONPART VITHE HOSPITAL IS PART OF LINCOLN COUNTY HEALTH CARE INC WHICH INCLUDES THE FOLLOWING SERVICES PROVIDED IN LINCOLN COUNTY A CRITICAL ACCESS HOSPITAL A SOLE COMMUNITY PROVIDER HOSPITAL TWO NURSING FACILITIES TWO ASSISTED LIVING FACILITIES TWO DEMENTIA CARE FACILITIES RURAL HEALTH CLINICS AT SEVERAL SITES GENERAL SURGERY PRACTICE ORTHOPEDIC SURGERY PRACTICE OBGYN PHYSICIAN PRACTICE PEDIATRICS HOME HEALTH CARE AND HOSPICE LINCOLN COUNTY HEALTH CARE LCH IN TURN IS PART OF THE MAINEHEALTH SYSTEM THE ABILITY TO IMPROVE HEALTH CARE AND THE HEALTH STATUS IN LINCOLN COUNTY IS ENHANCED BY THE COMMON GOVERNANCE MANAGEMENT AND ADMINISTRATION OF THESE DIVERSE HEALTH CARE SERVICES THE SYSTEMS COORDINATED APPROACH TO THE FOLLOWING ENHANCES THE RESOURCES THAT CAN BE ALLOCATED TO DIRECT PATIENT CARE AND HEALTH STATUS IMPROVEMENT ACCOUNTING ANALYSIS AND BUDGETING PATIENT BILLING MEDICAL RECORDS SUPPLY CHAIN MANAGEMENTPURCHASING HUMAN RESOURCES INFORMATION SERVICES MEDICAL STAFF EDUCATION COMMUNITY STAFF SHARED CLINICAL DEPARTMENT MANAGEMENT HOSPITALS THE SYSTEM APPROACH PROVIDES A MORE HOLISTIC APPROACH TO COMMUNITY NEEDS ASSESSMENT AND TO THE IMPLEMENTATION OF PROGRAMS TO IMPROVE COMMUNITY HEALTH STRATEGIC PLANNING AND BUDGETING CAN BETTER ALLOCATE RESOURCES ACROSS THE SPECTRUM OF CARE TO ACHIEVE BETTER OVERALL OUTCOMES MAINEHEALTH IS A NOTFORPROFIT FAMILY OF LEADING HIGHQUALITY PROVIDERS AND OTHER HEALTHCARE ORGANIZATIONS WORKING TOGETHER SO THEIR COMMUNITIES ARE THE HEALTHIEST IN AMERICA RANKED AMONG THE NATIONS TOP 100 INTEGRATED HEALTHCARE DELIVERY NETWORKS MAINEHEALTH IS GOVERNED BY A BOARD OF TRUSTEES CONSISTING OF COMMUNITY AND BUSINESS LEADERS FROM ITS SOUTHERN CENTRAL AND WESTERN MAINE REGIONAL SERVICE AREAS THE COLLABORATION OF MAINEHEALTH MEMBERS MAKES IT POSSIBLE TO OFFER AN EXTENSIVE RANGE OF CLINICAL INTEGRATION AND COMMUNITY HEALTH PROGRAMS MANY AIMED AT IMPROVING ACCESS TO PREVENTIVE AND PRIMARY CARE SERVICES MAINEHEALTH INCLUDES THE FOLLOWING MEMBER ORGANIZATIONS LINCOLN COUNTY HEALTH CARE MILES MEMORIAL HOSPITAL AND ST ANDREWS HOSPITAL MAINE MEDICAL CENTER MAINE MENTAL HEALTH PARTNERS SPRING HARBOR HOSPITAL PEN BAY HEALTHCARE PEN BAY MEDICAL CENTER SOUTHERN MAINE MEDICAL CENTER WALDO COUNTY HEALTHCARE WALDO COUNTY GENERAL HOSPITAL WESTERN MAINE HEALTHCARE STEPHENS MEMORIAL HOSPITAL HOMEHEALTH VISITING NURSES MAINE PHYSICIAN HOSPITAL ORGANIZATION NORDX AND SYNERNET AFFILIATES OF MAINEHEALTH INCLUDE MAINEGENERAL MEDICAL CENTER MID COAST HOSPITAL NEW ENGLAND REHABILITATION HOSPITAL AND ST MARYS REGIONAL MEDICAL CENTER
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILEDPART VIMAINE
ADDITIONAL INFORMATIONPART VITHE COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE REPORT PREPARED BY LINCOLN COUNTY HEALTH CARE INC SEE SCHEDULE O PART I LINE 3B ELIGIBILITY FOR FREE OR DISCOUNTED CARE IS BASED ON INCOME CRITERIA AS OUTLINED BELOW 175 FPL 100 WRITEOFF 200 FPL 75 WRITEOFF 225 FPL 50 WRITEOFF FEDERAL POVERTY LEVELS FPL TAKE INTO ACCOUNT FAMILY SIZE NO ASSET TEST OR OTHER CRITERIA IS EVALUATED FOR ELIGIBILITY THESE LEVELS SURPASS THE MINIMUM STATE REQUIREMENTS FOR FREE CARE ELIGIBILITY AT 150 OF FPL

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 (7 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBonus Related OrgsBonusRelatedOrgs
GARTH MILLER MD
44238910000447718922475788
MARK FOURRE MD
273178625716711296146
ROBERT MCARTOR MD
14306423135124366612185247
DANIEL FRIEDLAND MD
1550164808425914436178519
STEVEN FEDER DO
13867919335382815188177030
JAMES DONOVAN
2268411603165791636130781242000
WAYNE PRINTY
15788819455393515116196394

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTSSCHEDULE J, PAGE 1, PART I, LINE 4ROBERT MCARTOR, M.D. 0 18,046 0
OTHER ADDITIONAL INFORMATIONSCHEDULE J, PART IIIPART I, LINE 4: THE NONQUALIFIED PAYMENTS ARE FROM RELATED ORGANIZATIONS WHERE THE INDIVIDUAL IS EMPLOYED.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1MHHEFA REVENUE BOND SERIES 2011ABusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN010314384IssuerEIN
CUSIP Number560427LW4CUSIPNumber
Date Issued2011-08-31DateIssued
Issue Price8469460IssuePrice
Description Of PurposeREFINANCE BONDSDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired8465000AmountRetired
Total Proceeds8469460TotalProceeds
Amount In Reserve Fund692063AmountInReserveFund
Refunding Escrow8544562RefundingEscrow
Issuance Costs From Proceeds86804IssuanceCostsFromProceeds
Credit Enhancement384460CreditEnhancement
Other Spent Proceeds1932OtherSpentProceeds
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedfalseBondCounselRoutinelyEngaged
Post Issuance Compliance ProcdrsfalsePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE KReturnReference
ExplanationMHHEFA REVENUE BOND SERIES 2011A PART II LINE 1 AND 3 NOT IDENTICAL NET PREMIUM 384460 PRINCIPAL 50000 INTEREST 63981 DEBT SERVICE RESERVE FUND 741920Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSION- TO ESTABLISH, OPERATE, & MAINTAIN FOR SCIENTIFIC, CHARITABLE, EDUCATIONAL & BENEVOLENT PURPOSES A PUBLIC HOSPITAL, CLINIC, INFIRMARY & RETIREMENT COMMUNITY FOR THE CARE & TREATMENT OF SICK, WOUNDED, INFIRM OR AGED PERSONS, A DOCTOR'S OFFICE BUILDING & A SCHOOL FOR THE EDUCATION & TRAINING OF NURSES, ALL WITHOUT DISCRIMINATION AS TO RACE, COLOR, CREED, NATIONAL ORIGIN, AGE, GENDER, SEXUAL ORIENTATION OR FINANCIAL STATUS. - TO BE OPERATED & MAINTAINED AS A CRITICAL ACCESS HOSPITAL IN ACCORDANCE WITH THE STANDARDS ESTABLISHED FROM TIME TO TIME FOR THE MEDICARE RURAL HOSPITAL FLEXIBILITY PROGRAM. - TO ENCOURAGE & CARRY ON EDUCATIONAL ACTIVITIES PURSUANT TO CONTINUALLY IMPROVING THE QUALITY OF CARE PROVIDED. - TO COOPERATE & PARTICIPATE WITH ALLIED AGENCIES IN ALL ACTIVITIES DESIGNED TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY IN THE AREAS SERVED BY THE HOSPITAL. - THIS CORPORATION SHALL NOT BE CONDUCTED FOR GAIN OR PROFIT, & NO PART OF THE NET EARNINGS SHALL INURE TO THE BENEFIT OF ANY MEMBER.
FIRST ACHIEVEMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4APATIENT DAYS: ADULT & CHILDREN:3,780 NURSING FACILITY: 10,721 DISCHARGES: 331 DEPARTMENT AMOUNT STATISTICS OPERATING ROOM 304 PROCEDURES LABORATORY 29,289 TESTS CARDIOPULMONARY 2,309 PROCEDURES CT SCANS 1,136 PROCEDURES RADIOLOGY 2,860 PROCEDURES REHABILITATION SERVICES 6,882 VISITS OUTPATIENT DEPARTMENT: EMERGENCY ROOM 3,695 VISITS PLEASE SEE ATTACHED COMMUNITY BENEFITS STATEMENT
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6ST. ANDREWS HOSPITAL AND MILES MEMORIAL HOSPITAL SHARE LINCOLN COUNTY HEALTH CARE INC. (LCH) AS THEIR SOLE CORPORATE MEMBER. MAINEHEALTH (EIN 01-0431680), AS THE SOLE MEMBER OF LCH, HAS THE RIGHT TO APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BOARD OF LCH AND ITS SUBSIDIARIES.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ATHE MEMBER ELECTS THE BOARD OF TRUSTEES. ALL OFFICERS OF THE BOARD OF TRUSTEES ARE ELECTED BY THE BOARD, AND EACH MUST BE A TRUSTEE. OFFICERS OF THE CORPORATION ARE ELECTED ANNUALLY BY THE BOARD.
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 FINANCE COMMITTEE PERFORMS A DETAILED REVIEW OF THE FORM 990. THE FORM 990 IS THEN MADE AVAILABLE TO THE FULL BOARD. THE CHIEF FINANCIAL OFFICER ALSO PERFORMS A DETAILED REVIEW OF THE ENTIRE FORM 990 BEFORE SIGNING AND PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF A TRUSTEE, PHYSICIAN, OFFICER OR MANAGER (E.G., A MEMBER OF LINCOLN COUNTY HEALTHCARE LEADERSHIP TEAM, DIRECTOR, MANAGER OR PERSON RESPONSIBLE FOR PURCHASING) MUST BE DISCLOSED TO THE APPLICABLE BOARD, BOARD COMMITTEE OR, IN THE CASE OF AN ADMINISTRATIVE DECISION THAT IS NOT SUBJECT TO BOARD OR COMMITTEE APPROVAL, TO THE MANAGER'S IMMEDIATE SUPERVISOR. SUCH DISCLOSURES SHALL BE MADE A MATTER OF RECORD. DISCLOSURE WILL BE MADE AT THE TIME OF INITIAL AFFILIATION WITH LINCOLN COUNTY HEALTHCARE ANNUALLY AND WHEN THE INTEREST BECOMES A MATTER FOR BOARD OR COMMITTEE ACTION OR ADMINISTRATIVE DECISION. DISCLOSURE FORMS SHALL BE COMPLETED ANNUALLY BY TRUSTEES AND OFFICERS AT THE TIME OF THE ANNUAL MEETING, AND ANNUALLY BY VICE PRESIDENTS, DIRECTORS, AND MANAGERS IN CONJUNCTION WITH THEIR ANNUAL PERFORMANCE REVIEW.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15AIN CONSULTATION WITH SULLIVAN COTTER, THE MAINEHEALTH EXECUTIVE COMMITTEE ESTABLISHES APPROPRIATE COMPENSATION PARAMETERS FOR EACH MEMBER ORGANIZATION'S CEO AND CERTAIN MEMBERS OF THEIR SENIOR MANAGEMENT TEAM. WORKING WITHIN THOSE PARAMETERS, THE LCH COMPENSATION COMMITTEE DETERMINES THE LEVEL OF COMPENSATION FOR ITS CEO. THE FINDINGS OF THE COMPENSATION COMMITTEE ARE MADE TRANSPARENT TO, AND VOTED ON BY, THE FULL GOVERNING BOARD. THIS "TOTAL EXECUTIVE COMPENSATION" IS FILED PUBLICLY BY THE ORGANIZATION, AND INCLUDES "TOTAL CASH COMPENSATION" AND "TOTAL VALUE OF ALL BENEFITS AND PERQUISITES ASSOCIATED WITH POSITION (SUCH AS HOUSING ALLOWANCES, SOCIAL CLUB MEMBERSHIPS, SIGNING BONUSES, ETC.)". THE BOARD TAKES NECESSARY ACTION TO PREVENT THE CEO FROM VOTING OR DIRECTLY PARTICIPATING IN THE FINAL COMMITTEE DETERMINATION OF (HER/HIS) OWN COMPENSATION. THE ORGANIZATION'S EXECUTIVE COMPENSATION PROCEDURE RELIES UPON APPROPRIATE DATA FOR COMPARABILITY (E.G. COMPENSATION LEVELS PAID BY BOTH TAXABLE AND TAX-EXEMPT SIMILARLY SITUATED ORGANIZATIONS AND INDEPENDENT COMPENSATION SURVEYS BY NATIONALLY RECOGNIZED INDEPENDENT FIRMS). FINALLY, THE ORGANIZATION REFRAINS FROM ALLOWING EXECUTIVE COMPENSATION TO EVER BE BASED SOLELY ON LCHC'S REVENUES OR OTHER SIMILAR PROFIT-SHARING STRATEGIES.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BIN CONSULTATION WITH SULLIVAN COTTER, THE MAINEHEALTH EXECUTIVE COMMITTEE ESTABLISHES APPROPRIATE COMPENSATION PARAMETERS FOR EACH MEMBER ORGANIZATION'S CEO AND CERTAIN MEMBERS OF THEIR SENIOR MANAGEMENT TEAM. WORKING WITHIN THOSE PARAMETERS, THE LCH COMPENSATION COMMITTEE DETERMINES THE LEVEL OF COMPENSATION FOR ITS CEO. THE FINDINGS OF THE COMPENSATION COMMITTEE ARE MADE TRANSPARENT TO, AND VOTED ON BY, THE FULL GOVERNING BOARD. THIS "TOTAL EXECUTIVE COMPENSATION" IS FILED PUBLICLY BY THE ORGANIZATION, AND INCLUDES "TOTAL CASH COMPENSATION" AND "TOTAL VALUE OF ALL BENEFITS AND PERQUISITES ASSOCIATED WITH POSITION (SUCH AS HOUSING ALLOWANCES, SOCIAL CLUB MEMBERSHIPS, SIGNING BONUSES, ETC.)". THE BOARD TAKES NECESSARY ACTION TO PREVENT THE CEO FROM VOTING OR DIRECTLY PARTICIPATING IN THE FINAL COMMITTEE DETERMINATION OF (HER/HIS) OWN COMPENSATION. THE ORGANIZATION'S EXECUTIVE COMPENSATION PROCEDURE RELIES UPON APPROPRIATE DATA FOR COMPARABILITY (E.G. COMPENSATION LEVELS PAID BY BOTH TAXABLE AND TAX-EXEMPT SIMILARLY SITUATED ORGANIZATIONS AND INDEPENDENT COMPENSATION SURVEYS BY NATIONALLY RECOGNIZED INDEPENDENT FIRMS). FINALLY, THE ORGANIZATION REFRAINS FROM ALLOWING EXECUTIVE COMPENSATION TO EVER BE BASED SOLELY ON LCHC'S REVENUES OR OTHER SIMILAR PROFIT-SHARING STRATEGIES.
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.
RELATED ORGANIZATIONSFORM 990, PAGE 7, PART VIIFOR EACH OF THE BOARD OF TRUSTEE'S LISTED, 50 HOURS PER WEEK IS TO A RELATED ORGANIZATION: ALAN BARKER, M.D., MARK FOURRE, M.D., DANIEL FRIEDLAND, M.D., ROBERT MCARTOR, M.D., GARTH MILLER, M.D., STEVEN FEDER, D.O., JAMES DONOVAN AND WAYNE PRINTY.
ADDITIONAL INFORMATIONFORM 990, PART XITHE FINANCIAL RESULTS OF THE ORGANIZATION WERE PART OF A CONSOLIDATED FINANCIAL STATEMENT AUDIT PREPARED FOR LINCOLN COUNTY HEALTH CARE, INC. (EIN 26-1475629) AND ITS SUBSIDIARIES.
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5CHANGE IN UNREALIZED (153,525) EQUITY TRANSFERS TO AFFILIATES (273,865) CHANGE IN PERPETUAL TRUST (25,600) TOTAL OTHER CHANGES IN NET ASSETS (452,990)

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
LINCOLN COUNTY MEDICAL GROUP
6 ST ANDREWS LANEBOOTHBAY HARBORME04538263878235PHYS SVCME501C33LCHfalse
LINCOLN COUNTY HEALTH CARE INC
LCH 6 ST ANDREWS LANEBOOTHBAY HARBORME04538261475629HEALTH SVCME501C311CMHfalse
MILES MEMORIAL HOSPITAL
35 MILES STREETDAMARISCOTTAME04543010211796HOSP SVCME501C33LCHfalse
COVES EDGE INC
26 SCHOONER STREETDAMARISCOTTAME04543010382340LT CARE SVME501C33LCHfalse
MAINEHEALTH (MH)
110 FREE STREETPORTLANDME04101010431680HEALTHCAREME501C311CNAfalse
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 OrgfalseLoansOrGuaranteesToOtherOrg
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 FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE RReturnReference
ExplanationLINCOLN COUNTY MEDICAL GROUP HAS APPLIED FOR PUBLIC CHARITY TAXEXEMPT STATUS WITHIN THE DUE DATE REQUIRED TO RECEIVE IRS APPROVAL RETROACTIVE TO THE LEGAL DATE OF FORMATIONExplanation

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