HOSPICE OF SOUTHERN MAINE: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HOSPICE OF SOUTHERN MAINE (EIN 01-0540180)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-08-06
IRS object ID
201222199349300317
Schema version
2011v1.2
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)
Timestamp2012-08-06T08:58:02-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN010494526EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Baker Newman & NoyesBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 507AddressLine1
CityPortlandCity
StateMEState
ZIP Code04112ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN010540180EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Hospice of Southern MaineBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOSPNameControl
Phone2072893641Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1180 US Route 1AddressLine1
CityScarboroughCity
StateMEState
ZIP Code04074ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameArlene WingName
TitleCEOTitle
Phone2072893641Phone
Date Signed2012-08-06DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameE Drew CheneyName
PTINP00182972PTIN
Phone2078792100Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonArlene WingNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1180 US Route 1AddressLine1
CityScarboroughCity
StateMEState
ZIP Code04074ZIPCode
FieldValueIRS element (for citing)
Gross Receipts9228690GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.hospiceofsouthernmaine.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2003YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionHospice services: To provide compassion, care, and comfort through end of life.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members20NbrIndependentVotingMembers
Total Nbr Employees134TotalNbrEmployees
Total Nbr Volunteers180TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year713145ContributionsGrantsPriorYear
Contributions Grants Current Year718434ContributionsGrantsCurrentYear
Program Service Revenue Prior Year7822771ProgramServiceRevenuePriorYear
Program Service Revenue CY8414981ProgramServiceRevenueCY
Investment Income Prior Year20105InvestmentIncomePriorYear
Investment Income Current Year26461InvestmentIncomeCurrentYear
Other Revenue Prior Year-24169OtherRevenuePriorYear
Other Revenue Current Year35790OtherRevenueCurrentYear
Total Revenue Prior Year8531852TotalRevenuePriorYear
Total Revenue Current Year9195666TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4885849SalariesEtcPriorYear
Salaries Etc Current Year5352114SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year192236TotalFundrsngExpCurrentYear
Other Expense Prior Year3171310OtherExpensePriorYear
Other Expenses Current Year3439440OtherExpensesCurrentYear
Total Expenses Prior Year8057159TotalExpensesPriorYear
Total Expenses Current Year8791554TotalExpensesCurrentYear
Revenues Less Expenses Prior Year474693RevenuesLessExpensesPriorYear
Revenues Less Expenses CY404112RevenuesLessExpensesCY
Total Assets BOY8538449TotalAssetsBOY
Total Assets EOY8774788TotalAssetsEOY
Total Liabilities BOY3117108TotalLiabilitiesBOY
Total Liabilities EOY3141748TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5421341NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5633040NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionHospice servicesMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense7571095Expense
Revenue8429673Revenue
DescriptionHospice of Southern Maine (HSM) provides comprehensive hospice services through a free-standing, licensed, Medicare certified program consistent with the hospice philosophy, and consisting of physical, emotional and spiritual services to patients and their families in the setting most appropriate for the patient. HSM operates an 18-bed hospice facility to provide an alternative for those patients who are unable to remain in their homes and who require an inpatient level of care for acute pain and symptom management or occasionally for respite for their caregivers as a temporary residential alternative. HSM provides bereavement support to family members served by HSM, as well as the community at large, and volunteers are offered to patients and families at least 4 hrs a week. HSM participates in educating practitioners and multidisciplinary caregivers to better provide hospice and palliative care in the community. HSM supports the community by fostering awareness, encouraging volunteerism and advocating for an improved social framework regarding all end of life issues. HSM performs fundraising activities to support care for uninsured and unreimbursed care and program activity. In 2011, HSM cared for 1,194 patients/families primarily in York and Cumberland counties, with an average census of 109 patients each day. HSM provided approximately $215,000 in unreimbursed care in 2011. HSM volunteers provided approximately 10,000 hours of service.Description
Total Program Service Expense7571095TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109631NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees134NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members20NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Mary PintoBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2072893640TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1180 US Route 1AddressLine1
CityScarboroughCity
StateMEState
ZIP Code04074ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
Maryanna Arsenault
Director0.80X000
Joel Botler MD
Director0.80X000
Edward J McGeachey
Director1.10X000
Elaine Brady RN
Director2.00X000
Karl Turner
Director/Secretary2.60X000X
Laurence Gross
Director0.80X000
Daniel Hayes MD
Director0.90X000
Holly LeBlanc
Director/Vice Chair2.90X000X
Sally Daggett Esq
Director1.10X000
Miriam Leonard
Director0.90X000
Theresa Desfosses
Director2.00X000
Lucy Perkins
Director1.00X000
William Caron
Director0.90X000
Ann Stockbridge
Director0.80X000
David Perkins Esq
Director/Chair1.70X000X
Albert Swallow
Director/Treasurer1.80X000X
Roland Eon
Director1.20X000
Annette Gosnell
Director1.30X000
Betsey McCandless Esq
Director1.10X000
Bob Schools
Director1.30X000
Arlene Wing
CEO40.00130930013248X
Mark Wrona MD
Medical Director40.00230199013027X
FieldValueIRS element (for citing)
Total Reportable Comp From Org361129TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation26275TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events30680FundraisingEvents
All Other Contributions687754AllOtherContributions
Noncash Contributions9801NoncashContributions
Total Contributions718434TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient servicesDescription
Business Code621610BusinessCode
Total Revenue Column8414981TotalRevenueColumn
Related Or Exempt Function Income8414981RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue8414981TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column25105TotalRevenueColumn
Exclusion$25,105ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other8160Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other6804Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other1356Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1356TotalRevenueColumn
Exclusion$1,356ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events47318GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events30680CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses26220FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column21098TotalRevenueColumn
Exclusion$21,098ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column14692TotalRevenueColumn
Related Or Exempt Function Income14692RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue14692TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column9195666TotalRevenueColumn
Related Or Exempt Function Income8429673RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$47,559ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total144178Total
Management And General144178ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4300844Total
Program Services3827992ProgramServices
Management And General391069ManagementAndGeneral
Fundraising81783Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total44045Total
Program Services40946ProgramServices
Management And General2224ManagementAndGeneral
Fundraising875Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total506001Total
Program Services445672ProgramServices
Management And General50807ManagementAndGeneral
Fundraising9522Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total357046Total
Program Services308402ProgramServices
Management And General42055ManagementAndGeneral
Fundraising6589Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total5840Total
Management And General5840ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total18700Total
Management And General18700ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total284328Total
Program Services196747ProgramServices
Management And General56218ManagementAndGeneral
Fundraising31363Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total108490Total
Management And General108490ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total213038Total
Program Services112103ProgramServices
Management And General40628ManagementAndGeneral
Fundraising60307Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total109607Total
Program Services96454ProgramServices
Management And General13153ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total261827Total
Program Services146623ProgramServices
Management And General115204ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total195661Total
Program Services191357ProgramServices
Management And General4304ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total40972Total
Program Services36055ProgramServices
Management And General4917ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total150862Total
Program Services146336ProgramServices
Management And General4526ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total327510Total
Program Services317685ProgramServices
Management And General9825ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total135845Total
Program Services117963ProgramServices
Management And General16085ManagementAndGeneral
Fundraising1797Fundraising

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Patient related expense13709391370939
Bad debt215821215821

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total8791554Total
Program Services7571095ProgramServices
Management And General1028223ManagementAndGeneral
Fundraising192236Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY24624BOY
EOY18323EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3238759BOY
EOY3839008EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY224842BOY
EOY126674EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY903461BOY
EOY861342EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY93311BOY
EOY94969EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5190918LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1356446LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4053452BOY
EOY3834472EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8538449BOY
EOY8774788EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY617492BOY
EOY718081EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2309554BOY
EOY1762386EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY190062BOY
EOY130349EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY530932EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3117108BOY
EOY3141748EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY5059589BOY
EOY5288833EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY71656BOY
EOY74007EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY290096BOY
EOY270200EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5421341BOY
EOY5633040EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8538449BOY
EOY8774788EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses404112ReconcilationRevenueExpenses
Reconcilation Other Changes-192413ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years704748CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years556516CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years704525CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year713145CurrentTaxYearMinus1Year
Current Tax Year718434CurrentTaxYear
Total3397368Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years704748CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years556516CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years704525CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year713145CurrentTaxYearMinus1Year
Current Tax Year718434CurrentTaxYear
Total3397368Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total629989AmountsSubstContributorsTotal
Public Support Total1702767379PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years41401CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years54537CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16836CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19220CurrentTaxYearMinus1Year
Current Tax Year25105CurrentTaxYear
Total157099Total
FieldValueIRS element (for citing)
Total Support3554467TotalSupport
Gross Receipts From Admissions Etc33018210GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.77860PublicSupportPertcentage170
Public Support Pertcent Prior Year0.79040PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$598OtherActivitiesAmount
Total Lobbying Expenditures IIB598TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Other Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1i:ReturnReference
ExplanationNational Hospice and Palliative Care Organization portion of dues paid allocated to lobbying activities was $243. Home Care and Hospice Alliance of Maine portion of dues paid allocated to lobbying activities was $355.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance361752BeginningOfYearBalance
Contributions239503Contributions
Investment Earnings Or Losses109InvestmentEarningsOrLosses
Other Expenditures257157OtherExpenditures
End Of Year Balance344207EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance454893BeginningOfYearBalance
Contributions153052Contributions
Investment Earnings Or Losses68InvestmentEarningsOrLosses
Other Expenditures246261OtherExpenditures
End Of Year Balance361752EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance351905BeginningOfYearBalance
Contributions211462Contributions
Investment Earnings Or Losses41InvestmentEarningsOrLosses
Other Expenditures108515OtherExpenditures
End Of Year Balance454893EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance330200BeginningOfYearBalance
Contributions136970Contributions
Investment Earnings Or Losses33InvestmentEarningsOrLosses
Other Expenditures115298OtherExpenditures
End Of Year Balance351905EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.78500PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.21500TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis440000OtherCostOrOtherBasis
Book Value440000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3842280OtherCostOrOtherBasis
Depreciation878905Depreciation
Book Value2963375BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis908638OtherCostOrOtherBasis
Depreciation477541Depreciation
Book Value431097BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3834472TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionInterest rate swap liabilityDescription
Amount$530,932Amount
FieldValueIRS element (for citing)
Total Of Amounts530932TotalOfAmounts
Total Revenue9195666TotalRevenue
Total Expenses8791554TotalExpenses
Excess Or Deficit For Year404112ExcessOrDeficitForYear
Other-$192,413OtherAmount
Total Adjustments-192413TotalAdjustments
Excess Or Deficit Per FS211699ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt9221886TotRevenueEtcAuditedFinclStmt
Other Revenues26220OtherRevenues
Revenue Not Rptd F99026220RevenueNotRptdF990
Revenue Subtotal9195666RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9909195666TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt8817774TotExpensesEtcAuditedFinclStmt
Other Expenses Included26220OtherExpensesIncluded
Expenses Not Rptd F99026220ExpensesNotRptdF990
Expenses Subtotal8791554ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9908791554TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Intended Use of Endowment Funds:Part V, Line 4:To ensure the long-term financial viability of the organization
Description of Uncertain Tax Positions Under FIN 48:Part X:Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Organization has evaluated the positions taken on its filed tax returns. The Organization has concluded no uncertain income tax positions exist at December 31, 2011. The Organization's tax years from 2008 through 2011 are open and subject to examination.
Part XI, Line 8 - Other Adjustments:Change in fair value of interest rate swap -192,413.
Part XII, Line 2d - Other Adjustments:Special events expense 26,220.
Part XIII, Line 2d - Other Adjustments:Special events expense 26,220.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Twilight in the ParkNameOfEvent1
Gross Receipts Event124186GrossReceiptsEvent1
Charitable Contributions Event113180CharitableContributionsEvent1
Gross Revenue Event111006GrossRevenueEvent1
Other Direct Expenses Event17653OtherDirectExpensesEvent1
Name Of Event2Annual celebrationNameOfEvent2
Gross Receipts Event253812GrossReceiptsEvent2
Charitable Contributions Event217500CharitableContributionsEvent2
Gross Revenue Event236312GrossRevenueEvent2
Rent Facility Costs Event27267RentFacilityCostsEvent2
Food And Beverage Event22309FoodAndBeverageEvent2
Entertainment Event22950EntertainmentEvent2
Other Direct Expenses Event26041OtherDirectExpensesEvent2
Gross Receipts Total77998GrossReceiptsTotal
Charitable Contributions Total30680CharitableContributionsTotal
Gross Revenue Total Events47318GrossRevenueTotalEvents
Rent Facility Costs Total Events7267RentFacilityCostsTotalEvents
Food And Beverage Total Events2309FoodAndBeverageTotalEvents
Entertainment Total Events2950EntertainmentTotalEvents
Other Direct Expenses Total Events13694OtherDirectExpensesTotalEvents
Direct Expense Summary Events26220DirectExpenseSummaryEvents
Net Income Summary21098NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonMark Wrona MDNamePerson
Base Compensation Filing Org230199BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org13027NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org243226TotalCompensationFilingOrg
Total Compensation Related Orgs0TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 2Directors William Caron and Al Swallow have a business relationship with each other. Directors Elaine Brady and Edward McGeachey have a business relationship with each other. Directors William Caron and Maryanna Arsenault have a business relationship with each other.
Form 990, Part VI, Section A, line 4The substantive By-Law changes are: Article III Section 1: Number and Term - (Adds term limits for Directors and allows those serving as officers to exclude their officer time in the term limit calculation) Article III Section 2: Types of Directors - (Removes the right of Ex-Officio Directors to vote on Board matters) Article Section 3: Election of Directors - (Reduces the number of named supporting organizations for five to four and increases the community at large members from 15 to 16) Article IV Section 1: Committees - (Provides for seven standing committees and the creation of special purpose committees) Article IV Section 2: Executive Committee - (Outlines committee composition and responsibilities) Article IV Section 3: Governance Committee - (Folds Nomination Committee responsibilities into this committee and adds governance accountabilities to the committee's charge) Article IV Section 5: Quality and Clinical Operations Committee - Folds Professional Advisory Committee responsibilities in this committee) Article IV Section 6: Development Committee - (Creates Development Committee and outlines committee responsibilities) Article IV Section 7: Audit Committee - (Creates Audit Committee and outlines committee responsibilities) Article IV Section 8: Ethics Committee - (Creates Ethics Committee and outlines committee responsibilities) Article IV Section 9: Ad Hoc Committees - (Provides for the creation special purpose committees of limited duration) Article VI Section 1: Executive Management - (Creates new article and names the executive management position) Article VI Section 2: Chief Exec. Officer - (Moves CEO from Officer Section and outlines responsibilities) Article VI Section 3: Medical Director - (Moves Medical Director from Officer Section and outlines responsibilities and reporting lines of the position)
Form 990, Part VI, Section A, line 6The organization has members.
Form 990, Part VI, Section A, line 7aProvisions in bylaws pertaining to members of the corporation: -individuals may be admitted to membership from time to time by vote of members at annual or special meetings -nominating committee of the Board of Directors proposes new members -members must have an interest in, and ability to contribute to, the advancement of the mission and goals of the corporation -powers include election of Board of Directors, election of new members, changes in the corporate structure, and action on any matters brought to them by the bod, at the annual meeting or at special meetings Purpose: to strengthen links to the community, and ensure that effective governing bodies are elected Responsibilities: -understanding and affirmation of HSM's mission, principles and objectives. -advocacy in the community, fostering of public awareness and support for the organization's goals and programs and its fundraising efforts -attendance at the annual meeting, election of board and members of corporation, and action on any other matters brought by the board.
Form 990, Part VI, Section A, line 7bSee line 7a
Form 990, Part VI, Section B, line 11The 990 was reviewed by the finance committee. Then a complete copy of the 990 was distributed to the board, with the exception of the identity of a donor who preferred to remain anonymous.
Form 990, Part VI, Section B, line 12cAnnually all persons are required to review and sign the conflict of interest policy statement, which is then kept on file.
Form 990, Part VI, Section B, line 15aThe process for determining compensation for the CEO was as follows: Review of candidate's current responsibilities and compensation, and her expectations and performance as CEO of HSM Review of national and regional market data Discussion and decision by the Executive Committee of the Board
Form 990, Part VI, Section C, line 19All documents that are required to be made available are made available upon request.
Form 990, Part XI, line 5:Change in fair value of interest rate swap -192,413. Total to Form 990, Part XI, Line 5: -192,413.Changes in Net Assets or Fund Balances:
Form 990, Part XI, line 2c:The responsibility of the audit committee for overseeing the audit and selecting the independent accountant has not changed from prior years.

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