FURP.ORG / PUBLIC DATA EXPLORER

WESTERN MAINE NURSING HOME INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
WESTERN MAINE NURSING HOME INC (EIN 22-2842655)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-13
IRS object ID
201242269349300914
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)
Timestamp2012-08-13T09:28:03-05:00Timestamp
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)
EIN222842655EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WESTERN MAINE NURSING HOME INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWESTNameControl
Phone2077437086Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13 MARKET SQUAREAddressLine1
CitySOUTH PARISCity
StateMEState
ZIP Code04281ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN COXName
TitleSENIOR VP - FISCALTitle
Phone2077437086Phone
Date Signed2012-07-27DateSigned
Authorize Third PartyfalseAuthorizeThirdParty

Preparer Preparer

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

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTIMOTHY CHURCHILLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13 MARKET SQUAREAddressLine1
CitySOUTH PARISCity
StateMEState
ZIP Code04281ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6490855GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.WMHCC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionTO ENSURE A HIGH QUALITY, ACCESSIBLE, AFFORDABLE AND APPROPRIATE INTEGRATED HEALTH CARE SYSTEM TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees195TotalNbrEmployees
Total Nbr Volunteers18TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year10ContributionsGrantsPriorYear
Contributions Grants Current Year2168ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6495730ProgramServiceRevenuePriorYear
Program Service Revenue CY6474634ProgramServiceRevenueCY
Investment Income Prior Year695InvestmentIncomePriorYear
Investment Income Current Year317InvestmentIncomeCurrentYear
Other Revenue Prior Year14579OtherRevenuePriorYear
Other Revenue Current Year13736OtherRevenueCurrentYear
Total Revenue Prior Year6511014TotalRevenuePriorYear
Total Revenue Current Year6490855TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4425937SalariesEtcPriorYear
Salaries Etc Current Year4749777SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2543246OtherExpensePriorYear
Other Expenses Current Year2557880OtherExpensesCurrentYear
Total Expenses Prior Year6969183TotalExpensesPriorYear
Total Expenses Current Year7307657TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-458169RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-816802RevenuesLessExpensesCY
Total Assets BOY926134TotalAssetsBOY
Total Assets EOY1431104TotalAssetsEOY
Total Liabilities BOY624232TotalLiabilitiesBOY
Total Liabilities EOY663004TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY301902NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY768100NetAssetsOrFundBalancesEOY
Mission DescriptionTO ENSURE A HIGH QUALITY, ACCESSIBLE, AFFORDABLE AND APPROPRIATE INTEGRATED HEALTH CARE SYSTEM TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense6940049Expense
Revenue6488370Revenue
DescriptionTHE ORGANIZATION PROVIDES LONG-TERM NURSING AND RELATED MEDICAL CARE TO ITS RESIDENTS. SERVICES INCLUDE A RESIDENTIAL CARE UNIT, SKILLED NURSING CARE AND INTERMEDIATE NURSING CARE. IN 2011 THE ORGANIZATION SERVED 30,706 RESIDENT DAYS, INCLUDING 20,424 MAINECARE DAYS. SEE COMMUNITY BENEFIT STATEMENT.Description
Total Program Service Expense6940049TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
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 EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10965NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees195NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
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 OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSENIOR VP - FISCALNamePerson
Telephone Number2077435933TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13 MARKET SQUAREAddressLine1
CitySOUTH PARISCity
StateMEState
ZIP Code04281ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
GREGORY HARDY MD
MED STAFF PR1.00X036192921670
TIMOTHY CHURCHILL
PRESID & CEO5.00X030109828065X
ADAM KAZIMIERCZAK DO
MED STAFF PR1.00X024478918631
EUGENE BENNER
CHAIR1.00X000X
ANDREA BURNS
TRUSTEE1.00X000
PETER CHAPMAN
TRUSTEE1.00X000
C BRADLEY CUMMINGS
SECRETARY1.00X000X
ROBERT HARMON
TRUSTEE1.00X000
LARRY FARMER OD
TRUSTEE1.00X000
DAVID HOISINGTON
VICE CHAIR1.00X000X
DAVID KUMAKI MD
TRUSTEE1.00X000
REV ANNE STANLEY
TRUSTEE1.00X000
WILLIAM L MEDD MD
TRUSTEE1.00X000
OLA MELHUS MD
TRUSTEE1.00X000
WENDY PENLEY
TREASURER1.00X000X
LYNN HAMPER
TRUSTEE1.00X000
DAVID J PREBLE
TRUSTEE1.00X000
TED MOCCIA
TRUSTEE1.00X000
ROBIN J ZINCHUK
TRUSTEE1.00X000
PAT WEIGEL
TRUSTEE1.00X000
JOHN COX
SR VP-FISCAL5.00016715220487X
M PATRICIA COOK
SR VP-CLINIC1.00013858122147X
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs1213549TotalReportableCompFrmRltdOrgs
Total Other Compensation111000TotalOtherCompensation
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SELECT REHABILITATIONBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line135338 EAGLE WAYAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60678ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesPT STAFFINGDescriptionOfServices
Compensation484933Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions2168AllOtherContributions
Total Contributions2168TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column6474634TotalRevenueColumn
Related Or Exempt Function Income6474634RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue6474634TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column317TotalRevenueColumn
Exclusion$317ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
OTHER REVENUE9000991070310703
MEAL DELIVERY PROGRAM62421030333033
FieldValueIRS element (for citing)
Total Other Revenue13736TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6490855TotalRevenueColumn
Related Or Exempt Function Income6488370RelatedOrExemptFunctionIncome
Exclusion$317ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3515970Total
Program Services3344596ProgramServices
Management And General171374ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total110220Total
Program Services104852ProgramServices
Management And General5368ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total854963Total
Program Services813326ProgramServices
Management And General41637ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total268624Total
Program Services255542ProgramServices
Management And General13082ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total10693Total
Management And General10693ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total775467Total
Program Services716286ProgramServices
Management And General59181ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total736Total
Program Services736ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total577953Total
Program Services570985ProgramServices
Management And General6968ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total22185Total
Program Services21105ProgramServices
Management And General1080ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total300598Total
Program Services264644ProgramServices
Management And General35954ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total778Total
Program Services778ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total8077Total
Program Services8077ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total155480Total
Program Services147908ProgramServices
Management And General7572ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total302428Total
Program Services287729ProgramServices
Management And General14699ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total10786Total
Program Services10786ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PROVIDER TAX352875352875
MISCELLANEOUS1859918599
PROVISION FOR BAD DEBTS1754117541
DUES AND SUBSCRIPTIONS36843684

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7307657Total
Program Services6940049ProgramServices
Management And General367608ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY370BOY
EOY370EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY123445BOY
EOY124080EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY523750BOY
EOY1099270EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY25564BOY
EOY25916EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3453BOY
EOY3740EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY1913EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY249552BOY
EOY175815EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY926134BOY
EOY1431104EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY452982BOY
EOY473529EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY171250BOY
EOY189475EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY624232BOY
EOY663004EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY301902BOY
EOY766187EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY1913EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY301902BOY
EOY768100EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY926134BOY
EOY1431104EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-816802ReconcilationRevenueExpenses
Reconcilation Other Changes1283000ReconcilationOtherChanges
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)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years105CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7560CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years180CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10CurrentTaxYearMinus1Year
Current Tax Year2168CurrentTaxYear
Total10023Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6179288CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6178476CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6488950CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6510309CurrentTaxYearMinus1Year
Current Tax Year6488370CurrentTaxYear
Total31845393Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6179393CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6186036CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6489130CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6510319CurrentTaxYearMinus1Year
Current Tax Year6490538CurrentTaxYear
Total31855416Total
FieldValueIRS element (for citing)
Public Support Total50931855416PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9134CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2745CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2404CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year695CurrentTaxYearMinus1Year
Current Tax Year317CurrentTaxYear
Total15295Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9134CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2745CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2404CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year695CurrentTaxYearMinus1Year
Current Tax Year317CurrentTaxYear
Total15295Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6188527CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6188781CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6491534CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6511014CurrentTaxYearMinus1Year
Current Tax Year6490855CurrentTaxYear
Total31870711Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99950PublicSupportPercentage509
Prior Year Support Percentage0.99890PriorYearSupportPercentage
Investment Income Percentage0.00000InvestmentIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

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$2,072OtherActivitiesAmount
Total Lobbying Expenditures IIB2072TotalLobbyingExpendituresIIB
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
ExplanationALLOCATED PERCENTAGE OF MEMBERSHIP DUES PAID TO MAINE HEALTH CARE ASSOCIATION AND AMERICAN HEALTH CARE ASSOCIATION.Explanation

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)
Contributions1913Contributions
End Of Year Balance1913EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance6235BeginningOfYearBalance
Other Expenditures6235OtherExpenditures

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5235BeginningOfYearBalance
Contributions1000Contributions
End Of Year Balance6235EndOfYearBalance
FieldValueIRS element (for citing)
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
CASH SURRENDER VALUE-LIFE INSURANCE83399
AR UNDER REIMBURSEMENT AGREEMENTS64478
DUE FROM AFFILIATE27938
FieldValueIRS element (for citing)
Total Book Value Other Assets175815TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATES$172,857
PROFESSIONAL LIABILITY CLAIM ACCRUAL$16,618
FieldValueIRS element (for citing)
Total Of Amounts189475TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
INTENDED USES FOR ENDOWMENT FUNDSSCHEDULE D, PAGE 2, PART V, LINE 4TEMPORARILY RESTRICTED GIFTS ARE UTILIZED ACCORDING TO SPECIFIC DONOR STIPULATIONS. THESE INCLUDE EXPENDITURES FOR CAPITAL IMPROVEMENTS.
LIABILITY UNDER FIN 48 FOOTNOTESCHEDULE D, PAGE 3, PART XTHE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3)OF THE INTERNAL REVENUE CODE. THE ORGANIZATION HAS EVALUATED THE POSITION TAKEN ON ITS FILED TAX RETURNS. THE ORGANIZATION HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT SEPTEMBER 30, 2011. THE ORGANIZATION'S TAX YEARS FROM 2008 THROUGH 2011 ARE OPEN AND SUBJECT TO EXAMINATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
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 (5 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
GREGORY HARDY MD
34444216842645205919611383599
TIMOTHY CHURCHILL
2460003800017098505123014329163
ADAM KAZIMIERCZAK DO
173481411543015418631263420
JOHN COX
1605366616143519052187639
M PATRICIA COOK
12740111180365218495160728

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RELATED PARTY INFORMATION AMONG OFFICERSFORM 990, PAGE 6, PART VI, LINE 2DAVID KUMAKI WILLIAM MEDD SHAREHOLDER SHAREHOLDER BUSINESS RELATIONSHIP.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ATHE SOLE MEMBER HAS THE RESPONSIBILITY FOR THE ELECTION OF THE MEMBERS OF THE GOVERNING BODY.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BALL DECISIONS BY THE WESTERN MAINE NUSING HOME, INC.'S GOVERNING BODY ARE APPROVED BY DEFAULT BY THE MEMBER ORGANIZATION'S GOVERNING BODY. THIS IS BECAUSE THESE TWO ORGANIZATIONS SHARE A COMMON GOVERNING BODY.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE 990 WAS REVIEWED IN DETAIL BY A COMMITTEE OF THE BOARD OF TRUSTEES. THE PRESIDENT AND SENIOR VICE PRESIDENT - FISCAL LED THE DISCUSSION. SUBSEQUENT TO THAT REVIEW, A COPY OF THE ORGANIZATION'S 990 WAS DISTRIBUTED TO ALL TRUSTEES. THE 990 WAS REVIEWED IN SUMMARY AT A BOARD MEETING PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE OBTAINED ANNUALLY. THE PRESIDENT'S OFFICE COLLECTS AND REVIEWS THE RESPONSES. WHERE ANY REAL OR PERCEIVED CONFLICTS EXIST, OFFICERS AND TRUSTEES ARE EXPECTED TO RECUSE THEMSELVES (1) FROM MEETINGS DURING TIMES WHEN THE TOPICS OF POTENTIAL CONFLICT ARE DISCUSSED AND (2) FROM VOTING ON SUCH MATTERS. KEY EMPLOYEES MAY NOT USE THEIR POSITIONS TO PROFIT PERSONALLY OR TO ASSIST OTHERS IN PROFITING IN ANY WAY AT THE EXPENSE OF WESTERN MAINE NURSING HOME, INC.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE PARENT COMPANY OF WESTERN MAINE NURSING HOME, INC. IS WESTERN MAINE HEALTH CARE, CORP. (EIN 01-0411788) WHO THROUGH ITS PARENT COMPANY MAINEHEALTH, HAS A FORMAL WRITTEN COMPENSATION POLICY IN PLACE. IN CONSULTATION WITH SULLIVAN COTTER, THE MAINEHEALTH BOARD COMPENSATION COMMITTEE ESTABLISHES APPROPRIATE COMPENSATION PARAMETERS FOR EACH ORGANIZATION'S CEO AND CERTAIN MEMBERS OF THEIR SENIOR MANAGEMENT TEAM. WORKING WITHIN THESE PARAMETERS, THE WESTERN MAINE HEALTH CARE BOARD 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. THE "TOTAL EXECUTIVE COMPENSATION" IS FILED PUBLICLY BY THE ORGANIZATION, AND INCLUDES "TOTAL CASH COMPENSATION" AND "TOTAL VALUE OF ALL BENEFITS AND PERQUISITES" ASSOCIATED WITH THE POSITION. THE BOARD TAKES NECESSARY ACTION TO PREVENT THE CEO FROM VOTING OR DIRECTLY PARTICIPATING IN THE FINAL COMMITTEE DETERMINATION OF HIS OWN COMPENSATION. THE ORGANIZATION'S EXECUTIVE COMPENSATION PROCEDURES RELY UPON APPROPRIATE DATA FOR COMPARABILITY (E.G. COMPENSATION LEVELS PAID BY BOTH TAXABLE AND TAX-EXEMPT SIMILARLY SITUATED ORGANIZATIONS AND INDEPENDENT SURVEYS BY NATIONALLY RECOGNIZED INDEPENDENT FIRMS). FINALLY, THE ORGANIZATION REFRAINS FROM ALLOWING EXECUTIVE COMPENSATION TO EVER BE BASED SOLEY ON WESTERN MAINE HEALTH CARE, CORP.'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 VIIGREGORY HARDY 59 HOURS TIMOTHY CHURCHILL 55 HOURS ADAM KAZIMIERCZAK 59 HOURS JOHN COX 45 HOURS M. PATRICIA COOK 44 HOURS
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5THIS REPRESENTS AN EQUITY TRANSFER FROM AFFILIATE.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
WESTERN MAINE HEALTH CARE CORP
181 MAIN STREETNORWAYME04268010411788HEALTHCAREME501C311CMEHEALTHfalse
MAINEHEALTH
110 FREE STREETPORTLANDME04101010431680HEALTHCAREME501C311CNAfalse
WESTERN MAINE MULTI-MEDICAL SPECIAL
181 MAIN STREETNORWAYME04268010489824PHYS PRACTME501C33WMHCCfalse
STEPHENS MEMORIAL HOSPITAL ASSOC
181 MAIN STREETNORWAYME04268010219904HOSPITALME501C33WMHCCfalse
STEPHENS COMMUNITY HEALTHCARE FOUND
181 MAIN STREETNORWAYME04268311644144SUPP ORGME501C311AWMHCCfalse
CHAPEL VALLEY BOARDING HOME CORP
181 MAIN STREETNORWAYME04268010433206HEALTHCAREME501C37WMHCCfalse
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 OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg