ATHOL MEMORIAL HOSPITAL INCORPORATED: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- ATHOL MEMORIAL HOSPITAL INCORPORATED (EIN 04-2126583)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-08-11
- IRS object ID
- 201112239349300446
- Schema version
- 2009v1.7
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-08-11T10:35:19-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Bollus Lynch LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 89 Shrewsbury Street | AddressLine1 |
| City | Worcester | City |
| State | MA | State |
| ZIP Code | 01604 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042126583 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ATHOL MEMORIAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ATHO | NameControl |
| Phone | 9782493511 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2033 MAIN STREET | AddressLine1 |
| City | ATHOL | City |
| State | MA | State |
| ZIP Code | 01331 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DEAN FLEMING | Name |
| Title | CFO | Title |
| Phone | 9782493511 | Phone |
| Date Signed | 2011-08-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Barbara E King | Name |
| Phone | 5087557107 | Phone |
| Date Prepared | 2011-08-03 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DEAN FLEMING | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2033 MAIN STREET | AddressLine1 |
| City | ATHOL | City |
| State | MA | State |
| ZIP Code | 01331 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 21937233 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.atholhospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1918 | YearFormation |
| State Legal Domicile | MA | StateLegalDomicile |
| Activity Or Mission Description | HOSPITAL | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 20 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 20 | NbrIndependentVotingMembers |
| Total Nbr Employees | 287 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | -20900 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -20900 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 292977 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 184350 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 21697629 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 21427842 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 43022 | InvestmentIncomePriorYear |
| Investment Income Current Year | 54061 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -17423 | OtherRevenuePriorYear |
| Other Revenue Current Year | 135367 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 22016205 | TotalRevenuePriorYear |
| Total Revenue Current Year | 21801620 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 13104926 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 11706060 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10218592 | OtherExpensePriorYear |
| Other Expenses Current Year | 10800427 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 23323518 | TotalExpensesPriorYear |
| Total Expenses Current Year | 22506487 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1307313 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -704867 | RevenuesLessExpensesCY |
| Total Assets BOY | 12848504 | TotalAssetsBOY |
| Total Assets EOY | 11953499 | TotalAssetsEOY |
| Total Liabilities BOY | 6568384 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 6331500 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6280120 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 5621999 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE INPATIENT, OUTPATIENT, EMERGENCY CARE AND HOME CARE SERVICES FOR RESIDENTS OF WORCESTER AND FRANKLIN COUNTIES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 19500615 | Expense |
| Revenue | 21427842 | Revenue |
| Description | athol memorial hospital is a critical access hospital (CAH) serving the nine towns of the north quabbin region. the areas relatively small population (28,000) is dispersed over a large geographic area ( 357 square miles). inherent in the hospital mission of providing healthcare services are efforts to help improve the health and lives of our community. this intent is the framework for our community benefits activities.senior transportation van - one of our major community benefits programs is the athol memorial hospital senior transportation van, offering free door to door service to medical appointments for seniors (65+) to access care. many of the communities in the hospitals service area (which includes the towns of athol, erving, new salem, orange, pertersham, phillipston, royalston, warwick and wendell) are not served by the existing transportation and non-driving residents are dependent on family and neighbors for rides to medical appointments. the service has grown considerably since the van began operation in March of 2002. at that time, we provided service on a limited schedule: Tuesday and Thursday from 8 A.M. to 12 p.m. and by special arrangement. within six months service hours expanded to Monday through Friday from 7 a.m. to 3 p.m. to meet increase demand and since july 2004, our service hours increased by an additional five hours per week (until 4 p.m. each day).the average number of trips per month has increase to 196, up from last years 140, and the previous years 90 trips per month. this demonstrates the increasing value of the athol memorial hospital senior transportation van as a significant and reliable means of transportation for our area seniors in providing rides to the hospital and medical arts building for appointments and treatment. the hospital maintains an internal system for ride requests, dispatch, and tracking; a dedicated phone line for ride request phone calls; and a specially trained driver to guarantee safety and demonstrate sensitivity to persons with disability issues. publicity for the senior transportation van is completely designed and produced in-house to minimize costs. in previous years, advertising was through local media, and distribution of brochures and flyers throughout the community. target market opportunities, such as flyer distribution through council on aging programs and the good life senior newspaper, have also been used when appropriate.support group sponsorship - the hospital provides free space and publicity to the following support groups, which are open to the public. hospital staff members facilitate some of the groups, as indicated:acoa alanon- for adults raised by alcoholic caretakers/parentsalanon- for family and friends of people with alcohol related issuesals support - for people, caretakers, and family seeing help in coping with this illnessbereavement support - for people seeking compassionate environment to help cope with the death of a loved one. facilitated by kate hart, licsw, hospital social worker.cancer support - facilitated by the amh oncology clinics bonnie frank hume, licsw.diabetes education and support - offers practical information and caring emotional support. led by marjorie sobil, rd, ldn, hospital dietitian.healthy hearts and lungs club - for anyone with cardiac or lung disease or at risk for developing the diseases. facilitated by hospital staff members joyce sawyer, bsn, and ron rayment, rrt.smart recovery - is a cognitive/rational approach to overcoming addictive behavior and maintaining abstinence. facilitated by hospital staff member marcia maglione flynn.smoking cessation - facilitated by tim sweeney, tobacco treatment specialist. athol memorial hospital provides a stipend to the facilitator, who is not a hospital staff member.healthcare scholarship program - athol memorial hospital offers scholarships to local area students earning a degree in healthcare related fields. the purpose of the athol memorial hospital scholarship program is to encourage area residents to enter and train in healthcare fields. persons working toward an associates, bachelors, master, or other healthcare degree certification will be considered. qualifying areas of study include nursing (rn, lpn, or cna) clinical laboratory, radiology technologies, pharmacy, respiratory, occupational, physical and speech therapies, and registered dietician, amongst others. participation in any healthcare related field will be considered for this program. students planning to enter, or matriculating toward, a healthcare related degree program are invited to apply. the program is available to all residents of the north quabbin region, excluding current hospital staff. hospital staff members are eligible for other hospital-sponsored programs to help with educational costs. scholarships are awarded on a combination of academic achievement, extracurricular and community activities, references and students essays and not on a financial need basis.outreach activities - athol memorial hospital actively pursues educational and service opportunitites in the community. many hours are contributed to activities in the community such as wellness week at a local high school, health and safety fairs, and seminars on health related topics. the hospital also provides blood pressure and/or glucose and cholesterol screenings at senior clinics and community events. staff members visit local area schools to teach about topics such as recognizing signs and symptoms of stroke, healthy eating, and careers in healthcare. the hospital supports community initiatives such as the healthy smiles dental fair, senior health and fitness day, healthy kids day and is a major participant in the area annual food-a-thon. the hospital also sponsors brown bag medication checkups where individuals may bring in their prescriptions for pharmacists to review. | Description |
| Total Program Service Expense | 19500615 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 27 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 287 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 0 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 20 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 20 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEAN FLEMING | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9782493511 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2033 MAIN STREET | AddressLine1 |
| City | ATHOL | City |
| State | MA | State |
| ZIP Code | 01331 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| REBECCA BIALECKI | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| ROBIN BROOKS | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| CHENEY CASTINE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| LAWRENCE ESTELLE JR | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| DANILO FUNA MD | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| ROBERT KNIGHT MD | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| JANET KRAFT | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| ROY LAKE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| WAYNE MILLER MD | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| DONALD MRUK MD | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| CURTIS RAND | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| TIMOTHY SOULE-REGINE MD | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| DAVID SPACKMAN | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| DOUGLAS A STARRETT | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| YOGENDRA THAKER MD | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| JAMES MEEHAN JR | |||||||
| CHAIRPERSON | 2.00 | X | 0 | 0 | 0 | ||
| WILLIAM MEEHAN | |||||||
| 1ST VICE CHAIRPERSON | 2.00 | X | 0 | 0 | 0 | ||
| MOHSEN NORELDIN MD | |||||||
| 2ND VICE CHAIRMAN | 2.00 | X | 0 | 0 | 0 | ||
| LAUREY KENERSON | |||||||
| CLERK | 2.00 | X | 0 | 0 | 0 | ||
| STEVEN PENKA | |||||||
| PRESIDENT/CEO | 40.00 | 148089 | 0 | 0 | X | ||
| DEAN FLEMING | |||||||
| TREASURER/CFO | 40.00 | 128328 | 0 | 0 | X | ||
| mark wu md | |||||||
| physician | 40.00 | 406302 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 682719 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| baystate emergency service | |||||
| 44 crosby road | ashburnham | MA | 01430 | er doctors | 1564206 |
| robert sprague md | |||||
| 20 comes street | gardner | MA | 01440 | physician | 418456 |
| cpsi | |||||
| po box 850309 | mobile | AL | 36685 | it | 236267 |
| north quabbin computer | |||||
| 119 new athol road | orange | MA | 01364 | it | 132590 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| All Other Contributions | 184350 | AllOtherContributions |
| Total Contributions | 184350 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENU | Description |
| Business Code | 624100 | BusinessCode |
| Total Revenue Column | 21427842 | TotalRevenueColumn |
| Related Or Exempt Function Income | 21427842 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 21427842 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 54061 | TotalRevenueColumn |
| Exclusion | $54,061 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 270980 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 135613 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 135367 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 135367 | TotalRevenueColumn |
| Unrelated Business Revenue | -20900 | UnrelatedBusinessRevenue |
| Exclusion | $156,267 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 21801620 | TotalRevenueColumn |
| Related Or Exempt Function Income | 21427842 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -20900 | UnrelatedBusinessRevenue |
| Exclusion | $210,328 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9584343 | Total |
| Program Services | 8183741 | ProgramServices |
| Management And General | 1400602 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1369784 | Total |
| Program Services | 1169611 | ProgramServices |
| Management And General | 200173 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 751933 | Total |
| Program Services | 642050 | ProgramServices |
| Management And General | 109883 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 124737 | Total |
| Management And General | 124737 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36000 | Total |
| Management And General | 36000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 739600 | Total |
| Program Services | 729197 | ProgramServices |
| Management And General | 10403 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42935 | Total |
| Management And General | 42935 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30367 | Total |
| Management And General | 30367 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 429163 | Total |
| Program Services | 379489 | ProgramServices |
| Management And General | 49674 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25543 | Total |
| Program Services | 19477 | ProgramServices |
| Management And General | 6066 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 103707 | Total |
| Program Services | 103707 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 474313 | Total |
| Program Services | 397448 | ProgramServices |
| Management And General | 76865 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 222219 | Total |
| Program Services | 69116 | ProgramServices |
| Management And General | 153103 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 2424089 | 2328848 | 95241 |
| PHYSICIAN EXPENSE | 2200119 | 2069872 | 130247 |
| BAD DEBTS | 1361570 | 1361570 | |
| DRUGS | 874800 | 874800 | |
| SERVICE CONTRACTS | 788787 | 490485 | 298302 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 922478 | Total |
| Program Services | 681204 | ProgramServices |
| Management And General | 241274 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22506487 | Total |
| Program Services | 19500615 | ProgramServices |
| Management And General | 3005872 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 440830 | BOY |
| EOY | 502729 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5386940 | BOY |
| EOY | 4631752 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 519453 | BOY |
| EOY | 466543 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120817 | BOY |
| EOY | 186363 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 18556150 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 13429167 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5388081 | BOY |
| EOY | 5126983 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 992383 | BOY |
| EOY | 1039129 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12848504 | BOY |
| EOY | 11953499 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3745645 | BOY |
| EOY | 3282745 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1445461 | BOY |
| EOY | 1012345 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1377278 | BOY |
| EOY | 2036410 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6568384 | BOY |
| EOY | 6331500 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5174274 | BOY |
| EOY | 4395417 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 113463 | BOY |
| EOY | 187453 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 992383 | BOY |
| EOY | 1039129 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6280120 | BOY |
| EOY | 5621999 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12848504 | BOY |
| EOY | 11953499 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 992383 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 46746 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1039129 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1013033 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -20650 | InvestmentEarningsOrLosses |
| End Of Year Balance | 992383 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 71990 | OtherCostOrOtherBasis |
| Book Value | 71990 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6872045 | OtherCostOrOtherBasis |
| Depreciation | 4084196 | Depreciation |
| Book Value | 2787849 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10111223 | OtherCostOrOtherBasis |
| Depreciation | 9344971 | Depreciation |
| Book Value | 766252 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1500892 | OtherCostOrOtherBasis |
| Book Value | 1500892 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5126983 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | pooled investments | Description |
| Book Value | 1039129 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 1039129 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| due to third party payors | $956,410 |
| due to parent | $1,080,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2036410 | TotalOfAmounts |
| Total Revenue | 21801620 | TotalRevenue |
| Total Expenses | 22506487 | TotalExpenses |
| Excess Or Deficit For Year | -704867 | ExcessOrDeficitForYear |
| Other | $46,746 | OtherAmount |
| Total Adjustments | 46746 | TotalAdjustments |
| Excess Or Deficit Per FS | -658121 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 21983979 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 182359 | OtherRevenues |
| Revenue Not Rptd F990 | 182359 | RevenueNotRptdF990 |
| Revenue Subtotal | 21801620 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 21801620 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 22642100 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 135613 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 135613 | ExpensesNotRptdF990 |
| Expenses Subtotal | 22506487 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 22506487 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part V, Line 4: | Identifier |
| Return Reference | Description of Intended Use of Endowment Funds: | ReturnReference |
| Explanation | endowment assets are comprised of beneficial interests in perpetual trusts. the hospital is named as the beneficiary of this perpetual trust. under the terms of the trust, the hospital receives quarterly distributions equal to 40% of income from the trust. such distributions are recorded as unrestricted income when received. although the assets of the underlying trust are not owned or controlled by the hospital, the fair value of the trust's assets has been used as the basis for recording the hospital's interest in the future income of the trust. the beneficial interest, and any subsequent adjustments tot he fair vaue of the trust assets, is considered permanently restricted. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 0 | CharityCarePolicy |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4099850 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 247633 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3852217 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.17120 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4981806 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4690754 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 291052 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01290 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 96024 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 104403 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -8379 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9177680 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5042790 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4134890 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.18410 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9177680 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5042790 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4134890 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.18410 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,361,570 | BadDebtExpenseAmount |
| Amount Attributable To | 142520 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 4315580 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4272424 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 43156 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | athol memorial hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2033 main street | AddressLine1 |
| City | athol | City |
| State | MA | State |
| ZIP Code | 01331 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Footnote | Part III, Line 4: Bad debts are determined after a set procedure that involves several statements, letters and calls which are determined by a credit collection policy that has been approved by the Commonwealth of Massachusetts Attorney Generals office. After the accounts have been determined as bad debts they are forwarded to a collection agency for the final attempts at settlement. the amount on this form is the balance recorded as a provision of bad debts noted on our financial statement. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: Athol Memorial HOspital is a "critical access hospital" that is reimbursed by medicare at 101% of medicare costs. The amount of lines 5 and 6 are actual reimbursements from the medicare filed 2552 fy 2010 report. | ShortfallAsCommunityBenefit |
| Needs Assessment | Part VI, Line 2: the mission of the community benefits program is to encourage healthy lifestyles through outreach, education, and support to the communities we serve (Athol, Erving, New Salem, Orange, Petersham, Phillipston, Royalston, Warwick and Wendell).The underlying principle of encouraging healthy lives guides our existing community benefits activities and will be carried forward as we formalize our community benefits plan.the hospital spearheaded a community health needs assessment in 2008 for the specific purpose of identifying unmet needs in the community and to inform future community benefits activities. this exercise was critical to the hospital's community benefits process, an assessment had not been conducted in seven years.The community health needs assessment report was presented to the steering committee in September 2008. a similar steering committee will reconvene in another three years to direct the next community health needs assessment. the report was also presented to the hospital's board of trustees at their january 2009 meeting and accepted unanimously. the board determined that the report should be forwarded to the hospital's strategic planning committee, a sub-committee of the hospital's board of trustees. the board of trustees further determined to form a community benefits advisory committee that would review the reports and recommend a community benefits plan to the strategic planning committee. the community benefits advisory committee is comprised of members of the community health needs assessment steering committee, the hospital board of trustees, hospital staff, and community groups. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: athol memorial hopsital has two employees whose primary position is to educate and assist patients with questions on health care. they work closely with central registration and patient accounting personnel to protect the hospital's financial interest with regard to persons who present for services, and have no health insurance or may qualify for assistance as underinsured.They maintain knowledge of mass health virtual gateway and commonwealth connector application processes and health insurance products available; maintain knowledge of which commonwealth care and commonwealth choice plans athol memorial hospital and its staff physicians contract with in order to advise applicants of choices available within our nine-town area. They Assist patients to apply for Masshealth, commonwealth care, commonwealth choice, and uncompensated care by completing a virtual gateway common intake form or masshealth mbr or smbr form. They assist patients to apply for commonwealth care and commonwealth choice plans via the commonwealth connector. They Assist patients with re-enrollment and completion of masshealth review process and assists patients referred by nursing, social services, or other clinical areas that may be unable to afford prescription medications and may be eligible for assistance through the drug manufacturer or any other source. They assist patients who have insurance but may be unable to afford co-insurances or deductibles assessed by the health insurance plan to apply for additional asistance through health safety net. They make every effort to establish contact with any patient or their guarantor/guardian when admission to inpatient status has occurred and availability of health insurance coverage has not been established or declared health insurance is determined to be inactive. They contact patients who have been approved for masshealth, commonwealth care or commonwealth choice to offer assistance to help ensure patient activates and maintains coverage. They perform outreach by mailing information flyers, telephone calls, etc. patient accounting staff will forward names of patients, whom it has established are uninsured or underinsured, for outreach contact.they review daily private pay accounts for assigned segment of alpha to ensure accuracy;performs the necessary collection steps as specified in the hospital credit and collection policy (i.e. attempt phone contact, and send deliquent account reminder letters).They review patient pay statement list weekly to assure statements are being sent to the appropriate patients. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: athol memorial hospital is an independent, not-for-profit, critical access hospital primarily serving the nine towns of the north quabbin region (athol, erving, new salem, orange, petersham, phillipston, royalston, warwick and wendell).The area's population (approximately 28,000) is dispersed over a large geographic area (357 square miles). seven of the service area towns are sparsely populated, rural communities. the majority of the area residents live in the towns of athol and orange, former industrial centers where now only a few factories and major businesses remain. the service area sits across two counties, at the northwest corner of worcester county and the northeast corner of franlin county.athol memorial hospital is firmly rooted in the community. the hospital opened its doors in 1950 as the result of a grass roots effort to bring healthcare services into the area. the hospital is the region's primary acute care facility and the second largest private employer. strong ties to the area and institution exist within the staff and patients alike, as neighbors are often caring for neighbors. this spirit of community is inherent in the hospital's mission and has provided the framework for our community benefits activities to date.in fy 2010 the hospital contributed 9,530 hours of community benefit time, beyond its direct scope of services to efforts in and for the community. this included health and wellness education; cardiopulmonary resuscitation (CPR) training (AMH is a regional training center for the american heart association); flu and blood pressure clinics; support for a community food drive, dental fair, senior health fairs and other events; work force development through scholarships, externships and interships; assistance in accessing healthcare through direct referral; marketing and enrollment in health insurance programs; providing meeting space for support groups and other community entities, and substantial emergency preparedness efforts. | CommunityInformation |
| Reports Filed With States | MA | ReportsFiledWithStates |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | mark wu md | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Base Compensation Filing Org | 406302 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 0 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 406302 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 2 | james meehan jr, (chairman) and william meehan (vice-chairman) are brothers |
| Form 990, Part VI, Section B, line 11 | FORM 990 WILL BE CIRCULATED TO THE BOARD IN ELECTRONIC FORMAT PRIOR TO FILING. COMMENTS AND QUESTIONS WILL BE ADDRESSED BY THE CFO. ONCE APPROVED, THE RETURN WILL BE FILED. |
| Form 990, Part VI, Section B, line 12c | THE BOARD OF TRUSTEES REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ANNUALLY IN ORDER TO ENSURE THAT THE ORGANIZATION'S BOARD OF TRUSTEES, OFFICERS, AND EMPLOYEES ARE REGULARLY AND CONSISTENTLY MONITORING AND ENFORCING IT. |
| Form 990, Part VI, Section B, line 15 | SALARIES ARE DETERMINED BY THE BOARD OF DIRECTORS CONSIDERING COMPARABLE SALARY INFORMATION FOR OFFICERS OF OTHER ENTITIES OF A SIMILAR SIZE AND LEVEL OF ACTIVITY. |
| Form 990, Part VI, Section C, line 19 | REQUESTS FOR REVIEW OF THE FORM 990 ARE FORWARDED TO THE CFO WHO MAKES ARRANGEMENTS FOR THE REVIEW. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| greater quabbin health system | |||||||||
| 2033 main street | athol | MA | 01331 | 222720658 | manage, conduct fundraising, coordinate planning for athol memorial hospital | MA | 501(c)(3) | 170(b)(1)(a)(vi) | |
| quabbincare inc | |||||||||
| 2033 main street | athol | MA | 01331 | 222720562 | inactive | MA | 501(c)(3) | 170(b)(1)(a)(vi) | greater quabbin health system |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | greater quabbin health sustem | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | E | TransactionType |
| Amount Involved | 1080000 | AmountInvolved |