HENRIETTA D GOODALL HOSPITAL INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- HENRIETTA D GOODALL HOSPITAL INC (EIN 01-0078060)
- Tax period
- 2009-06-01 to 2010-05-31
- Filed
- 2011-04-02
- IRS object ID
- 201120929349300107
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-04-02T13:54:19-05:00 | Timestamp |
| Tax Period End Date | 2010-05-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FEELEY & DRISCOLL PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 PORTLAND STREET | AddressLine1 |
| City | BOSTON | City |
| State | MA | State |
| ZIP Code | 02114 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-06-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010078060 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRIETTA D GOODALL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HENR | NameControl |
| Phone | 2074907337 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 June Street | AddressLine1 |
| City | Sanford | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | darlene stromstad | Name |
| Title | CEO/President | Title |
| Phone | 2074907337 | Phone |
| Date Signed | 2011-04-01 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jeffrey T Rogers | Name |
| Phone | 6177427788 | Phone |
| Date Prepared | 2011-04-01 | 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 | Darlene Stromstad | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 June Street | AddressLine1 |
| City | Sanford | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 82727539 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.goodallhospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1927 | YearFormation |
| State Legal Domicile | ME | StateLegalDomicile |
| Activity Or Mission Description | Henrietta D. Goodall Hospital, Inc.'s mission is to serve as a leader in improving the health and well-being of its community. THE HOSPITAL OPENED AN OUTPATIENT SERVICES FACILITY IN KENNEBUNK, MAINE ON SEPTEMBER 14, 2009, CALLED "GOODALL OUTPATIENT SERVICES." THIS FACILITY EXTENDS HENRIETTA D. GOODALL HOSPITAL'S OUTPATIENT SERVICES TO KENNEBUNK, MAINE, FOR CONVENIENT ACCESS FOR THE COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1034 | TotalNbrEmployees |
| Total Nbr Volunteers | 83 | TotalNbrVolunteers |
| Total Gross UBI | 267043 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 34666 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1268024 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1551088 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 71105854 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 78388437 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -157202 | InvestmentIncomePriorYear |
| Investment Income Current Year | 505858 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -1509244 | OtherRevenuePriorYear |
| Other Revenue Current Year | 935761 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 70707432 | TotalRevenuePriorYear |
| Total Revenue Current Year | 81381144 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 44724532 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 44020030 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 83077 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 35721028 | OtherExpensePriorYear |
| Other Expenses Current Year | 36806772 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 80445560 | TotalExpensesPriorYear |
| Total Expenses Current Year | 80826802 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -9738128 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 554342 | RevenuesLessExpensesCY |
| Total Assets BOY | 85243771 | TotalAssetsBOY |
| Total Assets EOY | 84336393 | TotalAssetsEOY |
| Total Liabilities BOY | 40484585 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 37018987 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 44759186 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 47317406 | NetAssetsOrFundBalancesEOY |
| Mission Description | HENRIETTA D. GOODALL HOSPITAL, INC. OWNS AND OPERATES H. D. GOODALL HOSPITAL, INC. (ACUTE CARE HOSPITAL), GOODALL HEALTH PARTNERS (A MULTI-SPECIALTY PHYSICIAN AND SURGEON GROUP), THE MEDICAL GROUP (A MULTI-SPECIALTY PHYSICIAN AND SURGEON GROUP), GOODALL OUTPATIENT CLINIC (A FACILITY WHERE A VARIETY OF OUTPATIENT SERVICES ARE PERFORMED), GOODALL OUTPATIENT SERVICES-WATERBORO AND GOODALL ELDERCARE SERVICES (A LONG TERM CARE FACILITY) IN YORK COUNTY. YORK COUNTY CONSISTS OF 18 TOWNS AND CITIES LOCATED ON THE SOUTHERN MAINE COAST WITH A POPULATION OF OVER 200,000. HENRIETTA D. GOODALL HOSPITAL, INC FURTHERS ITS MISSION AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITY AND PROVIDES ACCESS TO NEEDED HEALTH CARE SERVICES 365 DAYS A YEAR, 24 HOURS A DAY. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 49290799 | Expense |
| Revenue | 57380104 | Revenue |
| Description | GOODALL HOSPITAL IS A 58 BED HOSPITAL WHICH STRIVES TO MEET THE HEALTH CARE NEEDS OF INDIVIDUALS AND FAMILIES THROUGHOUT YORK COUNTY. GOODALL HOSPITAL OFFERS A BROAD RANGE OF MEDICAL, SURGICAL, DIAGNOSTIC AND REHABILITATION SERVICES, WELLNESS EDUCATION, SUPPORT GROUPS AND OTHER COMMUNITY OUTREACH PROGRAMS. GOODALL HOSPITAL HAS HAD 22,271 EMERGENCY ROOM VISITS, 35,114 RADIOLOGY PROCEDURES, 341,907 LABORATORY PROCEDURES, 47,270 THERAPY PROCEDURES, 249 INFANTS BORN AND 2,586 SURGERY CASES. GOODALL HOSPITAL PROVIDED $882,162 IN CHARITY CARE TO THE COMMUNITY. THIS INCLUDES PATIENTS WHO ARE UNDERINSURED OR THOSE WITHOUT ANY INSURANCE. IN ADDITION TO THE CHARITABLE CARE SERVICES, WE ARE CONTINUALLY ABSORBING ALL THE COSTS ASSOCIATED WITH PROVIDING THE COMMUNITY A VARIETY OF SPECIAL COMPLIMENTARY SERVICES. GOODALL PROUDLY SPONSORS COMMUNITY ORGANIZATIONS, SCHOOL GROUPS, CIVIC ORGANIZATIONS AND SPECIAL EVENTS (LIKE THE LOCAL BASEBALL TEAM). GOODALL HOSPITAL SPONSORS TWO TO FOUR FREE EDUCATION EVENTS EACH MONTH OF THE YEAR ALONG WITH DOZENS OF SUPPORT GROUPS. GOODALL HOSPITAL ALSO ROUTINELY PARTICIPATES IN HEALTH FAIRS AND BUSINESS EVENTS, PERFORMING BLOOD PRESSURE CHECKS, CHOLESTEROL SCREENINGS AND CPR TRAINING. GOODALL HOSPITAL'S SENIOR ADVOCATE PROVIDES FREE ADVICE AND SERVICES TO ELDERLY MEMBERS OF THE COMMUNITY. SERVICES INCLUDE HELP WITH INSURANCE AND MEDICAL ISSUES, AS WELL AS PERSONAL ISSUES INCLUDING TAX INFORMATION, FINANCES AND HOME NEEDS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 8485026 | Expense |
| Revenue | 8545432 | Revenue |
| Description | GOODALL HEALTH PARTNERS CONSIST OF MANY PHYSICIANS WITH MULTI-SPECIALTY SERVICES IN DIFFERENT LOCATIONS THROUGHOUT YORK COUNTY. THESE PHYSICIANS COMPLIMENT THE HOSPITAL IN MAINTAINING ITS MISSION TO SERVE AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITY BY SERVING THE POPULOUS. THESE SPECIALTIES INCLUDE (BUT ARE NOT LIMITED TO) CARDIOLOGY, ENT, FAMILY PRACTICES, INTERNAL MEDICINE, PEDIATRICS, ORTHO AND GENERAL SURGERY. THE NUMBER OF PATIENTS SEEN WERE 19,307 FOR A TOTAL NUMBER OF VISITS OF 55,762. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6173942 | Expense |
| Revenue | 7319020 | Revenue |
| Description | GOODALL HOSPITAL ELDERCARE SERVICES PROVIDE LONG-TERM CARE AND MEDICAL SERVICES TO OUR SENIOR CITIZENS. ELDERCARE HAD ADMITTED 253 RESIDENTS FOR A TOTAL OF 25,684 PATIENT DAYS. WE CONTINUE TO GROW AND ADAPT TO THE NEEDS OF OUR COMMUNITY WITH THIS SERVICE. GOODALL HOSPITAL ELDERCARE PRIDES THEMSELVES BY CREATING A HOME-LIKE, COMFORTABLE ENVIRONMENT FOR THE RESIDENTS AND STAFF. THE NEWTON CENTER FOR REHABILITATION AND NURSING CARE PROMOTES HIGH QUALITY CARE; WITH DEDICATED STAFF FAMILY EDUCATIONAL ND INVOLVEMENT MAKE THIS PROGRAM SPECIAL. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6052464 | Expense |
| Revenue | 5143881 | Revenue |
| Description | THE MEDICAL GROUP CONSISTS OF MANY PHYSICIANS WITH MULTI-SPECIALTY SERVICES THAT EXTEND GOODALL HOSPITAL'S EXISTING SERVICES TO KENNEBUNK, ME. THESE PHYSICIANS COMPLIMENT THE HOSPITAL IN MAINTAINING ITS MISSION TO SERVE AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITY. THESE SERVICES INCLUDE (BUT ARE NOT LIMITED TO) FULL SERVICE PRIMARY CARE, WOMENS'S HEALTH, GASTROENTEROLGY, PULMONARY MEDICINE, ORTHOPEDICS AND PAIN MANAGEMENT. THE NUMBER OF PATIENTS SEEN WERE 9,543 FOR A TOTAL NUMBER OF VISITS OF 34,663. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 6052464 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 5143881 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 70002231 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| 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 | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | 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 | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 75 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1034 | 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 | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Taxable Distributions | 0 | TaxableDistributions |
| Distribution To Donor | 0 | DistributionToDonor |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | 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 | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| 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 | ME | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Darlene Stromstad presidentceo | NamePerson |
| Telephone Number | 2074907337 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 June Street | AddressLine1 |
| City | Sanford | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (24 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| lori Ann Black | |||||||||
| trustee | 2.00 | X | 0 | 0 | 0 | ||||
| Ann M Brooks MD | |||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||||
| Robert I Hardison | |||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||||
| George E Hissong Jr | |||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||||
| Mark Mickeriz | |||||||||
| vice chair/treasurer | 2.00 | X | 0 | 0 | 0 | X | |||
| David C Nickerson | |||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||||
| Merilee Mapes Perkins | |||||||||
| Chair | 2.00 | X | 0 | 0 | 0 | X | |||
| Michael L Ralston | |||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||||
| Rob Reinken | |||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||||
| susan T Roberts | |||||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | X | |||
| william frank | |||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||||
| Darlene Stromstad | |||||||||
| president | 40.00 | X | 350827 | 0 | 19971 | X | |||
| MARK RAUTENBERG MD | |||||||||
| TRUSTEE/President of Medical Staff | 2.00 | X | 273564 | 0 | 0 | ||||
| Patricia aprile | |||||||||
| VP of Operations | 40.00 | 175052 | 0 | 22348 | X | ||||
| ronald Bryant | |||||||||
| CFO | 40.00 | 192641 | 0 | 22972 | X | ||||
| charles caruso | |||||||||
| Chief Information Officer | 40.00 | 158834 | 0 | 22284 | X | ||||
| WEBER SHILL | |||||||||
| VP OF PHYSICIAN PRACTICES | 40.00 | 158385 | 0 | 23977 | X | ||||
| frank goudreau | |||||||||
| physician | 40.00 | 460424 | 0 | 25085 | X | ||||
| peter clark | |||||||||
| physician | 40.00 | 294079 | 0 | 24800 | X | ||||
| kent hall | |||||||||
| physician | 40.00 | 344852 | 0 | 26383 | X | ||||
| steven johnson | |||||||||
| physician | 40.00 | 302175 | 0 | 23108 | X | ||||
| John Thompson | |||||||||
| physician | 40.00 | 392607 | 0 | 22700 | X | ||||
| Lorraine D Masure | |||||||||
| Secretary | 2.00 | 0 | 0 | 0 | X | ||||
| David Hamlin | |||||||||
| VP OF PATIENT CARE | 40.00 | 138638 | 0 | 13307 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3103440 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 233628 | TotalOtherCompensation |
| Number Individuals GT100 K | 45 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MAK Anesthesia Inc | |||||
| 156 Country Club Road | Sanford | ME | 04073 | Anesthesia Services provided to Henriett | 526087 |
| Leonid Temkin MD PA | |||||
| 239 Arundel Road | Kennebunk | ME | 04046 | Anesthesia Services provided to Henriett | 461458 |
| Edward Burzon PC | |||||
| 1 Sarah Paul Hill | Madbury | NH | 03823 | Provides Physician services to Henrietta | 288050 |
| john h bartley md | |||||
| 17a bodwell street | Sanford | ME | 04073 | Provides Physician services to Henrietta | 288050 |
| Donald P Lyon MD PA | |||||
| PO Box 459 | Limerick | ME | 03869 | Provides Physician services to Henrietta | 282383 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 14 | NumberOfContractorsGT100K |
| Government Grants | 611820 | GovernmentGrants |
| All Other Contributions | 939268 | AllOtherContributions |
| Noncash Contributions | 2730 | NoncashContributions |
| Total Contributions | 1551088 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net Patient Service Re | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 78388437 | TotalRevenueColumn |
| Related Or Exempt Function Income | 78388437 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 78388437 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 543773 | TotalRevenueColumn |
| Exclusion | $543,773 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 810181 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1258584 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -448403 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -448403 | TotalRevenueColumn |
| Related Or Exempt Function Income | -448403 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 47407 | Securities |
| Other | 2489 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 60783 | Securities |
| Other | 27028 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -13376 | Securities |
| Other | -24539 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -37915 | TotalRevenueColumn |
| Related Or Exempt Function Income | -37915 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| rebate revenue | 900099 | 394606 | 394606 | |
| Laboratory revenue | 900099 | 267043 | 267043 | |
| Cafeteria Revenue | 900099 | 247039 | 247039 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 475476 | TotalRevenueColumn |
| Related Or Exempt Function Income | 475476 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1384164 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 81381144 | TotalRevenueColumn |
| Related Or Exempt Function Income | 79019240 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 267043 | UnrelatedBusinessRevenue |
| Exclusion | $543,773 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1179802 | Total |
| Management And General | 1179802 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35069822 | Total |
| Program Services | 31466569 | ProgramServices |
| Management And General | 3571409 | ManagementAndGeneral |
| Fundraising | 31844 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5439285 | Total |
| Program Services | 4736176 | ProgramServices |
| Management And General | 698428 | ManagementAndGeneral |
| Fundraising | 4681 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2331121 | Total |
| Program Services | 2029789 | ProgramServices |
| Management And General | 299326 | ManagementAndGeneral |
| Fundraising | 2006 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 237968 | Total |
| Management And General | 237968 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 246276 | Total |
| Management And General | 246276 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 127500 | Total |
| Management And General | 127500 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4951551 | Total |
| Program Services | 3606079 | ProgramServices |
| Management And General | 1345472 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 94677 | Total |
| Program Services | 3014 | ProgramServices |
| Management And General | 56948 | ManagementAndGeneral |
| Fundraising | 34715 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 120060 | Total |
| Program Services | 43455 | ProgramServices |
| Management And General | 71309 | ManagementAndGeneral |
| Fundraising | 5296 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 436352 | Total |
| Program Services | 93464 | ProgramServices |
| Management And General | 342888 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1494394 | Total |
| Program Services | 535297 | ProgramServices |
| Management And General | 959097 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40027 | Total |
| Program Services | 28353 | ProgramServices |
| Management And General | 11574 | ManagementAndGeneral |
| Fundraising | 100 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 86879 | Total |
| Program Services | 63618 | ProgramServices |
| Management And General | 22861 | ManagementAndGeneral |
| Fundraising | 400 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 838504 | Total |
| Program Services | 754654 | ProgramServices |
| Management And General | 83850 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3654792 | Total |
| Program Services | 3289313 | ProgramServices |
| Management And General | 365479 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1183349 | Total |
| Program Services | 1028248 | ProgramServices |
| Management And General | 155101 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| General Hospital Suppli | 7726999 | 7626905 | 99336 | 758 |
| Provision for doubtful | 5796802 | 5796802 | ||
| physician fees | 4271288 | 4271288 | ||
| Miscellaneous | 3965844 | 3095697 | 866870 | 3277 |
| Healthcare Provider tax | 1533510 | 1533510 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80826802 | Total |
| Program Services | 70002231 | ProgramServices |
| Management And General | 10741494 | ManagementAndGeneral |
| Fundraising | 83077 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4642 | BOY |
| EOY | 5185 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5109118 | BOY |
| EOY | 5414641 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8274854 | BOY |
| EOY | 7753284 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 851677 | BOY |
| EOY | 851677 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1392759 | BOY |
| EOY | 1535788 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1566693 | BOY |
| EOY | 2094494 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 71861323 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 37232353 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36683335 | BOY |
| EOY | 34628970 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5591401 | BOY |
| EOY | 8087521 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12842993 | BOY |
| EOY | 12710758 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12926299 | BOY |
| EOY | 11254075 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85243771 | BOY |
| EOY | 84336393 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12302117 | BOY |
| EOY | 12651004 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12967946 | BOY |
| EOY | 11814439 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13124541 | BOY |
| EOY | 12061491 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2089981 | BOY |
| EOY | 492053 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40484585 | BOY |
| EOY | 37018987 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35243475 | BOY |
| EOY | 36953692 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1338859 | BOY |
| EOY | 1451392 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8176852 | BOY |
| EOY | 8912322 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44759186 | BOY |
| EOY | 47317406 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85243771 | BOY |
| EOY | 84336393 | 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 Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $138,591 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 138591 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | Henrietta D. Goodall Hospital, Inc. has a contract for government relations services with the Grinnell Associates (formally known as the Liberty Square Group) to identify, research and champion efforts for appropriation funding opportunities to meet the Hospital's goals and objectives, including facility development, system technology enhancements, equipment acquisition, wellness and community health and emergency preparedness. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 20029729 | BeginningOfYearBalance |
| Contributions | 685453 | Contributions |
| Investment Earnings Or Losses | 1932748 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 255422 | OtherExpenditures |
| Administrative Expenses | 0 | AdministrativeExpenses |
| End Of Year Balance | 22392508 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 36660093 | BeginningOfYearBalance |
| Contributions | 802935 | Contributions |
| Investment Earnings Or Losses | -7213371 | InvestmentEarningsOrLosses |
| Other Expenditures | 10219928 | OtherExpenditures |
| End Of Year Balance | 20029729 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.55000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.40000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.05000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2728106 | OtherCostOrOtherBasis |
| Book Value | 2728106 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 43737534 | OtherCostOrOtherBasis |
| Depreciation | 19930274 | Depreciation |
| Book Value | 23807260 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4521887 | OtherCostOrOtherBasis |
| Depreciation | 1406330 | Depreciation |
| Book Value | 3115557 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 19677089 | OtherCostOrOtherBasis |
| Depreciation | 14916145 | Depreciation |
| Book Value | 4760944 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1196707 | OtherCostOrOtherBasis |
| Depreciation | 979604 | Depreciation |
| Book Value | 217103 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 34628970 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| alternative investments | 2410924 | F |
| beneficial interest in perpetual trusts | 8004553 | F |
| investment in real property | 2295281 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 12710758 | TotalOfBookValueSecurities |
Other Assets OtherAssets (9 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| investments in subsidiaries & joint ventures | 658496 |
| deferred financing costs | 190790 |
| Due from affiliates | 1265405 |
| trustee held funds (bond funds) | 1370260 |
| synernet workers' compensation capital contribution | 39633 |
| contribution receivable from remainder trust | 33101 |
| estimated settlements with mainecare | 6330540 |
| intangible asset - TMG Goodwill | 1347958 |
| intangible asset - ortho medical records | 17892 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 11254075 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Estimated Settlements due to third-party payors | Description |
| Amount | $492,053 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 492053 | TotalOfAmounts |
| Total Revenue | 81381144 | TotalRevenue |
| Total Expenses | 80826802 | TotalExpenses |
| Excess Or Deficit For Year | 554342 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 100747 | NetUnrealizedGLOnInvestments |
| Other | $1,903,131 | OtherAmount |
| Total Adjustments | 2003878 | TotalAdjustments |
| Excess Or Deficit Per FS | 2558220 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 82537019 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 1168962 | NetUnrealizedGainsInvestments |
| Other Revenues | 13943 | OtherRevenues |
| Revenue Not Rptd F990 | 1182905 | RevenueNotRptdF990 |
| Revenue Subtotal | 81354114 | RevenueSubtotal |
| Other Revenues Not Included | 27030 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 27030 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 81381144 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 0 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 0 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 0 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part V, Line 4: | Description of Intended Use of Endowment Funds: | Under the policy of the Organization, the endowment assets are invested conservatively with the intent of providing a predictable stream of funding to the Organization for purchases of capital, expansion projects and to supplement general operations. |
| Part X: | Description of Uncertain Tax Positions Under FIN 48: | The Accounting for Uncertainty in Income Taxes footnote per the HENRIETTA D. GOODALL HOSPITAL, INC. AND SUBSIDIARIES consolidated financial statements: In accordance with generally accepted accounting principles, the Organization annually evaluates its tax status and tax positions taken with respect to its operations and financial position. |
| Part XI, Line 8 - Other Adjustments: | Releases from temporarily restricted net assets: -15033. Net assets released from restriction used for operations: 14908. Increase in beneficial interest in perpetual trusts: 735134. UNrealized gain on securities: 1168962. OTHER CHANGE IN NET ASSETS: -840. | |
| Part XII, Line 2d - Other Adjustments: | RESTRICTED CONTRIBUTIONS RELEASED: 13943. | |
| Part XII, Line 4b - Other Adjustments: | per f/s - TEMPORARILY RESTRICTED CONTRIBUTIONS: 27030. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4329669 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4329669 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05770 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18839531 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11861429 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6978102 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09300 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 23169200 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11861429 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11307771 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.15070 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 688050 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 486817 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 201233 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00270 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8970 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8970 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 38584 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 38584 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 735604 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 486817 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 248787 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00330 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 23904804 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12348246 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11556558 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.15400 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 94260 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 81965 | DirectOffsettingRevenue |
| Net Community Building Expense | 12295 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 189320 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 163931 | DirectOffsettingRevenue |
| Net Community Building Expense | 25389 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 94260 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 81965 | DirectOffsettingRevenue |
| Net Community Building Expense | 12295 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 377840 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 327861 | DirectOffsettingRevenue |
| Net Community Building Expense | 49979 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,459,600 | BadDebtExpenseAmount |
| Amount Attributable To | 295739 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 12929473 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 12998030 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -68557 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (6 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| Cancer Care Center of York County | |||
| Support and perform medical proceedures for cancer patients | 0.33330 | 0.00000 | 0.00000 |
| GSM Realtor Inc | |||
| Real Estate holding company | 0.33330 | 0.00000 | 0.00000 |
| Goodall Hospital Real Estate Holding Co LLC | |||
| Real Estate holding company | 1.00000 | 0.00000 | 0.00000 |
| Waterboro Medical Office Building LLC | |||
| Real Estate holding company | 1.00000 | 0.00000 | 0.00000 |
| Goodall Hospital Medical Office Building LLC | |||
| Real Estate holding company | 1.00000 | 0.00000 | 0.00000 |
| Pine Tree Insurance A Reciprocal Risk Retention Group | |||
| Provide malpractice insurance for a group of health care providers | 0.27000 | 0.00000 | 0.00000 |
Form990 Schedule H Part V Form990ScheduleHPartV (12 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|
| Henrietta D Goodall Hospital Inc | |||||||
| 25 june street | sanford | ME | 04073 | X | X | X | |
| newton center (elder care) | |||||||
| 35 july street | sanford | ME | 04073 | nursing home | |||
| goodall health partners | |||||||
| 25 june street | sanford | ME | 04073 | physician practices | |||
| goodall health partners | |||||||
| 27 june street | sanford | ME | 04073 | physician practices | |||
| Wellness Center | |||||||
| 13 july street | sanford | ME | 04073 | clinic | |||
| Goodall health partners | |||||||
| 10 goodall drive | east waterboro | ME | 04070 | physician practices | |||
| goodall health partners | |||||||
| 272 cottage street | sanford | ME | 04073 | physician practices | |||
| the medical group | |||||||
| 3 shape drive | kennebunk | ME | 04043 | physician practices | |||
| goodall health partners | |||||||
| 15 daigle street | sanford | ME | 04073 | physician practices | |||
| goodall health partners | |||||||
| 312 cottage street | sanford | ME | 04073 | physician practices | |||
| occupational health services | |||||||
| 413 alfred street | biddeford | ME | 04005 | physician practices | |||
| Goodall Health Center | |||||||
| 7 Share Drive | Kennebunk | ME | 04043 | physician practices | |||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Footnote | Part III, Line 4: Footnote concerning bad debts: Management monitors and evaluates its allowance for doubtful accounts to ensure that receivables are stated at their net realizable value. The costing methodology consists of applying a cost to charge ratio to the recorded provision for bad debt (representing uncollected charges) and charity care revenues based on cost report. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: The costing methodology consists of applying a cost to charge ratio to inpatient and outpatient revenues based on Medicare cost report.The computed shortfall has not been included in community benefit. | ShortfallAsCommunityBenefit |
| Needs Assessment | Part VI, Line 2: Goodall Hospital's Board of Trustees is comprised of a diverse group of community members. The Board of Trustees provides insight and direction to the hospital. The hospital also participated in a community visioning session with the Town of Sanford and "Safe Schools, Healthy Students" to establish the Safe and Healthy Coalition. In addition, Goodall Hospital recognizes and acts on recommendations made by the Maine Center for Disease Control and Prevention and other external state groups such as the Health Maine Partnerships Collaborative. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: Goodall Hospital employs a financial counselor who assists and educates patients and their families on financial matters concerning the hospital charity care policy and eligibility for state and federal programs. This assistance can be as specific as assisting the patient and/or families in completing the various forms required by Medicaid and Medicare. The hospital's Senior Advocate program provides free advice and services to elderly members of the community. These services include assistance with insurance and medical issues, tax information, personal finances and home needs. The Senior Advocate has extensive knowledge of the issues facing seniors and can help with assessment of current needs and provide referrals to existing services.Goodall Hospital also provides a prescription assistance program called RX Assist. The program is designed to assist those who do not qualify for traditional assistance programs such as Medicare D or MaineCare. The program processed 1,438 prescriptions and saved patients $547,000. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: Goodall Hospital serves the population of western York County, Maine. Sanford is the town with the largest population in the hospital's service area. Sanford's population is approximately 22,000 with an elderly population rate of 16.2% and families representing 65.9% of the population. 95.1% of the population is white. The hospital's Medicaid volume of 21% is amongst the highest in the state and reflects the high percentage of families with income less than 100% of the Federal poverty level. Sanford's poverty rate is 16.4% for families and 17.8% for individuals. 56% of Sanford's elementary school children are eligible to receive free or subsidized meals. Sanford's unemployment rate of 10.1% exceeds the state's overall unemployment rate. Sanford has been hard hit by the foreclosure crisis and has the most home foreclosures of any of Maine's communities. Sanford has also been designated as a medically underserviced area. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: Community building activities are primarily administered through the hospital's Partners for Healthier Communities (PHC), a local Healthy Maine Partnership. Listed below are some of the recent programs provided by PHCSafe and Healthy Sanford Coalition: Collaborated with the Town of Sanford and Safe Schools, Health Students to create a community vision for healthy students. District Public Health Council: Worked collaboratively with Maine CDC and two other Health Maine Partnerships to co-convene a District Public Health Council service York County. Tobacco Cessation: Coordinated 8 classes at no charge to participants. Twenty-two individuals have completed the program. Trained three staff in tobacco cessation skills and provided education to the local community regarding the Maine Tobacco Helpline.Safe Routes to School: Coordinated this initiative for Sanford schools and assisted in the preparation of funding application.H1N1: Assisted the Maine CDC in dissemination of educational resources throughout the community.Worksite Wellness: Assisted seven worksites to establish or improve worksite wellness teams and action plans. School Health Coordinators: Funded School Health Coordinator position for Sanford schools. This position focuses on policy and environmental changes related to tobacco, physical activity and nutrition.Alcohol and Drug Awareness: Provided community information session on alcohol, marijuana and other dugs, responsible beverage seller and enforcement activities related to underage drinking patrols and education. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: Goodall Hospital also provides the following in an effort to promote the health of the community through Maine Families York County:Prenatal Support: Free and voluntary service that provides prenatal support to first time parents up to the time their first child reaches age five. The program is accredited by Health Families America and also ahs certified parents as teachers/educators on its staff.Families READ Family Literacy Program: Provides parents with the opportunity to access educational services.Health Promotions: Completed 1,530 home visits to 159 community families that provide services such as identification of childhood developmental delays, breastfeeding and infant nutrition education, assistance to parents in determining risk levels associated with lead poisoning, and assitance to parents regarding shaken baby syndrome and home safety. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: N/A | AffiliatedHealthCareSystem |
| Reports Filed With States | ME | ReportsFiledWithStates |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | 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 (11 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Darlene Stromstad | |||||||||||||
| 350827 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 19971 | 0 | 370798 | 0 | 0 | 0 |
| MARK RAUTENBERG MD | |||||||||||||
| 273564 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 273564 | 0 | 0 | 0 |
| Patricia aprile | |||||||||||||
| 175052 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 22348 | 0 | 197400 | 0 | 0 | 0 |
| ronald Bryant | |||||||||||||
| 192641 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 22972 | 0 | 215613 | 0 | 0 | 0 |
| charles caruso | |||||||||||||
| 158834 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 22284 | 0 | 181118 | 0 | 0 | 0 |
| WEBER SHILL | |||||||||||||
| 158385 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 23977 | 0 | 182362 | 0 | 0 | 0 |
| frank goudreau | |||||||||||||
| 460424 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 25085 | 0 | 485509 | 0 | 0 | 0 |
| peter clark | |||||||||||||
| 294079 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 24800 | 0 | 318879 | 0 | 0 | 0 |
| kent hall | |||||||||||||
| 344852 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 26383 | 0 | 371235 | 0 | 0 | 0 |
| steven johnson | |||||||||||||
| 302175 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 23108 | 0 | 325283 | 0 | 0 | 0 |
| John Thompson | |||||||||||||
| 392607 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 22700 | 0 | 415307 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 4a | ReturnReference |
| Explanation | 1. David Hamlin $138,638 | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer |
|---|---|---|---|---|---|---|
| maine health and higher educational facilities authority | ||||||
| 010314384 | 560425d49 | 2006-09-07 | 6020317 | renovate hospital and purchase equipment | 0 | 0 |
| maine health and higher educational facilities authority | ||||||
| 010314385 | 560425h37 | 2007-07-18 | 5108908 | Refinance MHHEFA Revenue Bond 1996A | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Amount UnspentAmountUnspent | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|
| 6470000 | 522453 | 293000 | 82639 | 5836740 | 2007 | 0 | 0 | 1 | 1 |
| 78484 | 451093 | 78484 | 0 | 1 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 0 | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 0 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | peter g booth | NamePerson |
| Purpose Of Loan | to provide retirement funds via a split dollar life insurance policy | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $851,677 | OriginalPrincipalAmount |
| Balance Due | 851677 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 851677 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| mark mickeriz | |||
| member of goodall's board and President of Sanford Institute for Savings | 4857997 | Sanford Institute for Savings (SIS) has three outstanding loans with Henrietta D. Goodall Hospital, Inc. The original amount of the loan was $7,330,000 and as of May 31, 2010, the remaining balance on the loans were $4,857,997. | 0 |
| Weber Shill | |||
| Member of Goodall's Board and former owner of The Medical Group. | 1567591 | Weber Shill has one outstanding loan with Henrietta D. Goodall Hospital Inc. for the purchase of The Medical Group. The original amount of the loan was $1,835,248 and as of May 31, 2010, the remaining balance of the loan was $1,567,591. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part III, line 2 | New Program Services | THE HOSPITAL OPENED AN OUTPATIENT SERVICES FACILITY IN KENNEBUNK, MAINE, ON SEPTEMBER 14, 2009, CALLED "GOODALL OUTPATIENT SERVICES". THIS FACILITY EXTENDS HENRIETTA D. GOODALL HOSPITAL'S OUTPATIENT SERVICES TO KENNEBUNK, MAINE, FOR CONVENIENT ACCESS FOR THE COMMUNITY. |
| Form 990, Part VI, Section B, line 11 | Management reviews the 990 with its external auditors prior to submission. Management will make the 990 available for Board review prior to signature and submission of the return. | |
| Form 990, Part VI, Section B, line 12c | The hospital ensures that the conflict of interest policy is enforced by requiring board members to sign conflict of interest documents on a yearly basis. These documents are reviewed annually by management to identify any conflicts, actual or perceived, and to develop necessary resolutions for any indentified conflicts. | |
| Form 990, Part VI, Section B, line 15 | 15a: The board of directors approves the compensation for the CEO after careful review of industry salary compensation information (compensation study) with an outside compensation consultant. 15b: Under the guidance of professional compensation consultants, the HR Director reviews the pay model with the CEO and COO to ensure that the Organization is able to recruit and retain a highly qualified workforce, while providing the necessary structure to effectively manage the competitive advantage of productivity, total quality, customer service and costs. | |
| Form 990, Part VI, Section C, line 18 | The organization will provide its Forms 1023, 990 and 990-T upon written request. It evaluates the reason for the request and deems whether it will offer these documents based on the intent and purpose of the request. | |
| Form 990, Part VI, Section C, line 19 | The hospital will provide its governing documents, financial statements and conflict of interest policy upon written request. It evaluates the reason for the request and deems whether it will offer these documents based on the intent and purpose of the request. | |
| Form VII, Line 1b | Description of compensation for Mark Rautenberg, M.D. | Mark Rautenberg, M.D., Ex-Officio TRUSTEE and President of the Medical Staff, received compensation from the Organization for physician services rendered as an emergency department physician and president of the medical staff and not for services performed as a trustee. |
| Schedule K, Part I, column e | Description of bond issue price | Amounts listed as bond issue price do not match IRS Form 8038, Part III, line 21(b), as the Hospital was a part of a group of organizations participating in the revenue bonds issuance. Thus, the amount listed is the Hospital's portion of the total bond issue price. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|
| Goodall Hospital Real Estate Holding Company LLC | |||||||
| 25 June Street | Sanford | ME | 04073 | 010078060 | Real estate holding company | ME | Henrietta D Goodall Hospital Inc |
| Waterboro Medical Office Building LLC | |||||||
| 25 June Street | Sanford | ME | 04073 | 010078060 | Real estate holding company | ME | Henrietta D Goodall Hospital Inc |
| Goodall Hospital Medical Office Building LLC | |||||||
| 25 June Street | Sanford | ME | 04073 | 010078060 | Real estate holding company | ME | Henrietta D Goodall Hospital Inc |
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Manor at Phillipstown Place Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 June Street | AddressLine1 |
| City | Sanford | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010473857 | EIN |
| Primary Activities | Provide care to the elderly | PrimaryActivities |
| Legal Domicile State | ME | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 9 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Henrietta D Goodall Hospital Inc | BusinessNameLine1 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | June Street Pharmacy llc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 JUne Street | AddressLine1 |
| City | Sanford | City |
| State | ME | State |
| ZIP Code | 04073 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020765952 | EIN |
| Primary Activity | Provide Pharmacy services to the community. | PrimaryActivity |
| Legal Domicile State | ME | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Henrietta D Goodall Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 113391 | ShareOfTotalIncome |
| Share Of EOY Assets | 770403 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | 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 | 0 | 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 | 1 | 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 | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| June Street Pharmacy llc | |
| A | 67975 |
| June Street Pharmacy llc | |
| P | 52296 |
| Manor at Phillipstown Place Inc | |
| P | 215925 |
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