2011-04-02T13:54:19-05:00 2010-05-31 FEELEY & DRISCOLL PC 200 PORTLAND STREET BOSTON MA 02114 990 2009-06-01 010078060 HENRIETTA D GOODALL HOSPITAL INC HENR 2074907337 25 June Street Sanford ME 04073 darlene stromstad 2074907337 2011-04-01 1 Jeffrey T Rogers 6177427788 2011-04-01 2009 2016-02-24 21:20:13Z Darlene Stromstad 25 June Street Sanford ME 04073 82727539 0 X www.goodallhospital.org X 1927 ME 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. 12 10 1034 83 267043 34666 1268024 1551088 71105854 78388437 -157202 505858 -1509244 935761 70707432 81381144 0 0 44724532 44020030 0 83077 35721028 36806772 80445560 80826802 -9738128 554342 85243771 84336393 40484585 37018987 44759186 47317406 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. 1 0 49290799 57380104 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. 8485026 8545432 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. 6173942 7319020 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. 6052464 5143881 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. 6052464 5143881 70002231 1 1 0 1 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 1 1 0 0 1 75 0 1 1034 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 12 10 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 ME X Darlene Stromstad presidentceo 2074907337 25 June Street Sanford ME 04073 lori Ann Black 2.00 X 0 0 0 Ann M Brooks MD 2.00 X 0 0 0 Robert I Hardison 2.00 X 0 0 0 George E Hissong Jr 2.00 X 0 0 0 Mark Mickeriz 2.00 X X 0 0 0 David C Nickerson 2.00 X 0 0 0 Merilee Mapes Perkins 2.00 X X 0 0 0 Michael L Ralston 2.00 X 0 0 0 Rob Reinken 2.00 X 0 0 0 susan T Roberts 2.00 X X 0 0 0 william frank 2.00 X 0 0 0 Darlene Stromstad 40.00 X X 350827 0 19971 MARK RAUTENBERG MD 2.00 X 273564 0 0 Patricia aprile 40.00 X 175052 0 22348 ronald Bryant 40.00 X 192641 0 22972 charles caruso 40.00 X 158834 0 22284 WEBER SHILL 40.00 X 158385 0 23977 frank goudreau 40.00 X 460424 0 25085 peter clark 40.00 X 294079 0 24800 kent hall 40.00 X 344852 0 26383 steven johnson 40.00 X 302175 0 23108 John Thompson 40.00 X 392607 0 22700 Lorraine D Masure 2.00 X 0 0 0 David Hamlin 40.00 X 138638 0 13307 3103440 0 233628 45 1 1 0 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 14 611820 939268 2730 1551088 Net Patient Service Re 900099 78388437 78388437 78388437 543773 543773 810181 1258584 -448403 -448403 -448403 47407 2489 60783 27028 -13376 -24539 -37915 -37915 rebate revenue 900099 394606 394606 Laboratory revenue 900099 267043 267043 Cafeteria Revenue 900099 247039 247039 475476 475476 1384164 81381144 79019240 267043 543773 1179802 1179802 35069822 31466569 3571409 31844 5439285 4736176 698428 4681 2331121 2029789 299326 2006 237968 237968 246276 246276 127500 127500 4951551 3606079 1345472 94677 3014 56948 34715 120060 43455 71309 5296 436352 93464 342888 1494394 535297 959097 40027 28353 11574 100 86879 63618 22861 400 838504 754654 83850 3654792 3289313 365479 1183349 1028248 155101 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 80826802 70002231 10741494 83077 4642 5185 5109118 5414641 8274854 7753284 851677 851677 1392759 1535788 1566693 2094494 71861323 37232353 36683335 34628970 5591401 8087521 12842993 12710758 12926299 11254075 85243771 84336393 12302117 12651004 12967946 11814439 13124541 12061491 2089981 492053 40484585 37018987 X 35243475 36953692 1338859 1451392 8176852 8912322 44759186 47317406 85243771 84336393 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 138591 138591 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: 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. 20029729 685453 1932748 0 255422 0 22392508 36660093 802935 -7213371 10219928 20029729 0.55000 0.40000 0.05000 1 0 2728106 2728106 43737534 19930274 23807260 4521887 1406330 3115557 19677089 14916145 4760944 1196707 979604 217103 34628970 alternative investments 2410924 F beneficial interest in perpetual trusts 8004553 F investment in real property 2295281 F 12710758 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 11254075 Estimated Settlements due to third-party payors 492053 492053 81381144 80826802 554342 100747 1903131 2003878 2558220 82537019 1168962 13943 1182905 81354114 27030 27030 81381144 0 0 0 0 0 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. 1 1 1 X 1 X 1 1 0 0 4329669 4329669 0.05770 18839531 11861429 6978102 0.09300 23169200 11861429 11307771 0.15070 688050 486817 201233 0.00270 8970 0 8970 0.00010 38584 0 38584 0.00050 735604 486817 248787 0.00330 23904804 12348246 11556558 0.15400 94260 81965 12295 0.00020 189320 163931 25389 0.00030 94260 81965 12295 0.00020 377840 327861 49979 0.00070 1 2459600 295739 12929473 12998030 -68557 X 1 1 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 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 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. 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. 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. 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. 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. 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. 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. Part VI, Line 7: N/A ME X X X X 1 0 0 0 0 0 0 0 0 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 Part I, Line 4a 1. David Hamlin $138,638 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 6470000 522453 293000 82639 5836740 2007 0 0 1 1 78484 451093 78484 0 1 1 1 0 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 peter g booth to provide retirement funds via a split dollar life insurance policy X 851677 851677 0 1 1 851677 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 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. 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 Manor at Phillipstown Place Inc 25 June Street Sanford ME 04073 010473857 Provide care to the elderly ME 501(c)(3) 9 Henrietta D Goodall Hospital Inc June Street Pharmacy llc 25 JUne Street Sanford ME 04073 020765952 Provide Pharmacy services to the community. ME Henrietta D Goodall Hospital Inc C 113391 770403 1.00000 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 June Street Pharmacy llc A 67975 June Street Pharmacy llc P 52296 Manor at Phillipstown Place Inc P 215925