2011-08-04T14:46:26-05:00 2010-12-31 BAKER NEWMAN & NOYES PO BOX 507 PORTLAND ME 04112 990 2010-01-01 010540180 HOSPICE OF SOUTHERN MAINE HOSP 2072893641 180 US ROUTE 1 SCARBOROUGH ME 04074 ALBERT G SWALLOW III 2072893641 2011-08-04 E DREW CHENEY 2078792100 2010 2016-02-24 21:20:13Z DAVID PERKINS 180 US ROUTE 1 SCARBOROUGH ME 04074 8563421 0 X WWW.HOSPICEOFSOUTHERNMAINE.COM X 2003 ME HOSPICE SERVICES 20 19 121 180 0 0 704525 713145 7190321 7822771 18919 20105 -7451 -24169 7906314 8531852 0 0 0 0 4443174 4885849 88500 0 154239 3123887 3171310 7655561 8057159 250753 474693 8562765 8538449 3543298 3117108 5019467 5421341 X HOSPICE SERVICES 0 0 7001021 7822771 HOSPICE OF SOUTHERN MAINE (HSM) PROVIDES COMPREHENSIVE HOSPICE SERVICES THROUGH A FREE-STANDING, LICENSED, MEDICARE CERTIFIED PROGRAM CONSISTENT WITH THE HOSPICE PHILOSOPHY, AND CONSISTING OF PHYSICAL, EMOTIONAL AND SPIRITUAL SERVICES TO PATIENTS AND THEIR FAMILIES IN THE SETTING MOST APPROPRIATE FOR THE PATIENT. HSM OPERATES AN 18-BED HOSPICE FACILITY TO PROVIDE AN ALTERNATIVE FOR THOSE PATIENTS WHO ARE UNABLE TO REMAIN IN THEIR HOMES AND REQUIRE AN INPATIENT LEVEL OF CARE FOR ACUTE PAIN AND SYMPTOM MANAGEMENT OR OCCASIONALLY FOR RESPITE FOR THEIR CAREGIVERS AS A RESIDENTIAL ALTERNATIVE. HSM PROVIDES BEREAVEMENT SUPPORT TO FAMILY MEMBERS SERVED BY HSM, AS WELL AS THE COMMUNITY AT LARGE, AND VOLUNTEERS ARE OFFERED TO PATIENTS AND FAMILIES AT LEAST 4 HRS A WEEK. HSM PARTICIPATES IN EDUCATING PRACTITIONERS AND MULTIDISCIPLINARY CAREGIVERS TO BETTER PROVIDE HOSPICE AND PALLIATIVE CARE IN THE COMMUNITY. HSM SUPPORTS THE COMMUNITY BY FOSTERING AWARENESS, ENCOURAGING VOLUNTEERISM AND ADVOCATING FOR AN IMPROVED SOCIAL FRAMEWORK REGARDING ALL END OF LIFE ISSUES. HSM PERFORMS FUNDRAISING ACTIVITIES TO SUPPORT CARE FOR UNINSURED AND UNREIMBURSED CARE AND PROGRAM ACTIVITY. IN 2010, HSM CARED FOR 1,050 PATIENTS/FAMILIES PRIMARILY IN YORK AND CUMBERLAND COUNTIES, WITH AN AVERAGE CENSUS OF 102 PATIENTS EACH DAY. HSM PROVIDED NEARLY $200,000 IN UNREIMBURSED CARE IN 2010. 7001021 1 1 0 1 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 31 0 1 121 1 0 0 0 0 0 0 0 0 0 0 X 20 19 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 X MARY PINTO 2072893640 180 US ROUTE 1 SUITE 1 SCARBOROUGH ME 04074 KATHERINE S POPE MD 10.40 X 0 0 0 JOEL BOTLER 0.70 X 0 0 0 EDWARD J MCGEACHEY 0.60 X 0 0 0 BONNIE BEAUDETTE DAVIS 0.60 X 0 0 0 KARL TURNER 2.50 X X 0 0 0 LAURENCE GROSS 0.60 X 0 0 0 DANIEL HAYES MD 0.90 X 0 0 0 HOLLY LEBLANC 3.50 X X 0 0 0 SALLY DAGGETT 1.10 X 0 0 0 MIRIAM LEONARD 0.80 X 0 0 0 THERESA DESFOSSES 1.90 X 0 0 0 LUCY GETCHELL 1.20 X 0 0 0 WILLIAM CARON 0.60 X 0 0 0 ANN STOCKBRIDGE 0.60 X 0 0 0 DAVID PERKINS ESQ 2.70 X X 0 0 0 ELAINE BRADY 1.70 X 0 0 0 AL SWALLOW 2.20 X X 0 0 0 ROLAND EON 0.60 X 0 0 0 ANNETTE GOSNELL 1.20 X 0 0 0 BETSEY MCCANDLESS 1.00 X 0 0 0 ARLENE WING 40.00 X X 104020 0 13357 REBECCA ROSEN 40.00 X X 24070 0 326 128090 0 13683 1 0 0 0 0 65159 647986 31417 713145 PATIENT SERVICES 621610 7822771 7822771 7822771 19220 19220 885 885 885 885 7400 65159 31569 -24169 -24169 8531852 7822771 0 -4064 141773 12198 129575 3922075 3489883 361479 70713 43364 39893 2665 806 446825 395038 43146 8641 331812 286897 39122 5793 35831 35831 24125 24125 239339 172287 58176 8876 83081 83081 217554 122331 37391 57832 108543 95518 13025 252511 214352 38159 184985 179576 5409 169729 164637 5092 323915 314198 9717 127880 110396 15906 1578 PATIENT RELATED EXPENSE 1220434 1220434 BAD DEBT 183383 183383 8057159 7001021 901899 154239 2874 24624 2658770 3238759 432498 224842 1065498 903461 79204 93311 5099154 1045702 4323921 4053452 8562765 8538449 678734 617492 2617554 2309554 247010 190062 3543298 3117108 X 4564574 5059589 124893 71656 330000 290096 5019467 5421341 8562765 8538449 X 474693 -72819 X X 0 1 1 X 0 X 528830 704748 556516 704525 713145 3207764 528830 704748 556516 704525 713145 3207764 517009 2690755 64458 41401 54537 16836 19220 196452 3404216 27103711 0.79040 0.70110 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 920 920 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: NATIONAL HOSPICE AND PALLIATIVE CARE ORG. DUES PAID WAS $8,095, OF WHICH 8.1% WAS ALLOCATED TO LOBBYING ACTIVITIES. HOME CARE AND HOSPICE ALLIANCE OF MAINE DUES PAID WAS $10,087, OF WHICH 2.62% WAS ALLOCATED TO LOBBYING ACTIVITIES. 454893 153052 68 246261 361752 351905 211462 41 108515 454893 330200 136970 33 115298 351905 0.80200 0.19800 0 0 440000 440000 3839927 676048 3163879 819227 369654 449573 4053452 8531852 8057159 474693 -72819 -72819 401874 8563421 31569 31569 8531852 0 8531852 8088728 31569 31569 8057159 0 8057159 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TO ENSURE THE LONG-TERM FINANCIAL VIABILITY OF THE ORGANIZATION PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS EXPENSE: 31,569 PART XIII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS EXPENSE: 31,569 TWILIGHT IN PARK 21926 21926 8342 ANNUAL CELEBRATION 50633 43233 7400 7428 15799 72559 65159 7400 7428 24141 31569 -24169 X 5 31417 STOCK EXCHANGE PRICE 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 DIRECTORS WILLIAM CARON, MIRIAM LEONARD, AND AL SWALLOW HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. DIRECTORS ELAINE BRADY AND EDWARD MCGEACHEY HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A PROVISIONS IN BYLAWS PERTAINING TO MEMBERS OF THE CORPORATION: -INDIVDUALS MAY BE ADMITTED TO MEMBERSHIP FROM TIME TO TIME BY VOTE OF MEMBERS AT ANNUAL OR SPECIAL MEETINGS -NO LIMIT TO TERM -NOMINATING COMMITTEE OF THE BOD PROPOSES NEW MEMBERS -MEMBERS MUST HAVE AN INTEREST IN, AND ABILITY TO CONTRIBUTE TO, THE ADVANCEMENT OF THE MISSION AND GOALS OF THE CORPORATION -POWERS INCLUDE ELECTION OF BOD, ELECTION OF NEW MEMBERS, CHANGES IN THE CORPORATE STRUCTURE, AND ACTION ON ANY MATTERS BROUGHT TO THEM BY THE BOD, AT THE ANNUAL MEETING OR AT SPECIAL MEETINGS PURPOSE: TO STRENGTHEN LINKS TO THE COMMUNITY, AND ENSURE THAT EFFECTIVE GOVERNING BODIES ARE ELECTED RESPONSIBILITIES: -UNDERSTANDING AND AFFIRMATION OF HSM'S MISSION, PRINCIPLES AND OBJECTIVES. -ADVOCACY IN THE COMMUNITY, FOSTERING OF PUBLIC AWARENESS AND SUPPORT FOR THE ORGANIZATION'S GOALS AND PROGRAMS AND ITS FUNDRAISING EFFORTS -ATTENDANCE AT THE ANNUAL MEETING, ELECTION OF BOD AND MEMBERS OF CORPORATION, AND ACTION ON ANY OTHER MATTERS BROUGHT BY THE BOD. FORM 990, PART VI, SECTION A, LINE 7B SEE LINE 7A FORM 990, PART VI, SECTION B, LINE 11 THE 990 WAS REVIEWED BY THE FINANCE COMMITTEE. THEN A COMPLETE COPY OF THE 990 WAS DISTRIBUTED TO THE BOARD, WITH THE EXCEPTION OF THE IDENTITY OF A DONOR WHO PREFERRED TO REMAIN ANONYMOUS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY ALL PERSONS ARE REQUIRED TO REVIEW AND SIGN THE CONFLICT OF INTEREST POLICY STATEMENT, WHICH IS THEN KEPT ON FILE. FORM 990, PART VI, SECTION B, LINE 15A HSM'S EXECUTIVE DIRECTOR RESIGNED IN EARLY JULY 2009. RECRUITMENT THEN TOOK PLACE FOR A NEW EXECUTIVE DIRECTOR/CEO, WHO WAS HIRED 3/31/10. DURING THE RECRUITMENT PHASE IN 2009/2010 THE PROCESS FOR DETERMINING COMPENSATION FOR THE NEW CEO WAS AS FOLLOWS: REVIEW OF CANDIDATE'S CURRENT RESPONSIBILITIES AND COMPENSATION, AND HIS/HER EXPECTATIONS AS CEO OF HSM REVIEW OF NATIONAL AND REGIONAL MARKET DATA DISCUSSION AND DECISION BY THE EXECUTIVE COMMITTEE OF THE BOARD FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS THAT ARE REQUIRED TO BE MADE AVAILABLE ARE MADE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -72,819. FORM 990, PART XI, LINE 2C THE RESPONSIBILITY OF THE AUDIT COMMITTEE FOR OVERSEEING THE AUDIT AND SELECTING THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM PRIOR YEARS.