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Nonprofiteer
← ANDROSCOGGIN VALLEY HOSPITAL INC

Form 990 for tax year 2023

Filed by ANDROSCOGGIN VALLEY HOSPITAL INC.

Totals

Total revenue
$94,030,287
Total expenses
$90,360,730
Contributions and grants received
$173,677
Grants paid
$5,000
Program service revenue
$93,056,193
Investment income
-$843,133
Other revenue
$1,643,550
Total assets, end of year
$64,738,399
Total liabilities, end of year
$14,118,679
Net assets or fund balances, end of year
$50,619,720
Program services expenses (Part IX)
$72,426,718
Management and general expenses
$17,934,012
Fundraising expenses
$0
Program service expenses (Part III)
$72,426,718

Program services were 80.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1c · Fundraising events

    $36,933

  • 1e · Government grants (contributions)

    $91,667

  • 1f · All other contributions, gifts and grants

    $45,077

  • 1g · Noncash contributions included above

    $16,560

  • 2a · Program service revenue: NET PATIENT REVENUE

    total $91,950,154 · related or exempt $91,950,154

  • 2b · Program service revenue: 340(B) PHARMACY REVENUE

    total $1,106,039 · related or exempt $1,106,039

  • 3 · Investment income

    total $28,621 · excluded $28,621

  • 6a · Gross rents

    real property $209,139

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $209,139

  • 6d · Net rental income or loss

    total $209,139 · excluded $209,139

  • 7a · Gross sales of assets other than inventory

    securities $848,751 · other assets $3,000

  • 7b · Less cost or other basis and sales expenses

    securities $0 · other assets $1,723,505

  • 7c · Gain or loss

    securities $848,751 · other assets -$1,720,505

  • 7d · Net gain or loss

    total -$871,754 · excluded -$871,754

  • 8a · Fundraising events: gross income

    $4,560

  • 8a · Fundraising events: contributions included on line 1c

    $36,933

  • 8b · Fundraising events: direct expenses

    $15,467

  • 8c · Net income from fundraising events

    total -$10,907 · excluded -$10,907

  • 11a · Other revenue: CAFETERIA REVENUE

    total $453,890 · excluded $453,890

  • 11d · All other revenue

    total $991,428 · excluded $991,428

  • 11e · Other revenue, total

    $1,445,318

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $5,000 · program services $5,000

  • 5 · Compensation of officers, directors and key employees

    total $854,640 · program services $431,239 · management and general $423,401

  • 7 · Other salaries and wages

    total $28,032,024 · program services $27,115,835 · management and general $916,189

  • 8 · Pension plan contributions

    total $752,131 · program services $740,601 · management and general $11,530

  • 9 · Other employee benefits

    total $6,079,627 · program services $5,690,188 · management and general $389,439

  • 10 · Payroll taxes

    total $1,870,349 · program services $1,841,870 · management and general $28,479

  • 11b · Fees: legal

    total $150,464 · management and general $150,464

  • 11d · Fees: lobbying

    total $14,557 · management and general $14,557

  • 11f · Fees: investment management

    total $33,940 · management and general $33,940

  • 11g · Fees: other

    total $13,248,327 · program services $12,454,306 · management and general $794,021

  • 12 · Advertising and promotion

    total $135,159 · program services $106,542 · management and general $28,617

  • 13 · Office expenses

    total $73,952 · program services $55,625 · management and general $18,327

  • 14 · Information technology

    total $136,610 · management and general $136,610

  • 16 · Occupancy

    total $695,612 · program services $683,935 · management and general $11,677

  • 17 · Travel

    total $402,722 · program services $383,144 · management and general $19,578

  • 19 · Conferences, conventions and meetings

    total $271,863 · program services $248,853 · management and general $23,010

  • 20 · Interest

    total $52,855 · program services $44,906 · management and general $7,949

  • 22 · Depreciation, depletion and amortization

    total $4,028,116 · program services $3,422,309 · management and general $605,807

  • 23 · Insurance

    total $1,515,860 · program services $1,515,860

  • 24a · Other expenses: INTERCOMPANY ALLOCATION

    total $11,267,390 · program services $704,094 · management and general $10,563,296

  • 24b · Other expenses: MEDICAL SUPPLIES

    total $7,431,930 · program services $7,416,645 · management and general $15,285

  • 24c · Other expenses: BAD DEBT EXPENSE

    total $7,124,863 · program services $7,124,863

  • 24d · Other expenses: MCD TAX

    total $3,428,199 · management and general $3,428,199

  • 24e · All other expenses

    total $2,754,540 · program services $2,440,903 · management and general $313,637

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $2,870 · end of year $2,820

  • 2 · Savings and temporary cash investments

    beginning of year $5,602,081 · end of year $10,878,313

  • 4 · Accounts receivable

    beginning of year $9,744,180 · end of year $13,071,667

  • 8 · Inventories for sale or use

    beginning of year $1,026,390 · end of year $1,736,783

  • 9 · Prepaid expenses and deferred charges

    beginning of year $846,828 · end of year $472,939

  • 10a · Land, buildings and equipment: cost or other basis

    $70,407,061

  • 10b · Land, buildings and equipment: accumulated depreciation

    $48,311,483

  • 10c · Land, buildings and equipment, net

    beginning of year $24,829,155 · end of year $22,095,578

  • 11 · Investments: publicly traded securities

    beginning of year $18,330,061 · end of year $15,991,693

  • 15 · Other assets

    beginning of year $16,779,202 · end of year $488,606

  • 17 · Accounts payable and accrued expenses

    beginning of year $8,986,192 · end of year $6,210,495

  • 20 · Tax-exempt bond liabilities

    beginning of year $3,322,832 · end of year $2,394,738

  • 25 · Other liabilities

    beginning of year $19,710,804 · end of year $5,513,446

  • 27 · Net assets without donor restrictions

    beginning of year $45,140,939 · end of year $50,619,720

Mission and programs · 2023

Mission

DELIVERING THE BEST HEALTHCARE EXPERIENCE FOR EVERY PATIENT, EVERY DAY.

Activities or mission (Part I)

CRITICAL ACCESS HOSPITAL

  • ANDROSCOGGIN VALLEY HOSPITAL IS A CRITICAL ACCESS HOSPITAL. THE HOSPITAL PROVIDES A BROAD RANGE OF INPATIENT AND OUTPATIENT SERVICES TO MEET THE HEALTH NEEDS OF THE UPPER ANDROSCOGGIN VALLEY AND SURROUNDING COMMUNITIES. WITH A COMMITMENT TO THE HIGHEST QUALITY SURGICAL CARE - AVH IS LEADING THE WAY TO A HEALTHIER FUTURE FOR OUR HEALTH CARE COMMUNITY.

    Expenses $72,426,718 · Grants $5,000 · Revenue $93,056,193

  • EDUCATIONAL PROGRAMS OFFERED BY AVH INCLUDE CHILDBIRTH CLASSES, BABYSITTING COURSE, WELLNESS FAIRS, LECTURE SERIES, CPR AND FIRST AID COURSES, NUTRITIONAL COUNSELING, AND A VARIETY OF SUPPORT GROUPS.

  • OTHER COMMUNITY BENEFITS PROVIDED BY THE HOSPITAL INCLUDE THE PROVISION OF CARE TO THE UNDERINSURED; THE PROMOTION OF GOOD HEALTH FOR CHILDREN THROUGH PARTICIPATION IN THE HEALTHY KIDS PROGRAM; AND THE SPONSORSHIP OF NUMEROUS CLINICS AND PROGRAMS SUPPORTING GOOD HEALTH IN THE COMMUNITY.

As filed on the 2023 return.

Listed in Part VII

  • David Backler

    CHAIR

    Total calculated
    $0
    Hours/week
    1
  • Donna Goodrich

    CHAIR (THRU 10/23)

    Total calculated
    $0
    Hours/week
    1 + 1.5 related
  • Martha Laflamme

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 0.5 related
  • Jay Poulin

    SECRETARY

    Total calculated
    $0
    Hours/week
    1 + 0.5 related
  • Javier Cardenas

    DIRECTOR/HOSPITALIST

    Total calculated
    $505,799
    From this org
    $493,874
    From related orgs
    $0
    Other
    $11,925
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $451,779
    Bonus
    $13,125
    Other
    $28,970
    Deferred
    $0
    Nontaxable benefits
    $11,925
    Filer's total
    $505,799
  • Jessica Foster-Hebert

    DIRECTOR/NCHHHA DIR. CLIN

    Total calculated
    $163,902
    From this org
    $0
    From related orgs
    $155,260
    Other
    $8,642
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $126,733 related
    Bonus
    $0 + $25,847 related
    Other
    $0 + $2,680 related
    Deferred
    $0 + $4,374 related
    Nontaxable benefits
    $0 + $4,268 related
    Filer's total
    $0 + $163,902 related
  • Christy Langlois

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Susan Lessard

    DIRECTOR/APRN

    Total calculated
    $0
    Hours/week
    30
  • Richard Luna

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Thomas McCue

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related
  • Jessie Perkins

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Brianne Teaboldt

    MEDICAL STAFF PRESIDENT (THRU 12/23)

    Total calculated
    $0
    Hours/week
    1
  • Daniel Van Buren

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Tyler White

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Thomas Mee

    SYSTEM CEO

    Total calculated
    $724,548
    From this org
    $0
    From related orgs
    $706,230
    Other
    $18,318
    Hours/week
    1 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $559,584 related
    Bonus
    $0 + $133,893 related
    Other
    $0 + $12,753 related
    Deferred
    $0 + $6,394 related
    Nontaxable benefits
    $0 + $11,924 related
    Filer's total
    $0 + $724,548 related
  • Michael Peterson

    PRESIDENT

    Total calculated
    $423,678
    From this org
    $412,863
    From related orgs
    $0
    Other
    $10,815
    Hours/week
    40 + 2 related

    Schedule J breakdown matched by us

    Base
    $312,811
    Bonus
    $75,921
    Other
    $24,131
    Deferred
    $0
    Nontaxable benefits
    $10,815
    Filer's total
    $423,678
  • Matthew Streeter

    SYSTEM CFO

    Total calculated
    $378,399
    From this org
    $0
    From related orgs
    $357,595
    Other
    $20,804
    Hours/week
    1 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $290,340 related
    Bonus
    $0 + $66,580 related
    Other
    $0 + $675 related
    Deferred
    $0 + $8,934 related
    Nontaxable benefits
    $0 + $11,870 related
    Filer's total
    $0 + $378,399 related
  • Keith Shute MD

    CHIEF MEDICAL OFFICER

    Total calculated
    $578,463
    From this org
    $540,836
    From related orgs
    $0
    Other
    $37,627
    Hours/week
    39.5 + 0.5 related

    Schedule J breakdown matched by us

    Base
    $460,537
    Bonus
    $63,642
    Other
    $16,657
    Deferred
    $14,306
    Nontaxable benefits
    $23,321
    Filer's total
    $578,463
  • Brian O'Hearn

    CNO

    Total calculated
    $240,835
    From this org
    $229,911
    From related orgs
    $0
    Other
    $10,924
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $187,858
    Bonus
    $31,779
    Other
    $10,274
    Deferred
    $0
    Nontaxable benefits
    $10,924
    Filer's total
    $240,835
  • Richard Kardell

    ENT MD

    Total calculated
    $599,919
    From this org
    $588,424
    From related orgs
    $0
    Other
    $11,495
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $446,947
    Bonus
    $89,083
    Other
    $52,394
    Deferred
    $0
    Nontaxable benefits
    $11,495
    Filer's total
    $599,919
  • Glenn Hall

    GENERAL SURGEON

    Total calculated
    $568,536
    From this org
    $554,792
    From related orgs
    $0
    Other
    $13,744
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $496,465
    Bonus
    $32,995
    Other
    $25,332
    Deferred
    $8,828
    Nontaxable benefits
    $4,916
    Filer's total
    $568,536
  • Krzysztof Plociennik

    MD PROVIDER

    Total calculated
    $544,087
    From this org
    $526,422
    From related orgs
    $0
    Other
    $17,665
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $461,375
    Bonus
    $13,350
    Other
    $51,697
    Deferred
    $0
    Nontaxable benefits
    $17,665
    Filer's total
    $544,087
  • Bradley Mahlon

    ORTHOPEDIC SURGEON

    Total calculated
    $649,978
    From this org
    $637,456
    From related orgs
    $0
    Other
    $12,522
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $578,937
    Bonus
    $29,200
    Other
    $29,319
    Deferred
    $0
    Nontaxable benefits
    $12,522
    Filer's total
    $649,978
  • Stephen Kraunz

    EMERGENCY MEDICINE PRACTITIONER

    Total calculated
    $472,759
    From this org
    $469,474
    From related orgs
    $0
    Other
    $3,285
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $434,162
    Bonus
    $0
    Other
    $35,312
    Deferred
    $0
    Nontaxable benefits
    $3,285
    Filer's total
    $472,759

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
NORTH COUNTRY HEALTHCARE, A RELATED ORGANIZATION, USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL OF THE FILING ORGANIZATION: - COMPENSATION COMMITTEE - FORM 990 OF OTHER ORGANIZATIONS - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B
THOMAS MEE, SYSTEM CEO, PARTICIPATED IN A 457(F) PLAN ADMINISTERED BY NORTH COUNTRY HEALTHCARE, A RELATED ORGANIZATION. THERE WERE NO CONTRIBUTIONS OR DISTRIBUTIONS IN 2023.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2023
Filed
15 August 2025
IRS schema version
2023v6.0
Source object
202532279349302913

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