TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) LORI ANN BLACK TRUSTEE	2.00	X			0	0
(2) ANN M BROOKS MD TRUSTEE	2.00	X			0	0
(3) GEORGE E HISSONG JR TRUSTEE	2.00	X			0	0
(4) MARK MICKERIZ CHAIR	2.00	X	X		0	0
(5) DAVID C NICKERSON TRUSTEE	2.00	X			0	0
(6) MERILEE MAPES PERKINS TRUSTEE	2.00	X			0	0
(7) MICHAEL L RALSTON TRUSTEE	2.00	X			0	0
(8) ROBERT REINKEN TRUSTEE	2.00	X			0	0
(9) SUSAN T ROBERTS SECRETARY/CHAIR OF PATIENT CARE	2.00	X			0	0
(10) WILLIAM FRANK VICE CHAIR/CHAIR OF FINANCE	2.00	X	X		18,675	0
(11) DARLENE STROMSTAD PRESIDENT THROUGH 5/31/11	40.00	X	X		416,547	13,635
(12) PATRICIA APRILE VP OF OPERATIONS	40.00	X		X	200,487	19,034
(13) RONALD BRYANT CFO THROUGH 9/30/10	40.00	X		X	123,130	15,000
(14) CHARLES CARUSO CHIEF INFORMATION OFFICER	40.00	X		X	161,469	22,052
(15) DANIEL FORGUES CFO EFFECTIVE 1/1/11	40.00	X		X	0	0
(16) KATHLEEN MORRIS MD PRESIDENT OF THE MEDICAL STAFF	2.00	X		X	197,940	12,813
(17) DAVID EAGLESON TRUSTEE	2.00	X			0	0

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(F) Estimated amount of other compensation from the organization and related organizations
(18) BECKY BRINK TRUSTEE	2.00	X				0	0
(19) MUKESH BHARGAVA MD VP OF MEDICAL AFFAIRS	16.00	X	X			150,127	0
(20) ADAM SCHLAGER VP OF PHYSCIANS SERVICES	40.00	X	X			19,539	101
(21) FRANK GOUDREAU PHYSICIAN	40.00			X		444,944	26,816
(22) JOHNATHAN SHILL PHYSICIAN	40.00			X		293,871	13,774
(23) KENT HALL PHYSICIAN	40.00			X		347,140	20,655
(24) NINA SHERVIN PHYSICIAN	40.00			X		396,205	16,296
(25) JOHN THOMPSON PHYSICIAN	40.00			X		413,702	26,010
(26) LORRAINE D MASURE FORMER SECRETARY	2.00				X	0	0
(27) MARK RAUTENBERG MD FORMER TRUSTEE	2.00				X	0	0
(28) WEBER SHILL FORMER VP OF PHYSICIAN PRACTICES	40.00				X	0	0
(29) DAVID HAMLIN FORMER VP OF PATIENT CARE	40.00				X	0	0
(30) ROBERT I HARDISON FORMER TRUSTEE	2.00				X	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
MAK ANESTHESIA INC 156 COUNTRY CLUB ROAD SANFORD,ME04073	ANESTHESIA SERVICES PROVIDED TO HENRIETT	574,527
LEONID TEMKIN MD PA 239 ARUNDEL ROAD KENNEBUNK,ME04046	ANESTHESIA SERVICES PROVIDED TO HENRIETT	521,309
THOMAS MOORE MD 17 MERRILL BROOK DR SCARBOTOURHG,ME04074	PHYSICIAN SERVICES PROVIDED TO HENRIETTA	287,302
MARK RAUTENBERG MD 300 SLIGO ROAD ROLLINGSFORD,NH03869	PHYSICIAN SERVICES PROVIDED TO HENRIETTA	266,131
EDWARD BURZON PC 1 SARAH PAUL HILL MADBURY,NH03823	PHYSICIAN SERVICES PROVIDED TO HENRIETTA	263,900
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 12

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	933,651		933,651
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	38,715,513	33,647,710	5,033,017	34,786
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....
9	Other employee benefits .......	5,902,283	5,130,671	767,297	4,315
10	Payroll taxes ...........	2,742,032	2,382,302	356,464	3,266
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	119,192		119,192
c	Accounting ...........	121,676		121,676
d	Lobbying ...........	126,000		126,000
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......
g	Other ..........	6,020,446	4,551,148	1,469,298
12	Advertising and promotion ....	96,874		96,874
13	Office expenses .......	102,814	86,681	16,101	32
14	Information technology ......	506,835	119,587	387,248
15	Royalties ..
16	Occupancy ...........	1,589,071	588,086	1,000,985
17	Travel ............	18,306	14,711	3,595
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	148,307	119,751	28,192	364
20	Interest ...........	846,629	771,891	74,738
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	3,647,794	3,283,015	364,779
23	Insurance ..............	1,059,414	969,785	89,629
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	GENERAL HOSPITAL SUPPLI	8,045,030	7,925,434	119,478	118
b	PROVISION FOR DOUBTFUL	5,914,783	5,914,783
c	MISCELLANEOUS	3,937,510	3,240,180	695,745	1,585
d	PHYSICIAN FEES	3,911,984	3,911,984
e	HEALTHCARE PROVIDER TAX	1,854,925	1,854,925
f	All other expenses
25	Total functional expenses. Add lines 1 through 24f	86,361,069	74,512,644	11,803,959	44,466
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	5,185	1	5,575
2	Savings and temporary cash investments .......	5,414,641	2	3,451,617
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	7,753,284	4	9,577,350
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........	851,677	5	851,677
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	1,535,788	8	1,481,101
9	Prepaid expenses and deferred charges ............	2,094,494	9	1,548,569
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	73,409,727
b	Less: accumulated depreciation. .....	10b	39,582,301	34,628,970	10c	33,827,426
11	Investments—publicly traded securities ..........	8,087,521	11	12,582,059
12	Investments—other securities. See Part IV, line 11 ......	12,710,758	12	14,607,527
13	Investments—program-related. See Part IV, line 11 ..		13
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	11,254,075	15	9,862,886
16	Total assets. Add lines 1 through 15 (must equal line 34)...	84,336,393	16	87,795,787
	17	Accounts payable and accrued expenses .	12,651,004	17	13,116,998
18	Grants payable ..........		18
19	Deferred revenue ..........		19
20	Tax-exempt bond liabilities ..........	11,814,439	20	10,610,766
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	12,061,491	23	12,924,027
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities. Complete Part X of Schedule D.....	492,053	25	791,067
26	Total liabilities. Add lines 17 through 25.....	37,018,987	26	37,442,858
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	36,953,692	27	38,397,945
28	Temporarily restricted net assets .....	1,451,392	28	1,572,577
29	Permanently restricted net assets .....	8,912,322	29	10,382,407
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	47,317,406	33	50,352,929
34	Total liabilities and net assets/fund balances .....	84,336,393	34	87,795,787

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

HENRIETTA D GOODALL HOSPITAL INC

Employer identification number

01-0078060

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2010

Name of organization

HENRIETTA D GOODALL HOSPITAL INC

Employer identification number

01-0078060

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization HENRIETTA D GOODALL HOSPITAL INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization HENRIETTA D GOODALL HOSPITAL INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
HENRIETTA D GOODALL HOSPITAL INC

Employer identification number

01-0078060

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below.
SchCMd Bullet

Attach to Form 990 or Form 990-EZ. SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

HENRIETTA D GOODALL HOSPITAL INC

Employer identification number

01-0078060

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities .................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2010

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check if the filing organization belongs to an affiliated group.
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated Group Totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots non-taxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2010

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Yes

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Yes

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? If "Yes," describe in Part IV ..........................

Yes

135,858

Total. lines 1c through 1i ...................................

135,858

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
EXPLANATION OF OTHER LOBBYING ACTIVITIES:	PART II-B, LINE 1I:	HENRIETTA D. GOODALL HOSPITAL, INC. HAS A CONTRACT FOR GOVERNMENT RELATIONS SERVICES WITH THE GRINNELL ASSOCIATES 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. INCLUDED IS AMOUNTS PAID AS PART OF DUES TO MHA/AHA FOR LOBBYIST ACTIVITIES.

Schedule C (Form 990 or 990EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

HENRIETTA D GOODALL HOSPITAL INC

Employer identification number

01-0078060

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year
1a	Beginning of year balance ....	17,085,103	14,720,200
b	Contributions ........	1,898,375	642,735
c	Investment earnings or losses ...	2,691,423	1,962,857
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	7,000	240,689
f	Administrative expenses ....
g	End of year balance ......	21,667,901	17,085,103

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

52.000 %

Permanent endowment: SchDMd Bullet

48.000 %

Term endowment: SchDMd Bullet

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

Yes

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	2,728,106		2,728,106
b	Buildings ................	43,978,411	21,815,780	22,162,631
c	Leasehold improvements ............	4,521,887	1,649,985	2,871,902
d	Equipment ................	18,902,264	14,948,138	3,954,126
e	Other .................	3,279,059	1,168,398	2,110,661
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........				33,827,426

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other (A) ALTERNATIVE INVESTMENTS	2,992,034	F
(B) BENEFICIAL INTEREST IN PERPETUAL TRUSTS	9,468,845	F
(C) INVESTMENT IN REAL PROPERTY	2,146,648	F






Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)	14,607,527

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) INVESTMENTS IN SUBSIDIARIES & JOINT VENTURES				493,126
(2) DEFERRED FINANCING COSTS				171,184
(3) DUE FROM AFFILIATES				1,671,001
(4) TRUSTEE HELD FUNDS (BOND FUNDS)				1,327,303
(5) SYNERNET WORKERS' COMPENSATION CAPITAL CONTRIBUTION				39,633
(6) CONTRIBUTION RECEIVABLE FROM REMAINDER TRUST				32,933
(7) ESTIMATED SETTLEMENTS WITH MAINECARE				4,688,424
(8) INTANGIBLE ASSET - TMG GOODWILL				1,347,958
(9) INTANGIBLE ASSET - ORTHO MEDICAL RECORDS				17,892
(10) HDG DUE FROM TEMP NET ASSETS				4,344
(11) HDG CAPITAL RESERVE CASH				69,088
Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........				9,862,886

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes
ESTIMATED SETTLEMENTS DUE TO THIRD-PARTY PAYORS		791,067








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		791,067
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1	86,515,607
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	86,361,069
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	154,538
4	Net unrealized gains (losses) on investments ..........................	4	102,480
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8	2,778,506
9	Total adjustments (net). Add lines 4 - 8 .............................	9	2,880,986
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	3,035,524

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	87,805,322
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	1,289,715
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d .....................			2e	1,289,715
3	Subtract line 2e from line 1.....................			3	86,515,607
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV): ...........	4b
c	Add lines 4a and 4b.......................			4c	0
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......			5	86,515,607

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............		1	86,361,069
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d......................		2e	0
3	Subtract line 2e from line 1.....................		3	86,361,069
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV): ............	4b
c	Add lines 4a and 4b.......................		4c	0
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......		5	86,361,069

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	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.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X:	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 -20,379. INCREASE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS 1,464,292. UNREALIZED GAIN ON SECURITIES 1,289,715. OTHER CHANGES IN NET ASSETS -3,686. RESTRICTED CONTRIBUTIONS 48,564.

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

HENRIETTA D GOODALL HOSPITAL INC

Employer identification number

01-0078060

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

If "Yes," is it a written policy? .......................

Yes

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low

income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If

"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....

Yes

200% 250% 300% 350% 400% Other

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Yes

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............

Does the organization prepare an annual community benefit report?.............

Yes

If "Yes," does the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Charity Care and Certain Other Community Benefits at Cost

	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Charity care at cost (from Worksheets 1 and 2) ..	4,858,211		4,858,211	5.630 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .	16,033,775	11,097,345	4,936,430	5.720 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....
dTotal Charity Care and Means-Tested Government Programs .....	20,891,986	11,097,345	9,794,641	11.350 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	1,046,016	841,847	204,169	0.240 %
f Health professions education (from Worksheet 5) ..
g Subsidized health services (from Worksheet 6) ..
h Research (from Worksheet 7)
i Cash and in-kind contributions to community groups (from Worksheet 8) ..
jTotal Other Benefits ...	1,046,016	841,847	204,169	0.240 %
kTotal. Add lines 7d and 7j. ..	21,938,002	11,939,192	9,998,810	11.590 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	99,204	87,947	11,257	0.010 %
3	Community support	62,002	54,967	7,035	0.010 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	31,001	27,483	3,518	0 %
7	Community health improvement advocacy	102,304	90,695	11,609	0.010 %
8	Workforce development	15,501	13,742	1,759	0 %
9	Other
10	Total	310,012	274,834	35,178	0.030 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense (at cost).....

2,469,304

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

710,475

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

12,992,147

Enter Medicare allowable costs of care relating to payments on line 5.....

14,010,714

Subtract line 6 from line 5. This is the surplus or (shortfall)........

-1,018,567

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......

Yes

Part IV

Management Companies and Joint Ventures

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
11 CANCER CARE CENTER OF YORK COUNTY	SUPPORT AND PERFORM MEDICAL PROCEEDURES FOR CANCER PATIENTS	33.330 %	0 %	0 %
22 GSM REALTOR INC	REAL ESTATE HOLDING COMPANY	33.330 %	0 %	0 %
33 GOODALL HOSPITAL REAL ESTATE HOLDING CO LLC	REAL ESTATE HOLDING COMPANY	100.000 %	0 %	0 %
44 WATERBORO MEDICAL OFFICE BUILDING LLC	REAL ESTATE HOLDING COMPANY	100.000 %	0 %	0 %
55 GOODALL HOSPITAL MEDICAL OFFICE BUILDING LLC	REAL ESTATE HOLDING COMPANY	100.000 %	0 %	0 %
66 PINE TREE INSURANCE A RECIPROCAL RISK RETENTION GROUP	PROVIDE MALPRACTICE INSURANCE FOR A GROUP OF HEALTH CARE PROVIDERS	25.860 %	0 %	0 %
7
8
9
10
11
12
13

Schedule H (Form 990) 2010

Page 3

Part VFacility Information

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?10 Name and address		Other (Describe)
1	HENRIETTA D GOODALL HOSPITAL INC 25 JUNE STREET SANFORD,ME04073	X	X	X
2	NEWTON CENTER (ELDER CARE) 35 JULY STREET SANFORD,ME04073				NURSING HOME
3	GOODALL HEALTH PARTNERS 25 JUNE STREET SANFORD,ME04073				PHYSICIAN PRACTICES
4	WELLNESS CENTER 13 JULY STREET SANFORD,ME04073				CLINIC
5	GOODALL HEALTH PARTNERS 10 GOODALL DRIVE EAST WATERBORO,ME04070				PHYSICIAN PRACTICES
6	GOODALL HEALTH PARTNERS 272 COTTAGE STREET SANFORD,ME04073				PHYSICIAN PRACTICES
7	THE MEDICAL GROUP 2 LIVEWELL DRIVE KENNEBUNK,ME04043				PHYSICIAN PRACTICES
8	COMMUNITY SERVICES 15 DAIGLE STREET SANFORD,ME04073				COMMUNITY PROGRAMS
9	OCCUPATIONAL HEALTH SERVICES 2 LIVEWELL DRIVE KENNEBUNK,ME04043				PHYSICIAN PRACTICES
10	GOODALL HEALTH CLINICS 2 LIVEWELL DRIVE KENNEBUNK,ME04043	CLINIC

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:HENRIETTA D GOODALL HOSPITAL INC

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9
	If “Yes,” indicate the FPG family income limit for eligibility for free care: %

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: %
11	Explained the basis for calculating amounts charged to patients?.................		11
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 7

Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, measured by total revenue per facility, from largest to smallest) How many non-hospital facilities did the organization operate during the tax year?
Name and address		Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2010

Page 8

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2	Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
		PART I, LINE 6A: PARTNERS FOR HEALTHIER COMMUNITIES HAS COLLABORATED WITH YORK DISTRICT HEALTHY MAINE PARTNERSHIPS, THE GREATER YORK COUNTY UNITED WAY, YORK COUNTY HEAD START, AND THE GREATER YORK COUNTY YMCA TO GUIDE A COUNTY-WIDE COMMUNITY NEEDS ASSESSMENT PROCESS UTILIZING MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP). THE ASSESSMENT REPORTS WERE SHARED AT VARIOUS COMMUNITY FORUMS.
		PART I, LINE 7: 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.
	PART 2 LINE 3:	COMMUNITY SUPPORT WAS ACHIEVED BY THE DIRECTOR OF PARTNERS FOR HEALTHIER COMMUNITIES CO-CHAIRING AND PARTICIPATING ON NUMEROUS WORKGROUPS/COMMITTEES WITHIN THE YORK COUNTY. THESE COMMITTEES WORKED WITH PARTICIPATION IN MANY EDUCATION SESSIONS WITHIN THE COMMUNITY BY PROVIDING CONFIDENTIALLY FOR INDIVIDUALS PARTICIPATING IN HEALTH RELATED PROMOTIONS. ALSO, PHC HAS BEEN ACTIVE IN ACTING AS A SPOKESPERSON FOR THE CONTINUED SUPPORT OF THE 211 PROGRAM AS IT PURSUES EXPANSION WITH ON-LINE ASSESSMENT. PHC HAS CONDUCTED ASSESSMENT OF GAPS IN SUPPORT GROUP RESOURCES AND WORKED WITH 211 TO UPDATE THE DATABASE. STROKE HAS BEEN IDENTIFIED AS A GAP TO ADDRESS.
	PART 2 LINE 4:	ENVIRONMENTAL IMPROVEMENTS ARE A VERY IMPORTANT ASPECT OF THE WORKINGS OF PARTNERS FOR HEALTHIER COMMUNITIES THROUGH THE LEAD POISONING PREVENTION SUPPLIES/EDUCATION THAT THE ORGANIZATION OFFERS AND ITS PARTICIPATION IN COMMUNITY EFFORTS. PHC CONTRIBUTED TO THE IMPLEMENTATION OF "MOOSE TRAILS" ON SIDEWALKS IN DOWNTOWN SANFORD TO PROMOTE SAFE PATHS FOR WALKING AS WELL AS BIKING TO SCHOOL. PHC PARTNERED WITH THE SANFORD YMCA TO LAUNCH AN INDOOR WALKING LOOP AT WAL-MART AS WELL AS APPLICABLE EDUCATION. PHC EDUCATED 300 BUSINESSES AND 11 RESTAURANTS ON THE NEW TOBACCO LAWS. PHC PROVIDED ASSISTANCE ON MAKING NECESSARY POLICY AND ENVIRONMENTAL CHANGES TO SUPPORT NEW REQUIREMENTS.
	PART II LINE 6:	PARTNERS FOR HEALTHIER COMMUNITIES WORKED WITH COMMUNITY ADVISORS TO CREATE A VISION FOR MOBILIZING AN ELEVEN TOWN SERVICE AREA. BASED ON THIS CONVERSATION, PHC HAS WORKED TO MOBILIZE OR PARTNER WITH EXISTING TASKFORCES IN 3 REGIONS OF THE SERVICE AREA. RECENT MONTHS HAVE BEEN SPENT RECRUITING ADVISORY BOARD MEMBERS.PARTNERS FOR HEALTHIER COMMUNITIES HAS COLLABORATED WITH YORK DISTRICT HEALTHY MAINE PARTNERSHIPS, THE GREATER YORK COUNTY UNITED WAY, YORK COUNTY HEAD START, AND THE GREATER YORK COUNTY YMCA TO GUIDE A COUNTY-WIDE COMMUNITY NEEDS ASSESSMENT PROCESS UTILIZING MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP). THE ASSESSMENT REPORTS WERE SHARED AT VARIOUS COMMUNITY FORUMS. PARTNERS FOR HEALTHIER COMMUNITIES HAVE FACILITATED STRATEGIC PLANNING PROCESSES IN THE SANFORD, WATERBORO, AND SACOPEE VALLEY COMMUNITIES. THE HMP DIRECTOR HAS DEDICATED 40 HOURS TO THIS COMPONENT OF THE COMMUNITY NEEDS PROCESS. THE COMMUNITIES ARE CURRENTLY IN THE ACTION PLANNING PHASE.PARTNERS FOR HEALTHIER COMMUNITIES IS COLLABORATING WITH THE TOWN OF SANFORD AND SAFE SCHOOLS HEALTHY SANFORD TO MOBILIZE THE SAFE AND HEALTHY SANFORD COALITION. AS A RESULT, THE TOWN WAS AWARDED A DRUG FREE COMMUNITIES GRANT OF $625,000 OVER A 5 YEAR PERIOD TO ADDRESS YOUTH SUBSTANCE ABUSE PREVENTION EFFORTS. PHC PARTICIPATED IN 8 PARENTAL/STUDENT INFORMATION NIGHTS RELATED TO SUBSTANCE ABUSE PREVENTION. THE HMP PREVENTION COORDINATOR HAS CONTRIBUTED 32 HOURS TO GRANT WRITING AND PLANNING IN THE SANFORD COMMUNITY AS WELL AS SERVING AS A LEADER IN SECURING THE DRUG FREE COMMUNITIES GRANT.PARTNERS FOR HEALTHIER COMMUNITIES HAS CONDUCTED ASSESSMENT OF GAPS IN SUPPORT GROUP RESOURCES AND WORKED WITH 211 TO UPDATE DATABASE. STROKE HAS BEEN IDENTIFIED AS A GAP TO ADDRESS.
	PART II LINE 7:	COMMUNITY HEALTH IMPROVEMENTS HAVE LEAD GOODALL TO PARTNER WITH YORK DISTRICT HEALTHY MAINE PARTNERSHIPS AND YORK COUNTY COMMUNITY ACTION TO COORDINATE TRAINING OF ALL YORK COUNTY HEAD START SITES ON THE 5-2-1-0 PHYSICAL ACTIVITY AND NUTRITION MODEL. GOODALL CONTINUED TO PROVIDE TECHNICAL ASSISTANCE TO SITES WITHIN THE SERVICE AREA. COMMUNITY HEALTH IMPROVEMENTS WILL LEAD GOODALL IN THE PURSUIT OF WORKING WITH YORK DISTRICT ENGAGED 40 YOUTH IN THE ANNUAL STICKER SHOCK CAMPAIGN TO AFFIX 25,000 STICKERS AT 36 STORES THROUGHOUT THE COMMUNITY TO INFORM ADULTS OF THE CONSEQUENCES ASSOCIATED WITH PURCHASING ALCOHOL FOR MINORS.PARTNERS FOR HEALTHIER COMMUNITIES FUNDED 2 $250 MINI-GRANTS TO AREA YOUTH GROUPS TO WORK ON ANTI-TOBACCO MESSAGING AND ADVOCACY PROJECTS. PHC STAFF WORKED WITH THE GROUPS TO DETERMINE PROJECT AND PROVIDED EDUCATION AND RESOURCES.PHC COORDINATED PRESENTATION BY DISTRICT TOBACCO COORDINATOR FOR 4 YOUTH GROUPS IN THE SANFORD SCHOOL DISTRICT. COORDINATED 8 CLASSES AT NO CHARGE FOR A TOBACCO CESSATION PROGRAM FOR THE COMMUNITY WITH 24 INDIVIDUALS COMPLETING.THE HMP DIRECTOR CONTRIBUTED TO EDUCATING PHYSICIAN PRACTICES AND/OR PATIENTS ON HEALTHY WEIGHT AWARENESS RESOURCES.THE HMP DIRECTOR CONDUCTED 1 COMMUNITY PRESENTATION RELATED TO SIGNS AND SYMPTOMS OF HEART ATTACK AND STROKE.AS A LET'S GO 5-2-1-0 DISSEMINATION PARTNER, PHC HAS PROVIDED LET'S GO CHILDCARE TOOLKITS TO DAYCARE PROVIDERS AND PEDIATRIC OFFICES, PHC HAS ALSO CONDUCTED 3 TRAININGS FOR CHILDCARE PROVIDERS, ATTENDED QUARTERLY STAKEHOLDERS MEETINGS, ENGAGED SANFORD SCHOOL DISTRICT IN REGISTERING AS "READY" 2 SITES FOR THE UPCOMING SCHOOL YEAR.PHC PARTNERED WITH SANFORD DOWNTOWN LEGACY TO LAUNCH DOUBLE YOUR EBT VALUE FOR FRUIT AND VEGGIE PURCHASES. PHC COLLABORATED WITH YORK DISTRICT PUBLIC HEALTH COUNCIL AND YORK COUNTY EMERGENCY MANAGEMENT TO LAUNCH WELL CHECK REGISTRY.PHC COORDINATED AN OUTREACH PRESENTATION TO YORK DISTRICT SUPERINTENDENTS. AS A RESULT, EACH HEALTHY MAINE PARTNERSHIP WILL BE MEETING ONE-ON-ONE WITH SCHOOL DISTRICTS TO DETERMINE HOW TO BEST COORDINATE PREVENTION EFFORTS ACROSS ALL SCHOOLS IN THE COUNTY. PHC WORKED WITH AN AREA FOOD PANTRY TO CREATE HEALTH RELATED INFORMATION PACKETS FOR CLIENTS AND ALSO ASSISTED WITH PLANNING A COMMUNITY OPEN HOUSE.THE HEALTH PREVENTION COORDINATOR CONTRIBUTED 40 HOURS TO COORDINATING THE DEVELOPMENT OF BRIDGE TO HOME HEALTH LITERACY PROGRAM WITH ROTARY, GOODALL HOSPITAL, AND LITERACY VOLUNTEERS. THE HEALTH PREVENTION COORDINATOR COORDINATED AND/OR PARTICIPATED IN THE MANY PARENTAL INFORMATION NIGHTS RELATED TO SUBSTANCE ABUSE PREVENTION INCLUDING IN PARTNERING WITH THE SANFORD AND YORK COUNTY SHERIFF DEPARTMENT IN CONDUCTING COMPLIANCES WITH ALCOHOL SALES.
	PART II LINE 8:	PARTNERS FOR HEALTHIER COMMUNITIES PROVIDED WORKSITE WELLNESS TRAINING WITH THE WABAN ORGANIZATION AS WELL AS HOSTED "SAFE AND RESPONSIBLE BEVERAGE SELLER / SERVER TRAINING" PROGRAMS THROUGHOUT THE YEAR.
		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. PARTNERS FOR HEALTHIER COMMUNITIES HAVE FACILITATED STRATEGIC PLANNING PROCESSES IN THE SANFORD, WATERBORO, AND SACOPEE VALLEY COMMUNITIES. THE HMP DIRECTOR HAS DEDICATED 40 HOURS TO THIS COMPONENT OF THE COMMUNITY NEEDS PROCESS. THE HMP PREVENTION COORDINATOR HAS DEDICATED 12 HOURS TO THE PROCESS. THE HMP HEALTH PROMOTION COORDINATOR HAS DEDICATED 12 HOURS TO THE PROCESS. THE COMMUNITIES ARE CURRENTLY IN THE ACTION PLANNING PHASE.PHC HAS WORKED WITH COMMUNITY ADVISORS TO CREATE A VISION FOR MOBILIZING AN ELEVEN TOWN SERVICE AREA. BASED ON THIS CONVERSATION, PHC HAS WORKED TO MOBILIZE OR PARTNER WITH EXISTING TASKFORCES IN 3 REGIONS OF THE SERVICE AREA. RECENT MONTHS HAVE BEEN SPENT RECRUITING ADVISORY BOARD MEMBERS.PHC IS COLLABORATING WITH THE TOWN OF SANFORD AND SAFE SCHOOLS HEALTHY SANFORD TO MOBILIZE THE SAFE AND HEALTHY SANFORD COALITION. AS A RESULT, THE TOWN WAS AWARDED A DRUG FREE COMMUNITIES GRANT OF $625,000 OVER A 5 YEAR PERIOD TO ADDRESS YOUTH SUBSTANCE ABUSE PREVENTION EFFORTS.THE HMP PREVENTION COORDINATOR HAS CONTRIBUTED 32 HOURS TO GRANT WRITING AND PLANNING IN THE SANFORD COMMUNITY AND ALSO SERVED AS A LEADER IN SECURING THE DRUG FREE COMMUNITIES GRANT.PHC CONDUCTED AN ASSESSMENT OF GAPS IN SUPPORT GROUP RESOURCES AND WORKED WITH 211 TO UPDATE THE DATABASE. STROKE HAS BEEN IDENTIFIED AS A GAP TO ADDRESS.
		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. COMMON TYPES OF ASSISTANCE, IN ADDITION TO ADVOCACY, MAY INCLUDE: MEDICARE D ENROLLMENT; ADVANCE DIRECTIVE PLANNING; ASSISTANCE AND EDUCATION IN PREVENTING FRAUD, EXPLOITATION, AND ABUSE; CONNECTION TO RESOURCES FOR TRANSPORTATION, HOME HEALTH CARE, MEALS, ETC. THE SENIOR ADVOCATE PROGRAM RECEIVED 2,232 INQUIRIES FOR ASSISTANCE THROUGHOUT THE YEAR WITH THE FOLLOWING BREAKDOWN BY CONCERN TYPE (MEDICARE D 20%, INSURANCE 20%, FINANCE ASSIST 15%, OTHER 45%). THE OTHER CONCERN TYPES INCLUDE THE FOLLOWING SUBJECT AREAS (POA/GUARDIANSHIP, FUEL ASSISTANCE, DENTAL, VISION, VA BENEFITS, TRANSPORTATION, HOUSING, SOCIAL SECURITY, DISABILITY, PAPERWORK, DME AND MEDICAL SUPPLIES, SNOW REMOVAL, PLACEMENT, HOME CARE, HOME REPAIR, FOOD RESOURCES, ADV. DIRECTIVES, ETC.). 107 FAMILIES WERE PROVIDED INFORMATION BY THE MAINE FAMILIES PROGRAM ON 144 COMMUNITY EVENTS AND AREA RESOURCES FOR A TOTAL OF 529 REFERRALS.MFYC HELD THE FOLLOWING EVENTS TO HELP LINK FAMILIES WITH OTHER FAMILIES THAT ARE EXPERIENCING SIMILAR LIFE CIRCUMSTANCES WITH RAISING CHILDREN. BREASTFEEDING SUPPORT, NUTRITION, SHAKEN BABY SYNDROME PREVENTION, HOME SAFETY AND LEAD POISONING RISK. THIS PROGRAM PROVIDED 1,377 VISITS WITH 129 FAMILIES IN THE COMMUNITY HEALTH IMPROVEMENT SERVICES, AND SERVES TO CREATE A NATURAL SUPPORT SYSTEM FOR YOUNG FAMILIES.RXASSIST PROGRAM - THE PRESCRIPTION ASSISTANCE PROGRAM PROVIDES HELP TO THOSE WHO CURRENTLY DO NOT HAVE PRESCRIPTION COVERAGE AND HAVE DIFFICULTY AFFORDING THEIR MEDICINES. THE PROGRAM IS DESIGNED TO ASSIST THOSE WHO DO NOT QUALIFY FOR OTHER TRADITIONAL ASSISTANCE PROGRAMS SUCH AS MEDICARE D OR MAINE CARE, BUT WHOSE FINANCIAL SITUATION QUALIFIES THEM TO RECEIVE SUPPORT. FREE OR LOW-COST PRESCRIPTION DRUGS CAN BE OBTAINED DIRECTLY FROM PHARMACEUTICAL COMPANIES IF ELIGIBILITY GUIDELINES ARE MET. THE HOSPITAL RECEIVED 214 APPLICATION REQUESTS FOR SUBMISSION TO THE APPROPRIATE PHARMACEUTICAL PRESCRIPTION ASSISTANCE PROGRAMS, COMPLETED 824 CLIENT CONTACTS, PROCESSED 1645 PRESCRIPTIONS, AND SAVED $836,513 FOR CLIENTS SERVED THROUGH THIS PROGRAM, DURING THE YEAR.
		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, WITH A POPULATION OF APPROXIMATELY 21,000 WITH AN ELDERLY POPULATION RATE OF 15% AND FAMILIES REPRESENTING 64% OF THIS POPULATION, WITH 93% BEING WHITE CAUCASIAN.THE HOSPITAL'S MEDICAID VOLUME IS 24% AND IS AMONGST THE HIGHEST IN THE STATE AND REFLECTS THE HIGH PERCENTAGE OF FAMILIES WITH THE INCOME LESS THAN 100% OF THE FEDERAL POVERTY LEVEL. SANFORD'S POVERTY RATE IS 17%, WHILE THE STATE OF MAINE IS AT 12%. 72% OF SANFORD'S ELEMENTARY SCHOOL CHILDREN ARE ELIGIBLE TO RECEIVE FREE OR SUBSIDIZED MEALS.SANFORD'S UNEMPLOYMENT RATE OF 10% EXCEEDS THE STATE'S OVERALL UNEMPLOYMENT RATE OF 8%. SANFORD HAS BEEN DESIGNATED AS A MEDICALLY UNDERSERVICED AREA.
		PART VI, LINE 6: GOODALL HOSPITAL PROVIDES NUMEROUS EDUCATIONAL CLASSES FOR THE COMMUNITIES IT SERVICES. THE ORGANIZATION PREPARES A QUARTERLY FLYER CALLED THE "COMMUNITY EDUCATION CALENDAR". THIS LISTING PROVIDES THE EDUCATIONAL SEMINARS THAT ARE OPEN FOR FREE PUBLIC PARTICIPATION. THESE SEMINARS ARE HELD ON MOST EVENINGS (FOR EASE OF COMMUNITY PARTICIPATION) AND ARE TYPICALLY 1 1/2 HOURS IN DURATION. THE SEMINARS ARE LED BY KNOWLEDGEABLE GOODALL PROFESSIONALS WHO ARE TRAINED AND EDUCATED IN THE SPECIFIC AREAS. THE EVENTS INCLUDE THE FOLLOWING AREAS: SPORTS MEDICINE, ALCOHOL AWARENESS, FUN WITH FRUITS & VEGGIES, WATER AEROBICS, WEIGHT MANAGEMENT, MEDICATION REVIEWS, DIABETES, BLOOD PRESSURE CHECKS AND MANY MORE.
		PART VI, LINE 7: N/A
REPORTS FILED WITH STATES	PART VI, LINE 7	ME

Schedule H (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

HENRIETTA D GOODALL HOSPITAL INC

Employer identification number

01-0078060

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported in prior Form 990 or Form 990-EZ
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) DARLENE STROMSTAD	(i) (ii)	356,547 0	60,000 0	0 0	2,278 0	11,357 0	430,182 0	0 0
(2) PATRICIA APRILE	(i) (ii)	197,138 0	3,349 0	0 0	1,216 0	17,818 0	219,521 0	0 0
(3) RONALD BRYANT	(i) (ii)
(4) CHARLES CARUSO	(i) (ii)	161,469 0	0 0	0 0	861 0	21,191 0	183,521 0	0 0
(5) DANIEL FORGUES	(i) (ii)
(6) KATHLEEN MORRIS MD	(i) (ii)	197,940 0	0 0	0 0	2,460 0	10,353 0	210,753 0	0 0
(7) MUKESH BHARGAVA MD	(i) (ii)	150,127 0	0 0	0 0	0 0	0 0	150,127 0	0 0
(8) ADAM SCHLAGER	(i) (ii)
(9) FRANK GOUDREAU	(i) (ii)	444,944 0	0 0	0 0	2,209 0	24,607 0	471,760 0	0 0
(10) JOHNATHAN SHILL	(i) (ii)	287,328 0	6,543 0	0 0	2,530 0	11,244 0	307,645 0	0 0
(11) KENT HALL	(i) (ii)	254,627 0	92,513 0	0 0	1,873 0	18,782 0	367,795 0	0 0
(12) NINA SHERVIN	(i) (ii)	371,205 0	25,000 0	0 0	288 0	16,008 0	412,501 0	0 0
(13) JOHN THOMPSON	(i) (ii)	413,702 0	0 0	0 0	2,160 0	23,850 0	439,712 0	0 0

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation

Schedule J (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
HENRIETTA D GOODALL HOSPITAL INC

Employer identification number
01-0078060

Part I

Bond Issues

(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	(g) Defeased		(h) On Behalf of Issuer		(i) Pool financing
(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	Yes	No	Yes	No	Yes	No
A	MAINE HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY	01-0314384	560425D49	09-07-2006	6,020,317	RENOVATE HOSPITAL AND PURCHASE EQUIPMENT		X		X		X
B	MAINE HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY	01-0314385	560425H37	07-18-2007	5,108,908	REFINANCE MHHEFA REVENUE BOND 1996A		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired. . . . .
2 Amount of bonds defeased . . . .
3 Total proceeds of issue . . . .	6,470,000		78,484
4 Gross proceeds in reserve funds . .	522,453		451,093
5 Capitalized interest from proceeds.
6 Proceeds in refunding escrow. . . . .
7 Issuance costs from proceeds . . .	82,639		78,484
8 Credit enhancement from proceeds.
9 Working capital expenditures from proceeds . .
10 Capital expenditures from proceeds . .	5,836,740
11 Other spent proceeds . .
12 Other unspent proceeds. . .	293,000
13 Year of substantial completion . . .	2007
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue?		X		X
15 Were the bonds issued as part of an advance refunding issue?		X	X
16 Has the final allocation of proceeds been made? . .	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .	X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .		X		X

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2010

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use?		X		X
b Are there any research agreements that may result in private business use of bond-financed property? . .		X		X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . .	0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .	0 %		0 %
6 Total of lines 4 and 5 . . .. . . . . .	0 %		0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities?		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .		X		X
2 Is the bond issue a variable rate issue?		X		X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?		X		X
b Name of provider .
c Term of hedge . .
d Was the hedge superintegrated? .
e Was a hedge terminated? .
4a Were gross proceeds invested in a GIC? .		X		X
b Name of provider .
c Term of GIC . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .
5 Were any gross proceeds invested beyond an available temporary period? .		X		X
6 Did the bond issue qualify for an exception to rebate? . . .		X		X

Schedule K (Form 990) 2010

Page 3

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule K (see instructions).

Identifier	Return Reference	Explanation

Schedule K (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

HENRIETTA D GOODALL HOSPITAL INC

Employer identification number

01-0078060

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(b) Description of transaction	(c) Corrected?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.

(a) Name of interested person and purpose	(b) Loan to or from the organization?		(c)Original principal amount	(d)Balance due	(e) In default?		(f) Approved by board or committee?		(g)Written agreement?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No
(1) PETER G BOOTH TO PROVIDE RETIREMENT FUNDS VIA A SPLIT DOLLAR LIFE INSURANCE POLICY		X	851,677	851,677		No	Yes		Yes





Total ............... $				851,677

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b)Relationship between interested person and the organization	(c)Amount of grant or type of assistance

For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2010

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) MARK MICKERIZ	CHAIR OF GOODALL'S BOARD AND PRESIDENT OF SANFORD INSTITUTE FOR SAVINGS	4,623,278	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, 2011, THE REMAINING BALANCE ON THE LOANS WERE $4,623,278.		No
(2) WEBER SHILL	FORMER OWNER OF TMG	1,405,483	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, 2011, THE REMAINING BALANCE OF THE LOAN WAS $1,405,483.		No
(3) WILLIAM FRANK	CHAIR OF THE FINANCE COMMITTEE	18,675	GOODALL HOSPITAL CONTRACTS WITH DR. FRANK TO PERFORM VARIOUS DUTIES AT THE HOSPITAL, SUCH AS ON CALL, IMPACT COVERAGE, AND SOME COMMITTEES.		No

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule L (see instructions).

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

HENRIETTA D GOODALL HOSPITAL INC

Employer identification number

01-0078060

Identifier	Return Reference	Explanation
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. DARLENE STROMSTAD CAN BE REACHED AT 377 THREE MILE HILL ROAD, MIDDLEBURY, CT 06762 AND RON BRYAN CAN BE REACHED AT 59 STONE ROAD, KENNEBUNKPORT, ME 04046, (207) 967-2383
	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.
DESCRIPTION OF BOND ISSUE PRICE	SCHEDULE K, PART I, COLUMN E	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.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 102,480. RELEASES FROM TEMPORARILY RESTRICTED NET ASSETS -20,379. INCREASE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS 1,464,292. UNREALIZED GAIN ON SECURITIES 1,289,715. OTHER CHANGES IN NET ASSETS -3,686. RESTRICTED CONTRIBUTIONS 48,564. TOTAL TO FORM 990, PART XI, LINE 5: 2,880,986.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

HENRIETTA D GOODALL HOSPITAL INC

Employer identification number

01-0078060

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(f) Direct controlling entity
(1) GOODALL HOSPITAL REAL ESTATE HOLDING COMPANY LLC 25 JUNE STREET SANFORD,ME04073 01-0078060	REAL ESTATE HOLDING COMPANY	ME	HENRIETTA D GOODALL HOSPITAL INC
(2) WATERBORO MEDICAL OFFICE BUILDING LLC 25 JUNE STREET SANFORD,ME04073 01-0078060	REAL ESTATE HOLDING COMPANY	ME	HENRIETTA D GOODALL HOSPITAL INC
(3) GOODALL HOSPITAL MEDICAL OFFICE BUILDING LLC 25 JUNE STREET SANFORD,ME04073 01-0078060	REAL ESTATE HOLDING COMPANY	ME	HENRIETTA D GOODALL HOSPITAL INC

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) MANOR AT PHILLIPSTOWN PLACE INC 25 JUNE STREET SANFORD,ME04073 01-0473857	PROVIDE CARE TO THE ELDERLY	ME	501(C)(3)	9	HENRIETTA D GOODALL HOSPITAL INC		No

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2010

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership
(1) JUNE STREET PHARMACY LLC 25 JUNE STREET SANFORD,ME04073 02-0765952	PROVIDE PHARMACY SERVICES TO THE COMMUNITY.	ME	HENRIETTA D GOODALL HOSPITAL INC	C	159,515	860,011	100.000 %

Schedule R (Form 990) 2010

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

Yes

b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1) JUNE STREET PHARMACY LLC	A	55,388	ACTUAL INTEREST CHARGED
(2) JUNE STREET PHARMACY LLC	I	934,673	ACTUAL COSTS INCURRED
(3) MANOR AT PHILLIPSTOWN PLACE INC	P	311,620	ACTUAL COSTS INCURRED
(4) JUNE STREET PHARMACY LLC	N	18,000	ACTUAL COSTS INCURRED
(5) MANOR AT PHILLIPSTOWN PLACE INC	N	36,000	ACTUAL COSTS INCURRED
(6) JUNE STREET PHARMACY LLC	E	424,708	ACTUAL PRINCIPAL DUE

Schedule R (Form 990) 2010

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Are all partners section 501(c)(3) organizations?		(e) Share of end-of-year assets	(f) Disproprtionate allocations?		(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2010

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: HENRIETTA D. GOODALL HOSPITAL, INC.'S MISSION IS TO SERVE AS A LEADER IN IMPROVING THE HEALTH AND WELL-BEING OF ITS COMMUNITY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	10
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	1,052
6	Total number of volunteers (estimate if necessary) ....	6	83
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	637,980
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	44,607

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,551,088	886,119
9	Program service revenue (Part VIII, line 2g) .........	78,388,437	84,756,137
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	505,858	392,370
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	935,761	480,981
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	81,381,144	86,515,607
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	44,020,030	48,293,479
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 44,466
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	36,806,772	38,067,590
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	80,826,802	86,361,069
19	Revenue less expenses. Subtract line 18 from line 12......	554,342	154,538
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	84,336,393	87,795,787
21	Total liabilities (Part X, line 26)............	37,018,987	37,442,858
22	Net assets or fund balances. Subtract line 21 from line 20 .....	47,317,406	50,352,929

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 52,959,453 including grants of $ ) (Revenue $ 63,567,757 )
	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, CLINICAL AND REHABILITATION SERVICES, WELLNESS EDUCATION, SUPPORT GROUPS AND OTHER COMMUNITY OUTREACH PROGRAMS. GOODALL HOSPITAL HAS HAD 21,684 EMERGENCY ROOM VISITS, 48,669 RADIOLOGY PROCEDURES, 389,153 LABORATORY PROCEDURES, 67,687 THERAPY PROCEDURES, 190 INFANTS BORN AND 2,585 SURGERY CASES. GOODALL HOSPITAL PROVIDED $1,457,760 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 EDUCATIONAL AND INFORMATIONAL 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.

4b	(Code: ) (Expenses $ 8,360,604 including grants of $ ) (Revenue $ 8,382,439 )
	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, WOMEN' HEALTH, INTERNAL MEDICINE, PEDIATRICS, ORTHO AND GENERAL SURGERY. THE NUMBER OF PATIENTS SEEN WERE 14,709 FOR A TOTAL NUMBER OF VISITS OF 54,019.

4c	(Code: ) (Expenses $ 6,550,394 including grants of $ ) (Revenue $ 7,957,160 )
	GOODALL HOSPITAL ELDERCARE SERVICES PROVIDE LONG-TERM CARE, MEDICAL SERVICES AND DAYCARE TO OUR SENIOR CITIZENS. ELDERCARE HAD ADMITTED 303 RESIDENTS FOR A TOTAL OF 39,025 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 AND INVOLVEMENT MAKE THIS PROGRAM SPECIAL.

	(Code: ) (Expenses $ 6,642,193 including grants of $ ) (Revenue $ 5,434,037 )
	THE MEDICAL GROUP CONSISTS OF MANY PHYSICIANS WITH MULTI-SPECIALTY SERVICES THAT EXTEND GOODALL HOSPITAL'S EXISTING SERVICES TO KENNEBUNK, ME. THESE PHYSICIANS COMPLEMENT 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 9,179 FOR A TOTAL NUMBER OF VISITS OF 35,315.

4d	Other program services. (Describe in Schedule O.)
	(Expenses $ 6,642,193 including grants of $ ) (Revenue $ 5,434,037 )
4e	Total program service expenses$ 74,512,644

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,183,776	0	186,186

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e		697,353

f	All other contributions, gifts, grants, and similar amounts not included above1f		188,766
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			886,119
			Business Code
2a	NET PATIENT SERVICE RE		900,099	84,756,137	84,119,202	636,935
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			84,756,137
3	Investment income (including dividends, interest
	and other similar amounts).....			565,661			565,661
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross Rents	714,880
b	Less: rental expenses	1,255,642
c	Rental income or (loss)	-540,762
d	Net rental income or (loss).......			-540,762	-540,762
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	1,082,611	7,248
b	Less: cost or other basis and sales expenses	1,241,441	21,709
c	Gain or (loss)	-158,830	-14,461
d	Net gain or (loss)..........			-173,291			-173,291
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a	REBATE REVENUE		900,099	426,703	426,703
b	CAFETERIA REVENUE		900,099	252,318	252,318
c	MISCELLANEOUS REVENUE		900,099	243,996	243,996
d	All other revenue ....			98,726	97,681	1,045
e	Total. Add lines 11a–11d ......			1,021,743
12	Total revenue. See Instructions....			86,515,607	84,599,138	637,980	392,370


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			5,185	1	5,575
2	Savings and temporary cash investments .......			5,414,641	2	3,451,617
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			7,753,284	4	9,577,350
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			851,677	5	851,677
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			1,535,788	8	1,481,101
9	Prepaid expenses and deferred charges ............			2,094,494	9	1,548,569
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	73,409,727
b	Less: accumulated depreciation. .....	10b	39,582,301	34,628,970	10c	33,827,426
11	Investments—publicly traded securities ..........			8,087,521	11	12,582,059
12	Investments—other securities. See Part IV, line 11 ......			12,710,758	12	14,607,527
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			11,254,075	15	9,862,886
16	Total assets. Add lines 1 through 15 (must equal line 34)...			84,336,393	16	87,795,787
17	Accounts payable and accrued expenses .			12,651,004	17	13,116,998
18	Grants payable ..........				18
19	Deferred revenue ..........				19
20	Tax-exempt bond liabilities ..........			11,814,439	20	10,610,766
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			12,061,491	23	12,924,027
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities. Complete Part X of Schedule D.....			492,053	25	791,067
26	Total liabilities. Add lines 17 through 25.....			37,018,987	26	37,442,858
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			36,953,692	27	38,397,945
28	Temporarily restricted net assets .....			1,451,392	28	1,572,577
29	Permanently restricted net assets .....			8,912,322	29	10,382,407
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			47,317,406	33	50,352,929
34	Total liabilities and net assets/fund balances .....			84,336,393	34	87,795,787