2022-06-01T05:39:12-05:00 2021-12-31 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2021-01-01 010376890 Pines Health Services PINE 2074982356 PO Box 40 Caribou ME 04736 Kris Doody Chief Executive Officer 2074982356 2022-05-27 1 Kris Doody 999009999 Joseph R Byrne P01289281 2077752387 2022-05-27 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z Kris Doody PO Box 40 Caribou ME 04736 25489346 0 X www.pineshealth.org X 1981 ME Group of health centers serving northern Maine. Six of the centers have FQHC designation. 9 9 171 10 0 0 5604370 5403590 17336455 20083770 2090 1986 0 0 22942915 25489346 0 0 0 0 16678137 17044679 0 0 0 6237882 7426267 22916019 24470946 26896 1018400 7947806 7660342 3318643 2012779 4629163 5647563 X Multi-specialty outpatient healthcare organization, promoting the development of quality health care, health care services and the development and operation of related activities necessary to encourage quality health care in Aroostook County. 0 0 6790222 5952147 Family Practice Services provide general care to families. The services are performed by physicians, physician assistants, and family nurse practitioners. The services have been provided since the date of inception. 403257 217332 Internal Medicine Services provide internal medicine to patients with more severe medical complications. The services are performed by physicians. The services have been provided since the date of inception. 2884176 2021134 Obstetrical and gynecological services are provided to female patients. These services are performed by physicians & Certified Nurse Midwives. The services have been provided since the date of inception. 11774450 11893157 Various other medical services provided to patients. 11774450 11893157 21852105 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 38 0 1 171 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Brandon Caverhill 2074982356 PO Box 40 Caribou ME 04736 Norm Collins Chair 1.00 X X 0 0 0 Tanya Sleeper Vice Chair 1.00 X X 0 0 0 Stev Rogeski Secretary 1.00 X X 0 0 0 Dana Rattray Treasurer 1.00 X X 0 0 0 Chelsea Desrosiers Director 1.00 X 0 0 0 Diane Gove Director 1.00 X 0 0 0 Betty Hatch Director 1.00 X 0 0 0 Jon Holabird Director 1.00 X 0 0 0 Kristie Moir Director 1.00 X 0 0 0 John Deveau Past Director 1.00 X 0 0 0 Kris Doody Chief Executive Officer 40.00 X 370688 0 17708 Lisa Caron Chief Operating Officer 40.00 X 113825 0 19274 Jean-Pierre Michaud Orthopedic Surgeon 40.00 X 735594 0 16407 Robert Bassett Orthopedic Surgeon 40.00 X 533885 0 30831 John Karod Urologist 40.00 X 515355 0 26078 Michael Porter Pathologist 40.00 X 492197 0 21478 Carl Flynn Family Physician 40.00 X 480821 0 24129 3242365 0 155905 35 0 1 0 Hayes Locums LLC PO Box 88122 Chicago IL 606801122 Locum Physician Staffing 731552 Dr Julio Arebalo 10372 NW 31st Terrace Doral FL 33172 General Surgeon 411600 Dr Alvin Wycoco 31464 Polo Creek Drive Temecula CA 92591 Hospitalist 328112 Dr Beril Bayrak 23 Heritage Drive Lexington MA 024201104 Pediatrician 130910 CompHealth Inc PO Box 972651 Dallas TX 753972651 Locum Physician Staffing 120588 5 4653590 750000 5403590 Patient Service Rev. 621110 21823277 21823277 Income Guarantee 621110 5025597 5025597 Bad Debt Expense 621110 -1844846 -1844846 Contractual/Char. Adj. 621110 -4920258 -4920258 20083770 1986 1986 25489346 20083770 0 1986 X 521495 521495 14116582 13860324 256258 78849 78599 250 1561419 1486163 75256 766334 724509 41825 3687878 2936393 751485 50542 50542 455643 185126 270517 291333 291333 834735 713346 121389 31573 25407 6166 187220 163209 24011 645021 539028 105993 Medical Supplies 1221691 777495 444196 Relocation 20000 20000 Other 631 631 24470946 21852105 2618841 0 X 2812395 2576268 1063071 975706 750000 750000 2260096 1865821 68834 90883 104694 145437 4771465 3810881 638892 960584 9606 9606 180002 176198 60216 109839 7947806 7660342 883696 954113 0 701173 2434947 357493 3318643 2012779 X 3879163 4897563 750000 750000 4629163 5647563 7947806 7660342 1018400 0 X 0 1 X 1 1 1 X 4312261 4089719 4833499 5604370 5403590 24243439 4312261 4089719 4833499 5604370 5403590 24243439 24243439 5746 3706 2912 2090 1986 16440 24259879 94874941 0.99930 0.99910 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 40025 40025 1520326 1170814 349512 2745466 2640067 105399 465648 465648 960584 Medicare Accelerated Payments 357493 357493 25489346 0 25489346 0 25489346 24470946 0 24470946 0 24470946 X X 0 0 0 0 0 0 0 1 0 Jean-Pierre Michaud Orthopedic Surgeon 711594 0 24000 0 0 0 2750 0 13657 0 752001 0 0 0 Robert Bassett Orthopedic Surgeon 533885 0 0 0 0 0 2750 0 28081 0 564716 0 0 0 John Karod Urologist 503355 0 12000 0 0 0 2750 0 23328 0 541433 0 0 0 Michael Porter Pathologist 392507 0 99690 0 0 0 1297 0 20181 0 513675 0 0 0 Carl Flynn Family Physician 342301 0 138520 0 0 0 2750 0 21379 0 504950 0 0 0 Kris Doody Chief Executive Officer 370688 0 0 0 0 0 2750 0 14958 0 388396 0 0 0 Part I, Line 7 Bonuses paid to providers are contractual agreements between the respective individuals and Pines Health Services. They are determined pursuant to the language within their respective contracts. Dr. Michaud receives a stipend with 2 payrolls per month (a total of 24 per year) for mid-level practitioners sponsorships. He is responsible and oversees their work within his specialty. Dr. Karod receives a stipend with 2 payrolls per month (a total of 24 per year) for mid-level practitioner sponsorship. He is responsible and oversees their work within his specialty. Dr. Porter receives a bonus when he is the only Pathologist working for an entire week. Throughout most of 2021 Dr. Porter was the only Pathologist at Pines. Due to his increased work load a bonus incentive was granted. Dr. Flynn too receives a Mid-Level Practitioner Supervision stipend for each mid-level practitioner that he oversees. He is also given a monthly stipend for his Skilled Nursing Facility Duties. Dr. Flynn also serves as the Medical Director of the Tufts/MaineMed LIC Program and is awarded a monthly stipend in recognition of the expenses incurred through this program. Form 990, Part VI, Section B, line 11b Pines Health Services has its Form 990 reviewed by the board prior to filing. The 990 is given to the CEO for review and forwarded to the Board of Directors to be discussed at a regularly scheduled Board of Directors meeting. If a meeting cannot be held prior to the submission deadline, the Organization forwards the 990 electronically to the Board of Directors for review and comment. Form 990, Part VI, Section B, line 12c Annually, the Board of Directors sign forms indicating there are no conflicts of interest. If a conflict is brought to the board's attention, appropriate action will take place depending on the situation. This includes not allowing the member to vote on issues where there is a conflict, or other actions deemed necessary and appropriate by the board. Form 990, Part VI, Section B, line 15 For executives, the Board Executive Committee will review local market conditions and other factors. Salaries are set using the MGMA annual Physician Compensation & Productivity Survey as a reference. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part IX, line 11g Other Professional Fees: Program service expenses 2,936,393. Management and general expenses 751,485. Fundraising expenses 0. Total expenses 3,687,878. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Pines Health Services PO Box 40 Caribou, ME 04736 EIN: 01-0376890 Pines Health Services is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).