KATAHDIN VALLEY HEALTH CENTER: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- KATAHDIN VALLEY HEALTH CENTER (EIN 23-7411014)
- Tax period
- 2021-04-01 to 2022-03-31
- Filed
- 2022-07-11
- IRS object ID
- 202221929349301422
- Schema version
- 2021v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-07-11T14:42:25-05:00 | ReturnTs |
| Tax Period End | 2022-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010411241 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHESTER M KEARNEY PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1550 | AddressLine1Txt |
| City | PRESQUE ISLE | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04769 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237411014 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KATAHDIN VALLEY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | KATA | BusinessNameControlTxt |
| Phone | 2075383700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 529 SOUTH PATTEN ROAD | AddressLine1Txt |
| City | PATTEN | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04765 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHRISTINE NICKERSON | PersonNm |
| Person Title | BOARD CHAIR | PersonTitleTxt |
| Phone | 2075282285 | PhoneNum |
| Signature | 2022-06-08 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CHRISTINE | PersonFirstNm |
| Person Last | NICKERSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TIMOTHY P POITRAS | PreparerPersonNm |
| PTIN | P00542788 | PTIN |
| Phone | 2077643171 | PhoneNum |
| Preparation | 2022-07-11 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHRISTINE NICKERSON | PrincipalOfficerNm |
| Gross Receipts | $25,947,619 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.KVHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Activity Or Mission | THE PURPOSE OF THE ORGANIZATION IS TO PROVIDE MEDICAL, DENTAL AND OTHER HEALTH CARE SERVICES TO INDIVIDUALS IN THE AREAS OF PATTEN, MILLINOCKET, BROWNVILLE, ASHLAND, ISLAND FALLS, LINCOLN, DOVER AND HOULTON, MAINE AREAS. IT IS A FEDERALLY QUALIFIED HEALTH CENTER. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 329 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $8,258,183 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,415,526 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $16,128,029 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,527,045 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,675 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,048 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $24,390,887 | PYTotalRevenueAmt |
| CY Total Revenue | $25,947,619 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $14,448,835 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,423,021 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,974,670 | PYOtherExpensesAmt |
| CY Other Expenses | $5,220,215 | CYOtherExpensesAmt |
| PY Total Expenses | $19,423,505 | PYTotalExpensesAmt |
| CY Total Expenses | $21,643,236 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,967,382 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,304,383 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $31,606,827 | TotalAssetsBOYAmt |
| Total Assets EOY | $35,547,578 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,558,087 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,194,455 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,048,740 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,353,123 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE PURPOSE OF THE ORGANIZATION IS TO PROVIDE MEDICAL, DENTAL AND OTHER HEALTH CARE SERVICES TO INDIVIDUALS IN THE AREAS OF PATTEN, MILLINOCKET, BROWNVILLE, ASHLAND, ISLAND FALLS, LINCOLN, DOVER AND HOULTON, MAINE AREAS. IT IS A FEDERALLY QUALIFIED HEALTH CENTER. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $14,476,432 | ExpenseAmt |
| Revenue | $17,527,045 | RevenueAmt |
| Desc | THE CENTER PROVIDES HEALTH CARE SERVICES FOR THE PEOPLE OF ALL AGES FROM THE SURROUNDING AREA, CENTRAL AND NORTHERN MAINE. | Desc |
| Total Program Service Expenses | $14,476,432 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 22 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 329 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CLAUDETTE HUMPHREY | PersonNm |
| Phone | 2075383700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 529 SOUTH PATTEN ROAD | AddressLine1Txt |
| City | PATTEN | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04765 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| CLAUDETTE HUMPHREY | |||||||
| CEO | 50.00 | Yes (X) | $315,874 | $0 | $33,271 | ||
| JEAN HAMLIN | |||||||
| PHYSICIAN | 40.00 | $221,720 | $0 | $34,261 | Yes (X) | ||
| MARTHA STEWART DO | |||||||
| DOCTOR | 40.00 | $212,129 | $0 | $38,974 | Yes (X) | ||
| LISA NIELSEN | |||||||
| DOCTOR | 40.00 | $206,332 | $0 | $28,151 | Yes (X) | ||
| ERIK JOHNSON DMD | |||||||
| DENTIST | 40.00 | $196,749 | $0 | $11,171 | Yes (X) | ||
| NICKI LARRABEE | |||||||
| MEDICAL DIRE | 40.00 | $167,903 | $0 | $32,671 | Yes (X) | ||
| RAYE PORTER | |||||||
| CFO | 40.00 | Yes (X) | $172,395 | $0 | $14,476 | ||
| RHONDA BROPHY | |||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| KATHLEEN CASE | |||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| JOHN DOE | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ELIZABETH DULIN | |||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| FRED GRANT | |||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| RACHEL HALE | |||||||
| TREASURER( T | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| BRANDI J MOORE | |||||||
| TREASUER (EF | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CHRISTINE NICKERSON | |||||||
| BOARD CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JASON J PARENT | |||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| CHAD PERKINS | |||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ALICIA M STONE | |||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,493,102 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $192,975 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ATHENA HEALTH | |||||
| 311 ARSENAL ST | WATERTOWN | MA | 02472 | CLAIMS | $700,135 |
| HALEY WARD | |||||
| MERCHANTES PLAZA SUITE 701 | BANGOR | ME | 04401 | ENGINEERING | $494,897 |
| BOWMAN CONSTRUCTORS | |||||
| 552 MOOSHEAD TRAIL | NEWPORT | ME | 04953 | CONTRACTOR | $151,591 |
| BARTON ASSOCIATES | |||||
| 300 JUBILEE DR | PEABODY | MA | 01960 | LOCUMS | $131,708 |
| VERRILL DANA LLP | |||||
| ONE PORTLAND SQUARE | PORTLAND | ME | 04101 | LEGAL | $111,049 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $8,415,526 | GovernmentGrantsAmt |
| Noncash Contributions | $402,883 | NoncashContributionsAmt |
| Total Contributions | $8,415,526 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| MEDICAL FEES | $13,629,614 | $13,629,614 |
| PHARMACY REVENUE | $2,527,629 | $2,527,629 |
| 340B PROGRAM | $568,162 | $568,162 |
| PCMH INCENTIVES | $513,249 | $513,249 |
| OTHER REVENUE | $288,391 | $288,391 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,527,045 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,048 | TotalRevenueColumnAmt |
| Exclusion | $5,048 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,947,619 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,527,045 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $5,048 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,991,278 | TotalAmt |
| Program Services | $9,171,478 | ProgramServicesAmt |
| Management And General | $4,819,800 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,431,743 | TotalAmt |
| Program Services | $1,429,555 | ProgramServicesAmt |
| Management And General | $1,002,188 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $614,003 | TotalAmt |
| Program Services | $378,737 | ProgramServicesAmt |
| Management And General | $235,266 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,951 | TotalAmt |
| Program Services | $309 | ProgramServicesAmt |
| Management And General | $11,642 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,863 | TotalAmt |
| Program Services | $1,640 | ProgramServicesAmt |
| Management And General | $95,223 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,596 | TotalAmt |
| Program Services | $310,268 | ProgramServicesAmt |
| Management And General | $110,328 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $156,539 | TotalAmt |
| Program Services | $77,491 | ProgramServicesAmt |
| Management And General | $79,048 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $424,990 | TotalAmt |
| Program Services | $424,990 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,092,157 | TotalAmt |
| Program Services | $889,144 | ProgramServicesAmt |
| Management And General | $203,013 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,371 | TotalAmt |
| Program Services | $54,061 | ProgramServicesAmt |
| Management And General | $54,310 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DATA PROCESSING | $764,244 | $724,700 | $39,544 |
| SUPPLIES | $698,892 | $666,185 | $32,707 |
| PROFESSIONAL DUES & FEES | $382,908 | $248,705 | $134,203 |
| 340B PROGRAM COSTS | $187,776 | $187,776 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $260,925 | TotalAmt |
| Program Services | $99,169 | ProgramServicesAmt |
| Management And General | $161,756 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,643,236 | TotalAmt |
| Program Services | $14,476,432 | ProgramServicesAmt |
| Management And General | $7,166,804 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,794,355 | BOYAmt |
| EOY | $11,464,723 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,457 | BOYAmt |
| EOY | $134,881 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,695,948 | BOYAmt |
| EOY | $2,347,877 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,995 | BOYAmt |
| EOY | $4,069 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,405,169 | BOYAmt |
| EOY | $1,865,573 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $290,655 | BOYAmt |
| EOY | $270,193 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $30,138,822 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,678,560 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,225,248 | BOYAmt |
| EOY | $19,460,262 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,606,827 | BOYAmt |
| EOY | $35,547,578 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,132,633 | BOYAmt |
| EOY | $1,274,654 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,425,454 | BOYAmt |
| EOY | $10,919,801 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,558,087 | BOYAmt |
| EOY | $12,194,455 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,048,740 | BOYAmt |
| EOY | $23,353,123 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,048,740 | BOYAmt |
| EOY | $23,353,123 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,606,827 | BOYAmt |
| EOY | $35,547,578 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,304,383 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,379,543 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,817,792 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,455,107 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,258,183 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,415,526 | CurrentTaxYearAmt |
| Total | $31,326,151 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,379,543 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,817,792 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,455,107 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,258,183 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,415,526 | CurrentTaxYearAmt |
| Total | $31,326,151 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $31,326,151 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,175 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $17,333 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23,385 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,675 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,048 | CurrentTaxYearAmt |
| Total | $54,616 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $31,380,767 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $71,199,677 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99830 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99820 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $968,725 | OtherCostOrOtherBasisAmt |
| Book Value | $968,725 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,732,486 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,315,385 | DepreciationAmt |
| Book Value | $18,417,101 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,437,611 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,363,175 | DepreciationAmt |
| Book Value | $74,436 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $19,460,262 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $25,947,619 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $25,947,619 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $25,947,619 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $21,643,236 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $21,643,236 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $21,643,236 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|
| CLAUDETTE HUMPHREY | |||||
| CEO | $275,740 | $40,134 | $19,500 | $13,771 | $349,145 |
| JEAN HAMLIN | |||||
| PHYSICIAN | $220,588 | $1,132 | $19,500 | $14,761 | $255,981 |
| MARTHA STEWART DO | |||||
| DOCTOR | $210,900 | $1,229 | $26,000 | $12,974 | $251,103 |
| LISA NIELSEN | |||||
| DOCTOR | $205,343 | $989 | $19,500 | $8,651 | $234,483 |
| ERIK JOHNSON DMD | |||||
| DENTIST | $195,591 | $1,158 | $4,500 | $6,671 | $207,920 |
| NICKI LARRABEE | |||||
| MEDICAL DIRECTOR | $156,179 | $11,724 | $19,500 | $13,171 | $200,574 |
| RAYE PORTER | |||||
| CFO | $161,291 | $11,104 | $8,702 | $5,774 | $186,871 |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | PPE | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $402,883 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | THE PURPOSE OF THE ORGANIZATION IS TO PROVIDE MEDICAL, DENTAL AND OTHER HEALTH CARE SERVICES TO INDIVIDUALS IN THE AREAS OF PATTEN, MILLINOCKET, BROWNVILLE, ASHLAND, ISLAND FALLS, LINCOLN, DOVER AND HOULTON, MAINE AREAS. IT IS A FEDERALLY QUALIFIED HEALTH CENTER. |
| FORM 990, PAGE 6, PART VI, LINE 2 | BRANDI MOORE BANGOR SAVINGS BANK TRUSTEE BANKING RELATIONSHIP ALICIA STONE BANGOR SAVINGS BANK TRUSTEE BANKING RELATIONSHIP FRED GRANT WHOU TRUSTEE ADVERTISING RELATIONSHIP |
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS REVIEWED AND APPROVED BY BOARD PRIOR TO SUBMISSION. |
| FORM 990, PAGE 6, PART VI, LINE 12C | IF A CONFLICT EXISTS, CHANNELS ARE PRESCRIBED BY ENTITY POLICY. |
| FORM 990, PAGE 6, PART VI, LINE 15A | REVIEWED BY COMPENSATION COMMITTEE AND APPROVED BY THE EXECUTIVE BOARD AND FULL BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SAME PROCESS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | AVAILABLE UPON REQUEST. |