Penobscot Bay Medical Center: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- Penobscot Bay Medical Center (EIN 01-0285286)
- Tax period
- 2018-10-01 to 2019-01-01
- Filed
- 2019-11-13
- IRS object ID
- 201943179349306544
- Schema version
- 2018v3.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-13T14:21:08-06:00 | ReturnTs |
| Tax Period End | 2019-01-01 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010285286 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Penobscot Bay Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PENO | BusinessNameControlTxt |
| Phone | 2075054378 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 287 | AddressLine1Txt |
| City | Belfast | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04915 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Linda Drinkwater | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2075054378 | PhoneNum |
| Signature | 2019-11-12 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 63.247.60.254 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-13 | IPDt |
| IP Tm | 15:18:38 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 829AE4A393A3EE33A28B50D291306587A51708D5 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 829AE4A393A3EE33A28B50D291306587A51708D5 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-01-14 16:20:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
| Principal Officer | Mark Fourre MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 287 | AddressLine1Txt |
| City | Belfast | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04915 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $35,642,137 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | mainehealth.org/pen-bay-medical-center | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1969 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | Penobscot Bay Medical Center (PBMC) is an acute care hospital that offers inpatient and outpatient care, diagnostic, therapeutic and rehabilitative services, patient and community education, and a full range of specialty services through the emergency department, special care unit, surgical services department, obstetrics and gynecology department, and the psychiatric addiction & recovery center. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 20 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 1312 | TotalEmployeeCnt |
| Total Volunteers | 89 | TotalVolunteersCnt |
| Total Gross UBI | $178,066 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $383,260 | PYContributionsGrantsAmt |
| CY Contributions Grants | $46,068 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $119,727,190 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $32,774,473 | CYProgramServiceRevenueAmt |
| PY Investment Income | $67,263 | PYInvestmentIncomeAmt |
| CY Investment Income | $23,770 | CYInvestmentIncomeAmt |
| PY Other Revenue | $10,340,190 | PYOtherRevenueAmt |
| CY Other Revenue | $2,797,826 | CYOtherRevenueAmt |
| PY Total Revenue | $130,517,903 | PYTotalRevenueAmt |
| CY Total Revenue | $35,642,137 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $61,143,790 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,556,637 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $67,943,803 | PYOtherExpensesAmt |
| CY Other Expenses | $17,627,765 | CYOtherExpensesAmt |
| PY Total Expenses | $129,087,593 | PYTotalExpensesAmt |
| CY Total Expenses | $34,184,402 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,430,310 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,457,735 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $120,617,755 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $77,329,816 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $43,287,939 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | See Schedule O | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $27,629,911 | ExpenseAmt |
| Revenue | $29,946,869 | RevenueAmt |
| Desc | Inpatient & Outpatient Hospital Care: Penobscot Bay Medical Center (PBMC) provides quality medical care regardless of race, creed, sex, national origin, handicap or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of PBMC, not all individuals possess the ability to purchase essential medical services. Our mission is to serve the community by providing health care services and health care education. In keeping with this hospital's commitment to serve all members of its community, we provide free care and subsidized care to persons covered by governmental programs below cost, and health activities and programs for the community. (Continued at Schedule O)(Continued from Part III, Line 4a)PBMC served 881 inpatients, including newborns and 47,343 outpatients including ER visits, during the short period. Twenty-four-hour medical emergency service is provided in the Emergency Room, staffed by full-time attending physicians. Patients are seen regardless of ability to pay. There were 4,654 visits to the Emergency Room during the short period. Recognizing its mission to the community, services are provided to both Medicare & MaineCare patients. To the extent reimbursement is below cost, PBMC recognizes these amounts as contractual adjustments. For the short period, the amount of unreimbursed costs reported as contractual adjustments totaled $43,255,621. During the short period, approximately 65% of services were to patients covered by these governmental programs. Additionally, PBMC provided $1,963,771 in free care to patients not covered by governmental programs. PBMC provides free conference room and meeting space for a variety of health related groups including Alcoholics Anonymous, Al Anon, Midcoast Cancer Support Group, Heart to Heart, Cardiac Spouse Support Group, Crohn's Disease Support Group, Visually Impaired and Blind Support Group, Pediatric Asthma Support Group, Ostomy Group, Midcoast Mastectomy Support Group, Northeast Health Consortium for Integrated Care, Breast Cancer Intervention Project, Mid-Coast Coalition for Domestic Abuse, Teen parenting, Women's and Children's Community Care Project. Assistance is provided to educators through our work with medical students, student nurses, physical therapy interns, emergency medical technicians, medical records and social service students.Through an arrangement with the University of Maine - Orono, our Education and Training department offers nurses with certificate degrees the opportunity to work toward a baccalaureate degree in the local area. The hospital maintains a research library which is open twenty-four-hours a day and available to the general public. During the short period, the community contributed approximately 1,533 hours toward the common purpose of servicing the health care needs of the community. The value of this contribution is given back to the community through lower costs in both patient services and other wellness programs such as those described above. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,341,874 | ExpenseAmt |
| Revenue | $3,622,113 | RevenueAmt |
| Desc | Physician Practices: Pen Bay Physician and Associates, a group of departments of PBMC, is composed of 18 practices covering many specialities. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,684,033 | ExpenseAmt |
| Revenue | $1,825,251 | RevenueAmt |
| Desc | The Knox Center for Long Term Care is an 84-bed long-term nursing care and skilled rehabilitation center. Since 1975, The Knox Center for Long Term Care has been caring for members of mid-coast families and providing them with a loving home where they receive both the sophisticated technical care they require and the dignity and respect they deserve. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $32,655,818 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | Yes (1) | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1312 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 20 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | ME | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dorcas Riley | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2075054378 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 287 | AddressLine1Txt |
| City | Belfast | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04915 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Ann Hooper | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Catherine Reynolds | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Cornelius Yetman DO | ||||||||
| Trustee | 1.00 | 50.00 | Yes (X) | $0 | $334,960 | $41,396 | ||
| Dale Kuhnert | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Deborah Peabody MD | ||||||||
| Trustee | 1.00 | 50.00 | Yes (X) | $0 | $117,501 | $27,611 | ||
| Elizabeth Connelly DO | ||||||||
| Medical Staff President - WCGH | 1.00 | 50.00 | Yes (X) | $0 | $460,406 | $35,537 | ||
| Gregory Dufour | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| James C Delehanty MD | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JB Turner | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Jennifer McKenna MD | ||||||||
| Trustee | 1.00 | 50.00 | Yes (X) | $0 | $310,869 | $31,531 | ||
| Joanne Billington | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Lee Webb | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Paul Klainer MD | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Stephanie Lash MD | ||||||||
| Medical Staff President - PBMC | 1.00 | 50.00 | Yes (X) | $0 | $287,535 | $26,532 | ||
| Syrena Gatewood | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| William Lambie MD | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Lee Woodward Jr | ||||||||
| President | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Carole Brand | ||||||||
| Vice President | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Stephen Hanscom | ||||||||
| Secretary | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| David Flanagan | ||||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Mark Fourre MD | ||||||||
| CEO | 50.00 | 0.00 | $461,980 | $0 | $33,173 | Yes (X) | ||
| Linda Drinkwater | ||||||||
| CFO | 0.00 | 50.00 | $0 | $316,002 | $35,266 | Yes (X) | ||
| Christopher Michalakes MD | ||||||||
| ED Medical Director | 50.00 | 0.00 | $263,783 | $0 | $45,640 | Yes (X) | ||
| John Nicolet MD | ||||||||
| ED Physician | 50.00 | 0.00 | $319,328 | $0 | $38,148 | Yes (X) | ||
| Mark McAllister MD | ||||||||
| ED Physician | 50.00 | 0.00 | $288,687 | $0 | $38,998 | Yes (X) | ||
| Mark Eggena MD | ||||||||
| Physician | 50.00 | 0.00 | $320,873 | $0 | $42,609 | Yes (X) | ||
| Comfort Hines MD | ||||||||
| ED Physician | 50.00 | 0.00 | $277,034 | $0 | $31,084 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,931,685 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,827,273 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $427,525 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 37 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Asha LLC | |||||
| 10126 E Cherry Bend Road | Traverse City | MI | 49684 | Staffing | $2,499,122 |
| PenBay Anesthesia LLC | |||||
| PO Box 1009 | Jackson | MI | 49204 | Anesthesiology | $590,570 |
| Bluewater Emergency Partners | |||||
| 14 Maine Street | Brunswick | ME | 04856 | Emergency Dept. Staffing | $354,482 |
| Spectrum Medical Group | |||||
| 324 Gannett Drive 200 | South Portland | ME | 04106 | Medical services | $224,833 |
| JK Kalloch | |||||
| PO Box 774 | Rockland | ME | 04841 | Grounds Maintenance | $215,189 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $46,068 | AllOtherContributionsAmt |
| Total Contributions | $46,068 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Inpatient & Outpatient Care | 624100 | $23,348,780 | $23,348,780 |
| Pen Bay Physicians & Assoc. | 621110 | $7,735,541 | $7,735,541 |
| Knox Center for LT Care | 623000 | $1,690,152 | $1,690,152 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $32,774,473 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,770 | TotalRevenueColumnAmt |
| Exclusion | $23,770 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $39,242 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $39,242 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,242 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $39,242 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Pharmacy | 446110 | $1,442,266 | $1,442,266 |
| Affiliate revenue | 900099 | $747,333 | $747,333 |
| Other revenue | 900099 | $337,200 | $337,200 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $231,785 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $53,719 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $178,066 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,758,584 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,642,137 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,394,233 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $178,066 | UnrelatedBusinessRevenueAmt |
| Exclusion | $23,770 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,513 | TotalAmt |
| Program Services | $88,491 | ProgramServicesAmt |
| Management And General | $5,022 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,392,595 | TotalAmt |
| Program Services | $11,727,113 | ProgramServicesAmt |
| Management And General | $665,482 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $382,123 | TotalAmt |
| Program Services | $361,603 | ProgramServicesAmt |
| Management And General | $20,520 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,687,672 | TotalAmt |
| Program Services | $2,543,344 | ProgramServicesAmt |
| Management And General | $144,328 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000,734 | TotalAmt |
| Program Services | $946,995 | ProgramServicesAmt |
| Management And General | $53,739 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,895 | TotalAmt |
| Management And General | $15,895 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,128 | TotalAmt |
| Management And General | $47,128 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,154 | TotalAmt |
| Management And General | $5,154 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,653,098 | TotalAmt |
| Program Services | $2,571,023 | ProgramServicesAmt |
| Management And General | $82,075 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $540,706 | TotalAmt |
| Program Services | $511,670 | ProgramServicesAmt |
| Management And General | $29,036 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,271 | TotalAmt |
| Program Services | $6,881 | ProgramServicesAmt |
| Management And General | $390 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,240,269 | TotalAmt |
| Program Services | $1,173,667 | ProgramServicesAmt |
| Management And General | $66,602 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,514 | TotalAmt |
| Program Services | $59,157 | ProgramServicesAmt |
| Management And General | $3,357 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $240,196 | TotalAmt |
| Program Services | $227,297 | ProgramServicesAmt |
| Management And General | $12,899 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,884,824 | TotalAmt |
| Program Services | $1,783,609 | ProgramServicesAmt |
| Management And General | $101,215 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $379,600 | TotalAmt |
| Program Services | $359,215 | ProgramServicesAmt |
| Management And General | $20,385 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical supplies | $5,091,856 | $5,091,856 | |
| Affiliate services | $4,515,821 | $4,273,321 | $242,500 |
| Hospital tax | $703,999 | $703,999 | |
| Collection fees | $78,090 | $73,897 | $4,193 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,344 | TotalAmt |
| Program Services | $152,680 | ProgramServicesAmt |
| Management And General | $8,664 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,184,402 | TotalAmt |
| Program Services | $32,655,818 | ProgramServicesAmt |
| Management And General | $1,528,584 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,722,711 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,788,095 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,649,718 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,876,247 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $430,033 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,316,579 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,893,793 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,940,579 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,617,755 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,872,836 | BOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,627 | BOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,998,415 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,415,938 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,329,816 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,895,786 | BOYAmt |
| EOY | $0 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,840,330 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,551,823 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,287,939 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,617,755 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,457,735 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$498,713 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $256 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$44,247,217 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $5,154 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,154 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Dues paid to the Maine Hospital Association of $13,523 and to the Maine Health Care Association of $6,951. The Maine Hospital Association and Maine Health Care Association used 20.30% and 34.66% respectively of their dues revenue for lobbying activity. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,551,823 | BeginningYearBalanceAmt |
| Other Expenditures | $6,551,823 | OtherExpendituresAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,405,415 | BeginningYearBalanceAmt |
| Contributions | $4,600 | ContributionsAmt |
| Investment Earnings Or Losses | $141,808 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $6,551,823 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,141,089 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $264,326 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $6,405,415 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,983,600 | BeginningYearBalanceAmt |
| Contributions | $25,727 | ContributionsAmt |
| Investment Earnings Or Losses | $131,762 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $6,141,089 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,022,956 | BeginningYearBalanceAmt |
| Contributions | $160,000 | ContributionsAmt |
| Investment Earnings Or Losses | -$199,356 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $5,983,600 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | The endowment funds are used to be invested in perpetuity to provide a permanent source of income. |
| Schedule D, Part V, Line 1e | As Penobscot Bay Medical Center merged into MaineHealth (EIN: 01-0238552) on 1/1/19, at the close of the period covered by this return the endowment balance was transferred to MaineHealth. The amount reported on line 1e is the transfer to MaineHealth. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 175.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $738,597 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $738,597 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02160 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,040,539 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,085,524 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,779,136 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,085,524 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $738,597 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02160 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,548,188 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,548,188 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04530 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,548,188 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,548,188 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04530 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,327,324 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,085,524 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,286,785 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06690 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,357,867 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $8,441,028 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,611,455 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$3,170,427 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Penobscot Bay Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 Glen Cove Drive | AddressLine1Txt |
| City | Rockport | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04856 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | See Part V Section C | WebsiteAddressTxt |
| State License | 38936 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Penobscot Bay Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Section C | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Section C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 175.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Section C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Section A: | Facility Information, Website Addressmainehealth.org/pen-bay-medical-center |
| Penobscot Bay Medical Center | Part V, Section B, Line 5: The hospital convened a group of people who represented the broad interests of the community served prior to holding forums. Members of the planning committee and engaged organizations were:- Rep. Pinny Beebe-Center, MA; House of Representative; State of Maine- Celine Bourke-Kuhn, MS; Program Manager, Community Health Improvement;MaineHealth- Al May, MPH; Midcoast District Public Health Liaison; Maine Center forDisease Control- Rachael McCormick, Manager, Community Health & Wellness; Pen Bay MedicalCenter- Joy Osterhout, MS, MCHES; Regional Director, Community Health & Wellness; Pen Bay Medical Center & Waldo County General Hospital- Connie Putnam; Director; Knox County Community Health Coalition |
| Penobscot Bay Medical Center | Part V, Section B, Line 6a: The CHNA was conducted through a partnership between Maine Healthcare, Central Maine Healthcare, Northern Light Health, MaineGeneral Health and the Maine Department of Health and Human Services. |
| Penobscot Bay Medical Center | Part V, Section B, Line 11: For the 2016-2018 CHNA, the organization has identified priorities and developed strategies to address the significant needs identified in its most recently conducted CHNA and provided reasons if identified needs are not being addressed. Please see the 2016-2018 Community Health Needs Assessment and Annual Implementation Plan Update FY18 at https://mainehealth.org/healthy-communities/community-health-needs-assessment for details of the activities undertaken by the organization. |
| Part V, Section B, Lines 7a & 10a: | The CHNA and implementation strategy are posted on the following website: https://mainehealth.org/healthy-communities/community-health-needs-assessment |
| Part V, Section B, Lines 16a, 16b, 16c: | The Financial Assistance Policy (Free Care Policy and Billing and Collection Policy), free care application and the plain language summary are available on the following website: https://mainehealth.org/patients-visitors/billing-insurance/financial-assistance/free-care |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Pen Bay Physicians & Associates | ||||
| 4 Glen Cove Drive | Rockport | ME | 04856 | Physician Practices |
| 2 - The Knox Center for Long Term Care | ||||
| 6 White Street | Rockland | ME | 04841 | Long Term Care |
| 4 - Pen Bay Physical Therapy | ||||
| 4 Glen Cove Drive | Rockport | ME | 04856 | Physical Therapy |
| 5 - Pen Bay Occupational Therapy | ||||
| 4 Glen Cove Drive | Rockport | ME | 04856 | Occupational Therapy |
| 6 - Pen Bay Physical Therapy | ||||
| 116 Union Street | Rockport | ME | 04856 | Physical Therapy |
| 7 - Pen Bay Physical Therapy | ||||
| 40 Washington Road | Waldoboro | ME | 04572 | Physical Therapy |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | Ratio of patient care costs to charges per Worksheet 2 of the instructions. |
| Part III, Line 2: | See Part III, Line 4 - Bad Debt Expense Footnote to Financial Statements |
| Part III, Line 4: | Penobscot Bay Medical Center (PBMC) does not have a specific footnote inthe financial statements that describes "bad debt expense." However,reference is made within the footnotes to a bad debt policy in a couple ofinstances. Within the footnote describing "Net Patient Service Revenue",the following explains the Provision for Bad Debts:"For receivables associated with self-pay patients (which includes bothpatients without insurance and patients with deductible and copaymentbalances due for which third-party coverage exists for part of the bill),the Corporation records a provision for bad debts in the period of servicebased on past experience, which indicates that many patients are unable orunwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or eligible) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts."The amount of expense associated with the provision of services, ultimately written off as bad debt at PBMC, has been calculated at $1,357,867 for the current short period. This amount was calculated using a cost to charge ratio. Bad debt expense represents healthcare services PBMC has provided without compensation. As a tax-exempt organization, PBMC provides necessary patient care regardless of the patient's ability to pay for the services. PBMC cannot determine the amount of bad debt expense that could be reasonably attributable to patients who likely would qualify for financial assistance under the Hospital free care policy. In addition, bad debt expense also includes amounts for services provided to individuals experiencing difficult personal or economic circumstances related to a portion of our community based patient population. Their medical bills often place these individuals in untenable positions where they are not able to handle their personal debt and then their new medical debt; however, because of their income level, they do not qualify for free care. By providing necessary healthcare services to those individuals either who fail to apply for financial assistance or who are experiencing difficult personal or economic circumstances, PMBC believes that bad debt expense should be included as a community benefit. |
| Part III, Line 8: | Cost Report Information:PBMC believes that the Medicare shortfall should be included as a Community Benefit because the hospital has a clear mission commitment to serving elderly patients and adults with disabilities through the provision of specific subsidized programs developed to help improve the health status of these patients. If these critical subsidized programs were not provided by the hospital, they would become the obligation of the Federal Government. |
| Part III, Line 9b: | Patients who qualify for free care have their account balance adjusted accordingly once free care has been approved. As a tax-exempt hospital, PBMC provides necessary patient care regardless of the patient's ability to pay for the services. |
| Part VI, Line 2: | PBMC is a member of Maine Healthcare, which conducts a thorough community needs assessment and directs its member organizations to respond to the needs identified. Maine Healthcare members also participate in various initiatives to keep those assessments up to date. Some of these initiatives include:- Clinical Strategic Planning- Financial Strategic Planning- Facility Planning- Human Resource Planning- Staff Development Planning- Physician Recruitment Strategic Planning- Emergency Preparedness PlanningIn addition to these internal assessments, Maine Healthcare member organizations also review and act on many of the recommendations provided by external groups and State health planning initiatives, such as: The Maine Department of Health and Human Services' Healthy Maine 2010 and Autism Spectrum Disorders Report, the Maine Center for Disease Control andPrevention and the "State Health Plan created by the Advisory Committeefor Health Systems Development. |
| Part VI, Line 3: | Financial assistance information is provided in the Admitting and Emergency Registration locations in the following manner:- Postings including Free Care and Monthly Payment Plan- Handouts- InterviewsIf the patient is self-pay, under insured or can't afford to pay theirhospital bill, they may receive a Financial Counseling Packet and/orreferred to financial counseling from the registration staff or ChangeHealthcare, an outside vendor who helps manage the self-pay accounts. Thepacket includes:- Information on Maine Healthcare's financial policies- Financial assistance information including Free Care Program- Monthly Payment Plan Program, and Care Partners, MedAccess and other community resource needs- Program applications and instructions for MaineHealth's Free CareProgram, and Monthly Payment Plan Application- Contact information for assistance with applications, bills or financialconcernsSelf-pay or underinsured patients registering in person or via a phoneinterview receive financial counseling including information on ourfinancial assistance programs. Registration staff or Change Healthcareprovide forms and assist with completing financial assistance applicationsand providing follow up contact information.Maine Healthcare's Web site includes on-line Registration and Patient Billinginformation:- Billing Process- Free Care- Monthly Payment Plan- Patient Statement- Price Information- Contact Us and QuestionsPrimary language, deaf and hard of hearing and interpreter needs are assessed during the registration interview and services are provided asneeded.If a patient does not respond at pre-registration, registration, or whilereceiving care, all of these programs are explained again by the SingleBilling Office staff. The intent of these efforts is to ensure that thepatient is fully informed of and able to take advantage of these assistance programs. |
| Part VI, Line 4: | The Community Health Needs Assessment describes the geographic area anddemographic constituents it services. See https://mainehealth.org/healthy-communities/community-health-needs-assessment for the completed CHNA. |
| Part VI, Line 5: | The tax exempt purpose of the organization to improve the health of thecommunity is promoted and enhanced in the following ways:- The majority of the governing body comprises people living within thehospital's service area that are neither employed by, nor have contractualrelationships with, the hospital or its affiliates- Medical staff privileges are available to all qualified physicians in the community- Solicitation of community input in the strategic planning process- Common governance of the hospital, long-term care, and physician services provided in the county to promote common health care and control costs- Annual investment in capital equipment and building improvements to ensure high quality care- Each year a portion of Net Assets is distributed to our parent,Maine Healthcare, for the specific purpose of promoting health statusimprovement programs throughout the Maine Healthcare service area |
| Part VI, Line 6: | Maine Healthcare is a not-for-profit family of leading high-quality providers and other healthcare organizations working together so their communities are the healthiest in America. Ranked among the nation's top 100 integrated healthcare delivery networks, Maine Healthcare is governed by a board of trustees consisting of community and business leaders from its southern, central and western Maine regional service areas. The collaboration of Maine Healthcare members makes it possible to offer an extensive range of clinical integration and community health programs, many aimed at improving access to preventive and primary care services. MaineHealth includes the following member organizations: LincolnHealth Group, MaineHealth, Maine Behavioral Healthcare (Spring Harbor Hospital), Coastal Healthcare Alliance (Pen Bay Medical Center and Waldo County General Hospital), Southern Maine Health Care (Southern Maine Medical Center and Goodall campuses), Western Maine Health Care (Stephens Memorial Hospital), The Memorial Hospital at North Conway, N.H., MaineHealth Care at Home, NorDx, Synernet and MaineHealth Accountable Care Organization. The strategic affiliates of Maine Healthcare are MaineGeneral Medical Center, Mid Coast Hospital and St. Marys Regional Medical Center. |
| Part VI, Line 7, Reports Filed With States | ME |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cornelius Yetman DO | ||||||||||||||
| Trustee | $0 | $314,817 | $0 | $19,533 | $0 | $610 | $0 | $8,250 | $0 | $33,146 | $0 | $376,356 | $0 | $0 |
| Elizabeth Connelly DO | ||||||||||||||
| Medical Staff President - WCGH | $0 | $441,614 | $0 | $2,448 | $0 | $16,344 | $0 | $8,250 | $0 | $27,287 | $0 | $495,943 | $0 | $0 |
| Jennifer McKenna MD | ||||||||||||||
| Trustee | $0 | $309,565 | $0 | $0 | $0 | $1,304 | $0 | $8,250 | $0 | $23,281 | $0 | $342,400 | $0 | $0 |
| Stephanie Lash MD | ||||||||||||||
| Medical Staff President - PBMC | $0 | $284,844 | $0 | $0 | $0 | $2,691 | $0 | $8,250 | $0 | $18,282 | $0 | $314,067 | $0 | $0 |
| Mark Fourre MD | ||||||||||||||
| CEO | $370,966 | $0 | $76,000 | $0 | $15,014 | $0 | $444 | $0 | $32,729 | $0 | $495,153 | $0 | $0 | $0 |
| Linda Drinkwater | ||||||||||||||
| CFO | $0 | $301,132 | $0 | $400 | $0 | $14,470 | $0 | $8,250 | $0 | $27,016 | $0 | $351,268 | $0 | $0 |
| Christopher Michalakes MD | ||||||||||||||
| ED Medical Director | $260,080 | $0 | $0 | $0 | $3,703 | $0 | $13,709 | $0 | $31,931 | $0 | $309,423 | $0 | $0 | $0 |
| John Nicolet MD | ||||||||||||||
| ED Physician | $318,536 | $0 | $0 | $0 | $792 | $0 | $8,250 | $0 | $29,898 | $0 | $357,476 | $0 | $0 | $0 |
| Mark McAllister MD | ||||||||||||||
| ED Physician | $288,241 | $0 | $0 | $0 | $446 | $0 | $8,250 | $0 | $30,748 | $0 | $327,685 | $0 | $0 | $0 |
| Mark Eggena MD | ||||||||||||||
| Physician | $319,261 | $0 | $0 | $0 | $1,612 | $0 | $13,750 | $0 | $28,859 | $0 | $363,482 | $0 | $0 | $0 |
| Comfort Hines MD | ||||||||||||||
| ED Physician | $276,411 | $0 | $0 | $0 | $623 | $0 | $0 | $0 | $31,084 | $0 | $308,118 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | Top management officials are compensated by this or other related organizations. These organizations used one or more of the methods shown at Part 1, Line 3 to establish the compensation of top management. For additional information see Schedule O - Form 990, Part VI, Section B, Line 15 - Compensation for Top Official. | ExplanationTxt |
Schedule N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail (20 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| MaineHealth | |||||||||
| Cash & cash equivalents | 2019-01-01 | $13,380,666 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Investments | 2019-01-01 | $14,227,399 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Patient accounts receivable, net | 2019-01-01 | $16,002,115 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Other current assets | 2019-01-01 | $1,021,874 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Net receivable from reimbursement regulations | 2019-01-01 | $4,765,435 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Inventory | 2019-01-01 | $1,970,390 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Prepaids | 2019-01-01 | $365,398 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Property, plant & equipment, net | 2019-01-01 | $144,367,266 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Other assets | 2019-01-01 | $20,341,797 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Accounts payable | 2019-01-01 | $4,196,317 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Accrued payroll, payroll taxes, withholdings, and earned time | 2019-01-01 | $7,195,728 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Net due to affiliates | 2019-01-01 | $29,960,511 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Accrued interest payable | 2019-01-01 | $318,250 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Deferred revenue | 2019-01-01 | $24,275 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Tax-exempt bonds | 2019-01-01 | $11,807,646 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Other long-term debt | 2019-01-01 | $5,839,950 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Other long-term liabilities | 2019-01-01 | $1,767,984 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Unrestricted net assets | 2019-01-01 | $34,869,400 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Temporarily restricted net assets | 2019-01-01 | $6,104,662 | Book value | 010238552 | 22 Bramhall Street | portland | ME | 04102 | 501(c)(3) |
| MaineHealth | |||||||||
| Permanently restricted net assets | 2019-01-01 | $6,551,823 | Book value | 010238552 | 22 Bramhall Street | Portland | ME | 04102 | 501(c)(3) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | Yes (1) | DirectorOfSuccessorInd |
| Employee Of Successor | Yes (1) | EmployeeOfSuccessorInd |
| Owner Of Successor | 0 | OwnerOfSuccessorInd |
| Receive Compensation | 0 | ReceiveCompensationInd |
| Assets Distributed | Yes (1) | AssetsDistributedInd |
| Required To Notify AG | Yes (1) | RequiredToNotifyAGInd |
| Attorney General Notified | Yes (1) | AttorneyGeneralNotifiedInd |
| Liabilities Paid | Yes (1) | LiabilitiesPaidInd |
| Bonds Outstanding | Yes (1) | BondsOutstandingInd |
| Bond Liabilities Discharged | 0 | BondLiabilitiesDischargedInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 2e: | Person(s) Involved: Gregory Dufour; Ann Hooper; Mark Fourre, MD; Linda Drinkwater; Cornelius Yetman, DO; Deborah Peabody, MD; Elizabeth Connelly, DO; Jennifer McKenna,MD |
| Part I, Line 2e: | Explanation of Involvement: Gregory Dufour and Ann Hooper, PBMC Trustees, became members of the MaineHealth (EIN: 01-0238552) Board of Trustees upon PMBC's merger with MaineHealth on 1/1/2019.Mark Fourre, CEO of PBMC, became an employee of MaineHealth upon the merger date.Linda Drinkwater, CFO of PBMC, is an employee of MaineHealth. Deborah Peabody and Elizabeth Connelly, Trustees of PBMC, are employees of MaineHealth. Cornelius Yetman, Jennifer McKenna, and Stephanie Lash, Trustees of PBMC, became employees of MaineHealth upon the merger date. |
| Part I, Line 6c: | MaineHealth (EIN: 01-0238552) assumed the liability of MBH's tax-exempt bond upon the merger date. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 990 Form, Part V, Line 1a | MaineHealth (EIN 01-0238552), acting on behalf of Maine Healthcare (EIN 01-0431680), filed 1,645 Form 1099s for the calendar year 2018 on behalf of the following organizations: Maine Healthcare, MaineHealth, Southern Maine Health Care, Coastal Healthcare Alliance, Pen Bay Medical Center, Waldo County General Hospital, Franklin Memorial Hospital, LincolnHealth Group, Memorial Hospital, Western Maine Health Care, Maine Behavioral Healthcare, NorDx, MaineHealth Care at Home. |
| Form 990, Part VI, Section A, line 6 | Coastal Healthcare Alliance (CHA) (EIN: 22-2494475) is the sole member of PBMC. Maine Healthcare (EIN: 01-0431680), as the sole member of CHA, has the right to approve significant decisions of the governing body of CHA and its subsidiaries. |
| Form 990, Part VI, Section A, line 7a | The sole member, CHA (EIN# 22-2494475) may elect the Board of Trustees from a slate of nominees submitted by the Corporation. The officers are elected by the Board of Trustees. |
| Form 990, Part VI, Section A, line 7b | Decisions of the governing body such as budgets, business strategies, significant financial commitments, amendments to the Articles of Incorporation, and election of the President/CEO among other decisions, are subject to approval by Coastal Healthcare Alliance (EIN: 22-2494475) and Maine Healthcare (EIN: 01-0431680). |
| Form 990, Part VI, Section B, line 11b | A detailed review of the Form 990 is performed by the Controller. The Form 990 is made available to the full board prior to filing. |
| Form 990, Part VI, Section B, line 12c | At the beginning of service, board members and officers are required to document any conflict of interest that may exist, and they are required to report any additional conflicts as they arise. Board member and officer conflict of interest forms are updated and reviewed annually. |
| Form 990, Part VI, Section B, line 15 | Compensation for Top Official The process followed for determining compensation of the CEO compensated by this or other related organization is a formal process performed annually by the Executive Committee of the Board of Directors. A related organization uses an outside firm, Sullivan Cotter, to perform an independent benchmark analysis for the CEO of Penobscot Bay Medical Center, along with other executives in the Maine Healthcare system. The firm meets with the Executive Committee to review each executive's benchmark report. The Committee then deliberates on Maine Healthcare's written salary and incentive plan philosophy before making a final decision. All decisions and meetings are captured in minutes and there are appropriate approvals at all levels. Compensation Process for Officers At the time of hire the Compensation department utilizes market data to provide an accurate, competitive and appropriate offer. On an annual basis officers receive a merit increase related to the results of their annual performance appraisal performed by the CEO. At this time it is evaluated if an additional bonus will be provided based upon budget and performance, this is at the discretion of the CEO, CFO and HR Director. |
| Form 990, Part VI, Section C, line 19 | Documents that are required to be open for the public inspection are made available upon request. |
| Form 990, Part XI, line 9: | Equity transfer from affiliates 100,000. Transfer net assets from Pen Bay Waldo Hlthcare Found. (EIN: 22-2482325) 3,178,668. Transfer of net assets to MaineHealth (EIN: 01-0238552) -47,525,885. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Coastal Healthcare Alliance | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 222494475 | Healthcare | ME | 501(c)(3) | Line 12b, II | Maine Healthcare | 0 | |
| Quarry Hill | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 010213976 | Long-term care | ME | 501(c)(3) | Line 10 | Coastal Healthcare Alliance | 0 | |
| Pen Bay Waldo Healthcare Foundation | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 222482325 | Fundraising | ME | 501(c)(3) | Line 7 | Coastal Healthcare Alliance | 0 | |
| Penobscot Bay Physicians & Assoc | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 010530517 | Physician services | ME | 501(c)(3) | Line 12b, II | Penobscot Bay Medical Center | Yes (1) | |
| Maine Healthcare | |||||||||||
| 110 Free Street | Portland | ME | 04101 | 010431680 | Healthcare | ME | 501(c)(3) | Line 12c, III-FI | 0 | N/A | |
| Waldo County General Hospital | |||||||||||
| 118 Northport Ave | Belfast | ME | 04915 | 010177170 | Hospital | ME | 501(c)(3) | Line 3 | Coastal Healthcare Alliance | 0 | |
| Coastal Medical Care | |||||||||||
| PO Box 287 | Belfast | ME | 04915 | 010487091 | Medical services | ME | 501(c)(3) | Line 10 | Coastal Healthcare Alliance | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| PBH Management Company | |||||||||
| PO Box 287 | Belfast | ME | 04915 | 010537278 | Management services | ME | N/A | C | 0 |
| Waldo County Healthcare Mgmt Co | |||||||||
| PO Box 287 | Belfast | ME | 04915 | 010485133 | Management services | ME | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pen Bay Physicians & Associates | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $4,381,524 | InvolvedAmt |
| Method Of Amount Determination | Fair Market Value | MethodOfAmountDeterminationTxt |