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Penobscot Bay Medical Center: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
Penobscot Bay Medical Center (EIN 01-0285286)
Tax period
2017-10-01 to 2018-09-30
Filed
2019-08-13
IRS object ID
201902259349301805
Schema version
2017v2.3
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

FieldValueIRS element (for citing)
Return2019-08-13T12:27:46-05:00ReturnTs
Tax Period End2018-09-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2017-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN010285286EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Penobscot Bay Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPENOBusinessNameControlTxt
Phone2073389378PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 287AddressLine1Txt
CityBelfastCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04915ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLinda DrinkwaterPersonNm
Person TitleCFOPersonTitleTxt
Phone2073389378PhoneNum
Signature2019-08-12SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address63.247.60.254IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-08-13IPDt
IP Tm13:25:30IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdB45CD6F9D1811B9916B2A423673B63195B36551FAtSubmissionCreationDeviceId
At Submission Filing Device Id829AE4A393A3EE33A28B50D291306587A51708D5AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMark Fourre MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 287AddressLine1Txt
CityBelfastCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04915ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$130,922,336GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.penbayhealthcare.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1969FormationYr
Legal Domicile StateMELegalDomicileStateCd
Activity Or MissionPenobscot 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
Voting Members Governing Body20VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee1332TotalEmployeeCnt
Total Volunteers89TotalVolunteersCnt
Total Gross UBI$728,533TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$134,104NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$141,033PYContributionsGrantsAmt
CY Contributions Grants$383,260CYContributionsGrantsAmt
PY Program Service Revenue$115,025,681PYProgramServiceRevenueAmt
CY Program Service Revenue$119,727,190CYProgramServiceRevenueAmt
PY Investment Income$507,196PYInvestmentIncomeAmt
CY Investment Income$67,263CYInvestmentIncomeAmt
PY Other Revenue$924,185PYOtherRevenueAmt
CY Other Revenue$10,340,190CYOtherRevenueAmt
PY Total Revenue$116,598,095PYTotalRevenueAmt
CY Total Revenue$130,517,903CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$65,733,932PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$61,143,790CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$56,020,543PYOtherExpensesAmt
CY Other Expenses$67,943,803CYOtherExpensesAmt
PY Total Expenses$121,754,475PYTotalExpensesAmt
CY Total Expenses$129,087,593CYTotalExpensesAmt
PY Revenues Less Expenses-$5,156,380PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,430,310CYRevenuesLessExpensesAmt
Total Assets BOY$121,309,094TotalAssetsBOYAmt
Total Assets EOY$120,617,755TotalAssetsEOYAmt
Total Liabilities BOY$80,353,043TotalLiabilitiesBOYAmt
Total Liabilities EOY$77,329,816TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$40,956,051NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$43,287,939NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSee Schedule OMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$106,733,528ExpenseAmt
Revenue$103,606,664RevenueAmt
DescInpatient & 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 3,595 inpatients, including newborns and 181,157 outpatients including ER visits, during FY 18. 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 20,203 visits to the Emergency Room during FY 18. 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 FY 18, the amount of unreimbursed costs reported as contractual adjustments totaled $144,432,371. During FY 18, approximately 65% of services were to patients covered by these governmental programs. Additionally, PBMC provided $6,267,988 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 FY 18, the community contributed approximately 6,132 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

FieldValueIRS element (for citing)
Expense$9,529,175ExpenseAmt
Revenue$9,250,008RevenueAmt
DescPhysician 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

FieldValueIRS element (for citing)
Expense$7,077,871ExpenseAmt
Revenue$6,870,518RevenueAmt
DescThe 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
FieldValueIRS element (for citing)
Total Program Service Expenses$123,340,574TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document67IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1332EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members20GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMEStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Dorcas RileyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2073389378PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 287AddressLine1Txt
CityBelfastCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04915ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Ann Hooper
Trustee1.0050.00Yes (X)$0$139,832$20,070
Benjamin Mailloux MD
Frmr Medical Staff President - WCGH1.0050.00Yes (X)$0$289,181$36,751
Catherine Reynolds
Trustee1.000.00Yes (X)$0$0$0
Cornelius Yetman DO
Trustee1.0050.00Yes (X)$0$357,047$38,880
Dale Kuhnert
Trustee1.000.00Yes (X)$0$0$0
Deborah Peabody MD
Trustee1.0050.00Yes (X)$0$188,074$27,394
Elizabeth Connelly DO
Medical Staff President - WCGH1.0050.00Yes (X)$0$443,350$31,840
Gregory Dufour
Trustee1.000.00Yes (X)$0$0$0
James C Delehanty MD
Trustee1.000.00Yes (X)$0$0$0
JB Turner
Trustee1.000.00Yes (X)$0$0$0
Jennifer McKenna MD
Trustee1.0050.00Yes (X)$0$316,339$29,454
Joanne Billington
Trustee1.000.00Yes (X)$0$0$0
Lee Webb
Trustee1.000.00Yes (X)$0$0$0
Paul Klainer MD
Trustee1.000.00Yes (X)$0$0$0
Stephanie Lash MD
Medical Staff President - PBMC1.0050.00Yes (X)$0$287,088$25,910
Syrena Gatewood
Trustee1.000.00Yes (X)$0$0$0
William Lambie MD
Trustee1.000.00Yes (X)$0$0$0
Lee Woodward Jr
President1.000.00Yes (X)$0$0$0Yes (X)
Carole Brand
Vice President1.000.00Yes (X)$0$0$0Yes (X)
Stephen Hanscom
Secretary1.000.00Yes (X)$0$0$0Yes (X)
David Flanagan
Treasurer1.000.00Yes (X)$0$0$0Yes (X)
Mark Fourre MD
CEO50.000.00$429,171$0$30,594Yes (X)
Linda Drinkwater
CFO0.0050.00$0$312,958$35,179Yes (X)
Christopher Michalakes MD
ED Medical Director50.000.00$307,563$0$43,407Yes (X)
Erik Frederick
Regional COO50.000.00$294,413$0$31,125Yes (X)
John Nicolet MD
ED Physician50.000.00$273,637$0$36,023Yes (X)
Mark McAllister MD
ED Physician50.000.00$240,544$0$34,971Yes (X)
James Curtis MD
ED Physician50.000.00$241,673$0$38,617Yes (X)
Mark Biscone
Former CEO0.000.00$0$242,078$2,928Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,787,001TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,575,947TotReportableCompRltdOrgAmt
Total Other Compensation$463,143TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K38IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
JK KALLOCH
PO BOX 774ROCKLANDME04841GROUNDS MAINT.$265,729
JF SCOTT CONSTRUCTION
20 ROYAL STWINTHROPME04364CONSTRUCTION$244,212
MICHAEL W SPROWL
2029 APPLETON RIDGE ROADAPPLETONME04862HOUSEKEEPING$133,373
PENOBSCOT BAY PATHOLOGY ASSOCIATES
PO BOX 1849LEWISTONME042411849PATHOLOGY$121,784
AHSA LLC
10126 E CHERRY BEND ROADTRAVERSE CITYMI49684STAFFING$110,318
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
All Other Contributions$383,260AllOtherContributionsAmt
Total Contributions$383,260TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Inpatient & Outpatient Care624100$103,606,664$103,606,664
Pen Bay Physicians & Assoc.621110$9,250,008$9,250,008
Knox Center for LT Care623000$6,870,518$6,870,518
FieldValueIRS element (for citing)
Total Program Service Revenue$119,727,190TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$83,737TotalRevenueColumnAmt
Exclusion$83,737ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$195,210RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$195,210RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$195,210TotalRevenueColumnAmt
Related Or Exempt Func Income$195,210RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$324,431SecuritiesAmt
Other$56,284OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$321,563SecuritiesAmt
Other$75,626OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,868SecuritiesAmt
Other-$19,342OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$16,474TotalRevenueColumnAmt
Related Or Exempt Func Income-$16,474RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$50,204FundraisingGrossIncomeAmt
Fundraising Direct Expenses$7,244FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$42,960TotalRevenueColumnAmt
Exclusion$42,960ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Pharmacy446110$4,762,772$4,762,772
Affiliate revenue900099$3,505,448$3,505,448
Other revenue900099$1,105,267$1,105,267

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$728,533TotalRevenueColumnAmt
Unrelated Business Revenue$728,533UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$10,102,020OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$130,517,903TotalRevenueColumnAmt
Related Or Exempt Func Income$129,279,413RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$728,533UnrelatedBusinessRevenueAmt
Exclusion$126,697ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$468,600TotalAmt
Program Services$443,436ProgramServicesAmt
Management And General$25,164ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$44,856,441TotalAmt
Program Services$42,447,650ProgramServicesAmt
Management And General$2,408,791ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,671,446TotalAmt
Program Services$1,581,689ProgramServicesAmt
Management And General$89,757ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$10,046,931TotalAmt
Program Services$9,507,411ProgramServicesAmt
Management And General$539,520ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,100,372TotalAmt
Program Services$3,880,182ProgramServicesAmt
Management And General$220,190ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$53,501TotalAmt
Management And General$53,501ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$35,281TotalAmt
Management And General$35,281ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$13,174TotalAmt
Management And General$13,174ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$13,082,669TotalAmt
Program Services$12,613,680ProgramServicesAmt
Management And General$468,989ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$7,214TotalAmt
Program Services$6,827ProgramServicesAmt
Management And General$387ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,940,939TotalAmt
Program Services$1,836,711ProgramServicesAmt
Management And General$104,228ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,353,403TotalAmt
Program Services$4,119,625ProgramServicesAmt
Management And General$233,778ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$346,098TotalAmt
Program Services$327,513ProgramServicesAmt
Management And General$18,585ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,049,548TotalAmt
Program Services$993,187ProgramServicesAmt
Management And General$56,361ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$7,750,944TotalAmt
Program Services$7,334,718ProgramServicesAmt
Management And General$416,226ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,540,063TotalAmt
Program Services$1,457,362ProgramServicesAmt
Management And General$82,701ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Affiliate services$17,384,131$16,450,603$933,528
Medical supplies$16,666,978$16,666,978
Hospital tax$2,847,264$2,847,264
Other$872,596$825,738$46,858

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$129,087,593TotalAmt
Program Services$123,340,574ProgramServicesAmt
Management And General$5,747,019ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,407,791BOYAmt
EOY$8,722,711EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,650,063BOYAmt
EOY$6,788,095EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$18,238,476BOYAmt
EOY$16,649,718EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,658,861BOYAmt
EOY$1,876,247EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$930,276BOYAmt
EOY$430,033EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$143,967,882LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$93,651,303LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$52,491,280BOYAmt
EOY$50,316,579EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$8,613,367BOYAmt
EOY$8,893,793EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$31,318,980BOYAmt
EOY$26,940,579EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$121,309,094BOYAmt
EOY$120,617,755EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,577,794BOYAmt
EOY$9,872,836EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$42,627EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,474,080BOYAmt
EOY$17,998,415EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$50,301,169BOYAmt
EOY$49,415,938EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$80,353,043BOYAmt
EOY$77,329,816EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$31,231,174BOYAmt
EOY$32,895,786EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,319,462BOYAmt
EOY$3,840,330EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,405,415BOYAmt
EOY$6,551,823EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$40,956,051BOYAmt
EOY$43,287,939EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$121,309,094BOYAmt
EOY$120,617,755EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,430,310ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$403,288NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$498,290OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$13,174OtherActivitiesAmt
Total Lobbying Expenditures$13,174TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationDues paid to the Maine Hospital Association of $53,030 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

FieldValueIRS element (for citing)
Beginning Year Balance$6,405,415BeginningYearBalanceAmt
Contributions$4,600ContributionsAmt
Investment Earnings Or Losses$141,808InvestmentEarningsOrLossesAmt
End Year Balance$6,551,823EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,141,089BeginningYearBalanceAmt
Investment Earnings Or Losses$264,326InvestmentEarningsOrLossesAmt
End Year Balance$6,405,415EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,983,600BeginningYearBalanceAmt
Contributions$25,727ContributionsAmt
Investment Earnings Or Losses$131,762InvestmentEarningsOrLossesAmt
End Year Balance$6,141,089EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,022,956BeginningYearBalanceAmt
Contributions$160,000ContributionsAmt
Investment Earnings Or Losses-$199,356InvestmentEarningsOrLossesAmt
End Year Balance$5,983,600EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,400,541BeginningYearBalanceAmt
Contributions$500,000ContributionsAmt
Investment Earnings Or Losses$122,415InvestmentEarningsOrLossesAmt
End Year Balance$6,022,956EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,021,020OtherCostOrOtherBasisAmt
Book Value$1,021,020BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$68,518,414OtherCostOrOtherBasisAmt
Depreciation$39,003,434DepreciationAmt
Book Value$29,514,980BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,902,370OtherCostOrOtherBasisAmt
Depreciation$2,005,490DepreciationAmt
Book Value$896,880BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$69,445,461OtherCostOrOtherBasisAmt
Depreciation$52,642,379DepreciationAmt
Book Value$16,803,082BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,080,617OtherCostOrOtherBasisAmt
Book Value$2,080,617BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$50,316,579TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
Due from Affiliates$1,606,985
Resident Account Deposits$7,477
Estimated Amounts from Third Party$4,111,730
Other$3,106,667
Prepaid Capital Costs$18,107,720
FieldValueIRS element (for citing)
Total Book Value Other Assets$26,940,579TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Amounts Due to Affiliates$47,640,477
Insurance Claim Liability$667,984
Medical Malpractice Tail Liab.$1,100,000
Resident Accounts & Deposits$7,477
FieldValueIRS element (for citing)
Total Liability$49,415,938TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:To be invested in perpetuity to provide a permanent source of income.
Part X, Line 2:The Corporation and its subsidiaries are not-for-profit corporations and have been recognized as tax-exempt pursuant to Section 501(c)(3) of the Internal Reveue Code. Tax-exempt organizations could be required to record an obligations for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board (FASB), assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Corporation has evaluated the position taken on its filed tax returns. The Corporation has concluded no uncertian income tax positions exist at September 30, 2018. The Corporation's tax years from 2015 through 2018 may be subject to examination.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Golf TournamentEvent1Nm
Gross Receipts Event1$50,204GrossReceiptsEvent1Amt
Gross Revenue Event1$50,204GrossRevenueEvent1Amt
Rent Facility Costs Event1$4,995RentFacilityCostsEvent1Amt
Food And Beverage Event1$2,160FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$89OtherDirectExpensesEvent1Amt
Gross Receipts Total$50,204GrossReceiptsTotalAmt
Gross Revenue Total Events$50,204GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$4,995RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$2,160FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$89OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$7,244DirectExpenseSummaryEventsAmt
Net Income Summary$42,960NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other175.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,547,200TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,547,200NetCommunityBenefitExpnsAmt
Total Expense0.01970TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,554,984TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,957,075DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,597,909NetCommunityBenefitExpnsAmt
Total Expense0.04340TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,102,184TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,957,075DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,145,109NetCommunityBenefitExpnsAmt
Total Expense0.06310TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,279,796TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,279,796NetCommunityBenefitExpnsAmt
Total Expense0.04090TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,279,796TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,279,796NetCommunityBenefitExpnsAmt
Total Expense0.04090TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,381,980TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,957,075DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,424,905NetCommunityBenefitExpnsAmt
Total Expense0.10400TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$5,877,827BadDebtExpenseAmt
Reimbursed By Medicare$29,655,636ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$41,738,403CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$12,082,767MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Penobscot Bay Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16 Glen Cove DriveAddressLine1Txt
CityRockportCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04856ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.penbayhealthcare.orgWebsiteAddressTxt
State License38936StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Penobscot Bay Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V, Section COwnWebsiteURLTxt
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part V, Section CStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care175.000000000000FPGFamilyIncmLmtFreeCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Part V, Section CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Part V, Section CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Section CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Penobscot Bay Medical CenterPart 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 CenterPart V, Section B, Line 6a: The CHNA was conducted through a partnership between MaineHealth, Central Maine Healthcare, Eastern Maine Healthcare Systems, MaineGeneral Health and the Maine Department of Health and Human Services.
Penobscot Bay Medical CenterPart 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
FieldValueIRS element (for citing)
Facility6FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Pen Bay Physicians & Associates
4 Glen Cove DriveRockportME04856Physician Practices
2 - The Knox Center for Long Term Care
6 White StreetRocklandME04841Long Term Care
4 - Pen Bay Physical Therapy
4 Glen Cove DriveRockportME04856Physical Therapy
5 - Pen Bay Occupational Therapy
4 Glen Cove DriveRockportME04856Occupational Therapy
6 - Pen Bay Physical Therapy
116 Union StreetRockportME04856Physical Therapy
7 - Pen Bay Physical Therapy
40 Washington RoadWaldoboroME04572Physical Therapy

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 $5,877,827 for the current fiscal year. 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 MaineHealth, which conducts a thorough community needs assessment and directs its member organizations to respond to the needs identified. MaineHealth 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, MaineHealth 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 MaineHealth'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.MaineHealth'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,MaineHealth, for the specific purpose of promoting health statusimprovement programs throughout the MaineHealth service area
Part VI, Line 6:MaineHealth is a not-for-profit family of leading high-quality providersand other healthcare organizations working together so their communities are the healthiest in America. Ranked among the nation's top 100 integrated healthcare delivery networks, MaineHealth 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 MaineHealth 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, Maine Medical Center, 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, Maine Physician Hospital Organization, NorDx, Synernet and MaineHealth Accountable Care Organization. The strategic affiliates of MaineHealth are MaineGeneral Medical Center, Mid Coast Hospital and St. Marys Regional Medical Center.
Part VI, Line 7, Reports Filed With StatesME

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Ann Hooper
Trustee$0$138,885$0$0$0$947$0$4,331$0$15,739$0$159,902$0$0
Benjamin Mailloux MD
Frmr Medical Staff President - WCGH$0$288,990$0$0$0$191$0$8,100$0$28,651$0$325,932$0$0
Cornelius Yetman DO
Trustee$0$356,500$0$0$0$547$0$8,100$0$30,780$0$395,927$0$0
Deborah Peabody MD
Trustee$0$186,949$0$0$0$1,125$0$5,472$0$21,922$0$215,468$0$0
Elizabeth Connelly DO
Medical Staff President - WCGH$0$437,346$0$0$0$6,004$0$8,100$0$23,740$0$475,190$0$0
Jennifer McKenna MD
Trustee$0$315,077$0$0$0$1,262$0$8,100$0$21,354$0$345,793$0$0
Stephanie Lash MD
Medical Staff President - PBMC$0$284,623$0$0$0$2,465$0$8,100$0$17,810$0$312,998$0$0
Mark Fourre MD
CEO$371,456$0$54,000$0$3,715$0$0$0$30,594$0$459,765$0$0$0
Linda Drinkwater
CFO$0$311,612$0$0$0$1,346$0$8,100$0$27,079$0$348,137$0$0
Christopher Michalakes MD
ED Medical Director$305,146$0$0$0$2,417$0$13,500$0$29,907$0$350,970$0$0$0
Erik Frederick
Regional COO$293,436$0$0$0$977$0$8,100$0$23,025$0$325,538$0$0$0
John Nicolet MD
ED Physician$273,085$0$0$0$552$0$7,038$0$28,985$0$309,660$0$0$0
Mark McAllister MD
ED Physician$240,261$0$0$0$283$0$6,830$0$28,141$0$275,515$0$0$0
James Curtis MD
ED Physician$239,142$0$0$0$2,531$0$10,532$0$28,085$0$280,290$0$0$0
Mark Biscone
Former CEO$0$241,987$0$0$0$91$0$2,928$0$0$0$245,006$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 3FormAndLineReferenceDesc
ExplanationTop 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 K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
Maine Health & Higher Educational Facilities Authority
A010314384560427EU42012-06-28$4,287,472See Part VI00Yes (1)
Maine Health & Higher Educational Facilities Authority
B010314384560427W772014-07-24$7,427,323See Part VI00Yes (1)
Maine Health & Higher Educational Facilities Authority
C0103143840000000002014-03-31$4,800,000Buildings & Facilities000
Maine Health & Higher Educational Facilities Authority
D0103143840000000002014-09-24$3,125,535Equipment000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYr
A$2,953,650$4,287,472$354,220$63,386$4,287,472Yes (1)0Yes (1)Yes (1)
B$3,688,047$7,427,323$955,230$78,140$7,427,323Yes (1)0Yes (1)Yes (1)
C$2,025,078$4,800,000$53,22500Yes (1)Yes (1)$4,746,7752014
D$1,343,087$3,125,53500Yes (1)Yes (1)$3,125,5352015

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndRemedial Action TakenRemedialActionTakenIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
B00000.000000.000000.000000Yes (1)00
C00000.000000.000000.00000000
D00000.000000.000000.00000000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)000Yes (1)0
B0Yes (1)0000000
C0Yes (1)0000000
D0Yes (1)0000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0
C0
D0

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Date Rebate Computation PerformedIssuer Name: Maine Health & Higher Educational Facilities Authority Date the Rebate Computation was Performed: 06/28/2017
Part I, Column F- Bond issued 6/28/12: Refund bonds issued 5/19/1999 and 8/3/2000 - Bond issued 7/24/14: Refund bonds issued 10/16/2003 and 6/3/2004 - Bond issued 6/28/16: Refund bond issued 9/7/2006 - Bond issued 12/28/17: Refund bonds issued 11/1/2007 and 6/19/2008
Part I, Column IMHHEFA Series 2012A, 2014A, 2016 and 2017B Bonds: Pooled Financing - PBMC's share of pooled financings constitutes less than 100% of each issue. Part I columns (e) and (f), and all of Parts II and III, have been answered with respect to PBMC's share of such pooled financings, not with respect to 100% of each issue.
Part II Line 17, Part III Line 9, Part IV Line 7, Part VThe following is applicable to all bond issues listed in Part I: During this fiscal year, the institution was in the process of implementing written compliance procedures.
Part II, Line 4, column A- Bond issued 6/28/12: The amount shown here consists of $288,650 in debt service reserve fund, plus $65,570 of debt service fund deposits. - Bond issued 7/24/14: The amount shown here consists of $768,700 in debt service reserve fund, plus $186,530 of debt service fund deposits. - Bond issued 6/28/16: The amount shown here consists of $179,600 in debt service reserve fund, plus $44,135 of debt service fund deposits. - Bond issued 12/28/17: The amount shown here consists of $419,888 in debt service reserve fund, plus $195,102 of debt service fund deposits.
Part IIIPart III has not been completed with respect to the refunding bonds issued 6/28/2012, since the bonds being refinanced by such bonds were issued before 2003.
Part IV, Line 6, Bond Issued 6/28/12The "yes" answer here refers to the debt service reserve fund that (in the aggregate for the entire issue, including the institution's portion plus all other participating institutions) exceeds the amount qualifying as a reasonably required reserve or replacement fund. It is our understanding that the Authority appropriately restricts the investment yield on the excess amounts.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
Maine Health & Higher Educational Facilities Authority
A01031438456042REW82016-06-28$1,349,217See Part VI00Yes (1)
Maine Health & Higher Educational Facilities Authority
B01031438456042RQL92017-12-28$8,909,963See Part VI00Yes (1)

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$250,000$1,349,217$223,735$25,510$1,349,217Yes (1)0Yes (1)Yes (1)
B$230,000$8,909,963$614,990$94,253$8,909,963Yes (1)0Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00000.000000.000000.00000000
B00000.000000.000000.00000000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A0Yes (1)0000000
B0Yes (1)0000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
990 Form, Part V, Line 1aMaine Medical Center (EIN 01-0238552), acting on behalf of MaineHealth (EIN 01-0431680), filed 1,030 Form 1099s for the calendar year 2017 on behalf of the following organizations: MaineHealth, Maine Medical Center, Southern Maine Health Care, 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. Prior to consolidating accounts payable operations with Maine Medical Center (EIN 01-0238552), the entity filed 67 Form 1099s for the calendar year 2017.
Form 990, Part VI, Section A, line 6Coastal Healthcare Alliance (CHA) (EIN# 22-2494475) is the sole member of PBMC. MaineHealth (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 7aThe 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 7bDecisions 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 MaineHealth (EIN# 01-0431680).
Form 990, Part VI, Section B, line 11bA detailed review of the Form 990 is performed by the Controller. The Form 990 is reviewed in detail with the Finance Committee. It is then made available to the full board prior to filing.
Form 990, Part VI, Section B, line 12cAt 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 15Compensation 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 MaineHealth system. The firm meets with the Executive Committee to review each executive's benchmark report. The Committee then deliberates on MaineHealth'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 19Documents that are required to be open for the public inspection are made available upon request.
Form 990, Part IX, line 11gOther fees for services: Program service expenses 4,387,709. Management and general expenses 248,991. Fundraising expenses 0. Total expenses 4,636,700. Temp personnel: Program service expenses 1,961,504. Management and general expenses 111,310. Fundraising expenses 0. Total expenses 2,072,814. Locum tenens: Program service expenses 1,915,303. Management and general expenses 108,688. Fundraising expenses 0. Total expenses 2,023,991. Lab services: Program service expenses 4,349,164. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,349,164.
Form 990, Part XI, line 9:Transfer from affiliates 203,379. Loss on investment in Pine Tree Insurance -19,310. Transfer of net assets from Kno-Wal-Lin 314,221.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Coastal Healthcare Alliance
PO Box 287BelfastME04915222494475HealthcareME501(c)(3)Line 12b, IIMaineHealth0
Quarry Hill
PO Box 287BelfastME04915010213976Long-term careME501(c)(3)Line 10Coastal Healthcare Alliance0
Pen Bay Behavioral Health
PO Box 287BelfastME04915010277794Behavioral healthME501(c)(3)Line 10Coastal Healthcare Alliance0
Kno-Wal-Lin Home Care and Hospice
PO Box 287BelfastME04915010340947Home healthME501(c)(3)Line 10Coastal Healthcare Alliance0
Kno-Wal-Lin Help at Home Inc
PO Box 287BelfastME04915222968726Home servicesME501(c)(3)Line 10Coastal Healthcare Alliance0
Pen Bay Waldo Healthcare Foundation
PO Box 287BelfastME04915222482325FundraisingME501(c)(3)Line 7Coastal Healthcare Alliance0
Penobscot Bay Physicians & Assoc
PO Box 287BelfastME04915010530517Physician servicesME501(c)(3)Line 12b, IIPenobscot Bay Medical CenterYes (1)
MaineHealth
110 Free StreetPortlandME04101010431680HealthcareME501(c)(3)Line 12c, III-FI0N/A
Waldo County General Hospital
118 Northport AveBelfastME04915010177170HospitalME501(c)(3)Line 3Coastal Healthcare Alliance0
Waldo County Home Healthcare Svcs
PO Box 287BelfastME04915222864960HospiceME501(c)(3)Line 10Coastal Healthcare Alliance0
Coastal Medical Care
PO Box 287BelfastME04915010487091Medical servicesME501(c)(3)Line 10Coastal Healthcare Alliance0
Belfast Public Health Nursing
PO Box 287BelfastME04915043359810Public healthME501(c)(3)Line 10Coastal Healthcare Alliance0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
PBH Management Company
PO Box 287BelfastME04915010537278Management servicesMEN/AC0
Waldo County Healthcare Mgmt Co
PO Box 287BelfastME04915010485133Management servicesMEN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Pen Bay Physicians & AssociatesBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeMTransactionTypeTxt
Involved$18,526,974InvolvedAmt
Method Of Amount DeterminationFair Market ValueMethodOfAmountDeterminationTxt