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Penobscot Bay Medical Center: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
Penobscot Bay Medical Center (EIN 01-0285286)
Tax period
2010-04-01 to 2011-03-31
Filed
2012-03-29
IRS object ID
201220899349300112
Schema version
2010v3.7
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)
Timestamp2012-03-29T10:11:25-05:00Timestamp
Tax Period End Date2011-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MAINEHEALTHBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1110 FREE STAddressLine1
CityPORTLANDCity
StateMEState
ZIP Code041013908ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN010285286EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PENOBSCOT BAY MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPENONameControl
Phone2075946747Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14 WHITE STREETAddressLine1
CityROCKLANDCity
StateMEState
ZIP Code048412953ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMAURA KELLYName
TitleVICE PRESIDENT FISCAL SERVICESTitle
Phone2075946747Phone
Date Signed2012-03-22DateSigned
Authorize Third PartyfalseAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Date Prepared2012-03-29DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMAURA KELLYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14 WHITE STREETAddressLine1
CityROCKLANDCity
StateMEState
ZIP Code048412953ZIPCode
FieldValueIRS element (for citing)
Gross Receipts108192576GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.PENOBSCOTBAYMEDICALCENTER.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1969YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionPENOBSCOT BAY MEDICAL CENTER IS AN ACCUTE 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 & GYNECOLOGY DEPARTMENT, AND THE PSYCHIATRIC ADDICTION & RECOVERY CENTER.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees1424TotalNbrEmployees
Total Nbr Volunteers162TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year481375ContributionsGrantsPriorYear
Contributions Grants Current Year593380ContributionsGrantsCurrentYear
Program Service Revenue Prior Year104534781ProgramServiceRevenuePriorYear
Program Service Revenue CY106544140ProgramServiceRevenueCY
Investment Income Prior Year464519InvestmentIncomePriorYear
Investment Income Current Year370672InvestmentIncomeCurrentYear
Other Revenue Prior Year3343849OtherRevenuePriorYear
Other Revenue Current Year684384OtherRevenueCurrentYear
Total Revenue Prior Year108824524TotalRevenuePriorYear
Total Revenue Current Year108192576TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year55375195SalariesEtcPriorYear
Salaries Etc Current Year54571039SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year432697TotalFundrsngExpCurrentYear
Other Expense Prior Year53958008OtherExpensePriorYear
Other Expenses Current Year51820666OtherExpensesCurrentYear
Total Expenses Prior Year109333203TotalExpensesPriorYear
Total Expenses Current Year106391705TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-508679RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1800871RevenuesLessExpensesCY
Total Assets BOY95160011TotalAssetsBOY
Total Assets EOY99565926TotalAssetsEOY
Total Liabilities BOY42326328TotalLiabilitiesBOY
Total Liabilities EOY44007798TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY52833683NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY55558128NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPENOBSCOT BAY MEDICAL CENTER IS AN ACCUTE 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 & GYNECOLOGY DEPARTMENT, AND THE PSYCHIATRIC ADDICTION & RECOVERY CENTER.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense78670709Expense
Revenue86770430Revenue
DescriptionINPATIENT CARE: PENOBSCOT BAY MEDICAL CENTER 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 PENOBSCOT BAY MEDICAL CENTER, 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. PENOBSCOT BAY MEDICAL CENTER SERVED 4,117 INPATIENTS, INCLUDING NEWBORNS AND (CONTINUED ON SCHEDULE O) (CONTINUED FROM PART III, LINE 4A) 180,886 OUTPATIENTS INCLUDING, ER VISITS, DURING FY 11. 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 22,519 VISITS TO THE EMERGENCY ROOM DURING FY 11. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE & MAINECARE PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, PENOBSCOT BAY MEDICAL CENTER RECOGNIZES THESE AMOUNTS AS CONTRACTUAL ADJUSTMENTS. THE UNREIMBURSED COSTS OF PROVIDING CARE TO THESE PATIENTS WERE 82,577,382. DURING FY 11, APPROXIMATELY 58% OF SERVICES WERE TO PATIENTS COVERED BY THESE GOVERNMENTAL PROGRAMS. ADDITIONALLY, PENOBSCOT BAY MEDICAL CENTER PROVIDED 3,191,732 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 24 HOURS A DAY AND AVAILABLE TO THE GENERAL PUBLIC. DURING FY 11 THE COMMUNITY CONTRIBUTED APPROXIMATELY 13,400 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.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense6692796Expense
Revenue7381868Revenue
DescriptionPHYSICIAN PRACTICES - PEN BAY PHYSICIAN AND ASSOCIATES, A GROUP OF DEPARTMENTS OF PENOBSCOT BAY MEDICAL CENTER, IS COMPOSED OF 18 PRACTICES COVERING MANY SPECIALITIES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense8752567Expense
Revenue9653707Revenue
DescriptionTHE 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.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense2482539Expense
Revenue2738135Revenue
DescriptionPEN BAY BEHAVIORAL HEALTH PHYSICIANS.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp2482539TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev2738135TotalOfOtherProgramServiceRev
Total Program Service Expense96598611TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109689NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1424NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledMEStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLYNN SOUCYNamePerson
Telephone Number2075946747TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14 WHITE STREETAddressLine1
CityROCKLANDCity
StateMEState
ZIP Code048412953ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JOEL D LAFLEUR MD
CHAIRMAN40.00XX026584020916
BETH KOESTER MD
MEDICAL STAF40.00XX0379101420
GREGORY A DUFOUR
SECRETARY1.00XX000
DAVID R WILLIAMS CPA
TREASURER1.00XX000
JACOB GERRITSEN MD
TRUSTEE1.00X000
DANA GOLDSMITH
VICE PRESIDE40.00X2540281955220472
MAURA KELLY
VICE PRESIDE40.00X207498016015
ERIC WATERS
VICE PRESIDE40.00X154225015948
PAULA DELAHANTY
VICE PRESIDE40.00X13989407373
CHRISTOPHER MICHALAKES
EMERGENCY DE40.00278732012846X
FREDERICK GOGGANS
PARC MEDICAL40.00262388022339X
NADIA RAMDIN
PHYSICIAN40.00256829013950X
KAREN BACKMAN
PHYSICIAN40.00247395022839X
MCKENZIE ABENDROTH
PHYSICIAN40.0024642808314X
WILLIAM MASTER MD
TRUSTEE1.00019584917773X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2047417TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs519151TotalReportableCompFrmRltdOrgs
Total Other Compensation180205TotalOtherCompensation
Number Individuals GT100 K32NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ATTORNEY CARL TRYNOR
PO BOX 4290PORTLANDME04101COLLECTIONS187774
PENOBSCOT BAY PATHOLOGY ASSOCIATES
PO BOX 1849LEWISTONME04240PATHOLOGY SERV.177500
DAVID HALL MD
905 BARNSTOWN ROADHOPEME04847PHYSICIAN SERV.128960
ANDREW FILDERMAN MD
4 GLEN COVE DRIVEROCKPORTME04856PHYSICIAN SERV.112000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Government Grants111477GovernmentGrants
All Other Contributions481903AllOtherContributions
Total Contributions593380TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
INPATIENT CARE6241008677043086770430
PEN BAY PHYSICIANS & ASSOC.62300096537079653707
KNOX CENTER FOR LT CARE62111073818687381868
OTHER62410027381352738135
FieldValueIRS element (for citing)
Total Program Service Revenue106544140TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column379009TotalRevenueColumn
Related Or Exempt Function Income379009RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other-8337Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-8337Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-8337TotalRevenueColumn
Related Or Exempt Function Income-8337RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
OTHER REVENUE621990370553370553
MRI REVENUE624100313831313831
FieldValueIRS element (for citing)
Total Other Revenue684384TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column108192576TotalRevenueColumn
Related Or Exempt Function Income107599196RelatedOrExemptFunctionIncome

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1018409Total
Program Services963044ProgramServices
Management And General55365ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total41838967Total
Program Services39564368ProgramServices
Management And General2274599ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total931647Total
Program Services880997ProgramServices
Management And General50650ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8015236Total
Program Services7579483ProgramServices
Management And General435753ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2766780Total
Program Services2616362ProgramServices
Management And General150418ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total4582428Total
Management And General4149731ManagementAndGeneral
Fundraising432697Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total67692Total
Management And General67692ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total4783Total
Management And General4783ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total16055Total
Management And General16055ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total2961Total
Program Services2800ProgramServices
Management And General161ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3562115Total
Program Services3368459ProgramServices
Management And General193656ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total231869Total
Program Services219263ProgramServices
Management And General12606ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3337511Total
Program Services3156065ProgramServices
Management And General181446ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total434953Total
Program Services411307ProgramServices
Management And General23646ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1462681Total
Program Services1383162ProgramServices
Management And General79519ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5740151Total
Program Services5427887ProgramServices
Management And General312264ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1577018Total
Program Services1491282ProgramServices
Management And General85736ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES & OTHER23292626220263091266317
PROVISION FOR BAD DEBTS50465215046521
HEALTH CARE PROVIDER TAX24613022461302

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total106391705Total
Program Services96598611ProgramServices
Management And General9360397ManagementAndGeneral
Fundraising432697Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1199596BOY
EOY7174520EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6073300BOY
EOY2679627EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY1750EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11213846BOY
EOY13397738EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY7529437BOY
EOY196648EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1411923BOY
EOY1606055EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1073807BOY
EOY1436464EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis116433656LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec75222672LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY43186869BOY
EOY41210984EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY16570613BOY
EOY17747524EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6900620BOY
EOY14114616EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY95160011BOY
EOY99565926EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY14416105BOY
EOY12978816EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY27690592BOY
EOY26299017EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
EOY646595EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY219631BOY
EOY4083370EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY42326328BOY
EOY44007798EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY45348507BOY
EOY47583279EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2364811BOY
EOY2654704EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5120365BOY
EOY5320145EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY52833683BOY
EOY55558128EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY95160011BOY
EOY99565926EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1800871ReconcilationRevenueExpenses
Reconcilation Other Changes923574ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
Form1120 Pol FiledfalseForm1120PolFiled
Form4720 FiledfalseForm4720Filed
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$16,055OtherActivitiesAmount
Total Lobbying Expenditures IIB16055TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax
Substantially All Dues NondeductfalseSubstantiallyAllDuesNondeduct
Only In House LobbyingfalseOnlyInHouseLobbying
Agree To Carryover Prior YearfalseAgreeToCarryoverPriorYear

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE C, PART II-B, LINE 1IReturnReference
ExplanationA PORTION OF MEMBERSHIP DUES PAID TO VARIOUS ORGANIZATIONS REPRESENT LOBBYING ACTIVITIES. LOBBYING PORTION OF AHA DUES: 5,673 LOBBYING PORTION OF MHA DUES: 8,340 LOBBYING PORTION OF MHCA DUES: 2,042Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance5120364BeginningOfYearBalance
Investment Earnings Or Losses199781InvestmentEarningsOrLosses
End Of Year Balance5320145EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance4475854BeginningOfYearBalance
Investment Earnings Or Losses644510InvestmentEarningsOrLosses
End Of Year Balance5120364EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5637758BeginningOfYearBalance
Investment Earnings Or Losses-1161904InvestmentEarningsOrLosses
End Of Year Balance4475854EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis951091OtherCostOrOtherBasis
Book Value951091BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis47836662OtherCostOrOtherBasis
Depreciation25395219Depreciation
Book Value22441443BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1778922OtherCostOrOtherBasis
Depreciation1373851Depreciation
Book Value405071BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis64995939OtherCostOrOtherBasis
Depreciation48453602Depreciation
Book Value16542337BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis871042OtherCostOrOtherBasis
Book Value871042BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings41210984TotalOfBookValueLandBuildings

Other Assets OtherAssets (8 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM THIRD PARTY5735000
INVESTMENT IN FIRST MAINE CAPTIVE2944394
TRUSTEE HELD BOND FUNDS1676723
PREPAID LIFE INSURANCE1468282
DUE FROM AFFILIATES1149385
OTHER ASSETS675291
BOND ISSUE COSTS455684
RESIDENT ACCOUNTS & DEPOSITS9857
FieldValueIRS element (for citing)
Total Book Value Other Assets14114616TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
DUE TO MAINEHEALTH & MEMBERS$3,506,079
DUE TO THIRD PARTY$567,434
RESIDENT ACCOUNTS$9,857
CAPITAL LEASES PAYABLE
FieldValueIRS element (for citing)
Total Of Amounts4083370TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierINTENDED USES FOR ENDOWMENT FUNDSIdentifier
Return ReferenceSCHEDULE D, PAGE 2, PART V, LINE 4ReturnReference
ExplanationTO BE INVESTED IN PERPETUITY TO PROVIDE A PERMANENT SOURCE OF INCOME.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3945457TotalCommunityBenefitExpense
Net Community Benefit Expense3945457NetCommunityBenefitExpense
Percent Of Total Expense0.03710PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense15683881TotalCommunityBenefitExpense
Direct Offsetting Revenue13399932DirectOffsettingRevenue
Net Community Benefit Expense2283949NetCommunityBenefitExpense
Percent Of Total Expense0.02150PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense19629338TotalCommunityBenefitExpense
Direct Offsetting Revenue13399932DirectOffsettingRevenue
Net Community Benefit Expense6229406NetCommunityBenefitExpense
Percent Of Total Expense0.05860PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense119986TotalCommunityBenefitExpense
Direct Offsetting Revenue136151DirectOffsettingRevenue
Net Community Benefit Expense-16165NetCommunityBenefitExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense119986TotalCommunityBenefitExpense
Direct Offsetting Revenue136151DirectOffsettingRevenue
Net Community Benefit Expense-16165NetCommunityBenefitExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense19749324TotalCommunityBenefitExpense
Direct Offsetting Revenue13536083DirectOffsettingRevenue
Net Community Benefit Expense6213241NetCommunityBenefitExpense
Percent Of Total Expense0.05860PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense91555TotalCommunityBuildingExpense
Direct Offsetting Revenue69141DirectOffsettingRevenue
Net Community Building Expense22414NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense129742TotalCommunityBuildingExpense
Direct Offsetting Revenue75000DirectOffsettingRevenue
Net Community Building Expense54742NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense221297TotalCommunityBuildingExpense
Direct Offsetting Revenue144141DirectOffsettingRevenue
Net Community Building Expense77156NetCommunityBuildingExpense
Percent Of Total Expense0.00060PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$2,891,657BadDebtExpenseAmount
Amount Reimbursed By Medicare25316842AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare32869388CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-7552546MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1PENOBSCOT BAY MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line16 GLEN COVE DRIVEAddressLine1
CityROCKPORTCity
StateMEState
ZIP Code04856ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PENOBSCOT BAY MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities6NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
PEN BAY PHYSICIANS & ASSOCIATES
4 GLEN COVE DRIVEROCKPORTME04856PHYSICIAN PRACTICES
THE KNOX CENTER FOR LONG TERM CARE
6 WHITE STREETROCKLANDME04841LONG TERM CARE
PEN BAY SLEEP CENTER
7 MADELYN LANEROCKPORTME04856SLEEP CENTER
PEN BAY PHYSICAL THERAPY
4 GLEN COVE DRIVEROCKPORTME04856PHYSICAL THERAPY
PEN BAY OCCUPATIONAL THERAPY
4 GLEN COVE DRIVEROCKPORTME04856OCCUPATIONAL THERAPY
PEN BAY PHYSICAL THERAPY
116 UNION STREETROCKPORTME04856PHYSICAL THERAPY

Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
COSTING METHODOLOGY EXPLANATIONPART I LINE 7RATIO OF PATIENT CARE COSTS TO CHARGES PER WORKSHEET 2 OF THE INSTRUCTIONS
COMMUNITY BUILDING ACTIVITIESPART IICOMMUNITY HEALTH IMPROVEMENT ADVOCACY PICKER FAMILY RESOURCE CENTER THE PICKER FAMILY RESOURCE CENTER PROMOTES BUILDING COMMUNITY BY PROVIDING HEALTH RESOURCES AND SUPPORT THAT SERVE THE NEEDS FOR WOMEN AND THEIR FAMILIES THROUGHOUT THEIR LIVES THE RESOURCE CENTER SERVES PATIENTS WHO WANT TO LEARN ABOUT A DISEASE CONDITION OR TREATMENT COMMUNITY MEMBERS WHO NEED HEALTHY LIVING TIPS AND RESOURCES AND HEALTHCARE PROVIDERS LOOKING FOR HEALTH EDUCATION MATERIALS AND RESOURCES WORKFORCE DEVELOPMENT NURSING EDUCATION PBMC PARTNERED WITH THE UNIVERSITY OF MAINE AT AUGUSTA TO PROVIDE COMMUNICATIONS TRAINING FOR NURSES AND OTHER EMPLOYEES
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4PEN BAY HEALTHCARE PBH PARENT COMPANY OF PENOBSCOT BAY MEDICAL CENTER ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY A PATIENT IS CLASSIFIED AS A FREE CARE PATIENT BY REFERENCE TO CERTAIN ESTABLISHED POLICIES OF PBH THESE POLICIES DEFINE FREE CARE SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED IN ASSESSING A PATIENTS ELIGIBILITY FOR FREE CARE PBH UTILIZES FEDERALLY ESTABLISHED POVERTY GUIDELINES FREE CARE PROVIDED IS NOT INCLUDED IN NET PATIENT SERVICE REVENUE AND IS MEASURED BASED ON PBHS CHARGES COSTS AND EXPENSES INCURRED IN PROVIDING THESE SERVICES ARE INCLUDED IN OPERATING EXPENSES SERVICES RENDERED TO INDIVIDUALS FROM WHOM PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED IS WRITTEN OFF AND INCLUDED AS PART OF THE PROVISION FOR BAD DEBTS 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 PBMC BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT
MEDICARE EXPLANATIONPART III LINE 8COST 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
COLLECTION PRACTICES EXPLANATIONPART III LINE 9BPATIENTS ARE NOTIFIED OF ASSISTANCE OPPORUNITIES VIA 1 PATIENT ADVOCATE 2 HOSPITAL FINANCIAL COUNSELOR 3 HOSPITAL POSTINGS IN VARIOUS OPTIONS 4 ON THE BACK OF EVERY BILL 5 COMMUNICATION WHEN CALLING OUR OFFICES
NEEDS ASSESSMENTPART VIWE ARE CONTINUALLY ASSESSING THE NEEDS OF THE COMMUNITIES WE SERVE TO THE EXTENT POSSIBLE IN REGARD TO HEALTH CARE SERVICES AND AVAILABILITY SEE PROGRAM SERVICE ACCOMPLISHMENTS
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VIPATIENTS ARE NOTIFIED OF ASSISTANCE OPPORUNITIES VIA 1 PATIENT ADVOCATE 2 HOSPITAL FINANCIAL COUNSELOR 3 HOSPITAL POSTINGS IN VARIOUS OPTIONS 4 ON THE BACK OF EVERY BILL 5 COMMUNICATION WHEN CALLING OUR OFFICES
COMMUNITY INFORMATIONPART VIPENOBSCOT BAY MEDICAL CENTER IS A FULL SERVICE 99 BED COMMUNITY HOSPITAL SERVING THE PEOPLE OF MIDCOAST MAINE
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VISEE PROGRAM SERVICE ACCOMPLISHMENTS
AFFILIATED HEALTH CARE INFORMATIONPART VIPENOBSCOT BAY MEDICAL CENTER IS AN ACUTE CARE HOSPITAL PROVIDING INPATIENT AND OUTPATIENT HOSPITAL SERVICES AS WELL AS EMERGENCY ROOM SERVICES PHYSICIANS PRACTICES AND LONG TERM CARE QUARRY HILL PROVIDES LONG TERM CARE SERVICES KNOWALLIN HOME HEALTH CARE PROVIDES INHOME HEALTH CARE AND HOSPICE SERVICES KNOWALLIN HELP AT HOME PROVIDES HOMEMAKER SERVICES

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
JOEL D LAFLEUR MD
265840612514791286756
DANA GOLDSMITH
1955219552254028571014762274500
MAURA KELLY
207498512510890223513
ERIC WATERS
154225400011948170173
CHRISTOPHER MICHALAKES
27873298003046291578
FREDERICK GOGGANS
262388980012539284727
NADIA RAMDIN
25682961257825270779
KAREN BACKMAN
247395980013039270234
MCKENZIE ABENDROTH
2464288314254742
WILLIAM MASTER MD
195849426413509213622

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MHHEFA SERIES 2003D
010314384560425QS22003-10-1636540048BUILDINGS & FACILITIESfalsefalsefalse
MHHEFA SERIES 2004A
010314384560425TL42004-06-0374141027BUILDING & FACILITIESfalsefalsefalse
MHHEFA SERIES 2006F
010314384560425G202006-09-0791723676BUILDING & FACILITIESfalsefalsefalse
MHHEFA SERIES 2007B
010314384560425V802007-11-0172040461BUILDING & FACILITIESfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Amount In Reserve FundAmountInReserveFundYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
2433342004falsefalsetruetrue
1866672006falsefalsetruetrue
1057832007falsefalsetruetrue
1566672007falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsetruetrue
falsefalsefalsefalsetruetrue
falsefalsefalsefalsetruetrue
falsefalsefalsefalsetruetrue

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsefalsefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MHHEFA SERIES 2003D
010314384560425QS22003-10-1636540048BUILDINGS & FACILITIESfalsefalsefalse
MHHEFA SERIES 2004A
010314384560425TL42004-06-0374141027BUILDING & FACILITIESfalsefalsefalse
MHHEFA SERIES 2006F
010314384560425G202006-09-0791723676BUILDING & FACILITIESfalsefalsefalse
MHHEFA SERIES 2007B
010314384560425V802007-11-0172040461BUILDING & FACILITIESfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Amount In Reserve FundAmountInReserveFundYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
2433342004falsefalsetruetrue
1866672006falsefalsetruetrue
1057832007falsefalsetruetrue
1566672007falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsetruetrue
falsefalsefalsefalsetruetrue
falsefalsefalsefalsetruetrue
falsefalsefalsefalsetruetrue

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsefalsefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONPENOBSCOT BAY MEDICAL CENTER IS AN ACCUTE 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 & GYNECOLOGY DEPARTMENT, AND THE PSYCHIATRIC ADDICTION & RECOVERY CENTER.
FIRST ACHIEVEMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4A(CONTINUED FROM PART III, LINE 4A) 180,886 OUTPATIENTS INCLUDING, ER VISITS, DURING FY 11. 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 22,519 VISITS TO THE EMERGENCY ROOM DURING FY 11. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE & MAINECARE PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, PENOBSCOT BAY MEDICAL CENTER RECOGNIZES THESE AMOUNTS AS CONTRACTUAL ADJUSTMENTS. THE UNREIMBURSED COSTS OF PROVIDING CARE TO THESE PATIENTS WERE 82,577,382. DURING FY 11, APPROXIMATELY 58% OF SERVICES WERE TO PATIENTS COVERED BY THESE GOVERNMENTAL PROGRAMS. ADDITIONALLY, PENOBSCOT BAY MEDICAL CENTER PROVIDED 3,191,732 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 24 HOURS A DAY AND AVAILABLE TO THE GENERAL PUBLIC. DURING FY 11 THE COMMUNITY CONTRIBUTED APPROXIMATELY 13,400 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.
ALL OTHER ACHIEVEMENTS DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4DPEN BAY BEHAVIORAL HEALTH PHYSICIANS.
SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTSFORM 990, PAGE 6, PART VI, LINE 4EFFECTIVE JANUARY 1, 2011, PEN BAY HEALTHCARE (PBH) (PARENT COMPANY OF PENOBSCOT BAY MEDICAL CENTER) BECAME A MEMBER ORGANIZATION OF MAINEHEALTH, WITH MAINEHEALTH BECOMING THE SOLE CORPORATE MEMBER OF PBH. THE BY-LAWS WERE REVISED TO REFLECT THIS CHANGE.
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6PEN BAY HEALTHCARE (PBHC) IS THE SOLE MEMBER OF PEN BAY MEDICAL CENTER. MAINEHEALTH (EIN01-0431680), AS THE SOLE MEMBER OF PBHC, HAS THE RIGHT TO APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BODY OF PBHC AND ITS SUBSIDIARIES.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ATHE SOLE MEMBER, PEN BAY HEALTHCARE MAY ELECT THE BOARD OF DIRECTORS FROM A SLATE OF NOMINEES SUBMITTED BY THE CORPORATION. THE OFFICERS ARE ELECTED BY THE BOARD OF TRUSTEES.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, 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 PEN BAY HEALTHCARE & MAINEHEALTH.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE FINANCE COMMITTEE PERFORMS A DETAILED REVIEW OF THE FORM 990. THE FORM 990 IS THEN MADE AVAILABLE TO THE FULL BOARD. A FINAL DETAILED REVIEW OF THE FORM 990 IS PERFORMED BY THE CHIEF FINANCIAL OFFICER BEFORE SIGNING AND PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CAT THE BEGINNING OF BOARD SERVICE, MEMBERS ARE REQUIRED TO DOCUMENT ANY CONFLICT OF INTEREST THAT MAY EXIST, THEY ARE REQUIRED TO REPORT ANY ADDITIONAL CONFLICTS THAT MAY ARISE. BOARD MEMBER CONFLICT OF INTEREST FORMS ARE UPDATED AND REVIEWED ANNUALLY.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15APEN BAY MEDICAL CENTER BOARD OF DIRECTORS ARE RESPONSIBLE FOR AN ANNUAL EVALUATION OF THE PRESIDENT/CEO AND THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. FOR THOSE KEY ADMINISTRATIVE EMPLOYEES THAT ARE SHARED WITH PBHC, COMPENSATION IS EVALUATED BY THE PBHC GOVERNANCE COMMITTEE AND APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE MEMBER IS RESPONSIBLE FOR AN ANNUAL EVALUATION OF THE PRESIDENT/CEO AND THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. COMPENSATION IS EVALUATED BY THE COMPENSATION COMMITTEE APPOINTED BY THE MEMBER, AND THE ORGANIZATION'S BOARD OF TRUSTEES MUST APPROVE OF THE COMPENSATION. IN ADDITION, THE ORGANIZATION UTILIZES THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTING FIRM AND INDUSTRY SURVEY.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR THE PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST.
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5OTHER CHANGES TO NET ASSETS INCLUDE THE FOLLOWING: 6,394 INVESTMENT INCOME EARNED ON TEMPORARILY RESTRICTED NET ASSETS 67,104 OTHER INCOME 850,074 TOTAL INCREASE IN THE MARKET VALUE OF UNRESTRICTED, TEMP RESTRICTED AND PERM RESTRICTED INVESTMENTS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
QUARRY HILL
4 WHITE STREETROCKLANDME04841010213976LT CAREME501C311CPEN BAY HCfalse
PEN BAY HEALTHCARE
4 WHITE STREETROCKLANDME04841222494475ADMIN.ME501C39MAINEHLTHfalse
PEN BAY BEHAVIORAL HEALTH
4 WHITE STREETROCKLANDME04841010277794BHV HLTHME501C39PEN BAY HCfalse
KNO-WAL-LIN HEALTH CARE INC
4 WHITE STREETROCKLANDME04841010340947HOME HCME501C39PEN BAY HCfalse
KNO-WAL-LIN HELP AT HOME
4 WHITE STREETROCKLANDME04841222968726HM MKR SVCME501C39PEN BAY HCfalse
PEN BAY HEALTHCARE FOUNDATION
4 WHITE STREETROCKLANDME04841222482325FNDRAISINGME501C311CPEN BAY HCfalse
PENOBSCOT BAY PHYSICIANS & ASSOC
4 WHITE STREETROCKLANDME04841010530517PHYS. SVCSME501C311CPB MED CENfalse
MAINEHEALTH
110 FREE STREETPORTLANDME04101010431680HEALTHCAREME501C311CNAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1NEH MANAGEMENT COMPANYBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14 WHITE STREETAddressLine1
CityROCKLANDCity
StateMEState
ZIP Code04841ZIPCode
FieldValueIRS element (for citing)
EIN010537278EIN
Primary ActivityMANAGEMENTPrimaryActivity
Legal Domicile StateMELegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PEN BAY HCBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1PEN BAY PHYSICIANS & ASSOCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeLTransactionType
Amount Involved13289799AmountInvolved
Method Of Amt DeterminationPHYSICIAN SALARIESMethodOfAmtDetermination