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MAINE COAST REGIONAL HEALTH FACILI DBA NORTHERN LIGHT MAINE COAST HOS: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MAINE COAST REGIONAL HEALTH FACILI DBA NORTHERN LIGHT MAINE COAST HOS (EIN 01-0198331)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201231369349301383
Schema version
2010v3.4
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)
Timestamp2012-05-15T09:30:56-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Berry Dunn McNeil & Parker LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1100AddressLine1
CityPortlandCity
StateMEState
ZIP Code041041100ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN010198331EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Maine Coast Regional Health FacilitiesBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMAINNameControl
Phone2076645303Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line150 Union StreetAddressLine1
CityEllsworthCity
StateMEState
ZIP Code04605ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCharles TherrienName
TitleCEOTitle
Phone2076645303Phone
Date Signed2012-05-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBarbara J McGuan CPAName
Phone2077752387Phone
Date Prepared2012-05-11DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Maine Coast Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonCharles TherrienNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line150 Union StreetAddressLine1
CityEllsworthCity
StateMEState
ZIP Code04605ZIPCode
FieldValueIRS element (for citing)
Gross Receipts92653395GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.mcmhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1964YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionThe hospital provides health care services through its acute care facilities.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees858TotalNbrEmployees
Total Nbr Volunteers188TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2887751ContributionsGrantsPriorYear
Contributions Grants Current Year714791ContributionsGrantsCurrentYear
Program Service Revenue Prior Year82802501ProgramServiceRevenuePriorYear
Program Service Revenue CY90654272ProgramServiceRevenueCY
Investment Income Prior Year380364InvestmentIncomePriorYear
Investment Income Current Year466102InvestmentIncomeCurrentYear
Other Revenue Prior Year271782OtherRevenuePriorYear
Other Revenue Current Year-45158OtherRevenueCurrentYear
Total Revenue Prior Year86342398TotalRevenuePriorYear
Total Revenue Current Year91790007TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year52215504SalariesEtcPriorYear
Salaries Etc Current Year52749855SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year64358TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year150703TotalFundrsngExpCurrentYear
Other Expense Prior Year32483648OtherExpensePriorYear
Other Expenses Current Year33462853OtherExpensesCurrentYear
Total Expenses Prior Year84763510TotalExpensesPriorYear
Total Expenses Current Year86212708TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1578888RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5577299RevenuesLessExpensesCY
Total Assets BOY71114704TotalAssetsBOY
Total Assets EOY74385385TotalAssetsEOY
Total Liabilities BOY31628313TotalLiabilitiesBOY
Total Liabilities EOY28857886TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY39486391NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY45527499NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe hospital is a not-for-profit entity established to provide health care services through its acute care facilities.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense80364538Expense
Revenue90657272Revenue
DescriptionAdmissions 3,745Patient Days 10,817Average Stay 2.89 DaysClinic Visits:Eleanor Widener Dixon Clinic 10,586S.W. Harbor Medical Center 5,125Emergency Room Visits 18,405Surgical Cases- Inpatient 875Surgical Cases- Outpatient 3,308Laboratory Tests: 294,310Radiology Exams:Diagnostic Radiology 18,173Ultrasound 4,867CT Scan 5,559Mammography 4,059Nuclear Medicine 2,438MRI 2,206Physical Therapy 53,133Births 309Description
Total Program Service Expense80364538TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109665NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees858NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMEStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Charles Therrien President & CEOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2076645303TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line150 Union StreetAddressLine1
CityEllsworthCity
StateMEState
ZIP Code04605ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Michelle H Beal
Trustee1.00X000
Edith R Dixon
Trustee0.50X000
Thomas J Fernald
Trustee1.00X000
Alan J Goldstein
Trustee0.50X000
Daniel A Hurley III
Trustee1.00X000
Adin M Tooker
Treasurer1.00X000X
Jeffrey R Dow
Trustee1.00X000
Nicholas S Vachon DPM
Trustee1.00X000
Robert J Williams
Secretary1.00X000X
John P Edwards
Trustee1.00X000
Debra A Ehrlenbach
Trustee1.00X000
Robert A Beekman MD
Trustee/Physician50.00X178303027519
Alan H Nauss MD
Trustee1.00X000
Katheryn Rensenbrink MD
President Medical Staff55.00X215678035279
Rebecca J Sargent
Vice Chairman10.00X000X
Robert D Merrill
Chairman10.00X000X
Sean T Maloney
Trustee/Physician50.00X213055034880
Charles D Therrien
CEO60.00X165787010341X
Christopher B Brown
Trustee1.00X000
Kevin Sedgwick
CFO50.00189031026040X
Sterling C Williamson
Physician50.00492693037903X
Thomas H Crowe
Physician50.00403462035961X
Bradley Goldstein
Physician50.00404892032715X
Martin R Curlick
Physician50.0041295506304X
Kerry Crowley
Physician50.00370338034796X
John McCormack
Former CEO50.0012154200X
Douglas T Jones
Former CEO0.0018753608992X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3355272TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation290730TotalOtherCompensation
Number Individuals GT100 K64NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Transcend Services Inc
PO Box 740209AtlantaGA303740209Transcription Svcs.333590
Eastern Maine Medical Center
43 Whiting Hill RoadBrewerME04412Medical Services289311
Baker Newman & Noyes LLC
PO Box 507PortlandME04112Audit/Consult. Svcs.245286
Vista Staffing Solutions Inc
275 East 200 SouthSalt Lake CityUT841112002Nursing & Physician Staff219387
Blue Hill Laundry Services Inc
PO Box 258SurryME04684Laundry Services214607
FieldValueIRS element (for citing)
Number Of Contractors GT100 K8NumberOfContractorsGT100K
Fundraising Events129120FundraisingEvents
Related Organizations103988RelatedOrganizations
All Other Contributions481683AllOtherContributions
Noncash Contributions24304NoncashContributions
Total Contributions714791TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
Net Patient Service Re9000998954243289542432
Other Medical Service621990705632705632
Cafeteria/Vending621990313246$313,246
Rehabilitation6219908490584905
Ellsworth Internal Med62111080578057
FieldValueIRS element (for citing)
Total Program Service Revenue90654272TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column353686TotalRevenueColumn
Exclusion$353,686ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real3000Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real3000Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column3000TotalRevenueColumn
Exclusion$3,000ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities899136Securities
Other4700Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities773275Securities
Other18145Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities125861Securities
Other-13445Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column112416TotalRevenueColumn
Exclusion$112,416ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events23810GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events129120CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses71968FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-48158TotalRevenueColumn
Exclusion-$48,158ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column91790007TotalRevenueColumn
Related Or Exempt Function Income90341026RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$734,190ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1110681Total
Program Services626918ProgramServices
Management And General483763ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total40519026Total
Program Services38861827ProgramServices
Management And General1553208ManagementAndGeneral
Fundraising103991Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total720647Total
Program Services319839ProgramServices
Management And General400808ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7684406Total
Program Services7344603ProgramServices
Management And General322669ManagementAndGeneral
Fundraising17134Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2715095Total
Program Services2571681ProgramServices
Management And General135949ManagementAndGeneral
Fundraising7465Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total125544Total
Program Services81ProgramServices
Management And General125463ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total168844Total
Management And General168844ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total11694Total
Management And General11694ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total64075Total
Management And General64075ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4392143Total
Program Services4035116ProgramServices
Management And General357027ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total137222Total
Program Services1932ProgramServices
Management And General130420ManagementAndGeneral
Fundraising4870Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2084285Total
Program Services1555232ProgramServices
Management And General529053ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total849308Total
Program Services771996ProgramServices
Management And General77259ManagementAndGeneral
Fundraising53Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1245268Total
Program Services1217958ProgramServices
Management And General27310ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total55395Total
Program Services53585ProgramServices
Management And General1776ManagementAndGeneral
Fundraising34Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total333271Total
Program Services282264ProgramServices
Management And General50710ManagementAndGeneral
Fundraising297Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total906381Total
Program Services843099ProgramServices
Management And General60288ManagementAndGeneral
Fundraising2994Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3520868Total
Program Services3147904ProgramServices
Management And General372089ManagementAndGeneral
Fundraising875Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1107733Total
Program Services658912ProgramServices
Management And General448821ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Medical Supplies91443639111565327971
Bad Debts52557915255791
Health Care Prov. Tax18548521854852
Repairs & Maintenance14834261455709223475370
Other7223903936743210977619

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total86212708Total
Program Services80364538ProgramServices
Management And General5697467ManagementAndGeneral
Fundraising150703Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4280BOY
EOY4335EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY17445631BOY
EOY17645714EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY197251EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7534940BOY
EOY7111606EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY711988BOY
EOY713309EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY874618BOY
EOY1224277EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis58533614LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec25195028LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY35134739BOY
EOY33338586EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4423040BOY
EOY6634129EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY319049BOY
EOY304003EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4666419BOY
EOY7212175EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY71114704BOY
EOY74385385EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10195970BOY
EOY9307744EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY13391775BOY
EOY13126775EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3646275BOY
EOY2913557EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4394293BOY
EOY3509810EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY31628313BOY
EOY28857886EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY38153521BOY
EOY44255901EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY663955BOY
EOY588127EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY668915BOY
EOY683471EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY39486391BOY
EOY45527499EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY71114704BOY
EOY74385385EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses5577299ReconcilationRevenueExpenses
Reconcilation Other Changes463809ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

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)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$12,219OtherActivitiesAmount
Total Lobbying Expenditures IIB12219TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Other Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1i:ReturnReference
ExplanationPortion of dues from Maine Hospital Association and American Hospital Association used for lobbying.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3349752BeginningOfYearBalance
Contributions7664082Contributions
Investment Earnings Or Losses710004InvestmentEarningsOrLosses
Other Expenditures11628OtherExpenditures
End Of Year Balance11712210EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2953215BeginningOfYearBalance
Contributions27935Contributions
Investment Earnings Or Losses383779InvestmentEarningsOrLosses
Other Expenditures15177OtherExpenditures
End Of Year Balance3349752EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4701120BeginningOfYearBalance
Contributions52994Contributions
Investment Earnings Or Losses-689342InvestmentEarningsOrLosses
Grants Or Scholarships68360GrantsOrScholarships
Other Expenditures1043197OtherExpenditures
End Of Year Balance2953215EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.80000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.20000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis361138OtherCostOrOtherBasis
Book Value361138BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis38530010OtherCostOrOtherBasis
Depreciation11597190Depreciation
Book Value26932820BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis245055OtherCostOrOtherBasis
Depreciation121073Depreciation
Book Value123982BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis19397411OtherCostOrOtherBasis
Depreciation13476765Depreciation
Book Value5920646BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings33338586TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
Construction in Progress426226
Other Assets43647
Estimated 3rd Party Payor Settlements5999094
Due from Related Parties44238
Deferred Compensation698970
FieldValueIRS element (for citing)
Total Book Value Other Assets7212175TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Deferred Compensation$698,970
Estimated Third-Party Payor Settlements$2,810,840
FieldValueIRS element (for citing)
Total Of Amounts3509810TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
ExplanationPart V, Line 4: The intended uses of the endowment funds are funded depreciation, the oncology clinic and the breast clinic. During the year, approximately 7 million dollars of board-designated funds were contributed to the endowment fund.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Poinsettia BallNameOfEvent1
Gross Receipts Event178665GrossReceiptsEvent1
Charitable Contributions Event169100CharitableContributionsEvent1
Gross Revenue Event19565GrossRevenueEvent1
Food And Beverage Event19975FoodAndBeverageEvent1
Other Direct Expenses Event129805OtherDirectExpensesEvent1
Name Of Event2Chef's GalaNameOfEvent2
Gross Receipts Event274265GrossReceiptsEvent2
Charitable Contributions Event260020CharitableContributionsEvent2
Gross Revenue Event214245GrossRevenueEvent2
Food And Beverage Event25659FoodAndBeverageEvent2
Other Direct Expenses Event226529OtherDirectExpensesEvent2
Gross Receipts Total152930GrossReceiptsTotal
Charitable Contributions Total129120CharitableContributionsTotal
Gross Revenue Total Events23810GrossRevenueTotalEvents
Food And Beverage Total Events15634FoodAndBeverageTotalEvents
Other Direct Expenses Total Events56334OtherDirectExpensesTotalEvents
Direct Expense Summary Events71968DirectExpenseSummaryEvents
Net Income Summary-48158NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1727796TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1727796NetCommunityBenefitExpense
Percent Of Total Expense0.02130PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense13167099TotalCommunityBenefitExpense
Direct Offsetting Revenue7945541DirectOffsettingRevenue
Net Community Benefit Expense5221558NetCommunityBenefitExpense
Percent Of Total Expense0.06450PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense14894895TotalCommunityBenefitExpense
Direct Offsetting Revenue7945541DirectOffsettingRevenue
Net Community Benefit Expense6949354NetCommunityBenefitExpense
Percent Of Total Expense0.08580PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense118489TotalCommunityBenefitExpense
Direct Offsetting Revenue2123DirectOffsettingRevenue
Net Community Benefit Expense116366NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense3000TotalCommunityBenefitExpense
Direct Offsetting Revenue3000DirectOffsettingRevenue

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense14310477TotalCommunityBenefitExpense
Direct Offsetting Revenue8989401DirectOffsettingRevenue
Net Community Benefit Expense5321076NetCommunityBenefitExpense
Percent Of Total Expense0.06570PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense7623TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense7623NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense14439589TotalCommunityBenefitExpense
Direct Offsetting Revenue8994524DirectOffsettingRevenue
Net Community Benefit Expense5445065NetCommunityBenefitExpense
Percent Of Total Expense0.06720PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense29334484TotalCommunityBenefitExpense
Direct Offsetting Revenue16940065DirectOffsettingRevenue
Net Community Benefit Expense12394419NetCommunityBenefitExpense
Percent Of Total Expense0.15300PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$2,420,292BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare16090210AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare17692151CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1601941MedicareSurplusOrShortfall
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
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 Line1Maine Coast Memorial HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line150 Union StreetAddressLine1
CityEllsworthCity
StateMEState
ZIP Code04605ZIPCode
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 Line1Maine Coast Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities15NumberOfOtherFacilities

Other Facilities OtherFacilities (15 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Ellsworth Internal Medicine
32 Resort WayEllsworthME04605Physician Practice
Ellsworth Family Practice
32 Resort WayEllsworthME04605Physician Practice
Maine Coast Pediatrics
32 Resort WayEllsworthME04605Physician Practice
Eleanor Widener Dixon Memorial Clinic
37 Clinic RoadEllsworthME04605Physician Practice
Southwest Harbor Medical Center
45 Herrick RoadEllsworthME04605Physician Practice
Maine Coast Specialty Clinic
306 Main StreetEllsworthME04605Physician Practice
Maine Coast Urology
50 Union StreetEllsworthME04605Physician Practice
Maine Coast Rheumatology
50 Union StreetEllsworthME04605Physician Practice
Down East Dermatology
50 Union StreetEllsworthME04605Physician Practice
Maine Coast General Surgery
50 Union StreetEllsworthME04605Physician Practice
Maine Coast Women Care
50 Union StreetEllsworthME04605Physician Practice
Maine Coast Hand & Shoulder
50 Union StreetEllsworthME04605Physician Practice
Frenchman Bay Orthopedics
50 Union StreetEllsworthME04605Physician Practice
Maine Coast Otolaryngolgy
50 Union StreetEllsworthME04605Physician Practice
Maine Coast Memorial Hospital Nocturnist
50 Union StreetEllsworthME04605Physician Practice

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 3c: Maine Coast Regional Health Facilities uses the Federal poverty guidelines to determine eligibility.
Part I, Line 7: The IRS 990H Instructions/Guidance provide a template (Worksheet 2 Template) as a way to determine the overall cost to charge ratio that could be applied throughout the IRS 990H form in order to convert charges to cost. Where applicable, we have utilized the worksheet 2 template calculation. The only areas we did not utilize this template calculation were the following. A. IRS 990H worksheet 6- Subsidized Health Services- (The supporting schedule for Part I, Line 7G) we did not utilize the worksheet 2 percentage when we were determining the profit/ loss of each of our provider based clinics. In addition, when we were compiling the subsidized provider based clinics listed in 1C above, we utilized the actual estimated costs on the modified Medicare cost report we prepared instead of applying the worksheet 2 cost to charge percentage. B. IRS 990H Worksheet 3- Unreimbursed Medicaid and other means tested government programs (the supporting schedule for Part I, Lines 7B and 7C) and worksheet 6 Medicaid allowable costs for the subsidized health services listed in line 1C above (part of the line 7G costs) - we did not utilize the worksheet 2 percentage when calculating the Medicaid allowable cost. Instead we utilized the actual Medicaid filed cost report for the allowable costs.
Part I, Line 7g: Maine Coast Regional Health Facilities has several provider based physician practices. Per the instructions for IRS Form 990H, Worksheet 6, we are allowed to include any applicable physician practice that the hospital subsidizes (i.e., operates at a loss). As such, we have included the following provider based physician practices that operate at a loss (i.e., are subsidized by the hospital) and the associated costs of these practices.A. Southwest Harbor ClinicB. Ellsworth Internal MedicineC. PediatricsD. RheumatologyE. Family PracticeF. Frenchman Bay ClinicG. Women Care ClinicH. Physician ClinicI. Specialty ClinicJ. Gouldsboro ClinicK. Urology ClinicL. Otolaryngology ClinicM. Dermatology ClinicN. General SurgeryThe above listed provider based physician practices have a community benefit (i.e., aggregate loss or subsidy from the hospital) of approximately $5.3 million. This community benefit does not include any hospital overhead allocated to these clinics. In addition, the community benefit also does not take into account bad debts, charity care and contractual adjustment. Thus this community benefit of approximately $5.3 million is a conservative figure that reconciles to the community benefit reported on IRS form 990H, Part I, Line 7G, Column E.
Part I, L7 Col(f): As part of the hospital's total expenses, there is $5,225,791 of bad debts. This amount has been removed from the Part I, Line 7 Column F calculation per the IRS instructions.
Maine Coast Regional Health Facilities prepares a community benefit report through its annual report process. The annual report is available three months after fiscal year end. Within the annual report the hospital describes community benefit in financial terms and a summary of services provided. This includes the losses from: subsidized physician practices; subsidized community health and wellness programs; the cost of patients who cannot afford to pay; Medicaid and Medicare shortfalls; and patients who do not pay.Community Benefit ReportSchedule H, Part I, Line 6a:
Part III, Line 4: Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to provision for bad debts and a credit to a valuation allowance based on its assessment of individual accounts and historical adjustments. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to patient accounts receivable.Maine Coast Regional Health Facilities classify bad debts as an operating expense. The hospital follows the Medicare guidelines for allowable bad debts. It uses the following criteria:A. Establishing that reasonable collection efforts were madeB. Establishing that the accounts were uncollectibleC. Establishing that there is no likelihood of recovery at anytime in the future.The bad debt expense at costs was the total write-offs reduced by the ratio of patient care cost to charges.
Part III, Line 8: The IRS 990H instructions/guidance provide a template (worksheet 2 template) as a way to determine the overall cost to charge ratio that could be applied throughout the IRS 990H form in order to convert charges to cost. Where applicable, we have utilized the worksheet 2 template calculation. The only area where we did not utilize this template calculation was in form 990H worksheet B, Line 2 & 6- Medicare allowable costs and payments related to the subsidized health services- we utilized the Medicare cost report estimated cost and payment for these services. The hospital believes that provider based clinics listed in 1C above should be and are considered a community benefit due to the fact that without the hospital subsidizing and offering the services that these clinics offer, the community at large would have to travel at least 45 minutes to the nearest like hospital and that hospital's service offerings. As such, Maine Coast believes that by offering and subsidizing these clinics within its community and thus enabling community members to have easy access and an easier commute for these services, that this benefits the whole community at large.
Part III, Line 9b: When a patient is referred out to collections but then applies for free or discounted care, we pull the account back from collections when it is determined they qualify for one of the programs. If the collection agency suspects that someone may need to apply for one of the programs, they send out an application and notify us. We make every effort to screen as many people as possible before we send them to collections.
Part VI, Line 2: Maine Coast Regional Health Facilities assessed the medical needs of the community as part of the process for establishing the medical staff development plan. The new medical staff and services were identified in the strategic planning process brought forth from the provider community. It then was determined and prioritized what services the hospital could comfortably address and implement.
Part VI, Line 3: We notify patients and customers about access to assistance in various ways. The simplest way is the signage, pamphlets and educational material located around the organization and in the offices. In every patient access/ patient financial services area, is a sign explaining the availability of free/ discounted care and the federal poverty guidelines. There are also pamphlets located in the outpatient areas explaining free care/ discounted care and providing information on Mainecare. For inpatients, there is a book in the room which provides all the information on all programs available.Scheduled medical imaging, surgery patients and inpatients all generally speak with a hospital employee who can provide information on available programs. Inpatients are also offered the services of unicare to assist them with applying for Mainecare. Patient accounting staff are generally available to assist any patient inquiring about programs when presenting for services. Through the patient accounting dept, we provide the information on the statements. We also counsel patients on the phone about all the programs available whether it is a hospital program or Medicaid.
Part VI, Line 4: Maine Coast Regional Health Facilities Services, D/B/A Maine Coast Memorial Hospital, is a 48 staffed bed full service acute care not-for profit hospital located in Ellsworth, Maine (Hancock County). The hospital is accredited by the Joint Commission and its mission is to serve its communities with excellence in health care. Its services include acute inpatient, 24 hours emergency center, and diagnostic and surgical services. Along with hospital services, the hospital employs the majority of primary and specialty care physicians in the area. It is the only full service hospital located in either Hancock or adjacent Washington County. The hospital is regularly used as referral facility by the four (4) critical access hospitals located in these two counties as well.Hancock and Washington county is considered rural by the state of Maine and the United States Census Bureau, under guidelines set forth by the office of Management and Budget (OMB). The hospital service area (HSA) as defined by the Maine Health Data Organization (MHDO) uses the statistical method where the greatest portion of residents received their inpatient care. The following towns make up the Maine Coast Memorial Hospital (HSA) as deferred by the MHDO:EastbrookBeddingtonDebloisCherryfieldEllsworthFranklinMilbridgeGouldsboroHancockLamoineMariavilleOsbornOtisSteubenSorrentoSullivanSurryTrentonWalthamWinter HarborOqiton TWPT3 NDT7 SDT8 SDT9 SDT10 SDT16 MDT22 MDT28 MDT34 MDT35 MDT39 MDT 40 MDT41 MDThe following demographics represent the counties served by Maine Coast Memorial Hospital: - Population: Hancock County 54,418; Washington County 32,856; State of Maine 1,328,361 - Persons < 5 yrs: Hancock County 5.0%; Washington County 5.4%; State of Maine 5.4% - Persons < 18 yrs: Hancock County 18.6%; Washington County 20.1%; State of Maine 20.6% - Persons 65 yrs & over: Hancock County 17.3%; Washington County 18.7%; State of Maine 15.6% - Median Household Income: Hancock County $47,849; Washington County $31,856; State of Maine $46,419 - Persons below poverty level: Hancock County 10.8%; Washington County 20.1%; State of Maine 12.6%
Part VI, Line 7: Maine Coast Regional Health Facilities is a local not for profit hospital that serves its local communities and people regardless of their ability to pay. Maine Coast provides financial assistance and sliding scale discounts to self pay and low income patients. Also the hospital participates in government sponsored health care programs including Medicare, Medicaid, Champus and Tricare. The volunteer Board of Trustees sets the strategic direction for the hospital and is comprised of community members from the hospital's service area. This group is made up of local business owners, professionals and retirees. Maine Coast's non-profit status allows the hospital to reinvest any excess of revenues over expense back into the hospital to continuously improve the medical care it delivers. The hospital allows access to healthcare that would otherwise be difficult. The hospital is the main employer for the local physicians, including specialty physicians that would otherwise have to be accessed out of the area.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E Expenses0WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Robert A Beekman MD
17701105000792041490233700205822000
Katheryn Rensenbrink MD
213831016670180049990302800250957000
Sean T Maloney
21237505000180049320299480247935000
Charles D Therrien
14571300020074000103410176128000
Kevin Sedgwick
188515000516043600216800215071000
Sterling C Williamson
3258060149964016923055120323910530596000
Thomas H Crowe
358108028095017259055130304480439423000
Bradley Goldstein
3469890577830120055120272030437607000
Martin R Curlick
4124390005160551307910419259000
Kerry Crowley
3115070583150516055130292830405134000
John McCormack
120211000133100000121542000
Douglas T Jones
18714000039600089920196528000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 4aDouglas Jones, Former CEO, received $196,528 in severance payments during the year.
Part IIIPart I, Line 1B: Travel for companions: The Board of Directors for the hospital are not compensated. In lieu of compensation meals are supplemented for their spouses when they are required to attend forums and seminars on behalf of the hospital. The amount involved is very minimal. Part I, Line 7: The bonus payments for Sterling C. Williamson, Bradley Goldstein, Kerry Crowley, Katheryn Rensenbrink and Thomas Crowe are RVU incentive payments.Supplemental Information

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MHHEFA
010314384560425NW62003-07-245695000Construction of ICU/ Cafeteria/ OR000
MHHEFA
0103143845604253L22008-12-036960000Construction of Emergency Dept.000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
5875000368171119201538762820050011
6960000937875131414589071120090011

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000011
000011

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000000
000000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonDaniel A HurleyNamePerson
FieldValueIRS element (for citing)
RelationshipTrusteeRelationship
Description Of TransactionMr. Hurley is an officer of a bank with which the Hospital does business. All transactions between the Hospital and the bank are at arm's length and for fair value. It is not possible to readily determine the monetary amount that the bank derives from this relationship.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 2Rebecca Sargent and Debra Ehrlenbach have a business relationship.
Form 990, Part VI, Section A, line 6Maine Coast Healthcare Corporation is the sole member of the Organization.
Form 990, Part VI, Section A, line 7aThe Member shall have the right to elect trustees and honorary trustees to the board of trustees.
Form 990, Part VI, Section A, line 7bThe following decisions are subject to approval by the Member of the Organization: 1. The removal of members of the Board of Trustees; 2. The change of the number of Trustees constituting the Board of Trustees with the limitations prescribed in the Articles of Incorporation; 3. The amendment, restatement, or modification of the Bylaws or Articles of Incorporation of the Corporation; 4. The approval of the sale, mortgage, lease, or other dispositions of all, or substantially all, of the assets and property of the Organization, the dissolution of the Organization, or its merger with or consolidation into another Organization; 5. The right to approve the donation, unfunded disposition, or other expenditure of corporate assets, whether principal or income; 6. The right to approve corporate strategic planning goals, objectives, and capital expenditure plans; 7. The right to approve substantial program changes, including health services; 8. The right to approve the Organization's cumulative annual borrowings in any amount exceeding one percent of the annual gross revenues of the Organization as set forth in the most recent annual financial statements of the Organization; 9. The right to approve the appointment of an auditor for the Organization; and 10. Upon recommendation of the Board of Trustees, the right to appoint or remove the President and Treasurer.
Form 990, Part VI, Section B, line 11Prior to filing, a presentaion on the Form 990 was provided to the leadership of the board of trustees, and a copy of the form was provided to the entire board.
MCMH's policies and procedures require that all board members, senior leaders, department managers, and medical staff members disclose any potential conflicts of interest in writing. These forms are reviewed by the Board Chair, the Human Resource Director, or the compliance officer, depending on the disclosing individual's role.Form 990, Part VI, Section B, Line 12C:
Examples of how potential conflicts are managed include disclosing the conflict when applicable, (e.g., during discussions at the board meeting) and excusing the party with the potential conflict from participation and voting.Form 990, Part VI, Section B, line 12c
Executive Committee with the help of the search firm and Maine Hospital Association salary survey was used to set the compensation levels for the CEO. The MHA survey was primarily used to set the compensation levels for the top management officials.Form 990, Part VI, Section B, line 15
Government documents and conflict of interest policy are available upon request. The financial statements are made public through the annual report.Form 990, Part VI, Section C, line 19
Changes in Net Assets or Fund Balances:Net unrealized gains on investments: 449,253. Change in Value of Trust 14,556. Total to Form 990, Part XI, Line 5: 463,809.Form 990, Part XI, line 5:
Oversight of AuditThe audit process has not changed from the prior year.Form 990, Part XII, Line 2c:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
Maine Coast Medical Realty Inc
50 Union StreetEllsworthME04605010390918Furnishing Medical FacilitiesME501(c)(3)Line 11a, IMaine Coast Regional Health Facilities0
Maine Coast Healthcare Corporation
50 Union StreetellsworthME04605223176167Parent Organization for HospitalME501(c)(3)Line 11b, II0N/A
Maine Coast Healthcare Foundation
50 Union StreetellsworthME04605262344952Raise and hold donations for hospitalME501(c)(3)Line 11a, IMaine Coast Regional Health Facilities0

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Maine Coast Physician AffiliatesBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line150 Union StreetAddressLine1
CityEllsworthCity
StateMEState
ZIP Code04605ZIPCode
FieldValueIRS element (for citing)
EIN010479952EIN
Primary ActivityInactivePrimaryActivity
Legal Domicile StateMELegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Maine Coast Healthcare CorporationBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Maine Coast Medical RealtyBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypePTransactionType
Amount Involved145278AmountInvolved
Method Of Amt DeterminationFMVMethodOfAmtDetermination