PINES HEALTH SERVICES: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- PINES HEALTH SERVICES (EIN 01-0376890)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-08-29
- IRS object ID
- 201232429349300218
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-29T15:07:48-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010523282 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1 |
| City | Portland | City |
| State | ME | State |
| ZIP Code | 041041100 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010376890 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pines Health Services | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PINE | NameControl |
| Phone | 2074982356 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 40 | AddressLine1 |
| City | Caribou | City |
| State | ME | State |
| ZIP Code | 04736 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | James M Davis | Name |
| Title | Chief Executive Officer | Title |
| Phone | 2074982356 | Phone |
| Date Signed | 2012-08-28 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Barbara J McGuan CPA | Name |
| PTIN | P00219457 | PTIN |
| Phone | 2077752387 | Phone |
| Date Prepared | 2012-08-28 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | James M Davis | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 40 | AddressLine1 |
| City | Caribou | City |
| State | ME | State |
| ZIP Code | 04736 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 16986000 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1981 | YearFormation |
| State Legal Domicile | ME | StateLegalDomicile |
| Activity Or Mission Description | Group of health centers serving northern Maine. Five of the centers have FQHC designation. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 163 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 3631412 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3937888 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 11345994 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 13048076 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -4413 | InvestmentIncomePriorYear |
| Investment Income Current Year | 36 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 14972993 | TotalRevenuePriorYear |
| Total Revenue Current Year | 16986000 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9716323 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10973649 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 6631740 | OtherExpensePriorYear |
| Other Expenses Current Year | 5129333 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 16348063 | TotalExpensesPriorYear |
| Total Expenses Current Year | 16102982 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1375070 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 883018 | RevenuesLessExpensesCY |
| Total Assets BOY | 5022043 | TotalAssetsBOY |
| Total Assets EOY | 6148962 | TotalAssetsEOY |
| Total Liabilities BOY | 1272344 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1516245 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3749699 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4632717 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Multi-specialty outpatient healthcare organization, promoting the development of quality health care, health care services and the development and operation of related activities necessary to encourage quality health care in Aroostook County. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4240639 | Expense |
| Revenue | 4062185 | Revenue |
| Description | Family Practice Services provide general care to families. The services are performed by physicians, physician assistants, and family nurse practitioners. This service has been provided since the date of inception. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1850251 | Expense |
| Revenue | 1223724 | Revenue |
| Description | Internal Medicine Services provide internal medicine to patients with more severe medical complications. The services are performed by physicians. This service has been provided since the date of inception. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2011415 | Expense |
| Revenue | 1911733 | Revenue |
| Description | Obstetrical and gynecological services are provided to female patients. These services are performed by physicians & Certified Nurse Midwives. This service has been provided since the date of inception. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 5757706 | Expense |
| Revenue | 5850434 | Revenue |
| Description | Various other medical services provided to patients. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 5757706 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 5850434 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 13860011 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 51 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 163 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Anthony Lahey | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2074982356 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 40 | AddressLine1 |
| City | Caribou | City |
| State | ME | State |
| ZIP Code | 04736 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Norm Collins | |||||||
| Chairman | 1.00 | X | X | 0 | 0 | 0 | |
| Paul Powers | |||||||
| Past Director | 1.00 | X | 0 | 0 | 0 | ||
| Kris Doody | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Darlene Higgins | |||||||
| Vice Chairman | 1.00 | X | X | 0 | 0 | 0 | |
| Doug Plourde | |||||||
| Past Director | 1.00 | X | 0 | 0 | 0 | ||
| Dana Rattray | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Mark Shea | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Betty Hatch | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Tanya Sleeper | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Jane White-McCall | |||||||
| Secretary/Treasurer | 1.00 | X | X | 0 | 0 | 0 | |
| Tim Poitras | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Chris Bell | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Shawn Rogers | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Peter Doebener | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| James Davis | |||||||
| Chief Executive Officer | 40.00 | X | 113105 | 0 | 13227 | ||
| Lisa Caron | |||||||
| Chief Operating Officer | 40.00 | X | 69591 | 0 | 11954 | ||
| Natania Piper | |||||||
| Urology Physician | 40.00 | 397081 | 0 | 20240 | X | ||
| Brian Wall | |||||||
| OB/GYN Physician | 40.00 | 357744 | 0 | 19490 | X | ||
| Carl Flynn | |||||||
| Family Practice Physician | 40.00 | 425458 | 0 | 18940 | X | ||
| Josette Hunter | |||||||
| OB/GYN Physician | 40.00 | 318287 | 0 | 15415 | X | ||
| Albert Whiting | |||||||
| Ophthalmologist | 40.00 | 287848 | 0 | 16798 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1969114 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 116064 | TotalOtherCompensation |
| Number Individuals GT100 K | 26 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Weatherby Locums Inc | |||||
| PO Box 972663 | Dallas | TX | 75397 | Locum Physicians | 891542 |
| Cary Medical Center | |||||
| 163 Van Buren Road Ste 1 | Caribou | ME | 04736 | Various Management Services | 465667 |
| Vista Staffing Solutions | |||||
| 275 East 200 South | Salt Lake City | UT | 84111 | Locum Provider Coverage | 229295 |
| Success EHS | |||||
| One Metroplex Drive Suite 500 | Birmingham | AL | 35209 | EMR Support and Services | 203152 |
| Aroostook Mental Health Center | |||||
| PO Box 1018 | Caribou | ME | 04736 | Behavior Health Specialist Coverage | 137723 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
| Government Grants | 1237888 | GovernmentGrants |
| All Other Contributions | 2700000 | AllOtherContributions |
| Total Contributions | 3937888 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Patient Service Rev. | 621110 | 14524809 | 14524809 |
| Income Guarantee | 621110 | 2334814 | 2334814 |
| EHR Revenue | 621110 | 637500 | 637500 |
| Contractual/Char. Adj. | 621110 | -4449047 | -4449047 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 13048076 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 36 | TotalRevenueColumn |
| Exclusion | $36 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16986000 | TotalRevenueColumn |
| Related Or Exempt Function Income | 13048076 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $36 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 207877 | Total |
| Management And General | 207877 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9144285 | Total |
| Program Services | 9004882 | ProgramServices |
| Management And General | 139403 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53960 | Total |
| Program Services | 52671 | ProgramServices |
| Management And General | 1289 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1011803 | Total |
| Program Services | 1011646 | ProgramServices |
| Management And General | 157 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 555724 | Total |
| Program Services | 530846 | ProgramServices |
| Management And General | 24878 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2113423 | Total |
| Program Services | 757499 | ProgramServices |
| Management And General | 1355924 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107197 | Total |
| Management And General | 107197 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 811714 | Total |
| Program Services | 701495 | ProgramServices |
| Management And General | 110219 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 626606 | Total |
| Program Services | 611784 | ProgramServices |
| Management And General | 14822 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 241385 | Total |
| Program Services | 62777 | ProgramServices |
| Management And General | 178608 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15599 | Total |
| Program Services | 1857 | ProgramServices |
| Management And General | 13742 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95187 | Total |
| Program Services | 94835 | ProgramServices |
| Management And General | 352 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 362626 | Total |
| Program Services | 319712 | ProgramServices |
| Management And General | 42914 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debts | 557067 | 557067 | |
| CME | 76572 | 76572 | |
| Physical Plant Expenses | 76368 | 76368 | |
| Moving Expenses | 45589 | 45589 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16102982 | Total |
| Program Services | 13860011 | ProgramServices |
| Management And General | 2242971 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 195777 | BOY |
| EOY | 452111 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2708355 | BOY |
| EOY | 2700000 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 837767 | BOY |
| EOY | 1139674 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24112 | BOY |
| EOY | 14500 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62977 | BOY |
| EOY | 48577 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40740 | BOY |
| EOY | 32764 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2731912 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1226463 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 904997 | BOY |
| EOY | 1505449 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 10884 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 225003 | BOY |
| EOY | 225003 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22315 | BOY |
| EOY | 20000 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5022043 | BOY |
| EOY | 6148962 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1099858 | BOY |
| EOY | 1376353 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 172486 | BOY |
| EOY | 139892 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1272344 | BOY |
| EOY | 1516245 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1049699 | BOY |
| EOY | 1932717 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2700000 | BOY |
| EOY | 2700000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3749699 | BOY |
| EOY | 4632717 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5022043 | BOY |
| EOY | 6148962 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 883018 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3318084 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3725251 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4157101 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3631412 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3937888 | CurrentTaxYear |
| Total | 18769736 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3318084 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3725251 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4157101 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3631412 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3937888 | CurrentTaxYear |
| Total | 18769736 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 18769736 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 36 | CurrentTaxYear |
| Total | 36 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 18769772 | TotalSupport |
| Gross Receipts From Admissions Etc | 60291001 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 1.00000 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 1.00000 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 40025 | OtherCostOrOtherBasis |
| Book Value | 40025 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 943823 | OtherCostOrOtherBasis |
| Depreciation | 746734 | Depreciation |
| Book Value | 197089 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1748064 | OtherCostOrOtherBasis |
| Depreciation | 479729 | Depreciation |
| Book Value | 1268335 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1505449 | TotalOfBookValueLandBuildings |
| Total Revenue | 16986000 | TotalRevenue |
| Total Expenses | 16102982 | TotalExpenses |
| Excess Or Deficit For Year | 883018 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 883018 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 16986000 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 16986000 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 16986000 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 16102982 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 16102982 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 16102982 | TotalExpensesPerForm990 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Natania Piper | |||||||||||||
| 397081 | 0 | 0 | 0 | 0 | 0 | 4050 | 0 | 16190 | 0 | 417321 | 0 | 0 | 0 |
| Brian Wall | |||||||||||||
| 357744 | 0 | 0 | 0 | 0 | 0 | 3300 | 0 | 16190 | 0 | 377234 | 0 | 0 | 0 |
| Carl Flynn | |||||||||||||
| 425458 | 0 | 0 | 0 | 0 | 0 | 2750 | 0 | 16190 | 0 | 444398 | 0 | 0 | 0 |
| Josette Hunter | |||||||||||||
| 318287 | 0 | 0 | 0 | 0 | 0 | 1324 | 0 | 14091 | 0 | 333702 | 0 | 0 | 0 |
| Albert Whiting | |||||||||||||
| 287848 | 0 | 0 | 0 | 0 | 0 | 1546 | 0 | 15252 | 0 | 304646 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Cary Medical Center | |||
| An entity of which Kris Doody, current director, is an officer | 158532 | Lease of Property | 0 |
| Cary Medical Center | |||
| An entity of which Kris Doody, current director, is an officer | 221496 | Pines Health Services receives housekeeping services and management and staffing services by Cary Medical Center, of which Kris Doody is Chief Executive Officer. | 0 |
| Cary Medical Center | |||
| An entity of which Kris Doody, current director, is an officer | 35000 | Pines Health Services provides management and staffing services to Cary Medical Center, of which Kris Doody is the Chief Executive Officer. | 0 |
| Cary Medical Center | |||
| An entity of which Kris Doody, current director, is an officer | 2700000 | Pines Health Services received charitable contributions in the form of a community benefit grant from Cary Medical Center, of which Kris Doody is Chief Executive Officer. | 0 |
| Cary Medical Center | |||
| An entity of which Kris Doody, current director, is an officer | 2334814 | Pines Health Services received an income guarantee as part of a contractual relationship for the recruitment and retention of providers pertaining to the non-FQHC side of operations from Cary Medical Center. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | Pines Health Services has its Form 990 reviewed by the board prior to filing. The 990 is given to the CEO for review and forwarded to the Board of Directors to be discussed at a regularly scheduled Board of Directors meeting. If a meeting cannot be held prior to the submission deadline, the Organization forwards the 990 electronically to the Board of Directors for review and comment. | |
| Form 990, Part VI, Section B, line 12c | Annually, the Board of Directors sign forms indicating there are no conflicts of interest. If a conflict is brought to the board's attention, appropriate action will take place depending on the situation. This includes not allowing the member to vote on issues where there is a conflict, or other actions deemed necessary and appropriate by the board. | |
| Form 990, Part VI, Section B, line 15 | For executives, the Board Executive Committee will review local market conditions and other factors. The salary is set below the MGMA national median range for practices of comparable size group by number of physicians, revenues and number of employees. For key employees (physicians, mid level providers), salary is set based on the MGMA annual Physician Compensation & Productivity Survey. | |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. | |
| Form 990, Part XI, Line 2c: | This audit process has not changed from prior years. | Oversight of Audit |