2012-08-29T15:07:48-05:00 2011-12-31 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2011-01-01 010376890 Pines Health Services PINE 2074982356 PO Box 40 Caribou ME 04736 James M Davis 2074982356 2012-08-28 1 Barbara J McGuan CPA P00219457 2077752387 2012-08-28 2011 2016-02-24 21:20:13Z James M Davis PO Box 40 Caribou ME 04736 16986000 0 X N/A X 1981 ME Group of health centers serving northern Maine. Five of the centers have FQHC designation. 12 12 163 0 0 0 3631412 3937888 11345994 13048076 -4413 36 0 0 14972993 16986000 0 0 0 0 9716323 10973649 0 0 0 6631740 5129333 16348063 16102982 -1375070 883018 5022043 6148962 1272344 1516245 3749699 4632717 X 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. 0 0 4240639 4062185 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. 1850251 1223724 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. 2011415 1911733 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. 5757706 5850434 Various other medical services provided to patients. 5757706 5850434 13860011 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 51 0 1 163 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Anthony Lahey 2074982356 PO Box 40 Caribou ME 04736 Norm Collins 1.00 X X 0 0 0 Paul Powers 1.00 X 0 0 0 Kris Doody 1.00 X 0 0 0 Darlene Higgins 1.00 X X 0 0 0 Doug Plourde 1.00 X 0 0 0 Dana Rattray 1.00 X 0 0 0 Mark Shea 1.00 X 0 0 0 Betty Hatch 1.00 X 0 0 0 Tanya Sleeper 1.00 X 0 0 0 Jane White-McCall 1.00 X X 0 0 0 Tim Poitras 1.00 X 0 0 0 Chris Bell 1.00 X 0 0 0 Shawn Rogers 1.00 X 0 0 0 Peter Doebener 1.00 X 0 0 0 James Davis 40.00 X 113105 0 13227 Lisa Caron 40.00 X 69591 0 11954 Natania Piper 40.00 X 397081 0 20240 Brian Wall 40.00 X 357744 0 19490 Carl Flynn 40.00 X 425458 0 18940 Josette Hunter 40.00 X 318287 0 15415 Albert Whiting 40.00 X 287848 0 16798 1969114 0 116064 26 0 1 0 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 9 1237888 2700000 3937888 Patient Service Rev. 621110 14524809 14524809 Income Guarantee 621110 2334814 2334814 EHR Revenue 621110 637500 637500 Contractual/Char. Adj. 621110 -4449047 -4449047 13048076 36 36 16986000 13048076 0 36 207877 207877 9144285 9004882 139403 53960 52671 1289 1011803 1011646 157 555724 530846 24878 2113423 757499 1355924 107197 107197 811714 701495 110219 626606 611784 14822 241385 62777 178608 15599 1857 13742 95187 94835 352 362626 319712 42914 Bad Debts 557067 557067 CME 76572 76572 Physical Plant Expenses 76368 76368 Moving Expenses 45589 45589 16102982 13860011 2242971 0 195777 452111 2708355 2700000 837767 1139674 24112 14500 62977 48577 40740 32764 2731912 1226463 904997 1505449 10884 225003 225003 22315 20000 5022043 6148962 1099858 1376353 172486 139892 1272344 1516245 X 1049699 1932717 2700000 2700000 3749699 4632717 5022043 6148962 883018 0 X X 0 1 1 X 1 1 X 3318084 3725251 4157101 3631412 3937888 18769736 3318084 3725251 4157101 3631412 3937888 18769736 18769736 36 36 18769772 60291001 1.00000 1.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 40025 40025 943823 746734 197089 1748064 479729 1268335 1505449 16986000 16102982 883018 883018 16986000 0 16986000 0 16986000 16102982 0 16102982 0 16102982 X X X 0 0 0 0 0 0 0 0 0 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 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 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. Oversight of Audit Form 990, Part XI, Line 2c: This audit process has not changed from prior years.