2011-07-05T07:18:57-05:00 2010-12-31 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2010-01-01 010376890 Pines Health Services PINE 2074982356 PO Box 40 Caribou ME 04736 James M Davis 2074982356 2011-06-30 1 Barbara J McGuan CPA 2077752387 2011-06-30 2010 2016-03-07 17:11:31Z James M Davis PO Box 40 Caribou ME 04736 14977406 0 X N/A X 1981 ME Group of health centers serving northern Maine. Five of the centers have FQHC designation. 11 11 167 0 0 0 4157101 3631412 10583841 11345994 -926 -4413 0 0 14740016 14972993 0 0 0 0 9354061 9716323 0 0 0 5192721 6631740 14546782 16348063 193234 -1375070 6154164 5022043 1029395 1272344 5124769 3749699 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 4392189 4655441 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. 1029159 570263 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. 2004898 1761654 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. 6887001 4358636 Various other medical services provided to patients. 6887001 4358636 14313247 1 1 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 36 0 167 1 0 0 0 0 0 0 0 0 0 0 X 11 11 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 X 0 0 0 John Swanberg 1.00 X X 0 0 0 Kathleen Ashley 1.00 X 0 0 0 Kris Doody 1.00 X 0 0 0 Darlene Higgins 1.00 X 0 0 0 Jane Kilcollins 1.00 X 0 0 0 Holly Nadeau 1.00 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 James Davis 40.00 X 100728 0 14089 Lisa Caron 40.00 X 68556 0 948 Natania Piper 40.00 X 390222 0 23846 Brian Wall 40.00 X 342526 0 23872 Carl Flynn 40.00 X 414180 0 24374 Hans Duvefelt 40.00 X 261713 0 19826 Santiago Duy 40.00 X 241890 0 24739 1819815 0 131694 22 0 1 0 Weatherby Locums Inc PO Box 972663 Dallas TX 75397 Locum Physicians 1321523 Federal National Commercial Inc PO Box 403826 Atlanta GA 30384 Locum Physicians 301374 Vista Staffing Solutions 275 East 200 South Salt Lake City UT 84111 Locum Physicians 181466 Stone Network Inc PO Box 86 Hatfield PA 19440 Medical Transcription Services 178132 Markiya Nichols MD 9120 Marlove Oaks Lane Owings Mills MD 21117 OB/GYN Services 138794 6 931412 2700000 3631412 Patient Service Revenu 621110 13302653 13302653 Income Guarantee 621110 2029316 2029316 Contractual/Charity Ad 621110 -3985975 -3985975 11345994 4413 -4413 -4413 -4413 14972993 11345994 0 -4413 184321 184321 7989613 7821137 168476 37688 36361 1327 997495 989805 7690 507206 480270 26936 6703853 5449300 1254553 130297 130297 639185 587784 51401 556732 540561 16171 105660 40126 65534 1756 1756 113988 111768 2220 510710 463501 47209 Bad Debts 1506325 1506325 Physical Plant Expenses 81675 81675 Moving Expenses 76925 76925 CME 69645 69645 Allocated Expenses -3865011 -3865011 16348063 14313247 2034816 0 172205 195777 3272052 2708355 1637924 837767 44389 24112 50351 62977 90621 40740 2056976 1151979 758640 904997 105003 225003 22979 22315 6154164 5022043 871939 1099858 157456 172486 1029395 1272344 X 1924769 1049699 3200000 2700000 5124769 3749699 6154164 5022043 -1375070 X X 0 1 1 X 1 1 X 3200000 3318084 3725251 4157101 3631412 18031848 3200000 3318084 3725251 4157101 3631412 18031848 18031848 18031848 57021278 1.00000 1.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 40025 40025 943823 808982 134841 714919 342997 371922 358209 358209 904997 14972993 16348063 -1375070 0 -1375070 14977406 4413 4413 14972993 0 14972993 16352476 4413 4413 16348063 0 16348063 Part XII, Line 2d - Other Adjustments: Loss on Disposal of Fixed Assets 4,413. Part XIII, Line 2d - Other Adjustments: Loss on Disposal of Fixed Assets 4,413. X X X 0 0 0 0 0 0 0 0 0 Natania Piper 390222 0 0 0 0 0 1671 0 22175 0 414068 0 0 0 Brian Wall 342526 0 0 0 0 0 1367 0 22505 0 366398 0 0 0 Carl Flynn 414180 0 0 0 0 0 2349 0 22025 0 438554 0 0 0 Hans Duvefelt 261713 0 0 0 0 0 0 0 19826 0 281539 0 0 0 Santiago Duy 241890 0 0 0 0 0 1864 0 22875 0 266629 0 0 0 Cary Medical Center An entity of which Kris Doody, current director, is an officer 139631 Lease of Property 0 Cary Medical Center An entity of which Kris Doody, current director, is an officer 190357 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 2029316 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. Form 990, Part I, Lines 8-18: Prior year numbers have been restated to present revenue net of contractual and charity care adjustments.