2018-05-15T09:40:27-05:00 2017-12-31 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2017-01-01 010376890 Pines Health Services PINE 2074982356 PO Box 40 Caribou ME 04736 Kris Doody Interim Chief Executive Officer 2074982356 2018-05-09 1 Joseph R Byrne CPA P01289281 2077752387 2018-05-09 69.49.157.66 2018-05-09 09:00:39 ED P 6C82C821AB68A0C56744A782C6F4D6D20AA82B05 85E4EF8485DD783FF01AAACB9DB7F493A64BECE0 2017 2021-01-29 14:40:06Z Kris Doody PO Box 40 Caribou ME 04736 22290360 0 X www.pineshealth.org X 1981 ME Group of health centers serving northern Maine. Six of the centers have FQHC designation. 12 12 198 13 0 0 4476990 4312261 18641539 17972353 1619 5724 0 0 23120148 22290338 30664 7016 0 0 15443107 17275853 0 0 0 7682218 6798799 23155989 24081668 -35841 -1791330 7149180 5452030 1196197 1290377 5952983 4161653 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 6290774 5606971 Family Practice Services provide general care to families. The services are performed by physicians, physician assistants, and family nurse practitioners. The services have been provided since the date of inception. 1206655 713585 Internal Medicine Services provide internal medicine to patients with more severe medical complications. The services are performed by physicians. The services have been provided since the date of inception. 2426902 2032838 Obstetrical and gynecological services are provided to female patients. These services are performed by physicians & Certified Nurse Midwives. The services have been provided since the date of inception. 12345616 7016 9618959 Various other medical services provided to patients. 12345616 7016 9618959 22269947 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 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 1 63 0 1 198 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 Betty Hatch Director 1.00 X 180 0 0 Chris Bell Director 1.00 X 120 0 0 Dana Rattray Vice Chair 1.00 X X 180 0 0 Kevin Barnes Director 1.00 X 150 0 0 Kris Doody Interim CEO/Past Director 40.00 X X 0 0 0 Norm Collins Chair 1.00 X X 150 0 0 Peter Doebener Secretary/Treasurer 1.00 X X 180 0 0 Steve Rogeski Director 1.00 X 0 0 0 Tanya Sleeper Director 1.00 X 0 0 0 Tim Poitras Director 1.00 X 60 0 0 Kristie Moir Director 1.00 X 90 0 0 Jennifer Flynn Director 1.00 X 90 0 0 Galen Dickinson Director 1.00 X 0 0 0 James Davis Past Chief Executive Officer 40.00 X 135148 0 15429 Lisa Caron Chief Operating Officer 40.00 X 100202 0 14031 Jean-Pierre Michaud Orthopedic Surgeon 40.00 X 777921 0 16575 Murad Bani Hani General Surgeon 40.00 X 502862 0 12042 Carl Flynn Family Physician 40.00 X 457881 0 18768 Nadia Rajack Hematologist/Oncologist 40.00 X 390680 0 18207 Brian Wall Ob-Gyn 40.00 X 377133 0 20804 2743027 0 115856 37 0 1 0 Weatherby Locums PO Box 972633 Dallas TX 75397 Locum Physican Staffing 1291197 CompHealth PO Box 972651 Dallas TX 75397 Locum Physican Staffing 617963 Dr Julio Arebalo 275 NE 18th Street Apt 205 Miami FL 33132 General Surgeon 435528 Hayes Locums 6700 N Andrews Avenue Ste 600 Fort Lauderdale FL 33309 Locum Physican Staffing 373980 Greenway PO Box 203658 Dallas TX 75320 EMR Support Services 230930 12 2712261 1600000 4312261 Patient Service Rev. 621110 20059748 20059748 Income Guarantee 621110 3815015 3815015 Meaningful Use Revenue 621110 8500 8500 Bad Debt Expense 621110 -651918 -651918 Contractual/Char. Adj. 621110 -5258992 -5258992 17972353 5746 5746 22 -22 -22 -22 22290338 17972353 0 5724 X 7016 7016 266010 266010 13340391 12983084 357307 76718 76193 525 2821971 2746872 75099 770763 727645 43118 3335141 3107700 227441 55134 55134 528230 272541 255689 199365 199365 787905 765828 22077 145497 86055 59442 254338 204680 49658 390848 324376 66472 Medical Supplies 876366 756982 119384 CME 136853 136853 Physical Plant Expenses 74122 74122 Relocation 15000 15000 24081668 22269947 1811721 0 X 111542 288211 1855826 351286 2103184 1626202 1329578 1525630 40548 37779 77539 83600 4122211 3056128 1188585 1066083 27092 130197 225003 225003 190283 118039 7149180 5452030 1159660 1267007 36537 23370 1196197 1290377 X 3952983 2561653 2000000 1600000 5952983 4161653 7149180 5452030 -1791330 0 X 0 1 X 1 1 1 X 3842833 3527579 3642207 4476990 4312261 19801870 3842833 3527579 3642207 4476990 4312261 19801870 19801870 268 329 2892 7629 5746 16864 19818734 88344430 0.99910 0.99940 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 40025 40025 1520326 1149611 370715 2535374 1906517 628857 26486 26486 1066083 22290338 0 22290338 0 22290338 24081668 0 24081668 0 24081668 X X 0 0 0 0 0 0 0 0 0 James Davis Past Chief Executive Officer 135148 0 0 0 0 0 1398 0 14031 0 150577 0 0 0 Jean-Pierre Michaud Orthopedic Surgeon 777921 0 0 0 0 0 2700 0 13875 0 794496 0 0 0 Murad Bani Hani General Surgeon 502862 0 0 0 0 0 2700 0 9342 0 514904 0 0 0 Carl Flynn Family Physician 457881 0 0 0 0 0 2700 0 16068 0 476649 0 0 0 Nadia Rajack Hematologist/Oncologist 390680 0 0 0 0 0 2052 0 16155 0 408887 0 0 0 Brian Wall Ob-Gyn 377133 0 0 0 0 0 2233 0 18571 0 397937 0 0 0 Cary Medical Center An entity of which Kris Doody, Interim CEO, is an officer 226223 Lease of Property 0 Cary Medical Center An entity of which Kris Doody, Interim CEO, is an officer 551829 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, Interim CEO, is an officer 29167 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, Interim CEO, is an officer 1600000 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, Interim CEO, is an officer 3815015 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 11b 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. Salaries are set using the MGMA annual Physician Compensation & Productivity Survey as a reference. 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 IX, line 11g Billing Services: Program service expenses 474,650. Management and general expenses 0. Fundraising expenses 0. Total expenses 474,650. Support Services: Program service expenses 473,707. Management and general expenses 0. Fundraising expenses 0. Total expenses 473,707. Professional Fees: Program service expenses 2,159,343. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,159,343. Other Fees: Program service expenses 0. Management and general expenses 227,441. Fundraising expenses 0. Total expenses 227,441. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Pines Health Services PO Box 40 Caribou, ME 04736 EIN: 01-0376890 Pines Health Services is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).