BETA

PORTLAND COMMUNITY HEALTH CENTER: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
PORTLAND COMMUNITY HEALTH CENTER (EIN 45-4960453)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-02-28
IRS object ID
201730599349300908
Schema version
2015v3.0
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)
Return2017-02-28T08:52:39-06:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010511973PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1NICHOLSON MICHAUD & COMPANYBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line176 SILVER STREETAddressLine1Txt
CityWATERVILLECityNm
State AbbreviationMEStateAbbreviationCd
ZIP04901ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN454960453EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PORTLAND COMMUNITY HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPORTBusinessNameControlTxt
Phone2078742141PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1180 PARK AVENUEAddressLine1Txt
CityPORTLANDCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04102ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLESLIE CLARKPersonNm
Person TitleCEOPersonTitleTxt
Phone2078742141PhoneNum
Signature2017-02-28SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonERIK NADEAU CPAPreparerPersonNm
PTINP00959193PTIN
Phone2078727077PhoneNum
Preparation2017-02-09PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1GREATER PORTLAND HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerLESLIE CLARKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1180 PARK AVEAddressLine1Txt
CityPORTLANDCityNm
State AbbreviationMEStateAbbreviationCd
ZIP041022957ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,981,102GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PORTLANDCOMMUNITYHEALTHCENTER.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2013FormationYr
Legal Domicile StateMELegalDomicileStateCd
Activity Or MissionTO PROVIDE HIGH QUALITY, PATIENT-CENTERED HEALTHCARE THAT IS ACCESSIBLE, AFFORDABLE, AND CULTURALLY SENSITIVE.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee70TotalEmployeeCnt
Total Volunteers26TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,246,513PYContributionsGrantsAmt
CY Contributions Grants$3,085,096CYContributionsGrantsAmt
PY Program Service Revenue$1,783,470PYProgramServiceRevenueAmt
CY Program Service Revenue$1,895,981CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$25CYInvestmentIncomeAmt
PY Other Revenue$28,846PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$4,058,829PYTotalRevenueAmt
CY Total Revenue$4,981,102CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,720,510PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,261,858CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,148,016PYOtherExpensesAmt
CY Other Expenses$1,582,931CYOtherExpensesAmt
PY Total Expenses$3,868,526PYTotalExpensesAmt
CY Total Expenses$4,844,789CYTotalExpensesAmt
PY Revenues Less Expenses$190,303PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$136,313CYRevenuesLessExpensesAmt
Total Assets BOY$593,304TotalAssetsBOYAmt
Total Assets EOY$1,102,113TotalAssetsEOYAmt
Total Liabilities BOY$419,320TotalLiabilitiesBOYAmt
Total Liabilities EOY$791,816TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$173,984NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$310,297NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE HIGH QUALITY, PATIENT-CENTERED HEALTHCARE THAT IS ACCESSIBLE, AFFORDABLE, AND CULTURALLY SENSITIVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$3,034,383ExpenseAmt
Revenue$1,459,905RevenueAmt
DescTHE ORGANIZATION PROVIDES A COMPREHENSIVE ARRAY OF PRIMARY CARE SERVICES TO ITS TARGET POPULATIONS ACROSS THE FULL LIFECYCLE - PEDIATRIC, ADOLESCENT, ADULT, AND GERIATRIC CARE. OUTREACH AND ENROLLMENT WORKERS ASSISTED NEW AND PROSPECTIVE PATIENTS WITH ENROLLMENT IN THE AFFORDABLE CARE ACT MARKETPLACE FOR INSURANCE COVERAGE, AND ASSISTED WITH IDENTIFYING ELIGIBILITY AND ENROLLMENT FOR MEDICAID, MEDICARE, AND/OR OTHER ASSISTANCE PROGRAMS. THE ORGANIZATION PROVIDED ENABLING SERVICES INCLUDING CASE MANAGEMENT, TRANSLATION SERVICES, AND TRANSPORTATION VOUCHERS TO ENSURE ACCESS TO CARE AND CONNECTION WITH NEEDED SOCIAL SERVICES AND BASIC NEEDS.REFERRALS FOR SPECIALTY CARE ARE FACILITATED BY A REFERRALS COORDINATOR, AND THROUGH FORMAL ARRANGEMENTS WITH LOCAL HOSPITALS AND SPECIALISTS WHO ACCEPT PORTLAND COMMUNITY HEALTH CENTER'S SLIDING FEE SCALE AND PROVIDE CHARITY CARE FOR THOSE PATIENTS UNABLE TO PAY.LABORATORY AND RADIOLOGY SERVICES ARE PROVIDED THROUGH LOCAL HOSPITAL SYSTEMS ON A SLIDING FEE SCALE THAT ENSURES THE SAME OR LOWER CHARGES FOR THE HEALTH CENTER'S PATIENTS. HEALTH FAIRS AND SCREENING CLINICS ARE PROVIDED AT LOCAL SCHOOLS, HOUSING AUTHORITY COMMUNITIES, LIBRARY, AND SOCIAL SERVICE AGENCIES. PLEASE SEE SCHEDULE O FOR ADDITIONAL DESCRIPTION OF PROGRAM SERVICES UNDERTAKEN DURING THE YEAR.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$906,374ExpenseAmt
Revenue$436,076RevenueAmt
DescTHE ORGNIZATION PROVIDED COMPREHENSIVE MENTAL HEALTH AND SUBSTANCE ABUSE COUNSELING SERVICES IN A FULLY INTEGRATED MANNER ON-SITE AT ITS PORTLAND, MAINE LOCATION.LICENSED CLINICAL SOCIAL WORKERS ON EACH HEALTH CARE TEAM HELP PATIENTS MAKE NEEDED CHANGES THROUGH HEALTH COACHING AND PROVIDING BEHAVIORAL STRATEGIES THAT IMPROVE HEALTH AND REDUCE HARM. SOME OF THESE INCLUDE STRESS MANAGEMENT TECHNIQUES, SMOKING CESSATION, AND MOTIVATIONAL INTERVIEWING. SUPPORT GROUPS AND EDUCATIONAL SESSIONS ARE OFFERED ON SITE AT NOMINAL OR NO FEE. THESE INCLUDE NUTRITION CLASSES, SUPPORT GROUPS FOR NEW IMMIGRANTS, MEETINGS OF ALCOHOLICS ANONYMOUS, AND A VARIETY OF SPECIAL INTEREST TOPIC HEALTH SESSIONS, FOR EXAMPLE, DIABETES EDUCATION. PLEASE SEE SCHEDULE O FOR A COMPREHENSIVE DESCRIPTION OF PROGRAM SERVICES UNDERTAKEN DURING THE YEAR.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$3,940,757TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document3IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee70EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANN TUCKER CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2078742141PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1180 PARK AVENUEAddressLine1Txt
CityPORTLANDCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04102ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeInd
VICTORIA FOLEY
PRESIDENT3.00Yes (X)Yes (X)$0$0$0
GRETE ZEMANS
VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
NADINE TWAGIRAYEZU
SECRETARY1.00Yes (X)Yes (X)$0$0$0
MICHAEL NELSON
TREASURER1.00Yes (X)Yes (X)$0$0$0
ADRIA MOYNIHAN RUSK
DIRECTOR0.50Yes (X)$0$0$0
AMY KUSTRA BARKSDALE
DIRECTOR0.50Yes (X)$0$0$0
BRUNO YOMOAH
DIRECTOR0.50Yes (X)$0$0$0
CHAMIS OMAR
DIRECTOR0.50Yes (X)$0$0$0
EILEEN SKILLINGS
DIRECTOR0.50Yes (X)$0$0$0
GLORIA HERBOLDSHEIMER
DIRECTOR0.50Yes (X)$0$0$0
JOYCE RACINE
DIRECTOR0.50Yes (X)$0$0$0
KARIN ANDERSON
DIRECTOR2.00Yes (X)$0$0$0
KATHLEEN STOKES
DIRECTOR0.50Yes (X)$0$0$0
MAURICE NAMWIRA
DIRECTOR0.50Yes (X)$0$0$0
NANCY RICKER
DIRECTOR0.50Yes (X)$0$0$0
VICTORIA CHICON
DIRECTOR0.50Yes (X)$0$0$0
LESLIE CLARK
CEO40.00Yes (X)$127,114$0$5,483
ANN TUCKER
CFO40.00Yes (X)$77,986$0$10,162
RENEE FAY-LEBLANC
CMO40.00$191,514$0$9,449Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$396,614TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$25,094TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$2,994,736GovernmentGrantsAmt
All Other Contributions$90,360AllOtherContributionsAmt
Total Contributions$3,085,096TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENU621400$1,832,231$1,832,231
MEANINGFUL USE621400$63,750$63,750
FieldValueIRS element (for citing)
Total Program Service Revenue$1,895,981TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$25TotalRevenueColumnAmt
Exclusion$25ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,981,102TotalRevenueColumnAmt
Related Or Exempt Func Income$1,895,981RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$25ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$220,114TotalAmt
Program Services$22,094ProgramServicesAmt
Management And General$198,020ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,571,263TotalAmt
Program Services$2,375,020ProgramServicesAmt
Management And General$196,243ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$238,548TotalAmt
Program Services$204,855ProgramServicesAmt
Management And General$33,693ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$231,933TotalAmt
Program Services$199,174ProgramServicesAmt
Management And General$32,759ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$38,568TotalAmt
Program Services$7,714ProgramServicesAmt
Management And General$30,854ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$26,495TotalAmt
Program Services$5,299ProgramServicesAmt
Management And General$21,196ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$26,158TotalAmt
Program Services$26,158ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$43,693TotalAmt
Program Services$36,047ProgramServicesAmt
Management And General$7,646ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$214,755TotalAmt
Program Services$193,279ProgramServicesAmt
Management And General$21,476ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$258,387TotalAmt
Program Services$232,548ProgramServicesAmt
Management And General$25,839ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$13,429TotalAmt
Program Services$13,429ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,097TotalAmt
Management And General$6,097ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$101,138TotalAmt
Program Services$82,877ProgramServicesAmt
Management And General$18,261ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$26,178TotalAmt
Program Services$20,704ProgramServicesAmt
Management And General$5,474ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CONTRACTUAL SERVICES$305,925$161,575$144,350
CONSULTING$135,737$20,361$115,376
REPAIRS AND MAINTENANCE$74,881$67,393$7,488
MEDICAL SUPPLIES$61,874$61,874

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$249,616TotalAmt
Program Services$210,356ProgramServicesAmt
Management And General$39,260ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$4,844,789TotalAmt
Program Services$3,940,757ProgramServicesAmt
Management And General$904,032ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$106,712BOYAmt
EOY$187,694EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$236,714EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$170,380BOYAmt
EOY$197,020EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$12,848EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$9,141BOYAmt
EOY$80,495EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$626,228LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$272,971LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$287,194BOYAmt
EOY$353,257EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$19,877BOYAmt
EOY$34,085EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$593,304BOYAmt
EOY$1,102,113EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$333,870BOYAmt
EOY$529,681EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$23,137BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$62,313BOYAmt
EOY$41,049EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$221,086EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$419,320BOYAmt
EOY$791,816EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$124,364BOYAmt
EOY$286,194EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$49,620BOYAmt
EOY$24,103EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$173,984BOYAmt
EOY$310,297EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$593,304BOYAmt
EOY$1,102,113EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$136,313ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$440,820OtherCostOrOtherBasisAmt
Depreciation$143,185DepreciationAmt
Book Value$297,635BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$185,408OtherCostOrOtherBasisAmt
Depreciation$129,786DepreciationAmt
Book Value$55,622BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$353,257TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescREFUNDABLE ADVANCESDesc
Amt$221,086Amt
FieldValueIRS element (for citing)
Total Liability$221,086TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$4,981,102TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$4,981,102RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$4,981,102TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$4,844,789TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$4,844,789ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$4,844,789TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonRENEE FAY-LEBLANCPersonNm
TitleCMOTitleTxt
Base Compensation Filing Org$191,514BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$9,449NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$200,963TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS FOR DISCUSSION, REVIEW AND APPROVAL BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS AND OTHER KEY EMPLOYEES ARE REQUIRED TO READ AND SIGN CONFLICT OF INTEREST STATEMENTS ON AN ANNUAL BASIS OR WHEN THERE IS A CHANGE IN BOARD MEMBER OR KEY OFFICER.
FORM 990, PART VI, SECTION B, LINE 15SENIOR MANAGEMENT SALARIES ARE BASED ON NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS SALARY SURVEY INFORMATION THAT IS PROVIDED AND REVIEWED ANNUALLY BY THE FINANCE COMMITTEE AND BOARD OF DIRECTORS. COMPENSATION IN THE RANGE IS BASED ON REQUISITE EXPERIENCE.
FORM 990, PART VI, SECTION C, LINE 19PRINT COPIES OF GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE AT ORGANIZATION HEADQUARTERS. FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC HOWEVER PERTINENT ANNUAL FINANCIAL RESULTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2C:THERE HAS BEEN NO CHANGE TO THE PROCESS FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY CARE PARTNERSHIP OF MAINE LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1103 MAINE AVE PO BOX 1358AddressLine1Txt
CityBANGORCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04401ZIPCd
FieldValueIRS element (for citing)
EIN463666823EIN
Primary ActivitiesACCOUNTABLE CARE ORGANIZATIONPrimaryActivitiesTxt
Legal Domicile StateMELegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PENOBSCOT COMMUNITY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income-$1,969ShareOfTotalIncomeAmt
Share Of EOY Assets$1,181ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
Ownership0.03850OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY CARE PARTNERSHIP OF MAINE LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeBTransactionTypeTxt
Involved$3,150InvolvedAmt
Method Of Amount DeterminationCASHMethodOfAmountDeterminationTxt

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