FURP.ORG / PUBLIC DATA EXPLORER

MILLINOCKET REGIONAL HOSPITAL: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
MILLINOCKET REGIONAL HOSPITAL (EIN 01-0223482)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-02-16
IRS object ID
201540489349300019
Schema version
2013v4.0
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)
Return2015-02-16T08:49:10-06:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010523282PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Berry Dunn McNeil & Parker LLCBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1100AddressLine1
CityPortlandCity
StateMEState
ZIP Code041041100ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN010223482EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Millinocket Regional HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlMILLBusinessNameControlTxt
Phone2077235161PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 Somerset StreetAddressLine1
CityMillinocketCity
StateMEState
ZIP Code04462ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRobert PetersonPersonNm
Person TitleChief Executive OfficerPersonTitleTxt
Phone2077235161PhoneNum
Signature2015-02-16SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBarbara J McGuan CPAPreparerPersonNm
PTINP00219457PTIN
Phone2077752387PhoneNum
Preparation2015-02-16PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRobert PetersonPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 Somerset StreetAddressLine1
CityMillinocketCity
StateMEState
ZIP Code04462ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$30,105,002GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.mrhme.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1952FormationYr
Legal Domicile StateMELegalDomicileStateCd
Activity Or MissionCritical Access HospitalActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee273TotalEmployeeCnt
Total Volunteers13TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$181,679PYContributionsGrantsAmt
CY Contributions Grants$8,877CYContributionsGrantsAmt
PY Program Service Revenue$27,112,248PYProgramServiceRevenueAmt
CY Program Service Revenue$24,974,746CYProgramServiceRevenueAmt
PY Investment Income$590,961PYInvestmentIncomeAmt
CY Investment Income$1,027,004CYInvestmentIncomeAmt
PY Other Revenue$72,713PYOtherRevenueAmt
CY Other Revenue$13,625CYOtherRevenueAmt
PY Total Revenue$27,957,601PYTotalRevenueAmt
CY Total Revenue$26,024,252CYTotalRevenueAmt
PY Grants And Similar Paid$2,301PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$17,409,296PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$17,644,553CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$10,229,103PYOtherExpensesAmt
CY Other Expenses$9,639,342CYOtherExpensesAmt
PY Total Expenses$27,640,700PYTotalExpensesAmt
CY Total Expenses$27,283,895CYTotalExpensesAmt
PY Revenues Less Expenses$316,901PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,259,643CYRevenuesLessExpensesAmt
Total Assets BOY$23,588,914TotalAssetsBOYAmt
Total Assets EOY$24,726,055TotalAssetsEOYAmt
Total Liabilities BOY$8,546,823TotalLiabilitiesBOYAmt
Total Liabilities EOY$10,221,431TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$15,042,091NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$14,504,624NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionMillinocket Regional Hospital is a 25 bed critical access hospital that serves as the primary care facility for the communities of Millinocket, Milo, Sherman, Staceyville, Patten, Island Falls and their surrounding territories.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$25,156,833ExpenseAmt
Revenue$24,974,746RevenueAmt
DescMillinocket Regional Hospital provides inpatient and outpatient services to the Katahdin region including; 749 inpatients served, 1,233 operating room patients served, 20,122 laboratory patients served, 1,412 radiology patients served, 6,790 pharmacy patients served, 1,901 therapy patients served, 17,487 clinic patients served, 6,367 emergency room patients served.The following seminars, promotions, advertisements, and clinics were provided to the community throughout fiscal 2014:1. MRH helped in sponsoring Town of Millinocket Public Pool to be open until August 23, 2013.2. MRH sponsored the Stearns-Schenck Musical "Nutcracker" in October of 2013.3. MRH provided Mammograms at a reduced rate during the Breast Cancer Awareness week October 20134. MRH sponsored the Community Christmas Party.5. MRH sponsored a Jr. Pro Hoop Classic in January of 2013.6. MRH provided catering for Boys Scouts of America Recognition Dinner in October 2013 and in March 2014.7. MRH Held Multiple Flu Shot and H1N1 Flu Shot Clinics from October 2013 to April 2014.8. MRH sponsored a chem-free post graduation party at Schenck HS for Class of 2014.9. MRH sponsored Stearns HS student Christopher Brown to travel with the People2People Program to Europe.10. MRH paid a sponsorship to Nollesemic Lodge #205 for the Bikes4Books program.11. MRH paid a sponsorship to Millinocket Little League in June of 2014 which paid for two teams, the Yankees and the Raptors, and also a scoreboard sign.12. MRH sponsored a Cardiac Support Group the first Wednesday of each month.13. MRH sponsors a MS Support Group the first Tuesday of every month.14. MRH Purchased ad space to raise money for multiple causes including: Schenck and Stearns' High School yearbook, Millinocket Historical Society 2014 calendars, VFW convention ad book, and also ads for special sections of the Bangor Daily News that covered area football and basketball teams.15. MRH operates a grant funded Healthy Maine Partnership organization which provided education services to the community on alcohol misuse, tobacco cessation, proper nutrition and physical activity. The staff works with businesses, clubs and the schools to extend the message of healthy living and good wellness choices. The Organization uses local media to reach the large region.16. MRH provides meeting space for non-profits at no cost, for example to American Cancer Society, Eastern Area on Aging, Martin's Point, Diabetic Support Group, Caring Connections, AA, and Weight Watchers.17. MRH participates in disaster preparedness regional committee with several other agencies including doctors' groups, other hospitals, local police and fire departments, schools and other organizations. The goal is to prepare for pandemic flu, natural disasters or other incidents that could affect our communities and work together to share resources to protect the community.Desc
Total Program Service Expenses$25,156,833TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
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 SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
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 EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document76IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee273EmployeeCnt
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 Members13GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
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 ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
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 VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldMEStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Robert PetersonBusinessNameLine1
FieldValueIRS element (for citing)
Phone2077235161PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 Somerset StreetAddressLine1
CityMillinocketCity
StateMEState
ZIP Code04462ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Wallace Tapley
Director5.00Yes (X)$0$0$0
Ronald Brown
Director5.00Yes (X)$0$0$0
Patrick Hunt Esq
Director5.00Yes (X)$0$0$0
Herbert Clark
Director5.00Yes (X)$0$0$0
Gail Fanjoy
Director5.00Yes (X)$0$0$0
Fred Lewis
Director5.00Yes (X)$0$0$0
Thomas Malcolm
Director5.00Yes (X)$0$0$0
Joyce Given
Hospital Aux. President5.00Yes (X)$0$0$0
Edward Dunstan
Medical Staff President60.00Yes (X)$203,139$0$31,332Yes (X)
Nilesh Patil
Medical Staff Vice President60.00Yes (X)$444,799$0$28,887Yes (X)
Jack Dinsmore
Past Director5.00Yes (X)$0$0$0
Molly Biehl
Past Medical Staff Secretary40.00Yes (X)$19,200$0$0Yes (X)
Mellissa Edwards
President5.00Yes (X)$0$0$0Yes (X)
Lee Lamson
Secretary/Treasurer5.00Yes (X)$0$0$0Yes (X)
Don Casko
Vice President5.00Yes (X)$0$0$0Yes (X)
Robert Peterson
CEO40.00$0$0$0Yes (X)
James Sexton
Interim CEO40.00$0$0$0Yes (X)
Marie Vienneau
Past CEO40.00$217,776$0$35,152Yes (X)
Christine McLaughlin
VP of Finance40.00$112,815$0$27,209Yes (X)
Joseph Aquilina
ER PA48.00$183,006$0$18,309Yes (X)
Kwaku Owusu-Abrokwa MD
Hospitalist60.00$205,707$0$17,664Yes (X)
Daniel Herbert MD
Hospitalist60.00$320,285$0$27,359Yes (X)
Stylianos Tsintzilonis
Surgeon60.00$273,956$0$20,252Yes (X)
Mark Kowalski
Surgeon60.00$443,186$0$37,759Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,423,869TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$243,923TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K23IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
Katahdin Shared Services Inc
200 Somerset StreetMillinocketME04462Ultrasound Services$469,366
CPSI
PO Box 850309MobileAL36685Computer Services$378,291
NEHE-MRI LLC
PO Box 6600Newport BeachCA92658MRI Radiology$307,020
Synernet Inc
110 Free StreetPortlandME04101Contract Services$210,518
Eastern Maine Medical Center
43 Whiting Hill RoadBrewerME04412Purchased Services$184,594
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
All Other Contributions$8,877AllOtherContributionsAmt
Total Contributions$8,877TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Ancillary Services621400$39,772,839$39,772,839
Routine Services621400$2,369,289$2,369,289
Miscellaneous Income621400$608,868$572,900$35,968
Provision for Bad Debts621400-$1,336,500-$1,336,500
Contractual/Char. Adj.621400-$16,439,750-$16,439,750
FieldValueIRS element (for citing)
Total Program Service Revenue$24,974,746TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$217,972TotalRevenueColumnAmt
Exclusion$217,972ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$35,710RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$16,073RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$19,637RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,637TotalRevenueColumnAmt
Exclusion$19,637ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$4,834,092SecuritiesAmt
Other$39,617OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$4,034,214SecuritiesAmt
Other$30,463OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$799,878SecuritiesAmt
Other$9,154OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$809,032TotalRevenueColumnAmt
Exclusion$809,032ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescLoss on Investment of AffiliateDesc
Business531120BusinessCd
Total Revenue Column-$6,012TotalRevenueColumnAmt
Exclusion-$6,012ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total-$6,012OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$26,024,252TotalRevenueColumnAmt
Related Or Exempt Func Income$24,938,778RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,076,597ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,101,110TotalAmt
Program Services$708,157ProgramServicesAmt
Management And General$392,953ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$12,531,919TotalAmt
Program Services$12,001,735ProgramServicesAmt
Management And General$530,184ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$345,527TotalAmt
Program Services$335,190ProgramServicesAmt
Management And General$10,337ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,799,843TotalAmt
Program Services$2,677,081ProgramServicesAmt
Management And General$122,762ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$866,154TotalAmt
Program Services$810,970ProgramServicesAmt
Management And General$55,184ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$29,153TotalAmt
Management And General$29,153ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$36,252TotalAmt
Management And General$36,252ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$44,315TotalAmt
Management And General$44,315ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,834,927TotalAmt
Program Services$2,239,148ProgramServicesAmt
Management And General$595,779ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$73,149TotalAmt
Management And General$73,149ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$338,569TotalAmt
Program Services$234,480ProgramServicesAmt
Management And General$104,089ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$506,469TotalAmt
Program Services$485,076ProgramServicesAmt
Management And General$21,393ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$42,257TotalAmt
Program Services$26,585ProgramServicesAmt
Management And General$15,672ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$223,915TotalAmt
Program Services$223,915ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$874,351TotalAmt
Program Services$874,351ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$324,651TotalAmt
Program Services$324,651ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$3,534,512$3,441,772$92,740
Medicaid Tax$602,878$602,878
Miscellaneous Expenses$132,051$128,951$3,100
Dues & Subscriptions$41,893$41,893

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$27,283,895TotalAmt
Program Services$25,156,833ProgramServicesAmt
Management And General$2,127,062ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$930BOYAmt
EOY$930EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,167,161BOYAmt
EOY$2,574,596EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,071,470BOYAmt
EOY$2,822,362EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$14,553BOYAmt
EOY$87,884EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$421,206BOYAmt
EOY$502,768EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$298,287BOYAmt
EOY$407,646EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$19,242,277LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$13,258,305LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,576,622BOYAmt
EOY$5,983,972EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$9,378,479BOYAmt
EOY$10,934,616EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,464,160BOYAmt
EOY$1,397,245EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$15,439BOYAmt
EOY$14,036EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$180,607BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$23,588,914BOYAmt
EOY$24,726,055EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,023,961BOYAmt
EOY$3,284,840EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,238,611BOYAmt
EOY$1,126,289EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,284,251BOYAmt
EOY$3,909,551EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,900,751EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,546,823BOYAmt
EOY$10,221,431EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,928,633BOYAmt
EOY$14,388,444EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$108,458BOYAmt
EOY$111,180EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,000BOYAmt
EOY$5,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,042,091BOYAmt
EOY$14,504,624EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$23,588,914BOYAmt
EOY$24,726,055EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,259,643ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$722,176NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$8,573OtherActivitiesAmt
Total Lobbying Expenditures$8,573TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationThe Organization pays dues to various organizations, a portion of which are attributable to lobbying expenses.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$49,951OtherCostOrOtherBasisAmt
Book Value$49,951BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,211,594OtherCostOrOtherBasisAmt
Depreciation$5,794,658DepreciationAmt
Book Value$3,416,936BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,307,885OtherCostOrOtherBasisAmt
Depreciation$6,928,197DepreciationAmt
Book Value$2,379,688BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$672,847OtherCostOrOtherBasisAmt
Depreciation$535,450DepreciationAmt
Book Value$137,397BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,983,972TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Investment in First Millinocket Regional Investment Corp$1,341,699C
Investment in Katahdin Shared Services$55,546C
FieldValueIRS element (for citing)
Total Book Value Securities$1,397,245TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescEstimated Third-Party Payor SettlementsDesc
Amt$1,900,751Amt
FieldValueIRS element (for citing)
Total Liability$1,900,751TotalLiabilityAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$797,176TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$797,176NetCommunityBenefitExpnsAmt
Total Expense0.02920TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,874,903TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$253,031DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,621,872NetCommunityBenefitExpnsAmt
Total Expense0.13270TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,672,079TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$253,031DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,419,048NetCommunityBenefitExpnsAmt
Total Expense0.16190TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,669TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,669NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,669TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,669NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,673,748TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$253,031DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,420,717NetCommunityBenefitExpnsAmt
Total Expense0.16200TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$863,879BadDebtExpenseAmt
Reimbursed By Medicare$10,367,098ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$10,278,523CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$88,575MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost Accounting SystemYes (X)CostAccountingSystemInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn0FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Millinocket Regional HospitalBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 Somerset StreetAddressLine1
CityMillinocketCity
StateMEState
ZIP Code04462ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Millinocket Regional HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted11CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
All Needs AddressedYes (1)AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Attached To InvoiceYes (X)AttachedToInvoiceInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Provided On AdmissionYes (X)ProvidedOnAdmissionInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Millinocket Regional HospitalPart V, Section B, Line 3: The OneMaine Health Collaborative, which was formed by EMHS/Maine General Health and Maine Health, contracted with the University of New England's Center for Community and Public Health (CCPH) to conduct a Statewide Community health needs Assessment (CHNA). The assessment conducted in collaboration with the University of Southern Maine and Market Decisions, Inc, was designed to identify the most important health issues in the state, both overall and by county, using scientifically valid health indicators and comparative information. The assessment also identifies priority health issues where better integration of public health and healthcare can improve access, quality, and cost effectiveness of services to residents of Maine. OneMaine shared this information with its fellow stakeholders so it can lead to improved health status and quality of care available to Maine residents, while building upon and strengthening Maine's existing infrastructure of services and providers.The four objectives of the OneMaine Community Health Needs Assessment were:1. Develop a comprehensive profile of health status, quality of care and care management indicators for residents of Maine overall and for residents by county.2. Identify a set of priority health needs (public health and health care) for follow-up.3. Provide recommendations on strategies that can be undertaken by healthcare providers, public health staff, communities, policy makers and others to follow-up on the information provided with actions that may improve the health status of Maine people. 4. Provide access to the CHNA data and assistance to stakeholders who are interested in using it.The methodology for the CHNA was a modified version of CCPH's Community and Institutional Assessment Process (CIAP). The CIAP is a comprehensive planning process that identifies salient healthcare related issues in the community through a systematic analysis of scientifically derived health indicators and comparative and best practice information. Indicators are computed from an extensive set of health-related data and a community household telephone survey.The CIAP starts with a comprehensive epidemiological-based health profile organized by health domain or condition such as cardiovascular health, respiratory health, cancer health, etc. Indicators for most domains are further organized by risk factors, prevalence or incidence of disease or condition, care management indicators and care outcomes. The analysis of indicators within each domain provides information to identify, and subsequently explore, which aspects of the healthcare delivery system may be over-or under-performing for that particular domain (e.g. primary prevention, secondary prevention, etc.)Community health needs assessments are designed, in part, to identify issues where changes in the healthcare delivery system can improve both patient care and preventive services for those at risk for health problems. Findings and recommendations:1. Maine has several underlying socio-demographic characteristics that impact many of the health indicators, for example, Maine has the oldest population in the U.S., a very high proportion of elderly (65+) compared to the U.S. Being older does not equate to poor health, the reality is that aging populations use more health services than younger populations.2. Maine has a lower median income than the U.S. but the proportion of Maine residents living below the Federal poverty line is slightly lower than the rest of the country. However, in Northern Maine the proportions of residents live below the Federal poverty line than the state as a whole or the U.S.3. Unemployment is an important demographic predictor of health and compared to the rest of the U.S., Maine has a lower unemployment rate, but several Maine counties individually have high rates of unemployment, many well over 10%.On May 26, 2011, Eastern Maine Health Systems (EMHS) presented the OneMaine Health Collaborative Community Health Needs Assessment to community leaders, which was hosted by Millinocket Regional Hospital and Penobscot Valley Hospital.Access to Health Care and ED UtilizationMRH received Rural Health Clinic status to stabilize primary care reimbursement. MRH has recruited a mid-level provider and is in the process of recruiting a part time family practitioner. MRH provided a sliding fee and charity care in practices to mirror the hospital to encourage access. The RHCs are seeking Patient Centered medical Home status which will encourage expanded coverage hours. Currently participating in MaineCare ED utilization project and implemented follow-up call on ED visits to question if primary care was sought.Obesity & Chronic Disease ManagementMRH employs a Wellness Coordinator and has a worksite wellness program. MRH incentivizes employee health and wellness via health plan. MRH subsidizes and runs only fitness facility north of Bangor. MRH supports and employ staff for healthy Maine Partnership. Physicians do community talks on nutrition. MRH hired a primary care Case Manager whose focus is on diabetes, heart disease, HTN, and COPD. MRH maintains a Cardiac Rehab, Diabetes Self-Management Training, and ADEF program.Behavioral HealthcareMRH has an ongoing relationship with CHCS Crisis Services for crisis evaluation. MRH developed Tele-Psychiatry Program with Acadia Hospital for emergent psychiatric assessment. MRH is developing plans to integrate Behavioral healthcare into primary care as part of Patient Centered Medical Home Project. MRH petitioned CMS to allow reimbursement of telemedicine in Metropolitan Statistical Areas to allow further expansion of Tele-Psychiatry.
Millinocket Regional HospitalPart V, Section B, Line 4: Statewide community health needs assessment "OneMaine Health Collaborative" sponsored by Eastern Maine Health System, MaineGeneral Health, and MaineHealth.
Millinocket Regional HospitalPart V, Section B, Line 20d: The Hospital billed amounts to individuals who did not have insurance at cost and applied a 10% discount to private pay patients.

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:Income guidelines as set by Hospital Finance Rules will be used in determining eligibility. Percentage of balance discounted will be determined based on patient's income level relative to the Federal Poverty Level guidelines. These guidelines are updated annually by the Financial Counselor.Up to 150% FPL 100% Balance Discounted151% to 200% FPL 50% Balance Discounted201% to 250% FPL 25% Balance Discounted251% to 300% FPL 10% Balance Discounted301% to 400% FPL 5% Balance Discounted
Part I, Line 7:Expenses calculated on Lines 7a & 7b were calculated using a cost-to-charge ratio while actual expenses were used in calculating the amount reported on line 7i.
Part III, Line 4:Patient accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to operations and a credit to a valuation allowance based on its assessment of individual accounts and historical adjustments. Balances that are still outstanding, after management has used reasonable collection efforts, are written off through a charge to the valuation allowance and a credit to patient accounts receivable.In evaluating the collectability of accounts receivable, the Hospital analyzes past results and identifies trends for each major payor source of revenue for the purposes of estimating the appropriate amounts of the allowance for doubtful accounts and the provision for bad debts. Data in each major payor source are regularly reviewed to evaluate the adequacy of the allowance for doubtful accounts. Specifically, for receivables relating to services provided to patients having third-party coverage, an allowance for doubtful accounts and a corresponding provision for bad debts are established at varying levels based on the age of the receivables and payor source. For receivables relating to self-pay patients, a provision for bad debts is made in the period services are rendered based on experience indicating the inability or unwillingness of patients to pay amounts for which they are financially responsible.
Part III, Line 8:The Organization used accounting methodology prescribed by the Medicare cost report as its costing methodology to determine the amount of Medicare allowable costs.
Part VI, Line 2:A formal community needs assessment is done every 2-3 years. These assessments are conducted to obtain information on successes, failures, weaknesses and strengths to be used for guidance in the vision for the future of healthcare delivery in our service areas.
Part VI, Line 3:Inpatients: In order to identify those patients who would be eligible for financial assistance, all uninsured inpatients are referred to the Financial Counselor by pre-registration or registration personnel. The Financial Counselor will do an initial screening for payment options prior to the patient leaving the hospital, if possible. If the patient has left the hospital, the Financial Counselor will attempt to contact the patient for information. All inpatients are given a copy of Patient Free Care and Discount Arrangements guidelines at time of admission.Surgical outpatients: The Financial Counselor will provide information about Patient Free Care, Discount Arrangements and term payment arrangements to all uninsured surgical outpatients. All surgical outpatients are provided a copy of Patient Free Care and Discount Arrangements guidelines at time of registration. Emergency room patients: All emergency room patients are provided a copy of Patient Free Care and Discount Arrangements guidelines at time of registration. All other outpatients: All other outpatients are provided a copy of the Patient Free Care/Discount Arrangements guidelines at time of registration. All patients will receive notice of availability of financial assistance included in their first-time statement. Patient Financial Services employees and Physician Practice employees receive training on patient free care and discount arrangements guidelines and are expected to be able to provide contact information about free care and discount arrangements.
Part VI, Line 4:Millinocket Regional Hospital has three communities in its primary service area, Millinocket, East Millinocket and Medway. There are multiple smaller communities in the secondary service area including, Brownville, Stacyville, Sherman, Patten and Island Falls. The area has struggled and realized an unemployment rate in the teens for the past ten years and community outmigration. The population of the primary service area is approximately 7500 people. The hospital has realized this population change by large volume declines in 2013. The average median household income is 22% behind the state average. The average resident age is 14% older than the state median age.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
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 PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Edward Dunstan
Medical Staff President$203,139$0$0$0$0$0$8,240$0$23,092$0$234,471$0$0$0
Nilesh Patil
Medical Staff Vice President$444,799$0$0$0$0$0$4,520$0$24,367$0$473,686$0$0$0
Marie Vienneau
Past CEO$217,776$0$0$0$0$0$8,558$0$26,594$0$252,928$0$0$0
Joseph Aquilina
ER PA$183,006$0$0$0$0$0$1,916$0$16,393$0$201,315$0$0$0
Kwaku Owusu-Abrokwa MD
Hospitalist$205,707$0$0$0$0$0$8,405$0$9,259$0$223,371$0$0$0
Daniel Herbert MD
Hospitalist$288,185$0$32,100$0$0$0$10,760$0$16,599$0$347,644$0$0$0
Stylianos Tsintzilonis
Surgeon$273,956$0$0$0$0$0$11,005$0$9,247$0$294,208$0$0$0
Mark Kowalski
Surgeon$443,186$0$0$0$0$0$13,298$0$24,461$0$480,945$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 7FormAndLineReferenceDesc
ExplanationA bonus was paid to Daniel Herbert as an incentive for entering into an employment agreement with the Hospital. If the agreement is terminated by the physician, a pro rata amount of the bonus is to be repaid to the Hospital.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Maine Health and Higher Educational Facilities AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Bond Issuer EIN010314384BondIssuerEIN
CUSIP560427WV4CUSIPNum
Bond Issued2013-05-23BondIssuedDt
Issue Price$1,423,837IssuePriceAmt
PurposeRefinancing of 2003 D bond issuePurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool FinancingYes (1)PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$297,548RetiredAmt
Total Proceeds$1,423,837TotalProceedsAmt
Issuance Costs From Proceeds$15,439IssuanceCostsFromProceedsAmt
Substantial Completion2013SubstantialCompletionYr
Current RefundingYes (1)CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Julie Brown
Family Member of Ronald Brown, member of Board of Directors$37,951Employment0
Rose Ann Hunt
Family Member of Patrick Hunt, member of Board of Directors$131,993Employment0
Dale McLaughlin
Family Member of Christine McLaughlin, CFO of Organization$94,776Employment0
Ona McAvoy
Family Member of Mellissa Edwards, Board President$65,696Employment0
Cynthia Morneault
Family Member of Joyce Given, member of Board of Directors$27,782Employment0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11Prior to the document's filing, the Organization's finance department reviews the initial draft. After any necessary changes, the Organization's board members are presented with a copy. The finalized document is subject to the board's approval.
Form 990, Part VI, Section B, line 12cEach board member is required to sign a conflict of interest disclosure form on an annual basis. In connection with any actual or possible conflicts of interest, an interested individual must disclose the existence of his or her conflict annually and whenever the conflict arises for action at a meeting. After receiving all annual attestations, the CEO will provide the signed statements to the Hospital's attorney for review. After review, the attorney will determine if a conflict exists and inform the CEO and Board chair of the conflicted individuals. There is a listing of Board, Medical Staff and Manager conflicts available at all meetings for reference. The Agenda for every Board, Medical Staff or Department meeting will clearly list the discussion items that require action during the meeting. At the beginning of the meeting, the President will ask the members to review the list of action items and declare whether or not they have a conflict. All conflicted members will be required to excuse themselves and leave the room during the discussion and vote. If the board or committee has reasonable cause to believe that a member has failed to disclose actual or possible conflicts of interest, it shall inform the member of the basis for such belief and afford the member an opportunity to explain the alleged failure to disclose.
Form 990, Part VI, Section B, line 15The Organization works with an independent compensation consultant to determine appropriate compensation levels. The Organization's executive committee reviews data used to determine compensation for its respective members. Any compensation related changes must be approved by the board of directors or the executive board.
Form 990, Part VI, Section C, line 19The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part IX, line 11gPurchased Services: Program service expenses 1,391,778. Management and general expenses 595,779. Fundraising expenses 0. Total expenses 1,987,557. Service Contracts: Program service expenses 356,035. Management and general expenses 0. Fundraising expenses 0. Total expenses 356,035. Professional Services: Program service expenses 477,982. Management and general expenses 0. Fundraising expenses 0. Total expenses 477,982. Outside Services: Program service expenses 13,353. Management and general expenses 0. Fundraising expenses 0. Total expenses 13,353.

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1First Millinocket Regional Investment CorpBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 Somerset StreetAddressLine1
CityMillinocketCity
StateMEState
ZIP Code04462ZIPCode
FieldValueIRS element (for citing)
EIN010396196EIN
Primary ActivitiesPhysician Program OperationsPrimaryActivitiesTxt
Legal Domicile StateMELegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Millinocket Regional HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$193,972ShareOfTotalIncomeAmt
Share Of EOY Assets$1,348,473ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
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 OrgYes (1)RentalOfFcltsFromOthOrgInd
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 OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
First Millinocket Regional Investment Corp
K$173,660FMV
First Millinocket Regional Investment Corp
Q$173,660FMV