PINES HEALTH SERVICES: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PINES HEALTH SERVICES (EIN 01-0376890)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-05-07
- IRS object ID
- 201401279349300430
- Schema version
- 2013v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-05-07T07:57:09-05:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1 |
| City | Portland | City |
| State | ME | State |
| ZIP Code | 041041100 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010376890 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pines Health Services | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PINE | BusinessNameControlTxt |
| Phone | 2074982356 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 40 | AddressLine1 |
| City | Caribou | City |
| State | ME | State |
| ZIP Code | 04736 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | James M Davis | PersonNm |
| Person Title | Chief Executive Officer | PersonTitleTxt |
| Phone | 2074982356 | PhoneNum |
| Signature | 2014-05-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Barbara J McGuan CPA | PreparerPersonNm |
| PTIN | P00219457 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2014-05-02 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | James M Davis | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 40 | AddressLine1 |
| City | Caribou | City |
| State | ME | State |
| ZIP Code | 04736 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $20,091,649 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | Group of health centers serving northern Maine. Five of the centers have FQHC designation. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 173 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,786,234 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,842,833 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,556,399 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,245,548 | CYProgramServiceRevenueAmt |
| PY Investment Income | $363 | PYInvestmentIncomeAmt |
| CY Investment Income | -$66 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $19,342,996 | PYTotalRevenueAmt |
| CY Total Revenue | $20,088,315 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,727,552 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,946,984 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,308,165 | PYOtherExpensesAmt |
| CY Other Expenses | $5,852,749 | CYOtherExpensesAmt |
| PY Total Expenses | $19,035,717 | PYTotalExpensesAmt |
| CY Total Expenses | $19,799,733 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $307,279 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $288,582 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,522,927 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,904,474 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,582,931 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,675,885 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,939,996 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,228,589 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,430,635 | ExpenseAmt |
| Revenue | $4,823,529 | RevenueAmt |
| Desc | Family Practice Services provide general care to families. The services are performed by physicians, physician assistants, and family nurse practitioners. This service has been provided since the date of inception. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,752,242 | ExpenseAmt |
| Revenue | $1,206,967 | RevenueAmt |
| Desc | Internal Medicine Services provide internal medicine to patients with more severe medical complications. The services are performed by physicians. This service has been provided since the date of inception. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,054,606 | ExpenseAmt |
| Revenue | $2,186,922 | RevenueAmt |
| Desc | Obstetrical and gynecological services are provided to female patients. These services are performed by physicians & Certified Nurse Midwives. This service has been provided since the date of inception. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $9,869,131 | ExpenseAmt |
| Revenue | $8,028,130 | RevenueAmt |
| Desc | Various other medical services provided to patients. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $9,869,131 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $8,028,130 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $18,106,614 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 53 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 173 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Anthony Lahey | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2074982356 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 40 | AddressLine1 |
| City | Caribou | City |
| State | ME | State |
| ZIP Code | 04736 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Norm Collins | |||||||
| Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Kris Doody | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Darlene Higgins | |||||||
| Past Vice Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Dana Rattray | |||||||
| Vice Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Betty Hatch | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Tanya Sleeper | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Jane White-McCall | |||||||
| Secretary/Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Tim Poitras | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Chris Bell | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Shawn Rogers | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Peter Doebener | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Kevin Barnes | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Steve Rogeski | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| James Davis | |||||||
| Chief Executive Officer | 40.00 | Yes (X) | $119,999 | $0 | $13,402 | ||
| Lisa Caron | |||||||
| Chief Operating Officer | 40.00 | Yes (X) | $75,870 | $0 | $15,895 | ||
| Jean-Pierre Michaud | |||||||
| Orthopedic Surgeon | 40.00 | $637,394 | $0 | $18,316 | Yes (X) | ||
| Carl Flynn | |||||||
| Family Physician | 40.00 | $422,098 | $0 | $20,797 | Yes (X) | ||
| Brian Wall | |||||||
| OB/GYN | 40.00 | $365,492 | $0 | $20,797 | Yes (X) | ||
| Scott Walton | |||||||
| Physician Assistant | 40.00 | $343,271 | $0 | $19,992 | Yes (X) | ||
| Natania Piper | |||||||
| Urologist | 40.00 | $334,592 | $0 | $20,958 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,298,716 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $130,157 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 35 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Weatherby Locums | |||||
| PO Box 972633 | Dallas | TX | 75397 | Locum Placements | $2,070,811 |
| Access Psychiatry LLC | |||||
| PO Box 31172 | St Louis | MO | 63131 | Telepsych Services | $305,120 |
| A&L Construction Inc | |||||
| PO Box 1613 | Presque Isle | ME | 04769 | Architectural Services | $243,245 |
| Aroostook Mental Health Services | |||||
| 43 Hatch Drive | Caribou | ME | 04736 | Behavioral Health Services | $214,739 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,142,833 | GovernmentGrantsAmt |
| All Other Contributions | $2,700,000 | AllOtherContributionsAmt |
| Total Contributions | $3,842,833 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Rev. | 621110 | $19,492,059 | $19,492,059 |
| Income Guarantee | 621110 | $4,244,310 | $4,244,310 |
| EMR Revenue | 621110 | $267,750 | $267,750 |
| Bad Debt Expense | 621110 | -$670,895 | -$670,895 |
| Contractual/Char. Adj. | 621110 | -$7,087,676 | -$7,087,676 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,245,548 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $268 | TotalRevenueColumnAmt |
| Exclusion | $268 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,334 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$334 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$334 | TotalRevenueColumnAmt |
| Exclusion | -$334 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,088,315 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,245,548 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$66 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225,166 | TotalAmt |
| Management And General | $225,166 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,845,222 | TotalAmt |
| Program Services | $11,489,038 | ProgramServicesAmt |
| Management And General | $356,184 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,606 | TotalAmt |
| Program Services | $69,669 | ProgramServicesAmt |
| Management And General | $937 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,131,830 | TotalAmt |
| Program Services | $1,059,572 | ProgramServicesAmt |
| Management And General | $72,258 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $674,160 | TotalAmt |
| Program Services | $631,238 | ProgramServicesAmt |
| Management And General | $42,922 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,186,461 | TotalAmt |
| Program Services | $3,016,535 | ProgramServicesAmt |
| Management And General | $169,926 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,968 | TotalAmt |
| Management And General | $97,968 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $414,090 | TotalAmt |
| Program Services | $262,012 | ProgramServicesAmt |
| Management And General | $152,078 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,346 | TotalAmt |
| Management And General | $155,346 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $514,886 | TotalAmt |
| Program Services | $496,266 | ProgramServicesAmt |
| Management And General | $18,620 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,592 | TotalAmt |
| Program Services | $41,800 | ProgramServicesAmt |
| Management And General | $72,792 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,466 | TotalAmt |
| Program Services | $13,466 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $351,024 | TotalAmt |
| Program Services | $161,537 | ProgramServicesAmt |
| Management And General | $189,487 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $377,509 | TotalAmt |
| Program Services | $325,816 | ProgramServicesAmt |
| Management And General | $51,693 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $363,900 | $363,900 | |
| CME | $94,312 | $94,312 | |
| Moving Expenses | $87,742 | $87,742 | |
| Physical Plant Expenses | $81,453 | $81,453 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,799,733 | TotalAmt |
| Program Services | $18,106,614 | ProgramServicesAmt |
| Management And General | $1,693,119 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $355,150 | BOYAmt |
| EOY | $522,452 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,399 | BOYAmt |
| EOY | $75,666 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,004,906 | BOYAmt |
| EOY | $2,700,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,200,689 | BOYAmt |
| EOY | $1,413,899 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,888 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,200 | BOYAmt |
| EOY | $43,233 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,411 | BOYAmt |
| EOY | $38,754 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,719,026 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,844,443 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,586,397 | BOYAmt |
| EOY | $1,874,583 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,884 | BOYAmt |
| EOY | $10,884 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $225,003 | BOYAmt |
| EOY | $225,003 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,522,927 | BOYAmt |
| EOY | $6,904,474 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,164,240 | BOYAmt |
| EOY | $1,249,331 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $76,888 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $418,691 | BOYAmt |
| EOY | $349,666 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,582,931 | BOYAmt |
| EOY | $1,675,885 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,939,996 | BOYAmt |
| EOY | $2,528,589 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,000,000 | BOYAmt |
| EOY | $2,700,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,939,996 | BOYAmt |
| EOY | $5,228,589 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,522,927 | BOYAmt |
| EOY | $6,904,474 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $288,582 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $11 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,157,101 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,631,412 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,937,888 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,786,234 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,842,833 | CurrentTaxYearAmt |
| Total | $19,355,468 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,157,101 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,631,412 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,937,888 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,786,234 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,842,833 | CurrentTaxYearAmt |
| Total | $19,355,468 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $19,355,468 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $36 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $363 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $268 | CurrentTaxYearAmt |
| Total | $667 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $19,356,135 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $71,050,703 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 1.00000 | PublicSupportCY170Pct |
| Public Support PY170 | 1.00000 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,025 | OtherCostOrOtherBasisAmt |
| Book Value | $40,025 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,167,347 | OtherCostOrOtherBasisAmt |
| Depreciation | $791,914 | DepreciationAmt |
| Book Value | $375,433 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,258,757 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,052,529 | DepreciationAmt |
| Book Value | $1,206,228 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $252,897 | OtherCostOrOtherBasisAmt |
| Book Value | $252,897 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,874,583 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $20,088,315 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $20,088,315 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $20,088,315 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $19,799,733 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $19,799,733 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $19,799,733 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jean-Pierre Michaud | ||||||||||||||
| Orthopedic Surgeon | $637,394 | $0 | $0 | $0 | $0 | $0 | $2,550 | $0 | $15,766 | $0 | $655,710 | $0 | $0 | $0 |
| Carl Flynn | ||||||||||||||
| Family Physician | $422,098 | $0 | $0 | $0 | $0 | $0 | $2,550 | $0 | $18,247 | $0 | $442,895 | $0 | $0 | $0 |
| Brian Wall | ||||||||||||||
| OB/GYN | $365,492 | $0 | $0 | $0 | $0 | $0 | $2,550 | $0 | $18,247 | $0 | $386,289 | $0 | $0 | $0 |
| Scott Walton | ||||||||||||||
| Physician Assistant | $343,271 | $0 | $0 | $0 | $0 | $0 | $1,644 | $0 | $18,348 | $0 | $363,263 | $0 | $0 | $0 |
| Natania Piper | ||||||||||||||
| Urologist | $334,592 | $0 | $0 | $0 | $0 | $0 | $2,550 | $0 | $18,408 | $0 | $355,550 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Cary Medical Center | |||
| An entity of which Kris Doody, current director, is an officer | $225,522 | Lease of Property | 0 |
| Cary Medical Center | |||
| An entity of which Kris Doody, current director, is an officer | $596,260 | Pines Health Services receives housekeeping services and management and staffing services by Cary Medical Center, of which Kris Doody is Chief Executive Officer. | 0 |
| Cary Medical Center | |||
| An entity of which Kris Doody, current director, is an officer | $35,000 | Pines Health Services provides management and staffing services to Cary Medical Center, of which Kris Doody is the Chief Executive Officer. | 0 |
| Cary Medical Center | |||
| An entity of which Kris Doody, current director, is an officer | $2,700,000 | Pines Health Services received charitable contributions in the form of a community benefit grant from Cary Medical Center, of which Kris Doody is Chief Executive Officer. | 0 |
| Cary Medical Center | |||
| An entity of which Kris Doody, current director, is an officer | $4,244,310 | 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 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 2 | Pines Health Services began offering Hematology/Oncology services in 2013 as a way to offer a more comprehensive service to its patients. This service is new to the Organization. |
| Form 990, Part VI, Section B, line 11 | Pines Health Services has its Form 990 reviewed by the board prior to filing. The 990 is given to the CEO for review and forwarded to the Board of Directors to be discussed at a regularly scheduled Board of Directors meeting. If a meeting cannot be held prior to the submission deadline, the Organization forwards the 990 electronically to the Board of Directors for review and comment. |
| Form 990, Part VI, Section B, line 12c | Annually, the Board of Directors sign forms indicating there are no conflicts of interest. If a conflict is brought to the board's attention, appropriate action will take place depending on the situation. This includes not allowing the member to vote on issues where there is a conflict, or other actions deemed necessary and appropriate by the board. |
| Form 990, Part VI, Section B, line 15 | For executives, the Board Executive Committee will review local market conditions and other factors. The salary is set below the MGMA national median range for practices of comparable size group by number of physicians, revenues and number of employees. For key employees (physicians, mid level providers), salary is set based on the MGMA annual Physician Compensation & Productivity Survey. |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. |
| Form 990, Part IX, line 11g | Billing Services: Program service expenses 276,254. Management and general expenses 0. Fundraising expenses 0. Total expenses 276,254. Support Services: Program service expenses 603,983. Management and general expenses 0. Fundraising expenses 0. Total expenses 603,983. Professional Fees: Program service expenses 2,136,298. Management and general expenses 169,926. Fundraising expenses 0. Total expenses 2,306,224. |
Comments