Mid Coast Hospital: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
Mid Coast Hospital (EIN 01-0215911)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-13
IRS object ID
201432259349301188
Schema version
2012v2.1
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)
Timestamp2014-08-13T10:00:12-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN010494526EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BAKER NEWMAN & NOYESBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1BOX 507AddressLine1
CityPORTLANDCity
StateMEState
ZIP Code04112ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN010215911EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mid Coast HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMIDCNameControl
Phone2077290181Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1123 Medical Center DriveAddressLine1
CityBrunswickCity
StateMEState
ZIP Code04011ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLois N SkillingsName
TitlePresident/CEOTitle
Phone2077290181Phone
Date Signed2014-08-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameNicholas E PortoName
PTINP01310283PTIN
Phone2078792100Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLois N SkillingsNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1123 Medical Center DriveAddressLine1
CityBrunswickCity
StateMEState
ZIP Code04011ZIPCode
FieldValueIRS element (for citing)
Gross Receipts140295912GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.midcoasthealth.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1991YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionAcute and specialty care hospitalActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees1285TotalNbrEmployees
Total Nbr Volunteers500TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1612976ContributionsGrantsPriorYear
Contributions Grants Current Year2256197ContributionsGrantsCurrentYear
Program Service Revenue Prior Year123422722ProgramServiceRevenuePriorYear
Program Service Revenue CY132145006ProgramServiceRevenueCY
Investment Income Prior Year1097814InvestmentIncomePriorYear
Investment Income Current Year2078490InvestmentIncomeCurrentYear
Other Revenue Prior Year27124OtherRevenuePriorYear
Other Revenue Current Year14883OtherRevenueCurrentYear
Total Revenue Prior Year126160636TotalRevenuePriorYear
Total Revenue Current Year136494576TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year21643GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY9588GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year66643916SalariesEtcPriorYear
Salaries Etc Current Year70398524SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year56416545OtherExpensePriorYear
Other Expenses Current Year60220079OtherExpensesCurrentYear
Total Expenses Prior Year123082104TotalExpensesPriorYear
Total Expenses Current Year130628191TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3078532RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5866385RevenuesLessExpensesCY
Total Assets BOY147788861TotalAssetsBOY
Total Assets EOY160736113TotalAssetsEOY
Total Liabilities BOY50646641TotalLiabilitiesBOY
Total Liabilities EOY56420671TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY97142220NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY104315442NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo provide quality health care and health-related services directed toward continually improving the health and wellbeing of the patients and communities we serve. We will provide compassionate, humanistic, accessible, personal, professional, efficient, cost-effective and quality services.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense112593633Expense
Grants9588Grants
Revenue132159889Revenue
DescriptionAcute and specialty health care services were provided to residents of the Mid-Coast Maine area. Charity care was provided to those patients who did not have the ability to pay for medical services.Description
Total Program Service Expense112593633TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096126NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1285NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Michael PerryBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2073736000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1123 Medical Center DriveAddressLine1
CityBrunswickCity
StateMEState
ZIP Code04011ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerAverage Hours Per Week RelatedAverageHoursPerWeekRelatedHighest Compensated EmployeeHighestCompensatedEmployee
Lenora Burke
Director0.30X000
Charles Frizzle
Director0.30X000
William S Gardiner
Director0.30X000
Donald Gerrish
Director0.30X000
Susan Gillies
Director0.30X000
Jill Haer
Director0.30X000
Patrice Hennin
Director0.30X000
Connie Jones
Director0.30X000
Steven Levesque
Director0.30X000
Lloyd Van Lunen MD
Director0.30X000
Anne Marsh
Director0.30X000
Daniel Morgenstern MD part year
Director0.30X000
Douglas Niven
Director0.30X000
Abigail Manny part year
Director/Auxiliary President0.30X000X
Ellen Hutchinson
Director/Auxiliary President0.30X000X
James Mullen MD
President Medical Staff0.30X1744800X
James Rines MD
VP of Medical Staff41.80X170879029179X
Ervin Snyder
Chairperson0.30X000X
Dean Patterson
Vice Chairperson0.30X000X
Glenn L Hutchinson
Treasurer0.30X000X
Charles Bridge
Secretary0.30X000X
Lois N Skillings
President/CEO30.50X035488470580X9.50
Robert McCue
CFO30.50025484457286X9.50
Jonathan Telsey MD
Physician41.50462454035080X
Robert Livingston MD
Physician41.50438250024739X
R Scott Schafer MD
Physician41.50316850035800X
Paul Burns MD
Physician41.50323785030931X
John Van Orden MD
Physician41.50305623027670X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2035289TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs609728TotalReportableCompFrmRltdOrgs
Total Other Compensation311265TotalOtherCompensation
Number Individuals GT100 K70NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Coastal Maine Emergency Physicians
PO Box 270South FreeportME04078ER Facility Coverage1096452
Midcoast Pediatrics
121 Medical Center Drive Suite 260BrunswickME04011Physician Coverage712280
Mid Coast Anesthesia PA
121 Medical Center Drive Box 6BrunswickME04011Anesthesiology Services488477
Spectrum Medical Group
PO Box 590PortlandME04112Physician Coverage418231
CompHealth Med Staff
PO Box 972670DallasTX753972670Physician Coverage405677
FieldValueIRS element (for citing)
Number Of Contractors GT100 K25NumberOfContractorsGT100K
Fundraising Events15640FundraisingEvents
Government Grants1528378GovernmentGrants
All Other Contributions712179AllOtherContributions
Noncash Contributions33178NoncashContributions
Total Contributions2256197TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Service Revenue621400127454468127454468
Miscellaneous Revenue62140028432102843210
Electronic Health Records Revenue62140018473281847328
FieldValueIRS element (for citing)
Total Program Service Revenue132145006TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1287261TotalRevenueColumn
Exclusion$1,287,261ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real14883Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real14883Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column14883TotalRevenueColumn
Related Or Exempt Function Income14883RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4564130Securities
Other15538Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3782395Securities
Other6044Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities781735Securities
Other9494Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column791229TotalRevenueColumn
Exclusion$791,229ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events12897GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events15640CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses12897FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column136494576TotalRevenueColumn
Related Or Exempt Function Income132159889RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,078,490ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total9588Total
Program Services9588ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total242011Total
Program Services233028ProgramServices
Management And General8983ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total58223900Total
Program Services51334045ProgramServices
Management And General6889855ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total981882Total
Program Services789011ProgramServices
Management And General192871ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8094141Total
Program Services6504210ProgramServices
Management And General1589931ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2856590Total
Program Services2295470ProgramServices
Management And General561120ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total75904Total
Management And General75904ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total61100Total
Management And General61100ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total12406047Total
Program Services9969134ProgramServices
Management And General2436913ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total401285Total
Program Services322461ProgramServices
Management And General78824ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8856436Total
Program Services7116771ProgramServices
Management And General1739665ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5472155Total
Program Services4397262ProgramServices
Management And General1074893ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total53425Total
Program Services42931ProgramServices
Management And General10494ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1706926Total
Program Services1371635ProgramServices
Management And General335291ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5359816Total
Program Services4306990ProgramServices
Management And General1052826ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1672656Total
Program Services1344097ProgramServices
Management And General328559ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Patient and Non Patient85605928317480243112
Provision for Bad Debts64317436431743
Pharmacy Expenses598880748124291176378
Revenue Tax22678312267831

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total905356Total
Program Services727517ProgramServices
Management And General177839ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total130628191Total
Program Services112593633ProgramServices
Management And General18034558ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3161304BOY
EOY5581029EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY13507857BOY
EOY25668602EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11940926BOY
EOY16023706EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2026841BOY
EOY2149927EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2456698BOY
EOY2589367EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis107833835LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec54022423LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY56037286BOY
EOY53811412EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY37940259BOY
EOY42832550EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY327155BOY
EOY309958EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY20390535BOY
EOY11769562EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY147788861BOY
EOY160736113EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY13125853BOY
EOY12470072EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY31789380BOY
EOY31460200EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5731408BOY
EOY12490399EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY50646641BOY
EOY56420671EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY80970585BOY
EOY86576067EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY8569246BOY
EOY9960251EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7602389BOY
EOY7779124EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY97142220BOY
EOY104315442EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY147788861BOY
EOY160736113EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses5866385ReconcilationRevenueExpenses
Reconciliation Unrealized Invest1317692ReconciliationUnrealizedInvest
Reconcilation Other Changes-10855ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$17,599GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB17599TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1:ReturnReference
ExplanationMid Coast Hospital paid dues to Maine Hospital Association totaling $46,628, of which 18.8% ($8,766) was available for lobbying; dues to American Hospital Association totaling $24,155 of which 23.65% ($5,713) was available for lobbying; dues to Maine Medical Association of $20,800, 15% ($3,120) of which was available for lobbying.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance21128741BeginningOfYearBalance
Contributions176735Contributions
Investment Earnings Or Losses1220014InvestmentEarningsOrLosses
Other Expenditures232306OtherExpenditures
End Of Year Balance22293184EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance20613770BeginningOfYearBalance
Contributions71499Contributions
Investment Earnings Or Losses611529InvestmentEarningsOrLosses
Other Expenditures168057OtherExpenditures
End Of Year Balance21128741EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance19263606BeginningOfYearBalance
Contributions89457Contributions
Investment Earnings Or Losses1420387InvestmentEarningsOrLosses
Other Expenditures159680OtherExpenditures
End Of Year Balance20613770EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance18850981BeginningOfYearBalance
Contributions85217Contributions
Investment Earnings Or Losses500960InvestmentEarningsOrLosses
Other Expenditures173552OtherExpenditures
End Of Year Balance19263606EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance18696946BeginningOfYearBalance
Contributions61289Contributions
Investment Earnings Or Losses360571InvestmentEarningsOrLosses
Other Expenditures267825OtherExpenditures
End Of Year Balance18850981EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.38690BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.34830PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.26480TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis329281OtherCostOrOtherBasis
Book Value329281BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis56184251OtherCostOrOtherBasis
Depreciation16259452Depreciation
Book Value39924799BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4417135OtherCostOrOtherBasis
Depreciation1972656Depreciation
Book Value2444479BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis46903168OtherCostOrOtherBasis
Depreciation35790315Depreciation
Book Value11112853BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings53811412TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
Construction in Progress561836
L-T Asset (Deferred Comp Plan)7083248
Due from Affiliates3291830
Other Assets832648
FieldValueIRS element (for citing)
Total Book Value Other Assets11769562TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Deferred Compensation Plan$7,083,248
Estimated Third-Party Payor Settlements$5,407,151
FieldValueIRS element (for citing)
Total Of Amounts12490399TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt137825165TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1317692NetUnrealizedGainsInvestments
Other Revenues12897OtherRevenues
Revenue Not Rptd F9901330589RevenueNotRptdF990
Revenue Subtotal136494576RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990136494576TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt130651943TotExpensesEtcAuditedFinclStmt
Other Expenses Included23752OtherExpensesIncluded
Expenses Not Rptd F99023752ExpensesNotRptdF990
Expenses Subtotal130628191ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990130628191TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Intended Use of Endowment Funds:Part V, Line 4:Endowment funds are invested and used in a manner that provides predictable streams of funding to the programs supported by the endowed funds, all while seeking to maintain the purchasing power of the endowment assets.
Description of Uncertain Tax Positions Under FIN 48:Part X, Line 2:The Hospital is a not-for-profit corporation and is tax-exempt under Section 501(c)(3) of the Internal Revenue Code. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Hospital has evaluated the position taken on its filed tax returns. The Hospital has concluded no uncertain income tax positions exist at September 30, 2013. The Hospital's tax years from 2010 through 2013 are open and subject to examination.
Part XI, Line 2d - Other Adjustments:Fundraiser Expenses 12,897.
Part XII, Line 2d - Other Adjustments:Fundraiser Expenses 12,897. Equity Transfer to Affiliates 10,855.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Golf TournamentNameOfEvent1
Gross Receipts Event128537GrossReceiptsEvent1
Charitable Contributions Event115640CharitableContributionsEvent1
Gross Revenue Event112897GrossRevenueEvent1
Cash Prizes Event1871CashPrizesEvent1
Rent Facility Costs Event17620RentFacilityCostsEvent1
Other Direct Expenses Event14406OtherDirectExpensesEvent1
Gross Receipts Total28537GrossReceiptsTotal
Charitable Contributions Total15640CharitableContributionsTotal
Gross Revenue Total Events12897GrossRevenueTotalEvents
Cash Prizes Total Events871CashPrizesTotalEvents
Rent Facility Costs Total Events7620RentFacilityCostsTotalEvents
Other Direct Expenses Total Events4406OtherDirectExpensesTotalEvents
Direct Expense Summary Events12897DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense5039222TotalCommunityBenefitExpense
Direct Offsetting Revenue839967DirectOffsettingRevenue
Net Community Benefit Expense4199255NetCommunityBenefitExpense
Percent Of Total Expense0.03380PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense11825972TotalCommunityBenefitExpense
Direct Offsetting Revenue10865531DirectOffsettingRevenue
Net Community Benefit Expense960441NetCommunityBenefitExpense
Percent Of Total Expense0.00770PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense16865194TotalCommunityBenefitExpense
Direct Offsetting Revenue11705498DirectOffsettingRevenue
Net Community Benefit Expense5159696NetCommunityBenefitExpense
Percent Of Total Expense0.04150PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense703444TotalCommunityBenefitExpense
Direct Offsetting Revenue32534DirectOffsettingRevenue
Net Community Benefit Expense670910NetCommunityBenefitExpense
Percent Of Total Expense0.00540PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense27222756TotalCommunityBenefitExpense
Direct Offsetting Revenue21082415DirectOffsettingRevenue
Net Community Benefit Expense6140341NetCommunityBenefitExpense
Percent Of Total Expense0.04940PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense27926200TotalCommunityBenefitExpense
Direct Offsetting Revenue21114949DirectOffsettingRevenue
Net Community Benefit Expense6811251NetCommunityBenefitExpense
Percent Of Total Expense0.05480PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense44791394TotalCommunityBenefitExpense
Direct Offsetting Revenue32820447DirectOffsettingRevenue
Net Community Benefit Expense11970947NetCommunityBenefitExpense
Percent Of Total Expense0.09630PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$3,240,612BadDebtExpenseAmount
Amount Reimbursed By Medicare27611099AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare32015330CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4404231MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mid Coast HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1123 Medical Center DriveAddressLine1
CityBrunswickCity
StateMEState
ZIP Code04011ZIPCode
FieldValueIRS element (for citing)
Website Addresswww.midcoasthealth.comWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Mid Coast HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted10NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Adopt BudgetXAdoptBudget
All Needs Addressed1AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Medical IndigencyXMedicalIndigency
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities10NumberOfOtherFacilities

Other Facilities OtherFacilities (10 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Mid Coast Hospital
121 Medical Center DriveBrunswickME04011General Medical & Surgical
Mid Coast Hospital
81 Medical Center DriveBrunswickME04011General Medical & Surgical
Mid Coast Hospital
11 Medical Center DriveBrunswickME04011General Medical & Surgical
Mid Coast Hospital
310 Bath RoadBrunswickME04011General Medical & Surgical
Mid Coast Hospital
430 Bath RoadBrunswickME04011General Medical & Surgical
Mid Coast Hospital
66 Baribeau DriveBrunswickME04011General Medical & Surgical
Mid Coast Hospital
30 So Bristol RoadDamariscottaME04543General Medical & Surgical
Mid Coast Hospital
1356A Washington AvenueBathME04530General Medical & Surgical
Mid Coast Hospital - Mid Coast Med Group
1 Bowdoin Mill IslandTopshamME04086General Medical & Surgical
Mid Coast Hospital
22 Maine Street StationBrunswickME04011General Medical & Surgical

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanationIdentifierIdentifier
Part I, Line 7: Based on the IRS Form 990, Schedule H, a worksheet was provided to determine the overall cost to charge ratio that could be used to apply throughout Schedule H of Form 990. Where applicable, the Organization utilized this worksheet to convert charges to costs. The Organization did not use the Worksheet 2 percentage for the IRS Form 990, Schedule H, Worksheet 3, Unreimbursed Medicaid and Other Means Tested Government Programs, or Worksheet 6, Subsidized Health Services, for the Medicaid allowable costs. Instead, the Organization utilized the actual Medicaid filed cost report for the Medicaid allowable costs. Additionally, the Organization used the modified Medicare allowable costs and payments related to these services in regards to the cardiopulmonary community program and psychiatric unit. For our provider based clinics, in this same section we used the actual costs for each clinic. In addition, for its addiction resource center and access health service, the Organization used the estimated costs calculated based on actual clinic costs estimated from reporting on these centers to the State of Maine.
Part I, Line 7g: Mid Coast Hospital has clinical services and hospital-owned physician practices. Mid Coast Hospital has included these practices in this section of the 990, Schedule H of subsidized health services if they are operating at a loss. The Hospital has included the following clinical services and hospital-owned physician practices that operate at a loss and the corresponding costs of these practices: primary care practice, OB/GYN practice, pulmonary practice, urology practice, primary care clinics, walk-in clinic, nephrology practice, orthopedics practice, gastroenterology practice, diabetes & endocrinology practice, general surgery practice, rheumatology practice, psychiatric department, cardiopulmonary community program, addiction resource center, access health service, and chemical dependency services. The above listed hospital clinical services and hospital-owned physician practices have a community benefit of approximately $6.1 million. In addition, the community benefit does not take into account bad debts, charity care, and contractual adjustments. Thus, this community benefit of approximately $6.1 million is a conservative number that reconciles to the community benefit on the IRS Form 990, Schedule H.
Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 6431743.
Part II: N/A
Part III, Line 4: Payments for services rendered to individuals from whom payment is expected and ultimately not received are written off and included as part of the provision for bad debts.In accordance with generally accepted accounting principles, the allowance for doubtful accounts and bad debt expense is provided based on an analysis by management of the collectibility of outstanding balances. Management considers the age of outstanding balances and past collection efforts in determining the allowance for doubtful accounts and bad debt expense. Accounts deemed uncollectible are charged off against the established allowance.
Part III, Line 8: The Hospital believes all of the clinical areas included in the Form 990, Schedule H should be and are considered a community benefit. Mid Coast Hospital believes that by offering and thus subsidizing these clinical services within the community, the community benefits by having easy access to these services. If these services were not available from Mid Coast Hospital there would be a greater burden on the community and many, if not all, of these services would not be available with such easy access. Based on the IRS Form 990, Schedule H, a worksheet was provided to assist in determining the overall cost-to-charge ratio that could be used to apply throughout the Schedule H of the Form 990 in order to convert charges to costs. Where applicable, we have utilized this worksheet to convert charges to costs. We did not use this worksheet percentage on the calculation of Medicare costs in this section. We used the Medicare allowable costs and payments related to the subsidized health service and we used the Medicare cost report estimated cost and payment for these services.
Part III, Line 9b: The Hospital currently starts with gross charges for all patient billing. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment may qualify for charity care. Those patients that qualify and have income levels below 200% of the federal poverty guidelines can receive 100% charity care. A sliding scale is used for patients with income levels between 200% and 400% of the federal poverty guidelines. The amount considered for charity will be based upon the evaluation of the patients' ability to pay. Patients who qualify for partial financial assistance are responsible for any remaining balance after the charity care adjustment and third party payments. Once an account has been processed through an internal routine collection process, it may be assigned to an attorney/agency for collection.
Part V, Section B, Line 3: Mid Coast Hospital, engaged in an assessment of the health needs of the mid coast community and this was the most comprehensive health needs assessment ever performed in our community. All told, over 1,000 community members attended one of many focus groups to discuss the current and future health needs in our region. In the process of developing priorities and a plan for how to operate over the next decade, Mid Coast Health Services listened and learned from the community - patients and families, faith community, municipal leaders, legislators, experts in public health, local businesses, employees, medical staff, hospital volunteers, auxiliary, Board members, and Corporators for guidance.Mid Coast Hospital
Part V, Section B, Line 20d: The Hospital currently starts with gross charges for all patient billing. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment may qualify for charity care. Those patients that qualify and have income levels below 200% of the federal poverty guidelines can receive 100% charity care. A sliding scale is used for patients with income levels between 200% and 400% of the federal poverty guidelines. The amount considered for charity will be based upon the evaluation of the patients' ability to pay. Patients who qualify for partial financial assistance are responsible for any remaining balance after the charity care adjustment and third party payments. Once an account has been processed through an internal routine collection process, it may be assigned to an attorney/agency for collection.Mid Coast Hospital
Part VI, Line 2: Mid Coast Hospital assesses the health care needs of the community on an ongoing basis. Mid Coast Hospital's strategic plan is a road map as to where and how to deliver services to the surrounding communities. This process of how to provide these services included listening and learning to/from the community - patients and families, faith community, municipal leaders, legislatures and local businesses. Mid Coast also looked inward, calling upon board members, corporators, medical staff, volunteers, auxiliary, and employees since they are all part of the community Mid Coast Hospital serves.
Part VI, Line 3: Mid Coast Hospital will notify patients about access to various financial assistance needs in different ways. We have postings in various departments as well has handouts informing patients how to access these programs if a need for financial assistance is required. There are signs and pamphlets in the Hospital settings indicating the poverty guidelines and how to obtain assistance to obtain free or discounted care. All of our patients can speak to one of the Hospital's employees on how to obtain financial assistance; and, if there is assistance needed, the employee will inform our patient financial services department who will then work with the patient to either help them apply for MaineCare or discuss options for free or discounted care.
Part VI, Line 4: Mid Coast Hospital's primary service area includes the following communities in the Mid Coast Maine: Arrowsic, Bailey Island, Bath, Bowdoin, Bowdoinham, Brunswick, Dresden, Durham, Freeport, Georgetown, Harpswell, Lisbon, Litchfield, North Yarmouth, Perkins Township, Phippsburg, Pownal, Richmond, Sabattus, Topsham, West Bath, Westport, Wiscasset, Woolwich, Yarmouth. Approximately 13% of Mid Coast Hospital patients utilize Medicaid and 42% of Mid Coast Hospital patients utilize Medicare. The population of the communities supported by Mid Coast Hospital with income under 200% of the poverty guidelines is about 21%.
Part VI, Line 5: Mid Coast Hospital is a local, not-for-profit, community hospital that serves the local communities and the people regardless of their ability to pay. The members on the board of directors and corporators are all members of the communities that Mid Coast Hospital serves. All Hospital net income gains are reinvested into the facilities, equipment and services for the community.
Part VI, Line 6: Mid Coast Hospital has a clinical affiliation with Maine Health to provide the best patient care to all of the communities that Mid Coast Hospital and Maine Health serves.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: During the tax year, the Organization only granted funds to local municipal school systems, further monitoring is not deemed necessary.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
James Rines MD
VP of Medical Staff17087900000178960112830200058000
Lois N Skillings
President/CEO03548840000060000010580042546400
Robert McCue
CFO02548440000046638010648031213000
Jonathan Telsey MD
Physician46245400000245000105800497534000
Robert Livingston MD
Physician4382500000020371043680462989000
R Scott Schafer MD
Physician31685000000245000113000352650000
Paul Burns MD
Physician3237850000024500064310354716000
John Van Orden MD
Physician3056230000021339063310333293000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 3Mid Coast Hospital's CEO, Lois Skillings, and CFO, Robert McCue, are compensated by a related organization, Mid Coast Health Management Corp & Sub (MCHMC). MCHMC uses an independent compensation consultant, compensation survey or study, and approval by the board or compensation committee to establish their annual compensation.
Part I, Line 4bThe Hospital has a deferred compensation arrangement under a nonqualified defined contribution plan to provide supplemental retirement benefits to certain employees. Lois Skillings and Robert McCue, who are officers of the Organization, participated in this plan and received $52,500 and $39,138, respectively.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Maine Health and Higher Ed Fac Auth (MHHEFA)
A010314384560425L402007-07-1897716087Refinance Series 1998B Revenue Bond000
Maine Health and Higher Ed Fac Auth (MHHEFA)
B0103143845604253622008-12-0341658395Hospital Facility Expansion Project000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindCapital ExpendituresCapitalExpenditures
A28930803198450026651099290758444620021111
B123939968927311387843382009001111362143

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A00000.000000.000000.00000000
B00000.000000.000000.00000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICTerm Of GICTermOfGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfiedGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
Trans America
A000100120.000000000000100
(no name)
B000100000

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A0
B0

Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Schedule K Part IV, Arbitrage, Line 2cDate Rebate Computation PerformedIssuer Name: Maine Health and Higher Ed Fac Auth (MHHEFA) Date the Rebate Computation was Performed: 07/18/2012 Issuer Name: Maine Health and Higher Ed Fac Auth (MHHEFA) Date the Rebate Computation was Performed: 12/03/2013
Schedule K, Part III, Line 9, Part IV, line 7 and Part V:At the time of this filing, the Hospital does not have written procedures to ensure that violations of federal tax requirements are timely identified and corrected. However, the Hospital does have a policy in place to accomplish these purposes. On an annual basis, the Hospital's controller and CFO review bond documents and bond covenants to ensure the Hospital is in full compliance. Currently, the Hospital is considering having these procedures in a formal, written policy going forward.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonLois SkillingsNamePerson
FieldValueIRS element (for citing)
RelationshipMember of board of directors of Medical Mutual Insurance CompanyRelationship
Amount Of Transaction1437718AmountOfTransaction
Description Of TransactionThe amount paid to Medical Mutual and identified in this section is for malpractice insurance coverage for the Hospital. Ms. Skillings serves on the board of directors for Medical Mutual and is the CEO of Mid Coast Hospital. Ms. Skillings was paid a nominal fee to serve on Medical Mutual's board of directors.The amount included in column c represents the total amount paid to Medical Mutual. The amounts paid during the time specifically relating to Ms. Skillings's tenure on the board are not easily determinable.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F99033178NoncashContribsRptdF990
Method Of Determining RevenuesMarket ValueMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used1ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierThird Party Use:Identifier
Return ReferencePart I, Line 32b:ReturnReference
ExplanationThe Organization sells contributions of securities through its investment broker. All gifts of securities are sold as soon as administratively possible.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 2Board of Directors members Glenn Hutchinson and Ellen Hutchinson have a family relationship.
Form 990, Part VI, Section A, line 6Mid Coast Health Services (MCHS) shall be the Organization's sole member with all rights and responsibilities of membership, including all voting rights.
Form 990, Part VI, Section A, line 7aAt each annual meeting of the sole member, the sole member shall elect directors to hold office until the election and qualification of their respective successors. The directors shall be persons who have demonstrated an interest in the Organization's goals and objectives and, to the extent reasonably feasible, shall represent the Mid-Coast area. To the extent feasible, fifty percent of all directors serving on the Organization's board of directors shall be persons who also serve on the board of directors of MCHS.
Form 990, Part VI, Section A, line 7bThe business and affairs of the Organization shall be conducted and managed by its board of directors which shall exercise all of the powers of the Organization. The board of directors shall approve an annual operating budget, develop a long-term capital expenditure plan and, through its own committees or the committees of its sole member, monitor the implementation of the plan. Notwithstanding the foregoing, the directors shall not submit any application for a certificate of need to the Maine Department of Health and Human Services, or incur any long-term debt without the approval of MCHS as the sole member. The board of directors may delegate such powers as it sees fit to committees and officers of the Organization.
Form 990, Part VI, Section B, line 11A draft of the return is reviewed by an officer of the Hospital prior to it being filed with the IRS.
Form 990, Part VI, Section B, line 12cThe Hospital has a compliance committee that meets on a quarterly basis to review any compliance issues that may arise.
Form 990, Part VI, Section B, line 15An independent consultant prepares a market analysis at the regional level for all officers and key employees of the Organization.
Form 990, Part VI, Section C, line 19The Organization makes its governing documents, conflict of interest policy and audited financial statements available to the public upon request.
Form 990, Part VII, Section A:Dr. James Rines receives compensation for his services to the Organization in his capacity as a physician. His salary and benefit amounts disclosed in Part VII do not reflect payments made to him for his services as a member of the board.
Form 990, Part XI, line 9:Equity Transfer to Affiliates -10,855.Changes in Net Assets or Fund Balances:
Form 990, Part XI, Line 2cThe audit process has not changed from the prior year.Oversight of Audit:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Mid Coast Health Services
123 Medical Center DriveBrunswickME04011010430069Health ServicesME501(c)(3)7N/A0
Mid Coast Geriatric Services Corporation
123 Medical Center DriveBrunswickME04011010496221Geriatric ServicesME501(c)(3)90Mid Coast Health Services
Community Health and Nursing Services
60 Baribeau DriveBrunswickME04011010211546Hospice ServicesME501(c)(3)90Mid Coast Health Services

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrg
Mid Coast Medical Group
123 Medical Center DriveBrunswickME04011010484592Medical ServicesMEMid Coast Health ServicesC0
Midcoast Health Management Corporation
123 Medical Center DriveBrunswickME04011010429598Management of Health ServicesMEMid Coast Health ServicesC0
Thornton Oaks Development Corporation
123 Medical Center DriveBrunswickME04011010448411Management of Health ServicesMEMid Coast Health ServicesC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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