Mid Coast Hospital: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
Mid Coast Hospital (EIN 01-0215911)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-13
IRS object ID
201332259349302433
Schema version
2011v1.5
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)
Timestamp2013-08-13T14:13:17-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

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 Date2011-10-01TaxPeriodBeginDate

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)
NameRobert McCueName
TitleCFOTitle
Phone2077290181Phone
Date Signed2013-08-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameNicholas E PortoName
PTINP00182972PTIN
Phone2078792100Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1123 Medical Center DriveAddressLine1
CityBrunswickCity
StateMEState
ZIP Code04011ZIPCode
FieldValueIRS element (for citing)
Gross Receipts137481852GrossReceipts
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 Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees1226TotalNbrEmployees
Total Nbr Volunteers500TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1757517ContributionsGrantsPriorYear
Contributions Grants Current Year1612976ContributionsGrantsCurrentYear
Program Service Revenue Prior Year119216128ProgramServiceRevenuePriorYear
Program Service Revenue CY123422722ProgramServiceRevenueCY
Investment Income Prior Year1907781InvestmentIncomePriorYear
Investment Income Current Year1097814InvestmentIncomeCurrentYear
Other Revenue Prior Year19416OtherRevenuePriorYear
Other Revenue Current Year27124OtherRevenueCurrentYear
Total Revenue Prior Year122900842TotalRevenuePriorYear
Total Revenue Current Year126160636TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year11675GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY21643GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year59523676SalariesEtcPriorYear
Salaries Etc Current Year66643916SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year54948897OtherExpensePriorYear
Other Expenses Current Year56416545OtherExpensesCurrentYear
Total Expenses Prior Year114484248TotalExpensesPriorYear
Total Expenses Current Year123082104TotalExpensesCurrentYear
Revenues Less Expenses Prior Year8416594RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3078532RevenuesLessExpensesCY
Total Assets BOY139681202TotalAssetsBOY
Total Assets EOY147788861TotalAssetsEOY
Total Liabilities BOY48796139TotalLiabilitiesBOY
Total Liabilities EOY50646641TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY90885063NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY97142220NetAssetsOrFundBalancesEOY
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
Expense104684280Expense
Grants21643Grants
Revenue123436882Revenue
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 Expense104684280TotalProgramServiceExpense
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 Art1DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096136NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1226NumberOfEmployees
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 Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
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 Number2077290181TelephoneNumber

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 (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
James Ashe
Director0.30X000
Lenora Burke
Director0.30X000
William S Gardiner
Director0.30X000
Charles Frizzle
Director0.30X000
Susan Gillies
Director0.30X000
Jill Haer
Director0.30X000
Partice Hennin
Director0.30X000
Connie Jones
Director0.30X000
Steven Levesque
Director0.30X000
Daniel Morgenstern MD
Director0.30X000
Douglas Niven
Director0.30X000
Donald Gerrish part year
Director0.30X000
Anne Marsh part year
Director0.30X000
Abigail Manny
Director/Auxiliary President0.30X000X
James Mullen MD
President Medical Staff0.30X11247500X
James Rines MD
VP of Medical Staff0.30X174677047890X
Ervin Snyder
Chairperson0.30X000X
Dean Patterson
Vice Chairperson0.30X000X
Glenn L Hutchinson
Treasurer0.30X000X
Charles Bridge
Secretary0.30X000X
Lois Skillings
CEO30.50X029676697354X
Robert McCue
CFO30.50024738779002X
Jonathan Telsey MD
Physician41.50480105062779X
John Taylor MD
Physician41.50314345056578X
R Scott Schafer MD
Physician41.50344051064442X
Paul Burns MD
Physician41.50336661048464X
Ellen Simon MD
Physician41.50307037054593X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2069351TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs544153TotalReportableCompFrmRltdOrgs
Total Other Compensation511102TotalOtherCompensation
Number Individuals GT100 K60NumberIndividualsGT100K
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 Coverage1113444
Mayo Collaborative SVC Inc
PO Box 9146MinneapolisMN554809146Laboratory Services827285
Midcoast Pediatrics
121 Medical Center Drive Suite 260BrunswickME04011Physician Coverage678645
Ouellete Associates Inc
56 Bibber ParkwayBrunswickME04011Building Contractor510524
Mid Coast Anesthesia PA
121 Medical Center Drive Box 6BrunswickME04011Anesthesiology Services510094
FieldValueIRS element (for citing)
Number Of Contractors GT100 K22NumberOfContractorsGT100K
Fundraising Events6250FundraisingEvents
Government Grants1226660GovernmentGrants
All Other Contributions380066AllOtherContributions
Noncash Contributions28363NoncashContributions
Total Contributions1612976TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Service Re621400120304123120304123
Miscellaneous Revenue62140022272322227232
Electronic Health Reco621400891367891367
FieldValueIRS element (for citing)
Total Program Service Revenue123422722TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1089412TotalRevenueColumn
Exclusion$1,089,412ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real14160Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real14160Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column14160TotalRevenueColumn
Related Or Exempt Function Income14160RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities11229976Securities
Other85838Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities11245906Securities
Other61506Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-15930Securities
Other24332Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column8402TotalRevenueColumn
Exclusion$8,402ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events26768GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events6250CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses13804FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column12964TotalRevenueColumn
Exclusion$12,964ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column126160636TotalRevenueColumn
Related Or Exempt Function Income123436882RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,110,778ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total21643Total
Program Services21643ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total335042Total
Program Services326139ProgramServices
Management And General8903ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total54893062Total
Program Services47758471ProgramServices
Management And General7134591ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total989409Total
Program Services781521ProgramServices
Management And General207888ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7566668Total
Program Services5993527ProgramServices
Management And General1573141ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2859735Total
Program Services2267130ProgramServices
Management And General592605ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total85550Total
Management And General85550ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total51993Total
Management And General51993ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total11924916Total
Program Services9453792ProgramServices
Management And General2471124ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total346281Total
Program Services274523ProgramServices
Management And General71758ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8827200Total
Program Services6999038ProgramServices
Management And General1828162ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5191544Total
Program Services4115733ProgramServices
Management And General1075811ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total53102Total
Program Services42098ProgramServices
Management And General11004ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1737924Total
Program Services1377785ProgramServices
Management And General360139ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5605267Total
Program Services4443723ProgramServices
Management And General1161544ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1661885Total
Program Services1317503ProgramServices
Management And General344382ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Patient Medical Expense66379186637918
Pharmacy Expenses530746442076321099832
Provision for Bad Debts52353695235369
Revenue Tax22226212222621

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1527511Total
Program Services1208114ProgramServices
Management And General319397ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total123082104Total
Program Services104684280ProgramServices
Management And General18397824ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4715779BOY
EOY3161304EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY14996767BOY
EOY13507857EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8689651BOY
EOY11940926EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2116406BOY
EOY2026841EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3881385BOY
EOY2456698EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis106112408LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec50075122LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY57932719BOY
EOY56037286EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY32321195BOY
EOY37940259EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY344351BOY
EOY327155EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY14682949BOY
EOY20390535EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY139681202BOY
EOY147788861EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY11130536BOY
EOY13125853EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY32877247BOY
EOY31789380EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4788356BOY
EOY5731408EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY48796139BOY
EOY50646641EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY76895478BOY
EOY80970585EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6460695BOY
EOY8569246EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7528890BOY
EOY7602389EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY90885063BOY
EOY97142220EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY139681202BOY
EOY147788861EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3078532ReconcilationRevenueExpenses
Reconcilation Other Changes3178625ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
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$19,721GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB19721TotalLobbyingExpendituresIIB
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
ExplanationThe Organization paid dues to MHA totaling $46,628, of which 29.8% was used for lobbying. The Organization also paid dues to AHA totaling $23,681 of which 24.6% was used for lobbying.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

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

Current Year Minus1 Year CurrentYearMinus1Year

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

Current Year Minus2 Years CurrentYearMinus2Years

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

Current Year Minus3 Years CurrentYearMinus3Years

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 Balance0.37080BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.35920PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.27000TermEndowmentEOYBalance
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 Basis55953330OtherCostOrOtherBasis
Depreciation14759249Depreciation
Book Value41194081BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4407382OtherCostOrOtherBasis
Depreciation1684844Depreciation
Book Value2722538BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis45422415OtherCostOrOtherBasis
Depreciation33631029Depreciation
Book Value11791386BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings56037286TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
Estimated Third-Party Payor Settlements9782352
Construction in Progress223465
L-T Asset (Deferred Comp Plan)5731408
Due from Affiliates3672477
Other Assets980833
FieldValueIRS element (for citing)
Total Book Value Other Assets20390535TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDeferred Compensation PlanDescription
Amount$5,731,408Amount
FieldValueIRS element (for citing)
Total Of Amounts5731408TotalOfAmounts
Total Revenue126160636TotalRevenue
Total Expenses123082104TotalExpenses
Excess Or Deficit For Year3078532ExcessOrDeficitForYear
Net Unrealized GL On Investments4013625NetUnrealizedGLOnInvestments
Other-$835,000OtherAmount
Total Adjustments3178625TotalAdjustments
Excess Or Deficit Per FS6257157ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt130188065TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments4013625NetUnrealizedGainsInvestments
Other Revenues13804OtherRevenues
Revenue Not Rptd F9904027429RevenueNotRptdF990
Revenue Subtotal126160636RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990126160636TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt123930908TotExpensesEtcAuditedFinclStmt
Other Expenses Included848804OtherExpensesIncluded
Expenses Not Rptd F990848804ExpensesNotRptdF990
Expenses Subtotal123082104ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990123082104TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 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: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, 2012. The Hospital's tax years from 2009 through 2012 are open and subject to examination.
Part XI, Line 8 - Other Adjustments:Equity Transfer to Affiliates -835,000.
Part XII, Line 2d - Other Adjustments:Fundraiser Expenses 13,804.
Part XIII, Line 2d - Other Adjustments:Fundraiser Expenses 13,804. Equity Transfer to Affiliates 835,000.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Golf TournamentNameOfEvent1
Gross Receipts Event133018GrossReceiptsEvent1
Charitable Contributions Event16250CharitableContributionsEvent1
Gross Revenue Event126768GrossRevenueEvent1
Cash Prizes Event1733CashPrizesEvent1
Rent Facility Costs Event17620RentFacilityCostsEvent1
Other Direct Expenses Event15451OtherDirectExpensesEvent1
Gross Receipts Total33018GrossReceiptsTotal
Charitable Contributions Total6250CharitableContributionsTotal
Gross Revenue Total Events26768GrossRevenueTotalEvents
Cash Prizes Total Events733CashPrizesTotalEvents
Rent Facility Costs Total Events7620RentFacilityCostsTotalEvents
Other Direct Expenses Total Events5451OtherDirectExpensesTotalEvents
Direct Expense Summary Events13804DirectExpenseSummaryEvents
Net Income Summary12964NetIncomeSummary

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 Expense4158278TotalCommunityBenefitExpense
Direct Offsetting Revenue888064DirectOffsettingRevenue
Net Community Benefit Expense3270214NetCommunityBenefitExpense
Percent Of Total Expense0.02770PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense12784339TotalCommunityBenefitExpense
Direct Offsetting Revenue10492085DirectOffsettingRevenue
Net Community Benefit Expense2292254NetCommunityBenefitExpense
Percent Of Total Expense0.01950PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense16942617TotalCommunityBenefitExpense
Direct Offsetting Revenue11380149DirectOffsettingRevenue
Net Community Benefit Expense5562468NetCommunityBenefitExpense
Percent Of Total Expense0.04720PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense513297TotalCommunityBenefitExpense
Direct Offsetting Revenue14211DirectOffsettingRevenue
Net Community Benefit Expense499086NetCommunityBenefitExpense
Percent Of Total Expense0.00420PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense29067792TotalCommunityBenefitExpense
Direct Offsetting Revenue23792737DirectOffsettingRevenue
Net Community Benefit Expense5275055NetCommunityBenefitExpense
Percent Of Total Expense0.04480PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense29581089TotalCommunityBenefitExpense
Direct Offsetting Revenue23806948DirectOffsettingRevenue
Net Community Benefit Expense5774141NetCommunityBenefitExpense
Percent Of Total Expense0.04900PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense46523706TotalCommunityBenefitExpense
Direct Offsetting Revenue35187097DirectOffsettingRevenue
Net Community Benefit Expense11336609NetCommunityBenefitExpense
Percent Of Total Expense0.09620PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$2,671,726BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare24952639AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare27469783CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2517144MedicareSurplusOrShortfall

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 Facilities11NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (11 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24Hours
Mid Coast Hospital
1123 Medical Center DriveBrunswickME04011XXX
Mid Coast Hospital
2121 Medical Center DriveBrunswickME04011X
Mid Coast Hospital
381 Medical Center DriveBrunswickME04011X
Mid Coast Hospital
411 Medical Center DriveBrunswickME04011X
Mid Coast Hospital
5310 Bath RoadBrunswickME04011X
Mid Coast Hospital
6430 Bath RoadBrunswickME04011X
Mid Coast Hospital
766 Baribeau DriveBrunswickME04011X
Mid Coast Hospital
830 So Bristol RoadDamariscottaME04543X
Mid Coast Hospital
91356A Washington AvenueBathME04530X
Mid Coast Hospital - Mid Coast Med Group
101 Bowdoin Mill IslandTopshamME04086X
Mid Coast Hospital
1122 Maine Street StationBrunswickME04011X

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
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 VI Form990ScheduleHPartVI (13 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 emergency department, 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, access health service, and senior psychiatric services, 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, emergency department, psychiatric department, cardiopulmonary community program, addiction resource center, access health service, senior psychiatric service, and chemical dependency services. The above listed hospital clinical services and hospital-owned physician practices have a community benefit of approximately $5.3 million. In addition, the community benefit does not take into account bad debts, charity care, and contractual adjustments. Thus, this community benefit of approximately $5.3 million is a conservative number that reconciles to the community benefit on the IRS Form 990, Schedule H.
Part I, L7 Col(f): Bad debt expense of $5,235,369 has been removed from the denominator of the calculation in Schedule H, Part I, Line 7, column f.
Part II: N/A
Part III, Line 4: Services rendered to individuals from whom payment is expected and ultimately not received is 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 by 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 19d: 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 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 primary service area includes the communities in the Mid Coast Maine communities including: 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 14% 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)
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
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)

Base 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
17467700000170980307920222567000
Lois Skillings
02967660000059850037504039412000
Robert McCue
02473870000046488032514032638900
Jonathan Telsey MD
48010500000238500389290542884000
John Taylor MD
31434500000237590328190370923000
R Scott Schafer MD
34405100000214630429790408493000
Paul Burns MD
33666100000212810271830385125000
Ellen Simon MD
30703700000169800376130361630000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 4bReturnReference
ExplanationThe 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.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Maine Health and Higher Ed Fac Auth (MHHEFA)
010314384560425L402007-07-1897716087Refinance Series 1998B Revenue Bond000
Maine Health and Higher Ed Fac Auth (MHHEFA)
0103143845604253622008-12-0341658395Hospital Facility Expansion Project000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindCapital ExpendituresCapitalExpenditures
28930803198450026651099290758444620021111
123939968927311387843382009001111362143

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00001
00001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICTerm Of GICTermOfGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfiedGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
Trans America
000120.000000000000100
(no name)
000000

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSchedule K, Part VIdentifier
ExplanationThe 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.Explanation

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 Transaction1420543AmountOfTransaction
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

Works Of Art WorksOfArt

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions4NumberOfContributions
Noncash Contribs Rptd F99014000NoncashContribsRptdF990
Method Of Determining RevenuesAppraisalMethodOfDeterminingRevenues

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions7NumberOfContributions
Noncash Contribs Rptd F99014363NoncashContribsRptdF990
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 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 VII, Section A:Lois Skillings, CEO and Robert McCue, CFO provided services as officers to several related organizations. Their hours per week disclosed in Part VII of this Form 990 reflect only time devoted to the Hospital. Their salary and benefit amounts reflect 2011 reportable compensation for their services in the entire Mid Coast network of entities.
Form 990, Part XI, line 5:Net unrealized gains on investments: 4,013,625. Equity Transfer to Affiliates -835,000. Total to Form 990, Part XI, Line 5: 3,178,625.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 EntityTypeOfEntity
Mid Coast Medical Group
123 Medical Center DriveBrunswickME04011010484592Medical ServicesMEMid Coast Health ServicesC
Midcoast Health Management Corporation
123 Medical Center DriveBrunswickME04011010429598Management of Health ServicesMEMid Coast Health ServicesC
Thornton Oaks Development Corporation
123 Medical Center DriveBrunswickME04011010448411Management of Health ServicesMEMid Coast Health ServicesC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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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