2012-08-13T09:05:30-05:00 2011-09-30 BAKER NEWMAN & NOYES LLC PO BOX 507 PORTLAND ME 04112 990 2010-10-01 010496221 Mid Coast Geriatric Services Corporation MIDC 2073736733 123 Medical Center Drive Brunswick ME 04011 Robert McCue 2073736733 2012-08-09 Nicholas E Porto 2078792100 2012-08-09 2010 2016-02-24 21:20:13Z Lois Skillings 123 Medical Center Drive Brunswick ME 04011 8726359 0 X www.midcoasthealth.com X 1995 ME Supportive and rehabilitative health services in a residential environment. 12 11 246 0 0 0 44729 33416 8530209 8692737 131 206 0 0 8575069 8726359 0 0 0 0 5313519 5204535 0 0 0 3405417 3420667 8718936 8625202 -143867 101157 13108603 12836468 11542259 11168967 1566344 1667501 X Our mission is to provide supportive and rehabilitative health services in a residential environment. These services are integrated within the Mid Coast Health Services Organization, which spans the continuum of elder care needs. Our care is delivered in a manner that is holistic, personalized, promoting independence, and designed to enhance the quality of life for each resident. Integrity, respect, and a commitment to excellence are our guiding principles in our interactions with residents, family members, colleagues, physicians, volunteers, and the community. 0 0 7111419 8692737 Continuum of services to promote independence, health, and wellness to senior citizens of the Mid Coast region in Maine. 7111419 1 1 0 1 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 31 0 246 1 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X Michael Perry 2073736733 123 Medical Center Drive Brunswick ME 04011 X Bruce McGlauflin 0.30 X 0 0 0 Cheryl Rust 0.30 X 0 0 0 James B Drake 0.30 X 0 0 0 Lawrence L Clampitt 0.30 X 0 0 0 Michael Feldman 0.30 X 0 0 0 Pamela Bowerman 0.30 X 0 0 0 Rev Richard Visser 0.30 X 0 0 0 Sherrie Bergman 0.30 X 0 0 0 Stephen DeWick 0.30 X 0 0 0 Barbara Reinertsen 0.30 X X 0 0 0 James Ward 0.30 X X 0 0 0 Lois Skillings 0.40 X X 0 243720 58252 Robert N McCue 0.30 X 0 234007 56523 Herbert Paris 0.40 X 0 405609 98504 0 883336 213279 0 0 1 0 0 17330 16086 33416 Patient Service Revenu 623000 8310590 8310590 Lifeline Revenue 623000 253713 253713 Miscellaneous Revenue 623000 52814 52814 Rent (Intercompany) 623000 52620 52620 Assisted Living Revenu 623000 23000 23000 8692737 206 206 8726359 8692737 0 206 4203713 3674200 529513 61927 54127 7800 626753 547805 78948 312142 272824 39318 13240 13240 26387 26387 385700 247906 137794 35917 50 35867 723223 485738 237485 1670 1670 355451 302133 53318 28024 4582 23442 495153 420880 74273 621523 429400 192123 62782 713 62069 Food Services 312114 312114 Nursing Home Tax 243003 243003 Provision for Bad Debt 115242 115242 1238 702 536 8625202 7111419 1513783 0 72283 245985 1116579 1194128 755367 712437 45481 69617 79259 60455 15035356 4913318 10587505 10122038 452129 431808 13108603 12836468 689584 657036 8375669 8292372 2477006 2219559 11542259 11168967 X 1357702 1456281 14225 15760 194417 195460 1566344 1667501 13108603 12836468 101157 0 X X 0 1 1 X 0 X 10993 293229 27299 44729 33416 409666 12762992 13337341 8400097 8530250 8692737 51723417 12773985 13630570 8427396 8574979 8726153 52133083 0 0 0 52133083 3771 8897 2198 131 206 15203 3771 8897 2198 131 206 15203 12777756 13639467 8429594 8575110 8726359 52148286 0.99970 0.99970 0.00030 0.00030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2360 2360 0 Explanation of Other Lobbying Activities: Part II-B, Line 1i: Maine Healthcare Association dues were $7,004, of which 33.7% was lobbying 208641 33041 -99 30364 211219 206316 44728 90 42493 208641 286289 27299 2198 109470 206316 0.00000 0.92600 0.07400 0 0 87465 87465 13051820 3715115 9336705 1781603 1179649 601954 114468 18554 95914 10122038 Due to Affiliates 2145548 Estimated Third-Party Payor Settlements 74011 2219559 8726359 8625202 101157 0 101157 8726359 0 8726359 0 8726359 8625202 0 8625202 0 8625202 Description of Intended Use of Endowment Funds: Part V, Line 4: The earnings from these endowed funds will be used to fund the upkeep of hospice rooms. Description of Uncertain Tax Positions Under FIN 48: Part X: The Company 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 Company has evaluated the positions taken on its filed tax returns. The Company has concluded no uncertain income tax positions exist at September 30, 2011. The Company's tax years from 2008 through 2011 are open and subject to examination. X X X 0 1 0 0 0 0 0 0 0 Lois Skillings 0 243720 0 0 0 0 0 38250 0 20002 0 301972 0 0 Robert N McCue 0 234007 0 0 0 0 0 36719 0 19804 0 290530 0 0 Herbert Paris 0 405609 0 0 0 0 0 78502 0 20002 0 504113 0 0 Part I, Line 4b Mid Coast Hospital, a related organization, has a deferred compensation arrangement under a nonqualified defined contribution plan to provide supplemental retirement benefits to certain employees. Herbert Paris (effective 10/1/10-6/30/11), Lois Skillings (effective 7/1/11-9/30/11), and Robert McCue, who are officers of the Corporation, participated in this plan and received $78,502, $38,250, and $36,719, respectively. Form 990, Part VI, Section A, line 6 The sole member of the Organization is Mid Coast Health Services. Form 990, Part VI, Section A, line 7a The sole member of the Organization shall meet within a reasonable time following the close of the Organization's fiscal year at a time and place within or out of the State of Maine as set by the board of directors. At this meeting, the sole member shall elect the Organization's directors and officers. To the extent feasible, seventy-five percent of all directors serving on the Organization's board of directors shall be persons who also serve on the board of directors of the sole member, Mid Coast Health Services. Form 990, Part VI, Section A, line 7b All rights and responsibilities vested in Mid Coast Health Services (MCHS) as the sole member, pursuant to the Organization's bylaws, shall be exercised by it through its board of directors acting either by unanimous consent or through a duly called meeting of the MCHS board of directors at which a quorum is present. The sole member, through its board of directors and committees, shall be responsible for the finance, development, and planning functions of the Organization and its board of directors. In carrying out its planning functions, the sole member shall solicit the active participation of the Organization's officers, managers, and administration. Form 990, Part VI, Section B, line 11 A 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 12c The Organization's conflict of interest policy is monitored by a representative from Mid Coast Health Services and the Organization's executive director as needed. Both of whom assist with resolution of any compliance issues. Form 990, Part VI, Section B, line 15 An 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 19 The organization makes the governing documents, conflict of interest policy, and audited financial statements available to the public upon request. Form 990, Part VII, Section A: Herbert Paris, CEO (10/1/10 - 6/30/11), Lois Skillings, CEO (effective 7/1/11), 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 Corporation. Their salary and benefit amounts reflect 2010 reportable compensation for their services in the entire Mid Coast network of entities. Form 990, Part VII, Section A: Lois Skillings is the current CEO of Mid Coast Geriatric Services Corporation, and started in that capacity during the fiscal year. Compensation represents amounts paid to her in her capacity as a regular employee of a related organization as was her position during calendar year 2010. Oversight of Audit Form 990, Part XI, Line 2c: The audit process has not changed from the prior year. Mid Coast Hospital 123 Medical Drive Brunswick ME 04011 010215911 Hospital ME 501(C)(3) 3 N/A 0 Mid Coast Health Services 123 Medical Drive Brunswick ME 04011 010430069 Health Services ME 501(C)(3) 7 N/A 0 Community Health and Nursing Services 60 Baribeau Drive Brunswick ME 04011 010211546 Hospice Services ME 501(C)(3) 9 N/A 0 Midcoast Health Management Corp 123 Medical Center Drive Brunswick ME 04011 010429598 Health Services ME N/A C Mid Coast Medical Group 123 Medical Center Drive Brunswick ME 04011 010484592 Health Services ME N/A C Thornton Oaks Development Corp 123 Medical Center Drive Brunswick ME 04011 010448411 Health Services ME N/A C 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0