Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2011 and ending 09-30-2012
BCheck if applicable:
CName of organization
MAINE MEDICAL CENTER
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
22 BRAMHALL STREET
 
Room/suite
City or town, state or country, and ZIP + 4
PORTLAND, ME04102
D Employer identification number

01-0238552
E Telephone number

G Gross receipts $ 1,605,220,640
F Name and address of principal officer:
RICHARD W PETERSEN
22 BRAMHALL STREET
PORTLAND,ME04102
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MMC.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1951
M State of legal domicile: ME
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: THE MAINE MEDICAL CENTER (THE MEDICAL CENTER) IS A VOLUNTARY, NOT-FOR-PROFIT COMMUNITY AND REFERRAL HOSPITAL, DEDICATED TO PROVIDING HIGH QUALITY HEALTH CARE SERVICES TO ALL PERSONS WHO SEEK CARE REGARDLESS OF THEIR SEX, RACE, RELIGION, AGE, COLOR, SEXUAL ORIENTATION, NATIONAL ORIGIN, PHYSICAL OR EMOTIONAL DISABILITY OR SOCIAL OR ECONOMIC STATUS. MAINE MEDICAL CENTER IS ALSO COMMITTED TO EDUCATION AT THE UNDERGRADUATE, GRADUATE, POST-GRADUATE AND CONTINUING EDUCATION LEVELS FOR PHYSICIANS, NURSES AND ALLIED HEALTH PERSONNEL, AND IN-SERVICE TRAINING FOR SUPPORT STAFF ALL OF WHICH ARE ESSENTIAL TO THE DELIVERY OF QUALITY PATIENT CARE. OUTREACH EDUCATION TO OTHER INSTITUTIONS AND AGENCIES IS ALSO VITAL TO THE FULFILLMENT OF THE MAINE MEDICAL CENTER'S MISSION. THE MEDICAL CENTER ALSO SUPPORTS BASIC AND CLINICAL RESEARCH AS ESSENTIAL TO THE ADVANCEMENT OF HEALTH CARE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 20
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 16
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 7,169
6 Total number of volunteers (estimate if necessary) .... 6 853
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 1,868,141
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b  
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 32,312,015 29,095,717
9 Program service revenue (Part VIII, line 2g) ......... 789,964,187 818,119,733
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 19,555,421 16,462,038
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 52,325,357 82,497,237
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 894,156,980 946,174,725
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,585,350 1,570,050
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 430,028,268 456,757,401
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 63,348 66,515
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet1,760,642    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 390,873,819 409,397,617
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 822,550,785 867,791,583
19 Revenue less expenses. Subtract line 18 from line 12....... 71,606,195 78,383,142
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,098,704,079 1,121,281,037
21 Total liabilities (Part X, line 26)............. 515,082,782 530,631,360
22 Net assets or fund balances. Subtract line 21 from line 20..... 583,621,297 590,649,677
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: THE MAINE MEDICAL CENTER (THE MEDICAL CENTER) IS A VOLUNTARY, NOT-FOR-PROFIT COMMUNITY AND REFERRAL HOSPITAL, DEDICATED TO PROVIDING HIGH QUALITY HEALTH CARE SERVICES TO ALL PERSONS WHO SEEK CARE REGARDLESS OF THEIR SEX, RACE, RELIGION, AGE, COLOR, SEXUAL ORIENTATION, NATIONAL ORIGIN, PHYSICAL OR EMOTIONAL DISABILITY OR SOCIAL OR ECONOMIC STATUS. MAINE MEDICAL CENTER IS ALSO COMMITTED TO EDUCATION AT THE UNDERGRADUATE, GRADUATE, POST-GRADUATE AND CONTINUING EDUCATION LEVELS FOR PHYSICIANS, NURSES AND ALLIED HEALTH PERSONNEL, AND IN-SERVICE TRAINING FOR SUPPORT STAFF ALL OF WHICH ARE ESSENTIAL TO THE DELIVERY OF QUALITY PATIENT CARE. OUTREACH EDUCATION TO OTHER INSTITUTIONS AND AGENCIES IS ALSO VITAL TO THE FULFILLMENT OF THE MAINE MEDICAL CENTER'S MISSION. THE MEDICAL CENTER ALSO SUPPORTS BASIC AND CLINICAL RESEARCH AS ESSENTIAL TO THE ADVANCEMENT OF HEALTH CARE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 165,324,613 including grants of $   ) (Revenue $ 287,624,643 )
ROUTINE SERVICES - ADULTS, PEDIATRICS, INTENSIVE CARE, NEONATAL INTENSIVE CARE, CORONARY CARE, NURSERY TOTAL PATIENT DAYS - 153,224 SEE ATTACHED COMMUNITY BENEFIT STATEMENT.
4b (Code:   ) (Expenses $ 131,159,653 including grants of $   ) (Revenue $ 392,770,029 )
OPERATING ROOM AND SCARBOROUGH SURGERY CENTER TOTAL VISITS - 28,972 THROUGH ITS 34 OPERATIVE SUITES, MAINE MEDICAL CENTER (THE MEDICAL CENTER) PROVIDES CRITICAL TRAUMA, EMERGENT, URGENT, AND ELECTIVE SURGICAL SERVICES TO THE COMMUNITY. THROUGH ITS EXPANSIVE ARRAY OF SURGICAL CAPABILITIES, THE MEDICAL CENTER PROVIDES MOST SURGICAL PROCEDURES WITHIN ITS COMMUNITY AS A GREAT CONVENIENCE TO ITS PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY.
4c (Code:   ) (Expenses $ 32,809,920 including grants of $   ) (Revenue $ 79,214,686 )
EMERGENCY DEPARTMENT AND BRIGHTON FIRST CARE (BFC) TOTAL VISITS - 88,264 THE EMERGENCY DEPARTMENT AND ESPECIALLY BFC SERVE AS THE PRIMARY CARE PHYSICIAN FOR A NUMBER OF LOW INCOME AND INDIGENT RESIDENTS OF GREATER PORTLAND. GIVEN THE MEDICAL CENTER'S COMMITMENT TO ACCESS TO CARE REGARDLESS OF ABILITY TO PAY, THESE EMERGENCY TREATMENT CENTERS SERVE A VITAL ROLE IN THE COMMUNITY'S HEALTH CARE NETWORK.
(Code:   ) (Expenses $ 429,716,011 including grants of $ 1,570,050 ) (Revenue $ 58,510,375 )
LABORATORY, EDUCATION, RESEARCH, RADIOLOGY, DELIVERY AND LABOR ROOM, ANESTHESIOLOGY, AND OTHER ANCILLARY SERVICES.
4d Other program services (Describe in Schedule O.)
(Expenses $ 429,716,011 including grants of $ 1,570,050 ) (Revenue $ 58,510,375 )
4e Total program service expensesMediumBullet$ 759,010,197
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II
Click to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part IIIClick to see attachment........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
Yes
 
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV
Click to see attachment
...................
9
Yes
 
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part IClick to see attachment
17
Yes
 
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II.......... Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see attachment
20b
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II
......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
Yes
 
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
922
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
7,169
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
20
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
16
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
ME
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
DIRECTOR OF ACCOUNTING
22 BRAMHALL STREET
PORTLAND,ME04102
(207) 396-6700
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) RICHARD W PETERSEN
PRESIDENT
50.00 X   X       1,093,556 0 90,952
(2) WILLIAM L CARON JR
TRUSTEE
2.00 X           0 1,071,394 99,218
(3) SAMUEL BROADDUS MD
TRUSTEE
50.00 X           433,846 0 47,341
(4) DAVID E WARREN
TRUSTEE
2.00 X           0 0 0
(5) CHRISTOPHER W EMMONS
CHAIRMAN
2.00 X   X       0 0 0
(6) JOYCE FOLEY
TRUSTEE
2.00 X           0 0 0
(7) REED QUINN MD
TRUSTEE
2.00 X           0 0 0
(8) MORRIS FISHER
TRUSTEE
2.00 X           0 0 0
(9) JERE G MICHELSON
TRUSTEE
2.00 X           0 0 0
(10) WILLIAM A BURKE
TRUSTEE
2.00 X           0 0 0
(11) WARD I GRAFFAM
TRUSTEE
2.00 X           0 0 0
(12) FRANK H FRYE
VICE CHAIR
2.00 X   X       0 0 0
(13) COSTAS T LAMBREW MD
TRUSTEE
2.00 X           0 0 0
(14) SUSANNAH SWIHART
TRUSTEE
2.00 X           0 0 0
(15) SUSAN HILTON
TRUSTEE
2.00 X           0 0 0
(16) PATRICIA B STOGSDILL MD
TRUSTEE
2.00 X           0 0 0
(17) HEIDI HANSEN
TRUSTEE
2.00 X           0 0 0
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) BRIAN PETROVEK
TRUSTEE
2.00 X           0 0 0
(19) KATHERINE POPE MD
TRUSTEE
2.00 X           0 0 0
(20) PARKER ROBERTS MD
TRUSTEE
2.00 X           0 0 0
(21) ELIZABETH LUNT
TRUSTEE
2.00 X           0 0 0
(22) BETH NEWLANDS CAMPBELL
TRUSTEE
2.00 X           0 0 0
(23) MARGARET BUSH
TRUSTEE
2.00 X           0 0 0
(24) BETH SHORR
TRUSTEE
2.00 X           0 0 0
(25) ELIZABETH KLEBE
TRUSTEE
2.00 X           0 0 0
(26) PETER BATES MD
CMO
50.00     X       535,115 0 65,548
(27) MARJORIE WIGGINS
CNO
50.00     X       429,444 0 59,134
(28) JEFFREY SANDERS
COO
50.00     X       415,305 0 57,422
(29) JOHN E HEYE
REG AGENT
50.00     X       414,343 0 68,120
(30) DONALD E QUIGLEY
ASST SECRTY
2.00     X       0 324,858 71,995
(31) KURT E KLEBE
SECRETARY
2.00     X       0 0 0
(32) LEE THIBODEAU MD
SURGEON
50.00         X   1,200,684 0 96,499
(33) KONRAD BARTH MD
SURGEON
50.00         X   1,109,349 0 134,341
(34) JAMES WILSON MD
SURGEON
50.00         X   1,103,447 0 125,785
(35) RAJIV DESAI MD
SURGEON
50.00         X   1,065,961 0 111,532
(36) JEFFREY FLORMAN MD
SURGEON
50.00         X   1,038,626 0 109,012
(37) GEORGE HIGGINS MD
FORMER CMO
50.00           X 281,311 0 63,719
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 9,120,987 1,396,252 1,200,618
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet532
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
LANGFORD & LOW INC
PO BOX 662
PORTLAND,ME04104
CONSTRUCTION 6,014,784
HURON CONSULTING GROUP LLC
3005 MOMENTUM PLACE
CHICAGO,IL606895330
CONSULTING 5,935,200
SPECTRUM MEDICAL GROUP PA
324 GANNETT DRIVE SUITE 200
SOUTH PORTLAND,ME04106
MEDICAL SERVICE 2,865,113
SUFFOLK CONSTRUCTION
99 CONIFER HILL DRIVE
DANVERS,MA01923
CONSTRUCTION 2,541,684
CHEST MEDICINE ASSOCIATES
100 FODEN ROAD WEST BLDG STE 103
SOUTH PORTLAND,ME041062351
MEDICAL SERVICE 2,541,206
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet131
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a 657,137
b Membership dues....1b  
c Fundraising events....1c 659,841
d Related organizations...1d 31,200
e Government grants (contributions)1e 17,931,263
f All other contributions, gifts, grants, and
similar amounts not included above
1f
9,816,276
g Noncash contributions included in lines 1a-1f:$ 97,935
h Total. Add lines 1a-1f.......MediumBullet 29,095,717
 Program Service Revenue Business Code
2a NET PATIENT SERVICE REVENUE 623,000 818,119,733 818,119,733    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 818,119,733
 Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 11,819,568     11,819,568
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 663,389,873 151,027
b Less: cost or other basis and sales expenses 658,861,469 36,961
c Gain or (loss) 4,528,404 114,066
d Net gain or (loss)..........MediumBullet 4,642,470     4,642,470
8a Gross income from fundraising events (not including
$ 659,841
of contributions reported on line 1c). See Part IV, line 18 ...
a 139,153
b Less: direct expenses ...b 147,485
c Net income or (loss) from fundraising events..MediumBullet -8,332   -8,332
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a OTHER REVENUE 722,210 79,261,175 79,261,175    
b ADMIN. SERVICES REVENUE 561,000 1,868,141   1,868,141  
c MISC REVENUE 900,099 1,376,253 1,376,253    
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 82,505,569
12 Total revenue. See Instructions....MediumBullet 946,174,725 898,757,161 1,868,141 16,453,706
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21    
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 1,570,050 1,570,050
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 3,799,991   3,799,991  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 343,722,392 300,337,409 42,346,597 1,038,386
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 36,360,680 31,881,044 4,479,636  
9 Other employee benefits ....... 48,854,375 42,835,516 6,018,859  
10 Payroll taxes ........... 24,019,963 20,992,586 2,959,259 68,118
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 1,425,788   1,408,288 17,500
c Accounting ........... 1,505,000   1,505,000  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17.. 66,515 66,515
f Investment management fees ...... 1,249,986   1,249,986  
g Other .......... 45,820,417 29,985,897 15,817,190 17,330
12 Advertising and promotion .... 1,585,987 1,390,593 195,394  
13 Office expenses ....... 127,403,379 126,097,052 1,211,878 94,449
14 Information technology ...... 9,219,116 8,083,321 1,135,795  
15 Royalties ..        
16 Occupancy ........... 22,134,426 19,283,881 2,726,961 123,584
17 Travel ............ 1,991,144 1,080,048 877,905 33,191
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 862,387 755,275 100,321 6,791
20 Interest ........... 3,501,555 3,070,163 431,392  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 52,609,822 46,128,292 6,481,530  
23 Insurance .............. 7,579,062 6,645,322 933,740  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a BAD DEBT 36,388,919 36,388,919    
b OUTSIDE MEDICAL SERVICES 26,012,833 26,012,833    
c HOSPITAL TAX 14,992,011 14,992,011    
d MAINTENANCE 13,620,790 11,888,701 1,678,081 54,008
e
f All other expenses 41,494,995 29,591,284 11,662,941 240,770
25 Total functional expenses. Add lines 1 through 24f 867,791,583 759,010,197 107,020,744 1,760,642
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year
(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1  
2 Savings and temporary cash investments ....... 15,080,285 2 29,199,767
3 Pledges and grants receivable, net ......... 6,513,362 3 5,644,775
4 Accounts receivable, net ......... 59,642,562 4 74,422,711
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net ............. 828,680 7 189,614
8 Inventories for sale or use .............. 6,988,718 8 6,695,687
9 Prepaid expenses and deferred charges ............ 41,582,449 9 2,668,891
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 880,971,348
b Less: accumulated depreciation. ..... 10b 447,938,802 429,571,999 10c 433,032,546
11 Investments—publicly traded securities .......... 407,507,981 11 415,118,622
12 Investments—other securities. See Part IV, line 11 ...... 28,901,615 12 38,207,433
13 Investments—program-related. See Part IV, line 11 .. 8,712,717 13 10,563,622
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 93,373,711 15 105,537,369
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,098,704,079 16 1,121,281,037
Liabilities 17 Accounts payable and accrued expenses . 67,340,720 17 74,294,075
18 Grants payable ..........   18  
19 Deferred revenue .......... 805,693 19 1,078,069
20 Tax-exempt bond liabilities .......... 118,017,071 20 109,955,508
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 2,761,850 23 1,873,690
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 326,157,448 25 343,430,018
26 Total liabilities. Add lines 17 through 25..... 515,082,782 26 530,631,360
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 484,027,534 27 487,537,746
28 Temporarily restricted net assets ..... 76,034,061 28 78,093,180
29 Permanently restricted net assets ..... 23,559,702 29 25,018,751
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 583,621,297 33 590,649,677
34 Total liabilities and net assets/fund balances ..... 1,098,704,079 34 1,121,281,037
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
946,174,725
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
867,791,583
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
78,383,142
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
583,621,297
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-71,354,762
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
590,649,677
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2011)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization
(ii)
EIN
(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv)
Is the organization in col. (i) listed in your governing document?
(v)
Did you notify the organization in col. (i) of your support?
(vi)
Is the organization in col. (i) organized in the U.S.?
(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2011
Name of organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions).
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  

Use duplicate copies of Part III if additional space is needed
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2011

Schedule C (Form 990 or 990-EZ) 2011
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check expenses, and share of excess lobbying expenditures).
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in)
(a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e))
         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))
         
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2011


Schedule C (Form 990 or 990-EZ) 2011
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
75,084
j
Total. Add lines 1c through 1i ...............................
75,084
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
No
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
No
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
No
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
No
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
  SCHEDULE C, PART II-B, LINE 1 PORTION OF DUES PAID THAT RELATE TO LOBBYING EXPENSES: MAINE HOSPITAL ASSOCIATION - 51,009 AMERICAN HOSPITAL ASSOCIATION - 18,544 NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS - 5,006 MAINE STATE CHAMBER OF COMMERCE - 525
Schedule C (Form 990 or 990EZ) 2011

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c 49,585,160
d Additions during the year .............................. 1d 17,912,541
e Distributions during the year ............................. 1e 13,917,796
f Ending balance ................................... 1f 53,579,905
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 89,682,688 91,020,571 82,336,677 82,100,837
b Contributions ........ 1,459,049 540,226 1,430,663 554,091
c Net investment earnings, gains, and losses ... 10,664,178 -1,878,109 7,253,231 -318,252
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........
-6,023,702      
f Administrative expenses ....        
g End of year balance ...... 95,782,213 89,682,688 91,020,571 82,336,677
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet26.000 %
c
Temporarily restricted endowment SchDMd Bullet74.000 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
Yes
 
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
No
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   21,425,398 21,425,398
b Buildings ................   405,416,963 185,637,560 219,779,403
c Leasehold improvements ............   2,589,752 1,221,752 1,368,000
d Equipment ................   410,987,558 261,079,490 149,908,068
e Other .................   40,551,677   40,551,677
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 433,032,546
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) AR UNDER REIMBURSEMENT REGULATIONS 53,175,000
(2) PREPAID CAPITAL COSTS 33,847,131
(3) DUE FROM RELATED PARTIES 11,876,315
(4) OTHER ASSETS 4,318,898
(5) INSURANCE RECEIVABLE 970,000
(6) DEFERRED FINANCING COSTS 662,238
(7) CHARITABLE REMAINDER TRUST 487,656
(8) INSURANCE RECEIVABLE - CURRENT 161,498
(9) CASH SURR. VALUE OF LIFE INSURANCE 38,633
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 105,537,369
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes  
ACCRUED RETIREMENT BENEFITS 232,707,723
A/P UNDER REIMBURSEMENT REGULATIONS 37,585,000
DUE TO RELATED PARTIES 20,243,160
SELF INSURANCE RESERVES 18,366,788
ASSET RETIREMENT OBLIGATION 16,884,250
SWAP AGREEMENTS 14,534,095
LEASES PAYABLE 1,903,073
INSURANCE CLAIMS PAYABLE 970,000
OTHER LIABILITIES 235,929
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 343,430,018
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8  
9 Total adjustments (net). Add lines 4 through 8 ......................... 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
TERMS FOR NOT REPORTING ASSETS PER SFAS 116 SCHEDULE D, PAGE 1, PART III, LINE 1A THE ORGANIZATION HAS ARTWORK THAT WAS RECEIVED DIRECTLY FROM THE ARTISTS. THIS ARTWORK IS NOT RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ARTWORK IS ON DISPLAY AT THE HOSPITAL.
COLLECTIONS AND RELATION TO EXEMPT PURPOSE SCHEDULE D, PAGE 2, PART III, LINE 4 MMC'S ARTWORK CREATES A HEALING AND COMFORTABLE ENVIRONMENT FOR OUR PATIENTS AND THEIR FAMILIES AND VISITORS.
EXPLANATION FOR UNREPORTED CONTRIBUTIONS OR ASSETS SCHEDULE D, PAGE 2, PART IV, LINE 1B THE INVESTMENT POOL AT MMC INCLUDES INVESTMENTS FROM SEVERAL RELATED ENTITIES. THESE INVESTMENTS ARE NOT INCLUDED IN MMC'S FINANCIAL STATEMENTS.
INTENDED USES FOR ENDOWMENT FUNDS SCHEDULE D, PAGE 2, PART V, LINE 4 THE ENDOWED FUNDS SUPPORT THE FOLLOWING TYPES OF ACTIVITIES: TUFTS SCHOLARSHIP PROGRAM, TRAINING AND EDUCATION OF NURSES, MMC RESEARCH AND EDUCATION PROGRAMS, SUPPORTING THE SALARY OF ENDOWED CHAIR OF PEDIATRICS AND FREE BED FUNDING.
LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X THE INTERNAL REVENUE SERVICE (IRS) HAS PREVIOUSLY DETERMINED THAT MMC AND ITS SUBSIDIARIES (EXCEPT MMP) ARE ORGANIZATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC.
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,or if the organization entered more than $15,000 on Form 990-EZ, line 6a.right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser)
(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity
(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i)
(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
ME, FL, NH
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

RADIOTHON/TELET
(event type)
(b) Event #2

MCCP STRIKE OUT
(event type)
(c) Other Events

10
(total number)
(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 149,401 141,510 508,083 798,994
2 Less: Charitable
contributions . . .
149,401 141,510 368,930 659,841
3 Gross income (line 1
minus line 2) . . .
    139,153 139,153
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . .     2,009 2,009
6 Rent/facility costs . . 358   49,494 49,852
7 Food and beverages . . 243 1,383 6,654 8,280
8 Entertainment . . . 651   5,000 5,651
9 Other direct expenses . 4,633 11,908 65,152 81,693
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 147,485
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow -8,332
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo
(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2011
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the
following was the family income limit for eligibility for discounted care: ............
3b
Yes
 
c
If the organization did not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year?...........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ...............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance
and Means-Tested Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
    18,517,063   18,517,063 2.230 %
b Medicaid (from Worksheet 3, column a) .....     113,664,843 69,369,448 44,295,395 5.330 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .            
dTotal Financial Assistance and
Means-Tested Government Programs .....
    132,181,906 69,369,448 62,812,458 7.560 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) ....
    305,548   305,548 0.040 %
f Health professions education
(from Worksheet 5) ..
    42,875,330 9,957,708 32,917,622 3.960 %
g Subsidized health services
(from Worksheet 6) ..
    34,586,421   34,586,421 4.160 %
h Research (from Worksheet 7)     7,007,749   7,007,749 0.840 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....     205,061   205,061 0.020 %
jTotal Other Benefits ...     84,980,109 9,957,708 75,022,401 9.020 %
kTotal. Add lines 7d and 7j. ..     217,162,015 79,327,156 137,834,859 16.580 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support     188,928   188,928 0.020 %
4 Environmental improvements            
5 Leadership development and training for community members     2,320   2,320  
6 Coalition building            
7 Community health improvement advocacy     1,470   1,470  
8 Workforce development     833,280 133,504 699,776 0.080 %
9 Other            
10 Total     1,025,998 133,504 892,494 0.100 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense........
2
15,747,180
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....
3
 
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
181,629,791
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
222,484,646
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-40,854,855
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures
(see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership%
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 MAINE MEDICAL CENTER
22 BRAMHALL STREET
PORTLAND,ME04102
X X X X   X X    
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
MAINE MEDICAL CENTER
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 175.0%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 225.0%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?33
Name and address Type of Facility (describe)
1 MMC SCARBOROUGH CAMPUS
100 CAMPUS DRIVE
SCARBOROUGH,ME04074
GENERAL MEDICAL AND SURGICAL
2 MMC SCARBOROUGH SURGICAL CENTER
84 CAMPUS DRIVE
SCARBOROUGH,ME04074
GENERAL MEDICAL AND SURGICAL
3 MMC BRIGHTON CAMPUS
335 BRIGHTON AVE
PORTLAND,ME04102
EMERGENCY CARE
4 MCGEACHY HALL
216 VAUGHN STREET
PORTLAND,ME04102
MENTAL HEALTH SERVICES
5 MMC FAMILY MEDICINE
272 CONGRESS STREET
PORTLAND,ME04101
GENERAL MEDICINE
6 MMC CLINICS
22 BRAMHALL STREET
PORTLAND,ME04102
GENERAL MEDICINE
7 COASTAL CANCER TREATMENT CENTER
175 CONGRESS STREET
BATH,ME04350
CANCER TREATMENT CENTER
8 CARDIOLOGY
96 CAMPUS DRIVE
SCARBOROUGH,ME04074
CARDIOLOGY
9 MENTAL HEALTH SERVICES
66 BRAMHALL STREET
PORTLAND,ME04102
MENTAL HEALTH SERVICES
10 NEUROSURGERY & SPINE AND NEUROLOGY
49 SPRING STREET
SCARBOROUGH,ME04074
NEUROSURGERY, SPINE AND NEUROLOGY CARE
11 MAINE TRANSPLANT PROGRAM
19 WEST STREET
PORTLAND,ME04102
KIDNEY AND PANCREAS TRANSPLANT
12 MAINE INSTITUTE FOR SLEEP AND
BREATHING DISORDERS
930 CONGRESS STREET
PORTLAND,ME04102
SLEEP AND BREATHING DISORDERS
13 MMC PEDIATRIC CLINIC
22 BRAMHALL STREET
PORTLAND,ME04102
PEDIATRICS
14 MMC FALMOUTH CAMPUS
5 BUCKNAM ROAD
FALMOUTH,ME04105
GENERAL MEDICINE
15 WOMEN'S HEALTH
DIVISION OF GYNECOLOGIC ONCOLOGY
102 CAMPUS DRIVE UNIT 116
SCARBOROUGH,ME04074
WOMEN'S HEALTHCARE
16 UROLOGY
100 BRICKHILL AVE SUITE 100
SOUTH PORTLAND,ME04106
UROLOGY
17 CAPE ELIZABETH INTERNAL MEDICINE
155 SPURWINK AVE
CAPE ELIZABETH,ME04107
GENERAL MEDICINE
18 MMC TURNING POINT REHAB CENTER
96 CAMPUS DRIVE
SCARBOROUGH,ME04074
REHAB FOR CARDIAC PATIENTS
19 ENDOCRINOLOGY & DIABETES
175 US ROUTE 1
SCARBOROUGH,ME04074
ENDOCRINOLOGY AND DIABETES
20 FALMOUTH INTERNALPEDIATRIC
MEDICINE
5 BUCKMAN ROAD SUITE 2A
FALMOUTH,ME04105
GENERAL MEDICINE
21 MMC BARIATRIC SURGERY CLINIC
12 ANDOVER ROAD
PORTLAND,ME04102
GENERAL MEDICAL AND SURGICAL
22 SCARBOROUGH FAMILY MEDICINE
96 CAMPUS DRIVE SUITE 2C
SCARBOROUGH,ME04074
GENERAL MEDICINE
23 ORTHOPEDICS
335 BRIGHTON AVE
PORTLAND,ME04102
ORTHOPEDIC CARE
24 AMBULATORY CLINIC SERVICES
48-52 GILMAN STREET
PORTLAND,ME04102
GENERAL MEDICINE
25 LAKES REGION PRIMARY CARE
584 ROOSEVELT TRAIL
WINDHAM,ME04062
GENERAL MEDICINE
26 OTOLARYNGOLOGY
1250 FOREST AVENUE
PORTLAND,ME04103
OTOLARYNGOLOGY SERVICES
27 MAINE CHILDREN'S CANCER PROGRAM
100 CAMPUS DRIVE UNIT 107
SCARBOROUGH,ME04074
CHILDREN'S CANCER PROGRAM
28 PEDIATRIC SURGERY & SPECIALTY CARE
887 CONGRESS STREET
PORTLAND,ME04102
PEDIATRICS
29 GORHAM FAMILY MEDICINE
94 MAIN STREET
GORHAM,ME04038
GENERAL MEDICINE
30 CENTER FOR TOBACCO INDEPENDENCE
315 PARK AVENUE SECOND FLOOR
PORTLAND,ME04101
TOBACCO TREATMENT CENTER
31 DEPARTMENT OF VOCATIONAL SERVICES
39 FOREST AVE
PORTLAND,ME04101
REHABILIATION SERVICES
32 PORTLAND PEDIATRICS
1577 CONGRESS STREET
PORTLAND,ME04102
PEDIATRICS
33 MAINE MENTAL HEALTH SERVICES
295 PARK AVE
PORTLAND,ME04102
MENTAL HEALTH SERVICES
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
SUBSIDIZED HEALTH SERVICES EXPLANATION PART I LINE 7G 24866969 OF EXPENSES RELATED TO PROVIDER BASED PHYSICIAN PRACTICES ARE INCLUDED IN THE SUBSIDIZED HEALTH SERVICES TOTAL IN PART I LINE 7G
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE PART I LINE 7 COLUMN F BAD DEBT EXPENSE OF 36388919 WAS REMOVED FROM THE TOTAL EXPENSES WHEN CALCULATING THE PERCENT OF TOTAL EXPENSES IN COLUMN F
COSTING METHODOLOGY EXPLANATION PART I LINE 7 THE COSTING METHODOLOGY FOR THE AMOUNTS REPORTED IN PART I LINE 7 OF THE SCHEDULE H IS BASED ON A RATIO OF PATIENT CARE COST TO CHARGES THIS COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 RATIO OF PATIENT CARE COSTTOCHARGES PROVIDED IN THE INSTRUCTIONS FOR SCHEDULE H
COMMUNITY BUILDING ACTIVITIES PART II COMMUNITY SUPPORT MAINE MEDICAL CENTER MMC IS DEEPLY INVOLVED IN DISASTER PLANNING AT THE LOCAL AND STATE LEVELS ONE OF THREE STATE REGIONAL RESOURCE CENTERS FOR EMERGENCY PREPAREDNESS IS LOCATED AT THE MEDICAL CENTER AND THE HOSPITAL HAS A FULLTIME DIRECTOR OF EMERGENCY PREPAREDNESS SOUTHERN MAINE REGIONAL RESOURCE CENTER FOR HEALTH EMERGENCY PREPAREDNESS COORDINATED ALL EMERGENCY PREPAREDNESS ACTIVITIES OF THE SOUTHERN 4 COUNTIES OF MAINE INCLUDING YORK CUMBERLAND SAGADAHOC AND LINCOLN THIS INCLUDES BOTH REGIONAL HOSPITALS AND OVER 300 MEDICAL CENTERS LABORATORIES CLINICS AMBULATORY CENTER PHYSICIAN PRACTICES LONG TERM CARE CENTERS HOME HEALTH AGENCIES IN OUR REGION THIS INCLUDES PUBLIC HEALTHCARE EMERGENCY PREPAREDNESS DEPARTMENT OF REHAB MEDICINE ORGANIZED A CAREER FAIR NIGHT CAREER EXPO AMERICAN HEART WALK AND THANKSGIVING FOOD DRIVE SESSION AT THE PORTLAND FAMILY MEDICINE CENTER INVOLVING UPWARD BOUND STUDENTS THE STUDENTS WERE PROVIDED A TOUR OF THE FACILITY WITH THE OPPORTUNITY TO SPEAK TO A VARIETY OF HEALTH PROFESSIONALS A HANDSON CLINICAL EXPERIENCE INJECTING ORANGES AND A DISCUSSION ABOUT THE PATHWAY TO BECOMING A PHYSICIAN WITH INFORMATION ABOUT THE MAINE TRACK PROGRAM A SPECIALITY PHYSICIAN FROM THE DIVISION OF GENETICS PRESENTS AN ANNUAL LECTURE OR LEADS AN OPEN PARENT MEDICAL DISCUSSION AT THE MDSN ANNUAL MEETING MMC IS A DUES PAYING MEMBER OF THE PORTLAND REGIONAL AND MAINE STATE CHAMBERS OF COMMERCE PLACEMENT OF PASTORAL CARE STUDENTS IN COMMUNITY AGENCIES ONE DAY PER WEEK DURING THE SUMMER OUTPATIENT CANCER PREBLE STREET NURSING HOMES AND SEAFARERS LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS DOC4ADAY PROGRAM HANLEY LEADERSHIP DEVELOPMENT SUMMER INTERN COMMUNITY HEALTH IMPROVEMENT ADVOCACY 21 REASONS FORMERLY PORTLAND CMCA IS A COALITION BASED ON THECMCA MODEL MMC BRINGS TOGETHER INDIVIDUALS ORGANIZATIONS AND BUSINESSES WITH A COMMON GOAL TO BUILD A HEALTHY COMMUNITY ENVIRONMENT WITH POLICIES PRACTICES AND ATTITUDES THAT SUPPORT THE DRUGFREE DEVELOPMENT OF ALL YOUTH WORKFORCE DEVELOPMENT LIFELINE WORKPLACE WELLNESS LIFELINE OFFERS A MENU OF WELLNESS SERVICES AND PROGRAMS TO EMPLOYERS INTERESTED IN WORKSITE WELLNESS EMPLOYERS CAN ALSO JOIN THE MMC SOUTHERN MAINE WELLNESS COUNCIL WHICH PROVIDES OPPORTUNITIES FOR NETWORKING RESOURCE ACCESS AND PROFESSIONAL TRAINING TRAINING FOR SURGICAL TECHS CNA TRAINING PROGRAM MAINE MEDICAL CENTERS MINI MEDICAL SCHOOL IS A WEEK LONG SUMMER PROGRAM DESIGNED TO GIVE MAINE COLLEGE STUDENTS AN IDEA OF WHAT A CAREER IN MEDICINE IS ALL ABOUT THE PROGRAM OFFERS A SERIES OF LECTURES HANDS ON ACTIVITIES AND CLINICAL EXPERIENCES DESIGNED TO EXPOSE ASPIRING STUDENTS TO A COMBINATION OF SMALL GROUP DIDACTIC SESSIONS RESEARCH EXPERIENCE AND CLINICAL PROCEDURES
BAD DEBT EXPENSE EXPLANATION PART III LINE 4 MAINE MEDICAL CENTER DOES NOT HAVE A SPECIFIC FOOTNOTE IN THE FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE MAINE MEDICAL CENTER REPORTS ACCOUNTS RECEIVABLE FOR SERVICES RENDERED NET OF ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS THIRD PARTY REIMBURSING AGENCIES FREE CARE AND BAD DEBTS A BAD DEBT ALLOWANCE IS ESTABLISHED FOR ACCOUNTS THE HOSPITAL BELIEVES WILL BECOME UNCOLLECTIBLE THE ALLOWANCE IS ESTABLISHED BY EXAMINING HISTORICAL DATA AGING TRENDS OF COMMERCIAL INSURANCE AND SELFPAY BALANCES AND ECONOMIC TRENDS THE OFFSET TO THE ALLOWANCE ACCOUNT IS TO BAD DEBT EXPENSE ON THE STATEMENT OF OPERATIONS RECOVERIES ON ACCOUNTS PREVIOUSLY WRITTEN OFF ARE ACCOUNTED FOR ON A CASH BASIS AND ARE APPLIED DIRECTLY TO THE PROVISION FOR BAD DEBTS ON THE STATEMENT OF OPERATIONS AMOUNTS WRITTEN OFF OR RECOVERED FROM BAD DEBTS DURING THE YEAR ARE CHARGED AGAINST THE ALLOWANCE ACCOUNT ON THE BALANCE SHEET BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES MAINE MEDICAL CENTER HAS PROVIDED WITHOUT COMPENSATION AS A TAXEXEMPT HOSPITAL MAINE MEDICAL CENTER PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENTS ABILITY TO PAY FOR THE SERVICES A PORTION OF MAINE MEDICAL CENTERS BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THAT FOR A VARIETY OF REASONS DO NOT COMPLETE THE FINANCIAL ASSISTANCE APPLICATION PROCESS MAINE MEDICAL CENTER CAN NOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE MEDICAL CENTERS FREE CARE POLICY IN ADDITION BAD DEBT EXPENSE ALSO INCLUDES AMOUNTS FOR SERVICES PROVIDED TO INDIVIDUALS EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES RELATED TO A PORTION OF OUR COMMUNITY BASED PATIENT POPULATION THEIR MEDICAL BILLS OFTEN PLACE THESE INDIVIDUALS IN UNTENABLE POSITIONS WHERE THEY ARE NOT ABLE TO HANDLE THEIR PERSONAL DEBT AND THEN THEIR NEW MEDICAL DEBT HOWEVER BECAUSE OF THEIR INCOME LEVEL THEY DO NOT QUALIFY FOR FREE CARE BY PROVIDING NECESSARY HEALTHCARE SERVICES TO THOSE INDIVIDUALS EITHER WHO FAIL TO APPLY FOR FINANCIAL ASSISTANCE OR WHO ARE EXPERIENCING DIFFICULT PERSONAL OR ECONOMIC CIRCUMSTANCES MAINE MEDICAL CENTER BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT
MEDICARE EXPLANATION PART III LINE 8 MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO MAINE MEDICAL CENTER BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE MEDICAL CENTER HAS A CLEAR MISSION COMMITMENT TO SERVING ELDERLY PATIENTS AND ADULTS WITH DISABILITIES THROUGH THE PROVISION OF SPECIFIC SUBSIDIZED PROGRAMS DEVELOPED TO HELP IMPROVE THE HEALTH STATUS OF THESE PATIENTS IF THESE CRITICAL SUBSIDIZED PROGRAMS WERE NOT PROVIDED BY THE MEDICAL CENTER THEY WOULD BECOME THE OBLIGATION OF THE FEDERAL GOVERNMENT
COLLECTION PRACTICES EXPLANATION PART III LINE 9B PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE HAVE THEIR ACCOUNT BALANCE ADJUSTED ACCORDINGLY ONCE FINANCIAL ASSISTANCE HAS BEEN APPROVED FOR PATIENTS THAT DO NOT QUALIFY FOR 100 FINANCIAL ASSISTANCE THE APPROPRIATE DISCOUNT PERCENTAGE IS APPLIED AND THE REMAINING BALANCE IS BILLED TO THE RESPONSIBLE PARTY MONTHLY PAYMENT ARRANGEMENTS CAN BE ESTABLISHED BY THE RESPONSIBLE PARTY BY CONTACTING THE PATIENT FINANCIAL SERVICES CUSTOMER SERVICE DEPARTMENT AS A TAXEXEMPT HOSPITAL MAINE MEDICAL CENTER PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENTS ABILITY TO PAY FOR THE SERVICES A PORTION OF MAINE MEDICAL CENTERS BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THAT FOR A VARIETY OF REASONS DO NOT COMPLETE THE FINANCIAL ASSISTANCE APPLICATION PROCESS MAINE MEDICAL CENTER CAN NOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE MEDICAL CENTERS FREE CARE POLICY
NEEDS ASSESSMENT PART VI MMCS BOARD IS MADE UP OF A DIVERSE SET OF COMMUNITY MEMBERS THE BOARD REQUIRES A THOROUGH COMMUNITY NEEDS ASSESSMENT ON BEHALF OF THE ORGANIZATION AND DIRECTS THE ORGANIZATION TO ANALYZE AND RESPOND TO THE CURRENT NEEDS ASSESSMENT MAINE MEDICAL CENTER ALSO PARTICIPATES IN VARIOUS INITIATIVES TO HELP SUPPORT AND PROVIDE UPDATES TO COMMUNITY NEEDS ASSESSMENT PLANNING SOME OF THESE INITIATIVES INCLUDE CLINICAL STRATEGIC PLANNING FINANCIAL STRATEGIC PLANNING FACILITY PLANNING MANPOWER PLANNING PHYSICIAN RECRUITMENT STRATEGIC PLANNING EMERGENCY PREPAREDNESS PLANNING ALONG WITH THE INTERNAL ASSESSMENTS MAINE MEDICAL CENTER ALSO REVIEWS AND ACTS ON MANY OF THE RECOMMENDATIONS PROVIDED BY EXTERNAL GROUPS SUCH AS THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION AND THE STATE HEALTH PLAN CREATED BY THE ADVISORY COMMITTEE FOR HEALTH SYSTEMS DEVELOPMENT IN ADDITION MAINEHEALTH AND ITS PARTNERS IN THE ONEMAINE HEALTH COLLABORATIVE EASTERN MAINE HEALTH SYSTEM AND MAINEGENERAL HEALTH RELEASED THE ONEMAINE HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT REPORT IN MARCH 2011 THE REPORT IS A COMPREHENSIVE COMPILATION AND ANALYSIS CONTAINING PRIMARY AND SECONDARY HEALTH DATA SOURCES THE REPORT CONTAINS A HEALTH STATUS PROFILE FOR THE STATE AS A WHOLE AND FOR EACH OF MAINES SIXTEEN COUNTIES THE PRIMARY DATA SOURCE WAS A RANDOMIZED TELEPHONE SURVEY THE SAMPLING METHODOLOGY WAS DESIGNED TO PERMIT COMPARISONS AT THE COUNTY LEVEL SECONDARY DATA SOURCES INCLUDE NUMEROUS STATE AND FEDERAL SOURCES THIS REPORT PROVIDES BASELINE DATA ON HUNDREDS OF HEALTH INDICATORS THAT ARE RELEVANT TO MAINE MEDICAL CENTER TO INFORM PLANNING AND EVALUATION ACTIVITIES PLANS CALL FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT TO BE REPLICATED EVERY THREE YEARS MAINEHEALTH WILL HOLD COMMUNITY FORUMS IN PARTNERSHIP WITH MAINE MEDICAL CENTER IN ORDER TO INCREASE UNDERSTANDING AND USE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND TO INFORM IDENTIFICATION AND ACTION ON LOCALCOMMUNITYBASED HEALTH PRIORITIES
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI FINANCIAL ASSISTANCE INFORMATION IS PROVIDED IN THE ADMITTING OUTPATIENT AND EMERGENCY REGISTRATION LOCATIONS IN THE FOLLOWING MANNER POSTINGS INCLUDING FREE CARE PROMPT PAYMENT PROGRAM MONTHLY PAYMENT PLAN AND EXPANDED FREE CARE PROGRAM HANDOUTS INTERVIEWS ALL PATIENTS RECEIVE MMCS FREE CARE GUIDELINES AND FINANCIAL POLICIES BROCHURE EXPLAINING OUR BILLING POLICIES AND CONTACT INFORMATION IF THE PATIENT IS SELF PAY UNDER INSURED OR CAN NOT AFFORD TO PAY THEIR HOSPITAL BILL THEY RECEIVE A FINANCIAL POLICIES BOOK AND FINANCIAL COUNSELING FROM THE REGISTRATION STAFF OR CEA THE BOOKLET INCLUDES INFORMATION ON MMCS FINANCIAL POLICIES FINANCIAL ASSISTANCE INFORMATION INCLUDING FREE CARE PROGRAM INCOME BASED DISCOUNT PROGRAM PROMPT PAY DISCOUNT PROGRAM MONTHLY PAYMENT PLAN PROGRAM AND CARE PARTNERS PROGRAM APPLICATIONS AND INSTRUCTIONS FOR MMCS FREE CARE PROGRAM INCOME BASED DISCOUNT PROGRAM AND MONTHLY PAYMENT PLAN APPLICATION CONTACT INFORMATION FOR ASSISTANCE WITH APPLICATIONS BILLS OR FINANCIAL CONCERNS SELF PAY OR UNDERINSURED PATIENTS REGISTERING IN PERSON OR VIA A PHONE INTERVIEW RECEIVE FINANCIAL COUNSELING INCLUDING INFORMATION ON OUR FINANCIAL ASSISTANCE PROGRAMS AND MAINECARE REGISTRATION STAFF OR CEA PROVIDE FORMS AND ASSIST WITH COMPLETING FINANCIAL ASSISTANCE APPLICATIONS AND PROVIDING FOLLOW UP CONTACT INFORMATION INPATIENTS WHO ARE UNINSURED UNDER INSURED OR ANY PATIENTS WHO MAY HAVE DIFFICULTY PAYING THEIR HOSPITAL BILLS ARE VISITED BY AN ADMITTING FINANCIAL COUNSELOR OR CEA TO DISCUSS FINANCIAL ASSISTANCE PROGRAMS AND ASSIST WITH APPLICATIONS MMCS WEB SITE INCLUDES ON LINE REGISTRATION AND PATIENT BILLING INFORMATION BILLING PROCESS FREE CARE DISCOUNT PROGRAM PROMPT PAY DISCOUNT MONTHLY PAYMENT PLAN PATIENT STATEMENT PRICE INFORMATION CONTACT US AND QUESTIONS PRIMARY LANGUAGE DEAF AND HARD OF HEARING AND INTERPRETER NEEDS ARE ASSESSED DURING THE REGISTRATION INTERVIEW AND SERVICES ARE PROVIDED AS NEEDED IF A PATIENT DOES NOT RESPOND AT PREREGISTRATION REGISTRATION OR WHILE RECEIVING CARE ALL OF THESE PROGRAMS ARE EXPLAINED AGAIN BY THE PATIENT ACCOUNTS STAFF THE INTENT OF THESE EFFORTS IS TO ENSURE THAT THE PATIENT IS FULLY INFORMED OF AND ABLE TO TAKE ADVANTAGE OF THESE ASSISTANCE PROGRAMS
COMMUNITY INFORMATION PART VI MOST OF MAINE MEDICAL CENTERS SERVICES ARE FOUND AT OUR MAIN CAMPUS AT 22 BRAMHALL STREET IN MAINES LARGEST CITY PORTLAND A CITY OF 66000 IS LOCATED ON MAINES SOUTHERN COAST THE COST OF LIVING INDEX IS 115 SERVICES ARE ALSO LOCATED AT OUR BRIGHTON CAMPUS AND OUR FAMILY MEDICINE CENTER BOTH LOCATED IN PORTLAND AS WELL AS AT OUR CAMPUSES IN SCARBOROUGH THE FALMOUTH FAMILY HEALTH CENTER AND COASTAL CANCER TREATMENT CENTER IN BATH A JOINT VENTURE WITH SOUTHERN MAINE MEDICAL CENTER AND GOODALL HOSPITAL THE CANCER CARE CENTER OF YORK COUNTY IS LOCATED IN SANFORD NEW ENGLAND REHABILITATION HOSPITAL OF PORTLAND A JOINT VENTURE WITH HEALTHSOUTH IS LOCATED ON OUR BRIGHTON CAMPUS MAINE MEDICAL CENTER IS THE TERTIARY CARE HOSPITAL FOR ALL OF MAINE CARING FOR NEARLY ONE OF EVERY FIVE HOSPITAL INPATIENTS IN THE STATE AS A NONPROFIT INSTITUTION MAINE MEDICAL CENTER PROVIDES 20 PERCENT OF ALL THE CHARITY CARE DELIVERED IN MAINE PORTLAND WHERE OUR MAIN CAMPUS IS LOCATED HAS A LARGE REFUGEE AND IMMIGRANT POPULATION WHILE SERVING ALL SIXTEEN COUNTIES IN MAINE 84 OF ALL INPATIENT AND OUTPATIENT SERVICES PROVIDED BY MAINE MEDICAL CENTER WERE FOR THE RESIDENTS OF BOTH CUMBERLAND AND YORK COUNTIES
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI MAINE MEDICAL CENTERS DAYTODAY OPERATIONS AS A TAXEXEMPT ORGANIZATION INCLUDE MANY SYSTEMWIDE INITIATIVES IN CUMBERLAND COUNTY AND IN THE STATE OF MAINE AND THE NORTHERN NEW ENGLAND REGION CLINICAL SERVICES RANGE FROM OUTPATIENT CLINICS FOR A DIVERSE POPULATION TO FULL INPATIENT AND SURGICAL SERVICES TO A REGIONAL TRAUMA CENTER AND A NEUROSCIENCE INSTITUTE MANY OF OUR SERVICES AND SPECIALTIES ARE NOT AVAILABLE ELSEWHERE IN THE STATE OR IN OUR REGION WE HAVE PROGRAMS IN UNDERGRADUATE GRADUATE POSTGRAUDATE AND CONTINUING EDUCATION ENGAGE IN CLINICAL RESEARCH AND SUPPORT ORGANIZATIONS AND EFFORTS WHOSE MISSIONS AUGMENT OR COMPLEMENT OURS WE STRIVE TO BE A GOOD INSTITUTIONAL CITIZEN OF OUR REGION AND STATE WITH THESE PROGRAMS MAINE MEDICAL CENTER HOPES TO FILL EXISTING LOCAL GAPS WHILE MAKING A POSITIVE IMPACT IN THE COMMUNITIES WE SERVE THESE PROGRAMS INCLUDE SUBSIDIZED HEALTH SERVICES COMMUNITYBASED CLINICAL SERVICES COMMUNITY EDUCATION SERVICES HEALTH CARE SUPPORT SERVICES COMMUNITY BUILDING ACTIVITIES MEDICAL EDUCATION AND RESEARCH SEE THE ATTACHED COMMUNITY BENEFIT REPORT FOR ADDITIONAL INFORMATION ON EACH OF THESE PROGRAMS AND SERVICES MAINE MEDICAL CENTER MADE A NET ASSET TRANSFER TO ITS WHOLLY OWNED SUBSIDIARY MAINE MEDICAL PARTNERS IN THE AMOUNT OF 27684217 TO COVER THE LOSSES RELATED TO MISSIONCRITICAL PHYSICIAN PRACTICES TO ENSURE ACCESS FOR THE COMMUNITY TO SUCH SPECIALTIES AS TRAUMA SURGERY NEUROSURGERY UROLOGY VARIOUS PEDIATRIC SPECIALTIES AND HIGHRISK OBSTETRICS
AFFILIATED HEALTH CARE INFORMATION PART VI MAINEHEALTH IS A NOTFORPROFIT FAMILY OF LEADING HIGHQUALITY PROVIDERS AND OTHER HEALTHCARE ORGANIZATIONS WORKING TOGETHER SO THEIR COMMUNITIES ARE THE HEALTHIEST IN AMERICA RANKED AMONG THE NATIONS TOP 50 INTEGRATED HEALTHCARE DELIVERY NETWORKS MAINEHEALTH IS GOVERNED BY A BOARD OF TRUSTEES CONSISTING OF COMMUNITY AND BUSINESS LEADERS FROM ITS SOUTHERN CENTRAL AND WESTERN MAINE REGIONAL SERVICE AREAS THE COLLABORATION OF MAINEHEALTH MEMBERS MAKES IT POSSIBLE TO OFFER AN EXTENSIVE RANGE OF CLINICAL INTEGRATION AND COMMUNITY HEALTH PROGRAMS MANY AIMED AT IMPROVING ACCESS TO PREVENTIVE AND PRIMARY CARE SERVICES MAINEHEALTH INCLUDES THE FOLLOWING MEMBER ORGANIZATIONS LINCOLN COUNTY HEALTHCARE MILES MEMORIAL HOSPITAL AND ST ANDREWS HOSPITAL HEALTHCARE CENTER MAINE MEDICAL CENTER MAINE MENTAL HEALTH PARTNERS SPRING HARBOR HOSPITAL PEN BAY HEALTHCARE PEN BAY MEDICAL CENTER SOUTHERN MAINE MEDICAL CENTER GOODALL HOSPITAL WALDO COUNTY HEALTHCARE WALDO COUNTY GENERAL HOSPITAL WESTERN MAINE HEALTH STEPHENS MEMORIAL HOSPITAL HOMEHEALTH VISITING NURSES MAINE PHYSICIAN HOSPITAL ORGANIZATION NORDX SYNERNET AND MAINEHEALTH ACCOUNTABLE CARE ORGANIZATION THE STRATEGIC AFFILIATES OF MAINEHEALTH ARE MAINEGENERAL MEDICAL CENTER MID COAST HOSPITAL AND ST MARYS REGIONAL MEDICAL CENTER
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED PART VI MAINE
ADDITIONAL INFORMATION PART VI PART I LINE 3B MAINE MEDICAL CENTER USES FEDERAL POVERTY GUIDELINES FPG FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS THE FAMILY INCOME LIMIT FOR ELIGIBILITY FOR DISCOUNTED CARE IS 176 225
MAINE MEDICAL CENTER LINE NUMBER 1 PART V LINE 11H PART V LINE 11H UPON RECEIPT OF AN APPLICATION MAINE MEDICAL CENTER SHALL DETERMINE THAT AN INDIVIDUAL SEEKING FREE CARE QUALIFIES FOR SUCH CARE IF SERVICES RENDERED WERE MEDICALLY NECESSARY
MAINE MEDICAL CENTER LINE NUMBER 1 PART V LINE 19D PART V LINE 19D MAINE MEDICAL CENTER USES ITS CHARGES FROM ITS CHARGE DESCRIPTION MASTER TO DETERMINE THE FULL CHARGE THEN MAINE MEDICAL CENTER USES FEDERAL POVERTY GUIDELINES FPG FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS THE FAMILY INCOME LIMIT FOR ELIGIBILITY FOR DISCOUNTED CARE IS 176 225
Schedule H (Form 990) 2011
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
MAINE MEDICAL CENTER
 
Employer identification number
01-0238552
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed
......................... lBullet
(a) Name and address of organization
or government
(b) EIN (c) IRC Code section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
 
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance
(1) SCHOLARSHIPS 167 1,570,050      













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES SCHEDULE I, PAGE 1, PART I, LINE 2 FOR THE NURSING SCHOLARSHIPS, AS AN APPLICATION REQUIREMENT, EACH SCHOLARSHIP APPLICANT MUST PROVIDE CONFIRMATION OF ENROLLMENT IN A PROGRAM OF STUDIES IN NURSING. FOR THE MEDICAL EDUCATION SCHOLARSHIPS FOR STUDENTS IN THE MAINE TRACK OF THE MMC.TUSM MEDICAL SCHOOL PROGRAM, THE MEDICAL CENTER TRANSFERS THE SCHOLARSHIP FUNDS TO THE TUFTS SCHOOL OF MEDICINE FINANCIAL AID DEPARTMENT FOR DISBURSEMENT TO THE STUDENTS. TUFTS HANDLES ANY OVERSIGHT TO ENSURE THAT THE FUNDS ARE USED AS INTENDED. MAINE MEDICAL CENTER'S ROLE IS LIMITED TO MATCHING ELIGIBLE STUDENTS WITH SCHOLARSHIP SELECTION CRITERIA AND DETERMINING WHO RECEIVES EACH SCHOLARSHIP AWARD.
Schedule I (Form 990) 2011


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) RICHARD W PETERSEN (i)
(ii)
625,338
 
173,500
 
294,718
 
75,608
 
15,344
 
1,184,508
 
 
 
(2) WILLIAM L CARON JR (i)
(ii)
 
678,670
 
183,000
 
209,724
 
83,614
 
15,604
 
1,170,612
 
 
(3) SAMUEL BROADDUS MD (i)
(ii)
397,462
 
29,500
 
6,884
 
31,737
 
15,604
 
481,187
 
 
 
(4) PETER BATES MD (i)
(ii)
421,221
 
60,633
 
53,261
 
49,944
 
15,604
 
600,663
 
 
 
(5) MARJORIE WIGGINS (i)
(ii)
272,749
 
38,997
 
117,698
 
50,313
 
8,821
 
488,578
 
 
 
(6) JEFFREY SANDERS (i)
(ii)
346,653
 
68,112
 
540
 
41,647
 
15,775
 
472,727
 
 
 
(7) JOHN E HEYE (i)
(ii)
283,450
 
41,206
 
89,687
 
52,472
 
15,648
 
482,463
 
 
 
(8) DONALD E QUIGLEY (i)
(ii)
 
269,359
 
38,000
 
17,499
 
56,686
 
15,309
 
396,853
 
 
(9) LEE THIBODEAU MD (i)
(ii)
540,334
 
296,731
 
363,619
 
81,111
 
15,388
 
1,297,183
 
 
 
(10) KONRAD BARTH MD (i)
(ii)
486,924
 
406,499
 
215,926
 
118,566
 
15,775
 
1,243,690
 
 
 
(11) JAMES WILSON MD (i)
(ii)
492,910
 
419,704
 
190,833
 
110,441
 
15,344
 
1,229,232
 
 
 
(12) RAJIV DESAI MD (i)
(ii)
488,277
 
381,458
 
196,226
 
95,757
 
15,775
 
1,177,493
 
 
 
(13) JEFFREY FLORMAN MD (i)
(ii)
492,565
 
408,112
 
137,949
 
93,624
 
15,388
 
1,147,638
 
 
 
(14) GEORGE HIGGINS MD (i)
(ii)
239,318
 
21,670
 
20,323
 
48,115
 
15,604
 
345,030
 
 
 


Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 RICHARD W. PETERSEN 0 272,888 0 WILLIAM L. CARON, JR. 0 192,125 0 SAMUEL BROADDUS, M.D. 0 3,130 0 PETER BATES, M.D. 0 49,622 0 MARJORIE WIGGINS 0 114,134 0 JOHN E. HEYE 0 83,884 0 DONALD E. QUIGLEY 0 10,480 0 LEE THIBODEAU, M.D. 0 360,055 0 KONRAD BARTH, M.D. 0 214,684 0 JAMES WILSON, M.D. 0 190,023 0 RAJIV DESAI, M.D. 0 195,416 0 JEFFREY FLORMAN, M.D. 0 137,409 0 GEORGE HIGGINS, M.D. 0 522 0
OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III TOP MANAGEMENT OFFICIALS THAT ARE COMPENSATED BY RELATED ORGANIZATIONS USED ONE OR MORE OF THE METHODS AT PART I, LINE 3 TO ESTABLISH THE COMPENSATION OF TOP MANAGEMENT.
Schedule J (Form 990) 2011

Additional Data


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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.

OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
MAINE MEDICAL CENTER
 
Employer identification number
01-0238552
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer
(i) Pool
financing
Yes No Yes No Yes No
A MHHEFA REVENUE BONDS SERIES 2008A
 
01-0314384 560425W48 05-22-2008 107,180,000 REFUND BONDS ISSUED 5/18/2006 AND 7/12/2006   X   X   X
B MHHEFA REVENUE BONDS SERIES 2008B
 
01-0314384 560425W55 06-19-2008 25,985,000 REFUND BONDS ISSUED 5/18/2006   X   X   X
C MHHEFA REVENUE BONDS SERIES 2011A
 
01-0314384 560427LW4 08-31-2011 17,998,986 REFUND BONDS ISSUED 7/9/1998, 12/10/1998, 5/19/1999, AND 11/15/2001   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . 10,850,000 16,685,000 755,000  
2 Amount of bonds legally defeased . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . 107,180,008 25,985,000 17,998,986  
4 Gross proceeds in reserve funds . . . . . . . . 11,661,440 4,692,066 1,745,875  
5 Capitalized interest from proceeds . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . 484,392 163,914 186,573  
8 Credit enhancement from proceeds . . . . . . . . . . 38,754 9,396    
9 Working capital expenditures from proceeds . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . 4,226      
11 Other spent proceeds . . . . . . . . . . . 106,009,079 25,811,690 17,812,413  
12 Other unspent proceeds . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . X   X   X      
15 Were the bonds issued as part of an advance refunding issue? . . . .   X   X   X    
16 Has the final allocation of proceeds been made? . . . . . . X   X   X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . X   X   X      
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2011
Schedule K (Form 990) 2011
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . .   X   X   X    
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .   X   X   X    
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .   X   X   X    
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet   %   %   %   %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet   %   %   %   %
6 Total of lines 4 and 5 . . .. . . . . . . . .   %   %   %   %
7 Does the bond issue meet the private security or payment test? . . . X   X   X      
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X   X      
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . . X     X   X    
2 Is the bond issue a variable rate issue? X   X     X    
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X   X     X    
b Name of provider . . . . . . . . SEE PART V
 
MORGAN STANLEY
 
 
 
 
 
c Term of hedge . . . . . . . . 6.0 6.0    
d Was the hedge superintegrated? . . . .   X   X        
e Was a hedge terminated? . . . . .   X   X        
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . X   X     X    
b Name of provider . . . . . . SEE PART V
 
SEE PART VI
 
 
 
 
 
c Term of GIC . . . . . . . 28.1 6.0    
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . . X   X          
5 Were any gross proceeds invested beyond an available temporary period? . . . . . . X   X     X    
6 Did the bond issue qualify for an exception to rebate? . X   X   X      
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X      
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
ADDITIONAL INFORMATION SCHEDULE K MHHEFA REVENUE BONDS SERIES 2008A PART IV LINES 3B AND 3C COLUMN A THERE ARE THREE SEPARATE HEDGING CONTRACTS IDENTIFIED WITH THESE BONDS WITH MORGAN STANLEY CAPITAL SERVICES INC TERM 281 YEARS MERRILL LYNCH CAPITAL SERVICES INC TERM 181 YEARS AND MORGAN STANLEY CAPITAL SERVICES INC TERM 281 YEARS PART II LINE 4 COLUMN A THE AMOUNT SHOWN HERE CONSISTS OF 8840406 IN A DEBT SERVICE RESERVE FUND PLUS 2821034 OF DEBT SERVICE FUND DEPOSITS PART IV LINE 4B COLUMN A TRANSAMERICA LIFE PART IV LINE 5 COLUMNS A AND B SUCH AMOUNTS WERE APPROPRIATELY YIELDRESTRICTED PART IV COMPARISON OF LINES 1 AND 6 COLUMN A THE CURRENT REFUNDING ESCROW FUND MET THE REQUIREMENTS OF THE SIXMONTH SPENDING EXCEPTION WHICH WAS NOT UTILIZED AS THOSE AMOUNTS WERE INVESTED AT A LOWER YIELD REBATE WAS PAID ON THE BONDS WHICH AROSE ENTIRELY DUE TO A HIGHERYIELDING INVESTMENT CONTRACT ON THE DEBT SERVICE RESERVE FUND FOR THE BONDS MHHEFA REVENUE BONDS SERIES 2008B PART IV LINES 4B COLUMN B TRANSAMERICA LIFE PART II LINE 4 COLUMN B THE AMOUNT SHOWN HERE CONSISTS OF 2598500 IN A DEBT SERVICE RESERVE FUND PLUS 2093566 OF DEBT SERVICE FUND DEPOSITS PART III HAS NOT BEEN COMPLETED WITH RESPECT TO THE BONDS SHOWN IN COLUMNS B AND C SINCE THE ORIGINAL PROJECTS BEING REFINANCED BY SUCH BONDS ARE TRACEABLE TO BONDS ISSUED BEFORE 2003 COLUMN B OR THE BONDS BEING REFINANCED BY SUCH BONDS WERE ISSUED BEFORE 2003 COLUMN C HAD COMPLETION OF PART III BEEN REQUIRED LINE 7 WOULD HAVE BEEN ANSWERED YES FOR THESE BONDS MHHEFA REVENUE BONDS SERIES 2011A SERIES 2011 BONDS WITH RESPECT TO PART I COLUMN E AND PART II LINES 112 THE INSTITUTION IS REPORTING ITS ALLOCABLE PORTION OF THIS BOND ISSUE THE REMAINDER OF WHICH IS ALLOCABLE TO AFFILIATED ENTITIES FOR PURPOSES OF PART I COLUMN I THE INSTITUTION HAS ASSUMED THAT THIS ARRANGEMENT DOES NOT CONSTITUTE A POOLED FINANCING THE DIFFERENCE BETWEEN THE ISSUE PRICE PART I AND TOTAL PROCEEDS PART II LINE 3 IN COLUMN A IS DUE TO INVESTMENT EARNINGS PART II LINE 4 COLUMN C THE AMOUNT SHOWN HERE CONSISTS OF 1402046 IN A DEBT SERVICE RESERVE FUND PLUS 343829 OF DEBT SERVICE FUND DEPOSITS
Schedule K (Form 990) 2011

Additional Data


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Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2011
Schedule L (Form 990 or 990-EZ) 2011
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) CHRISTOPHER EMMONS SEE PART V 525,219 SEE PART V   No
(2) MORRIS FISHER SEE PART V 929,087 SEE PART V   No
(3) KATHERINE POPE MD SEE PART V 6,217,060 SEE PART V   No
(4) PETER BATES MD SEE PART V 6,217,060 SEE PART V   No
(5) BRIAN PETROVEK SEE PART V 350,136 SEE PART V   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
ADDITIONAL INFORMATION SCHEDULE L PART V CHRISTOPHER EMMONS IS A MEMBER OF THE BOARD OF TRUSTEES OF MAINE MEDICAL CENTER AS WELL AS THE PRESIDENT OF GORHAM SAVINGS BANK MAINE MEDICAL CENTER HAS COPIER LEASES THROUGH GORHAM SAVINGS LEASING GROUP WHICH IS A WHOLLY OWNED SUBSIDIARY OF GORHAM SAVINGS BANK ALL TRANSACTIONS WERE AT ARMS LENGTH FOR FAIR VALUE AND IN THE ROUTINE COURSE OF BUSINESS MORRIS FISHER IS A MEMBER OF THE BOARD OF TRUSTEES OF MAINE MEDICAL CENTER AS WELL AS THE PRESIDENT OF THE BOULOS COMPANY THE BOULOS COMPANY PROVIDES PROPERTY MANAGEMENT SERVICES TO MAINE MEDICAL CENTER ALL TRANSACTIONS WERE AT ARMS LENGTH FOR FAIR VALUE AND IN THE ROUTINE COURSE OF BUSINESS KATHERINE POPE MD IS A MEMBER OF THE BOARD OF TRUSTEES OF MAINE MEDICAL CENTER AND MEDICAL MUTUAL INSURANCE CO OF MAINE PETER BATES MD IS AN OFFICER OF MAINE MEDICAL CENTER AND A MEMBER OF THE BOARD OF TRUSTEES OF MEDICAL MUTUAL INSURANCE CO OF MAINE MEDICAL MUTUAL INSURANCE PROVIDES MALPRACTICE INSURANCE TO MAINE MEDICAL CENTER ALL TRANSACTIONS WERE AT ARMS LENGTH FOR FAIR VALUE AND IN THE ROUTINE COURSE OF BUSINESS BRIAN PETROVEK IS A MEMBER OF THE BOARD OF TRUSTEES OF MAINE MEDICAL CENTER AND THE UNITED WAY OF GREATER PORTLAND MAINE MEDICAL CENTER EMPLOYEES CONTRIBUTE TO THE UNITED WAY THROUGH THEIR PAYROLL ALL TRANSACTIONS WERE AT ARMS LENGTH FOR FAIR VALUE AND IN THE ROUTINE COURSE OF BUSINESS
Schedule L (Form 990 or 990-EZ) 2011

Additional Data


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Software Version:  




SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Part I
Types of Property
(a)
Check if applicable
(b)
Number of Contributions or items contributed
(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g
(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications .. X 35 SELLING PRICE
5 Clothing and household
goods .......
X 1,355 SELLING PRICE
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 19 87,865 FAIR MARKET VALUE
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles ..... X 7 574 SELLING PRICE
19 Food inventory ... X 5 1,200 SELLING PRICE
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( TREASURY BONDS ) X 2   FAIR MARKET VALUE
26 Other Right pointing arrow large image ( AUCTION ITEMS ) X 44 6,906 SELLING PRICE
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2011
Schedule M (Form 990) 2011
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33 and whether the organization is reporting in Part I, column (b) the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Identifier Return Reference Explanation
EXPLANATION FOR NOT REPORTING REVENUE SCHEDULE M, PAGE 1, PART I, LINE 33 THERE WAS ONE CONTRIBUTION OF STOCK THAT WAS RECEIVED DURING FY12 AS A PAYMENT ON A PRIOR YEAR PLEDGE. ACCORDINGLY, NO ADDITIONAL REVENUE WAS RECORDED FOR THIS CONTRIBUTION. THE CONTRIBUTION IS INCLUDED IN COLUMN (B).
Schedule M (Form 990) 2011
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Identifier Return Reference Explanation
ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION THE MAINE MEDICAL CENTER (THE MEDICAL CENTER) IS A VOLUNTARY, NOT-FOR-PROFIT COMMUNITY AND REFERRAL HOSPITAL, DEDICATED TO PROVIDING HIGH QUALITY HEALTH CARE SERVICES TO ALL PERSONS WHO SEEK CARE REGARDLESS OF THEIR SEX, RACE, RELIGION, AGE, COLOR, SEXUAL ORIENTATION, NATIONAL ORIGIN, PHYSICAL OR EMOTIONAL DISABILITY OR SOCIAL OR ECONOMIC STATUS. MAINE MEDICAL CENTER IS ALSO COMMITTED TO EDUCATION AT THE UNDERGRADUATE, GRADUATE, POST-GRADUATE AND CONTINUING EDUCATION LEVELS FOR PHYSICIANS, NURSES AND ALLIED HEALTH PERSONNEL, AND IN-SERVICE TRAINING FOR SUPPORT STAFF ALL OF WHICH ARE ESSENTIAL TO THE DELIVERY OF QUALITY PATIENT CARE. OUTREACH EDUCATION TO OTHER INSTITUTIONS AND AGENCIES IS ALSO VITAL TO THE FULFILLMENT OF THE MAINE MEDICAL CENTER'S MISSION. THE MEDICAL CENTER ALSO SUPPORTS BASIC AND CLINICAL RESEARCH AS ESSENTIAL TO THE ADVANCEMENT OF HEALTH CARE.
ALL OTHER ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4D LABORATORY, EDUCATION, RESEARCH, RADIOLOGY, DELIVERY AND LABOR ROOM, ANESTHESIOLOGY, AND OTHER ANCILLARY SERVICES.
CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 MAINEHEALTH (EIN 01-0431680) IS THE SOLE MEMBER OF THE ORGANIZATION.
ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A THE SOLE MEMBER OF THE ORGANIZATION HAS THE RESPONSIBILITY FOR THE ELECTION OF THE MEMBERS OF THE GOVERNING BODY.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B THERE ARE DECISIONS BY THE GOVERNING BODY THAT REQUIRE THE APPROVAL OF ITS SOLE MEMBER. THEY INCLUDE: 1. THE ADOPTION OF OPERATING AND CAPITAL BUDGETS; 2. THE APPROVAL OF ANY SIGNIFICANT STRATEGIC PLAN FOR PROGRAMS OR FACILITIES; 3. THE AUTHORIZATION OF DEBT INCURRED, ASSUMED, OR GUARANTEED BY THE MEDICAL CENTER IN EXCESS OF 1,000,000 AND ITS SUBSIDIARIES IN EXCESS OF 1,000,000 OTHER THAN AS PROVIDED FOR IN ANNUAL CAPITAL AND OPERATING BUDGETS; 4. THE AUTHORIZATION FOR ANY ACQUISITION, DISPOSITION, ORGANIZATION OR INVESTMENT IN ANY OTHER CORPORATION, PARTNERSHIP, LIMITED LIABILITY COMPANY OR JOINT VENTURE; 5. THE AUTHORIZATION FOR ANY SALE, ASSIGNMENT, TRANSFER, MORTGAGE OR ENCUMBRANCE OF ANY PROPERTIES OR ASSETS HAVING AN AGGREGATE VALUE IN EXCESS OF 1,000,000; 6. THE AUTHORIZATION FOR ANY MERGER OR CONSOLIDATION INVOLVING THE MEDICAL CENTER OR ITS SUBSIDIARIES AS A CONSTITUENT ENTITY OR ANY SALE OR OTHER DISPOSITION OF SUBSTANTIALLY ALL OF THE ASSETS OF THE MEDICAL CENTER OR ITS SUBSIDIARIES; 7. THE AUTHORIZATION FOR THE INSTITUTION OF ANY BANKRUPTCY, INSOLVENCY OR REORGANIZATION PROCEEDINGS; 8. THE AUTHORIZATION FOR THE CAPITAL INVESTMENT IN ANY INDIVIDUAL, ENTITY, OR PROJECT IN THE FORM OF CASH OR EITHER TANGIBLE OR INTANGIBLE PROPERTY IN EXCESS OF 1,000,000; 9. THE AMENDMENT OF THE ARTICLES OF INCORPORATION; 10. THE SELECTION, ANNUAL ELECTION, EVALUATION, AND TERMINATION OF THE MEDICAL CENTER'S CEO; 11. THE AUTHORIZATION FOR THE COMMENCEMENT OF LITIGATION BY THE MEDICAL CENTER OTHER THAN ROUTINE COLLECTION ACTIONS; 12. THE ADOPTION OF THE MEDICAL CENTER'S BYLAWS AND ANY AMENDMENTS AND MODIFICATIONS TO THE MEDICAL CENTER'S BYLAWS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE 990 WAS REVIEWED IN DETAIL BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. THE 990 WAS ALSO MADE AVAILABLE TO THE FULL BOARD OF TRUSTEES. THE BOARD WAS THEN GIVEN AN OPPORTUNITY TO ASK QUESTIONS OF THE CHAIRMAN OF THE BOARD, THE CEO, OR THE SR. VICE PRESIDENT FOR FINANCE & CFO. THE SR. VICE PRESIDENT FOR FINANCE & CFO ALSO REVIEWED THE 990 IN DETAIL BEFORE SIGNING THE RETURN.
ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C CONFLICTS OF INTEREST STATEMENTS ARE OBTAINED ANNUALLY. MAINEHEALTH'S AUDIT & COMPLIANCE SERVICES DEPARTMENT COLLECTS AND REVIEWS THE RESPONSES TO THESE DOCUMENTS AND ADDRESSES ANY ISSUES IMMEDIATELY. THE RESULTS ARE SHARED WITH BOARD LEADERSHIP.
COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A MAINE MEDICAL CENTER USES AN OUTSIDE FIRM, SULLIVAN COTTER, TO PERFORM AN INDEPENDENT BENCHMARK ANALYSIS. THEY MEET WITH THE BOARD OF TRUSTEES EXECUTIVE COMPENSATION COMMITTEE TO REVIEW THE CEO'S BENCHMARK REPORT. THE EXECUTIVE COMMITTEE THEN DELIBERATES ON MMC'S WRITTEN SALARY AND INCENTIVE COMPENSATION PLAN PHILOSOPHY AND DOCUMENTS BEFORE MAKING A FINAL DECISION. ALL DECISIONS AND MEETINGS ARE CAPTURED IN MINUTES. THERE IS APPROPRIATE REPORTING AT ALL LEVELS.
COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B MAINE MEDICAL CENTER USES AN OUTSIDE FIRM, SULLIVAN COTTER, TO PERFORM AN INDEPENDENT BENCHMARK ANALYSIS. THEY MEET WITH THE BOARD OF TRUSTEES EXECUTIVE COMPENSATION COMMITTEE TO REVIEW EACH EXECUTIVE BENCHMARK REPORT. THE EXECUTIVE COMMITTEE THEN DELIBERATES ON MMC'S WRITTEN SALARY AND INCENTIVE PLAN PHILOSOPHY AND DOCUMENTS BEFORE MAKING A FINAL DECISION. ALL DECISIONS AND MEETINGS ARE CAPTURED IN MINUTES. THERE IS APPROPRIATE REPORTING AT ALL LEVELS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST.
RELATED ORGANIZATIONS FORM 990, PAGE 7, PART VII WILLIAM CARON AND DONALD QUIGLEY WORK AN AVERAGE OF 50 HOURS PER WEEK FOR A RELATED ORGANIZATION - MAINEHEALTH.
OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 CHANGE IN PV OF POOLED LIFE AND CHARITABLE REMAINDER TRUSTS - (257,311) NET ASSETS RELEASED FROM RESTRICTIONS - (8,040,744) RECOGNIZED GAIN IN FV OF INVESTMENTS - 20,601,955 EQUITY TRANSFER TO AFFILIATES - (29,738,714) CHANGE IN NET UNREALIZED LOSS ON CASH FLOW HEDGE INSTRUMENTS - (415,984) RETIREMENT BENEFIT PLAN ADJUSTMENTS - (53,503,964)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MAINE MEDICAL CENTER
 
Employer identification number

01-0238552
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income



(e)
End-of-year assets


(f)
Direct controlling
entity



















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section



(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled organization
Yes No
(1) MAINEHEALTH (MH)

110 FREE STREET

PORTLAND,ME04101
01-0431680
HEALTHCARE ME 501C3 11C NA
 
 
No
(2) MMC REALTY

22 BRAMHALL STREET

PORTLAND,ME04102
01-0434215
PROP MGMT ME 501C3 11A MMC
 
Yes
 
(3) MAINE MENTAL HEALTH PARTNERS

123 ANDOVER ROAD

WESTBROOK,ME04092
26-3426990
HEALTHCARE ME 501C3 11C MH
 
 
No
(4) LINCOLN COUNTY HEALTH CARE INC

6 ST ANDREWS LANE

BOOTHBAY HARBOR,ME04538
26-1475629
HEALTHCARE ME 501C3 11C MH
 
 
No
(5) WESTERN MAINE HEALTH CARE CORP

181 MAIN STREET

NORWAY,ME04268
01-0411788
HEALTHCARE ME 501C3 11C MH
 
 
No
(6) WALDO COUNTY HEALTHCARE INC

PO BOX 287

BELFAST,ME049150287
22-2864961
HEALTHCARE ME 501C3 11C MH
 
 
No
(7) GERIATRIC RESOURCE NETWORK

110 FREE STREET

PORTLAND,ME04101
01-0542842
HEALTHCARE ME 501C3 7 MH
 
 
No
(8) WEBBER HOSPITAL ASSOC DBA SMMC

PO BOX 626

BIDDEFORD,ME040050626
01-0179500
HOSPITAL ME 501C3 3 MH
 
 
No
(9) HOMEHEALTH VISITING NURSES OF SO ME

15 INDUSTRIAL PARK DRIVE

SACO,ME04072
22-2571902
HEALTHCARE ME 501C3 9 MH
 
 
No
(10) NORDX

301A US ROUTE ONE

SCARBOROUGH,ME04074
01-0511356
LABORATORY ME 501C3 9 MH
 
 
No
(11) PEN BAY HEALTHCARE

4 WHITE STREET

ROCKLAND,ME04841
22-2494475
ADMIN ME 501C3 11C MH
 
 
No
(12) HENRIETTA D GOODALL HOSPITAL INC

25 JUNE STREET

SANFORD,ME04073
01-0078060
HOSPITAL ME 501C3 3 MH
 
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) MAINEHEALTH ACCOUNTABLE CARE ORG

110 FREE STREET
PORTLAND,ME04101
45-2929273
ADMINSERV ME N/A
        No     No  












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



(b)
Primary activity



(c)
Legal domicile
(state or
foreign
country)
(d)
Direct controlling
entity


(e)
Type of entity
(C corp, S corp,
or trust)

(f)
Share of total income



(g)
Share of
end-of-year
assets

(h)
Percentage
ownership


(1) MAINE MEDICAL PARTNERS (MMP)
22 BRAMHALL STREET
PORTLAND,ME04102
01-0442142
HEALTHCARE ME N/A
       
(2) SYNERNET INC
110 FREE STREET
PORTLAND,ME04101
01-0539789
ADMINSERV ME N/A
       
(3) MAINE PHYSICIAN HOSPITAL ORG
110 FREE STREET
PORTLAND,ME04101
01-0527540
HEALTHCARE ME N/A
       
(4) MMC CLINICAL SERVICES SUPPORT CORP
22 BRAMHALL STREET
PORTLAND,ME04102
20-3656876
ADMINSERV ME N/A
       






Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type(a-r)
(c)
Amount involved
(d)
Method of determining amount involved
(1) MAINE MEDICAL PARTNERS

N 13,453,727 FAIR MARKET VALUE
(2) MAINE MEDICAL PARTNERS

O 1,898,136 FAIR MARKET VALUE
(3) MAINE MEDICAL PARTNERS

P 62,538,862 FAIR MARKET VALUE
(4) MAINE MEDICAL PARTNERS

Q 75,934,538 FAIR MARKET VALUE
(5) MAINE MEDICAL PARTNERS

R 1,880,079 FAIR MARKET VALUE
(6) MMC REALTY

J 2,560,709 FAIR MARKET VALUE
(7) MMC REALTY

N 191,201 FAIR MARKET VALUE
(8) MMC REALTY

P 3,697,943 FAIR MARKET VALUE
(9) MMC REALTY

Q 1,639,688 FAIR MARKET VALUE
(10) MAINE MEDICAL PARTNERS

N 13,453,727 FAIR MARKET VALUE
(11) MAINE MEDICAL PARTNERS

O 1,898,136 FAIR MARKET VALUE
(12) MAINE MEDICAL PARTNERS

P 62,538,862 FAIR MARKET VALUE
(13) MAINE MEDICAL PARTNERS

Q 75,934,538 FAIR MARKET VALUE
(14) MAINE MEDICAL PARTNERS

R 1,880,079 FAIR MARKET VALUE
(15) MMC REALTY

J 2,560,709 FAIR MARKET VALUE
(16) MMC REALTY

N 191,201 FAIR MARKET VALUE
(17) MMC REALTY

P 3,697,943 FAIR MARKET VALUE
(18) MMC REALTY

Q 1,639,688 FAIR MARKET VALUE
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID:  
Software Version: