Form990
Click to see list of attachments
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 09-25-2011 and ending 09-29-2012
BCheck if applicable:
CName of organization
Eastern Maine Medical Center
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO Box 404 489 State Street
 
Room/suite
City or town, state or country, and ZIP + 4
Bangor, ME04402
D Employer identification number

01-0211501
E Telephone number

G Gross receipts $ 1,306,168,409
F Name and address of principal officer:
Derrick Hollings
43 Whiting Hill Road
Brewer,ME04412
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.emmc.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 MediumBullet5247
K Form of organization:
 
L Year of formation: 1892
M State of legal domicile: ME
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: Eastern Maine Medical Center strives to provide exceptional primary and specialty healthcare with a passionate pursuit of excellence in patient safety, clinical quality, and service. Our mission is to care for patients, families, communities, and one another.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 19
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 13
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 3,965
6 Total number of volunteers (estimate if necessary) .... 6 461
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 82,812
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) ......... 6,997,361 7,281,171
9 Program service revenue (Part VIII, line 2g) ......... 1,124,604,344 1,232,940,927
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,890,054 1,530,402
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,713,647 11,792,864
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 1,135,205,406 1,253,545,364
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...   0
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) 303,365,535 327,970,731
16a Professional fundraising fees (Part IX, column (A), line 11e).....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 813,219,289 862,986,866
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,116,584,824 1,190,957,597
19 Revenue less expenses. Subtract line 18 from line 12....... 18,620,582 62,587,767
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 459,472,780 573,340,985
21 Total liabilities (Part X, line 26)............. 220,225,914 261,582,289
22 Net assets or fund balances. Subtract line 21 from line 20..... 239,246,866 311,758,696
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: Eastern Maine Medical Center strives to provide exceptional primary and specialty healthcare with a passionate pursuit of excellence in patient safety, clinical quality, and service. Our mission is to care for patients, families, communities, and one another.
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 $ 999,999,999 including grants of $   ) (Revenue $   )
Provide healthcare services regardless of ability to pay as well as education, research and promotion of health. Provided other uncompensated care (at cost) of $11,594,760.Eastern Maine Medical Center (EMMC) has served communities throughout our region for 120 years. Under community direction, it has grown from a five-bed general hospital into a comprehensive, 411 bed tertiary medical center with primary and secondary care components. EMMC is a nonprofit hospital, serving all who need care, regardless of ability to pay.EMMC also provides outreach clinics to many local hospitals in the region, allowing easier access to patients and supporting the role of those hospitals in their communities. EMMC provides access to medical data to hospitals across the State through its PACS system, helping to improve the quality of care patients receive. Additional information can be found at EMMC's website: www.emmc.org.Additional StatisticsTotal admissions 21,533Percent Occupancy of Available Beds 78.5%Cardiac Catherization Procedures 5,597Cardiac Surgery Cases 381Emergency Room Visits 40,223Medical Imaging Procedures 146,225Surgery Cases 18,742Live Births 1,644Family Practice Visits 30,801Total Outpatient Visits 414,750Patient Days 106,059Services provided to those who could not pay $48,922,587
4b (Code:   ) (Expenses $ 33,376,515 including grants of $   ) (Revenue $   )
Medicaid shortfalls (at cost) 87,740 persons served
4c (Code:   ) (Expenses $ 24,363,872 including grants of $   ) (Revenue $   )
Medicare shortfalls (at cost) 114,366 persons served
4d Other program services (Describe in Schedule O.)
(Expenses $ 58,149,382 including grants of $   ) (Revenue $ 1,243,220,384 )
4e Total program service expensesMediumBullet$ 1,115,889,768
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
 
No
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
 
No
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 I
17
 
No
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..........
18
 
No
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...................
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..
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.....
22
 
No
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
Yes
 
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
Yes
 
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
 
No
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
183
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
3,965
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
 
No
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
 
No
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
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
No
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
0
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
 
No
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
No
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
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
No
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
No
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
 
No
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
 
No
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
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
No
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
19
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
13
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
Yes
 
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
Yes
 
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
 
No
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
 
No
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
 
No
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
Jeffrey A Sanford
43 Whiting Hill Road
Brewer,ME04412
(207) 973-7894
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) Scott Solman
Board Member
.50 X           0 0 0
(2) Julie Long MD
Board Member
50.00 X           487,881 0 20,441
(3) Elizabeth C Warren
Board Member
.50 X           0 0 0
(4) John A Vickery Sr
Board Member
.50 X           0 0 0
(5) Iyad Sabbagh MD
Board Member
50.00 X           228,889 0 37,024
(6) Senator Kevin L Raye
Board Member
.50 X           0 0 0
(7) Donald Hagstrom
Board Member
.50 X           0 0 0
(8) John M Long Sr MD
Board Member
.50 X           0 0 0
(9) David L Levy MD
Board Member
.50 X           0 0 0
(10) Liane E M Judd
Vice Chair
.50 X   X       0 0 0
(11) Gary Eckmann
Board Member
.50 X           0 0 0
(12) Jennifer Brooker
Board Member
.50 X           0 0 0
(13) Mary Cathcart
Board Member
.50 X           0 0 0
(14) Sally Arata
Board Member
.50 X           0 0 0
(15) Michael J McInnis
Chairman
1.00 X   X       0 0 0
(16) Deborah Carey Johnson CEO
Ex-Officio
50.00 X   X       509,489 0 508,559
(17) Mary M Hood PresidentCEO
Ex-Officio
20.00 X   X       0 886,467 230,569
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) John Miller
Board Member
.50 X           0 0 0
(19) Ashley Robertson MD
Board Member
50.00 X           332,577 0 22,541
(20) EE comp is for admin svcs
not brd respons
0.00 X           0 0 0
(21) Elmer Doucette VPCFO
Treasurer
50.00     X       246,867 0 37,245
(22) Michael P Donahue
VP/PHY PRACTICE
50.00     X       275,888 0 31,744
(23) Derrick Hollings
EMHS Treasurer
50.00     X       0 0 0
(24) Glenn Martin VP Gen Counsel
Secretary
14.00     X       0 265,008 38,778
(25) Jodi Galli RN
CNO
50.00     X       0 0 0
(26) Jill McDonald
VP/COMM & MKT
50.00     X       182,311 0 23,329
(27) Helen Q McKinnon RN
VP/SUPPORT SVC
50.00     X       229,160 0 41,916
(28) G Gregory Howat Esq
VP/HR
50.00     X       243,229 0 42,094
(29) James A Raczek MD
VP/OPER & CMO
50.00     X       385,920 0 36,904
(30) Robert A Clough MD
Surgeon
40.00         X   788,285 0 35,035
(31) Wayne R Waterman MD
Neuro Surgeon
40.00         X   786,434 0 25,717
(32) James W Turner MD
Neuro Surgeon
40.00         X   582,043 0 26,690
(33) Michael A Johnson MD
Retinal Surgeon
40.00         X   1,158,028 0 34,037
(34) John D Klemperer MD
Physician
40.00         X   577,811 0 37,249
(35) Daniel B Coffey
Former Treasurer
0.00           X 0 450,533 44,909
(36) Lorraine Rodgerson
Former VP Patient Care & CNO
0.00           X 211,429 0 34,689
(37) Scott Oxley
Former Treasurer
0.00           X 0 283,116 37,273
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 7,226,241 1,885,124 1,346,743
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet383
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
WEATHERBY LOCUMS INC
PO BOX 972633
DALLAS,TX753972633
STAFFING SERVICES 2,984,959
PENOBSCOT RESPIRATORY
417 STATE STREET SUITE 400
BANGOR,ME044016690
RESPIRATORY THERAPY 3,847,495
NURSE ANESTHESIA OF MAINE
141 N MAIN ST STE 205
BREWER,ME04412
COVERAGE SERVICES 9,835,664
DAHL CHASE DIAGNOSTIC SERVICES
417 STATE STREET SUITE 441
BANGOR,ME04401
DIAGNOSTIC SERVICES 2,355,656
CERNER CORPORATION
PO BOX 412702
KANSAS CITY,MO641412702
SOFTWARE SUPPORT 5,106,927
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet77
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 3,587,858
e Government grants (contributions)1e 1,170,665
f All other contributions, gifts, grants, and
similar amounts not included above
1f
2,522,648
g Noncash contributions included in lines 1a-1f:$ 25,115
h Total. Add lines 1a-1f.......MediumBullet 7,281,171
 Program Service Revenue Business Code
2a Patient Care Services 621,990 614,289,436 614,289,436    
b Patient Care Service 621,990 614,683,807 614,677,727 6,080  
c Hotel/Lodging 721,110 376,500     376,500
d Healthcare Education 611,710 477,305 477,305    
e Cafeteria 722,210 3,113,879   3,758 3,110,121
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 1,232,940,927
 Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 1,217,271     1,217,271
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 36,858 12,000
b Less: rental expenses 2,969  
c Rental income or (loss) 33,889 12,000
d Net rental income or (loss).......MediumBullet 45,889   12,000 33,889
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 52,930,589 2,618
b Less: cost or other basis and sales expenses 52,611,637 8,439
c Gain or (loss) 318,952 -5,821
d Net gain or (loss)..........MediumBullet 313,131     313,131
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
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 0      
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 0      
Miscellaneous Revenue Business Code
11a Meaningful Use 621,990 9,208,548 9,208,548    
b Clinical Engineering 541,300 540,738 514,862 25,876  
c 340B Pharmacy Benefits 621,990 1,479,518     1,479,518
d All other revenue .... 518,171 483,073 35,098  
e Total. Add lines 11a–11d ......MediumBullet 11,746,975
12 Total revenue. See Instructions....MediumBullet 1,253,545,364 1,239,650,951 82,812 6,530,430
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 0  
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 3,924,008 2,130,885 1,793,123  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 259,438,942 251,335,883 8,103,059  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 11,940,661 11,392,309 548,352  
9 Other employee benefits ....... 37,253,318 33,628,117 3,625,201  
10 Payroll taxes ........... 15,413,802 14,504,813 908,989  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 361,413 126,314 235,099  
c Accounting ........... 101,844   101,844  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 293,745 18,201 275,544  
g Other .......... 85,186,965 41,472,052 43,714,913  
12 Advertising and promotion .... 1,300,311 1,288,902 11,409  
13 Office expenses ....... 14,749,456 11,100,458 3,648,998  
14 Information technology ...... 6,634,985 3,975,917 2,659,068  
15 Royalties .. 0      
16 Occupancy ........... 10,447,625 7,970,347 2,477,278  
17 Travel ............ 829,421 736,724 92,697  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 1,231,806 1,122,273 109,533  
20 Interest ........... 3,229,884 3,064,815 165,069  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 22,170,949 17,283,011 4,887,938  
23 Insurance .............. 7,567,466 7,217,092 350,374  
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 Charity Care 23,648,543 23,648,543    
b Provision for uncollectible ac 25,274,044 25,270,908 3,136  
c Medical Supplies 90,107,627 90,038,726 68,901  
d Contractual Allowances 548,435,397 548,435,397    
e
f All other expenses 21,415,385 20,128,081 1,287,304  
25 Total functional expenses. Add lines 1 through 24f 1,190,957,597 1,115,889,768 75,067,829 0
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 .......... 14,545 1 16,070
2 Savings and temporary cash investments ....... 21,679,210 2 38,015,413
3 Pledges and grants receivable, net ......... 160,017 3 111,820
4 Accounts receivable, net ......... 102,619,912 4 140,623,481
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 29,818 5 58,402
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 0
7 Notes and loans receivable, net ............. 1,265,828 7 1,320,817
8 Inventories for sale or use .............. 2,339,963 8 2,324,446
9 Prepaid expenses and deferred charges ............ 12,873,521 9 16,293,847
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 462,226,306
b Less: accumulated depreciation. ..... 10b 280,040,122 167,908,518 10c 182,186,184
11 Investments—publicly traded securities .......... 58,700,535 11 70,165,579
12 Investments—other securities. See Part IV, line 11 ......   12 0
13 Investments—program-related. See Part IV, line 11 ..   13 0
14 Intangible assets .........   14 0
15 Other assets. See Part IV, line 11 ........... 91,880,913 15 122,224,926
16 Total assets. Add lines 1 through 15 (must equal line 34)... 459,472,780 16 573,340,985
Liabilities 17 Accounts payable and accrued expenses . 70,292,273 17 94,156,443
18 Grants payable ..........   18  
19 Deferred revenue .......... 210,796 19 250,431
20 Tax-exempt bond liabilities .......... 65,353,071 20 63,184,024
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 ..   23  
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..... 84,369,774 25 103,991,391
26 Total liabilities. Add lines 17 through 25..... 220,225,914 26 261,582,289
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 ..... 212,116,573 27 280,737,439
28 Temporarily restricted net assets ..... 16,791,222 28 20,348,188
29 Permanently restricted net assets ..... 10,339,071 29 10,673,069
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 ..... 239,246,866 33 311,758,696
34 Total liabilities and net assets/fund balances ..... 459,472,780 34 573,340,985
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
1,253,545,364
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
1,190,957,597
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
62,587,767
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
239,246,866
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
9,924,063
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
311,758,696
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: 11000144
Software Version: 2011v1.5
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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
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: 11000144
Software Version: 2011v1.5
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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
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: 11000144
Software Version: 2011v1.5
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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
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
 
56,152
j
Total. Add lines 1c through 1i ...............................
56,152
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
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
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
Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description Non-deductible dues
Schedule C (Form 990 or 990EZ) 2011

Additional Data


Software ID: 11000144
Software Version: 2011v1.5

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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
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  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
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 .... 21,018,620 21,974,979 20,890,628  
b Contributions ........ 124,365 148,655 54,006  
c Net investment earnings, gains, and losses ... 3,506,614 236,593 2,264,755  
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........
1,142,926 1,341,607 1,234,409  
f Administrative expenses ....        
g End of year balance ...... 23,506,673 21,018,620 21,974,980  
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet1.600 %
b
Permanent endowment SchDMd Bullet98.400 %
c
Temporarily restricted endowment SchDMd Bullet  
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)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
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 .................   2,222,321 2,222,321
b Buildings ................   119,574,016 59,394,370 60,179,646
c Leasehold improvements ............   12,200,697 2,930,067 9,270,630
d Equipment ................   285,899,200 209,146,949 76,752,251
e Other .................   42,330,072 8,568,736 33,761,336
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 182,186,184
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) Self-Insurance Funds Held by Trustee 9,665,396
(2) Investment in Net Assets held @ EMHSF 29,254,670
(3) Funds Held by Bond Trustee 1,326,249
(4) Estimated Prof. Liab. Claims Receivable 22,839,719
(5) Board Designated Funded Depreciation 57,088,077
(6) Beneficial Trust Assets 2,050,815



Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 122,224,926
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes  
Reserve for Prof. Liab. Self Ins. 22,839,719
Reserve for Asset Disposal Costs 656,128
Notes Payable to Related Org, EMHS 663,725
Lt Liability - Cerner RHO 1,199,994
Liability Under Cap Lease Obligation 714,207
Accrued Post Retirement Benefits 77,917,618



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 103,991,391
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
Part X Part X : FIN48 Footnote Income TaxesEMHS, its hospitals, and certain other affiliates have been determined by the Internal Revenue Service to be tax-exempt charitable organizations as described in Section 501(c)(3) or 501(c)(2) of the Internal Revenue Code ("Code") and, accordingly, are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Accordingly, no provision for federal income taxes has been recorded in the accompanying consolidated financial statements for these organizations.Tax-exempt charitable organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board (FASB), assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The System has evaluated its tax position taken or expected to be taken on income tax returns and concluded the impact to be not material.Certain of the System's affiliates are taxable entities. Deferred taxes related to these entities are based on the difference between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect in the years the differences are expected to reverse. The deferred tax assets and liabilities for these entities are not material.
Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Transfer from exempt subsidiaries-EMHS Foundation $106651 Transfer from exempt subsidiaries-Rosscare $0 Transfer from exempt subsidiaries-EMHRE $7571 Transfer from exempt parent-Eastern Maine Healthcare Systems $1455876 Transfer from exempt sub.-Eastern Maine Medical Center Auxil $4017 Change in interest in net assets held @ EMHS Foundation $4219262 Post Retirement Health Benefit FAS158 $3701868 Contribution to Strategic Planning Pool per Affiliation Agre $ -973260 Change in interest in net assets held @ Healthcare Charities $ -0 Post Retirement Health Benefit FAS158 $ -0
Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. Endowment Funds are designated for purposes that align within this organization's exempt purpose.
Schedule D (Form 990) 2011

Additional Data


Software ID: 11000144
Software Version: 2011v1.5




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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
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
Yes
 
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
 
No
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) ..
  3,437 11,004,380 323,525 10,680,855 1.800 %
b Medicaid (from Worksheet 3, column a) .....   87,740 115,823,214 82,446,699 33,376,515 5.620 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .     7,491,400   7,491,400 1.260 %
dTotal Financial Assistance and
Means-Tested Government Programs .....
  91,177 134,318,994 82,770,224 51,548,770 8.680 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) ....
8 721 2,711,050 9 2,711,041 0.460 %
f Health professions education
(from Worksheet 5) ..
7 973 92,999   92,999 0.020 %
g Subsidized health services
(from Worksheet 6) ..
1   86,017   86,017 0.010 %
h Research (from Worksheet 7) 3 190 832,028   832,028 0.140 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) .... 1   10,000   10,000  
jTotal Other Benefits ... 20 1,884 3,732,094 9 3,732,085 0.630 %
kTotal. Add lines 7d and 7j. .. 20 93,061 138,051,088 82,770,233 55,280,855 9.310 %
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            
4 Environmental improvements 1   510   510  
5 Leadership development and training for community members            
6 Coalition building 1   9,000   9,000  
7 Community health improvement advocacy            
8 Workforce development 2 84 10,237   10,237  
9 Other            
10 Total 4 84 19,747   19,747  
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
Yes
 
2
Enter the amount of the organization's bad debt expense........
2
11,594,760
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
222,952,453
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
247,316,325
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-24,363,872
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)
0 Eastern Maine Medical Center
489 State Street
Bangor,ME04401
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)
Eastern 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 Yes  
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 Yes  
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 Yes  
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5 Yes  
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   No
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: 200.0000%
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: 300.0000%
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?12
Name and address Type of Facility (describe)
1 Lafayette Family Cancer Center
33 Whiting Hill Road
Brewer,ME04412
Med Office Building-Cancer treatment
2 EMMC-Phy Prac in Webber Bld
417 State Street
Bangor,ME04401
Med Ofice Building-physician svc
3 EMMC-Gynecology Associates
404 State St Suite 310
Bangor,ME04401
Med Office Building-physician svc
4 EMMC-ME Urologic Surgery of ME
55 Broadway Suite 2
Bangor,ME04401
Med Office Building-physician svc
5 EMMC-Neuropsychology of ME
824 Stillwater Ave Ste B
Bangor,ME04401
Med Office Building-physician svc
6 EMMC Orono Family Medicine
84 Kelly Road
Orono,ME04473
Med Office Building-physician svc
7 Husson Family MedPedInternal
302 Husson Ave
Bangor,ME04401
Med Office Building-physician svc
8 Lincoln Lake Regional Dialysis
250 Enfield Rd
Lincoln,ME04457
Med Office Building-outpatient svc
9 EMMC-Sleep Center of Maine
290 State Street
Bangor,ME04401
Med Office Building-outpatient svc
10 EMMC-Family Medicine of Brewer
234 State Street
Brewer,ME04412
Med Office Building-physician svc
11 EMMC-Ellsworth Dialysis
11 Short Street
Ellsworth,ME04605
Med Office Building-dialysis svc
12 Eastern Maine Healthcare Mall
885-925 Union Street
Bangor,ME04401
Medical Office Building - physician svc,
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
  Part VI - Additional Information Part II, line 4 - Community Building ActivitiesThrough public health screenings, professional and community education, and charity care, EMMC, as a member of EMHS system, works hard to make a difference in our community. These community benefits reflect EMMC's nonprofit mission. Eastern Maine Medical Center demonstrated its ongoing commitment to improving the health status of Maines workforce by renewing its regional sponsorship of the Wellness Council of Maine. Largely as a result of the work of this group, our region was designated as the nation's first ""Well Region"" with many employers qualifying as ""Well Workplaces"" under the Wellness Councils of America criteria. Having earned, for the second time, the Wellness Councils of Americas Platinum Well Workplace Award (Welcoa's highest honor), EMMC is investing both inside its own walls and outside to promote healthy choices, healthy lifestyles, and lower healthcare costs. For FY2012, EMMC delivered a total community benefit of more than $79.9 million.
  Part V - Explanation of Number of Facility Type N/A
  Part VI - States Where Community Benefit Report Filed ME
  Part VI - Affilated Health Care System Roles and Promotion Using the data in the EMHS Community Health Needs Assessment, EMMC collaborates with other EMHS hospitals and with others in the community on solutions to some of most significant healthcare problems such as overcoming barriers accessing to care, healthcare provider shortages, and obesity. EMMC is reaching out to providers across the region to formulate strategies for better patient access to care, including improved scheduling, aggressive recruiting of physicians, and enhanced communication regarding care transitions. With the help of technology, such as tele-trauma, specialists at our hospital are able to assist with traumas and specialized clinical cases at other hospitals using high resolution, remote cameras and communication equipment. With a shortage of healthcare providers in rural areas of Maine, investments such as this are sharing specialty level medical and surgical resources with rural communities, maximizing our region's ability to respond to medical needs and, when appropriate, supporting patient care closer to home.
  Part VI - Community Building Activities EMMC's Wellness Services offers a wide variety of health and wellness programs designed to improve the lifestyles of people in the Bangor area. The goal is to support families, and communities to live healthier lives. Through these programs, EMMC promotes and provides guidance for healthy lifestyles and the prevention of disease. Trained and certified staff work with area organizations, employers, youth and the community at large, to help determine health needs through health risk appraisals, culture and interest surveys, and/or other data as available. Education, screenings, health coaching, training and collaboration with all resources within Eastern Maine Medical Center and EMHS are provided to meet the community or individual business needs. EMMC continues to be committed to investing in Maine's future health through the Way to Optimal Weight (WOW) program for children -- a program that coaches children with morbid obesity to address their weight and resulting other health issues,by improving eating and fitness habits, boosting self esteem, and engaging in family coaching. EMMC also hosts a number of support groups that provide education and a support system to our patients and their families afflicted with certain illnesses and conditions.
  Part VI - Community Information EMMC is a comprehensive, 411-bed medical center serving the greater Bangor area and the northern two thirds of Maine. The medical center and its medical staff of more than 400 physicians provide three-quarters of the primary-care hospital services offered in the Bangor area, as well as specialty and intensive services for patients from Waterville to the Canadian border. EMMC also provides outreach clinics to many local hospitals in the region, allowing easier access for patients and supporting the role of those hospitals in their communities. EMMC is an American College of Surgeons verified Level II trauma center, bariatric center, community cancer center and host of Lifeflight of Maine, a statewide medical helicopter service that transports critically ill and injured patients. EMMC is also a Joint Commission certified Joint Center and Stroke Center. In the Community Health Needs Assessment for EMHS, it states: 1) Penobscot County has the highest percentage of females in any county with no medical checkup in the past two years. 2) Penobscot County has the highest percentage of obese residents of any county. 3) Penobscot County has a low percentage of males 50+ who've received a prostate exam within the past two years.
  Part VI - Patient Education of Eligibility for Assistance Financial assistance or free care is available only for medically necessary services. Posters are displayed in patient care areas, information and forms are available online on the hospital website, and patient billing representatives are also available to answer questions and take calls.
  Part VI - Needs Assessment The EMHS Community Health Needs Assessment examines the health status of the residents of Bangor and Penobscot, counties and provides comprehensive research data and recommendations on a variety of critical target areas including community health education, access to primary care, care for chronic conditions, geriatric care, and mental health and substance abuse. As a follow up to the studies conducted in 2001 and 2007, EMHS contracted with the Center for Health Policy, Planning and Research (CHPPR) at the University of New England (led by Ron Deprez, PhD. MPH) to determine changes in health status and barriers to care since 2001. The 2007 Community Health Needs Assessment was funded again as a community service of Healthcare Charities, the philanthropic center of EMHS. EMHS participated in another Community Health Needs assessment in late 2010. Those results were made available in 2011, and in late June of 2011, EMMC, as a member of EMHS, hosted a community health needs assessment forum at the Spectacular Event Center in Bangor so community leaders and public health officials could discuss a collaborative effort to best address the needs of residents in Penobscot County. EMMC also had representatives at several other community forums since we serve as the leading tertiary referral center for the northern two-thirds of the state. In 2012, we continued the implementation of the strategies developed in that process.
Number of Hospital Faciltiy - 0 Part V, Line 19d - Other Billing Determination of Individuals Without Insurance 19d. Hospital charges are discounted at 100% for patients who qualify for free care with income at or below 200% FPL.
Number of Hospital Faciltiy - 0 Part V, Line 13g - Other Means Hospital Facility Publicized the Policy 13g. Posted signs and individual notices containing information on the availability of free care are located in key public areas in the hospital. Signs and notices inform the patient of the availability of free care and include eligibility criteria, instructions on how to apply and how to obtain additional information or assistance. The "Billing Help" section of the hospital web pages provides a link to the free care application form, instructions and eligibility criteria.
Number of Hospital Faciltiy - 0 Part V, Line 7 - Explanation of Needs Not Addressed and Reasons Why - Increase capacity for detox, because other organizations in the community, including Acadia Hospital have taken on that responsibility and we need to avoid duplication.- Payment reform was mentioned several times in these group discussions, and though EMMC can advocate for changes in the payment structure to support primary and secondary prevention, and participate in collaborative efforts like the Bangor Beacon Community and development of Accountable Care Organizations, this is not a need that we can address on our own.
Number of Hospital Faciltiy - 0 Part V, Line 6i - Describe Other Needs Identified 6a. Eastern Maine Medical Center plans to meet the prioritized needs through the following initiatives and resources:6b. Continued sponsorship and mentoring of the Wellness Council of Maine-EMMC is the regional sponsor of this initiative that brings wellness coaching and initiatives into the workplace.6c. Continued to be an active partner in the Bangor Beacon Community initiative which brings together a variety of care providers and stakeholders in the community to better coordinate care, educate consumers, encourage earlier access to medical care and better management of chronic disease with the goal of a healthier population and reduced use of emergency intervention.6d. Ongoing work in our primary care provider offices (all of which are patient centered medical homes) with regard to coaching on primary prevention of at risk populations and care management for secondary prevention in those with chronic disease. Integration of Mental Health/Substance Abuse services into primary care setting. Expanding use of Care Managers/coordinators in accordance with demonstrated success of Bangor Beacon Community.6e. Ongoing efforts to recruit as well as fund the Family Practice Residency Program (about half those who complete this program choose to set up practice here in the region). Increase family practice provider options in the community, including planning for new office in Hampden and recruiting additional primary care practitioners to our region.6f. Continue to develop and grow the Way to Optimum Weight (WOW) Program for children with obesity related illness. This three year old program is showing significant promise in introducing sustainable behavior change in children with obesity.6g. Breakout #1 - Access, Quality and Effectiveness - Access to clinic and coaching services in the workplace- Tethering resources to primary care, more collaboration, more consistency in the models used in primary care settings- Consumer "triage" problematic, knowing when to use primary care and when to access Walk In or Emergency- Leverage electronic medical record systems to connect providers, increase continuity- Increase preventive care compliance among men- Need additional primary care physicians in region- Episodes of care must link back to patient's medical homeBreakout #2 - Chronic Disease - Increased community conversation about chronic disease and management resources- Increased education of physician community regarding resources- Better management in community settings will decrease hospitalizations and improve CHNA results next time- Health literacy and prevention educationBreakout #3 - Mental Health and Substance Abuse - Over prescribing of medications /use "small volume" prescriptions- Increased coordination of mental health/substance abuse treatment, including coaching/care management for relapse prevention- Increased capacity to detox patientsBreakout #4 - Prevention, Obesity - Online resource for providers needed- Multifaceted approach- Need to decrease youth obesity rates/prevention is key
Number of Hospital Faciltiy - 0 Part V, Line 5c - Description of Making Needs Assessment Widely Available In conjunction with EMHS, Eastern Maine Medical Center hosted a community forum to present an overview of local assessment results and recommendations. Invitees included: Other area hospitals, Physician leaders, Federally Qualified Health Centers, Healthy Maine Partnerships, District Liaisons linked to Maine CDC, Home Health and Long Term Care leaders, Social Service Agencies, Leaders of the tribal communities, Business leaders, Legislative leaders, Representatives of the State administration.Attendees were provided an executive summary of the assessment as well as a summary table of data reflective of the service area. A presentation was made by EMHS staff who were members of the assessment development steering committee providing selected data results, trends over time and the priorities and recommendations as suggested by the research consultants.In addition to the community forums, the entire statewide assessment (both narrative and data sets) were posted to the EMHS website. After the forums, Power Point presentations used at the Forum as well as input collected in the breakout sessions were also posted on the website. Forum participants were encouraged to go to the website to review the assessment in detail, and access the data for local planning. Media releases were also sent to local news outlets in combination with the forums, encouraging new articles on the forum and inviting all members of the public to view the report on the website.Instructions on the website assist viewers to download and /or print sections of the report. Individuals without computer or printer access were provided a phone number where they can request a printed assessment.
Number of Hospital Faciltiy - 0 Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment The needs assessment was developed as a statewide collaborative between the state's three largest health systems: EMHS (in central, eastern and northern Maine), MaineGeneral (in central Maine) and MaineHealth (in southern Maine). Multiple collaborators were involved in the dissemination of the assessment findings and establishment of priorities (see Section 5).
Number of Hospital Faciltiy - 0 Part V, Line 3 - Account Input from Person Who Represent the Community On a statewide basis, the research consultants developed an advisory committee that met two times during the assessment research and drafting of the publication. These individuals represented a broad spectrum of backgrounds, and they are named: Carol Bell, Healthy Maine Partnership Director; Kelly Bentley, Healthy Maine Partnership Director; Gail Dana-Sacco, Wabanaki Center (serving tribal populations); Patricia Hart, Maine Development Foundation; Barbara Leonard, MPH, Maine Health Access Foundation (philanthropic foundation focused on access to care in Maine); Becca Matusovich, Maine Center for Disease Control; Lisa Miller, Bingham Foundation (philanthropic foundation); Dora Ann Mills, MD, Maine Center for Disease Control; Elizabeth Mitchell, Maine Health Management Coalition (representing the state's major employers, insurers and providers); Trish Riley, Governor's Office of Health Policy and Finance (GOHPF); Brian Rines, Advisory Committee for Health System Development (overseen by GOHPF); Rachel Talbot-Ross, Maine Chapter, NAACP; Ted Trainer, Public Health Coordinating Council Shawn Yardley, City of Bangor, Department of Health and Welfare.
Number of Hospital Faciltiy - 0 Part V, Line 1j - Description of Other Needs Assessment 1a. EMMC's primary service area includes the contiguous towns in the Greater Bangor area. While EMMC has a tertiary mission that encompasses a larger geographic area, and we do collaborate with primary providers in more distant regions, the needs assessment identifies largely primary healthcare issues -- the purview of primary hospitals--so we have foused on our primary service area.1b. Eastern Maine Medical Center and its related physician practices utilize extensive electronic medical records, including disease registries, which provide a vast amount of data relative to patients in care. The needs assessment provides a much broader picture of the community as a whole, including the health status of individuals not in care, as well as functional health status and social-demographics (such as employment, income and education levels). The local units of the state's public health infrastructure (known as Healthy Maine Partnerships) are also integrated into the process so that their data relative to health, environmental and social measures are part of the community dissemination process.1c. Eastern Maine Medical Center engaged multiple health resource leaders in the community forum invitation list (as described in Section 1g). Additional resources and leaders needed were identified in the breakout sessions (see question for breakout participants, Section 1g). In the EMMC primary service area, key collaborators going forward will include: EMMCPenobscot Community Health CenterSt. Joseph HospitalCommunity Health and Counseling ServicesAcadia HospitalOthers involved in the Beacon Community1d-1e-1f. EMHS, the parent company of Eastern Maine Medical Center, routinely conducts a community health needs assessment (Hereafter needs assessment) across the service area of all of its member hospitals. The most recent assessment, published in 2011, was conducted under a contract with the University of New England Center for Health Planning, Policy and Research (CHPPR) and the University of Southern Maine's Muskie School for Public Health. Using a methodology developed by CHPPR over decades of work, the assessment integrates primary data from a telephone survey to heads of households with secondary data retrieved from state databases (ED usage, Mortality, Cancer Registry, etc.). That data is reviewed in the context of multiple health related domains to develop a composite view of health status, behavioral risks, and barriers to access and care. Results are compared to national and state benchmarks to produce priorities and recommendations as prepared by the consultants.1g. See question #31h. On a statewide basis, the research consultants developed an advisory committee that met two times during the assessment research and drafting of the publication. These individuals represented a broad spectrum of backgrounds, and they are named: Carol Bell, Healthy Maine Partnership Director; Kelly Bentley, Healthy Maine Partnership Director; Gail Dana-Sacco, Wabanaki Center (serving tribal populations); Patricia Hart, Maine Development Foundation; Barbara Leonard, MPH, Maine Health Access Foundation (philanthropic foundation focused on access to care in Maine); Becca Matusovich, Maine Center for Disease Control; Lisa Miller, Bingham Foundation (philanthropic foundation); Dora Ann Mills, MD, Maine Center for Disease Control; Elizabeth Mitchell, Maine Health Management Coalition (representing the state's major employers, insurers and providers); Trish Riley, Governor's Office of Health Policy and Finance (GOHPF); Brian Rines, Advisory Committee for Health System Development (overseen by GOHPF); Rachel Talbot-Ross, Maine Chapter, NAACP; Ted Trainer, Public Health Coordinating Council Shawn Yardley, City of Bangor, Department of Health and Welfare. In the local area served by the assessment, multiple parties were engaged in dissemination of the assessment findings and establishment of priorities (see Section 5).Part V, Line 2, Indicate the tax year the hospital facility last conducted a Needs Assessment.As a result of a software defect the 2011 tax year is not populating.
  Part III, Line 9b - Provisions On Collection Practices For Qualified Patients All account guarantors who express an inability to pay inpatient and outpatient services will be screened for eligibility for charity care using an application and guidelines established by Eastern Maine Medical Center. An account may be reconsidered for charity care at any time when new information is available about a patients inability to pay.
  Part III, Line 8 - Explanation Of Shortfall As Community Benefit Medicare losses should be treated as a community benefit because the losses are incurred in performing an important public service, and Maine hospitals experience one of the lowest Medicare reimbursement rates in the country.
  Part III, Line 4 - Bad Debt Expense Patient and trade accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to earnings and a valuation allowance based on its assessment of the current status of individual accounts. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and the applicable patient accounts receivable. Credit is extended without collateral. The costing methodology used to determine the amount reported on line 2 is cost to charge ratio.
  Part I, Line 7, Column F - Explanation of Bad Debt Expense $25,274,044 of bad debt expense, $23,648,543 of charity care, $548,435,397 of contractual allowances is included on Form 990, Part IX, line 25, column (A).
  Part I, Line 7 - Explanation of Costing Methodology Worksheet 2, Ratio of Patient Care Cost-to-Charges is used in calculation
  Part I, Line 6a - Related Organization Community Benefit Report The EMMC community benefit report is contained in an annual community benefit report prepared by Eastern Maine Healthcare Systems which is the parent organization of all related organizations.
Schedule H (Form 990) 2011
Additional Data


Software ID: 11000144
Software Version: 2011v1.5
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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
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
Yes
 
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
Yes
 
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
 
No
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) Wayne R Waterman MD (i)
(ii)
685,279
 
76,833
 
24,322
 
4,889
 
20,828
 
812,151
 
 
 
(2) Scott Oxley (i)
(ii)
 
244,322
 
20,880
 
17,914
 
17,316
 
19,957
 
320,389
 
 
(3) Robert A Clough MD (i)
(ii)
767,561
 
300
 
20,424
 
19,600
 
15,435
 
823,320
 
 
 
(4) Michael P Donahue (i)
(ii)
243,885
 
21,714
 
10,289
 
21,469
 
10,275
 
307,632
 
 
 
(5) Michael A Johnson MD (i)
(ii)
625,056
 
515,662
 
17,310
 
17,150
 
16,887
 
1,192,065
 
 
 
(6) Mary M Hood PresidentCEO (i)
(ii)
 
637,564
 
235,578
 
13,325
 
213,458
 
17,111
 
1,117,036
 
 
(7) Lorraine Rodgerson (i)
(ii)
151,073
 
17,014
 
43,342
 
20,802
 
13,887
 
246,118
 
 
 
(8) Julie Long MD (i)
(ii)
476,465
 
300
 
11,116
 
8,575
 
11,866
 
508,322
 
 
 
(9) John D Klemperer MD (i)
(ii)
553,199
 
22,820
 
1,792
 
17,150
 
20,099
 
615,060
 
 
 
(10) Jill McDonald (i)
(ii)
170,831
 
9,688
 
1,792
 
10,798
 
12,531
 
205,640
 
 
 
(11) James W Turner MD (i)
(ii)
532,534
 
300
 
49,209
 
11,025
 
15,665
 
608,733
 
 
 
(12) James A Raczek MD (i)
(ii)
339,440
 
27,201
 
19,279
 
22,050
 
14,854
 
422,824
 
 
 
(13) Iyad Sabbagh MD (i)
(ii)
227,706
 
300
 
883
 
12,583
 
24,441
 
265,913
 
 
 
(14) Helen Q McKinnon RN (i)
(ii)
209,990
 
16,183
 
2,987
 
22,046
 
19,870
 
271,076
 
 
 
(15) Glenn Martin VP Gen Counsel (i)
(ii)
 
238,440
 
25,014
 
1,554
 
15,289
 
23,489
 
303,786
 
 
(16) G Gregory Howat Esq (i)
(ii)
202,426
 
17,370
 
23,433
 
18,192
 
23,902
 
285,323
 
 
 
(17) Elmer Doucette VPCFO (i)
(ii)
221,851
 
17,531
 
7,485
 
16,515
 
20,730
 
284,112
 
 
 
(18) Deborah Carey Johnson CEO (i)
(ii)
438,151
 
58,434
 
12,904
 
487,158
 
21,401
 
1,018,048
 
 
 
(19) Daniel B Coffey (i)
(ii)
 
368,115
 
61,031
 
21,387
 
29,400
 
15,509
 
495,442
 
 
(20) Ashley Robertson MD (i)
(ii)
248,676
 
43,782
 
40,119
 
12,608
 
9,933
 
355,118
 
 
 
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
Sch J, Part I, Line 1a Part I, Line 1a: Relevant information in regards to selections on 1a. Michael Donahue, officer and John D. Klemperer, MD, highly compensated employee received an employee stipend towards a fitness center. The taxable benefit for each was for $130. Helen McKinnon, officer received an employee stipend towards a fitness center for partial year. The taxable benefit for her was for $32.50. The benefit is available for all employees. The EMMC Employee Wellness Department structured a Fitness Center Network for EMMC employees. Any EMMC employee who participates in wellness activities at an EMMC Fitness Center Network health club or health facility shall receive a discount at the facility, and will be reimbursed for their participation by EMMC on a bi-weekly or yearly basis at one facility.
Schedule J (Form 990) 2011

Additional Data


Software ID: 11000144
Software Version: 2011v1.5
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
Eastern Maine Medical Center
 
Employer identification number
01-0211501
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 Maine Health and Higher Educational Facilities Authority
 
01-0314384 560427GZ3 04-22-2010 72,656,251 Refund 1998 & 1999 issue, Outpatient Cancer Center, Parking   X   X X  
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . .        
2 Amount of bonds legally defeased . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . 76,541,297      
4 Gross proceeds in reserve funds . . . . . . . . 5,354,450      
5 Capitalized interest from proceeds . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . 26,480,000      
7 Issuance costs from proceeds . . . . . . . . . . . 652,336      
8 Credit enhancement from proceeds . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . 39,500,000      
11 Other spent proceeds . . . . . . . . . . . 4,554,511      
12 Other unspent proceeds . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . .   X            
15 Were the bonds issued as part of an advance refunding issue? . . . . X              
16 Has the final allocation of proceeds been made? . . . . . . X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . 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            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   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            
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? . . . . .                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .   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? .                
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              
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              
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            
2 Is the bond issue a variable rate issue?   X            
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider . . . . . . . . NA
 
 
 
 
 
 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .   X            
b Name of provider . . . . . . NA
 
 
 
 
 
 
 
c Term of GIC . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .                
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .   X            
6 Did the bond issue qualify for an exception to rebate? .   X            
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   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
Schedule K (Form 990) 2011

Additional Data


Software ID: 11000144
Software Version: 2011v1.5

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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
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
(1) Ashley Robertson MD
physician loan
  X 113,654 11,369   No   No Yes  
(2) James W Turner MD
physician loan
  X 93,171 23,063   No   No Yes  
(3) Wayne R Waterman MD
physician loan
  X 40,000 23,970   No   No Yes  
Total ...............Small Bullet $ 58,402
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) Helen Q McKinnon officer=bd member 727,173 condo fee expense   No
(2) Colette Sabbagh spouse of bd memb 108,485 compensation   No
(3) Mary M Hood officer=board memb 247,171 membership dues-MHA   No
(4) Sheryl Winchester spouse of officer 95,405 compensation   No
(5) David L Levy MD trustee=25% owner/treasur 233,892 prof srv-Northeast Nephro   No
(6) Susan Dow fam mem of officer 109,066 compensation   No
(7) Deborah C Johnson officer=brd member 179,546 nursing prog assis-Husson   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
    Deborah C. Johnson, officer is a board member of Husson University. EMMC had business transactions with Husson University during the fiscal year.Susan Dow is a family member of an officer and is an employee of EMMC.David L. Levy, MD, trustee is Treasurer and 25% owner of Northeast Nephrology, PA. EMMC had business transactions with Northeast Nephrology, PA during the fiscal year.Sheryl Winchester is a family member of an officer and is an employeee of EMMC.Mary M. Hood, officer is a board member of Maine Hospital Association. EMMC had business transactions with Maine Hospital Association during the fiscal year.Colette Sabbagh is a family member of a board member and is an employee of EMMC.Helen Q. McKinnon, officer is a board member of Webber Condo Association. EMMC had business transactions with Webber Condo Association during the fiscal year.
Schedule L (Form 990 or 990-EZ) 2011

Additional Data


Software ID: 11000144
Software Version: 2011v1.5




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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
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 .... X 1 50 FMV
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications .. X 300 FMV
5 Clothing and household
goods .......
X 905 FMV
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
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 1 1,125 FMV
19 Food inventory ... X 20 8,092 FMV
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( Jewlery ) X 1 1,799 FMV
26 Other Right pointing arrow large image ( Golf Balls ) X 1 60 FMV
27 Other Right pointing arrow large image ( Coffee Machine ) X 1 500 FMV
28 Other Right pointing arrow large image ( Bike ) X 1 2,330 FMV
Other Right pointing arrow large image ( Toys ) X 2 925 FMV
Other Right pointing arrow large image ( Wigs ) X 4 919 FMV
Other Right pointing arrow large image ( Gift Cert ) X 18 8,110 FMV
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
Schedule M (Form 990) 2011
Additional Data


Software ID: 11000144
Software Version: 2011v1.5
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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
Identifier Return Reference Explanation
Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Eastern Maine Medical Center makes its governing documents, conflict of interest policy and financial statements available to the public upon request.
Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees Compensation of other officers and key employees of the organization is established by the Human Resources department who utilize external market research to establish compensation ranges for specific positions. The compensation of officers and key employees are reviewed by the system President/CEO and EMMC Executive & Finance committee. On an annual basis, the compensation ranges are compared to the updated survey information. The hiring manager will determine where the employee will fall within the ranges established by the Human Resources department based on experience and credentials.
Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The organization requests updates of potential conflicts and relationships from the officers and Board members on an annual basis. The request requires disclosure of all business relationships, board memberships, and family relationships. A database is maintained that is compared to payroll records and the accounts payable vendor list to identify any potential conflicts of interest. Transactions are reviewed for reasonableness as an arm's length transaction. The first agenda item for board meetings and board committee meetings is for members to declare any conflict of interest with upcoming agenda items or deliberations. At any point when consideration is being given to purchase/contract with a party in interest, the member with the conflict is either excused from the discussion and consideration process or abstains from voting on the matter. All transactions identified with parties in interest are disclosed within the Form 990. All are deemed to be arm's length transactions.
Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process Form 990 is reviewed by the CFO of Eastern Maine Medical Center. It is provided to each board member either electronically or in hard copy and was reviewed at the July 24, 2013 meeting of the board of trustees prior to filing with the IRS.
Form 990, Part VI, Line 7b Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders EMHS has authority to approve or disapprove amendments to the Corporation's articles of incorporation, amendments to its bylaws, its budget and its strategic plan, and to appoint and remove the president of the Corporation.
Form 990, Part VI, Line 7a Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body Each year at their annual meeting, the directors elect replacements for those directors whose terms are expiring Election of directors is subject to ratification by EMHS.
Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Eastern Maine Medical Center (the "Corporation") is a Maine nonprofit corporation. Eastern Maine Healthcare Systems ("EMHS"), also a Maine nonprofit corporation, is the sole corporate member of the Corporation.
Form 990, Part VI, Line 4 Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents The organization amended the bylaws; Article V, Committees; Section 10.3, Nominating to include: "Only members of the Committee who are "independent" (as defined in Article VIII) and not up for re-election may participate in the nomination process. If there are not at least three (3) such Committee members, the Chair may appoint one or more Board members who are so qualified to participate in the nomination process."
Form 990, Part VI, Line 2 Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Gary Eckmann, trustee and John M. Long, MD, trustee are board members of Ronald McDonald House.
Form 990, Part III, Line 4d Form 990, Part III, Line 4d : Other Program Services Description OTHER PROGRAM SERVICES 4: Provide healthcare services regardless of ability to pay as well as education, research and promotion of health. Provided other uncompensated care (at cost) of $11,594,760.Eastern Maine Medical Center (EMMC) has served communities throughout our region for 120 years. Under community direction, it has grown from a five-bed general hospital into a comprehensive, 411 bed tertiary medical center with primary and secondary care components. EMMC is a nonprofit hospital, serving all who need care, regardless of ability to pay.EMMC also provides outreach clinics to many local hospitals in the region, allowing easier access to patients and supporting the role of those hospitals in their communities. EMMC provides access to medical data to hospitals across the State through its PACS system, helping to improve the quality of care patients receive. Additional information can be found at EMMC's website: www.emmc.org.Additional StatisticsTotal admissions 21,533Percent Occupancy of Available Beds 78.5%Cardiac Catherization Procedures 5,597Cardiac Surgery Cases 381Emergency Room Visits 40,223Medical Imaging Procedures 146,225Surgery Cases 18,742Live Births 1,644Family Practice Visits 30,801Total Outpatient Visits 414,750Patient Days 106,059Services provided to those who could not pay $48,922,587 OTHER PROGRAM SERVICES 5: Please see the following excerpt from the EMHS Annual Report to the Community for details of community benefit projects by EMMC.Leadership: Deborah Carey Johnson, RN, President and CEO; Michael J. McInnis, ChairLocation: Bangor, Brewer, OronoEmployees: 3745 Description: Eastern Maine Medical Center is the 411-bed regional referral center for the northern two-thirds of Maine, offering specialty and sub-specialty surgical and medical services, as well as a full range of primary to intensive care services.Eastern Maine Medical Center Highlights- Received approval from the EMHS Board of Directors to move forward with a modernization project that will bring updates to surgery, cardiac, and women and infants services, benefiting patients from throughout the region who receive care at EMMC.- Trauma Program re-verified as a Level II Trauma Center by the American College of Surgeons Committee on Trauma.- Recognized as the first, and only, general and bariatric robotic surgery epicenter in the nation.- Named one of the nation's 100 Most Wired Hospitals, according to Hospitals & Health Networks magazine, the flagship publication of the American Hospital Association.- Earned an "A" Hospital Safety Score (the highest possible rating) from The Leapfrog Group, an independent national nonprofit run by employers and other large purchasers of health benefits.- Stroke Center earned the Get With The Guidelines-Stroke Gold Plus Achievement Award and Target Stroke Award for their commitment to providing high quality healthcare.Total Community Benefit: $79,664,474Community Health Improvement Services: $1,111,041Health Professions Education: $92,999Subsidized Health Services: $86,017Research: $832,028Financial and In-Kind Contributions: $10,000Community Building Activities: $19,747Community Benefit Operations: $1,600,000Unrecoverable interest cost on funds used to subsidize state MaineCare/Medicaid underpayments of $76.7M; $7,491,400Traditional Charity Care: $10,680,855Unpaid Cost of Public Programs: Medicaid: $33,376,515 Medicare: $24,363,872Philanthropy: $2,157,143 OTHER PROGRAM SERVICES 6: OTHER PROGRAM SERVICES 7:
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: 11000144
Software Version: 2011v1.5
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
Eastern Maine Medical Center
 
Employer identification number

01-0211501
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) Sebasticook Valley Work Health LLC

447 North Main Street

Pittsfield,ME04967
45-3359446
Provide patient care ME 501(c)(3) 3 SVH
 
Yes
 
(2) Capitol Convenient Care LLC

43 Whiting Hill Road Ste 500

Brewer,ME04412
27-3671960
Provide patient care ME 501(c)(3) 11, Type II EMHS
 
Yes
 
(3) Beacon Health LLC

43 Whiting Hill Road

Brewer,ME04412
45-2967056
Accountable care organization ME 501(c)(3) 11, Type II EMHS
 
Yes
 
(4) Sebasticook Valley Health Convenient Car

447 North Main Street

Pittsfield,ME04967
27-3129791
Provide patient care ME 501(c)(3) 3 SVH
 
Yes
 
(5) Sebasticook Valley Family Practice Assoc

447 North Main Street

Pittsfield,ME04967
01-0357854
Provide patient care ME 501(c)(3) 9 SVH
 
Yes
 
(6) Inland Family Practice Associates LLC

200 Kennedy Memorial Drive

Waterville,ME04901
27-2942245
Provide patient care ME 501(c)(3) 3 Inland Hospital
 
Yes
 
(7) Meadow Wood LLC

43 Whiting Hill Road

Brewer,ME04412
27-2935243
Provide patient care ME 501(c)(3) 9 AHI
 
Yes
 
(8) Blue Hill Memorial Hospital

57 Water Street

Blue Hill,ME046145231
01-0227195
Provide healthcare services ME 501(c)(3) 3 EMHS
 
Yes
 
(9) Maine Institute for Human Genetics and H

43 Whiting Hill Road

Brewer,ME04412
55-0894346
Biomedical research and development ME 501(c)(3) 9 EMHS
 
Yes
 
(10) Eastern Maine HomeCare

PO Box 688

Caribou,ME04736
01-0328442
Provide home health and hospice services ME 501(c)(3) 9 EMHS
 
Yes
 
(11) Horizons Health Services

PO Box 151 140 Academy Street

Presque Isle,ME047690151
01-0504393
Provide patient care ME 501(c)(3) 3 TAMC
 
Yes
 
(12) TAMC Endowments

PO Box 151 140 Academy Street

Presque Isle,ME047690151
01-0389222
Raise funds for exempt organizations ME 501(c)(3) 11, Type I TAMC
 
Yes
 
(13) TAMC Title Corp

PO Box 151 140 Academy Street

Presque Isle,ME047690151
01-0389226
Real estate holding company ME 501(c)(2)   TAMC
 
Yes
 
(14) The Aroostook Medical Center TAMC

PO Box 151 140 Academy Street

Presque Isle,ME047690151
01-0372148
Provide healthcare services ME 501(c)(3) 3 EMHS
 
Yes
 
(15) Sebasticook Valley Health SVH

447 North Main Street

Pittsfield,ME04967
01-0263628
Critical care hospital ME 501(c)(3) 3 EMHS
 
Yes
 
(16) CA Dean Memorial Hospital

Pritham Avenue PO Box 1129

Greenville,ME044411129
04-3341666
Provide healthcare services ME 501(c)(3) 3 EMHS
 
Yes
 
(17) Lakewood A Continuing Care Center

220 Kennedy Memorial Drive

Waterville,ME04901
01-0421234
Provide skilled and long-term nursing care ME 501(c)(3) 3 Inland Hospital
 
Yes
 
(18) Inland Hospital

200 Kennedy Memorial Drive

Waterville,ME04901
01-0217211
Provide healthcare services ME 501(c)(3) 3 EMHS
 
Yes
 
(19) Norumbega Medical Specialists LTD

43 Whiting Hill Rd Ste 400

Brewer,ME04412
01-0465231
Provide patient care and education ME 501(c)(3) 9 EMMC
 
Yes
 
(20) EMHS Foundation

43 Whiting Hill Road Ste 400

Brewer,ME04412
22-2514163
Raise and manage funds for exempt organizations ME 501(c)(3) 11, Type II EMHS
 
Yes
 
(21) Acadia Healthcare Inc

43 Whiting Hill Road

Brewer,ME04412
22-3183888
Provide healthcare services ME 501(c)(3) 9 AHC
 
Yes
 
(22) Eastern Maine Medical Center Auxiliary

43 Whiting Hill Road

Brewer,ME04412
01-0377901
Fund raising for exempt Eastern Maine Medical Center ME 501(c)(3) 9 EMMC
 
Yes
 
(23) Acadia Hospital Corp AHC

43 Whiting Hill Road

Brewer,ME04412
01-0459837
Provide healthcare services ME 501(c)(3) 3 EMHS
 
Yes
 
(24) Eastern Maine Healthcare Systems EMHS

43 Whiting Hill Road

Brewer,ME04412
01-0527066
Supporting organization for healthcare affiliates ME 501(c)(3) 11, Type II N/A
Yes
 
(25) Rosscare Nursing Homes Inc

43 Whiting Hill Road

Brewer,ME04412
01-0430751
Operation of nursing homes ME 501(c)(3) 9 Rosscare
 
Yes
 
(26) Rosscare

43 Whiting Hill Road

Brewer,ME04412
01-0391038
Provide services to elderly ME 501(c)(3) PF EMHS
 
Yes
 
(27) Eastern Maine Healthcare Real Estate

43 Whiting Hill Road

Brewer,ME04412
01-0391036
Leases real estate ME 501(c)(2)   EMHS
 
Yes
 
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












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) Dirigo Pines Development Company LLC
9 Alumni Drive
Orono,ME04473
01-0537924
RetCottag ME AHS
 
C      
(2) Dirigo Funding LLC
9 Alumni Drive
Orono,ME04473
01-0599968
Prov Finance ME AHS
 
C      
(3) Dirigo Pines Inn LLC
9 Alumni Drive
Orono,ME04473
02-0547749
Contin Care ME Rosscare
 
C      
(4) Dirigo Pines Retirement Community LLC
9 Alumni Drive
Orono,ME04473
01-0537924
Holding Co. ME AHS
 
C      
(5) Maine Network for Health
PO Box 2813
Bangor,ME044022813
01-0496352
Support srv ME EMHS
 
C      
(6) Meridian Mobile Health LLC
931 Union St PO Box 940
Bangor,ME044020940
01-0512673
Ambulance ME AHS
 
C      
(7) DE Collections DBA Affiliated Collecti
PO Box 2759
Bangor,ME044022759
01-0366209
Collections ME AHS
 
C      
(8) Affiliated Pharmacy Services
917 Union St Suite 7
Bangor,ME04401
01-0587230
Pharmacy ME AHS
 
C      
(9) Affiliated Materiel Services
PO Box 1300
Bangor,ME044021300
01-0381189
Purchasing ME AHS
 
C      
(10) Affiliated Laboratory Inc
PO Box 638
Bangor,ME044020638
01-0381283
Clinicl lab ME AHS
 
C      
(11) Affiliated Healthcare Management
PO Box 811
Bangor,ME044020811
01-0349339
Hlthcr mgmt ME AHS
 
C      
(12) Affiliated Healthcare Systems AHS
PO Box 940
Bangor,ME044020904
01-0385322
Holding co. ME EMHS
 
C      
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
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
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
 
No
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
Yes
 
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
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
 
No
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
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) Meridian Mobile Health LLC

l 487,500 FMV
(2) Meridian Mobile Health LLC

k 62,730 FMV
(3) Meridian Mobile Health LLC

a 12,000 FMV
(4) DE Collections DBA Affiliated Collecti

l 480,542 FMV
(5) Affiliated Materiel Services

o 21,320,498 FMV
(6) Affiliated Materiel Services

l 3,324,668 FMV
(7) Affiliated Laboratory Inc

l 15,844,607 FMV
(8) Affiliated Laboratory Inc

k 89,287 FMV
(9) Affiliated Healthcare Management

l 3,592,806 FMV
(10) Beacon Health LLC

k 217,761 FMV
(11) Blue Hill Memorial Hospital

k 809,666 FMV
(12) The Aroostook Medical Center TAMC

k 521,828 FMV
(13) Sebasticook Valley Health SVH

k 519,996 FMV
(14) CA Dean Memorial Hospital

k 178,640 FMV
(15) Inland Hospital

k 2,089,332 FMV
(16) Norumbega Medical Specialists LTD

k 978,390 FMV
(17) EMHS Foundation

r 2,403,726 FMV
(18) EMHS Foundation

l 1,600,000 FMV
(19) EMHS Foundation

j 125,266 FMV
(20) Eastern Maine Medical Center Auxiliary

k 185,083 FMV
(21) Acadia Hospital Corp AHC

o 135,979 FMV
(22) Acadia Hospital Corp AHC

l 1,046,996 FMV
(23) Acadia Hospital Corp AHC

k 544,957 FMV
(24) Eastern Maine Healthcare Systems EMHS

r 2,746,660 FMV
(25) Eastern Maine Healthcare Systems EMHS

q 973,260 FMV
(26) Eastern Maine Healthcare Systems EMHS

o 45,541,126 FMV
(27) Eastern Maine Healthcare Systems EMHS

l 35,427,217 FMV
(28) Eastern Maine Healthcare Systems EMHS

k 810,163 FMV
(29) Eastern Maine Healthcare Systems EMHS

j 3,714,410 FMV
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: 11000144
Software Version: 2011v1.5