Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
FRANKLIN MEMORIAL HOSPITAL |
010211503 | 3 | Yes | 291,677 | 0 | |
| (B)
GERIATRIC RESOURCE NETWORK |
010542842 | 7 | Yes | 0 | 0 | |
| (C)
LINCOLNHEALTH |
010153960 | 3 | Yes | 108,032 | 0 | |
| (D)
MAINE BEHAVIORAL HEALTHCARE |
010528434 | 3 | Yes | 71,593 | 0 | |
| (E)
MAINE MEDICAL CENTER |
010238552 | 3 | Yes | 818,912 | 0 | |
| (F)
MAINEHEALTH CARE AT HOME |
222571902 | 9 | Yes | 3,052 | 0 | |
| (G)
NORDX |
010511356 | 9 | Yes | 3,243 | 0 | |
| (H)
PENOBSCOT BAY MEDICAL CENTER |
010285286 | 3 | Yes | 250,093 | 0 | |
| (I)
SOUTHERN MAINE HEALTH CARE |
010179500 | 3 | Yes | 332,431 | 0 | |
| (J)
STEPHENS MEMORIAL HOSPITAL ASSOCIATION |
010219904 | 3 | Yes | 112,423 | 0 | |
| (K)
THE MEMORIAL HOSPITAL |
020222156 | 3 | Yes | 131,368 | 0 | |
| (L)
WALDO COUNTY GENERAL HOSPITAL |
010177170 | 3 | Yes | 177,674 | 0 | |
| Total 12 | 2,300,498 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART I, LINE 11H | MAINEHEALTH CARE AT HOME 22-2571902 9 X 3,052 0 NORDX 01-0511356 9 X 3,243 0 PENOBSCOT BAY MEDICAL CENTER 01-0285286 3 X 250,093 0 SOUTHERN MAINE HEALTH CARE 01-0179500 3 X 332,431 0 STEPHENS MEMORIAL HOSPITAL ASSOCIATION 01-0219904 3 X 112,423 0 THE MEMORIAL HOSPITAL 02-0222156 3 X 131,368 0 WALDO COUNTY GENERAL HOSPITAL 01-0177170 3 X 177,674 0 |
| PART IV, SECTION A, LINE 5A | (I) SUPPORTED ORGANIZATIONS ADDED: THE MEMORIAL HOSPITAL AT NORTH CONWAY, N.H., EIN 02-0222156 FRANKLIN COMMUNITY HEALTH NETWORK, EIN 02-0211503 (II) THE SUPPORTED ORGANIZATIONS ADDED WERE TAX-EXEMPT SUBSIDIARIES THAT JOINED THE MAINEHEALTH NETWORK. (III) THE ARTICLES OF INCORPORATION REQUIRE APPROVAL FROM THE BOARD OF CORPORATORS FOR MERGERS OF MAINEHEALTH WITH ANOTHER ENTITY AND AMENDMENTS TO THE ARTICLES OF INCORPORATION OF MAINEHEALTH. (IV) ARTICLES OF AMENDMENT WERE FILED OCTOBER 21, 2015 BY MAINEHEALTH TO CLARIFY THE CHARITABLE PURPOSES OF THE CORPORATION WITH RESPECT TO THE NAMES OF THE TAX-EXEMPT SUBSIDIARIES FOR WHICH MAINEHEALTH IS A SUPPORTING ORGANZATION. THE AMENDMENT WAS APPROVED BY THE MEMBERS AT A MEETING IN WHICH A QUORUM WAS PRESENT AND THE AMENDMENT RECEIVED AT LEAST A MAJORITY OF THE VOTES WHICH MEMBERS WERE ENTITLED TO CAST. |
| PART IV, SECTION A, LINE 6 | SEE SCHEDULE I FOR SUPPORT PROVIDED TO OTHER ORGANIZATIONS. |
| PART IV, SECTION E, LINE 3B | DECISIONS OF THE GOVERNING BODY SUCH AS BUDGETS, BUSINESS AND MARKETING STRATEGIC PLANS, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION, AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO APPROVAL BY MAINEHEALTH. |
| SUPPLEMENTAL INFORMATION | PART I, LINE 11G, COLUMN (VI): IN APRIL 2016, HOME HEALTH VISITING NURSES OF SOUTHERN MAINE FILED ARTICLES OF AMENDMENT FOR A NAME CHANGE TO MAINEHEALTH CARE AT HOME. MAINEHEALTH ALSO PROVIDES VARIOUS MANAGEMENT SERVICES TO ITS SUPPORTED ORGANIZATIONS INCLUDING; PROGRAM DEVELOPMENT SERVICES, INFORMATION TECHNOLOGY SERVICES, LEGAL SERVICES AND AUDIT & COMPLIANCE SERVICES. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | MAINEHEALTH WILL LEAD THE DEVELOPMENT OF THE PREMIER COMMUNITY CARE NETWORK THAT PROVIDES A BROAD RANGE OF INTEGRATED HEALTH CARE SERVICES IN MAINE AND NORTHERN NEW ENGLAND. THROUGH MAINEHEALTH'S AFFILIATED ORGANIZATIONS, THE NETWORK WILL ORGANIZE SERVICES ALONG THE FULL CONTINUUM OF CARE NECESSARY TO IMPROVE THE HEALTH STATUS OF THE POPULATIONS IT SERVES IN A COST EFFECTIVE MANNER. |
| FORM 990, PAGE 2, PART III, LINE 4B | (CONTINUED FROM PAGE 2 OF 990, LINE 4C) PROGRAMS IN INPATIENT CARE FOCUS ON SURGICAL QUALITY IMPROVEMENT, SEPSIS CARE, AMI, INFECTION PREVENTION, HOSPITAL MEDICINE, INFORMATICS AND PHARMACY AND THERAPEUTICS. WE HAVE PROGRAMS THAT FOCUS ON TRANSITIONS OF CARE SUCH AS EMERGENCY MEDICINE, REDUCING READMISSIONS, PRE-HOSPITAL CARE AND HEART FAILURE. IN ADDITION THERE ARE PROGRAMS THAT CUT ACROSS THE CONTINUUM SUCH AS TELEHEALTH, ELDER CARE SERVICES, EDUCATION SERVICES, HIGH VALUE HEALTHCARE COLLABORATIVE, AND OTHER PROGRAMS MORE BROADLY FOCUSED ON IMPROVING QUALITY AND VALUE. |
| FORM 990, PAGE 2, PART III, LINE 4D | MAINEHEALTH'S OTHER PROGRAMS INCLUDE ACCESS TO CARE PROGRAMS (CAREPARTNERS AND MEDACCESS);COMMUNITY EDUCATION PROGRAMS (MAINEHEALTH LEARNING RESOURCE CENTERS, NORTHERN NEW ENGLAND POISON CENTER, CANCER RESOURCE CENTER, AND SHARED DECISION MAKING RESOURCE CENTER) AND SUBSIDIZED HEALTH SERVICES. |
| FORM 990, PART V | MAINE MEDICAL CENTER, ACTING ON BEHALF OF MAINEHEALTH (EIN 01-0431680), FILED 952 FORM 1099S FOR THE CALENDAR YEAR 2015 ON BEHALF OF THE FOLLOWING ORGANIZATIONS: MAINEHEALTH, MAINE MEDICAL CENTER, WALDO COUNTY HEALTHCARE, INC., WALDO COUNTY GENERAL HOSPITAL, COASTAL HEALTHCARE ALLIANCE, MMC REALTY, MAINE MEDICAL PARTNERS, NORDX, AND HOME HEALTH VISITING NURSES. |
| FORM 990, PAGE 6, PART VI, LINE 4 | THE ARTICLES OF INCORPORATION WERE AMENDED FOR TWO PURPOSES: 1) TO CLARIFY THE CHARITABLE PURPOSES OF THE CORPORATION WITH RESPECT TO THE NAMES OF THE TAX-EXEMPT SUBSIDIARIES FOR WHICH MAINEHEALTH IS A SUPPORTING ORGANIZATION. 2) TO CLARIFY CERTAIN ACTIONS REQUIRING APPROVAL BY THE CORPORATE MEMBERS. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE ORGANIZATION HAS MEMBERS WHO SERVE ON A BOARD OF CORPORATORS. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE ORGANIZATION'S BOARD OF CORPORATORS HAS THE ABILITY TO ELECT TRUSTEES, EXCEPT FOR "TRANSITIONAL TRUSTEES", AT AN ANNUAL OR A SPECIAL MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 7B | AS STATED IN THE ORGANIZATION'S BY LAWS, THE BOARD OF CORPORATORS SHALL ACT ON ANY MATTERS BROUGHT TO IT BY THE BOARD OF TRUSTEES. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 WAS REVIEWED IN DETAIL BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. THE EXECUTIVE VICE PRESIDENT & TREASURER ALSO REVIEWED THE 990 IN DETAIL PRIOR TO SIGNING THE RETURN. THE FORM 990 WAS PROVIDED TO THE FULL BOARD OF TRUSTEES PRIOR TO FILING THE RETURN. |
| FORM 990, PAGE 6, PART VI, LINE 12C | CONFLICT OF INTEREST STATMENTS ARE OBTAINED ANNUALLY. THE ORGANIZATION REVIEWS THE RESPONSES TO THESE DOCUMENTS AND ADDRESSES ANY ISSUES IMMEDIATELY. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE PROCESS FOLLOWED FOR DETERMINING COMPENSATION OF THE CEO AND OTHER KEY ADMINISTRATIVE EMPLOYEES COMPENSATED BY THIS OR OTHER RELATED ORGANIZATION IS A FORMAL PROCESS PERFORMED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. A RELATED ORGANIZATION USES AN OUTSIDE FIRM, SULLIVAN COTTER, TO PERFORM AN INDEPENDENT BENCHMARK ANALYSIS FOR THE CEO OF MAINEHEALTH, ALONG WITH OTHER EXECUTIVES IN THE MAINEHEALTH SYSTEM. THE FIRM MEETS WITH THE EXECUTIVE COMMITTEE TO REVIEW EACH EXECUTIVE'S BENCHMARK REPORT. THE COMMITTEE THEN DELIBERATES ON MAINEHEALTH'S WRITTEN SALARY AND INCENTIVE PLAN PHILOSOPHY BEFORE MAKING A FINAL DECISION. ALL DECISIONS AND MEETINGS ARE CAPTURED IN MINUTES AND THERE ARE APPROPRIATE APPROVALS AT ALL LEVELS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE EXPLANATION ABOVE UNDER FORM 990, PART VI, LINE 15A - COMPENSATION FOR TOP OFFICIAL. |
| FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART VII | AMOUNTS INCLUDED IN PART VII, SECTION B. INDEPENDENT CONTRACTORS MAY INCLUDE PAYMENTS THAT ARE MADE BY MAINEHEALTH ON BEHALF OF ITS MEMBER ORGANIZATIONS. REFER TO PART V, LINE 1A - ADDITIONAL INFORMATION RESPONSE. |
| FORM 990, PART XI | MAINEHEALTH HAS ESTABLISHED AN INFORMATION SYSTEMS PROJECT, KNOWN AS THE SHARED ELECTRONIC HEALTH RECORD (SEHR), TO IMPLEMENT A SYSTEM-WIDE INTEGRATED ELECTRONIC HEALTH RECORD SYSTEM AND FINANCIAL SYSTEM. IN 2014, FUNDING FOR A PORTION OF THE SEHR PROJECT WAS ACQUIRED BY MAINEHEALTH THROUGH THE ISSUANCE OF A TAX EXEMPT REVENUE BOND THROUGH THE FINANCE AUTHORITY OF MAINE IN THE AMOUNT OF 94,800,000. SECTION 168 OF THE INTERNAL REVENUE CODE REQUIRES THAT PROJECTS FUNDED BY TAX-EXEMPT SOURCES OF FINANCING BE DEPRECIATED USING THE ALTERNATIVE DEPRECIATION SYSTEM (ADS). THE ADS SYSTEM REQUIRES THAT COMPUTER TECHNOLOGY SYSTEMS BE DEPRECIATED OVER A PERIOD OF 60 MONTHS. FOR GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP), MAINEHEALTH IS USING BETWEEN 120 AND 144 MONTH USEFUL LIVES FOR THE SEHR SYSTEM, AS MANAGEMENT BELIEVES THAT THESE PERIODS BETTER REFLECT THE USEFUL LIFE GIVEN THE AMOUNT INVESTED AND THE COMPLEXITY OF IMPLEMENTATION. AS A RESULT, THERE IS A SIGNIFICANT TEMPORARY BOOK TO TAX DIFFERENCE RECORDED AT SEPTEMBER 30, 2016 IN THE AMOUNT OF 62,105, 101. DURING FY 2016, BOOK TO TAX DEPRECIATION DIFFERENCE IN THE AMOUNT OF 42,044,309 WAS RECORDED AS A REDUCTION IN NET ASSETS TO REFLECT THE IMPACT FOR FISCAL YEARS 2014 AND 2015. THE FISCAL YEAR 2016 BOOK TO TAX DEPRECIATION ADJUSTMENT OF 20,060,792 WAS RECORDED AS AN INCREASE TO CURRENT YEAR DEPRECIATION EXPENSE. HAD THE CURRENT YEAR BOOK TO TAX DIFFERENCE NOT BEEN RECORDED, MAINEHEALTH WOULD HAVE REPORTED A NET GAIN FOR FY 2016 OF 2,982,814. |
| FORM 990, PART XI, LINE 9 | EQUITY TRANSFER FROM AFFILIATES 2,000,000 SEHR DEPRECIATION -42,044,309 TOTAL -40,044,309 |
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