TY 2020 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) Miguel Arguedas MD...................................................................... Physician	41.50 ................. 0.00			X		721,422	0	45,140
(2) Calin Stoicov MD...................................................................... Physician	41.50 ................. 0.00			X		638,712	0	45,140
(3) Michael Mason MD...................................................................... Physician	41.50 ................. 0.00			X		626,400	0	43,895
(4) Patrick Keaney...................................................................... Former Officer	41.50 ................. 0.00				X	598,515	0	45,140
(5) Joseph Yu MD...................................................................... Physician	41.50 ................. 0.00			X		592,229	0	46,085
(6) Peter Hutchinson MD...................................................................... Physician	41.50 ................. 0.00			X		591,833	0	36,590
(7) Lois N Skillings...................................................................... President/CEO	30.50 ................. 11.00	X	X			0	496,757	90,209
(8) Ira Bird MD...................................................................... Former Officer	0.30 ................. 0.60				X	494,063	0	36,590
(9) Melissa Streeter MD...................................................................... Medical Staff Vice President	0.30 ................. 0.60	X	X			443,899	0	43,895
(10) Michael Perry...................................................................... CFO	30.50 ................. 11.00		X			0	295,207	66,356
(11) Ranjiv Advani MD...................................................................... Medical Staff President	0.30 ................. 0.60	X	X			2,000	0	0
(12) Pamela Bowerman...................................................................... Director	0.30 ................. 0.60	X				0	0	0
(13) Joan Boomsma MD...................................................................... Director	0.30 ................. 0.60	X				0	0	0
(14) Marcus Deck MD...................................................................... Director	0.30 ................. 0.60	X				0	0	0
(15) Michael Field...................................................................... Director	0.30 ................. 0.60	X				0	0	0
(16) Charles Frizzle...................................................................... Director	0.30 ................. 0.60	X				0	0	0
(17) Ted Huskins...................................................................... Director	0.30 ................. 0.60	X				0	0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(18) Margo Knight........................................................................ Director	0.30 .......................0.60	X
(19) Bruce McGlauflin........................................................................ Director	0.30 .......................0.60	X
(20) Alain Montegut MD........................................................................ Director	0.30 .......................0.60	X
(21) Daniel Morgenstern MD........................................................................ Director	0.30 .......................0.60	X
(22) Richard Petersen........................................................................ Director	0.30 .......................0.60	X
(23) Sue Spann........................................................................ Director	0.30 .......................0.60	X
(24) Lloyd Van Lunen........................................................................ Director	0.30 .......................0.60	X
(25) Joan Shea........................................................................ Director/Aux. President	0.30 .......................0.60	X
(26) Glenn L Hutchinson........................................................................ Chairperson	0.30 .......................0.60	X	X
(27) Lenora Burke........................................................................ Vice Chairperson	0.30 .......................0.60	X	X
(28) Matthew Orlando........................................................................ Treasurer	0.30 .......................0.60	X	X
(29) Charles Bridge........................................................................ Secretary	0.30 .......................0.60	X	X
(30) Sandy Morrell Rooney........................................................................ Immedicate Past Chair	0.30 .......................0.60	X	X

(A) Name and business address	(B) Description of services	(C) Compensation
Innovative Business Technology PO Box 3822 Portland,ME04101	Collection Services	331,267
Lanford & Low 248 Warren Avenue Portland,ME04103	Construction Services	270,035
LocumTenenscom LLC PO Box 405347 Atlanta,GA30384	Staffing Services	117,739


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 3

- TIN:

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

Mid Coast Hospital

Employer identification number

01-0215911

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2020

Page 2

Part II

Support Schedule for Organizations Described in Sections 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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2020 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2020. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2019. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2020

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2019. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2020

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2020

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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 0.015 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 0.035	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2020

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2020 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2020	(iii) Distributable Amount for 2020
1 Distributable amount for 2020 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2020:
a From 2015.......
b From 2016.......
c From 2017.......
d From 2018.......
e From 2019.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2020 distributable amount
i Carryover from 2015 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2020 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2020 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2021. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2016.....
b Excess from 2017.....
c Excess from 2018.....
d Excess from 2019.....
e Excess from 2020.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Name of the organization

Mid Coast Hospital

Employer identification number

01-0215911

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 its Form 990PF, Part I, line 2, to certify that it doesn't 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) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2

Name of organization Mid Coast Hospital

Part I Contributors	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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 3

Name of organization Mid Coast Hospital		Employer identification number 01-0215911

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) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 4


Name of organization Mid Coast Hospital			Employer identification number 01-0215911
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2020)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

Mid Coast Hospital

Employer identification number

01-0215911

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, 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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB 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)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2020

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII 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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on 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 ....	35,123,951	35,123,951	31,804,227	28,671,333	27,481,709
b	Contributions ...		120,122	48,660	57,499	57,894
c	Net investment earnings, gains, and losses		2,447,575	3,512,182	3,299,010	1,328,130
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	35,123,951	63,912	241,118	223,615	196,400
f	Administrative expenses ....
g	End of year balance ......		37,627,736	35,123,951	31,804,227	28,671,333

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

0 %

Term endowment SchDMd Bullet

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .......................

3a(i)

(ii) Related organizations .......................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. 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 .....
b	Buildings ....
c	Leasehold improvements
d	Equipment ....
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..		0

Schedule D (Form 990) 2020

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. 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........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2020

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	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 XIII.) ...........	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 XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 XIII.) ............	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 XIII.) ............	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 XIII

Supplemental Information

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Part V, Line 4:	Endowment funds are invested and used in a manner that provides predictable streams of funding to the programs supported by the endowed funds, all while seeking to maintain the purchasing power of the endowment assets. All funds were transferred to MaineHealth.

Schedule D (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

Mid Coast Hospital

Employer identification number

01-0215911

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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, as a factor in determining eligibility for free or discounted care.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	1,192,324	99,254	1,093,070	1.910 %
b	Medicaid (from Worksheet 3, column a) . . . . .	4,365,053	3,624,151	740,902	1.300 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	5,557,377	3,723,405	1,833,972	3.210 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	252,752	9,410	243,342	0.430 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .	20,969,468	13,894,729	7,074,739	12.390 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	21,222,220	13,904,139	7,318,081	12.820 %
k	Total. Add lines 7d and 7j .	26,779,597	17,627,544	9,152,053	16.030 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020

Schedule H (Form 990) 2020

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
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

2,338,658

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

9,047,609

Enter Medicare allowable costs of care relating to payments on line 5.....

11,278,923

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-2,231,314

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—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) 2020

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	Mid Coast Hospital 123 Medical Center Drive Brunswick,ME04011 www.midcoasthealth.com 38168	X	X	X

Schedule H (Form 990) 2020

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Mid Coast Hospital
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): see Part V, Section C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): see Part V, Section C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Mid Coast Hospital
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

see Part V, Section C

The FAP application form was widely available on a website (list url):

see Part V, Section C

A plain language summary of the FAP was widely available on a website (list url):
see Part V, Section C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

	Mid Coast Hospital
Name of hospital facility or letter of facility reporting group

Yes

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 all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Mid Coast Hospital
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual 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? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2020

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Mid Coast Hospital	Part V, Section B, Line 5: For its 2019 CHNA, Mid Coast Hospital was included in the Maine Shared Community Health Needs Assessment (Maine CHNA), a collaborative effort between multiple Maine-based organizations. The Maine CHNA determined the health priorities of Sagadahoc County, to which Mid Coast provides significant services, through community participation and voting at community forums. The forums were an opportunity for review of the County Health Profile, discussion of community needs, and prioritization in small break-out sessions followed by a forum session vote.Forum agenda items included remarks from health leaders; a review of previous health improvement efforts; a review of county-level data, discussion, and prioritization in small groups; and an overall forum-wide voting process. Small groups had 35-45 minutes to discuss the data in the presentation and the full county profile, and to share their own experiences in order to identify their top county health priorities. Health priorities identified during these small groups were collated and presented to the larger plenary session, where each attendee voted for their top four priorities Votes were tallied and a hierarchy emerged. The summary votes for each forum were used to develop the county level priorities If multiple forums were held in a county, the forum results for forums held with the general community were included in the total votes for the county. In cases where a forum was held with a specific population, for example, LGBTQ youth or older adults, then the results of their voting and discussion were included in the section describing the needs of that particular population. The community forum participants also shared knowledge on gaps and assets available in their communities to address each of the top four priorities identified.Additionally, Community outreach and engagement for the Maine Shared CHNA included coordination at both the statewide, public health district, and county level The statewide Community Engagement Committee met monthly from March 2018 through January 2019 to review and provide input on every aspect of engagement process. In addition to the state-level Community Engagement Committee, a Local Community Engagement Planning Committee in each of Maine's 16 counties planned and implemented the logistics of community forums and events within each district. These committees were comprised of hospitals, public health district liaisons, and a variety of additional partners. The 2018 Community Engagement Toolkit was designed to assist the Local Community Engagement Planning Committees in this effort.
Mid Coast Hospital	Part V, Section B, Line 6a: Mid Coast Hospital routinely prepares and updates its Community Health Needs Assessment in coordination with many other health care providers, institutions, and hospital facilities. For its 2019 CHNA, the Hospital participated in the Maine Shared Community Health Needs Assessment (Maine CHNA), a collaborative effort between multiple Maine-based organizations. A full list of the hospital facilities that Mid Coast Hospital conducted its CHNA with can be found in its published CHNA reports, as available on Mid Coast Hospital's website:https://www.midcoasthealth.com/about/community-health/
Mid Coast Hospital	Part V, Section B, Line 6b: Mid Coast Hospital routinely prepares and updates its Community Health Needs Assessment in coordination with many other health care providers, institutions, and hospital facilities. For its 2019 CHNA, the Hospital participated in the Maine Shared Community Health Needs Assessment (Maine CHNA), a collaborative effort between multiple Maine-based organizations. A full list of the organizations other than hospital facilities that Mid Coast Hospital conducted its CHNA with can be found in its published CHNA reports, as available on Mid Coast Hospital's website:https://www.midcoasthealth.com/about/community-health/
Mid Coast Hospital	Part V, Section B, Line 11: The Hospital's most recent needs assessment and implementation plan identifies four primary health priorities:1. Mental Health/Adverse Childhood Experiences2. Social Determinants of Health3. Health Weight, Physical Activity & Healthy Living4. Substance UseThe Hospital is addressing these needs through a variety of healthcare solutions unique to each priority. However, there are common solutions implemented by the Hospital that address all of these identified health needs. For example, the Hospital has taken steps to:- Improve its staff training and retention in areas of need; - To expand and support community engagement, local partnerships, and community-led initiatives;- To expand access to healthcare providers and wellness resources; and- To support and improve research and best practices of healthcare. More information regarding the Hospital's efforts to address its community's significant needs can be found in the Hospital's needs assessment and implementation plans located on its website. See Part V, Section C.
Schedule H, Part V, Section B, line 7a & 10a:	The current CHNA & Implementation Strategy, as well as archived previous CHNAs, are available on the Hospital's website:http://www.midcoasthealth.com/about/community-health/
Schedule H, Part V, Section B, Line 16a, 16b, & 16c:	The Hospital's Financial Assistance Policy, Financial Assistance Applications, and Plain Language Summary can be found at: Policy:https://www.midcoasthealth.com/patient-accounts/pdf/Mid-Coast-Hospital-Charity-Care-Policy.pdf Applications:https://www.midcoasthealth.com/patient-accounts/pdf/Financial-Assistance-Application-ENGLISH.pdfhttps://www.midcoasthealth.com/patient-accounts/pdf/Financial-Assistance-Application-SPANISH.pdfPlain Language Summary:https://www.midcoasthealth.com/patient-accounts/financial-assistance/

Schedule H (Form 990) 2020

Page 9

Part VFacility Information (continued)

Section D. 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?16
Name and address		Type of Facility (describe)
1	1 - Mid Coast Hospital 121 Medical Center Drive Brunswick,ME04011	General Medical & Surgical
2	2 - Mid Coast Hospital 81 Medical Center Drive Brunswick,ME04011	General Medical & Surgical
3	3 - Mid Coast Hospital 430 Bath Road Brunswick,ME04011	General Medical & Surgical
4	4 - Mid Coast Hospital 66 Baribeau Drive Brunswick,ME04011	General Medical & Surgical
5	5 - Mid Coast Hospital 30 So Bristol Road Damariscotta,ME04543	General Medical & Surgical
6	6 - Mid Coast Hospital 108 Center Street Bath,ME04530	General Medical & Surgical
7	7 - Mid Coast Hospital - Mid Coast Med Group One Wellness Way Topsham,ME04086	General Medical & Surgical
8	8 - Mid Coast Hospital 22 Maine Street Station Brunswick,ME04011	General Medical & Surgical
9	9 - Mid Coast Hospital 30 Governors Way Topsham,ME04086	General Medical & Surgical
10	10 - Mid Coast Hospital 120 Harpswell Road Brunswick,ME04011	General Medical & Surgical
11	11 - Mid Coast Hospital 331 Maine Street Brunswick,ME04011	General Medical & Surgical
12	12 - Mid Coast Hospital 130 Center Street Bath,ME04530	General Medical & Surgical
13	13 - Mid Coast Hospital 8 Mason Street Brunswick,ME04011	General Medical & Surgical
14	14 - Mid Coast Hospital 44 Elm Street Topsham,ME04086	General Medical & Surgical
15	15 - Mid Coast Hospital 329 Maine Street Brunswick,ME04011	General Medical & Surgical
16	16 - Mid Coast Hospital 329 Bath Road Brunswick,ME04011	General Medical & Surgical

Schedule H (Form 990) 2020

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
Part I, Line 7:	Based on the IRS Form 990, Schedule H, a worksheet was provided to determine the overall cost to charge ratio that could be used to apply throughout Schedule H of Form 990. Where applicable, the Organization utilized this worksheet to convert charges to costs. The Organization did not use the Worksheet 2 percentage for the IRS Form 990, Schedule H, Worksheet 3, Unreimbursed Medicaid and Other Means Tested Government Programs, or Worksheet 6, Subsidized Health Services, for the Medicaid allowable costs. Instead, the Organization utilized the actual Medicaid filed cost report for the Medicaid allowable costs. Additionally, the Organization used the modified Medicare allowable costs and payments related to these services in regards to the cardiopulmonary community program and psychiatric unit. For our provider based clinics, in this same section we used the actual costs for each clinic. In addition, for its addiction resource center and maternity, hospitalist, and senior psychiatric services, the Organization used the estimated costs calculated based on actual clinic costs estimated from reporting on these centers to the State of Maine.
Part I, Line 7g:	Mid Coast Hospital has clinical services and hospital-owned physician practices. Mid Coast Hospital has included these practices in this section of the 990, Schedule H of subsidized health services if they are operating at a loss. The Hospital has included the following clinical services and hospital-owned physician practices that operate at a loss and the corresponding costs of these practices: primary care practice, OB/GYN practice, hospitalist services, urology practice, neurology practice, senior psychiatric services, nephrology practice, orthopedics practice, gastroenterology practice, diabetes & endocrinology practice, general surgery practice, rheumatology practice, geriatric services clinic, addiction resource center, palliative care clinic, chemical dependency services, breast health clinic, oncology practice, physiatry practice, wound clinic, pulmonary practice, cardiology practice, nephrology practice, gastroenterology practice, ophthalmology practice, and an ENT practice. The above listed hospital clinical services and hospital-owned physician practices have a community benefit of approximately $7.1 million. In addition, the community benefit does not take into account bad debts, charity care, and contractual adjustments. Thus, this community benefit of approximately $7.1 million is a conservative number that reconciles to the community benefit on the IRS Form 990, Schedule H.
Part I, Line 7, Column (f):	The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 5,443,187.
Part II, Community Building Activities:	Mid Coast Hospital strives to promote numerous activities that build its community, and that enhances the health of the populations it serves. In collaboration with other Central Maine healthcare providers and institutions, Mid Coast Hospital works to improve health-related literacy and education through regular community needs assessments and public health forums. By increasing staff training, funding research, and by improving best practices within and between care providers, Mid Coast Hospital will be able to reduce health care risks within its community and to mitigate future health threats. Mid Coast Hospital also aims to meet the health needs of its priority populations through supporting community partnerships that address issues of transportation, homelessness, hunger, poverty, access to health care and health resources, All of these endeavors by the Hospital build the health and wellbeing of its community.
Part III, Line 2:	The amount reported on Part III line 2 was derived by applying the cost tocharge ratio against the amount of bad debt expense reported on Form 990, Part IX, line 24, column (A) ($5,443,187). Accounts written off to baddebt include gross charges being written off less any payments receivedagainst those charges. Any cash collected on accounts previously writtenoff is included as an offset to bad debt expense as recoveries of baddebt. The Hospital calculates the ratio in a manner consistent withworksheet 2, patient care charges to patient care expenses, to arrive atthe ratio of costs to charges.
Part III, Line 3:	The Hospital does not consider any amount of its bad debt at cost to be attributable to patients eligible to receive financial assistance under the Hospital's financial assistance policy.
Part III, Line 4:	See Footnote 2 on Page 8 of the attached audited financial statements.
Part III, Line 8:	The Hospital believes all of the clinical areas included in the Form 990, Schedule H should be and are considered a community benefit. Mid Coast Hospital believes that by offering and thus subsidizing these clinical services within the community, the community benefits by having easy access to these services. If these services were not available from Mid Coast Hospital there would be a greater burden on the community and many, if not all, of these services would not be available with such easy access. Based on the IRS Form 990, Schedule H, a worksheet was provided to assist in determining the overall cost-to-charge ratio that could be used to apply throughout the Schedule H of the Form 990 in order to convert charges to costs. Where applicable, we have utilized this worksheet to convert charges to costs. We did not use this worksheet percentage on the calculation of Medicare costs in this section. We used the Medicare allowable costs and payments related to the subsidized health service and we used the Medicare cost report estimated cost and payment for these services.
Part III, Line 9b:	The Hospital currently starts with gross charges for all patient billing. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment may qualify for charity care. Those patients that qualify and have income levels below 200% of the federal poverty guidelines can receive 100% charity care. A sliding scale is used for patients with income levels between 200% and 300% of the federal poverty guidelines. The amount considered for charity will be based upon the evaluation of the patients' ability to pay. Patients who qualify for partial financial assistance are responsible for any remaining balance after the charity care adjustment and third party payments. Once an account has been processed through an internal routine collection process, it may be assigned to an attorney/agency for collection.
Part VI, Line 2:	Mid Coast Hospital assesses the health care needs of the community on an ongoing basis. Mid Coast Hospital's strategic plan is a road map as to where and how to deliver services to the surrounding communities. This process of how to provide these services included listening and learning to/from the community - patients and families, faith community, municipal leaders, legislatures and local businesses. Mid Coast also looked inward, calling upon board members, corporators, medical staff, volunteers, auxiliary, and employees since they are all part of the community Mid Coast Hospital serves.For its 2019 CHNA, Mid Coast Hospital participated in the Shared Maine CNHA. Refer to the full Section B, Line 5 description for how the Shared Maine CHNA gathered input from its community.After gathering extensive input from its priority populations and community, Mid Coast Hospital, in collaboration with other health care providers, assessed the health care needs of its community through rigorous data analysis and personal testimony. Per the Maine Shared CHNA charter, the effort was conducted by the Steering Committee, Metrics Committee, and Community Engagement Committee The Community Engagement Committee was led by the program manager who was the point of contact for all entities and partners and was responsible for meeting planning and facilitation These committees worked in partnership with the Maine CDC and the contracted vendor, JSI Maine CDC and its epidemiol-ogy contractor, University of Southern Maine, provided a significant amount of data analyses, technical sup-port, and website development JSI was contracted to support forum facilitation, a subset of data analysis, profile development, and report writing.The Community Engagement Committee is charged with making recommendations for approval by the Steering Committee outlining a consistent and robust community engagement process This process should identify priorities among significant health issues and identify local, regional, or statewide assets and resources that may potentially address the significant health needs identified Members of the Community Engagement Committee share their expertise create processes and deliverables for the Steering Committee to review and approve Members of the Community Engagement committee include representatives of the Steering Committee, public health system partners, Federally Qualified Health Centers, academia, and Maine non-profits such as United Ways, Community Action Programs, and others with an interest in broad community representation and input.
Part VI, Line 3:	Mid Coast Hospital will notify patients about access to various financial assistance needs in different ways. We have postings in various departments as well has handouts informing patients how to access these programs if financial assistance is required. There are signs and pamphlets in the Hospital settings indicating the poverty guidelines and how to obtain assistance to obtain free or discounted care. All of our patients can speak to one of the Hospital's employees on how to obtain financial assistance; and, if there is assistance needed, the employee will inform our patient financial services department who will then work with the patient to either help them apply for MaineCare or discuss options for free or discounted care.
Part VI, Line 4:	Mid Coast Hospital's primary service area includes the following communities in the Mid Coast Maine: Arrowsic, Bailey Island, Bath, Bowdoin, Bowdoinham, Brunswick, Dresden, Durham, Freeport, Georgetown, Harpswell, Lisbon, Litchfield, North Yarmouth, Perkins Township, Phippsburg, Pownal, Richmond, Sabattus, Topsham, West Bath, Westport, Wiscasset, Woolwich, Yarmouth. Approximately 11.3% of Mid Coast Hospital patients utilize Medicaid and 48% of Mid Coast Hospital patients utilize Medicare. The population of the communities supported by Mid Coast Hospital with income under 200% of the poverty guidelines is about 21%.Additionally, the Shared Maine CHNA took efforts to better understand the demographics of Central Maine communitiies across multiple metrics, including age, race, ethnicity, and economic status.AGE: Age is a fundamental factor to consider when assessing individual and community health status In particular, older individuals typically have more physical and mental health vulnerabilities, and are more likely to rely on immediate community resources for support compared to young people. An aging population leads to increased pressure on the healthcare system and shortages in the healthcare workforce, especially geriatricians, nurses, social workers, and direct care workers like home health aides and certified nursing assistants, to meet the needs of older adults; in Sagadahoc County, 19.4% of the population is 65 years of age or older.RACE/ETHNICITY: An extensive body of research illustrates the health disparities that exist for racial/ethnic minorities, non-English speakers, and foreign-born populations. According to the US Center for Disease Control, non-Hispanic Blacks have higher rates of premature death, infant mortality, and preventable hospitalization than non-Hispanic Whites17 Individuals with limited English proficiency (LEP), defined as the ability to read, speak, write, or understand English less than very well, have lower levels of health literacy or comprehension of medical information This leads to higher rates of medical issues and complications, such as adverse reactions to medication. Cultural differences such as, but not limited to, the expectations of who is involved in medical decisions can also impact access to health care and to health information. These disparities show the disproportionate and often avoidable inequities that exist within communities and reinforce the importance of understanding the demographic makeup of a community to identify populations more likely to experience adverse health outcomes. The population is predominantly White (95.7%); 2.4% of the population is two or more races and 1.5% are Hispanic.SOCIOECONOMIC STATUS: Socioeconomic status (SES), as measured by income, poverty, employment, education, and the extent to which one lives in areas of economic disadvantage, is closely linked to morbidity, mortality, and overall health status. Low income status is highly correlated to a lower than average life expectancy. Lack of gainful employment is linked to several barriers to care, such as lack of health insurance, inability to pay for health care services, and inability to pay for transportation to receive services. Higher education is associated with improved health outcomes and social development at individual and community levels. The health benefits of higher education typically include better access to resources, safer and more stable housing, and better engagement with providers. Proximate factors associated with low education that affect health outcomes include the inability to navigate the healthcare system, educational disparities in personal health behaviors, and exposure to chronic stress. The estimated high school graduation rate was lower than the state overall (84.8% vs 86.9%) in 2017. The percent of the population over 25 with an associates degree or higher was higher than the state overall in 2017 (42.5% vs 37.3%) in 2012-2016.SPECIAL POPULATIONS: Through community engagement activities, several populations in Sagadahoc County were identified as being particularly vulnerable or at-risk for poor health or health inequities.1.) Older Adults: Maine is the oldest state in the nation by median age Older adults are more likely to develop chronic illnesses and related disabilities, such as heart disease, hypertension, diabetes, depression, anxiety, Alzheimers disease, Parkinsons disease, and dementia. They also lose the ability to live independently at home. According to qualitative information gathered through interviews and forums, issues around older adult health and healthy aging were priorities in Sagadahoc County, specifically barriers to access to care for older adults, including lack of transportation, inability to pay for needed healthcare services/high cost of medications, and depression/isolation.2.) Youth: Youth were identified as a priority population in community forums. Specific issues of concern were youth mental health issues (specifically depression and stress), substance misuse (specifically opioids, marijuana, and tobacco), and lack of education and promotion around nutrition and physical activity. One key informant who works with youth identified a need for them to be able to access low-cost and anonymous health services, specifically reproductive and substance use treatment services, without parent permission.3.) LGBTQ: LGBTQ individuals, specifically youth, were identified as a population with significant and specialized health needs. Forum participants and interviewees discussed the need for more comprehensive and affordable mental health care for LGBTQ and non-binary adults and youth, as there is a lack of providers who have the cultural competency to treat these populations and address their health needs. Key informant interviewees identified a number of differences between the health status of LGBTQ and non-LGBTQ youth; LGBTQ youth are more likely to be depressed, experience violence, use tobacco and other substances, and self-harm. Data from the Maine Integrated Youth Health Survey analysis shows that youth who identify as bisexual, gay or lesbian, or other sexual orientation experience higher rates of feeling sad or hopeless, considering suicide, being bullied on school property, and sexual assault, as compared to youth who identify as heterosexual. Statewide analysis of Behavioral Risk Surveillance Survey confirms, among adults, higher rates of depression diagnosis over the lifetime when comparing those who identify as bisexual, gay or lesbian, or other sexual orientation to those who identify as heterosexual. Besides the need for more mental health services, there is also a need for inclusive health insurance, specifically for transgender and non-binary people; better services for individuals in rural areas of the state; LGBTQ-inclusive sexual education in schools; and surgical resources specifically for transgender youth The number of high school students in Sagadahoc County who identified as LGB (13.8%) is higher than state average (10.8%) and has increased over time from 2011 (6.2%) to 2017 (13.8%).In addition to the data collected and analyzed for the County Health Profiles, the Maine CDC created Health Equity Data Sheets (available at www.mainechna.org) which provides selected data for the statewide population, cut by sex, race, ethnicity, sexual orientation, education, and income. These data are at the state level, as much of the county level data would be suppressed due to small numbers and privacy concerns, and the previous analyses have shown that health disparities found at the state level are generally similar in individual counties.
Part VI, Line 5:	Mid Coast Hospital is a local, not-for-profit, community hospital that serves the local communities and the people regardless of their ability to pay. The members on the board of directors and corporators are all members of the communities that Mid Coast Hospital serves. All Hospital net income gains are reinvested into the facilities, equipment and services for the community.Additionally, the Hopsital takes significant efforts to promote the health of its community through various public programs and initiatives, including: senior exercise and nutrition; medical transportation and general transit resources; access to dental care; access to womens' health resources; access to sexual and reproductive health resources; improved mental health resources; increased access to therapeautic resources; chilrens and family health programs; education, health care training, and research; and community health and engagement initiatives
Part VI, Line 6:	Mid Coast Hospital has a clinical affiliation with MaineHealth to provide the best patient care to all of the communities that Mid Coast Hospital and MaineHealth serve. Additionally, effective March 1, 2020, Mid Coast-Parkview Health, the sole member of Mid Coast Hospital, merged into MaineHealth and MaineHealth became the sole corporate member of Mid Coast-Parkview Health. The merger will allow all organizations involved to access and provide higher quality resources and services.
Part VI, Line 7, Reports Filed With States	ME

Schedule H (Form 990) 2020

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
Mid Coast Hospital

Employer identification number
01-0215911

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) Town of Brunswick 85 Union Street Brunswick,ME04011		Gov	5,000	General Support
(2) People Plus 35 Union Street Brunswick,ME04011	01-0349949	501(c)(3)	5,000	General Support
(3) Southern Midcoast Maine Chapter 8 Venture Avenue Brunswick,ME04011	01-0486584	501(c)(6)	5,000	General Support
(4) Brunswick Downtown Association 124 Main Street Brunswick,ME04011	75-3131242	501(c)(3)	5,500	General Support
(5) Bath YMCA 303 Centre Street Bath,ME04530	01-0211812	501(c)(3)	5,000	General Support

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2020

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
Part I, Line 2:	The Organization only awards grants to local municipal school systems or other tax-exempt organizations for general operating support use towards furthering their charitable missions.

Schedule I (Form 990) 2020

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow

Attach to Form 990.
Graphic Arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

Mid Coast Hospital

Employer identification number

01-0215911

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used 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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on 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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2020

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 on 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 (E) amounts for that individual.

(A) Name and Title		(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 in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Miguel Arguedas MD Physician	(i) (ii)	721,422 ------------- 0	0 ------------- 0	0 ------------- 0	28,050 ------------- 0	17,090 ------------- 0	766,562 ------------- 0	0 ------------- 0
2Calin Stoicov MD Physician	(i) (ii)	638,712 ------------- 0	0 ------------- 0	0 ------------- 0	28,050 ------------- 0	17,090 ------------- 0	683,852 ------------- 0	0 ------------- 0
3Michael Mason MD Physician	(i) (ii)	626,400 ------------- 0	0 ------------- 0	0 ------------- 0	28,050 ------------- 0	15,845 ------------- 0	670,295 ------------- 0	0 ------------- 0
4Patrick Keaney Former Officer	(i) (ii)	598,515 ------------- 0	0 ------------- 0	0 ------------- 0	28,050 ------------- 0	17,090 ------------- 0	643,655 ------------- 0	0 ------------- 0
5Joseph Yu MD Physician	(i) (ii)	592,229 ------------- 0	0 ------------- 0	0 ------------- 0	28,050 ------------- 0	18,035 ------------- 0	638,314 ------------- 0	0 ------------- 0
6Peter Hutchinson MD Physician	(i) (ii)	591,833 ------------- 0	0 ------------- 0	0 ------------- 0	19,500 ------------- 0	17,090 ------------- 0	628,423 ------------- 0	0 ------------- 0
7Lois N Skillings President/CEO	(i) (ii)	0 ------------- 496,757	0 ------------- 0	0 ------------- 0	0 ------------- 80,304	0 ------------- 9,905	0 ------------- 586,966	0 ------------- 0
8Ira Bird MD Former Officer	(i) (ii)	494,063 ------------- 0	0 ------------- 0	0 ------------- 0	19,500 ------------- 0	17,090 ------------- 0	530,653 ------------- 0	0 ------------- 0
9Melissa Streeter MD Medical Staff Vice President	(i) (ii)	443,899 ------------- 0	0 ------------- 0	0 ------------- 0	28,050 ------------- 0	15,845 ------------- 0	487,794 ------------- 0	0 ------------- 0
10Michael Perry CFO	(i) (ii)	0 ------------- 295,207	0 ------------- 0	0 ------------- 0	0 ------------- 50,202	0 ------------- 16,154	0 ------------- 361,563	0 ------------- 0

Schedule J (Form 990) 2020

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

Part I, Line 3

Mid Coast Hospital's CEO, Lois Skillings, and CFO, Michael Perry, are compensated by a related organization, Mid Coast Health Management Corp & Sub (MCHMC). MCHMC uses an independent compensation consultant, compensation survey or study, and approval by the board or compensation committee to establish their annual compensation.

Part I, Line 4b

The Hospital and its related organizations have a deferred compensation arrangement under a non-qualified defined contribution plan to provide supplemental retirement benefits to certain employees. Lois Skillings and Michael Perry, who are officers of the Organization, participated in this plan and received $71,754 and $41,652, respectively, from Mid Coast Health Management Corp & Sub (MCHMC). Other physician employees listed on Form 990, Part VII that participated in the nonqualified defined contribution plan are: Dr. Melissa Streeter, Dr. Ira Bird, Dr. Patrick Keaney, Dr. Miguel Arguedas, Dr. Michael Mason, Dr. Calin Stoicov, Dr. Joseph Yu, and Dr. Peter Hutchinson. The Hospital compensated each of these individuals $19,500 relative to the plan. These individuals' non-qualified plan contributions are included in the figures reported on Schedule J, Part II, Column C.

Schedule J (Form 990) 2020

Additional Data

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

Mid Coast Hospital

Employer identification number

01-0215911

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	9	271,563	Market Value
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

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

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

Yes

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2020)

Page 2

Part IISupplemental Information. 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.

Return Reference	Explanation
Part I, Line 32b:	The Organization sells contributions of securities through its investment broker. All gifts of securities are sold as soon as administratively possible.

Schedule M (Form 990) (2020)

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SCHEDULE N
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Liquidation, Termination, Dissolution, or Significant Disposition of Assets
bullet

Complete if the organization answered "Yes" on Form 990, Part IV, lines 31 or 32; or Form 990-EZ, line 36.
bullet

Attach certified copies of any articles of dissolution, resolutions, or plans.
bullet

Attach to Form 990 or 990-EZ.
bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
Mid Coast Hospital

Employer identification number
01-0215911

Part I

Liquidation, Termination, or Dissolution. Complete this part if the organization answered "Yes" on Form 990, Part IV, line 31, or Form 990-EZ, line 36. Part I can be duplicated if additional space is needed.

1(a) Description of asset(s) distributed or transaction expenses paid	(b) Date of distribution	(c) Fair market value of asset(s) distributed or amount of transaction expenses	(d) Method of determining FMV for asset(s) distributed or transaction expenses	(e) EIN of recipient	(f) Name and address of recipient	(g) IRC section of recipient(s) (if tax-exempt) or type of entity
Cash & Cash Equivalents	12-31-2020	27,778,505	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Accounts Receivable	12-31-2020	37,616,875	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Notes Receivable	12-31-2020	5,198,232	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Inventories	12-31-2020	4,071,357	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Prepaid Expenses	12-31-2020	2,410,673	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Property, Plant, and Equipment - Net of A/D	12-31-2020	63,857,483	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Investments and Publicly Traded Securities	12-31-2020	101,805,217	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Other Receivables	12-31-2020	5,066,027	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Accounts Payable & Accrued Expenses	12-31-2020	19,486,973	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Deferred Revenue	12-31-2020	86,452	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Mortgages and Secured Liabilities	12-31-2020	23,104,856	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Due to Affiliates	12-31-2020	19,763,858	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Estimated 3rd Party Payor Settlements	12-31-2020	24,749,389	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)
Deferred Compensation Plan	12-31-2020	19,921,615	Book Value	01-0431680	MaineHealth 110 Free Street Portland,ME04101	501(c)(3)

Yes

Did or will any officer, director, trustee, or key employee of the organization:

Become a director or trustee of a successor or transferee organization? ...........................

Yes

Become an employee of, or independent contractor for, a successor or transferee organization? .....................

Yes

Become a direct or indirect owner of a successor or transferee organization? .....................

Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? ........

If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.

Cat. No. 50087Z

Schedule N (Form 990 or 990-EZ) (2020)

Page 2

Part I

Liquidation, Termination, or Dissolution (continued)

Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.

Yes

Did the organization distribute its assets in accordance with its governing instrument(s)? If "No," describe in Part III .............

Yes

Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? ......

Yes

If "Yes," did the organization provide such notice? .....................

Yes

Did the organization discharge or pay all of its liabilities in accordance with state laws? .....................

Yes

Did the organization have any tax-exempt bonds outstanding during the year? .....................

If "Yes" on line 6a, did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws?

If "Yes" on line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If "No" on line 6b, explain in Part III.

Part II

Sale, Exchange, Disposition, or Other Transfer of More Than 25% of the Organization's Assets. Complete this part if the organization answered "Yes" on Form 990, Part IV, line 32, or Form 990-EZ, line 36. Part II can be duplicated if additional space is needed.

1(a) Description of asset(s) distributed or transaction expenses paid	(b) Date of distribution	(c) Fair market value of asset(s) distributed or amount of transaction expenses	(d) Method of determining FMV for asset(s) distributed or transaction expenses	(e) EIN of recipient	(f) Name and address of recipient	(g) IRC section of recipient(s) (if tax-exempt) or type of entity

Yes

Did or will any officer, director, trustee, or key employee of the organization:

Become a director or trustee of a successor or transferee organization? .........................

Yes

Become an employee of, or independent contractor for, a successor or transferee organization? .....................

Yes

Become a direct or indirect owner of a successor or transferee organization? .....................

Receive, or become entitled to, compensation or other similar payments as a result of the organization's significant disposition of assets? ........

If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.

Cat. No. 50087Z

Schedule N (Form 990 or 990-EZ) (2020)

Page 3

Part III

Supplemental Information. Provide the information required by Part I, lines 2e and 6c, and Part II, line 2e. Also complete this part to provide any additional information.

Return Reference	Explanation

Part I, Line 2e:

Person(s) Involved: See Form 990, Part VII, Section A.

Part I, Line 2e:

Explanation of Involvement: All of the individuals listed in Form 990, Part VII that were formerly paid employees of Mid Coast Hospital or an affiliate through the merger date of December 31, 2020 will become employees of the successor organization, MaineHealth. Only Lois Skillings, the President and CEO of Mid Coast Hospital, will serve as an officer of MaineHealth.Sandra Morrell-Rooney also became a trustee of MaineHealth.

Schedule N (Form 990 or 990-EZ) (2020)

Additional Data

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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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

Mid Coast Hospital

Employer identification number

01-0215911

Return Reference	Explanation
Form 990, Part III, line 3	Effective December 31, 2020 the Hospital legally dissolved and transferred all its assets and activities to MaineHealth, a 501(c)(3) healthcare organization.
Form 990, Part VI, Section A, line 6	Mid Coast-Parkview Health (MCPH) shall be the Organization's sole member with all rights and responsibilities of membership, including all voting rights. Effective March 1, 2020, MCPH merged into MaineHealth and MaineHealth became the sole corporate member of MCPH. The two health care systems completed their work toward full integration effective December 31, 2020, which allowed all organizations involved in the merger to access and provide higher quality resources and services.
Form 990, Part VI, Section A, line 7a	At each annual meeting of the Sole Member, the Sole Member shall elect Directors to hold office until the election and qualification of their respective successors. The Directors shall be persons who have demonstrated an interest in the Organization's goals and objectives and, to the extent reasonably feasible, shall represent the Mid-Coast area. To the extent feasible, all directors serving on the Organization's Board of Directors shall be persons who also serve on the board of directors of MCPH. The Board of Directors shall consist of not less than thirteen persons elected by MaineHealth Services (MaineHealth Services is the sole corporate member of the Hospital's own sole member, Mid Coast-Parkview Health). One-third of the total number of Directors shall be elected at each annual meeting of MaineHealth Services. Vacancies on the Board of Directors occurring between annual meetings of MaineHealth Services may be filled by the remaining members of the Board, and the persons so becoming Directors shall serve until the next annual meeting of MaineHealth Services. At each annual meeting of MaineHealth Services, MaineHealth Services shall elect Directors to fill such terms or vacancies as may exist at that time. Additionally, any member of the Board may be removed with or without cause by vote of the MaineHealth Services at any meeting of the MaineHealth Services, provided a statement of such proposed action is given to the Director affected.
Form 990, Part VI, Section A, line 7b	The business and affairs of the Corporation shall be conducted and managed by its Board of Directors which shall exercise all of the powers of the Corporation. The Board of Directors shall approve an annual operating budget, develop a long-term capital expenditure plan, and, through its own committees or the committees of its Sole Member, monitor the implementation of the plan. The Board of Directors may delegate such powers as it sees fit to committees and/or officers of the Corporation. However, the powers of the Corporation's Board of Directors may be limited and/or subject to approval by its Sole Member and MaineHealth Services for the following exercises: 1.) adoption of annual budgets and modifications thereof; 2.) approval of any business, marketing, and strategic plans; 3.) authorization of certain debts incurred, assumed, or guaranteed in excess of $500,000; 4.) authorization for any acquisition, disposition, organization, or investment in a direct subsidiary or other investment; 5.) authorization of any sale, capitalized lease, assignment, transfer, mortgage, or encumbrance of properties valued in excess of $500,000; 6.) authorization for any merger or consolidation involving the Corporation; 7.) authorization for the institution of bankruptcy; 8.) authorization for certain capital investments in excess of $500,000; 9.) authorization for changes to programs and services within pre-approved strategic plans; and 10.) modifications to the Articles of Incorporation. Additionally, the approval of Mid Coast-Parkview Health, but not MaineHealth Services, shall be required for the following actions by the Board of the Hospital: 1.) Election, evaluation, and termination of the President/CEO; 2.) authorization for the commencement of certain litigation; and 3.) adoption of the Corporation's Bylaws and its amendments.
Form 990, Part VI, Section B, line 11b	The Form 990 is prepared by an independent public accounting firm with the assistance of information provided by key financial staff. An initial draft is reviewed in detail by key financial staff. Once any changes are incorporated, a draft copy is presented to the Board and copies are provided upon request. For the Form 990 for December 31, 2020, the Board was provided copies of the return after it was filed with the IRS.
Form 990, Part VI, Section B, line 12c	The Hospital has a compliance committee that meets on a quarterly basis to review any compliance issues that may arise.
Form 990, Part VI, Section B, line 15	An independent consultant prepares a market analysis at the regional level for all officers and key employees of the Organization. Compensation is also approved by the board and/or compensation committee annually.
Form 990, Part VI, Section C, line 19	The Organization makes its governing documents, conflict of interest policy and audited financial statements available to the public upon request.
Form 990, Part VII:	Dr. Patrick Keaney and Dr. Ira Bird were listed on prior Form 990s of the Organization as officers due to their respective roles as the Medical Staff President and the Medical Staff Vice President. Dr. Keaney and Dr. Bird did not serve in these capacities during the fiscal year and therefore they are not listed as current officers in Form 990, Part VII. They remain employed by the Hospital as physicians and have been reported as former officers in Part VII in accordance with IRS instructions. The compensation and benefits reported for them in Part VII as well as Schedule J, Part II represents compensation for their continued service as physicians and do not reflect payments in their capacity as a former officers.
Form 990, Part XI, line 9:	Transfer to MaineHealth -140,691,249.
Form 990, Part XI, Line 2c	The Hospital was unable to issue audited financial statements for the short period ending December 31, 2020 in advance of the filing deadline for its final Form 990. The organization had administratively and legally dissolved as of December 31, 2020 and all assets and activities were transferred to MaineHealth on that date. Going forward the Hospital's activities will be consolidated in the audited financial statements of MaineHealth.
Form 990:	In June 2019, the Boards of Mid Coast Parkview Health (MPHC) and MaineHealth (MH) voted and agreed to an integration plan and, in September 2019, an interim definitive agreement was executed to formalize this plan. As a result, MCPH and MH executed a series of corporate transactions, the result of which culminated with Mid Coast Hospital merging into MH, and specified subsidiaries (as listed in Schedule R) of MCPH became subsidiaries of MH effective December 31, 2020.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

Mid Coast Hospital

Employer identification number

01-0215911

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) 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 entity?
(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	Yes	No
(1)Mid Coast-Parkview Health 123 Medical Center Drive Brunswick,ME04011 01-0430069	Health Services	ME	501(c)(3)	Line 12a, I	MaineHealth		No
(2)Mid Coast Geriatric Services Corporation 123 Medical Center Drive Brunswick,ME04011 01-0496221	Geriatric Services	ME	501(c)(3)	Line 10	Mid Coast-Parkview Health		No
(3)Community Health and Nursing Services 60 Baribeau Drive Brunswick,ME04011 01-0211546	Hospice Services	ME	501(c)(3)	Line 10	Mid Coast-Parkview Health		No
(4)MaineHealth 22 Bramhall Street Portland,ME04102 01-0238552	Health Services	ME	501(c)(3)	Line 3	N/A		No
(5)Belfast Public Health Nursing Association Inc PO Box 287 Belfast,ME04915 04-3359810	Public Health	ME	501(c)(3)	Line 10	Coastal Healthcare Alliance		No
(6)Cancer Care Center of York County 22 Bramhall Street Portland,ME04102 20-1600381	Medical Services	ME	501(c)(3)	Line 3	Maine Medical Center		No
(7)Coastal Healthcare Alliance PO Box 287 Belfast,ME04915 22-2494475	Healthcare	ME	501(c)(3)	Line 12b, II	MaineHealth		No
(8)Coastal Medical Care PO Box 287 Belfast,ME04915 01-0487091	Medical Services	ME	501(c)(3)	Line 10	Coastal Healthcare Alliance		No
(9)Evergreen Behavioral Services 131 Franklin Health Commons Farmington,ME04938 01-0492747	Mental Health	ME	501(c)(3)	Line 10	Franklin Community Health Network		No
(10)Franklin Community Health Network 111 Franklin Health Commons Farmington,ME04938 22-3209406	Healthcare	ME	501(c)(3)	Line 12b, II	MaineHealth		No
(11)Franklin Memorial Hospital 111 Franklin Health Commons Farmington,ME04938 01-0211503	Hospital	ME	501(c)(3)	Line 3	Franklin Community Health Network		No
(12)Geriatric Resource Network 110 Free Street Portland,ME04101 01-0542842	Healthcare	ME	501(c)(3)	Line 7	MaineHealth		No
(13)Healthy Community Coalition 105 Mt Blue Circle Farmington,ME04938 22-3305743	Community Services	ME	501(c)(3)	Line 7	Franklin Community Health Network		No
(14)Kno-Wal-Lin Help At Home Inc PO Box 287 Belfast,ME04915 22-2968726	Home Services	ME	501(c)(3)	Line 10	Coastal Healthcare Alliance		No
(15)Kno-Wal-Lin Home Health Care Inc PO Box 287 Belfast,ME04915 01-0340947	Home Health	ME	501(c)(3)	Line 10	Coastal Healthcare Alliance		No
(16)Lincolnhealth 35 Miles Street Darmariscotta,ME04543 01-0153960	Hospital	ME	501(c)(3)	Line 3	LincolnHealth Group		No
(17)Lincolnhealth Coves Edge 35 Miles Street Darmariscotta,ME04543 01-0382340	Healthcare	ME	501(c)(3)	Line 3	LincolnHealth Group		No
(18)Lincolnhealth Group 6 St Andrews Lane Boothbay Harbor,ME04538 26-1475629	Healthcare	ME	501(c)(3)	Line 12b, II	MaineHealth		No
(19)Lincolnhealth Medical Partners Inc 35 Miles Street Darmariscotta,ME04543 26-3878235	Physician Practices	ME	501(c)(3)	Line 7	LincolnHealth Group		No
(20)Maine Behavioral Healthcare 78 Atlantic Place South Portland,ME04106 01-0524834	Hospital	ME	501(c)(3)	Line 3	MaineHealth		No
(21)MMC Realty Corp 22 Bramhall Street Portland,ME04102 01-0434215	Property Management	ME	501(c)(3)	Line 12a, I	Maine Medical Center		No
(22)Mainehealth Cardiology 110 Free Street Portland,ME04101 45-2525629	Healthcare	ME	501(c)(3)	Line 10	MaineHealth		No
(23)Mainehealth Care At Home 15 Industrial Park Saco,ME04072 22-2571902	Home Health	ME	501(c)(3)	Line 10	MaineHealth		No
(24)Memorial Hospital Foundation At North Conway Inc 3073 White Mountain Highway North Conway,NH03860 46-2137291	Fundraising	NH	501(c)(3)	Line 12a, I	The Memorial Hospital		No
(25)Nordx 301A US Route One Scarborough,ME04074 01-0511356	Laboratories	ME	501(c)(3)	Line 10	MaineHealth		No
(26)Pen Bay Behavioral Health PO Box 287 Belfast,ME04915 01-0277794	Behavioral Health	ME	501(c)(3)	Line 10	Coastal Healthcare Alliance		No
(27)Penobscot Bay Medical Center PO Box 287 Belfast,ME04915 01-0285286	Hospital	ME	501(c)(3)	Line 3	Coastal Healthcare Alliance		No
(28)Pen Bay Waldo Healthcare Foundation PO Box 287 Belfast,ME04915 22-2482325	Fundraising	ME	501(c)(3)	Line 7	Coastal Healthcare Alliance		No
(29)Penobscot Bay Physicians & Associates PO Box 287 Belfast,ME04915 01-0530517	Physician Practices	ME	501(c)(3)	Line 12b, II	Penobscot Bay Medical Center		No
(30)Quarry Hill PO Box 287 Belfast,ME04915 01-0213976	Long-Term Care	ME	501(c)(3)	Line 10	Coastal Healthcare Alliance		No
(31)Southern Maine Health Care PO Box 626 Biddeford,ME04005 01-0179500	Hospital	ME	501(c)(3)	Line 3	MaineHealth		No
(32)Saint Joseph's Manor 1133 Washington Avenue Portland,ME04103 01-0339489	Nursing Home	ME	501(c)(3)	Line 10	Maine Medical Center		No
(33)Stephens Community Healthcare Foundation 181 Main Street Norway,ME04268 31-1644144	Healthcare	ME	501(c)(3)	Line 12a, I	Western Maine Health Care Corp		No
(34)Stephens Memorial Hospital Association 181 Main Street Norway,ME04268 01-0219904	Hospital	ME	501(c)(3)	Line 3	Western Maine Health Care Corp		No
(35)Memorial Hospital 3073 White Mountain Highway North Conway,NH03860 02-0222156	Hospital	ME	501(c)(3)	Line 3	MaineHealth		No
(36)Waldo County General Hospital 118 Northport Avenue Belfast,ME04915 01-0177170	Hospital	ME	501(c)(3)	Line 3	Coastal Healthcare Alliance		No
(37)Waldo County Home Healthcare Services PO Box 287 Belfast,ME04915 22-2864960	Hospice Services	ME	501(c)(3)	Line 10	Coastal Healthcare Alliance		No
(38)Western Maine Health Care Corp 181 Main Street Norway,ME04268 01-0411788	Healthcare	ME	501(c)(3)	Line 12b, II	MaineHealth		No
(39)Western Maine Multi-Medical Specialists 181 Main Street Norway,ME04268 01-0489824	Physician Practices	ME	501(c)(3)	Line 10	Western Maine Health Care Corp		No
(40)Western Maine Nursing Home Inc 181 Main Street Norway,ME04268 22-2842655	Nursing Home	ME	501(c)(3)	Line 10	Western Maine Health Care Corp		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2020

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	(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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) GSM Realty LLC 22 Bramhall Street Portland,ME04102 20-4582952	Real Estate	ME	N/A				No			No
(2) MaineHealth ACO 110 Free Street Portland,ME04101 45-2929273	Accountable Care Organization	ME	N/A				No			No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) Mid Coast Medical Group 123 Medical Center Drive Brunswick,ME04011 01-0484592	Medical Services	ME	N/A	C					No
(2) Midcoast Health Management Corporation 123 Medical Center Drive Brunswick,ME04011 01-0429598	Management of Health Services	ME	N/A	C					No
(3) Thornton Oaks Development Corporation 123 Medical Center Drive Brunswick,ME04011 01-0448411	Management of Health Services	ME	N/A	C					No
(4) Maine Medical Partners 22 Bramhall Street Portland,ME04102 01-0442142	Healthcare	ME	N/A	C					No
(5) Synernet Inc 110 Free Street Portland,ME04101 01-0539789	Administrative Services	ME	N/A	C					No
(6) Waldo County Healthcare Managemetn Co PO Box 287 Belfast,ME04915 01-0485133	Management Services	ME	N/A	C					No
(7) Schooner Cove Cooperative Inc 35 Schooner Street Darmariscotta,ME04543 01-0428308	Management Services	ME	N/A	C					No
(8) SMHC Physician Services PA PO Box 626 Biddeford,ME04005 26-3345134	Medical Services	ME	N/A	C					No
(9) June Street Pharmacy 25 June Street Sanford,ME04073 01-0765952	Pharmacy	ME	N/A	C					No
(10) PBH Management Company PO Box 287 Belfast,ME04915 01-0537278	Management Services	ME	N/A	C					No

Schedule R (Form 990) 2020

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

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, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2020

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2020

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2020

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Acute and specialty care hospital
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	22
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	19
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	1,750
6	Total number of volunteers (estimate if necessary) .............	6	238
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	13,136,363	809,218
9	Program service revenue (Part VIII, line 2g) .........	203,706,935	58,791,039
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	6,488,793	17,298
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	16,306	7,980
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	223,348,397	59,625,535
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	31,625	26,300
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	121,841,462	33,442,167
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	111,800,376	29,097,839
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	233,673,463	62,566,306
19	Revenue less expenses. Subtract line 18 from line 12.......	-10,325,066	-2,940,771
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	233,202,756	0
21	Total liabilities (Part X, line 26).............	89,570,736	0
22	Net assets or fund balances. Subtract line 21 from line 20.....	143,632,020	0

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 53,852,636 including grants of $ 26,300 ) (Revenue $ 58,791,039 )
	Acute and specialty health care services were provided to residents of the Mid-Coast Maine area. Charity care was provided to those patients who did not have the ability to pay for medical services. Effective December 31, 2020 the Hospital legally dissolved and transferred all its assets and activities to MaineHealth, a 501(c)(3) healthcare organization.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses53,852,636

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	4,709,073	791,964	499,040

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	809,218

g	Noncash contributions included in lines 1a - 1f:$		1g	271,563

h Total. Add lines 1a-1f.......		809,218

		Business Code
2a	Net Patient Service Revenue	621400	58,536,090	58,536,090
b	Various Patient Services	621400	254,949	254,949
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		58,791,039

3 Investment income (including dividends, interest, and othersimilar amounts) ......			17,298			17,298
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		7,980	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		7,980	6c
d	Net rental income or (loss).......			7,980			7,980
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			59,625,535	58,791,039	0	25,278

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	26,300	26,300
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	489,794	434,268	55,526
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	27,160,309	24,163,415	2,996,894
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,086,296	929,769	156,527
9	Other employee benefits .......	2,245,950	1,922,326	323,624
10	Payroll taxes ...........	2,459,818	2,188,399	271,419
11	Fees for services (non-employees):
a	Management ......	876,196		876,196
b	Legal .........	134,180		134,180
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	5,392,810	4,329,638	1,063,172
12	Advertising and promotion ....	25,613	21,932	3,681
13	Office expenses .......	4,130,274	3,313,408	816,866
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	2,120,331	1,700,982	419,349
17	Travel ............	11,468	9,200	2,268
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	208,034	166,890	41,144
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	1,714,044	1,375,049	338,995
23	Insurance ...	666,498	534,681	131,817
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Pharmacy Expenses	5,470,922	4,388,910	1,082,012
b	Provision for Bad Debts	5,443,187	5,443,187
c	Medical Supplies/Expens	1,889,404	1,889,404
d	Revenue Tax	1,014,878	1,014,878
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	62,566,306	53,852,636	8,713,670	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			17,144,618	1	0
2	Savings and temporary cash investments .........			13,233,232	2	0
3	Pledges and grants receivable, net ......			116,731	3	0
4	Accounts receivable, net .............			32,612,983	4	0
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6	0
7	Notes and loans receivable, net ...........				7	0
8	Inventories for sale or use ............			3,637,759	8	0
9	Prepaid expenses and deferred charges ......			4,074,545	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	0
b	Less: accumulated depreciation	10b		58,674,754	10c	0
11	Investments—publicly traded securities .			77,780,067	11	0
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 ...........			25,928,067	15	0
16	Total assets. Add lines 1 through 15 (must equal line 33)...			233,202,756	16	0

17	Accounts payable and accrued expenses .....	46,363,106	17
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	22,916,297	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	20,291,333	25	0
26	Total liabilities. Add lines 17 through 25..	89,570,736	26	0

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	117,425,481	27	0
28	Net assets with donor restrictions ...........	26,206,539	28	0
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	143,632,020	32	0
33	Total liabilities and net assets/fund balances ........	233,202,756	33	0