2019-10-28T14:48:03-05:00 2018-12-31 010523282 Berry Dunn McNeil & Parker LLC 1000 Elm Street 4th Floor Manchester NH 03101 990 2018-01-01 010514750 Penobscot Community Health Center PENO 2079929200 103 Maine Avenue PO Box 1358 Bangor ME 04401 Lori L Dwyer President & CEO 2079929200 2019-10-21 1 Dimitrios Panacopoulos P01603705 6036697337 2019-10-21 69.49.157.66 2019-10-21 16:44:04 ED P BCE379EC6B2F882893C3F02DE0A5A3D951B1B2ED 32BC52385E097AD1B92E63E6016D3C1011811B46 2018 2020-01-14 16:20:31Z Lori L Dwyer 103 Maine Avenue PO Box 1358 Bangor ME 04401 73578426 0 X WWW.PCHC.COM X 1997 ME We provide comprehensive, integrated primary health care services for all to improve the health and wellbeing of our patients and the Maine communities we serve. 16 16 1007 16 8328 0 9839773 10139108 63647047 63272582 46040 18467 -26085 -8575 73506775 73421582 0 0 0 0 53585946 54204971 0 0 2890 20847351 22042258 74433297 76247229 -926522 -2825647 38680931 36465781 24165609 24776106 14515322 11689675 X See Schedule O 0 0 35261235 40948581 PCHC's Family Medicine Services provided 218,193 patient visits in 2018. 6361184 7865571 PCHC's Dental Services provided 44,098 patient visits in 2018. 14575256 14458430 All other services as described in Line 1, including 26,427 other visits in 2018. 56197675 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 123 0 1 1007 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X Christine McLaughlin 2079929200 103 Maine Avenue PO Box 1358 Bangor ME 04402 Mark Woodward Chair 1.00 X X 0 0 0 Chris Winstead Vice Chair 1.00 X X 0 0 0 Michael Jones Treasurer 1.00 X X 0 0 0 Robert P Allen MD Director 1.00 X 0 0 0 Michael Aube Director 1.00 X 0 0 0 Aaron Ballman Director 1.00 X 0 0 0 Rev Mark Doty PhD Director 1.00 X 0 0 0 Alan DuPlessis Director 1.00 X 0 0 0 Jennifer Eastman Esq Director 1.00 X 0 0 0 Monique Gautreau Director 1.00 X 0 0 0 Meredith Jones Past Director 1.00 X 0 0 0 Ryan Low Director 1.00 X 0 0 0 James Nason Past Director 1.00 X 0 0 0 Jessamine Pottle Director 1.00 X 0 0 0 Ned Robertson DMD Director 1.00 X 0 0 0 Kelly Strout PhD RN Director 1.00 X 0 0 0 Carin Sychterz Director 1.00 X 0 0 0 Jacques W Weinstein MBA Director 1.00 X 0 0 0 Lori L Dwyer President & CEO 40.00 X 235561 0 29622 Christine Finn-McLaughlin CFO 40.00 X 161460 0 28570 Noah Nesin Chief Medical Officer 40.00 X 274730 0 29986 Vernon Gardner Chief Psychiatric Officer 40.00 X 223898 0 24046 Dawn Cook Chief Operations Officer 40.00 X 179504 0 30753 Theresa Knowles Chief Quality Officer 40.00 X 159256 0 21828 Megan Sanders Chief HR & Legal Officer 40.00 X 161059 0 25685 Laura L Matones Physician/Internist 40.00 X 231488 0 17098 Laurie E Yntema Physician/Internist 40.00 X 224975 0 28990 Alexandra M Craig Physician/Internist 40.00 X 223954 0 4195 Warren Shearer Physician/Medical Director 40.00 X 216062 0 31194 Susan E Cheff Physician/Medical Director 40.00 X 204187 0 23891 2496134 0 295858 86 0 1 0 GEVerience PO Box 840952 Dallas TX 752840952 EMR 720213 Hilltop Inn 11 Bangor Mall Blvd Suite 1 Bangor ME 04401 Rent 657047 Wilson St Holdings 2402 Route 2 Suite G Hermon ME 04401 Rent 654718 Eremita & Valley 11 Bangor Mall Blvd Suite 1 Bangor ME 04401 Rent 460469 Hardy Construction 431 Odlin Road Bangor ME 04401 Contractor 232289 6 76623 8467052 1595433 913041 10139108 Net Patient Revenue 621110 53030234 53030234 Care Management Revenue 621110 4362817 4362817 Low Cost Pharmaceuticals 446110 3716710 3716710 Other Program Income 621110 2162821 2162821 63272582 18467 18467 133919 125591 8328 8328 8328 0 76623 31253 -31253 -31253 Forgiveness of Debt 900099 14350 14350 14350 73421582 63272582 8328 1564 1871361 1871361 42052118 34172588 7879530 639189 518539 120650 6649620 5072766 1576854 2992683 2371636 621047 154410 154410 41780 41780 28454 28454 1253208 808597 444611 185829 7380 178449 1052449 483013 569436 1304043 186223 1117820 3607531 1322133 2285398 202997 105546 97451 652765 19 652746 2077934 594843 1483091 176387 17986 158401 Program Supplies 9899078 9825867 73211 Other Expenses 1402503 710539 691964 Fundraising 2890 2890 76247229 56197675 20046664 2890 2246530 377132 479696 3012262 3520088 442829 5843616 6844917 940262 993021 401936 354833 44681854 20241067 25248803 24440787 38680931 36465781 5805490 6062417 2508140 15751979 16998735 100000 1714954 24165609 24776106 X 14293862 11515002 221460 174673 14515322 11689675 38680931 36465781 -2825647 0 X 0 1 X 1 1 1 X 7226668 7066328 8701151 9839773 10139108 42973028 53460583 59594806 60577626 63647047 63272582 300552644 60687251 66661134 69278777 73486820 73411690 343525672 0 0 0 343525672 2761 7183 35523 21752 152386 219605 1943 1943 2761 7183 37466 21752 152386 221548 14350 14350 60690012 66668317 69316243 73508572 73578426 343761570 0.99930 0.99970 0.00060 0.00020 X Schedule A, Part III, Line 12, Explanation of Other Income: Forgiveness of Debt - 2018 Amount: $ 14,350. 793 793 793 159 40 0 634 0 858 159 1017 1526 4291 793 5084 215 40 255 383 0 Part I-A, Line 1: To meet with members of Congress to ask them reauthorize Community Health Centers and to discuss the preservation of the PPS rate, 340b program, and block grants. Capital Hill visits to discuss the reauthorization of the THC program. 1106639 1106639 18650418 5219397 13431021 11840732 4379526 7461206 12975933 10642144 2333789 108132 108132 24440787 Due to Third Party Payers 1500000 Deferred Compensation 214954 1714954 X 73578426 156844 156844 73421582 0 73421582 76404073 156844 156844 76247229 0 76247229 Part X, Line 2: The Organization is a public charity under Section 501(c)(3) of the Internal Revenue Code (IRC). As a public charity, the Organization is exempt from state and federal income taxes on income earned in accordance with its tax exempt purpose. Unrelated business income is subject to state and federal income tax. Management has evaluated the Organization's tax positions and concluded that the Organization has no unrelated business income or uncertain tax positions that require adjustment to the financial statements. Part XI, Line 2d - Other Adjustments: Rental Expenses 125,591. Fundraising Expenses 31,253. Part XII, Line 2d - Other Adjustments: Rental Expenses 125,591. Fundraising Expenses 31,253. Over the Edge 76623 76623 31253 76623 76623 31253 31253 -31253 X X 0 0 0 0 0 0 0 0 0 Lori L Dwyer President & CEO 235561 0 0 0 0 0 3015 0 26607 0 265183 0 0 0 Christine Finn-McLaughlin CFO 161460 0 0 0 0 0 2877 0 25693 0 190030 0 0 0 Noah Nesin Chief Medical Officer 274730 0 0 0 0 0 4641 0 25345 0 304716 0 0 0 Vernon Gardner Chief Psychiatric Officer 223898 0 0 0 0 0 3904 0 20142 0 247944 0 0 0 Dawn Cook Chief Operations Officer 179504 0 0 0 0 0 3142 0 27611 0 210257 0 0 0 Theresa Knowles Chief Quality Officer 159256 0 0 0 0 0 2412 0 19416 0 181084 0 0 0 Megan Sanders Chief HR & Legal Officer 161059 0 0 0 0 0 2877 0 22808 0 186744 0 0 0 Laura L Matones Physician/Internist 231488 0 0 0 0 0 3394 0 13704 0 248586 0 0 0 Laurie E Yntema Physician/Internist 224975 0 0 0 0 0 3893 0 25097 0 253965 0 0 0 Alexandra M Craig Physician/Internist 223954 0 0 0 0 0 3733 0 462 0 228149 0 0 0 Warren Shearer Physician/Medical Director 216062 0 0 0 0 0 3508 0 27686 0 247256 0 0 0 Susan E Cheff Physician/Medical Director 204187 0 0 0 0 0 3392 0 20499 0 228078 0 0 0 X 1 913041 FMV 0 1 0 Form 990, Part III, Line 1 - Organization's Mission Penobscot Community Health Center (PCHC) is a non-profit organization incorporated in 1997 that is governed by a Board of community volunteers and is the largest Federally Qualified Health Center in Maine. PCHC is driven by its mission statement "to provide comprehensive, integrated primary health care services for all to improve the health and wellbeing of our patients and the Maine Communities we serve," regardless of the ability to pay and demonstrates its dedication to quality care through Accreditation Association for Ambulatory Health Care as well as NCQA certification as a Primary Care Medical Home. As part of its Patient Centered Medical Home model, PCHC is proud to provide high quality family medical care to over 60,000 people in the greater Bangor Region, Waldo County and Jackman area. PCHC's four largest medical practices in Bangor, Brewer and Old Town, Maine are open seven days a week and offer an integrated care model with medical care. Four of our practices provide pharmacy and physical therapy under one roof. Also available are same day sick care, convenient early morning and evening hours, providers or nurses available by telephone call 24-hours a day, and seven day Walk-in Care at four locations. In addition to family medicine, PCHC offers a full range of services including pediatrics, dental care, pharmacy, psychiatry, mental health counseling, geriatrics care and nursing home care, laboratory and x-ray services, physical therapy, speech therapy, audiology, homeless health care and emergency shelter and transitional housing, as well as GYN, podiatry, chiropractic, and other specialty services. To learn more about PCHC's many services, providers, and locations, please visit www.PCHC.com. Our mission is to provide comprehensive, integrated primary health care services for all to improve the health and wellbeing of our patients and Maine Communities we serve. We commit not only to building the infrastructure for patient centeredness, but also to embracing the evolution of our personal roles, responsibilities and attitudes as we shift to a collaborative, team based model of care, partnered with the patient. We work to integrate community based resources, family, and health care services in order to promote wellness, manage disease, advocate for helpful public policy, and celebrate successes. We strive to understand the full picture of our patients' lives and all of the factors which impact their wellbeing, to consider those strengths and challenges as we provide care, to understand who they are in their family, workplace and community, and to ask about and listen for what matters most to them. We also commit, on a daily basis, to understand the role of our co-workers, to support each other in those roles, to properly value the contribution that every person makes to our success in fulfilling our mission, to communicate richly, to work together to solve problems and address challenges, and to interact with humor and good nature. We believe that health care is an inherent human right. We share an intellectual and emotional commitment to the care of our patients, which motivates us, sustains us and creates a generosity of spirit as we work together to fulfill our mission. We understand that quality occurs both in medical decision making and in human interaction, and that there is value both in that which we can measure, and in that which relies on our best nature and commitment to serve. We work for continuous improvement, in systems, in the effectiveness and efficiency of our care, in the experience of our patients and in the satisfaction of our team. We seek to challenge ourselves and each other, to innovate and to evaluate our work with humility as we undertake this bold endeavor. We embrace a collaborative spirit as we strive to fulfill our mission, and as we work with partners in our communities and across the state to transform health care. Form 990, Part VI, Section B, line 11b The Treasurer of the Board initially reviews the 990 return. The Treasurer then reviews the 990 return with the Finance Committee and discusses any issues raised with the Board of Directors. The Vice President of Finance sends a final draft of the 990 to each Board Member asking them to review and approve at the board meeting or via e-mail. Form 990, Part VI, Section B, line 12c The Compliance Officer does regular board updates and policy reviews, and a conflict of interest statement is completed annually. Form 990, Part VI, Section B, line 15 1. The Compensation Committee: The Executive Committee of the PCHC Board of Directors shall serve as the Compensation Committee. Pursuant to the PCHC's Bylaws, the Executive Committee (and, therefore, the Compensation Committee) shall consist of the following Board members: the Chair, Vice-Chair, Chair of Finance Committee, Chair of Quality Management Committee, and Chair of the Governance/Corporate Compliance Committee. With respect to all compensation levels other than the compensation for the President & CEO, the President & CEO shall serve as ex officio member(s) of the Compensation Committee and shall make recommendations to the committee on appropriate and reasonable compensation levels for the Executives. 2. The Board Chair shall be responsible for leading the review of the compensation package of the President & CEO. The President & CEO shall not participate in the compensation review of his or her own salary. However, the President & CEO may negotiate with respect to compensation level, provided the final review and decision on compensation is made independently by the Compensation Committee. 3. The President/CEO will be responsible for initiating and leading the Compensation Committee in the review of compensation packages for all Executives other than the President & CEO (as defined in the policy). 4. Compensation levels of other key executives shall be approved by the Compensation Committee as the Board's designee. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy and financial statements are maintained in the administrative office and are available to the public during standard business hours. Community Care Partnership ME LLC PO Box 1358 Bangor ME 04402 463666823 ACO ME N/A Related 0 1 0.42830 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 Community Care Partnership of ME LLC L 248652 FMV Community Care Partnership of ME LLC S 709546 FMV