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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
2019
Open to Public
Inspection
Name of the organization
Eastern Maine Healthcare Systems EMHSF
EMHS Foundation EMHSF
Employer identification number
22-2514163
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to 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 (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) Acadia Hospital Corp
43 Whiting Hill Rd
Brewer,ME04412 		01-0459837 501(c)(3) 104,643 0     General Support
(2) Blue Hill Memorial Hospital
57 Water Street
Blue Hill,ME04614 		01-0227195 501(c)(3) 111,587 0     General support
(3) Charles A Dean Memorial Hospi
Pritham Ave PO Box 1129
Greenville,ME04441 		04-3341666 501(c)(3) 68,094 0     General Support
(4) Eastern Maine Medical Center
PO Box 404 489 State Street
Bangor,ME04402 		01-0211501 501(c)(3) 6,585,350 0     General support
(5) EMMC Auxiliary
43 Whiting Hill Rd
Brewer,ME04412 		01-0377901 501(c)(3) 21,314 0     General support
(6) Husson University
One College Circle
Bangor,ME04401 		01-0271210   19,706 0     Nursing and accounting scholarships
(7) Inland Hospital
200 Kennedy Memorial Drive
Waterville,ME04901 		01-0217211 501(c)(3) 38,532 0     General support
(8) Maine Coast Regional Health F
50 Union Street
Ellsworth,ME04605 		01-0198331 501(c)(3) 356,434 0     General Support
(9) Mercy Hospital
144 State Street
Portland,ME04101 		01-0211534 501(c)(3) 8,316,016 0     General support
(10) Sebasticook Valley Health
447 North Main Street
Pittsfield,ME04967 		01-0263628 501(c)(3) 6,012 0     General Support
(11) The Aroostook Medical Center
PO Box 151 140 Academy St
Presque Isle,ME04769 		01-0372148 501(c)(3) 500,999 0     General support
(12) VNA Home Health & Hospice
50 Foden Road
South Portland,ME04106 		01-0246804 501(c)(3) 207,066 0     General Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
11
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019
Page 2

Schedule I (Form 990) 2019
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) Healthcare expense assistance 27 23,582      
(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
Grantmaker's Description of How Grants are Used EMHS Foundation procedure for grant monitoring and review process includes the following:Recipients are required to provide an accounting of expenditures. These are reviewed by the Director of Finance and Operations before being disbursed.
Schedule I (Form 990) 2019



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