Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Millinocket Regional Hospital
 
Employer identification number

01-0223482
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2019
Page 2
Schedule L (Form 990 or 990-EZ) 2019
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Joyce Given Family Member is employee of Hospital 50,652 Joyce Given served as a Trustee of Millinocket Regional Hospital until April 2020. A family member, Cynthia Morneault, is an employee of the Hospital. 2019 W-2 compensation paid to Cynthia Morneault was $42,807. As a Hospital employee, Ms. Morneault also received deferred compensation in the amount of $1,376 and fringe benefits of $6,469.   No
(2) Daniel Herbert Family Member is employee of Hospital 106,718 Daniel C. Herbert, MD serves as Chief Medical Officer and a Trustee of Millinocket Regional Hospital. A family member, Laurie Vickers-Herbert, is an employee of the Hospital. 2019 W-2 compensation paid to Laurie Vickers-Herbert was $75,305. As a Hospital employee, Ms. Vicker-Herbert also received deferred compensation in the amount of $2,311 and fringe benefits of $29,102.   No
(3) Patrick E Hunt Esq Family Member is employee of Hospital 120,510 Patrick E. Hunt, Esq. serves as a Trustee of Millinocket Regional Hospital. A family member, Rose Ann Hunt, PA, is an employee of the Hospital. 2019 W-2 compensation paid to Rose Ann Hunt was $116,783. As a Hospital employee, Ms. Hunt also received deferred compensation in the amount of $3,510 and fringe benefits of $217.   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L, Part IV:  
Schedule L (Form 990 or 990-EZ) 2019


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