2016-08-09T13:55:49-05:00 2015-09-30 990 2014-10-01 010211503 FRANKLIN MEMORIAL HOSPITAL FRAN 2077792500 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 WAYNE BENNETT VICE PRESIDENT & CFO 2077792500 2016-08-02 2014 2016-09-27 15:27:22Z TIMOTHY CHURCHILL 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 78255283 false X WWW.FCHN.ORG X 1926 ME TO PROVIDE HIGH-QUALITY, COST-EFFECTIVE, PATIENT-CENTERED HEALTHCARE TO OUR WEST CENTRAL MAINE COMMUNITY. WE WORK WITH OUR COMMUNITY AND OTHER HEALTHCARE PROVIDERS TO INTEGRATE SERVICES AND ENSURE THE HEALTH OF OUR COMMUNITY. 17 13 840 154 0 221054 191801 18510323 77961887 1605 6287 50087 18737664 78205380 0 0 12844145 47257671 0 0 7449087 31558782 20293232 78816453 -1555568 -611073 51298014 50797144 29468157 31158241 21829857 19638903 X TO PROVIDE HIGH-QUALITY, COST-EFFECTIVE, PATIENT-CENTERED HEALTHCARE TO OUR WEST CENTRAL MAINE COMMUNITY. WE WORK WITH OUR COMMUNITY AND OTHER HEALTHCARE PROVIDERS TO INTEGRATE SERVICES AND ENSURE THE HEALTH OF OUR COMMUNITY. false false 44714958 60391249 ROUTINE INPATIENT AND ANCILLARY OUTPATIENT SERVICES FRANKLIN MEMORIAL HOSPITAL IS A NON-FOR-PROFIT COMMUNITY HOSPITAL WHICH PROVIDES HIGH-QUALITY, COST-EFFECTIVE, PATIENT-CENTERED INPATIENT AND OUTPATIENT HEALTHCARE SERVICES TO THE WEST CENTRAL MAINE COMMUNITY. THE 65-BED HOSPITAL IS FULLY QUALIFIED AND ACCREDITED TO HANDLE A BROAD RANGE OF MEDICAL, SURGICAL, PEDIATRIC, WOMEN'S CARE AND DIAGNOSTIC SERVICES. FRANKLIN MEMORIAL HOSPITAL OFFERS TOP QUALITY SPECIALTY CARE INCLUDING ROUTINE ADULT, PEDIATRIC AND INTENSIVE CARE INPATIENT SERVICES AS WELL AS A VARIETY OF OUTPATIENT SERVICES INCLUDING ONCOLOGY, HEMATOLOGY, CARDIOLOGY, OTOLARYNGOLOGY, ORTHOPEDICS, BEHAVIORAL SERVICES, OCCUPATIONAL HEALTH, (CONTINUED AT SCHEDULE O) (CONTINUED FROM PART III, LINE 4A) DERMATOLOGY, PULMONOLOGY, PAIN MANAGEMENT, PEDIATRIC ENDOCRINOLOGY, PHYSICAL REHABILITATION, SPORTS MEDICINE AND WOUND CARE. DURING THE TWELVE MONTHS ENDING SEPTEMBER 30, 2015 THERE WERE 2,406 INPATIENT DISCHARGES, 1,724 OUTPATIENT SURGERIES, 243,300 OUTPATIENT LAB TESTS AND 39,218 OUTPATIENT IMAGING PROCEDURES. 16997230 10343487 FRANKLIN HEALTH PHYSICIAN PRACTICES FRANKLIN MEMORIAL HOSPITAL IDENTIFIED ACCESS TO PRIMARY CARE AS A CENTRAL COMMUNITY NEED AND IS COMMITTED TO PROVIDING HIGH QUALITY PHYSICIAN SERVICES OF FAMILY PRACTICE, INTERNAL MEDICINE, PEDIATRICS AND WOMEN'S CARE. IN ADDITION, FRANKLIN MEMORIAL HOSPITAL OFFERS A VARIETY OF SPECIALTY CARE SERVICES INCLUDING DERMATOLOGY, SURGERY, ORTHOPAEDICS AND BEHAVIORAL HEALTH SERVICES. DURING THE TWELVE MONTHS ENDING SEPTEMBER 30, 2015 FRANKLIN MEMORIAL HOSPITAL PROVIDED 53,700 PRIMARY CARE VISITS AND 13,100 SPECIALTY CARE VISITS IN THE FRANKLIN HEALTH PHYSICIAN PRACTICES. 4956689 7227151 EMERGENCY ROOM FRANKLIN MEMORIAL HOSPITAL OPERATES AN EMERGENCY DEPARTMENT WHICH OPERATES 24 HOURS A DAY SEVEN DAYS A WEEK. THE EMERGENCY DEPARTMENT SERVES AS THE PRIMARY CARE PHYSICIAN FOR A NUMBER OF LOW INCOME AND INDIGENT RESIDENTS OF THE WEST CENTRAL MAINE COMMUNITY. GIVEN FRANKLIN MEMORIAL HOSPITAL'S COMMITMENT TO ACCESS TO CARE REGARDLESS OF THE ABILITY TO PAY, THE EMERGENCY DEPARTMENT SERVES A VITAL ROLE IN THE COMMUNITY'S HEALTH CARE NETWORK. DURING TWELVE MONTHS ENDING SEPTEMBER 30, 2015 FRANKLIN MEMORIAL HOSPITAL HAD 16,300 EMERGENCY ROOM VISITS. 66668877 true true false true false false false false false true true false false true true false false true false false false false false false false false true true false false true true false false false false false false false false true false false false false false false true false false false true 134 0 true 840 true false false false false false false false false false false X 17 13 false false true false true true true true true false false true true true true true true true true false ME X WAYNE BENNETT CFO 2077792613 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 REBECCA ARSENAULT PRESIDENT/CE 50.00 7.00 X X 380636 0 12932 HEIDI DECKER MD MEDICAL STAF 50.00 0.20 X 187564 0 18555 CONNIE ADLER MD SECRETARY 50.00 0.20 X X 135359 0 8558 CAROL TIMBERLAKE DIRECTOR 0.80 0.20 X 0 0 0 CLINT BOOTHBY VICE CHAIR 0.80 0.20 X X 0 0 0 JOSEPH BUJOLD CHAIRMAN 2.80 0.20 X X 0 0 0 GILLY HITCHCOCK DIRECTOR 0.80 0.20 X 0 0 0 MEREDITH TIPTON DIRECTOR 0.80 0.20 X 0 0 0 JOHN BOGAR TREASURER 0.80 0.20 X X 0 0 0 DAVID DIXON MD DIRECTOR 0.80 0.20 X 0 0 0 PETER JUDKINS DIRECTOR 0.80 0.20 X 0 0 0 SHEENA BUNNELL DIRECTOR 0.80 0.20 X 0 0 0 RONALD ASELTINE DIRECTOR 0.80 0.20 X 0 0 0 DARRYL WOOD DIRECTOR 0.80 0.20 X 0 0 0 MICHAEL CORMIER DIRECTOR 0.80 0.20 X 0 0 0 CHRISTINE TROPEANO DIRECTOR 0.80 0.20 X 0 0 0 CONNIE COGGINS DIRECTOR 0.80 0.20 X 0 0 0 WAYNE BENNETT CFO 50.00 4.00 X 223425 0 20326 GERALD CAYER VP PHYS. & C 50.00 1.00 X 218107 0 19847 JOSHUA D SPARLING MD DERMATOLOGIS 32.00 0.00 X 492013 0 21429 NANCY CUMMINGS MD ORTHOPEDIC S 50.00 X 387592 0 17061 HEATHER DECAROLIS MD ANESTHESIOLO 50.00 0.00 X 365164 0 21301 JAMES LANCASTER MD ANESTHESIOLO 50.00 0.00 X 364450 0 21301 G THOMAS MARSHALL MD GENERAL SURG 50.00 0.00 X 356683 0 18576 MICHAEL FRALEY MD MEDICAL STAF 50.00 0.00 X 373266 0 21301 ROBERT O'REILLY MD FMR MED. STA 50.00 0.00 X 197016 0 19639 ARMAND AUGER MD FORMER DIREC 50.00 0.00 X 56690 0 2261 3737965 223087 65 true true false SYNERNET INC 110 FREE STREET PORTLAND ME 04101 TRANSCRIPTION 585142 COMPHEALTH 6440 SOUTH MILLROCK DR SUITE 175 SALT LAKE CITY UT 84121 PHYS. STAFFING 519685 MAINEGENERAL MEDICAL CENTER 33 STONE STREET AUGUSTA ME 04330 PHYS. STAFFING 496771 DAHL-CHASE DIAGNOSTIC SERVICES 417 STATE ST WEBBER WEST SUITE 441 BANGOR ME 04401 LAB DIAGNOSTICS 486655 QUEST DIAGNOSTICS INC 415 MASSACHUSETTS AVE CAMBRIDGE MA 02139 LAB DIAGNOSTICS 426589 13 99270 92531 191801 PATIENT SERVICES 621990 74208495 74208495 OTHER 621990 2745722 2745722 AMBULANCE SUBSIDIES 621910 894264 894264 CAFETERIA 722514 113406 113406 77961887 92839 42752 50087 50087 50087 8756 7151 1605 1605 1605 78205380 77963492 50087 X 1318619 350036 968583 670173 670173 36904268 32582510 4321758 630412 545252 85160 5201975 4499261 702714 2532224 2190156 342068 102473 102473 75417 75417 12590 12590 9593849 7196943 2396906 118296 118296 944184 553096 391088 2180521 669747 1510774 1872408 1856230 16178 97287 93124 4163 234435 160284 74151 909838 803289 106549 3726093 3289740 436353 1049901 938834 111067 MEDICAL SUPPLIES 7387860 7387860 HOSPITAL TAX 1934637 1934637 OTHER 1318993 947705 371288 78816453 66668877 12147576 0 3605 3505 2042543 1815471 8645112 8387622 1361507 1546204 976562 2714667 88239510 58460907 31620535 29778603 2966805 274430 3406915 6551072 51298014 50797144 7996692 9286919 76917 21394 19772957 18805455 1621591 3044473 29468157 31158241 X 18956619 16876394 1602575 1525939 1270663 1236570 21829857 19638903 51298014 50797144 X -611073 -1579881 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 12590 12590 false SCHEDULE C, PART II-B, LINE 1 THE ORGANIZATION PAYS DUES TO VARIOUS ASSOCIATIONS, A PORTION OF WHICH IS ATTRIBUTABLE TO LOBBYING EXPENSES. 2799451 408226 -187776 -327969 2691932 2874474 53718 -71709 -57032 2799451 2604155 11967 316743 58391 2874474 2325015 126671 166297 13828 2604155 2341310 216215 -63416 169094 2325015 0.46000 0.54000 false true true 1268949 1268949 48768717 26245458 22523259 32423798 28962550 3461248 5778046 3252899 2525147 29778603 INTERST IN FCHN NET ASSETS 2411746 DEFERRED COMPENSATION 1791845 EST. DUE FROM THIRD PARTY 1631015 BENEFICIAL INT. IN PERPETUAL TRUST 280187 DUE FROM RELATED PARTIES 268925 WMPHO INVESTMENT 167354 6551072 DEFERRED COMPENSATION 1791845 LINE OF CREDIT 750000 DUE TO AFFILIATES 502628 3044473 SCHEDULE D, PAGE 2, PART V, LINE 4 THE ORGANIZATION'S ENDOWMENT FUNDS ARE HELD BY THE FRANKLIN COMMUNITY HEALTH NETWORK AND ARE INTENDED TO SUPPORT VARIOUS PROGRAMS OFFERED BY THE ORGANIZATION, SUCH AS THE CHARITY PROGRAM, COMMUNITY OUTREACH, EDUCATION, MEDICAL LIBRARY, MARTHA B. WEBBER BREAST CARE CENTER AND OTHERS. true true true X 1.750000000000 true X 2.250000000000 true true false true true 1310807 1310807 0.01660 12850303 10358888 2491415 0.03160 14161110 10358888 3802222 0.04820 556115 63513 492602 0.00620 200663 96524 104139 0.00130 9190052 4330804 4859248 0.06170 24300 24300 0.00030 9971130 4490841 5480289 0.06950 24132240 14849729 9282511 0.11780 2000 2000 2000 2000 false 1605108 19282573 24014872 -4732299 X true true WESTERN MAINE PHO PHYSICIAN HOSPITAL ORGANIZATION 0.50000 SCOREKEEPER LLC WELLNESS SOFTWARE 0.40000 1 1 FRANKLIN MEMORIAL HOSPITAL 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 WWW.FCHN.ORG/ABOUT ME STATE LIC. 38278 X X X FRANKLIN MEMORIAL HOSPITAL 1 false false true X X X X X X X X 12 true false false true X WWW.FCHN.ORG/ABOUT X true 13 true WWW.FCHN.ORG/ABOUT false false true X 175.000000000000 225.000000000000 X X true true X X X true X WWWFCHNORGPAYINGFORCARE X X X true X true X X X X true X false false FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, LINE 5 THE WORKING GROUP FOR DEVELOPING THE COMMUNITY HEALTH NEEDS ASSESSMENT CONSISTED OF PERSONS WHO ARE CONSIDERED PUBLIC HEALTH EXPERTS, SUCH AS MEREDITH TIPTON, PHD, MPH, ASSOCIATE DEAN FOR COMMUNITY PROGRAMS, UNIVERSITY OF NEW ENGLAND, FCHN BOARD MEMBER; SARAH MARTIN, PHD EPIDEMIOLOGY, HEALTHY COMMUNITY COALITION, HUSSON COLLEGE SCHOOL OF PHARMACY; AND MICHAEL ROWLAND, MD, MPH, VICE PRESIDENT MEDICAL AFFAIRS, FRANKLIN MEMORIAL HOSPITAL. THE WORKING GROUP TOOK INPUT FROM VARIOUS COMMUNITY GROUPS INTERESTED IN PROMOTING WELLBEING OF THE POPULATION IN OUR COMMUNITY, INCLUDING: - FCHN BOARD, REPRESENTING COMMUNITIES IN FRANKLIN COUNTY - HEALTHY COMMUNITY COALITION BOARD, REPRESENTING DIVERSE GROUPS INVOLVED WITH HEALTH IMPROVEMENT - FRANKLIN HEALTH COLLABORATIVE, REPRESENTING HEALTH-RELATED ORGANIZATIONS AND INITIATIVES COUNTY WIDE (LONG-TERM CARE, HOME HEALTH, PUBLIC HEALTH NURSING, MENTAL HEALTH AGENCIES, SCHOOL DISTRICTS, DOMESTIC VIOLENCE VICTIM ADVOCACY, EMERGENCY RESPONSE SERVICES, UNIVERSITY OF MAINE AT FARMINGTON, FRANKLIN COUNTY CHILDREN'S TASK FORCE, WESTERN MOUNTAINS ALLIANCE) - FMH PRIMARY CARE SERVICE, REPRESENTING PRIMARY CARE PROVIDERS IN FRANKLIN COUNTY - WESTERN MAINE PUBLIC HEALTH DISTRICT, COORDINATING REGIONAL HEALTH IMPROVEMENT WORK WITH MAINE CDC IN ADDITION TO NUMEROUS FACE-TO-FACE MEETINGS WITH THE COMMUNITY GROUPS IDENTIFIED ABOVE, DIRECT INPUT FROM COMMUNITY MEMBERS WAS OBTAINED VIA COMMUNITY SURVEY, CONDUCTED BY HEALTHY COMMUNITY COALITION IN 2013, MEETINGS WITH FRANKLIN HEALTH PATIENT ADVISORY GROUP AND COMMUNITY VISIONING PUBLIC MEETINGS CONDUCTED EVERY 2 YEARS. DURING FY 2015, A NEW COMMUNITY HEALTH NEEDS ASSESSMENT WAS INITIATED THAT WILL BE PUBLISHED AND IMPLEMENTED IN FY 2016. RECOGNIZING FRANKLIN MEMORIAL HOSPITAL'S NEW AFFILIATION WITH MAINEHEALTH, THIS NEW COMMUNITY HEALTH NEEDS ASSESSMENT IS BEING CONDUCTED BY MAINEHEALTH FOR ALL MAINEHEALTH MEMBER HOSPITALS. FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, LINE 11 THE ORGANIZATION HAS CONTINUED TO WORK ON ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENT CHNA AND IMPLEMENTATION PLAN. PLEASE SEE THE ATTACHED IMPLEMENTATION PLAN UPDATE FOR DETAILS OF THE ACTIVITIES UNDERTAKEN BY THE ORGANIZATION TO MEET THE IDENTIFIED NEEDS OF ITS COMMUNITY. OTHER NEEDS IDENTIFIED IN THE CHNA NOT CURRENTLY BEING ADDRESSED BY FMH INCLUDE DENTAL CARE, DOMESTIC VIOLENCE, FATAL MOTOR VEHICLES, SUICIDE AND SUBSTANCE ABUSE. THE ORGANIZATION HAS IDENTIFIED OTHER COMMUNITY ORGANIZATIONS WHO ARE CURRENTLY ADDRESSING THESE NEEDS. FACILITY 1, FRANKLIN MEMORIAL HOSPITAL - PART V, LINE 16I FRANKLIN MEMORIAL HOSPITAL TAKES A NUMBER OF STEPS TO PUBLICIZE THE AVAILABILITY OF THE FINANCIAL ASSISTANCE TO PATIENTS: 1. NOTICES OF THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE POSTED IN LOCATIONS WITHIN THE HOSPITAL AT WHICH MEMBERS OF THE PUBLIC GENERALLY TRANSACT BUSINESS WITH THE HOSPITAL OR PRESENT THEMSELVES TO RECEIVE OR REQUEST HOSPITAL SERVICES, INCLUDING ADMITTING AREAS, WAITING ROOMS, BUSINESS OFFICES AND OUTPATIENT RECEPTION AREAS. 2. WITH RESPECT WITH INPATIENT ADMISSIONS, INDIVIDUAL WRITTEN NOTICE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IS PRESENTED TO EACH PATIENT UPON ADMISSION OR IN THE CASE OF EMERGENCY ADMISSION BEFORE DISCHARGE. IN ADDITION, ALL INPATIENTS ARE VISITED BY A PATIENT FINANCIAL ADVOCATE TO DISCUSS AVAILABILITY OF FINANCIAL ASSISTANCE AND GOVERNMENT COVERAGE OPTIONS. 3. AVAILABILITY OF FINANCIAL ASSISTANCE IS PUBLICIZED ON THE PATIENT INVOICES SUPPLYING PATIENTS WITH A CONTACT NUMBER TO OBTAIN FURTHER INFORMATION ABOUT AVAILABLE OPTIONS. 4. FINANCIAL ASSISTANCE OPTIONS ARE OUTLINED ON THE HOSPITALS' WEBSITE AND ARE READILY AVAILABLE TO THE PUBLIC. 5. RACK CARDS AND FINANCIAL ASSISTANCE APPLICATIONS ARE LOCATED THROUGHOUT THE HOSPITAL AND PHYSICIAN PRACTICES. 6. HOSPITAL BOOKLETS ARE AVAILABLE IN ALL PATIENT ROOMS WITH A SECTION REGARDING FINANCIAL ASSISTANCE. 7. PATIENT FINANCIAL ADVOCATES WORK WITH ALL PATIENTS WITHOUT HEALTH INSURANCE COVERAGE TO NOTIFY THEM ABOUT AVAILABLE FINANCIAL ASSISTANCE RESOURCES AND ASSIST WITH MAINECARE APPLICATIONS FOR ELIGIBLE INDIVIDUALS. 15 FRANK HLTH LIVERMORE FALLS FAM PRAC 21 MAIN STREET LIVERMORE FALLS ME 04254 FAMILY PRACTICE FRANKLIN HLTH FARMINGTON FAM PRACT 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 FAMILY PRACTICE FRANKLIN HEALTH INTERNAL MEDICINE 131 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 INTERNAL MEDICINE PRACTICE FRANKLIN HEALTH PEDIATRICS 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 PEDIATRICIAN PRACTICE FRANKLIN HEALTH ORTHOPAEDICS 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 ORTHOPAEDIC PRACTICE FRANKLIN HEALTH SURGERY 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 GENERAL SURGERY PRACTICE OUTPATIENT SRVCS AT LIVERMORE FALLS 21 MAIN STREET LIVERMORE FALLS ME 04254 OUTPATIENT CLINIC NORTHSTAR 15 SCHOOL STREET RANGELEY ME 04970 AMBULANCE BASE NORTHSTAR 138C PARK STREET PHILLIPS ME 04966 AMBULANCE BASE NORTHSTAR 119 FEDERAL ROAD LIVERMORE ME 04254 AMBULANCE BASE NORTHSTAR 1001 CARRIAGE ROAD CARRABASSET VALLEY ME 04947 AMBULANCE BASE NORTHSTAR 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 AMBULANCE BASE FRANKLIN HEALTH WOMEN'S CARE 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 OB/GYN FRANKLIN HEALTH BEHAVIORAL SERVICES 131 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 BEHAVIORAL HEALTH PRACTICE FRANKLIN HEALTH DERMATOLOGY 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 DERMATOLOGY PRACTICE PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE COSTING METHODOLOGY FOR THE AMOUNTS REPORTED IN PART I, LINE 7 OF THE SCHEDULE H IS BASED ON A RATIO OF PATIENT CARE COST TO CHARGES. THIS COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST- TO-CHARGES PROVIDED IN THE INSTRUCTIONS FOR SCHEDULE H. PART II - COMMUNITY BUILDING ACTIVITIES SEE 990, SCHEDULE H, PART VI, LINE 5. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY FRANKLIN MEMORIAL HOSPITAL USED THE RCC CALCULATED FROM WORKSHEET 2 AND MULTIPLIED IT BY THE BAD DEBTS EXPENSE PER THE FINANCIAL STATEMENTS. BAD DEBTS INCLUDE 100% OF THE CHARGES WRITTEN OFF DUE TO NO PAYMENT. IF A PAYMENT IS MADE ON A BAD DEBT ACCOUNT, THEN THAT PAYMENT REDUCES THE BAD DEBT EXPENSE IN THE YEAR RECEIVED. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS BAD DEBT EXPENSE REPRESENTS HEALTHCARE SERVICES THAT FRANKLIN MEMORIAL HOSPITAL HAS PROVIDED WITHOUT COMPENSATION. AS A TAX EXEMPT HOSPITAL, FRANKLIN MEMORIAL HOSPITAL PROVIDES NECESSARY PATIENT CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES. A PORTION OF FRANKLIN MEMORIAL HOSPITAL'S BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THAT FOR A VARIETY OF REASONS, DO NOT COMPLETE THE FINANCIAL ASSISTANCE APPLICATION PROCESS. FRANKLIN MEMORIAL HOSPITAL CANNOT DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE REASONABLY ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE FRANKLIN MEMORIAL HOSPITAL'S FREE CARE POLICY. PAGES 8 AND 13 OF THE ATTACHED FINANCIAL STATEMENTS PROVIDE FOOTNOTES RELATED TO BAD DEBT EXPENSE AND BAD DEBT ALLOWANCE. PART III, LINE 8 - MEDICARE EXPLANATION THE MEDICARE PRINCIPLES OF REIMBURSEMENT WERE USED TO DETERMINE THE MEDICARE INPATIENT AND OUTPATIENT COSTS BASED ON THE ORGANIZATION'S COST REPORT. FRANKLIN MEMORIAL HOSPITAL BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE MEDICAL CENTER HAS A CLEAR MISSION COMMITMENT TO SERVING ELDERLY PATIENTS AND ADULTS WITH DISABILITIES THROUGH THE PROVISION OF SPECIFIC SUBSIDIZED PROGRAMS DEVELOPED TO HELP IMPROVE THE HEALTH STATUS OF THESE PATIENTS. IF THESE CRITICAL SUBSIDIZED PROGRAMS WERE NOT PROVIDED BY THE MEDICAL CENTER, THEY WOULD BECOME THE OBLIGATION OF THE FEDERAL GOVERNMENT. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION COLLECTION AGENCIES WORK WITH PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE AND REFER PATIENTS WHO INQUIRE ABOUT FINANCIAL ASSISTANCE BACK TO FRANKLIN MEMORIAL HOSPITAL FOR FOLLOW UP WITH A PATIENT FINANCIAL ADVOCATE AS NEEDED. BALANCES THAT ARE OWED TO THE HOSPITAL AFTER APPLYING ANY FINANCIAL ASSISTANCE ARE COLLECTED IN THE SAME MANNER AS ANY OTHER SELF PAY BALANCES. PART VI, LINE 2 - NEEDS ASSESSMENT THE FRANKLIN MEMORIAL HOSPITAL NETWORK CONDUCTS A HEALTH VISIONING PROCESS EVERY TWO YEARS THAT IS USED TO IDENTIFY NEEDS AND PERCEIVED PRIORITIES IN THE COMMUNITY. A PHYSICIAN SURVEY IS CONDUCTED PERIODICALLY TO ASSIST IN GATHERING INFORMATION ABOUT CLINICAL CARE NEEDS, REFERRAL PATTERNS, SPECIALIST NEEDS, ETC. THE LONG-RANGE PLANNING COMMITTEE, BOARD OF DIRECTORS AND SENIOR LEADERSHIP USE THIS AND OTHER DATA IN DEVELOPING GOALS AND PRIORITIES, MAKING DECISIONS, AND SETTING LONG-TERM GOALS AND STRATEGIES. THE ORGANIZATION SEEKS TO MEET THE NEEDS OF THE POPULATION WHENEVER FEASIBLE THROUGH DIRECT PROVISION OF SERVICES, CONTRACTUAL RELATIONSHIPS, OR THROUGH REFERRAL. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE WHEN PATIENTS ARE REGISTERED THERE ARE BROCHURES AVAILABLE THAT DESCRIBE FRANKLIN MEMORIAL HOSPITAL'S CHARITY CARE PROGRAMS. WHEN A PATIENT IS ADMITTED WITH NO INSURANCE, REGISTRATION SENDS A PATIENT FINANCIAL ADVOCATE UP TO THE PATIENT'S ROOM TO MEET THE PATIENT. EACH BILL PROVIDED TO A PATIENT HAS THE PHONE NUMBER TO CALL IF THE PATIENT NEEDS FINANCIAL ASSISTANCE. THE ORGANIZATION'S BILLERS ALSO REFER PATIENTS TO THE ORGANIZATION'S PATIENT FINANCIAL ADVOCATE WHEN A PATIENT IS IDENTIFIED AS NEEDING ASSISTANCE. PART VI, LINE 4 - COMMUNITY INFORMATION FRANKLIN MEMORIAL HOSPITAL'S SERVICE AREA COVERS 2,200 SQUARE MILES WHICH EXTENDS TO THE CANADIAN BORDER. IT IS ONE OF THE MOST RURAL AND ECONOMICALLY CHALLENGED REGIONS IN MAINE, INCLUDING SEVERAL AREAS THAT HAVE BEEN FEDERALLY DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AND MEDICALLY UNDERSERVED AREAS. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH COMMUNITY BUILDING PHYSICAL IMPROVEMENTS AND HOUSING: 1. DEVELOPMENT AND MAINTENANCE OF THE RAIL TRAIL WHICH IS ON FMH PROPERTY AND IS AVAILABLE TO THE PUBLIC TO ENCOURAGE HEALTH AND WELLNESS. ECONOMIC DEVELOPMENT: 1. MEMBER OF GREATER FRANKLIN DEVELOPMENT CORPORATION - AN ORGANIZATION COMMITTED TO ECONOMIC DEVELOPMENT. COMMUNITY SUPPORT: 1. PERFORM DISASTER DRILLS WITH THE COMMUNITY 1-2 TIMES A YEAR 2. COMMUNITY DENTAL (PROVIDE LOW COST RENTAL SPACE) COALITION BUILDING: 1. HEALTHY COMMUNITY COALITION OF GREATER FRANKLIN COUNTY, FOUNDED IN 1989, IS ONE OF THE OLDEST HEALTH COALITIONS IN THE COUNTRY. ITS MISSION IS TO MEASUREABLY IMPROVE THE WELL-BEING OF ALL PEOPLE IN GREATER FRANKLIN COUNTY AND NEIGHBORING TOWNS USING A COORDINATED PUBLIC HEALTH APPROACH OF EDUCATION, PROMOTION, AND OUTREACH. WITH ITS QUALIFIED STAFF OF PUBLIC HEALTH PROFESSIONALS, HEALTHY COMMUNITY COALITION OFFERS HEALTH SCREENINGS, HEALTH INFORMATION, AND PROGRAMS AND EVENTS TO SUPPORT HEALTHY LIFESTYLES THAT PREVENT DISEASE AND IMPROVE QUALITY OF LIFE. ITS COMMUNITY OUTREACH EFFORTS APPEAR IN EVERY TOWN AND CORNER OF THE REGION. IN THE PAST YEAR, MORE THAN 2,000 INDIVIDUALS BENEFITED FROM OUTREACH ACTIVITIES PROVIDED THROUGH MOBILE HEALTH UNIT WHERE HEALTH RISK APPRAISALS (HRAS) ARE ROUTINELY OFFERED. HRAS INCLUDE A BLOOD PRESSURE AND CHOLESTEROL CHECK AND INDIVIDUALIZED HEALTH EDUCATION. ADDITIONAL OUTREACH EVENTS WERE HELD THROUGHOUT THE REGION SUCH AS: BONE DENSITY SCREENINGS, FLU IMMUNIZATIONS, BODY COMPOSITION ANALYSIS, FREE CLINICAL BREAST EXAMS, EDUCATION ON TOBACCO, NUTRITION, PHYSICAL ACTIVITY AND SUBSTANCE ABUSE, AND EDUCATION ON THE PREVENTION OF BREAST, CERVICAL, COLON, LUNG, PROSTATE, AND SKIN CANCER. 2. AHEC EDUCATION CENTER - ESTABLISHED IN 2004 THE FRANKLIN AHEC PROGRAM WAS DEVELOPED OUT OF GREAT INTEREST FROM EMPLOYEES AND COMMUNITY MEMBERS REQUESTING LOCAL OPPORTUNITIES TO PURSUE CAREERS IN THE HEALTH FIELD AND EDUCATIONAL PROGRAMS FOR RETENTION AND PROFESSIONAL GROWTH. THE FRANKLIN AHEC ALLOWS US TO MEET THE NEEDS OF THE RURAL POPULATION. IT ALSO BRINGS TO THE MAINE AHEC NETWORK THE RESOURCES OF A LARGE INNOVATIVE RURAL HEALTH SYSTEM THAT INCLUDES A COMMUNITY HOSPITAL, MAINE'S OLDEST HEALTHY COMMUNITY COALITION AND THE BEN FRANKLIN CENTER WHICH HOUSES A STATE OF THE ART EDUCATION CENTER, MEDICAL LIBRARY FACILITIES, AND DISTANCE LEARNING OPPORTUNITIES. THE PROGRAM HAS GREATLY EXPANDED TO INCLUDE MANY ASPECTS AND ACTIVITIES FOR RETENTION AND RECRUITMENT FOR HEALTH CAREERS IN OUR VAST RURAL CATCHMENT AREA. BECOMING AN AHEC CENTER ALLOWS US TO PARTNER WITH YOUTH PROGRAMS, PUBLIC SCHOOLS, MULTIPLE COLLEGES, ADULT EDUCATION, A LOCAL CAREER CENTER AND OTHER HEALTH CAREER PROGRAMS TO OFFER COMMUNITY MEMBERS, DISPLACED WORKERS AND CURRENT HEALTHCARE EMPLOYEES THE OPPORTUNITY TO CONTINUE OR PURSUE CAREERS. 3. HEALTHINFONET: FMH, ALONG WITH ALL OTHER MAINE HOSPITALS AND HUNDREDS OF PHYSICIAN PRACTICES IN MAINE NOW HAVE ACCESS TO A NEW, CONSOLIDATED ELECTRONIC HEALTH RECORD MADE POSSIBLE BY HEALTHINFONET THAT CONTAINS CRITICAL INFORMATION DRAWN FROM RECORDS THAT HAVE TRADITIONALLY BEEN SEPARATELY MAINTAINED IN PHYSICIAN PRACTICES, HOSPITALS AND OTHER SETTINGS. ARMED WITH MORE COMPLETE AND TIMELY INFORMATION ABOUT A PATIENT, CLINICIANS CAN PROVIDE BETTER QUALITY CARE AND IMPROVE THE COORDINATION OF CARE, PARTICULARLY FOR THOSE PATIENTS WHO SEE SEVERAL PROVIDERS AND RECEIVE CARE IN MORE THAN ONE COMMUNITY OR SETTING. 4. HEALTH WORKS: WORKSITE WELLNESS AWARD PROGRAM IS A NEW AND FREE AWARD PROGRAM OFFERED BY HEALTH COMMUNITY COALITION OF GREATER FRANKLIN COUNTY. THE AWARD PROGRAM PROVIDES BUSINESSES AND ORGANIZATIONS WITH THE OPPORTUNITY TO BE RECOGNIZED AS A COMMUNITY LEADER IN HEALTH PROMOTION. THE PURPOSE OF THE HEALTHY MAINE WORKS (HMW) IS TO GUIDE AND SUPPORT MAINE EMPLOYERS IN DEVELOPING WORKSITE WELLNESS PROGRAMS THAT SUPPORT THE HEALTH OF EMPLOYEES. HWM IS A PROJECT OF MAINE'S CENTER FOR DISEASE CONTROL, OFFICE OF SUBSTANCE ABUSE, AND DEPARTMENT OF EDUCATION AND IS DELIVERED IN COLLABORATION WITH LOCAL HEALTHY MAINE PARTNERSHIPS ACROSS THE STATE. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM FRANKLIN COMMUNITY HEALTH NETWORK: SUPPORTING ORGANIZATION FRANKLIN MEMORIAL HOSPITAL: COMMUNITY HOSPITAL HEALTHY COMMUNITY COALITION: A SUBSIDIARY OF FCHN - HCC'S MISSION IS TO MEASURABLY IMPROVE THE HEALTH AND WELL-BEING OF ALL PEOPLE IN GREATER FRANKLIN COUNTY USING A COORDINATED APPROACH OF EDUCATION, HEALTH PROMOTION, AND OUTREACH. HCC OFFERS HEALTH SCREENINGS, HEALTH INFORMATION, AND PROGRAMS AND EVENTS TO SUPPORT HEALTHY LIFESTYLES THAT PREVENT DISEASE AND IMPROVE QUALITY OF LIFE. EVERGREEN BEHAVIORAL SERVICES: OPERATES 24/7 EMERGENCY MENTAL HEALTH RESPONSE SERVICES FOR THE GREATER FRANKLIN COUNTY AREA AS WELL AS BORDERING TOWNS OF ANDROSCOGGIN & OXFORD COUNTIES. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT MAINE ADDITIONAL INFORMATION PART I, LINE 7G: THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH PRIMARY CARE (FAMILY PRACTICE, PEDIATRICS, INTERNAL MEDICINE AND WOMEN'S CARE) AND BEHAVIORAL SERVICES. false false false false false false false false false REBECCA ARSENAULT PRESIDENT/CEO 350488 12648 17500 5200 7732 393568 HEIDI DECKER MD MEDICAL STAFF PRES. 177274 10290 2931 15624 206119 WAYNE BENNETT CFO 205925 17500 4423 15903 243751 GERALD CAYER VP PHYS. & COMM. SVC 218107 4504 15343 237954 JOSHUA D SPARLING MD DERMATOLOGIST 431229 43364 17420 5200 16229 513442 NANCY CUMMINGS MD ORTHOPEDIC SURGEON 378092 9500 5200 11861 404653 HEATHER DECAROLIS MD ANESTHESIOLOGIST 365164 5200 16101 386465 JAMES LANCASTER MD ANESTHESIOLOGIST 364450 5200 16101 385751 G THOMAS MARSHALL MD GENERAL SURGEON 325103 14080 17500 5200 13376 375259 MICHAEL FRALEY MD MEDICAL STAFF PRES. 373266 5200 16101 394567 ROBERT O'REILLY MD FMR MED. STAFF PRES. 178766 750 17500 3920 15719 216655 ARMAND AUGER MD FORMER DIRECTOR 47660 9030 1139 1122 58951 SCHEDULE J, PAGE 1, PART I, LINE 3 TOP MANAGEMENT OFFICIALS ARE COMPENSATED BY THIS OR RELATED ORGANIZATIONS. THESE ORGANIZATIONS USE ONE OR MORE OF THE METHODS SHOWN ABOVE TO ESTABLISH THE COMPENSATION OF TOP MANAGEMENT. A MAINE HEALTH & HIGHER ED FAC AUTH 010314384 560425G20 2006-09-07 15270692 MRI, MEDICAL OFFICE BUILDING false false true B MAINE HEALTH & HIGHER ED FAC AUTH 010314384 560427NM4 2011-11-30 10452958 REFUNDING OF SERIES 2001A false false true A 3324750 15270692 234232 221065 13274282 2008 false false true true B 3333189 10452958 169845 117007 9633963 2002 true false true true A false false false false false false false B false false false false false false false A true false false false false false B false false false false false false false false false A false B false KYES INSURANCE BUSINESS 187005 BOARD MEMBER IS OFF. false SCHEDULE L, PART V THE HOSPITAL PURCHASES SEVERAL INSURANCE POLICIES THROUGH KYES INSURANCE AGENCY. JOHN BOGAR, BOARD TREASURER IS AN OFFICER OF KYES. FORM 990 - ORGANIZATION'S MISSION TO PROVIDE HIGH-QUALITY, COST-EFFECTIVE, PATIENT-CENTERED HEALTHCARE TO OUR WEST CENTRAL MAINE COMMUNITY. WE WORK WITH OUR COMMUNITY AND OTHER HEALTHCARE PROVIDERS TO INTEGRATE SERVICES AND ENSURE THE HEALTH OF OUR COMMUNITY. FORM 990, PAGE 2, PART III, LINE 4A (CONTINUED FROM PART III, LINE 4A) DERMATOLOGY, PULMONOLOGY, PAIN MANAGEMENT, PEDIATRIC ENDOCRINOLOGY, PHYSICAL REHABILITATION, SPORTS MEDICINE AND WOUND CARE. DURING THE TWELVE MONTHS ENDING SEPTEMBER 30, 2015 THERE WERE 2,406 INPATIENT DISCHARGES, 1,724 OUTPATIENT SURGERIES, 243,300 OUTPATIENT LAB TESTS AND 39,218 OUTPATIENT IMAGING PROCEDURES. FORM 990, PAGE 6, PART VI, LINE 4 THE PARENT ORGANIZATION FRANKLIN COMMUNITY HEALTH NETWORK (FCHN) (EIN 22- 3209406) AND IT'S SUBSIDIARIES, INCLUDING FRANKLIN MEMORIAL HOSPITAL (FMH), BECAME A MEMBER OF MAINEHEALTH (EIN 01-0431680) EFFECTIVE OCTOBER 1, 2014. THE FMH BY-LAWS HAVE BEEN AMENDED AND RESTATED TO REFLECT THIS CHANGE. FORM 990, PAGE 6, PART VI, LINE 6 MAINEHEALTH (EIN: 01-0431680), IS THE SOLE MEMBER OF FRANKLIN COMMUNITY HEALTH NETWORK (FCHN) (EIN: 22-3209406). FCHN IS THE SOLE MEMBER OF FMH. FORM 990, PAGE 6, PART VI, LINE 7A MAINEHEALTH AND FRANKLIN COMMUNITY HEALTH NETWORK HAVE THE RESPONSIBILITIY FOR THE ELECTION OF THE MEMBERS OF THE GOVERNING BODY. FORM 990, PAGE 6, PART VI, LINE 7B DECISIONS OF THE GOVERNING BODY SUCH AS BUDGETS, BUSINESS STRATEGIES, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER. FORM 990, PAGE 6, PART VI, LINE 11B A COMPLETE COPY OF THE FORM 990 WAS DISTRIBUTED TO EACH MEMBER OF THE BOARD PRIOR TO FILING WITH IRS. IN ADDITION, THE 990 WAS REVIEWED WITH THE BOARD OF DIRECTORS PRIOR TO FILING THE TAX RETURN IN A FORM OF A PRESENTATION AND A Q&A SESSION TO ADDRESS ANY QUESTIONS OR CONCERNS. FORM 990, PAGE 6, PART VI, LINE 12C ON AN ANNUAL BASIS BOARD MEMBERS AND OFFICERS ARE REQUIRED TO SUBMIT A CONFLICT OF INTEREST STATEMENT WHICH IS THEN REVIEWED BY THE COMPLIANCE COMMITTEE. THE COMPLIANCE COMMITTEE IS RESPONSIBLE FOR REGULARLY AND CONSISTENTLY MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PAGE 6, PART VI, LINE 15A THE MEMBER IS RESPONSIBLE FOR AN ANNUAL EVALUATION OF THE PRESIDENT/CEO AND THE OTHER KEY ADMINISTRATIVE EMPLOYEES OF THE ORGANIZATION. COMPENSATION IS EVALUATED BY THE COMPENSATION COMMITTEE APPOINTED BY THE MEMBER, AND THE ORGANIZATION'S BOARD OF TRUSTEES MUST APPROVE OF THE COMPENSATION. IN ADDITION, THE ORGANIZATION UTILIZES THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTING FIRM AND INDUSTRY SURVEY. FORM 990, PAGE 6, PART VI, LINE 15B SEE EXPLANATION ABOVE FOR PART VI, LINE 15A. FORM 990, PAGE 6, PART VI, LINE 19 DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G TRANSCRIPTION SERVICES 224,426 74,744 0 PHYSICIAN LOCUM TENENS 2,026,152 674,800 0 CONTRACTED SERVICES 1,291,843 430,242 0 COLLECTION SERVICES 129,887 43,258 0 CONSULTING SERVICES 206,160 68,661 0 PHYSICIAN FEES 571,920 190,475 0 OTHER 2,746,555 914,726 0 FORM 990, PART XI, LINE 9 CHANGE IN INTEREST OF RELATED PARTY NET ASSETS -73,425 CHANGE IN INTEREST IN PERPETUAL TRUST -34,093 TRANSFER TO AFFILIATE -1,472,363 FRANKLIN COMMUNITY HEALTH NETWORK 111 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 223209406 SUPP. ORG ME 501C3 11B MAINEHLTH false HEALTHY COMMUNITY COALITION 105 MT BLUE CIRCLE SUITE 1 FARMINGTON ME 04938 223305743 COM. OTRCH ME 501C3 7 FCHN false PINE TREE MEDICAL ASSOCIATES 131 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 010469478 CM HTH AG ME 501C3 9 FCHN false EVERGREEN BEHAVIORAL SERVICES 131 FRANKLIN HEALTH COMMONS FARMINGTON ME 04938 010492747 MNTL HLTH ME 501C3 9 FCHN false MAINEHEALTH 110 FREE STREET PORTLAND ME 04101 010431680 HEALTHCARE ME 501C3 11C NA false WILLIAM A HOWELL TRUST FUND WILLIAM A HOWELL TRUST FUND PO BOX 830269 DALLAS TX 75283 016032170 PERP. TRST ME N/A false false false true false false false false false false true false false false false false false false false true