2015-10-14T08:11:35-05:00 2014-06-30 MAINEHEALTH 110 FREE ST PORTLAND ME 041013908 990 2013-07-01 020222156 MEMORIAL HOSPITAL MEMO 6033565461 3073 WHITE MOUNTAIN HIGHWAY NORTH CONWAY NH 03860 GENE BERGOFFEN TREASURER 6033565461 2015-05-14 2015-10-14 2013 2016-02-25 16:41:14Z SCOTT MCKINNON 3073 WHITE MOUNTAIN HIGHWAY NORTH CONWAY NH 03860 64241290 false X WWW.MEMORIALHOSPITALNH.ORG X 1910 NH MEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO THE RESIDENTS AND VISITORS OF THE MOUNT WASHINGTON VALLEY AREA OF NEW HAMPSHIRE. 15 11 546 75 0 555036 505520 62396653 62765892 233086 174816 -27966 -52962 63156809 63393266 0 0 35117259 34972037 72000 802709 26505961 28863995 61623220 63908032 1533589 -514766 74062812 66702509 25061742 24854786 49001070 41847723 MEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO THE RESIDENTS AND VISITORS OF THE MOUNT WASHINGTON VALLEY AREA OF NEW HAMPSHIRE. false false 56340033 62563226 MEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO THE RESIDENTS AND VISITORS OF THE MOUNT WASHINGTON AREA OF NEW HAMPSHIRE. MEMORIAL HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL AND A 45 BED INTERMEDIATE CARE FACILITY (MERRIMAN HOUSE). THE HOSPITAL PROVIDES MED/SURG, ICU, ICF, OBSTETRICS, RADIOLOGY/IMAGING, ONCOLOGY/INFUSION, CARDIAC REHAB, WOUND CARE, SPECIALTY CARE, ED AND PRIMARY CARE. THE HOSPITAL HAD 4,582 ACUTE INPATIENT DAYS AND 11,461 ED OUTPATIENT VISITS IN FISCAL YEAR 2014. 56340033 true true false true false false false false false true true false false false true true false true false false false false false true true false true true false false true true false false false false false false false false false false false false false false false true true true false false true 95 0 true 546 true false false false false false false false false false false false false X 15 11 false false false false true true true true true false false true true true true true true true true false NH X SCOTT MCKINNON CEO 6033565461 3073 WHITE MOUNTAIN HIGHWAY NORTH CONWAY NH 038605001 WILLIAM CARON MAINEHEALTH 1.00 50.00 X 0 1034119 79809 SCOTT MCKINNON PRESIDENT/CE 40.00 X X 317783 0 36846 MARNI MADNICK MEDICAL STAF 40.00 X X 20000 297536 38488 RAYMOND RABIDEAU CMO 40.00 X X 0 293200 29434 STEVEN WYRSCH COO 40.00 X X 219539 0 6657 PHIL DAVIES BOARD CHAIR 1.00 X X 0 0 0 LAURA JAWITZ 1ST VICE CHA 1.00 X X 0 0 0 KEN CARGILL 2ND VICE CHA 1.00 X X 0 0 0 BARBARA HOPKINS SECRETARY 1.00 X X 0 0 0 THAIRE BRYANT TREASURER 1.00 X X 0 0 0 MELISSA MYERS AT LARGE MEM 1.00 X 0 0 0 GENE BERGOFFEN AT LARGE MEM 1.00 X 0 0 0 ALLAN STAM BOARD MEMBER 1.00 X 0 0 0 JOAN AUBREY BOARD MEMBER 1.00 X 0 0 0 BILL BECK BOARD MEMBER 1.00 X 0 0 0 DAPHNE WALL BOARD MEMBER 1.00 X 0 0 0 JANICE CRAWFORD BOARD MEMBER 1.00 X 0 0 0 KIMBERLY GOODWIN MEDICAL DIRE 40.00 X 229941 0 26656 VERA SCHUMANN SENIOR VP/CF 40.00 0.00 X 202008 0 20881 DIANE MAHEUX VP OF FINANC 40.00 X 71892 0 14240 DOUGLAS TAYLOR ORTHOPEDIC S 40.00 X 0 515568 38488 BRIAN SPONSELLER PHYSICIAN 40.00 X 0 467545 22381 MORICE DENNERY SURGEON 40.00 X 0 456295 38488 DAVID RISS PHYSICIAN X 0 444956 30035 WILLIAM MARTIN PHYSICIAN 40.00 X 0 442300 38488 JOHN NEWTON PAST CFO X 106667 0 0 1167830 3951519 420891 37 true true false NORDX 301 US ROUTE 1 SUITE A SCARBOROUGH ME 04074 LAB TESTING 442984 DIVERSIFIED CLINICAL SERVICES PO BOX 636981 CINCINNATI OH 45263 WOUND CARE SVCS 318326 WEATHERBYS LOCUMS INC PO BOX 972663 DALLAS TX 75397 LOCUMS SERVICES 291675 HINCKLEY ALLEN & SNYDER 11 SOUTH MAIN STREET CONCORD NH 03301 LEGAL SERVICES 252890 ADVANTAGE RN 4184 RELIABLE PARKWAY CHICAGO IL 60686 RN SERVICES 159773 10 72422 433098 505520 PATIENT SERVICE REVENUE 621110 60964205 60964205 OTHER PATIENT SERVICE REVENUE 621110 1542024 1542024 CAFETERIA & PHARMACY REVENUE 621110 259663 259663 62765892 117819 117819 138364 174745 -36381 -36381 -36381 666382 6500 613104 2781 53278 3719 56997 56997 40813 72422 57394 -16581 -16581 63393266 62563226 324520 1469153 531976 937177 27228169 24955235 2200068 72866 491172 436701 53243 1228 4395926 3934619 450244 11063 1387617 1233730 150418 3469 284746 284746 111035 111035 72000 72000 34827 34827 5827039 5220162 606877 184828 9178 13014 162636 3580288 3422232 140133 17923 701141 701141 1408692 1348015 60677 111061 83227 27496 338 989569 989569 4026388 3579861 436461 10066 705810 354790 351020 MEDICAL SUPPLIES 6390610 6390610 MEDICAID ENHANCEMENT TAX 3051392 3051392 EQUIPMENT LEASE 583782 580225 3557 COMMUNITY BENEFIT 431871 431871 440916 218511 203156 19249 63908032 56340033 6765290 802709 6688420 3564652 15444451 19497889 8592470 10538805 2131649 1647508 350006 972220 67764226 40915744 28515822 26848482 9047979 1726291 302088 262308 2727619 1906662 74062812 66702509 4599974 4316412 18680037 18235000 320731 95111 1461000 2208263 25061742 24854786 X 47917756 40466764 469951 767596 613363 613363 49001070 41847723 74062812 66702509 X -514766 1039857 -7678438 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 7984 7984 false SCHEDULE C, PART II-B, LINE 1 THE ORGANIZATION PAYS DUES TO VARIOUS ASSOCIATIONS, A PORTION OF WHICH IS ATTRIBUTABLE TO LOBBYING EXPENSES. 7872190 4466317 396727 12735234 6740032 1132158 7872190 6639144 100888 6740032 3575593 2400000 663551 6639144 3311699 263924 3575593 0.89150 0.04820 0.06030 false false 598483 598483 42955489 23816633 19138856 22167088 15431579 6735509 2043166 1667532 375634 26848482 INSURANCE SETTLEMENT PAYABLE 1523000 ESTIMATED THIRD PARTY SETTLEMENTS 685263 2208263 X SCHEDULE D, PAGE 3, PART X THE ORGANIZATION IS A NON-PROFIT CORPORATION AS DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. X true DAVENPORT BARR INC PO BOX 430 INTERVALE NH 03845 PHILANT false 113235 72000 41235 113235 72000 41235 NH GALA 60450 37200 23250 13539 18840 3076 GOLF TOURNAMENT 52785 35222 17563 21939 113235 72422 40813 21939 13539 18840 3076 57394 -16581 SCHEDULE G, PART IV DAVENPORT AND BARR INC. MANAGES THE PHILANTHROPY DEPARTMENT. true true true X 2.500000000000 true X true true false true true 2024784 2024784 0.03170 9718133 9486078 232055 0.00360 11742917 9486078 2256839 0.03530 331959 331959 0.00520 331959 331959 0.00520 12074876 9486078 2588798 0.04050 true 3734482 15746797 15914642 -167845 X true true 1 1 MEMORIAL HOSPITAL 3073 WHITE MOUNTAIN HIGHWAY NORTH CONWAY NH 03860 X X X X MEMORIAL HOSPITAL 1 true X X X X 13 true false true X WWW.MEMORIALHOSPITALNH.ORG X X X X X true false true true 250.000000000000 true 400.000000000000 true X X X X X X true true X X X true false X X X true X false false FACILITY 1, MEMORIAL HOSPITAL - PART V, LINE 3 THE ASSESSMENT PROCESS WAS INITIATED AND CHAIRED BY MEMORIAL HOSPITAL IN COLLABORATION WITH THE MEMBERS OF THE WHITE MOUNTAIN VALLEY COMMUNITY HEALTH COUNCIL (WMVCHC). THE HOSPITAL PROVIDED FINANCIAL AND IN-KIND SUPPORT FOR THE ASSESSMENT PROCESS; HOWEVER, THE OTHER MEMBERS OF THE COALITION ALSO PARTICIPATED THROUGH MONTHLY MEETINGS AND PROVIDED INPUT INTO THE PROCESS, AND FEEDBACK ON THE FINDINGS. THIS GROUP CONTINUES TO MEET TO DEVELOP THE IMPLEMENTATION PLANS AND TO ADOPT STRATEGIES RELEVANT TO THEIR INDIVIDUAL ORGANIZATIONS. PARTICIPATING MEMBERS OF THE COUNCIL INCLUDE THE FOLLOWING INDIVIDUALS AND AGENCY REPRESENTATIVES WHO PROVIDE THE INDICATED SERVICES: -MEMORIAL HOSPITAL: BOARD MEMBER LAURA JAWITZ; CEO SCOTT MCKINNON; MEDICAL DIRECTOR DR. RAYMOND RABIDEAU; VP OF QUALITY AND ELDERLY SERVICES SUSAN RUKA, RN PHD. -VNHCH (SEE EARLIER SERVICES DESCRIPTION): EXECUTIVE DIRECTOR SANDY RUKA, RN MSN AND BOARD MEMBER NAN BARTLETT. -SACO RIVER MEDICAL GROUP (PRIMARY CARE GROUP INCLUDING WALK-IN SERVICES AND PEDIATRICS): HEIDI ROOT, MD AND ROB ROSE, MD. -MINERAL SPRINGS REHABILITATION CENTER (LONG TERM CARE, ASSISTED LIVING, AND REHABILITATION): ADMINISTRATOR BARBARA WHITE AND ADMISSIONS COORDINATOR JANE GALLOWAY. -MWV ECONOMIC COUNCIL: EXECUTIVE DIRECTOR JAC CUDDY -NORTHERN HUMAN SERVICES (MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES): JANE MACKAY AND DR. MELISSA MYERS -WHITE MOUNTAIN COMMUNITY HEALTH CENTER (SEE EARLIER SERVICES DESCRIPTION): EXECUTIVE DIRECTOR PATRICIA MCMURRY. -T. MURRAY WELLNESS CENTER, INC.: OWNER/PROVIDER PATRICIA MURRAY, DO AND CHERIE JEWELL -ADDITIONAL PARTICIPANTS WHO PROVIDED OCCASIONAL INPUT AND COMMENT INCLUDED MARY REED, EXECUTIVE DIRECTOR OF THE CARROLL COUNTY COALITION FOR PUBLIC HEALTH; MEMBERS OF MEMORIAL HOSPITALS COMMUNITY ADVISORY COUNCIL; AND REPRESENTATIVES FROM EVERGREEN INSTITUTE FOR WELLNESS, CARROLL COUNTY UNITED HEALTH AND WELLNESS TEAM,AND SAU 9 AND 13. FACILITY 1, MEMORIAL HOSPITAL - PART V, LINE 20D UNINSURED INDIVIDUALS RECEIVED A DISCOUNT OF 15% AUTOMATICALLY (THE AVERAGE DISCOUNT ON CHARGES OF THE THREE LARGEST VOLUME COMMERCIAL PAYORS). INDIVIDUALS THAT APPLIED AND RECEIVED ASSISTANCE WERE GRANTED DISCOUNTS BASED UPON INCOME LEVEL AND ASSET LEVEL. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION A COST REPORTING SYSTEM WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. A COST-TO-CHARGE RATIO WAS USED. PART II - COMMUNITY BUILDING ACTIVITIES THE ORGANIZATION SPONSERS OR PARTICIPATES IN A VARIETY OF COMMUNITY ACTIVITIES AND PROGRAMS. THESE INCLUDE: -FREE WEEKLY BREASTFEEDING SUPPORT GROUP - A WEEKLY SUPPORT GROUP FOR MOTHERS WHO ARE BREASTFEEDING, FACILITATED BY CERTIFIED LACTATION SPECIALISTS. ALL BREASTFEEDING WOMEN, REGARDLESS OF WHERE THEY GAVE BIRTH, ARE INVITED. INCLUDES SEASONAL EVENTS. -NORTH COUNTRY DIABETES FORUM - PRESENTED A 3 SPEAKER EVENT WITH FREE ADMISSION FOR THE COMMUNITY ON DIABETES PREVENTION, EDUCATION AND AWARENESS. -PATIENT FINANCIAL ADVOCATES - ASSIST PATIENTS IN SIGNING UP FOR VARIOUS HEALTH INSURANCE OPTIONS INCLUDING AFFORDABLE CARE ACT MARKETPLACE PLANS AND MEDICAID AND MEDICAID EXPANSION PLANS. -AFFORDABLE CARE ACT COMMUNITY MEETING - HELD A LARGE PUBLIC EDUCATION FORUM AT CONFERENCE CENTER AND BROUGHT IN SPEAKERS TO INFORM THE COMMUNITY ABOUT THE AFFORDABLE CARE ACT. -MEDICATION BRIDGE - ASSIST PATIENTS IN GETTING FREE PRESCRIPTION DRUGS BASED ON INCOME ELIGIBILITY THROUGH VARIOUS PHARMACEUTICAL COMPANIES. -CAR SEAT PROGRAM - WHEN A NEW BORN OR ANY FAMILY IN NEED REQUIRES A CAR SEAT, AND NO OTHER RESOURCE IS AVAILABLE, MEMORIAL HOSPITAL DONATES A NEW CAR SEAT. -CHILDBIRTH EDUCATION - CHILDBIRTH EDUCATION IS OFFERED ONE TIME PER MONTH FOR NEW PARENTS-TO-BE. -FREE ALZHEIMER'S CAREGIVERS SUPPORT GROUP - OFFERS EDUCATION, SUPPORT AND COPING SKILLS FOR CAREGIVERS. PRE-ARRANGED CARE IS AVAILABLE FOR THE FAMILY MEMBER WHILE THE CAREGIVER ATTENDS THE MEETING. -FREE DIABETES SUPPORT GROUP - FOR DIABETICS AND THEIR SUPPORT PEOPLE. AN OPPORTUNITY FOR EDUCATION AND DISCUSSION WITH OTHER PEOPLE WHO HAVE DIABETES OR ARE DEALING WITH IT IN THE FAMILY. -FREE CANCER SUPPORT GROUP - MEETS MONTHLY TO PROVIDE SUPPORT ALONG WITH INFORMATION, EDUCATION, SPEAKERS AND ENCOURAGEMENT FOR THOSE WITH CANCER AND THEIR SUPPORT PEOPLE. THIS GROUP IS FACILITATED BY AN ONCOLOGY CERTIFIED NURSE AND SOCIAL SERVICES. -ALCOHOLICS ANONYMOUS - SPACE IS DONATED FREE OF CHARGE FOR WEEKLY AA MEETINGS. -CHRONIC ILLNESS MANAGEMENT CLASSES - BETTER CHOICES BETTER HEALTH IS A FREE SIX-WEEK PROGRAM DESIGNED TO HELP MANAGE CHRONIC HEALTH CONDITIONS. IT WASDESIGNED TO HELP THOSE LIVING WITH LONG-TERM HEALTH CONDITIONS REGAIN CONTROL OF THEIR LIVES. BETTER CHOICES BETTER HEALTH WAS DEVELOPED BY STANFORD UNIVERSITY AND OUR PROGRAM LEADERS ARE LICENSED AND CERTIFIED BY STANFORD. -COMMUNITY CPR CLASSES - PARTNER WITH LOCAL FIRE DEPARTMENTS TO OFFER COMMUNITY CPR CLASSES AT A SUBSIDIZED COST. THIS IS AN AMERICAN HEART ASSOCIATION CPR AND AED CLASS BEING OFFERED TO MEMBERS OF THE COMMUNITY IN COLLABORATION WITH SOME OF THE LOCAL FIRE AND EMS DEPARTMENTS. THE 25 FEE IS TO COVER MATERIALS ONLY, NOT STAFF TIME (IE BOOKS, CARDS AND ADMIN. FEES). -STUDENT HEALTH & WELLNESS INITIATIVE - MEMORIAL HOSPITAL EMPLOYEES AND MEDICAL STAFF DONATED THEIR TIME TO OFFER IN-SCHOOL PROGRAMMING OFFERING EDUCATION AND OUTREACH TO ELEMENTARY, MIDDLE AND HIGH SCHOOL STUDENTS IN THE MOUNT WASHINGTON VALLEY THROUGHOUT THE SCHOOL YEAR. THE PROGRAM SERVED THOUSANDS OF STUDENTS AND COMMUNITY MEMBERS IN 9 SCHOOLS. -JACKSON HEALTH FAIR AND CONWAY ELEMENTARY HEALTH FAIR- HUNDREDS OF STUDENTS, TEACHERS AND COMMUNITY MEMBERS LEARNED ABOUT GOOD NUTRITION, HEART HEALTH, FITNESS AND MORE. -AMERICAN RED CROSS BLOOD DRIVES - ORGANIZED 3 BLOOD DRIVES WITH 80 EMPLOYEES DONATING THEIR TIME AND BLOOD TO PARTICIPATE. VOLUNTEER DIRECTOR ORGANIZES THE EVENT AND SIGNS UP STAFF, COORDINATES WITH RED CROSS, ETC. -FOOD DRIVES - CONDUCTED YEAR-ROUND FOOD DRIVE FOR END 68 HOURS OF HUNGER, A NON-PROFIT THAT PROVIDES FOOD FOR STUDENTS WHO OTHERWISE GO HUNGRY ON WEEKENDS. ALSO CONDUCTED HOLIDAY FOOD DRIVE FOR LOCAL FOOD PANTRY, VAUGHN COMMUNITY SERVICES, AND PET FOOD AND SUPPLIES FOR LOCAL ANIMAL SHELTER. EMPLOYEES DONATED THEIR TIME AND FOOD ITEMS INCLUDING DELIVERING FOOD ITEMS TO THE PROGRAM WAREHOUSE. -NORTHWAY BANK "LUNCH N' LEARN" WORKSHOPS - PRESENT WORKSHOPS AND HEALTH SCREENINGS EACH MONTH FOR LARGE LOCAL EMPLOYER. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS PATIENT ACCOUNTS RECEIVABLE ARE STATED AT THE AMOUNT MANAGEMENT EXPECTS TO COLLECT FROM OUTSTANDING BALANCES. MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS THROUGH A CHARGE TO PROVISION FOR BAD DEBTS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF INDIVIDUAL ACCOUNTS AND HISTORICAL ADJUSTMENTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH MAJOR PAYOR SOURCE OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE BASED ON PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY AMOUNTS FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR ELIGIBLE) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. DURING 2014, THE HOSPITAL INCREASED THE ALLOWANCE FROM 3,783,299 TO 4,116,330. DURING 2014, SELF-PAY WRITE-OFFS INCREASED FROM 7,001,207 TO 7,354,871. SUCH INCREASES RESULTED FROM TRENDS EXPERIENCED IN THE COLLECTION OF AMOUNTS FROM SELF-PAY PATIENTS. PART III, LINE 8 - MEDICARE EXPLANATION THE ORGANIZATION USED A COST REPORT AS THE COSTING METHODOLOGY TO DETERMINE THE AMOUNT OF ALLOWABLE MEDICARE COSTS. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION WITH THE EXCEPTION OF INSURANCE COVERAGE THE COLLECTION ACTIVITY SHALL NOT BE INITIATED OR PURSUED FOR ANY AMOUNT APPROVED UNDER THE MEMORIAL HOSPITAL HEALTHCARE ASSISTANCE PROGRAM. PART VI, LINE 2 - NEEDS ASSESSMENT THE COMMUNITY NEEDS ASSESSMENT WAS CHAIRED BY MEMORIAL HOSPITAL IN COLLABORATION OF THE WHITE MOUNTAIN VALLEY COMMUNITY HEALTH COUNCIL. WMVCHC IS COMPRISED OF AN INTERDISCIPLINARY PROFESSIONALS THAT SERVE THE WHITE MOUNTAIN VALLEY COMMUNITY. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PATIENTS ARE REFERRED TO THE PATIENT FINANCIAL ADVOCATES FOR ASSISTANCE AT POINTS OF REGISTRATION AND DURING THE BILLING CYCLE. PART VI, LINE 4 - COMMUNITY INFORMATION THE PRIMARY SERVICE AREA IS NORTHERN CARROLL COUNTY AND SEVERAL BORDERING TOWNS IN THE OXFORD COUNTY, MAINE AREA. THE MEDIAN AGE OF THE POPULATION IS 47. THE COMMUNITY EXPERIENCED A POPULATION INCREASE OF 9.5% IN CARROLL COUNTY AND 5.6% IN OXFORD COUNTY IN THE YEARS 2000 TO 2010. MORE THAN 20% OF CARROLL COUNTY'S POPULATION AND 17% OF OXFORD COUNTY'S POPULATION ARE AGED 65 YEARS OR OLDER. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT MAINE, NEW HAMPSHIRE ADDITIONAL INFORMATION PART I, LINE 3C - CHARITY CARE LEVELS ARE DETERMINED BY A THREE PRONG TEST FOR ELIGIBILITY. INCOME LEVEL, CASH IN BANK, AND ASSETS ARE ALL EXAMINED TO DETERMINE LEVEL OF ELIGIBILITY. X X X X X true true false false false false false false false WILLIAM CARON MAINEHEALTH CEO 699295 334824 59222 20587 1113928 SCOTT MCKINNON PRESIDENT/CEO 250283 67500 7578 29268 354629 MARNI MADNICK MEDICAL STAFF PRES 297536 20000 7650 30838 20000 336024 RAYMOND RABIDEAU CMO 235000 58200 7050 22384 322634 STEVEN WYRSCH COO 188343 31196 5467 1190 226196 KIMBERLY GOODWIN MEDICAL DIRECTOR 229941 7031 19625 256597 VERA SCHUMANN SENIOR VP/CFO 160483 5000 36525 548 20333 222889 DOUGLAS TAYLOR ORTHOPEDIC SURGEON 515568 7650 30838 554056 BRIAN SPONSELLER PHYSICIAN 435745 31800 22381 489926 MORICE DENNERY SURGEON 456295 7650 30838 494783 DAVID RISS PHYSICIAN 444956 7650 22385 474991 WILLIAM MARTIN PHYSICIAN 442300 7650 30838 480788 JOHN NEWTON PAST CFO 106667 106667 SCHEDULE J, PAGE 1, PART I, LINE 4 WILLIAM CARON 0 315,764 0 JOHN NEWTON 106,667 0 0 A NH HEALTH AND EDUC FACILITIES AUTH 020279866 644614QC6 2006-06-14 20955000 TO CONTRUCT AND RENOVATE HOSPITAL. false false false A 2274963 20955000 1726140 324775 20630225 2009 false false true true A false false false false false false false A false false true false false false false false false SCHEDULE K - ADDITIONAL INFORMATION NH HEALTH AND EDUC FACILITIES AUTH (A) ISSUER NAME: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY (F) DESCRIPTION OF PURPOSE: TO CONSTRUCT & RENOVATE HOSPITAL FACILITY AND PAY OFF EXISTING DEBT. FORM 990, PAGE 6, PART VI, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS MAINEHEALTH (EIN 01-0431680). FORM 990, PAGE 6, PART VI, LINE 7A THE SOLE MEMBER OF THE ORGANIZATION ELECTS THE TRUSTEES OF THE ORGANIZATION AT THEIR ANNUAL MEETING OF THE CORPORATION. FORM 990, PAGE 6, PART VI, LINE 7B DECISIONS OF THE GOVENING BODY SUCH AS BUDGETS, BUSINESS AND MARKETING STRATEGIC PLANS, SIGNIFICANT FINANCIAL COMMITMENTS, AMENDMENTS TO THE ARTICLES OF INCORPORATION , AND ELECTION OF THE PRESIDENT/CEO AMONG OTHER DECISIONS, ARE SUBJECT TO APPROVAL BY MAINEHEALTH (EIN 01-0431680). FORM 990, PAGE 6, PART VI, LINE 11B THE 990 IS PROVIDED TO THE FINANCE COMMITTEE AND THE FULL BOARD OF TRUSTEES. IT IS SENT TO THE ENTIRE FINANCE COMMITTEE VIA ELECTRONIC MEANS AND THEN FORWARDED TO THE FULL BOARD OF TRUSTEES. FORM 990, PAGE 6, PART VI, LINE 12C CONFLICT OF INTEREST DECLARATION FORMS ARE SUBMITTED IN JANUARY BY MEMBERS OF THE BOARD OF TRUSTEES AND ARE SHARED WITH THE FULL BOARD FOR INFORMATION PURPOSES AND REVIEWED IN DEPTH BY THE GOVERNANCE COMMITTEE. IT IS THE MEMBER'S RESPONSIBILTY TO NOTIFY THE BOARD OF ANY CONFLICTS THAT THEY BECOME AWARE OF AND TO RECUSE THEMSELVES FROM DISCUSSIONS AND VOTES ON THE ISSUE. FORM 990, PAGE 6, PART VI, LINE 15A THE COMPENSATION COMMITTEE OF THE BOARD CONDUCTS THE CEO EVALUATION AND COMPENSATION PROCESS. THE CEO'S PERFORMANCE IS REVIEWED AGAINST TARGETS SET FOR THE YEAR AND HIS SEMI-ANNUAL BONUS DETERMINATION. THE CEO COMPENSATION IS COMPARED TO THE SULLIVAN COTTER AND ASSOCIATES INFORMATION AND PERIODICALLY REVIEWED BY OUR COMPENSATION CONSULTANT. NO ONE WITH A CONFLICT OF INTEREST RELATIVE TO THE HOSPITAL IS INVOLVED IN THESE DISCUSSIONS AND MINUTES ARE RECORDED BY THE SECRETARY OF THE BOARD. DETERMINING COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES INCLUDED REFERENCE TO PROFESSIONAL ASSOCIATION COMPENSATION DATA FOR COMPARABLE ORGANIZATIONS AND POSITION SCOPE. COMPENSATION WAS REVIEWED AND APPROVED BY THE CEO AND/OR THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES ACTING AS THE COMPENSATION COMMITTEE. FORM 990, PAGE 6, PART VI, LINE 15B SEE 990, PART VI, SECTION B, LINE 15A FOR COMPENSATION PROCESS. 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 XI, LINE 9 EQUITY TRANSFER TO AFFILIATE 7,678,438 MEMORIAL DEVELOPMENT FOUNDATION PO BOX 5001 NORTH CONWAY NH 03860 223160795 HEALTHCARE NH 501C3 11A NA false VN& HCS OF NORTHERN CARROLL CITY PO BOX 432 NORTH CONWAY NH 03860 020311473 HEALTH SVC NH 501C3 9 NA false WHITE MOUNTAIN COMMUNITY HEALTH PO BOX 2800 CONWAY NH 03818 020358715 COMM HLTH NH 501C3 9 NA false CARROLL COUNTY HEALTH & HOME CARE SERVICES PO BOX 420 CHOCORUA NH 03817 237337000 HOME CARE NH 501C3 7 NA false MEMORIAL HOSPITAL FOUNDATION 3073 WHITE MOUNTAIN HIGHWAY NORTH CONWAY NH 03860 462137291 SUPP ORG NH 501C3 11B MEMORIAL HOSPITAL true MAINEHEALTH 110 FREE STREET PORTLAND ME 04101 010431680 HEALTHCARE ME 501C3 11C NA false MAINE MEDICAL CENTER 22 BRAMHALL STREET PORTLAND ME 04102 010238552 HOSPITAL ME 501C3 3 MEHEALTH false NORDX 102 CAMPUS DRIVE 118 SCARBOROUGH ME 04074 010511356 LAB ME 501C3 9 MEHEALTH false LINCOLN COUNTY HEALTH CARE INC 6 ST ANDREWS LANE BOOTHBAY HARBOR ME 04538 261475629 HEALTHCARE ME 501C3 11B MEHEALTH false WALDO COUNTY HEALTHCARE INC PO BOX 287 BELFAST ME 04915 222864961 HEALTHCARE ME 501C3 11C MEHEALTH false HOME HEALTH-VISITING NURSES OF SME 15 INDUSTRIAL PARK SACO ME 04072 222571902 HOME HLTH ME 501C3 9 MEHEALTH false PEN BAY HEALTHCARE 4 WHITE STREET ROCKLAND ME 04841 222494475 HEALTHCARE ME 501C3 11C MEHEALTH false MAINEHEALTH CARDIOLOGY 110 FREE STREET PORTLAND ME 04101 452525629 HEALTHCARE ME 501C3 11C NA false MAINE BEHAVIORAL HEALTHCARE 78 ATLANTIC PLACE WESTBROOK ME 04106 010524834 BEHAV HLTH ME 501C3 3 MEHEALTH false SOUTHERN MAINE HEALTH CARE PO BOX 626 BIDDEFORD ME 04005 010179500 HEALTHCARE ME 501C3 11C MEHEALTH false MAINEHEALTH ACO 110 FREE STREET PORTLAND ME 04101 452929273 ACO ME 01-0431680 RELATED false true SYNERNET INC 110 FREE STREET PORTLAND ME 04101 010539789 CLAIMS MGT ME N/A false MAINE PHYSICIAN HEALTH ORG 110 FREE STREET PORTLAND ME 04101 010527540 HEALTHCARE ME N/A false MWV HEALTHCARE ASSOC INC PO BOX 2540 NORTH CONWAY NH 03860 020477066 HEALTHCARE NH MEMORIAL C CORP 33693 1.00000 false false false false false false false false false false true false false false false false true true false false MWV HEALTHCARE ASSOC INC P 4092758 AMOUNTS PAID WHITE MOUNTAIN COMMUNITY HEALTH J 79613 AMOUNTS PAID WHITE MOUNTAIN COMMUNITY HEALTH Q 83600 AMOUNTS PAID WHITE MOUNTAIN COMMUNITY HEALTH P 70400 AMOUNTS PAID