2015-02-16T08:49:10-06:00 2014-06-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2013-07-01 010223482 Millinocket Regional Hospital MILL 2077235161 200 Somerset Street Millinocket ME 04462 Robert Peterson Chief Executive Officer 2077235161 2015-02-16 1 Barbara J McGuan CPA P00219457 2077752387 2015-02-16 2013 2016-02-25 16:41:14Z Robert Peterson 200 Somerset Street Millinocket ME 04462 30105002 0 X www.mrhme.org X 1952 ME Critical Access Hospital 13 7 273 13 0 0 181679 8877 27112248 24974746 590961 1027004 72713 13625 27957601 26024252 2301 0 0 0 17409296 17644553 0 0 0 10229103 9639342 27640700 27283895 316901 -1259643 23588914 24726055 8546823 10221431 15042091 14504624 X Millinocket Regional Hospital is a 25 bed critical access hospital that serves as the primary care facility for the communities of Millinocket, Milo, Sherman, Staceyville, Patten, Island Falls and their surrounding territories. 0 0 25156833 24974746 Millinocket Regional Hospital provides inpatient and outpatient services to the Katahdin region including; 749 inpatients served, 1,233 operating room patients served, 20,122 laboratory patients served, 1,412 radiology patients served, 6,790 pharmacy patients served, 1,901 therapy patients served, 17,487 clinic patients served, 6,367 emergency room patients served.The following seminars, promotions, advertisements, and clinics were provided to the community throughout fiscal 2014:1. MRH helped in sponsoring Town of Millinocket Public Pool to be open until August 23, 2013.2. MRH sponsored the Stearns-Schenck Musical "Nutcracker" in October of 2013.3. MRH provided Mammograms at a reduced rate during the Breast Cancer Awareness week October 20134. MRH sponsored the Community Christmas Party.5. MRH sponsored a Jr. Pro Hoop Classic in January of 2013.6. MRH provided catering for Boys Scouts of America Recognition Dinner in October 2013 and in March 2014.7. MRH Held Multiple Flu Shot and H1N1 Flu Shot Clinics from October 2013 to April 2014.8. MRH sponsored a chem-free post graduation party at Schenck HS for Class of 2014.9. MRH sponsored Stearns HS student Christopher Brown to travel with the People2People Program to Europe.10. MRH paid a sponsorship to Nollesemic Lodge #205 for the Bikes4Books program.11. MRH paid a sponsorship to Millinocket Little League in June of 2014 which paid for two teams, the Yankees and the Raptors, and also a scoreboard sign.12. MRH sponsored a Cardiac Support Group the first Wednesday of each month.13. MRH sponsors a MS Support Group the first Tuesday of every month.14. MRH Purchased ad space to raise money for multiple causes including: Schenck and Stearns' High School yearbook, Millinocket Historical Society 2014 calendars, VFW convention ad book, and also ads for special sections of the Bangor Daily News that covered area football and basketball teams.15. MRH operates a grant funded Healthy Maine Partnership organization which provided education services to the community on alcohol misuse, tobacco cessation, proper nutrition and physical activity. The staff works with businesses, clubs and the schools to extend the message of healthy living and good wellness choices. The Organization uses local media to reach the large region.16. MRH provides meeting space for non-profits at no cost, for example to American Cancer Society, Eastern Area on Aging, Martin's Point, Diabetic Support Group, Caring Connections, AA, and Weight Watchers.17. MRH participates in disaster preparedness regional committee with several other agencies including doctors' groups, other hospitals, local police and fire departments, schools and other organizations. The goal is to prepare for pandemic flu, natural disasters or other incidents that could affect our communities and work together to share resources to protect the community. 25156833 1 0 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 76 0 1 273 1 0 0 0 0 0 0 0 0 0 0 X 13 7 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 ME X Robert Peterson 2077235161 200 Somerset Street Millinocket ME 04462 Wallace Tapley Director 5.00 X 0 0 0 Ronald Brown Director 5.00 X 0 0 0 Patrick Hunt Esq Director 5.00 X 0 0 0 Herbert Clark Director 5.00 X 0 0 0 Gail Fanjoy Director 5.00 X 0 0 0 Fred Lewis Director 5.00 X 0 0 0 Thomas Malcolm Director 5.00 X 0 0 0 Joyce Given Hospital Aux. President 5.00 X 0 0 0 Edward Dunstan Medical Staff President 60.00 X X 203139 0 31332 Nilesh Patil Medical Staff Vice President 60.00 X X 444799 0 28887 Jack Dinsmore Past Director 5.00 X 0 0 0 Molly Biehl Past Medical Staff Secretary 40.00 X X 19200 0 0 Mellissa Edwards President 5.00 X X 0 0 0 Lee Lamson Secretary/Treasurer 5.00 X X 0 0 0 Don Casko Vice President 5.00 X X 0 0 0 Robert Peterson CEO 40.00 X 0 0 0 James Sexton Interim CEO 40.00 X 0 0 0 Marie Vienneau Past CEO 40.00 X 217776 0 35152 Christine McLaughlin VP of Finance 40.00 X 112815 0 27209 Joseph Aquilina ER PA 48.00 X 183006 0 18309 Kwaku Owusu-Abrokwa MD Hospitalist 60.00 X 205707 0 17664 Daniel Herbert MD Hospitalist 60.00 X 320285 0 27359 Stylianos Tsintzilonis Surgeon 60.00 X 273956 0 20252 Mark Kowalski Surgeon 60.00 X 443186 0 37759 2423869 0 243923 23 0 1 0 Katahdin Shared Services Inc 200 Somerset Street Millinocket ME 04462 Ultrasound Services 469366 CPSI PO Box 850309 Mobile AL 36685 Computer Services 378291 NEHE-MRI LLC PO Box 6600 Newport Beach CA 92658 MRI Radiology 307020 Synernet Inc 110 Free Street Portland ME 04101 Contract Services 210518 Eastern Maine Medical Center 43 Whiting Hill Road Brewer ME 04412 Purchased Services 184594 9 8877 8877 Ancillary Services 621400 39772839 39772839 Routine Services 621400 2369289 2369289 Miscellaneous Income 621400 608868 572900 35968 Provision for Bad Debts 621400 -1336500 -1336500 Contractual/Char. Adj. 621400 -16439750 -16439750 24974746 217972 217972 35710 16073 19637 19637 19637 4834092 39617 4034214 30463 799878 9154 809032 809032 Loss on Investment of Affiliate 531120 -6012 -6012 -6012 26024252 24938778 0 1076597 X 1101110 708157 392953 12531919 12001735 530184 345527 335190 10337 2799843 2677081 122762 866154 810970 55184 29153 29153 36252 36252 44315 44315 2834927 2239148 595779 73149 73149 338569 234480 104089 506469 485076 21393 42257 26585 15672 223915 223915 874351 874351 324651 324651 Medical Supplies 3534512 3441772 92740 Medicaid Tax 602878 602878 Miscellaneous Expenses 132051 128951 3100 Dues & Subscriptions 41893 41893 27283895 25156833 2127062 0 930 930 2167161 2574596 3071470 2822362 14553 87884 421206 502768 298287 407646 19242277 13258305 6576622 5983972 9378479 10934616 1464160 1397245 15439 14036 180607 0 23588914 24726055 3023961 3284840 1238611 1126289 4284251 3909551 0 1900751 8546823 10221431 X 14928633 14388444 108458 111180 5000 5000 15042091 14504624 23588914 24726055 -1259643 722176 0 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 8573 8573 0 Part II-B, Line 1: The Organization pays dues to various organizations, a portion of which are attributable to lobbying expenses. 49951 49951 9211594 5794658 3416936 9307885 6928197 2379688 672847 535450 137397 5983972 Investment in First Millinocket Regional Investment Corp 1341699 C Investment in Katahdin Shared Services 55546 C 1397245 Estimated Third-Party Payor Settlements 1900751 1900751 1 1 1 X 1 X 1 1 1 0 0 797176 797176 0.02920 3874903 253031 3621872 0.13270 4672079 253031 4419048 0.16190 1669 1669 0.00010 1669 1669 0.00010 4673748 253031 4420717 0.16200 1 863879 10367098 10278523 88575 X 1 0 1 1 Millinocket Regional Hospital 200 Somerset Street Millinocket ME 04462 X X X Millinocket Regional Hospital 1 1 X X X X X X X X 11 1 1 1 X X 1 0 1 1 150.000000000000 1 400.000000000000 1 X 1 1 X X X X X 1 0 X X X X 1 X 0 0 Millinocket Regional Hospital Part V, Section B, Line 3: The OneMaine Health Collaborative, which was formed by EMHS/Maine General Health and Maine Health, contracted with the University of New England's Center for Community and Public Health (CCPH) to conduct a Statewide Community health needs Assessment (CHNA). The assessment conducted in collaboration with the University of Southern Maine and Market Decisions, Inc, was designed to identify the most important health issues in the state, both overall and by county, using scientifically valid health indicators and comparative information. The assessment also identifies priority health issues where better integration of public health and healthcare can improve access, quality, and cost effectiveness of services to residents of Maine. OneMaine shared this information with its fellow stakeholders so it can lead to improved health status and quality of care available to Maine residents, while building upon and strengthening Maine's existing infrastructure of services and providers.The four objectives of the OneMaine Community Health Needs Assessment were:1. Develop a comprehensive profile of health status, quality of care and care management indicators for residents of Maine overall and for residents by county.2. Identify a set of priority health needs (public health and health care) for follow-up.3. Provide recommendations on strategies that can be undertaken by healthcare providers, public health staff, communities, policy makers and others to follow-up on the information provided with actions that may improve the health status of Maine people. 4. Provide access to the CHNA data and assistance to stakeholders who are interested in using it.The methodology for the CHNA was a modified version of CCPH's Community and Institutional Assessment Process (CIAP). The CIAP is a comprehensive planning process that identifies salient healthcare related issues in the community through a systematic analysis of scientifically derived health indicators and comparative and best practice information. Indicators are computed from an extensive set of health-related data and a community household telephone survey.The CIAP starts with a comprehensive epidemiological-based health profile organized by health domain or condition such as cardiovascular health, respiratory health, cancer health, etc. Indicators for most domains are further organized by risk factors, prevalence or incidence of disease or condition, care management indicators and care outcomes. The analysis of indicators within each domain provides information to identify, and subsequently explore, which aspects of the healthcare delivery system may be over-or under-performing for that particular domain (e.g. primary prevention, secondary prevention, etc.)Community health needs assessments are designed, in part, to identify issues where changes in the healthcare delivery system can improve both patient care and preventive services for those at risk for health problems. Findings and recommendations:1. Maine has several underlying socio-demographic characteristics that impact many of the health indicators, for example, Maine has the oldest population in the U.S., a very high proportion of elderly (65+) compared to the U.S. Being older does not equate to poor health, the reality is that aging populations use more health services than younger populations.2. Maine has a lower median income than the U.S. but the proportion of Maine residents living below the Federal poverty line is slightly lower than the rest of the country. However, in Northern Maine the proportions of residents live below the Federal poverty line than the state as a whole or the U.S.3. Unemployment is an important demographic predictor of health and compared to the rest of the U.S., Maine has a lower unemployment rate, but several Maine counties individually have high rates of unemployment, many well over 10%.On May 26, 2011, Eastern Maine Health Systems (EMHS) presented the OneMaine Health Collaborative Community Health Needs Assessment to community leaders, which was hosted by Millinocket Regional Hospital and Penobscot Valley Hospital.Access to Health Care and ED UtilizationMRH received Rural Health Clinic status to stabilize primary care reimbursement. MRH has recruited a mid-level provider and is in the process of recruiting a part time family practitioner. MRH provided a sliding fee and charity care in practices to mirror the hospital to encourage access. The RHCs are seeking Patient Centered medical Home status which will encourage expanded coverage hours. Currently participating in MaineCare ED utilization project and implemented follow-up call on ED visits to question if primary care was sought.Obesity & Chronic Disease ManagementMRH employs a Wellness Coordinator and has a worksite wellness program. MRH incentivizes employee health and wellness via health plan. MRH subsidizes and runs only fitness facility north of Bangor. MRH supports and employ staff for healthy Maine Partnership. Physicians do community talks on nutrition. MRH hired a primary care Case Manager whose focus is on diabetes, heart disease, HTN, and COPD. MRH maintains a Cardiac Rehab, Diabetes Self-Management Training, and ADEF program.Behavioral HealthcareMRH has an ongoing relationship with CHCS Crisis Services for crisis evaluation. MRH developed Tele-Psychiatry Program with Acadia Hospital for emergent psychiatric assessment. MRH is developing plans to integrate Behavioral healthcare into primary care as part of Patient Centered Medical Home Project. MRH petitioned CMS to allow reimbursement of telemedicine in Metropolitan Statistical Areas to allow further expansion of Tele-Psychiatry. Millinocket Regional Hospital Part V, Section B, Line 4: Statewide community health needs assessment "OneMaine Health Collaborative" sponsored by Eastern Maine Health System, MaineGeneral Health, and MaineHealth. Millinocket Regional Hospital Part V, Section B, Line 20d: The Hospital billed amounts to individuals who did not have insurance at cost and applied a 10% discount to private pay patients. Part I, Line 3c: Income guidelines as set by Hospital Finance Rules will be used in determining eligibility. Percentage of balance discounted will be determined based on patient's income level relative to the Federal Poverty Level guidelines. These guidelines are updated annually by the Financial Counselor.Up to 150% FPL 100% Balance Discounted151% to 200% FPL 50% Balance Discounted201% to 250% FPL 25% Balance Discounted251% to 300% FPL 10% Balance Discounted301% to 400% FPL 5% Balance Discounted Part I, Line 7: Expenses calculated on Lines 7a & 7b were calculated using a cost-to-charge ratio while actual expenses were used in calculating the amount reported on line 7i. Part III, Line 4: 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 operations 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 collectability of accounts receivable, the Hospital analyzes past results and identifies trends for each major payor source of revenue for the purposes of estimating the appropriate amounts of the allowance for doubtful accounts and the provision for bad debts. Data in each major payor source are regularly reviewed to evaluate the adequacy of the allowance for doubtful accounts. Specifically, for receivables relating to services provided to patients having third-party coverage, an allowance for doubtful accounts and a corresponding provision for bad debts are established at varying levels based on the age of the receivables and payor source. For receivables relating to self-pay patients, a provision for bad debts is made in the period services are rendered based on experience indicating the inability or unwillingness of patients to pay amounts for which they are financially responsible. Part III, Line 8: The Organization used accounting methodology prescribed by the Medicare cost report as its costing methodology to determine the amount of Medicare allowable costs. Part VI, Line 2: A formal community needs assessment is done every 2-3 years. These assessments are conducted to obtain information on successes, failures, weaknesses and strengths to be used for guidance in the vision for the future of healthcare delivery in our service areas. Part VI, Line 3: Inpatients: In order to identify those patients who would be eligible for financial assistance, all uninsured inpatients are referred to the Financial Counselor by pre-registration or registration personnel. The Financial Counselor will do an initial screening for payment options prior to the patient leaving the hospital, if possible. If the patient has left the hospital, the Financial Counselor will attempt to contact the patient for information. All inpatients are given a copy of Patient Free Care and Discount Arrangements guidelines at time of admission.Surgical outpatients: The Financial Counselor will provide information about Patient Free Care, Discount Arrangements and term payment arrangements to all uninsured surgical outpatients. All surgical outpatients are provided a copy of Patient Free Care and Discount Arrangements guidelines at time of registration. Emergency room patients: All emergency room patients are provided a copy of Patient Free Care and Discount Arrangements guidelines at time of registration. All other outpatients: All other outpatients are provided a copy of the Patient Free Care/Discount Arrangements guidelines at time of registration. All patients will receive notice of availability of financial assistance included in their first-time statement. Patient Financial Services employees and Physician Practice employees receive training on patient free care and discount arrangements guidelines and are expected to be able to provide contact information about free care and discount arrangements. Part VI, Line 4: Millinocket Regional Hospital has three communities in its primary service area, Millinocket, East Millinocket and Medway. There are multiple smaller communities in the secondary service area including, Brownville, Stacyville, Sherman, Patten and Island Falls. The area has struggled and realized an unemployment rate in the teens for the past ten years and community outmigration. The population of the primary service area is approximately 7500 people. The hospital has realized this population change by large volume declines in 2013. The average median household income is 22% behind the state average. The average resident age is 14% older than the state median age. X X X X X 0 0 0 0 0 0 0 1 0 Edward Dunstan Medical Staff President 203139 0 0 0 0 0 8240 0 23092 0 234471 0 0 0 Nilesh Patil Medical Staff Vice President 444799 0 0 0 0 0 4520 0 24367 0 473686 0 0 0 Marie Vienneau Past CEO 217776 0 0 0 0 0 8558 0 26594 0 252928 0 0 0 Joseph Aquilina ER PA 183006 0 0 0 0 0 1916 0 16393 0 201315 0 0 0 Kwaku Owusu-Abrokwa MD Hospitalist 205707 0 0 0 0 0 8405 0 9259 0 223371 0 0 0 Daniel Herbert MD Hospitalist 288185 0 32100 0 0 0 10760 0 16599 0 347644 0 0 0 Stylianos Tsintzilonis Surgeon 273956 0 0 0 0 0 11005 0 9247 0 294208 0 0 0 Mark Kowalski Surgeon 443186 0 0 0 0 0 13298 0 24461 0 480945 0 0 0 Part I, Line 7 A bonus was paid to Daniel Herbert as an incentive for entering into an employment agreement with the Hospital. If the agreement is terminated by the physician, a pro rata amount of the bonus is to be repaid to the Hospital. A Maine Health and Higher Educational Facilities Authority 010314384 560427WV4 2013-05-23 1423837 Refinancing of 2003 D bond issue 0 0 1 A 297548 1423837 15439 2013 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 0 0 0 0 0 0 A 0 Julie Brown Family Member of Ronald Brown, member of Board of Directors 37951 Employment 0 Rose Ann Hunt Family Member of Patrick Hunt, member of Board of Directors 131993 Employment 0 Dale McLaughlin Family Member of Christine McLaughlin, CFO of Organization 94776 Employment 0 Ona McAvoy Family Member of Mellissa Edwards, Board President 65696 Employment 0 Cynthia Morneault Family Member of Joyce Given, member of Board of Directors 27782 Employment 0 Form 990, Part VI, Section B, line 11 Prior to the document's filing, the Organization's finance department reviews the initial draft. After any necessary changes, the Organization's board members are presented with a copy. The finalized document is subject to the board's approval. Form 990, Part VI, Section B, line 12c Each board member is required to sign a conflict of interest disclosure form on an annual basis. In connection with any actual or possible conflicts of interest, an interested individual must disclose the existence of his or her conflict annually and whenever the conflict arises for action at a meeting. After receiving all annual attestations, the CEO will provide the signed statements to the Hospital's attorney for review. After review, the attorney will determine if a conflict exists and inform the CEO and Board chair of the conflicted individuals. There is a listing of Board, Medical Staff and Manager conflicts available at all meetings for reference. The Agenda for every Board, Medical Staff or Department meeting will clearly list the discussion items that require action during the meeting. At the beginning of the meeting, the President will ask the members to review the list of action items and declare whether or not they have a conflict. All conflicted members will be required to excuse themselves and leave the room during the discussion and vote. If the board or committee has reasonable cause to believe that a member has failed to disclose actual or possible conflicts of interest, it shall inform the member of the basis for such belief and afford the member an opportunity to explain the alleged failure to disclose. Form 990, Part VI, Section B, line 15 The Organization works with an independent compensation consultant to determine appropriate compensation levels. The Organization's executive committee reviews data used to determine compensation for its respective members. Any compensation related changes must be approved by the board of directors or the executive board. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part IX, line 11g Purchased Services: Program service expenses 1,391,778. Management and general expenses 595,779. Fundraising expenses 0. Total expenses 1,987,557. Service Contracts: Program service expenses 356,035. Management and general expenses 0. Fundraising expenses 0. Total expenses 356,035. Professional Services: Program service expenses 477,982. Management and general expenses 0. Fundraising expenses 0. Total expenses 477,982. Outside Services: Program service expenses 13,353. Management and general expenses 0. Fundraising expenses 0. Total expenses 13,353. First Millinocket Regional Investment Corp 200 Somerset Street Millinocket ME 04462 010396196 Physician Program Operations ME Millinocket Regional Hospital C 193972 1348473 1.00000 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 First Millinocket Regional Investment Corp K 173660 FMV First Millinocket Regional Investment Corp Q 173660 FMV