2014-05-15T07:41:17-07:00 2013-06-30 Macpage LLC 30 Long Creek Dr South Portland ME 04106 990 2012-07-01 010284446 REDINGTON-FAIRVIEW GENERAL HOSPITAL REDI 2074745121 PO BOX 468 SKOWHEGAN ME 04976 DANA C KEMPTON 2014-05-15 true George Rafuse P00340697 2077745701 X 2012 2015-11-30 17:44:51Z 78963358 false false X N/A X 1969 ME REDINGTON-FAIRVIEW GENERAL HOSPITAL'S MISSION IS TO DEVELOP, PROVIDE AND FACILITATE HIGH QUALITY, COMPREHENSIVE, COST EFFECTIVE HEALTH SERVICES FOR THE PEOPLE WE SERVE. WE AFFIRM A COMMITMENT TO MAINTAIN OUR UNIQUE COMMUNITY HOSPITAL IDENTITY, OFFERING PERSONALIZED SERVICES. 9 6 740 35 0 1699975 2323659 70592055 75333058 1063037 1054884 247483 251757 73602550 78963358 0 0 43418582 44421042 0 0 28986705 35327969 72405287 79749011 1197263 -785653 98454205 95979301 39078365 35479448 59375840 60499853 X REDINGTON-FAIRVIEW GENERAL HOSPITAL WILL PROVIDE A LEADERSHIP ROLE TO DEVELOP, PROVIDE AND/OR FACILITATE HEALTH CARE SERVICES THAT ARE CONSISTENT, EFFECTIVE, ACCESSIBLE, SAFE, PATIENT CENTERED, TIMELY, AND EFFICIENTLY PROVIDED.RFGH AND ITS HOSPITAL STAFF WILL ADHERE TO THE HOSPITALS' MISSION, VISION AND STRATEGIC PLAN IN PROVIDING EXCEPTIONAL HEALTHCARE TO THE COMMUNITY IT SERVES. false false 39285395 50550189 RFGH PROVIDES 24 HOUR SEVEN DAY A WEEK EMERGENCY SERVICES. THESE SERVICES INCLUDE AN EMERGENCY DEPARTMENT STAFFED WITH PHYSICIANS 24 HOURS A DAY AS WELL AS AN AMBULANCE SERVICE WHICH OPERATES 24 HOURS A DAY. DURING FISCAL 2013, RFGH HAD 23,434 EMERGENCY DEPARTMENT VISITS AND 3,849 AMBULANCE RUNS. IN ADDITION TO EMERGENCY SERVICES, THE HOSPITAL PROVIDES A FULL RANGE OF SERVICES, RADIOLOGY, C.T., ULTRASOUND, NUCLEAR MEDICINE, BLOOD BANK, PATHOLOGY, CARDIOLOGY AND LABORATORY SERVICES. IN TOTAL, THESE SERVICES TREATED APPROXIMATELY 46,364 PATIENTS. 15467662 6238974 RFGH OPERATES A NUMBER OF PHYSICIAN OFFICES IN ORDER TO BETTER SERVE THE RESIDENTS OF SOMERSET COUNTY. DURING FISCAL 2013, THESE PHYSICIAN SPECIALTIES INCLUDED INTERNAL MEDICINE,ENDORINOLOGY,GENERAL SURGERY, ORTHOPEDICS, PEDIATRICS,FAMILY MEDICINE,OBSTETRICS GASTROENTEROLY AND NEUROLOGY. DURING FISCAL 2013, THESE PHYSICIAN SPECIALTIES SERVED 11,549 PATIENTS WHO TOTALLED 43,537 VISITS AT THESE OFFICES. 12333933 18795652 REDINGTON-FAIRVIEW GENERAL HOSPITAL (RFGH) IS LICENSED AS A CRITICAL ACCESS HOSPITAL OPERATING 25 BEDS. RFGH EMPLOYS HOSPITALISTS WHO ARE PHYSICIANS DEDICATED TO THE TREATMENT OF INPATIENTS. INPATIENTS SERVICES INCLUDES MEDICAL AND SURGICAL, SPECIAL CARE, OBSTETRICS AND PEDIATRICS. DURING FISCAL 2013, RFGH PROVIDED INPATIENT SERVICES TO 1,568 PATIENTS WHO STAYED 5,270 PATIENT DAYS. MEDICARE AND MEDICAID PATIENTS REPRESENTED 77% OF RFGH'S INPATIENTS. 1917537 1917537 69004527 true true false true false false false false false false true false false true true true false false false false false false false false false false true true false false true true false true false false false false false false false false false false false false true true false false false false true 93 0 true 740 true false false false false false false false false 0 false false false false false false false false false false X 9 6 false false false false false false false true true false false false true true true true true true false false X RICHARD D WILLETT 2078582315 46 FAIRVIEW AVE SKOWHEGAN ME 049760468 GINA GOMEZ MD 50.00 0.00 X 309843 0 0 JOHN WITHERSPOON 2.00 0.00 X 0 0 0 MICHAEL LAMBKE MD 2.00 0.00 X 215019 0 0 WILLIAM LANEY 2.00 0.00 X X 0 0 0 MICHAEL CURRAN MD 50.00 0.00 X 464884 0 0 DONNA FINLEY 2.00 0.00 X 0 0 0 JEFFREY LLOYD 2.00 0.00 X 0 0 0 L JOSEPH CLARK 2.00 0.00 X X 0 0 0 CHRISTOPHER PERKINS 2.00 0.00 X X 0 0 0 DANA C KEMPTON 50.00 0.00 X 1193623 0 0 RICHARD D WILLETT 50.00 0.00 X 1871894 0 0 TIRUNELLAI R SHANKAR 50.00 0.00 X 353229 0 0 AMIR BAIG MD 50.00 0.00 X 331674 0 0 JOHN COMIS MD 50.00 0.00 X 331958 0 0 MANJUNATH BANNUR MD 50.00 0.00 X 286165 0 0 ANNETTE GOODMAN MD 50.00 0.00 X 286333 0 0 5644622 37 false true false WEATHERBY LOCUMS PO BOX 972633 DALLAS TX 753972633 CLINICAL STAFFING 358347 VISTA STAFFING SOLUTIONS 275 EAST 200 SOUTH SALT LAKE CITY UT 84111 CLINICAL STAFFING 1727914 QUEST DIAGNOSTIC INC 5763 COLLECTION CENTER DR CHICAGO IL 60693 LAB TESTING 458973 DAHL-CHASE DIAGNOSTIC SERVICES 417 STATE STREET BANGOR ME 04401 LAB TESTING 330722 AETNA-HARTFORD PO BOX 532424 CHARLOTTE NC 28290 THIRD PARTY ADMN. 773415 18 818219 1505440 2323659 NET PATIENT REVENUE 75333058 75333058 75333058 1054884 1054884 0 0 0 0 0 0 0 OTHER MISCELLANEOUS 17191 17191 CAFETERIA 234566 234566 251757 78963358 75350249 1289450 0 0 0 0 1535850 989746 546104 0 32715311 28766256 3949055 1706601 1430132 276469 6151430 5154898 996532 2311850 1937330 374520 0 83913 6200 77713 77668 41771 35897 9617 9617 0 240881 1042 239839 4823289 4598923 224366 154018 154018 4999404 4593584 405820 2942932 1032471 1910461 0 1214036 1062788 151248 129744 126264 3480 0 232242 193228 39014 1116536 960221 156315 0 3933201 3275052 658149 711173 580858 130315 MEDICAID PROVIDER TAX 1519330 1519330 Equipment & Maintenance 2020769 1862366 158403 PHARMACEUTICALS 3272581 3272581 Bad Debt Expense 6554465 6554465 1292170 1045021 247149 79749011 69004527 10744484 0 3249915 3009011 4121807 5094548 0 10639363 10512090 0 0 417904 496491 1309026 1392696 100294 96401 67597747 41290813 28238296 26306934 40439720 39835391 0 0 0 9937880 9235739 98454205 95979301 9107676 7083803 23891500 23135190 6079189 5260455 39078365 35479448 X 58497358 59687418 878482 812435 59375840 60499853 98454205 95979301 X -785653 2072384 -162718 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false 9617 9617 9617 9617 9617 9617 1923 1923 481 481 7694 7694 false 1000000 1000000 1000000 1000000 4000000 6000000 9734 8973 9178 9617 37502 250000 250000 250000 250000 1000000 1500000 340981 340981 38851758 18604290 20247468 28405008 22686523 5718485 26306934 SOMERSET FITNESS CENTER 118797 ESTIMATED THIRD PARTY SETTLEMENTS 8431284 DISCOUNT ON BONDS PAYABLE 55211 DEFERRED FINANCING CHARGES 630447 9235739 LIABILITY FOR PENSION BENEFITS 5260455 5260455 X 74481277 2072384 2072384 72408893 6554465 6554465 78963358 73194546 73194546 6554465 6554465 79749011 Part XII, Line 4b Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S BAD DEBT EXPENSE $6554465 Part XI, Line 4b Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S BAD DEBT EXPENSE $6554465 Part X Part X : FIN48 Footnote SCHEDULE D - PART X:THE HOSPITAL IS EXEMPT FROM TAXES UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE.MANAGEMENT EVALUATED THE HOSPITAL'S TAX POSITIONS AND CONCLUDED THAT THE HOSPITAL HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRED ADJUSTMENTS TO THE FINANCIAL STATEMENTS. WHEN NECESSARY, THE HOSPITAL ACCOUNTS FOR INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS AS PART OF ITS PROVISION FOR FEDERAL AND STATE INCOME TAXES.THE HOSPITAL DOES NOT EXPECT THAT UNRECOGNIZED TAX BENEFITS OR LIABILITIES ARISING FROM TAX POSITIONS WILL CHANGE SIGNIFICANTLY WITHIN THE NEXT TWELVE MONTHS. THE HOSPITAL IS SUBJECT TO U.S FEDERAL AND STATE EXAMINATIONS BY TAX AUTHORITIES FOR YEARS ENDING JUNE 30,2010 THROUGH 2013. true true true X true X true true true false false false 1407488 1407488 0.01760 1407488 1407488 0.01760 1984001 1984001 0.02490 15467662 6238974 9228688 0.11570 17451663 6238974 11212689 0.14060 18859151 6238974 12620177 0.15820 true 3422184 26855367 26729785 125582 X true true 1 1 REDINGTON-FAIRVIEW GENERAL HOS

46 FAIRVIEW AVENUE PO BOX 468 SKOWHEGAN ME 04976

X X true X X X X X X 12 true true true X X X X X X X true false false true true 150.0000 true 225.0000 false X false true X X X X X false false X X X true X false false Part VI - Additional Information PART VI RE: PART III QUESTIONS 4BAD DEBTS: IN FULFILLING ITS CHARITABLE MISSION, THE HOSPITAL GRANTS CREDIT WITHOUT COLLATERAL TO THEIR PATIENTS, MANY OF WHOM ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. AT JUNE 30, 2013 AND 2012, NET ACCOUNTS RECEIVABLE RELATING TO PATIENTS WITHOUT INSURANCE WAS 13.5% AND 8.9%, RESPECTIVELY.ACCOUNTS RECEIVABLE ARE STATED AT THE AMOUNT THAT MANAGEMENT EXPECTS TO COLLECT. MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS THROUGH A CHARGE TO THE STATMENT OF CHANGES IN NET ASSETS AND A CREDIT TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON ITS ASSESSMENT OF THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE ALLOWANCE ACCOUNT AND A CREDIT TO ACCOUNTS RECEIVABLE. Part VI - Affilated Health Care System Roles and Promotion REDINGTON-FAIRVIEW GENERAL HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose SEE ATTACHED STATEMENT Part VI - Community Building Activities SEE ATTACHED STATEMENT Part VI - Patient Education of Eligibility for Assistance SEE ATTACHED STATEMENT Part VI - Needs Assessment SEE ATTACHED STATEMENT Number of Hospital Faciltiy - 1 Part V, Line 20d - Other Billing Determination of Individuals Without Insurance See Attached Statement. Number of Hospital Faciltiy - 1 Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment The Community Needs Assessment was conducted in collaboration with:MaineGeneral HealthEastern Maine Medical CenterMaine Medical Center Number of Hospital Faciltiy - 1 Part V, Line 3 - Account Input from Person Who Represent the Community The original source of the Community Needs Assessment is the Somerset County Health Collaborative which is composed of many community organizations such as the Police Department, small businesses, religious groups, behavorial health groups, school systems and other resource groups. At the regional level, Somerset Heart Health has two representatives that participate on the Central District Group where collaboration with other health systems occurs. Part III, Line 4 - Bad Debt Expense See attached statement. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Bad Debt Expense is recorded at gross charges. In order to reduce gross charges to the estimated cost of bad debts, the Hospital reduced the operating cost on the Form 990 by removing Bad Debt Expense, Community Health Improvement, Medicaid Provider Tax and the costs associated with Subsidized Health Services. Operating Revenues were reduced by the operating revenues associated with Subsidized Health Services. The resulting ratio of 52.2% was applied to both Charity Care and Bad Debts to arrive at the cost of those items. X X X X false false false false false false false false false false TIRUNELLAI R SHANKAR 247103 91091 15035 353229 RICHARD D WILLETT 321774 1550120 1871894 1527742 MICHAEL LAMBKE MD 174085 30560 10374 215019 MICHAEL CURRAN MD 347213 103596 14075 464884 MANJUNATH BANNUR MD 274342 11823 286165 JOHN COMIS MD 317680 14278 331958 GINA GOMEZ MD 226853 12068 70922 309843 DANA C KEMPTON 224360 969263 1193623 950713 ANNETTE GOODMAN MD 195096 78312 12925 286333 AMIR BAIG MD 316030 15644 331674 B MAINE HEALTH & HIGHER EDUCATION FACILITY 010314384 560427JA5 2010-06-24 108030000 BOND REFINANCING true false A MAINE HEALTH & HIGHER EDUCATION FACILITY AUTHORITY 010314384 560425V80 2007-11-01 72040461 REPLACEMENT OF TWO BOILERS, PURCHASE OF A BACK-UP GENERATOR false false B 4867784 389000 4187686 38937 false true true true A 23882032 1513579 304303 23577729 false false true true B false false false false false false true A false false false false false false true B false true false false false false A false true false false false false Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Decreases ROUNDING = -$6 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Decreases EFFECT OF THE SAC 715 = -$96665 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Decreases DECREASE IN TEMPORARILY RESTRICTED ASSETS = -$66047 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available REDINGTON FAIRVIEW GENERAL MAKE ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST Form 990, Part VI, Line 15a Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management SEE SCHEDULE J Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts ANNUALLY THE CONFLICT OF INTERESTS DISCLOSURE IS REVIEWED WITH THE MEMBERS OF THE BOARD AND DIRECTORS, WHO THEN SIGN THE DISCLOSURE Form 990, Part VI, Line 11b Form 990, Part VI, Line 11b: Form 990 Review Process PRIOR TO THE FILING THE FORM 990, THE HOSPITAL'S CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER REVIEWED THE FILING IN DETAIL WITH THE EXECUTIVE COMMITTEE OF THE HOSPITAL BOARD, WHICH IS COMPOSED OF THE PRESIDENT, THE VICE PRESIDENT, AND THE TREASURER OF THE HOSPITAL. THE OFFICERS FOUND THE FILING TO BE COMPREHENSIVE AND COMPLETE. THE OTHER SIX HOSPITAL BOARD MEMBERS HAVE BEEN NOTIFIED THAT THE FORM 990 IS AVAILABLE FOR THE DETAILED REVIEW IF THEY SHOULD SO DESIRE. Form 990, Part III, Line 4d Form 990, Part III, Line 4d: Other Program Services Description OTHER PROGRAM SERVICES 4: FORM 990, PART III, LINE 4D: OTHER PROGRAM SERVICES DESCRIPTIONSee attached statement SOMERSET FITNESS CENTER INC PO BOX 3158 SKOWHEGAN ME 04976 010524417 FITNESS ACTIVITIES FOR MEMBERS ME 298147 121084 REDINGTON FAIRVIEW GENERAL HOSPITAL FAIRVIEW HOSPITAL INC PO BOX 468 SKOWHEGAN ME 04976 010222130 SOLE SUPPORTING ORGANIZATION OF RFGH ME 501 c (3) 11 (d) NA false REDINGTON MEMORIAL HOSPITAL ASSN PO BOX 468 SKOWHEGAN ME 04976 010211154 SOLE SUPPORTING ORGANIZATION OF RFGH ME 501 c (3) 11 (d) NA false SOMERSET SPORTS & FITNESS CENTER 6 COMMERCE DRIVE SKOWHEGAN ME 04976 010524417 FITNESS CENTER ME RFGH 1.00000 false false false true false false false false false false false false false false false false false false false false FAIRVIEW HOSPITAL INC c 28078 Cash Rec'd