2014-08-08T09:35:36-07:00 2013-09-30 990 2012-10-01 020222131 FRISBIE MEMORIAL HOSPITAL FRIS 6033325211 11 WHITEHALL RD ROCHESTER NH 03867 JOHN A MARZINZIK 6033325211 2014-07-15 2012 2015-11-30 17:44:51Z JOHN A MARZINZIK 11 WHITEHALL RD ROCHESTER NH 03867 147324082 false X www.frisbiehosiptal.com X 1941 NH To excel at caring for the community by providing safe, effective, equitable, timely healthcare services. We will ally ourselves with other community healcare providers to enhance our mutual ability to improve the health of our community and the quality of life for the people we serve. 14 14 1103 226 8400 186422 128941 119509000 122362506 1093576 2979278 1744208 0 122533206 125470725 0 0 67689648 66243193 0 121725 58076799 57291623 125766447 123534816 -3233241 1935909 126806905 127347179 45436535 42138909 81370370 85208270 To excel at caring for the community by providing safe, effective, equitable,and false false 106079162 122362506 FRISBIE MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL THAT CONTINUOSLY EVALUATES AND ADDRESSES THE COMPREHENSIVE HEALTHCARE NEEDS OF ROCHESTER, NH AND THE SURROUNDING COMMUNITIES. IN RESPONSE TO THESE HEALTHCARE NEEDS, THE HOSPITAL COORDINATES, DEVELOPS, AND PROVIDES HIGH QUALITY, AFFORADABLE, PREVENTATIVE, EDUACTIONAL, ACUTE AND CHRONIC CARE SERVICES. IN FY2013 27,837 PATIENTS WERE TREATED IN OUR EMERGENCY DEPARTMENT, 5,660 AMBULANCE CALLS WERE MADE, 3,721 INPATIENTS WERE CARED FOR, AND SURGERY PERFORMED ON 12,707 PATIENTS. 391 NEWBORNS WERE WELCOMED INTO THE WORLD,47,669 RADIOLOGY PROCEDURES/TESTS PROVIDED, GAVE 64,972 REHABILITATIVE TREATMENTS, PERFORMED 424,163 LABORATORY TESTS AND TREATED 5,407 ONCOLOGY PATIENTS. 7270609 FRISBIE MEMORIAL HOSPITAL PROVIDED UNCOMPENSATED CARE FOR THOSE IN NEED. FRISBIE RANKS AMOUNG THE TOP IN NEW HAMPSHIRE FOR THE MONEY VALUE OF CHARITY CARE PROVIDED TO PATIENTS. 604277 FRISBIE MEMORIAL HOSPITAL PRESENTED OR SPONSORED NUMEROUS COMMUNITY PROGRAMS WHICH ASSISTED WITH THE SPECIAL NEEDS OF OUR MOST VULNERABLE AT RISK POPULATION GROUPS. THESE PROGRAMS IMPROVED EDUCATION AND HEALTH AWARENESS IN THE COMMUNITY AND PROVIDED GREATER ACCESS TO HEALTH SERVICES. 113954048 true false 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 false true false false false false false true false false false true 51 0 1103 true true true false false false false false false false false false false false false X 14 14 true false false false false false false true true false false false true true true true true true true false NH X X JOHN A MARZINZIK 6033325211 11 WHITEHALL RD ROCHESTER NH 03867 GREGORY SMITH 3.00 X X 0 0 0 RONALD POULIN 3.00 X X 0 0 0 PETER GOWELL 3.00 X X 0 0 0 BRIAN HUGHES 3.00 X X 0 0 0 ALVIN FELGAR 40.00 X 492096 0 109107 JOHN MARZINZIK 40.00 X 251992 0 54505 JOSEPH BERE 2.00 X 0 0 0 JOHN BRITTON MD 2.00 X 0 0 0 ROBERT HARRIGAN MD 2.00 X 0 0 0 MARK HOURIHANE 2.00 X 0 0 0 DAVID KEEFE 2.00 X 0 0 0 JOSEPH MORONE 2.00 X 0 0 0 JEANETTE POULIN 2.00 X 0 0 0 STEVEN POGGI 2.00 X 0 0 0 MICHAEL RIGALLE 2 X ROBERT STEELE 2 X CAROL THEMELIS 40 X 578355 54695 PAULA MAHONEY 40 X 170277 46397 MICHAEL METZGER 40 X 394246 16492 JAY BURNS 40 X 390342 7286 SACHIN SAKSENA 40 X 388512 9035 MATHURIN MALBY 40 X 371927 30702 TRICIA MENDOZA 40 X 371717 15038 3409464 343257 94 false true false CROTHALL FACILITIES MGMT 13028 COLLECTIONS CTR CHICAGO IL 60693 Facilities Management 3166457 SURGICAL ASSOCIATES 21 WHITEHALL RD ROCHESTER NH 03867 Physician Practice 1605202 UNIDINE CORP 1000 WASHINGTON ST BOSTON MA 03867 Dietary Services 1678901 LABCORP OF AMERICA PO BOX 470 PORTSMOUTH NH 03802 LAboratory Services 610600 ALLIANCE HEALTHCARE PO BOX 96485 CHICAGO IL 60693 MRI/PET Imaging 877985 22 24918 104023 128941 Net Patient Service Revenue 622110 118220089 Other Operating Revenue 900099 2028358 8400 Net Assets Released from Restriction 900099 241213 Meaningful Use 900099 1872846 122362506 593769 593769 24238866 21853357 2385509 2385509 2385509 24918 125470725 122354106 8400 2979278 1157881 0 1157881 0 51498890 50186469 1227242 85179 1375529 1336152 36822 2555 8716700 8506712 196359 13629 3494193 3393921 93884 6388 152837 0 152837 0 72150 0 72150 0 12544 12544 0 0 14653403 12706255 1944368 2780 466058 25802 440256 0 1114249 466414 642346 5489 4780034 4417635 362399 0 14938 8345 5896 697 231075 202892 27845 338 1384403 1384403 0 0 5885121 5885121 0 0 1894675 0 1894675 0 Repair & Maintenance 2330638 1453365 877273 0 Supplies 17622595 17428178 190072 4345 Equip Maint/Dues&Subs 997724 860661 136738 325 Medicaid Enhancement Tax 5613736 5613736 0 0 65443 65443 0 0 123534816 113954048 9459043 121725 7756793 6664662 631696 13907619 14634090 2805317 2895987 1273010 2430783 133786689 71693861 64754966 62092828 28561169 31102443 1131612 6616419 6894690 126806905 127347179 13466897 14883056 24995192 22813896 6974446 4441957 45436535 42138909 X 79573728 83342468 73950 65110 1722692 1800692 81370370 85208270 126806905 127347179 1935909 1901991 X false true X true false X 0 0 0 0 0 0 Pt II-B Line 1i Lobbying portion of hospital association dues 28491800 78472 2898384 241213 31227443 24732265 3759535 28491800 25552520 59916 -816743 63428 24732265 23618029 13042 2021449 100000 25552520 27248420 24976 197883 100000 3753250 23618029 true false false 181776 181776 73621024 25914520 47706504 3201124 1800107 1401017 41331199 30803843 10527356 15451566 13175391 2276175 62092828 Other Assets 2177986 Deferred Finance Costs 216108 Investment in Affiliates 2482205 Collateralization of Interest Rate Swap 2018391 6894690 Interest Rate Swap 4441957 4441957 Pt V Line 4 To further the hospital's charitable mission true true true X false false true false true true 7270609 7270609 0.05890 17269062 4539843 12729219 0.10300 24539671 4539843 19999828 0.16190 604277 604277 0.00490 200000 200000 0.00160 1517838 998974 518864 0.00420 85000 85000 0.00070 2407115 998974 1408141 0.01140 26946786 5538817 21407969 0.17330 true 5935856 593586 26053009 35689779 -9636770 X true true 1 1 FRISBIE MEMORIAL HOSPITAL

11 WHITEHALL RD ROCHESTER NH 03867

X X X Geropsychiatric Unit FRISBIE MEMORIAL HOSPITAL 1 true X X X X X X X X 13 false true X X X X X true false true true 200 false true X X X X true true X X X true X X false true X false false Pt I Line 3c Organization uses 200% FPG to determine eligibility Pt I Line 6a A community benefit report is prepared yearly and is available on the organization public website Pt III Line 2 The Medicare cost report ratio of cost to charge is used to determine cost of bad debt expense Pt III Line 9b Collection policy provides for accounts known to qualify for free care Pt III Line 9b be removed from transfer to an outside agency for further collection activity Pt III Line 4 Financial Statement footnote: Patient Accounts Receivable are stated at the amount Pt III Line 4 expects to collect from outatanding balances. Management provides for probable Pt III Line 4 uncollectable amounts through a charge to operations and a credit to a valuation Pt III Line 4 allowance based on its assessment of individual accounts and historical adjustments. Pt III Line 8 Medicare shortfall is reported on the annual Community Benefit Report Pt III Line 8 to the state of New Hampshire under "unreimbursed costs" government sponsored healthcare. Pt VI Line 2 Frisbie Memorial Hospital conducts a Community Needs Assessment every five years, the most recent completed in 2013. Pt VI Line 2 FMH worked with Health Strategies Plus to bring together healthcare and Pt VI Line 2 and public service stakeholders, collecting quantitative and qualitative data. Pt VI Line 4 FMH's PSA is urban consisting of northern Stafford, NH and western York, ME counties. Pt VI Line 4 Population served is over 70,000 with a medium income of $47,626 and 4.7% of community Pt VI Line 4 residents living below the federal poverty guidelines. Pt V Sec B 21 The maximum amount charged to FAP-eligible individuals is gross charge less 15% Pt VI Line 7 NH X X X false true false false false false false false false ALVIN FELGAR 372446 25000 94650 89505 19602 601203 89355 JOHN MARZINZIK 235742 16250 27332 27173 306497 34004 CAROL THEMELIS 173616 7500 397239 39081 15614 633050 43914 PAULA MAHONEY 162777 7500 21984 24413 216674 26179 MICHAEL METZGER 393946 300 16492 410738 JAY BURNS 235762 154580 7286 397628 SACHIN SAKSENA 388212 300 9035 397547 MATHURIN MALBY 214746 157181 30702 402629 TRICIA MENDOZA 167546 204171 15038 386755 Pt I Line 4b The hospital has a 457(f) deffered compensation plan which covers highly compensated employees. The organization incurred liabilities relating to salary continuation agreements with highly compensated employees. Under the terms of the agreements they are entitled to receive a lump sum of their account balance, including earnings, within 30 days after the employee's date certain, which is elected by the employee. Alvin Felgar and Carol Themelis received lump sums distributions in the amounts of 94,650 and 397,239 respectively in calendar year 2012. A NHHEFA 020279866 644614KT5 2005-03-04 10650000 Refunding Series 2003 Bonda false false false B NHHEFA 020279866 644614QD4 2006-07-27 25000000 Building Construction false false false A 10650000 10385167 270950 2005 true false true true B 25000000 386805 24613195 2008 true false true true A false false false false true true B false false false false true true A false false false false false false B false false false false false false JOHN BRITTON MD Trustee 1897738 Subsidy false JOHN BRITTON MD Trustee -1427087 Transfer of AR true Pt VI, Line 11b The final form 990 is reviewed by each member of the board audit/finance committee and CFO. The form 990 is made available to the board of directors prior to filing. Pt VI, Line 12c In accordance with the writted conflict of interest policy the office of the President annually secures a signed copy of the Trustee/Officer Conflict of interest statement and maintains on file. Pt VI, Line 15a Each year the executive compensation committee comprised of four members of the FMH Board reviews the hospital CEO performance and compensation. The VP of Human Resources presents the compensation committee with comparative salary and benefit data. Pt VI, Line 19 The Hospital will provide its governing documents, financial statements, and conflict of interest policy upon written request based on the intent and purpose of the request Pt VI, Line 2 Trustees Ronald Poulin and Jeanette Poulin are husband and wife. Pt VI, Line 15b Senior manangement compensation is also reviewed by the committee, but compensation is determined by the CEO. Pt IX Line 24d The New Hampshire Medicaid Enhancement (MET) tax is a 5.5% tax on net patient Pt IX Line 24d service revenue paid by hospitals to the State of New Hampshire. Unlike previous years where the Pt IX Line 24d State provided hospitals with uncompensated care payments towards the cost of care Pt IX Line 24d of patients without insurance from matching federal funds, uncompensated care payments Pt IX Line 24d were reduced or eliminated to hospitals. The impact to Frisbie Memorial Hospital Pt IX Line 24d in 2012 was payment of MET in the amount of $5,613,736. FRISBIE FOUNDATION 11 WHITEHALL RD ROCHESTER NH 03867 020465942 Coordinate Funds raised for hospital NH 501(c)(3) 11 false false false false false false false false false false true false false false false false true false false FRISBIE FOUNDATION j 2642172 FMV FRISBIE FOUNDATION p 131220 FMV