2014-05-16T09:29:08-07:00 2013-09-30 CYNTHIA M THOMPSON CPA 1723 US HWY 1 CARY PLT ME 044713010 990 2012-10-01 237134386 HOULTON REGIONAL HOSPITAL HOUL 2075322900 20 HARTFORD ST HOULTON ME 04730 THOMAS MOAKLER 2014-05-13 true Non-paid Preparer P00707659 2075322900 2012 2015-11-30 17:44:51Z 43075250 false false X houltonregional.org X 1973 ME HOULTON REGIONAL HOSPITAL'S MISSION IS TO PROVIDE SAFE, COMPASSIONATE, QUALITY, COST EFFECTIVE CARE TO THE COMMUNITIES WE SERVE. OUR RESOURCES WILL BE DEDICATED TOWARDS IMPROVING THE HEALTH STATUS OF THOSE WE SERVE THROUGH EDUCATION, TREATMENT AND REHABILITATION. 13 8 504 77 7938 -12615 96482 58420 42135117 41234948 370362 686781 0 42601961 41980149 0 0 27126908 27568493 0 0 16900603 17665191 44027511 45233684 -1425550 -3253535 30980901 26099568 23557839 21825940 7423062 4273628 HOULTON REGIONAL HOSPITAL'S MISSION IS TO PROVIDE SAFE, COMPASSIONATE, QUALITY, COST EFFECTIVE CARE TO THE COMMUNITIES WE SERVE. OUR RESOURCES WILL BE DEDICATED TOWARDS IMPROVING THE HEALTH STATUS OF THOSE WE SERVE THROUGH EDUCATION, TREATMENT AND REHABILITATION. false false 35906165 41361529 PROVISION OF HEALTH CARE SERVICES IN RURAL MAINE. DURING THE FISCAL YEAR ENDED 9/30/13, 1,459 PEOPLE HAD AN INPATIENT STAY (INCLUDING THE PROGRESSIVE CARE FACILITY); 87,330 OUTPATIENT SERVICES WERE RENDERED; 10,580 PEOPLE WERE SERVED IN THE EMERGENCY ROOM. OF THESE SERVICES, 1,824 ACCOUNTS (REPRESENTING 369 PEOPLE AND $1,312,896) WERE WRITTEN OFF AS CHARITY CARE. HOULTON REGIONAL HOSPITAL (HRH) ALSO ASSISTS ELDERLY CITIZENS WITH THEIR WISH TO REMAIN INDEPENDENT AS LONG AS POSSIBLE. TO ACCOMPLISH THIS GOAL, HRH ASSISTS WITH THE RENTAL OF LIFELINE EMERGENCY RESPONSE UNITS. DURING FISCAL YEAR 9/30/13, A DAILY AVERAGE OF 53 LIFELINE UNITS WERE RENTED. 35906165 true true false true false false false false false true true false false false true false true false false false false false false false false false true true false false true true false false false false false false false true true true false false false false false false false false false false true 49 0 true 504 true true false false false false false false 0 false false false false false false false false false false X 13 8 false false false false false false false true true false false true true true true true true true true false X CYNTHIA M THOMPSON 2075322900 20 HARTFORD ST HOULTON ME 04730 X PHILIP MCFARLANE MD 40.00 0.00 X 259476 0 12504 NANCY KETCH 1.00 0.00 X 0 0 0 MAX LYNDS 1.00 0.00 X 0 0 0 WALTER GOODRICH 1.00 0.00 X 0 0 0 HASSAN E ABOULEISH MD 40.00 0.00 X X 67057 0 0 GARY BOSSIE 1.00 0.00 X 0 0 0 BRIAN GRIFFIN MD 40.00 0.00 X 285037 0 16696 DOUG HAZLETT 1.00 0.00 X 0 0 0 STEPHEN NELSON 1.00 0.00 X X 0 0 0 REV JESSIE DRYSDALE 1.00 0.00 X X 0 0 0 LYNETTE MCLAUGHLIN 1.00 0.00 X X 0 0 0 JOHN CLARK 1.00 0.00 X 0 0 0 KARL WOODS DMD 1.00 0.00 X 0 0 0 CYNTHIA THOMPSON 40.00 0.00 X 106599 0 0 THOMAS MOAKLER 40.00 0.00 X 242343 0 7903 ROBERT MOSENFELDER MD 40.00 0.00 X 247832 0 12504 SANTIAGO DUY 40.00 0.00 X 320979 0 16696 PAUL M ALEXANDER 40.00 0.00 X 238450 0 0 CATHY CHASSE 40.00 0.00 X 219307 0 6357 EUN-KYUNG HONG 40.00 0.00 X 224182 0 12504 2211262 85164 28 false true false AROOSTOOK RADIOLOGY SERVICES 20 HARTFORD ST HOULTON ME 04730 RADIOLOGIST 520200 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 LOCUM SERVICES 500878 VISTA STAFFING SOLUTIONS 675 EAST 2100 SOUTH SUITE 390 SALT LAKE CITY UT 841069813 LOCUM SVCS 331757 THE SHERIDAN CORPORATION PO BOX 359 FAIRFIELD ME 04937 CONSTRUCTION 415736 HOULTON INTERNAL MEDICINE PA 22 HARTFORD ST HOULTON ME 04730 INTERNAL MEDICINE 1227271 15 58420 58420 VENDING, CAFETERIA, MISC. 1252522 1108257 144265 PATIENT FEES 52091387 52091387 MEDICARE & MEDICAID PYMTS 24413507 24413507 CONFERENCE ROOM RENTAL 722320 7938 7938 CHARITY CARE -1312896 -1312896 -35217510 -35217510 41234948 146803 146803 0 0 0 1356295 278784 1095101 261194 278784 539978 278784 261194 0 0 0 0 41980149 41361529 7938 552262 X 0 0 0 0 997615 640770 356845 0 20284369 18178449 2105920 8000 8000 4846140 4846140 1432369 1284835 147534 0 81101 81101 45000 45000 10011 10011 0 14959 14959 4862963 4607101 255862 17693 17693 295816 29741 266075 25854 25854 0 1181266 1181266 130166 112121 18045 0 0 725136 578223 146913 0 1594985 1271841 323144 385648 170662 214986 CONTRACT LABOR 445040 445040 MAINTENANCE/SERVICE CONTRACTS 603533 603533 MEDICAID TAX - STATE OF MAINE 1130958 1130958 SUPPLIES 5237705 5224044 13661 877357 447581 429776 45233684 35906165 9327519 0 20067 23902 722464 97178 247500 40483 8379146 6576482 0 0 0 785159 768382 727030 695225 40912065 27895555 13659461 13016510 3279671 3618425 0 0 377587 365047 2782816 897934 30980901 26099568 4888872 5501231 10944022 10338213 979085 722425 6745860 5264071 23557839 21825940 X 7138923 4207331 232475 14633 51664 51664 7423062 4273628 30980901 26099568 X -3253535 104105 -4 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 10011 10011 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description OTHER LOBBYING AMOUNTS REPRESENT AN ALLOCABLE PORTION OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE MAINE HOSPITAL ASSOCIATION. 103490 11075 226 114339 85541 18149 200 103490 88511 -2770 200 85541 79673 9038 200 88511 761985 -84267 597107 938 79673 1.00000 false false false 193107 193107 23371375 14385539 8985836 11196777 8617370 2579407 6150806 4892646 1258160 13016510 DUE TO THIRD PARTY PAYORS 4868957 457 PLAN ASSETS 395114 5264071 42069293 104105 104105 41965188 14959 2 14961 41980149 45218727 2 2 45218725 14959 14959 45233684 Part XII, Line 2d Part XII, Line 2d: Other expenses and losses per audited F/S ROUNDING $2 Part XI, Line 4b Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S ROUNDING $2 Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. THE CORPUS OF THE ENDOWMENT IS PERMANENTLY RESTRICTED, WITH ANY EARNINGS AVAILABLE TO PROMOTE THE HOSPITAL'S EXEMPT PURPOSE. true true true X true X 150.000000000 false true false false false false 751732 751732 0.01580 10370293 8229044 2141248 0.04500 11122025 8229044 2892980 0.06080 15767 288 15479 0.00030 66426 28304 38122 0.00080 57565 7560 50005 0.00110 139758 36152 103606 0.00220 11261783 8265196 2996586 0.06300 false 1316980 209400 16955610 17483031 -527421 X true true 1 1 HOULTON REGIONAL HOSPITAL

20 HARTFORD ST HOULTON ME 04730

X X X SKILLED NURSING FACILITY & 2 RHCS HOULTON REGIONAL HOSPITAL 1 true X X X X X X 11 true true true X X X X X true false false true true 150.0000 true 150.0000 true X X true true X X X X X X true false true X false false 3 HOULTON FAMILY PRACTICE

22 HARTFORD STREET HOULTON ME 04730

RURAL HEALTH CENTER SIGRID E TOMPKINS RURAL HEALTH CENTER

22 HARTFORD STREET HOULTON ME 04730

RURAL HEALTH CENTER HOULTON REGIONAL HOSPITAL PROGRESSIVE CARE FACILITY

20 HARTFORD STREET HOULTON ME 04730

SKILLED NURSING FACILITY Part VI - Explanation Of How Organization Furthers Its Exempt Purpose AT HRH, ALL QUALIFIED PHYSICIANS IN THE COMMUNITY ARE ELIGIBLE FOR MEDICAL STAFF PRIVILEGES AT THE HOSPITAL. NO QUALIFIED PHYSICIANS HAVE BEEN DENIED PRIVILEGES.THE HOSPITAL IS GOVERNED BY A COMMUNITY BOARD WITH BOARD MEMBERS RESIDING IN THE HOSPITAL'S SERVICE AREA. BOARD MEMBERS COME FROM VARIOUS PROFESSIONAL BACKGROUNDS. THE BOARD MEETS A MINIMUM OF TEN TIMES PER YEAR. EACH MEETING STARTS OFF WITH A BOARD EDUCATION SESSION ON TOPICS SUCH AS QUALITY IMPROVEMENT, REIMBURSEMENT METHODOLOGIES, AND REGULATORY REPORTING OR CHANGES.THE HOSPITAL COORDINATES CONTINUING MEDICAL EDUCATION (CME) FOR ITS MEDICAL STAFF. MANY OF THE SESSIONS ARE PERFORMED IN CONJUNCTION WITH THE MONTHLY MEDICAL STAFF MEETINGS AND ARE TOPICS THAT THE MEDICAL STAFF HAS EXPRESSED AN INTEREST IN. THE MAJORITY OF THE SESSIONS ARE SPONSORED BY THE HOSPITAL, HELD IN THE HOSPITAL CONFERENCE ROOMS, AND THE SPEAKERS DONATE THEIR TIME.THE HOSPITAL PROVIDES VARIOUS MEDICAL SCREENING PROGRAMS TO THE COMMUNITY. THE HOSPITAL ALSO HOLDS VARIOUS HEALTH EDUCATION PROGRAMS AND HOSTS SUPPORT GROUPS IN ITS CENTER FOR COMMUNITY HEALTH EDUCATION. Part VI - Community Information HRH SERVES THE COMMUNITIES LOCATED IN SOUTHERN AROOSTOOK COUNTY AS WELL AS A FEW COMMUNITIES IN BORDERING COUNTIES. THE SERVICE AREA IS GEOGRAPHICALLY ISOLATED FROM THE LARGER POPULATION CENTER OF BANGOR, ME. TRAVEL WITHIN THE SERVICE AREA AND TO OUT-OF-AREA DESTINATIONS IS FURTHER COMPLICATED BY THE HARSH MAINE WINTERS.THE POPULATION IN AROOSTOOK COUNTY IS OLDER THAN THE STATEWIDE AVERAGE. BASED ON THE 2012 US CENSUS, 20.0% OF THE SERVICE AREA POPULATION IS ELDERLY (65+ YEARS), WHICH IS HIGHER THAN THE STATE % OF ELDERLY. THIS HIGHER CONCENTRATION OF ELDERLY COULD CONTRIBUTE TO A DISPROPORTIONATE UTILIZATION OF HEALTH CARE SERVICES. HRH SERVICE AREA RESIDENTS ARE POORER AND CONFRONTED BY A SIGNIFICANTLY HIGHER UNEMPLOYMENT RATE THAN MAINERS AS A WHOLE. MOST INCOME MEASURES FOR AROOSTOOK COUNTY ARE LOWER AND POVERTY IS HIGHER THAN STATEWIDE AVERAGES. 31.8% OF THE SERVICE AREA RESIDENTS ARE CONSIDERED TO BE LOW-INCOME (LESS THAN 200% OF THE FEDERAL POVERTY LEVEL) ACCORDING TO THE 2012 CENSUS COMPARED TO 26.6% IN MAINE AS A WHOLE. AVERAGE UNEMPLOYMENT IN AROOSTOOK COUNTY FOR 2012 WAS 9.2% COMPARED TO 7.3% FOR MAINE AS A WHOLE.WITH RESPECT TO INSURANCE STATUS IN COMPARISON TO THE STATE, MORE SERVICE AREA RESIDENTS ARE COVERED BY MEDICAID AND MEDICARE OR ARE UNINSURED. Part VI - Patient Education of Eligibility for Assistance PATIENTS ARE MADE AWARE OF THE CHARITY CARE POLICY THROUGH SIGNAGE IN WAITING ROOMS, DIRECT NOTIFICATION BY STAFF, INFORMATIONAL BROCHURES, AND NOTICES PRINTED ON THE BACK OF PATIENT BILLS. IN ORDER TO QUALIFY FOR CHARITY CARE, THE PATIENT IS ASKED TO PROVIDE A MEDICAID DENIAL LETTER. IF THE PATIENT DOES NOT KNOW HOW TO APPLY FOR STATE ASSISTANCE PROGRAMS, THEY ARE REFERRED TO THE LOCAL HEALTH AND HUMAN SERVICES OFFICE. IF THE PATIENT IS AN INPATIENT, THE HOSPITAL'S SOCIAL SERVICES DEPARTMENT WILL ASSIST THE PATIENT IN FILING STATE AND FEDERAL ASSISTANCE APPLICATIONS.IN ADDITION, THE HOSPITAL HAS A STAFF PERSON AVAILABLE TO ASSIST INDIVIDUALS IN SELECTING WHICH MEDICARE PART D PLAN WOULD BE BEST FOR THE PATIENT'S SPECIFIC MEDICATION NEEDS. THAT SAME STAFF PERSON ADMINISTERS THE HOSPITAL'S PRESCRIPTION ASSISTANCE PROGRAM. Part VI - Needs Assessment THE HOSPITAL IS A STRATEGIC AFFILIATE OF EASTERN MAINE HEALTHCARE SYSTEMS (EMHS) AND IS ABLE TO RECEIVE MANY SERVICES SUCH AS GROUP PURCHASING AND COMMUNITY NEEDS ASSESSMENT FACILITATION AS A RESULT. EASTERN MAINE MEDICAL CENTER (EMMC)IS THE TERTIARY FACILITY FOR OUR SERVICE AREA AND IS THE FLAGSHIP HOSPITAL OF EMHS. MANY OF OUR PATIENTS ARE REFERRED TO EMMC FOR SERVICES THAT CANNOT BE PROVIDED HERE.EMHS, MAINE HEALTH, AND MAINE GENERAL HEALTH FORMED A PARTNERSHIP NAMED, THE ONEMAINE HEALTH COLLABORATIVE (ONEMAINE). IN JANUARY 2010, ONEMAINE CONTRACTED WITH THE UNIVERSITY OF NEW ENGLAND'S CENTER FOR COMMUNITY AND PUBLIC HEALTH TO CONDUCT A STATEWIDE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THIS ASSESSMENT WAS CONDUCTED IN COLLABORATION WITH THE UNIVERSITY OF SOUTHERN MAINE AND MARKED DECISION INC TO IDENTIFY THE MOST IMPORTANT HEALTH ISSUES IN ALL THE COUNTIES IN THE STATE.A COMMUNITY NEEDS HEALTH ASSESSMENT COMMUNITY FORUM WAS CONDUCTED AT THE HOSPITAL ON WEDNESDAY, SEPTEMBER 14, 2011 AND OTHER FORUMS WERE HELD THROUGHOUT THE COUNTY. THE HOSPITAL HAS RECEIVED A SUMMARY OF THESE FORUMS AND HAS ALSO RECEIVED THE 2010 COMMUNITY HEALTH NEEDS ASSESSMENT FROM EMHS. THIS REPORT HAS BEEN LINKED TO OUR WEBSITE.THE REPORT SUMMARIZES KEY FINDINGS IN TWO MAJOR AREAS: RISK FACTORS AND DISEASE INCIDENCE AND PREVALENCE. MANY COMMUNITY AGENCIES UTILIZE THIS DATA TO ASSIST THEM IN PRIORITIZING THEIR STRATEGIC OBJECTIVES. THESE ITEMS HAVE BEEN INCORPORATED INTO OUR 2013 STRATEGIC PLAN.IN ADDITION, THE HOSPITAL RELIES ON FEEDBACK FROM OUR PATIENTS, EMPLOYEES, MEDICAL STAFF, AND BOARD MEMBERS REGARDING SERVICE NEEDS. WE ALSO FOLLOW RECOMMENDATIONS PROMPTED THROUGH QUALITY INTIATIVES SPONSORED BY OUR PATIENT INSURANCE PLANS. Number of Hospital Faciltiy - 1 Part V, Line 20d - Other Billing Determination of Individuals Without Insurance IF A PATIENT IS KNOWN TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE CHARGES ARE WRITTEN OFF WHEN INCURRED OR BILLED TO THE PATIENT AT THE SLIDING SCALE OR REDUCED RATE. IF ELIGIBILITY IS NOT KNOWN AT THE TIME OF SERVICE, THE PATIENT WILL RECEIVE A BILL AT OUR STANDARD RATES. CHARGES WOULD BE REDUCED OR WRITTEN OFF COMPLETELY AFTER IT WAS DETERMINED THEY QUALIFIED FOR FREE OR DISCOUNTED CARE. Number of Hospital Faciltiy - 1 Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment THE HOSPITAL PARTICIPATED IN THE ONE MAINE HEALTH COLLABORATIVE ASSESSMENT FOR THE ENTIRE STATE OF MAINE. WHILE ALL HOSPITALS HAVE PARTICIPATED WITH THIS COLLABORATIVE, IT WAS LED BY EASTERN MAINE HEALTHCARE SYSTEMS, MAINE HEALTH AND MAINE GENERAL. Number of Hospital Faciltiy - 1 Part V, Line 3 - Account Input from Person Who Represent the Community HOULTON REGIONAL HOSPITAL HOSTED A COMMUNITY FORUM TO REVIEW THE AROOSTOOK COUNTY RESULTS. ATTENDING THIS FORUM WERE REPRESENTATIVES FORM A LOCAL FQHC, A HOME CARE AGENCY, A COUNSELING SERVICE, AND LOCAL LAW ENFORCEMENT, AMONG OTHERS. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients THE HOSPITAL HAS MANY INDIVIDUAL POLICIES THAT RELATE TO COLLECTIONS. THE HOSPITAL HAS A FREE CARE DISCOUNT POLICY WHICH SPECIFIES THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE. WHEN AN APPLICATION IS RECEIVED THAT MEETS THE INCOME ELIGIBILITY REQUIREMENTS, A SEARCH OF THE BILLING/ACCOUNTS RECEIVABLE IS PERFORMED TO LOCATE ALL ACCOUNTS FOR MEMBERS OF THE HOUSEHOLD. THE ACCOUNTS FOR HOUSEHOLD MEMBERS ARE THEN FLAGGED AS "FREE", BALANCES ARE WRITTEN OFF, AND AN APPROVAL LETTER IS MAILED TO THE APPLICANT. A COPY OF THE APPLICATION IS PLACED IN THE FREE CARE BINDER AND RETAINED THERE FOR THREE MONTHS, WHICH IS THE LENGTH OF TIME AN APPLICATION IS VALID AND IN EFFECT. SELF-PAY ACCOUNTS ARE REVIEWED FOR OPEN/ACTIVE FREE CARE APPLICATIONS BEFORE BILLING THE PATIENT. IF THE PATIENT HAS AN OPEN/ACTIVE FREE CARE APPLICATION, THE BALANCE IS WRITTEN-OFF AS CHARITY CARE AND THE PATIENT IS NOT BILLED. A SIMILAR PROCESS IS IN PLACE FOR THE SLIDING FEE DISCOUNTS THAT ARE AVAILABLE TO PATIENTS OF THE HOSPITAL-BASED RURAL HEALTH CLINICS. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The portion of the Medicare shortfall related to the skilled nursing facility should constitute community benefit because the hospital provided the service while subsidizing the financial losses incurred by the unit. Due to the extent of financial losses and the declining census on this unit, the hospital did close the skilled nursing facility on September 30,2013.SNF reimbursement $ 933,921SNF allowable costs $1,874,864SNF shortfall ($ 940,943)Additional Medicare shortfall - revenue and costs not included in the Medicare cost report: Cost Professional Report Fees TotalReimbursement $16,955,610 $1,423,115 $18,378,725Costs $17,483,031 $2,272,862 $19,755,893Shortfall ($ 527,421) ($ 849,747) ($ 1,377,168)The hospital bills for various physician services throughout the year. The charges and costs related to those professional services are not reported in the hospital's cost report.Professional Fee Reimbursement: when preparing the cost report total charges by department are taken from the general ledger, detail reports by procedure and inpatient/outpatient are generated for those departments that include professional service revenue, and professional service revenue is then subtracted from total revenue to arrive at revenue to report on worksheet C on the cost report. The same reports were run for only Medicare professional service revenue by inpatient and outpatient. Inpatient Medicare professional fee revenue was then reduced by the inpatient medicare professional fee deductions from revenue on the general ledger to arrive at inpatient professional fee reimbursement. Outpatient Medicare professional fee reimbursement was derived by multiplying the gross reimbursement on the CAH-fee reimbursed provider summary report (report type 855) by the percentage of professional charges included in the same report. Professional fee costs: Medicare professional fee costs were derived by determining the percentage of professional fee revenue by specialty service related to Medicare and multiplying the specific professional costs summarized by specialty service (A-8-2 support) by the Medicare percentage.Shortfall: the professional fee reimbursement is $849,747 less than the professional fee costs. Part III, Line 4 - Bad Debt Expense 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 earnings and a credit to a valuation allowance 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 valuation allowance and a credit to patient accounts receivable. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit This amount is based on the organization's bad debt expense at cost (calculated at Line 2) multiplied by the percentage of persons in Aroostook County below the poverty level (15.9%). The hospital uses the Federal Poverty Guidelines to determine eligibility for providing free care to low income individuals. The family income limit for eligibility for free care is 150% of poverty level. We assume that the demographics of the patients comprising our bad debt expense are similar to the demographics of ARoostook County (the County we are located in). Per the US Census Bureau QuickFacts for Aroostook County, Maine, 15.9% of persons in 2012 are below poverty level. Since our eligibility criteria for our hospital is 150% poverty level and we used the percentage below 100% to estimate the potential charity care written off as bad debt, we believe our calculation is reasonable and conservative. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense We used Worksheet A to estimate bad debt expense (at cost), which is a cost-to-charge methodology. Part I, Line 7g - Costs Associated With Physicans Clinics SUBSIDIZED HEALTH SERVICES CONSIST OF TWO SERVICES: CARDIAC & RESPIRATORY REHABILITATION CLASSES AND LIFELINE UNIT RENTALS.CARDIAC REHAB PHASE III AND RESPIRATORY REHAB PHASE III CLASSES ARE OFFERED TO THE HRH PATIENT BASE, BUT ARE NOT ELIGIBLE FOR REIMBURSEMENT FROM THIRD PARTY INSURANCES. PATIENTS PAY UP FRONT TO ATTEND THESE SESSIONS, THEREFORE CHARITY CARE AND BAD DEBT DO NOT APPLY. COSTS FOR THESE SESSIONS HAS BEEN DETERMINED BY USING ACTUAL STAFF TIME LOGGED TO TEACH THE SESSIONS. FACILITY COSTS HAVE BEEN INCLUDED BASED ON THE TIME USAGE OF THE CLASSES COMPARED TO THE AVAILABLE SQUARE FOOTAGE. THIS PERCENTAGE WAS THEN MULTIPLIED AGAINST THE FACILITY COSTS DRAWN DOWN BY THE CARDIAC DEPARTMENT ON THE MEDICARE COST REPORT.DIRECT STAFFING & BENEFIT COSTS $16,225FACILITY COSTS $29,872CLASS REVENUES COLLECTED ($ 8,743)NET COMMUNITY BENEFIT $37,354HRH RENTS LIFELINE EMERGENCY RESPONSE UNITS TO INDIVIDUALS IN OUR SERVICE AREA. THIS PROGRAM IS OPERATED TO ASSIST THE ELDERLY WITH THEIR DESIRE TO REMAIN INDEPENDENT AND LIVING IN THEIR OWN HOME. HRH PAYS A FEE FOR THE UNIT AND A RELATED CONNECTION COST. HRH ALSO INCURS STAFFING COSTS FOR INSTALLATION AND DISCONNECTION OF THE UNITS. A LOG OF THESE COSTS WAS CREATED FROM THE RELATED INVOICES AND TIMECARDS:STAFFING, UNIT RENTAL & CONNECTION COSTS $20,329UNIT RENTAL FEES COLLECTED ($19,561)NET COMMUNITY BENEFIT $ 768 Part I, Line 7 - Explanation of Costing Methodology COST-TO-CHARGE RATIO WAS USED TO DERIVE CHARITY CARE AT COST IN THE TABLE. COST-TO-CHARGE RATIO WAS ALSO USED TO DERIVE THE COST OF MEDICAID SERVICES, WHICH IS INCLUDED AS A PORTION OF THE UNREIMBURSED MEDICAID COMMUNITY BENEFIT EXPENSE. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARECOST-TO-CHARGES. Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) DISCOUNTED CARE PROVIDED IN THE RHC SETTING, BEGINNING AT 150% OF FPG. X X X false false false false false false false false false false THOMAS MOAKLER 233575 8768 7903 250246 SANTIAGO DUY 319791 1188 16696 337675 ROBERT MOSENFELDER MD 246644 1188 12504 260336 PHILIP MCFARLANE MD 258742 734 12504 271980 PAUL M ALEXANDER 237676 774 238450 EUN-KYUNG HONG 224002 180 12504 236686 CATHY CHASSE 218893 414 6357 225664 BRIAN GRIFFIN MD 284623 414 16696 301733 A MAINE HEALTH & HIGHER EDU 010314384 560427WV4 2013-05-23 2380000 REFINANCE EXISTING DEBT false false true A 2653988 34370 true false true true A false false false false A false D MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 2010B 010314384 560427JA5 2010-06-24 2965000 REFINANCE EXISTING DEBT false false true C MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 010314384 5604253L2 2008-11-01 3600000 CONSTRUCTION false false true B MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 010314384 560425469 2006-07-01 1400000 51% CONSTRUCTION, 49% REFINANCING false false true A MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 010314384 560425L40 2007-07-01 2345000 REFINANCE EXISTING DEBT false false true D 510000 3171803 44927 true false true true C 200000 3572529 65821 577759 2928949 false false true true B 420000 1529734 46860 1482874 false false true true A 550000 2371246 45535 true false true true C false false false false false B false true false false false 0.00500 0.00500 false D false false false true false false C false false false true false false B false false true FSA 29.0000 true false false A false false true TRANSAMERICA 33.0000 true false false D false C false B false A false Supplemental Information Part VI SCHEDULE K, PART III, LINE 7 AND SCHEDULE K, PART VTHE HOSPITAL HAS CURRENTLY ESTABLISHED SOME OF THE PRACTICES AND PROCEDURES NECESSARY FOR POST-ISSUANCE COMPLIANCE. THE HOSPITAL CURRENTLY MONITORS COMPLIANCE WITH BOND DOCUMENTS THROUGH OUR INTERNAL COMPLIANCE COMMITTEE. WE ARE ALSO REQUIRED BY THE ISSUER TO SUBMIT QUARTERLY DOCUMENTS AS PART OF OUR BOND AGREEMENTS. WE ARE WORKING WITH OUR AUDITORS AND ATTORNEY TO DEVELOP WRITTEN POLICIES. ELISABETH CLARK DIR DAUGH-LAW 17081 WAGES/EMPLOYMENT false SARAH LYNDS DIR DAUGH-LAW 45721 WAGES/EMPLOYMENT false HOULTON WATER COMPANY DIRECTOR - OFFICER 561479 UTILITY SERVICES false MATTHEW QUINT BROTHER OF CFO 28945 WAGES/EMPLOYMENT false COMMUNITY LIVING ASSOCIATION CEO A DIRECTOR 29363 WASTE COLLECTION SVCS false TERAN CLARK WIFE OF DIR 68085 WAGES/EMPLOYMENT false BARBARA MOAKLER SPOUSE OF CEO 62723 WAGES/EMPLOYMENT false HASSAN E ABOULEISH INC DIR 100% OWNER 67057 PHYSICIAN SERVICES false Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Decreases ROUNDING = -$4 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available THE BY-LAWS OF HOULTON REGIONAL HOSPITAL ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees PHYSICIAN SALARIES ARE COMPARED AGAINST TWO DIFFERENT SETS OF COMPARATIVE DATA - THE MGMA PHYSICIAN COMPENSATION SURVEY AND THE MAINE RECRUITMENT CENTER SURVEY. Form 990, Part VI, Line 15a Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management WAGES FOR THE CEO AND CFO ARE COMPARED AGAINST THE MHA EXECUTIVE COMPENSATION SURVEY ON A BI-ANNUAL BASIS BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts ANNUALLY, DIRECTORS, OFFICERS, AND KEY EMPLOYEES SHALL COMPLETE A CONFLICT OF INTEREST STATEMENT, IN ACCORDANCE WITH THE HOSPITAL'S CONFLICT OF INTEREST POLICY, DISCLOSING ANY POTENTIAL BUSINESS AND PROFESSIONAL CONFLICTS WHICH MAY ARISE. POTENTIAL CONFLICTS WILL BE REVIEWED ON AN ANNUAL BASIS BY THE BOARD OF DIRECTORS. SHOULD A DIRECTOR ENCOUNTER A SPECIFIC CONFLICT OF INTEREST IN ANY MEETING OF THE BOARD OR A BOARD COMMITTEE, THAT DIRECTOR WILL EXCUSE THEMSELVES FROM THE MEETING, WILL NOT PARTICIPATE IN DISCUSSION OF THE ISSUE AND WILL NOT VOTE. Form 990, Part VI, Line 11b Form 990, Part VI, Line 11b: Form 990 Review Process REVIEWED WITH THE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED MEETING.