HOULTON REGIONAL HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HOULTON REGIONAL HOSPITAL (EIN 23-7134386)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-05-08
IRS object ID
201331289349301073
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-08T10:17:33-07:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CYNTHIA M THOMPSON CPABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11723 US HWY 1AddressLine1
CityCARY PLTCity
StateMEState
ZIP Code044713010ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237134386EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HOULTON REGIONAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOULNameControl
Phone2075322900Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line120 HARTFORD STAddressLine1
CityHOULTONCity
StateMEState
ZIP Code04730ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTHOMAS MOAKLERName
TitleCEOTitle
Date Signed2013-05-02DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameNon-paid PreparerName
Phone2075322900Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS MOAKLERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line120 HARTFORD STAddressLine1
CityHOULTONCity
StateMEState
ZIP Code04730ZIPCode
FieldValueIRS element (for citing)
Gross Receipts44831563GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitehoultonregional.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1973YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionHOULTON 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees506TotalNbrEmployees
Total Nbr Volunteers86TotalNbrVolunteers
Total Gross UBI11028TotalGrossUBI
Net Unrelated Business Txbl Income-25742NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year232556ContributionsGrantsPriorYear
Contributions Grants Current Year96482ContributionsGrantsCurrentYear
Program Service Revenue Prior Year45124621ProgramServiceRevenuePriorYear
Program Service Revenue CY42135117ProgramServiceRevenueCY
Investment Income Prior Year425658InvestmentIncomePriorYear
Investment Income Current Year370362InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year45782835TotalRevenuePriorYear
Total Revenue Current Year42601961TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year28294609SalariesEtcPriorYear
Salaries Etc Current Year27126908SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year17040288OtherExpensePriorYear
Other Expenses Current Year16900603OtherExpensesCurrentYear
Total Expenses Prior Year45334897TotalExpensesPriorYear
Total Expenses Current Year44027511TotalExpensesCurrentYear
Revenues Less Expenses Prior Year447938RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1425550RevenuesLessExpensesCY
Total Assets BOY29323445TotalAssetsBOY
Total Assets EOY30980901TotalAssetsEOY
Total Liabilities BOY20845027TotalLiabilitiesBOY
Total Liabilities EOY23557839TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8478418NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7423062NetAssetsOrFundBalancesEOY
Mission DescriptionHOULTON 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense35931179Expense
Revenue42135117Revenue
DescriptionPROVISION OF HEALTH CARE SERVICES IN RURAL MAINE. DURING THE FISCAL YEAR ENDED 9/30/12, 1,583 PEOPLE HAD AN INPATIENT STAY (INCLUDING THE PROGRESSIVE CARE FACILITY); 84,107 OUTPATIENT SERVICES WERE RENDERED; 11,833 PEOPLE WERE SERVED IN THE EMERGENCY ROOM. OF THESE SERVICES, 1,988 ACCOUNTS (REPRESENTING 378 PEOPLE AND $1,713,780) 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 9/30/12, A DAILY AVERAGE OF 61 LIFELINE UNITS WERE RENTED.Description
Total Program Service Expense35931179TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109641NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees506NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCYNTHIA M THOMPSONNamePerson
Telephone Number2075322900TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line120 HARTFORD STAddressLine1
CityHOULTONCity
StateMEState
ZIP Code04730ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
JERRY YORK
Director1.00X000
PHILIP MCFARLANE MD
Director40.00X224018012504
NANCY KETCH
Director1.00X000
MAX LYNDS
Director1.00X000
ROBERT ELLIS OD
Director1.00X000
HASSAN E ABOULEISH MD
Vice President40.00X11283000X
ALISON BOSSIE
Director1.00X000
BRIAN GRIFFIN MD
Med Staff Pres.40.00X250206016696
DOUG HAZLETT
Director1.00X000
STEPHEN NELSON
Secretary1.00X000X
REV JESSIE DRYSDALE
President1.00X000X
LYNETTE MCLAUGHLIN
Treasurer1.00X000X
JOHN CLARK
Director1.00X000
KARL WOODS DMD
Director1.00X000
CYNTHIA THOMPSON
CFO40.007421000X
THOMAS MOAKLER
CEO40.0023742907903X
CINDY DAIGLE
PAST CFO40.00114853015305X
ROBERT MOSENFELDER MD
OB/GYN PHYSICIAN40.00240008012504X
SANTIAGO DUY
SURGEON40.00237838017854X
PAUL M ALEXANDER
CRNA40.0023357000X
CATHY CHASSE
CRNA40.0021516706357X
MICHAEL NORTHWAY
CRNA40.0021497907903X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2155108TotalReportableCompFromOrg
Total Other Compensation97026TotalOtherCompensation
Number Individuals GT100 K27NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
JAMES C MADIX MD
20 HARTFORD STHOULTONME04730RADIOLOGIST323810
VISTA STAFFING SOLUTIONS
675 EAST 2100 SOUTH SUITE 390SALT LAKE CITYUT841069813LOCUM SVCS317388
PHYSICIAN SERVICES INC
126 OSBORNE RDFARMINGTONME04938HOSPITALIST SVCS215750
HOULTON INTERNAL MEDICINE PA
22 HARTFORD STHOULTONME04730INTERNAL MEDICINE1300180
COMPHEALTH ASSOCIATES INC
PO BOX 972651DALLASTX753972625LOCUM SERVICES361874
FieldValueIRS element (for citing)
Number Of Contractors GT100 K17NumberOfContractorsGT100K
All Other Contributions96482AllOtherContributions
Noncash Contributions800NoncashContributions
Total Contributions96482TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmountBusiness CodeBusinessCodeUnrelated Business RevenueUnrelatedBusinessRevenue
VENDING, CAFETERIA, MISC.845696685542$160,154
PATIENT FEES4897906948979069
MEDICARE & MEDICAID PYMTS2455781224557812
CONFERENCE ROOM RENTAL1102872232011028

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column-32258488TotalRevenueColumn
Related Or Exempt Function Income-32258488RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue42135117TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column145121TotalRevenueColumn
Exclusion$145,121ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2454843Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2229602Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities225241Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column225241TotalRevenueColumn
Exclusion$225,241ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column42601961TotalRevenueColumn
Related Or Exempt Function Income41963935RelatedOrExemptFunctionIncome
Unrelated Business Revenue11028UnrelatedBusinessRevenue
Exclusion$530,516ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1065954Total
Program Services616254ProgramServices
Management And General449700ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total20489582Total
Program Services18731581ProgramServices
Management And General1758001ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8500Total
Management And General8500ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4097368Total
Management And General4097368ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1465504Total
Program Services1316023ProgramServices
Management And General149481ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total74086Total
Management And General74086ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total44000Total
Management And General44000ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total10392Total
Management And General10392ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total14669Total
Management And General14669ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total13725Total
Management And General13725ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total97600Total
Program Services35738ProgramServices
Management And General61862ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total123664Total
Program Services94983ProgramServices
Management And General28681ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total338288Total
Program Services338288ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total155332Total
Program Services124177ProgramServices
Management And General31155ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total751973Total
Program Services612407ProgramServices
Management And General139566ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1446103Total
Program Services1177706ProgramServices
Management And General268397ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total549996Total
Program Services182771ProgramServices
Management And General367225ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
UTILITIES976700976700
MEDICAID TAX - STATE OF MAINE12411021241102
PROFESSIONAL SERVICES41456304006422139208
SUPPLIES5157106514162015485

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1760237Total
Program Services1335407ProgramServices
Management And General424831ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total44027511Total
Program Services35931179ProgramServices
Management And General8096332ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY25138BOY
EOY20067EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1227068BOY
EOY722464EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6878103BOY
EOY8379146EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY874335BOY
EOY785159EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1322482BOY
EOY974530EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis40393838LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec26734377LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY13104082BOY
EOY13659461EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2952559BOY
EOY3279671EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2939678BOY
EOY3160403EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY29323445BOY
EOY30980901EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4732321BOY
EOY4888872EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY11571848BOY
EOY10944022EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY600223BOY
EOY979085EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3940635BOY
EOY6745860EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY20845027BOY
EOY23557839EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY7916668BOY
EOY7138923EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY510086BOY
EOY232475EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY51664BOY
EOY51664EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8478418BOY
EOY7423062EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY29323445BOY
EOY30980901EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1425550ReconcilationRevenueExpenses
Reconcilation Other Changes370194ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$10,392OtherActivitiesAmount
Total Lobbying Expenditures IIB10392TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1iIdentifier
Return ReferencePart II-B, Line 1i - Other Activities DescriptionReturnReference
ExplanationOTHER LOBBYING AMOUNTS REPRESENT AN ALLOCABLE PORTION OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION, THE MAINE HOSPITAL ASSOCIATION, AND THE MAINE HEALTH CARE ASSOCIATION.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance85541BeginningOfYearBalance
Investment Earnings Or Losses18149InvestmentEarningsOrLosses
Administrative Expenses200AdministrativeExpenses
End Of Year Balance103490EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance88511BeginningOfYearBalance
Investment Earnings Or Losses-2770InvestmentEarningsOrLosses
Administrative Expenses200AdministrativeExpenses
End Of Year Balance85541EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance79673BeginningOfYearBalance
Investment Earnings Or Losses9038InvestmentEarningsOrLosses
Administrative Expenses200AdministrativeExpenses
End Of Year Balance88511EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis193107OtherCostOrOtherBasis
Book Value193107BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis23158048OtherCostOrOtherBasis
Depreciation13982564Depreciation
Book Value9175484BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis10864532OtherCostOrOtherBasis
Depreciation7972234Depreciation
Book Value2892298BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6178151OtherCostOrOtherBasis
Depreciation4779579Depreciation
Book Value1398572BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13659461TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
Rounding2
DUE FROM THIRD PARTY PAYORS2103153
DEFERRED FINANCING COSTS377587
457 PLAN ASSETS278031
FieldValueIRS element (for citing)
Total Book Value Other Assets3160403TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
LINE OF CREDIT$1,615,817
DUE TO THIRD PARTY PAYORS$4,852,012
457 PLAN ASSETS$278,031
FieldValueIRS element (for citing)
Total Of Amounts6745860TotalOfAmounts
Total Revenue42601961TotalRevenue
Total Expenses44027511TotalExpenses
Excess Or Deficit For Year-1425550ExcessOrDeficitForYear
Net Unrealized GL On Investments370197NetUnrealizedGLOnInvestments
Other-$3OtherAmount
Total Adjustments370194TotalAdjustments
Excess Or Deficit Per FS-1055356ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt42957487TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments370197NetUnrealizedGainsInvestments
Revenue Not Rptd F990370197RevenueNotRptdF990
Revenue Subtotal42587290RevenueSubtotal
Investment Expenses Not Included14669InvestmentExpensesNotIncluded
Other Revenues Not Included2OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt14671RevenueNotRptdOnFinStmt
Total Revenue Per Form99042601961TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt44012843TotExpensesEtcAuditedFinclStmt
Expenses Subtotal44012843ExpensesSubtotal
Investment Expenses Not Included214669InvestmentExpensesNotIncluded2
Other Expenses Not Included-1OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt14668ExpensesNotRptdOnFinStmt
Total Expenses Per Form99044027511TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XII, Line 4bPart XII, Line 4b: Other revenue amounts included on 990 but not included in F/SROUNDING $2
Part XI, Line 8Part XI, Line 8: Other Changes in Net Assets or Fund BalancesROUNDING $ -3
Part V, Line 4Part 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.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage150.000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigentfalseFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport
Report Publically AvailablefalseReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense997313TotalCommunityBenefitExpense
Net Community Benefit Expense997313NetCommunityBenefitExpense
Percent Of Total Expense0.02170PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense10243741TotalCommunityBenefitExpense
Direct Offsetting Revenue9403950DirectOffsettingRevenue
Net Community Benefit Expense839791NetCommunityBenefitExpense
Percent Of Total Expense0.01830PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense11241054TotalCommunityBenefitExpense
Direct Offsetting Revenue9403950DirectOffsettingRevenue
Net Community Benefit Expense1837104NetCommunityBenefitExpense
Percent Of Total Expense0.04000PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense20508TotalCommunityBenefitExpense
Direct Offsetting Revenue960DirectOffsettingRevenue
Net Community Benefit Expense19548NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense2912TotalCommunityBenefitExpense
Net Community Benefit Expense2912NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense81616TotalCommunityBenefitExpense
Direct Offsetting Revenue34122DirectOffsettingRevenue
Net Community Benefit Expense47494NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense70793TotalCommunityBenefitExpense
Direct Offsetting Revenue7560DirectOffsettingRevenue
Net Community Benefit Expense63233NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense175829TotalCommunityBenefitExpense
Direct Offsetting Revenue42642DirectOffsettingRevenue
Net Community Benefit Expense133187NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense11416883TotalCommunityBenefitExpense
Direct Offsetting Revenue9446592DirectOffsettingRevenue
Net Community Benefit Expense1970291NetCommunityBenefitExpense
Percent Of Total Expense0.04290PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$1,141,688BadDebtExpenseAmount
Amount Attributable To179245AmountAttributableTo
Amount Reimbursed By Medicare16127545AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare16947786CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-820241MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number0FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1HOULTON REGIONAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line120 HARTFORD STAddressLine1
CityHOULTONCity
StateMEState
ZIP Code04730ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours
OtherSKILLED NURSING FACILITY & 2 RHCSOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1HOULTON REGIONAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Include Operational PlansXIncludeOperationalPlans
Prioritize ServicesXPrioritizeServices
All Needs AddressedtrueAllNeedsAddressed
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent150.0000FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent150.0000FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymentfalseActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities3NumberOfOtherFacilities

Other Facilities OtherFacilities (3 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
HOULTON FAMILY PRACTICE
22 HARTFORD STREETHOULTONME04730RURAL HEALTH CENTER
SIGRID E TOMPKINS RURAL HEALTH CENTER
22 HARTFORD STREETHOULTONME04730RURAL HEALTH CENTER
HOULTON REGIONAL HOSPITAL PROGRESSIVE CARE FACILITY
20 HARTFORD STREETHOULTONME04730SKILLED NURSING FACILITY

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeAT 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 InformationHRH 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 2011 US CENSUS, 19.5% 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. 31.4% OF THE SERVICE AREA RESIDENTS ARE CONSIDERED TO BE LOW-INCOME (LESS THAN 200% OF THE FEDERAL POVERTY LEVEL) ACCORDING TO THE 2011 CENSUS COMPARED TO 25.6% IN MAINE AS A WHOLE. AVERAGE UNEMPLOYMENT IN AROOSTOOK COUNTY FOR 2012 WAS 9.5% COMPARED TO 8% 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 AssistancePATIENTS 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 AssessmentTHE 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 2012 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.
Part V, Line 19d - Other Billing Determination of Individuals Without InsuranceIF 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 - 0
Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs AssessmentTHE 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 - 0
Part V, Line 3 - Account Input from Person Who Represent the CommunityHOULTON REGIONAL HOSPITAL HOSTED A COMMUNITY FORUM TO REVIEW THE AROOSTOOK COUNTY RESULTS. ATTENDING THIS FORUM WERE REPRESENTATIVES FROM A LOCAL FQHC, A HOME CARE AGENCY, A COUNSELING SERVICE, AND LOCAL LAW ENFORCEMENT, AMONG OTHERS.Number of Hospital Faciltiy - 0
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsTHE 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 BenefitPORTION OF MEDICARE SHORTFALL RELATED TO THE SKILLED NURSING FACILITY SHOULD CONSTITUTE COMMUNITY BENEFIT BECAUSE THE HOSPITAL CONTINUES TO PROVIDE THE SERVICE WHILE SUBSIDIZING THE FINANCIAL LOSSES INCURRED BY THE UNIT. THE CENSUS ON THIS UNIT HAS DECLINED IN THE PAST FEW YEARS AND IN THE CURRENT FISCAL YEAR (10/1/12 TO 9/30/13) THE HOSPITAL HAS REDUCED THE NUMBER OF AVAILABLE BEDS FROM 26 TO 18. THIS HAS HELPED TO REDUCE SOME OF THE OPERATING COSTS WHILE STILL MAINTAINING THE SERVICE.SNF REIMBURSEMENT $1,250,479SNF ALLOWABLE COSTS $2,184,942SNF SHORTFALL ($934,463)ADDITIONAL MEDICARE SHORTFALL - REVENUE AND COSTS NOT INCLUDED IN THE MEDICARE COST REPORT: COST PROFESSIONAL REPORT FEES TOTALREIMBURSEMENT $16,127,545 $1,325,078 $17,452,624COSTS $16,947,786 $1,994,190 $18,941,976SHORTFALL ($820,241) ($669,111) ($1,489,352)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 DEDCUTIONS 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 $669,111 LESS THAN THE PROFESSIONAL FEE COSTS.
Part III, Line 4 - Bad Debt ExpenseFOOTNOTE THAT DESCRIBES 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 FOF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE.COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINE 2 - ORGANIZATION BAD DEBT EXPENSE (AT COST): WE USED WORKSHEET A TO ESTIMATE BAD DEBT EXPENSE (AT COST), WHICH IS A COST-TO-CHARGE METHODOLOGY.PAYMENTS OR DISCOUNTS ON BAD DEBT ACCOUNTS: ANY PAYMENTS OR DISCOUNTS ON PATIENT ACCOUNTS AFTER THE ACCOUNT HAS BEEN WRITTEN OFF ARE RECORDED THROUGH THE VALUATION ACCOUNT. PERIODICALLY RESONABLENESS OF THE BALANCE IN THE VALUATION ACCOUNT IS EVALUATED. IF THE BALANCE NEEDS TO BE ADJUSTED AN ENTRY IS MADE TO THE VALUATION ACCOUNT WITH AN OFFSETTING ENTRY POSTED TO BAD DEBT EXPENSE.COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 3 - BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE: THE 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 (15.7%). 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, 15.7% OF PERSONS IN 2011 ARE BELOW POVERTY LEVEL. SINCE OUR ELIGIBILITY CRITERIA FOR OUR HOSPITAL IS 150% OF 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 I, Line 7g - Costs Associated With Physicans ClinicsSUBSIDIZED 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 $22,005FACILITY COSTS 35,286CLASS REVENUES COLLECTED (11,329)NET COMMUNITY BENEFIT $45,962HRH 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 $24,325UNIT RENTAL FEES COLLECTED ( 22,793)NET COMMUNITY BENEFIT 1,532
Part I, Line 7 - Explanation of Costing MethodologyCOST-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.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
THOMAS MOAKLER
22907583547903245332
SANTIAGO DUY
23738645217854255692
ROBERT MOSENFELDER MD
238820118812504252512
PHILIP MCFARLANE MD
22304697212504236522
PAUL M ALEXANDER
233156414233570
MICHAEL NORTHWAY
2142057747903222882
CATHY CHASSE
2147534146357221524
BRIAN GRIFFIN MD
24993627016696266902

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 2010BBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN010314384IssuerEIN
CUSIP Number560427JA5CUSIPNumber
Date Issued2010-06-24DateIssued
Issue Price3171803IssuePrice
Description Of PurposeREFINANCE EXISTING DEBTDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingtruePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired335000AmountRetired
Total Proceeds3171803TotalProceeds
Issuance Costs From Proceeds44927IssuanceCostsFromProceeds
Capital Expenditures3126876CapitalExpenditures
Year Of Subst Completion2010YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Regulatory Safe Harbor SatisfiedtrueRegulatorySafeHarborSatisfied
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY
0103143845604253L22008-11-013572529CONSTRUCTIONfalsefalsetrue
MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY
010314384560425QS22003-10-164606976REFINANCE EXISTING BONDfalsefalsetrue
MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY
0103143845604254692006-07-01152973451% CONSTRUCTION, 49% REFINANCINGfalsefalsetrue
MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY
010314384560425L402007-07-012371246REFINANCE EXISTING DEBTfalsefalsetrue

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Amount RetiredAmountRetiredTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
13000035725296582157775929289492010falsefalsetruetrue
171500046069768332545236512003truefalsetruetrue
35500015297344686014828742006falsefalsetruetrue
45000023712464553523257112007truefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrsEngage Bond Counsel ContractsEngageBondCounselContractsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUse
falsefalsefalsefalsefalse
falsetruefalsefalsefalsefalse0.045000.006000.05100

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfiedGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebateTerm Of GICTermOfGIC
(no name)
falsefalsefalsefalsetruefalsefalse
FSA
truefalsefalsetruetruefalsefalse20.0000
FSA
falsefalsefalsetruetruefalsefalse29.0000
TRANSAMERICA
falsefalsefalsetruetruefalsefalse33.0000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (10 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
NANCY PUTNAM
SISTER OF DIR111105WAGES/EMPLOYMENTfalse
ELISABETH CLARK
DIR DAUGH-LAW17287WAGES/EMPLOYMENTfalse
SARAH LYNDS
DIR DAUGH-LAW45059WAGES/EMPLOYMENTfalse
HOULTON WATER COMPANY
DIRECTOR - OFFICER524372UTILITY SERVICESfalse
KAREN GALLOP
MOTHER OF TREAS21204WAGES/EMPLOYMENTfalse
MATTHEW QUINT
BROTHER OF CFO30009WAGES/EMPLOYMENTfalse
COMMUNITY LIVING ASSOCIATION
CEO A DIRECTOR17843WASTE COLLECTION SVCSfalse
TERAN CLARK
SPOUSE OF PRES70925WAGES/EMPLOYMENTfalse
BARBARA MOAKLER
SPOUSE OF CEO58616WAGES/EMPLOYMENTfalse
HASSAN E ABOULEISH INC
DIR 100% OWNER112830PHYSICIAN SERVICESfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I SUMMARYIN JULY 2011, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) AMENDED ACCOUNTING STANDARDS CODIFICATION (ASC) 954, HEALTH CARE ENTITIES, TO REQUIRE HEALTH CARE ENTITIES TO CHANGE THE PRESENTATION OF THE STATEMENT OF OPERATIONS BY RECLASSIFYING THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS). ADDITIONALLY, ENHANCED DISCLOSURES ARE REQUIRED ABOUT THE POLICIES FOR RECOGNIZING REVENUES AND ASSESSING BAD DEBTS. THE AMENDMENTS ALSO REQUIRE DISCLOSURE OF QUALITATIVE AND QUANTITATIVE INFORMATION ABOUT SIGNIFICANT CHANGES IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE AMENDMENTS TO ASC 954 ARE EFFECTIVE FOR THE FIRST ANNUAL PERIOD ENDING AFTER DECEMBER 15, 2012. THE HOSPITAL ELECTED TO EARLY ADOPT THESE AMENDMNETS FOR FISCAL YEAR ENDED SEPTEMBER 30, 2012. REVENUES AND EXPENSES FOR OUR 9/30/11 TAX YEAR HAVE BEEN RESTATED ON THE 990 SUMMARY TO MATCH THE ABOVE PRESENTATION FOR THE CURRENT TAX YEAR 9/30/12.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableTHE 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 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesPHYSICIAN 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 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsANNUALLY, 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 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessREVIEWED WITH THE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED MEETING.Form 990, Part VI, Line 11

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.