2013-05-08T10:17:33-07:00 2012-09-30 CYNTHIA M THOMPSON CPA 1723 US HWY 1 CARY PLT ME 044713010 990 2011-10-01 237134386 HOULTON REGIONAL HOSPITAL HOUL 2075322900 20 HARTFORD ST HOULTON ME 04730 THOMAS MOAKLER 2013-05-02 true Non-paid Preparer 2075322900 2011 2016-02-25 16:41:14Z THOMAS MOAKLER 20 HARTFORD ST HOULTON ME 04730 44831563 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 7 506 86 11028 -25742 232556 96482 45124621 42135117 425658 370362 0 45782835 42601961 0 0 28294609 27126908 0 0 17040288 16900603 45334897 44027511 447938 -1425550 29323445 30980901 20845027 23557839 8478418 7423062 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 35931179 42135117 PROVISION 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. 35931179 true true false true false false false false false true true false false true 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 41 0 true 506 true true true false false false false false false false false false 0 false false false false false false false false false false false X 13 7 false false false false false false false true true false false false true true true true true true true true false false X CYNTHIA M THOMPSON 2075322900 20 HARTFORD ST HOULTON ME 04730 X JERRY YORK 1.00 X 0 0 0 PHILIP MCFARLANE MD 40.00 X 224018 0 12504 NANCY KETCH 1.00 X 0 0 0 MAX LYNDS 1.00 X 0 0 0 ROBERT ELLIS OD 1.00 X 0 0 0 HASSAN E ABOULEISH MD 40.00 X X 112830 0 0 ALISON BOSSIE 1.00 X 0 0 0 BRIAN GRIFFIN MD 40.00 X 250206 0 16696 DOUG HAZLETT 1.00 X 0 0 0 STEPHEN NELSON 1.00 X X 0 0 0 REV JESSIE DRYSDALE 1.00 X X 0 0 0 LYNETTE MCLAUGHLIN 1.00 X X 0 0 0 JOHN CLARK 1.00 X 0 0 0 KARL WOODS DMD 1.00 X 0 0 0 CYNTHIA THOMPSON 40.00 X 74210 0 0 THOMAS MOAKLER 40.00 X 237429 0 7903 CINDY DAIGLE 40.00 X 114853 0 15305 ROBERT MOSENFELDER MD 40.00 X 240008 0 12504 SANTIAGO DUY 40.00 X 237838 0 17854 PAUL M ALEXANDER 40.00 X 233570 0 0 CATHY CHASSE 40.00 X 215167 0 6357 MICHAEL NORTHWAY 40.00 X 214979 0 7903 2155108 97026 27 false true false JAMES C MADIX MD 20 HARTFORD ST HOULTON ME 04730 RADIOLOGIST 323810 VISTA STAFFING SOLUTIONS 675 EAST 2100 SOUTH SUITE 390 SALT LAKE CITY UT 841069813 LOCUM SVCS 317388 PHYSICIAN SERVICES INC 126 OSBORNE RD FARMINGTON ME 04938 HOSPITALIST SVCS 215750 HOULTON INTERNAL MEDICINE PA 22 HARTFORD ST HOULTON ME 04730 INTERNAL MEDICINE 1300180 COMPHEALTH ASSOCIATES INC PO BOX 972651 DALLAS TX 753972625 LOCUM SERVICES 361874 17 96482 800 96482 VENDING, CAFETERIA, MISC. 845696 685542 160154 PATIENT FEES 48979069 48979069 MEDICARE & MEDICAID PYMTS 24557812 24557812 CONFERENCE ROOM RENTAL 722320 11028 11028 -32258488 -32258488 42135117 145121 145121 0 0 0 2454843 2229602 225241 225241 225241 0 0 0 0 42601961 41963935 11028 530516 0 0 0 0 1065954 616254 449700 0 20489582 18731581 1758001 8500 8500 4097368 4097368 1465504 1316023 149481 0 74086 74086 44000 44000 10392 10392 0 14669 14669 0 13725 13725 97600 35738 61862 123664 94983 28681 0 338288 338288 155332 124177 31155 0 0 751973 612407 139566 0 1446103 1177706 268397 549996 182771 367225 UTILITIES 976700 976700 MEDICAID TAX - STATE OF MAINE 1241102 1241102 PROFESSIONAL SERVICES 4145630 4006422 139208 SUPPLIES 5157106 5141620 15485 1760237 1335407 424831 44027511 35931179 8096332 0 25138 20067 1227068 722464 0 6878103 8379146 0 0 0 874335 785159 1322482 974530 40393838 26734377 13104082 13659461 2952559 3279671 0 0 0 2939678 3160403 29323445 30980901 4732321 4888872 11571848 10944022 600223 979085 3940635 6745860 20845027 23557839 X 7916668 7138923 510086 232475 51664 51664 8478418 7423062 29323445 30980901 X -1425550 370194 X false true true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 10392 10392 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, THE MAINE HOSPITAL ASSOCIATION, AND THE MAINE HEALTH CARE ASSOCIATION. 85541 18149 200 103490 88511 -2770 200 85541 79673 9038 200 88511 1.00000 false false false 193107 193107 23158048 13982564 9175484 10864532 7972234 2892298 6178151 4779579 1398572 13659461 Rounding 2 DUE FROM THIRD PARTY PAYORS 2103153 DEFERRED FINANCING COSTS 377587 457 PLAN ASSETS 278031 3160403 LINE OF CREDIT 1615817 DUE TO THIRD PARTY PAYORS 4852012 457 PLAN ASSETS 278031 6745860 42601961 44027511 -1425550 370197 -3 370194 -1055356 42957487 370197 370197 42587290 14669 2 14671 42601961 44012843 44012843 14669 -1 14668 44027511 Part XII, Line 4b Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S ROUNDING $2 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances ROUNDING $ -3 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 true false false false 997313 997313 0.02170 10243741 9403950 839791 0.01830 11241054 9403950 1837104 0.04000 20508 960 19548 0.00040 2912 2912 0.00010 81616 34122 47494 0.00100 70793 7560 63233 0.00140 175829 42642 133187 0.00290 11416883 9446592 1970291 0.04290 false 1141688 179245 16127545 16947786 -820241 X true true 1 0 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 true true true X X X X X true true true 150.0000 true 150.0000 true X X true true X X X X X X false X 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 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 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 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. Number of Hospital Faciltiy - 0 Part V, Line 19d - 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 - 0 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 - 0 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 FROM 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 PORTION 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 Expense FOOTNOTE 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 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 $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 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 229075 8354 7903 245332 SANTIAGO DUY 237386 452 17854 255692 ROBERT MOSENFELDER MD 238820 1188 12504 252512 PHILIP MCFARLANE MD 223046 972 12504 236522 PAUL M ALEXANDER 233156 414 233570 MICHAEL NORTHWAY 214205 774 7903 222882 CATHY CHASSE 214753 414 6357 221524 BRIAN GRIFFIN MD 249936 270 16696 266902 MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 2010B 010314384 560427JA5 2010-06-24 3171803 REFINANCE EXISTING DEBT false false true 335000 3171803 44927 3126876 2010 true false true true false false false false true false false MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 010314384 5604253L2 2008-11-01 3572529 CONSTRUCTION false false true MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 010314384 560425QS2 2003-10-16 4606976 REFINANCE EXISTING BOND false false true MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 010314384 560425469 2006-07-01 1529734 51% CONSTRUCTION, 49% REFINANCING false false true MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 010314384 560425L40 2007-07-01 2371246 REFINANCE EXISTING DEBT false false true 130000 3572529 65821 577759 2928949 2010 false false true true 1715000 4606976 83325 4523651 2003 true false true true 355000 1529734 46860 1482874 2006 false false true true 450000 2371246 45535 2325711 2007 true false true true false false false false false false true false false false 0.04500 0.00600 0.05100 false false false false false true false false true false false true FSA 20.0000 true false false false false false true FSA 29.0000 true false false false false false true TRANSAMERICA 33.0000 true false false NANCY PUTNAM SISTER OF DIR 111105 WAGES/EMPLOYMENT false ELISABETH CLARK DIR DAUGH-LAW 17287 WAGES/EMPLOYMENT false SARAH LYNDS DIR DAUGH-LAW 45059 WAGES/EMPLOYMENT false HOULTON WATER COMPANY DIRECTOR - OFFICER 524372 UTILITY SERVICES false KAREN GALLOP MOTHER OF TREAS 21204 WAGES/EMPLOYMENT false MATTHEW QUINT BROTHER OF CFO 30009 WAGES/EMPLOYMENT false COMMUNITY LIVING ASSOCIATION CEO A DIRECTOR 17843 WASTE COLLECTION SVCS false TERAN CLARK SPOUSE OF PRES 70925 WAGES/EMPLOYMENT false BARBARA MOAKLER SPOUSE OF CEO 58616 WAGES/EMPLOYMENT false HASSAN E ABOULEISH INC DIR 100% OWNER 112830 PHYSICIAN SERVICES false PART I SUMMARY IN 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 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 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 11 Form 990, Part VI, Line 11: Form 990 Review Process REVIEWED WITH THE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED MEETING.