2025-03-17T09:38:49-05:00 2024-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-07-01 010284446 REDINGTON-FAIRVIEW GENERAL HOSPITAL REDI 2074745121 PO BOX 468 SKOWHEGAN ME 049760468 ELMER DOUCETTE CFO 2074745121 2025-03-13 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-03-13 2023 2025-03-06 01:10:19Z RICHARD D WILLETT PO BOX 468 SKOWHEGAN ME 049760468 158945613 0 X WWW.RFGH.NET X 1969 ME SEE SCHEDULE OREDINGTON-FAIRVIEW GENERAL HOSPITAL'S MISSION IS TO DEVELOP, PROVIDE, AND FACILITATE QUALITY, SAFE, COMPREHENSIVE, COST-EFFECTIVE HEALTH SERVICES FOR THE PEOPLE WE SERVE. WE AFFIRM A COMMITMENT TO MAINTAIN OUR UNIQUE COMMUNITY HOSPITAL IDENTITY, OFFERING PERSONALIZED SERVICES. 9 6 927 6 0 0 2127484 2420816 146275462 154200128 1612340 1935765 4460749 388904 154476035 158945613 0 0 0 0 85631258 87405348 0 0 0 66348907 65182140 151980165 152587488 2495870 6358125 133113690 148620726 31577767 32776995 101535923 115843731 X REDINGTON-FAIRVIEW GENERAL HOSPITAL'S MISSION IS TO DEVELOP, PROVIDE, AND FACILITATE QUALITY, SAFE, COMPREHENSIVE, COST-EFFECTIVE HEALTH SERVICES FOR THE PEOPLE WE SERVE. WE AFFIRM A COMMITMENT TO MAINTAIN OUR UNIQUE COMMUNITY HOSPITAL IDENTITY, OFFERING PERSONALIZED SERVICES. 0 0 81886863 0 127629477 RFGH PROVIDES 24 HOUR SEVEN DAY A WEEK EMERGENCY SERVICES. THESE SERVICES INCLUDE AN EMERGENCY DEPARTMENT STAFFED WITH PHYSICIANS 24 HOURS A DAY AS WELL AS AN AMBULANCE SERVICE WHICH OPERATES 24 HOURS A DAY. DURING FISCAL 2024, RFGH HAD 22,169 EMERGENCY DEPARTMENT VISITS AND 4,773 AMBULANCE RUNS. IN ADDITION TO EMERGENCY SERVICES, THE HOSPITAL PROVIDES A FULL RANGE OF SERVICES SUCH AS RADIOLOGY, C.T. SCAN, ULTRASOUND, NUCLEAR MEDICINE, BLOOD BANK, PATHOLOGY, LABORATORY, CARDIOLOGY, RESPIRATORY, AND REHAB SERVICES. 33495355 0 18697868 RFGH OPERATES A NUMBER OF PHYSICIAN OFFICES IN ORDER TO BETTER SERVE THE RESIDENTS OF SOMERSET COUNTY. DURING FISCAL 2024, THESE PHYSICIAN SPECIALTIES INCLUDED INTERNAL MEDICINE, ENDOCRINOLOGY, GENERAL SURGERY, ORTHOPEDICS, PEDIATRICS, FAMILY MEDICINE, OBSTETRICS & GYNECOLOGY, GASTROENTEROLOGY, NEUROLOGY, PODIATRY, & CARDIOLOGY. DURING FISCAL 2024, THESE PHYSICIAN SPECIALTIES HAD 70,454 VISITS. 17039554 0 7872782 RFGH IS LICENSED AS A CRITICAL ACCESS HOSPITAL OPERATING 25 BEDS. RFGH EMPLOYS HOSPITALISTS WHO ARE PHYSICIANS DEDICATED TO THE TREATMENT OF INPATIENTS. INPATIENT SERVICES INCLUDE MEDICAL AND SURGICAL, SPECIAL CARE, OBSTETRICS AND PEDIATRICS. DURING FISCAL 2024, RFGH PROVIDED INPATIENT SERVICES TO 1,067 PATIENTS WHO STAYED 4,299 PATIENT DAYS. MEDICARE AND MEDICAID PATIENTS REPRESENTED 80% OF RFGH'S INPATIENTS. 1461600 0 0 REDINGTON-FAIRVIEW GENERAL HOSPITAL OPERATES SOMERSET PUBLIC HEALTH, A PROGRAM WHOSE PURPOSE IS TO PROTECT AND IMPROVE THE QUALITY OF LIFE AND HEALTH OF ALL GREATER SOMERSET COUNTY RESIDENTS. 1461600 0 0 133883372 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 34 0 1 927 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X ELMER DOUCETTE 2078582300 46 FAIRVIEW AVE SKOWHEGAN ME 049760468 MICHAEL CURRAN MD DIRECTOR/SURGEON 50.00 X 552385 0 23620 TIRUNELLAI R SHANKAR MD SURGEON 50.00 X 532719 0 23857 AMIR BAIG MD ANESTHESIOLOGIST 50.00 X 477964 0 23081 JOHN COMIS MD ER PHYSICIAN 50.00 X 466938 0 25858 RICHARD D WILLETT CEO/SECRETARY 50.00 X 453648 0 28292 GINA GOMEZ MD DIRECTOR 50.00 X 394666 0 28604 SAMUEL LEVINE MD ANESTHESIOLOGIST 50.00 X 399819 0 21054 GANNA CHUGAY MD ANESTHESIOLOGIST 50.00 X 389353 0 23358 DANA C KEMPTON ASSOCIATE DIRECTOR 50.00 X 326342 0 28752 ELMER DOUCETTE CFO 50.00 X 260031 0 21001 MICHAEL LAMBKE MD DIRECTOR 50.00 X 219526 0 18447 CHRISTOPHER PERKINS PRESIDENT 2.00 X X 0 0 0 L JOSEPH CLARK VICE PRESIDENT 2.00 X X 0 0 0 JEFFREY MCGOWN TREASURER 2.00 X X 0 0 0 VICKY ALWARD DIRECTOR 2.00 X 0 0 0 SAM HIGHT DIRECTOR 2.00 X 0 0 0 WILLIAM LANEY DIRECTOR 2.00 X 0 0 0 4473391 0 265924 117 0 1 0 FOCUSONE SOLUTIONS PO BOX 850861 MINNEAPOLIS MN 554850861 CLINICAL STAFFING 3615354 CHG COMPANIES PO BOX 972651 DALLAS TX 753972651 CLINICAL STAFFING 1282014 CHG MEDICAL STAFFING PO BOX 972633 DALLAS TX 753972633 CLINICAL STAFFING 1101755 HURON CONSULTING 3005 MOMENTUM PLACE CHICAGO IL 606895330 INFO SYSTEMS CONSULTING 776170 LANGFORD & LOW CONSTRUCTION 248 WARREN AVE PORTLAND ME 04103 CONSTRUCTION 566877 22 971156 945637 504023 2420816 OUTPATIENT SERVICES 621990 122992365 122992365 PHYSICIAN PRACTICES 621990 18697868 18697868 INPATIENT SERVICES 621990 7872782 7872782 340B CONTRACTED PHARMACY 456110 4249895 4249895 387218 387218 154200128 1935765 1935765 CAFETERIA 722514 388904 388904 388904 158945613 154200128 0 2324669 2206598 1166577 1040021 59837493 55117678 4719815 1275863 1024825 251038 19916852 15998031 3918821 4168542 3348344 820198 27594 27594 445061 445061 11587 11587 240416 240416 12709600 10053666 2655934 78994 78994 7749213 6800338 948875 4196363 3650851 545512 2229100 1290655 938445 92897 78963 13934 278690 236886 41804 613768 496330 117438 6145733 4969810 1175923 763820 527017 236803 BAD DEBT EXPENSE 13038031 13038031 PHARMACEUTICALS 11436549 11436549 HOSPITAL PROVIDER TAX 2224506 2224506 EQUIPMENT & MAINTENANCE 1315195 1315195 1585023 1109120 475903 152587488 133883372 18704116 0 3099682 9301510 2470647 5744289 10451487 8801482 1183468 1248016 3054344 2663211 645023 859088 87069193 66023974 23448177 21045219 74933224 82057729 13827638 16900182 133113690 148620726 13925267 13638441 17652500 16270022 0 2868532 31577767 32776995 X 100430888 114535081 1105035 1308650 101535923 115843731 133113690 148620726 X 6358125 6163336 1786347 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 11587 11587 152575864 152587451 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 9954 10343 10423 11587 42307 250000 250000 250000 250000 1000000 1500000 396680 396680 52786737 42750808 10035929 33011007 23273166 9737841 874769 874769 21045219 PENSION ASSET 16900182 16900182 ESTIMATED THIRD PARTY SETTLEMENTS 2868532 2868532 152070918 6163336 6163336 145907582 13038031 13038031 158945613 139549457 0 139549457 13038031 13038031 152587488 PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 13,038,031. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 13,038,031. 1 1 1 X 1 X 225.000000000000 1 1 0 0 3364137 980978 2383159 0.01560 3364137 980978 2383159 0.01560 1527831 1183863 343968 0.00230 33495355 18697868 14797487 0.09700 35023186 19881731 15141455 0.09930 38387323 20862709 17524614 0.11490 1 7238181 25542295 27313734 -1771439 X 1 1 1 1 REDINGTON-FAIRVIEW GENERAL HOSPITAL 46 FAIRVIEW AVENUE PO BOX 468 SKOWHEGAN ME 04976 WWW.RFGH.NET 38095 X X X REDINGTON-FAIRVIEW GENERAL HOSPITAL 1 0 0 1 X X X X X X 22 1 1 1 1 X HTTPS://WWW.RFGH.NET/COMMUNITY/HEALTH-REPORTS.XHTML X 1 22 1 HTTPS://WWW.RFGH.NET/COMMUNITY/HEALTH-REPORTS.XHTML 0 1 X 150.000000000000 225.000000000000 1 1 X X X 1 X WWW.RFGH.NET X WWW.RFGH.NET X WWW.RFGH.NET X X X X X X 0 0 X X X X 1 X 0 0 REDINGTON-FAIRVIEW GENERAL HOSPITAL PART V, SECTION B, LINE 5: HOW THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY AND IDENTIFY THE PERSONS THE HOSPITAL FACILITY CONSULTED:COMMUNITY OUTREACH AND ENGAGEMENT FOR THE MAINE SHARED CHNA INCLUDED 17 COUNTY FORUMS, 9 COMMUNITY SPONSORED EVENTS, AND 1,000 ORAL SURVEYS. ONE VIRTUAL COMMUNITY FORUM WAS HELD IN SOMERSET COUNTY WITH 42 ATTENDEES. PERSONS FROM THE FOLLOWING ORGANIZATIONS REPRESENTING BROAD INTERESTS OF THE COMMUNITY WHO WERE CONSULTED DURING THE ENGAGEMENT PROCESS: COBURN PARK COMMISSION, HEALTHY LIVING FOR ME, KENNEBEC BEHAVIORAL HEALTH, MAINE CENTER FOR DISEASE CONTROL & PREVENTION, MAINE GENERAL HEALTH, MAINE GENERAL MEDICAL CENTER, NORTHERN LIGHT HEALTH, NORTHERN LIGHT HOMECARE & HOSPICE, NORTHERN LIGHT INLAND HOSPITAL, NORTHERN LIGHT SEBASTICOOK VALLEY HOSPITAL, OFFICE OF CHILD & FAMILY SERVICES, REDINGTON-FAIRVIEW GENERAL HOSPITAL, RSU #74 SCHOOL DISTRICT, SKOWHEGAN REGIONAL CHAMBER OF COMMERCE, SOMERSET PUBLIC HEALTH, AND TRUSTED RIDE CERTIFIED. REDINGTON-FAIRVIEW GENERAL HOSPITAL PART V, SECTION B, LINE 6A: OTHER HOSPITALS INCLUDED IN CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENT:RFGH HAS COLLABORATED WITH THE MAINE SHARED COMMUNITY HEALTH NEEDS ASSESSMENT (MAINE SHARED CHNA) A COLLABORATION BETWEEN CENTRAL MAINE HEALTHCARE, MAINE CENTER FOR DISEASE CONTROL & PREVENTION, MAINEGENERAL HEALTH, MAINEHEALTH, AND NORTHERN LIGHT HEALTH. THE VISION OF THE MAINE SHARED CHNA IS TO TURN HEALTH DATA INTO ACTION SO THAT MAINE WILL BECOME THE HEALTHIEST STATE IN THE U.S. THE MISSION OF THE MAINE SHARED CHNA IS TO : CREATE SHARED CHNA REPORTS, ENGAGE AND ACTIVATE COMMUNITIES, AND SUPPORT DATA-DRIVEN HEALTH IMPROVEMENTS FOR MAINE PEOPLE. REDINGTON-FAIRVIEW GENERAL HOSPITAL PART V, SECTION B, LINE 11: HOW THE HOSPITAL FACILITY IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AND ANY SUCH NEEDS THAT ARE NOT BEING ADDRESSED TOGETHER WITH THE REASONS WHY SUCH NEEDS ARE NOT BEING ADDRESSED.VISIT HTTPS://WWW.RFGH.NET/COMMUNITY/HEALTH-REPORTS.XHTML FOR ANNUAL UPDATES ON PROGRESS. PART V, SECTION B, LINE 22D: HOW HOSPITAL DETERMINED THE MAXIMUM AMOUNTS THAT CAN BE CHARGED FAP-ELIGIBLE INDIVIDUALS:ALL ACCOUNT GUARANTORS WHO EXPRESS AN INABILITY TO PAY FOR SERVICES ARE SCREENED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE USING AN APPLICATION AND GUIDELINES ESTABLISHED BY THE HOSPITAL. UNDER THESE GUIDELINES, ELIGIBLE APPLICANTS MAY QUALIFY FOR 100% CHARITY CARE OR DISCOUNTED CHARGES RANGING FROM 25% TO 100%. PART I, LINE 7: METHODOLOGY USED TO ESTIMATE FINANCIAL ASSISTANCE AT COST: CHARITY CARE WRITE-OFFS ARE RECORDED AT GROSS CHARGES. IN ORDER TO COMPUTE THE COST OF THESE SERVICES, THE HOSPITAL ADJUSTED BOTH GROSS CHARGES AND EXPENSES BY EXCLUDING THE GROSS CHARGES AND EXPENSES ASSOCIATED WITH SUBSIDIZED HEALTH SERVICES REPORTED IN SCHEDULE H PART I LINE 7G AND CALCULATED A RATIO OF COST-TO-CHARGES. THE RESULTING RATIO OF 55.52% WAS APPLIED TO THE GROSS CHARGES PERTAINING TO CHARITY CARE WRITE-OFFS.PART I, LINE 7E: METHODOLOGY USED TO ESTIMATE COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS: THESE COMMUNITY BENEFIT EXPENSES REPRESENT THE ACTUAL EXPENDITURES OF OPERATING THE SOMERSET PUBLIC HEALTH COLLABORATIVE WHICH SERVES MOST OF MAINE'S SOMERSET COUNTY. PART I, LINE 7G: METHODOLOGY USED TO ESTIMATE SUBSIDIZED HEALTH SERVICES: THESE COMMUNITY BENEFIT EXPENSES REPRESENT THE DIRECT AND INDIRECT COSTS OF OPERATING PHYSICIAN PRACTICES WHICH OPERATE WITH REVENUES THAT ARE INSUFFICIENT TO COVER THE OVERALL COSTS. INDIRECT COSTS ARE CALCULATED USING AN ALLOCATION METHOD SIMILAR TO MEDICARE COST REPORT METHODS OF ALLOCATING OVERHEAD COSTS. PART III, LINE 2: BAD DEBT WRITE-OFFS ARE RECORDED AT GROSS CHARGES. IN ORDER TO COMPUTE THE COST OF THESE SERVICES, THE HOSPITAL ADJUSTED BOTH GROSS CHARGES AND EXPENSES BY EXCLUDING THE GROSS CHARGES AND EXPENSES ASSOCIATED WITH SUBSIDIZED HEALTH SERVICES REPORTED IN SCHEDULE H PART I LINE 7G AND CALCULATED A RATIO OF COST-TO-CHARGES. THE RESULTING RATIO OF 55.52% WAS APPLIED TO THE GROSS CHARGES PERTAINING TO BAD DEBT WRITE-OFFS. PART III, LINE 4: FOOTNOTE DESCRIBING IMPLICIT PRICE CONCESSIONS, FORMERLY REFERRED TO AS BAD DEBTS, CAN BE FOUND IN THE 1ST PARAGRAPH ON PAGE 14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE SHORTFALL METHOD OF CALCULATING:MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B. INPATIENT MEDICARE COSTS ARE CALCULATED BASED UPON A COMBINATION OF ALLOWABLE COST PER DAY MULTIPLIED BY MEDICARE DAYS FOR ROUTINE SERVICES PLUS A COST-TO-CHARGE RATIO MULTIPLIED BY MEDICARE CHARGES BY ANCILLARY DEPARTMENT. OUTPATIENT COST IS CALCULATED BASED ON A COST-TO-CHARGE RATIO MULTIPLIED BY MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: COLLECTION PRACTICES:THE HOSPITAL'S COLLECTION POLICY CONTAINS THE GUIDELINES FOR FINANCIAL ASSISTANCE, AND CONTAINS PROVISIONS FOR HOSPITAL STAFF TO EXTEND TO QUALIFIED PATIENTS WHO WOULD LIKELY MEET SLIDING SCALE FEE CRITERIA THE OPPORTUNITY TO APPLY FOR DISCOUNTED CARE. HOSPITAL RESOURCES ARE MADE AVAILABLE TO PATIENTS REQUIRING ASSISTANCE IN COMPLETING APPLICATIONS. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY ARE PROVIDED DISCOUNTS RANGING FROM 25% TO 100% OF CHARGES. ONCE QUALIFIED PATIENTS MAY BE EXTENDED REDUCED FEE FOR HEALTH CARE SERVICES RECEIVED IN THE FUTURE. ALL PATIENTS ARE ASKED TO REAPPLY ANNUALLY TO THE FINANCIAL ASSISTANCE PROGRAM. OUTSIDE COLLECTION AGENCIES CONTRACTED WITH THE HOSPITAL MUST SPECIFY THEIR STANDARDS AND SCOPE OF PRACTICES, ALL OF WHICH MUST BE IN COMPLIANCE WITH THE COLLECTION POLICY. PART VI, LINE 2: NEEDS ASSESSMENT: DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES, IN ADDITION TO ANY CHNAS REPORTED.REDINGTON-FAIRVIEW GENERAL HOSPITAL OPERATES SOMERSET PUBLIC HEALTH (SPH), A PROGRAM WHOSE PURPOSE IS TO PROTECT AND IMPROVE THE QUALITY OF LIFE AND HEALTH OF ALL GREATER SOMERSET COUNTY RESIDENTS. SPH PROVIDES PLANNING AND EVALUATION OF BOTH LONG AND SHORT RANGE STRATEGIES FOR ESSENTIAL PUBLIC HEALTH SERVICES. SPH INVOLVES CITIZENS IN DEVELOPING AND CARRYING OUT CHRONIC DISEASE PREVENTION THROUGH VARIOUS INITIATIVES. SPH MOBILIZES BOTH PUBLIC AND PRIVATE RESOURCES IN SUPPORT OF THESE INITIATIVES AND COORDINATES EFFORTS THROUGHOUT THE COMMUNITY. BY WORKING WITH CITIZENS, SPH SERVES AS ADVOCATES ON MATTERS OF POLICIES THAT AFFECT HEALTH STATUS, WHILE PROMOTING INSTITUTIONAL IMPROVEMENT AND DESIRABLE CHANGES IN SOCIAL POLICY AND ENVIRONMENTAL CHANGE. SPH IMPLEMENTS PROGRAMS FINANCED THROUGH GRANTS, OR DELEGATES IMPLEMENTATION TO OTHER AGENCIES. SPH ALSO IDENTIFIES AND PURSUES OTHER AVAILABLE FUNDS DEEMED IMPORTANT FOR THE HEALTH OF CITIZENS. IN ITS WORK TO IMPROVE AND PROTECT PUBLIC HEALTH AND REDUCE CHRONIC DISEASE, SPH FOCUSES ITS EFFORTS AND FUNDING ON SUBSTANCE ABUSE AND TOBACCO PREVENTION, PHYSICAL ACTIVITY AND NUTRITION PROMOTION, AND WORKSITE WELLNESS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:REDINGTON-FAIRVIEW GENERAL HOSPITAL PROVIDES THE FOLLOWING INFORMATION IN THE FIRST BILL THAT EACH PATIENT RECEIVES:FINANCIAL ASSISTANCE PROGRAM & AND PLAIN LANGUAGE SUMMARY. THE FULL DETAIL OF THESE DOCUMENTS ARE FOUND ON THE ORGANIZATIONS WEBSITE UNDER BILLING INFORMATION: HTTPS://WWW.RFGH.NET/PATIENTINFORMATION/BILLING-AND-INSURANCE.XHTML PART VI, LINE 4: COMMUNITY INFORMATION:REDINGTON-FAIRVIEW GENERAL HOSPITAL IS AN INDEPENDENT 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN SKOWHEGAN, MAINE. THE HOSPITAL PROVIDES HEALTH CARE TO MORE THAN 51,000 RESIDENTS LIVING IN SOMERSET COUNTY, MAINE. ITS PRIMARY SERVICE AREA EXTENDS FROM SKOWHEGAN TO THE CANADIAN BORDER. A STATE OF THE ART MEDICAL OFFICE BUILDING ADJACENT TO THE HOSPITAL PROVIDES EASY ACCESS TO PRIMARY AND SPECIALTY CARE. A MEDICAL STAFF OF MORE THAN 40 PHYSICIANS SKILLED IN A VARIETY OF FIELDS, AND APPROXIMATELY 840 FULL AND PART-TIME PROFESSIONAL AND TECHNICAL EMPLOYEES ENSURE THE DELIVERY OF PROGRESSIVE HEALTH AND MEDICAL SERVICES. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:THE HOSPITAL IS LOCATED IN A MEDICALLY UNDERSERVED AREA. CONSEQUENTLY, THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF. THE BOARD OF DIRECTORS CONSISTS OF 6 INDEPENDENT COMMUNITY MEMBERS AND 3 MEDICAL STAFF MEMBERS. IN ADDITION TO THE PROGRAMS OUTLINED IN OTHER AREAS OF THE FORM 990, THE HOSPITAL OPERATES A FITNESS FACILITY WHICH OPERATES AT A LOSS. THE FITNESS FACILITY OPERATES MANY PROGRAMS WHICH PROMOTES WELLNESS. OTHER WELLNESS PROGRAMS ARE ALSO PROVIDED THROUGH THE INDOOR POOL THAT THE HOSPITAL OPERATES AT A LOSS. THE POOL PROMOTES WELLNESS AMONG INDIVIDUALS WHO WOULD NOT BE ABLE TO OTHERWISE EXERCISE (DISABLED INDIVIDUALS WITH CHRONIC PAIN, MS AND OTHER DEBILITATING DISEASES). THE HOSPITAL ALSO OPERATES SOMERSET PUBLIC HEALTH, A PROGRAM WHOSE PURPOSE IS TO PROTECT AND IMPROVE THE QUALITY OF LIFE AND HEALTH OF ALL GREATER SOMERSET COUNTY RESIDENTS.SEE THE RFGH COMMUNITY HEALTH 2022-2025 WORK PLAN FOR PRIORITY AREAS WHICH INCLUDES: ACCESS TO CARE MENTAL HEALTH SOCIAL DETERMINANTS OF HEALTH SUBSTANCE AND ALCOHOL USE X X X X 0 0 0 1 0 0 0 0 0 MICHAEL CURRAN MD DIRECTOR/SURGEON 446597 0 105788 0 0 0 6385 0 17235 0 576005 0 0 0 TIRUNELLAI R SHANKAR MD SURGEON 339775 0 192944 0 0 0 6622 0 17235 0 556576 0 0 0 AMIR BAIG MD ANESTHESIOLOGIST 477964 0 0 0 0 0 4446 0 18635 0 501045 0 0 0 JOHN COMIS MD ER PHYSICIAN 466938 0 0 0 0 0 6344 0 19514 0 492796 0 0 0 RICHARD D WILLETT CEO/SECRETARY 453648 0 0 0 0 0 11083 0 17209 0 481940 0 0 0 GINA GOMEZ MD DIRECTOR 394666 0 0 0 0 0 9969 0 18635 0 423270 0 0 0 SAMUEL LEVINE MD ANESTHESIOLOGIST 399819 0 0 0 0 0 2419 0 18635 0 420873 0 0 0 GANNA CHUGAY MD ANESTHESIOLOGIST 389353 0 0 0 0 0 4723 0 18635 0 412711 0 0 0 DANA C KEMPTON ASSOCIATE DIRECTOR 326342 0 0 0 0 0 11539 0 17213 0 355094 0 0 0 ELMER DOUCETTE CFO 260031 0 0 0 0 0 3810 0 17191 0 281032 0 0 0 MICHAEL LAMBKE MD DIRECTOR 202246 0 17280 0 0 0 2813 0 15634 0 237973 0 0 0 PART I, LINE 5 PHYSICIANS EMPLOYED BY THE HOSPITAL PARTICIPATE IN AN INCENTIVE BASED COMPENSATION PROGRAM. THE PROGRAM IS BASED UPON A REVENUE TARGET WHICH WILL PRODUCE A TARGET COMPENSATION LEVEL, WHICH IS BASED ON BOTH LOCAL AND NATIONAL BENCHMARK INFORMATION. IN ORDER TO ALIGN THE PHYSICIAN WITH THE CHARITABLE MISSION OF THE HOSPITAL, THE PROGRAM IS BASED ON THE HOSPITAL'S ACTUAL CHARGES, SO THAT THE PHYSICIAN WILL HAVE AN INCENTIVE TO TAKE ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SUM OF ALL CHARGES FOR SERVICES PERFORMED BY THE PHYSICIAN IS TABULATED ON A QUARTERLY BASIS. THAT TABULATION IS THEN DIVIDED BY THE REVENUE TARGET, WHICH IS MULTIPLIED TIMES THE TARGET COMPENSATION LEVEL. IF A PHYSICIAN'S ACTUAL COMPENSATION IS LESS THAN THE CALCULATED SALARY, THE PHYSICIAN WILL RECEIVE A BONUS PAYMENT THAT RECOGNIZES THE PHYSICIAN'S CONTRIBUTION TO THE HOSPITAL'S ACHIEVEMENT OF IT'S CHARITABLE MISSION TO PROVIDE HEALTH SERVICES FOR THE BENEFIT OF THE COMMUNITY. A MAINE HEALTH & HIGHER EDUCATION FACILITY AUTHORITY 010314384 2016-01-20 7500000 ED EXPANSION AND INPATIENT RENOV 0 0 0 B MAINE HEALTH & HIGHER EDUCATION FACILITY AUTHORITY 010314384 56042RQL9 2017-12-28 48573817 BOND REFUNDING 1 0 1 A 4000000 7500000 7500000 2016 0 0 1 1 B 4015000 18815225 1316450 19456877 191946 2007 0 1 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING THE FORM 990, THE HOSPITAL'S CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER REVIEWED THE FILING IN DETAIL WITH THE HOSPITAL BOARD. THE BOARD FOUND THE REPORT TO BE COMPREHENSIVE AND COMPLETE AND SUPPORTED ITS FILING AS REVIEWED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY THE CONFLICT OF INTERESTS DISCLOSURE IS REVIEWED WITH THE MEMBERS OF THE BOARD AND DIRECTORS, WHO THEN SIGN THE DISCLOSURE. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION FOR THE CEO IS ESTABLISHED BY APPROVAL OF THE BOARD OR COMPENSATION COMMITTEE AND UTILIZES INFORMATION FROM INDUSTRY SURVEYS AND FORM 990 INFORMATION FROM OTHER ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 REDINGTON-FAIRVIEW GENERAL HOSPITAL MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: EFFECT OF ASC 715 1,786,347. REDINGTON MEMORIAL HOSPITAL ASSN PO BOX 468 SKOWHEGAN ME 04976 010211548 SOLE SUPPORTING ORGANIZATION OF RFGH ME 501 C (3) LINE 12C, III-FI N/A 0 FAIRVIEW HOSPITAL INC PO BOX 468 SKOWHEGAN ME 04976 010222130 SOLE SUPPORTING ORGANIZATION OF RFGH ME 501 C (3) LINE 12C, III-FI N/A 0 SOMERSET FITNESS CENTER INC 6 COMMERCE DRIVE SKOWHEGAN ME 04976 010524417 FITNESS CENTER ME REDINGTON FAIRVIEW GENERAL HOSPITAL C 323280 93603 1.00000 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 REDINGTON MEMORIAL HOSPITAL ASSOCIATION C 872398 CASH FAIRVIEW HOSPITAL INC C 98758 CASH REDINGTON MEMORIAL HOSPITAL ASSOCIATION K 224700 CASH