2012-08-15T12:21:33-05:00 2011-09-30 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2010-10-01 020222150 LRGHEALTHCARE LRGH 6035243211 80 HIGHLAND STREET LACONIA NH 032463298 HENRY D LIPMAN 6035272802 2012-08-15 TIMOTHY R HEPBURN CPA 8002447444 2010 2016-02-24 21:20:13Z THOMAS A CLAIRMONT 80 HIGHLAND STREET LACONIA NH 032463298 222154306 0 X WWW.LRGH.ORG X 1893 NH PROVIDE ACCESSIBLE, QUALITY, COMPASSIONATE CARE AND STRENGTHEN THE WELL-BEING OF OUR COMMUNITY. 22 17 1686 246 16560 15560 2194918 2020537 196526579 200432187 475629 849217 -8885910 4442962 190311216 207744903 0 219660 0 0 87326321 89526915 0 0 336308 115688144 117301665 203014465 207048240 -12703249 696663 211748584 210535466 173328329 177731272 38420255 32804194 X LRGHEALTHCARE'S MISSION IS TO SERVE THE LAKES REGION, FRANKLIN, AND SURROUNDING COMMUNITIES BY PROMOTING PHYSICAL, MENTAL, EMOTIONAL, SOCIAL, ENVIRONMENTAL, AND SPIRITUAL HEALTH AND PROVIDING ACCESS TO THE FULLEST RANGE OF QUALITY, MODERN AND EFFICIENT HEALTH CARE SERVICES PRACTICAL FOR THE ORGANIZATION, REGARDLESS OF RACE, SEX, RELIGION, PRIMARY LANGUAGE, DISABILITY OR HANDICAP, NATIONAL ORIGIN, OR ABILITY TO PAY. 0 0 181264665 219660 204848732 LRGHEALTHCARE(THE INSTITUTION) IS A NEW HAMPSHIRE NON PROFIT CORPORATION THAT OWNS AND OPERATES TWO HOSPITALS AND THEIR AFFILIATED PROGRAMS AND SERVICES IN THE TWIN RIVERS AND LAKE WINNIPESAUKEE REGIONS OF NH APPROXIMATELY 90 MILES NORTH OF BOSTON, MA. THE INSTITUTION IS THE CORPORATE NAME FOR THE HEALTHCARE SYSTEM COMPRISED OF LAKES REGION GENERAL HOSPITAL (LRGH) AND FRANKLIN REGIONAL HOSPITAL (FRH AND COLLECTIVELY WITH LRGH, THE HOSPITALS). LRGH WAS FOUNDED IN 1893 AND WAS ORIGINALLY KNOWN AS THE COTTAGE HOSPITAL. IN 1908, COMMUNITY NEED FOR THE HOSPITAL HAD OUTGROWN ITS LOCATION SO A NEW FACILITY WAS OPENED AT THE PRESENT SITE ON HIGHLAND STREET. THE FACILITY WAS RENAMED LACONIA HOSPITAL AND MAINTAINED SUCH NAME UNTIL 1966 WHEN THE NAME OF THE HOSPITAL CHANGED TO LAKES REGION GENERAL HOSPITAL. LRGH IS LOCATED IN LACONIA, NEW HAMPSHIRE. LRGH, DESIGNATED AS A RURAL REFERRAL CENTER AND SOLE COMMUNITY HOSPITAL UNDER MEDICARE, IS A COMMUNITY AND REGIONAL ACUTE CARE FACILITY WITH A LICENSED BED CAPACITY OF 137 BEDS. FRH WAS FOUNDED IN 1909 AS A NOT-FOR-PROFIT CHARITABLE CORPORATION BY THE FRANKLIN LADIES HOSPITAL AID SOCIETY, WITH THE STATED CHARITABLE PURPOSE OF PROVIDING ACUTE HEALTHCARE SERVICES TO RESIDENTS OF THE CITY OF FRANKLIN AND SURROUNDING COMMUNITIES. IN 1909, THE FRANKLIN LADIES HOSPITAL AID SOCIETY PURCHASED A MANSION KNOWN AS THE AIKEN HOMESTEAD WHICH OPENED ITS DOORS AS THE SITE OF THE FIRST FRANKLIN HOSPITAL ON JANUARY 1, 1910. FROM THAT TIME TO THE PRESENT, THE FRANKLIN HOSPITAL GREW INTO FRH WITH A FOCUS OF SERVING THE GREATER FRANKLIN, NEW HAMPSHIRE COMMUNITY. FRH, DESIGNATED AS A CRITICAL ACCESS HOSPITAL UNDER MEDICARE, IS A 25 BED COMMUNITY HOSPITAL. ON JULY 1, 2002, LRGH MERGED WITH FRH TO BECOME LRGHEALTHCARE. THE INSTITUTION OFFERS A BROAD RANGE OF MEDICAL, SURGICAL, SPECIALTY AND SUB-SPECIALTY SERVICES TO ADULTS, CHILDREN AND INFANTS. AS A COMMUNITY BASED INSTITUTION, THE INSTITUTION OFFERS ALL THE INPATIENT SERVICES OF AN ACUTE CARE, COMMUNITY HOSPITAL SYSTEM. IN ADDITION, THE INSTITUTION OFFERS SPECIALTY SERVICES NOT COMMONLY FOUND IN COMPARABLE HOSPITALS, INCLUDING VASCULAR SURGERY AND SPECIALTY SERVICES IN ONCOLOGY AND NEPHROLOGY. TRADITIONAL SERVICES INCLUDE: MEDICAL, SURGICAL AND PEDIATRIC CARE; PSYCHIATRIC SERVICES; SKILLED NURSING CARE; INTENSIVE CARE; OBSTETRICS/GYNECOLOGY; CLINICAL LABORATORY SERVICES; NUTRITION SERVICES; PHARMACY SERVICES; RADIOLOGY SERVICES INCLUDING CT, MRI, PET/CT AND NUCLEAR MEDICINE; REHABILITATION SERVICES (PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY); CARDIOPULMONARY/RESPIRATORY SERVICES; PATIENT EDUCATION SERVICES; CHAPLAINCY; AND PATIENT/FAMILY (SOCIAL) SERVICES. LRGH ALSO HAS ESTABLISHED A PHYSICIAN HOSPITALIST PROGRAM AND INTENSIVISTS PROGRAM TO ACCEPT REFERRALS IN A MORE STREAMLINED FASHION AND FACILITATE EFFICIENCIES IN INPATENT CARE. TOTAL ACUTE INPATIENT ADMISSIONS WERE 4,911. THE INSTITUTION MAINTAINS SWING BEDS AT BOTH LRGH AND FRH. SWING BEDS ARE ACUTE CARE LICENSED BEDS THAT CAN BE USED AS NURSING HOME BEDS WHICH PROVIDE THE HOSPITALS WITH ADDITIONAL REIMBURSEMENT FOR THEIR SENIOR OR OTHER LONG-TERM PATIENTS. BOTH LRGH AND FRH ARE ELIGIBLE TO MAINTAIN SWING BEDS. TOTAL SWING BED ADMISSIONS WERE 836. THE INSTITUTION PROVIDES A COMPREHENSIVE ARRAY OF OUTPATIENT SERVICES WHICH INCLUDE: AMBULATORY SURGERY, EMERGENCY MEDICINE, ONCOLOGY SERVICES, GENERAL HEALTH SCREENINGS, CARDIAC AND PULMONARY REHABILITATION PROGRAMS, LABORATORY SERVICES, PATIENT EDUCATION, NUTRITION COUNSELING, RADIOLOGY SERVICES, CARDIOPULMONARY SERVICES, REHABILITATION SERVICES AND PATIENT/FAMILY SERVICES. THE INSTITUTION MAINTAINS AND OPERATES EMERGENCY DEPARTMENTS AT THE HOSPITALS SERVING THE PUBLIC AROUND THE CLOCK, 365 DAYS A YEAR WITH SPECIALTY TRAINED PHYSICIANS, NURSES AND STAFF. BOTH EMERGENCY DEPARTMENTS ARE EQUIPPED WITH STATE OF THE ART DIAGNOSTIC EQUIPMENT AND OFFER GROUND AND AIR TRANSFER CAPABLIITY TO TERTIARY CARE FACILITIES. LRGH IS A STATE DESIGNATED LEVEL 3 TRAUMA CENTER. IN ADDITION TO ITS TWO HOSPITAL FACILITIES, THE INSTITUTION HAS OVER 24 OTHER SITES WHERE IT OPERATES OUTPATIENT AND AMBULATORY SERVICES. THE OUPATIENT REGISTRATIONS WERE 185,358. HERE IS A SUMMARY OF THE MOST SIGNIFICANT FACILITIES: THE LACONIA CLINIC (THE CLINIC) IS A 25-PHYSICIAN PROVIDER-BASED DEPARTMENT (UNDER MEDICARE) OF LRGH. THE CLINIC AND LRGH OPERATING AGREEMENTS BENEFIT THE COMMUNITY BY PRESERVING AN ENHANCING ACCESS TO A BROAD RANGE OF BENEFITS AND MEDICAL SERVICES. BOTH ENTITIES BELIEVE THAT THE CONCEPT HAS PROVIDED COMMUNITY BENEFITS AND EFFICIENCIES AND ALSO OFFERED OPPORTUNITIES TO MORE EFFECTIVELY ADVANCE QUALITY HEALTHCARE INCLUDING OUTCOMES. THE MAJOR COMPONENTS OF THE CLINIC IN LACONIA, NH CONSIST OF A TWO OPERATING ROOM AMBULATORY SURGICAL CENTER AND ANCILLARY SERVICES INCLUDING LABORATORY, XRAY AND PHYSICAL THERAPY. THE CLINIC IS LESS THAN ONE MILE FROM THE MAIN LACONIA CAMPUS. LRGHEALTHCARE AMBULATORY SURGICAL CENTER (ASC) AT HILLSIDE MEDICAL PARK (WHICH IS APPROXIMATELY, 1.4 MILES FROM THE LRGH CAMPUS) IS OWNED AND OPERATED BY LRGH. ASC PROVIDES AN ALTERNATE LOCATION FOR PATIENTS REQUIRING ONE-DAY ORTHOPEDIC SURGERIES (SUCH AS HAND, WRIST, KNEE AND SHOULDER SURGERIES), ENT SURGERIES, AS WELL AS PAIN MANAGEMENT SERVICES. THE SERVICES OFFERED BY ASC ARE DESIGNED TO COMPLEMENT THE BROADER RANGE OF INPATIENT AND OUTPATIENT SURGICAL SERVICES AVAILABLE AT LRGH. ALSO AT THE HILLSIDE MEDICAL PARK LOCATION THE INSTITUTION OWNS APPROXIMATELY 29,000 SQUARE FEET OF SPACE WHERE IT OPERATES ITS SLEEP LAB, OUTPATIENT REHABILITATION FOR THE LACONIA REGION, AN OCCUPATIONAL HEALTH PROGRAM AND A PRIMARY CARE PHYSICIAN PRACTICE. LRHEALTHCARE INTERLAKES MEDICAL CENTER CONSISTS OF 14,000 GROSS SQUARE FEET AND IS COMPRISED OF PHYSICIAN PRACTICE EXAMINATION ROOMS AND SHARED PROVIDER OFFICES, A CLINICAL LABORATORY, REHABILITATION SERVICES AND MEDICAL IMAGING. THE FACILITY LOCATED IN MEREDITH IS APPROXIMATELY 10 MILES FROM THE LRGH CAMPUS. IN FULFILLING ITS MISSION AS A NOT-FOR-PROFIT COMMUNITY HEALTHCARE SYSTEM, THE INSTITUTION PROVIDES A SUBSTANTIAL LEVEL OF COMMUNTIY BENEFITS AND CHARITY CARE. THE RESPONSIBILITY FOR THESE PROGRAMS AND SERVICES IS SHARED THROUGHOUT THE ORGANIZATION ON BOTH CAMPUSES. THE INSTITUTION'S GOAL IS TO MAKE QUALITY HEALTHCARE AVAILABLE, ACCESSIBLE, AND AFFORDABLE TO ALL, REGARDLESS OF THEIR ABILITY TO PAY. LARGELY AS A RESULT OF THE INSTITUTION'S STRONG EMPHASIS ON COMMUNITY BENEFIT ACTIVITIES, IT RECEIVED THE BUSINESS OF THE DECADE AWARD FOR HEALTH CARE FROM BUSINESS NEW HAMPSHIRE MAGAZINE. IN 2011, THE INSTITUTION PROVIDED $30,134,577 (VALUED AT COST) IN COMMUNITY BENEFIT PROGRAMS AND SERVICES TO ADDRESS LOCAL HEALTHCARE NEEDS. THE INSTITUTION PROVIDES THESE SERVICES TO ACHIEVE THE FOLLOWING GOALS: HEALTHCARE ACCESS TO THE UNINSURED AND UNDERINSURED. FREE OR REDUCED FEE SERVICES ARE PROVIDED TO COMMUNITY MEMBERS WHO ARE UNINSURED OR UNDERINSURED AND LACK THE MEANS TO PAY FOR MEDICAL CARE. THESE SERVICES INCLUDE INPATIENT, EMERGENCY AND DIAGNOSTIC CARE AT THE HOSPITALS AND ARE ADMINISTERED THROUGH THE FOLLOWING PROGRAMS: COMMUNITY/CHARITABLE CARE, HEALTHLINK, HEALTHY BEGINNINGS, CHEMICAL DEPENDENCY PROGRAM AND AMBULANCE SERVICE. DENTAL CARE: THE INSTITUTION PROVIDES DENTAL SERVICES FOR UNINSURED OR UNDERINSURED COMMUNITY MEMBERS WHO ARE IN NEED OF DENTAL CARE THROUGH THE DENTAL RESOURCE CENTER. COMMUNITY HEALTH AND OUTREACH: THE INSTITUTION PROVIDES SEVERAL COMMUNITY HEALTH AND WELLNESS PROGRAMS INCLUDING CARDIAC AND PULMONARY REHABILITATION, A DIABETES MANAGEMENT PROGRAM, COMMUNITY CARE MANAGEMENT, MEDICATION CONNECTION PROGRAM AND A BREAST HEALTH PROGRAM. THE INSTITUTION ALSO PROMOTES COMMUNITY HEALTH THROUGH NUTRITION AND FITNESS PROGRAMS IN CONJUNCTION WITH COMMUNITY VOLUNTEER SERVICES. IN ADDITION, THE INSTITUTION HAS FORMED MANY COMMUNITY PARTNERSHIPS THAT ARE INVOLVED IN SUPPORTING THE HEALTH OF THE COMMUNITY AT LARGE IN BOTH THE LAKE WINNIPESAUKEE AND THREE RIVERS REGIONS. DURING 2005 THE INSTITUTION PARTNERED WITH COMMUNITY HEALTH AND HOSPICE, GENESIS BEHAVIORAL HEALTH, THE AMERICAN RED CROSS (LAKES REGION CHAPTER), LAKES REGION COMMUNITY SERVICES COUNCIL, AND THE BELKNAP-MERRIMACK COMMUNITY PARTNERSHIP FOR PUBLIC HEALTH. THE MISSION OF THE LAKES REGION PARTNERSHIP FOR PUBLIC HEALTH IS TO IMPROVE THE HEALTH AND WELL BEING OF THE LAKES REGION THROUGH INTERORGANIZATIONAL COLLABORATION AND COMMUNITY AND PUBLIC HEALTH IMPROVEMENT ACTIVITIES. THE INSTITUTION IS ALSO A MEMBER OF THE CARING COMMUNITY NETWORK OF THE THREE RIVERS. 181264665 1 1 0 1 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 0 1 95 0 1 1686 1 1 1 0 0 0 0 1 1 0 0 0 0 0 X 22 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NH X THOMAS A CLAIRMONT PRESIDENT 6035272801 80 HIGHLAND STREET LACONIA NH 03246 X THOMAS A CLAIRMONT 40.00 X X 452368 0 35579 PETER WALKLEY -CHIEF OF STAFF 40.00 X 232192 0 33323 PAUL RACICOT MD 1.00 X 0 0 0 JUDIE REEVER 1.00 X 0 0 0 STUART TRACHY 1.00 X X 0 0 0 PETER RUSSELL 1.00 X X 0 0 0 SCOTT CLARENBACH 1.00 X X 0 0 0 CYNTHIA BARON 1.00 X 0 0 0 BJ ECKARDT 1.00 X 0 0 0 ROBERT EVANS MD 1.00 X 0 0 0 DONALD FLANDERS 1.00 X 0 0 0 WILLIAM GRIMM 1.00 X 0 0 0 ALIDA MILLHAM 1.00 X 0 0 0 DAVID PALFREY 1.00 X 0 0 0 PEG PLUMER 1.00 X 0 0 0 JAMES ABERG 1.00 X 0 0 0 GIL SCHOHAN 1.00 X 0 0 0 NANCY LEROY 1.00 X 0 0 0 K MARK PRIMEAU 1.00 X 0 0 0 SCOTT SULLIVAN 1.00 X 0 0 0 MIKE SEYMOUR 1.00 X 0 0 0 GLENN FUSONIE PHYSICIAN 40.00 X 311931 0 39125 VERCIN EPHREM PHYSICIAN 40.00 X 314008 0 38954 HENRY D LIPMAN 40.00 X 235711 0 45182 DAVID COLEMAN 40.00 X 309634 0 20899 JOHN VIGNATI 40.00 X 315647 0 41632 ELIZA DEERY 40.00 X 289760 0 41807 MICHELE J GAIER RUSH 40.00 X 327095 0 12948 CAROLYN DRAKE 40.00 X 271240 0 40600 3059586 0 350049 88 0 1 0 LACONIA CLINIC 724 MAIN STREET LACONIA NH 03246 HEALTH SERVICES 12210898 CENTRAL NH ER ASSOC PA 174 PHILBROOK RD SANBORNTON NH 03269 EMERGENCY ROOM COVERAGE 5500670 ORTHOPEDIC PROFESSIONAL ASSOC 14 MAPLE ST STE 100 GILFORD NH 03249 HEALTH SERVICES 2143301 NH IMAGING SERVICES ONE PILLSBURY ST STE 200 CONCORD NH 03301 MEDICAL IMAGING SERVICES 1549791 LR ANESTHESIOLOGY PA 87 SPRING STREET LACONIA NH 03246 PROFESSIONAL SERVICES 1368669 38 114300 190239 1715998 2020537 NET PATIENT SERVICES 900099 189049726 189049726 DISPROPORTIONATE SHARE 900099 9751772 9751772 OTHER SERVICES 900099 1039269 1039269 CAFETERIA 900099 591420 591420 200432187 681147 681147 219358 192658 26700 26700 16560 10140 14340399 14155439 16890 184960 -16890 168070 168070 44133 114300 44416 -283 -283 OTHER MISC 900099 4227316 4227316 SALE OF INTEREST IN SU 900099 189229 189229 4416545 207744903 204848732 16560 859074 219660 219660 1616876 859064 757812 73918154 63263910 10422037 232207 1487990 1277531 210459 7302122 6253442 1030186 18494 5201773 4451734 733375 16664 194161 194161 114480 114480 45993 45993 276714 276714 6527839 5600999 922704 4136 3639898 3125076 514822 4898621 4204436 692635 1550 57110 49032 8078 606452 520676 85776 5664925 4863686 801239 8093551 6948810 1144741 1838539 1578499 260040 PURCHASED SERVICES 37910840 32512154 5392208 6478 PROVISION FOR BAD DEBTS 12901762 12901762 PHARMARCY SUPPLIES 12458019 12458019 SUPPLIES 10594695 9096196 1498499 NH MEDICAID ENHANCEMENT 7051743 7051743 4426323 3751522 618022 56779 207048240 181264665 25447267 336308 1049539 3063245 924874 27115557 30541469 4246663 4514508 3604070 2425511 199893289 100964223 74373516 98929066 17103274 12713292 119663 64932 84136302 57358569 211748584 210535466 18911961 23169269 143520000 143520000 7420016 4388834 2500000 976352 6653169 173328329 177731272 X 32512309 25672511 3708209 4931946 2199737 2199737 38420255 32804194 211748584 210535466 X 696663 -6312724 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 45993 45993 207002247 207048240 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 159154 106724 45993 311871 250000 250000 250000 250000 1000000 1500000 12011538 1664340 129685 912670 12892893 10993203 1840639 132307 954611 12011538 12741965 353584 -460992 1641354 10993203 0.44690 0.17060 0.38250 0 0 1816626 1816626 48230898 30686719 17544179 3166719 2093238 1073481 97695330 68184266 29511064 48983716 48983716 98929066 BOND PROCEEDS FUNDS AND INVESTMENTS 49823052 UNAMORTIZED BOND ISSUANCE COSTS & CSV LIFE INS 5721983 WORKERS COMP FUNDS AND INVESTMENTS 1813534 57358569 ACCRUED WORKERS COMP LIABILITIES 1144900 ACCRUED PENSION COSTS 5508269 6653169 207744903 207048240 696663 -25542 -6287182 -6312724 -5616061 211857315 4301641 4301641 207555674 189229 189229 207744903 210208579 3160339 3160339 207048240 0 207048240 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TO FURTHER THE HOSPITALS' MISSION. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: INCOME TAXES - THE HOSPITALS, WITH THE EXCEPTION OF HILLSIDE, ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. MANAGEMENT EVALUATED THE HOSPITALS' TAX POSITIONS AND CONCLUDED THE HOSPITALS HAVE MAINTAINED THEIR TAX-EXEMPT STATUS, DO NOT HAVE ANY SIGNIFICANT UNRELATED BUSINESS INCOME AND HAVE TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. WITH FEW EXCEPTIONS, THE HOSPITALS ARE NO LONGER SUBJECT TO TAX EXAMINATION BY THE U.S. FEDERAL OR STATE TAX AUTHORITIES FOR YEARS BEFORE 2008. HILLSIDE IS A FOR-PROFIT SUBSIDIARY AND IS A LIMITED LIABILITY COMPANY. AS SUCH, THE SUBSIDIARY IS SUBJECT TO STATE TAXATION BUT IS NOT SUBJECT TO FEDERAL TAXATION. DEFERRED TAXES ARE NOT SIGNIFICANT AT SEPTEMBER 30, 2011, 2010 AND 2009. PART XI, LINE 8 - OTHER ADJUSTMENTS: ADJUSTMENT TO PENSION LIABILITY $(7,328,262) HILLSIDE NET ASSETS $1,041,080 PART XII, LINE 2D - OTHER ADJUSTMENTS: NET REVENUE OF SUBSIDIARY $4,108,983 RENTAL EXPENSES NETTED AGAINST RENTAL INCOME $192,658 PART XII, LINE 4B - OTHER ADJUSTMENTS: SALE OF INTEREST IN SUBSIDIARY IN CHANGE IN NET ASSETS IN F/S PART XIII, LINE 2D - OTHER ADJUSTMENTS: OCCUPANCY COSTS FOR RENTALS $192,658 EXPENSES IN SUBSIDIARY $2,967,681 RED DRESS GALA EVENT 87971 62200 25771 0 0 15503 8665 HEALTHLINK GOLF TOURNAMENT 70462 52100 18362 0 920 14763 4565 158433 114300 44133 920 30266 13230 44416 -283 1 1 X 1 X 225.000000000000 1 X 325.000000000000 1 1 1 0 1 1 1 26397 8545037 0 8545037 0.04400 1 23326 22793889 14384106 8409783 0.04330 0 0 0 0 2 49723 31338926 14384106 16954820 0.08730 23 11315 819296 23479 795817 0.00410 8 501 425697 88833 336864 0.00170 8 249343 36846518 25120448 11726070 0.06040 0 0 0 0 37 99590 57669 0 57669 0.00030 76 360749 38149180 25232760 12916420 0.06650 78 410472 69488106 39616866 29871240 0.15380 13 99590 125780 0 125780 0.00060 4 99590 23773 0 23773 0.00010 1 2 784 0 784 0.00000 1 99590 113000 0 113000 0.00060 19 298772 263337 263337 0.00130 1 6517474 2853024 53756196 66570217 -12814021 X 1 1 2 1 LAKES REGION GENERAL HOSPITAL

80 HIGHLAND STREET LACONIA NH 03246

X X X HOSPITAL 2 FRANKLIN REGIONAL HOSPITAL

15 AIKEN AVENUE FRANKLIN NH 03235

X X X X HOSPITAL LAKES REGION GENERAL HOSPITAL 1 1 X X X X X X X 08 1 0 1 X X X X X X 0 1 1 225.000000000000 1 325.000000000000 1 X X X 1 1 X X X X X X X 1 X X X 1 X X X X X X 1 X 0 0 FRANKLIN REGIONAL HOSPITAL 2 1 X X X X X X X 07 1 0 1 X X X X X X 0 1 1 225.000000000000 1 325.000000000000 1 X X X 1 1 X X X X X X X 1 X X X 1 X X X X X X 1 X 0 0 24 LACONIA CLINIC

724 N MAIN STREET LACONIA NH 03246

OUPATIENT PHYSICIAN CLINIC, ASC HILLSIDE MEDICAL PARK

14 MAPLE STREET GILFORD NH 03249

ASC, REHAB, SLEEP CENTER LAKES REGION VASCULAR & ENDOVASCULAR

85 SPRING STREET LACONIA NH 03246

VASCULAR SURGEONS CARING FOR WOMEN

734 NORTH MAIN STREET LACONIA NH 03246

WOMEN'S HEALTH CENTER WESTSIDE HEALTHCARE

125 SOUTH MAIN STREET WEST FRANKLIN NH 03235

FAMILY PRACTICE PULMONARY AND CRITICAL MEDICINE

85 SPRING STREET LACONIA NH 03246

PULMONARY/CRITICAL CARE BELKNAP FAMILY HEALTH CENTER - BELMONT

14 MILL STREET BELMONT NH 03220

FAMILY PRACTICE BELKNAP FAMILY HEALTH CENTER - MEREDITH

238 DANIEL WEBSTER HIGHWAY MEREDITH NH 03253

FAMILY PRACTICE INTERLAKES MEDICAL CENTER

238 DANIEL WEBSTER HIGHWAY MEREDITH NH 03253

CLINICAL LAB, REHAB SERVICES, MEDICAL IMAGING LAKES REGION FAMILY PRACTICE

85 SPRING STREET LACONIA NH 03246

FAMILY PRACTICE DENTAL RESOURCE CENTER

29 ELLIOT STREET LACONIA NH 03246

DENTAL CENTER HILLSIDE FAMILY MEDICINE

14 MAPLE STREET GILFORD NH 03249

FAMILY PRACTICE NEWFOUND FAMILY PRACTICE

2 SCHOOL STREET BRISTOL NH 03222

FAMILY PRACTICE LACONIA CLINIC TILTON OFFICE

630 W MAIN STREET STE 200 TILTON NH 03276

FAMILY PRACTICE MOULTONBORO FAMILY HEALTH

60 WHITTIER HIGHWAY UNIT 12 MOULTONBORO NH 03254

FAMILY PRACTICE LACONIA CLINIC ENDOCRINOLOGY

724 N MAIN STREET LACONIA NH 03246

DIABETES/ENDOCRINE NEW HAMPTON FAMILY HEALTH

5 ACADEMY DRIVE NEW HAMPTON NH 03256

FAMILY PRACTICE HOLISTIC HEALTH CENTER

14 MAPLE STREET GILFORD NH 03249

HOLISTIC HEALTH FRH INTERNAL MEDICINE

15 AIKEN AVENUE FRANKLIN NH 03235

INTERNAL MEDICINE FRANKLIN SURGICAL SPECIALISTS

15 AIKEN AVENUE FRANKLIN NH 03235

GENERAL SURGEONS CARING FOR WOMEN

15 AIKEN AVENUE FRANKLIN NH 03235

WOMEN'S HEALTH CENTER ANDOVER FAMILY PRACTICE

8 LAWRENCE STREET ANDOVER NH 03216

FAMILY PRACTICE COMMUNITY WELLNESS CENTER

22 STRAFFORD STREET LACONIA NH 03246

WELLNESS CENTER WINNIPESAUKEE WELLNESS CENTER

78 WHITTIER HIGHWAY UNIT 4 MOULTONBORO NH 03254

WELLNESS CENTER PART I, LINE 3C: HEALTHLINKHEALTHLINK IS OUR COMMUNITY'S FRONT DOOR TO HEALTHCARE INFORMATION AND RESOURCES FOR EVERYONE. IT IS AN INFORMATION AND REFERRAL SYSTEM THAT PROVIDES HEALTHCARE FINANCIAL COUNSELING AND ACCESS TO MEDICAL, DENTAL, AND WELLNESS SERVICES FOR THOSE IN FINANCIAL NEED.HEALTHLINK IS A PARTNERSHIP BETWEEN LRGHEALTHCARE, LOCAL PHYSICIANS AND MEDICAL PROVIDERS, AND AREA SERVICE AGENCIES. SINCE OUR CREATION IN 1993, WE HAVE HELPED TO CONNECT MORE THAN 20,600 PEOPLE IN THE LAKES AND THREE RIVERS REGIONS TO THE SERVICES THEY NEED, BOTH LOCALLY AND THROUGH PROGRAMS SUCH AS MEDICAID, MEDICARE, HEALTHY KIDS, AND SERVICES AVAILABLE TO VETERANS THROUGH THE VETERAN'S ADMINISTRATION. IN ADDITION TO THE INFORMATION AND REFERRAL SERVICES THAT ARE AVAILABLE FREE-OF-CHARGE TO EVERYONE IN THE COMMUNITY, HEALTHLINK ALSO HAS THREE MEMBERSHIP PROGRAMS FOR WHICH LOCAL RESIDENTS MAY APPLY.HEALTHLINK ACCESSTHE HEALTHLINK ACCESS PROGRAM IS A PROGRAM DESIGNED TO PROVIDE PEOPLE WHO ARE UNINSURED WITH ACCESS TO THE HEALTHCARE SERVICES THEY NEED. IF A PERSON QUALIFIES, HE OR SHE WILL BE GIVEN A CO-PAY RESPONSIBILITY OR A SET DISCOUNT BASED UPON A SLIDING FEE SCALE, AND WILL THEN HAVE ACCESS TO PROVIDERS AND SERVICES IN THE HEALTHLINK NETWORK.ELIGIBILITY: ELIGIBILITY IS BASED ON SEVERAL FACTORS. APPLICANTS MUST MEET INCOME REQUIREMENTS BASED ON THE FEDERAL POVERTY GUIDELINES. LOCAL RESIDENCY IS REQUIRED. IN GENERAL, THEY CANNOT HAVE ACCESS TO HEALTH INSURANCE, THOUGH CONSIDERATION MAY BE GIVEN BASED ON INCOME LEVEL IN SOME CASES IN WHICH INSURANCE IS AVAILABLE BUT UNAFFORDABLE. ASSETS, INCLUDING SAVINGS, PROPERTY, INVESTMENTS, AND VEHICLES WILL ALSO BE CONSIDERED IN DETERMINING ELIGIBILITY. HEALTHLINK ASSISTANCETHE HEALTHLINK ASSISTANCE PROGRAM IS DESIGNED FOR PEOPLE WHO MAY HAVE ACCESS TO INSURANCE, BUT STILL MEET HEALTHLINK FINANCIAL GUIDELINES AND FACE FINANCIAL HARDSHIP IN PAYING FOR THEIR HEALTHCARE COSTS. MEMBERS MAY HAVE DIFFICULTY MEETING A HIGH DEDUCTIBLE OR COVERING CO-PAYMENTS OR OTHER COSTS REQUIRED BY THEIR PLAN. THEY OFTEN NEED ONE-TIME OR SHORT-TERM ASSISTANCE MEETING A HEALTHCARE FINANCIAL OBLIGATION RATHER THAN NEEDING LONG-TERM FINANCIAL ASSISTANCE. HEALTHLINK ASSISTANCE WILL PROVIDE SHORT-TERM SUPPLEMENTAL SUPPORT TO AN EXISTING INSURANCE PLAN; OR SHORT-TERM SUPPORT PAYING A PARTICULAR HEALTHCARE COST. THIS PROGRAM WAS FORMERLY KNOWN AS COMMUNITY CARE.ELIGIBILITY: ELIGIBILITY IS BASED ON SEVERAL FACTORS. APPLICANTS MUST MEET INCOME REQUIREMENTS BASED ON THE FEDERAL POVERTY GUIDELINES. ASSETS, INCLUDING SAVINGS, PROPERTY, INVESTMENTS, AND VEHICLES WILL ALSO BE CONSIDERED IN DETERMINING ELIGIBILITY. APPLICANTS MAY HAVE AN INSURANCE PLAN, BUT MUST HAVE DEMONSTRATED DIFFICULTY PAYING THEIR COPAYS, DEDUCTIBLES, OR OTHER HEALTHCARE COSTS. HEALTHLINK CATASTROPHICTHE HEALTHLINK CATASTROPHIC PROGRAM IS AVAILABLE NOT ONLY TO HEALTHLINK ACCESS OR ASSISTANCE MEMBERS, BUT TO ANYONE MEETING FINANCIAL GUIDELINES WHO INCURS AN OUT-OF-POCKET EXPENSE OF $10,000 OR MORE FOR A SINGLE MEDICALLY-NECESSARY HOSPITAL STAY OR OUTPATIENT TREATMENT. COSTS INCURRED OVER TIME DO NOT QUALIFY AS PART OF THIS $10,000 MINIMUM UNLESS THEY ARE ALL THE RESULT OF A SINGLE INJURY OR HEALTH EPISODE. ONCE A PATIENT QUALIFIES FOR HEALTHLINK CATASTROPHIC, AND DISCOUNT ELIGIBILITY IS DETERMINED (RANGING FROM 20% - 40%), THAT DISCOUNT WILL APPLY FOR ANY ADDITIONAL COSTS INCURRED DURING THE SIX MONTHS AFTER APPROVAL.ELIGIBILITY: HEALTHLINK CATASTROPHIC ELIGIBILITY IS BASED SOLELY ON GROSS INCOME. THE FEDERAL POVERTY LEVEL GUIDELINES WILL BE USED TO DETERMINE ELIGIBILITY AND THE PERCENTAGE OF DISCOUNT PROVIDED. OUR STAFF WILL DETERMINE WHETHER COSTS RESULTED FROM A SINGLE, QUALIFYING HOSPITALIZATION OR COURSE OF TREATMENT. VETLINKTHE VETLINK PROGRAM IS A LRGHEALTHCARE PROGRAM THAT ASSISTS ALL VETERANS AND FAMILIES OF VETERANS WITH THEIR QUESTIONS AND CONCERNS ABOUT THEIR HEALTHCARE. THE VA SYSTEM IS COMPLICATED, AND VETLINK CAN HELP VETERANS NAVIGATE THE SYSTEM TO ACCESS THE BENEFITS AND SERVICES THAT THEY DESERVE. SINCE ITS CREATION, VETLINK HAS HELPED MORE THAN 800 VETERANS ACCESS THE HEALTHCARE SERVICES THEY NEED.ELIGIBILITY: ALL VETERANS WHO HAVE EARNED AN HONORABLE DISCHARGE FROM MILITARY SERVICE ARE ELIGIBLE. ________________________________________THE MEDICATION CONNECTIONTHE MEDICATION CONNECTION PROGRAM HELPS QUALIFIED PATIENTS ACCESS REDUCED-RATE PRESCRIPTIONS OFFERED THROUGH PHARMACEUTICAL COMPANY PROGRAMS. WHILE THESE PROGRAMS ARE AVAILABLE TO THE GENERAL PUBLIC, THEY OFTEN INVOLVE A CUMBERSOME APPLICATION PROCESS, WHICH CAN BE CONFUSING FOR PATIENTS TO COMPLETE ON THEIR OWN. THE MEDICATION CONNECTION PROGRAM IS HERE TO HELP MAKE SURE PATIENTS DON'T HAVE TO CHOOSE BETWEEN PRESCRIPTION MEDICATIONS AND OTHER NECESSITIES OF LIFE.ELIGIBILITY: THE MEDICATION CONNECTION PROGRAM IS AVAILABLE TO THOSE WHO CANNOT AFFORD TO PAY FOR THEIR PRESCRIPTION MEDICATIONS, AND WHO HAVE NO OTHER SOURCE FOR ASSISTANCE WITH MEDICATIONS. MANY HAVE TOO MUCH INCOME TO QUALIFY FOR STATE AID, BUT NOT ENOUGH TO PURCHASE A SUPPLEMENTAL PRESCRIPTION PLAN. DEPENDING ON THE MEDICATION NEEDED, DIFFERENT PHARMACEUTICAL COMPANIES HAVE INDIVIDUAL GUIDELINES FOR ELIGIBILITY. NOT ALL MEDICATIONS ARE AVAILABLE THROUGH THIS PROGRAM; PARTICIPATION BY PHARMACEUTICAL COMPANIES IS VOLUNTARY. ________________________________________ PART I, LINE 7: CHARITY CARE - RATIO OF COST TO CHARGE USING W/S 1 AND W/S 3.UNREIMBURSED MEDICAID - COST TO CHARGE RATIO USING THE AS FILED COST REPORT.COMMUNITY HEALTH - ACTUAL COSTS.HEALTH PROFESSIONS EDUCATION - ACTUAL COSTS.SUBSIDIZED HEALTH SERVICES - EXPENSES IN EXCESS OF NET REVENUES EXCLUDING CHARITY CARE INCLUDED IN LINE 1.CONTRIBUTIONS TO COMMUNITY GROUPS - ACTUAL COSTS INCLUDING VOLUNTEER TIME OF EMPLOYEES DURING WORK HOURS. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES - $11,839,070 LRGHEALTHCARE PROVIDES A NUMBER OF HEALTH SERVICES BECAUSE THEY MEET AN ESSENTIAL COMMUNITY NEED, EVEN THOUGH WE REALIZE A LOSS ON THEM EACH YEAR. THESE SERVICES SPECIFICALLY ADDRESS THE NEED FOR PRIMARY CARE AND SPECIALTY SERVICES, WHICH WERE IDENTIFIED AS TOP PRIORITIES IN THE 2011 COMMUNITY NEEDS ASSESSMENT.ACCESS TO PRIMARY CARE SERVICES ($8,015,541) IS ONE OF THE BIGGEST CHALLENGES FACING THIS, AND OTHER NEW HAMPSHIRE COMMUNITIES. LRGHEALTHCARE SUBSIDIZES PRIMARY CARE PRACTICES TO ENSURE ONGOING ACCESS-NOT JUST IN THE COMMUNITIES WHERE OUR HOSPITALS OPERATE, BUT THROUGHOUT OUR SERVICE AREAS. WITHOUT THESE SUBSIDIES, MANY OF THESE PRACTICES WOULD NOT BE ABLE TO SUSTAIN THEIR OPERATIONS.INCLUDED IN THE ABOVE TOTAL IS $220,000 GIVEN TO HELP SUPPORT THE OPERATION OF HEALTHFIRST FAMILY CARE CENTER, A RURAL HEALTH PRIMARY CARE CLINIC WITH LOCATIONS IN BOTH LACONIA AND FRANKLIN. HEALTHFIRST ALONE SAW 3,586 PATIENTS LAST YEAR, NEARLY ONE THIRD OF WHOM HAD NO INSURANCE. ACCESS TO SPECIALTY AND DENTAL SERVICES ($3,120,968): THE 2011 COMMUNITY NEEDS ASSESSMENT IDENTIFIED ACCESS TO SPECIALTY CARE AND ACCESS TO DENTAL CARE IN THE TOP 10 MOST IMPORTANT HEALTH ISSUES. LRGHEALTHCARE PROVIDES SUBSIDIES TO BOTH SPECIALTY SERVICES AND THE DENTAL RESOURCE CENTER TO ENSURE ACCESS TO A BROAD SPECTRUM OF SERVICES WITHIN OUR RURAL HEALTHCARE SYSTEM.CHRONIC DISEASE MANAGEMENT ($190,900) PROGRAMS HAVE BEEN PROVEN TO NOT ONLY PROVIDE BETTER HEALTH OUTCOMES AND QUALITY OF LIFE FOR THOSE SUFFERING FROM CHRONIC DISEASES, BUT ALSO TO BE FISCALLY WISE INVESTMENTS. LRGHEALTHCARE OFFERS MANY SERVICES AND SUPPORTS FOR THOSE LIVING WITH CHRONIC DISEASE INCLUDING CARDIAC AND PULMONARY REHABILITATION PROGRAMS, DIABETES EDUCATION PROGRAMS, CHRONIC DISEASE SELF MANAGEMENT CLASSES AND THE NATHAN BRODY CHEMICAL DEPENDENCY PROGRAM.OUR ENDOCRINE SERVICES DEPARTMENT PROVIDES A WIDE VARIETY OF DIABETES MANAGEMENT PROGRAMS. LAST YEAR THE CERTIFIED DIABETES EDUCATORS PROVIDED EDUCATION FOR 1030 CLIENTS AND 3,259 CLIENTS WERE SERVED IN THE DIABETIC FOOT CLINIC. LRGHEALTHCARE'S OUTPATIENT CHEMICAL DEPENDENCY PROGRAM MEETS A CRITICAL NEED IN THE STATE AND THE REGION, AS THERE IS A SHORTAGE OF SUCH PROGRAMS TO ASSIST THOSE WITH ADDICTION ISSUES. IN THE RECENT COMMUNITY NEEDS ASSESSMENT, ALCOHOL AND DRUG ABUSE CAME FORWARD AS THE THIRD MOST IMPORTANT HEALTH ISSUE FACING OUR COMMUNITY. SUBSTANCE ABUSE EMERGED AS ONE OF THE TOP THREE KEY CONCERNS DISCUSSED IN THE COMMUNITY LEADER FOCUS GROUPS AS WELL.LAST YEAR, THE NATHAN BRODY CHEMICAL DEPENDENCY PROGRAM COUNSELED 456 PATIENTS EITHER BY PHONE OR IN PERSON AND 55 INDIVIDUALS WERE ADMITTED TO THE INTENSIVE, 18-WEEK, OUTPATIENT PROGRAM. ADDITIONALLY, OUR CHEMICAL DEPENDENCY PROGRAM NOW PROVIDES DOT EVALUATION FOR COMPANIES THAT PROVIDE SAFETY SENSITIVE JOBS.ACCESS TO EMERGENCY RESPONSE SERVICES ($398,661): LRGHEALTHCARE PARTNERS EMERGENCY AMBULANCE SERVICES WITH THE CITY OF LACONIA. LAST YEAR ALONE THE AMBULANCE SERVICES RESPONDED TO 2,178 CALLS. REGIONALLY, LRGHEALTHCARE IS ALSO VERY ACTIVELY PARTNERING WITH EMS PROGRAMS ON EDUCATION AND TRAINING, COST RECOVERY AND COMPLIANCE, CLINICAL CQI AND CENTRAL PURCHASING PROGRAMS. AN ON-LINE RECERTIFICATION TRAINING PROGRAM IS BEING DEVELOPED FOR EMT PROVIDERS. THIS RECERTIFICATION PROGRAM WILL ALLOW DEPARTMENTS TO MEET THEIR ANNUAL STATE AND NATIONAL RECERTIFICATION REQUIREMENTS IN A MORE COST-EFFECTIVE WAY, WHILE MAINTAINING A STANDARD OF HIGH QUALITY TRAINING. COLLABORATING ON THESE INITIATIVES HELPS TO MAINTAIN STRONG, EMS PROGRAMS IN OUR COMMUNITIES. WORKFORCE DEVELOPMENT ($113,000): THE CITIES OF LACONIA AND FRANKLIN ARE FEDERALLY-DESIGNATED AS MEDICALLY UNDERSERVED COMMUNITIES; AND BELKNAP COUNTY IS DESIGNATED AS A PHYSICIAN SCARCITY AREA FOR PRIMARY CARE. LRGHEALTHCARE WORKS HARD TO COMBAT THESE CHALLENGES. PHYSICIAN RECRUITMENT IS A CRITICAL TO MEETING THE NEED FOR ACCESS TO PRIMARY, SPECIALTY AND DENTAL CARE IN OUR COMMUNITIES. PART I, L7 COL(F): IT IS A WELL-ESTABLISHED STANDARD THAT 50 PERCENT OF BAD DEBT CAN BE CONSIDERED COMMUNITY BENEFIT, SINCE IT IS ESTIMATED THAT AT LEAST HALF OF BAD DEBT REPRESENTS INDIVIDUALS WHO WERE UNWILLING OR UNABLE TO PROVIDE THE INFORMATION NECESSARY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. IN ACCORDANCE WITH DHHS REPORTING STANDARDS, LRGHEALTHCARE REPORTED $2,853,024 IN UNCOLLECTABLE DEBT LAST YEAR. IN ADDITION, THROUGH OUR PATIENT ADVANTAGE PROGRAM, WE LEVELED THE PLAYING FIELD BY GIVING ALL PATIENTS AT LEAST A MEDIAN DISCOUNT. THROUGH THAT PROGRAM, WE PROVIDED COMMUNITY BENEFIT IN THE AMOUNT OF $2,395,698 IN FY 2011. PART II: COMMUNITY BUILDING ACTIVITIES- $150,337SUPPORT SYSTEM ENHANCEMENT ($9,078): LRGHEALTHCARE HAS BEEN A KEY MEMBER OF COMMUNITY SAFETY AND SUPPORT SYSTEMS ENHANCEMENT EFFORTS OVER THE PAST YEAR. WE SUPPORT EMERGENCY PREPAREDNESS AND DISEASE SURVEILLANCE EFFORTS IN BOTH BELKNAP AND MERRIMACK COUNTIES.ENVIRONMENTAL IMPROVEMENT ($23,773): WE HAVE UNDERTAKEN A NUMBER OF INITIATIVES TO LESSEN OUR ENVIRONMENTAL FOOTPRINT THROUGH TRANSITIONING TO ENVIRONMENTALLY-FRIENDLY STERILIZATION MATERIALS, EXPANDING OUR RECYCLING PROGRAM, CONTINUING OUR MERCURY WASTE REDUCTION AND PROVIDING A SHARPS DISPOSAL PROGRAM. OUR ENVIRONMENTAL SPECIALIST IS AN ACTIVE PARTICIPANT IN THE CITY OF LACONIA RECYCLING COMMITTEE.COALITION BUILDING ($117,486): LRGHEALTHCARE WORKS IN PARTNERSHIP WITH A NUMBER OF LOCAL ORGANIZATIONS AND INITIATIVES TO STRENGTHEN THE PUBLIC HEALTH, SAFETY AND ECONOMIC ENVIRONMENT OF OUR COMMUNITY. SENIOR EXECUTIVES AND STAFF ARE ACTIVE PARTICIPANTS IN MANY ECONOMIC DEVELOPMENT INITIATIVES, INCLUDING THE BELKNAP COUNTY ECONOMIC DEVELOPMENT COUNCIL, THE CHAMBER OF COMMERCE AND "CHOOSE FRANKLIN" AS WELL AS PUBLIC HEALTH AND SAFETY INITIATIVES INCLUDING WORK WITH THE LAKES REGION PARTNERSHIP FOR PUBLIC HEALTH, THE CARING COMMUNITY NETWORK OF THE TWIN RIVERS, SPAULDING YOUTH CENTER, ROTARY AND LEADERSHIP LAKES REGION TO NAME A FEW. OUR PUBLIC HEALTH WORK WITH COMMUNITY PARTNERS ADDRESSES SUBSTANCE ABUSE, INJURY PREVENTION, LEAD POISONING PREVENTION, PHYSICAL ACTIVITY AND NUTRITION. PART III, LINE 4: BAD DEBT EXPENSE IS THE YEAR'S CHARGE FOR ACTUAL OR EXPECTED DOUBTFUL ACCOUNTS RESULTING FROM THE EXTENSION OF CREDIT.WE VALUED BAD DEBTS AT COST USING A COST TO CHARGE RATIO W/S 3.WE BELIEVE BASED ON HOSPITAL ASSOCIATION INFORMATION IN NEW HAMPSHIRE, THE SERVICE AREAS OF OUR HOSPITALS AND PRACTICES, AND THE ECONOMY DURING THIS TIME PERIOD, THAT 50% OF OUR BAD DEBTS IS A REASONABLE ESTIMATE THAT WOULD HAVE BEEN CONSIDERED COMMUNITY BENEFIT (CHARITY CARE).PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IV, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF THE PERCENTAGE IN THIS COLUMN IS $12,901,762. PART III, LINE 8: FOR LRGHEALTHCARE MEDICARE PAYMENT LEVELS ARE SO SIGNIFICANTLY BELOW THE ACTUAL COST TO PROVIDE SERVICES TO MEDICARE BENEFICIARIES, THAT THE CONTINUANCE OF OPEN ACCESS AND THE SCOPE OF SERVICES AVAILABLE TO MEDICARE BENEFICIARIES IN LIGHT OF THE SHORTFALL IS JUDGED AS A NOTEWORTHY DISCLOSURE OF THE BENEFIT TO THE COMMUNITY.THE COSTING METHODOLOGY USED WAS THE MEDICARE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT. PART III, LINE 9B: LRGHEALTHCARE DEVELOPED AND ADMINISTERS THE HEALTHLINK, A CHARITABLE/FINANCIAL ASSISTANCE PROGRAM. HEALTHLINK IS PROVIDED TO PATIENTS WHO ARE UNABLE TO PAY FOR THE COSTS OF THEIR CARE, AND FOR WHICH THERE IS NO OTHER SOURCE OF FUNDING AVAILABLE. DETERMINATION OF FINANCIAL ASSISTANCE IS MADE PROSPECTIVELY FOR A ONE-YEAR PERIOD FOR HEALTHLINK ASSISTANCE AND HEALTHLINK ACCESS. THE EVALUTION PROCESS IS CONDUCTED IN A MANNER SUFFICIENT TO IDENTIFY THE PATIENT'S INABLIITY TO PAY AND APPLIED UNIFORMLY TO ALL PERSONS REGARDLESS OF RACE, COLOR, NATURAL ORIGIN, RELIGION, SEX, AGE (FOR PERSONS BEYOND THE AGE OF MAJORITY), PHYSICAL CHALLENGE OR INABLIITY TO PAY. LAKES REGION GENERAL HOSPITAL PART V, SECTION B, LINE 3: THE 2008 COMMUNITY NEEDS ASSESSMENT SURVEY WAS CONDUCTED COLLABORATIVELY WITH THE FOLLOWING 8 COMMUNITY PARTNER AGENCIES, BELKNAP COUNTY CITIZENS COUNCIL ON CHILDREN AND FAMILIES, COMMUNITY ACTION PROGRAM BELKNAP-MERRIMACK COUNTIES, COMMUNITY HEALTH AND HOSPICE, GENESIS BEHAVIORAL HEALTH, LAKES REGION COMMUNITY SERVICES, LAKES REGION PARTNERSHIP FOR PUBLIC HEALTH, LAKES REGION UNITED WAY AND TAYLOR COMMUNITY. SURVEYS WERE MAILED TO A RANDOM SAMPLE OF RESIDENTS, WERE DISTRIBUTED TO TOWN HALLS AND LIBRARIES AND WERE AVAILABLE ON ALL THE PARTIES' WEBSITES. FOCUS GROUPS WERE ALSO CONDUCTED WITH SENIOR CITIZENS, PUBLIC SCHOOL TEACHERS AND ADMINISTRATORS, STAFF AT THE LOCAL MENTAL HEALTH CENTER AND A GROUP OF REPRESENTATIVES FROM THE FAITH COMMUNITY. FRANKLIN REGIONAL HOSPITAL PART V, SECTION B, LINE 3: THE 2007 COMMUNITY NEEDS ASSESSMENT SURVEY WAS CONDUCTED COLLABORATIVELY WITH THE CARING COMMUNITY NETWORK OF THE TWIN RIVERS. THE PARTNERS CONSISTED OF FRANKLIN VNA, MERRIMACK BELKNAP COUNTY COMMUNITY ACTION PROGRAM, LRGHEALTHCARE D/B/A FRANKLIN REGIONAL HOSPITAL, HEALTHFIRST FAMILY CARE CENTER AND CASEY FAMILY SERVICES. SURVEYS WERE MAILED TO A RANDOM SAMPLE OF RESIDENTS, WERE DISTRIBUTED TO TOWN HALLS AND LIBRARIES AND WERE AVAILABLE ON ALL THE PARTNER'S WEBSITES. FOCUS GROUPS WERE ALSO CONDUCTED AT SEVERAL LOCATIONS THROUGHOUT THE SERVICE AREA. LAKES REGION GENERAL HOSPITAL PART V, SECTION B, LINE 7: THE HOSPITAL DID NOT ADDRESS ALL NEEDS IDENTIFIED IN THE SURVEY, AS THE SURVEY WAS BROAD AND ASSESSED SOCIAL, CULTURAL, PHYSICAL INFRASTRUCTURE AS WELL AS HEALTH NEEDS IN OUR COMMUNITY. HOWEVER, THE HOSPITAL'S STRATEGIC INITIATIVES ADDRESS, IN CONJUNCTION WITH COMMUNITY PARTNERS, THE TOP PRIORITY HEALTH NEEDS IDENTIFIED IN THE SURVEY. FRANKLIN REGIONAL HOSPITAL PART V, SECTION B, LINE 7: THE HOSPITAL DID NOT ADDRESS ALL NEEDS IDENTIFIED IN THE SURVEY, AS THE SURVEY WAS BROAD AND ASSESSED SOCIAL, CULTURAL, PHYSICAL INFRASTRUCTURE AS WELL AS HEALTH NEEDS IN OUR COMMUNITY. HOWEVER, THE HOSPITAL'S STRATEGIC INITIATIVES ADDRESS, IN CONJUNCTION WITH COMMUNITY PARTNERS, THE TOP PRIORITY HEALTH NEEDS IDENTIFIED IN THE SURVEY. LAKES REGION GENERAL HOSPITAL PART V, SECTION B, LINE 11H: HEALTHLINK CATASTROPHIC PROGRAM - LAKES REGION GENERAL HOSPITAL PATIENTS INCURRING CATASTROPHIC COSTS ASSOCIATED WITH AN ILLNESS OR INJURY MAY QUALIFY TO OBTAIN A DISCOUNT BASED UPON THEIR INCOME LEVEL. CATASTROPHIC FOR THE PURPOSES OF THIS PROGRAM IS ANY PATIENT WHO INCURS A $10,000 OR GREATER OUT-OF-POCKET EXPENSE FOR A MEDICALLY NECESSARY HOSPITAL OUTPATIENT SINGLE ENCOUNTER OR A CONTINUOUS HOSPITAL INPATIENT STAY. THIS MAY APPLY TO PATIENTS WHO ARE UNINSURED OR UNDERINSURED. ELIGIBILITY WILL BE DETERMINED SOLELY ON GROSS INCOME. THE FEDERAL POVERTY LEVEL GUIDELINES WILL BE USED TO DETERMINE THE PERCENTAGE OF DISCOUNT BASED ON GROSS INCOME AND FAMILY SIZE. ELIGIBILITY WILL BE FOR A PERIOD OF 6 MONTHS FROM THE DATE OF THE APPLICATION AND WILL APPLY TO ANY COSTS INCURRED FOR THAT 6-MONTH PERIOD THAT MEET THE DEFINITION OF CATASTROPHIC. NEW PROOF OF INCOME MUST BE FILED AFTER THIS 6-MONTH PERIOD. PEOPLE WHOSE INCOME FALLS BETWEEN 300%-400% OF THE FEDERAL POVERTY LEVEL WILL BE ELIGIBLE FOR A 40% DISCOUNT. THOSE WITH INCOME GREATER THAN 400% BUT LESS THAN 500% WILL BE ELIGIBLE FOR A 25% DISCOUNT. WHEN INCOME EXCEEDS 500% PATIENTS WILL BE OFFERED THE CURRENT PATIENT ADVANTAGE PROGRAM DISCOUNT OF 20%. WHEN OUT-OF-THE-POCKET EXPENSES ARE BETWEEN $10,000 AND $20,000, THE GUIDELINE ALLOWED FOR RESOLVING THE BALANCE ON THEIR ACCOUNT IS 60 DAYS FROM THE DATE OF THEIR FIRST STATEMENT. WHEN OUT-OF-THE-POCKET EXPENSES ARE GREATER THAN $20,000, THE GUIDELINE IS 90 DAYS FOR RESOLVING THE BALANCE ON THEIR ACCOUNT FROM THE DATE OF THEIR FIRST STATEMENT. FRANKLIN REGIONAL HOSPITAL PART V, SECTION B, LINE 11H: HEALTHLINK CATASTROPHIC PROGRAM - FRANKLIN REGIONAL HOSPITAL PATIENTS INCURRING CATASTROPHIC COSTS ASSOCIATED WITH AN ILLNESS OR INJURY MAY QUALIFY TO OBTAIN A DISCOUNT BASED UPON THEIR INCOME LEVEL. CATASTROPHIC FOR THE PURPOSES OF THIS PROGRAM IS ANY PERESON WHO INCURS A $10,000 OR GREATER OUT-OF-POCKET EXPENSE FOR A MEDICALLY NECESSARY HOSPITAL OUTPATIENT SINGLE ENCOUNTER OR A CONTINUOUS HOSPITAL INPATIENT STAY. THIS MAY APPLY TO PATIENTS WHO ARE UNINSURED OR UNDERINSURED. ELIGIBILITY WILL BE DETERMINED SOLELY ON GROSS INCOME. THE FEDERAL POVERTY LEVEL GUIDELINES WILL BE USED TO DETERMINE THE PERCENTAGE OF DISCOUNT BASED ON GROSS INCOME AND FAMILY SIZE. ELIGIBILITY WILL BE FOR A PERIOD OF 6 MONTHS FROM THE DATE OF THE APPLICATION AND WILL APPLY TO ANY COSTS INCURRED FOR THAT 6-MONTH PERIOD THAT MEET THE DEFINITION OF CATASTROPHIC. NEW PROOF OF INCOME MUST BE FILED AFTER THIS 6-MONTH PERIOD. PEOPLE WHOSE INCOME FALLS BETWEEN 300%-400% OF THE FEDERAL POVERTY LEVEL WILL BE ELIGIBLE FOR A 40% DISCOUNT. THOSE WITH INCOME GREATER THAN 400% BUT LESS THAN 500% WILL BE ELIGIBLE FOR A 25% DISCOUNT. WHEN INCOME EXCEEDS 500% PATIENTS WILL BE OFFERED THE CURRENT PATIENT ADVANTAGE PROGRAM DISCOUNT OF 20%. WHEN OUT-OF-THE-POCKET EXPENSES ARE BETWEEN $10,000 AND $20,000, THE GUIDELINE ALLOWED FOR RESOLVING THE BALANCE ON THEIR ACCOUNT IS 60 DAYS FROM THE DATE OF THEIR FIRST STATEMENT. WHEN OUT-OF-THE-POCKET EXPENSES ARE GREATER THAN $20,000, THE GUIDELINE IS 90 DAYS FOR RESOLVING THE BALANCE ON THEIR ACCOUNT FROM THE DATE OF THEIR FIRST STATEMENT. LAKES REGION GENERAL HOSPITAL PART V, SECTION B, LINE 13G: RADIO ANNOUNCEMENTS AND MEETINGS WITH COMMUNITY NON-PROFIT PARTNERS FRANKLIN REGIONAL HOSPITAL PART V, SECTION B, LINE 13G: RADIO ANNOUCEMENTS AND MEETINGS WITH COMMUNITY NON-PROFIT PARTNERS PART VI, LINE 2: LRGHEALTHCARE, COMPOSED OF LAKES REGION GENERAL HOSPITAL (LRGH) AND FRANKLIN REGIONAL HOSPITAL (FRH), IS A HEALTHCARE CHARITABLE TRUST. WE ARE DRIVEN BY HEALTHCARE NEEDS OF THE COMMUNITIES WE SERVE, AND FOR MORE THAN 100 YEARS, WE HAVE BEEN GUIDED BY OUR MISSION TO PROVIDE QUALITY, COMPASSIONATE CARE AND TO STRENGTHEN THE WELL-BEING OF OUR COMMUNITY.WE CARRY OUT OUR MISSION IN A VARIETY OF WAYS, AND WE TAKE SERIOUSLY OUR RESPONSIBILITY TO THE COMMUNITIES WE SERVE. WE PROVIDE THE COMMUNITY WITH HEALTHCARE SERVICES 24 HOURS A DAY, SEVEN DAYS A WEEK, AND INVEST IN PREVENTIVE CARE AND HEALTH SCREENING SERVICES, EDUCATION AND TRAINING FOR HEALTH PROFESSION STUDENTS, AS WELL AS PROVIDE EMERGENCY RESPONSE SYSTEMS TO HELP ASSURE THE HEALTH AND SAFETY OF THOSE WE SERVE. THE 2011 COMMUNITY NEEDS ASSESSMENT INFORMS US THAT ACCESS TO PRIMARY CARE IS THE MOST IMPORTANT HEALTH ISSUE IN OUR COMMUNITY. LRGHEALTHCARE'S COMMITMENT TO ACCESS IS DEMONSTRATED BY OUR SUPPORT OF PRIMARY AND SPECIALTY CARE SERVICES AND BY THE ACCESS WE PROVIDE TO OUR MOST VULNERABLE POPULATIONS THROUGH OUR HEALTHLINK PROGRAM WHICH SERVED 897 MORE PEOPLE IN 2011 THAN IN FY 2010. THE LAST SEVERAL YEARS OF ECONOMIC DOWNTURN HAVE AFFECTED EVERYONE IN OUR COMMUNITY, AND ACCORDING TO THE UNITED STATES ECONOMIC RESEARCH SERVICES, THE POVERTY LEVEL OF LRGHEALTHCARE'S SERVICE AREA IS 9.5%, WHILE THE OVERALL POVERTY LEVEL FOR THE STATE OF NEW HAMPSHIRE IS 8.6%. THESE FACTORS CONTRIBUTE TO THE LARGEST PORTION OF THE LRGHEALTHCARE COMMUNITY BENEFIT BEING COMPOSED OF THE PROVISION OF CHARITABLE CARE FOR THE UNINSURED OR PATIENTS WHO CANNOT AFFORD CARE; AS WELL AS THE UNREIMBURSED COSTS FOR CARING FOR PATIENTS WITH MEDICAID COVERAGE. DESPITE THESE CHALLENGES, WE ARE COMMITTED TO ENSURING OUR HEALTHCARE SYSTEM IS HERE TODAY AND INTO THE FUTURE. LRGHEALTHCARE'S TOTAL COMMUNITY BENEFIT FOR FY 2011 IS $30,134,577. PART VI, LINE 3: HEALTHCARE FINANCIAL COUNSELING AND ASSISTANCELRGHEALTHCARE'S MISSION IS TO SERVE THE LAKES REGION, FRANKLIN, AND SURROUNDING COMMUNITIES BY PROMOTING PHYSICAL, MENTAL, EMOTIONAL, SOCIAL ENVIRONMENT, AND SPIRITUAL HEALTH AND PROVIDING ACCESS TO THE FULLEST RANGE OF QUALITY, MODERN AND EFFICIENT HEALTH CARE SERVICES PRACTICAL FOR THE ORGANIZATION, REGARDLESS OF RACE, SEX, RELIGION, PRIMARY LANGUAGE, DISABILITY OR HANDICAP, NATIONAL ORIGIN, OR ABILITY TO PAY. IN THE SPIRIT OF OUR MISSION, WE OFFER A NUMBER OF DIFFERENT FINANCIAL ASSISTANCE AND REFERRAL PROGRAMS TO MEET THE FULL RANGE OF NEED IN OUR COMMUNITY. WE ALSO PARTICIPATE IN STATEWIDE EFFORTS TO KEEP QUALITY HEALTHCARE ACCESSIBLE FOR ALL.WHETHER YOU ARE INSURED OR UNINSURED, IN NEED OF EXTENSIVE MEDICAL SERVICES OR JUST A CHECK-UP FROM TIME TO TIME, EVERYONE DESERVES TO HAVE ACCESS TO HEALTHCARE. OUR PROGRAMS ENSURE THAT COST WILL NOT BE A BARRIER TO ANYONE IN OUR COMMUNITY ACCESSING THE HEALTHCARE SERVICES THEY NEED.IF COST IS PREVENTING YOU FROM GETTING HEALTHCARE SERVICES YOU NEED, OR YOU FEEL YOU NEED HEALTHCARE FINANCIAL ASSISTANCE, PLEASE CALL HEALTHLINK AT (603) 527-7171 TODAY. EVEN IF YOU DO NOT FEEL YOU QUALIFY FOR ANY OF OUR PROGRAMS, PLEASE BE SURE TO CALL US FOR AN APPLICATION. THERE ARE MANY FACTORS TAKEN INTO CONSIDERATION WHEN DETERMINING ELIGIBILITY. IN ADDITION, WE MAY BE ABLE TO CONNECT YOU WITH OTHER FEDERAL, STATE, OR COMMUNITY RESOURCES FOR WHICH YOU MAY QUALIFY.WE ARE HERE TO HELP! PART VI, LINE 4: LRGHEALTHCARE SERVES THE TWIN RIVERS AREA AROUND FRANKLIN, NH AND THE LAKES REGION AREA AROUND LACONIA, NH. OUR COMMUNITIES INCLUDE SMALL BUT GROWING POPULATIONS AND INCLUDE LOW-INCOME, UNINSURED ADULTS AND CHILDREN SUPPORTED BY THE HOSPITAL'S HEALTHLINK PROGRAM. PART VI, LINE 6: COMMUNITY HEALTH SERVICES - $772,901LRGHEALTHCARE PROVIDES A VARIETY OF SERVICES DESIGNED TO HELP OUR COMMUNITY ACCESS HEALTHCARE SERVICES, AS WELL AS PROVIDE EDUCATION TO HELP COMMUNITY MEMBERS LIVE HEALTHIER LIVES. COMMUNITY HEALTH EDUCATION ($298,988): THE COMMUNITY EDUCATION DEPARTMENT PARTICIPATED IN 184 PREVENTIVE HEALTH AND SAFETY PROGRAMS AND SPECIAL EVENTS IN THE LAST FISCAL YEAR, REACHING OVER 4,100 PEOPLE. OUR PROGRAMS ARE DESIGNED TO ADDRESS IDENTIFIED COMMUNITY NEEDS, INCLUDING, BUT NOT LIMITED TO CHRONIC DISEASE PREVENTION AND CARE, TOBACCO CESSATION, OBESITY, HEALTHCARE FOR SENIORS, CPR TRAINING, ALCOHOL AND DRUG ABUSE PREVENTION AND COMMUNITY SAFETY AND INJURY PREVENTION INITIATIVES. LRGHEALTHCARE IS COMMITTED TO THE HEALTH OF OUR NEXT GENERATION. OUR PRENATAL EDUCATION INCLUDES TRADITIONAL CHILDBIRTH EDUCATION CLASSES; SPECIALIZED CLASSES FOR TEEN MOTHERS (IN PARTNERSHIP WITH THE LAKES REGION BOYS AND GIRLS CLUB); AS WELL AS A SPECIALIZED CHILDBIRTH EDUCATION COURSE FOR RECENTLY RESETTLED BHUTANESE FAMILIES. OUR CLASSES ALSO OFFER OPPORTUNITIES FOR NEW PARENTS TO PARTICIPATE IN INFANT CPR CLASSES AND CAR SEAT SAFETY INSPECTIONS. IN 2011, BOTH THE LACONIA AND FRANKLIN REGIONS CONTINUED TO PARTICIPATE IN HEALTHY EATING, ACTIVE LIVING (HEAL) GRANTS FROM THE FOUNDATION FOR HEALTHY COMMUNITIES. THE EVIDENCE IS STRONG THAT PROVIDING EDUCATION ABOUT AND OPPORTUNITIES FOR HEALTHY EATING AND PHYSICAL ACTIVITY IS ESPECIALLY IMPORTANT IN COMMUNITIES IN THE LAKES REGION. THE PERCENT OF LOW INCOME PRE-SCHOOL CHILDREN IN THE LAKES REGION WHO ARE OVERWEIGHT OR OBESE IS SIGNIFICANTLY HIGHER THAN THE NH STATE AVERAGE. ADDITIONALLY, OBESITY AND WEIGHT RELATED HEALTH CONCERNS WERE IDENTIFIED AS THE SECOND MOST OFTEN RANKED HEALTH ISSUE IN OUR 2011 COMMUNITY NEEDS ASSESSMENT. LRGHEALTHCARE HAS BEEN A VITAL PARTNER IN HEAL ACTIVITIES IN THE LAKES AND THREE RIVERS REGIONS. EXAMPLES OF THE COMMUNITY WORK ON HEALTHY EATING AND ACTIVE LIVING INCLUDE WORK WITH SCHOOL WELLNESS COMMITTEES, AFTER SCHOOL PROGRAMMING AND COMMUNITY ENVIRONMENTAL CHANGES. IN THE THREE RIVERS REGION, WE WORKED WITH OTHER HEAL PARTNERS ON THE ODELL PARK CENTENNIAL PROJECT TO IMPROVE THE PARK. THE PROJECT INCLUDED ADDING NEW PLAYGROUND EQUIPMENT AND HALF MILE WALKING TRAIL, EQUIPPED WITH FITNESS STATIONS. ALL OF THESE EFFORTS SUPPORT THE CONCEPT OF MAKING THE "HEALTHY CHOICE THE EASY CHOICE," WHICH IS A KEY PRINCIPLE IN EFFORTS TO IMPROVE OUR COMMUNITY'S HEALTH. CONCERNS ABOUT ALCOHOL AND DRUG ABUSE IN OUR COMMUNITIES CLEARLY CAME FORWARD AS A TOP CONCERN IN BOTH OUR COMMUNITY LEADERS FOCUS GROUP AND IN THE 2011 COMMUNITY NEEDS ASSESSMENT. IN FRANKLIN, WE ARE COLLABORATING WITH THE FRANKLIN MAYOR'S DRUG & ALCOHOL TASK FORCE, WHICH RECEIVED A 5 YEAR $650,000 FEDERAL DRUG-FREE COMMUNITIES GRANT. LRGHEALTHCARE IS ABLE TO SUPPORT THIS COMMUNITY COLLABORATION BY FACILITATING EDUCATIONAL SESSIONS FOR PARENTS AND SENIORS ON THE DANGERS OF PRESCRIPTION DRUG ABUSE, WORK WITH LOCAL YOUTH TO FIGHT PEER PRESSURED DRUG USE AND SERVE AS A BRIDGE TO OUR MEDICAL COMMUNITY. COMMUNITY BASED CLINICAL SERVICES ($18,000): BREAST CANCER HAS LONG BEEN ONE OF THE TOP CAUSES OF CANCER DEATH IN OUR REGION. CONCERN ABOUT CANCER, PREVENTION AND TREATMENT WAS IDENTIFIED IN THE TOP 10 IMPORTANT HEALTH ISSUES IN THE 2011 COMMUNITY NEEDS ASSESSMENT. LRGHEALTHCARE HAS BEEN AGGRESSIVE IN OUR EFFORTS TO FIGHT THIS DISEASE, OFFERING REDUCED-RATE SCREENING MAMMOGRAMS IN THE MONTH OF OCTOBER, AND PARTICIPATING IN THE STATE'S BREAST AND CERVICAL CANCER PROGRAM (BCCP). WE ALSO OFFERED THE MAMMOGRAPHY BRIDGE PROGRAM. THE PROGRAM PROVIDES VERY LOW COST SCREENING MAMMOGRAMS TO WOMEN WHO DO NOT QUALIFY FOR EITHER MEDICAID OR THE BCCP, BUT HAVE FINANCIAL BARRIERS TO RECEIVING SCREENING MAMMOGRAMS. IN FY'11, MAMMOGRAPHY BRIDGE AND BCCP PROGRAM SERVED 364 PATIENTS IN OUR SERVICE AREAS. HEALTHCARE SUPPORT SERVICES ($455,913): HEALTHCARE SUPPORT SERVICES ARE VITAL TO OUR MISSION OF PROVIDING QUALITY, COMPASSIONATE CARE AND TO STRENGTHENING THE WELL-BEING OF OUR COMMUNITY. BEING ABLE TO ACCESS CARE AND THE COORDINATION OF CARE WERE KEY THEMES THAT EMERGED FROM THE LAKES REGION AND FRANKLIN REGION COMMUNITY LEADER FOCUS GROUPS. UNINSURED ADULTS IN THE LAKES REGION MAKE UP 12.2% OF THE ADULT POPULATION COMPARED TO THE STATE AVERAGE OF 10.1%. THIS INFORMATION SUPPORTS OUR COMMITMENT TO OUR HEALTHLINK, VETLINK AND CARE COORDINATION PROGRAMS.OUR HEALTHLINK PROGRAM IS A RESOURCE AND REFERRAL PROGRAM THAT PROVIDES FINANCIAL COUNSELING AND SUPPORT. LAST YEAR, WE ENROLLED 4,610 PEOPLE (897 MORE THAN FY'10) IN THE HEALTHLINK PROGRAM. LRGHEALTHCARE ALSO ACTIVELY PARTICIPATES IN THE NEW HAMPSHIRE HEALTHY KIDS PROGRAM. OUR VETLINK PROGRAM IS A UNIQUE PROGRAM TO HELP VETERANS NAVIGATE THE VA SYSTEM, AND ACCESS THE BENEFITS AND SERVICES TO WHICH THEY ARE ENTITLED. LAST YEAR, VETLINK SERVED MORE THAN 300 VETERANS AND THEIR FAMILIES. OUR MEDICATION CONNECTION PROGRAM HELPS PATIENTS IN NEED ACCESS PHARMACEUTICAL COMPANY PROGRAMS OFFERING FREE OR REDUCED-COST MEDICATIONS THAT THOSE PATIENTS OTHERWISE COULD NOT AFFORD. DURING FY'11, THE MEDICATION CONNECTION SERVED 401 CLIENTS. AS THE ECONOMIC CLIMATE CONTINUED TO DECLINE, THE NUMBER OF REFERRALS TO THE PROGRAM GREATLY INCREASED, AND DURING FY'11 PRESCRIPTIONS ORDERED TOTALED 3,977. THESE PRESCRIPTIONS WERE VALUED AT $1.9 MILLION.LRGHEALTHCARE IS IN THE SECOND YEAR OF PARTICIPATION IN THE NEW HAMPSHIRE COLORECTAL SCREENING PROGRAM. THROUGH THIS PROGRAM, 75 PATIENTS WHO MET FINANCIAL GUIDELINES WERE ABLE TO RECEIVE FREE SCREENING COLONOSCOPIES. HEALTH PROFESSIONS EDUCATION ($336,863):LRGHEALTHCARE IS COMMITTED TO HELPING BUILD THE HEALTHCARE WORKFORCE OF TOMORROW. AS THE LARGEST EMPLOYER IN THE REGION, WE ALSO TAKE SERIOUSLY OUR RESPONSIBILITY TO HELP ENSURE THAT LOCAL WORKERS CAN ACCESS THE EDUCATION THEY NEED TO EARN LIVABLE WAGES IN HEALTHCARE FIELDS. TO THESE ENDS, WE PROVIDE OPPORTUNITIES FOR STUDENTS WHO WISH TO ENGAGE IN OR FURTHER DEVELOP THEIR HEALTH CARE CAREERS.IN AUGUST 2010, WE WELCOMED OUR SECOND CLASS OF SEVEN, THIRD-YEAR OSTEOPATHIC MEDICAL STUDENTS FROM THE UNIVERSITY OF NEW ENGLAND, WHO COMPLETED MULTIPLE ROTATIONS IN OUR HOSPITALS AND PRACTICES. LRGHEALTHCARE PROVIDED 55 HOURS OF ADVANCED CARDIAC LIFE SUPPORT (ACLS) AND PEDIATRIC ADVANCED LIFE SUPPORT (PALS) TRAINING HOURS, AS WELL AS CONTINUING EDUCATION AND REFRESHER COURSES FOR EMERGENCY RESPONDERS. MORE THAN 250 FIRST RESPONDERS, PARAMEDICS, PHYSICIANS AND NURSES PARTICIPATED IN THESE VALUABLE TRAINING PROGRAMS.WE ALSO PROVIDE CLINICAL SETTINGS FOR UNDERGRADUATE TRAINING IN A NUMBER OF FIELDS-NURSING, MEDICAL IMAGING, PHARMACY, PHYSICAL THERAPY, EMERGENCY MEDICAL SERVICES, SOCIAL WORK, MEDICAL ASSISTING AND PHLEBOTOMY. THIS REQUIRES EXTENSIVE STAFF COORDINATION TIME; 190 STUDENTS PARTICIPATED IN CLINICAL ACTIVITIES AT LRGHEALTHCARE LAST YEAR. LRGHEALTHCARE SUPPORTS LAKES REGION COMMUNITY COLLEGE'S NURSING PROGRAM WITH A UNIQUE, EDUCATIONAL GRANT OF $154,718 HELPING TO BUILD THE HEALTHCARE WORKFORCE FOR OUR COMMUNITY AND THE STATE. WE ALSO CONTINUED TO PROVIDE OUR POPULAR CARING STUDENT INTERNS (CSI) PROGRAM, WHICH ALLOWS TEENS TO EXPLORE HEALTHCARE CAREERS. LAST YEAR, 24 STUDENTS PARTICIPATED IN CSI, AND ANOTHER 37 PARTICIPATED IN INFORMATIONAL INTERVIEWS OR OBSERVATIONS, TO ASSIST THEM IN THEIR CAREER DECISION-MAKING PROCESS. REPORTS FILED WITH STATES PART VI, LINE 7 NH 1 HEALTH FIRST FAMILY CARE CENTER INC 841 CENTRAL STREET FRANKLIN NH 03235 020492976 501(C)(3) 219660 BOOK TO SUPPORT HEALTH FIRST FAMILY CARE CENTER, INC. IN ITS MISSION TO PROVIDE CHARITY CARE TO THE LAKES REGION AND TWIN RIVERS COMMUNITIES. 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: LRGHEALTHCARE MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS AWARDED TO ORGANIZATIONS IN DETAILED EXCEL FILES AND MONITORS THE AMOUNT OF EXPENDITURES USING THE EXCEL WORKSHEETS. X X X X X 0 1 0 0 0 0 0 1 0 THOMAS A CLAIRMONT 450196 0 0 0 2172 0 13293 0 22286 0 487947 0 0 0 PETER WALKLEY -CHIEF OF STAFF 232192 0 0 0 0 0 10637 0 22686 0 265515 0 0 0 GLENN FUSONIE PHYSICIAN 311931 0 0 0 0 0 8655 0 30470 0 351056 0 0 0 VERCIN EPHREM PHYSICIAN 314008 0 0 0 0 0 8484 0 30470 0 352962 0 0 0 HENRY D LIPMAN 234576 0 0 0 1135 0 11713 0 33469 0 280893 0 0 0 DAVID COLEMAN 309634 0 0 0 0 0 10577 0 10322 0 330533 0 0 0 JOHN VIGNATI 315647 0 0 0 0 0 11162 0 30470 0 357279 0 0 0 ELIZA DEERY 268402 0 21358 0 0 0 11144 0 30663 0 331567 0 0 0 MICHELE J GAIER RUSH 280095 0 47000 0 0 0 8781 0 4167 0 340043 0 0 0 CAROLYN DRAKE 206989 0 64251 0 0 0 8622 0 31978 0 311840 0 0 0 PART I, LINE 4B LRGHEALTHCARE HAS A SPLIT DOLLAR LIFE INSURANCE ARRANGEMENT WITH HENRY LIPMAN, EXECUTIVE VICE-PRESIDENT/CFO. THE EMPLOYER'S SHARE OF THE POLICY PREMIUMS PAID IS RECOVERED EITHER UPON TERMINATION OF THE POLICY OR AT THE DEATH OF THE PARTICIPANT. NOTE THE SPLIT-DOLLAR ARRANGEMENT IS PART OF AN EMPLOYEE BENEFIT AND NOT A DIRECT EXTENSION OF CREDIT. ALSO, THE REPORTABLE COMPENSATION OF HENRY LIPMAN INCLUDES THE ANNUAL VALUE OF THE LIFE INSURANCE AND AMOUNTED TO $1,135. PART I, LINE 7 PHYSICIAN/MIDLEVEL SALARIES ARE ESTABLISHED ANNUALLY USING THE MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA) SALARY SURVEY DATA WITH A SETTLEMENT EACH YEAR BASED ON THE RELATIVE VALUE UNITS (RVU'S) PROVIDED DURING THE YEAR AS IS PREVALENT THROUGH OUT THE HEALTH CARE INDUSTRY. NHHEFA REVENUE BONDS SERIES 2009 THRU HUD 020279866 644614ZM4 2009-12-09 143520000 CAPITAL PROJECTS AND REFINANCING 0 0 0 146869869 11785000 2713902 48932163 25958530 2011 0 0 0 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 NICOLE ARSENAULT EMPLOYED MEDICAL RECORDS DEPT LRGH 31343 WAGES PAID BY LRGHEALTHCARE. SHE IS THE GRANDDAUGHTER IN LAW OF A TRUSTEE. 0 MELISSA ROWLEY-LIPMAN EMPLOYED RESPIRATORY THERAPIST DEPT LRGH 17170 WAGES PAID BY LRGHEALTHCARE. SHE IS THE WIFE OF THE SVP FINANCIAL STRATEGY & EXTERNAL RELATIONS. 0 CAROL WALKLEY EMPLOYED CARDIAC REHAB DEPT LRGH 37818 WAGES PAID BY LRGHEALTHCARE. SHE IS THE WIFE OF THE CHIEF OF STAFF. 0 GRANITE SHIELD INSURANCE EXCHANGE CURRENT OFFICER SERVES BOTH ORGANIZATIONS 876463 IN DECEMBER 2010, LRGHEALTHCARE MADE AN INITIAL CAPITAL CONTRIBUTION TO GRANITE SHIELD INSURANCE EXCHANGE (GSIE) OF $211,000 BRINGING LRGHEALTHCARE'S OWNERSHIP INTEREST IN GSIE TO APPROXIMATELY 7%. PREMIUMS PAID DURING FISCAL YEAR 9/30/11 AMOUNTED TO $665,463. GSIE WILL NOT FILE A TAX RETURN UNTIL THE YEAR ENDING DECEMBER 31, 2011. 1 0 0 ROBERT EVANS MD BOARD MEMBER RECEIVES PAYMENTS INDIRECTLY FOR PROFESSIONAL SERVICES 3919986 DR EVANS IS AN OWNER OF LAKES REGION ANESTHESIA, WHICH RECEIVED PAYMENTS TOTALING $3,919,986 RELATING TO PROFESSIONAL SERVICES PROVIDED IN ACCORDANCE WITH AN ANESTHESIA SERVICES AGREEMENT IN THE FISCAL YEAR ENDED 9/30/11. THE PAYMENTS WERE FOR ARM'S-LENGTH TRANSACTIONS AT FAIR MARKET RATES. 0 PAUL RACICOT MD OWNERSHIP INTEREST IN VENDOR PROVIDING SERVICES TO LRGHEALTHCARE 5440960 DR RACICOT IS AN OWNER OF CENTRAL NH ER ASSOCIATES, INC. IN THE FISCAL YEAR ENDED 9/30/11, CENTRAL NH ER ASSOCIATES, INC. WAS PAID $5,440,960 TO PROVIDE SERVICES TO BOTH HOSPITALS' EMERGENCY DEPARTMENTS. THIS AMOUNT IS GROSS AND DOES NOT TAKE INTO CONSIDERATION ANY EXPENSES INCURRED BY CENTRAL NH ER ASSOCIATES IN PROVIDING THESE SERVICES. 0 FORM 990, PART VI, SECTION A, LINE 6 LRGHEALTHCARE HAS 850 MEMBERS WHO ARE ALSO CONSIDERED STAKEHOLDERS WHO ARE ELIGIBLE TO VOTE. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS ALSO KNOWN AS STAKEHOLDERS MAY ELECT ONE OR MORE BOARD MEMBERS OF THE GOVERNING BODY AT AN ANNUAL MEETING. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS ALSO KNOWN AS STAKEHOLDERS APPROVE BYLAWS AND ARTICLES OF INCORPORATION CHANGES. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE FORM 990 IS INITIALLY REVIEWED IN DETAIL BY KEY FINANCE EMPLOYEES AND THERE AFTER THE ORGANIZATION'S TAX ACCOUNTANTS ARE ASKED FOR THEIR GENERAL REVIEW AND COMMENTS. THEN EACH MEMBER OF THE BOARD IS PROVIDED WITH A DRAFT COPY OF THE FORM 990 IN ADVANCE OF THE MEETING. THEREAFTER, THE FINAL COPY IS PRESENTED TO THE FULL BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C A COPY OF LRGHEALTCARE'S CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY TO ALL OFFICERS, TRUSTEES, MEDICAL STAFF OFFICERS AND COMMITTEE MEMBERS, AND SENIOR TEAM. ALL ARE REQUIRED TO REPORT ANY CONFLICTS AND SIGN, DATE, AND RETURN THE POLICY, WHETHER OR NOT A CONFLICT EXISTS, TO CONFIRM COMPLIANCE. CONFLICTS ARE DISCLOSED IN ACCORDANCE WITH STATE OF NEW HAMPSHIRE RSA 7 19-A, IN THE LOCAL NEWSPAPER AND SUBMITTED TO THE NEW HAMPSHIRE ATTORNEY GENERAL. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION AND BENEFITS ARE REVIEWED, ADJUSTED AND VOTED UPON BY THE FULL BOARD ANNUALLY. THE BOARD OF TRUSTEES USES COMPARATIVE DATA PROVIDED BY A CONSULTANT WHO SURVEYS COMPENSATION FOR HEALTHCARE EXECUTIVES IN THE NEW HAMPSHIRE AND BROADER NEW ENGLAND AREA. SURVEY DATA FROM NEW HAMPSHIRE HOSPITAL ASSOCIATION(NHHA) AND THE AMERICAN SOCIETY FOR HEALTHCARE HUMAN RESOURCES(ASHHRA) IS ALSO USED TO VALIDATE THAT THE SALARY, BENEFITS AND PAY RANGE FOR THE CEO IS FAIR, REASONABLE AND COMPETITIVE. THE CEO IS EXCUSED FROM DISCUSSIONS SURROUNDING CEO COMPENSATION. THE CEO USES DATA PROVIDED FROM HUMAN RESOURCES CONSULTANTS, NHHA AND ASHHRA SURVEYS TO EVALUATE SALARIES AND APPROVE MARKET ADJUSTMENTS FOR EMPLOYEES AT THE VICE PRESIDENT LEVEL AND BELOW. PHYSICIAN SALARY RANGES ARE ESTABLISHED ANNUALLY USING THE MEDICAL GROUP MANAGEMENT ASSOCIATION(MGMA) SALARY SURVEY DATA. THESE REVIEWS ARE ALSO CONDUCTED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 LRGHEALTHCARE FILES AUDITED FINANCIAL STATEMENTS ANNUALLY WITH THE NEW HAMPSHIRE ATTORNEY GENERAL'S CHARITABLE TRUST UNIT. CURRENT COPIES OF THE BYLAWS, CONFLICT OF INTEREST POLICY AND FORM 990 ARE ON FILE WITH THE CHARITABLE TRUST UNIT. REPORTABLE COMPENSATION FROM THE ORGANIZATION FORM 990, PART VII, SECTION A, COLUMN D THE 2011 COMPENSATION REPORTED FOR DR. WALKLEY, DR. FUSONIE, AND DR. EPHREM WAS PAID BY LAKES REGION GENERAL HOSPITAL FOR THEIR SERVICES AS THE CHIEF OF STAFF AND AS PHYSICIANS RESPECTIVELY. DR. WALKLEY, DR. FUSONIE AND DR. EPHREM WERE NOT COMPENSATED FOR THEIR SERVICES AS TRUSTEES OF LRGHEALTHCARE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -25,542. ADJUSTMENT TO PENSION LIABILITY $(7,328,262) -7,328,262. HILLSIDE NET ASSETS $1,041,080 1,041,080. TOTAL TO FORM 990, PART XI, LINE 5: -6,312,724. AUDIT OVERSIGHT FORM 990, PART XII, LINE 2(C) LRGHEALTHCARE DID NOT CHANGE ITS OVERSIGHT OF THE AUDIT PROCESS THIS YEAR. GOVERNING BODY AND MANAGEMENT FORM 990, PART VI, LINE 1A AND LINE 1B MARK K. PRIMEAU IS A TRUSTEE OF LRGHEALTHCARE AND PRESIDENT AND BOARD MEMBER OF LACONIA SAVINGS BANK. LRGHEALTHCARE MAINTAINS MULTIPLE CASH ACCOUNTS WITH LACONIA SAVINGS BANK. TRANSACTIONS IN FYE 9/30/11 WERE IN EXCESS OF $10,000. AN EXACT FIGURE CANNOT BE STATED DUE TO DAILY ACCOUNT ACTIVITY AND BALANCE CHANGES. THE ACCOUNTS WERE ACTIVE PRIOR TO MR. PRIMEAU JOINING THE BOARD AND ALL TRANSACTIONS WITH LACONIA SAVINGS BANK ARE AT FAIR MARKET VALUE FOR FYE 9/30/11. MR. PRIMEAU HAS BEEN CLASSIFIED AS AN INDEPENDENT TRUSTEE. MIKE SEYMOUR AND STUART TRACHY ARE TRUSTEES OF LRGHEALTHCARE. MR. SEYMOUR IS AN EXECUTIVE AND MR. TRACHY IS A TRUSTEE AT FRANKLIN SAVINGS BANK. LRGHEALTHCARE MAINTAINS A LOCKBOX ACCOUNT WITH FRANKLIN SAVINGS BANK. TRANSACTIONS IN FYE 9/30/11 WERE IN EXCESS OF $10,000. AN EXACT FIGURE CANNOT BE STATED DUE TO DAILY ACCOUNT ACTIVITY AND BALANCE CHANGES. THE ACCOUNT WAS ACTIVE PRIOR TO MR. SEYMOUR AND MR. TRACHY JOINING THE BOARD AND ALL TRANSACTIONS WITH FRANKLIN SAVINGS BANK ARE AT FAIR MARKET VALUE FOR FYE 9/30/11. MR. SEYMOUR AND MR. TRACHY HAVE BEEN CLASSIFIED AS INDEPENDENT TRUSTEES. HILLSIDE ASC LLC C/L LRGH 80 HIGHLAND STREET LACONIA NH 03246 208146980 AMBULATORY SURGICAL CENTER NH N/A RELATED 1153788 694138 0 1 0.70000 0 1 0 1 0 0 0 0 0 1 0 0 0 1 0 1 0 0 HILLSIDE ASC LLC D 0 PAID OFF 1/31/11 HILLSIDE ASC LLC J 267072 AGREEMENT HILLSIDE ASC LLC N 775762 AGREEMENT HILLSIDE ASC LLC P 1924846 AGREEMENT