2012-06-12T08:38:36-07:00 2011-09-30 CYNTHIA M THOMPSON CPA 1723 US HWY 1 CARY PLT ME 044713010 990 2010-10-01 237134386 HOULTON REGIONAL HOSPITAL HOUL 2075322900 20 HARTFORD ST HOULTON ME 04730 THOMAS MOAKLER 2012-05-08 Non-paid Preparer 2010 2016-02-24 21:20:13Z THOMAS MOAKLER 20 HARTFORD ST HOULTON ME 04730 49178138 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. 14 7 506 80 8260 -11515 420042 232556 43426074 46534621 373011 425658 0 44219127 47192835 0 0 27363465 28294609 0 0 16589344 18450288 43952809 46744897 266318 447938 29534896 29323445 21237309 20845027 8297587 8478418 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 34553795 46534621 PROVISION OF HEALTH CARE SERVICES IN RURAL MAINE. DURING THE FISCAL YEAR ENDED 9/30/11, 1,673 PEOPLE HAD AN INPATIENT STAY (INCLUDING THE PROGRESSIVE CARE FACILITY); 82,976 OUTPATIENT SERVICES WERE RENDERED; 12,464 PEOPLE WERE SERVED IN THE EMERGENCY ROOM. OF THESE SERVICES, 1,310 ACCOUNTS (REPRESENTING 348 PEOPLE AND $1,610,524) 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 9/30/11, 61 LIFELINE UNITS WERE RENTED. 34553795 true true false true false false false false false true true false false true true false false true 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 true true false false false true 38 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 14 7 false false false false false false false true true false false false true true true true true true true true false false ME X CYNTHIA M THOMPSON 2075322900 20 HARTFORD ST HOULTON ME 04730 X THOMAS MOAKLER 40.00 X 237271 0 7634 STEPHEN NELSON 1.00 X 0 0 0 ROBERT MOSENFELDER 40.00 X 235963 0 12002 ROBERT ELLIS OD 1.00 X 0 0 0 RICHARD CLEARY 1.00 X 0 0 0 REV JESSIE DRYSDALE 1.00 X X 0 0 0 PHILIP MCFARLANE MD 40.00 X 214016 0 12002 PEDRO HERNANDEZ MD 40.00 X 272880 0 9155 PAUL M ALEXANDER 40.00 X 226919 0 0 NANCY KETCH 1.00 X 0 0 0 MICHAEL NORTHWAY 40.00 X 215037 0 7634 MAX LYNDS 1.00 X 0 0 0 LYNETTE MCLAUGHLIN 1.00 X X 0 0 0 JOHN CLARK 1.00 X X 0 0 0 JERRY YORK 1.00 X 0 0 0 HASSAN E ABOULEISH MD 40.00 X X 124856 0 0 DOUG HAZLETT 1.00 X 0 0 0 CINDY DAIGLE 40.00 X 128312 0 16000 CHRISTIAN ANDERSEN 40.00 X 224865 0 16000 BRIAN GRIFFIN MD 40.00 X 254565 0 16000 ALISON BOSSIE 1.00 X 0 0 0 2134684 96427 27 false true false JAMES CURTIS MADIX MD 20 HARTFORD ST HOULTON ME 04730 RADIOLOGIST 484975 VISTA STAFFING SOLUTIONS 675 EAST 2100 SOUTH SUITE 390 SALT LAKE CITY UT 841069813 LOCUM SURGEON SVCS 209528 HOULTON INTERNAL MEDICINE PA 22 HARTFORD ST HOULTON ME 04730 INTERNAL MEDICINE 1144904 E-PHARMPRO INC 3605 EDGMONT AVE BACK BLDG STE 1 BROOKHAVEN PA 19015 PHARMACIST COVERAGE 178626 COMPHEALTH ASSOCIATES INC PO BOX 972651 DALLAS TX 753972625 LOCUM SERVICES 271327 18 15755 216801 232556 VENDING MACHINES & MISC. 277531 269354 8177 PHARMACY 17341 17341 PATIENT FEES 44647729 44647729 MEDICARE & MEDICAID PYMTS 27631967 27631967 CAFETERIA SALES 128063 128063 -26168010 -26176270 8260 46534621 157291 157291 0 0 0 2253670 1985303 268367 268367 268367 0 0 0 0 47192835 46372780 8260 579239 0 0 0 0 1010656 621439 389217 0 20267189 18481221 1785968 42460 42460 5543444 5543444 1430860 1284912 145948 0 108545 108545 44144 44144 9163 9163 0 14316 14316 0 11144 11144 85989 36903 49086 8253 8253 0 351950 351950 109507 86533 22974 0 0 642691 489216 153475 0 1280747 974905 305842 512741 207062 305679 UTILITIES 844242 844242 SUPPLIES 5509086 5487057 22029 PROVISION FOR BAD DEBTS 1410000 1410000 PROFESSIONAL SERVICES 4114343 3973851 140492 MEDICAID TAX - STATE OF MAINE 1196733 1196733 2196694 1714504 482190 46744897 34553795 12191102 0 21507 25138 549230 1227068 0 5516033 6878103 0 0 0 888495 874335 1230583 1322482 39669784 26565702 13666400 13104082 3233923 2952559 0 0 0 4428725 2939678 29534896 29323445 4653008 4732321 12189673 11571848 336320 600223 4058308 3940635 21237309 20845027 X 7930948 7916668 314975 510086 51664 51664 8297587 8478418 29534896 29323445 X 447938 -267107 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 9163 9163 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. 88511 -2770 200 85541 79673 9038 200 88511 761985 -84267 597107 938 79673 1.00000 false false false 193107 193107 23131189 13422984 9708205 10365208 8505656 1859552 5980280 4637062 1343218 13104082 DUE FROM THIRD PARTY PAYORS 1997612 DUE FROM MEDICAL ARTS DEFERRED FINANCING COSTS 409098 457 PLAN ASSETS 157330 2939678 Rounding 1 LINE OF CREDIT 1461276 DUE TO THIRD PARTY PAYORS 2322028 457 PLAN ASSETS 157330 3940635 47192835 46744897 447938 -266840 -267 -267107 180831 73087949 -266840 26176270 25909430 47178519 14316 14316 47192835 72907116 26176535 26176535 46730581 14316 14316 46744897 Part XIII, Line 2d Part XIII, Line 2d: Other expenses and losses per audited F/S CONTRACTUAL ADJUSTMENTS $24565746 CHARITY CARE $1610524 LOSS ON INVESTMENT IN SUBSIDIARY $265 Part XII, Line 2d Part XII, Line 2d: Other revenue amounts included in F/S but not included on form 990 CONTRACTUAL ADJUSTMENTS $24565746 CHARITY CARE $1610524 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances LOSS ON INVESTMENT IN SUBSIDIARY $ -265 ROUNDING $ -2 Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. THE CORPUS OF THE ENDOWMENT IS PERMANENTLY RESTRICTED, WITH ANY EARNINGS AVAILABLE TO PROMOTE THE HOSPITAL'S EXEMPT PURPOSE. true true true X false false true true false false false 976317 976317 0.02160 10874003 10943730 -69727 11850320 10943730 906590 0.02160 23717 711 23006 0.00050 87777 35383 52395 0.00120 73746 7723 66024 0.00150 185240 43817 141425 0.00320 12035560 10987547 1048015 0.02480 false 854742 131630 16298331 16845673 -547342 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 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 2010 US CENSUS, 19% 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. 30.8% OF THE SERVICE AREA RESIDENTS ARE CONSIDERED TO BE LOW-INCOME (LESS THAN 200% OF THE FEDERAL POVERTY LEVEL) ACCORDING TO THE 2010 CENSUS COMPARED TO 25.2% IN MAINE AS A WHOLE. AVERAGE UNEMPLOYMENT IN AROOSTOOK COUNTY FOR 2011 WAS 9.5% COMPARED TO 7.5% 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 2007. 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. 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.IN ADDITION, THE HOSPITAL RELIES ON FEEDBACK FROM OUR PATIENTS, EMPLOYEES, MEDICAL STAFF, AND BOARD MEMBERS REGARDING SERVICE NEEDS. 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 THAT CONSTITUTES COMMUNITY BENEFIT:THE PORTION OF THE MEDICARE SHORTFALL RELATED TO THE SKILLED NURSING FACILITY SHOULD CONSTITUTE COMMUNITY BENEFIT SINCE WE CONTINUE TO PROVIDE THIS SERVICE REGARDLESS OF THE LEVEL OF LOSSES IT CONTINUES TO SUSTAIN. THIS IS THE REMAINING SERVICE LINE THAT WE SUPPORT THAT IS NOT AN ESSENTIAL SERVICE THAT A HOSPITAL TYPICALLY PROVIDES AND IS NOT COST REIMBURSABLE. IF WE DISCONTINUED THIS SERVICE LINE THERE WOULD BE A SHORTAGE OF SKILLED NURSING SERVICES IN OUR SERVICE AREA AND MEMBERS OF THE COMMUNITY WOULD HAVE TO SEEK THE SERVICES FURTHER FROM HOME, WHICH MAY POSE ISSUES WITH THEIR FAMILY SUPPORT SYSTEM THAT CAN LEAD TO A HINDERED RECOVERY. OUR SKILLED NURSING FACILITY IS LICENSED FOR 28 BEDS AND HAD AN OCCUPANCY % OF 76.07% IN 2011. IF WE WERE TO CLOSE OUR FACILITY, BASED ON THE OCCUPANCY PERCENTAGE 21.29 PATIENTS WOULD BE DISPLACED AT ANY GIVEN TIME. THE OTHER TWO FACILITIES IN OUR COMMUNITY WOULD ONLY BE ABLE TO ACCOMMODATE 7 OF THOSE PATIENTS LEAVING 14 TO SEEK SERVICES AWAY FROM HOME. IN ADDITION, ALTHOUGH OUR FACILITY HAS ONLY 7% OF THE NURSING FACILITY BEDS IN THE PATTEN TO CARIBOU MARKET, WE SERVED 32% OF THE MEDICARE POPULATION, WHICH INDICATES THAT INDIVIDUALS REQUIRING POST-ACUTE, SKILLED NURSING/REHAB STAYS TEND TO COME TO OUR FACILITY. THE NEXT HIGHEST MEDICARE POPULATION % SERVED WAS 16%, SO IT IS DOUBTFUL THAT THE OTHER FACILITIES WOULD HAVE THE INFRASTRUCTURE/STAFFING IN PLACE TO ASSUME THE ADDITIONAL MEDICARE POPULATION IF WE WERE TO DISCONTINUE OUR SKILLED NURSING FACTILITY SERVICES.SNF REIMBURSEMENT $1,506,308SNF ALLOWABLE COSTS $2,060,544SNF SHORTFALL ($554,236)ADDITIONAL MEDICARE SHORTFALL - REVENUE AND COSTS NOT INCLUDED IN THE MEDICARE COST REPORT: COST PROFESSIONAL REPORT FEES TOTALREIMBURSEMENT $16,298,331 $1,053,524 $17,351,855COSTS 16,845,673 1,962,866 18,808,539SHORTFALL (547,342) (909,342) (1,456,684)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 REPROTS 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 INPATINET MEDICARE PROFESSIONAL FEE DEDUCTIONS FROM REVENUE ON THE GENERAL LEDGER TO ARRIVE AT INPATINET 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 $909,342 LESS THEN THE PROFESSIONAL FEE COSTS.TOTAL REVENUE RECEIVED FROM MEDICARE REPORTED ON LINE 5 WAS REDUCED BY $157,187 RELATED TO PRIOR YEAR ACTIVITY. THE AMOUNT CONSISTS OF AN EXCEPTION REPORT FILED FOR THE HOSPITAL RELATING TO THE SOLE COMMUNITY HOSPITAL DESIGNATION FROM 2004. 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 OFF 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 REASONABLENESS 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 (15.4%). 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, 15.4% OF PERSONS IN 2010 ARE BELOW POVERTY LEVEL. SINCE OUR ELIGIBILITY CRITERIA FOR OUR HOSPITAL IS 150% POVERTY LEVEL AND WE USED THE PERCENTAGE BELOW 100% TO ESTIMATE THE POTENTIAL CHARITY CARE WRITTEN OFF AS BAD DEBT, WE BELIEVE OUR CALCULATION IS REASONABLE AND CONSERVATIVE. Part 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 $27,343FACILITY COSTS 35,967CLASS REVENUES COLLECTED (13,006)NET COMMUNITY BENEFIT $50,304HRH 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 COST 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 $24,467UNIT RENTAL FEES COLLECTED ( 22,377)NET COMMUNITY BENEFIT 2,091 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 228997 8274 7634 244905 ROBERT MOSENFELDER 234775 1188 12002 247965 PHILIP MCFARLANE MD 212111 1905 12002 226018 PEDRO HERNANDEZ MD 272106 774 9155 282035 PAUL M ALEXANDER 226505 414 226919 MICHAEL NORTHWAY 214263 774 7634 222671 CHRISTIAN ANDERSEN 224595 270 16000 240865 BRIAN GRIFFIN MD 254295 270 16000 270565 MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 2010B 010314384 560427JA5 2010-06-24 3171803 REFINANCE EXISTING DEBT false false false 3680810 295081 3339864 44927 938 2010 false 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 false MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 010314384 560425QS2 2003-10-16 4606976 REFINANCE EXISTING BOND false false false MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 010314384 560425469 2006-07-01 1529734 51% CONSTRUCTION, 49% REFINANCING false false false MAINE HEALTH & HIGHER EDUCATIONAL FACILITIES AUTHORITY 010314384 560425L40 2007-07-01 2371246 REFINANCE EXISTING DEBT false false false 3572529 575156 54116 2928949 2604 2010 false false true true 5120949 384170 4652011 79427 1442 2003 false false true true 1529734 119500 30689 1363375 2006 false false true true 2584832 191153 2346112 38601 2033 2007 false false true true false false false false false false false true false false false 0.08200 0.00800 0.09000 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 SCHEDULE K, PART III, LINE 7THE HOSPITAL HAS CURRENTLY ESTABLISHED SOME OF THE PRACTICES AND PROCEDURES NECESSARY FOR POST-ISSUANCE COMPLIANCE. THE REMAINING ONES ARE BEING EDITED AND WILL BE PUT INTO PRACTICE IN THE NEAR FUTURE. SARAH LYNDS DIR DAUGH-LAW 29642 WAGES/EMPLOYMENT false HOULTON WATER COMPANY PRES - OFFICER 507539 UTILITY SERVICES false KAREN GALLOP MOTHER OF TREAS 39164 WAGES/EMPLOYMENT false NANCY PUTNAM FNP SISTER OF DIRECTOR 118398 WAGES/EMPLOYMENT false COMMUNITY LIVING ASSOCIATION CEO A DIRECTOR 25650 WASTE COLLECTION SVCS false TERAN CLARK SPOUSE OF PRES 67353 WAGES/EMPLOYMENT false BARBARA MOAKLER SPOUSE OF CEO 55068 WAGES/EMPLOYMENT false HASSAN E ABOULEISH INC DIR 100% OWNER 124856 ED PHYSICIAN false 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. N/A true MEDICAL ARTS INC 22 HARTFORD ST HOULTON ME 04730 010456638 PHYSICIAN PRACTICE ME NA C CORP 1.00000 true false false false false false false false false false false false false false false false false false THIS RETURN WAS ORIGINALLY SUBMITTED ELECTRONICALLY ON MAY 10, 2012 AND REJECTED BY THE IRS. THE DIAGNOSTICS WERE CLEAN ON THE RETURN BEFORE FILING, SO RESEARCH HAD TO BE DONE TO DETERMINE THE REASON FOR THE REJECTION. CALLS WERE MADE TO THE SOFTWARE VENDOR AND THE FILE SUBMITTED TO THE VENDOR FOR REVIEW. THE VENDOR DETERMINED THAT THE REJECTION WAS DUE TO A STREET ADDRESS OMISSION. THIS WAS CORRECTED AND THE FILE RESUBMITTED TO THE IRS. IT REJECTED AGAIN ON MAY 24, THIS TIME WITH A REASON THAT THE REQUIRED PDF ATTACHMENT FOR AUDITED FINANCIAL STATEMENTS WAS NOT THERE. THEY WERE DELETED AND RE-ATTACHED, BUT THE FILE REJECTED AGAIN ON MAY 30. WE AGAIN SPOKE WITH THE SOFTWARE VENDOR AND THEY SUGGESTED THAT PERHAPS THE SIZE OF THE PDF FILE WAS A PROBLEM. WE SHORTENED THE FILE ATTACHMENT AND RESUBMITTED ELECTRONICALLY. IT REJECTED AGAIN ON JUNE 1, 2012. THE FILE WAS AGAIN SENT TO THE SOFTWARE VENDOR, THEY RAN MANY TESTS ON THE RETURN, DETERMINED THAT THE ATTACHMENT WAS THERE, AND THERE WERE NO XML ERRORS WITH THE RETURN. WE THEN REACHED OUT TO THE IRS TO SEE WHY THEY WERE REJECTING THE FILE. THEY STATED THAT THEY WERE NOT RECEIVING THE PDF AUDITED FINANCIAL STATEMENTS WITH THE RETURN SUBMISSION FROM THE SOFTWARE VENDOR.