2011-05-19T07:43:36-07:00 2010-06-30 Macdonald Page & Co LLC 30 Long Creek Dr South Portland ME 04106 990 2009-07-01 010284446 REDINGTON-FAIRVIEW GENERAL HOSPITAL REDI 2074745121 PO BOX 468 SKOWHEGAN ME 04976 DANA C KEMPTON 2011-05-19 George Rafuse 2077745701 X 2009 2016-02-24 21:20:13Z 69928031 false false X N/A X 1969 ME REDINGTON-FAIRVIEW GENERAL HOSPITAL'S MISSION IS TO DEVELOP, PROVIDE AND FACILITATE HIGH QUALITY, 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 7 666 36 0 803485 724054 62920407 68259527 1702313 675029 306813 269421 65733018 69928031 0 0 36823801 41783803 0 0 23872879 26249366 60696680 68033169 5036338 1894862 91398270 95475177 43124747 43761463 48273523 51713714 REDINGTON-FAIRVIEW GENERAL HOSPITAL WILL PROVIDE A LEADERSHIP ROLE TO...DEVELOP, PROVIDE AND/OR FACILITATE HEALTH CARE SERVICES THAT ARE CONSISTENT, EFFECTIVE, ACCESSIBLE, SAFE, PATIENT CENTERED, TIMELY, AND EFFICIENTLY PROVIDED.PROVIDE, MAINTAIN, COORDINATE OR FACILITATE SERVICES THAT ASSURE ACCESS TO PREVENTATIVE, EMERGENCY, ACUTE, AMBULATORY, AND REHABILITATIVE CARE.RECRUIT AND MAINTAIN COMPETENT, PROFESSIONAL MEDICAL AND HOSPITAL STAFF AND SUPPORT THEM IN ACCOMPLISHING THE GOALS OF OUR MISSION,VISION AND STRATEGIC PLAN.MAINTAIN FLEXIBILITY TO RESPOND TO THE NEEDS OF THOSE WE SERVE.DEVELOP COLLABORATIVE AND COOPERATIVE RELATIONSHIPS WITH OTHER HEALTH CARE DELIVERERS, SUPPORT ORGANIZATIONS AND EMPLOYERS IN THE AREA false false 35452539 52571416 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 2010, RFGH HAD 24,648 EMERGENCY DEPARTMENT VISITS AND 3,105 AMBULANCE RUNS. IN ADDITION TO EMERGENCY SERVICES, THE HOSPITAL PROVIDES A FULL RANGE OF SERVICES, RADIOLOGY, C.T., ULTRASOUND, NUCLEAR MEDICINE, BLOOD BANK, PATHOLOGY, CARDIOLOGY AND LABORATORY SERVICES. IN TOTAL, THESE SERVICES TREATED APPROXIMATELY 55,000 PATIENTS. 12444655 9265280 REDINGTON-FAIRVIEW GENERAL HOSPITAL (RFGH) IS LICENSED AS A CRITICAL ACCESS HOSPITAL OPERATING 25 BEDS. RFGH EMPLOYS HOSPITALISTS WHO ARE PHYSICIANS DEDICATED TO THE TREATMENT OF INPATIENTS. INPATIENTS SERVICES INCLUDES MEDICAL AND SURGICAL, SPECIAL CARE, OBSTETRICS AND PEDIATRICS. DURING FISCAL 2010, RFGH PROVIDED INPATIENT SERVICES TO 1,685 PATIENTS WHO STAYED 5,121 PATIENT DAYS. MEDICARE AND MEDICAID PATIENTS REPRESENTED 85% OF RFGH'S INPATIENTS. 9904190 6422832 RFGH OPERATES A NUMBER OF PHYSICIAN OFFICES IN ORDER TO BETTER SERVE THE RESIDENTS OF SOMERSET COUNTY. DURING FISCAL 2010, THESE PHYSICIAN SPECIALTIES INCLUDED INTERNAL MEDICINE, GENERAL SURGERY, ORTHOPEDICS, PEDIATRICS,FAMILY MEDICINE AND NEUROLOGY. DURING FISCAL 2010, THESE PHYSICIAN SPECIALTIES HAD 39,243 PATIENT VISITS. 618463 618463 58419847 true true false true false false false false false false true true false false false false false false false false false true false false true true false false false false false false false false false false false false false false true true false false false true 66 0 true 666 true false false false false false false false false false false false 0 false false false false false false false false 9 7 false false false false false false false true true false false false true true true true true true true false false false X RICHARD D WILLETT 2078582315 46 FAIRVIEW AVE SKOWHEGAN ME 049760468 WILLIAM LANEY 2.00 X X 0 0 0 VIRGINIA HOWARD 2.00 X 0 0 0 TIRUNELLAI R SHANKAR 50.00 X 378341 0 9638 RICHARD D WILLETT 50.00 X 303780 0 245037 MICHAEL LAMBKE MD 2.00 X 0 0 0 MICHAEL CURRAN MD 50.00 X 433237 0 9692 MICHAEL BLAB MD 50.00 X 343932 0 9692 L JOSEPH CLARK 2.00 X X 0 0 0 JOHN COMIS MD 50.00 X 306699 0 9692 JEFFREY LLOYD 2.00 X 0 0 0 GINA GOMEZ MD 50.00 X 199238 0 12525 DONNA FINLEY 2.00 X 0 0 0 DONALD ZAFROS MD 0. X 218604 0 11872 DEEP ACHARYA 50.00 X 300325 0 9558 DANA C KEMPTON 50.00 X 203724 0 99461 CHRISTOPHER PERKINS 2.00 X X 0 0 0 2687880 417167 22 false true false VISTA STAFFING SOLUTIONS 275 EAST 200 SOUTH SALT LAKE CITY UT 84111 CLINICAL STAFFING 632543 QUEST DIAGNOSTIC INC 5763 COLLECTION CENTER DR CHICAGO IL 60693 LAB TESTING 270134 MONITOR BUILDERS INC 225 FRIEND STREET BOSTON MA 02114 CONTRACTOR 3372979 MAINE GENERAL HEALTH ASSOCIATE 333 STONE ST AUGUSTA ME 04330 LAB TESTING 279463 COMPHEALTH 6440 SO MILLROCK DR SALT LAKE CITY UT 84121 CLINICAL STAFFING 322872 5 332792 391262 724054 NET PATIENT REVENUE 68259527 68259527 68259527 675029 675029 0 0 0 0 0 0 0 OTHER MISCELLANEOUS 45367 45367 CAFETERIA 224054 224054 269421 69928031 68304894 899083 0 0 0 0 1495209 643207 852002 0 29536011 25831086 3704925 1952925 1707955 244970 6708423 5866935 841488 2091235 1828916 262319 0 79707 79707 51100 51100 9378 9378 0 136352 136352 2035522 2035522 190180 190180 4447207 3965880 481327 1363046 170977 1192069 0 1367865 1178222 189643 59825 48311 11514 0 221169 190506 30663 1246385 1073584 172801 0 3673688 3288849 384839 778045 778045 PHARMACEUTICALS 2779374 2779374 Misc and other expenses 1468804 1468804 MEDICAID PROVIDER TAX 1103698 1103698 Equipment & Maintenance 1548890 1548890 Bad debt EXPENSE 3689131 3689131 0 68033169 58419847 9613322 0 3578172 7925485 11200487 3813445 0 7037536 7759417 0 0 909886 601779 1145036 1231570 340102 324134 59546045 28589912 31335956 30956133 27941314 35242494 0 0 0 7909781 7620720 91398270 95475177 9954462 9295468 25715377 25310978 7454908 9155017 43124747 43761463 X 47501010 50934656 772513 779058 48273523 51713714 91398270 95475177 X false true true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false 9734 9734 68023432 68033166 1000000 250000 false 1000000 1000000 1000000 1000000 4000000 6000000 8880 9094 9378 9734 37086 250000 250000 250000 250000 1000000 1500000 278681 278681 35820882 12639186 23181696 23446482 15950726 7495756 30956133 SOMERSET FITNESS CENTER 46659 ESTIMATED THIRD PARTY SETTLEMENTS 6759405 DISCOUNT ON BONDS PAYABLE 70268 DEFERRED FINANCING CHARGES 744388 7620720 LIABILITY FOR PENSION BENEFITS 9155017 9155017 69928031 68033169 1894862 1868550 -323221 1545329 3440191 71796581 1868550 1868550 69928031 69928031 68033169 68033169 68033169 Part X Part X : FIN48 Footnote SCHEDULE D - PART X:IN JUNE 2006, THE FINANCIAL ACCOUNTING BOARD (FASB) ISSUED FASB INTERPRETATION 48 (FIN 48), ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT 109. FIN 48 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS IN ACCORDANCE WITH FASB STATEMENT NO.109, ACCOUNTING FOR INCOME TAXES, FIN 48 ALSO PRESCRIBES A "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN AS WELL AS PRESCRIBES A COMPREHENSIVE MODEL FOR DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION.IN DECEMBER 2009, THE FASB PUBLISHED FASB STAFF POSITION 48-3, EFFECTIVE DATE OF FASB INTERPRETATION NO. 48 FOR CERTAIN NONPUBLIC ENTERPRISES (FSP FIN 49-3), WHICH DEFERS THE EFFECTIVE DATE OF FIN 48 FOR NONPUBLIC ENTERPRISES FOR FISCAL YEARS BEGINNING AFTER DECEMBER 15, 2008. THE HOSPITAL HAS ELECTED THE DEFERRAL OF THE EFFECTIVE DATE AND WILL ADOPT FIN 48 IN ITS 2010 FISCAL YEAR FINANCIAL STATEMENTS.THE HOSPITAL PRESENTLY EVALUATES THE LIKELIHOOD OF UNCERTAIN TAX POSITION BY USING THE PROVISION OF FASB STATEMENT NO.5, ACCOUNTING FOR CONTINGENCIES. THE HOSPITAL DOES NOT EXPECT THERE TO BE AN IMPACT ON ITS FINANCIAL POSITION AND CHANGES IN NET ASSET AS A RESULT OF ADOPTING FIN 48.SCHEDULE D, PART XI LINE 8:THE EFFECT OF THE ADOPTION OF FASB STATEMENT NO. 158 AND THE CONTINGENT APPLICATION. Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances ADOPTION OF FASB 158 AND CONTINUING APPLICATION $ -323221 true true true X 240.000000000 true X 336.000000000 true true false false false false 996875 996875 0.01470 996875 996875 0.01470 618572 618572 0.00910 9904190 8307355 1596835 0.02350 10522762 8307355 2215407 0.03260 11519637 8307355 3212282 0.04720 true 2474617 123731 23565587 22726298 839289 true true REDINGTON-FAIRVIEW GENERAL

46 FAIRVIEW AVENUE PO BOX 468 SKOWHEGAN ME 04976

X X SEE ATTACHED STATEMENT SEE ATTACHED STATEMENT SEE ATTACHED STATEMENT SEE ATTACHED STATEMENT true X X X X false true false false false false false true false false TIRUNELLAI R SHANKAR 248078 130263 9638 387979 RICHARD D WILLETT 303780 224521 20516 548817 MICHAEL CURRAN MD 345781 87456 9692 442929 MICHAEL BLAB MD 343932 9692 353624 JOHN COMIS MD 306699 9692 316391 GINA GOMEZ MD 187753 11485 12525 211763 DONALD ZAFROS MD 218604 11872 230476 DEEP ACHARYA 300325 9558 309883 DANA C KEMPTON 203724 85774 13687 303185 Sch J, Part I, Line 7 Part I, Line 7: Non-Fixed payments not listed above SCH J, PART 1, LINE 7 - NON-FIXED PAYMENTS NOT LISTED ABOVE ~ PHYSCIANS 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 UPON BOTH LOCAL AND NATIONAL BENCHMARK INFORMATION IN ORDER FOR THE INCENTIVES FOR THE PHYSICIANS TO MATCH THE HOSPITALS MISSION,THE PROGRAM IS BASED UPON THE HOSPITAL'S ACTUAL CHARGES, SO THAT THE PHYSICIAN WILL HAVE AN INCENTIVE TO TAKE ALL PATIENTS REGARDLESS OF ABILITY TO PAY THE SUM OF ALL CHARGES FOR SERVICES PERFORMED BY THE PHYSICIAN IS TABULATED ON A QUARTERLY BASIS THAT TABULATION ISTHEN DIVIDED BY THE REVENUE TARGET, WHICH IS MULTIPLIED TIMES THE TARGET COMPENSATION LEVEL IF A PHYSICIAN ACTUAL COMPENSATION IS LESS THANN THE CALCULATED SALARY, THE PHYSICIAN WILL RECEIVE A BONUS PAYMENT THAT RECOGNIZES THE PHYSICIAN'S CONTRIBUTION TO THE HOSPITAL'S ACHIEVEMENT OF ITS CHARITABLE MISSION TO PROVIDE HEALTHY SERVICES FOR THE BENEFIT OF THE COMMUNITY. MAINE HEALTH & HIGHER EDUCATION FACILITY 010314384 560427JA5 2010-06-24 108030000 BOND REFINANCING false false MAINE HEALTH & HIGHER EDUCATION FACILITY AUTHORITY 010314384 560425V80 2007-11-01 72040461 REPLACEMENT OF TWO BOILERS, PURCHASE OF A BACK-UP GENERATOR false false 4867784 389000 4187686 38937 2010 true true true true false false false false false true false false false false false false Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available REDINGTON FAIRVIEW GENERAL MAKE ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts 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, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process PRIOR TO THE FILING THE FORM 990, THE HOSPITAL'S CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER REVIEWED THE FILING IN DETAIL WITH THE EXECUTIVE COMMITTEE OF THE HOSPITAL BOARD, WHICH IS COMPOSED OF THE PRESIDENT, THE VICE PRESIDENT, AND THE TREASURER OF THE HOSPITAL. THE OFFICERS FOUND THE FILING TO BE COMPREHENSIVE AND COMPLETE. THE OTHER SIX HOSPITAL BOARD MEMBERS HAVE BEEN NOTIFIED THAT THE FORM 990 IS AVAILABLE FOR THE DETAILED REVIEW IF THEY SHOULD SO DESIRE. Form 990, Part III, Line 4d Form 990, Part III, Line 4d : Other Program Services Description OTHER PROGRAM SERVICES 4: FORM 990, PART III, LINE 4D: OTHER PROGRAM SERVICES DESCRIPTIONThe Healthy Maine Partnership (HMP) work-plan is being carried out by through the funding of the HMP grant, support of RFGH, and additional funding obtained through the efforts of GSPHC. The New Balance Foundation has partially funded the Physical Activity Program Coordinator (HMP/NB) and in this second year a Nutrition Program Coordinator (HMP) Angela Norton was hired. The Substance Abuse Prevention Program Director was a grant funded position for Substance Abuse Prevention (OSA) however beginning July 2010 RFGH will be hiring a Substance Use Prevention program Coordinator to add to SHH staff. This is community work done primarily through schools and worksites in partnership with a variety of community partners.Work plan objectives are all on line in a program called KIT, and are required to be kept current with quarterly reports to Me. CDC and OSA. The following additional funds have been secured or are being pursued for carrying out continued work:New Balance Foundation grant for Move More Kids ($170,000)Lifeboat Foundation ($16,000)Living Well Chronic Disease Self Management ($4,000)Lead Poisoning regional HMP funds ($30,501.81)Additional OSA funds for programming ($34,280.27)Maine Community Foundation ($7,502.73)Maine CVH funds for Worksites ($34,081)EMHS Lets Go 5210 Grant ($4,000)SVH Travel and Technology grant ($880)In addition, we received the following grants:Maine Community Foundation ($5,000) for a Jackman Consolidated School Greenhouse grant Rotary Feed the Kids initiative (Business and NBF supported winter feeding program donations for Rotary) USDA funding for community summer feeing programs (Bingham, Skowhegan and SAD 74 Carrabec started still looking to do Madison area) Program Data (much of our work is establishing policy and environmental changes which impacts large populations of people and is hard to measure total impact besides # of policies or environmental changes made ie trail developed or tobacco policy put in place for SAD 54).Move More Kids! 2010 Highlightso 2010 Move More Kids 8-week Summer Transit Service- over 1,400 familieso 8,766 children and adults involved in physical activityo 1,593 hours dedicated to support MMK activities from other sources of fundingand/or through volunteers.o 11 new area trained lifeguardso Over 1,300 school children snow shoed as part of the Snow Shoe Program thiswinter despite lack of snow.o Successful After school physical activity programs offered in both Madison &Bingham schoolso Over 100 certified trainers trained to use equipment/offer programs related tophysical activity.Additional partnerships formed as a result of the Move More Kids Initiative to provide:* Feed the Kids Program w/Skowhegan Rotary: served 1,458 hot meals to Madison families.* Lifeboat Foundation- expanding nutrition & physical activity opportunities to alternativeeducation students.Additional partnerships formed as a result of the Move More Kids Initiative. Move More:.498 active members enrolled in the Move More Program. Monthly newsletter e-mailed to over 396 members 12 Indoor Walking locations offered indoor walking in Somerset County. Jackman 'Big Losers' and Move, More Kids Program, (MMK), both received recognition at the Maine Fitness Awards. Work site Wellness: 25 businesses worked with in 3 chambers to deliver policy and environmental changes (tobacco and Substance Abuse policies) Wellnotes distributed through these businesses to their employees and familiesTobaccoSuccesses - We delivered 248 packets to businesses in our service area that included information on therecent law changes in September 2009, the 6"x6" "Smoke Free Area" signs, sample business sized cards for the tobacco Help Line and Secondhand smoke as well as a letter describing the services that our Coalition can provide for policy and environmental change. Callbacks were made, with contacts reached at 46 of the businesses. Two motels sought further T SOMERSET FITNESS CENTER INC PO BOX 3158 SKOWHEGAN ME 04976 010524417 FITNESS ACTIVITIES FOR MEMBERS ME -9298 146617 REDINGTON FAIRVIEW GENERAL HOSPITAL FAIRVIEW HOSPITAL INC PO BOX 468 SKOWHEGAN ME 04976 010222130 SOLE SUPPORTING ORGANIZATION OF RFGH ME 501 c (3) 11 (d) NA REDINGTON MEMORIAL HOSPITAL ASSN PO BOX 468 SKOWHEGAN ME 04976 010211154 SOLE SUPPORTING ORGANIZATION OF RFGH ME 501 c (3) 11 (d) NA SOMERSET SPORTS & FITNESS CENTER PO BOX 3158 SKOWHEGAN ME 04976 010524417 FITNESS CENTER ME RFGH 1.00000 false false false false false false false false false false false false false false false false false false