2017-08-11T07:46:22-05:00 2016-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2015-10-01 020223332 Huggins Hospital HUGG 6035697571 PO Box 912 Wolfeboro NH 03894 Jeremy Roberge President & CEO 6035697571 2017-08-01 1 Barbara J McGuan CPA P00219457 2077752387 2017-07-31 2015 2021-01-29 14:40:06Z Jeremy Roberge PO Box 912 Wolfeboro NH 03894 71357124 0 X www.hugginshospital.org X 1907 NH Critical Access Hospital 14 10 576 115 0 0 973393 850288 50453210 53109529 1627001 863588 198886 122431 53252490 54945836 0 0 0 0 32324713 33491192 0 0 269060 21257128 21329204 53581841 54820396 -329351 125440 109545610 116430471 47454366 54741446 62091244 61689025 X It is the mission of Huggins Hospital to provide quality health care services and to promote well being in the communities we serve. 0 0 46205018 53109529 Huggins Hospital is a 25 bed critical access hospital that provides acute care and primary health care from emergency services to family medical practice care, along with essential wellness and prevention services to the residents of the Eastern Lakes Region of NH (lower Carroll County and North/Northeastern Belknap County). A significant portion of the hospital's service area is uninsured, underinsured and/or dependent on Medicaid/Medicare benefits. Carroll County has one of the largest elderly populations in the state, and also has a significant number of rural, low-income families.Physician Practices. The hospital is committed to providing primary care services throughout our service area. Huggins Hospital has 138 credentialed providers. 17 provide primary care including pediatrics, and 56 are specialists covering general surgery, anesthesiology, orthopedics, emergency medicine, and hospitalists. 46205018 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 1 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 115 0 1 576 1 0 0 0 0 0 1 1 0 0 0 1 0 X 14 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Jeremy Roberge 6035697510 PO Box 912 Wolfeboro NH 03894 Stephen Wainwright Trustee 1.00 X 0 0 0 Cecile M Chase Trustee 1.00 X 0 0 0 Timothy Sullivan Chairman 1.00 X X 0 0 0 John J Daigneault CPA CVA Treasurer 1.00 X X 0 0 0 Michael Connelly CPA Past President/CEO 40.00 1.00 X X 386120 0 9335 David Booth Trustee 1.00 X 0 0 0 Judith Cole APRN Trustee 30.00 X 44647 0 1786 James Cubeddu PA-C Trustee 40.00 X 102630 0 12447 George Walker Trustee 1.00 X 0 0 0 Kathy Barnard Trustee 1.00 X 0 0 0 Leslie MacLeod Vice Chairman 1.00 X X 0 0 0 Roy C Ballentine CLU ChFC CFP Past Trustee 1.00 X 0 0 0 Howie Knight Assistant Treasurer 1.00 X X 0 0 0 Eric Lewis MD Trustee 40.00 X 216080 0 23785 William M Marsh MD Secretary 1.00 X X 0 0 0 Jeremy Roberge Acting President/CFO 40.00 1.00 X X 202491 0 5430 John S Boornazian Chief Medical Officer 40.00 X 248028 0 28629 George Costello Physician 30.00 X 314742 0 26357 William Barton Physician 40.00 X 309388 0 1000 Thomas Barton Physician 30.00 X 297242 0 27785 Thomas Molano Physician 40.00 X 256728 0 20130 Barbara Quealy VP Physician Services 40.00 X 199750 0 23654 2577846 0 180338 26 0 1 0 Central NH ER Associates PA 6 Pickett Fence Road Meredith NH 03253 ER Physicians 1623822 Staff Care Inc PO Box 218923 Atlanta GA 303841923 Nursing Services 591827 Barton Associates Inc PO Box 417844 Boston MA 02241 Locums 535433 Comphealth Associates Inc PO Box 972651 Dallas TX 75397 Locums 477343 ABM Healthcare Support PO Box 935695 Atlanta GA 31193 Facilities Support 265842 12 16800 833488 155653 850288 Patient Service Revenue 621990 97743011 97743011 Miscellaneous 621990 3870142 1781805 2088337 Provision for Bad Debts 621990 -1921019 -1921019 Contractual/Char. Adj. 621990 -46582605 -46582605 53109529 487446 487446 113976 0 113976 113976 113976 16767635 16391493 376142 376142 376142 28250 16800 19795 8455 8455 54945836 51021192 0 3074356 1281407 678032 603375 26348479 22576207 3603171 169101 463045 397648 62342 3055 3835824 3222593 589398 23833 1562437 1315105 237741 9591 932913 790084 142829 65056 55096 9960 3140662 2638817 477037 24808 119895 101539 18356 1435226 1173518 259831 1877 264501 224006 40495 1986772 1722954 263784 34 53684 45380 8204 100 30504 25834 4670 1386306 1174063 212243 4695362 3976502 718860 564694 478239 86455 Medical Supplies 3912614 3313593 599021 Medicaid Provider Tax 1984941 1681047 303894 Miscellaneous 756074 614761 104652 36661 54820396 46205018 8346318 269060 X 6484277 6073857 5213379 9842803 41783 36303 5274530 5374216 31082 539246 559345 233653 222864 85409998 36453810 51196638 48956188 32191984 36944063 8339038 8420832 109545610 116430471 9469389 9602107 23448657 23116123 14536320 22023216 47454366 54741446 X 44995970 44367863 7281067 7375949 9814207 9945213 62091244 61689025 109545610 116430471 X 125440 1723002 -2250661 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8329 8329 0 Part II-B, Line 1: Huggins Hospital is a member of the NH Hospital Association and the American Hospital Association. A portion of the dues paid to these organizations is available for lobbying expenditures on behalf of Huggins and other organizations in furtherance of their exempt purposes. Huggins Hospital does not directly perform any lobbying activities. 10583678 793302 564000 10812980 11267269 -131591 552000 10583678 10839793 12040 766867 351431 11267269 10445409 6065 702496 314177 10839793 9500670 7819 1570384 633464 10445409 0.00000 0.32460 0.67540 0 0 1638476 1638476 54494768 19713054 34781714 22492083 14077774 8414309 6784671 2662982 4121689 48956188 Due from Subsidiary 737365 Cash Surrender Value Life Insurance 1248266 Beneficial Interest in Perpetual Trust 6435201 8420832 Interest Rate Swap 3756583 Estimated Third-Party Payor Settlements 18266633 22023216 Part V, Line 4: The intended use of the endowment fund is to support health care services including indigent care, health education, adult daycare as well as capital improvements and acquisitions. Central America and the Caribbean 0 0 Investments 1012735 0 0 0 0 0 0 1012735 0 1012735 0 0 1 0 0 0 2015 Golf Tournament 45050 16800 28250 6811 11473 1511 45050 16800 28250 6811 11473 1511 19795 8455 1 1 1 X 125.000000000000 1 X 1 1 0 1 1 1300422 383220 917202 0.01670 5750294 3994483 1755811 0.03200 7050716 4377703 2673013 0.04870 288584 288584 0.00530 164436 164436 0.00300 10563141 7370109 3193032 0.05820 68608 68608 0.00130 11084769 7370109 3714660 0.06780 18135485 11747812 6387673 0.11650 8145 8145 0.00010 31875 31875 0.00060 40020 40020 0.00070 1 952283 20400741 20807148 -406407 X 1 1 1 1 Huggins Hospital PO Box 912 Wolfeboro NH 03894 www.hugginshospital.org 01990 X X X X Huggins Hospital 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X www.hugginshospital.org/about/community-health-needs-assessment X 1 15 1 www.hugginshospital.org/assets/pdf/HugginsCHNA-IP.pdf 1 0 1 X 125.000000000000 200.000000000000 X 1 1 X X X X 1 X www.hugginshospital.org/resources/financial-assistance-and-billing X www.hugginshospital.org/assets/pdf/Financial_Aid_Application_14.pdf X www.hugginshospital.org/resources/financial-assistance-and-billing/ X X X X X 1 X 0 X X X X 1 X 0 0 Huggins Hospital Part V, Section B, Line 5: Over sixty individuals from over forty community and health care organizations collaborated to conduct a comprehensive CHNA process focused on identifying and defining significant health needs, issues, and concerns of Carroll County. The process centered on gathering and analyzing data as well as receiving input from persons who represented the broad interests of the community and who had special knowledge and expertise in public health. The participants helped provide direction for the Hospital to create a plan to improve the health of the community. Information gathering, using secondary public health sources, occurred in April and May of 2016. Over 300 community surveys were conducted from April 27 through May 13, 2016. A Community Health Summit was held on May 26, 2016 with 45 community stakeholders attending. The audience consisted of healthcare providers, the Carroll County Coalition for Public Health, businesses, law enforcement, EMS, government representatives, human services, not-for-profit organizations (hospitals, home health, mental health, substance abuse, elderly services) and other community members. During Huggins Hospital's Community Health Summit, attendees identified and prioritized the most significant health needs in the community to be addressed in the next three-year period. The group used specific criteria to prioritize the health needs. The groups brainstormed goals and actions to form the foundation of Carroll County's health initiatives. Using a nominal group technique, each attendee posted their ideas of the top three health needs at the front of the room. The group, as a whole, then voted to establish priority. From these priorities, the groups strategized to develop focus areas. From these strategies and focus areas, Huggins Hospital developed the Community Health Needs Assessment's Implementation Plan. Huggins Hospital Part V, Section B, Line 11: Please see attached Community Health Needs Assessment and Implementation Plan. The Huggins Hospital Community Health Needs Assessment and Implementation Plan can also be found online at: www.hugginshospital.org/about/community-health-needs-assessment Huggins Hospital Part V, Section B, Line 16i: Huggins Hospital is currently improving public posting of the organization's Financial Assistance Policy information. The information is currently posted in all waiting areas and other public areas within the hospital and the off-site physician practices. By the end of September 2017, these postings will be redesigned to be easier to read and more visible and the public posting sites will include more places in our community where the appropriate populations of people will see how they can access Financial Assistance at Huggins Hospital. Part I, Line 7: The amounts reported on Lines 7a & 7b were computed using a cost-to-charge ratio. Part II, Community Building Activities: Community-building activities include cash, in-kind donations, and budgeted expenditures by the Trust for the development of programs and partnerships intended to address social and economic determinants of health. Huggins Hospital supports the community through numerous programs and resources as well as involvement and direct donations.Line II, Economic Development: Huggins Hospital is one of the New Hampshire Eastern Lakes Region's primary economic drivers as a large regional employer. The hospital provides assurance to year-round and seasonal residents and visitors that 24/7 access to health care is available every day of the year. The economic health and quality of life hinges on the financial strength and the ability of the hospital to provide healthcare in the region. Multiple Leadership Team members sit on local boards and assist with economic development initiatives with groups such as the Wolfeboro Chamber, the Wolfeboro Economic Development Corporation and the Eastern Lakes Region Housing Coalition. The hospital also supports these agencies with cash and in-kind donations listed in the Community Building Activities section of the hospital's Community Benefits Report. Line III, Community Support: Huggins Hospital works collaboratively with the community to offer high quality, cost-effective care. The hospital maintains relationships with many organizations to promote and create better community health including GraniteOne Health (affiliation of Huggins Hospital, Catholic Medical Center and Monadnock Community Hospital), Governor Wentworth Regional School District, Starting Point, Carroll County Coalition for Public Health, Central NH VNA & Hospice, Northern Human Services, local summer camps and many more. Huggins Hospital provides direct in-kind and cash donations to organizations who also strive to support a healthy community that you can find listed in the Financial Contributions section of the Community Benefits Report. The hospital also works together with local emergency preparedness groups to train and drill in order to be ready for any situation that may arise in our community. As part of our community support, Huggins Hospital also provides paramedic-level services out in the community through the Paramedic Intercept Program. This program allows for a faster connection to a higher level of care that many rural areas do not have available. These quick connections to this high-level emergency care helps save lives and get people the care they need sooner. This program is counted on the Community Benefits Report under Community-Based Clinical Services.Line VI, Coalition Building: Huggins Hospital staff members sit on multiple public health and regional health network groups to address healthcare concerns in multiple areas including chronic disease, substance misuse, mental health, behavioral health, elderly health, healthy childhood development and more. Together with other hospitals and health care organizations, these groups develop priorities and initiatives to affect actual change in our community that has made Carroll County one of the top counties in New Hampshire in statewide health rankings. Line VII, Community Health Improvement Advocacy: Huggins Hospital develops its Community Health Needs Assessment through aggressive community outreach and involvement that creates a natural path to health improvement advocacy in our community. This outreach contribution is referenced in the Community Benefits Report in the Community Benefits Operations section. This process includes a Community Health Summit which involved almost 50 people including residents, government officials, healthcare organizations and local residents. Through this process, we developed an Implementation Plan to continue to advocate for and improve the health of our community.As mentioned before, employees at Huggins Hospital involved in many community groups dedicated to the health of our community. Our employees are professionals in health care and are passionate about what they do. Not only do the employees sit on numerous health advocacy committees and boards, they also volunteer at other local healthcare organizations and support community healthcare initiatives. The Huggins volunteer coordinator assists in overseeing the regional Medical Reserve Corps (MRC), which is affiliated with the federal government's Division of Civilian Volunteer Medical Reserve Corps, and is open to both medical and non-medical volunteers. Huggins Hospital offers free health education to the community in the form of physician and professional lectures, news stories and public service announcements. Emergency medical professionals at Huggins Hospital train local EMS for emergency preparedness and strive to improve the quality of emergency care. Huggins Hospital supports other local non-profits that provide needed support outside the hospital's scope-of-care including mental health agencies and agencies for domestic violence support. This support includes allowing local support groups and a domestic violence prevention agency to use Huggins Hospital space to conduct support groups and other services. These groups include Meals on Wheels, End 68 Hours of Hunger, Starting Point, and more. The support for these initiatives is represented in multiple categories of the Community Benefits Report. Line VIII, Workforce development: As a rural hospital with rural primary care locations, Huggins Hospital needs extra support in finding healthcare providers in the current physician shortage situation happening nationwide. Huggins Hospital uses a support system to help recruit qualified providers to the Eastern Lakes Region community in order to provide the healthcare services the community needs. Part III, Line 4: 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 operations and a credit to a valuation allowance based on its assessment of individual accounts and historical adjustments. 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. In evaluating the collectability of accounts receivable, the Hospital analyzes past results and identifies trends for each major payor source of revenue for the purpose of estimating the appropriate amounts for the allowance for doubtful accounts and the provision for bad debts. Data in each major payor source are regularly reviewed to evaluate the adequacy of the allowance for doubtful accounts. Specifically, for receivables relating to services provided to patients having third-party coverage, an allowance for doubtful accounts and a corresponding provision for bad debts are established at varying levels based on the age of the receivables and payor source. For receivables relating to self-pay patients, a provision for doubtful accounts and corresponding allowance for doubtful accounts is made in the period services are rendered based on experience indicating the inability or unwillingness of patients to pay amounts for which they are financially responsible. Actual write-offs are charged against the allowance for doubtful accounts. The Hospital used a cost-to-charge ratio as its costing methodology for amounts reported in Part III, Section A. Part III, Line 8: The Organization used a cost-to-charge ratio as its costing methodology to determine the amount of Medicare allowable costs. Part III, Line 9b: As a not-for-profit, tax-exempt, and charitable organization, Huggins Hospital serves all in medical need regardless of ability to pay. The Organization is governed by a volunteer Board of Trustees committed to balancing community needs with our available resources to meet those needs. As a hospital-employed medical staff, all twelve physician practices accept patients regardless of ability to pay. Part VI, Line 2: Please see Part V, Section B as well as the attached Community Health Needs Assessment and Implementation Plan. The Huggins Hospital Community Health Needs Assessment and Implementation Plan can also be found online at: www.hugginshospital.org/about/community-health-needs-assessment. Part VI, Line 3: Huggins Hospital provides a notice to all patients both in the hospital and its physician practices of the financial assistance programs available to them. There is a staff of financial counselors who work with the uninsured and underinsured to assist in qualifying for Charity Care or a sliding fee schedule depending on the family income. Financial councilors also assist those uninsured in applying for and receiving assistance through the Medicaid program. Information about our financial assistance programs can be found on our website and in print or in person at all of our locations. Part VI, Line 4: Huggins Hospital is a non-profit, rural, Critical Access Hospital. Our community's year-round population is approximately 33,000 citizens which expands in the tourist season to about 120,000 residents. Huggins Hospital is the second largest employer in Wolfeboro. The primary service area for Huggins Hospital includes: Alton, Brookfield, Effingham, Freedom, Ossipee, Tamworth, Tuftonboro, Wakefield and Wolfeboro. Secondary service areas include parts of Barnstead, Gilford, Moultonborough and New Durham. These towns are located in Carroll, Belknap and Strafford Counties. Part VI, Line 5: Huggins Hospital has played an important role in the Eastern Lakes Region of New Hampshire for more than 100 years, enabling unwavering support to patients and their families, community members and employees. Gifts made to the hospital's annual giving program and special initiatives support programs that are important to the region like the Adult Day Program, Diabetes Prevention and Paramedic Program. The Hospital's professional medical staff has a reputation for excellence in primary care, inpatient and outpatient surgery, medical imaging and diagnostics, gynecology, orthopedics, pediatrics, physical therapy, cardiac and occupational rehabilitation, and emergency services. Other offerings include urology, cardiology, audiology, gastroenterology services and ear, nose & throat. Huggins Hospital provides emergency care to anyone and everyone in the community, or visiting the community, regardless of their ability to pay. Part VI, Line 7, Reports Filed With States NH X X X 1 0 0 0 0 0 0 1 0 Michael Connelly CPA Past President/CEO 385722 0 0 0 398 0 7950 0 1385 0 395455 0 0 0 Eric Lewis MD Trustee 171154 0 44265 0 661 0 5449 0 18336 0 239865 0 0 0 Jeremy Roberge Acting President/CFO 185000 0 17345 0 146 0 5430 0 0 0 207921 0 0 0 John S Boornazian Chief Medical Officer 230723 0 16531 0 774 0 9793 0 18836 0 276657 0 0 0 George Costello Physician 313968 0 0 0 774 0 7950 0 18407 0 341099 0 0 0 William Barton Physician 308200 0 0 0 1188 0 0 0 1000 0 310388 0 0 0 Thomas Barton Physician 296054 0 0 0 1188 0 7950 0 19835 0 325027 0 0 0 Thomas Molano Physician 236728 0 20000 0 0 0 6958 0 13172 0 276858 0 0 0 Barbara Quealy VP Physician Services 181628 0 17502 0 620 0 3915 0 19739 0 223404 0 0 0 Part I, Line 4a Michael Connelly was paid severance payment by the organization in the amount of $14,004.03. Part I, Line 7 Bonuses paid to Eric Lewis, Thomas Molano and Barbara Quealy are based on relative value units (RVU's). The incentive payment was paid to Dr. John Boornazian as Medical Director for his oversight of Cardiopulmonary. The bonus paid to Jeremy Roberge was objectively measured and data driven, and was based 50% on group goals and 50% on individual goals. A Business Finance Authority of the State of New Hampshire 521304598 64448KBF2 2007-11-15 10000000 Financing of Construction Project 0 0 0 B Business Finance Authority of the State of New Hampshire 521304598 64468KBM7 2009-10-06 15000000 Financing of Construction Project 0 0 0 A 610000 10000000 187687 9812313 2010 0 0 1 1 B 810000 15000000 1211021 188500 13601684 2010 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 1 0 0 0 0 0 0 B 0 0 1 0 0 0 0 0 0 A 0 B 0 X 1 4000 Value at Auction X 2 151653 Fair Market Value 0 0 1 Part I, Line 32b: Contributions of securities are sold through an investment broker. All gifts of securities are sold as soon as administratively possible. Form 990, Part VI, Section B, line 11 A designated officer or management official meets with the preparer to discuss a draft of the Form 990 in detail. Once any necessary revisions are made, this draft is then submitted to the Finance & Budget Committee for further review. Afterwards, a copy of the public inspection copy of Form 990 is made available to the full board for their general review and comment prior to filing the return. A designated officer then signs the return after considering board comments. Form 990, Part VI, Section B, line 12c A copy of the conflict of interest policy is given to every officer, board member, and key employee on an annual basis, along with an annual disclosure statement. Each person is asked to complete, date and sign the disclosure statement, listing any known financial interest that the individual, or a member of the individual's family, has in any business entity that transacts business with the Organization. The Chairman of the board then reviews and maintains the disclosure statements for future reference. If a conflict arises, the board member will recuse themselves from participation in the deliberations and decisions relating to that conflict. Form 990, Part VI, Section B, line 15 The Hospital relies on externally available market data to determine the appropriate salary and any incentive compensation for the President as well as other officers and key employees of the organization. Each year, the President provides the Board with a listing of the five highest paid senior staff. Base salary and incentive compensation provided to the President is determined by three members of the Executive Committee of the Board as part of an annual performance review and their recommendation is shared with the full Board for final approval. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements are made available to the public upon request for inspection in the President's office. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Huggins Hospital PO Box 912 Wolfeboro, NH 03894 EIN 02-0223332 Section 1.263(a)-3(n) Election: Huggins Hospital is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Pension Liability Adjustment -1,640,911. Change in Value of Interest Rate Swap -740,756. Change in Beneficial interest in Perpetual Trust 131,006. Hospital and Community Aid Association Inc PO Box 1377 Wolfeboro NH 03894 026008048 Purchases equipment for the benefit of Huggins Hospital and its' patients. NH 501(c)(3) Line 11b, II 0 Huggins Senior Housing PO Box 912 Wolfeboro NH 03894 020490445 Elderly Housing NH N/A C 780704 457956 1.00000 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Huggins Senior Housing D 737365 Fair Market Value