2016-08-12T10:02:35-05:00 2015-09-30 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2014-10-01 020223332 Huggins Hospital HUGG 6035697571 PO Box 912 Wolfeboro NH 03894 Jeremy Roberge President & CEO 6035697571 2016-08-12 1 Barbara J McGuan CPA P00219457 2077752387 2016-08-12 2014 2016-09-27 15:27:22Z Jeremy Roberge PO Box 912 Wolfeboro NH 03894 70122566 0 X www.hugginshospital.org X 1907 NH Critical Access Hospital 15 11 528 135 0 0 814519 973393 46023344 50453210 1761916 1627001 114942 198886 48714721 53252490 0 0 0 0 28544980 32324713 0 0 364736 24597118 21257128 53142098 53581841 -4427377 -329351 105282891 109545610 43902792 47454366 61380099 62091244 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 45378226 50453210 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. 45378226 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 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 1 140 0 1 528 1 0 0 0 0 0 1 1 0 0 0 0 X 15 11 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 President/CEO 40.00 1.00 X X 372319 0 7800 David Booth Trustee 1.00 X 0 0 0 Judith Cole APRN Trustee 30.00 X 42248 0 18849 James Cubeddu PA-C Trustee 40.00 X 97165 0 11660 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 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 211107 0 21977 William M Marsh MD Secretary 1.00 X X 0 0 0 Jeremy Roberge CFO 40.00 1.00 X 193180 0 5368 John S Boornazian Chief Medical Officer 40.00 X 238935 0 28303 George Costello Physician 30.00 X 315072 0 27600 Dennis Badman Physician 40.00 X 277270 0 21264 William Barton Physician 40.00 X 307698 0 10499 Thomas Barton Physician 30.00 X 307748 0 28222 Charles H Hiles Jr Physician 40.00 X 207332 0 11692 2570074 0 193234 26 0 1 0 Central NH ER Associates PA 6 Pickett Fence Road Meredith NH 03253 ER Physicians 1794170 Comphealth Associates Inc PO Box 972651 Dallas TX 75397 Locums 755812 Barton Associates Inc PO Box 417844 Boston MA 02241 Locums 557968 Francis J Tranfa MD PO Box 306 Melvin Village NH 03850 Anesthesiologist 216417 Dan Balser 24 Brice Lane Brookfield NH 03872 Anesthesiologist 208333 10 17050 956343 93516 973393 Patient Service Revenue 621990 96821690 96821690 Miscellaneous 621990 4154024 2125439 2028585 Provision for Bad Debts 621990 -3563591 -3563591 Contractual/Char. Adj. 621990 -46958913 -46958913 50453210 482067 482067 189466 0 189466 189466 189466 17991967 11463 16858496 0 1133471 11463 1144934 1144934 21000 17050 11580 9420 9420 53252490 48424625 0 3854472 1248911 649967 598944 26134271 22487423 3420925 225923 402291 348906 49790 3595 3147324 2671735 449020 26569 1391916 1177061 203332 11523 211851 180645 31206 83877 71522 12355 3105534 2617700 452196 35638 195345 166571 28774 2145942 1826449 315511 3982 110934 94593 16341 2049662 1745526 301532 2604 35581 23904 4129 7548 35701 30442 5259 1418461 1209522 208939 4598163 3920854 677309 660257 563001 97256 Medical Supplies 3564738 3039652 525086 Medicaid Provider Tax 2375400 2025504 349896 Miscellaneous 665682 527249 91079 47354 53581841 45378226 7838879 364736 X 5247425 6484277 4781416 5213379 107500 41783 5660764 5274530 52951 0 0 31082 483305 539246 509128 233653 84607703 33411065 52623183 51196638 33630220 32191984 2186999 8339038 105282891 109545610 8260966 9469389 23766191 23448657 449120 11426515 14536320 43902792 47454366 X 49462861 44995970 8407226 7281067 3510012 9814207 61380099 62091244 105282891 109545610 X -329351 -2171672 6774844 -3562676 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10449 10449 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. 11267269 0 -131591 552000 10583678 10839793 12040 766867 351431 11267269 10445409 6065 702496 314177 10839793 9500670 7819 1570384 633464 10445409 9918249 9152 -307873 118858 9500670 0.00000 0.33160 0.66840 0 0 1638475 1638475 54465345 16958708 37506637 22090895 14150737 7940158 6412988 2301620 4111368 51196638 Due from Subsidiary 741274 Cash Surrender Value Life Insurance 1293569 Beneficial Interest in Perpetual Trust 6304195 8339038 Interest Rate Swap 3015827 Estimated Third-Party Payor Settlements 11520493 14536320 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. 2014 Golf Tournament 38050 17050 21000 4469 4631 2480 38050 17050 21000 4469 4631 2480 11580 9420 1 1 1 X 125.000000000000 1 X 1 1 0 1 1 1452966 506366 946600 0.01770 5192203 4152939 1039264 0.01940 6645169 4659305 1985864 0.03710 519368 519368 0.00970 180000 180000 0.00340 52000 52000 0.00100 751368 751368 0.01410 7396537 4659305 2737232 0.05120 5935 5935 0.00010 33617 33617 0.00060 52451 52451 0.00100 790 790 0.00000 92793 92793 0.00170 1 1726203 16909312 16909312 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 12 1 1 0 1 X www.hugginshospital.org/about/community-health-needs-assessment X 1 13 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 1 X 0 X X X X 1 X 0 0 Huggins Hospital Part V, Section B, Line 5: The Hospital conducted focus groups, interviews, and a survey with community members and community health service providers. For further details, please see attached Community Health Needs Assessment & Implementation Plan. Huggins Hospital Part V, Section B, Line 6a: Huggins Hospital teamed up with the Central NH VNA and Hospice in 2013 to bring together key healthcare and public service stakeholders, collect quantitative and qualitative data, and reach out to the community in order to elicit feedback directly from them and their service providers. Huggins Hospital Part V, Section B, Line 11: Please see attached Community Health Needs Assessment and Implementation Plan. The Community Health Needs Assessment and Implementation Plan can also be found online at the following URLs:CHNA: www.hugginshospital.org/about/community-health-needs-assessmentImplementation Plan: www.hugginshospital.org/assets/pdf/HugginsCHNA-IP.pdf Part V, Section B, Line 16 Financial Assistance Policy Website Availability Huggins Hospital Part V, Section B, line 16a website: www.hugginshospital.org/resources/financial-assistance-and-billing Huggins Hospital Part V, Section B, line 16b website: www.hugginshospital.org/assets/pdf/Financial_Aid_Application_14.pdf Huggins Hospital Part V, Section B, line 16c website: www.hugginshospital.org/resources/financial-assistance-and-billing/ 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 for the development of programs and partnerships intended to address social and economic determinants of health. Sub-categories in this area include:Line 2, Economic Development: Huggins Hospital is the New Hampshire Eastern Lakes Region's primary economic driver as being its largest private employer and providing assurance to year-round and seasonal residents, and visitors that critical access health care is available 24/7 every day of the year. The economic health and quality of life of the Region hinges on the financial strength of the Hospital. Huggins Hospital President & CEO Michael Connelly was appointed by the Governor to sit on the State of New Hampshire's Commission on Rural Affairs, a development committee for studying and recommending public policy that specifically affects rural areas and rural people. Mr. Connelly also sits on the Wolfeboro Area Chamber of Commerce and the Town Economic Development Committee.Line 3, Community Support: Huggins Hospital works collaboratively with the community to offer high quality, cost-effective care. The Hospital's relationships for promoting better community health include Catholic Medical Center, Brewster Academy, Governor Wentworth Regional School District, Starting Point, Central NH VNA & Hospice, the Child Advocacy Center, Wolfeboro Camp School, Camp Brookwoods, YMCA Camp Belknap and various nursing homes. We have several employees that are specially trained as part of the Carroll County Emergency Preparedness team for the State of New Hampshire. Being designated as part of that team, our employees must attend specialized training and perform drills that stretch across Carroll County. As part of our Emergency Preparedness team mission, Huggins provides flu clinics for all of our surrounding EMS providers.Line 5, Leadership development and training for community members: Ms. Janet Williamson, chair of Huggins Hospital Emergency Preparedness Committee and the Hospital's EMS Interceptor assists in providing continued education to our local EMS providers which she does several times a year.Line 6, Coalition building: In addition to the regional work described above, Mr. Connelly, Huggins CEO, also sits on the Rural Health Coalition of the New Hampshire Hospital Association's Foundation for Health Communities Rural Health Quality Improvement Network. The Rural Health Coalition was created to meet the challenges of an ever-changing healthcare environment by assuring rural New Hampshire residents access to care from essential community providers through community care networks as well as favorably affecting the health status of all residents served in rural environments of New Hampshire. Line 7, Community Health Improvement Advocacy: Employees at Huggins Hospital are professionals in health care and are passionate about improving the health of the community. Not only do the employees sit on numerous health advocacy committees and boards, they also volunteer at other local health care organizations and support community healthcare initiatives including the Carroll County Coalition for Public Health, a nonprofit organization dedicated to improving public health in Carroll County and which operates the Substance Misuse Prevention, Public Health Emergency Preparedness and School-based Flu Immunization Clinic programs. 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. As mentioned above, 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. 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 collectibility 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: The Affordable Care Act of 2010 requires not-for-profit hospitals to conduct a Community Health Needs Assessment (CHNA) every three years. Huggins Hospital teamed up with the Central NH VNA and Hospice in 2013 to bring together key healthcare and public service stakeholders, collect quantitative and qualitative data, and reach out to the community in order to elicit feedback directly from them and their service providers. The results of that study formed the Community Health Needs Assessment Implementation Plan in which the hospital describes the greatest needs and, where possible, the plans to address those needs or, where applicable, the reasons why the hospital cannot address any needs. The full report is available upon request or on the hospital's website at www.hugginshospital.org. 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 two financial councilors 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. 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 90,000 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 Huggins Hospital Trust annual giving program and special initiatives support programs that are important to the region like the Adult Day Program, Diabetes Prevention, Patient Care Coordinator Program 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 0 0 0 0 0 1 0 1 0 Michael Connelly CPA President/CEO 353500 0 18750 0 69 0 7800 0 0 0 380119 0 0 0 Eric Lewis MD Trustee 171350 0 39628 0 129 0 3845 0 18132 0 233084 0 0 0 Jeremy Roberge CFO 171153 0 22000 0 27 0 5368 0 0 0 198548 0 0 0 John S Boornazian Chief Medical Officer 189527 0 49279 0 129 0 9171 0 19132 0 267238 0 0 0 George Costello Physician 314943 0 0 0 129 0 7800 0 19800 0 342672 0 0 0 Dennis Badman Physician 220926 0 56153 0 191 0 4235 0 17029 0 298534 0 0 0 William Barton Physician 307500 0 0 0 198 0 7999 0 2500 0 318197 0 0 0 Thomas Barton Physician 307550 0 0 0 198 0 5922 0 22300 0 335970 0 0 0 Charles H Hiles Jr Physician 207179 0 0 0 153 0 3031 0 8661 0 219024 0 0 0 Part I, Line 6 Portions of the bonus payment made to Dr. Michael Connelly are based in part on the following factors: -Huggins Hospital exceeding its prior year's operating results. -Huggins Hospital meeting or exceeding its budget for the year. Part I, Line 7 Bonuses paid to Dennis Badman and Eric Lewis are based on relative value units (RVU's). An incentive payment was paid to John S. Boornazian as Medical Director. 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 480000 10000000 187687 9812313 2010 0 0 1 1 B 585000 15000000 1209816 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 2 93516 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 -2,366,450. Change in Value of Interest Rate Swap -725,577. Change in Beneficial interest in Perpetual Trust -470,649. Form 990, Part XI, Line 8, Prior Period Adjustment: The audited financial statements for fiscal year 2014 have been restated to record a beneficial interest in perpetual trust. Permanently restricted net assets were increased by $6,774,844 as of September 30, 2014. Huggins Senior Housing PO Box 912 Wolfeboro NH 03894 020490445 Elderly Housing NH N/A C 762747 796832 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 741274 Fair Market Value