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Committed to Our Values

Pride | Innovation | Caring | Excellence

Franklin Community Health Network 2012 / 2013 Annual Report

Franklin Community Health Network Franklin Community Health Network is a locally controlled, nonprofit, integrated network of rural health care providers, created by Franklin Memorial Hospital in 1991. Its affiliates include Franklin Memorial Hospital, Franklin Health, Evergreen Behavioral Services, Healthy Community Coalition of Greater Franklin County, and NorthStar EMS. Franklin Memorial Hospital is a progressive, not-for-profit community hospital whose mission is to provide high quality, costeffective, patient- and family-centered health care. The hospital actively works with the community and with other health care providers integrating services to ensure the optimum health of people within its service area. Franklin Health is a multi-specialty group practice sponsored by Franklin Memorial Hospital that includes nine medical and surgical practices. Franklin Health is the largest provider of health care services in the region. The practices are linked together by technology, an integrated medical record, and a common concept of patient- and family-centered care. Evergreen Behavioral Services provides 24/7 emergency mental health response and community outreach services in Greater Franklin County. Its crisis team helps both children and adults stabilize a crisis by tailoring interventions to each person’s unique needs, strengths, and situation.


Healthy Community Coalition of Greater Franklin County has a mission to measurably improve the well-being of all people using a coordinated public heath approach of education, health promotion, and outreach. Healthy Community Coalition offers health screenings, health information, programs and events that prevent disease and improve quality of life. Its community outreach efforts appear in every town and corner of the region. NorthStar is the regional ambulance service of Greater Franklin County. NorthStar follows its mission of providing respectful and excellent patient care, positive community activities, and good stewardship of resources. NorthStar responds to more than 5,000 calls per year in 71 communities spread over 2,800 square miles. With state-ofthe-art equipment and ambulances, the service is ready, responsive, and reliable.

Our Mission: working cooperatively with others to achieve the highest level of health and wellness possible for the people of west central Maine. Our values Pride To nurture pride and enthusiasm about the mission of FCHN within our organization and the communities we serve by engaging staff and residents through connections to our work, values and vision. Innovation To create the best means of fulfilling our mission with limited resources by using our creativity and being open to change.

Caring To consistently show respect for all we serve and the staff and members of Franklin Community Health Network based on the human dignity of every person. Excellence To become the best we can be.

Franklin Community Health Network has grown exponentially in the range and sophistication of services offered since its inception. Services are integrated to achieve a medical home model that supports population-based health care and focuses on prevention, primary care, mental health services, and care management.


A message from the president This annual report highlights our accomplishments over the past year toward the vision of Franklin Community Health Network “being the best we can be.” Inside you will read about significant accomplishments that demonstrate our values of pride, innovation, caring, and excellence in the work we do every day. Indeed we have much to be proud of. This past fiscal year, Franklin Memorial Hospital also experienced challenges that include a negative financial position never witnessed before. Significant and emerging key financial challenges affecting our organization include federal and state budget cuts; decreases in payment for services from all payers; volume decreases in essentially all service lines; and significant increases in charity care and bad debt. However, we are not alone. The tough economic climate has contributed to financial struggles at most hospitals in Maine, and many are responding by downsizing, joining bigger systems, and looking for new business models. There is no single factor that has caused us to arrive at this juncture. As you know, the health care industry is in a state of great change, and it is more complex than it has ever been. As a result, the costs and challenges of running a hospital are greater than ever. Hospitals and health systems nationwide are looking for the same kind of solutions as we are. I assure you, this is not something we could have avoided. We have made numerous organizational changes this past fiscal year to reengineer and right size the organization to the new realities of lower reimbursement, lower volume, consumer-driven health care, and value-based purchasing. Among the changes are: reductions in our compensation and benefit plans; discontinuation of ear, nose and throat services; transitioning child psychiatry services to a telemedicine model; consolidating Wilton Family Practice into existing Farmington and Livermore Falls medical practices; reduction of our workforce through attrition and layoffs; and reduced capital expenditures. Moving forward in order to position for the future, the Franklin Community Health Network/Franklin Memorial Hospital board will examine methodically and thoroughly the following possible options: • Mix of programs and services provided to meet community needs; • Collaborative relationships with other health care providers; and • Establishing additional partnerships with other health care organizations.


being the best we can be by expressing our values of pride, innovation, caring and excellence. In closing, this annual report is a tribute to our health system employees, physicians, nurses, and community members who volunteer and contribute to the good work of Franklin Community Health Network. I hope you will read it with a sense of pride.

Rebecca Ryder President & Chief Executive Officer Franklin Community Health Network

“We have been very fortunate. This is the first big challenge in our history, and that says a lot about how well the hospital has been managed over the years. We've always been viewed as cutting edge: finding unusual solutions to our problems. We are confident that we will find a solution to our current situation.� -Rebecca Ryder

Above: Rebecca Ryder joined Franklin Community Health Network as its President and CEO in January 2009.


Introducing our newest providers Gabriel Civiello, MD Franklin Health Pediatrics

Gabriel Civiello, MD, is a pediatrician who received his medical degree from Dartmouth Medical School, before completing his residency at Maine Medical Center. While at medical school, Dr. Civiello received the Saul Blatman Award for Excellence in Maternal and Child Health. During his residency, Dr. Civiello was the recipient of the Barbara Chilmonczyk Resident Scholar Award.

Sarah Dooley, PA-C Franklin Health Orthopaedics

Sarah Dooley is a graduate of the University of New England’s physician assistant studies program and is certified by the National Commission for the Certification of Physician Assistants. Before joining Franklin Health Orthopaedics, Dooley saw patients at the Harold Alfond Center for Cancer Care in Augusta and in the Oncology/Hematology Unit at Franklin Memorial Hospital.

Beth Hartsock, ANP, FNP Franklin Health Internal Medicine

Beth Hartsock has provided primary care for patients since 2002, most recently at York Family Practice. Before that she was a provider at Farmington Family Practice from 2006–2010. Besides primary care, her professional interests include research, domestic violence prevention, and international medicine. Hartsock received her master’s degree in the adult nurse practitioner program from Simmons College. She later received a post-master’s family certificate from the University of Southern Maine.


Our health care practitioners listen to and honor patient and family perspectives and choices. Patient and family knowledge, values, beliefs, and cultural backgrounds are incorporated into the planning and delivery of care.

We are advancing the practice of patient- and family-centered care and creating partnerships in all health care settings. James Smith, DO Franklin Health Livermore Falls Family Practice

Dr. Smith has provided primary care for patients since 1994. He was a provider at Farmington Family Practice from 1994–2010 before moving to York, Maine. Besides family medicine, his professional interests also include international medicine in underserved areas. Dr. Smith received his medical degree from the University of New England College of Osteopathic Medicine. He is board-certified by the American Board of Family Medicine.

Jennifer Zeliger, MD Franklin Health Women’s Care

Dr. Zeliger recently completed a four-year obstetrics and gynecology residency at Maine Medical Center. Before that, she received her medical degree from the University of Louisville School of Medicine. While there, she was a member of the Alpha Omega Alpha Medical Honor Society and the recipient of the Janke B. Mains Memorial Award for Outstanding Performance in Microstructure and Development.

Franklin Community Health Network establishes its position as employer of choice in the region by emphasizing values-based recruitment, employee and physician satisfaction, retention, and leadership development.

Our health care practitioners communicate and share complete and unbiased information with patients and families in ways that are affirming and useful. Patients and families receive timely, complete and accurate information in order to effectively participate in care and decision-making.


Franklin Health Physician Practices Behavioral Services

Arthur Dingley, JD, DO Linda Lockhart, PMHNP-BC Rebecca Chandler, PMH-NP, CS


Joshua Sparling, MD

Farmington Family Practice J. Bertrand Audette, DO Armand Auger, MD Kendra Emery, DO Calli Meader, PA-C Kristine Sanden, DO Linda Seabold, PA-C

Internal Medicine

Stephen Goss, DO Beth Hartsock, ANP, FNP Stacy Hershfeld, DO Robert O’Reilly, DO

Lorien Batt, MD, FAAP Gabriel Civiello, MD, FAAP John Hickey, MD, FAAP Kathleen Hickey, MD, FAAP Iris Silverstein, MD, FAAP (Developmental Pediatrics)


Eric Gunther, MD Shane Lydon, MD, FACS G. Thomas Marshall, MD, FACS

Women’s Care

Constance Adler, MD Tara Aumand, MD Jacques Belair, MD Deborah Hamilton, MD Susan Kearing, DO Jay Naliboff, MD Rebecca Sylvester, FNP

Livermore Falls Family Practice

Susan Tinguely, FNP Jennifer Zeliger, MD


The nine practices are linked together by technology, an integrated medical record, and a common concept of patient- and family-centered care.

Heidi Decker, MD Mary Dunlap, FNP James Smith, DO

Nancy Cummings, MD Sarah Dooley, PA-C Thomas Pulling, MD



Patients and families are encouraged and supported in participating in care and decision-making at the level they choose.

The Inpatient experience


atients at Franklin Memorial Hospital receive care from our highly qualified medical/ surgical team that includes doctors, a physician assistant, nurses, nursing and medical students, pharmacists, physical therapists, respiratory therapists, medical specialists, a case manager, dietician, and others who help make our patients’ experience positive, comfortable, and healing. Single rooms offer patients privacy and quiet and are equipped with white boards to enhance communication between patients, families, and health care providers. Amenities include a private bathroom, telephone, television, and wireless Internet access. Hospitalists take care of patients from admission through discharge. They are specially trained physicians who care for patients during a hospital stay. The hospitalist staff remains in contact with each patient’s primary care clinician, sending

regular updates and asking for additional information as needed. Nearly 40 hospitalbased registered nurses hold advanced certifications in at least one of the following areas: emergency critical care, medical/surgical care, oncology, chronic disease management, wound care, and diabetes education, among others. Each of these certifications requires years of clinical practice in the specialty, the completion of continuing education credits, and passing rigorous exams. Doctors and nurses, together with a physical therapist, respiratory therapist, and dietician meet every morning to discuss discharge plans to ensure that patients have the services they need when they leave our hospital. A case manager arranges for these services for patients such as home care visits, rehabilitation in nursing care facilities, and continued physical therapy.

The inpatient team is made up of doctors, a physician assistant, nurses, pharmacists, physical therapists, respiratory therapists, medical specialists, a case manager, dietician, and many others who help make our patients’ experience positive, comfortable, and healing.


Living Our Values: pride


Caregiver of the Year In May, Rebecca Wood was named Caregiver of the Year for Franklin Memorial Hospital. This annual award honors a caregiver who on a daily basis demonstrates extraordinary commitment to the delivery of care to patients and their families. As surgical services Rebecca Wood director, Wood oversees: day surgery, operating room, post-anesthesia care unit, preadmission testing, endoscopy, and pain clinic. These busy departments combined treat approximately 4,600 patients each year. During her time at the helm, she has brought all levels of staff together resulting in improved staff morale, and changes that contribute to better patient care and improved patient satisfaction.

Ralph Johnson Named CIO of the Year The Healthcare Information and Management Systems Society’s (HIMSS) New England Chapter, named Ralph Johnson, chief information officer (CIO) at Franklin Community Health Network, as the New England HIMSS CIO of the Year at its annual Awards Event in December. Johnson has worked in the health care information technology field for 28 years. Since joining FCHN in 2006, he has led major IT initiatives to improve patient safety. He is a certified health care CIO from the College of Healthcare Information Management Executives and the first health system CIO in Maine to earn the designation. He is a volunteer advisor for HealthInfoNet and additionally serves as a board member with the ConnectME Authority, advancing the adoption of broadband technology in rural areas of Maine.

Grassroots Champion In April, the American Hospital Association (AHA), in partnership with the Maine Hospital Association awarded Rebecca Ryder, president and CEO of Franklin Memorial Hospital with the AHA Grassroots Champion Award for her exceptional leadership in generating grassroots and community activity in support of her hospital’s mission. The award was created to recognize those leaders who have done an exemplary job in broadening the base of community support for the hospital and who tirelessly advocate for the hospital and its patients. Ryder was one of 52 individuals honored this year.

Excellence in Nursing Award Roseanne McKeen was the recipient of the organization’s second annual Excellence in Nursing Award. Nursing leaders and peers nominated five individuals for the award that was established to recognize outstanding contributions by nurses who support the advancement of nursing. Her nomination cited her as being “caring, kind, thoughtful, gentle, helpful, and compassionate. When you meet Roseanne you know these words describe someone special. Her patients feel it and comment on it. They leave feeling that they have been touched by an angel.”

Pride: To nurture pride and enthusiasm about the mission of FCHN within our organization and the communities we serve by engaging staff and residents through connections to our work, values, and vision.

Pride Achieving Zero Defects for Elective Deliveries In June 2012, MaryAnne Goodwin, RN, Maternal and Child Health nurse manager and Margaret Mitchell RN, LC, attended the Association of Women’s Health Obstetric and Neonatal Nurses National Convention in Washington DC and presented a poster on Achieving Maryanne Goodwin Zero Defects for Elective Deliveries Before 39 Weeks Gestation through the use of quality improvement processes involving education, tracking of data, and strict enforcement of clinical practice policies. Results on elective delivery before 39 weeks gestation are publicly reported and Franklin Memorial Hospital has had zero defects for four consecutive years. Numerous professional associations and The Joint Commission recommend that no elective delivery should be performed before the gestational age of 39 weeks. Thirty-six Recognized for professional development Franklin Community Health Network reinforces the benefit of investing in education with the goal of attracting, retaining, and developing a workforce that is recognized as our greatest asset. In June, the Professional Development Council recognized 36 employees for earning advanced degrees and certifications in the past year. The mission of the interdisciplinary professional council is “fostering opportunities for professional growth through lifelong learning.”

Clockwise from top: Steven Michaud, Maine Hospital Association president, Rebecca Ryder, and Rich Umbdenstock, AHA president, at a Breakfast of Grassroots Champions in Washington DC; Ralph Johnson, CHCIO, New England HIMSS CIO of the Year; and Roseanne McKeen, RN, the recipient of the Nursing Excellence Award.


Living Our Values: Innovation Nurse Navigator Pilot Project In January, the Maine Health Access Foundation awarded Franklin Memorial Hospital $197,818 over two years to implement Franklin CARES, a nurse navigator pilot program to improve care coordination, Tracy Harty access to care, and integration of behavioral health care for uninsured and underinsured patients qualifying for free or discounted care. Franklin CARES is partnering with Franklin Health primary care practices and its behavioral services practice, Evergreen Behavioral Services, and Healthy Community Coalition to develop and implement the program. Nurse navigator for the initiative is Tracy Harty, RN, BSN, who acts as the project lead. Fuel Conversion FCHN is in the process of converting the fuel source of the hospital, Franklin Health Medical Arts Center, Greenwood Building and the maintenance garage from No. 2 fuel oil to propane. This conversion will increase boiler efficiencies, reduce emissions of noxious gases, and lower our annual heating costs by approximately $200,000 annually. This conversion will also put the organization in prime position to use natural gas, should an underground gas pipeline go through this area. Future options of choosing from three different fuel sources will increase annual fuel savings going forward.


Most Wired For the third consecutive year Franklin Memorial Hospital was named among 289 of the nation’s “Most Wired” hospitals according to the results of the 2013 Most Wired Survey Benchmarking Study released in the July issue of Hospitals & Health Networks, the journal of the American Hospital Association. This award speaks volumes to the dedication of all of Franklin Memorial Hospital’s medical staff, nurses, and other employees who use technology and innovation every day to create an exceptional experience for our patients. Choosing Wisely The Choosing Wisely campaign, an initiative of the ABIM Foundation, aims to promote conversations between physicians and patients in choosing care that is supported by evidence; not duplicative of other tests or procedures already received; free from harm; and truly necessary. Twenty-six national medical specialty organizations have identified tests or procedures commonly used in their field, whose necessity should be discussed. These recommendations are meant to spur conversations between physicians and patients to determine the most appropriate treatment plan together. Dr. Jay Naliboff, Franklin Health medical director, has been instrumental in spreading the word about this initiative locally by educating the hospital board of directors, medical staff, the Franklin Health Patient Care Clinical Advisory Committee, and community members.

Innovation: To create the best means of fulfilling our mission with limited resources by using our creativity and being open to change.

Innovation treating Pain with Radiofrequency Thermocoagulation In January, neurologist Daniel Lalonde, MD, started providing radiofrequency thermocoagulation for patients with chronic pain who had found no relief with other treatment methods. With this new minimally-invasive service, Dr. Lalonde uses fluoroscopy x-ray guidance to direct radiofrequency needles that generate heat over painful nerves when electrical current is applied. The current creates lesions on the nerve tissue, thereby interrupting pain signals from that particular area. Radiofrequency treatment blocks pain signals for a prolonged period of time, typically one year. Conditions that respond well to this technique include chronic low back pain, thoracic spine pain, and sacroiliac joint dysfunction. Web-based patient Portal Available In 2013, access to a patient portal was given to all Franklin Health primary care patients with computer access. A patient portal is a secure online Web site that gives patients convenient 24hour access to personal health information from anywhere with an Internet connection. Using a secure user name and password, patients can view their test results, office visit summaries, medication list, and request prescription refills and appointments. Patient portals enhance patient-provider communication, empower patients, support care between visits and, most importantly, improve patient outcomes.

From top: Neurologist Dr. Daniel Lalonde provides radiofrequency thermocoagulation for patients with chronic pain; Franklin Health primary care patients now have convenient 24-hour access to their personal health information from anywhere with an Internet connection. Here, Nancy Johnson reviews her recent lab results using an Ipad.


Living Our Values: caring Safe Disposal of Medical waste A year ago, Franklin Memorial Hospital in concert with area towns and the Maine Department of Environmental Protection, developed informational rack cards on safe disposal of home-generated medical waste such insulin syringes, lancets, and sharps. The cards are placed in all FCHN facilities and medical practices so that those who generate this type of waste can safely dispose of them in municipal trash. Proper disposal of used sharps keeps everyone safe including children, pets, family, community members, and sanitation workers. CT Scanner Upgraded In November, the Radiology Department performed a major Adaptive Statistical iterative Reconstruction (ASiR) upgrade of its 64-slice CT (computed tomography) scanner. ASiR removes unwanted noise from the raw data to maintain image quality while at the same time using a lower dose of radiation. The upgrade of this CT is an example of purchasing the right level of technology upgrade to extend the life of the scanner while making the imaging safer for our patients. CT protocols had their doses lowered by 30 percent except for heads which were lowered by 20 percent. As the technologists and radiologists spend more time using this system, all of the protocols will continue to be assessed with the goal of reducing radiation doses even further.


Walk-in X-Ray Services Added Franklin Memorial Hospital added a third location for patients to receive diagnostic x-rays—on the second floor of the Franklin Health Medical Arts Center in space called MAC Radiology. The digital x-ray service operates Monday–Friday from 8 a.m.–4:30 p.m. For maximum convenience, walkin services are provided, although patients can make appointments if preferred by calling Franklin Health Orthopaedics. The new location is efficient for patients with registration and the procedure taking place in one location. Patients must have a physician’s order to receive the service. Conference addresses the trauma of war In September, Evergreen Behavioral Services hosted a free conference titled Providing Behavioral Health Services for Service Members, Veterans, and their Families. More than 75 medical and behavioral health providers, social workers, and pre-hospital personnel attended the conference that featured speakers from Togus VA Medical Center. Col. Jack Mosher, director of operations of the Maine National Guard, also spoke regarding his experiences returning from active duty with post-traumatic stress disorder. The program provided an overview concerning the best practices for identifying, assessing, and treating mental health disorders in veterans.

Caring: To consistently show respect for all we serve and the staff and members of Franklin Community Health Network based on the human dignity of every person.

caring Breast care support nurses Kelly Alley, RN, and Katrina Tozier, RN, BSN, (left) are the breast care support nurses for the Martha B. Webber Breast Care Center. Their role is to help make breast health a seamless process for their patients from the moment the primary doctor schedules a mammogram, to prompt follow-up radiological testing, and support for those who are undergoing cancer treatment and are in need of oncology, physical therapy, dietary, chaplaincy, and other services. The breast care support nurse position has been key to the center’s mission since its inception. Gardening Education As part of an initiative to encourage residents to grow their own vegetables and improve overall health, the Healthy Community Coalition (HCC) conducted a series of educational events that offered free container gardens, and gardening and canning instruction at the Hope Harvest Garden, located on the hospital campus. HCC staff, along with Master Gardeners trained by the Cooperative Extension Service, provided the gardening expertise for approximately 250 individuals who dropped by during the month of June. Produce grown at the Hope Harvest Garden is distributed to local food pantries. Children’s Services Expanded In June, the Franklin Memorial Hospital Auxiliary presented Franklin Memorial Hospital with a $10,000 gift to provide needed services for children. The donation is funding two new services: first, to provide the technology and infrastructure needed to offer child psychiatry services in the pediatrics’ medical practice via telemedicine; and second, to establish a series of curriculum-based support groups for children and their caregivers affected by domestic violence. The latter is the first of its kind in Franklin County.

From top: HCC staff member Angela Norton, RD, LD, working in the Hope Harvest Garden; Carolyn Hastings, RT(R)(CT), is a radiologic technologist who staffs the new location for patients needing diagnostic x-rays.


Living Our Values: Excellence NCQA Recognition The National Committee for Quality Assurance (NCQA) has awarded recognition to Franklin Health Farmington Family Practice and Franklin Health Internal Medicine. NCQA recognition is the first step to transitioning the practices to a Patient-Centered Medical Home (PCMH) model of care. PCMHs use evidencebased, patient-centered processes that focus on highly coordinated care and long-term participative relationships. The PCMH model demonstrates the benchmarks of patient-centered care, including same day appointments as needed, expanded hours, 24/7 access to a provider, and appropriate use of proven health information systems. Research shows that medical homes can lead to higher quality and lower costs, and improve patients’ and providers’ reported experiences of care. Infection Control Preventing the spread of infections is a key goal of health care providers. Data related to infection prevention strategies is reported to both the national and Maine Centers of Disease Control (CDC). Starting in 2012, secret shoppers from the Maine Infection Prevention Collaborative in partnership with the Maine CDC, began visiting Maine hospitals to report hand hygiene compliance rates. Franklin Memorial Hospital’s reported hand hygiene compliance rate is 91 percent, well above the mean hand hygiene rate for the state, which is 81 percent.


Excellence: To become the best we can be.

Professional Practice Councils This past year the Nursing Department initiated formal collaborative relationships with staff and managers from patient care departments in the form of interdisciplinary professional practice councils. The council members have identified patient safety topics that bridged all disciplines and developed measurable goals and outcomes to increase quality in all areas of the hospital and office settings. The councils have been given oversight of a variety of projects such as patient safety, patient experience, medication safety, and professional development. Increased collaboration has created a sense of shared accountability and responsibility for quality outcomes and best-in-class performance across interdisciplinary lines. Cardiac Rehabilitation Certification In August 2012, the hospital’s cardiac rehabilitation program achieved its first-ever certification by the American Association of Cardiovascular and Pulmonary Rehabilitation. The application process required extensive documentation of the program’s practices. Cardiac rehabilitation is an individualized program of monitored exercise and education to help patients recover after a heart attack or heart surgery. A team of registered nurses, dieticians, diabetes educators, respiratory therapists, and a cardiologist work together to ensure that patients regain strength, prevent their condition from worsening, and reduce risks of future heart problems.

excellence Employee Influenza Immunization Rates In November, representatives from the Maine Centers for Disease Control and Prevention (CDC) presented officials at Franklin Memorial Hospital a certificate for vaccinating more than 85 percent of its employees against influenza last flu season. Just 15 of 40 Maine hospitals achieved or surpassed this level. The FMH rate of flu vaccination for employees was 89.4 Pam Hadley percent, while the average rate for Maine hospitals was 77.1 percent. According to Pam Hadley, infection prevention and control/employee health coordinator, vaccine for employees is offered by all Franklin Health medical practices, the Androscoggin Valley Medical Arts Center, and at rotating locations throughout the hospital, September through December. Patient Financial Services Franklin Memorial Hospital is committed to treating all patients who need care regardless of their health insurance or ability to pay. In June, our patient financial services fully relocated to the Greenwood Building on our campus with the goal of providing comprehensive and seamless patient financial services, and exemplary customer service for our patients. Our patient financial advocates (PFA) were extensively trained before this transition in order to assist all patients with any financial questions and payment issues that may arise. They can help explain confusing bills, set up payment plans, or make arrangements for financial assistance to those who qualify. For patients’ convenience, the office is available for walk-in assistance Monday–Friday, 8 a.m.–4:30 p.m., or by telephone after business hours until 8 p.m. PFA are additionally available to go to departments where a patient is being seen to provide one-on-one assistance at the point of care.

From top: In June, Patient Financial Services fully relocated to the Greenwood Building; The cardiac rehabilitation team includes Vicki Adams, RN, Paul Sweeney, MD, and Meghan Hoar, CRT; Part of the team at NCQA-recognized Franklin Health Farmington Family Practice includes: Sue Gallant, MA; Bert Audette, DO; Nancy Taylor, RN-care support nurse; Kelly Eldridge, MA; and Lucy Sorensen, business office.


Donor Spotlight Battle for Breast Cancer Tournament Paula Doughty, Skowhegan High School field hockey coach and a resident of Farmington, came up with the idea of having a benefit field hockey tournament in 2011 as a means to get her players and others involved in a rewarding community fundraising project. Doughty chose the Martha B. Webber Breast Care Center to be the beneficiary of the event she spearheaded with 100 percent of funds raised to be used for working people with breast cancer who are uninsured or underinsured. Doughty, together with longtime friend and hospital volunteer Elizabeth Richards, organize the tournament each year, and education of the players is of utmost importance. Prior to the tournament, players learn about mammograms and breast cancer through videos and discussions with breast cancer survivors and staff of the breast care center. And, every team is offered a tour of the center. This year the tournament was moved to Thomas College so more teams could participate. There, two games take place simultaneously on side-byside turf fields. Eight Central Maine high school field hockey teams took part: Skowhegan, Winslow, Messalonski, Mt. Blue, Lawrence, Mt. View, Leavitt, and Nokomis.


“In the end the unified effort of all involved to do something good for their greater community is the most rewarding aspect of the event.” –Paula Doughty

A moving closing ceremony has become a highlight of the tournament. As dusk arrives and the final games end, players, coaches, parents, and fans holding pink and white inspirational balloons release them into the sky with their thoughts of hope, prayers, and memories of loved ones. Franklin Community Health Network extends its thanks to Doughty and Richards, along with the many student-athletes, coaches, volunteer referees, parents, businesses and others who have and continue to support this successful event. This year’s tournament proceeds exceeded $25,000.

Donor acknowledgement of all gifts received between July 1, 2012 and June 30, 2013 can be viewed on our Web site at

The charitable gifts of our friends and neighbors support the work and vision of Franklin Community Health Network.

From left clockwise: Winslow and Mt. Blue High School field hockey teams compete against one another during in the Battle for Breast Cancer tournament; A moving inspirational balloon release has become a highlight of the tournament; As dusk arrives players, coaches, parents, and fans gather for the closing ceremony.


Franklin Community Health Leadership Award Each year, Franklin Community Health Network presents the Community Health Leadership Award to an individual who has worked to improve the health of his or her community and its members. Through the award, FCHN recognizes the unsung heroes who work to ensure that those around them achieve their greatest health potential. Gerald Cayer, MPH BU '90, UMF '85 Franklin Community Health Network’s executive vice president was the recipient of the Franklin Community Health Leadership Award in September 2012. Cayer was cited for advancing the availability of dental services through a collaboration with Community Dental; recognizing local veterans for their service to our country; and leading a local campaign organizing men and boys to take a stand against domestic violence in collaboration with Safe Voices. Utilizing his public health background this past October, Cayer shared a concept with the local domestic violence task force of creating a powerful visual representing the 15 individuals who had been killed at the hands of a “loved” one since May 2011. The resulting dramatic high contrast black and white placards depicting the victims’ silhouettes were created and displayed at numerous statewide domestic violence awareness events including: the University of Maine Farmington, Husson College, Cony High School, the Androscoggin Valley Medical Arts Center, the Franco-American Heritage Center, and the Blaine House; and at Safe Voices annual meeting. A Marine Corps veteran, Cayer’s recent public service work beyond Franklin Community Health Network is vast and a sampling includes: Safe Voices Franklin County Task Force, University of Maine Farmington (UMF) Board of Visitors, Search Committee for UMF VP of Advancement, DHHS and Maine Hospital Association Licensing Reform Committee, the Muskie School MPH Advisory Committee, past chair of the American Lung Association, and the search committee for a new Waterville High School varsity basketball coach. An avid sports fan, Cayer is also a youth basketball and baseball coach, a volunteer supporting high school basketball, and a member of the International Association of Approved Basketball Officials Maine Board 20, and the Kennebec/Somerset Baseball Umpires Association. For fun and competition, Jerry plays ball for the Notre Dame Knights. He resides in Waterville with his wife Tami and their children: Chelsea, Ethan, and Annie; and dog Molly.


“We must take a stronger role in supporting the healthy development of our boys; all boys must have the opportunity to develop into healthy men. Healthy men do not pull triggers of guns aimed at women and children.”–Gerald Cayer

Finances Franklin Community Health Network and Subsidiaries Unaudited Consolidated Statement of Operations Fiscal Year Ended June 30, 2013 Financial Highlights • Operating loss of $8.4 million for fiscal year ended June 30, 2013 • Committed $1.1 million from operations toward capital projects and equipment during the year • Provided $6.6 million in charity care to patients of Franklin Memorial Hospital • Provided $54 million in salaries and benefits for the local economy employing over 800 individuals • Network friends provided $206,724 in donations Patient Services Amount Billed.......................................................................................... 167,253,891 Less amounts not received from Medicare, MaineCare and other insurance companies........................................................................................................... (86,789,944) Less amounts not received because of the Network’s commitment to access for all......... (6,622,920)

Net Patient Services Revenue Received...................................................................... $73,841,027 Other Operating Revenue.........................................................................................................3,056,137

Net Revenue......................................................................................................................... $76,897,164 Total Operating Expenses....................................................................................................... 85,342,783

Net Bottom Line From Operations...............................................................................($8,445,619) Other Nonoperating Gains/Losses..........................................................................................(1,166,402)

Loss from Operating the Network..........................................................................($7,279,217)


Our Leadership Franklin Community Health Network Leadership Team

Franklin Memorial Hospital Medical Staff Executive Committee

Rebecca Ryder, President/CEO

Joline Hart, Vice President Human Resources

Jacques Belair, MD Chief of Maternal Child Health Services

David Hyde, DO Medical Director

Heidi Decker, MD Chief of Primary Care Services

Wayne Bennett, Vice President and Chief Financial Officer Gerald Cayer, Executive Vice President, Chief Operating Officer Mavis Dubord, RN Director of Clinical & Administrative Services, Franklin Health Pam Ernest, RN, BSN, MSB, Chief Nursing Officer, Vice President Patient Care

Ralph Johnson, Chief Information Officer Jay Naliboff, MD, Medical Director, Franklin Health Michael Rowland, MD, MPH, Vice President Medical Staff Affairs

April Guagenti, Executive Director, Evergreen Behavioral Services

Pamela Ernest, RN, BSN, MSB, Chief Nursing Officer (exofficio member) Michael Fraley, MD President-elect David Hyde, DO FMH Medical Director

Larry Labul, DO Chief of Adult Medicine Services G. Thomas Marshall, MD Secretary/Treasurer Robert O’Reilly, DO Medical Staff President Michael Rowland, MD Vice President Medical Affairs Rebecca Ryder President/CEO (ex-officio member)

Evergreen Behavioral Services Board Annette Backus

Western Maine Physicians Hospital Organization


Susan Kearing, DO Chief of Surgical Services

Wayne Bennett

Shane Lydon, MD

Joseph Caldwell, MD

Rebecca Ryder

David Dixon, MD

Kristine Sanden, DO

Mavis Dubord

Tom Walker

Michelle Knapp, DO

Paul Wooden, MD

Jennifer Chretien Walter Gooley Jack Peck, Secretary

Rebecca Ryder, President/CEO, Chair Stephen Zanella, DO Rhonda Wiles-Rosell Treasurer

The tradition of the annual meeting of Franklin Community Health Network is a reminder that Franklin Community Health Network and its affiliates remain community-owned and community-centered.

Our boards give unselfishly of their time and talent to achieve the mission of franklin community health network. Healthy Community Coalition Board

Franklin Community Health Network and Franklin Memorial Hospital Board

Becky Davis-Allen, Treasurer

Connie Adler, MD

Peter Judkins

Emma Ansara, FNP

Ron Aseltine

Randy Easter

Clinton Boothby

Chris Farmer

Joseph Bujold, Chair

Rebecca Ryder, President/CEO Paul Soucie

Patricia Flint, Secretary

Sheena Bunnell, PhD

Tracy Harty

L. Michael Fraley, MD President of Medical Staff

Betsey Hyde Scott Landry Maurice Martin, PhD Marlie Mochamer

Leslie Gatchell Gilly Hitchcock, Vice Chair

Meredith Tipton, PhD Carol Timberlake Tim Wallace Doug Walrath Waine Whittier

Jef Howell, Treasurer

Sara Mulvey Gary Perlson Rebecca Ryder, President/CEO Kawika Thompson, Chair Judy Upham, Vice Chair

Annual Report Credits: Editor and graphic design: Jill Gray, FCHN community relations manager; Photography: James Daigle, Jill

Gray, and Nancy Johnson.


Above–Rangeley Region Physical Rehabilitation is a program of Franklin Memorial Hospital located at the Rangeley Health and Wellness Pavilion on the Dallas Road in Rangeley. A broad range of outpatient orthopaedic and physical therapy services is provided for residents and visitors of the Rangeley Lakes region.

Franklin Community Health Network 111 Franklin Health Commons Farmington, Maine 04938 207-778-6031 800-398-6031 (in Maine)

Franklin Community Health Network Annual Report 2013