2024-08-14T10:54:40-07:00 2023-09-30 990 2022-10-01 050258954 Rhode Island Hospital RHOD 4014444000 593 Eddy Street Providence RI 02903 Peter K Markell Treasurer 2024-08-14 true 2022 2024-08-08 14:25:15Z John Fernandez 593 Eddy Street Providence RI 02903 2133719604 false X www.rhodeislandhospital.org X 1863 RI As a founding hospital in the Lifespan health system, Rhode Island Hospital (RIH) is committed to its mission: Delivering health with care. 16 10 10564 622 3623230 226591 31096513 22502740 1735923678 1947305531 -10057212 22321225 -3438494 -7190757 1753524485 1984938739 1089144 1139002 0 684650846 739595418 0 0 1107964290 1212937750 1793704280 1953672170 -40179795 31266569 1447653955 1459844730 661025952 619668440 786628003 840176290 X As a founding hospital in the Lifespan health system, RIH is committed to its mission: Delivering health with care. false false 1560950831 1139002 1818604299 Patient Care:RIH is the State's largest hospital, and its only Level I trauma center and verified burn center. It provides a comprehensive range of diagnostic and therapeutic health care services to inpatients and outpatients. RIH has particular expertise in cancer, cardiology, diabetes, emergency medicine, neurosciences, orthopedics, and more. Hasbro Children's Hospital (HCH), RIH's pediatric division, is the region's premier provider of pediatric clinical care. HCH offers a broad spectrum of both routine care and specialty programs not available elsewhere and has the only pediatric emergency department, Level I trauma center, pediatric critical care teams, and 24-hour ambulance in the region. (Continued on Schedule O) 141584115 20654196 Medical Education:RIH provides the setting for and substantially supports medical education in various clinical training and nursing programs. RIH is designated as the Principal Teaching Hospital of The Warren Alpert Medical School of Brown University. The total cost of direct medical education provided by RIH exceeded the reimbursement received from third-party payors by $120.9 million in fiscal year 2023. (Continued on Schedule O) 87130455 89960044 Research:RIH conducts extensive medical research and is in the forefront of biomedical health care delivery research and among the leaders nationally in the National Institutes of Health programs. RIH also sponsors a significant level of research activities. Federal support accounts for approximately 57% of all externally funded research at Lifespan. Researchers focus on basic research projects and clinical trials which investigate prevention and treatment of HIV/AIDS, obesity, cancer, diabetes, cardiac disease, neurological problems, orthopedic advancements, mental health concerns, and brain science. Included in the totals are $2.6 million of research grants from for-profit organizations that are not reported in Schedule H. (Continued on Schedule O) 1789665401 true true false true false false false true false true true false false true true true false true false false true false false false false false true true true true true true false false false false false false false false false true true false false false true true true true true false true 497 0 true 10564 true true true false false false false false false 0 false false false false false false false X 16 10 true false false false true true true true true false false true true true true true true true true true true RI X Peter K Markell 4014447914 167 Point Street Providence RI 02903 X Timothy J Babineau Fmr. Trustee 0.00 0.00 0 6453503 383339 Ziya L Gokaslan MD Trustee 0.50 42.50 X 0 1671096 49960 Todd A Conklin CPA Fmr. Key Employee 0.25 50.00 0 956612 19333 Saul N Weingart MD PhD Pres. - 4/23 60.00 2.00 X 0 887216 48295 Paul J Adler Secretary 23.75 16.25 X 0 744106 145044 David A Kirshner Treas.- 11/22 0.00 0.00 X 0 857218 20609 G Dean Roye MD Chief Medical Officer 50.00 0.00 582160 0 129525 G Alan Kurose MD Fmr. Trustee 0.00 50.00 0 636825 63815 Nicholas P Dominick SVP of Service Lines 40.00 0.00 0 420990 93800 Cynthia H Danner Chief Nursing Officer 40.00 0.00 435220 0 29995 Arthur J Sampson Pres.- 1/23 0.00 8.00 X 0 417696 18300 Eric Klein MD Physician 40.00 0.00 369954 0 42667 Qian Chen MD Sr. Researcher 40.00 0.00 346758 0 49594 Donna Marasigan Registered Nurse 40.00 0.00 357163 0 29112 Christie Rath VP Supply Chain 20.00 20.00 262465 83648 36531 Anna P Ferreira Registered Nurse 40.00 0.00 338919 0 10972 Eva Greenwood Treasurer 0.50 39.50 X 0 198973 34915 Lawrence A Aubin Sr Chair 1.00 7.00 X X 0 0 0 Emanuel Barrows Trustee 1.50 5.50 X 0 0 0 Roger N Begin Trustee 2.00 10.50 X 0 0 0 Peter Capodilupo Vice Chair 0.00 5.00 X X 0 0 0 Sarah T Dowling JD LLM Trustee 3.00 10.00 X 0 0 0 Edward D Feldstein Esq Trustee 0.10 2.00 X 0 0 0 Michael L Hanna Trustee 2.00 6.60 X 0 0 0 Phillip Kydd Trustee 1.00 5.50 X 0 0 0 Alan H Litwin Vice Chair 1.00 8.50 X X 0 0 0 Martha B Mainiero MD Trustee 1.00 2.10 X 0 0 0 Steven Pare Trustee 0.00 3.00 X 0 0 0 Lawrence B Sadwin Trustee 2.00 15.00 X 0 0 0 Shivan Subramaniam Trustee 0.25 5.25 X 0 0 0 Jane Williams PhD RN Trustee 7.00 25.00 X 0 0 0 John Fernandez President 7.00 43.00 X 0 0 0 Peter K Markell EVP & CFO 6.00 44.00 X 0 0 0 2692639 13327883 1205806 1201 true true false AMN Healthcare 2735 Collection Center Dr Chicago IL 606930027 Contract Labor 41524728 Brown Medicine 110 Elm Street Providence RI 02903 Medical Services 38331915 Brown Surgical Associates 75 Newman Avenue Rumford RI 02916 Medical Services 13445256 AYA Healthcare PO Box 123519 Dallas TX 753123519 Contract Labor 8817463 Brown Emergency Medicine 125 Whipple St 3rd Fl Providence RI 02908 Medical Services 8794974 95 13864297 7564586 1073857 26000 22502740 Direct Rev from Research 900099 89960044 89960044 Lifespan Pharmacy 446110 224092693 224092693 Patient Service Revenue 900099 1625217633 1625217633 Rental 531120 7250735 7250735 Temp Restricted (SPF's) 900099 784426 784426 1947305531 16133363 16133363 0 0 3389660 2234560 1155100 1155100 1155100 152653736 1200 146385756 81318 6267980 -80118 6187862 6187862 0 0 76948 79231 -2283 -2283 Cafeteria Revenue 722210 6026088 6026088 Lab Services Revenue 621500 2300305 2300305 Other/Services Rendered 900099 2795664 2795664 -19465631 -20882656 1325208 91817 -8343574 1984938739 1929218539 3623230 29594230 X 1104002 1104002 35000 35000 0 0 1292135 1292135 0 570996012 569237879 1758133 34581295 34581295 92130221 91799869 330352 40595755 40386592 209163 0 0 0 15365 15365 0 1124792 1124792 208053464 208053464 179802 178802 1000 37932483 29398757 8533726 0 0 32380458 27098994 5281464 1541579 1537034 4545 0 2748566 2725496 23070 9325309 9325309 0 58225088 53404825 4820263 21409271 21409271 Medical & Surgical Supplies 493599800 493594783 5017 Purch Svs & Equip Contracts 192973975 53277059 139696916 License Fee 71822639 71822639 Provision for Bad Debts 47706611 47706611 33898548 32972355 926193 1953672170 1789665401 164006769 0 6724459 353930 51009894 43998077 12492201 12010479 165027850 180136217 0 0 0 34252212 36641204 4539007 4964339 1124115742 647722674 498508627 476393068 309972336 353489958 61103738 58184694 0 0 304023631 293672764 1447653955 1459844730 139275778 132770929 811819 348032 150888983 137394352 147750000 147750000 14708188 13088938 207591184 188316189 661025952 619668440 X 393450696 420824437 393177307 419351853 786628003 840176290 1447653955 1459844730 X 31266569 28793229 -6511511 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 15365 15365 false false Part II-B, Line 1i - Other Activities Description RIH pays membership fees to 340B Health, America's Essential Hospitals, the Association of American Medical Colleges, and the Greater New York Hospital Association. A portion of the membership dues paid to these organizations is allocated to their lobbying efforts. Part IV - Additional Information 76305 X false 532724063 127087720 50052523 135904905 573959401 722992773 98490852 -79688422 209071140 532724063 475684077 302153870 107027228 161872402 722992773 463288111 82296737 36982884 106883655 475684077 480080475 74419354 9352353 100564071 463288111 0.40700 0.07140 0.52160 true true true 35133997 35133997 773900914 470825644 303075270 302440784 176897030 125543754 12640047 12640047 476393068 Deferred Financing Costs 1535680 Intercompany Receivables 4241794 Interest in Net Assets of RIH Foundation 70482740 Other Non-Current Assets 618172 Other Receivables 26269816 Right-of-Use Assets,Net Operating Leases 28239813 293672764 Accrued Interest Payable 3952870 Accrued Pension Liability 52057600 Health Care Benefit Self-insurance 6134534 Operating Lease Liabilities 28239813 Other Liabilities 65898050 Post-retirement Benefit Liability 4789200 Third-party Payor Settlements 27244122 188316189 X Part III, Line 4: Description of organization's collections and how it furthers its purpose. Rhode Island Hospital's (RIH) collection of artwork consists of paintings, photographs, etchings, silkscreens, watercolors, charcoals, and lithographs. The works of art are displayed throughout the RIH campus for the viewing pleasure of patients, visitors, and employees. Part V, Line 4: Intended uses of the endowment fund. RIH's endowment funds consist of both donor-restricted endowment funds and funds designated by RIH to function as endowments. RIH's largest permanently restricted endowments support patient care, particularly cardiology, hematology/oncology, and neurology, as well as pediatric care at RIH's pediatric division, Hasbro Children's Hospital (HCH), research, and charity care. RIH's unrestricted endowment includes designated assets set aside by RIH's Board for future capital improvements, over which the Board retains control and may at its discretion subsequently use for other purposes.Significant temporarily restricted funds held by RIH are used for the purposes of: (1) the care and treatment of crippled children;(2) cardiology fellowship educational support; (3) orthopedic research; (4) strategic energy management planning; and (5) building maintenance and improvements. Part X : FIN48 Footnote RIH is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and is exempt from Federal income taxes pursuant to Section 501(a) of the Code. RIH recognizes the effect of income tax positions only if those positions are more likely than not to be sustained. Recognized income tax positions are measured at the largest amount of benefit that is greater than fifty percent likely to be realized upon settlement. Changes in measurement are reflected in the period in which the change in judgment occurs. RIH did not recognize the effect of any income tax positions in either 2023 or 2022. true Central America and the Carib 0 0 Program Services Research 16880 East Asia and the Pacific 0 0 Program Services Research 93847 Europe 0 0 Program Services Research 430171 South America 0 0 Program Services Research 109288 South Asia 0 0 Program Services Research 376337 Sub-Saharan Africa 0 0 Program Services Research 145187 1171710 1171710 false false false false false true Part I, Line 2 - Grantmakers Explanation For Monitoring Use of Funds Outside US When a foreign institution is the subrecipient of an award received by a Lifespan affiliate, the following procedures are adhered to: A subrecipient agreement is prepared and executed between the foreign institution and the Lifespan affiliate. The agreement describes the funding source, terms and conditions of the award, statement of work, payment method, and audit process. The foreign institution prepares an invoice to the Lifespan affiliate for expenses incurred under the agreement. Once received, the invoice is reviewed and approved by both the principal investigator at the Lifespan affiliate and the responsible research administrator in the Lifespan Office of Research Administration.Check requests and wire transfer forms are prepared by the principal investigator, approved by the responsible research administrator, and forwarded to the Finance Department, where payment is processed to the foreign institution.Additionally, when the award is a federal award, a questionnaire is completed by the appropriate subrecipient official supplying information about the foreign institution's financial system and method of accounting for the award. A request is also made for the institution's audited financial statements. When a foreign individual is not associated with an institution, a Professional Services Agreement (PSA) is executed and the individual sends an invoice to the Lifespan affiliate principal investigator associated with the project or sponsored agreement that states the number of hours, dates of services, work performed, expense reimbursement request, and compensation amount. The same approval and payment process is used as described above.Expenditures related to foreign activities are recorded on the accrual basis of accounting. true true true X true X true true true false true true 26339540 6013332 20326208 0.01070 426562855 383086103 43476752 0.02280 452902395 389099435 63802960 0.03350 401088 45613 355475 0.00020 141584115 20654196 120929919 0.06340 56331597 42612778 13718819 0.00720 91146247 74715343 16430904 0.00860 375736 375736 0.00020 289838783 138027930 151810853 0.07960 742741178 527127365 215613813 0.11310 true 13108796 853579 192737811 195864993 -3127182 X true true 1 1 Rhode Island Hospital 593 Eddy Street Providence RI 02903 http://www.rhodeislandhospital HOS00121 X X X X X X Rhode Island Hospital 1 false false true X X X X X X X X X X 22 true true false true X See Schedule H, Part V, Section C X true 22 true See Schedule H, Part V, Section C false false true X 200.0000 300.0000 X X X X X X true true X X X X true X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X X X X X X X true X false X X X X true X false false Facility: Rhode Island Hospital - Part V, Section B, Line 3j Part V, Line 3e- On February 27, 2020, the first patient with COVID-19 was admitted to a hospital in Rhode Island, moving the nations smallest state onto the worldwide coronavirus map. After that date, cases began to increase quickly throughout the state. The first stay-at-home order was issued on March 20, 2020, requiring all Rhode Island residents to stay at home unless getting food, medicine, or other essentials. Originally scheduled to remain in effect until April 13, the order also banned gatherings of more than five individuals and required out-of-state visitors to quarantine for 14 days. As cases increased, Governor Gina Raimondo announced on April 23 that schools would remain closed for the rest of the academic year. Many hospitals also postponed elective and non-emergent procedures until a later date. By April 28, 2020 COVID hospitalization rates were at their first all-time high at 373, with 88 of these patients in the ICU and 59 on ventilators. Eventually, hospitalization rates and case numbers began to decrease, reaching a low on July 7, 2020 with only 58 Rhode Islanders hospitalized due to COVID.During the month of July 2020, the state started to slowly re-open allowing some beaches, restaurants, and entertainment businesses to resume operations (with maximum capacity restrictions), and hospitals to begin performing elective procedures again. By fall, most schools were also able to open up again. After an increase in COVID cases in November, 2020, Raimondo announced a statewide pause reclosing many bars, gyms, and recreational venues By December 15, 2020, hospitalization rates reached a high of 514 inpatients.After this COVID peak, rates slowed for a period, partly due to the distribution of vaccines that started in February 2021 with doses initially being offered to individuals aged 75 and older. After first distributing the vaccine to those most at risk, Rhode Island gradually allowed other groups of residents to register.On July 20, 2021, hospitalization rates hit another low when only 23 patients were admitted with a diagnosis of COVID. However, as the season changed to winter, rates spiked again with a new all-time high of 618 inpatients on January 17, 2022. Despite this being the highest record of hospitalizations, the greatest number of COVID-related fatalities still occurred at the beginning of the pandemic.Since the beginning of 2022, COVID rates have decreased, with a slight increase as of the drafting of this report (June, 2022). Overall, the town of Central Falls has the highest rate of COVID cases in the state, followed by Pawtucket, East Greenwich, and Providence (respectively at 2nd, 3rd, and 4th place). In contrast, the towns of Little Compton and Jamestown have the lowest COVID rates and related hospitalizations. Across the state of Rhode Island, over 8 million COVID tests have been administered; approximately 400,000 positive cases have been reported; and over 3,500 COVID-related deaths have occurred. As of the June 2022, 98.5% of the Rhode Island population is at least partially vaccinated; 83% have completed their primary series; and 41.2% have received boosters. These statistics vary depending on age, gender, and race. For example, 99% of residents between the ages of 70 and 79 have received their primary COVID-19 vaccine series while those between 19 and 24 have a lower primary vaccination rate of 62.2%.Specifically at RIH, visitation was suspended with the exception of one parent/guardian for pediatric patients on March 9, 2020. By March 18, elective procedures at RIH were suspended. A week later, on March 26, 2020, John Murphy, MD, interim president of RIH and HCH, agreed to stay on as president, delaying his planned retirement, as well as continuing to lead Lifespan's COVID-19 response as incident commander. An additional week later, on April 3, RIH established its first warm unit on the Medical Intensive Care Unit. April 27, 2020 marked the day the Lifespan Alternative Hospital Site, operated by RIH and one of two alternative hospitals stood up in Rhode Island, was ready for operations. Just two days later, the state experienced the largest one-day volume of COVID-positive inpatients (241), as the first wave crested. With COVID cases declining, restrictions on elective procedures were lifted on May 11, 2020. Six months later, on December 14, 2020, RIH became the first hospital in Rhode Island to begin vaccinating frontline workers with the Pfizer COVID-19 vaccine and by October 1, 2021, 98% of Lifespans workforce was vaccinated against COVID-19. RIH and HCH research milestones include: Lifespan researchers were at the forefront of investigating the potential of remdesivir, the experimental antiviral drug from Gilead Sciences, Inc., to shorten the course of COVID-19 illness in patients being treated at TMH, NH and RIH. HCH offered monoclonal antibody treatments to pediatric patients who contracted COVID-19. HCH joined the $470 million Researching COVID to Enhance Recovery (RECOVER) Initiative to study the impact of Long COVID in infants, children, and adolescents. The nationwide study includes such partners as NYU Langone Health, Virginia Commonwealth University, and Northeastern University. Through a series of multicenter trials, RIH teamed up with researchers at Johns Hopkins University to test the efficacy of convalescent plasma therapy as a potential early treatment for COVID-19. Regarding the significant needs identified in RIH's 9/30/2022 CHNA, those needs have been prioritized in order of significant needs of the community, as determined by a steering committee comprised of the Community Liaisons, RIH liaison, Lifespan Community Health Institute (LCHI) leadership, RIH leadership, and Lifespan leadership. Facility: Rhode Island Hospital - Part V, Section B, Line 5 The CHNA process involved the integration of information from a range of data sources to identify the significant health needs of the community served by RIH, prioritization of those needs, and identification of resources, facilities, and programs to address the prioritized needs. Both qualitative primary data and secondary quantitative data were gathered to identify the significant health needs of the community. Additionally, the ongoing COVID-19 pandemic has impacted the health concerns of the communities served by RIH as well as the hospitals provision of health services.The primary data sources included community health forums, individual surveys, and key informant interviews. Secondary data sources included national and local publications of state-specific data. These sources varied in sample size, method of data collection and measures reported, but all are publicly available sources, and in each case, the most recent publicly accessible data was presented. The data sources are described in more detail below.Community Health Forums:Qualitative data was collected through Community Health Forums (CHFs) to solicit input from individuals representing the broad interests and perspectives of the community. Participants in the CHFs included members of the medically underserved, low-income, and minority populations in the RIH service area.Community forums are a standard qualitative social science data collection method, used in community-based or participatory action research. Six CHFs were held between April 5 and May 31, 2022 across the RIH service area. Participants were recruited using social media, electronic newsletter, email, and word of mouth. A mix of in-person and virtual forums were scheduled at easily accessible locations and at various times of the day. In-person RIH forums were held at a federally qualified health center and a local elementary school. At each in-person forum, a full meal was provided, along with childcare and interpretation if requested in advance. All CHF were open to the public and participants were fully engaged throughout the 90-minute discussion. In lieu of the provision of a meal, five $25 grocery store gift cards were raffled off as an appreciation of participation at each virtual forum. A community outreach representative of RIH served as a hospital liaison to help plan and facilitate the CHF. The hospital liaison was a critical link between the LCHI as the coordinating body, the expertise and resources within the hospital, and the Community Liaisons described below.An important and unique component of the CHF was the involvement of Community Liaisons. Seven people representing the diverse populations served by RIH were hired as consultants to assist with the CHNA but due to varying circumstances in the lives of the community liaisons, only three were able to fulfill the role of a community liaison. These Community Liaisons helped plan the CHF, recruited participants, and co-facilitated the forums. Community Liaisons were chosen through a competitive selection process and completed a 2-hour training prior to leading the CHF. The training included project planning tips, role-playing activities, conflict management tips, and logistical expectations. Community Liaisons were responsible for identifying an accessible community venue for each forum, selecting a food vendor and menu that would be appealing to the target audience, and co-facilitating the discussion at the CHF with their hospital liaison.Each CHF was two hours in duration and followed a similar format that began with a meal, followed by a 90-minute discussion, co-facilitated by RIH and the Community Liaison. The discussion generated consensus on the participants health concerns, their prioritization of those concerns, and their ideas for how RIH could respond to those concerns. Discussion began with a brief presentation of RIHs 2019 CHNA priorities and examples of activities RIH has performed in response. Participants were invited to share their reactions to what was presented as well as their current health concerns. Virtual forums were 90 minutes in duration and followed the same discussion format as the in-person CHF. The input gathered during the CHFs was assessed qualitatively to extract themes and quantitatively to determine the frequency with which those themes were cited. Community Liaisons also met with the LCHI and the hospital liaison to debrief the forums and offer their interpretation of the findings to ensure all input was captured and that priorities were appropriately aligned.Hiring, training, and empowering community members to serve as Community Liaisons in the CHNA process enriched the quantity and quality of community input. It also allowed RIH to build relationships with communities that might not otherwise have become aware of or engaged in the needs assessment process.Individual Surveys:To broaden the reach of community input, an online survey was promoted, and paper surveys were distributed and collected by LCHI staff at community events they attended in June 2022. The surveys addressed the same questions as the CHFs. Sixty-six individual surveys were received for RIH.Key Informant Interviews:Public health and health policy leaders who could inform the 2022 CHNA process and had knowledge, information, or expertise about the community that RIH serves were invited to be interviewed as part of the CHNA. Key informant interviews were conducted with these leaders to supplement the other quantitative and qualitative data collected. Key informants included: Chief Strategy Officer, Executive Office of Health and Human Services, State of Rhode Island Director of Policy, Planning and Research, Executive Office of Health and Human Services, State of Rhode Island Director, Health Equity Institute and Maternal and Child Health, Rhode Island Department of Health Vice President and Chief Medical Officer, Providence Community Health Centers Executive Director, Rhode Island Parent Information Network Director, Community Health Worker Association of Rhode Island Executive Vice President and Chief Medical Officer, Blue Cross Blue Shield Rhode IslandThe key informants identified the following statewide health priorities, with the first three named by multiple leaders: Apply hospital resources to address the social determinants of health, including housing, food, transportation, and employment, among other barriers to care. Improve access to behavioral health care for children and adults, especially noting access challenges for children and the burden of substance misuse among adults. Ensure the provision of equitable care with particular attention to ensuring equal access to high quality care for persons regardless of their race, ethnicity, language spoken or disability status. They noted that equitable care also required a workforce representative of the patients and implementation of the principles of anti-racism. Improve access to primary and specialty care locally. Grow the healthcare and behavioral health workforces through career pathways, higher reimbursement rates, and increased compensation. Improve access to community-based services including home-based therapeutic services for children with special needs. Reduce racial and ethnic disparities in maternal and child health.The interviewed leaders noted several opportunities for hospitals to contribute to efforts to address these goals including: innovate around care delivery models for behavioral health services for adults; invest in systems and technology to facilitate improved care coordination between primary and specialty care, as well as hospital and community-based providers; partner with state and community-based agencies on workforce development pathways for high-demand roles- notably behavioral health providers and community health workers; provide assistance to patients to help them navigate the healthcare system; and sustain access to telemedicine that was made available during the peak of the COVID-19 pandemic. Facility: Rhode Island Hospital - Part V, Section B, Line 6a The Miriam HospitalEmma Pendleton Bradley HospitalNewport Hospital Facility: Rhode Island Hospital - Part V, Section B, Line 11 RIH's Community Health Needs Assessment issued for the fiscal year ended September 30, 2022 identified six significant health issue areas requiring a further implementation strategy. Those significant health issue areas include: (1) improve access to healthcare services; (2) increase access to mental and behavioral health services; (3) address social determinants of health; (4) assist with navigating hospital and community services; (5) provide community-based health education; and (6) assist with chronic disease management. The implementation strategy to address those significant health needs outlined between October 1, 2022 - September 30, 2025 is available at: https://www.lifespan.org/sites/default/files/2023-04/2022-RIH-CHNA-Implementation-Plan.pdfDuring the fiscal year ended September 30, 2023, RIH implemented specific actions listed below in order to address the significant community health needs outlined in its CHNA dated September 30, 2022.ACCESS TO CARE:- During the fiscal year ended September 30, 2023, The Lifespan Patient Experience Committee formed to improve patience experience through improved communication between providers, patients and caregivers. An NRC platform was selected, RIH Patient Experience Teams were formed to track metrics as well as develop improvement plans, and two key performance indicators were selected: Net Promoter Score and Average Days to Close Alerts. Additionally, a system-wide Ambulatory Committee was created with a plan to establish quality metrics in FY24 to optimize flow of the emergency department, which will will lead to an improved patient experience and reduce the number of patients who leave without being seen. Additionally, it will increase referrals to appropriate follow-up care.-Roundtrip, a cloud-based application for ordering patient rides, provides access to reliable, free or discounted transportation to medical appointments. This reduces cancelled, no-show and missed appointments and improves access to care for patients with limited mobility or challenges with transportation. -Eighteen (18) Community Health Workers (CHW) were hired among the RIH Emergency Department, Hasbro Childrens Hospital Primary Care, and RIH Inpatient. The addition of these positions in key service lines serves to improve quality of care and patient outcomes through increased colorectal, breast and cervical cancer screening rates, advancing health equity in populations who often have lower screening rates, and helping patients to overcome barriers to accessing screening services.-LCHI continued to offer free skin cancer screenings are add locations to diversify their audience. In FY23, they added two new additional screening sites/partners: Women in Agriculture Conference (19 screened) and RI Pride (49 screened). - Continue to offer community-based biometric screenings and flu clinics for low-income and uninsured residents in partnership with the Lifespan Community Health Institute (LCHI) to promote primary prevention with appropriate referrals to treatment. Provided blood pressure and glucose screenings across 60 events, serving 997 people, and provided 826 flu vaccinations during 46 free clinic events;MENTAL AND BEHAVIORAL HEALTH:-RIH is collaborating with John Hopkins University, RI Department of Education and municipal school districts to offer Mental Health First Aid (MHFA) in English and Spanish. The goal is to reduce the stigma associated with mental and behavioral health as well as increase community support by increasing in the number of individuals and school staff who can identify, understand, and respond to signs of mental illnesses and substance use disorders and who will reach out and provide initial help and support. As of 9/30/23, MHFA is offered in English and a bilingual Spanish/English MHFA trainer is being recruited.-In FY23, RIH hired an Addiction Medicine Division Director and has plans to open an Addiction Medicine Ambulatory Clinic in FY24. This will create walk-in and scheduled, culturally-sensitive visits for patients, helping to reduce barriers and disparities in evidence-based addiction treatments.-The Lifespan Transitions and Recovery Clinic at RIH recruited a new provider to increase access for patients transitioning from prison. The Clinic offers services to manage addiction disorders among the adult population transitioning out of incarceration. -Lifespan researchers contribute to statewide initiatives to reduce opioid overdose and fatality rates through research aimed at understanding the mechanisms underlying opioid use disorder, and the development of innovative solutions. The VP of Community Health & Equity continued to serve as Chair of the statewide Opioid Settlement Advisory Committee. Drs. Jody Rich and Tracy Greene continue to lead the Center of Biomedical Research Excellence on Opioids and Overdose (COBRE) at RIH, the first of its kind center in the nation, to focus on collaboratively addressing the opioid epidemic. In FY23, the COBRE received a second, five-year grant award of $12 million from the National Institute of General Medical Sciences to cultivate skilled researchers who specialize in opioid use disorders.-Through participation in the Governors Overdose Task Force and Opioid Settlement Advisory, $20 million of family and community based strategies that address social drivers of health, prevention, harm reduction, treatment, and recovery were funded in FY23.SOCIAL DETERMINANTS OF HEALTH:-LCHIs Connect for Health program worked to expand social needs screening and navigation assistance to serve key service lines including LCI, CVI and Psychiatry. Connect for Health accepts referrals from Hearts at Home (CVI), and primary care (adult, adolescent, pediatric, and medicine pediatrics) opening a total of 4,123 cases in FY23. One of the greatest social needs identified is improved food security among patients. In FY23, 76 grocery gift cards were distributed to RIH patients, and 81 patients were served by VeggieRX produce prescription program. Through Hopes Harvest, a program of Farm Fresh RI, free, fresh produce from local farms is distributed at HCH monthly. In FY23, 729 people participated in food demonstrations, Food is Medicine, and A Taste of African Heritage food & nutrition programs.-RIH contracted with Crossroads RI for four medical respite beds and partnered with RI Executive Office of Health and Human Services and other healthcare partners to open a medical respite facility, through which RIH was allocated five beds. Medical respite care is crucial is reducing length of stay and readmissions among patients experiencing homelessness.-The Center for Health and Justic Transformation (CHJT) at Lifespan hosted the first Community Grand Rounds at RIH in partnership with the Department of Medicine with more than 80 physician attendees. CHJT also developed a training series-Beyond Screen and Refer: Addressing the Social Needs of Your Patients that launched in FY23 and is available as continuing education. RIHs VP of Belonging and Equity, hired in October of 2022, will help with GME and nursing education activities.COMMUNITY-BASED HEALTH EDUCATION:-Twelve (12) Lifespan Community Health Ambassador workshops were delivered to 251 participants on topics generated by community partners. An additional twelve (12) conferences and workshops on topics requested by the community were delivered to 298 participants. The goal of these workshops is to provide access to group education and peer support in both virtual format and live events, increase referrals to and utilization of health maintenance programs, increase health literacy among attendees, and help participants understand available resources and services, as well as the benefits of risk factor management.-Sixteen (16) hands-only CPR classes were held with 141 participants trained during FY23.-Three cohorts of Diabetes Prevention Program launches with 38 people enrolled. Initiation of Medicare Diabetes Prevention Program supplier is planned for FY25.-Six (6) Tar Wars sessions were held with 229 total students in attendance. Tar Wars is a tobacco-free education program designed to reduce the initiation of tobacco products among youth and to build skills for long-lasting behavior change.-Thirty-nine (39) Safe Sitter classes were held for 379 students to provide training on safe and responsible babysitting and how to prevent unintentional injuries among children.-Twelve (12) Lifespan Community Health Ambassador workshops were delivered to 251 participants on topics generated by community partners as part of a monthly lecture series for the general public. Topics included: Oral Health Equity, Online Safety and Prevention, Overview of RI Life Index, Lead Safe Homes, Healthy Eating for Your Heart, Learning from Lifespans 2022 CHNA, Living Kidney Donation, Advance Care Plans, Building a Resilient Brain, Sleep Well Live Well, Pediatric Anxiety, and Retirement/SSI/Disability.CHRONIC DISEASE MANAGEMENT:-In partnership wi Facility: Rhode Island Hospital - Part V, Section B, Line 16j An abbreviated version of RIH's Financial Assistance Policy is posted in various admitting and outpatient areas of RIH. Additionally, registration personnel refer uninsured and/or low-income patients to Patient Financial Counselors to discuss the policy and/or answer any questions they might have. Lifespan Cancer Institute Prgm of RIH at TMH 164 Summit Avenue Providence RI 02906 Comprehensive Cancer Center Physician Visits, Infusion Therapy Lifespan Cancer Institute Prgm of RIH 1454 South County Trail East Greenwich RI 02818 Comprehensive Cancer Center Physician Visits, Infusion Therapy Lifespan Cancer Institute Prgm of RIH at Newport Hosp 11 Friendship Street Newport RI 02840 Comprehensive Cancer Center Physician Visits, Infusion Therapy Lifespan Cancer Institute 701 George Washington Highway Ste 1 Lincoln RI 02865 Comprehensive Cancer Center Physician Visits, Infusion Therapy RIH Rheumatology Infusion Center 407 East Avenue Suite 250 Pawtucket RI 02860 Infusion Services East Providence Infusion Center 375 Wampanoag Trail Suite 101A East Providence RI 02915 Infusion Services Dialysis Center of RIH 22 Baker Street Providence RI 02905 Hemodialysis, Home Peritoneal Dialysis, Home Hemodialysis RIH Norman Prince Spine Institute 690 Eddy Street Providence RI 02903 Comprehensive, multidisciplinary care for spine patients RIH Center for Wound Care and Hyperbaric Medicine 950 Warren Avenue Suite 103 East Providence RI 02914 Wound Care and Hyperbaric Medicine Radiosurgery Center of RI LLC 593 Eddy Street Providence RI 02903 Radiosurgery Services Dialysis Center of RIH 950 Warren Avenue East Providence RI 02914 Hemodialysis RIH Hasbro Childrens Outpatient Rehab Center 765 Allens Avenue 2nd Floor Suite 2 Providence RI 02905 Children's Physical and Occupational Therapy RIH Center for Primary Care and Specialty Medicine 245 Chapman Street Suite 300 Providence RI 02905 Primary Care and Specialty Medical Services RIH Pediatric Heart Center 1 Hoppin Street Providence RI 02903 Outpatient Pediatric Cardiology Services RIH Outpatient Rehabilitation Services 765 Allens Avenue 1st Floor Suite 1 Providence RI 02905 Adult Physical and Occupational Therapy Childrens Neurology & Development Clinic 335R Prairie Avenue Suite 2B Providence RI 02905 Pediatric Services Medicine Pediatrics 245 Chapman Street Suite 100 Providence RI 02905 Primary Care Medicine Lifespan Research Center 1 Hoppin Street CORO Building Providence RI 02903 Study, Design, Analysis, Medical & Regulatory Oversight Research RIH Surgery Center at Wayland Square 17 Seekonk Street Providence RI 02906 Outpatient Surgery RIH Outpatient Specialty Svcs Pedi Endocrinology 111 Plain Street 3rd Floor Providence RI 02903 Pediatric Endocrinology Services RIH Sleep Disorders Center 70 Catamore Boulevard East Providence RI 02914 Outpatient Professional and Technical Evaluation of Sleep Disorders RIH Pediatric and Adolescent Health Care Center 1 Hoppin Street Suite 3055 Providence RI 02903 Outpatient Adolescent Services Lifespan Recovery Center 200 Corliss Street Suite 1 Providence RI 02904 Treatment of Opioid and Related Drug Addictions Pediatric Multi-Discipline Clinic & Rehab Satellite 1454 South County Trail 1st Floor East Greenwich RI 02818 Pediatric Specialties & Physical Therapy inclusive of Psychiatry Ctr Innovative Neurotechnology for Neural Repair 117 Chapman Street Suite 100 Providence RI 02905 Physical Therapy Rhode Island Hospital East Greenwich Lab 1454 South County Trail East Greenwich RI 02818 Clinical Core Laboratory Testing General Internal Medicine Research Group 111 Plain Street Providence RI 02903 Behavioral Research Studies Pediatric and Adult Medicine 900 Warren Avenue 2nd floor East Providence RI 02914 Pediatric and Adult Specialty Services RIH Molecular Laboratory 167 Point Street CORO East 3rd Floo Providence RI 02903 Clinical Laboratory Testing - Molecular Diagnostics RIH Rehabilitation Services Hand Therapy 235 Plain Street Suite 203 Providence RI 02903 Occupational Therapy Lifespan Sleep Disorders Ctr-East Greenwich 1407 South County Trail Suite 430 East Greenwich RI 02818 Outpatient Professional and Technical Evaluation of Sleep Disorders Audiology and Speech-Language Pathology Services 115 Georgia Avenue Providence RI 02905 Speech-Language Pathology and Audiology Services RI Dept of Human Genetics and Genetics Clinic 111 Plain Street 2nd Floor Providence RI 02903 Human Genetics West River Infusion 148 West River Street Suite 2B Providence RI 02904 Infusion Services Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) Rhode Island Hospital (RIH) uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at RIH is intended to define probable eligibility for public assistance (Medicaid or Community Free Service ("CFS")) for those patients who do not have the means to pay for hospital services rendered, as follows:1. Upon patient indication of an inability to pay required monies, the patient is offered the financial screening option to determine eligibility for public assistance (Medicaid, CFS).2. The application for CFS is completed and includes information relative to income, expense, and other available resources, and requires proof of such information which may include:- most recently filed Federal income tax return and W-2 form(s)- copies of most recent savings and/or checking account statements- two most recently received payroll check stubs- copy of rent receipts for the last six months for proof of residency- copy of utility bills for the last month for proof of residency3. If the patient's financial situation falls within the guidelines for eligibility for Medicaid, RIte Care, or CFS, or if the patient has a long-term disability, the appropriate application process is completed. (Assistance to complete such applications is available from the Patient Financial Advocates (PFA) Office at RIH.)4. Uninsured patients receive a discount equal to the discount received by Medicare beneficiaries on RIH charges using the prospective method. Under Section 501(r)(5), the maximum amounts that can be charged to Financial Assistance Policy (FAP)-eligible individuals for emergency or other medically necessary care are the amounts generally billed to individuals who have Medicare insurance covering such care. In no case was there a situation where an uninsured patient paid more than amounts reimbursed from Medicare.5. Eligibility for CFS above the discount is provided for those applicants whose family gross income is at or below twice the Federal Poverty Guidelines, with a sliding scale for individuals up to three times the poverty level in effect at the time of application. Full charity care applicants with assets worth more than $9,400 for an individual (or $14,100 for a family) may not qualify for care without charge, but will qualify for discounted care. While the maximum 100% discount may not be available to all charity care applicants based on the results of their asset test, all uninsured patients who receive care are eligible for, at a minimum, the same charity care discount as provided by the Medicare program. 6. For patients who qualify for less than 100% of the financial assistance program, a payment schedule is determined and agreed upon (discussed further below). Payment arrangements are established prior to service for non-urgent care. 7. In any case, the final results of the financial screening are recorded in the comments section of RIH's billing system.Requests for Payment Arrangements:Patient Financial Advocates (PFA) will qualify patients that are receiving non-urgent, medically indicated procedures prior to services. The PFA will request 75% to 100% of estimated discounted charges if the balance is under $5,000 and 50% to 100% of estimated discounted charges if the estimated bill equals or exceeds $5,000.For elective or non-urgent cases, the policy requires financial clearance prior to services or an exception from the Medical Director based on the clinical circumstances if the patient cannot meet the above payment agreement.Patients who do not qualify for total or partial CFS, but who have difficulty in paying their bills after services are rendered, may request enrollment in a payment plan. Eligibility for the payment plan includes the following guidelines:1. Immediate payment in full will result in financial hardship to the patient or the patient's family.2. Deposit of one-half of the estimated total bill is requested prior to admission.3. The minimum monthly payment of $50.00.4. The maximum length of the payment plan is twenty-four months.The Customer Service staff will set up the payment plan using the above guidelines as well as complete the necessary information on the "Payment Agreement" form and mail to the patient for signature. Account documentation will be done online. The pre-collect agency will be sent a copy of the payment agreement and all forms will be scanned into the PFS Optical Imaging System. Part I, Line 6a - Related Organization Community Benefit Report The community benefit report for all Lifespan affiliated hospitals (Rhode Island Hospital (RIH), The Miriam Hospital (TMH), Emma Pendleton Bradley Hospital (EPBH), and Newport Hospital (NH)) is maintained by Lifespan Corporation and included in Lifespan's annual report. The annual report for the year ended September 30, 2022 is available at the following link. https://www.lifespan.org/sites/default/files/2023-08/LS-Annual-Report-2022-230816.pdf The annual report for the year ended September 30, 2023 is not yet available at:https://www.lifespan.org/sites/default/files/2024-08/LS-Annual-Report-2023-final-8-6-2024.pdf Part I, Line 7 - Explanation of Costing Methodology RIH's costing methodology used to calculate the amounts reported in Part I, Line 7 is as follows:a) Financial assistance at cost- involves utilization of a ratio derived from dividing patient costs, as defined, by patient charges, as defined, and applying that percentage to total charity care charges.Patient costs reported in the cost accounting system are calculated based on Medicare principles of reimbursement by reducing total operating expenses (as calculated by Form 990 requirements) by items such as bad debt expense, the cost of medical education, internally funded research, subsidized health services, community services, charitable contributions, and other operating revenue. Patient costs are then divided by patient charges to determine a ratio of cost to charges (RCC). This RCC is applied as the costing methodology for determining charity care expense.b) Medicaid- Medicaid expense is determined at cost as calculated by RIH's cost accounting system. The system uses historical costing methods applied to all patient segments based on various patient demographics and utilizations. These costing standards exclude bad debt, charity care, and the Medicaid portion of costs of health professions education, which are reported on other areas of Line 7. These expenses include Medicaid provider taxes. Direct offsetting revenue is reported as amounts received from Medicaid, as well as other payments which include reimbursement under Federal "Upper Payment Limit" (UPL) and "Disproportionate Share Hospital" (DSH) programs.e) Community health improvement services and community benefit operations- Community benefit operations expense is recorded as direct expenses incurred as reported by RIH's Community Health Services Department. Revenue received for these services is reported as direct offsetting revenue. f) Health professions education- Health professions education expenses represent direct costs related to amounts associated with resident and intern programs utilized at RIH. These costs are determined by reporting actual direct costs taken from the Medicare cost report. Direct offsetting revenue is reported as any direct Medicare reimbursements received for such services provided, as reported in the RIH's Medicare cost report.g) Subsidized health services- Subsidized health services' community benefit expense is determined by RIH's cost accounting system. These subsidized health services are recorded at cost in RIH's cost accounting system for all qualified subsidized health service divisions. This expense is adjusted to remove all related Graduate Medical Education (GME) expenses, as well as bad debt, Medicaid, and charity costs already reported in the applicable sections of Line 7. Net patient service revenue is recorded as amounts received from various payer types related to these services. Revenue associated with Medicare GME and Medicaid is excluded from the amount disclosed for subsidized health services.h) Research- RIH conducts extensive medical research focused on the prevention and treatment of HIV/AIDS, obesity, cancer, diabetes, cardiac disease, neurological problems, orthopedic advancements, and mental health concerns. For all internal and external research conducted, the costs associated with these activities are calculated by combining the direct and indirect costs as reported within RIH's cost accounting system. Revenue received for these services is reported as direct offsetting revenue. i) Cash and in-kind contributions for community benefit- Expenses for cash and in-kind community benefit contributions are incurred by RIH, including an allocation of contributions made by Lifespan Corporation on RIH's behalf. Part I, Line 7, Column F - Explanation of Bad Debt Expense The calculation of percentages disclosed for Schedule H, Part I, Line 7, column (f) "percent of total expense", does not include bad debt expense. Form 990, Part IX, Line 25 includes provision for bad debts of $47,706,611. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense The amount reported as bad debt expense is determined by applying the ratio of cost to charges (RCC) to the total charges written off to bad debt. The RCC rate is determined using data from the Hospital's cost accounting system and is adjusted for medical education, internally funded research, subsidized health services, community services, and charitable contributions. Discounts and payments are applied to patient accounts before such account balances are transferred to bad debt. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit Accounts pending transfer to bad debt are reviewed by RIH's Patient Financial Advocate staff to determine qualification for financial assistance under RIH's policy. Accounts with insufficient information to determine eligibility are assigned a separate identifying code. These accounts are ultimately transferred to bad debt if the appropriate qualifying documentation is not received. The amount reported on Schedule H, Part III, Section A, Line 3 represents the account balances at charge written off to bad debt from the pending code, which are in turn converted to cost by applying the RCC rate as identified in Schedule H, Part III, Section A, Line 2. Part III, Line 4 - Bad Debt Expense Due to the adoption of ASU No. 2014-09 in 2019 - Revenue From Contracts With Customers (Topic 606), bad debt expense is no longer reported in the audited financial statements as a separate line item, but rather is treated as a price concession. RIHs adoption of the ASU did not materially change the timing or amount of revenue recognized. However, the ASU requires that patient service revenue be presented in the statement of operations and changes in net assets at the transaction price, i.e., net of any provision for bad debts. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare shortfall for fiscal year 2023 was not treated as a community benefit.The source of the Medicare allowable costs reported on Part III, Section B, Line 6 is the Medicare cost report, Form 2552-10. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients RIH does not bill for the excess of charges over agreed upon reimbursement amounts from third-party payors. Rather, such differences are recorded as a reduction of revenue through contractual adjustments. Collection efforts are focused on copayments, deductibles, and amounts denied by insurers. After all collection attempts are exhausted, any remaining balances, including any copayments and deductibles, are written off as bad debts. RIH classifies its bad debts as uncompensated care. This does not apply to Medicaid, however, as there are no associated copayments or deductibles for this payor.RIH generally does not require collateral or other security in extending credit to patients; however, it routinely obtains assignment of patients' benefits payable under their health insurance programs, plans, or policies. Uninsured patients are offered Community Free Service and/or payment plan options.Lifespan's Patient Financial Services Department (PFS) has the responsibility for communicating and administering collection policies and procedures to all patient accounts. PFS engages the services of various pre-collect agencies as necessary. The following are highlights of the overall collection effort:* If a patient presents for admission who is not insured, staff assists the family with a Medicaid application.* If the patient is ineligible for Medicaid, a financial screening is performed to determine status of qualification for charity care. All patients without medical insurance receive at a minimum a self-pay discount calculated using the Prospective Method of amounts generally billed by Medicare.* If the patient does not qualify for charity care, PFS or the pre-collect agency attempts at least four contacts with the responsible party within the first 120 days.* If the third-party carrier denies in writing any responsibility for payment, arrangements regarding an extended payment plan are discussed with the patient.* At 120 days, if there is no payment activity or no hold placed on the account, the account is transferred to the appropriate collection agency. Part VI, Line 2 - Needs Assessment Lifespan's Office of Strategic Planning and Analysis performs population-based studies for RIH regarding the need for inpatient medical and surgical services for both adults and children and a wide range of outpatient services including: primary care office visits, specialty care, emergency services, imaging, ambulatory surgery, and specific high technology services such as radiation therapy and bone marrow transplantation. A population-based study examines the growth and changes in the population, the resources in the community, and the changing prevalence of diseases. In addition to this approach, Lifespan Strategic Planning also examines experience with wait times, the level of staffing, and the changing standards of care. All of this information is used to assess the demand for additional services to provide access to high quality care.In addition to population approaches to assessing and estimating need, all specialties and services monitor demand at the service-specific level by considering changing patterns of care and methods of treatment for the specific medical problem, wait times for visits/queues, and community resources. The service leadership then goes through a review process to add staff, expanded hours, and/or new subcomponents to round out core services on an as-needed basis. At times, expansion requires more space, equipment, and staff, but often accommodation of community demand is achieved through expanded hours. Facilities are added as needed to accommodate these expansions, but most often minor renovations of existing locations with better, more modern layouts and equipment allow for greater patient access.The Rhode Island State Certificate of Need program requires a focused study of need for all projects over $5.25 million, which is an important part of the program development process across Lifespan.Based on a broad understanding of community health needs, RIH provides a wide range of services to both its primary and secondary areas. Lifespan and its hospital affiliates monitor health trends in Rhode Island in an effort to identify areas of unmet demands regarding clinical services. Previous examples of addressing this unmet demand include RIH adding a biplane neurointerventional radiology suite, equipped with the latest technology and staff 24/7 and located less than 100 steps from the ambulance bays of RIH's Andrew F. Anderson Emergency Center. No other emergency department in the world has this stroke surgery suite within it. Two new minimally invasive treatments are offered at RIH's Comprehensive Spine Center: balloon kyphoplasty, for treatment of vertebral compression fractures, and indirect spinal decompression with an interspinous spacer device, to decompress spinal stenosis and relieve symptoms of neurogenic claudication, including pain or pressure when standing or walking. Additionally, RIH's pediatric division, Hasbro Children's Hospital, is the State's only facility dedicated to pediatric care. RIH has continued its pioneering work on treatments for inoperable tumors as well as radiofrequency ablation. Also of note is Hasbro's Medical/Psychiatric Program. This program is expressly designed for children and adolescents with challenging mental health and medical conditions who require hospitalization. A collaboration with Emma Pendleton Bradley Hospital, it is the only program in the region created to meet the complex needs of these children. In June 2022, Hasbro completed its $41 million renovation of its 6th floor unit renovation, caring for children ages 6 to 18, who are treated in a secure 16-bed unit located on the 6th floor of Hasbro Children's Hospital. This renovation was achieved through money raised as part of the "Every Child, Every Day" campaign. The unit was designed with input from both pediatrics and psychiatry to provide the very best care for children with psychiatric and medical illness. The safe, comfortable environment offers both private and semi-private rooms and areas for family, group, and milieu therapy. Part VI, Line 3 - Patient Education of Eligibility for Assistance RIH has multilingual signage in its main lobby and waiting areas which provides information on financial aid contacts. The Registration Department meets with patients at the outset of care to discuss eligibility for assistance. The Registration staff provides interested patients with a "Welcome" booklet which includes information on patient rights and responsibilities. The signage and booklets contain a telephone number which connects patients with Registration staff who can answer any additional questions that may arise after the patient has left RIH. Assistance eligibility is also summarized on RIH's website.As part of RIH's inpatient intake process, RIH provides a summary of its financial assistance policy, along with all assistance applications and the Patient Financial Services contact number, to all self-pay patients. The same process is also used for patients seen during the outpatient discharge process. Attempts are made to contact patients prior to their visit to screen for financial assistance and to inform them what documents are required for their financial assistance determination or to set up an appointment to see a "Patient Financial Advocate" (PFA) prior to service. PFAs discuss with patients the various government programs that might be available to them for financial assistance. PFAs also offer assistance with the financial application process and/or understanding the qualification factors for Medicaid, the Affordable Care Act, Medicare, Social Security Disability, the Supplemental Nutrition Assistance Program (SNAP), and Rhode Island Temporary Disability Insurance and Unemployment. This is done for both inpatient and outpatient services. Part VI, Line 4 - Community Information Rhode Island Hospital, located in Providence, Rhode Island, is a 719-bed nonprofit general acute care teaching hospital with university affiliation providing a comprehensive range of diagnostic and therapeutic services for the acute care of patients principally from Rhode Island and southeastern Massachusetts. As a complement to its role in service and education, RIH actively supports research. RIH is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and participates as a provider primarily in Medicare, Blue Cross, and Medicaid programs. RIH is also a member of the formerly-named Voluntary Hospitals of America, Inc., which has partnered with UHC Alliance Newco, Inc. to become Vizient, Inc., the largest member-owned health care company in the United States.In 1969, RIH and certain other Rhode Island hospitals entered into an affiliation agreement to participate jointly in various clinical training programs and research activities with The Warren Alpert Medical School of Brown University (Brown). In 2010, Brown named RIH its Principal Teaching Hospital. The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically. RIH currently sponsors graduate medical education programs accredited by or under the auspices of the Accreditation Council for Graduate Medical Education (ACGME), while also sponsoring hospital-approved residency and fellowship programs.With respect to nursing education, RIH has developed educational affiliations with a number of accredited colleges and universities. RIH does not receive any compensation from the various schools for providing a clinical setting for the student nurse training.RIH conducts extensive medical research and is in the forefront of biomedical health care delivery research and among the leaders nationally in the National Institutes of Health programs. Part VI, Line 4 - Community Building Activities RIH substantially subsidizes various health services including the following programs: dental, Alzheimer's, and the Center for Special Children, as well as certain other specialty services. RIH also provides numerous other services to the community for which charges are not generated. These services include certain emergency services, community health screenings for cardiac health, prostate cancer and other diseases, smoking cessation, immunization and nutrition programs, diabetes education, community health training programs, patient advocacy, foreign language translation, physician referral services, and charitable contributions. Part VI, Line 5 - Promotion of Community Health RIH is governed by a Board of Trustees, which is composed of leaders of the local community elected by Lifespan Corporation. RIH's purpose is to be staffed, equipped, and ready to serve the hospital needs of the community and its people from all walks of life. RIH works collaboratively with physicians, its employees, other health care organizations, and the community to create a measurably healthier community through the provision of high quality, cost-effective, customer-focused health care services in an environment that promotes patient safety. RIH monitors the healthcare needs of its service area to ensure alignment of its resources with its mission. RIH measures the results of the programs and services it provides based on the value added to the community as well as the financial health of each program and its impact on RIH. RIH is organized and operated for the benefit of the community it serves. Part VI, Line 6 - Affilated Health Care System Lifespan's mission is delivering health with care. Lifespan is an academically based healthcare system at the forefront of medical care, continually engaging in research that will lead to medical breakthroughs. Lifespan affiliates provide comprehensive inpatient and outpatient medical, surgical, and psychiatric services for adults and children. Lifespan and its affiliates employ approximately 17,000 people. The Lifespan system has approximately 4,100 physicians on the medical staffs of its affiliated hospitals, operates 1,165 licensed beds in four hospital complexes, and in 2023 generated approximately $2.9 billion in total operating revenue. By each of these measures, Lifespan is Rhode Island's largest health system, serving a population of about 1.1 million. Three of its hospital members, Rhode Island Hospital (RIH), The Miriam Hospital (TMH), and Emma Pendleton Bradley Hospital (EPBH), are teaching affiliates of The Warren Alpert Medical School of Brown University.Lifespan is a Rhode Island nonprofit corporation that is community-based and community-governed. As a nonprofit organization, Lifespan is run by a voluntary Board of Directors who are community representatives. Lifespan and all of its nonprofit hospital affiliates have received written notification from the Internal Revenue Service that they have been recognized as being organized and operated as entities described in Internal Revenue Code (IRC) Section 501(c)(3) and are generally exempt from income taxes under IRC Section 501(a).As of September 30, 2023, Lifespan Corporation employed approximately 1,200 full-time and part-time personnel, most of whom are located in Providence, Rhode Island. Lifespan Corporation provides support services to its affiliates, such as information services, risk management, legal, communications and public affairs, fundraising, facility development, strategic planning, internal audit/compliance, human resources, finance, payor contracting, and investment management, for which each affiliate is charged a fee equivalent to the estimated costs incurred by Lifespan in providing these services.CORPORATE AUTHORITY AND ROLELifespan Corporation has no members and is governed by its Board of Directors. The Board has responsibility for planning, directing, and establishing policies intended to assure the development and delivery of quality health services, professional education, and biomedical research on an integrated, cost-effective basis. The Board's powers include the power to set accounting policies for its affiliates, approve all managed care agreements, negotiate, develop, and approve affiliations with other institutions for educational and research purposes, and approve human resource plans, executive compensation, and benefits for system affiliates. The bylaws of RIH confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination, and support of the system. Powers specifically reserved to Lifespan as sole member of RIH include: to approve the amendment of the Articles of Incorporation and Bylaws and other Charter documents; to develop and approve strategic plans; to approve capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness.For a complete listing of affiliated members of Lifespan's integrated healthcare delivery system, please refer to Schedule R. Part VI, Line 7 - States Filing of Community Benefit Report RI Part VI - Additional Information Schedule H, Part V, Line 7:The website which makes RIH's 9/30/2022 CHNA report widely available is located at the following URL:https://www.lifespan.org/sites/default/files/2023-03/RIH2022CommunityHealthNeedsAssessment_03282023.pdfSchedule H, Part V, Line 10a:The URL to view RIH's most recently adopted implementation strategy is below:https://www.lifespan.org/sites/default/files/2023-04/2022-RIH-CHNA-Implementation-Plan.pdfForm 990, Schedule H, Part V, Line 16a: The URL to view and download RIH's Financial Assistance Policy is below:https://www.lifespan.org/sites/default/files/2023-04/2023_04_23_Lifespan-Financial-Assistance-Policy.pdfForm 990, Schedule H, Part V, Line 16b: The URL to view and download RIH's Financial Assistance Policy application form is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/cfs-english_051920.pdfForm 990, Schedule H, Part V, Line 16c: The URL to view RIH's plain language summary of the Financial Assistance Policy is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/Lifespan-Financial-Assistance-Summary_052020.pdf true Brown University 45 Prospect Street Providence RI 02912 050258809 501(c)(3) 1092502 0 General Support Rhode Island Hospital Fnd 167 Point Street Providence RI 02903 050468736 501(c)(3) 9000 0 General Support 2 0 Educational Assistance 10 35000 Grantmaker's Description of How Grants are Used Rhode Island Hospital is committed to community programs and provides support to various charitable organizations in Rhode Island and southeastern Massachusetts. Donations are made to organizations recognized by the IRS as being described in IRC Section 501(c). All contributions are approved by management and are made to organizations whose missions and goals align with those of the Hospital.Individual scholarships are awarded annually to applicants by a joint decision making body comprised of both IBT (International Brotherhood of Teamsters) and RIH representatives. Payments are made directly to qualified educational institutions on behalf of scholarship recipients. X true true X X X X X true true false false false false false true false Anna P Ferreira Registered Nurse 338528 391 10972 349891 Arthur J Sampson Pres.- 1/23 412504 5192 18300 435996 Christie Rath VP Supply Chain 237505 72708 24960 10940 24030 12501 286495 96149 Cynthia H Danner Chief Nursing Officer 357886 77334 18300 11695 465215 David A Kirshner Treas.- 11/22 662492 194726 12141 8468 877827 Donna Marasigan Registered Nurse 356957 206 29112 386275 Eric Klein MD Physician 364424 5530 18300 24367 412621 Eva Greenwood Treasurer 134109 50000 14864 27186 7729 233888 G Alan Kurose MD Fmr. Trustee 589012 36227 11586 39196 24619 700640 G Dean Roye MD Chief Medical Officer 479223 102937 96035 33490 711685 72370 Nicholas P Dominick SVP of Service Lines 341550 79440 73267 20533 514790 51863 Paul J Adler Secretary 616787 127319 116284 28760 889150 86715 Qian Chen MD Sr. Researcher 293429 50470 2859 18300 31294 396352 Saul N Weingart MD PhD Pres. - 4/23 691861 195355 18300 29995 935511 Timothy J Babineau Fmr. Trustee 1010777 3000000 2442726 358564 24775 6836842 4007802 Todd A Conklin CPA Fmr. Key Employee 221864 734748 9830 9503 975945 Ziya L Gokaslan MD Trustee 1511572 152000 7524 18300 31660 1721056 Part I, Line 1a: Relevant information in regards to selections on 1a. Tax Indemnification and Grossed Up Payments:The Lifespan Executive Long Term Disability program provides financial protection to designated Lifespan physicians and executives in the event that they become disabled. Premiums are paid to the insurance carrier by the insureds on an after-tax basis to allow for income replacement at a reasonable cost. The income associated with the premiums is grossed up to cover the total cost of the benefit as provided in the Lifespan Executive Benefit Plan and is included in Medicare wages, more specifically on Schedule J, Part II, Column B (iii). Part I, Line 7: Non-Fixed payments not listed above Certain physicians and executives participate in incentive compensation plans arranged through individual contractual agreements which stipulate non-fixed payments based on meeting criteria comprised of various quality and productivity markers. A RIHEBC Series 2016 521300173 762244FP1 2016-08-11 227078594 Refund 1996, 2006, 2009 Bonds false false true A 10988670 227078594 1671247 225407347 2016 true true true true A false false false true true false false true A false true false false false false false true A true Part VI Schedule K, Part I, Line A(f):On August 11, 2016, the Rhode Island Health and Educational Building Corporation (RIHEBC) issued, on behalf of the Lifespan Obligated Group, which consists of Rhode Island Hospital, The Miriam Hospital, Emma Pendleton Bradley Hospital, Rhode Island Hospital Foundation, and The Miriam Hospital Foundation, $265,470,000 of tax-exempt fixed rate serial and term bonds (the 2016 Bonds) used for the purpose of refunding existing bonds issued to the Lifespan Obligated Group, as well as to pay certain expenses of issuance with respect to the 2016 Bonds. The portion of the 2016 Bonds' proceeds allocable to RIH is $227,078,594. For purposes of RIH, the 2016 issuance resulted in the complete refinancing of its RIHEBC Series 1996, 2006A and 2009A Bonds. Schedule K, Part I, Line 3:The bond proceeds listed in line 3 differ from the bond issue price disclosed per IRS Form 8038 due to the fact that RIH is part of the Lifespan Obligated Group previously mentioned in Part I, line A(f). Of the $308,112,067 disclosed in Form 8038, RIH was allocated $227,078,594 of the total issuance proceeds. The Gemini Group LLC Spouse 117600 Consulting false Schedule L, Part V Supplemental Information Part IV*The spouse of Phillip Kydd, Trustee, is an owner of The Gemini Group, LLC, which provided business consulting and advisory services. During fiscal year 2023, RIH paid fees of $117,600 to The Gemini Group, LLC under a standard business agreement transacted at fair market value terms. X Gift Cards Feast & Fettle 1 26000 Cost false true false Form 990, Part VI, Section A, Line 2 Nicholas P. Dominick, Senior Vice President of RIH and Paul J. Adler, Lifespan Secretary, are officers of Lifespan MSO, Inc.(MSO), a related for-profit organization. Lawrence A. Aubin, Sr., Chairman, and Michael L. Hanna, Trustee, are partners in the same for-profit organization. Form 990, Part VI, Section A, Line 6 Lifespan Corporation is the sole member of RIH. Form 990, Part VI, Section A, Line 7a Effective October 23, 2012, the Board of Directors of Lifespan and the Boards of Trustees of RIH, The Miriam Hospital, Newport Health Care Corporation, Newport Hospital, and Emma Pendleton Bradley Hospital approved a restructuring of their governance. Gateway Healthcare, Inc. joined the Lifespan health system on July 1, 2013 and adopted this restructured governance. The restructuring has increased governance effectiveness and has streamlined governance operation, as well as provided a single strategic perspective for the Lifespan system hospitals. Pursuant to the restructuring, the bylaws of each of the affiliates were amended such that the composition of the Boards of Trustees of each of the hospitals and Newport Health Care Corporation is defined as those persons serving from time to time as the directors of Lifespan. As a result, the Boards of each entity are comprised of the same individuals. The Board of each entity retains its responsibilities and authorities notwithstanding the revision in its composition. The Board of Directors of Lifespan consists of not less than fourteen nor more than thirty-one directors, including the President & CEO of Lifespan, who serves ex-officio with vote.Additionally, the bylaws of RIH confer certain reserved powers upon Lifespan to provide it with the means of effective oversight, coordination, and support of the system. Powers reserved to Lifespan include: to elect and remove RIH trustees and to approve the election or removal of certain officers. Form 990, Part VI, Section A, Line 7b The RIH Board is comprised of the same individuals who serve on the Lifespan Board. Lifespan has the responsibility for planning, directing, and establishing policies intended to assure the development and delivery of quality health services on an integrated, cost-effective basis. Powers reserved to Lifespan, in addition to those noted above, include: to approve amendment of the Articles of Incorporation and Bylaws and other charter documents; to approve strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness. Form 990, Part VI, Section B, Line 11b The preparation and filing of the Form 990 and supporting schedules is the responsibility of the Executive Vice President & Chief Financial Officer (EVP/CFO) and Lifespan's Finance Department. The Form 990 is prepared by the accounting staff upon completion of Lifespan's annual independent audit and is reviewed by the Corporate Services Tax Compliance Manager and the Director of Finance. The draft Form 990 is then provided to the EVP/CFO for final management review. Prior to filing the return with the Internal Revenue Service, a copy of the entire form is posted to RIH's Board of Trustees website portal in advance of its next Board meeting. At the time of the Board Meeting the 990 is presented by the Lifespan Director of Finance and EVP/CFO, at which time all questions and concerns of the members of the Board are addressed by the EVP/CFO and incorporated into the Form 990 when appropriate. Once the Form 990 is complete and ready to be filed, the members of the Board are notified via email that a copy of the final version of the Form 990 is accessible through the same password-protected website portal. The EVP/CFO is authorized to file the Form 990 Form 990, Part VI, Section C, Line 19 Lifespan and the Lifespan Obligated Group, which consists of RIH, The Miriam Hospital, Emma Pendleton Bradley Hospital, Rhode Island Hospital Foundation, and The Miriam Hospital Foundation, currently make their annual and quarterly consolidated financial statements available to the public via DAC (Digital Assurance Certification, LLC), a disclosure dissemination agent for issuers of tax-exempt bonds which electronically posts and transmits Lifespan's financial information to repositories and investors alike. In addition, copies of RIH's Articles of Incorporation, Bylaws, and Conflict of Interest Policy are available upon request from the office of the Lifespan EVP/CFO, either in person or by mail. Form 990, Part XI, Line 9 Change in funded status of pension and other postretirement = $31070282 Form 990, Part XI, Line 9 Increase in Interest in Net Assets of RIHF = $4032657 Form 990, Part XI, Line 9 Investment in Captis = $197280 Form 990, Part XI, Line 9 Joint Venture Equity Transfer = -$41688009 Form 990, Part XI, Line 9 Net asset Transfer HPI/RIHV = -$123721 . Additional special services, facilities, and programs furnished by RIH include: the endovascular hybrid operating room suite (the only one of its kind in Rhode Island, the suite's design provides vascular surgeons with the flexibility to perform minimally invasive procedures and traditional open surgeries simultaneously with limited anesthesia); adult and pediatric kidney and pancreas transplant center; Alzheimer's disease and memory disorders center; an adult and pediatric hemostasis and thrombosis center; an adult and pediatric diabetes and endocrinology center; colorectal care center; and the transfusion-free medicine and surgery program, one of only two such formalized programs in New England. RIH also holds designation or certification as: a bariatric surgery center of excellence; adult and pediatric burn center; breast imaging center of excellence; comprehensive stroke center; knee and hip replacement, and treatment of complex and rare cancers.One of the impacts of the Affordable Care Act is the transformation of American health care systems to integrated health care delivery systems, with patients at the center of all activity. To that end, RIH, along with the other Lifespan affiliates, has worked hard to expand beyond its campus to broaden the services it provides, investing in a new electronic health record system in 2015, and partnering with new physician groups. One of RIH's major strategic goals is to provide care in settings that are more patient-focused and cost-effective, thus ensuring better continuity of care. Since 2011, RIH has opened ambulatory care centers in areas throughout Rhode Island, addressing a common barrier to care. By locating services, testing, and treatment in such a manner, RIH enables patients to access services when and where they need them, often in their own communities. The result is often earlier diagnosis, better adherence to treatment regimens, more cost-effective care and, eventually, better outcomes and a better patient experience.To address barriers for those who are treated and discharged from RIH, Lifespan Pharmacy, LLC (LRX), the sole member of which is RIH, was opened in May 2013 on the RIH campus to provide pharmaceutical services. LRX now operates five locations and is available to the public and offers convenient, fast, and professional service with easy refill options during the day or night via phone. LRX also offers free home delivery and appointment or walk-in flu and COVID vaccinations, as well as pneumonia and shingles vaccinations for adults. LRX pharmacists interact with physicians to provide comprehensive and safe care. Physicians can electronically transmit prescriptions to LRX, greatly reducing wait times. LRX pharmacists also work with physicians and insurance companies to find the least expensive, fully effective medications to best manage a patient's health.LRX enables patients to leave the hospital with the prescriptions they need, thereby reducing anxiety, enhancing recovery, and reducing the likelihood of readmission. LRX especially benefits patients for whom a lack of transportation is a major barrier by providing access to pharmaceutical drugs onsite at RIH. RIH provides full charity care for individuals at or below twice the federal poverty level, with a sliding scale for individuals based upon the federal poverty level guidelines, as set by the U.S. Department of Health and Human Services. In addition, a substantial discount consistent with Medicare program reimbursement is offered to all other uninsured patients. RIH determines the costs associated with providing charity care by aggregating the applicable direct and indirect costs, including compensation and benefits, supplies, and other operating expenses, based on data from its costing system. The total cost, excluding medical education and research, incurred by RIH to provide charity care amounted to $20,326,208 in fiscal year 2023. Charges forgone, based on established rates, amounted to $73,927,000.RIH substantially subsidized various health services including the following programs: dental, Alzheimer's, and the Center for Special Children, as well as certain other specialty services at a net cost of $13,718,818 in fiscal 2023. RIH also provides numerous other services to the community for which charges are not generated. These services include certain emergency services, community health screenings for cardiac health, prostate cancer and other diseases, smoking cessation, immunization and nutrition programs, diabetes education, community health training programs, patient advocacy, foreign language translation, physician referral services, and charitable contributions. The net cost of these services amounted to $355,475 in fiscal year 2023.Featured Awards and Recognition:In 2023, The American Heart Association/American Stroke Association recognized Rhode Island with the Get with the GuidelinesStroke Gold Plus award, for their commitment to ensuring stroke patients receive the most appropriate, leading-edge treatment, as quickly as possible, in accordance with nationally recognized, evidence-based guidelines.Rhode Island Hospital was named to the Stroke Honor Roll Elite with Advanced Therapy Achievement Target, and the Type 2 Diabetes Honor Roll.The Pediatric Trauma Center at Hasbro Childrens Hospital was reverified as a Level 1 Trauma Center by the American College of Surgeons (ACS) and the Pediatric Burn Center at Hasbro Childrens was reverified as a center by the American Burn Association (ABA).Rhode Island Hospital was recognized for excellence in pulmonary care by Healthgrades, citing its superior clinical outcomes in treating chronic obstructivepulmonary disease (COPD) and pneumonia.Hasbro Childrens Hospital Rehabilitation Services was designated by Blue Cross & Blue Shield of Rhode Island as an LGBTQ Safe Zone, a certification that indicates that a center can provide quality care that meets the needs of LGBTQ+ patients.The Blue Cross Blue Shield Association named Rhode Island Hospital a Blue Distinction Center for Cancer Care and a Blue Distinction Center + for both Cancer Care and Spine Surgery. This designation recognizes health care facilities across the nation that demonstrate expertise in delivering quality specialty care.In 2023, Rhode Island Hospitals Medical Intensive Care Unity (MICU) received a four-year silver designation of the Beacon Award for Excellence by the American Association for Critical Care Nursing. In 2023-2024, U.S. News & World Report named Rhode Island Hospital a high performer in the areas of lung cancer surgery, aortic valve surgery, diabetes care, and stroke treatment.Accreditations:(1) Only Level I Trauma Center in southeastern New England, verified by the American College of Surgeons.(2) Only verified Burn Center in Rhode Island.(3) First hospital in the State awarded advanced certification as a Comprehensive Stroke Center; and(4) Pulmonary Hypertension Center holds the Pulmonary Hypertension Associations Center of Comprehensive Care Accreditation.(5) RIH is accredited by The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Accreditation Council for Graduate Medical Education for residency and fellowship training, the Accreditation Council for Continuing Medical Education of the Rhode Island Medical Society, the American College of Surgeons' Commission on Cancer, the Joint Review Committees on Educational Programs in Nuclear Medicine Technology and Radiologic Technology, the Commission on Accreditation of Allied Health Education Programs, and the National Accrediting Agency for Clinical Laboratory Sciences. . Base Salary Actions: The CEO recommends any salary adjustments for participants in the executive compensation program, using the results of the valuation study and his/her assessment of individual performance or other pertinent information, for the Committee's consideration.New Participants in Executive Compensation Program: With respect to compensation offers for individuals expected to participate in the executive compensation program, certain members of the Lifespan CEO's leadership team work with the Committee's independent compensation consultant or rely on information previously provided by the consultant to establish a range of reasonable cash compensation within which recruitment is expected to conclude with acceptance of a reasonable compensation offer. Form 990, Part I, Line 6 Volunteers support and contribute to the mission of RIH and HCH every day, giving their time, energy, and enthusiasm. They are able to learn, meet other dedicated volunteers, better understand the healthcare environment, and gain personal satisfaction knowing they are making a difference to patients, families, and visitors alike.Volunteer opportunities are available to both teens and adults in a wide variety of areas including: ambassadors, art activities, book cart, canine assisted therapy, comfort cart for families, diagnostic imaging, emergency department, employee snack cart, endoscopy, food pantry, geriatric champions, hand massage, infection control, music activities, office support, oncology, outpatient clinics, patient and guest services, pediatric partial day program, pediatric pre-op and post-op, pediatric playrooms, PICU, PT/OT, and recovery room. Volunteers include college and high school students, retirees, working professionals, individuals considering a career change or returning to the work force, and individuals with a special skill or talent. Form 990, Part III, Line 4a, continued RIH is a 719-bed, nonprofit general acute care teaching hospital with university affiliation, the largest hospital in the State of Rhode Island (the State) providing a comprehensive range of diagnostic and therapeutic services to patients. RIH has particular expertise in cardiology, including the State's only open heart surgery program; oncology; neurosciences; orthopedics; organ transplantation; pediatrics; psychiatry; and diabetes. RIH is the only Level I Trauma Center for southeastern New England, providing expert staff and equipment in emergency situations 24 hours a day. It is the Principal Teaching Hospital of The Warren Alpert Medical School of Brown University and the largest and most comprehensive of the Brown affiliated hospitals. RIH's pediatric division, HCH, is the State's premier pediatric facility with the area's only pediatric intensive care unit, pediatric oncology and cardiac programs, pediatric imaging center, and separate emergency and operating suites designated for pediatric patients. RIH has earned worldwide recognition for its family-centered environment and expert staff. It is the founding partner of Lifespan, a comprehensive health system providing accessible, high-value services to the people of Rhode Island and southeastern New England. RIH employs/contracts 7,220 full-time equivalents and is nationally and internationally recognized as a research and academic medical center. In 2023, RIH discharged 32,008 inpatients with total inpatient days of 202,294, treated 129,628 patients in its emergency departments, performed 23,308 inpatient and outpatient surgical procedures, and cared for 321,046 patients in outpatient clinics. RIH is the designated Level I Trauma Center for the State of Rhode Island and southeastern New England, with a state-of-the-art emergency department (ED) and a dedicated pediatric ED. RIH's adult ED includes a radiology unit comprised of CT scanners as well as ultrasound and x-ray machines; an all-inclusive chest pain center; a critical care unit for the most seriously injured and ill; and private treatment rooms. RIH offers imaging with PET/CT technology for cancer staging, while cardiac MRI and 64-slice cardiac CT scanners provide powerful tools for evaluating heart disease and function. The Anne C. Pappas Center for Breast Imaging has earned the Breast Imaging Center of Excellence designation by the American College of Radiology. In the area of cancer services, RIH has pioneered image-guided tumor ablation, shrinking or eliminating tumors by destroying them with heat (microwave ablation and radiofrequency ablation) or by freezing them (cryoablation). In addition, radiation oncology services include a linear accelerator for image-guided radiotherapy and stereotactic radiosurgery, as well as electronic brachytherapy for early-stage breast cancer patients, which reduces average treatment times from eight weeks to five days. In the area of surgical oncology, RIH is the only hospital in Rhode Island and one of only a few hospitals in New England to offer hyperthermic intraperitoneal chemoperfusion (HIPEC) for patients with advanced cancer of the abdomen. In the sphere of neurosurgery, RIH features one of the first gamma knife surgical centers in the United States, which offers intracranial stereotactic radiosurgery for the non-invasive treatment of brain lesions previously inaccessible or unsuccessfully treated by conventional therapies.Special services and programs provided by RIH include the Lifespan Cancer Institute; the Lifespan Cardiovascular Institute, which provides cardiac catheterization, balloon angioplasty, and open heart surgery; The Comprehensive Stroke Center; The Norman Prince Spine Institute; critical care services; microvascular surgery; nuclear cardiology; radiology; laboratory; renal dialysis; computed tomography; orthopedics, including minimally invasive carpal tunnel surgery and cartilage transplants for knee defects; magnetic resonance imaging (MRI); and dental care. HCH's specialties include cardiology, orthopedics, hematology & oncology, and medicine/psychiatry. HCH also has the area's only center for pediatric imaging, as well as the area's only pediatric intensive care unit, pediatric oncology and outpatient cardiac programs, pediatric emergency department, and pediatric surgical unit. It operates specialty clinics treating children ranging in age from newborn to 18 years. Services and programs include adolescent medicine, the Asthma and Allergy Center, the Children's Neurodevelopment Center, the Child Life Program, the Child Protection Program, dermatology, gastroenterology, infectious disease, the Injury Prevention Center, the Kidney Transplant Center, nephrology, neurosurgery, nutrition, the Partial Hospitalization Program, surgery, plastic surgery, primary care clinic, rehabilitation services, the Sickle Cell Clinic, and urology. HCH was the first hospital in Rhode Island to offer minimally invasive pediatric urologic surgeries.A wide range of adult, adolescent, and child behavioral health services and research programs are also provided, including: psychiatry emergency services for adults, adolescents, and children; psychiatry consultation liaison services; correctional psychiatry program; inpatient and geriatric psychiatry programs; mood disorders program; gambling treatment program; anxiety disorders program; body dysmorphic disorder program; behavioral sleep medicine program; substance abuse treatment program; neuropsychiatric services; adult and pediatric neuropsychology services; adult and pediatric partial hospitalization programs; family research program; and the Bradley Hasbro Children's Research Center. Form 990, Part III, Line 4b, continued Under an affiliation agreement with The Warren Alpert Medical School of Brown University (Brown), RIH participates jointly in various clinical training programs and research activities. In 2010, Brown named RIH its Principal Teaching Hospital. The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically. RIH sponsors graduate medical education programs accredited by or under the auspices of the Accreditation Council for Graduate Medical Education (ACGME), while also sponsoring hospital-approved residency and fellowship programs. RIH serves as the principal setting for these clinical training programs, which encompass many disciplines. RIH provides stipends to residents and physician fellows while in training.In 2023, students enrolled in Brown University's undergraduate medical education programs received training at RIH. RIH teaching faculty ensure that the experience for both undergraduate and graduate medical education trainees remains transformative - dramatically changing novice practitioners into physicians able to think, act, and keep their focus on the ultimate goal of providing the best and most appropriate care for patients no matter what the setting or circumstances.RIH is also a participating clinical training site for residents and fellows from other programs.Various departments and specialties at RIH serve as clinical sites for physician assistant schools. In addition, Behavioral Medicine at RIH, in collaboration with Brown, sponsors research and clinical psychology training programs for interns, postdoctoral fellows, and faculty trainees.With respect to nursing education, RIH has developed educational affiliations with various Schools of Nursing, pursuant to which their nursing students obtain clinical training and experience at RIH. RIH does not receive any compensation from the various schools for providing a clinical setting for the student nurse training.The Lifespan School of Medical Imaging collaborates with Rhode Island College in the following programs: diagnostic medical sonography; nuclear medicine technology; radiography; and magnetic resonance imaging. Students complete educational experiences at RIH, as well as other outpatient sites. RIH also sponsors education programs in computed tomography and mammography. At RIH, clinical affiliations/student clinical training programs are provided through contracts with several colleges and universities in the professional areas of speech-language pathology and audiology, physical therapy, physical therapy assistants, occupational therapy, certified occupational therapy assistants, and child development. RIH has clinical training affiliations in respiratory therapy with New England Institute of Technology and CCRI. In addition, RIH is the host for training programs in histology, cytology, phlebotomy, and medical laboratory science (medical technology) sponsored jointly through the University of Rhode Island, Salve Regina University, and Rhode Island College. These programs allow students to obtain didactic coursework at partner universities and at RIH, and clinical education and experience on site at RIH, resulting in certification for careers in clinical laboratories.RIH also has clinical affiliations/student clinical training programs for pharmacy students provided through contracts with a number of colleges and universities. RIH's Pharmacy Department sponsors a postgraduate year one (PGY1) residency program in pharmacy practice. In addition, RIH's Pharmacy Department co-sponsors second-year postgraduate specialized residency programs in oncology and ambulatory care pharmacy. RIH's pharmacists participate in the education of pharmacy, nursing, and physician assistant students by providing didactic lectures at various universities. In addition, RIH has clinical social work student contracts with various educational facilities. Form 990, Part III, Line 4c, continued RIH provided $16.4 million in support of research activities in fiscal year 2023. Major areas of research include:Cancer: RIH participates in clinical trials of new therapeutic agents in both adult and pediatric medicine. These trials are supported by National Institutes of Health (NIH) sponsored groups such as Alliance and Childrens' Oncology Group (COG). RIH is a participating hospital in the Brown-sponsored Cancer Oncology Group (BrUCOG).Heart Disease: Research continues in areas of invasive therapy, such as angioplasty, artherectomy, coronary stenting, laser treatment of coronary artery disease, and the reasons for sudden heart failure.Neurological Illness: The Alzheimer's Disease and Memory Disorder Center combines high quality neurological, neuropsychologic, and psychiatric services, thus creating a comprehensive diagnostic and treatment option for patients with memory disorders.Infectious Diseases: RIH's research team has been at the heart of the global COVID-19 response, from being sought after for comment by national media, to being selected as a site for vaccine trials.RIH research is also focused on the treatment and prevention of opioid abuse. Form 990, Part VI Section B, Line 12c Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including RIH, and administered by Lifespan's Corporate Compliance Department as follows: Each designated person subject to Lifespan's conflict of interest policy is required to provide Lifespan with an initial disclosure statement and thereafter an annual statement attesting that: (i) the designated person has read and is familiar with this policy, and (ii) the designated person and, to the best of his/her knowledge, family members, have not in the past engaged in, are not presently engaging in, or plan to engage in, any activity which contravenes this policy.If, at any time during the course of employment or association, a designated person has reason to believe that an existing or contemplated activity may contravene this policy, the person shall submit a full written description of the activity to the Lifespan Compliance Officer or the Office of the General Counsel to seek a determination as to whether the contemplated activity does or does not contravene this policy. If the activity in question involves either the Chief Executive Officer, the Senior Vice President and General Counsel, or a Trustee, a full written disclosure must be made to, and a determination sought from, the Chairman of the Board of Directors of Lifespan Corporation.Annually, the Lifespan Compliance Officer shall review and report to the Lifespan Executive Corporate Compliance Committee and to the Lifespan Audit and Compliance Committee on the administration of this policy.Failure on the part of any designated person to comply with this policy, including failure to submit in a timely fashion the conflict of interest disclosure statement, will be grounds for removal from his/her position and/or termination of his/her employment with Lifespan. Form 990, Part VI Section B, Lines 15 a&b The following applies to Lifespan and all of its affiliates, including RIH:EXECUTIVE COMPENSATIONLifespan's executive compensation philosophy balances appropriate stewardship of resources and the need to be competitive in recruiting and retaining talented individuals. It incorporates market-competitive and performance-related principles, and covers the President and CEO of Lifespan as well as other officers, senior management, and key employees. Lifespan's executive compensation program complies both with law and with contemporary ethical norms, and is administered consistent with the organization's tax-exempt status under Section 501(c)(3) of the Internal Revenue Code (IRC) and the avoidance of transactions subject to intermediate sanctions under Section 4958 of the IRC. Executive compensation is also administered consistent with Lifespan's Corporate Compliance Policy on Excess Benefit Transactions.The Compensation Committee of the Lifespan Corporation Board of Directors (the Committee), comprised of disinterested Lifespan Board members, is responsible for diligent oversight of executive compensation to ensure compliance with IRC requirements. Its duties include:* Approving eligibility for participation in the executive compensation program * Approving changes in compensation for existing executive participants * Approving guidelines, such as salary ranges and contract terms, on appropriate levels of compensation for other key employees* Approving new, and modifying or terminating existing, executive compensation plans including, but not limited to, annual incentive and executive benefit plans* Approving performance objectives associated with Lifespan's annual incentive plan, including measuring points, and using verified actual performance relative to these objectives as a precondition to approving the payment of any awards under the plan* Authorizing periodic performance benchmark studies to be conducted for purposes of assessing Lifespan's performance within the healthcare industry and the degree to which total remuneration levels at Lifespan are generally commensurate with Lifespan performance relative to healthcare industry performance* Conducting an annual performance review of Lifespan's Chief Executive Officer. The Chair of the Committee conducts and documents this review, based on his/her observations and interpretation of feedback from members of the Board of Directors.* Selecting and engaging qualified, independent, third-party compensation valuation consultants that the Committee charges with rendering opinions with respect to the reasonableness and comparability of compensation as well as the comparative organizations against which compensation is assessed, in accordance with relevant sections of the IRC and Lifespan's executive compensation philosophy. Lifespan's Chief Executive Officer works closely with the Committee to make recommendations on the above topics and keep the Committee informed about contemplated compensation changes for executives and other key employees, as well as candidates for these roles. The CEO also provides periodic updates to the Committee regarding Lifespan's performance relative to compensation-related performance objectives.The Committee's deliberations and actions are documented in minutes prepared for each meeting.PROCESS FOR DETERMINING COMPENSATION Valuation of Total Cash and Total Remuneration: No less frequently than annually, the Committee receives and reviews a total cash compensation valuation of all existing executive compensation program participants prepared by its independent compensation consultant. Annually, the Committee also receives and reviews a total remuneration valuation of all existing executive compensation participants. Form 990, Part VI, Section A, Line 1b: *Shivan S. Subramaniam, Trustee, is the Lead Director on the Board of Directors at Citizens Bank, N.A. During fiscal year 2023, Lifespan paid Citizens Bank, N.A.,in its normal course of business as part of Lifespan's accounts payable function.*Lawrence A. Aubin, Sr., Chair, and Michael Hanna, Trustee, are owners of New England Real Estate Holding Group, LLC (NEREHG), with which Lifespan has entered into an operating lease of a health care facility. During fiscal year 2023, Lifespan paid rent to NEREHG under the terms of its lease. Terms of the rent expense related to the lease have been established at fair market value. Form 990, Part XII, Line 2 RIH was included in the Lifespan Corporation and Affiliates audited consolidated financial statements as of and for the fiscal year ended September 30, 2023. Included in the amounts reported for RIH include activity of RIH, RIH Ventures, Radiosurgery Center of Rhode Island, LLC, and Lifespan Pharmacy, LLC. The Lifespan Audit and Compliance Committee assumes responsibility for oversight of the audit of Lifespan's consolidated financial statements and the selection of Lifespan's independent accountant. Lifespan Pharmacy LLC 593 Eddy Street Providence RI 02903 461697290 Pharmaceutical Sales RI 97179506 25251839 Rhode Island Hospital Radiosurgery Center of Rhode Island LLC 593 Eddy Street Providence RI 02903 262171671 Radiosurgery RI 6643660 4037445 Rhode Island Hospital ALC dba HSR 1 Virginia Avenue Suite 200 Providence RI 02905 050442015 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Bayberry Courts Inc 1 Virginia Avenue Suite 200 Providence RI 02905 204590384 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Bradley Hospital Foundation 167 Point Street Providence RI 02903 050500688 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false Brown Neurology Inc 593 Eddy Street APC5 Providence RI 02903 050448314 Medical Care RI 501(c)(3) 12 NA false Capital City Community Centers Inc 1 Virginia Avenue Suite 200 Providence RI 02905 050259090 Daycare Services RI 501(c)(3) 7 Gateway Healthcare Inc false Coastal 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RI 02903 222861978 Holding Company/Mgmnt Services RI 501(c)(3) 12(II) NA false Lifespan Foundation 167 Point Street Providence RI 02903 050493219 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false Lifespan of Massachusetts Inc 45 Baker Street 2nd Floor Providence RI 02905 043408517 Holding Company MA 501(c)(3) 12(I) Lifespan Corporation false Lifespan Physician Group Inc 167 Point Street Providence RI 02903 050389801 Physician Health Care Services RI 501(c)(3) 10 Lifespan Corporation false Lifespan School Solutions Inc 140 Broadway Providence RI 02903 464910847 Educational Services RI 501(c)(3) 2 Emma Pendleton Bradley Hospital false LJR Corporation 1 Virginia Avenue Suite 200 Providence RI 02905 030508346 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Mill River Community Housing Corporation 1 Virginia Avenue Suite 200 Providence RI 02905 050427152 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Newport Health Care Corporation 11 Friendship Street Newport RI 02840 222535537 Holding Company/Mgmnt Services RI 501(c)(3) 7 Lifespan Corporation false Newport Health Property Management Inc 11 Friendship Street Newport RI 02840 222335539 Property Management RI 501(c)(3) 12(I) Newport Health Care Corporation false Newport Hospital 11 Friendship Street Newport RI 02840 050258914 Health Care Services RI 501(c)(3) 3 Lifespan Corporation false Newport Hospital Foundation Inc 11 Friendship Street Newport RI 02840 222535533 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false NHCC Medical Associates Inc 11 Friendship Street Newport RI 02840 050472268 Health Care Services RI 501(c)(3) 10 Lifespan Corporation false Obed Apartments inc 1 Virginia Avenue Suite 200 Providence RI 02905 050422771 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Pathways Inc 1 Virginia Avenue Suite 200 Providence RI 02905 050393004 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Rhode Island Hospital Foundation 167 Point Street Providence RI 02903 050468736 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false RIH Ventures 593 Eddy Street Providence RI 02903 050448686 Parking Facilities/Phlebotomy Services RI 501(c)(3) 10 Lifespan Corporation false Shore Courts Inc 1 Virginia Avenue Suite 200 Providence RI 02905 050504003 Housing for Elderly and Mentall Ill RI 501(c)(3) 10 Gateway Healthcare Inc false The Autism Project 1516 Atwood Avenue Johnston RI 02919 050512037 Services for Children with Autism RI 501(c)(3) 9 Gateway Healthcare Inc false The Miriam Hospital 164 Summit Avenue Providence RI 02906 050258905 Health Care Services RI 501(c)(3) 3 Lifespan Corporation false The Miriam Hospital Foundation 167 Point Street Providence RI 02903 050377502 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false TLR Realty 1 Virginia Avenue Suite 200 Providence RI 02905 043742771 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Wentworth Corporation 1 Virginia Avenue Suite 200 Providence RI 02905 050488520 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Westerly Courts Inc 1 Virginia Avenue Suite 200 Providence RI 02905 611439766 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false RI Sound Enterprises Insurance Co 65 Front Street Hamilton BD HM 12 Offshore Insurance Captive BD N/A N/A Lifespan Corporation false Lifespan Health Alliance LLC 167 Point Street Providence RI 02903 812732225 Account. 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