2021-08-13T12:01:28-07:00 2020-09-30 135565207 KPMG LLP 2 Financial Center 60 South St Boston MA 02111 990 2019-10-01 050258954 Rhode Island Hospital RHOD 4014444000 593 Eddy Street Providence RI 02903 Mary A Wakefield Treasurer 2021-08-13 true P00247720 6179881000 2019 2022-09-23 18:48:47Z Saul N Weingart MD PhD 1850656032 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. 17 14 10189 526 2789895 77076 11486068 103832186 1470988569 1499935217 23684572 21622578 -8090084 -15628651 1498069125 1609761330 1170367 1528452 0 623768975 652604760 0 0 902706381 934920171 1527645723 1589053383 -29576598 20707947 1274041361 1444910459 590394519 716705585 683646842 728204874 X As a founding hospital in the Lifespan health system, RIH is committed to its mission: Delivering health with care. false false 1202540302 1395855651 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) 107808259 15799461 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 $92.0 million in fiscal year 2020. (Continued on Schedule O) 79216491 63908490 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 many clinical trials which provide valuable research information as well as cutting edge treatment for patients in the region. Federal support accounts for approximately 65% of all externally funded research at RIH. Researchers focus on clinical trials which investigate prevention and treatment of HIV/AIDS, obesity, cancer, diabetes, cardiac disease, neurological problems, orthopedic advancements, and mental health concerns. Included in the totals are $16.9 million of research grants from for-profit organizations that are not reported in Schedule H. (Continued on Schedule O) 1389565052 true true false true false false false true false true true true 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 false true false false false true true true true true false true 533 0 true 10189 true true true false false false false false false 0 false false false false false false false X 17 14 true false false false true true true true true false false true true true true true true true true true true RI X Mary A Wakefield 4014447093 593 Eddy Street Providence RI 02903 X Timothy J Babineau MD Trustee 14.80 25.20 X 0 1761978 1423050 Margaret M Van Bree MHADrPH Pres thru 12/19 2.00 3.50 X 0 810873 1187192 Ziya L Gokaslan MD Trustee 0.50 43.50 X 0 1494856 57956 Mary A Wakefield Treasurer 10.00 30.00 X 0 870016 242111 John B Murphy President 2.00 11.00 X 0 716018 36992 Douglas Anthony MD Physician 40.00 0.00 660784 0 53608 Barbara P Riley RN Chief Nursing Officer 40.00 0.00 367928 0 341532 Alexios G Carayannopoulos DO Physician 40.00 0.00 660044 0 34593 Paul J Adler Secretary 5.00 35.00 X 0 559976 126299 Latha Sivaprasad MD Chief Medical Officer 40.00 0.00 484966 0 110125 Murray Resnick MD Physician 40.00 0.00 487471 0 44756 Keith-Austin Scarfo MD Physician 40.00 0.00 444754 0 48186 Latha Pisharodi MD Physician 40.00 0.00 437659 0 28489 Nicholas P Dominick SVP-Clin. Svc. Lines & Facil. Devel 40.00 0.00 348653 0 93086 Lawrence A Aubin Sr Chair 1.00 15.00 X X 0 0 0 Emanuel Barrows Trustee 0.60 3.00 X 0 0 0 Roger N Begin Trustee 1.00 5.00 X 0 0 0 Peter Capodilupo Vice Chair 0.20 3.70 X X 0 0 0 Sarah T Dowling JD LLM Trustee 1.00 4.00 X 0 0 0 Jonathan D Fain Trustee 0.25 2.00 X 0 0 0 Edward D Feldstein Esq Trustee 1.00 9.00 X 0 0 0 Michael L Hanna Trustee 2.00 5.50 X 0 0 0 Pamela A Harrop MD Trustee- 10/19 0.50 2.00 X 0 0 0 Phillip Kydd Trustee 0.25 2.00 X 0 0 0 Alan H Litwin Vice Chair 1.00 10.10 X X 0 0 0 Martha B Mainiero MD Trustee 0.50 3.00 X 0 0 0 Joseph J MarcAurele Trustee- 10/19 0.00 2.50 X 0 0 0 Steven Pare Trustee 2.00 10.00 X 0 0 0 Lawrence B Sadwin Trustee 0.25 12.45 X 0 0 0 Shivan Subramaniam Trustee 0.25 5.25 X 0 0 0 Jane Williams PhD RN Trustee 1.00 2.80 X 0 0 0 3892259 6213717 3827975 786 false true false Brown Medicine 110 Elm Street Providence RI 02903 Medical Services 32127894 University Surgical Assoc Inc 75 Newman Avenue Rumford RI 02916 Medical Services 11427619 Brown Emergency Medicine 125 Whipple St 3rd Fl Providence RI 02908 Medical Services 7928596 Brown Neurology 110 Elm Street Providence RI 02903 Medical Services 6744995 Brown University 45 Prospect Street Providence RI 02912 Subcontracted Svcs. 5848277 5 15073729 87189110 1569347 52999 103832186 Direct Rev from Research 900099 63908490 63908490 Lifespan Pharmacy 446110 90606350 90606350 Patient Service Revenue 900099 1339147513 1339147513 Rental 531120 4719952 4719952 Temp Restricted (SPF's) 900099 1552912 1552912 1499935217 5326299 5326299 0 0 3125447 1980551 1144896 1144896 1144896 254605761 238268777 40705 16336984 -40705 16296279 16296279 0 0 508614 604669 -96055 -96055 Cafeteria Revenue 722210 4720827 4720827 Indirect Rev from Grants 900099 14281805 14281805 Other/Services Rendered 900099 7204473 7204473 -42884597 -45857893 2885950 87346 -16677492 1609761330 1475563602 2789895 27575647 1493452 1493452 35000 35000 0 0 961935 386621 575314 0 499306416 498106091 1200325 43395988 43373059 22929 74161289 73946023 215266 34779132 34655080 124052 0 0 0 3575 3575 0 2244841 2244841 118944340 118934640 9700 65550 63108 2442 27523652 20572361 6951291 0 0 27896183 22565519 5330664 741426 739919 1507 0 1048090 1043022 5068 6136901 1443 6135458 0 57198487 57198487 21780747 21786405 -5658 Medical & Surgical Supplies 341136149 341184044 -47895 Purch Svs & Equip Contracts 167530107 48820848 118709259 License Fee 75663560 75663560 Provision for Bad Debts 46114399 46114399 40892164 40076883 815281 1589053383 1389565052 199488331 0 552063 28472 20478272 176114224 7555356 8725243 153743024 158868894 0 0 0 23972506 26338144 3703448 4298411 1387312025 879253898 520425172 508058127 322420794 323550204 122482028 118450825 0 0 98708698 120477915 1274041361 1444910459 115010581 100035797 538770 26122229 189160892 176756087 5318871 23680000 3600000 256685405 410191472 590394519 716705585 X 318466858 344090494 365179984 384114380 683646842 728204874 1274041361 1444910459 X 20707947 17753557 6096528 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 3575 3575 false false Part II-B, Line 1i - Other Activities Description RIH pays membership fees to 340B Health, the Association of American Medical Colleges, and the American Society of Health-System Pharmacists. A portion of the membership dues paid to these organizations is allocated to their lobbying efforts. 75705 X false 463288111 82296737 36982884 106883655 475684077 480080475 74419354 9352353 100564071 463288111 480453623 70377312 23675697 94426157 480080475 469816601 61895738 46265035 97523751 480453623 456888675 66813380 21926308 75811762 469816601 0.34130 0.08570 0.57300 true true true 31159682 31159682 827591543 515592555 311998988 506816381 363661343 143155038 21744419 21744419 508058127 118450825 Deferred Financing Costs 1087468 Intercompany Receivables 1669855 Interest in Net Assets of RIH Foundation 64936036 Other Non-Current Assets 589328 Other Receivables 18512180 120477915 Accrued Interest Payable 2902725 Accrued Pension Liability 172902800 Cares Act Deferred Emp Payroll Tax 14719328 Health Care Benefit Self-insurance 6210322 Other Liabilities 52070380 Post-retirement Benefit Liability 9331900 Third-party Payor Settlements 152054017 410191472 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) strategic energy management planning;(3) orthopedic research;(4) support of the Norman Prince Neurosciences Institute at RIH; and (5) Hasbro Children's Hospital renovations. 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 2020 or 2019. true Central America and the Carib 0 0 Program Services Research 8995 East Asia and the Pacific 0 0 Program Services Research 10800 Europe 0 0 Program Services Research 305697 South America 0 0 Program Services Research 18819 South Asia 0 0 Program Services Research 245767 Sub-Saharan Africa 0 0 Program Services Research 19900 609978 609978 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 24265118 5423372 18841746 0.01220 371687634 316981031 54706603 0.03550 395952752 322404403 73548349 0.04770 284725 16847 267878 0.00020 107808259 15799461 92008798 0.05960 35056736 22057441 12999295 0.00840 62340972 47032972 15308000 0.00990 536755 536755 0.00040 206027447 84906721 121120726 0.07850 601980199 407311124 194669075 0.12620 true 12824645 805010 205249428 207751263 -2501835 X true true Orthopedic MRI of RI LLC Imaging Services 0.33333 0.13333 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 19 true true false true X See Schedule H, Part V, Section C X true 19 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- In January 2020, the Secretary of HHS declared a national public health emergency due to a novel strain of coronavirus (COVID-19) and in March 2020, the World Health Organization announced the spread of the virus to be a pandemic. While this significant health need was not predicted at the time that RIH completed its CHNA for the fiscal year ending September 30, 2019, RIH stepped to the forefront of this critical health issue impacting Rhode Island and its residents and made it one of its primary focuses during 2020. In coordination with State of Rhode Island health authorities, in March 2020 RIH initiated emergency measures, expanded critical care bed capacity, acquired personal protective equipment, expanded testing capabilities, and created a redeployment process for clinical and nonclinical staff to work in areas where the need was most urgent.The Lifespan Alternative Hospital Site was constructed within the Rhode Island Convention Center in Providence, Rhode Island in response to the anticipated need for surge capacity during the COVID-19 Pandemic.In partnership with the State, including the Governors office, the Rhode Island Department of Health, and the Rhode Island National Guard, Lifespan leadership brought to fruition a 600-bed facility under RIH's license with a full complement of hospital-level care capabilities.In a matter of weeks, the group engineered and executed a complex construction project, including negative pressure ventilation, electrical service throughout the cavernous space, walls erected to mimic the corridors and curtains of a hospital, and finishing touches like walkways named for familiar streets throughout the States communities.Completed in April 2020, the site stood at the ready through the first peak of COVID-19 cases in Rhode Island, but was not operationalized until the second peak in the fall of 2020. On December 1, 2020, the Lifespan Alternative Hospital Site (the Site) welcomed its first patients, caring for 516 patients over twelve weeks. In this second wave, in contrast to the first, the Site played an important role in enabling the Lifespan Hospitals to continue normal operations, serving the everyday health care needs of their patients, despite the Pandemic.The Site's presence decompressed busy emergency departments and allowed COVID patients meeting certain criteria to be cared for in its dedicated COVID-only warm space, reserving more hospital beds for their usual purposes.While fortunately the Site never neared its massive capacity, it served between 30 and 40 inpatients on most days, a significant relief to the stressed hospitals. The dedicated corps of Site staff included those who stepped up from all corners of the Lifespan organization. Physicians, nurses, respiratory therapists, nursing assistants, social workers, pharmacists, phlebotomists, EMS personnel, food service staff, environmental services specialists, chaplains and others put in countless hours of service, many of them beyond their ordinary working hours.Lifespan is working in partnership with the Rhode Island Department of Health (RIDOH) to ensure that the COVID-19 vaccine is offered to all eligible patients and in all the communities we serve. RIH is following RIDOH guidance on vaccine eligibility, depending on age and underlying health conditions. Regarding the significant needs identified in RIH's 9/30/2019 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.The primary data sources included community health forums, key informant interviews, and individual surveys. 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. Twelve CHFs were held between April 29 and June 12, 2019 across the RIH service area. Participants were recruited using social media, posted flyers, email, and word of mouth. Locations were selected to be easily accessible to the public and hospital patients, and forums were held at various times of the day on weekdays and weekends. RIH forums were held at community centers, places of worship, a high school, a homeless shelter, local non-profit agencies, and RIH. At each forum, a meal was provided, along with child care and interpretation if requested in advance. All CHFs were open to the public and participants were fully engaged throughout the 90-minute discussions.A representative of RIH served as a hospital liaison to help plan and facilitate the CHFs. The RIH liaison was a critical link between the LCHI as the coordinating body, the expertise and resources within RIH, and the Community Liaisons described below.An important and unique component of the CHFs was the involvement of Community Liaisons. Six people representing the diverse populations served by RIH were hired as consultants to assist with the CHNA. These Community liaisons helped plan the CHFs, recruited participants, and co-facilitated the forums. All Community Liaisons were chosen through a competitive selection process and completed a two-hour training prior to leading the CHFs. The training included project planning tips, role-playing activities, conflict management strategies, and logistical expectations. Community Liaisons were responsible for identifying an accessible 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 2016 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. 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 ranked.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, surveys were distributed and collected by LCHI staff at events they attended in May and June 2019, such as the annual Pride Festival. The surveys addressed the same questions as the CHFs. Fifteen individual surveys were received for RIH.Key Informant Interviews:The director of the LCHI identified public health and health policy leaders who could inform the 2019 CHNA process and who had knowledge, information, or expertise about the community that RIH serves. Key informant interviews were conducted with state leaders to supplement the other quantitative and qualitative data collected. Key informants included the: Acting Chief of Staff, Executive Office of Health and Human Services, State of Rhode Island and Policy Director, Rhode Island Childrens Cabinet Director of Policy, Planning, and Research, Executive Office of Health and Human Services, State of Rhode Island Director, Health Equity Institute and Special Needs Director, Rhode Island Department of Health Physician Lead, Health Equity Institute, Rhode Island Department of HealthWhen crafting the RIH implementation strategy, RIH reflected upon the key themes that emerged from these conversations. The statewide priorities and recommendations of the key informants included: incorporate health equity targets; generate and monitor data on health disparities, especially by race, ethnicity, and income; build strategies that incorporate the social determinants of health; go beyond individual interventions to family/household level interventions; make investments in early childhood; consider comorbidities, especially between behavioral health and chronic diseases; confront racism and bias to improve care; provide personalized care; be sensitive to misalignments within healthcare; and continue to address substance misuse and behavioral health conditions.To ensure representation from a broad cross-section of the community, CHF's were held in the following locations:Amos House, Providence, Rhode IslandThe Multicultural Innovation Center (x2), Providence, Rhode IslandUnited Way of Rhode Island, Providence, Rhode IslandBlessed Sacrament Church, Providence, Rhode IslandSt. Patricks Church, Providence, Rhode IslandThe Met School, Providence, Rhode IslandInstitute for the Study and Practice of Nonviolence, Providence, Rhode IslandSouthside Cultural Center, Providence, Rhode IslandSt. Martin de Porres, Providence, Rhode IslandCrossroads, Providence, Rhode IslandRIH, Providence, Rhode Island 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, 2019 identified four significant health issue areas requiring a further implementation strategy. Those significant health issue areas include: (1) access to care; (2) disease management; (3) mental and behavioral health; and (4) community-based outreach and education. The implementation strategy to address those significant health needs outlined between October 1, 2019 - September 30, 2022 is available at: https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/RIH-CHNA-Implementation-Plan.pdfDuring the fiscal year ended September 30, 2020, RIH implemented the specific actions listed below in order to address the significant community health needs outlined in its CHNA dated September 30, 2019.ACCESS TO CARE:- During the fiscal year ended September 30, 2020, RIH's Cardiac and Pulmonary Rehabilitation (CPR) program run by the Lifespan Cardiovascular Institute (CVI) created a virtual/hybrid Cardiac and Pulmonary Rehab platform in conjunction with an organization called Chanl Health. This platform is staffed by the CVI and increases the enrollment of non-captured patients. It also increases utilization of CPR services, which improves patient's clinical, psychosocial, and quality of life outcomes;-CPR also began implementing a "Home-Based Plan of Care" while the CVI locations at RIH, The Miriam Hospital, and Newport Hospital were closed for eight weeks during FY '20 due to measures taken as a result of the COVID-19 Pandemic;-RIH's Department of Psychiatry began implementing a weekly virtual support group during the COVID-19 closures as a way to provide patient access to psychiatric services, focusing on quality of life outcomes as they relate to social isolation and depression;-In conjunction with Lifespan's Communications and Marketing Department, RIH created a YouTube channel for improved access to exercise, meditation, and nutritional options for patients. This feature allows patients to improve adherence to healthier lives and provides them with increased flexibility to exhibit healthy living practices;-RIH and TMH began working with Nationwide Transportation to coordinate the transportation to/from rehabilitation appointments for individuals who do not drive. This partnership has allowed for increased access to cardiac rehab programs and services.MENTAL AND BEHAVIORAL HEALTH:-The Buprenorphine (Suboxone) Induction Hotline, a Rhode Island Department of Health-funded outreach project, went live on April 13, 2020. The project offers emergency/urgent Suboxone induction and bridge prescriptions over the phone until the patient is scheduled with an appointment at the Lifespan Recovery Center (LRC). The on-call Buprenorphine Induction Hotline is staffed by several RIH Emergency Department doctors consisting of emergency medicine, medical toxicology, internal medicine, and addiction medicine trained physicians. The goal is harm reduction by reducing the risk of overdose through street drug use or unsupervised withdrawal; The LRC clinicians also provide consultation with community providers in Providence, Rhode Island to increase awareness and educate medical professionals about the availability and effectiveness of treatment; Lifespan providers have been involved in several social media pieces to describe the nature of substance use disorders and the availability of treatment in order to educate the public and reduce stigma. The LRC recently hired a full-time social worker. The goal of this position is to ensure that a patients full spectrum of biopsychosocial needs are being met, with an emphasis on addressing social determinants of health that may negatively impact the patient's ability to engage in treatment. -In response to the COVID-19 Pandemic, the LRC has been offering telehealth appointments to patients, which has improved access to care. For patients with certain hardships, our system was able to provide Kindle Fires in order to engage in virtual appointments. The Lifespan Psychiatry and Behavioral Health Access Center continues to provide a streamlined way to make an appointment or be referred to the appropriate resource for all adult outpatient programs for mental, emotional, and behavioral health issues. We expanded our capabilities to provide a Telehealth Technical Support Line (TTSL). As RIH continued to build its telehealth capabilities this past year, it recognized the need to have technical support readily available to patients during the day, evening, and weekend hours. The support service was developed to help address the barriers patients face with accessing care through telehealth. To provide patients with greater flexibility and on demand appointments, the LRC now offers open access time for patients to walk-in for intake appointments (M,T,F: 9:30-11:30). Researchers across Lifespan are committed to advancing the science and practice of the treatment of substance use disorders. Recent grant submissions have included investigating the role of mobile peer support for Opioid Use Disorder, evaluating changes to buprenorphine treatment in the context of COVID-19, and feasibility/acceptability/safety of completing buprenorphine inductions through pharmacy-based care.-Same day appointments for urgent evaluations are available at RIH's East Providence and East Greenwich outpatient programs. In addition, on May 3rd, 2021 RIH will go live with its inpatient bridge clinic. Through this bridge clinic, patients being discharged from the RIH and Newport Hospital psychiatric inpatient units will be scheduled to meet with a psychiatrist in a telehealth capacity within 7 days post-discharge. Telehealth is a vital mechanism to allow individuals with preexisting mental health conditions to continue with their treatment. RIH recognized that a subset of our patient population experienced barriers to telehealth care, as they lacked the technology to support certain platforms. Last spring, RIH was awarded a Rhode Island Foundation grant to purchase and provide Kindle Fire tablets to patients in need so they could effectively participate in behavioral health services. This technology allowed RIH's vulnerable/underrepresented population to continue to seek treatment for opioid use disorder. In FY '20 RIH hired a psychologist with specialization in young adults and substance use disorders (SUD) with the goal of growing this program (e.g., counseling for young adults with SUDs). COMMUNITY BASED OUTREACH & EDUCATION:Lifespan Community Health Institute held 23 Diabetes Prevention Program (DPP) sessions during FY '20. DPP started with 20 participants and ended with 7 who completed the program on 7/27/20. LCHI also ran a DPP cohort in partnership with the RIH Center for Primary Care in FY '20. That class also had 23 sessions. 18 participants started and 3 finished by the end of FY '20.LCHI opened The Transitions Clinic (TTC) in FY '20. TTC is a primary care clinic with wrap-around supports, including community health workers for patients who have multiple chronic conditions and were released by the State of Rhode Island Department of Corrections in the previous year. TCC at RIH served 118 patients in FY '20.LCHI also offered a free community lecture series during FY '20 available to the public which included a Financial Literacy course, two "Food is Medicine" series (4 week sessions), 10 cooking demonstrations to almost 100 participants, 18 Safe Sitter lectures (136 participants) and 9 events on becoming a Lifespan Community Health Ambassador to promote health in the community (131 participants).DISEASE MANAGEMENT:-The Lifespan Center for Weight and Wellness (CWW) converted to a virtual program at the onset of the pandemic. The program is currently functioning as a virtual program, with all in-person groups and fitness classes having been temporarily discontinued during the Pandemic. These groups and classes will be re-established once in-person groups are able to resume. The Weight and Wellness Academies were offered prior to COVID-19. They include topics related to meal prep, stress management, and skill building, as well as embracing the new you post weight loss. CWWs first venture to deliver on-site weight and wellness programs to employees has been successful. Feedback was positive from both the employer and employees who engaged in the program. Program leadership continues to meet with other interested businesses to develop on-site and wellness programs to their employees. Hypnosis for Weight Loss was very popular amongst patients. Although the program has been discontinued during the Pandemic, we will re-establish this program when in-person groups are able to resume. The teen weight and wellness program Lighten-Up continues to be a successful program targeted towards helping teens achieve a healthy weight and wellness and develop life-long habits of healthful eating and exercise. A health fair was held on Thursday, September 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. Facility: Rhode Island Hospital - Part V, Section B, Line 22d RIH uses the prospective method in determining amounts generally billed. Internal Revenue Code Section 501(r) defines the prospective method as the amount that Medicare would reimburse RIH for billed care (including both the amount that would be reimbursed by Medicare and the amount that the beneficiary would be personally responsible for paying in the form of copayments, coinsurance, and deductibles) if the patient was a Medicare fee-for-service beneficiary. 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 East Providence Infusion Center 375 Wampanoag Trail Suite 101A East Providence RI 02915 Infusion Services Lifespan Cancer Institute Prgm of RIH at Newport Hosp 11 Friendship Street Newport RI 02840 Comprehensive Cancer Center Physician Visits, Infusion Therapy Dialysis Center of RIH 22 Baker Street Providence RI 02905 Hemodialysis, Home Peritoneal Dialysis, Home Hemodialysis RIH Rheumatology Infusion Center 407 East Avenue Suite 250 Pawtucket RI 02860 Infusion Services RIH Surgery Center at Wayland Square 17 Seekonk Street Providence RI 02906 Outpatient Surgery Lifespan Cancer Institute 701 George Washington Highway Ste 1 Lincoln RI 02865 Comprehensive Cancer Center Physician Visits, Infusion Therapy RIH Center for Wound Care and Hyperbaric Medicine 950 Warren Avenue Suite 103 East Providence RI 02914 Wound Care and Hyperbaric Medicine 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 Outpatient Rehabilitation Services 765 Allens Avenue 1st Floor Suite 1 Providence RI 02905 Adult Physical and Occupational Therapy RIH Pediatric Heart Center 1 Hoppin Street Providence RI 02903 Outpatient Pediatric Cardiology Services Lifespan Research Center 1 Hoppin Street CORO Building Providence RI 02903 Study, Design, Analysis, Medical & Regulatory Oversight Research Childrens Neurology & Development Clinic 335R Prairie Avenue Suite 2B Providence RI 02905 Pediatric Services Ophthalmology Clinic 1 Hoppin Street Suite 200 Providence RI 02903 General & Specialty Ophthalmic Examinations, Testing & Procedures Medicine Pediatrics 245 Chapman Street Suite 100 Providence RI 02905 Primary Care Medicine Audiology and Speech-Language Pathology Services 115 Georgia Avenue Providence RI 02905 Speech-Language Pathology and Audiology Services RIH Pediatric and Adolescent Health Care Center 1 Hoppin Street Suite 3055 Providence RI 02903 Outpatient Adolescent Services RIH Sleep Disorders Center 70 Catamore Boulevard East Providence RI 02914 Outpatient Professional and Technical Evaluation of Sleep Disorders RIH Outpatient Specialty Svcs Pedi Endocrinology 111 Plain Street 3rd Floor Providence RI 02903 Pediatric Endocrinology Services Lifespan Recovery Center 200 Corliss Street Suite 1 Providence RI 02904 Treatment of Opioid and Related Drug Addictions Rhode Island Hospital East Greenwich Lab 1454 South County Trail 1st Floor East Greenwich RI 02818 Clinical Core Laboratory Testing Pediatric Multi-Discipline Clinic & Rehab Satellite 1454 South County Trail 1st Floor East Greenwich RI 02818 Pediatric Specialties & Physical Therapy inclusive of Psychiatry Pediatric and Adult Medicine 900 Warren Avenue 2nd Floor East Providence RI 02914 Pediatric and Adult Specialty Services Radiosurgery Center of RI LLC 593 Eddy Street Providence RI 02903 Radiosurgery 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 General Internal Medicine Research Group 111 Plain Street Providence RI 02903 Behavioral Research Studies Ctr Innovative Neurotechnology for Neural Repair 117 Chapman Street Suite 100 Providence RI 02905 Physical Therapy Orthopedic MRI of RI LLC 1 Kettle Point Avenue East Providence RI 02914 Radiosurgery 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, 2020 is available at the following link. https://issuu.com/lifespanmc/docs/ls-annual-report-2020-210527?fr=sYjZhOTM3NDAwMDAPlease see pages 5-17 and 39-40 of the Lifespan Annual Report for community benefit information. 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 $46,114,399. 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 2020 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. For example, RIH added a new 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. Children ages 6 to 18 are treated in a newly-renovated, secure 16-bed unit located on the 6th floor of Hasbro Children's Hospital. 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 50 graduate medical education programs accredited by or under the auspices of the Accreditation Council for Graduate Medical Education (ACGME), while also sponsoring another 35 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 16,000 people. The Lifespan system has approximately 3,700 physicians on the medical staffs of its affiliated hospitals, operates 1,165 licensed beds in four hospital complexes, and in 2020 generated approximately $2.5 billion in total operating revenue. By each of these measures, Lifespan is Rhode Island's largest health system, serving a population of over 1.0 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, with 79 percent of the residents and fellows in this program based at RIH, TMH, and EPBH.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, 2020, Lifespan Corporation employed approximately 1,100 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 9/30/2019 CHNA report widely available is located at the following URL:https://www.lifespan.org/sites/default/files/lifespan-files/documents/centers/lifespan-community-health/9-30-2019-RIH-CHNA.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/lifespan-files/documents/lifespan-main/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/2020-11/financial-assistance-policy-en_100120.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) 944759 0 General Support Gloria Gemma Breast Cancer 249 Roosevelt Avenue Ste 201 Pawtucket RI 02860 134283582 501(c)(3) 8500 0 General Support Inst Study & Prac Nonviolence 265 Oxford Street Providence RI 02905 050517863 501(c)(3) 125000 0 General Support Rhode Island Hospital Fnd 167 Point Street Providence RI 02903 050468736 501(c)(3) 399193 0 General Support The Miriam Foundation 167 Point Street Providence RI 02903 050377502 501(c)(3) 10000 0 General Support 5 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 Alexios G Carayannopoulos DO Physician 597386 60000 2658 16800 17793 694637 Barbara P Riley RN Chief Nursing Officer 298788 69140 321395 20137 709460 Douglas Anthony MD Physician 575358 73750 11676 16800 36808 714392 John B Murphy President 586315 129703 16800 20192 753010 Keith-Austin Scarfo MD Physician 365398 78515 841 16800 31386 492940 Latha Pisharodi MD Physician 426260 5000 6399 16800 11689 466148 Latha Sivaprasad MD Chief Medical Officer 404681 80285 88503 21622 595091 57822 Margaret M Van Bree MHADrPH Pres thru 12/19 676238 134635 1166285 20907 1998065 98449 Mary A Wakefield Treasurer 725836 144180 222120 19991 1112127 105275 Murray Resnick MD Physician 480218 7253 16800 27956 532227 Nicholas P Dominick SVP-Clin. Svc. Lines & Facil. Devel 285989 62664 67889 25197 441739 41133 Paul J Adler Secretary 482452 77524 100931 25368 686275 46564 Timothy J Babineau MD Trustee 1325243 436735 1391844 31206 3185028 334018 Ziya L Gokaslan MD Trustee 1340498 148750 5608 16800 41156 1552812 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. Part III, Additional Information Part I, Line 1a:Certain executives and management personnel receive financial planning services paid for by RIH. In calendar year 2019 RIH provided this benefit to two executives listed in this return. The taxable amount paid for this benefit is included in Medicare wages, more specifically on Schedule J, Part II, Column B (iii). A RIHEBC Series 2016 521300173 762244FP1 2016-08-11 227078594 Refund 1996, 2006, 2009 Bonds false false true A 9492560 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. X Donated equipment 1 52999 FMV false true false Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Timothy J. Babineau, MD, Lifespan President & CEO, and Mary A. Wakefield, Lifespan Treasurer/EVP/CFO, are board members of VNA Technicare, Inc. (VNA), a related for-profit corporation. Dr. Babineau is a director and Ms. Wakefield is an officer of VNA. Additionally, Ms. Wakefield and Paul J. Adler, Lifespan Secretary, are board members of Lifespan MSO, Inc. (MSO) and Lifespan Risk Services, Inc. (LRS), separate related for-profit organizations. Mr. Adler is a director of MSO and LRS while Ms. Wakefield is an officer of those two organizations. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Lifespan Corporation is the sole member of RIH. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body 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, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders 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, Line 11b: Form 990 Review Process The preparation and filing of the Form 990 and supporting schedules is theresponsibility of the Executive Vice President & Chief Financial Officer (EVP/CFO)and Lifespan's Finance Department, with review by Lifespan's tax advisors, KPMG LLP(KPMG). The Form 990 is prepared by the accounting staff upon completion ofLifespan's annual independent audit and reviewed by the Corporate Services TaxCompliance Manager, the Director of Finance, and the Vice President of Finance -Corporate Services. The Form 990 is forwarded to KPMG for further review. KPMGprovides the Tax Compliance Manager with any recommended changes which are reviewed,and if agreed upon, are incorporated into the return. The draft Form 990 is thenprovided to the EVP/CFO for final management review.Prior to filing the return with the Internal Revenue Service, a copy of the entire form, along with a video presentation detailing form highlights, are posted to RIH's Board of Trustees website portal in advance of the next Board meeting, at which 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, Line 19: Other Organization Documents Publicly Available 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. Other Changes In Net Assets Or Fund Balances - Other Increases Change in Funded Status of Pension and Other Postretirement = $7731529 Other Changes In Net Assets Or Fund Balances - Other Decreases Decrease in Interest in Net Assets of RIHF = -$1637003 Other Changes In Net Assets Or Fund Balances - Other Increases Transfers from Hospital Properties, Inc. = $2002 . 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; and the distinction center for spine surgery, 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 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 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 $18,841,746 in fiscal 2020. Charges forgone, based on established rates, amounted to $66,112,000.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 $12,999,295 in fiscal 2020. 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 $267,878 in fiscal 2020.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.RIH's Comprehensive Stroke Center was recognized by the American Heart Association/American Stroke Association with a Get the Guidelines - Stroke Gold Plus with Target: Stroke Honor Roll Elite and Advanced Therapy Achievement Award for 2020. This award honors the hospital's commitment to ensuring that stroke patients receive the most appropriate, leading-edge treatment, as quickly as possible, in accordance with nationally recognized, evidence-based guidelines. Timely treatment critically influences patient outcomes.RIH was designated a Blue Distinction Center + for Cardiac Care and a Blue Distinction Center for Cancer Care. The Blue Cross Blue Shield Association recognizes health care facilities across the nation that demonstrate expertise in delivering quality specialty care.The Comprehensive Stroke Center at RIH reached an aggressive goal of treating patients with 85 percent or higher compliance to core standard levels of care as outlined by the American Heart Association/American Stroke Association for two consecutive calendar years.RIH was also named to the list of 50 Top Cardiovascular Hospitals 2019 by IBM Watson Health. Selected based on a study that analyzed key performance metrics, including survival rates, complications, length of stay, cost, and readmission rates, RIH earned the distinction along with just two others in New England. RIH has now made this list five times and is the only hospital in the State to be included. The Cardiothoracic Intensive Care Unit at RIH was given the silver designation of the Beacon Award for Excellence by the American Association for Critical Care Nursing in 2018. It is one of only 42 cardiothoracic ICUs to achieve this level of recognition.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. . 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 Council 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: greeters, family liaisons, emergency room, gift shop, nurses' aides, office support, animal visitation, physical therapy, patient visitors, recovery room, art activities, pediatric playrooms, outpatient clinics, reading programs, tours, intensive care unit, and oncology. 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 6,839 full-time equivalents and is nationally and internationally recognized as a research and academic medical center. In 2020, RIH discharged 33,293 inpatients with total inpatient days of 203,137, treated 128,487 patients in its emergency departments, performed 21,917 inpatient and outpatient surgical procedures, and cared for 267,453 patients in outpatient clinics. RIH is the designated Level I Trauma Center for the State of Rhode Island and southeastern Massachusetts, 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 is the only facility in the State of Rhode Island to be designated a Breast Imaging Center of Excellence by the American College of Radiologists. 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 Cardiovascular Institute, which provides cardiac catheterization, balloon angioplasty, and open heart surgery; 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 currently sponsors 50 graduate medical education programs accredited by or under the auspices of the Accreditation Council for Graduate Medical Education (ACGME), while also sponsoring another 35 hospital-approved residency and fellowship programs. RIH serves as the principal setting for these clinical training programs, which encompass the following disciplines: anesthesiology; internal medicine and medicine subspecialties, including hematology and oncology; orthopedics and orthopedic subspecialties; clinical neurosciences and related subspecialties; general surgery and surgical subspecialties; pediatrics and pediatric subspecialties, including hematology and oncology; dermatology; radiology and radiology subspecialties; pathology; child psychiatry; emergency medicine and emergency medicine subspecialties; dentistry; and medical physics. RIH provides stipends to residents and physician fellows while in training.In 2020, Brown enrolled 604 students in undergraduate medical education programs. All medical students at Brown receive training at RIH. RIH teaching faculty help to 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 another 263 residents and fellows from other programs in anesthesiology, family medicine, internal medicine, emergency medicine, hematology/oncology, obstetrics/gynecology (OB/Gyn) and OB/Gyn subspecialties, dermatology, dermatopathology and pediatric pathology, otolaryngology, pediatric dentistry, podiatry, psychiatry and its subspecialties of forensic psychiatry, consult liaison psychiatry and geriatric psychiatry, orthopedics, rheumatology, and radiation oncology. Various departments and specialties at RIH serve as clinical sites for the physician assistant schools of Johnson & Wales University, Bryant University, and the Massachusetts College of Pharmacy and Health Sciences. 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 the University of Rhode Island College of Nursing; Community College of Rhode Island (CCRI); Salve Regina University; Boston College; Yale University; Regis College; Simmons College; the University of Massachusetts campuses at Dartmouth, Boston, Amherst, and Worcester; Framingham State University; the University of Connecticut; the New England Institute of Technology; Northeastern University; Drexel University; Walden University; Georgetown University School of Nursing and Health Studies; Duke University School of Nursing; and the University of Pennsylvania, as well as other 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. Most of the pharmacy students attend the University of Rhode Island, Massachusetts College of Pharmacy and Health Sciences, and Northeastern University. 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 the University of Rhode Island's College of Pharmacy, Rhode Island College's Advanced Practice Nursing Program, Johnson & Wales University's Center for Physician Assistant Studies, and Bryant University's Physician Assistant Program. In addition, RIH has clinical social work student contracts with Rhode Island College, Boston University, Boston College, Smith College, Simmons College, and Bridgewater State University. Form 990, Part III, Line 4c, continued RIH provided $15.3 million in support of research activities in fiscal year 2020. 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: *Lawrence A. Aubin, Sr., Chair, is the owner of Lawrence Investments, LLC, with which Lifespan entered into a ten-year operating lease of certain health care facilities in July 2015. During fiscal year 2020, Lifespan paid rent to Lawrence Investments, LLC under the terms of this lease. Terms of the rent expense related to this lease have been established at fair market value.*Pamela A. Harrop, MD, Trustee through October 2019, is the President of Medical Associates of Rhode Island, Inc. (MARI). Beginning in 2020, Lifespan and MARI engaged for Dr. Harrop to provide physician consulting services to the Lifespan hospitals. During fiscal year 2020, Lifespan paid MARI $54,000 as part of this consulting contract. Form 990, Part XII, Line 2 RIH was included in RIH and Affiliates' audited consolidated financial statements as of and for the fiscal year ended September 30, 2020, which consist 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 RIH's consolidated financial statements and the selection of Lifespan's independent accountant. 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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 Mentally 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 Orthopedic MRI of Rhode Island LLC 1 Kettle Point Avenue Riverside RI 02915 261293469 Medical Imaging Svcs RI NA related -42713 106170 false false 0.33330 Lifespan Health Alliance LLC 167 Point Street Providence RI 02903 812732225 Account. Care Org. RI N/A false false AHB Will co Bank of America 100 Westminster Street Providence RI 029032305 Philanthropy RI NA T 20399 440412 1.00000 true Lifespan MSO Inc 167 Point Street Providence RI 02903 050508717 Mgmnt Svcs RI Lifespan Corp C false Lifespan Risk Services Inc 167 Point Street Providence RI 02903 050459767 Risk Mgmnt RI Lifespan Corp C false VNA Technicare Inc 200 Corliss Street Providence RI 02904 050472710 DME Sales RI The Miriam Hospital C false false true true false false false false false false true true true true true true true true false true Hospital Properties b 70314 accrual Hospital Properties c 72315 accrual Hospital Properties k 617122 accrual