2020-08-14T12:12:03-07:00 2019-09-30 135565207 KPMG LLP 2 Financial Center 60 South St Boston MA 02111 990 2018-10-01 050258954 Rhode Island Hospital RHOD 4014444000 593 Eddy Street Providence RI 02903 Mary A Wakefield Treasurer 2020-08-14 true Tara D'Agostino P01245482 6179881000 2018 2020-09-23 17:36:50Z John B Murphy MD 1820197837 false 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 13 9553 625 3133634 393085 7517072 11486068 1422019640 1470988569 25532489 23684572 -8097219 -8090084 1446971982 1498069125 1228599 1170367 0 601901711 623768975 0 0 833955883 902706381 1437086193 1527645723 9885789 -29576598 1284809986 1274041361 511822928 590394519 772987058 683646842 X As a founding hospital in the Lifespan health system, RIH is committed to its mission: Delivering health with care. false false 1161308618 1143601 1376263309 Patient Care:RIH is the State's largest hospital, and its only Level I trauma center and verified burn center. It is the Principal Teaching Hospital of The Warren Alpert Medical School of Brown University, and 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) 102191193 15228027 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 $87.0 million in fiscal year 2019. (Continued on Schedule O) 73625526 61852102 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 59% 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 $18.8 million of research grants from for-profit organizations that are not reported in Schedule H. (Continued on Schedule O) 1337125337 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 false false false false true true true true true false true 532 0 true 9553 true true true false false false false false false 0 false false false false false false false false false false false false X 17 13 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 Lawrence A Aubin Sr Chair 2.50 12.50 X X 0 0 0 Timothy J Babineau MD Trustee 20.00 20.00 X 0 1928054 318064 Emanuel Barrows Trustee 0.60 3.00 X 0 0 0 Roger N Begin Trustee 2.00 5.00 X 0 0 0 Peter Capodilupo Vice Chair 0.10 3.90 X X 0 0 0 Sarah T Dowling 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 8.50 X 0 0 0 Ziya L Gokaslan MD Trustee 0.50 43.50 X 0 1482390 43334 Michael L Hanna Trustee 1.50 4.80 X 0 0 0 Pamela A Harrop MD Trustee 3.00 3.00 X 0 0 0 Alan H Litwin Vice Chair 1.00 9.50 X X 0 0 0 Joseph J MarcAurele Trustee 0.00 2.50 X 0 0 0 Steven Pare Trustee 2.00 10.50 X 0 0 0 Lawrence B Sadwin Trustee 0.20 14.15 X 0 0 0 Shivan Subramaniam Trustee 0.25 5.25 X 0 0 0 Jane Williams Trustee 1.00 2.80 X 0 0 0 Paul J Adler Secretary 5.00 35.00 X 0 551087 106582 Margaret M Van Bree MHADrPH President 35.00 5.00 X 0 873065 134112 Mary A Wakefield Treasurer 10.00 30.00 X 0 939142 101891 Nicholas P Dominick SVP-Clin. Svc. Lines & Facil. Devel 40.00 0.00 X 367431 0 78035 Barbara P Riley RN Chief Nursing Officer 40.00 0.00 X 388799 0 31541 Latha Sivaprasad MD Chief Medical Officer 40.00 0.00 X 515556 0 95817 Alexios G Carayannopoulos DO Physician 40.00 0.00 X 643729 0 30320 Deus J Cielo MD Physician 40.00 0.00 X 829115 0 42298 Petra M Klinge MD Physician 40.00 0.00 X 723260 0 37809 Adetokunbo A Oyelese MD Physician 40.00 0.00 X 828277 0 45428 Albert E Telfeian MD Physician 40.00 0.00 X 831459 0 42334 John B Murphy MD EVP - Physician Affairs 40.00 0.00 X 0 769010 35185 5127626 6542748 1142750 767 true true false Brown Medicine 110 Elm Street Providence RI 02903 Medical Services 37562586 Alternative Workforce Inc 1055 W Maple Road Clawson MI 48017 Contract Labor 11278254 University Surgical Assoc Inc 75 Newman Avenue Rumford RI 02916 Medical Services 10769612 Brown Neurology 110 Elm Street Providence RI 02903 Medical Services 7009376 Brown University 45 Prospect Street Providence RI 02912 Subcontracted Svcs. 6253992 99 10563923 77000 845145 11486068 Direct Rev from Research 900099 61852102 61852102 Lifespan Pharmacy 446110 58191135 58191135 Patient Service Revenue 900099 1342789768 1342789768 Rental 531120 4329710 4329710 Temp Restricted (SPF's) 900099 3825854 3825854 1470988569 6406826 6406826 0 0 3105996 2003414 1102582 1102582 1102582 336982495 319635977 68772 17346518 -68772 17277746 17277746 0 0 336815 420549 -83734 -83734 Cafeteria Revenue 722210 5228576 5228576 Indirect Rev from Grants 900099 14036277 14036277 Other/Services Rendered 900099 4066720 4066720 -32440505 -35748128 3217368 90255 -9108932 1498069125 1453343438 3133634 30105985 1135367 1135367 35000 35000 0 0 1425734 1002691 423043 0 478086697 476757816 1328881 29582938 29491354 91584 80418647 80167782 250865 34254959 34128739 126220 0 0 0 1672 1672 0 2348262 2348262 120973520 120942291 31229 64466 64466 23144464 21024007 2120457 0 0 27877154 23184518 4692636 1704504 1699832 4672 0 1576474 1563575 12899 6621527 4055 6617472 0 55988093 55988093 22045025 22053133 -8108 Medical & surgical supplies 320670731 320670731 Purch Svs & Equip Contracts 165710898 50374056 115336842 License Fee 71815141 71815141 Provision for Bad Debts 43403708 43403708 38760742 37605403 1155339 1527645723 1337125337 190520386 0 1187044 552063 37725110 20478272 5976142 7555356 133300600 153743024 0 0 0 25152917 23972506 3425635 3703448 1342837350 822412178 520182657 520425172 318971601 322420794 143505737 122482028 0 0 95382543 98708698 1284809986 1274041361 87788119 115549351 201235326 189160892 10550536 5318871 3760000 23680000 208488947 256685405 511822928 590394519 X 417343605 318466858 278454542 288172143 77188911 77007841 772987058 683646842 1284809986 1274041361 X -29576598 -11639185 -48124433 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 1672 1672 false false Part II-B, Line 1i - Other Activities Description RIH pays membership fees to the Association of American Medical Colleges and the Trauma Center Association of America. A portion of the membership dues paid to these organizations is allocated to their lobbying efforts. 75705 X false 480080475 74419354 9352353 100564071 463288111 480453623 70377312 23675697 94426157 480080475 469816601 61895738 46265035 97523751 480453623 456888675 66813380 21926308 75811762 469816601 471966702 64741784 -9161940 70657871 456888675 0.36200 0.08700 0.55100 true true true 31159682 31159682 808071354 489693721 318377633 483484449 332718457 150765992 20121865 20121865 520425172 122482028 Deferred Financing Costs 1219022 Intercompany Receivables 701583 Interest in Net Assets of RIH Foundation 66573039 Other Non-Current Assets 1134725 Other Receivables 10695040 98708698 Accrued Interest Payable 3115677 Accrued Pension Liability 167607800 Health Care Benefit Self-insurance 10348160 Other Liabilities 35342475 Post-retirement Benefit Liability 9789800 Third-party Payor Settlements 30481493 256685405 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) cancer research and the study, prevention, care, and treatment of cancer; and (5) support of the Norman Prince Neurosciences Institute at RIH. 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 2019 or 2018. true Central America and the Carib 0 0 Program Services Research 5742 East Asia and the Pacific 0 0 Program Services Research 58187 South America 0 0 Program Services Research 27939 South Asia 0 0 Program Services Research 130841 Sub-Saharan Africa 0 0 Program Services Research 52427 275136 275136 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 23657859 5445888 18211971 0.01220 367092795 317545477 49547318 0.03340 390750654 322991365 67759289 0.04560 303377 22735 280642 0.00020 102191193 15228027 86963166 0.05860 21039661 12200768 8838893 0.00600 54776706 43002706 11774000 0.00790 559283 559283 0.00040 178870220 70454236 108415984 0.07310 569620874 393445601 176175273 0.11870 true 11662576 526168 216456376 213625563 2830813 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 Sched. 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- The significant needs identified in RIH's 9/30/2019 CHNA 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, prioritize those needs, and identify 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 include 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 co-morbidities, 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.pdf.During the fiscal year ended September 30, 2019, RIH implemented the specific actions listed below in order to address the significant community health needs outlined in its CHNA dated September 30, 2016.ACCESS TO CARE AND HEALTH LITERACY- Continue to invest in high-quality primary care in partnership with LPG and Metacom Associates: A full-time physician was added to this practice during the fiscal year to assist in expanding the RIH community's access to primary care services;- Continue to provide oral health screening to children in Rhode Island Head Start programs: Provided 505 screenings at the RIH Samuel's Sinclair Dental Center during the fiscal year ended September 30, 2018 and anticipated similar volume during the fiscal year ended September 30, 2019;- Continue to improve existing interpreter and translation services to better meet the needs of patients: Interpreter services at RIH were reorganized during FY 2019 under a system leadership restructuring to expedite efforts to standardize interpreter service practices and improve efficiency in delivering interpretation services to patients and families across Lifespan. A revised policy on interpreter services for the deaf and hard of hearing was also issued during FY 2019 to improve both timely access to interpreters and patient satisfaction;- Continue to provide free lectures at community sites such as community centers, churches, and schools on topics related to health access and health literacy: FY 2019 statistics include: Financial Literacy: 3 classes (412 participants); "Food is Medicine": 9 classes (74 participants); food demonstrations: 2 events (20 participants); "Safe Sitter": 17 classes (186 participants); and community health lectures: 30 presentations (737 participants);- Continue to offer community-based biometric screenings and flu clinics for low-income and uninsured residents in partnership with the LCHI to promote primary prevention with appropriate referrals to treatment: Provided blood pressure screenings to 580 individuals across 39 events, 335 glucose screenings across 26 events, and provided 647 flu vaccinations during 33 free clinic events;- Continue to provide community-based CPR (both certified and non-certified) and AED training through the Community Training Center at the LCHI: During FY 2019, LCHI provided 97 certified CPR classes to 705 participants and 18 non-certified classes to 278 participants.HEALTHY FOOD ACCESS- Continue to offer services to adolescents and promote participation in the HCH Adolescent Weight Management Program services: In June 2019, HCH piloted a 7-week "Summer Health in Nutrition and Exercise" program for adolescents. The program served thirty youths through group-based education, exercise, and cooking classes.- Increase the number of participants in "Food is Medicine" classes and begin offering classes in Spanish: Delivered nine "Food is Medicine" courses during FY 2019 to 74 students and 2 food demonstrations to 20 participants;- Continue to provide free community lectures on nutrition and healthy weight: Offered the "Hunger is a Healthcare Issue" lecture on 10/9/18;- Begin offering the Center for Disease Prevention and Controls proven effective Diabetes Prevention Program (DPP), which teaches people at risk of developing diabetes how to prevent the condition through diet and exercise: LCHI became a CDC-certified DPP provider and launched three year-long cohorts in the fiscal year ended September 2018 (two in November 2017 and one in January 2018). A fourth cohort began in August 2019.SUBSTANCE USE DISORDERS- Continue to provide free community lectures and conferences, such as Parenting Matters and Temas Familiares, on topics related to substance abuse prevention, treatment, and mental health: FY 2019 activity was as follows: *Parenting Matters Workshop on 3/23/19 (196 participants);*Temas Familiares Conference on 5/4/19 (42 participants);*"Working with Grieving Children, Teens, and Families" lecture on June 11, 2019; and* "Cultural Considerations when Working with the Latinx Population" lecture on July 9, 2019;- Establish a Center of Excellence for the Treatment of Opioid Use Disorder to work in coordination with the RIH Emergency Department: During FY 2019, 561 people were treated in the program for either an opioid use disorder or another substance use disorder;- Begin offering Mental Health First Aid (MHFA) to the general public and first responders in the RIH service area. Behavioral health and mental health disorders often co-occur, so it is important to address mental health concerns using a preventative technique with respect to behavioral health disorders like substance abuse. MHFA is an innovative eight-hour course that trains people to recognize the signs and symptoms of common mental health disorders, to provide immediate initial on-site help, and to guide individuals toward appropriate professional assistance. During FY 2019, LCHI offered 66 MHFA classes to 1,062 participants.CARDIAC HEALTH- Continue to provide free blood pressure screening for low-income and uninsured residents, with appropriate referrals to treatment: During FY 2019, LCHI provided 580 blood pressure screenings at 39 events;- Continue to provide community-based CPR (both certified and non-certified) and AED training through the Community Training Center at LCHI: During FY 2019, LCHI provided 97 certified CPR classes to 705 participants and 18 non-certified classes to 278 participants;- Offered a community lecture on October 9, 2018 titled "Hunger is a Healthcare IssueX;- Continue to provide services through the Comprehensive Stroke Center (CSC) at RIH: Notable achievements of the CSC include being Rhode Island's first and only Joint Commission-certified Comprehensive Stroke Center, earning the 2019 "Get With the Guidelines Target Stroke Elite Plus Honor Roll" Award, which recognizes an aggressive goal of 85% or higher compliance in core standard levels of care as outlined by the American Heart Association and the American Stroke Association for two consecutive calendar years;CANCER- Continue to provide community-based education programs like Avenues of Healing, tobacco cessation, Kick Butts Day, and Cancer Survivors Day events. Programs provided by LCHI during FY 2019 included:*Avenues of Healing delivered on 10/13/18 to 225 attendees; *Cancer Survivors Day event held Sunday, 9/22/19 with 259 participants;*Provided a community lecture on 2/12/19 focused on "CT Screening for Lung Cancer: How to Save Lives and Stop Cigarette Smoking in Rhode IslandX;*Held the "Preventable.Treatable.Beatable: Reduce your risk for colorectal cancer" community lecture on 3/12/19; - Continue to provide preventative screenings such as "See, Test & Treat" and "SunSmarts for Cancers", in partnership with LCHI: During FY 2019, LCHI conducted 515 skin cancer screenings during seven events;- Improve patient access, patient experience, and communications, including establishing a Telephone Triage Center to serve as one-stop shopping for medical oncology and infusion patients. A single point of entry Lifespan Cancer Institute (LCI) telephone response and triage line was established in FY 2017 and continued throughout FY 2019. This line improves response times and patient satisfaction with respect to accessing their oncology providers; 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 co-payments, co-insurance, 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 Dialysis Center of RIH 950 Warren Avenue East Providence RI 02914 Hemodialysis RIH Center for Wound Care and Hyperbaric Medicine 950 Warren Avenue Suite 103 East Providence RI 02914 Wound Care and Hyperbaric Medicine 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 Childrens Neurology & Development Clinic 335R Prairie Avenue Suite 2B Providence RI 02905 Pediatric Services Audiology and Speech-Language Pathology Services 115 Georgia Avenue Providence RI 02905 Speech Language Pathology and Audiology 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 RIH Sleep Disorders Center 70 Catamore Boulevard East Providence RI 02914 Outpatient Professional and Technical Evaluation of Sleep Disorders RIH Pediatric and Adolescent Health Care Center 1 Hoppin Street Suite 3055 Providence RI 02903 Outpatient Adolescent Services RIH Outpatient Specialty Svcs Pedi Endocrinology 111 Plain Street 3rd Floor Providence RI 02903 Pediatric Endocrinology Services RIH Rehabilitation Services Hand Therapy 235 Plain Street Suite 203 Providence RI 02903 Occupational Therapy Pediatric Multi-Discipline Clinic & Rehab Satellite 1454 South County Trail 1st Floor East Greenwich RI 02818 Pediatric Specialties & Physical Therapy inclusive of Psychiatry Lifespan Recovery Center 200 Corliss Street Suite 1 Providence RI 02904 Treatment for Opioid and Related Drug Addictions Radiosurgery Center of RI LLC 593 Eddy Street Providence RI 02903 Radiosurgery Services Pediatric and Adult Medicine 900 Warren Avenue 2nd Floor East Providence RI 02914 Pediatric and Adult Specialty Services General Internal Medicine Research Group 111 Plain Street Providence RI 02903 Behavioral Research Studies RIH Molecular Laboratory 167 Point Street CORO East 3rd Floo Providence RI 02903 Clinical Laboratory Testing - Molecular Diagnostics Lifespan Cancer Institute 701 George Washington Highway Ste 1 Lincoln RI 02865 Comprehensive Cancer Center Physician Visits, Infusion Therapy Orthopedic MRI of RI LLC 1 Kettle Point Avenue Riverside RI 02915 Medical Imaging Services Lifespan Clinical Research Center 1 Hoppin Street CORO Building Providence RI 02903 Study, Design, Analysis, Medical & Regulatory Oversight Research 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 either 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 will require 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, 2019 is available at the following link. https://issuu.com/lifespanmc/docs/ls-annual-report-2019-200602?fr=sMjliMTEzOTMwNDMPlease see pages 5 and 29-30 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 $43,403,708. 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 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 - 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. Please see the following audited financial statement footnote which describes this pronouncement.Accounting Pronouncements Adopted - Footnote 3(b) from the audited financial statements.Adoption of Topic 606RIHs 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 There is no Medicare shortfall for fiscal year 2019. If there was, it would not be 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.* 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 RI 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, is located less than 100 steps from the ambulance bays of the 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 the 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. PFA's also offer assistance with the financial application process and/or understanding the qualification factors for Medicaid, the Affordable Care Act, Medicare, Social Security Disability, 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 RI 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 15,000 people. The Lifespan system has approximately 3,500 physicians on the medical staffs of its affiliated hospitals, operates 1,165 licensed beds in four hospital complexes, and in 2019 generated approximately $2.4 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 77 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, 2019, Lifespan Corporation employed approximately 1,150 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 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 CHNA report widely available is located at the following URL:https://www.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.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 application form is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/financial-assistance-policy-en_052020.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) 929401 0 General Support Inst Study & Prac Nonviolence 265 Oxford Street Providence RI 02905 050517863 501(c)(3) 125000 0 General Support Lifespan Foundation 167 Point Street Providence RI 02903 050493219 501(c)(3) 26766 0 Fundraising support Rhode Island Hospital Fnd 167 Point Street Providence RI 02903 050468736 501(c)(3) 26000 0 General Support Rhode Island Metro EMS Inc 913 Broadway East Providence RI 02914 800552808 501(c)(6) 10000 0 General Support The Miriam Foundation 167 Point Street Providence RI 02903 050377502 501(c)(3) 10000 0 General Support 4 1 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 false true false false false false false true false false Adetokunbo A Oyelese MD Physician 666325 157950 4002 16500 28928 873705 Albert E Telfeian MD Physician 670887 157950 2622 16500 25834 873793 Alexios G Carayannopoulos DO Physician 596119 45000 2610 16500 13820 674049 Barbara P Riley RN Chief Nursing Officer 289507 33397 65895 12915 18626 420340 Deus J Cielo MD Physician 669455 157950 1710 16500 25798 871413 John B Murphy MD EVP - Physician Affairs 569091 75900 124019 16500 18685 804195 Latha Sivaprasad MD Chief Medical Officer 392962 44844 77750 75691 20126 611373 57164 Margaret M Van Bree MHADrPH President 658349 84000 130716 114927 19185 1007177 97327 Mary A Wakefield Treasurer 704974 96500 137668 83352 18539 1041033 104077 Nicholas P Dominick SVP-Clin. Svc. Lines & Facil. Devel 277788 31500 58143 54648 23387 445466 37706 Paul J Adler Secretary 441391 50000 59696 82536 24046 657669 27861 Petra M Klinge MD Physician 581437 139200 2623 16500 21309 761069 Timothy J Babineau MD Trustee 1287694 245234 395126 288958 29106 2246118 301810 Ziya L Gokaslan MD Trustee 1342488 135000 4902 16500 26834 1525724 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 2018 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 9039305 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 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. Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Timothy J. Babineau, MD, President & CEO, and Mary A. Wakefield, 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, 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 corporate 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. 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 and 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 of and 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 the responsibility 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 of Lifespan's annual independent audit and reviewed by the Corporate Services Tax Compliance Manager, the Director of Finance, and the Vice President of Finance - Corporate Services. The Form 990 is forwarded to KPMG for further review. KPMG provides 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 then provided to the EVP/CFO for final management review. Prior to filing the return with the Internal Revenue Service, a copy of the entire form, 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 Decreases Change in funded status of pension and other postretirement = -$41810492 Other Changes In Net Assets Or Fund Balances - Other Increases Equity Transfer from Lifespan Corporation = $7700000 Other Changes In Net Assets Or Fund Balances - Other Decreases Equity transfer to Lifespan Corporation = -$16251000 Other Changes In Net Assets Or Fund Balances - Other Increases Increase in Interest in Net Assets of RIHF = $2333851 Other Changes In Net Assets Or Fund Balances - Other Increases Transfers from Hospital Properties, Inc. = $58685 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfers to Hospital Properties, Inc. = -$155477 . 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 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, 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 $18,211,971 in fiscal 2019. Charges forgone, based on established rates, amounted to $65,007,000.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 $8,838,893 in fiscal 2019. 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 $280,642 in fiscal 2019.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 was designated a Blue Distinction Center + for Cardiac 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 2 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 in the rankings. 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. RIH, the only comprehensive stroke center in the State, received top honors in 2018 from the American Heart Association/American Stroke Associations Get With The Guidelines" stroke program -- a "Gold-Plus" quality achievement award and Target: Stroke Honor Roll Elite Plus award. RIH was recognized in the 2018U.S. News & World Reportannual review of Best Regional Hospitals as a high performer in the areas of chronic obstructive pulmonary disease (COPD) andheart failure. In spring 2018, RIH earned an "A" grade for hospital safety from The Leapfrog Group for the fifth consecutive time. RIH was named a "Distinguished Hospital for Clinical Excellence" by Healthgrades Operating Co., marking it among the top five percent among nearly 4,500 hospitals in the United States. . 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, nurse 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 6,883 full-time equivalents and is nationally and internationally recognized as a research and academic medical center. In 2019, RIH discharged 36,896 inpatients with total inpatient days of 209,833, treated 152,118 patients in its emergency departments, performed 23,314 inpatient and outpatient surgical procedures, and cared for 266,390 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, 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 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 2019, Brown enrolled 592 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 268 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. 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 Allied 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 $11.8 million in support of research activities in fiscal year 2019. 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, and laser treatment of coronary artery disease. Others are researching 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.Research is also focused on the treatment and prevention of opioid abuse. The Infectious Diseases group is delving into new antibiotic treatments for superbugs. 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 audited 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 2019, Lifespan paid rent to Lawrence Investments, LLC under the terms of this lease. Terms of the rent expense related to this lease have been made at fair market value.*Pamela A. Harrop, MD, Trustee, is the President of Medical Associates of Rhode Island, Inc. (MARI). Lifespan and MARI participate in a shared savings program with various medical insurance carriers. During fiscal year 2019, Lifespan paid MARI $157,592 as part of this shared savings program. 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, 2019, 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. Lifespan Pharmacy LLC 593 Eddy Street Providence RI 02903 461697290 Pharmaceutical Sales RI 29965259 7849953 Rhode Island Hospital Radiosurgery Center of Rhode Island LLC 593 Eddy Street Providence RI 02903 262171671 Radiosurgery RI 703378 1541393 Rhode Island Hospital ALC dba HSR 249 Roosevelt Avenue Pawtucket RI 02860 050442015 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Bayberry Courts Inc 249 Roosevelt Avenue Pawtucket RI 02860 204590384 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Bradley Hospital Foundation 167 Point Street Providence RI 02903 050500688 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false Brown Neurology Inc 593 Eddy Street APC5 Providence RI 02903 050448314 Medical Care RI 501(c)(3) 12 NA false Capital City Community Centers Inc 249 Roosevelt Avenue Pawtucket RI 02860 050259090 Daycare Services RI 501(c)(3) 7 Gateway Healthcare Inc false Emma Pendleton Bradley Hospital 1011 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Holding Company/Mgmnt Services RI 501(c)(3) 7 Lifespan Corporation false Newport Health Property Management Inc 11 Friendship Street Newport RI 02840 222335539 Property Management RI 501(c)(3) 12(I) Newport Health Care Corporation false Newport Hospital 11 Friendship Street Newport RI 02840 050258914 Health Care Services RI 501(c)(3) 3 Lifespan Corporation false Newport Hospital Foundation Inc 11 Friendship Street Newport RI 02840 222535533 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false NHCC Medical Associates Inc 11 Friendship Street Newport RI 02840 050472268 Health Care Services RI 501(c)(3) 10 Lifespan Corporation false Obed Apartments Inc 249 Roosevelt Avenue Pawtucket RI 02860 050422771 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Pathways Inc 249 Roosevelt Avenue Pawtucket RI 02860 050393004 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Rhode Island Hospital Foundation 167 Point Street 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