2020-08-14T12:10:20-07:00 2019-09-30 135565207 KPMG LLP 2 Financial Center 60 South St Boston MA 02111 990 2018-10-01 050258914 Newport Hospital NEWP 4018466400 11 Friendship Street Newport RI 02840 Mary A Wakefield Treasurer 2020-08-14 true Todd P Teresco P00247720 6179881000 2018 2020-09-22 18:59:49Z Crista F Durand 11 Friendship Street Newport RI 02840 193254002 false false X www.lifespan.org/newport/ X 1873 RI As a member hospital in the Lifespan health system, Newport Hospital (NH) is committed to its mission: Delivering health with care. 17 13 1013 244 113601 4416497 3550461 116019885 120091861 4363716 3910131 215523 147001 125015621 127699454 2885 1264 0 58918576 61329645 0 0 58481099 60472124 117402560 121803033 7613061 5896421 315400939 299224842 44563398 50046941 270837541 249177901 X As a member hospital in the Lifespan health system, NH is committed to its mission: Delivering health with care. false false 45116826 51726164 During the fiscal year ended September 30, 2019, NH reported 23,824 inpatient days, 5,147 discharges, 451 newborn deliveries, and 1,126 inpatient surgeries. NH provides a range of diagnostic therapeutic healthcare services including: behavioral medicine, cardiac services, childbirth, orthopedics, and pulmonary medicine. (See Schedule O, Part III, Line 4a) 43690406 1264 64175929 NH provides certain healthcare services on an outpatient basis. In fiscal year 2019, NH experienced outpatient volume of 48,819 equivalent outpatient days and performed 4,786 outpatient surgeries. Outpatient services are also provided in NH's Emergency Department, which had 32,214 patient visits in fiscal 2019.(See Schedule O, Part III, Line 4b) 4579320 4189768 The Noreen Stonor Drexel Birthing Center (the Center) at NH delivered 451 newborns during the fiscal year ended September 30, 2019. The Center is a separate unit at NH for labor and delivery, enabling patients to remain in the same location for labor, delivery, recovery, and postpartum care. The Center's staff includes board-certified obstetricians, pediatricians, family practitioners, anesthesiologists, a certified nurse midwife, and registered nurses who have received national certifications in obstetrical nursing. The Center at NH has received the "Baby Friendly" designation from the World Health Organization and UNICEF. 93386552 true true false false false false false false false true true true false true true true true true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true false false false true 94 0 true 1013 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 false RI X Mary A Wakefield 4014447914 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 1.00 39.00 X 0 1928054 318064 Emanuel Barrows Trustee 0.60 3.00 X 0 0 0 Roger N Begin Trustee 0.25 6.75 X 0 0 0 Peter Capodilupo Vice Chair 0.10 3.90 X X 0 0 0 Sarah T Dowling Trustee 0.25 4.75 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 0.75 5.55 X 0 0 0 Pamela A Harrop MD Trustee 0.00 6.00 X 0 0 0 Alan H Litwin Vice Chair 0.50 10.00 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 MD Trustee 0.20 3.60 X 0 0 0 Paul J Adler Secretary 1.00 39.00 X 0 551087 106582 Crista F Durand President 30.00 10.00 X 0 459510 91189 Mary A Wakefield Treasurer 1.25 38.75 X 0 939142 101891 Orla M Brandos Chief Nursing Officer 40.00 0.00 X 258098 0 58077 Thomas E McGue MD Chief Medical Officer 40.00 0.00 X 353420 0 13232 Marielen Maguire Ultrasound Tech. 40.00 0.00 X 127792 0 16158 Pamela McLaughlin Dir.-Patient Exper 40.00 0.00 X 126539 0 31196 Christopher J Monteiro Mgr.-Diag. Imaging 40.00 0.00 X 137821 0 29678 Paul W Parchesky Pharmacy Mgr. 40.00 0.00 X 132754 0 27954 Perry J Wein Director-Op. Room 40.00 0.00 X 153348 0 2728 Frank J Byrne Director of Finance 0.00 40.00 X 0 303063 60921 Arthur J Sampson President 0.00 40.00 X 0 590083 35165 1289772 6253329 936169 47 true true false APG Security Services 171 Service Avenue Warwick RI 02886 Security Services 933192 Ringo LLC 445 Broadhollow Road Melville NY 11747 Staffing Services 747063 Michael Mason DO 24 Brown Howard Wharf 304 Newport RI 02840 Medical Services 572127 Aquidneck Radiologists Inc 11 Friendship Street Newport RI 02840 Medical Services 300000 University Orthopedics PO Box 1119 Providence RI 02901 Medical Services 255625 13 3526608 9750 14103 3550461 Ancillary OP Service Rev. 622110 64160863 64160863 Cafe./Misc Pharm. sales 622110 15066 15066 Inpatient Service Revenue 622110 51726164 51726164 Obstetrics - Birthing Ctr 622110 4189768 4189768 120091861 1362779 1362779 0 0 0 68101900 65554548 2547352 2547352 2547352 0 0 0 Auxiliary 900099 10000 10000 Lab Services 621500 113601 113601 Medical Staff Association 900099 23400 23400 147001 127699454 120091861 113601 3943531 1264 1264 0 0 0 319140 319140 0 48438896 43101966 5336930 2036866 1811796 225070 7229478 6438798 790680 3305265 2940039 365226 0 0 0 0 0 523557 523557 4243920 4243920 128454 128454 89579 76142 13437 0 0 7442587 6326199 1116388 51239 47652 3587 0 0 458690 458690 0 7231433 7231433 2072986 1762038 310948 Purchased services 14189259 2323766 11865493 Medical & surgical supplies 12767898 12760698 7200 License fee 5997306 5997306 Provision for bad debts 4174197 4174197 1101019 933177 167842 121803033 93386552 28416481 0 7946224 6121972 0 0 9385526 10450214 0 0 0 1850633 2006865 432914 447002 193630382 127311054 61383983 66319328 64243956 64046809 31375968 25900885 0 1330893 1330893 137450842 122600874 315400939 299224842 9676942 10820581 15617723 14389723 19268733 24836637 44563398 50046941 X 185172938 168483642 74607722 69584115 11056881 11110144 270837541 249177901 315400939 299224842 X 5896421 -2305003 -25251058 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 98114438 3020936 985185 9504125 92616434 95218917 4632042 3873778 5610299 98114438 85685917 4807335 7710459 2984794 95218917 84279294 1734227 3083962 3411566 85685917 88297544 677962 -2508607 2187605 84279294 0.16560 0.12000 0.71440 true true true 1406761 1406761 114358733 68373891 45984842 1234440 1135336 99104 76630448 57801827 18828621 66319328 25900885 Cash and short-term investments 1383517 Deferred financing costs & other assets 102254 HBCS 2360 Intercorporate financing 558390 Interest in Net Assets of NH Foundation 118586173 Outside trusts 1285223 Third-party Payor Settlements 682957 122600874 Accrued Pension Liability 22220900 Accrued Postretirement Liability 628299 Health care benefit self-insurance 1132127 Third-party Payor Liabilities 855311 24836637 X 95445639 -2305003 -25251058 -27556061 123001700 523557 4174197 4697754 127699454 117105279 117105279 523557 4174197 4697754 121803033 Part V, Line 4: Intended uses of the endowment fund. Newport Hospital's (NH) endowment funds consist of both donor-restricted endowment funds and funds designated by NH to function as endowments. NH's largest permanently restricted endowments support its emergency department, as well as promoting athletic activity and wellness among youth and families of Newport County. Other endowments of NH support patient care, including a comprehensive range of diagnostic and therapeutic health care services, as well as providing financial aid for persons requiring medical and nursing services.NH's largest board-designated endowment is used to support and maintain its facilities and operations. Significant temporarily restricted funds held by NH are used for the purposes of: (1) supporting the operations of NH's Emergency Department; (2) funding charity care; (3) the purchase of medical equipment; (4) support of NH's Cancer Center; and (5) support of NH's Emergency Department renovations. Part X : FIN48 Footnote NH 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. NH 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. NH did not recognize the effect of any income tax positions in either 2019 or 2018. Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S Provision for bad debts $4174197 Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S Provision for bad debts $4174197 true true true X true X true true true false true true 2227651 1457810 769841 0.00860 26805425 21978479 4826946 0.05410 29033076 23436289 5596787 0.06270 299125 9744 289381 0.00320 15337350 13186625 2150725 0.02410 52948 52948 0.00060 15689423 13196369 2493054 0.02790 44722499 36632658 8089841 0.09060 true 1152913 50459 20687223 24483034 -3795811 X true true 1 1 Newport Hospital 11 Friendship Street Newport RI 02840 https://www.newporthospital.or HOS00127 X X X Newport 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: Newport Hospital - Part V, Section B, Line 3j Part V, Line 3e- The significant needs identified in NH's 9/30/2016 CHNA have been prioritized in order of significant needs of the community, as determined by the organization. Facility: Newport 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 NH, 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 vary 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 is presented. The data sources are described in more detail below.Community Health ForumsQualitative 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 NH service area.CHFs are a standard qualitative social science data collection method, used in community-based or participatory action research. Seven CHFs were held between May 15 and June 13, 2019 across the NH 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. NH forums were held at community centers, places of worship, a high school, a homeless shelter, local non-profit agencies, and NH. 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 NH served as a hospital liaison to help plan and facilitate the CHFs. The hospital liaison was a critical link between the Lifespan Community Health Institute (LCHI) as the coordinating body, the expertise and resources within NH, and the Community Liaisons described below.An important and unique component of the CHFs was the involvement of Community Liaisons. Three people representing the diverse populations served by NH 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 NH and Community Liaisons. The discussion generated consensus on the participants health concerns, their prioritization of those concerns, and their ideas for how NH could respond to those concerns. Discussion began with a brief presentation of NHs 2016 CHNA priorities and examples of activities NH 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 NH to build relationships with communities that might not otherwise have become aware of or engaged in the needs assessment process.Individual SurveysTo 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. Three individual surveys were received for NH.Key Informant InterviewsThe 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 NH 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 NH implementation strategy, NH 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:Community Forum Host SitesTiverton Senior Center, 207 Canonicus Street, Tiverton, Rhode IslandJamestown Recreational Center, 41 Conanicus Avenue, Jamestown, Rhode IslandCommunity College of RI, 1 John H. Chafee Blvd., Newport, Rhode IslandSt. Clare's Church, 309 Spring Street, Newport, Rhode IslandThe Pennfield School, 110 Sandy Point Avenue, Portsmouth, Rhode IslandMiddletown Town Hall, 350 East Main Road, Middletown, Rhode IslandNewport Hospital, Gudoian Conference Room, 11 Friendship Street, Newport, Rhode Island. Facility: Newport Hospital - Part V, Section B, Line 6a Rhode Island HospitalThe Miriam HospitalEmma Pendleton Bradley Hospital Facility: Newport Hospital - Part V, Section B, Line 11 NH's Community Health Needs Assessment issued for the fiscal year ended September 30, 2019 identified five significant health issue areas requiring a further implementation strategy. Those significant health issue areas include: (1) access to primary care and specialty services; (2) outreach and education; (3) mental and behavioral health services;(4) wellness programs; and (5) aging in place. 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/NH-CHNA-Implementation-Plan.pdfDuring the fiscal year ended September 30, 2019, NH 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 offer expanded access to primary care and laboratory services on evenings and weekends. To combat the shortage of primary care providers within the State, Lifespan is continuing its effort to develop the alignment of its health system and physicians to better meet the needs of patients. NH has four community-based family medicine offices that provide primary care for all members of the family, from birth to geriatric years. During FY 2019, NH enhanced access to care with the addition of Quick Sick Walk-In Hours in all practice locations from 8-9am. The Newport practice location now has a full-day, adults only walk-in from 11am-7pm Monday-Thursday and a Saturday clinic for patients of all ages from 8am-2pm. NH opened a new orthopedics practice during FY '17 and has expanded its orthopedics service line that now includes three surgeons and two physician assistants. Orthopedic surgeries have increased 7% during FY '19. During FY '18, NH launched an Emergency Department (ED) Transformation Project. This eighteen-month project to reimagine and remodel the ED has increased the number of ED beds from seventeen to twenty-nine, added a new, secure behavioral health pod, added a clinical decision unit, and remodeled three triage bays. This project was completed in October 2019;- NH will encourage practices to seek patient-centered medical home (PCMH) Level 3 recognition from the National Committee for Quality Assurance (NCQA). NH has made access to quality primary health care a strategic priority in recent years. The PCMH is a way of organizing primary care that emphasizes care coordination and communication to transform primary care into what patients want it to be: The Lifespan Ambulatory Quality & Safety Council was established in July 2018. The Councils work supported a system-wide PCMH initiative during FY '19 through standardization of workflows and adoption of some PCMH reporting requirements;- Continue to participate in the Newport Partnership for Families and the Newport Health Equity Zone (HEZ). Community Health Forum (CHF) participants stressed the need for physical activity programs in the community, and increasing physical activity among youth is one of the Newport HEZ's key strategies. NH sponsored the Newport HEZ Summer Farmer's Market in July and August 2019, and also supported/promoted the Newport HEZs Diabetes Prevention Programs at monthly community lecture events as well as the Newport Hospital Hour of Health on WADK radio. NH also continued to participate as a member of the Newport Partnership for Families during FY '19. This is an association of social services agencies, community organizations, educational institutions, and businesses striving to strengthen the City of Newport by prioritizing and supporting the needs of children, families, and individuals;- Offer the nationally distributed Healthwise health literacy program in English and Spanish in the NH service areas. The LCHI dedicated a 0.5 FTE community outreach specialist to support the NH service area during FY '19. This position coordinated and delivered health promotion and health literacy classes, as well as serving as a hospital liaison to partner with other community organizations;- Continue to offer a Community Lecture Series (CLS). NH launched a monthly CLS that is open to the public at no cost covering a diverse range of health and social topics. During FY '19 NH continued to present on topics relevant to its community, focused specifically on priorities defined in the 2016 CHNA, including: an MD Wellness Panel (October '18), ED Transformation Update (November '18), "10 Questions I wished I'd asked my Cardiologist" (February '19), "A Good Night's Sleep: Tips to Rest your Best" (March '19), "Move Like You Are Meant To: Orthopedic Care for All Ages" (April '19), Mental Health Awareness Event, Art Display & Panel Discussion (May '19), and Spinal Stenosis (September '19); MENTAL AND BEHAVIORAL HEALTH- Offer mental health topics targeting adults and youth in the CLS. NH offers a CLS that is open to the public at no cost covering a diverse range of health and social topics.- Develop Stress Buster activities for community members and NH employees. During FY '19, NH offered Community Yoga in collaboration with Thames Street Yoga, consisting of hour-long yoga classes focused on steadying the mind and strengthening the body in a healing and peaceful setting;- Partner with EPBH to increase access to outpatient child psychiatric services. Through this partnership, a child psychiatrist, child psychologist, and related outpatient services are available to the service area as an extension of EPBHs Pediatric Referral Consultation Clinic (PERC) program. During FY '18, NH assigned 0.8 FTEs to this service line as a response to meet current demand, which continued during FY '19;- Explore using existing telemedicine capacity to provide mental health consultation. Families in the NH community were encouraged to use a new hotline service called KIDS Link, furnished jointly by Lifespan affiliates. KIDS Link provides 24/7 free and confidential access for kids and families in emotional crisis to professionals who will help steer the caller to the appropriate help. Additionally, community members were encouraged to use a new service called PediPRN that connects primary care providers to a behavioral health specialist for phone consultation. This has been determined to be a more valuable and immediate service to providers and their patients in response to the national shortage of behavioral health providers;SUBSTANCE ABUSE DISORDERS- Continue offering certified recovery coaches in the Emergency Department (ED) and increase the proportion of people admitted to the ED due to an overdose who engage the services of a peer counselor to seek treatment. During FY '19, NH continued to provide certified recovery coaches in its ED.CANCER- Continue to provide community-based education programs such as "Avenues of Healing", tobacco cessation programs, and Cancer Survivors Day events. NH offered the following cancer-related education programs during FY 2019:*"CT Screening for Lung Cancer: How to Save Lives and Stop Cigarette Smoking in Rhode Island" community lecture on February 2, 2019;* "Preventable. Treatable. Beatable: Reduce your Risk from Colorectal Cancer" community lecture on March 12, 2019.- Continue to provide preventative screenings like "See, Test & Treat" and "Skin Check" in partnership with the LCHI, which organized seven Skin Check skin cancer screening events serving 515 people;- Expand community partnerships to reach underserved populations and improve access to prevention and screening events with strategic partners like the American Cancer Society, such as:* Avenues of Health, Making Strides Against Breast Cancer Screening, Skin Check skin cancer screenings, the Lifespan Cancer Institute's (LCI) "Rising Above Cancer" 5K walk/run and fundraiser, and National Cancer Survivor's Day celebration, all held annually in conjunction with NH.- Improve patient access, patient experience, and communications, including establishing a Telephone Triage Center to serve as a single point of entry for medical oncology and infusion patients. The LCI telephone response and triage line was established in FY 2017 and continued during FY 2019, improving response times and patient satisfaction with respect to accessing their oncology providers.HEALTHIER WEIGHT- Continue to fund community programs to prevent childhood obesity through the Frederick Henry Prince Memorial Fund. During FY 2019, the Fund awarded $121,100 to several local entities for community programs ranging from biking, ballet, and soccer, to rugby and trail guiding;- Provide free community lectures on nutrition and healthy weight. NH offered a walking program throughout FY '19. Facility: Newport Hospital - Part V, Section B, Line 16j An abbreviated version of NH's Financial Assistance Policy is posted in various admitting and outpatient areas of NH. 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: Newport Hospital - Part V, Section B, Line 22d NH 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 NH 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. Portsmouth Imaging Center 69 Turnpike Avenue Portsmouth RI 02871 Diagnostic Imaging Services Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) Newport Hospital (NH) uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at NH 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 the Hospital.)4. Uninsured patients receive a discount equal to the discount received by Medicare beneficiaries on NH 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 services for non-urgent care. 7. In either case, the final results of the financial screening are recorded in the comments section of NH'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 (NH, Rhode Island Hospital (RIH), The Miriam Hospital (TMH), and Emma Pendleton Bradley Hospital (EPBH)) 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 NH'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 NH's cost accounting system are calculated based on Medicare principles of reimbursement by reducing total operating expenses (as calculated per Form 990 requirements) by items such as bad debt expense, 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 NH'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 expense and charity care, 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 NH's Community Health Services Department. Revenue received for these services is reported as direct offsetting revenue. g) Subsidized health services- Subsidized health services' community benefit expense is determined by NH's cost accounting system. These subsidized health services are recorded at cost in NH's cost accounting system for all qualified subsidized health service divisions. This expense is adjusted to remove all related 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 Medicaid is excluded from the amount disclosed for subsidized health services.i) Cash and in-kind contributions for community benefit- Expenses for cash and in-kind community benefit contributions are incurred by NH, including an allocation of contributions made by Lifespan Corporation on NH's behalf. Part I, Line 7, Column F - Explanation of Bad Debt Expense The calculation of percentages disclosed in 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 $4,174,197. 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 NH's cost accounting system and is adjusted for 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 NH's patient advocate staff to determine qualification for financial assistance under NH'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 606NHs 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 Medicare shortfall has not been 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 NH 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 a bad debt. NH 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.NH 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 Community Free Service.* If the patient does not qualify for Community Free Service, 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 NH continually assesses community needs in several ways. NH has a formal survey process for patient feedback but more importantly, NH uses a physician liaison position to facilitate physician communication with NH. Doctors in the community provide information on what services patients need. Recent examples of the usefulness of this information include NH's establishment of a wound care service, a dermatology practice, and a hand surgery practice. In addition, NH reviews volumes in service areas to glean information on the utilization of various types of care. NH functions as the first line of defense against illness, injury, and disease for its communities. With an Emergency Department that is open and staffed 24 hours a day with the ability to evaluate and treat everything from minor conditions to urgent care and stroke, as well as a dedicated, award-winning nursing staff that provides care for inpatients, NH's importance to the community cannot be overstated. NH is the designated disaster planning leader for its region of the State of Rhode Island and as such holds regular meetings and drills with first responders from the various municipalities within the region, as well as representatives from other facilities (e.g., nursing homes, hotels, and physician groups).Newport's significant seasonal patient population and large numbers of uninsured patients present financial challenges that NH strives to deal with each year as part of its mission. Uncompensated care provided to members of the community signals commitment to the residents and visitors of Newport County and its surrounding towns.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. Part VI, Line 3 - Patient Education of Eligibility for Assistance NH does not deny necessary medical treatment to anyone, regardless of insurance status or ability to pay. Financial counselors of NH inform patients personally about their potential eligibility for payment assistance. In addition, at such public events as health fairs, NH actively promotes financial assistance programs. When patients believe they might be eligible, financial counselors set up appointments to talk with them privately to determine their eligibility. Applications for financial assistance are provided in the registration office, the Emergency Department, the financial counseling office, and other departments providing care. As part of NH's inpatient intake process, NH provides self-pay patients with a summary of its Financial Assistance Policy, along with all assistance applications and the Patient Financial Services contact number. The same steps are 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. PFA's 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, the Supplemental Nutrition Assistance Program (SNAP), and Rhode Island Temporary Disability Insurance and Unemployment. This is done for both inpatient and outpatient services.Uninsured patients receive a discount on charges equal to the amount calculated using the Prospective Method, which is the amount that Medicare or Medicaid would allow for the care. Medicare patients may receive waivers of cost-sharing amounts if they qualify based on financial need; qualification is determined through an application for charity care. Further discounts may apply, depending on a patient's income level. Part VI, Line 4 - Community Information NH is the only hospital on Aquidneck Island and in Newport County, which comprises a population of approximately 100,000. Located in Newport, the southernmost town in Newport County, NH is approximately 20 miles from other hospitals; bridges link Newport and Aquidneck Island with the rest of the State of Rhode Island (two bridges to the west, one to the northwest, and one to the north). The community includes people on government assistance, working-class and middle-class constituents, U.S. Navy personnel and retirees, students from three colleges, and a small percentage of families of significant wealth. NH 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. Part VI, Line 4 - Community Building Activities NH connects with the community in several ways, both within the Hospital walls and at other venues. More than a dozen monthly support groups are held at NH, some facilitated by medical professionals and others by community members. An annual health fair provides hundreds of screenings for diseases and health conditions, and NH follows up with individuals whose tests identify a problem. Screenings for breast and prostate cancers are conducted free of charge at various times during the year.Several NH committees exist to provide interaction between NH and the community. NH supports community initiatives such as Rebuilding Together, the Newport Partnership for Families, a local mentoring program, and a program to identify middle school children who require help. In addition, NH has partnered with a major philanthropist to form a committee to oversee grants funded by NH to help children become active and healthy. The committee began distributing grants in 2011. Parenting and breastfeeding support are available through NH's Birthing Center, and a series of bimonthly presentations and lectures on relevant health topics is scheduled for the community to attend free of charge. Part VI, Line 5 - Promotion of Community Health NH is governed by a Board of Trustees, which is comprised of leaders of the local community elected by Lifespan Corporation. NH works collaboratively with physicians, its employees, other health care organizations, and the community to create a measurably healthier Newport County through the provision of high quality, cost-effective, customer-focused health care services in an environment that promotes patient safety. NH monitors the healthcare needs of its service area to ensure alignment of its resources with its mission. NH 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 NH. NH 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, RI. 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 NH 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 NH 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 NH website which makes NH's CHNA report widely available is located at the following URL:https://www.lifespan.org/sites/default/files/lifespan-files/documents/centers/lifespan-community-health/9-30-2019-NH-CHNA.pdfSchedule H, Part V, Line 10a: The URL to view NH's most recently adopted implementation strategy is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/NH-CHNA-Implementation-Plan.pdfForm 990, Schedule H, Part V, Line 16a: The URL to view and download NH'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 NH'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 NH'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 X true true X X X X X false true false false false false false true false false Arthur J Sampson President 437910 59500 92673 16500 18665 625248 Christopher J Monteiro Mgr.-Diag. Imaging 132551 4831 439 6334 23344 167499 Crista F Durand President 348529 40000 70981 68192 22997 550699 52039 Frank J Byrne Director of Finance 247042 22500 33521 37961 22960 363984 25072 Mary A Wakefield Treasurer 704974 96500 137668 83352 18539 1041033 104077 Orla M Brandos Chief Nursing Officer 224354 21800 11944 35110 22967 316175 413 Pamela McLaughlin Dir.-Patient Exper 120111 4458 1970 5845 25351 157735 Paul J Adler Secretary 441391 50000 59696 82536 24046 657669 27861 Paul W Parchesky Pharmacy Mgr. 127956 4647 151 5078 22876 160708 Perry J Wein Director-Op. Room 147675 5168 505 2259 469 156076 Thomas E McGue MD Chief Medical Officer 286538 24000 42882 13100 132 366652 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. A RIHEBC Series 2014 521300173 2014-11-05 20390000 See Schedule K, Part VI false false false A 5269937 20887660 154665 20732995 true false true true A false false false false false false true A false true true false false false false true A true Part VI Schedule K, Part I, Line A, Column (f): The proceeds of the Series 2014 Bonds were used for the purpose of the full redemption of Newport Hospital's Series 1999 Bonds.Schedule K, Part II, Line 3, Column (A):The variance between the issue price and total proceeds of the 2014 bond issuance is due to accrued interest of $497,660 outstanding on the Series 1999 Bonds. This balance was incorporated into the Series 2014 bond issue proceeds. Schedule K, Part IV, Line 2b: No arbitrage calculation is required because the Series 2014 Bonds meet the 6-month spending exception. 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 NH. 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 Rhode Island Hospital, The Miriam Hospital, Newport Health Care Corporation, NH, 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 NH 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 NH 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 NH 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 Vice President of Finance - Newport Hospital, 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, is posted to NH's Board of Trustees website portal in advance of its 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, as well as the Newport Hospital Obligated Group (NH and Newport Hospital Foundation), currently make their annual and quarterly consolidated/combined 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 and the Newport Hospital Obligated Group's financial information to repositories and investors alike. Newport Hospital's financial statements are included in the Newport Hospital Obligated Group's combined financial statements. NH'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 ASC 410-20 Environmental Remediation Liability = -$78500 Other Changes In Net Assets Or Fund Balances - Other Decreases Change in funded status of pension plan = -$5723900 Other Changes In Net Assets Or Fund Balances - Other Decreases Change in interest in net assets of NHF = -$9058047 Other Changes In Net Assets Or Fund Balances - Other Decreases Net asset transfer to NHCCMA = -$5581101 Other Changes In Net Assets Or Fund Balances - Other Decreases Net asset transfer to NHPM = -$2674710 Other Changes In Net Assets Or Fund Balances - Other Decreases Non-service periodic pension costs = -$2134800 Form 990, Part III, Line 4a NH first received the Magnet designation from the American Nurses Credentialing Center (ANCC) in 2004. Of more than 5,000 hospitals in the United States, approximately 4 percent have achieved Magnet status. Standards for Magnet status are rigorous and include not only outstanding patient care but also best practices in nursing, management philosophy, national standards for quality improvement, leadership by the chief nursing officer, nurse education levels, and professional models of care. The Magnet process is continuous; the ANCC again redesignated NH as a Magnet hospital in 2009, 2014, and 2019.The Noreen Stonor Drexel Birthing Center at NH has received the prestigious Baby Friendly designation from the World Health Organization and UNICEF. NH is recognized for providing an optimal environment for the promotion, protection, and support of breastfeeding. Hospitals are awarded this status only when trained, independent evaluators have determined that all hospital practices meet the rigorous Baby Friendly standards.During 2019, NH received an "A" in the national Leapfrog Hospital Safety Grade ratings from The Leapfrog Group. In 2017, NH was the only community hospital in Rhode Island to be recognized as a high performer in two clinical areas chronic obstructive pulmonary disease (COPD) and heart failure by U.S. News & World Report in its 2017 Best Regional Hospitals rankings. Additionally, NH received The Joint Commission Gold Seal of Approval for health care quality and safety. NH was selected as a Guardian of Excellence Award recipient for the quality of its inpatient rehabilitation. Deemed to be in the 95th percentile or above by the awarding group, Press Ganey Associates, NH recently expanded its rehabilitation capacity with the creation of a physiatry service line and the addition of two physiatrists. The new staff work closely with NHs Vanderbilt Rehabilitation Center staff, providing medical support, enhanced services, and continuum of care after discharge. Other significant accreditations earned by NH include: certification as a Primary Stroke Center by the Joint Commission on Accreditation of Healthcare Organizations, certification by The American College of Radiology as a Breast Imaging Center of Excellence, and accreditation and recognition from the American Association of Blood Banks, the College of American Pathologists, the American Association of Cardiovascular and Pulmonary Rehab, the Commission on Accreditation of Rehab Facilities and the Intersocietal Commission for the Accreditation of Echocardiography Laboratories.NH has developed formal and informal educational affiliations with the University of Rhode Island College of Nursing; Community College of Rhode Island; Salve Regina University; and the University of Massachusetts-Dartmouth, pursuant to which their nursing students obtain clinical training and experience at NH, which does not receive any compensation from the various schools for providing a clinical setting for the student nurse training.NH 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. NH 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 net cost incurred by NH to provide charity care amounted to $769,841 in fiscal 2019. Charges forgone, based on established rates, amounted to approximately $5,810,000 in fiscal 2019.NH substantially subsidized various health services including adult psychiatry, obstetrics, and certain other specialty services at a net cost of $2,150,725 in fiscal 2019.NH 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 $289,381 in fiscal 2019.NH subsidizes the cost of treating patients who receive government assistance where reimbursement is below cost. Medicaid is a means-tested health insurance program, jointly funded by state and federal governments. States administer the program and set rules for eligibility, benefits, and provider payments within broad federal guidelines. The program provides health care coverage to low-income children and families, pregnant women, long-term unemployed adults, seniors, and persons with disabilities. Eligibility is determined by a variety of factors, which include income relative to the federal poverty line, age and immigration status, and assets. Form 990, Part III, Line 4b Outpatient services include an emergency department, diagnostic medical imaging, laboratory, Vanderbilt Rehabilitation, and wound care, among others. The Emergency Department (ED) is open and staffed 24 hours a day, 365 days a year, with emergency medicine physicians and specially trained physician assistants and nurses. The ED, in accordance with NH's mission and civic obligations, treats every person who seeks care, regardless of their ability to pay. 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 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 VI, Section B, Line 12c Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including NH, 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 15a and b The following applies to Lifespan and all of its affiliates, including NH: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. 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 through acceptance of a reasonable compensation offer. Form 990, Part XII, Line 2: NH produced audited financial statements as of and for the year ended September 30, 2019. Additionally, it was included in Newport Health Care Corporation's audited combined financial statements as well as Lifespan Corporation's audited consolidated financial statements, in which one column is used for the Newport Hospital Obligated Group, which includes Newport Hospital and Newport Hospital Foundation. The Lifespan Audit and Compliance Committee assumes responsibility for oversight of the audit of Lifespan Corporation's consolidated financial statements and the selection of Lifespan Corporation's independent accountant. 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 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 Veterans Memorial Parkway East Providence RI 02915 050258806 Pediatric Psych. Health Care Services RI 501(c)(3) 3 Lifespan Corporation false Families Reaching Into Each New Day Inc 249 Roosevelt Avenue Pawtucket RI 02860 050504841 Bereavement Services for Children RI 501(c)(3) 7 Gateway Healthcare Inc false Gateway Healthcare Inc 249 Roosevelt Avenue Pawtucket RI 02860 050309043 Subst. Abuse & Psych. Health Care Svcs RI 501(c)(3) 10 Lifespan Corporation false Hospital Properties Inc 167 Point Street Providence RI 02903 222869743 Property Management RI 501(c)(4) N/A Lifespan Corporation false JM Apartments Inc 249 Roosevelt Avenue Pawtucket RI 02860 050435537 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Lifespan Corporation 167 Point Street Providence RI 02903 222861978 Holding Company/ Mgmnt Services RI 501(c)(3) 12(II) N/A false Lifespan Diversified Services Inc 167 Point Street Providence RI 02903 050258935 Holding Company/ Mgmnt Services RI 501(c)(3) 10 Lifespan Corporation false Lifespan Foundation 167 Point Street Providence RI 02903 050493219 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false Lifespan of Massachusetts Inc c/o Archstone Law 57 Wells Ave Newton MA 02459 043408517 Holding Company MA 501(c)(3) 12(I) Lifespan Corporation false Lifespan Physician Group Inc 167 Point Street Providence RI 02903 050389801 Health Care Services RI 501(c)(3) 10 Lifespan Corporation false Lifespan School Solutions Inc 140 Broadway Providence RI 02903 464910847 Educational Services RI 501(c)(3) 2 Emma Pendleton Bradley Hospital false LJR Corporation 249 Roosevelt Avenue Pawtucket RI 02860 030508346 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Mill River Community Housing Corporation 249 Roosevelt Avenue Pawtucket RI 02860 050427152 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Newport Health Care Corporation 11 Friendship Street Newport RI 02840 222535537 Holding Company/ Mgmnt Services RI 501(c)(3) 7 Lifespan Corporation false Newport Health Property Management Inc 11 Friendship Street Newport RI 02840 222335539 Property Management RI 501(c)(3) 12(I) Newport Health Care Corporation false Newport Hospital 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 593 Eddy Street Providence RI 02903 050258954 Health Care Services RI 501(c)(3) 3 Lifespan Corporation false Rhode Island Hospital Foundation 167 Point Street Providence RI 02903 050468736 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false RIH Ventures 593 Eddy Street Providence RI 02903 050448686 Parking Facilities/Phlebotomy Services RI 501(c)(3) 10 Lifespan Corporation false Shore Courts Inc 249 Roosevelt Avenue Pawtucket RI 02860 050504003 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false The Autism Project 1516 Atwood Avenue Johnston RI 02919 050512037 Services for Children with Autism RI 501(c)(3) 10 Gateway Healthcare Inc false The Miriam Hospital 164 Summit Avenue Providence RI 02906 050258905 Health Care Services RI 501(c)(3) 3 Lifespan Corporation false The Miriam Hospital Foundation 167 Point Street Providence RI 02903 050377502 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false TLR Realty 249 Roosevelt Avenue Pawtucket RI 02860 043742771 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Wentworth Corporation 249 Roosevelt Avenue Pawtucket RI 02860 050488520 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false Westerly Courts Inc 249 Roosevelt Avenue Pawtucket RI 02860 611439766 Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc false RI Sound Enterprises Insurance Co Ltd 65 Front Street Hamilton HM BD 12 Offshore Insurance Captive BD N/A N/A Lifespan Corporation false Lifespan Health Alliance LLC 167 Point Street Providence RI 02903 812732225 Accountable Care Org. RI N/A false false Lifespan MSO Inc 167 Point Street Providence RI 02903 050508717 Mgmnt Svcs RI Lifespan Corp C corp false Lifespan Risk Services Inc 167 Point Street Providence RI 02903 050459767 Risk Mgmnt RI Lifespan Corp C corp false VNA Technicare Inc 200 Corliss Street Providence RI 02904 050472710 DME Sales RI The Miriam Hospital C corp false false true true false true false false false false true true true true true true true true true false