2019-08-09T10:04:05-05:00 2018-09-30 050409384 KAHN LITWIN RENZA & CO LTD 951 NORTH MAIN STREET PROVIDENCE RI 02904 990 2017-10-01 050259026 ST JOSEPH HEALTH SERVICES OF RI STJO 4014536400 ONE PARK ROW PROVIDENCE RI 02903 DAVID M HIRSCH PRESIDENT/TREASURER/CLERK 4014536400 2019-08-09 1 DEBORAH A HOPKINS P00167843 4012742001 71.117.160.66 2019-08-09 09:38:49 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 2017 2019-02-21 02:37:17Z DAVID M HIRSCH ONE PARK ROW PROVIDENCE RI 02903 585001 0 X WWW.SAINTJOSEPHRI.COM X 1946 RI THE MISSION OF ST. JOSEPH HEALTH SERVICES IS TO PRESERVE, RESTORE AND ENHANCE THE HEALTH OF INDIVIDUALS AND FAMILIES WE SERVE WITHIN OUR COMMUNITIES. 3 2 0 0 0 0 0 0 336273 300153 11213 1572 0 283276 347486 585001 0 0 0 0 0 0 0 0 0 343410 461258 343410 461258 4076 123743 6520625 6848008 136699438 136699438 -130178813 -129851430 THE MISSION OF ST. JOSEPH HEALTH SERVICES OF RI IS TO PRESERVE, RESTORE AND ENHANCE THE HEALTH OF INDIVIDUALS AND FAMILIES WE SERVE WITHIN OUR COMMUNITIES. 0 0 201055 300153 IN JUNE 2014, SUBSTANTIALLY ALL ASSETS OF ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND WERE TRANSFERRED TO PROSPECT CHARTERCARE, LLC, UNDER A PLAN APPROVED BY THE RHODE ISLAND ATTORNEY GENERAL AND UNDER THE SUPERVISION OF THE RHODE ISLAND DEPARTMENT OF HEALTH. THE NON-PROFIT CORPORATION REMAINS IN EXISTENCE TO ALLOW FOR THE ORDERLY WIND-DOWN OF THE AFFAIRS OF THE HOSPITAL, PRINCIPALLY THE COLLECTION OF REVENUE FROM MEDICARE AND OTHER THIRD PARTY PAYORS FOR MEDICAL SERVICES PREVIOUSLY PROVIDED AND PAYMENT OBLIGATIONS FOR THE PENSION LIABILITY OF THE HOSPITAL. 201055 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 RI X RICHARD LAND 4014536400 ONE PARK ROW PROVIDENCE RI 02903 X DAVID M HIRSCH PRESIDENT/CLERK/TREASURER 2.00 4.00 X X 0 0 0 REVEREND TIMOTHY REILLY DIRECTOR 2.00 4.00 X 0 0 0 JOSEPH P MAZZA MD DIRECTOR 2.00 2.00 X 0 0 0 0 0 0 0 0 0 0 CHACE RUTTENBERG & FREEDMAN LLP ONE PARK ROW 300 PROVIDENCE RI 02903 ADMINISTRATIVE SERVICES 132023 1 MEDICARE REIMBURSEMENT 621110 300153 300153 300153 1572 1572 TRUST DISTRIBUTIONS 900099 283276 283276 283276 585001 300153 0 284848 X 10000 10000 234650 234650 SJHSRI PENSION SUPPORT 158780 158780 REIMBURSEMENT OF OVERPA 32495 32495 MALPRACTICE INSURANCE 11239 11239 TPA AGREEMENT REIMBURSE 9780 9780 4314 4314 461258 201055 260203 0 850116 1660636 1825012 1341875 3845497 3845497 6520625 6848008 136699438 136699438 136699438 136699438 X -130178813 -129851430 -130178813 -129851430 6520625 6848008 123743 -1450 205090 0 X 0 0 0 X 344981 344981 106852782 336273 300153 107489208 107197763 336273 300153 107834189 0 0 0 107834189 78803 275478 104893 11213 1572 471959 78803 275478 104893 11213 1572 471959 3833588 283276 4116864 111110154 275478 104893 347486 585001 112423012 0.95920 0.97450 0.00420 0.00360 X 0 OTHER ASSETS 461815 MALPRACTICE INSURANCE RECEIVABLE 3383682 3845497 ESTIMATED SETTLEMENTS TO THIRD PARTIES 266892 INSURANCE RESERVES 9714826 PENSION LIABILITIES 126717720 136699438 FORM 990, PART VI, SECTION A, LINE 6 CHARTERCARE COMMUNITY BOARD F/K/A CHARTERCARE HEALTH PARTNERS IS THE SOLE MEMBER OF ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND. FORM 990, PART VI, SECTION A, LINE 7A CHARTERCARE COMMUNITY BOARD, AS THE SOLE MEMBER, RESERVES THE POWER TO AMEND THE ARTICLES AND BYLAWS OF THE ENTITY, APPOINT OR REMOVE A MEMBER OF THE BOARD OF TRUSTEES, ENTER INTO CONTRACTS, AND EFFECT ANY DISSOLUTION, AFFILIATION, MERGER OR REORGANIZATION, AND HAS THE EXCLUSIVE POWER TO APPOINT OR REMOVE THE CEO, CFO AND THE COO (IF ANY). FORM 990, PART VI, SECTION A, LINE 7B CHARTERCARE COMMUNITY BOARD, AS THE SOLE MEMBER, RESERVES THE POWER TO AMEND THE ARTICLES AND BYLAWS OF THE ENTITY, APPOINT OR REMOVE A MEMBER OF THE BOARD OF TRUSTEES, ENTER INTO CONTRACTS, AND EFFECT ANY DISSOLUTION, AFFILIATION, MERGER OR REORGANIZATION, AND HAS THE EXCLUSIVE POWER TO APPOINT OR REMOVE THE CEO, CFO AND THE COO (IF ANY). FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE EXTERNAL ACCOUNTANTS AND REVIEWED BY MANAGEMENT. ONCE ALL ARE SATISFIED WITH THE FORM, IT IS FINALIZED AND A COPY IS SENT TO ALL BOARD MEMBERS. AT THE SUBSEQUENT BOARD MEETING, THE MEMBERS ARE ASKED IF THEY HAVE ANY QUESTIONS OR COMMENTS AND A GENERAL REVIEW OF THE FORM IS CONDUCTED BY MANAGEMENT. REVISIONS, CORRECTIONS, ETC. ARE MADE AS NECESSARY. SUBSEQUENT TO THIS MEETING THE FORM IS SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY INCLUDED IN THE BY-LAWS IS TO PROTECT THE CORPORATION'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE CORPORATION. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND ALL MATERIAL FACTS TO THE OFFICERS, DIRECTORS, AND MEMBERS OF ANY COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. ON AN ANNUAL BASIS, EACH MEMBER OF THE BOARD IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT AND ALL RESPONSES ARE SUBMITTED AND REVIEWED BY LEGAL COUNSEL. ANY ACTUAL AND POSSIBLE CONFLICTS OF INTEREST ARE REVIEWED WITH THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 NO COMPENSATION WAS DURING THE REPORTING YEAR. FORM 990, PART VI, SECTION C, LINE 19 ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND MAKES ITS TAX RETURN, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PENSION CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 76,975. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 76,975. ADMINISTRATIVE CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 139,054. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 139,054. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 18,621. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,621. ROGER WILLIAMS MEDICAL CENTER ONE ROW SUITE 300 PROVIDENCE RI 02903 050258959 HEALTHCARE RI 501 (C)(3) LINE 10 CCB 1 CHARTERCARE COMMUNITY BOARD ONE ROW SUITE 300 PROVIDENCE RI 02903 264235815 MANAGEMENT RI 501 (C)(3) LINE 12B, II N/A 0 ST JOSEPH WORKERS COMP TRUST ONE ROW SUITE 300 PROVIDENCE RI 02903 056106574 WORKERS' COMPENSATION RI 501 (C)(3) LINE 12A, I SJHSRI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0