2018-08-15T05:12:26-07:00 2017-09-30 KPMG LLP 2 Financial Center 60 South Street Boston MA 02111 990 2016-10-01 050258905 The Miriam Hospital MIRI 4017932500 164 Summit Avenue Providence RI 02906 Mary A Wakefield Treasurer 2018-08-15 true Tara D'Agostino P01245482 6179881000 2016 2022-09-23 18:48:47Z Arthur J Sampson 164 Summit Avenue Providence RI 02906 626037721 false false X www.miriamhospital.org X 1926 RI As a founding hospital in the Lifespan health system, The Miriam Hospital (TMH) is committed to its mission: Delivering health with care. 16 12 3498 842 1581795 3776212 4596292 428218355 448769301 3690206 9977338 15711077 11556045 451395850 474898976 304910 433117 0 202259106 221318006 0 0 245184022 240424471 447748038 462175594 3647812 12723382 464791526 488693019 151396187 152214148 313395339 336478871 X As a founding hospital in the Lifespan health system, TMH is committed to its mission: Delivering health with care. false false 353193197 433117 436820957 Patient Care:TMH offers expertise in cardiology, oncology, orthopedics, men's health, and minimally invasive surgery and is home to the State's first Joint Commission- certified Stroke Center and robotic surgery program. Services and programs provided by TMH include general medicine; general surgery; emergency medicine; cardiovascular care; orthopedics; nuclear cardiology; radiology; laboratory; renal dialysis; urology; gastroenterology; endocrinology; gynecology; nephrology; neurology; ophthalmology; trauma care; computerized tomography; and magnetic resonance imaging (MRI). The Hospital is nationally known for its HIV/AIDS and behavioral and preventive medicine research, including weight control, physical activity, and smoking cessation. (Continued on Schedule O). 21444729 18589729 Research:Since 1969, the level of research has increased from seven projects totaling $127,000 involving nine investigators to 398 projects totaling $21.4 million involving 76 investigators and 127 employees. The Hospital 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. The Hospital also sponsors a significant level of these research activities. Federal support accounts for approximately 80% of all externally funded research at the Hospital. TMH provided $2.9 million in support of research activities in fiscal year 2017. (Continued on Schedule O). 20496519 3375246 Medical Education:TMH provides the setting for and substantially supports medical education in various clinical training and nursing programs. TMH is designated as a major teaching affiliate of The Warren Alpert Medical School of Brown University. The total cost of direct medical education provided by TMH exceeded the reimbursement received from third-party payors by $17.1 million in fiscal year 2017. (Continued on Schedule O). 395134445 true true false false false false false false false true true true false true true true true true false false true false true false false false true true true false true true false false false false false false false false false false false false false false false true false false false false true 226 0 true 3498 true true true false false false false false false 0 false false false false false false false false false false X 16 12 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 4014447093 593 Eddy Street Providence RI 02903 X Thomas Anders MD Trustee- 12/16 0.00 0.50 X 0 0 0 Lawrence A Aubin Sr Chair 1.00 13.50 X X 0 0 0 Timothy J Babineau MD Trustee 9.00 31.00 X 0 2080990 476156 Emanuel Barrows Trustee 0.45 2.25 X 0 0 0 Roger N Begin Trustee 0.50 11.50 X 0 0 0 Peter Capodilupo Vice Chair 0.50 13.50 X X 0 0 0 Jonathan D Fain Trustee 0.25 1.00 X 0 0 0 Edward D Feldstein Esq Trustee 2.00 10.00 X 0 0 0 Michael L Hanna Trustee 0.75 3.40 X 0 0 0 Pamela Harrop MD Trustee 0.25 7.75 X 0 35000 0 Alan H Litwin Vice Chair 1.00 7.00 X X 0 0 0 Joseph J MarcAurele Trustee 0.25 3.75 X 0 0 0 Steven Pare Trustee 2.50 10.00 X 0 0 0 Lloyd Robertson Trustee- 12/16 0.00 0.00 X 0 0 0 Lawrence B Sadwin Trustee 0.50 12.00 X 0 0 0 Shivan Subramaniam Trustee 0.25 3.75 X 0 0 0 Jane Williams MD Trustee 0.25 3.25 X 0 0 0 Brian J Zink MD Trustee 0.75 2.25 X 0 0 0 Paul J Adler Secretary 5.00 35.00 X 0 432549 77273 Arthur J Sampson President 34.00 6.00 X 0 640826 33545 Mary A Wakefield Treasurer 5.00 35.00 X 0 1014544 187388 Robert W Corwin Chief Medical Officer 40.00 0.00 X 212375 0 17485 Maria P Ducharme Chief Nursing Officer 40.00 0.00 X 352290 0 74394 Thomas F Tracy Fmr. Chief Medical Officer 40.00 0.00 X 278690 0 15083 Jinnette D Abbott MD Physician 40.00 0.00 X 474802 0 38898 Herbert D Aronow MD Physician 40.00 0.00 X 509744 0 41477 Samuel C Dudley MD Physician 40.00 0.00 X 492573 0 16760 Paul C Gordon MD Physician 40.00 0.00 X 499610 0 18129 Athena Poppas MD Physician 40.00 0.00 X 513242 0 39291 Kenneth E Arnold Former Secretary 0.00 0.00 X 0 514583 347820 3333326 4718492 1383699 237 true true false University Medicine Fdtn 17 Virginia Avenue Providence RI 02903 Medical Services 7361397 University Surgical Associates Inc PO Box 16149 Rumford RI 02916 Medical Services 4131130 RINGO LLC 445 Broadhollow Road Melville NY 11747 Staffing Services 1937312 Sodexo Inc 25 Royal Little Drive Providence RI 02904 Dietary/Cafe Service 1902492 Quest Diagnostics 12436 Collections Center Drive Chicago IL 60693 System Services 1784203 35 4575292 8500 12500 4596292 Direct Rev from Research 900099 20632113 20632113 Patient Service Rev 900099 426922134 426922134 Temp Restricted (SPFs) 900099 1215054 1215054 448769301 4616991 4616991 3 3 0 1829692 1872073 -42381 -42381 -42381 154623501 3515 149264633 2039 5358868 1476 5360344 5360344 0 0 0 Indirect Rev from Grants 900099 4109642 4109642 Joint Program Revenue 900099 2475353 2475353 Lab Services Revenue 621500 1538243 1538243 3475188 3431636 43552 11598426 474898976 458785932 1581795 9934957 426382 426382 0 6735 6735 0 745146 745146 457875 457875 170200149 165372772 4827377 7348325 7140379 207946 30690721 29888950 801771 11875790 11541144 334646 0 0 0 0 0 769503 769503 19268516 18090789 1177727 117094 117094 83930864 83444999 485865 0 0 12115469 10932763 1182706 588173 565997 22176 0 385429 377886 7543 1760952 1760952 0 17292557 17292557 3696244 3696244 Purch Svs & Equip Contr 53900119 16243427 37656692 License Fee 21401190 21401190 Provision for Bad Debts 15894520 15894520 Indirect Research & Other 9303841 8790153 513688 0 462175594 395134445 67041149 0 0 41922794 32003679 1439297 1810763 37635536 39532553 0 0 179793 179793 4295974 5519935 2892657 5089591 396509192 211824448 189822000 184684744 88301279 113272150 39192308 45236363 0 0 59109888 61363448 464791526 488693019 32019201 33891093 56908692 53465396 6850999 5180484 55617295 59677175 151396187 152214148 X 265950491 285415433 27538361 31066087 19906487 19997351 313395339 336478871 464791526 488693019 X 12723382 4506677 5853473 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 130155405 41953120 13531256 24489813 161149968 122853669 26598596 6425189 25722049 130155405 124326086 27341321 -2425603 26388135 122853669 117435496 30903911 5559275 29572596 124326086 111167306 33540223 6309324 33581357 117435496 0.86150 0.13850 false true true 5414289 5414289 239822701 101311977 138510724 148380636 110512471 37868165 2891566 2891566 184684744 45236363 Deferred financing costs 383328 Held by third parties under LTD Agrts. Interest in net assets of TMH Foundation 58288229 Other 50436 61363448 Accrued pension liability 36421500 Due to affiliates 9351339 Health Care Benefit Self-insurance 3750701 Post-retirement benefit liability 76600 Third-party payor settlements 10077035 59677175 X 470467176 4506677 5853473 10360150 460107026 769503 14022447 14791950 474898976 447383644 447383644 769503 14022447 14791950 462175594 Part V, Line 4: Intended uses of the endowment fund. The Miriam Hospital's (TMH) unrestricted endowment consists of designated assets set aside by TMH's Board for future capital improvements, over which the Board retains control and may at its discretion subsequently use for other purposes. The largest temporarily restricted funds held by TMH are used to support: (1) the Women's Medicine Collaborative, a comprehensive, multidisciplinary center dedicated to meeting the health care needs of women; (2) the advancement of patient care, research, and education related to cardiology; (3) upgrade of patient call system technology; (4) recruitment for the Director of the Weight Control & Diabetes Center; (5) the Department of Psychiatry operations, education, and research; (6) operational needs of all emergency medicine programs; (7) assistance to cancer patients with expenses incurred while undergoing cancer treatment; (8) clinical care, research, and education to develop treatment for pelvic floor disorders; (9) The Center for Prisoner Health and Human Rights, a program which seeks to improve the health and human rights of criminal justice populations through education, research, and advocacy; (10) the Surgery Department's educational and investigational functions; (11) TMH's capital equipment and operating needs in providing services to patients; (12) cardiology labs and programs; and (13) the treatment and prevention of cancer, including the Cancer Patient Navigator Program, which assists cancer patients through the entire course of their care. Part X : FIN48 Footnote TMH, as a not-for-profit corporation, is recognized under Section 501(c)(3) of the Internal Revenue Code and is exempt from Federal income taxes. TMH 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. TMH did not recognize the effect of any income tax positions during the fiscal year ended September 30, 2017. Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990 Change in funded status of pension $3509700 Increase in net assets of TMHF $2343773 Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S Non-UBI debt-financed rental expenses $-6280 Non-debt-financed rental expenses $-1865793 Provision for bad debts $15894520 Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S Non-UBI debt-financed rental expenses $-6280 Non-debt-financed rental expenses $-1865793 Provision for bad debts $15894520 true Sub-Saharan Africa 0 0 Program Services Research 97544 South America 0 0 Program Services Research 15903 Europe 0 0 Program Services Research 4263 East Asia and the Pacific 0 0 Program Services Research 2656 Middle East and North Africa 0 0 Grant Recipient in Region Philanthropy 6735 127101 127101 Cash grant North Africa 1 3801 Wire transfer 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 followed: 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 Office of Research Administration.Check requests and wire transfer forms are prepared by the principal investigator, approved by the 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, reimbursement for expenses, and compensation amount. The same approval and payment process is used as described above.Expenditures related to foreign activities are recorded using the accrual method of accounting. true true true X true X true true true false true true 7565717 998940 6566777 0.01471 70457178 51001757 19455421 0.04359 78022895 52000697 26022198 0.05830 225723 33161 192562 0.00043 20496519 3375246 17121273 0.03836 17065300 6386215 10679085 0.02393 21444729 18589729 2855000 0.00640 209597 209597 0.00047 59441868 28384351 31057517 0.06959 137464763 80385048 57079715 0.12789 true 3957735 489690 96887554 100781283 -3893729 X true true 1 1 The Miriam Hospital 164 Summit Avenue Providence RI 02906 www.miriamhospital.org HOS00122 X X X X X The Miriam Hospital 1 false false true X X X X X X X X 16 true true false true X Please refer to Schedule O X X true 16 true Please refer to Schedule O supplemental info for full URL false false true X 200.0000 300.0000 X X X X X X true true X X X X true X Please refer to Schedule O X Please refer to Schedule O X Please refer to Schedule O X X X X X X X true false X X X X true X false false Part V, Line 5 - Account Input from Persons Who Represent the Community The CHNA encompassed intensive data collection and analysis, as well as qualitative research in the forms of interviews with internal and external stakeholders, including hospital-based physicians, nurses, social workers, administrators, and other professionals, as well as community-based stakeholders representing constituencies served by TMH and Lifespans three other hospitals. TMH also conducted four Community Health Forums (CHFs) which are a qualitative social science data collection method used in community-based or participatory action research. These CHFs were held strategically throughout various locations identified within TMH's patient population community as a way to increase the mix of the participants in an effort to identify the entire community's most significant health needs. The CHFs were open to the public and provided opportunities for residents to share their health concerns and needs with Lifespan staff. TMHs leadership team shaped the CHNA by recommending institutional and community leaders for participation, offering observations about community needs, and providing insight about existing and planned programs.Qualitative data collected during the CHNA consist of: (1) interviews completed with internal stakeholders (i.e., hospital-based and Lifespan-based); (2) interviews with key informant community leaders, representing an array of constituencies; and (3) four Community Health Forums held within the communities of the TMH patient population.Interviews with leaders of organizations encompassed a wide range of issues and populations, including historically underserved communities, such as minority populations, children and youth, and immigrant/refugee populations, and also included leaders of organizations with specific interests or expertise in key issues such as obesity, cancer, and asthma. To ensure representation from a broad cross-section of the community, CHF's were held in the following locations:- Laurelmead, an active senior living center located at 355 Blackstone Boulevard, Providence, RI 02906;- New Dimension Apostolic Church, located at 100 Niantic Avenue, Providence, Rhode Island 02907;-Olney Street Baptist Church, located at 100 Olney Street, Providence, Rhode Island 02906; and-Rochambeau Library, located at 708 Hope Street, Providence, Rhode Island 02906. Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment Rhode Island HospitalEmma Pendleton Bradley HospitalNewport Hospital Part V, Line 7d - Description of Making Needs Assessment Widely Available A copy of the Community Health Needs Assessment report issued for TMH as of September 30, 2016 can be obtained by visiting: https://www.lifespan.org/sites/default/files/lifespan-files/documents/centers/lifespan-community-health/The-Miriam-Hospital-2016-CHNA.pdf Part V, Line 16i - Other Means Hospital Facility Publicized the Policy An abbreviated version of TMH's financial assistance policy is posted in various admitting and outpatient areas of TMH. 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. Part V, Line 22d - Other Billing Determination of Individuals Without Insurance TMH uses the prospective method in determining amounts generally billed. Internal Revenue Code section 501(r) defines the prospective method as the amount Medicare would reimburse TMH for billed care (including both the amount that would be reimbursed by Medicare and the amount 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. Womens Medicine Collaborative 146 West River Street Providence RI 02904 Comprehensive Women's Outpatient Clinic Cardiovascular Institute 950 Warren Avenue East Providence RI 02914 Outpatient Cardiac Clinic TMH Diagnostic Imaging Center 195 Collyer Street Suite 101 Providence RI 02904 Outpatient Radiology Cardiovascular Institute 208 Collyer Street Suites 100 102 Providence RI 02904 Outpatient Cardiac Clinic Cardiovascular Institute 1454 South County Trail Suite 2000 East Greenwich RI 02818 Outpatient Cardiac Clinic TMH Cardiac RehabPulmonary Rehab 208 Collyer Street Providence RI 02904 Outpatient Cardiac Clinic TMH Immunology Research Center 14 Third Street 11 Fourth Street Providence RI 02906 Outpatient Counseling TMH Weight Control & Diabetes Research 196 Richmond Street Providence RI 02903 Outpatient Research & Education TMH Behavioral Medicine Research 1 Hoppin Street Providence RI 02903 Outpatient Research & Education TMH Outpatient Rehabilitation 195 Collyer Street Providence RI 02904 Outpatient PT, OT, and Speech Rehab TMH Laboratory 1 Hoppin Street Providence RI 02903 Phlebotomy Lab TMH Laboratory 1 Commerce Street Lincoln RI 02904 Phlebotomy Lab TMH Laboratory 400 Bald Hill Road Warwick RI 02886 Phlebotomy Lab TMH Immunology Center 1125 North Main Street Providence RI 02904 Outpatient Clinic Womens & Mens Health Rehabilitation Services 148 West River Street Suite 1D Providence RI 02904 Outpatient Rehab Clinic The Center for Weight & Wellness 1377 South County Trail East Greenwich RI 02818 Outpatient Clinic RISE TB Clinic 14 Third Street Providence RI 02906 TB Clinic East Providence Imaging 375 Wampanoag Trail Suite 101B Riverside RI 02915 Outpatient Diagnostic Imaging TMH Behavioral Medicine Clinic 146 West River Street Providence RI 02904 Outpatient Clinic TMH Pre-Admission Testing Center 208 Collyer Street Third Floor Providence RI 02904 Outpatient Pre-admission Assessment and Education Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) The Miriam Hospital (TMH) uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at TMH 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 TMH charges using the prospective method. Under Section 501(r)(5), the maximum amounts that can be charged to 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 the Hospital'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 maintained for all Lifespan affiliated hospitals (The Miriam Hospital, Rhode Island Hospital, Emma Pendleton Bradley Hospital, and Newport Hospital) is maintained by Lifespan Corporation and included in Lifespan's annual report. The annual report for the year ended September 30, 2017 is available at the following link. http://issuu.com/lifespanmc/docs/lifespan-2017-annual-report-180419?e=28083767/60417355Please see pages 22-23 of the Lifespan Annual Report for community benefit information. Part I, Line 7 - Explanation of Costing Methodology TMH'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 TMH'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 TMH'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 TMH. 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 TMH's Medicare cost report.g) Subsidized health services- Subsidized health services' community benefit expense is determined by TMH's cost accounting system. These subsidized health services are recorded at cost in TMH'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- TMH 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 is calculated by combining the direct and indirect costs as reported within TMH'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 contributions for community benefit are made by the Hospital, including an allocation of contributions made by Lifespan Corporation on TMH'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 bad debt expense of $15,894,520. 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 TMH'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 TMH's patient advocate staff to determine qualification for financial assistance under TMH'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 Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, TMH analyzes its past history and identifies its revenue trends for each of its major payors to estimate the appropriate allowance for doubtful accounts and the associated provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, TMH analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), TMH records a significant allowance for doubtful accounts and provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates, if applicable) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.TMH's allowance for doubtful accounts for self-pay patients increased from 76% of self-pay accounts receivable at September 30, 2016 to 79% of self-pay accounts receivable at September 30, 2017. TMH's self-pay writeoffs for the years ended September 30, 2017 and 2016 amounted to approximately $18,144,000 and $12,123,000, respectively. TMH did not change its charity care or uninsured discount policies during the years ended September 30, 2017 and 2016, respectively. Part III, Line 8 - Explanation Of Shortfall As Community Benefit Medicare shortfall has not been treated as 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 TMH 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 co-payments, deductibles and amounts denied by insurers. After all collection attempts are exhausted, any remaining balances, including any co-payments and deductibles, are written off as a bad debt. TMH classifies its bad debts as uncompensated care. This does not apply to Medicaid, however, as there are no associated co-payments or deductibles for this payor.TMH 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 - Needs Assessment Lifespan's Office of Strategic Planning and Analysis performs population-based studies for TMH 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. 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 sub-components 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, TMH provides a wide range of services to both its primary and secondary service areas. Lifespan and its hospital affiliates monitor health trends in Rhode Island in an effort to identify areas of unmet demand regarding clinical services. Part VI - Patient Education of Eligibility for Assistance TMH 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 TMH. Assistance eligibility is also summarized on TMH's website, http://miriamhospital.org.As part of TMH's inpatient intake process, TMH provides a summary of the 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. 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, Supplemental Nutrition Assistance Program (SNAP), and Rhode Island Temporary Disability Insurance and Unemployment. This is done for both inpatient and outpatient services. Part VI - Community Information TMH, located in Providence, Rhode Island, is a 247-bed nonprofit general acute care teaching hospital with university affiliation providing a comprehensive range of diagnostic and therapeutic services (excluding obstetrics) for the acute care of patients principally from Rhode Island and southeastern Massachusetts. As a complement to its role in service and education, the Hospital actively supports research. TMH 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. TMH is also a member of the formally named Voluntary Hospitals of America, Inc., which has partnered with UHC Alliance NewCo, Inc. to become Vizient, Inc. Vizient, Inc. is the largest member-owned health care company in the United States.In 1969, TMH 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). TMH is designated as a major teaching affiliate of Brown. The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically.With respect to nursing education, TMH has developed formal and informal educational affiliations with a number of accredited New England colleges and universities. TMH does not receive any compensation from the various schools for providing a clinical setting for the student nurse training.TMH conducts extensive medical research and is in the forefront of biomedical health care delivery research and among the leaders nationally in National Institutes of Health programs. Part VI - Community Building Activities TMH substantially subsidizes various health services including various clinics and certain other specialty services. TMH 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 - Explanation Of How Organization Furthers Its Exempt Purpose TMH is governed by a Board of Trustees, which is composed of leaders of the local community elected by Lifespan Corporation. TMH's purpose is to at all times be operated exclusively as a tax-exempt charitable hospital and, as such, shall dispense medical and surgical aid and care to the sick and disabled of any race, creed, or color in keeping with Jewish ethical aspirations; shall act in a fashion designed to further, improve, and advance the science or art of health care delivery, patient care, and the knowledge, practice, and teaching of medicine and nursing; and assist in the advancement of medical research and investigation and in the improvement of medical teaching facilities and methods. TMH 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. TMH monitors the healthcare needs of its service area to ensure alignment of its resources with its mission. TMH 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 TMH. TMH is organized and operated for the benefit of the community it serves. Part VI - Affilated Health Care System Roles and Promotion 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 2,500 physicians on the medical staffs of its affiliated hospitals, operates 1,165 licensed beds in four hospital complexes, and in 2017 generated approximately $2.1 billion in total operating revenue. By each of these measures, Lifespan is Rhode Island's largest health system, serving a population of over 1.5 million. Three of its hospital members, Rhode Island Hospital, The Miriam Hospital, and Emma Pendleton Bradley Hospital, are teaching affiliates of The Warren Alpert Medical School of Brown University, with 72 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, 2017, Lifespan Corporation employed approximately 1,030 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, telecommunications, 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, develop, negotiate, and approve all managed care agreements, develop affiliations with other institutions for educational and research purposes, and approve human resource plans, executive compensation, and benefits for system affiliates. The bylaws of TMH confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination, and support of the system. Powers reserved to Lifespan as sole member include: to elect and remove trustees; to approve the election of and to remove certain officers; to approve the 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.For a complete listing of affiliated members of Lifespan's integrated healthcare delivery system, please refer to Schedule R. Part VI - States Where Community Benefit Report Filed RI Part VI - Additional Information DISCLOSURES DESCRIBED IN SECTION 7 OF REVENUE PROCEDURE 2015-21:During the fiscal year ended September 30, 2017, TMH revised its Financial Assistance Policy (FAP) to further clarify the description of the method used when calculating amounts generally billed (AGB). AGB is the maximum amount TMH would bill a patient qualifying for assistance under TMH's FAP. While TMH has historically utilized the Prospective Method to determine AGB for FAP-eligible patients, reference to the Prospective Method was not previously included in the FAP. Additionally, the FAP was revised during the fiscal year ended September 30, 2017 to include a list of all physician groups providing emergency and medically necessary services within TMH. Distinction as to which of these groups either follow or do not follow TMH's FAP is made in this list and is updated on a quarterly basis. TMH's Billing and Collections policy is a document separate from its FAP. In an effort to make all FAP-related documents more readily available to patients and potential patients, TMH has included a link of its Billing and Collections policy on its website. Please visit https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/Billing-Collection-eng.pdf to review TMH's Billing and Collections Policy.Lastly, versions of TMH's FAP and all FAP-related documents have been translated into languages serving limited English proficiency populations which represent the lesser of 1,000 persons or 5% of the population of persons eligible to be served by TMH or likely to be affected or encountered by TMH. All documents have been made readily available to the public. Please visit https://www.lifespan.org/financial-assistance for links to all translated FAP documents. true Billy Taylor House 185 - 187 Camp Street Providence RI 02906 461249425 501(c)(3) 12000 0 General Support Brown University 164 Angell Street Providence RI 02912 050258809 501(c)(3) 158402 0 General Support City of Providence 25 Dorrance Street Providence RI 02903 056000329 Gov't Org. 108000 0 Payment in lieu of taxes Everett Co Stage & School 9 Duncan Avenue Providence RI 02906 050451784 501(c)(3) 12000 0 General Support Festival Ballet Providence 825 Hope Street Providence RI 02906 050377245 501(c)(3) 11605 0 General Support Groundwork Providence 1005 Main Street Pawtucket RI 02860 050397766 501(c)(3) 22000 0 General Support Hope Street Merchants Assoc 804 Hope Street Providence RI 02906 263772899 501(c)(3) 9000 0 General Support Mt Hope Learning Center 140 Cypress Street Providence RI 02906 050502405 501(c)(3) 12000 0 General Support Social Enterprise Greenhouse 10 Davol Square Providence RI 02903 263772899 501(c)(3) 12000 0 General Support Summit Neighborhood Assoc Box 41092 Providence RI 02940 050465260 501(c)(3) 12000 0 General Support Thundermist Health Center 171 Service Avenue Warwick RI 02886 050355097 501(c)(3) 53100 0 Health Program Support 11 0 Additional Supplemental Information The Miriam Hospital is committed to community programs and provides support to various charitable organizations in Rhode Island. Donations are made to organizations recognized by the IRS as being described in IRC Section 501(c)(3). All contributions are approved by management and are made to organizations whose missions and goals align with those of the Hospital. X X true true X X X X X false true false false false false false true false false Arthur J Sampson President 417159 138000 85667 15900 17645 674371 Athena Poppas MD Physician 415997 95564 1681 15275 24016 552533 Herbert D Aronow MD Physician 424697 81700 3347 15275 26202 551221 Jinnette D Abbott MD Physician 366281 107281 1240 15275 23623 513700 Kenneth E Arnold Former Secretary 281706 119500 113377 329850 17970 862403 Maria P Ducharme Chief Nursing Officer 234012 69500 48778 52492 21902 426684 32622 Mary A Wakefield Treasurer 671632 225000 117912 169371 18017 1201932 87712 Paul C Gordon MD Physician 368118 127947 3545 15275 2854 517739 Paul J Adler Secretary 322274 69000 41275 55063 22210 509822 549 Robert W Corwin Chief Medical Officer 202050 10325 17485 229860 Samuel C Dudley MD Physician 490006 2567 15275 1485 509333 Thomas F Tracy Fmr. Chief Medical Officer 196509 82181 4375 10708 293773 Timothy J Babineau MD Trustee 1201309 653549 226132 450763 25393 2557146 102285 Part I, Line 1a: Relevant information in regards to selections on 1a. Tax Indemnification and Gross-up Payments:The Lifespan Executive Long Term Disability program provides financial protection to designated Lifespan executives in the event that they become disabled. Premiums are paid to the insurance carrier by the insureds on an after tax basis to allow for income replacement at a reasonable cost. The income associated with the premiums is grossed-up to cover the total cost of the benefit as provided in the Lifespan Executive Benefit Plan and is included in Medicare wages, more specifically on Schedule J, Part II, Column B (iii). Part I, Line 7: Non-Fixed payments not listed above Certain physicians and executives participate in incentive compensation plans arranged through individual contractual agreements which stipulate non-fixed payments based on meeting criteria comprised of various quality and productivity markers. A RIHEBC Series 2016 521300173 762244FP1 2016-08-11 57000732 Refund 1996, 2006, 2009 Bonds false false true A 57000732 419512 56581220 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 The Miriam Hospital, Rhode Island Hospital, Emma Pendleton Bradley Hospital, Rhode Island Hospital Foundation, and The Miriam 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 TMH is $57,000,732. For purposes of TMH, 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 TMH is part of the Lifespan Obligated Group previously mentioned in Part I, line A(f). Of the $308,112,067 disclosed in Form 8038, TMH was allocated $57,000,732 of the total issuance proceeds. Marilyn J Weigner Employee 484315 Employee Comp. false Roberts Carroll Feldste Partner 120581 Legal Services false Schedule L, Part V Supplemental Information * The spouse of Pamela Harrop, MD, Trustee, is employed as a physician at The Miriam Hospital (TMH). In fiscal year 2017, TMH paid Marilyn J. Weigner $484,315 for her services.* Edward D. Feldstein, Esq., Trustee, is a partner in Roberts, Carroll, Feldstein and Peirce, a law firm that provides legal services to a sister company, Lifespan Risk Services. The common parent of TMH and Lifespan Risk Services is Lifespan Corporation. During fiscal year 2017, Lifespan Risk Services paid Roberts, Carroll, Feldstein and Peirce $120,581 for services related to TMH matters. Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Timothy J. Babineau, MD, Trustee, and Mary A. Wakefield, Treasurer, 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), a separate related for-profit organization. Mr. Adler is a director and Ms. Wakefield is an officer of MSO.Lawrence A. Aubin, Sr., Chairman, and Shivan Subramaniam, Trustee, are Directors of the same for-profit organization. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Lifespan Corporation is the sole corporate member of TMH. 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, TMH, 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 TMH 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 TMH trustees and to approve the election of and to remove certain officers. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The TMH 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 TMH'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 and the Lifespan Obligated Group, which consists of TMH, RIH and Affiliates, 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 issues of tax-exempt bonds which electronically posts and transmits Lifespan's financial information to repositories and investors alike. In addition, copies of TMH's Articles of Incorporation, Bylaws, and Conflict of Interest Policy are available upon request from the office of the Lifespan EVP/CFO, either in person or by mail. Other Changes In Net Assets Or Fund Balances - Other Increases Change in funded status of pension and other postretirement = $3509700 Other Changes In Net Assets Or Fund Balances - Other Increases Increase in Net Assets of TMHF = $2343773 . Also during 2016, TMH became the first hospital in New England to use laparoscopic robotic-assisted surgery to treat bladder cancer. In being able to perform this difficult surgery laparoscopically from beginning to end, TMH is able to remain on the leading edge of bladder cancer treatments by offering patients the latest, most innovative care available. The result is improved outcomes for the hospital's patients. This further demonstrates TMH's commitment to advanced urologic treatments.Environmental Partnership Award:TMH has received the "Partner Recognition Award" from Practice Greenhealth, a health care membership community that promotes efficiency and environmental stewardship while improving patient safety and care.TMH has been named among the nation's 100 top hospitals for cardiovascular care by Thompson Healthcare. Thompson's annual study identifies hospitals that are setting benchmark levels of performance for cardiovascular services throughout the nation. It recognizes the hospitals and their management teams for superior clinical, operational, and financial performance in the area of cardiovascular service.Thanks to the latest evolution in surgical technology, physicians now have an effective alternative to traditional open surgery and laparoscopy that allows them to provide patients with the best of both approaches. This alternative is the da Vinci Surgical System, which TMH uses to treat different types of cancer.TMH's surgeons are leaders in their field. TMH, as part of an academic medical center, prizes the mastery of new technologies in order to improve the quality of life for patients. TMH surgeons have successfully performed over 1,000 procedures using the da Vinci surgical system and have made its use a cornerstone of cancer treatment at TMH. The Hospital's Adult Outpatient Behavioral Medicine Services help individuals improve health through behavior change. Services are offered to help patients adjust to chronic medical conditions, including their associated physical and emotional distress; modify unhealthy ways of living (for example, smoking cessation) to help prevent the onset or progression of disease; and treat mood and anxiety disorders that interfere with management of medical conditions. Services are available to help individuals with behavioral and psychosocial management of medical conditions such as headache, pain, cancer, heart disease (including those with implanted cardiac devices), pulmonary disease, and diabetes. The Weight Management Program provides comprehensive, medically supervised treatment for mild, moderate, and severely overweight adults. Specialized programs are also available for adolescents and diabetics. Treatment combines medical monitoring, behavioral therapy, exercise instruction, three levels of calorie reduction, and nutrition education. The Hospital's clinicians include surgical oncologists, medical oncologists, radiation oncologists, hematologists, pathologists, physical therapists, radiologists, nurses, clinical social workers, patient advocates, pharmacists, and nutritionists. These dedicated specialists work with patients every step of the way, from diagnosis to treatment to follow-up care.To help patients and their families cope with breast cancer, TMH offers the Breast Health Navigator Program. The program assists breast cancer patients through the entire course of their cancer care with breast health navigators, registered nurses trained in oncology who possess an in-depth understanding of breast cancer and theprocess undergone by patients. They guide patients through diagnosis, treatment, andrecovery, while helping them make informed decisions and cope with the variety of issues they face.TMH and RIH were named Blue Distinction Centers for Complex and Rare Cancers by Blue Cross and Blue Shield of Rhode Island. TMH and RIH are the only two hospitals in the State to receive this distinction. Blue Distinction Centers for Complex and Rare Cancers are facilities within participating Blue Cross and Blue Shield network service areas that offer comprehensive inpatient cancer care programs for adults, delivered by multidisciplinary teams with subspecialty training and distinguished clinical expertise in treating complex and rare subtypes of cancer. TMH and RIH have both been recognized for excellence in treating esophageal, gastric, liver, pancreatic, rectal, and thyroid cancer.The division of gastrointestinal and liver pathology is committed to providing high quality diagnostic services for gastrointestinal and liver diseases in patients.Collectively, gastrointestinal cancers are among the most common form of malignancies suffered today, affecting nearly a quarter of a million Americans each year. To address this, the Lifespan Cancer Institute has brought together a team of nationally recognized leaders in the treatment and research of gastrointestinal cancers.The gastrointestinal cancer care services available through the Lifespan Cancer Institute provide state-of-the-art care for patients who have or are at risk for the following types of cancer: bile duct, esophagus, gallbladder, endocrine, and cystic tumors of the pancreas, liver, and stomach. TMH also offers medical nutrition therapy on an outpatient basis designed to help prevent and control gastrointestinal disorders. Form 990, Part I, Line 6 Volunteers support and contribute to the mission of TMH every day. 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, visitors, and vendors alike. Volunteer opportunities are available for both teens and adults in a wide variety of positions, including greeters, family liaisons, emergency room support, gift shop support, nurse aides, office support, pet therapy, physical therapy, patient visitors, recovery room support, art therapy, and central transporters. Volunteers also transport students and serve as guides, escorts, and interpreter aides. Form 990, Part III, 4a: TMH is licensed to operate 247 acute care beds by the Rhode Island Department of Health. Notable medical accomplishments of TMH include performance of Rhode Island's first lung operation, first kidney transplant, and first aortic valvuloplasty (a procedure to clear blocked heart valves). In 2017, TMH discharged 18,572 inpatients, logged more than 68,000 visits in its Emergency Department, and performed nearly 12,000 inpatient and outpatient surgical procedures. Services provided in 2017 represent 72,678 inpatient days and more than 123,000 clinic visits. TMH is staffed by more than 1,000 privileged physicians, approximately 70 full-time house staff (medical school graduates), and a nursing staff of 800. In total, TMH employs more than 3,100 people. TMH is a major teaching affiliate for The Warren Alpert Medical School of Brown University, providing clinical rotations for residents.TMH provides full charity care for individuals at or below twice the federal poverty level, with a sliding scale for individuals up to three times the poverty level. In addition, a substantial discount consistent with Medicare program reimbursement is offered to all other uninsured patients. TMH 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 TMH to provide charity care amounted to $6,566,777 in fiscal 2017. Charges forgone, based on established rates, amounted to $19,280,459.TMH substantially subsidized various health services including the following programs: adult psychiatry, tuberculosis, and certain other specialty services at a net cost of $10,679,085 in fiscal year 2017. TMH 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 $192,562 in fiscal year 2017.TMH 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.TMH offers expertise in total joint replacement, minimally invasive and robotic surgery, and bariatric surgery, among many other specialties.The Leonard and Adele R. Decof Family Comprehensive Cancer Center at TMH:This Comprehensive Cancer Center brings together world-renowned physicians and a team of specialists from Rhode Island Hospital (RIH), TMH, and Newport Hospital (NH), forming a multidisciplinary team whose level of knowledge and experience are unparalleled in the State of Rhode Island. TMH, as a part of the Lifespan Cancer Institute, provides state-of-the-art care for patients with cancer.Award-Winning Care:The Miriam Hospital has received numerous distinctions and awards. It is certified by the Joint Commission as a Primary Stroke Center, and was the first in Rhode Island to be designated as such. TMH has received the American Heart Association/American Stroke Association's Gold or Gold Plus designation for stroke care every year since 2008. TMH, which treats over 300 stroke patients a year, received the awards for attaining targeted quality measures and ensuring stroke patients receive the most appropriate medical treatment based on nationally recognized, research-based guidelines. Blue Cross Blue Shield of Rhode Island awarded TMH a Blue Distinction Center+ designation for bariatric surgery. The Center for Bariatric Surgery at TMH has been a Center of Excellence in Bariatric Surgery and was reaccredited in 2017 by the American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. The Total Joint Center at TMH is recognized by the Joint Commission with a Gold Seal of Approval for its total knee and total hip replacement programs. TMH has earned the prestigious Magnet Award for nursing excellence and is one of the very few hospitals in the country to receive Magnet designation continuously over 20 years. The hospital has been named multiple times as a top regional hospital by U.S. News & World Report.In 2017, the Leapfrog Group, a nonprofit aimed at driving quality, safety, and transparency in the U.S. health system, named TMH among the 36 Top Teaching Hospitals in its Top Hospitals Awards. TMH is one of four in New England to win the top teaching hospital honor.During 2017, Rhode Island Hospital, The Miriam Hospital, and Newport Hospital all received an "A" in the national Leapfrog Hospital Safety Grade ratings from The Leapfrog Group. Lifespan was the only health system in Rhode Island to earn the top score at each of its eligible hospitals.The Leapfrog Group gives grades of A, B, C, D and F, based on performance in preventing medical errors, infections and other harms. Nationally, 2,632 hospitals were graded, and just 832 earned an A, putting the three Lifespan hospitals in the top third of hospitals across the country for this measure.In 2017, The Miriam Hospital and Rhode Island Hospital were among the nation's top hospitals for clinical excellence, according to Healthgrades, a leading online resource for comprehensive information about the nation's physicians and hospitals.According to Healthgrades, the Distinguished Hospitals for Clinical Excellence Award recipients demonstrate comprehensive, consistent quality across a range of conditions and procedures, while other hospitals may possess specific areas of expertise and high-quality outcomes for some conditions and procedures.TMH was recognized for COPD, colorectal surgeries, inpatient coronary interventional procedures, esophageal/stomach surgeries, GI bleed, heart attack, heart failure, pneumonia, pulmonary embolism, respiratory failure, sepsis, and stroke.The Total Joint Center:The Total Joint Center at The Miriam Hospital (the Center) is dedicated to providing the most technologically advanced and specialized procedures focused on the replacement of joints and rehabilitation and care in treating diseases of, or injuries to, hips, knees, and shoulders. TMH is a Blue Cross Blue Shield Blue Distinction Center for Knee and Hip Replacement, which is a designation given to hospitals that demonstrate an expertise in quality care by meeting objective clinical measures, resulting in better outcomes for patients. In 2017, the Gold Seal of Approval for Advanced Certification for Total Hip and Total Knee Replacement was awarded to the Center. The Miriam's second Joint Commission Gold Seal of Approval, the advanced designation which recognizes quality, consistency and safety of services and patient care set by The Joint Commission and the Total Joint Center, is the only Rhode Island program to achieve advanced certification.Medical and surgical services at the Center are provided in a personalized, caring environment within the context of an academic medical center. All services focus on the patient experience from initial consultation through recovery.Multidisciplinary medical teams include many dedicated specialists - surgeons, internal medicine specialists, anesthesiologists, nurses, rehabilitation therapists, and social workers who work with patients from diagnosis to treatment to follow-up care. The physical therapy and nursing teams work together after surgery to get patients moving for faster recovery, and physicians, nurses, and therapists work collaboratively to follow up care.Each patient benefits from individualized treatment plans and rehabilitation to aid recovery and restore functionality as quickly as possible. Whenever possible, minimally invasive surgical techniques are used to perform surgery. These techniques have dramatically improved the quality of the post-operative and recovery experience for the patient. In certain cases, computer navigation technology is used for knee and hip replacement surgeries. Computer navigation can assist the surgeon and improve the level of accuracy, bringing the precision of bone cuts and implant alignment in joint replacement surgery to a whole new level of accuracy, reliability, and longevity.During 2016, TMH was one of Form 990, Part III, 4b: TMH conducts extensive medical research and is in the forefront of biomedical health care delivery research and among the leaders nationally in National Institutes of Health programs. TMH also sponsored a significant level of these research activities in the amount of $2,855,000 during 2017.Major areas of research include:Cancer - TMH conducts clinical and behavioral research focusing on the many facets of cancer including prevention, education, and therapeutics which are supported by the National Cancer Institute, CALGB, and NSABP. TMH is a participating hospital in the Brown University-sponsored Cancer Oncology Group (BrUCOG).AIDS - As part of the Lifespan/Tufts/Brown Center for AIDS Research (CFAR), division researchers engage in clinical, basic, and translational research designed to improve the prevention and treatment of HIV/AIDS, with a major focus on women, racial and ethnic minorities, and individuals with substance abuse problems.The Lifespan/Tufts/Brown CFAR is a joint research effort among Brown University and Tufts University and their affiliated hospitals and centers. It is one of 20 centers located at academic medical centers throughout the United States that are part of the national CFAR program of the National Institutes of Health. The program emphasizes the importance of interdisciplinary collaboration, especially between basic and clinical investigators, and also encourages training and mentoring of young investigators as well as an inclusion of women and minorities.HIV - At TMH, research focuses on the treatment and prevention of HIV infections, especially in hard-to-reach populations, both in the U.S. and abroad. There are international sites located in Cambodia, India, Kenya, Indonesia, The Philippines, and South Africa. The TB Clinic performs research in the area of co-infections of HIV and tuberculosis. The Centers for Behavioral and Preventive Medicine aims to improve health through behavioral change and the integration of behavioral and biomedical science using clinical, community, and laboratory-based research. The Centers' research bridges biomedical, sociobehavioral, and population/public health scientific disciplines. Faculty members are committed to both basic research on discovering the mechanisms underlying behavioral factors in health and illness (e.g., examining the stress response among children and adolescents, neuroimaging of AIDS, and other medical conditions), as well as to applied research on the translation of these discoveries for clinical and community health improvement. Programs range from those that focus on primary prevention (e.g., promoting smoking cessation, preventing weight gain, increasing physical activity, and HIV/AIDS prevention) to improving the effectiveness of treatment and enhancing quality of life in populations such as cancer survivors and patients enrolled in cardiac rehabilitation programs. Form 990, Part III, 4c: TMH provides the setting for and substantially supports medical education in various clinical training and nursing programs. The total cost of medical education provided by TMH exceeded the reimbursement received from third party payors by $17,121,273 in 2017.In 1969, TMH and certain other Rhode Island hospitals entered into an affiliation agreement to participate jointly in various clinical training programs and research activities with Brown Medical School, renamed The Warren Alpert Medical School of Brown University (Brown). The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically.TMH participates in Brown programs in internal medicine and medicine subspecialties, general surgery and surgical subspecialties, psychiatry, emergency medicine and emergency medicine subspecialties, orthopedics and orthopedics subspecialties, and dermatology. TMH provides stipends to residents and physician fellows while in training.In addition, TMH is a participating clinical training site for residents from other programs in anesthesiology, family medicine, internal medicine, hematology/oncology, obstetrics/gynecology (OB/Gyn) and OB/Gyn subspecialties, otolaryngology, pediatric dentistry, podiatry, psychiatry and its subspecialties of forensic psychiatry and geriatric psychiatry, orthopedics, rheumatology, and radiation oncology. Various departments and specialties at TMH 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 the Hospital, in collaboration with Brown, sponsors research and clinical psychology training programs for interns, postdoctoral fellows, and faculty trainees.With respect to nursing education, TMH has developed educational affiliations with the University of Rhode Island College of Nursing; Rhode Island College School of Nursing; Community College of Rhode Island (CCRI); Salve Regina University; Boston College; Yale University; Regis College; Simmons College; St. Josephs Health Services School of Nursing; 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 the Hospital. TMH does not receive any compensation from the various schools for providing a clinical setting for the student nurse training. TMH also serves as a clinical site for Medical Assistants.The Lifespan School of Medical Imaging collaborates with Rhode Island College in the following programs: diagnostic medical sonography; nuclear medicine technology; radiologic technology; and magnetic resonance imaging. Students complete educational experiences at the Hospital, as well as other outpatient sites.TMH sponsors training programs for a variety of allied health care professionals including required clinical and fieldwork experiences in physical, speech, and occupational therapy, to university students in each discipline through contracts with the various universities. TMH acts as a clinical training site for students from CCRI in its vascular and cardiology ultrasound programs and provides training experiences for both phlebotomy students and physical therapy assistant students. TMH serves as a clinical training site for students from The Nuclear Medicine Institute of the University of Findlay (Ohio) and has educational affiliations with the respiratory programs at both CCRI and The New England Institute of Technology. TMHs EEG Department provides clinical training to neurodiagnostic technology students from Laboure College (Massachusetts).TMH has clinical affiliations/student clinical training programs for pharmacy students provided through contracts with a number of colleges and universities. A majority of the pharmacy students attend the University of Rhode Island, Massachusetts College of Pharmacy and Allied Health Sciences, and Northeastern University. In addition, the Hospital 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 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 2017, Lifespan paid rent to Lawrence Investments, LLC under the terms of this lease. Form 990, Part VI, Section B, Line 12c Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including TMH, 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. This requirement shall be acknowledged as part of the annual performance evaluation process. 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 The Miriam Hospital: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. The independent consultants are not engaged by management to perform any services for Lifespan without prior approval by the Committee.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 with acceptance of a reasonable compensation offer. Form 990, Schedule H, Part V, Line 10a: The URL to view TMH's most recently adopted implementation strategy is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/centers/lifespan-community-health/The-Miriam-Hospital-2016-CHNA.pdfPlease refer to page 19 of the CHNA to view details of the implementation strategy. Form 990, Schedule H, Part V, Line 16b: The URL to view and download TMH's Financial Assistance Policy application form is below:https://www.lifespan.org/uploadedFiles/Lifespan/Content/Patient_Financial_Services/Lifespan-FAF-ENG.pdf Form 990, Schedule H, Part V, Line 16c: The URL to view TMH'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.pdf Form 990, Schedule H, Part V, Line 7: The TMH website which makes the hospital's CHNA report widely available is located at the following URL:https://www.lifespan.org/centers-services/lifespan-community-health-institute/community-health-reports-and-resources 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 Foundation 249 Roosevelt Avenue Pawtucket RI 02860 464002163 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false Gateway Healthcare Inc 249 Roosevelt Avenue Pawtucket RI 02860 050309043 Subs. 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 Human Services Realty Inc 249 Roosevelt Avenue Pawtucket RI 02860 050398161 Housing for Elderly and Mentally Ill RI 501(c)(2) N/A Gateway Healthcare Inc 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) NA 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 245 Winter St Waltham MA 02451 043408517 Holding Company RI 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 167 Point Street 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 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 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 Foundation 167 Point Street Providence RI 02903 050377502 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false The Miriam Hospital Womens Assoc 164 Summit Avenue Providence RI 02906 050268165 Patient Support RI 501(c)(3) 12(II) NA 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 JRR Housing 249 Roosevelt Avenue Pawtucket RI 02860 263121266 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 BD HM 12 Offshore Insurance Captive BD N/A N/A Lifespan Corporation false Lifespan Health Alliance LLC 167 Point Street Providence RI 02903 812732225 Account. Care Org. RI N/A false false Lifespan MSO Inc 167 Point Street Providence RI 02903 050508717 Mgmnt Services 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 LDS Inc C Corp false Gateway Professional Group Inc 249 Roosevelt Avenue Pawtucket RI 02860 050498391 Psychotherapy RI Gateway Healthcare C Corp false false false true false false false false false false true true true true true true true true false false Entity Merger: Effective April 1, 2017, Alternative Living Concepts, Inc. (ALC) and Human Services Realty, Inc., related Lifespan organizations, underwent a merger whereby ALC became the surviving corporation. However, ALC will continue its operations using the d/b/a name of Human Services Realty.