2018-08-13T15:04:07-05:00 2017-09-30 135565207 KPMG LLP 345 PARK AVENUE NEW YORK NY 10154 990 2016-10-01 460543230 LMW HEALTHCARE INC LMWH 8604420711 365 MONTAUK AVENUE NEW LONDON CT 06320 SETH VAN ESSENDELFT INTERIM CFO 8604420711 2018-08-13 0 ROBERT ROBINSON P00741489 2127589700 2016 2022-09-23 18:48:47Z WESTERLY HOSPITAL PATRICK GREEN 365 MONTAUK AVENUE NEW LONDON CT 06320 64058423 0 X WWW.WESTERLYHOSPITAL.ORG X 2012 RI TO PROVIDE MEDICAL CARE IN THE WESTERLY, RHODE ISLAND COMMUNITY AND SURROUNDING TOWNS. 11 8 717 128 0 0 0 222938 63216981 61523067 378553 370501 618510 495880 64214044 62612386 10600 7605 0 0 35607457 34617397 0 0 327153 33946856 35631547 69564913 70256549 -5350869 -7644163 62779155 72725888 28740264 36791210 34038891 35934678 X TO PROVIDE MEDICAL CARE IN THE WESTERLY, RHODE ISLAND COMMUNITY AND SURROUNDING TOWNS. 0 0 52573317 7605 61523067 SEE SCHEDULE O 52573317 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 40 0 717 1 0 0 0 0 0 0 0 0 0 0 X 11 8 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X DENIS DONEGAN 2036886088 789 HOWARD AVENUE NEW HAVEN CT 06519 STEPHEN M GREENE CHAIRMAN AND TRUSTEE 1.00 1.00 X X 0 0 0 BRUCE D CUMMINGS END 517 PRESIDENT/CEO AND TRUSTEE 1.00 39.00 X X 0 1752901 48773 ANN M LAIN SECRETARY AND TRUSTEE 1.00 1.00 X X 0 0 0 DEBORAH LAMM VICE CHAIRMAN AND TRUSTEE 1.00 1.00 X X 0 0 0 STEVEN RUZZO TREASURER AND TRUSTEE 1.00 0.00 X X 0 0 0 WILLIAM CONLIN END 1216 TRUSTEE 1.00 39.00 X 2500 101314 26023 ADRIAN K HAMBURGER TRUSTEE 1.00 39.00 X 0 735683 49784 THOMAS J LIGUORI TRUSTEE 1.00 0.00 X 0 0 0 RACHEL MCCORMICK TRUSTEE 1.00 0.00 X 2500 0 0 CHRISTOPHER O'CONNOR TRUSTEE 1.00 39.00 X 0 1244457 435873 RICHARD SMITH TRUSTEE 1.00 0.00 X 0 0 0 PATRICK L GREENE START 617 PRESIDENT/CEO 0.00 0.00 X X 0 0 0 DAVID CAMERON START 117 TRUSTEE 1.00 0.00 X 0 0 0 MAUREEN ANDERSON ASSISTANT SECRETARY 1.00 39.00 X 0 358945 37575 SETH VAN ESSENDELFT VP/CFO 1.00 39.00 X 0 506116 35761 LINDA BROCATO PHARMACY MANAGER 40.00 0.00 X 142150 0 12222 EMILY FLYNN CLINICAL PHARMACIST 40.00 0.00 X 122657 0 24982 KARL NG CLINICAL PHARMACIST 40.00 0.00 X 146031 0 11499 LAURIE K BATASTINI DIRECTOR PATIENT CARE SERVICES 40.00 0.00 X 122197 0 18529 SHEILA SANDOVAL CLINICAL PHARMACIST 40.00 0.00 X 135022 0 6500 673057 4699416 707521 18 0 1 0 FASTAFF LLC 6399 S FIDDLERS GREEN CIRCLE GREENWOOD VILLAGE CO 80111 RECRUITMENT SERVICES 908881 IPC HOSPITALISTS OF NEW ENGLAND PC 15 SALT CREEK LANE SUITE 444 HINSDALE IL 60521 MEDICAL SERVICES 534990 QUEST DIAGNOSTICS 40 ACCORD PARK DRIVE NORWELL MA 02061 LAB SERVICES 500271 SUNQUEST INFORMATION SYSTEMS INC 3300 EAST SUNRISE DRIVE TUCSON AZ 85718 LAB SERVICES 447422 UNITEX TEXTILE RENTAL SERVICES INC 565 TAXTER ROAD SUITE 620 ELMSFORD NY 105232300 UNIFORM LAUNDERING 273682 16 169938 50500 2500 222938 PATIENT SERVICE REVENUE 900099 61523067 61523067 0 61523067 201563 201563 327360 111578 215782 215782 215782 1306239 197158 1281722 52737 24517 144421 168938 168938 CAFETERIA/FOOD SALES 900099 239407 239407 OTHER ANCILLARY REVENUE 900099 40691 40691 280098 62612386 61523067 0 866381 X 2985 2985 4620 4620 27295024 20424999 6742581 127444 480144 359294 118608 2242 4749974 3554429 1173367 22178 2092255 1565645 516841 9769 1058868 792356 266512 384553 287763 96790 63215 47304 15911 21270 21270 27957 20920 7037 10330399 7724934 2605465 289346 216519 72827 224458 166049 58409 332274 248642 83632 1642924 1229408 413516 12857 9621 3236 75358 56391 18967 329034 246218 82816 2639971 1975503 664468 4358893 3261781 1097112 1675963 1254131 421832 MEDICAL SUPPLIES 9681195 7244485 2436710 0 OTHER SUPPLIES 1726104 1291652 268932 165520 REPAIRS & MAINTENANCE 705238 527733 177505 0 MEMBERSHIP DUES & SUBSC 51670 38665 13005 0 70256549 52573317 17356079 327153 1535344 3624427 147654 135470 6019277 5283267 200500 0 1660088 1166404 152144 134763 48489293 4432531 33918339 44056762 8466484 8596754 4202770 4509421 2230125 0 4246430 5218620 62779155 72725888 6653263 4497797 22087001 32293413 28740264 36791210 X 24311364 25540316 715500 9727527 9678862 34038891 35934678 62779155 72725888 X -7644163 630108 7954309 955533 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 1 500 0 0 1 6000 0 1 14770 21270 0 PART II-B, LINE 1: THE AMOUNT REPORTED IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING DURING FY 2017. ALSO, THE HEALTH SYSTEM OFFICIALS HAD MEETINGS AND CONTACTS WITH STATE GOVERNMENT OFFICIALS,INCLUDING STATE LEGISLATORS AND THEIR STAFF TO DISCUSS VARIOUS HEALTH CARE REFORM PROPOSALS. LMW HEALTHCARE INC. IS PART OF A CONTROLLED GROUP WITH THE FOLLOWING LOBBYING EXPENSES: YALE NEW HAVEN HOSPITAL EIN 06-0646652 $ 672,272 BRIDGEPORT HOSPITAL EIN 06-0646554 $ 133,079 GREENWICH HOSPITAL EIN 06-0646659 $ 104,856 NORTHEAST MEDICAL GROUP EIN 06-1330992 $ 66,674 LAWRENCE + MEMORIAL HOSPITAL EIN 06-0646704 $ 94,495 7716486 85767 857775 32525 30749 8596754 7144384 92360 515574 -2035 37867 7716486 7087069 77827 49427 30444 39495 7144384 6624154 18975 474133 30193 7087069 6524115 122157 22118 6624154 0.37760 0.62240 0.00000 0 0 4882000 4882000 25073537 1604013 23469524 758000 176271 581729 16985194 2650745 14334449 790562 1502 789060 44056762 FUNDS HELD IN TRUST 4509421 F 4509421 MALPRACTICE INSURANCE RECEIVABLE 3882166 DUE FROM YNHHSC 383626 DUE FROM THIRD PARTIES 202828 CONTRIBUTION RECEIVABLE 750000 5218620 3RD PARTY PAYOR SETTLEMENTS 1627073 ASSET RETIREMENT OBLIGATION 1389172 MALPRACTICE INSURANCE LIABILITY 5812402 DUE TO AFFILIATES 23464766 32293413 X PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUND FUNCTIONS TO SUPPORT AND PROVIDE INCOME FOR THE FURTHERANCE OF THE HEALTH CARE MISSION OF LMW HEALTHCARE, INC. PART X, LINE 2: LMW HEALTHCARE INC IS INCLUDED IN THE CONSOLIDATED LAWRENCE + MEMORIAL CORPORATION AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS. FOLLOWING IS THE FOOTNOTE FROM THE CONSOLIDATED FINANCIAL STATEMENTS: MOST ENTITIES WITHIN THE CORPORATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, AND ARE GENERALLY EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. PROVISIONS FOR INCOME TAXES AND DEFERRED TAXES, WHICH ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS, HAVE BEEN MADE FOR THE TAXABLE ENTITIES LISTED ABOVE UNDER THE DESCRIPTION OF THE CORPORATION. U.S. GAAP REQUIRES THE CORPORATION TO EVALUATE TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE CORPORATION'S TAX RETURNS TO DETERMINE WHETHER THE TAX POSITIONS ARE "MORE LIKELY THAN NOT" OF BEING SUSTAINED BY THE APPLICABLE TAX AUTHORITY BASED UPON THE TECHNICAL MERITS OF THE POSITION. THE CORPORATION RECOGNIZES THE EFFECT OF TAX POSITIONS ONLY IF THEY ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. THIS EVALUATION HAD NO IMPACT ON THE OPERATIONS OF THE CORPORATION AS OF AND FOR THE YEAR ENDED SEPTEMBER 30, 2017. 1 1 X 1 X 250.000000000000 1 X 550.000000000000 1 1 1 0 1 1 0 1061 2685372 3215885 0 0.00000 0 14656 8545268 4479060 4066208 0.05790 0 0 0 0 15717 11230640 7694945 4066208 0.05790 17 3227 386309 6702 379607 0.00540 5 104 331593 0 331593 0.00470 0 0 0 0 0 0 0 0 4 12 4916 0 4916 0.00010 26 3343 722818 6702 716116 0.01020 26 19060 11953458 7701647 4782324 0.06810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3235596 29727342 37857053 -8129711 X 1 1 1 1 LMW HEALTHCARE INC 25 WELLS STREET WESTERLY RI 02891 HTTP://WESTERLYHOSPITAL.ORG HOS00129 X X X LMW HEALTHCARE INC 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X SEE PART V X SEE PART V X X 1 16 1 SEE PART V 0 1 X 250.000000000000 550.000000000000 X X X X 1 1 X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X X 1 X 0 X X X X X 1 X 0 0 LMW HEALTHCARE, INC. PART V, SECTION B, LINE 5: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE CHNA PROCESS. THROUGHOUT, LMW HEALTHCARE INC. SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL THROUGH COMMUNITY MEETINGS AND INCLUSION OF RESIDENTS AND COMMUNITY PARTNERS IN THE PRIORITIZATION AND IMPLEMENTATION PLANNING PROCESS. PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS SHARED KNOWLEDGE AND EXPERTISE ABOUT HEALTH ISSUES, WHILE LEADERS AND REPRESENTATIVES OF NON-PROFIT AND COMMUNITY-BASED ORGANIZATIONS PROVIDED INSIGHT ON THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS. LMW HEALTHCARE, INC. PART V, SECTION B, LINE 6A: LMW HEALTHCARE INC PARTICIPATED IN A STATEWIDE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) LED BY THE HOSPITAL ASSOCIATION OF RHODE ISLAND (HARI) AND ITS MEMBER HOSPITALS. ITS MEMBER HOSPITALS INCLUDE:BUTLER HOSPITALELEANOR SLATER HOSPITALFATIMA HOSPITALKENT HOSPITALLANDMARK MEDICAL CENTERPROVIDENCE VA MEDICAL CENTERROGER WILLIAMS MEDICAL CENTERSOUTH COUNTY HOSPITALWOMEN & INFANTS HOSPITAL LMW HEALTHCARE, INC. PART V, SECTION B, LINE 6B: LMW HEALTHCARE INC. PARTICIPATED IN A STATEWIDE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) LED BY THE HOSPITAL ASSOCIATION OF RHODE ISLAND (HARI) AND ITS MEMBER HOSPITALS. THROUGH A COORDINATED STATEWIDE EFFORT, HARI AND ITS HOSPITAL MEMBERS WORKED WITH THE RHODE ISLAND DEPARTMENT OF HEALTH AND LOCAL COMMUNITY PARTNERS TO COLLECT HEALTH DATA, GATHER FEEDBACK ON REGIONAL AND LOCAL HEALTH NEEDS, AND DEVELOP COORDINATED PLANS TO ADDRESS PRIORITY HEALTH NEEDS ACROSS THE STATE. BAKER-TILLY CONSULTINGTHE HOSPITAL ASSOCIATION OF RHODE ISLANDCARE NEW ENGLAND HEALTH SYSTEM: BUTLER HOSPITAL; KENT HOSPITAL; MEMORIAL HOSPITAL OF RHODE ISLAND; WOMEN & INFANTS HOSPITAL OF RHODE ISLANDCHARTERCARE: OUR LADY OF FATIMA HOSPITAL; ROGER WILLIAMS MEDICAL CENTERDOMESTIC VIOLENCE RESOURCE CENTER OF SOUTH COUNTYGATEWAY HEALTHCAREJONNYCAKE CENTERLANDMARK MEDICAL CENTEROCEAN COMMUNITY YMCAPAWCATUCK NEIGHBORHOOD CENTERRHODE ISLAND DEPARTMENT OF HEALTHRHODE ISLAND FOUNDATIONRHODE ISLAND LAND TRUSTSOUTH COUNTY COMMUNITY ACTIONSOUTH COUNTY HEALTHWARM CENTERWASHINGTON COUNTY HEALTH EQUITY ZONE STEERING COMMITTEEWESTERLY AMBULANCE CORPS.WESTERLY PUBLIC SCHOOLSWESTERLY TOWN PLANNINGWOOD RIVER HEALTH SERVICESSCHEDULE H, PART V, SEC B, LINE 7A AND 10A:HTTPS://WWW.WESTERLYHOSPITAL.ORG/ABOUT/COMMUNITY-BENEFITS.ASPXSCHEDULE H, PART V, SEC B, LINE 7B:HTTPS://STATIC1.SQUARESPACE.COM/STATIC/546D61B5E4B049F0B10B95C5/T/58F20895B8A79B050D67D77B/1492256919901/WESTERLYHOSPITALCHNAREPORTFINAL20160729.PDF LMW HEALTHCARE, INC. PART V, SECTION B, LINE 7D: THE CHNA REPORT WAS RELEASED AT A PRESENTATION OPEN TO THE PUBLIC ON MAY 17, 2016. IN ATTENDANCE WERE COMMUNITY PARTNERS REPRESENTING OTHER NON-PROFIT ORGANIZATIONS, BUSINESS LEADERS, INDIVIDUALS REPRESENTING THE EDUCATION SECTOR, HOSPITAL STAFF, MEMBERS OF THE MEDIA, AND COMMUNITY MEMBERS. SUBSEQUENT TO ITS RELEASE, THERE HAD BEEN NEWS ARTICLES IN THE LOCAL MEDIA ABOUT THE ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN. PRINTED COPIES OF THE REPORT HAVE BEEN AVAILABLE FOR THOSE INTERESTED AND THE REPORT IS POSTED ON THE HOSPITAL AND PARTNER AGENCIES WEBSITES. LMW HEALTHCARE, INC. PART V, SECTION B, LINE 11: THE 2016 CHNA REVEALED THAT THE WESTERLY COMMUNITY IS GREATLY CHALLENGED BY BEHAVIORAL HEALTH - MENTAL HEALTH AND SUBSTANCE USE DISORDER RELATED ISSUES. FROM A LACK OF RESOURCES TO TREAT MENTAL HEALTH CONDITIONS TO SUBSTANCE ABUSE ADDICTION, BEHAVIORAL HEALTH IS A KEY HEALTH CONCERN IN OUR COMMUNITY. BECAUSE OF THE FAR-REACHING EFFECTS OF BEHAVIORAL HEALTH ON THE OVERALL HEALTH AND QUALITY OF LIFE FOR RESIDENTS IN OUR COMMUNITY, LMW HEALTHCARE INC. AND THE HEALTH IMPACT COLLABORATIVE OF GREATER WESTERLY MADE A COMMITMENT TO FOCUS COMMUNITY HEALTH IMPROVEMENT EFFORTS ON BEHAVIORAL HEALTH OVER THE NEXT SEVERAL YEARS. WHILE WE REMAIN COMMITTED TO PROVIDING QUALITY HEALTHCARE FOR ALL, AND OUR ONGOING WORK TOWARD CHRONIC DISEASE PREVENTION AND CANCER CARE WILL NOT STOP, WE WILL PLACE A HEIGHTENED EMPHASIS ON TACKLING BEHAVIORAL HEALTH NEEDS ACROSS OUR COMMUNITY. TO BETTER UNDERSTAND THE NEEDS AND RESOURCES ASSOCIATED WITH BEHAVIORAL HEALTH, WE SOLICITED INPUT FROM OUR COMMUNITY PARTNERS AND RESIDENTS THROUGH THE CHNA RESEARCH AND COMMUNITY DIALOG. LMW HEALTHCARE INC. HAS PLAYED A LEADERSHIP ROLE IN SOUTH COUNTY HEALTHY BODIES, HEALTHY MINDS (HBHM), A PARTNERSHIP WITH THE RHODE ISLAND DEPARTMENT OF HEALTH HEALTH EQUITY ZONE (HEZ) PROJECT TO HELP ALL SOUTH COUNTY RESIDENTS LEAD HEALTHY LIVES. IN COLLABORATION WITH THE HBHM COMMITTEE AND OTHER COMMUNITY PARTNERS, WE WILL WORK TOWARD OUR GOAL OF IMPROVING BEHAVIORAL HEALTH ACCESS AND OUTCOMES FOR ALL RESIDENTS: BEHAVIORAL HEALTH GOAL STATEMENT: IMPROVE OUTCOMES FOR RESIDENTS LIVING WITH BEHAVIORAL HEALTH CONDITIONS.OBJECTIVES:-INCREASE ACCESS TO APPROPRIATE, QUALITY BEHAVIORAL HEALTH SERVICES AND IMPROVE SELF-MANAGEMENT AMONG PATIENTS-INCREASE AWARENESS OF SIGNS AND SYMPTOMS OF BEHAVIORAL HEALTH CONDITIONS AND COMMUNITY RESOURCES-INCREASE EARLY IDENTIFICATION AND SCREENINGS FOR BEHAVIORAL HEALTH CONDITIONS IN ALL CARE SETTINGS-TO EDUCATE THE COMMUNITY ABOUT HOW LMW HEALTHCARE INC. AND ITS COMMUNITY PARTNERS ARE ACTIVELY ENGAGED IN MEETING NEEDS IDENTIFIED IN THE CHNA. LMW HEALTHCARE, INC. PART V, SECTION B, LINE 13H: THESE PROGRAMS COVER EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ONLY. LMW HEALTHCARE, INC. PART V, SECTION B, LINE 16J: WEBSITE PROVIDES DIRECT EMAIL LINK TO FINANCIAL COUNSELORS. LMW HEALTHCARE, INC. PART V, SECTION B, LINE 20E: PRIOR TO INITIATION OF ANY COLLECTION ACTION, THE HOSPITAL DOCUMENTED ITS DETERMINATION OF WHETHER INDIVIDUALS WHO SUPPLIED A COMPLETED FINANCIAL ASSISTANCE APPLICATION WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART V, SECTION B, LINE 16A, 16B AND 16C: HTTPS://WWW.WESTERLYHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE.ASPX 6 1 - LMW HEALTHCARE LAB 45 WELLS STREET WESTERLY RI 02891 BLOOD DRAW CENTER 2 - LMW HEALTHCARE LAB 25 WELLS STREET WESTERLY RI 02891 BLOOD DRAW CENTER 3 - CENTER FOR MUSCULOSKELETAL CARE 45 WELLS STREET WESTERLY RI 02891 MUSCULOSKELETAL CARE 4 - OUTPATIENT LAB SERVICES - HOPE VALLEY 823 MAIN STREET HOPE VALLEY RI 02832 BLOOD DRAW CENTER 5 - PHYSICAL THERAPY AND REHAB SERVICES 81 BEACH STREET WESTERLY RI 02891 PHYSICIAL THERAPY; REHAB 6 - WOOD RIVER HEALTH SERVICES 823 HOPE STREET HOPE VALLEY RI 02832 MAMMOGRAPHY; XRAY SERVICE PART I, LINE 3C: IT IS THE PHILOSOPHY AND POLICY OF LMW HEALTHCARE INC THAT MEDICALLY NECESSARY HEALTH CARE SERVICES SHOULD BE AVAILABLE TO ALL INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY.CHARITY CARE APPLIES TO ALL UNINSURED PATIENTS (DEFINED AS EARNING LESS THAN 250% OF THE POVERTY GUIDELINES). CARE WILL BE PROVIDED FREE FOR THOSE UNINSURED PATIENTS WHO REQUEST ASSISTANCE AND VERIFY THEIR ANNUAL INCOME IS LESS THAN 250% OF THE FEDERAL INCOME POVERTY LEVEL ("FPL"). PART I, LINE 7: THE AMOUNTS REPORTED ON PART 1, LINE 7 WERE CALCULATED AS DIRECT AND SEPARATELY IDENTIFIABLE COSTS INCURRED BY THE HOSPITAL PLUS AN ALLOCATION OF OVERHEAD. PART II, COMMUNITY BUILDING ACTIVITIES: LMW HEALTHCARE INC., ALONG WITH MANY OTHER HOSPITALS ACROSS THE COUNTRY, UTILIZES THE COMMUNITY BENEFITS INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) DATABASE DEVELOPED BY LYON SOFTWARE TO CATALOG ITS COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES AND THE GUIDELINES DEVELOPED BY THE CATHOLIC HOSPITAL ASSOCIATION (CHA) IN ORDER TO CATALOG THESE BENEFITS. THESE TWO ORGANIZATIONS HAVE WORKED TOGETHER FOR OVER 20 YEARS TO PROVIDE SUPPORT TO NOT-FOR-PROFIT HOSPITALS TO DEVELOP AND SUSTAIN EFFECTIVE COMMUNITY BENEFIT PROGRAMS.THE MOST RECENT VERSION OF THE CHA GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT DEFINES COMMUNITY BUILDING ACTIVITIES AS PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL PROBLEMS. THESE ACTIVITIES ARE CATEGORIZED INTO EIGHT DISTINCT AREAS INCLUDING PHYSICAL IMPROVEMENT AND HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, COALITION BUILDING, ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS, AND WORKFORCE DEVELOPMENT. LMW HEALTHCARE INC. ENHANCES THE LIVES OF THOSE WE SERVE BY PROVIDING ACCESS TO INTEGRATED, HIGH-VALUE, PATIENT-CENTERED CARE IN COLLABORATION WITH OTHERS WHO SHARE OUR VALUES. AS SUCH, LMW HEALTHCARE INC. IS INCREASINGLY AWARE OF HOW SOCIAL DETERMINANTS IMPACT THE HEALTH OF INDIVIDUALS AND COMMUNITIES. A PERSON'S HEALTH AND CHANCES OF BECOMING SICK AND DYING EARLY ARE GREATLY INFLUENCED BY POWERFUL SOCIAL FACTORS SUCH AS EDUCATION, INCOME, NUTRITION, HOUSING AND NEIGHBORHOODS. PART III, LINE 2: LMW HEALTHCARE INC USES A COST REPORTING SYSTEM TO DETERMINE THE BAD DEBT EXPENSE. THE AMOUNT OF BAD DEBT EXPENSE (AT COST) REPORTED ON PART III, LINE 2 IS TAKEN DIRECTLY FROM THE GENERAL LEDGER AND INCLUDED WITHIN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. PART III, LINE 3: THE ORGANIZATION DOES NOT CURRENTLY HAVE A METHODOLOGY TO ACCURATELY QUANTIFY OR ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE THAT WOULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: LMW HEALTHCARE INC ("WESTERLY HOSPITAL") IS INCLUDED IN THE CONSOLIDATED LAWRENCE + MEMORIAL CORPORATION AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS. FOLLOWING IS THE FOOTNOTE FROM THE CONSOLIDATED FINANCIAL STATEMENTS:THE CORPORATION'S COMMITMENT TO COMMUNITY SERVICE IS EVIDENCED BY SERVICES PROVIDED TO THE POOR AND BENEFITS PROVIDED TO THE BROADER COMMUNITY. SERVICES PROVIDED TO THE POOR INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES, AND/OR WHO ARE UNINSURED OR UNDERINSURED.THE CORPORATION PROVIDES FREE CARE PROGRAMS FOR QUALIFYING PATIENTS. IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE CORPORATION, DURING THE REGISTRATION, BILLING, AND COLLECTION PROCESS, A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED. FOR PATIENTS WHO WERE DETERMINED BY THE CORPORATION TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE THE PROVISION FOR BAD DEBTS. FOR PATIENTS WHO DO NOT AVAIL THEMSELVES OF ANY FREE CARE PROGRAM, AND WHOSE ABILITY TO PAY CANNOT BE DETERMINED BY THE CORPORATION, CARE GIVEN BUT NOT PAID FOR IS CLASSIFIED AS CHARITY CARE.TOGETHER, CHARITY CARE AND PROVISION FOR BAD DEBTS REPRESENT UNCOMPENSATED CARE. THE ESTIMATED COST OF TOTAL UNCOMPENSATED CARE IS APPROXIMATELY $6.2 MILLION FOR THE YEAR ENDED SEPTEMBER 30, 2017. THE ESTIMATED COST OF UNCOMPENSATED CARE IS BASED ON THE RATIO OF COST TO CHARGES, AS DETERMINED BY CLAIMS ACTIVITY.THE ESTIMATED COST OF CHARITY CARE PROVIDED WAS $0.6 MILLION FOR THE YEAR ENDED SEPTEMBER 30, 2017. THE ESTIMATED COST OF CHARITY CARE IS BASED ON THE RATIO OF COST TO CHARGES. THE ALLOCATION BETWEEN BAD DEBT AND CHARITY CARE IS DETERMINED BASED ON MANAGEMENT'S ANALYSIS ON THE PREVIOUS 12 MONTHS OF HOSPITAL DATA. THIS ANALYSIS CALCULATES THE ACTUAL PERCENTAGE OF ACCOUNTS WRITTEN OFF OR DESIGNATED AS BAD DEBT VERSUS CHARITY CARE WHILE TAKING INTO ACCOUNT THE TOTAL COSTS INCURRED BY THE CORPORATION FOR EACH ACCOUNT ANALYZED.FOR THE YEAR ENDED SEPTEMBER 30, 2017, THE PROVISION FOR BAD DEBTS, AT CHARGES, WAS APPROXIMATELY $18.0 MILLION AND THE PROVISION FOR BAD DEBT AT COST WAS APPROXIMATELY $5.6 MILLION. THE PROVISION FOR BAD DEBTS IS MULTIPLIED BY THE RATIO OF COST TO CHARGES FOR PURPOSES OF INCLUSION IN THE TOTAL UNCOMPENSATED CARE AMOUNT IDENTIFIED ABOVE.THE CONNECTICUT DISPROPORTIONATE SHARE HOSPITAL PROGRAM (CDSHP) WAS ESTABLISHED TO PROVIDE FUNDS TO HOSPITALS FOR THE PROVISION OF UNCOMPENSATED CARE AND IS FUNDED, IN PART, BY AN ASSESSMENT ON HOSPITAL NET PATIENT SERVICE REVENUE. DURING THE YEAR ENDED SEPTEMBER 30, 2017, THE CORPORATION RECEIVED $3.3 MILLION IN CDSHP DISTRIBUTIONS, OF WHICH APPROXIMATELY $0.6 MILLION WAS RELATED TO CHARITY CARE. THE CORPORATION MADE PAYMENTS INTO THE CDSHP OF $18.2 MILLION FOR THE YEAR ENDED SEPTEMBER 30, 2017 FOR THE ASSESSMENT. THESE ARE RECORDED IN NET PATIENT SERVICE REVENUE.THE STATE OF RHODE ISLAND DISPROPORTIONATE SHARE HOSPITAL (DSH) AND UPPER PAYMENT LIMIT (UPL) PROGRAMS WERE ESTABLISHED TO PROVIDE FUNDS TO HOSPITALS FOR THE PROVISION OF UNCOMPENSATED CARE AND IS FUNDED, IN PART, BY AN ASSESSMENT OR LICENSE FEE PAID BY THE STATE'S HOSPITALS WHICH IS MATCHED BY THE FEDERAL GOVERNMENT. DURING THE YEAR ENDED SEPTEMBER 30, 2017, LMW RECEIVED $3.2 MILLION IN DSH AND UPL DISTRIBUTIONS. LMW MADE LICENSE FEE PAYMENTS INTO THE DSH AND UPL PROGRAMS OF $2.4 MILLION AND FOR THE YEAR ENDED SEPTEMBER 30, 2017 FOR THE ASSESSMENT. THESE ARE RECORDED IN NET PATIENT SERVICE REVENUE.ADDITIONALLY, THE CORPORATION PROVIDES BENEFITS FOR THE BROADER COMMUNITY WHICH INCLUDES SERVICES PROVIDED TO OTHER NEEDY POPULATIONS THAT MAY NOT QUALIFY AS POOR BUT NEED SPECIAL SERVICES AND SUPPORT. BENEFITS INCLUDE THE COST OF HEALTH PROMOTION AND EDUCATION OF THE GENERAL COMMUNITY, INTERNS AND RESIDENTS, HEALTH SCREENINGS, AND MEDICAL RESEARCH. THE BENEFITS ARE PROVIDED THROUGH THE COMMUNITY HEALTH CENTERS, SOME OF WHICH SERVICE NON ENGLISH SPEAKING RESIDENTS, DISABLED CHILDREN, AND VARIOUS COMMUNITY SUPPORT GROUPS. THE CORPORATION VOLUNTARILY ASSISTS WITH THE DIRECT FUNDING OF SEVERAL CITY OF NEW LONDON PROGRAMS, INCLUDING AN ECONOMIC DEVELOPMENT PROGRAM AND HEALTHCARE SUPPORT SERVICES FOR THE HOMELESS.IN ADDITION TO THE QUANTIFIABLE SERVICES DEFINED ABOVE, THE CORPORATION PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY THROUGH ITS ADVOCACY OF COMMUNITY SERVICE BY EMPLOYEES. THE CORPORATION'S EMPLOYEES SERVE NUMEROUS ORGANIZATIONS THROUGH BOARD REPRESENTATION, MEMBERSHIP IN ASSOCIATIONS, AND OTHER RELATED ACTIVITIES. THE CORPORATION ALSO SOLICITS THE ASSISTANCE OF OTHER HEALTHCARE PROFESSIONALS TO PROVIDE THEIR SERVICES AT NO CHARGE THROUGH PARTICIPATION IN VARIOUS COMMUNITY SEMINARS AND TRAINING PROGRAMS. PART III, LINE 8: THE MEDICARE SHORTFALL REPORTED IN PART III, LINE 7 WAS CALCULATED BASED ON COST REPORTING. THE COSTING METHOD WAS FROM THE MEDICARE COST REPORT'S OWN METHODOLOGY OF ALLOCATING COST BY DEPARTMENT AND DERIVING A RATIO OF COST TO CHARGE. THIS AMOUNT SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE THE RATES PAID BY MEDICARE DO NOT ACCURATELY REFLECT THE COST OF CARE PROVIDED BY LMW HEALTHCARE. LMW HEALTHCARE MUST SUBSIDIZE THE COST OF CARE TO MEDICARE BENEFICIARIES WITH OTHER REVENUES. PART III, LINE 9B: IN ACCORDANCE WITH ITS WRITTEN CREDIT AND COLLECTION POLICY, LMW HEALTHCARE INC WILL NOT PURSUE COLLECTION EFFORTS, DIRECTLY OR THROUGH COLLECTION AGENCIES, ON THE PORTION OF A PATIENT'S BILL FOR WHICH THAT PATIENT HAS ESTABLISHED ELIGIBILITY FOR CHARITY CARE. PART VI, LINE 2: IN ADDITION TO THE METHODOLOGY EMPLOYED IN CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT, LMW HEALTHCARE INC CARRIES OUT A VARIETY OF OTHER STRATEGIES IN GAUGING THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. THESE STRATEGIES INCLUDE REVIEW OF DISEASE INCIDENCE AND PREVALENCE RATES FOR THE LOCAL COMMUNITY, STATE, AND NATION WITH RATES COLLECTED FROM PUBLICLY AVAILABLE SOURCES, AND SEEKING PERIODIC RESIDENT INPUT ON PRIORITY AREAS. THIS ANALYSIS INFORMS LMW HEALTHCARE INC ON THE HEALTH STATUS OF THE COMMUNITY AND IS USED TO FOCUS PROGRAM AND SERVICE DEVELOPMENT ON AREAS OF GREATEST CONCERN. INFORMATION ON COMMUNITY NEEDS IS ALSO GATHERED THROUGH PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS SUCH AS THE PUBLIC SCHOOLS, WOOD RIVER HEALTH SERVICES, AND OTHER LOCAL NON-PROFITS. PERIODIC REVIEW OF DATA AND UPDATING AS APPROPRIATE IS CONDUCTED. PART VI, LINE 3: IN ACCORDANCE WITH ITS CHARITY CARE POLICY, LMW HEALTHCARE NOTIFIES PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE USING SEVERAL METHODS.1) SIGNAGE INDICATING THE AVAILABILITY OF CHARITY CARE IS POSTED IN ENGLISH AND SPANISH IN PATIENT ACCOUNTS, HEALTH ACCESS MANAGEMENT AND CERTAIN CLINICAL AREAS. SUMMARIES OF THE PROGRAMS WILL ALSO BE AVAILABLE IN THOSE AREAS.2) PATIENT FINANCIAL ADVISORS WILL ATTEMPT TO VISIT ALL INPATIENTS REGISTERED AS SELF PAY PATIENTS. A SUMMARY EXPLAINING CHARITY CARE WILL BE GIVEN TO THE PATIENT OR GUARANTOR WHEN THIS VISIT OCCURS.3) PATIENTS WITH NO INSURANCE WILL RECEIVE AN INITIAL LETTER WITHIN ONE WEEK OF DISCHARGE INFORMING THEM THEY ARE CONSIDERED "UNINSURED". IT IS THE RESPONSIBILITY OF THE PATIENT TO ADVISE LMW IF THEY BELIEVE THEY QUALIFY AS "UNINSURED" (AT OR UNDER 250% OF THE FPG).4) A SERIES OF MONTHLY STATEMENTS WILL BE SENT FOLLOWING DISCHARGE. EACH STATEMENT WILL REMIND THE PATIENT OF THE AVAILABILITY OF CHARITY CARE. PART VI, LINE 4: THE COMMUNITIES THAT COMPRISE THE SERVICE AREA OF LMW HEALTHCARE INC. INCLUDE EIGHT TOWNS IN SOUTHWESTERN RHODE ISLAND/WASHINGTON COUNTY: ASHAWAY, BLOCK ISLAND, BRADFORD, CHARLESTOWN, HOPE VALLEY, HOPKINTON, WESTERLY AND WOOD RIVER JUNCTION, WITH A TOTAL POPULATION OF APPROXIMATELY 40,785. THESE COMMUNITIES ARE LARGELY RURAL WITH THE IMMEDIATE WESTERLY AREA BEING SUBURBAN. ALTHOUGH IT IS ANTICIPATED THAT THERE WILL BE A SLIGHT DECLINE IN OVERALL POPULATION IN THE NEXT FIVE YEARS, THE FASTEST GROWING AGE GROUP IN THE PRIMARY SERVICE AREA WILL BE 65+.THE POPULATION ACROSS LMW HEALTHCARE INC.'S SERVICE AREA IS PRIMARILY WHITE ALTHOUGH MORE RACIALLY AND ETHNICALLY DIVERSE THAN THE SURROUNDING WASHINGTON COUNTY, BUT LESS SO THAN THE STATE. IN WASHINGTON COUNTY IN 2016, HISPANICS REPRESENTED 3.2% OF THE POPULATION, BLACK/AFRICAN AMERICANS 1.3%, ASIANS 2.0%, AND THOSE INDICATING OTHER 1.7%. THE MEDIAN AGE OF RESIDENTS IS HIGHER THAN THE STATE, AS IS THE MEDIAN HOUSEHOLD INCOME. THE POPULATION OVER AGE 65 IS EXPECTED TO INCREASE IN WASHINGTON COUNTY BY 2021. IN AGGREGATE, BLACK/AFRICAN AMERICAN AND HISPANIC/LATINO RESIDENTS HAVE A LOWER MEDIAN INCOME THAN ASIAN OR WHITE RESIDENTS. THE LANGUAGES SPOKEN IN THE SERVICE AREA MIMIC THE RACIAL CHARACTERISTICS. APPROXIMATELY 91% OF RESIDENTS SPEAK ENGLISH. LESS THAN 3% SPEAK SPANISH AS THEIR PRIMARY LANGUAGE. ANOTHER 3.5% SPEAK AN INDO-EUROPEAN LANGUAGE. LMW HEALTHCARE INC.'S SERVICE AREA ENCOMPASSES 48,949 HOUSING UNITS, 67.8% ARE OWNER-OCCUPIED AND 32.2% ARE RENTER-OCCUPIED. THE MEDIAN HOME VALUE FOR OWNER-OCCUPIED UNITS IS $283,711, WHICH IS LOWER WHEN COMPARED TO WASHINGTON COUNTY ($320,447), BUT HIGHER WHEN COMPARED TO RHODE ISLAND ($252,604).THE MEDIAN HOUSEHOLD INCOME IN WASHINGTON COUNTY IS $72,267; HOWEVER, INCOME VARIES NOTABLY BY RACE AND ETHNICITY. THE MEDIAN INCOME FOR BLACKS/AFRICAN AMERICANS AND HISPANICS/LATINOS IS $46,300 AND $54,676 RESPECTIVELY. THE SAME DISPARITY IN INCOME IS SEEN ACROSS RHODE ISLAND.THE PERCENTAGE OF ALL RESIDENTS LIVING IN POVERTY WITHIN THE LMW HEALTHCARE INC. SERVICE AREA IS 8.4%; 14.1% OF WHICH ARE CHILDREN. POVERTY AMONG CHILDREN IN THE WESTERLY SERVICE AREA IS HIGHER THAN WASHINGTON COUNTY BY 3.7% POINTS, BUT LOWER THAN THE STATE.APPROXIMATELY 70% OF SERVICE AREA RESIDENTS AGE 16 YEARS OR OVER ARE IN THE WORKFORCE AND 4.8% ARE UNEMPLOYED, WHICH IS LOWER THAN THE STATE AND NATIONAL AVERAGES (6.4% AND 5.5% RESPECTIVELY). THE MAJORITY OF RESIDENTS IN THE WORKFORCE ARE FOR-PROFIT PRIVATE WORKERS (65.1%) AND HOLD WHITE COLLAR POSITIONS (61.8%). RESIDENTS ARE MOST LIKELY TO WORK IN OFFICE/ADMINISTRATIVE SUPPORT (12.7%), MANAGEMENT (10.4%), AND SALES (10%).EDUCATION IS THE LARGEST PREDICTOR OF POVERTY AND ONE OF THE MOST EFFECTIVE MEANS OF REDUCING INEQUALITIES. IN LMW HEALTHCARE INC.'S SERVICE AREA, 8.2% OF RESIDENTS 25 YEARS OR OVER HAVE LESS THAN A HIGH SCHOOL DIPLOMA, 29.4% HAVE A HIGH SCHOOL DIPLOMA, AND 34.4% HAVE AT LEAST A BACHELOR'S DEGREE. RESIDENTS IN THE LMW HEALTHCARE INC. SERVICE AREA HAVE LOWER EDUCATION ATTAINMENT COMPARED TO ALL WASHINGTON COUNTY RESIDENTS, BUT HAVE HIGHER EDUCATION ATTAINMENT THAN THE STATE AVERAGE.HISPANIC/LATINO RESIDENTS IN THE LMW HEALTHCARE INC. SERVICE AREA HAVE NOTABLY LOWER EDUCATIONAL ATTAINMENT. APPROXIMATELY 18% DO NOT HAVE A HIGH SCHOOL DIPLOMA AND 23.3% OBTAIN A BACHELOR'S DEGREE OR HIGHER. GREATER DISPARITIES EXIST WHEN COMPARED TO WASHINGTON COUNTY.IN WASHINGTON COUNTY, SERVICES AND PUBLIC TRANSPORTATION FALL SHORT OF MEETING DEMAND, CREATING A BARRIER TO ACCESS. PART VI, LINE 5: LMW HEALTHCARE INC.'S COMMUNITY BENEFIT PROGRAMS AND SERVICES FORWARD THE ORGANIZATIONAL MISSION "TO IMPROVE THE HEALTH OF THE REGION AND ALIGN WITH THE PRINCIPLES AS SET FORTH IN THE ORGANIZATION'S COMMUNITY BENEFIT POLICY. THOSE PRINCIPLES INCLUDE:1.EMPHASIS ON PROGRAMS TO MEET A SIGNIFICANT UNMET HEALTH NEED INCLUDING EFFORTS TO IDENTIFY AND INCLUDE VULNERABLE POPULATIONS OR THOSE MOST AT-RISK AS DETERMINED BY RISK FACTORS WHICH PREDISPOSE THOSE POPULATIONS TOWARD A HIGHER INCIDENCE OF DISEASE AND/OR BARRIERS TO OBTAINING APPROPRIATE HEALTHCARE.2. EMPHASIS ON PRIMARY PREVENTION AND INCLUDING AT LEAST ONE OF THREE PRIMARY PREVENTION STRATEGIES: HEALTH PROMOTION, DISEASE PREVENTION, AND HEALTH PROTECTION. HEALTH PROMOTION ENTAILS ENCOURAGING HEALTHY LIFESTYLES; DISEASE PREVENTION FOCUSES ON INDIVIDUALS IDENTIFIED AS AT-RISK FOR HEALTH PROBLEMS; HEALTH PROTECTION ACTIVITIES INFLUENCE THE ENVIRONMENT TO SUPPORT HEALTHY BEHAVIORS.3. PROGRAMS SHOULD DEVELOP EVIDENCE-BASED LINKS BETWEEN CLINICAL SERVICES AND HEALTH IMPROVEMENT ACTIVITIES DELIVERED BOTH INSIDE AND OUTSIDE THE HOSPITAL. 4. PROGRAMS SHOULD FOCUS ON TARGETING CHARITABLE RESOURCES THAT MOBILIZE AND BUILD CAPACITY WITHIN EXISTING COMMUNITY ASSETS WHILE MINIMIZING DUPLICATION OF EFFORT.5. PROGRAMS SHOULD EMPHASIS COLLABORATION WITH COMMUNITY STAKEHOLDERS.AS EVIDENCED BY THE WIDE RANGE OF COMMUNITY BENEFIT PROGRAMS AND SERVICES OFFERED, LMW HEALTHCARE INC. IS ENGAGED IN MEETING THE IDENTIFIED HEALTH NEEDS OF THE COMMUNITIES WE SERVE. THERE IS AN ORGANIZATIONAL HISTORY OF COLLECTING DATA TO DETERMINE HOW BEST TO DIRECT OUR RESOURCES AND HOW TO MAKE THE GREATEST IMPACT IN PROMOTING COMMUNITY HEALTH. OUR ANNUAL COMMUNITY BENEFIT REPORT PUBLICATION DESCRIBES A SAMPLING OF PROGRAMS AND THE AMOUNT OF INVESTMENT THAT LMW HEALTHCARE INC. MAKES IN CARRYING OUT THESE PROGRAMS.COMMUNITY INVOLVEMENT IN GOVERNANCE AND ADVISORY GROUPSCOMMUNITY ENGAGEMENT IN THE PLANNING, IMPLEMENTATION AND EVALUATION OF LMW HEALTHCARE INC. INITIATIVES IS OF UTMOST IMPORTANCE. CONSUMERS AND STAKEHOLDER ORGANIZATIONS PARTICIPATE IN A RANGE OF ACTIVITIES SO AS TO ENSURE THAT MANY PERSPECTIVES ARE CONSIDERED. A COMMUNITY MEMBER IS INVOLVED IN THE EMERGENCY DEPARTMENT PATIENT EXPERIENCE COMMITTEE. THE COMMITTEE WORKS ON IMPROVING THE PATIENT EXPERIENCE, COMMUNICATION AND CARE PROVIDED IN THE EMERGENCY DEPARTMENT. THROUGH THE PRESS GANEY SURVEYS, WE RECEIVE WRITTEN COMMENTS FROM PATIENTS AND FAMILIES THAT WE VIEW AS VALUABLE FEEDBACK ON HOW WE CAN IMPROVE OUR SERVICES AND THE PATIENT EXPERIENCE. THE PATIENT EXPERIENCE TEAM AT LMW HEALTHCARE INC. RECEIVES ONGOING FEEDBACK FROM CONSUMERS AND COMMUNITY MEMBERS ABOUT THEIR EXPERIENCES. THEY OFTEN IDENTIFY OPPORTUNITIES FOR IMPROVEMENT, WHICH IS SHARED WITH LEADERS THROUGHOUT THE ORGANIZATION.LMW HEALTHCARE INC.'S BOARD OF DIRECTORS IS MADE UP OF COMMUNITY LEADERS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THESE VOLUNTEERS GIVE COUNTLESS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE. THEY ARE INVOLVED IN THE STRATEGIC PLANNING, IN FUNDRAISING, AND IN GENERAL STEWARDSHIP AMONG OTHER RESPONSIBILITIES. MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. PART VI, LINE 6: L+M HEALTHCARE IS AFFILIATED WITH THE YALE NEW HAVEN HEALTH SYSTEM. THE ENTITIES OF L+M HEALTHCARE INCLUDE L+M HOSPITAL, THE VISITING NURSE ASSOCIATION OF SOUTHEASTERN CT (VNASC), AND LMW HEALTHCARE INC. (RHODE ISLAND) EACH OF WHICH HAVE A ROLE IN PROMOTING THE HEALTH OF OUR COMMUNITIES. THE L+M HOSPITAL ROLE IS DESCRIBED IN QUESTION 5 ABOVE AND LMW HEALTHCARE INC. OPERATES IN SIMILAR FASHION: IMPLEMENTING COMMUNITY HEALTH IMPROVEMENT ACTIVITIES, PROVIDING OPPORTUNITIES FOR HEALTH PROFESSIONS STUDENTS, ENSURING ACCESS TO CARE, PROMOTING PRIMARY PREVENTIVE CARE, PROVIDING SUBSIDIZED HEALTH SERVICES AND SERVING AS A SAFETY NET PROVIDER. VNASC CARES FOR EVERYONE FROM THE ELDERLY WHO WISH TO REMAIN IN THEIR HOMES FOR AS LONG AS THEY CAN AND PATIENTS RECOVERING FROM SURGERY OR ILLNESS, TO NEW MOTHERS, SCHOOLCHILDREN, AND THE HOMELESS USING THE MOST CURRENT MEDICAL ADVANCES AND TECHNOLOGIES IN HOME HEALTHCARE, AND STRENGTHEN COMMUNITY RESOURCES FOR EVERYONE. PART VI, LINE 7, REPORTS FILED WITH STATES RI 0 1 0 0 0 0 0 0 0 BRUCE D CUMMINGS END 517 PRESIDENT/CEO AND TRUSTEE 0 631803 0 183387 0 937711 0 30351 0 18422 0 1801674 0 826713 ADRIAN K HAMBURGER TRUSTEE 0 357612 0 377771 0 300 0 28311 0 21473 0 785467 0 0 CHRISTOPHER O'CONNOR TRUSTEE 0 873909 0 274428 0 96120 0 416036 0 19837 0 1680330 0 0 MAUREEN ANDERSON ASSISTANT SECRETARY 0 300312 0 51527 0 7106 0 14282 0 23293 0 396520 0 3518 SETH VAN ESSENDELFT VP/CFO 0 381609 0 123697 0 810 0 12468 0 23293 0 541877 0 0 LINDA BROCATO PHARMACY MANAGER 142150 0 0 0 0 0 12222 0 0 0 154372 0 0 0 KARL NG CLINICAL PHARMACIST 145935 0 0 0 96 0 3446 0 8053 0 157530 0 477 0 PART I, LINE 3 THE PRESIDENT/CEO OF LMW HEALTHCARE, INC. RECEIVES NO COMPENSATION FROM THE ORGANIZATION. HE IS AN EMPLOYEE AT LAWRENCE & MEMORIAL HOSPITAL, A RELATED ORGANIZATION, AND HIS COMPENSATION IS SET BY THE HOSPITAL. THE HOSPITAL, IN DETERMINING COMPENSATION RELIES UPON A COMPENSATION COMMITTEE; AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS OR STUDIES, AND APPROVAL BY ITS BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B THE INDIVIDUAL LISTED BELOW IS A PARTICIPANT IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN OF A RELATED ORGANIZATION. THESE ACCRUALS ARE INCLUDED IN THE AMOUNTS REPORTED IN PART II, COLUMN C (DEFERRED COMPENSATION) AND REPRESENTS BOTH THE REPORTING ENTITY'S AND RELATED ENTITY'S COMBINED AMOUNTS THAT HAVE NOT YET BEEN VESTED CONSISTENT WITH THE COMPENSATION REPORTING PER IRS. SEVERANCE NONQUALIFIED EQUITY-BASED CHRISTOPHER O'CONNOR $0 $219,224 $0 THE SUPPLEMENTAL RETIREMENT INCOME PLAN (SRIP) IS DESIGNED TO ENSURE THE PAYMENT OF A COMPETITIVE LEVEL OF RETIREMENT INCOME WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME IN ORDER TO ATTRACT AND RETAIN KEY MANAGEMENT EMPLOYEES SERVING AS CORPORATE OFFICERS. THE PLAN PROVIDES SUPPLEMENTAL RETIREMENT INCOME THROUGH AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT UNDER SECTION 457(F) AND THROUGH A DEFERRED COMPENSATION PLAN UNDER SECTION 409A OF THE INTERNAL REVENUE CODE AND A MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES' PLAN UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). LAWRENCE & MEMORIAL HOSPITAL (A RELATED ORGANIZATION) ESTABLISHED A SECTION 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR THE HOSPITAL'S SENIOR MANAGEMENT. AMOUNT FOR BRUCE CUMMINGS IS CREDITED TO THE RETIREMENT ACCOUNT IN MONTHLY INSTALLMENTS THROUGHOUT EACH PLAN YEAR. PLAN AMOUNTS WILL BE PAID ONLY IF CERTAIN CONDITIONS ARE MET, INCLUDING REMAINING EMPLOYED BY THE HOSPITAL THROUGH AGE 65, AS OUTLINED IN THE PLAN AGREEMENT. SECTION 457(F) CONTRIBUTIONS ARE PAID OUT AND REPORTED ON HIS W-2. DURING 2016, THE REQUIRED SECTION 457(F) CONDITIONS WERE MET AND THE FOLLOWING INDIVIDUAL RECEIVED THEIR PAYOUT AS FOLLOWS: BRUCE CUMMINGS $913,658 FORM 990, PART III, LINE 4 WESTERLY HOSPITAL IS A 125-BED HOSPITAL THAT PROVIDES WASHINGTON (RI) AND NEW LONDON (CT) COUNTIES WITH FAMILY-CENTERED MEDICAL CARE AND A WIDE ARRAY OF MEDICAL, SURGICAL, LABORATORY AND REHABILITATIVE SERVICES. IN ADDITION, THE HOSPITAL OFFERS INTERVENTIONAL PAIN MANAGEMENT, WOUND CARE, AN ANTI-COAGULATION CLINIC AND CARDIAC PULMONARY REHABILITATION SERVICES. WITH 130 PRIMARY AND SPECIALTY PHYSICIANS, WESTERLY HOSPITAL, AS PART OF YALE NEW HAVEN HEALTH SYSTEM, SERVES THE ENTIRE COMMUNITY WITH FAMILY-CENTERED MEDICAL CARE. WESTERLY HOSPITAL FOCUSED ON ENGAGING THE WORKFORCE, COLLABORATING WITH COMMUNITY PARTNERS TO IMPROVE THE HEALTH AND WELL-BEING OF AREA RESIDENTS AND STRENGTHENING BOTH CLINICAL AND FINANCIAL PERFORMANCE. YNHHS INVESTED IN FACILITY AND INFRASTRUCTURE IMPROVEMENTS THIS YEAR, INCLUDING HVAC SYSTEM RENOVATIONS; A NEW WATER PURIFICATION SYSTEMS; UPGRADED INPATIENT BEDS AND REPLACEMENT OF AN AGING NUCLEAR GAMMA CAMERA. BEING PART OF COMMUNITY THAT IS GREATLY CHALLENGED BY MENTAL HEALTH AND SUBSTANCE ABUSE-RELATED ISSUES, WESTERLY HOSPITAL REMAINED COMMITTED TO INCREASING PATIENT ACCESS TO QUALITY BEHAVIORAL HEALTH SERVICES AND HEALTH EDUCATION. WESTERLY HOSPITAL ADDED 3-D TOMOSYNTHESIS MAMMOGRAPHY TO ITS BREAST CANCER SCREENING TOOLS, WHICH INCLUDE BREAST MRI, AUTOMATED WHOLE BREAST ULTRASOUND AND STEREOTACTIC BREAST BIOPSY. THE 3-D TOMOSYNTHESIS MAMMOGRAPHY PROVIDES A MORE PRECISE IMAGE THAN TRADITIONAL MAMMOGRAPHY, ALLOWING PHYSICIANS TO CATCH BREAST CANCER EARLIER AND REDUCING THE INCIDENCE OF FALSE POSITIVES. THE HOSPITAL OUTFITTED TWO INTENSIVE CARE PATIENT ROOMS WITH AUDIOVISUAL EQUIPMENT TIED TO YALE NEW HAVEN HEALTH SYSTEM'S INSIGHT TELE-ICU SYSTEM. THIS TECHNOLOGY ALLOWS REAL-TIME, REMOTE MONITORING BY A TEAM OF CRITICAL CARE PHYSICIANS AND NURSES BASED AT YALE NEW HAVEN HOSPITAL IN NEW HAVEN. IN ADDITION, A TELEMEDICINE CART IS NOW USED IN SEVEN OTHER ICU ROOMS. STAFF USES THE SYSTEM FOR REMOTE CONSULTATIONS TO ACCESS SPECIALISTS AS WELL AS REVIEW PATIENT VITAL SIGNS, PHYSIOLOGICAL STATUS AND LABORATORY AND DIAGNOSTIC TEST RESULTS. THE TECHNOLOGY CONTRIBUTES TO ENHANCED PATIENT SAFETY, IMPROVED PATIENT OUTCOMES AND INCREASED PROVIDER COLLABORATION. WESTERLY HOSPITAL AND THE HEALTH IMPACT COLLABORATIVE COMMITTED TO FOCUS COMMUNITY HEALTH IMPROVEMENT EFFORTS ON BEHAVIORAL HEALTH OVER THE NEXT SEVERAL YEARS, BASED ON THE WESTERLY COMMUNITY HEALTH NEEDS ASSESSMENT WHICH REVEALED THAT THE AREA IS CHALLENGED BY MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES. PROGRAMMING INCLUDES COMMUNITY EDUCATION ACTIVITIES AND TRAININGS IN YOUTH MENTAL HEALTH FIRST AID AND SUICIDE PREVENTION. PART I, LINE 4 & PART VI, LINE 1B NUMBER OF INDEPENDENT VOTING MEMBERS OF THE GOVERNING BODY THE ORGANIZATION SOUGHT TO CONFIRM THE INDEPENDENCE OF EACH VOTING MEMBER OF ITS GOVERNING BODY BY REQUESTING THAT EACH SUCH VOTING MEMBER RESPOND TO A QUESTIONNAIRE CONTAINING THE PERTINENT INSTRUCTIONS AND DEFINITIONS AND DESIGNED TO ELICIT THE INFORMATION NECESSARY TO DETERMINE INDEPENDENCE. BASED ON RESPONSES TO THE QUESTIONNAIRES RECEIVED BY THE ORGANIZATION AND ANNUAL CONFLICTS OF INTEREST DISCLOSURES, THE ORGANIZATION WAS ABLE TO CONFIRM THAT SEVEN (8) VOTING MEMBERS ARE INDEPENDENT. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES THE ORGANIZATION'S CURRENT OFFICERS AND/OR TRUSTEES SERVE AS OFFICERS AND/OR DIRECTORS OF TAXABLE AFFILIATES WITHIN THE ORGANIZATION'S CORPORATE SYSTEM OR JOINT VENTURES IN WHICH THE ORGANIZATION'S CORPORATE SYSTEM HAS AN OWNERSHIP INTEREST. THE INDIVIDUAL OFFICERS DO NOT HAVE PERSONAL FINANCIAL INTERESTS IN THE TAXABLE AFFILIATE AND SERVE ONLY AS A FUNCTION OF THEIR ROLES WITH THE ORGANIZATION OR WITHIN THE ORGANIZATION'S CORPORATE SYSTEM. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE SEPTEMBER 8, 2016, LAWRENCE + MEMORIAL CORPORATION ("LMC") AND ITS RELATED ORGANIZATIONS BECAME AFFILIATED WITH THE YALE NEW HAVEN HEALTH SYSTEM PURSUANT TO THE TERMS OF AN AFFILIATION AGREEMENT BETWEEN LMC AND YALE NEW HAVEN HEALTH SERVICES CORPORATION ("YNHHSC") DATED AS OF JULY 17, 2015 (THE "AFFILIATION AGREEMENT"). AS A RESULT OF THE CLOSING OF THE AFFILIATION TRANSACTION, YNHHSC BECAME THE SOLE MEMBER OF LMC. ADDITIONALLY, THE CERTIFICATES OF INCORPORATION AND BYLAWS OF LMC AND ITS SUBSIDIARIES LAWRENCE + MEMORIAL HOSPITAL, LMW HEALTHCARE, INC., L+M PHYSICIAN ASSOCIATION, INC. AND VISITING NURSE ASSOCIATION OF SOUTHEASTERN CONNECTICUT, INC. WERE REVISED AS AGREED UPON IN THE AFFILIATION AGREEMENT TO REFLECT YNHHSC AS THE ULTIMATE CORPORATE PARENT AND DESCRIBE THE RETAINED POWERS AND OF YNHHSC CONSISTENT WITH ITS OTHER AFFILIATED ENTITIES. FORM 990, PART VI, SECTION A, LINE 6 L&M CORPORATION IS THE SOLE MEMBER OF LMW HEALTHCARE, INC. FORM 990, PART VI, SECTION A, LINE 7A LAWRENCE + MEMORIAL CORPORATION, AS SOLE MEMBER OF LMW HEALTHCARE, INC., ELECTS THE BOARD OF TRUSTEES OF LMW HEALTHCARE, INC., SUBJECT TO THE ADDITIONAL APPROVAL OF LAWRENCE + MEMORIAL CORPORATION'S SOLE MEMBER, YALE NEW HAVEN HEALTH SERVICES CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE HOSPITAL'S SOLE MEMBER, LAWRENCE + MEMORIAL CORPORATION, HAS THE RIGHT TO ELECT THE BOARD OF TRUSTEES OF THE ORGANIZATION AND APPOINT THE PRESIDENT, AND HAS THE FOLLOWING ADDITIONAL RIGHTS, ALL SUBJECT THE ADDITIONAL APPROVAL OF ITS SOLE MEMBER, YALE NEW HAVEN HEALTH SERVICES CORPORATION: TO APPROVE OPERATING, CASH FLOW AND CAPITAL BUDGETS; TO APPROVE GRADUATE AND UNDERGRADUATE MEDICAL EDUCATION ARRANGEMENTS; TO APPROVE MAJOR NEW CLINICAL PROGRAMS AND SERVICES AND CONTINUATION OF SAME; APPROVAL OF STRATEGIC PLANS; AND ADOPTION OF SAFETY AND QUALITY ASSESSMENT POLICIES; TO APPROVE THE MERGER, CONSOLIDATION, DISSOLUTION OR THE SALE OF ALL OR SUBSTANTIALLY ALL THE ORGANIZATION'S ASSETS; TO AMEND THE CERTIFICATE OF INCORPORATION AND BYLAWS OF THE ORGANIZATION, TO APPROVE THE EXECUTION OF LONG-TERM OR MATERIAL AGREEMENTS, AND TO AUTHORIZE THE EXECUTION OF CONTRACTS WITH AN UNRELATED THIRD PARTY FOR MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE ORGANIZATION. YALE-NEW HAVEN HEALTH SERVICES CORPORATION RETAINS THE FOLLOWING AUTHORITY: ADOPTION OF BUDGETARY TARGETS, INDEBTEDNESS, MANAGEMENT AND CONTROL OF LIQUID ASSETS, AND APPOINTMENT OF THE INDEPENDENT AUDITOR. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S PROCESS TO REVIEW FORM 990: THE FORM 990 TAX RETURN AND ATTACHED SCHEDULES WERE PREPARED BY EMPLOYEES OF THE SYSTEM TAX DEPARTMENT. THE RETURN IS INITIALLY REVIEWED BY THE HOSPITAL DIRECTOR OF CORPORATE FINANCE. SUBSEQUENTLY, IT IS SENT TO KPMG LLP FOR THEIR INITIAL REVIEW. AFTER ALL COMMENTS FROM THE ABOVE GROUPS ARE RECEIVED AND REVIEWED, THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE HOSPITAL AND A FINAL VERSION OF THE RETURN IS SENT BACK TO KPMG US LLP FOR FINAL REVIEW. PRIOR TO FILING, THE ORGANIZATION MADE AVAILABLE A COMPLETE COPY OF THE RETURN TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C LMW HEALTHCARE IS COVERED UNDER THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY. THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY AND INDIVIDUAL ANNUAL DISCLOSURE FORM APPLIES TO A POOL OF EMPLOYEES, BOARD MEMBERS AND NON-BOARD MEMBERS SERVING ON BOARD COMMITTEES. THESE "COVERED INDIVIDUALS" ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, UPON BEGINNING EMPLOYMENT OR OTHERWISE BECOMING A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER. COVERED INDIVIDUALS ARE ALSO REQUIRED TO IMMEDIATELY REPORT MATERIAL CHANGES TO THEIR MOST RECENTLY COMPLETED DISCLOSURE STATEMENT. THESE DISCLOSURE STATEMENTS AND REPORTS ARE REVIEWED BY THE OFFICE OF PRIVACY AND CORPORATE COMPLIANCE AND/OR THE LEGAL AND RISK SERVICES DEPARTMENT TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF A POTENTIAL CONFLICT ARISES, THE PRESIDENT AND CEO WOULD CONSULT WITH THE BOARD CHAIRPERSON AND THE LEGAL AND RISK SERVICES DEPARTMENT AND TAKE ANY ACTIONS THAT HE DEEMS REQUIRED OR APPROPRIATE TO MANAGE OR RESOLVE A POTENTIAL CONFLICT OF INTEREST. FOR EXAMPLE, A VOTING BOARD OR COMMITTEE MEMBER WOULD BE REQUIRED TO RECUSE HIMSELF OR HERSELF FROM VOTING ON MATTERS RELATED TO THE POTENTIAL CONFLICT AND THE POTENTIAL CONFLICT WOULD BE DISCLOSED TO OTHER VOTING MEMBERS. FORM 990, PART VI, SECTION B, LINES 13 AND 14: AS AN AFFILIATE OF YALE NEW HAVEN HEALTH SYSTEM, THE "SYSTEM", THE ORGANIZATION IS COVERED BY THE SYSTEM'S DOCUMENT RETENTION AND WHISTLEBLOWER POLICIES. FORM 990, PART VI, SECTION B, LINE 15 THE OFFICERS' COMPENSATION AND BENEFITS REPORTED IN PART VII ARE DETERMINED BY L&M HOSPITAL. L&M HOSPITAL'S EXECUTIVE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE SALARIES OF ITS EXECUTIVE MANAGEMENT AND KEY EMPLOYEES. UTILIZING INDEPENDENT COMPENSATION CONSULTANTS, THE EXECUTIVE COMPENSATION COMMITTEE MAKES ITS RECOMMENDATIONS. THE COMMITTEE'S DELIBERATIONS ARE REFLECTED IN ITS MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 7,305,251. MANAGEMENT AND GENERAL EXPENSES 2,464,303. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,769,554. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 419,683. MANAGEMENT AND GENERAL EXPENSES 141,162. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 560,845. FORM 990, PART XI, LINE 9: TRANSFERS FROM AFFILIATES 681,370. VALUATION OF RI RENAL 85,767. INCREASE IN FUNDS HELD IN TRUST BY OTHERS 309,488. ADJUSTMENT IN NET ASSET BETWEEN WESTERLY HOSPITAL AND FOUNDATION -121,092. 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