2017-08-14T07:17:56-07:00 2016-09-30 KPMG LLP 2 Financial Center 60 South St Boston MA 02111 990 2015-10-01 050258954 Rhode Island Hospital RHOD 4014444000 593 Eddy Street Providence RI 02903 Mary A Wakefield Treasurer 2017-08-14 true Tara D'Agostino P01245482 6179881000 2015 2021-01-29 14:40:06Z Margaret M Van Bree DrPH 593 Eddy Street Providence RI 02903 1646009956 false false X www.rhodeislandhospital.org X 1863 RI As a founding hospital in the Lifespan health system, Rhode Island Hospital (RIH) is committed to its mission: Delivering health with care. 18 13 9061 712 3221558 56368 13122393 7979547 1192542766 1283975995 20638401 11970845 -186783 -11956686 1226116777 1291969701 2166527 1444276 0 550611587 566987805 0 0 668326760 740292114 1221104874 1308724195 5011903 -16754494 1296043009 1277698494 614517266 628579871 681525743 649118623 X As a founding hospital in the Lifespan health system, RIH is committed to its mission: Delivering health with care. false false 967632859 1444276 1208920860 Patient Care:RIH, the principal teaching hospital of The Warren Alpert Medical School of Brown University, provides a comprehensive range of diagnostic and therapeutic health care services to inpatients and outpatients. RIH has particular expertise in cardiology, hematology/oncology, neurology, burn care, neurosurgery, orthopedics, pediatric care at RIH's pediatric division, Hasbro Children's Hospital, and emergency medicine, with RIH being the designated Level One Trauma Center for Rhode Island and Southeastern Massachusetts. Licensed to operate 719 acute care beds, RIH is the largest of the state's general acute care teaching hospitals, employing 6,402 full-time equivalents. (Continued on Schedule O) 97876385 14876362 Medical Education:RIH provides the setting for and substantially supports medical education in various clinical training and nursing programs. The total cost of medical education provided by the Hospital exceeded the reimbursement received from third-party payors by $83 million in fiscal year 2016.(Continued on Schedule O) 52347883 40791883 Research:RIH conducts extensive medical research and is in the forefront of biomedical health care delivery research, among the leaders nationally in the National Institutes of Health programs. RIH also sponsors many clinical trials which provide valuable research information as well as cutting edge treatment for patients in the region. Federal support accounts for approximately 65% of all externally funded research at RIH. Researchers focus on clinical trials which investigate prevention and treatment of HIV/AIDS, obesity, cancer, diabetes, cardiac disease, neurological problems, orthopedic advancements, and mental health concerns. RIH provided $11.6 million in support of research activities in fiscal year 2016.(Continued on Schedule O) 1117857127 true true false true false false false true false true true true false true true true false true false false true false false false false false true true true true true true false false false false false false true false false true false false false false true true true true true false true 554 0 true 9061 true true true false false false false false false 0 false false false false false false false false false false X 18 13 true false false false true true true true true false false true true true true true true true true true true RI X Mary A Wakefield 4014447093 593 Eddy Street Providence RI 02903 X Thomas Anders MD Trustee 0.00 2.00 X 0 0 0 Lawrence A Aubin Sr Chair 0.50 8.00 X X 0 0 0 Timothy J Babineau MD Trustee 20.00 20.00 X 0 1627372 355993 Emanuel Barrows Trustee 0.40 2.00 X 0 0 0 Roger N Begin Trustee 2.00 2.00 X 0 0 0 Peter Capodilupo Trustee 0.00 8.00 X 0 0 0 Jonathan D Fain Trustee 0.00 0.95 X 0 0 0 Edward D Feldstein Trustee 0.00 6.50 X 0 0 0 David Gorelick MD Trustee 0.00 0.00 X 0 0 0 Michael L Hanna Trustee 0.75 3.50 X 0 0 0 Pamela Harrop MD Trustee 2.50 6.50 X 0 0 0 Marie J Langlois Trustee 0.00 3.00 X 0 0 0 Alan H Litwin Vice Chair 0.50 5.50 X X 0 0 0 Joseph J MarcAurele Director 3.00 3.00 X 0 0 0 Steven Pare Trustee 2.50 12.50 X 0 0 0 Lloyd Robertson Trustee 0.00 0.00 X 0 0 0 Lawrence B Sadwin Trustee 0.00 9.25 X 0 0 0 Fred J Schiffman MD Trustee 0.00 4.00 X 0 0 0 Shivan Subramaniam Trustee 0.00 4.00 X 0 0 0 Jane Williams Trustee 0.00 4.00 X 0 0 0 Brian J Zink MD Trustee 1.00 2.00 X 1000 0 0 Paul J Adler Secretary 5.00 35.00 X 0 286328 57747 Kenneth E Arnold Secty thru 5/16 8.00 32.00 X 0 610563 41004 Frederick J Macri EVP & COO 40.00 0.00 X 0 657458 1001971 Margaret M Van Bree DrPH President 30.00 10.00 X 0 669003 110124 Mary A Wakefield Treasurer 10.00 30.00 X 0 799484 142023 Nicholas P Dominick SVP-Diag. & Support Svcs 40.00 0.00 X 288029 0 65334 Barbara Riley RN Chief Nursing Officer 40.00 0.00 X 533697 0 27945 Latha Sivaprasad MD Chief Medical Officer 40.00 0.00 X 424951 0 68730 Deus J Cielo MD Physician 40.00 0.00 X 949245 0 39982 Curtis Doberstein MD Physician 40.00 0.00 X 1509415 0 40042 Petra M Klinge MD Physician 40.00 0.00 X 739304 0 34694 Adetokunbo A Oyelese MD Physician 40.00 0.00 X 992153 0 38917 Albert E Telfeian MD Physician 40.00 0.00 X 789438 0 38982 John B Murphy MD EVP - Physician Affairs 10.00 30.00 X 0 612014 26620 6227232 5262222 2090108 724 true true false University Medicine Foundation 17 Virginia Ave Providence RI 02905 Medical Services 25740053 University Surgical Associates 75 Newman Avenue Rumford RI 02916 Medical Services 10439637 Ringo LLC 445 Broadhollow Road Melville NY 11747 Staffing Services 10169637 Neurology Foundation 34 Parsonage Street Providence RI 02903 Medical Services 5637495 Brown University 45 Prospect Street Providence RI 02912 Subcontracted Svcs. 5121230 80 6339680 1639867 7979547 Direct Rev from Research 900099 52927713 52927713 Lifespan Pharmacy 446110 27034378 27034378 Patient Service Revenue 900099 1194100793 1194100793 Rental 531120 3712054 3712054 Temp Restricted (SPF's) 900099 4231190 4231190 1969867 1969867 1283975995 7783082 7783082 11041 11041 0 3300561 1814011 1486550 1486550 1486550 356287520 352103731 7067 4183789 -7067 4176722 4176722 0 0 103426 115446 -12020 -12020 Cafeteria Revenue 722210 4660550 4660550 Indirect Rev from Grants 900099 11387493 11387493 Other/Services Rendered 900099 3371911 3371911 -32851170 -34146294 1263711 31413 -13431216 1291969701 1262619238 3221558 18149358 1409276 1409276 35000 35000 0 0 1215002 460632 754370 0 429065362 427308464 1756898 25168413 25038473 129940 80639939 80136229 503710 30899089 30720982 178107 0 0 0 8915 8915 0 2585787 2585787 100617486 100615804 1682 157403 157403 257891580 256780372 1111208 0 0 23150295 19799351 3350944 1352197 1348890 3307 0 1469497 1431786 37711 12720624 3528 12717096 0 48971350 48971350 13437957 13437957 Purch Svs & Equip Cont 139173421 35648132 103525289 License Fee 58734157 58734157 Provision for bad debts 41113887 41113887 Indirect Research & Other 38872965 23633296 15239669 34593 34593 1308724195 1117857127 190867068 0 1037642 1361174 36044509 47507099 4129567 4886630 135091883 118762088 0 0 0 17876593 19747380 2346654 2376670 1270128034 719966705 567552571 550161329 284130867 310100439 154893507 137766051 0 0 92939216 85029634 1296043009 1277698494 83013627 81692697 228328075 226711923 25736475 20757943 42000000 31920000 235439089 267497308 614517266 628579871 X 367836453 330293388 239546433 243973723 74142857 74851512 681525743 649118623 1296043009 1277698494 X -16754494 12735961 -28388587 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 8915 8915 false false Part II-B, Line 1i - Other Activities Description Rhode Island Hospital pays membership fees to the National Association of Children's Hospitals and the Trauma Center Association of America. A portion of the membership dues paid to these organizations is allocated to their lobbying efforts. 75705 X false 456888674 66813380 21926308 75811761 469816601 471966702 64741784 -9161940 70657871 456888675 489649597 63951673 27343261 108977829 471966702 507691681 69186295 27579726 114808105 489649597 478839711 70020787 50634789 91803606 507691681 0.42820 0.08350 0.48830 true true true 31159681 31159681 765551504 417243457 348308047 464186526 302723248 161463278 9230323 9230323 550161329 137766051 Deferred Financing Costs 1684991 Intercompany Receivables 39256 Interest in Net Assets of RIH Foundation 51627722 Other Non-Current Assets 3357468 Other Receivables 6270060 85029634 Accrued Interest Payable 1434422 Accrued Pension Liability 191796500 Asbestos Abatement Liability 2406863 Health Care Benefit Self-insurance 7733278 Other Liabilities 15058475 Post-retirement Benefit Liability 13229200 Third-party Payor Settlements 35838570 267497308 X Part III, Line 4: Description of organization's collections and how it furthers its purpose. Rhode Island Hospital's (RIH) collection of artwork consists of paintings, photographs, etchings, silkscreens, watercolors, charcoals, and lithographs. The works of art are displayed throughout the hospital campus for the viewing pleasure of patients, visitors, and employees of the hospital. Part V, Line 4: Intended uses of the endowment fund. RIH's endowment funds consist of both donor-restricted endowment funds and funds designated by RIH to function as endowments. RIH's largest permanently restricted endowments support patient care, particularly cardiology, hematology/oncology, and neurology, as well as pediatric care at RIH's pediatric division, Hasbro Children's Hospital (HCH), research, and charity care. RIH's unrestricted endowment includes designated assets set aside by RIH's Board for future capital improvements, over which the Board retains control and may at its discretion subsequently use for other purposes.Significant temporarily restricted funds held by RIH are used for the purposes of: (1) orthopedic research; (2) the care and treatment of crippled children; (3) the creation of the hospital primary care physician transition program to improve patient care quality; (4) strategic energy management planning; and (5) the establishment of the Norman Prince Neurosciences Institute at RIH. Part X : FIN48 Footnote RIH, 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. RIH recognizes the effect of income tax positions only if those positions are more likely than not to be sustained. Recognized income tax positions are measured at the largest amount of benefit that is greater than fifty percent likely to be realized upon settlement. Changes in measurement are reflected in the period in which the change in judgment occurs. RIH did not recognize the effect of any income tax positions during the fiscal year ended September 30, 2016. true East Asia and the Pacific 0 0 Program Services Research 230641 Europe 0 0 Program Services Research 81059 South America 0 0 Program Services Research 27500 Sub-Saharan Africa 0 0 Program Services Research 23156 362356 362356 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. The foreign institution prepares an invoice to the Lifespan affiliate for expenses incurred under the agreement. Once received, the invoice is 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 process and payment method is used as described above. true true true X true X true true false false true true 24546708 6167614 18379094 0.01450 294434372 264223129 30211243 0.02380 318981080 270390743 48590337 0.03830 270510 39688 230822 0.00020 97876385 14876362 83000023 0.06550 47052407 36631138 10421269 0.00820 52347883 40791883 11556000 0.00910 684270 684270 0.00050 198231455 92339071 105892384 0.08350 517212535 362729814 154482721 0.12180 true 11154197 936554 238760284 221166034 17594250 X true true Orthopedic MRI of RI LLC Imaging Services 0.33333 0.13333 1 1 Rhode Island Hospital 593 Eddy Street Providence RI 02903 http://www.rhodeislandhospital HOS00121 X X X X X X Rhode Island Hospital 1 false false true X X X X X X X X 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 true X true X 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 RIH and Lifespans three other hospitals. RIH also conducted eight 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 the RIH'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. RIHs 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) eight Community Health Forums held within the community of the RIH 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 interest 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:- Refugeee Dream Center- a post resettlement refugee agency center which facilitates the resettlement process and integration into the new lives of refugees who enter the United States. The center is located at 340 Lockwood Street, Providence, RI 02907;- Empowerment Temple of the International Central Gospel Church, located at 30 E. Dunnell Lane, Pawtucket, RI 02860;-Abundant Blessing Church, located at 825 Mineral Spring Avenue, Pawtucket, RI 02860;-Renaissance Adult Day Health Care Center- located at 1090 Eddy Street, Providence, RI 02905;-John Hope Settlement House- an organization which provides community outreach and advocacy services for children, youth and families within the Providence area. The organization is located at 7 Thomas P. Whiten Way, Providence, RI 02903;-Drug Abuse Resistance Education (D.A.R.E.)- located at 340 Lockwood Street, Providence, RI 02907;-ACI Women's and Men's Minimum Security Center- located at 40 Howard Avenue, Cranston, RI 02920;-St. Michael's Church- located at 239 Oxford Street, Providence, RI 02905. Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment The Miriam 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 RIH as of September 30, 2016 can be obtained by visiting: https://www.lifespan.org/sites/default/files/lifespan-files/documents/centers/lifespan-community-health/Rhode-Island-Hospital-2016-CHNA.pdf Part V, Line 16i - Other Means Hospital Facility Publicized the Policy An abbreviated version of RIH's financial assistance policy is posted in various admitting and outpatient areas of the Hospital. 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 18d - Other Collection Actions Against a Patient Once an account balance or a portion thereof is classified as self-pay, it is placed with RIH's pre-collect company until the balance is paid in full, a monthly payment plan is in place, or insurance information is provided for billing.After 120 days, if there is no payment activity, the account qualifies for bad debt and the pre-collect company returns the account to Patient Financial Services, which in turn forwards it to a collection agency.The collection agency sends 3 to 5 notices to the patient requesting payment. If there are no responses after the notices are sent, collection calls are made. If there is no response after 120 days, the account is reviewed for legal action in the appropriate court.If there are no assets to pursue, the collection agency deems the account uncollectible and returns it to Patient Financial Services for write-off.Note: In accordance with Center for Medicare and Medicaid Services mandates, Medicare patient accounts are held 130 days from last payment, after which if there has been no activity, the account is referred to collection. Part V, Line 19d - Other Actions Took Before Any Collection Actions RIH engages third parties to perform certain collection actions on its behalf. A pre-collect company is used for all self-pay accounts. Additionally, a collection agency is used if there is no payment activity on such accounts after 120 days. The collection process is explained in further detail in the response to Question 18d above. 30 Comprehensive Cancer Ctr Prgm of RIH at TMH 164 Summit Avenue Providence RI 02906 Comprehensive Cancer Center Physician Visits, Infusion Therapy Dialysis Center of Rhode Island Hospital 22 Baker Street Providence RI 02905 Hemodialysis, Home Peritoneal Dialysis, Home Hemodialysis Comprehensive Cancer Ctr at East Greenwich Prgm of RIH 1454 South County Trail East Greenwich RI 02918 Comprehensive Cancer Center Physician Visits, Infusion Therapy Comprehensive Cancer Ctr Prgm of RIH at NPT Hospital 11 Friendship Street Newport RI 02840 Comprehensive Cancer Center Physician Visits, Infusion Therapy Rhode Island Surgery Center at Wayland Square 17 Seekonk Street Providence RI 02906 Outpatient Surgery Dialysis Center of Rhode Island Hospital 950 Warren Avenue East Providence RI 02914 Hemodialysis RIH Outpatient Rehabilitation Services 765 Allens Avenue 1st Floor Suite 1 Providence RI 02905 Adult Physical and Occupational Therapy RIH Center for Wound Care 950 Warren Avenue Suite 103 East Providence RI 02914 Wound Care and Hyperbaric Medicine RI Hospital Hasbro Childrens Outpatient Rehab Services 765 Allens Avenue 2nd Floor Suite 2 Providence RI 02903 Children's Physical and Occupational Therapy RIH Pediatric Heart Center 1 Hoppin Street Providence RI 02903 Outpatient Pediatric Cardiology Services Childrens Neurology & Development Clinic 224 R Prairie Avenue Suite 1A Providence RI 02905 Pediatric Services RIH Center for Primary Care and Specialty Medicine 245 Chapman Street Suite 300 Providence RI 02905 Primary Care and Specialty Medical Services Audiology and Speech-Language Pathology Services 115 Georgia Avenue Providence RI 02905 Speech Language Pathology and Audiology Services Hallett Center for Diabetes & Endocrinology 900 Warren Avenue East Providence RI 02914 Outpatient Services for Diabetes, Endocrinology & Metabolism RIH Department of Psychiatry 146 West River Street Providence RI 02904 Outpatient Psychiatric and Behavioral Health Services RIH Pediatric and Adolescent Health Care Center 1 Hoppin Street Suite 3055 Providence RI 02903 Outpatient Adolescent Services Ophthalmology Clinic 1 Hoppin Street Suite 200 Providence RI 02903 General & Specialty Ophthalmic Examinations, Testing & Procedures RIH Sleep Disorders Center 70 Catemore Boulevard East Providence RI 02914 Outpatient Professional and Technical Evaluation of Sleep Disorders Medicine Pediatrics 245 Chapman Street Suite 100 Providence RI 02905 Primary Care Medicine RIH Child Research Center 1 Hoppin Street Providence RI 02903 Outpatient Psychiatric Services East Providence Infusion Center 375 Wampanoag Trail Suite 101A East Providence RI 02915 Infusion Services RIH Rehabilitation Services Hand Therapy 235 Plain Street Suite 203 Providence RI 02903 Occupational Therapy Radiosurgery Center of RI LLC 593 Eddy Street Providence RI 02903 Radiosurgery Services RIH Molecular Laboratory 167 Point Street CORO East 3rd Floo Providence RI 02903 Clinical Laboratory Testing - Molecular Diagnostics Pediatric Multi-Discipline Clinic & Rehab Satellite 1454 South County Trail 1st Floor East Greenwich RI 02818 Pediatric Specialties & Physical Therapy inclusive of Psychiatry Pediatric and Adult Medicine 900 Warren Avenue 2nd Floor East Providence RI 02914 Pediatric and Adult Specialty Services General Internal Medicine Research Group 111 Plain Street Providence RI 02903 Behavioral Research Studies Orthopedic MRI of RI LLC 100 Butler Drive Providence RI 02906 Medical Imaging Services Lifespan Clinical Research Center 1 Hoppin Street CORO Building Providence RI 02903 Study, Design, Analysis, Medical & Regulatory Oversight Research Pre-Admission Testing 79 Plain Street Providence RI 02903 Pre-Anesthesia Testing, Assessments for Surgery Patients Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) Rhode Island Hospital (RIH) uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at RIH is intended to define probable eligibility for public assistance (Medicaid or Community Free Service ("CFS")) for those patients who do not have the means to pay for hospital services rendered, as follows:1. Upon patient indication of an inability to pay required monies, the patient is offered the financial screening option to determine eligibility for public assistance (Medicaid, CFS).2. The application for CFS is completed and includes information relative to income, expense, and other available resources, and requires proof of such information which may include:- most recently filed Federal income tax return and W-2 form(s)- copies of most recent savings and/or checking account statements- two most recently received payroll check stubs- copy of rent receipts for the last six months for proof of residency- copy of utility bills for the last month for proof of residency3. If the patient's financial situation falls within the guidelines for eligibility for Medicaid, RIte Care, or CFS, or if the patient has a long-term disability, the appropriate application process is completed. (Assistance to complete such applications is available from the Patient Financial Advocates (PFA) Office at RIH.)4. Uninsured patients receive a discount equal to the discount received by Medicare beneficiaries on RIH charges. 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 RIH's billing system.Requests for Payment Arrangements:Patient Financial Advocates (PFA) will qualify patients that are receiving non-urgent, medically indicated procedures prior to services. The PFA will request 75% to 100% of estimated discounted charges if the balance is under $5,000 and 50% to 100% of estimated discounted charges if the estimated bill equals or exceeds $5,000.For elective or non-urgent cases, the policy will require financial clearance prior to services or an exception from the Medical Director based on the clinical circumstances if the patient cannot meet the above payment agreement.Patients who do not qualify for total or partial CFS, but who have difficulty in paying their bills after services are rendered, may request enrollment in a payment plan. Eligibility for the payment plan includes the following guidelines:1. Immediate payment in full will result in financial hardship to the patient or the patient's family.2. Deposit of one-half of the estimated total bill is requested prior to admission.3. The minimum monthly payment of $50.00.4. The maximum length of the payment plan is twenty-four months.The Customer Service staff will set up the payment plan using the above guidelines as well as complete the necessary information on the "Payment Agreement" form and mail to the patient for signature. Account documentation will be done online. The pre-collect agency will be sent a copy of the payment agreement and all forms will be scanned into the PFS Optical Imaging System. Part I, Line 6a - Related Organization Community Benefit Report The community benefit report 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, 2016 is available at the following link. https://issuu.com/lifespanmc/docs/lifespan_2016_annual_report?e=28083767/49287282Please see pages 22-23 for community benefit information. Part I, Line 7 - Explanation of Costing Methodology RIH's costing methodology used to calculate the amounts reported in Part I, Line 7 is as follows:a) Financial assistance at cost- involves utilization of a ratio derived from dividing patient costs, as defined, by patient charges, as defined, and applying that percentage to total charity care charges.Patient costs reported in the cost accounting system are calculated based on Medicare principles of reimbursement by reducing total operating expenses (as calculated by Form 990 requirements) by items such as bad debt expense, the cost of medical education, internally funded research, subsidized health services, community services, charitable contributions, and other operating revenue. Patient costs are then divided by patient charges to determine a ratio of cost to charges (RCC). This RCC is applied as the costing methodology for determining charity care expense.b) Medicaid- Medicaid expense is determined at cost as calculated by RIH's cost accounting system. The system applies historical costing methods applied to all patient segments based on various patient demographics and utilizations. These costing standards exclude bad debt, charity care, and the Medicaid portion of costs of health professions education, which are reported on other areas of Line 7. These expenses include Medicaid provider taxes. Direct offsetting revenue is reported as amounts received from Medicaid, as well as other payments which include reimbursement under Federal "Upper Payment Limit" (UPL) and "Disproportionate Share Hospital" (DSH) programs.e) Community health improvement services and community benefit operations- Community benefit operations expense is recorded as direct expenses incurred as reported by RIH's Community Health Services Department. Revenue received for these services is reported as direct offsetting revenue. f) Health professions education- Health professions education expenses represent direct costs related to amounts associated with resident and intern programs utilized at RIH. These costs are determined by reporting actual direct costs taken from the Medicare cost report. Direct offsetting revenue is reported as any direct Medicare reimbursements received for such services provided, as reported in the Hospital's Medicare cost report.g) Subsidized health services- Subsidized health services' community benefit expense is determined by RIH's cost accounting system. These subsidized health services are recorded at cost in RIH's cost accounting system for all qualified subsidized health service divisions. This expense is adjusted to remove all related Graduate Medical Education (GME) expenses, as well as bad debt, Medicaid, and charity costs already reported in the applicable sections of Line 7. Net patient service revenue is recorded as amounts received from various payer types related to these services. Revenue associated with Medicare GME and Medicaid is excluded from the amount disclosed for subsidized health services.h) Research- RIH conducts extensive medical research focused on the prevention and treatment of HIV/AIDS, obesity, cancer, diabetes, cardiac disease, neurological problems, orthopedic advancements, and mental health concerns. For all internal and external research conducted, the costs associated with these activities is calculated by combining the direct and indirect costs as reported within RIH's cost accounting system. Revenue received for these services is reported as direct offsetting revenue. i) Cash and in-kind contributions for community benefit- Expenses for cash and in-kind contributions for community benefit are made by RIH, including an allocation of contributions made by Lifespan Corporation on RIH's behalf. Part I, Line 7, Column F - Explanation of Bad Debt Expense The calculation of percentages disclosed for Schedule H, Part I, Line 7, column (f) "percent of total expense", does not include bad debt expense. Form 990, Part IX, Line 25 includes bad debt expense of $41,113,887. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense The amount reported as bad debt expense is determined by applying the ratio of cost to charges (RCC) to the total charges written off to bad debt. The RCC rate is determined using data from the Hospital's cost accounting system and is adjusted for medical education, internally funded research, subsidized health services, community services, and charitable contributions. Discounts and payments are applied to patient accounts before such account balances are transferred to bad debt. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit Accounts pending transfer to bad debt are reviewed by RIH's patient advocate staff to determine qualification for financial assistance under RIH's policy. Accounts with insufficient information to determine eligibility are assigned a separate identifying code. These accounts are ultimately transferred to bad debt if the appropriate qualifying documentation is not received. The amount reported on Schedule H, Part III, Section A, Line 3 represents the account balances at charge written off to bad debt from the pending code, which are in turn converted to cost by applying the RCC rate as identified in Schedule H, Part III, Section A, Line 2. Part III, Line 4 - Bad Debt Expense Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectibility of accounts receivable, RIH 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, RIH 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), RIH 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.RIH's allowance for doubtful accounts for self-pay patients increased from 69% of self-pay accounts receivable at September 30, 2015 to 86% of self-pay accounts receivable at September 30, 2016. RIH's self-pay writeoffs for the years ended September 30, 2016 and 2015 amounted to approximately $38,316,000 and $45,184,000, respectively. RIH did not change its charity care or uninsured discount policies during the years ended September 30, 2016 and 2015, respectively. Part III, Line 8 - Explanation Of Shortfall As Community Benefit There is no Medicare shortfall for fiscal year 2016. If there was, it would not be treated as a community benefit.The source of the Medicare allowable costs reported on Part III, Section B, Line 6 is the Medicare cost report, Form 2552-10. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients RIH does not bill for the excess of charges over agreed upon reimbursement amounts from third-party payors. Rather, such differences are recorded as a reduction of revenue through contractual adjustments. Collection efforts are focused on 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 bad debts. RIH 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.RIH 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, primarily Medicaid. 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 the Hospital regarding the need for inpatient medical and surgical services for both adults and children and a wide range of outpatient services including: primary care office visits, specialty care, emergency services, imaging, ambulatory surgery, and specific high technology services such as radiation therapy and bone marrow transplantation. A population-based study examines the growth and changes in the population, the resources in the community, and the changing prevalence of diseases. In addition to this approach, Lifespan Strategic Planning also examines experience with wait times, the level of staffing, and the changing standards of care. All of this information is used to assess the demand for additional services to provide access to high quality care.In addition to population approaches to assessing and estimating need, all specialties and services monitor demand at the service-specific level by considering changing patterns of care and methods of treatment for the specific medical problem, wait times for visits/queues, and community resources. The service leadership then goes through a review process to add staff, expanded hours, and/or new 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, RIH provides a wide range of services to both its primary and secondary areas. Lifespan and its hospital affiliates monitor health trends in Rhode Island in an effort to identify areas of unmet demands regarding clinical services. For example, over the past decade, RIH added a new state-of-the-art emergency department and opened the 110-room Bridge Building expansion, with three new floors dedicated to the care of cardiac, medical, and surgical patients. RIH's pediatric division, Hasbro Children's Hospital, is the state's only facility dedicated to pediatric care. The Hospital has continued its pioneering work on treatments for inoperable tumors as well as radiofrequency ablation. Also of note is Hasbro's Medical/Psychiatric Program. This program is expressly designed for children and adolescents with challenging mental health and medical conditions who require hospitalization. A collaboration with Emma Pendleton Bradley Hospital, it is the only program in the region created to meet the complex needs of these children. Children ages 6 to 18 are treated in a newly-renovated, secure 16-bed unit located on the 6th floor of Hasbro Children's Hospital. The unit was designed with input from both pediatrics and psychiatry to provide the very best care for children with psychiatric and medical illness. The safe, comfortable environment offers both private and semi-private rooms and areas for family, group, and milieu therapy. Part VI - Patient Education of Eligibility for Assistance RIH has multilingual signage in the Hospital's main lobby and waiting areas which provides information on financial aid contacts. The Registration Department meets with patients at the outset of care to discuss eligibility for assistance. The Registration staff provides interested patients with a "Welcome" booklet which includes information on patient rights and responsibilities. The signage and booklets contain a telephone number which connects patients with Registration staff who can answer any additional questions that may arise after the patient has left RIH. Assistance eligibility is also summarized on RIH's website.As part of RIH's inpatient intake process, RIH provides a summary of 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 Rhode Island Hospital, located in Providence, Rhode Island, is a 719-bed nonprofit general acute care teaching hospital with university affiliation providing a comprehensive range of diagnostic and therapeutic services for the acute care of patients principally from RI and southeastern Massachusetts. As a complement to its role in service and education, RIH actively supports research. RIH is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and participates as a provider primarily in Medicare, Blue Cross, and Medicaid programs. RIH is also a member of the formally named VoluntaryHospitals 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, RIH and certain other Rhode Island hospitals entered into an affiliation agreement to participate jointly in various clinical training programs and research activities with The Warren Alpert Medical School of Brown University (Brown). In 2010, Brown named RIH its Principal Teaching Hospital. The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically. RIH currently sponsors 49 graduate medical education programs accredited by or under the auspices of the Accreditation Council for Graduate Medical Education (ACGME), while also sponsoring another 34 hospital-approved residency and fellowship programs.With respect to nursing education, RIH has developed educational affiliations with a number of accredited colleges and universities. RIH does not receive any compensation from the various schools for providing a clinical setting for the student nurse training.RIH conducts extensive medical research and is in the forefront of biomedical health care delivery research and is among the leaders nationally in National Institutes of Health programs. Part VI - Community Building Activities RIH substantially subsidizes various health services including the following programs: adult psychiatry, diabetes, dental, and Alzheimer's, as well as the Center for Special Children, early intervention, and certain other specialty services. RIH also provides numerous other services to the community for which charges are not generated. These services include certain emergency services, community health screenings for cardiac health, prostate cancer and other diseases, smoking cessation, immunization and nutrition programs, diabetes education, community health training programs, patient advocacy, foreign language translation, physician referral services, and charitable contributions. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose RIH is governed by a Board of Trustees, which is composed of leaders of the local community elected by Lifespan Corporation. RIH's purpose is to be staffed, equipped, and ready to serve the hospital needs of the community and its people from all walks of life. RIH works collaboratively with physicians, its employees, other health care organizations, and the community to create a measurably healthier community through the provision of high quality, cost-effective, customer-focused health care services in an environment that promotes patient safety. RIH monitors the healthcare needs of its service area to ensure alignment of its resources with its mission. RIH measures the results of the programs and services it provides based on the value added to the community as well as the financial health of each program and its impact on RIH. RIH is organized and operated for the benefit of the community it serves. Part VI - 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 14,000 people. The Lifespan system has approximately 2,400 physicians on the medical staffs of its affiliated hospitals, operates 1,155 licensed beds in four hospital complexes, and in 2016 generated approximately $2.0 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 69 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, 2016, Lifespan Corporation employed approximately 990 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 RIH 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 true Brown University 164 Angell Street Providence RI 02912 050258809 501(c)(3) 940386 0 General Support Inst Study & Prac Nonviolence 265 Oxford Street Providence RI 02905 050517863 501(c)(3) 125000 0 General Support Rhode Island Hospital Fnd 167 Point Street Providence RI 02903 050468736 501(c)(3) 58400 0 General Support Rhode Island Medical Society 405 Promenade Street Providence RI 02908 050250010 501(c)(3) 18000 0 Health Program Support Thundermist Health Center 191 Social Street Woonsocket RI 02895 050355097 501(c)(3) 100500 0 Health Program Support UNAPRIH Education Trust Fund 375 Branch Avenue Providence RI 02904 412139381 501(c)(3) 150000 0 Employee Education Support 6 0 Educational Assistance 10 35000 Grantmaker's Description of How Grants are Used Rhode Island Hospital is committed to community programs and provides support to various charitable organizations in Rhode Island and southeastern Massachusetts. Donations are made to organizations recognized by the IRS as being described in IRC Section 501(c)(3). All contributions are approved by management and are made to organizations whose missions and goals align with those of the Hospital.Individual scholarships are awarded annually to applicants by a joint decision making body comprised of both IBT (International Brotherhood of Teamsters) and RIH representatives. Payments are made directly to qualified educational institutions on behalf of scholarship recipients. X X true true X X X X X true true false false false false false true false false Adetokunbo A Oyelese MD Physician 697410 123821 170922 15275 23642 1031070 Albert E Telfeian MD Physician 669853 112821 6764 15275 23707 828420 Barbara Riley RN Chief Nursing Officer 272134 261563 7950 19995 561642 111451 Curtis Doberstein MD Physician 1163579 173821 172015 15276 24766 1549457 Deus J Cielo MD Physician 660960 118821 169464 15275 24707 989227 Frederick J Macri EVP & COO 454718 202740 985869 16102 1659429 John B Murphy MD EVP - Physician Affairs 506930 105084 6625 19995 638634 Kenneth E Arnold Secty thru 5/16 507389 103174 23250 17754 651567 Latha Sivaprasad MD Chief Medical Officer 372363 52588 58173 10557 493681 Margaret M Van Bree DrPH President 608452 60551 92809 17315 779127 Mary A Wakefield Treasurer 683686 115798 125469 16554 941507 84972 Nicholas P Dominick SVP-Diag. & Support Svcs 244313 43716 45331 20003 353363 2224 Paul J Adler Secretary 251646 34682 36440 21307 344075 Petra M Klinge MD Physician 476263 93821 169220 15275 19419 773998 Timothy J Babineau MD Trustee 1202478 424894 332557 23436 1983365 85364 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).Housing Allowances or Residences for Personal Use:A temporary housing allowance may be provided on a case-by-case basis as part of the recruitment of key executives. The allowance is documented in the individual employment contract or employment offer. In calendar year 2015 Rhode Island Hospital provided this benefit to one executive and the taxable amounts paid for the temporary housing resulting from relocation are included in Medicare wages, more specifically on Schedule J, Part II, column B (iii). Part I, Line 7: Non-Fixed payments not listed above Certain physicians and executives participate in incentive compensation plans arranged through individual contractual agreements which stipulate non-fixed payments based on meeting criteria comprised of various quality and productivity markers. Part III, Additional Information Included in the Schedule J, Part II, Line (B)(iii) calendar year 2015 compensation for Timothy J. Babineau, MD, President & Chief Executive Officer, was a retention payment of $250,000 (earned during the transition to a new Lifespan CEO) made by Lifespan Corporation to Dr. Babineau in his capacity as President & CEO of the Lifespan health system.Included in the Schedule J, Part II, Line (B)(iii) calendar year 2015 compensation for Barbara Riley, Chief Nursing Officer of RIH, was a retention payment of $100,000 made by RIH.Part I, Line 1a- Certain executives and management personnel received financial planning services paid for on behalf of RIH. In calendar year 2015 RIH provided this benefit to one executive. The taxable amount paid for this benefit is included in Medicare wages, more specifically on Schedule J, Part II, column B (iii). A RIHEBC Series 2016 521300173 762244FP1 2016-08-11 227078594 Refund 1996, 2006, 2009 Bonds false false true A 227078594 1671247 225407347 2016 true true true true A false false false true true false false true A false true false false false false false true A false 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 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 Bonds. The portion of the 2016 Bonds proceeds issued which related to RIH is $227,078,594. For purposes of RIH, the 2016 issuance resulted in the complete refinancing of its RIHEBC Series 2006A and 2009A Bonds. Schedule K, Part I, Line 3:The bond proceeds listed in line 3 differ from the bond issue price disclosed per IRS Form 8038 due to the fact that RIH is part of the Lifespan Obligated Group previously mentioned in Part I, line A(f). Of the $308,112,067 disclosed in Form 8038, RIH was allocated $227,078,594 of the total issuance. Schedule K, Part V:Because the proceeds of the 2016 bond issuance were used solely for the purpose of retirement and redemption of RIH's 2006A & 2009A Series Bonds, RIH does not have in place written post-issuance tax compliance procedures for tax-exempt obligations but is in the process of putting one in place. RIH did not use the funds from these private placement bond issues to fund any other projects associated with RIH or any of its other affiliates. Brian Zink MD Trustee 1000 Cash Tuition Assist. Roberts Carroll Feldste Partner 409698 Legal Services false Schedule L, Part V Supplemental Information * Edward Feldstein, Trustee, is a partner in Roberts, Carroll, Feldstein and Peirce, a law firm that provides legal services to a sister company, Lifespan Risk Services,Inc. (LRS). The common parent of RIH and LRS is Lifespan Corporation. During fiscalyear 2016, LRS paid Roberts, Carroll, Feldstein and Peirce $409,698 for servicesrelated to RIH matters.*Brian Zink, MD, Trustee, received taxable tuition reimbursement of $1,000 from RIH during fiscal year 2016. 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 Aubin, Chairman, and Shivan Subramaniam, Trustee, are Directors of Citizens Bank. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Lifespan Corporation is the sole corporate member of RIH. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body Effective October 23, 2012, the Board of Directors of Lifespan and the Boards of Trustees of RIH, The Miriam Hospital, Newport Health Care Corporation, Newport Hospital, and Emma Pendleton Bradley Hospital approved a restructuring of their governance. The restructuring has increased governance effectiveness and has streamlined governance operation, as well as provided a single strategic perspective for the Lifespan system hospitals. Pursuant to the restructuring, the bylaws of each of the affiliates were amended such that the composition of the boards of trustees of each of the hospitals and Newport Health Care Corporation is defined as those persons serving from time to time as the directors of Lifespan. As a result, the Boards of each entity are comprised of the same individuals. The Board of each entity retains its responsibilities and authorities notwithstanding the revision in its composition. The Board of Directors of Lifespan consists of not less than fourteen nor more than thirty-one directors, including the President and CEO of Lifespan, who serves ex-officio with vote.Additionally, the bylaws of RIH confer certain reserved powers upon Lifespan to provide it with the means of effective oversight, coordination, and support of the system. Powers reserved to Lifespan include: to elect and remove RIH trustees and to approve the election of and to remove certain officers. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The RIH Board is comprised of the same individuals who serve on the Lifespan Board. Lifespan has the responsibility for planning, directing, and establishing policies intended to assure the development and delivery of quality health services on an integrated, cost-effective basis. Powers reserved to Lifespan, in addition to those noted above, include: to approve amendment of the Articles of Incorporation and Bylaws and other charter documents; to approve strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness. Form 990, Part VI, Line 11b: Form 990 Review Process The preparation and filing of the Form 990 and supporting schedules is the responsibility of the Executive Vice President & Chief Financial Officer (EVP/CFO) and Lifespan's Finance Department, with review by Lifespan's tax advisors, KPMG LLP (KPMG). The Form 990 is prepared by the accounting staff upon completion of Lifespan's annual independent audit and reviewed by the Corporate Services Tax Compliance Manager, the Director of Finance, and the Vice President of Finance - Corporate Services. The Form 990 is forwarded to KPMG for further review. KPMG provides the Tax Compliance Manager with any recommended changes which are reviewed, and if agreed upon, are incorporated into the return. The draft Form 990 is then provided to the EVP/CFO for final management review. Prior to filing the return with the Internal Revenue Service, a copy of the entire form, along with a video presentation detailing form highlights, are posted to the RIH'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 RIH, The Miriam Hospital, Emma Pendleton Bradley Hospital, Rhode Island Hospital Foundation, and The Miriam Hospital Foundation, currently make their annual and quarterly consolidated financial statements available to the public via DAC (Digital Assurance Certification LLC), a disclosure dissemination agent for issuers of tax-exempt bonds which electronically posts and transmits Lifespan's financial information to repositories and investors alike. In addition, copies of RIH's Articles of Incorporation, Bylaws, and Conflict of Interest Policy are available upon request from the office of the Lifespan EVP/CFO, either in person or by mail. Other Changes In Net Assets Or Fund Balances - Other Decreases Change in funded status of pension and other postretirement = -$28670800 Other Changes In Net Assets Or Fund Balances - Other Increases Increase in Net Assets of RIHF = $274793 Other Changes In Net Assets Or Fund Balances - Other Increases Transfer from Hospital Properties, Inc. = $43757 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfer to Hospital Properties, Inc. = -$36337 . RIH also offers pediatric services through its pediatric division, Hasbro Children's Hospital (HCH). HCH's specialties include cardiology, orthopedics, hematology & oncology, and medicine/psychiatry. HCH also has the area's only center for pediatric imaging, as well as the area's only pediatric intensive care unit, pediatric oncology and outpatient cardiac programs, pediatric emergency department, and pediatric surgical unit. It operates specialty clinics treating children ranging in age from newborn to 18 years. Services and programs include adolescent medicine, the Asthma and Allergy Center, the Children's Neurodevelopment Center, the Child Life Program, the Child Protection Program, dermatology, gastroenterology, infectious disease, the Injury Prevention Center, the Kidney Transplant Center, nephrology, neurosurgery, nutrition, the Partial Hospitalization Program, surgery, plastic surgery, primary care clinic, rehabilitation services, the Sickle Cell Clinic, and urology. HCH was the first hospital in the state to offer minimally invasive pediatric urologic surgeries.Additional special services, facilities, and programs furnished by RIH include: the endovascular hybrid operating room suite (the only one of its kind in Rhode Island, the suite's design provides vascular surgeons with the flexibility to perform minimally invasive procedures and traditional open surgeries simultaneously with limited anesthesia); adult and pediatric kidney and pancreas transplant center; Alzheimer's disease and memory disorders center; an adult and pediatric hemostasis and thrombosis center; an adult and pediatric diabetes and endocrinology center; colorectal care center; and the transfusion-free medicine and surgery program, one of only two such formalized programs in New England. RIH also holds designation or certification as a bariatric surgery center of excellence; adult and pediatric burn center; breast imaging center of excellence; comprehensive stroke center; and the distinction center for spine surgery, knee and hip replacement, and complex and rare cancers.One of the impacts of the Affordable Care Act is the radical transformation of American health care systems to integrated health care delivery systems, with patients at the center of all activity. To that end, RIH, along with the other Lifespan affiliates, has worked hard to expand beyond its campus to broaden the services it provides, investing in a new electronic health record system, and partnering with new physician groups. One of RIH's major strategic goals is to provide care in settings that are more patient-focused and cost effective, thus ensuring better continuity of care. Since 2011, RIH has opened ambulatory care centers in areas around the state, addressing a common barrier to care. By locating services, testing, and treatment in communities, RIH enables patients to access services when and where they need them, often in their own communities. The result is often earlier diagnosis, better adherence to treatment regimens, more cost-effective care and, eventually, better outcomes and a better patient experience.To address barriers for those who are treated and discharged from RIH, Lifespan Pharmacy, LLC (LRX) was opened in May 2013 on the RIH campus to provide pharmaceutical services. LRX is available to the public and offers convenient, fast, and professional service with easy refill options during the day or night via phone. LRX also offers free home delivery, appointment or walk-in flu vaccinations, as well as pneumonia and shingles vaccinations for adults. LRX pharmacists interact with physicians to provide comprehensive and safe care. Physicians can electronically transmit prescriptions to LRX, greatly reducing wait times. LRX pharmacists also work with physicians and insurance companies to find the least expensive, fully effective medications to best manage a patient's health.LRX enables patients to leave the hospital with the prescriptions they need, thereby reducing anxiety, enhancing recovery, and reducing the likelihood of readmission. LRX especially benefits patients for whom a lack of transportation is a major barrier by providing access to pharmaceutical drugs on-site at RIH. RIH provides full charity care for individuals at or below twice the federal poverty level, with a sliding scale for individuals based upon the federal poverty level guidelines, as set by the Department of Health and Human Services. In addition, a substantial discount consistent with Medicare program reimbursement is offered to all other uninsured patients. RIH determines the costs associated with providing charity care by aggregating the applicable direct and indirect costs, including compensation and benefits, supplies, and other operating expenses, based on data from its costing system. The total cost, excluding medical education and research, incurred by RIH to provide charity care amounted to $18,379,094 in fiscal 2016. Charges forgone, based on established rates, amounted to $67,031,000.RIH substantially subsidized various health services including the following programs: adult psychiatry, diabetes, dental, and Alzheimer's, as well as the Center for Special Children, early intervention, and certain other specialty services at a net cost of $10,421,269 in fiscal year 2016. RIH also provides numerous other services to the community for which charges are not generated. These services include certain emergency services, community health screenings for cardiac health, prostate cancer and other diseases, smoking cessation, immunization and nutrition programs, diabetes education, community health training programs, patient advocacy, foreign language translation, physician referral services, and charitable contributions. The net cost of these services amounted to $230,822 in fiscal 2016.RIH is accredited by The Joint Commission, the Accreditation Council for Graduate Medical Education for residency and fellowship training, the Accreditation Council for Continuing Medical Education of the Rhode Island Medical Society, the American College of Surgeons' Commission on Cancer, the Joint Review Committees on Educational Programs in Nuclear Medicine Technology and Radiologic Technology, the Commission on Accreditation of Allied Health Education Programs, and the National Accrediting Agency for Clinical Laboratory Sciences.In 2015, Rhode Island Hospital was the first hospital in Rhode Island to be recognized by The Joint Commission as meeting its standards for Disease-Specific Care Comprehensive Stroke Center Certification, joining an elite group of providers in the United States (82 of 5,000) to earn this designation. RIH's Comprehensive Cancer Center earned the Midyear 2015 Outstanding Achievement Award given by the American College of Surgeons' Commission on Cancer and is the only health care facility in the country to earn this national honor for excellence in providing care to cancer patients. The Comprehensive Cancer Center (CCC) sites at Rhode Island Hospital, The Miriam Hospital and Newport Hospital were named to Becker's Hospital Review 2015 "100 Hospitals and Health Systems With Great Oncology Programs. The Comprehensive Cancer Center at Rhode Island Hospital was recognized in both 2012 and 2015 by the Quality Oncology Practice Initiative Certification Program for delivering high-quality patient care. Rhode Island Hospitals Coop 3 and Hasbro Childrens Hospital Pediatric Intensive Care Unit received the prestigious Beacon Award for Critical Care Excellence.In 2016, RIH received the highest designation possible in the "Hospital Safety Scores" report by The Leapfrog Group. Form 990, Part I, Line 6 Volunteers support and contribute to the mission of RIH and HCH every day, giving their time, energy, and enthusiasm. They are able to learn, meet other dedicated volunteers, better understand the healthcare environment, and gain personal satisfaction knowing they are making a difference to patients, families, and visitors alike.Volunteer opportunities are available for both teens and adults in a wide variety of areas including: greeters, family liaisons, emergency room, gift shop, nurse aides, office support, pet therapy, physical therapy, patient visitors, recovery room, art activities, pediatric playrooms, outpatient clinics, reading programs, tours, intensive care unit, and oncology. Volunteers include college and high school students, retirees, working professionals, individuals considering a career change or returning to the work force, and individuals with a special skill or talent. Form 990, Part III, Line 4a, continued In 2016, RIH discharged 36,770 inpatients with total inpatient days of 193,323, treated 153,580 patients in its emergency departments, performed 23,006 inpatient and outpatient surgical procedures, and cared for 239,738 patients in outpatient clinics.Some of the special services, facilities, and programs provided by RIH include the Comprehensive Cancer Center for adults; the Cardiovascular Institute, comprised of cardiac catheterization, balloon angioplasty, and open heart surgery; critical care services; microvascular surgery; nuclear cardiology; radiology; laboratory; renal dialysis; computerized tomography; orthopedics, including minimally invasive carpal tunnel surgery and cartilage transplants for knee defects; magnetic resonance imaging (MRI); and dental care. RIH is the designated Level I Trauma Center for the State of Rhode Island and southeastern Massachusetts, with a state-of-the-art emergency department (ED) and a dedicated pediatric ED. RIH's adult ED includes a radiology unit comprised of 4-slice and 16-slice CT scanners, ultrasound and x-ray machines; an all-inclusive chest pain center; a critical care unit for the most seriously injured and ill; and private treatment rooms. RIH provides a full range of services to patients, with particular expertise in diagnostic imaging, cardiology, oncology (both medical and radiation), neurosciences, and orthopedics. RIH offers imaging with PET/CT technology for cancer staging, while cardiac MRI and 64-slice cardiac CT scanners are powerful tools for evaluating heart disease and function. The Anne C. Pappas Center for Breast Imaging is the only facility in the State to be designated a Breast Imaging Center of Excellence by the American College of Radiologists. In the area of cancer services, RIH pioneered image-guided tumor ablation, which shrinks or eliminates tumors by destroying them with heat (microwave ablation and radio-frequency ablation) or by freezing them (cryoablation). In addition, radiation oncology services include a linear accelerator for image-guided radiotherapy and stereotactic radiosurgery, as well as electronic brachytherapy for early-stage breast cancer patients, which reduces average treatment times from eight weeks to five days. In the area of surgical oncology, RIH is the only hospital in the State and one of only a few hospitals in New England to offer hyperthermic intraperitoneal chemoperfusion (HIPEC) for patients with advanced cancer of the abdomen. In the sphere of neurosurgery, RIH features one of the first gamma knife surgical centers in the United States, which offers intracranial stereotactic radiosurgery for the non-invasive treatment of brain lesions previously inaccessible or unsuccessfully treated by conventional therapies.RIH provides a wide range of adult, adolescent, and child behavioral health services and research programs, including: psychiatry emergency services for adults, adolescents, and children; psychiatry consultation liaison services; correctional psychiatry program; inpatient and geriatric psychiatry programs; mood disorders program; gambling treatment program; anxiety disorders program; body dysmorphic disorder program; behavioral sleep medicine program; substance abuse treatment program; neuropsychiatric services; adult and pediatric neuropsychology services; adult and pediatric partial hospitalization programs; family research program; and Bradley/Hasbro Children's Research Center. Form 990, Part III, Line 4b, continued Under an affiliation agreement with The Warren Alpert Medical School of Brown University (Brown), RIH participates jointly in various clinical training programs and research activities. In 2010, Brown named RIH its Principal Teaching Hospital. The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically. RIH currently sponsors 49 graduate medical education programs accredited by or under the auspices of the Accreditation Council for Graduate Medical Education (ACGME), while also sponsoring another 34 hospital-approved residency and fellowship programs. RIH serves as the principal setting for these clinical training programs, which encompass the following disciplines: internal medicine and medicine subspecialties, including hematology and oncology; orthopedics and orthopedic subspecialties; clinical neurosciences and related subspecialties; general surgery and surgical subspecialties; pediatrics and pediatric subspecialties, including hematology and oncology; dermatology; radiology and radiology subspecialties; pathology; child psychiatry; emergency medicine and emergency medicine subspecialties; dentistry; and medical physics. In 2016, Brown enrolled 543 students in undergraduate medical education programs. All medical students at Brown receive training at RIH. RIH teaching faculty help to ensure that the experience for both undergraduate and graduate medical education trainees remains transformative - transforming novice practitioners into physicians able to think, act, and keep their focus on the ultimate goal of providing the best and most appropriate care for patients no matter what the setting or circumstances. RIH is also a participating clinical training site for another 270 residents and fellows from other programs in anesthesiology, emergency medicine, family medicine, hematology/oncology, internal medicine, obstetrics/gynecology (OB/Gyn) and OB/Gyn subspecialties, otolaryngology, pediatric pathology, pediatric dentistry, podiatry, psychiatry and its subspecialties of forensic psychiatry and geriatric psychiatry, orthopedics, rheumatology, and radiation oncology. RIH serves as a clinical site for physician assistant schools of Johnson & Wales University, Bryant University, and the Massachusetts College of Pharmacy. In addition, Behavioral Medicine at RIH, in collaboration with Brown, sponsors research and clinical psychology training programs for interns, postdoctoral fellows, and faculty trainees.With respect to nursing education, RIH has developed educational affiliations with the University of Rhode Island College of Nursing; Rhode Island College School of Nursing; Community College of Rhode Island (CCRI); Salve Regina University; Boston College; Yale University; Regis College; Simmons College; St. Joseph's Health Services' School of Nursing; the University of Massachusetts campuses at Dartmouth, Boston, Amherst, and Worcester; Framingham University; the University of Connecticut; the New England Institute of Technology; Northeastern University; Drexel University; Walden University; Georgetown University School of Nursing and Health Studies; Duke University School of Nursing; and the University of Pennsylvania, as well as other Schools of Nursing, pursuant to which their nursing students obtain clinical training and experience at RIH. RIH does not receive any compensation from the various schools for providing a clinical setting for the student nurse training. RIH also serves as a clinical site for Certified Nursing 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 RIH, as well as other outpatient sites. RIH also sponsors programs in computed tomography and mammography. At RIH, clinical affiliations/student clinical training programs are provided through contracts with a number of colleges and universities in the professional areas of speech-language pathology and audiology, physical therapy, physical therapy assistants, occupational therapy, and certified occupational therapy assistants. RIH has clinical training affiliations in respiratory therapy with New England Institute of Technology and CCRI. In addition, RIH serves as the clinical setting for training programs in histology, cytology, phlebotomy, child development, and medical-laboratory science (medical technology); related clinical affiliations with the University of Rhode Island, Salve Regina, and Rhode Island College allow students to obtain clinical education and experience on site at RIH.RIH also 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, RIH's Pharmacy Department co-sponsors second-year postgraduate specialized residency programs in oncology and ambulatory care pharmacy. RIH's pharmacists also participate in the education of pharmacy, nursing, and physician assistant students by providing didactic lectures at the University of Rhode Island's College of Pharmacy, Rhode Island College's Advanced Practice Nursing Program, Johnson & Wales University's Center for Physician Assistant Studies, and Bryant University's Physician Assistant Program. In addition, RIH has clinical social work student contracts with Rhode Island College, Boston University, Boston College, Smith College, Simmons College, and Bridgewater State University. Form 990, Part III, Line 4c, continued Major areas of research include:Cancer: RIH participates in clinical trials of new therapeutic agents in both adult and pediatric medicine. These trials are supported by NIH sponsored groups such as Alliance, Childrens' Oncology Group (COG), and the National Surgical Adjuvant Breast and Bowel Project (NSABP). RIH is a participating hospital in the Brown-sponsored Cancer Oncology Group (BrUCOG).The Liver Research Center: The Liver Research Center emphasizes studies relating to the molecular biology of liver diseases such as Hepatitis B and C and cellular carcinoma.Heart Disease: General research continues in areas of invasive therapy, such as angioplasty, artherectomy, coronary stenting, and laser treatment of coronary artery disease.Neurological Illness: The Alzheimer's Disease and Memory Disorder Center combines high quality neurological, neuropsychologic, and psychiatric services, thus creating a comprehensive diagnostic and treatment option for patients with memory disorders.Stroke: The Stroke Center at RIH provides services to adult and geriatric patients with suspected transient ischemic attack (TIA) or stroke in Rhode Island and Southeastern Massachusetts. As the region's only primary stroke center located within a Level 1 trauma center, RIH is uniquely qualified to provide the most advanced clinical care to acute stroke patients. Other major research areas included multiple sclerosis, epilepsy, Parkinson's disease, and other movement disorders. Form 990, Part VI Section B, Line 12c Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including RIH, and administered by Lifespan's Corporate Compliance Department as follows: Each designated person subject to Lifespan's conflict of interest policy is required to provide Lifespan with an initial disclosure statement and thereafter an annual statement attesting that: (i) the designated person has read and is familiar with this policy, and (ii) the designated person and, to the best of his/her knowledge, family members, have not in the past engaged in, are not presently engaging in, or plan to engage in, any activity which contravenes this policy.If, at any time during the course of employment or association, a designated person has reason to believe that an existing or contemplated activity may contravene this policy, the person shall submit a full written description of the activity to the Lifespan Compliance Officer or the Office of the General Counsel to seek a determination as to whether the contemplated activity does or does not contravene this policy. 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 RIH:EXECUTIVE COMPENSATIONLifespan's executive compensation philosophy balances appropriate stewardship of resources and the need to be competitive in recruiting and retaining talented individuals. It incorporates market-competitive and performance-related principles, and covers the President and CEO of Lifespan as well as other officers, senior management, and key employees. Lifespan's executive compensation program complies with both law and 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 and affiliate 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. Form 990, Part VI Section B, Lines 15 a&b cont 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 relies on information previously provided by the consultant to establish a range of reasonable cash compensation within which recruitment is expected to conclude with acceptance of a reasonable compensation offer. Form 990, Part VI, Section A, Line 1b: *Lawrence A. Aubin, 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 2016, Lifespan paid rent to Lawrence Investments, LLC under the terms of this lease.*The spouse of Pamela Harrop, Trustee, is employed as a cardiologist by the Miriam Hospital. Form 990, Part XII, Line 2 While RIH did not produce a separate audited financial statement as of and for the fiscal year ended September 30, 2016, it was included in RIH and Affiliates' consolidated audited financial statements, which include RIH, RIH Ventures, Radiosurgery Center of Rhode Island, LLC, and Lifespan Pharmacy, LLC. There are no regulatory or creditor stipulations which require the preparation of a separate audited financial statement for the organization.The Lifespan Audit and Compliance Committee assumes responsibility for oversight of the audit of RIH's consolidated financial statements and the selection of Lifespan's independent accountant. Schedule H, Part V, Line 10a: The URL to view RIH's most recently adopted implementation strategy is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/centers/lifespan-community-health/Rhode-Island-Hospital-2016-CHNA.pdfPlease refer to page 20 of the CHNA to view the implementation strategy. Schedule H, Part V, Line 16b: The URL to view and download RIH's FAP application form is below:https://www.lifespan.org/uploadedFiles/Lifespan/Content/Patient_Financial_Services/Lifespan-FAF-ENG.pdf Schedule H, Part V, Line 16c: The URL to view RIH's plain language summary of the FAP is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/Lifespan-Financial-Assistance-Summary.pdf Schedule H, Part V, Line 7: The RIH 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 Lifespan Pharmacy LLC 167 Point Street Providence RI 02903 461697290 Pharmaceutical Sales RI 17508910 3829803 Rhode Island Hospital Radiosurgery Center of Rhode Island LLC 593 Eddy Street Providence RI 02903 262171671 Radiosurgery RI 570410 2304186 Rhode Island Hospital Alternative Living Concepts 249 Roosevelt Avenue 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