2017-08-14T10:57:00-05:00 2016-09-30 135565207 KPMG LLP 345 PARK AVENUE NEW YORK NY 10154 990 2015-10-01 460543230 LMW HEALTHCARE INC LMWH 8604420711 365 MONTAUK AVENUE NEW LONDON CT 06320 SETH VAN ESSENDELFT SR VP OF FINANCE 8604420711 2017-08-14 0 ROBERT ROBINSON P00741489 2127589700 2015 2021-01-29 14:40:06Z SETH VAN ESSENDELFT 365 MONTAUK AVENUE NEW LONDON CT 06320 64895077 0 X WWW.WESTERLYHOSPITAL.ORG X 2012 RI TO PROVIDE MEDICAL CARE IN THE WESTERLY, RHODE ISLAND COMMUNITY AND SURROUNDING TOWNS. 11 7 757 215 0 0 0 0 70443136 63216981 235779 378553 574220 618510 71253135 64214044 0 10600 0 0 35753806 35607457 0 0 96484 34878215 33946856 70632021 69564913 621114 -5350869 57561387 62779155 10535344 28740264 47026043 34038891 X TO PROVIDE MEDICAL CARE IN THE WESTERLY, RHODE ISLAND COMMUNITY AND SURROUNDING TOWNS. 0 0 48632433 10600 63216981 SEE SCHEDULE O 48632433 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 61 0 757 1 0 0 0 0 0 0 0 0 0 0 X 11 7 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X DENIS DONEGAN 2036886088 789 HOWARD AVENUE NEW HAVEN CT 06519 STEPHEN M GREENE CHAIRMAN AND TRUSTEE 1.00 1.00 X X 0 0 0 BRUCE D CUMMINGS PRESIDENT/CEO AND TRUSTEE 1.00 39.00 X X 0 639099 50765 ANN M LAIN SECRETARY AND TRUSTEE 1.00 1.00 X X 0 0 0 DEBORAH LAMM VICE CHAIRMAN AND TRUSTEE 1.00 1.00 X X 0 0 0 STEVEN RUZZO TREASURER AND TRUSTEE 1.00 0.00 X X 0 0 0 WILLIAM CONLIN TRUSTEE 1.00 0.00 X 2500 0 0 ADRIAN K HAMBURGER TRUSTEE 1.00 39.00 X 0 777864 67942 THOMAS J LIGUORI TRUSTEE 1.00 0.00 X 0 0 0 RACHEL MCCORMICK TRUSTEE 1.00 0.00 X 0 0 0 CHRISTOPHER O'CONNOR START 916 TRUSTEE 1.00 39.00 X 0 1210574 388215 RICHARD SMITH TRUSTEE 1.00 0.00 X 0 0 0 MAUREEN ANDERSON ASSISTANT SECRETARY 1.00 39.00 X 0 285844 74161 SETH VAN ESSENDELFT VP/CFO 1.00 39.00 X 0 374982 48016 LINDA BROCATO PHARMACY MANAGER 40.00 0.00 X 138985 0 23974 EMILY FLYNN CLINICAL PHARMACIST 40.00 0.00 X 124780 0 27496 KARL NG CLINICAL PHARMACIST 40.00 0.00 X 127708 0 25805 MARK ROGERS MANAGER CLINICAL PHARMACY 40.00 0.00 X 119921 0 16230 SHEILA SANDOVAL CLINICAL PHARMACIST 40.00 0.00 X 113667 0 10787 627561 3288363 733391 12 0 1 0 QUEST DIAGNOSTICS 40 ACCORD PARK DRIVE NORWELL MA 02061 LAB SERVICES 794448 PRESIDIO NETWORKED SOLUTIONS INC PO BOX 677638 DALLAS TX 752677638 IT SERVICES 654108 UNITEX TEXTILE RENTAL SERVICES INC 565 TAXTER ROAD SUITE 620 ELMSFORD NY 105232300 UNIFORM LAUNDERING 290872 IPC HOSPITALISTS OF NEW ENGLAND PC 15 SALT CREEK LANE SUITE 444 HINSDALE IL 60521 MEDICAL SERVICES 275255 CHRISTOPHER M MULHEARN ESQ 55 PINE STREET PROVIDENCE RI 02903 CONSULTING 210000 16 PATIENT SERVICE REVENUE 900099 63216981 63216981 63216981 359459 359459 445954 151694 294260 294260 294260 548433 529339 19094 19094 19094 CAFETERIA/FOOD SALES 900099 245832 245832 OTHER ANCILLARY REVENUE 900099 78418 78418 324250 64214044 63216981 0 997063 X 8750 8750 1850 1850 28589021 23337295 5251726 158983 129778 29205 4665123 3808153 856970 2194330 1791238 403092 630210 630210 302631 302631 1662 1662 66063 66063 13577684 3958489 9522711 96484 231471 231471 162999 162999 1457594 1060545 397049 29092 12859 16233 264821 45210 219611 416336 416336 4626375 3366150 1260225 850641 618926 231715 MEDICAL SUPPLIES 8429160 8417186 11974 OTHER SUPPLIES 2277749 1723598 554151 MISCELLANEOUS EXPENSES 413122 155679 257443 EQUIPMENT RENTAL & MAIN 118806 118806 0 90440 11858 78582 69564913 48632433 20835996 96484 815211 1535344 133813 147654 8601329 6019277 0 200500 1960488 1660088 245795 152144 48084240 14165901 30486831 33918339 7144380 8466484 4049023 4202770 2604375 2230125 1520142 4246430 57561387 62779155 7105170 6653263 3430174 22087001 10535344 28740264 X 36465409 24311364 1217275 0 9343359 9727527 47026043 34038891 57561387 62779155 X -5350869 83017 -7719299 X 0 1 X 1 0 X 0 0 0 0 0 0 1 54000 0 1 12063 66063 0 PART II-B, LINE 1: THE AMOUNT REPORTED IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING DURING FY 2016. ALSO, THE HEALTH SYSTEM OFFICIALS HAD MEETINGS AND CONTACTS WITH STATE GOVERNMENT OFFICIALS,INCLUDING STATE LEGISLATORS AND THEIR STAFF TO DISCUSS VARIOUS HEALTH CARE REFORM PROPOSALS. LMW HEALTHCARE INC. IS PART OF A CONTROLLED GROUP WITH THE FOLLOWING LOBBYING EXPENSES: YALE-NEW HAVEN HOSPITAL EIN 06-0646652 $1,099,541 BRIDGEPORT HOSPITAL EIN 06-0646554 $ 596,691 GREENWICH HOSPITAL EIN 06-0646659 $ 120,642 NORTHEAST MEDICAL GROUP EIN 06-1330992 $ 42,892 LAWRENCE + MEMORIAL HOSPITAL EIN 06-0646704 $ 97,147 7144384 92360 515574 -2035 37867 7716486 7087069 77827 49427 0 30444 39495 7144384 6624154 18975 474133 0 0 30193 7087069 0 6524115 122157 0 0 22118 6624154 0.38000 0.62000 0.00000 0 0 1090000 1090000 19076086 1983226 17092860 25463851 12182675 13281176 2454303 2454303 33918339 FUNDS HELD IN TRUST 4202770 F 4202770 MALPRACTICE INSURANCE RECEIVABLE 4246430 4246430 3RD PARTY PAYOR SETTLEMENTS 1650991 ASSET RETIREMENT OBLIGATION 1356217 MALPRACTICE INSURANCE LIABILITY 4246430 DUE TO AFFILIATES 14833363 22087001 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUND FUNCTIONS TO SUPPORT AND PROVIDE INCOME FOR THE FURTHERANCE OF THE HEALTH CARE MISSION OF LMW HEALTHCARE, INC. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 266 4747867 4288763 459104 0.00660 16285 8584904 6411678 2173226 0.03120 0 0 0 16551 13332771 10700441 2632330 0.03780 21 3641 287342 8348 278994 0.00400 2 132 261360 0 261360 0.00380 0 0 0 0 0 0 0 0 2 50 4840 0 4840 0.00010 25 3823 553542 8348 545194 0.00790 25 20374 13886313 10708789 3177524 0.04570 0 0 0 0 0 0 0 0 1 0 4000 0 4000 0.00010 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 4000 4000 0.00010 1 2847911 32229976 42664268 -10434292 X 1 1 1 1 LMW HEALTHCARE INC 25 WELLS STREET WESTERLY RI 02891 HTTP://WESTERLYHOSPITAL.ORG HOS00129 X X X LMW HEALTHCARE INC 1 0 0 1 X X X X X X X X X 15 1 0 1 1 X SEE PART V X WWW.LEDGELIGHTHD.ORG/ASSESSMENT X X 1 15 1 SEE PART V 0 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X 1 X 0 X 1 X 0 0 LMW HEALTHCARE, INC. PART V, SECTION B, LINE 5: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE CHNA PROCESS THROUGHOUT, LMW HEALTHCARE, INC SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL THROUGH COMMUNITY MEETINGS AND INCLUSION OF RESIDENTS AND COMMUNITY PARTNERS IN THE PRIORITIZATION AND IMPLEMENTATION PLANNING PROCESS. PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS SHARED KNOWLEDGE AND EXPERTISE ABOUT HEALTH ISSUES, WHILE LEADERS AND REPRESENTATIVES OF NON-PROFIT AND COMMUNITY-BASED ORGANIZATIONS PROVIDED INSIGHT ON THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS. LMW HEALTHCARE, INC. PART V, SECTION B, LINE 6B: LMW HEALTHCARE, INC PARTICIPATED IN A STATEWIDE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) LED BY THE HOSPITAL ASSOCIATION OF RHODE ISLAND (HARI) AND ITS MEMBER HOSPITALS. THROUGH A COORDINATED STATEWIDE EFFORT, HARI AND ITS HOSPITAL MEMBERS WORKED WITH THE RHODE ISLAND DEPARTMENT OF HEALTH AND LOCAL COMMUNITY PARTNERS TO COLLECT HEALTH DATA, GATHER FEEDBACK ON REGIONAL AND LOCAL HEALTH NEEDS, AND DEVELOP COORDINATED PLANS TO ADDRESS PRIORITY HEALTH NEEDS ACROSS THE STATE. THE CHNA WAS CONDUCTED WITH THE FOLLOWING:BAKER-TILLY CONSULTINGTHE HOSPITAL ASSOCIATION OF RHODE ISLANDCARE NEW ENGLAND HEALTH SYSTEM: BUTLER HOSPITAL; KENT HOSPITAL; MEMORIAL HOSPITAL OF RHODE ISLAND; WOMEN & INFANTS HOSPITAL OF RHODE ISLANDCHARTERCARE: OUR LADY OF FATIMA HOSPITAL; ROGER WILLIAMS MEDICAL CENTERDOMESTIC VIOLENCE RESOURCE CENTER OF SOUTH COUNTYGATEWAY HEALTHCAREJONNYCAKE CENTERLANDMARK MEDICAL CENTEROCEAN COMMUNITY YMCAPAWCATUCK NEIGHBORHOOD CENTERRHODE ISLAND DEPARTMENT OF HEALTHRHODE ISLAND FOUNDATIONRHODE ISLAND LAND TRUSTSOUTH COUNTY COMMUNITY ACTIONSOUTH COUNTY HEALTHWARM CENTERWASHINGTON COUNTY HEALTH EQUITY ZONE STEERING COMMITTEEWESTERLY AMBULANCE CORPS.WESTERLY PUBLIC SCHOOLSWESTERLY TOWN PLANNINGWOOD RIVER HEALTH SERVICESSCHEDULE H, PART V, SEC B, LINE 7A AND 10A:HTTPS://WWW.WESTERLYHOSPITAL.ORG/ABOUT/COMMUNITY-BENEFITS.ASPX LMW HEALTHCARE, INC. PART V, SECTION B, LINE 7D: THE CHNA REPORT WAS RELEASED AT A PRESENTATION OPEN TO THE PUBLIC ON MAY 17, 2016. IN ATTENDANCE WERE COMMUNITY PARTNERS REPRESENTING OTHER NON-PROFIT ORGANIZATIONS, BUSINESS LEADERS, INDIVIDUALS REPRESENTING THE EDUCATION SECTOR, HOSPITAL STAFF, MEMBERS OF THE MEDIA, AND COMMUNITY MEMBERS. LMW HEALTHCARE, INC. PART V, SECTION B, LINE 11: THE 2016 CHNA REVEALED THAT THE WESTERLY COMMUNITY IS GREATLY CHALLENGED BY BEHAVIORAL HEALTH - MENTAL HEALTH AND SUBSTANCE ABUSE-RELATED ISSUES. FROM A LACK OF RESOURCES TO TREAT MENTAL HEALTH CONDITIONS TO SUBSTANCE ABUSE ADDICTION, BEHAVIORAL HEALTH IS A KEY HEALTH CONCERN IN OUR COMMUNITY. BECAUSE OF THE FAR-REACHING EFFECTS OF BEHAVIORAL HEALTH ON THE OVERALL HEALTH AND QUALITY OF LIFE FOR RESIDENTS IN OUR COMMUNITY, LMW HEALTHCARE,INC AND THE HEALTH IMPACT COLLABORATIVE MADE A COMMITMENT TO FOCUS COMMUNITY HEALTH IMPROVEMENT EFFORTS ON BEHAVIORAL HEALTH OVER THE NEXT SEVERAL YEARS. WHILE WE REMAIN COMMITTED TO PROVIDING QUALITY HEALTHCARE FOR ALL, AND OUR ONGOING WORK TOWARD CHRONIC DISEASE PREVENTION AND CANCER CARE WILL NOT STOP, WE WILL PLACE A HEIGHTENED EMPHASIS ON TACKLING BEHAVIORAL HEALTH NEEDS ACROSS OUR COMMUNITY. TO BETTER UNDERSTAND THE NEEDS AND RESOURCES ASSOCIATED WITH BEHAVIORAL HEALTH, WE SOLICITED INPUT FROM OUR COMMUNITY PARTNERS AND RESIDENTS THROUGH THE CHNA RESEARCH AND COMMUNITY DIALOG. LMW HEALTHCARE, INC HAS PLAYED A LEADERSHIP ROLE IN SOUTH COUNTY HEALTHY BODIES, HEALTHY MINDS (HBHM), A PARTNERSHIP WITH THE RHODE ISLAND DEPARTMENT OF HEALTH HEALTH EQUITY ZONE (HEZ) PROJECT TO HELP ALL SOUTH COUNTY RESIDENTS LEAD HEALTHY LIVES. IN COLLABORATION WITH THE HBHM COMMITTEE AND OTHER COMMUNITY PARTNERS, WE WILL WORK TOWARD OUR GOAL OF IMPROVING BEHAVIORAL HEALTH ACCESS AND OUTCOMES FOR ALL RESIDENTS: BEHAVIORAL HEALTH GOAL STATEMENT: IMPROVE OUTCOMES FOR RESIDENTS LIVING WITH A BEHAVIORAL HEALTH CONDITION AND THEIR FAMILIES.OBJECTIVES:-INCREASE ACCESS TO APPROPRIATE, QUALITY BEHAVIORAL HEALTH SERVICES AND IMPROVE SELF-MANAGEMENT AMONG PATIENTS-INCREASE AWARENESS OF SIGNS AND SYMPTOMS OF BEHAVIORAL HEALTH CONDITIONS AND COMMUNITY RESOURCES-INCREASE EARLY IDENTIFICATION AND SCREENINGS FOR BEHAVIORAL HEALTH CONDITIONS IN ALL CARE SETTINGSTO LEARN MORE ABOUT HOW LMW HEALTHCARE, INC AND ITS COMMUNITY PARTNERS ARE MEETING THESE NEEDS PLEASE REVIEW THE COMMUNITY HEALTH IMPROVEMENT PLAN ATTACHED TO THIS FILING. LMW HEALTHCARE, INC. PART V, SECTION B, LINE 13B: THE HOSPITAL SHALL PROVIDE DISCOUNTED CARE ON A SLIDING SCALE FOR SELF-PAY PATIENTS IF THE PATIENT'S: (A) ANNUAL INCOME IS BETWEEN 251% AND UP TO 400% OF THE FEDERAL POVERTY LEVELS, TAKING INTO CONSIDERATION FAMILY UNIT SIZE; AND (B) ASSETS DO NOT EXCEED $50,000 WHICH EXCEEDS THE ASSET THRESHOLD (AS DEFINED IN THE RHODE ISLAND STATEWIDE STANDARDS FOR THE PROVISION OF CHARITY CARE; SEE R23-17.14-HCA). LMW HEALTHCARE, INC. PART V, SECTION B, LINE 13H: THESE PROGRAMS COVER MEDICALLY NECESSARY CARE ONLY. LMW HEALTHCARE, INC. PART V, SECTION B, LINE 16I: WEBSITE PROVIDES DIRECT EMAIL LINK TO FINANCIAL COUNSELORS. LMW HEALTHCARE, INC. PART V, SECTION B, LINE 20E: PRIOR TO INITIATION OF ANY COLLECTION ACTION, THE HOSPITAL DOCUMENTED ITS DETERMINATION OF WHETHER INDIVIDUALS WHO SUPPLIED A COMPLETED FINANCIAL ASSISTANCE APPLICATION WERE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY. LMW HEALTHCARE, INC. PART V, SECTION B, LINE 22D: THE HOSPITAL PROVIDES FULL CHARITY CARE TO PATIENTS WITH ANNUAL INCOME UP TO AND INCLUDING 250% OF THE FEDERAL POVERTY GUIDELINES (FPG). HOSPITAL PROVIDES DISCOUNTED CARE ON A SLIDING SCALE FOR SELF-PAY PATIENTS IF THE PATIENT'S: (A) ANNUAL INCOME IS BETWEEN 251% AND UP TO 400% OF THE FEDERAL POVERTY LEVELS, TAKING INTO CONSIDERATION FAMILY UNIT SIZE; AND(B) ASSETS DO NOT EXCEED $50,000 WHICH EXCEEDS THE ASSET THRESHOLD.DISCOUNTS ARE BASED ON THE GROSS AMOUNTS CHARGED UNIFORMLY ACCORDING TO THE PUBLISHED CHARGEMASTER AND WILL BE AUTHORIZED AS FOLLOWS:251% - 300% = 50%301% - 350% = 40%351% - 400% = 30% SCHEDULE H, PART V, SECTION B, LINE 16A, 16B AND 16C: HTTPS://WWW.WESTERLYHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE.ASPX PART I, LINE 3C: IT IS THE PHILOSOPHY AND POLICY OF LMW HEALTHCARE INC THAT MEDICALLY NECESSARY HEALTH CARE SERVICES SHOULD BE AVAILABLE TO ALL INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY.CHARITY CARE APPLIES TO ALL UNINSURED PATIENTS (DEFINED AS EARNING LESS THAN 250% OF THE POVERTY GUIDELINES). CARE WILL BE PROVIDED FREE FOR THOSE UNINSURED PATIENTS WHO REQUEST ASSISTANCE AND VERIFY THEIR ANNUAL INCOME IS LESS THAN 250% OF THE FEDERAL INCOME POVERTY LEVEL ("FPL").LIQUID ASSETS MUST NOT EXCEED $50,000 (STOCKS, BONDS, CASH, IRA, CD, ETC.) EXCLUDING PRIMARY RESIDENCE AND PRIMARY MOTOR VEHICLE, BUSINESS ASSETS, RENTAL PROPERTY, SECONDARY RESIDENCES, RECREATIONAL VEHICLES AND OTHER SUCH LUXURY ITEMS WILL BE APPLIED TO THE LIQUID ASSETS. CARE WILL BE DISCOUNTED ON A SLIDING SCALE FOR SELF PAY PATIENTS WHO HAVE NO THIRD PARTY INSURANCE TO COVER SERVICES WITH AN ANNUAL INCOME THAT IS BETWEEN 250% AND 400% OF THE FPL AND HAVE ASSETS LESS THAN $50,000, IN ACCORDANCE WITH THE FOLLOWING:251%-300%= COST OF CHARGE301%-350%= 40%351%-400%= 30% PART I, LINE 7: THE AMOUNTS REPORTED ON PART 1, LINE 7 WERE CALCULATED AS DIRECT AND SEPARATELY IDENTIFIABLE COSTS INCURRED BY THE HOSPITAL PLUS AN ALLOCATION OF OVERHEAD. PART II, COMMUNITY BUILDING ACTIVITIES: LMW HEALTHCARE INC, ALONG WITH MANY OTHER HOSPITALS ACROSS THE COUNTRY, UTILIZES THE COMMUNITY BENEFITS INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) DATABASE DEVELOPED BY LYON SOFTWARE TO CATALOG ITS COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES AND THE GUIDELINES DEVELOPED BY THE CATHOLIC HOSPITAL ASSOCIATION (CHA) IN ORDER TO CATALOG THESE BENEFITS. THESE TWO ORGANIZATIONS HAVE WORKED TOGETHER FOR OVER 20 YEARS TO PROVIDE SUPPORT TO NOT-FOR-PROFIT HOSPITALS TO DEVELOP AND SUSTAIN EFFECTIVE COMMUNITY BENEFIT PROGRAMS.THE MOST RECENT VERSION OF THE CHA GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT DEFINES COMMUNITY BUILDING ACTIVITIES AS PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL PROBLEMS. THESE ACTIVITIES ARE CATEGORIZED INTO EIGHT DISTINCT AREAS INCLUDING PHYSICAL IMPROVEMENT AND HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, COALITION BUILDING, ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS, AND WORKFORCE DEVELOPMENT. LMW HEALTHCARE INC ENHANCES THE LIVES OF THOSE WE SERVE BY PROVIDING ACCESS TO INTEGRATED, HIGH-VALUE, PATIENT-CENTERED CARE IN COLLABORATION WITH OTHERS WHO SHARE OUR VALUES. AS SUCH, LMW HEALTHCARE INC IS INCREASINGLY AWARE OF HOW SOCIAL DETERMINANTS IMPACT THE HEALTH OF INDIVIDUALS AND COMMUNITIES. A PERSON'S HEALTH AND CHANCES OF BECOMING SICK AND DYING EARLY ARE GREATLY INFLUENCED BY POWERFUL SOCIAL FACTORS SUCH AS EDUCATION, INCOME, NUTRITION, HOUSING AND NEIGHBORHOODS. PART III, LINE 2: LMW HEALTHCARE INC USES A COST REPORTING SYSTEM TO DETERMINE THE BAD DEBT EXPENSE. THE AMOUNT OF BAD DEBT EXPENSE (AT COST) REPORTED ON PART III, LINE 2 IS TAKEN DIRECTLY FROM THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 3: THE ORGANIZATION DOES NOT CURRENTLY HAVE A METHODOLOGY TO ACCURATELY QUANTIFY OR ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE THAT WOULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A BAD DEBT FOOTNOTE. PART III, LINE 8: THE MEDICARE SHORTFALL REPORTED IN PART III, LINE 7 WAS CALCULATED BASED ON COST REPORTING. THE COSTING METHOD WAS FROM THE MEDICARE COST REPORT'S OWN METHODOLOGY OF ALLOCATING COST BY DEPARTMENT AND DERIVING A RATIO OF COST TO CHARGE. THIS AMOUNT SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE THE RATES PAID BY MEDICARE DO NOT ACCURATELY REFLECT THE COST OF CARE PROVIDED BY LMW HEALTHCARE. LMW HEALTHCARE MUST SUBSIDIZE THE COST OF CARE TO MEDICARE BENEFICIARIES WITH OTHER REVENUES. PART III, LINE 9B: IN ACCORDANCE WITH ITS WRITTEN CREDIT AND COLLECTION POLICY, LMW HEALTHCARE INC WILL NOT PURSUE COLLECTION EFFORTS, DIRECTLY OR THROUGH COLLECTION AGENCIES, ON THE PORTION OF A PATIENT'S BILL FOR WHICH THAT PATIENT HAS ESTABLISHED ELIGIBILITY FOR CHARITY CARE. PART VI, LINE 2: IN ADDITION TO THE METHODOLOGY EMPLOYED IN CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT, LMW HEALTHCARE INC CARRIES OUT A VARIETY OF OTHER STRATEGIES IN GAUGING THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. THESE STRATEGIES INCLUDE REVIEW OF DISEASE INCIDENCE AND PREVALENCE RATES FOR THE LOCAL COMMUNITY, STATE, AND NATION WITH RATES COLLECTED FROM PUBLICLY AVAILABLE SOURCES, AND SEEKING PERIODIC RESIDENT INPUT ON PRIORITY AREAS. THIS ANALYSIS INFORMS WESTERLY HOSPITAL ON THE HEALTH STATUS OF THE COMMUNITY AND IS USED TO FOCUS PROGRAM AND SERVICE DEVELOPMENT ON AREAS OF GREATEST CONCERN. INFORMATION ON COMMUNITY NEEDS IS ALSO GATHERED THROUGH PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS SUCH AS THE PUBLIC SCHOOLS, WOOD RIVER HEALTH SERVICES, AND OTHER LOCAL NON-PROFITS. PERIODIC REVIEW OF DATA AND UPDATING AS APPROPRIATE IS CONDUCTED. PART VI, LINE 3: IN ACCORDANCE WITH ITS CHARITY CARE POLICY, LMW HEALTHCARE NOTIFIES PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE USING SEVERAL METHODS.1) SIGNAGE INDICATING THE AVAILABILITY OF CHARITY CARE IS POSTED IN ENGLISH AND SPANISH IN PATIENT ACCOUNTS, HEALTH ACCESS MANAGEMENT AND CERTAIN CLINICAL AREAS. SUMMARIES OF THE PROGRAMS WILL ALSO BE AVAILABLE IN THOSE AREAS.2) PATIENT FINANCIAL ADVISORS WILL ATTEMPT TO VISIT ALL INPATIENTS REGISTERED AS SELF PAY PATIENTS. A SUMMARY EXPLAINING CHARITY CARE WILL BE GIVEN TO THE PATIENT OR GUARANTOR WHEN THIS VISIT OCCURS.3) PATIENTS WITH NO INSURANCE WILL RECEIVE AN INITIAL LETTER WITHIN ONE WEEK OF DISCHARGE INFORMING THEM THEY ARE CONSIDERED "UNINSURED". IT IS THE RESPONSIBILITY OF THE PATIENT TO ADVISE LMW IF THEY BELIEVE THEY QUALIFY AS "UNINSURED" (AT OR UNDER 250% OF THE FPG).4) A SERIES OF MONTHLY STATEMENTS WILL BE SENT FOLLOWING DISCHARGE. EACH STATEMENT WILL REMIND THE PATIENT OF THE AVAILABILITY OF CHARITY CARE. PART VI, LINE 4: THE COMMUNITIES THAT COMPRISE THE SERVICE AREA OF LMW HEALTHCARE INC INCLUDE EIGHT TOWNS IN SOUTHWESTERN RHODE ISLAND/WASHINGTON COUNTY: ASHAWAY, BLOCK ISLAND, BRADFORD, CHARLESTOWN, HOPE VALLEY, HOPKINTON, WESTERLY AND WOOD RIVER JUNCTION, WITH A TOTAL POPULATION OF APPROXIMATELY 40,785. THESE COMMUNITIES ARE LARGELY RURAL WITH THE IMMEDIATE WESTERLY AREA BEING SUBURBAN. ALTHOUGH IT IS ANTICIPATED THAT THERE WILL BE A SLIGHT DECLINE IN OVERALL POPULATION IN THE NEXT FIVE YEARS, THE FASTEST GROWING AGE GROUP IN THE PRIMARY SERVICE AREA WILL BE 65+. THE POPULATION ACROSS LMW HEALTHCARE INC'S SERVICE AREA IS PRIMARILY WHITE ALTHOUGH MORE RACIALLY AND ETHNICALLY DIVERSE THAN THE SURROUNDING WASHINGTON COUNTY, BUT LESS SO THAN THE STATE. THE MEDIAN AGE OF RESIDENTS IS HIGHER THAN THE STATE, AS IS THE MEDIAN HOUSEHOLD INCOME. IN AGGREGATE, BLACK/AFRICAN AMERICAN AND HISPANIC/LATINO RESIDENTS HAVE A LOWER MEDIAN INCOME THAN ASIAN OR WHITE RESIDENTS. THE LANGUAGES SPOKEN IN THE SERVICE AREA MIMIC THE RACIAL CHARACTERISTICS. APPROXIMATELY 91% OF RESIDENTS SPEAK ENGLISH. LESS THAN 3% SPEAK SPANISH AS THEIR PRIMARY LANGUAGE. ANOTHER 3.5% SPEAK AN INDO-EUROPEAN LANGUAGE. LMW HEALTHCARE INC'S SERVICE AREA ENCOMPASSES 48,949 HOUSING UNITS, 67.8% ARE OWNER-OCCUPIED AND 32.2% ARE RENTER-OCCUPIED. THE MEDIAN HOME VALUE FOR OWNER-OCCUPIED UNITS IS $283,711, WHICH IS LOWER WHEN COMPARED TO WASHINGTON COUNTY ($320,447), BUT HIGHER WHEN COMPARED TO RHODE ISLAND ($252,604).THE MEDIAN HOUSEHOLD INCOME IN LMW HEALTHCARE INC'S SERVICE AREA IS $69,658; HOWEVER, INCOME VARIES NOTABLY BY RACE AND ETHNICITY. THE MEDIAN INCOME FOR BLACKS/AFRICAN AMERICANS AND HISPANICS/LATINOS IS $46,300 AND $54,676 RESPECTIVELY. THE SAME DISPARITY IN INCOME IS SEEN ACROSS RHODE ISLAND.THE PERCENTAGE OF ALL RESIDENTS LIVING IN POVERTY WITHIN THE LMW HEALTHCARE INC'S SERVICE AREA IS 8.4%; 14.1% OF WHICH ARE CHILDREN. POVERTY AMONG CHILDREN IN THE WESTERLY SERVICE AREA IS HIGHER THAN WASHINGTON COUNTY BY 3.7% POINTS, BUT LOWER THAN THE STATE.APPROXIMATELY 70% OF SERVICE AREA RESIDENTS AGE 16 YEARS OR OVER ARE IN THE WORKFORCE AND 4.8% ARE UNEMPLOYED, WHICH IS LOWER THAN THE STATE AND NATIONAL AVERAGES (6.4% AND 5.5% RESPECTIVELY). THE MAJORITY OF RESIDENTS IN THE WORKFORCE ARE FOR-PROFIT PRIVATE WORKERS (65.1%) AND HOLD WHITE COLLAR POSITIONS (61.8%). RESIDENTS ARE MOST LIKELY TO WORK IN OFFICE/ADMINISTRATIVE SUPPORT (12.7%), MANAGEMENT (10.4%), AND SALES (10%).EDUCATION IS THE LARGEST PREDICTOR OF POVERTY AND ONE OF THE MOST EFFECTIVE MEANS OF REDUCING INEQUALITIES. IN LMW HEALTHCARE INC'S SERVICE AREA, 8.2% OF RESIDENTS 25 YEARS OR OVER HAVE LESS THAN A HIGH SCHOOL DIPLOMA, 29.4% HAVE A HIGH SCHOOL DIPLOMA, AND 34.4% HAVE AT LEAST A BACHELOR'S DEGREE. RESIDENTS IN THE LMW HEALTHCARE INC SERVICE AREA HAVE LOWER EDUCATION ATTAINMENT COMPARED TO ALL WASHINGTON COUNTY RESIDENTS, BUT HAVE HIGHER EDUCATION ATTAINMENT THAN THE STATE AVERAGE.HISPANIC/LATINO RESIDENTS IN THE LMW HEALTHCARE INC SERVICE AREA HAVE NOTABLY LOWER EDUCATIONAL ATTAINMENT. APPROXIMATELY 18% DO NOT HAVE A HIGH SCHOOL DIPLOMA AND 23.3% OBTAIN A BACHELOR'S DEGREE OR HIGHER. GREATER DISPARITIES EXIST WHEN COMPARED TO WASHINGTON COUNTY.IN WASHINGTON COUNTY, SERVICES AND PUBLIC TRANSPORTATION FALL SHORT OF MEETING DEMAND, CREATING A BARRIER TO ACCESS. PART VI, LINE 5: LMW HEALTHCARE INC'S COMMUNITY BENEFIT PROGRAMS AND SERVICES FORWARD THE ORGANIZATIONAL MISSION "TO IMPROVE THE HEALTH OF THE REGION AND ALIGN WITH THE PRINCIPLES AS SET FORTH IN THE ORGANIZATION'S COMMUNITY BENEFIT POLICY. THOSE PRINCIPLES INCLUDE:1. EMPHASIS ON PROGRAMS TO MEET A SIGNIFICANT UNMET HEALTH NEED INCLUDING EFFORTS TO IDENTIFY AND INCLUDE VULNERABLE POPULATIONS OR THOSE MOST AT-RISK AS DETERMINED BY RISK FACTORS WHICH PREDISPOSE THOSE POPULATIONS TOWARD A HIGHER INCIDENCE OF DISEASE AND/OR BARRIERS TO OBTAINING APPROPRIATE HEALTHCARE.2. EMPHASIS ON PRIMARY PREVENTION AND INCLUDING AT LEAST ONE OF THREE PRIMARY PREVENTION STRATEGIES: HEALTH PROMOTION, DISEASE PREVENTION, AND HEALTH PROTECTION. HEALTH PROMOTION ENTAILS ENCOURAGING HEALTHY LIFESTYLES; DISEASE PREVENTION FOCUSES ON INDIVIDUALS IDENTIFIED AS AT-RISK FOR HEALTH PROBLEMS; HEALTH PROTECTION ACTIVITIES INFLUENCE THE ENVIRONMENT TO SUPPORT HEALTHY BEHAVIORS.3. PROGRAMS SHOULD DEVELOP EVIDENCE-BASED LINKS BETWEEN CLINICAL SERVICES AND HEALTH IMPROVEMENT ACTIVITIES DELIVERED BOTH INSIDE AND OUTSIDE THE HOSPITAL. 4. PROGRAMS SHOULD FOCUS ON TARGETING CHARITABLE RESOURCES THAT MOBILIZE AND BUILD CAPACITY WITHIN EXISTING COMMUNITY ASSETS WHILE MINIMIZING DUPLICATION OF EFFORT.5. PROGRAMS SHOULD EMPHASIS COLLABORATION WITH COMMUNITY STAKEHOLDERS. AS EVIDENCED BY THE WIDE RANGE OF COMMUNITY BENEFIT PROGRAMS AND SERVICES OFFERED, LMW HEALTHCARE INC IS ENGAGED IN MEETING THE IDENTIFIED HEALTH NEEDS OF THE COMMUNITIES WE SERVE. THERE IS AN ORGANIZATIONAL HISTORY OF COLLECTING DATA TO DETERMINE HOW BEST TO DIRECT OUR RESOURCES AND HOW TO MAKE THE GREATEST IMPACT IN PROMOTING COMMUNITY HEALTH. OUR ANNUAL COMMUNITY BENEFIT REPORT PUBLICATION DESCRIBES A SAMPLING OF PROGRAMS AND THE AMOUNT OF INVESTMENT THAT LMW HEALTHCARE INC MAKES IN CARRYING OUT THESE PROGRAMS.COMMUNITY INVOLVEMENT IN GOVERNANCE AND ADVISORY GROUPSCOMMUNITY ENGAGEMENT IN THE PLANNING, IMPLEMENTATION AND EVALUATION OF LMW HEALTHCARE INC INITIATIVES IS OF UTMOST IMPORTANCE. CONSUMERS AND STAKEHOLDER ORGANIZATIONS PARTICIPATE IN A RANGE OF ACTIVITIES SO AS TO ENSURE THAT MANY PERSPECTIVES ARE CONSIDERED. LMW HEALTHCARE INC'S BOARD OF DIRECTORS IS MADE UP OF COMMUNITY LEADERS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THESE VOLUNTEERS GIVE COUNTLESS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE. THEY ARE INVOLVED IN THE STRATEGIC PLANNING, IN FUNDRAISING, AND IN GENERAL STEWARDSHIP AMONG OTHER RESPONSIBILITIES. OUR CORPORATORS ARE OUR COMMUNITY-LIAISONS AND REPRESENT ALL SECTORS OF OUR COMMUNITIES PROVIDING INPUT AND FEEDBACK REGULARLY. MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. PART VI, LINE 6: THE ENTITIES OF L+M HEALTHCARE INCLUDE L+M HOSPITAL, THE L+M MEDICAL GROUP (L+MMG, PHYSICIAN PRACTICES), THE VISITING NURSE ASSOCIATION OF SOUTHEASTERN CT (VNASC), AND LMW HEALTHCARE (RHODE ISLAND) EACH OF WHICH HAS A ROLE IN PROMOTING THE HEALTH OF OUR COMMUNITIES. THE LMW AND L+M HOSPITALS' ROLES ARE: IMPLEMENTING COMMUNITY HEALTH IMPROVEMENT ACTIVITIES, PROVIDING OPPORTUNITIES FOR HEALTH PROFESSIONS STUDENTS, ENSURING ACCESS TO CARE, PROMOTING PRIMARY PREVENTIVE CARE, PROVIDING SUBSIDIZED HEALTH SERVICES AND SERVING AS A SAFETY NET PROVIDER. VNASC CARES FOR EVERYONE FROM THE ELDERLY WHO WISH TO REMAIN IN THEIR HOMES FOR AS LONG AS THEY CAN AND PATIENTS RECOVERING FROM SURGERY OR ILLNESS, TO NEW MOTHERS, SCHOOLCHILDREN, AND THE HOMELESS USING THE MOST CURRENT MEDICAL ADVANCES AND TECHNOLOGIES IN HOME HEALTHCARE, AND STRENGTHENS COMMUNITY RESOURCES FOR EVERYONE. L+MMG, THROUGH ITS PATIENT-CENTERED MEDICAL HOME PRIMARY CARE AND SPECIALTY PRACTICES PROVIDES DIAGNOSTIC, THERAPEUTIC AND PREVENTIVE HEALTH CARE THROUGH PHYSICIANS OF FAMILY PRACTICE, INTERNAL MEDICINE, PEDIATRICS, DERMATOLOGY, ENDOCRINOLOGY, GENERAL SURGERY, ORTHOPEDIC SURGERY, NEUROSURGERY, BREAST AND RECONSTRUCTIVE SURGERY, NEUROLOGY, REHABILITATION MEDICINE, OBSTETRICS, GYNECOLOGY, CARDIOLOGY AND INTERVENTIONAL PAIN MANAGEMENT IN MULTIPLE LOCATIONS THROUGHOUT SOUTHEASTERN CT AND SOUTHWESTERN RI. PART VI, LINE 7, REPORTS FILED WITH STATES RI 0 1 0 0 0 0 0 0 0 BRUCE D CUMMINGS PRESIDENT/CEO AND TRUSTEE 0 505747 0 0 0 133352 0 10600 0 40165 0 689864 0 0 ADRIAN K HAMBURGER TRUSTEE 0 311287 0 450917 0 15660 0 10600 0 57342 0 845806 0 0 CHRISTOPHER O'CONNOR START 916 TRUSTEE 0 822935 0 283340 0 104299 0 358561 0 29654 0 1598789 0 0 MAUREEN ANDERSON ASSISTANT SECRETARY 0 269134 0 0 0 16710 0 10600 0 63561 0 360005 0 0 SETH VAN ESSENDELFT VP/CFO 0 356172 0 0 0 18810 0 10600 0 37416 0 422998 0 0 LINDA BROCATO PHARMACY MANAGER 127166 0 0 0 11819 0 5571 0 18403 0 162959 0 0 0 EMILY FLYNN CLINICAL PHARMACIST 117875 0 0 0 6905 0 5469 0 22027 0 152276 0 0 0 KARL NG CLINICAL PHARMACIST 115792 0 0 0 11916 0 5889 0 19916 0 153513 0 0 0 PART I, LINE 3 THE PRESIDENT/CEO OF LMW HEALTHCARE, INC. RECEIVES NO COMPENSATION FROM THE ORGANIZATION. HE IS AN EMPLOYEE AT LAWRENCE & MEMORIAL HOSPITAL, A RELATED ORGANIZATION, AND HIS COMPENSATION IS SET BY THE HOSPITAL. THE HOSPITAL, IN DETERMINING COMPENSATION RELIES UPON A COMPENSATION COMMITTEE; AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS OR STUDIES, AND APPROVAL BY ITS BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B THE INDIVIDUAL LISTED BELOW IS A PARTICIPANT IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN OF A RELATED ORGANIZATION. THESE ACCRUALS ARE INCLUDED IN THE AMOUNTS REPORTED IN PART II, COLUMN C (DEFERRED COMPENSATION) AND REPRESENTS BOTH THE REPORTING ENTITY'S AND RELATED ENTITY'S COMBINED AMOUNTS THAT HAVE NOT YET BEEN VESTED CONSISTENT WITH THE COMPENSATION REPORTING PER IRS. SEVERANCE NONQUALIFIED EQUITY-BASED CHRISTOPHER O'CONNOR $0 $198,811 $0 THE SUPPLEMENTAL RETIREMENT INCOME PLAN (SRIP) IS DESIGNED TO ENSURE THE PAYMENT OF A COMPETITIVE LEVEL OF RETIREMENT INCOME WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME IN ORDER TO ATTRACT AND RETAIN KEY MANAGEMENT EMPLOYEES SERVING AS CORPORATE OFFICERS. THE PLAN PROVIDES SUPPLEMENTAL RETIREMENT INCOME THROUGH AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT UNDER SECTION 457(F) AND THROUGH A DEFERRED COMPENSATION PLAN UNDER SECTION 409A OF THE INTERNAL REVENUE CODE AND A MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES' PLAN UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA). LAWRENCE & MEMORIAL HOSPITAL (A RELATED ORGANIZATION) ESTABLISHED A SECTION 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR THE HOSPITAL'S SENIOR MANAGEMENT. AMOUNTS FOR BRUCE CUMMINGS ARE CREDITED TO THE RETIREMENT ACCOUNT IN MONTHLY INSTALLMENTS THROUGHOUT EACH PLAN YEAR. PLAN AMOUNTS FOR ALL OTHER MEMBERS OF SENIOR MANAGEMENT ARE CREDITED TO THE PLAN ANNUALLY. PLAN AMOUNTS WILL BE PAID ONLY IF CERTAIN CONDITIONS ARE MET, INCLUDING REMAINING EMPLOYED BY THE HOSPITAL THROUGH AGE 65, AS OUTLINED IN THE PLAN AGREEMENT. SECTION 457 (F) CONTRIBUTIONS ARE PAID OUT AND REPORTED ON THEIR W-2'S. DURING 2015, SECTION 457(F) CONTRIBUTIONS WERE CREDITED TOWARDS THE PLAN AS FOLLOWS: BRUCE CUMMINGS $86,945 FORM 990, PART III, LINE 4 THE DEFINING CHANGE OF THE PAST YEAR FOR WESTERLY HOSPITAL WAS THE INTEGRATION WITH YALE NEW HAVEN HEALTH SYSTEM. IN ADDITION, WESTERLY HOSPITAL INCREASED ITS NEUROSURGERY CAPACITY WITH THE ADDITION OF A YALE MEDICINE NEUROSURGEON, WHO SUPPORTED BY TWO ADDITIONAL NEUROSURGEONS, BRING CRITICAL RESOURCES AND CARE TO RESIDENTS OF SOUTHEASTERN CONNECTICUT AND WESTERN RHODE ISLAND. WESTERLY HOSPITAL ALSO PARTICIPATED IN THE OVERALL L+M HEALTHCARE CLINICAL SUSTAINABILITY INITIATIVE DESIGNED TO INCREASE VALUE BY IMPROVING CARE DELIVERY PROCESSES WHILE SIMULTANEOUSLY REDUCING COSTS. IN TWO YEARS, THESE EFFORTS HAVE REALIZED OF APPROXIMATELY $37 MILLION OF SAVINGS ACROSS THE ENTIRE L+M HEALTHCARE SYSTEM. THE HOSPITAL IMPROVED HEATING AND COOLING IN ITS FACILITY, AS WELL AS OPERATING ROOM LIGHTING AND CARDIAC CATHETERIZATION LAB EQUIPMENT. PART I, LINE 4 & PART VI, LINE 1B NUMBER OF INDEPENDENT VOTING MEMBERS OF THE GOVERNING BODY THE ORGANIZATION SOUGHT TO CONFIRM THE INDEPENDENCE OF EACH VOTING MEMBER OF ITS GOVERNING BODY BY REQUESTING THAT EACH SUCH VOTING MEMBER RESPOND TO A QUESTIONNAIRE CONTAINING THE PERTINENT INSTRUCTIONS AND DEFINITIONS AND DESIGNED TO ELICIT THE INFORMATION NECESSARY TO DETERMINE INDEPENDENCE. BASED ON RESPONSES TO THE QUESTIONNAIRES RECEIVED BY THE ORGANIZATION AND ANNUAL CONFLICTS OF INTEREST DISCLOSURES, THE ORGANIZATION WAS ABLE TO CONFIRM THAT SEVEN (7) VOTING MEMBERS ARE INDEPENDENT. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES THE ORGANIZATION'S CURRENT OFFICERS AND/OR TRUSTEES SERVE AS OFFICERS AND/OR DIRECTORS OF TAXABLE AFFILIATES WITHIN THE ORGANIZATION'S CORPORATE SYSTEM OR JOINT VENTURES IN WHICH THE ORGANIZATION'S CORPORATE SYSTEM HAS AN OWNERSHIP INTEREST. THE INDIVIDUAL OFFICERS DO NOT HAVE PERSONAL FINANCIAL INTERESTS IN THE TAXABLE AFFILIATE AND SERVE ONLY AS A FUNCTION OF THEIR ROLES WITH THE ORGANIZATION OR WITHIN THE ORGANIZATION'S CORPORATE SYSTEM. FORM 990, PART VI, SECTION A, LINE 6 L&M CORPORATION IS THE SOLE MEMBER OF LMW HEALTHCARE, INC. FORM 990, PART VI, SECTION A, LINE 7A L&M CORPORATION, AS SOLE MEMBER OF LMW HEALTHCARE, INC., SHALL ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S PROCESS TO REVIEW FORM 990: THE FORM 990 TAX RETURN AND ATTACHED SCHEDULES WERE PREPARED BY EMPLOYEES OF THE SYSTEM TAX DEPARTMENT. THE RETURN IS INITIALLY REVIEWED BY THE HOSPITAL DIRECTOR OF CORPORATE FINANCE. SUBSEQUENTLY, IT IS SENT TO KPMG LLP FOR THEIR INITIAL REVIEW. AFTER ALL COMMENTS FROM THE ABOVE GROUPS ARE RECEIVED AND REVIEWED, THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE HOSPITAL AND A FINAL VERSION OF THE RETURN IS SENT BACK TO KPMG US LLP FOR FINAL REVIEW. PRIOR TO FILING, THE ORGANIZATION MADE AVAILABLE A COMPLETE COPY OF THE RETURN TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C LMW HEALTHCARE REQUIRES THAT ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. QUESTIONNAIRES ARE COMPLETED ANNUALLY AND ARE REVIEWED BY LMW'S GENERAL COUNSEL. ANY ACTUAL OR POTENTIAL CONFLICTS ARE PRESENTED TO THE BOARD. APPROPRIATE CORRECTIVE ACTIONS ARE DECIDED ON A CASE BY CASE BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE OFFICERS' COMPENSATION AND BENEFITS REPORTED IN PART VII ARE DETERMINED BY L&M HOSPITAL. L&M HOSPITAL'S EXECUTIVE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE SALARIES OF ITS EXECUTIVE MANAGEMENT AND KEY EMPLOYEES. UTILIZING INDEPENDENT COMPENSATION CONSULTANTS, THE EXECUTIVE COMPENSATION COMMITTEE MAKES ITS RECOMMENDATIONS. THE COMMITTEE'S DELIBERATIONS ARE REFLECTED IN ITS MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,958,489. MANAGEMENT AND GENERAL EXPENSES 9,522,711. FUNDRAISING EXPENSES 96,484. TOTAL EXPENSES 13,577,684. FORM 990, PART XI, LINE 9: TRANSFERS FROM AFFILIATES -8,178,000. CHANGE IN VALUE OF IRREVOCABLE TRUST 180,409. INCREASE IN FUNDS HELD IN TRUST BY OTHERS 153,747. FOUNDATION TRANSFER 124,545. ASSOCIATED SPECIALISTS OF SOUTHEASTERN CONNECTICUT INC 365 MONTAUK AVENUE NEW LONDON CT 06320 208006123 HEALTHCARE SERVICES CT 501C3 LINE 11A, I LAWRENCE MEMORIAL HOSPITAL INC 1 BRIDGEPORT HOSPITAL 267 GRANT STREET BRIDGEPORT CT 06610 060646554 HEALTHCARE SERVICES CT 501C3 LINE 3 YALE NEW HAVEN HEALTH SERVICES CORP 0 BRIDGEPORT HOSPITAL AUXILIARY INC 267 GRANT STREET BRIDGEPORT CT 06610 066042500 SYSTEM SUPPORT SERVICES CT 501C3 LINE 11A, I BRIDGEPORT HOSPITAL 1 BRIDGEPORT HOSPITAL FOUNDATION INC 267 GRANT STREET BRIDGEPORT CT 06610 222908698 SYSTEM SUPPORT SERVICES CT 501C3 LINE 7 BRIDGEPORT HOSPITAL 1 BRIDGEPORT HOSPITAL FRIENDS OF PEDIATRICS INC 120 COLUMBINE DRIVE TRUMBULL CT 06611 066048427 SYSTEM SUPPORT SERVICES CT 501C3 LINE 11A, I YALE NEW HAVEN HOSPITAL 1 GREENWICH HEALTH CARE SERVICES INC - MERGED WITH GH 5122016 5 PERRYRIDGE ROAD GREENWICH CT 06830 222593399 SYSTEM SUPPORT SERVICES CT 501C3 LINE 11B, II YALE NEW HAVEN HEALTH SERVICES CORP 0 GREENWICH HOSPITAL 5 PERRYRIDGE ROAD GREENWICH CT 06830 060646659 HEALTHCARE SERVICES CT 501C3 LINE 3 SEE SCHEDULE R PART VII 0 L&M PHYSICIAN ASSOCIATION INC 365 MONTAUK AVENUE NEW LONDON CT 06320 271094375 HEALTHCARE SERVICES CT 501C3 LINE 11A, I LAWRENCE MEMORIAL CORPORATION 1 LAWRENCE MEMORIAL CORPORATION 365 MONTAUK AVENUE NEW LONDON CT 06320 222553028 PROMOTE HEALTHCARE CT 501C3 LINE 9 YALE NEW HAVEN HEALTH SERVICES CORP 0 LAWRENCE AND MEMORIAL FOUNDATION INC 365 MONTAUK AVENUE NEW LONDON CT 06320 222553026 FUNDRAISING SERVICES CT 501C3 PF LAWRENCE MEMORIAL CORPORATION 1 LAWRENCE & MEMORIAL HOSPITAL INC 365 MONTAUK AVENUE NEW LONDON CT 06320 060646704 HEALTHCARE SERVICES CT 501C3 LINE 3 LAWRENCE MEMORIAL CORPORATION 1 NORTHEAST MEDICAL GROUP INC 99 HAWLEY LANE STRATFORD CT 06614 061330992 HEALTHCARE SERVICES CT 501C3 LINE 9 YALE NEW HAVEN HEALTH SERVICES CORP 0 NORTHEAST MEDICAL GROUP PLLC 99 HAWLEY LANE STRATFORD CT 06614 352380180 HEALTHCARE SERVICES CT 501C3 LINE 11A, I NORTHEAST MEDICAL GROUP INC 1 PERRYRIDGE CORPORATION 5 PERRYRIDGE ROAD GREENWICH CT 06830 061207316 SYSTEM SUPPORT SERVICES CT 501C3 LINE 11B, II SEE SCHEDULE R PART VII 1 SOUTHERN CONNECTICUT HEALTH SYSTEM PROPERTIES INC 267 GRANT STREET BRIDGEPORT CT 06610 061297708 TITLE HOLDING CT 501C2 BRIDGEPORT HOSPITAL 1 THE GREENWICH HOSPITAL ENDOWMENT FUND INC 5 PERRYRIDGE ROAD GREENWICH CT 06830 061526642 SYSTEM SUPPORT SERVICES CT 501C3 LINE 11B, II SEE SCHEDULE R PART VII 1 THE WESTERLY HOSPITAL FOUNDATION INC 25 WELLS STREET WESTERLY RI 02891 050508064 FUNDRAISING SERVICES RI 501C3 LINE 11A, I LMW HEALTHCARE INC 1 VISITING NURSE ASSOCIATION OF SOUTHEREASTERN CONNECTICUT INC 403 NORTH FRONTAGE ROAD WATERFORD CT 06385 060646616 HOME HEALTHCARE SERVICES CT 501C3 LINE 9 LAWRENCE MEMORIAL CORPORATION 1 WESTERLY HOSPITAL AUXILIARY INC 25 WELLS STREET WESTERLY RI 02891 222507181 FUNDRAISING ACTIVITIES RI 501C3 LINE 11C, III-FI LMW HEALTHCARE INC 1 YALE NEW HAVEN HEALTH SERVICES CORP 789 HOWARD AVE NEW HAVEN CT 06519 222529464 SYSTEM SUPPORT SERVICES CT 501C3 LINE 11A, I N/A 0 YALE NEW HAVEN HOSPITAL 20 YORK STREET NEW HAVEN CT 06504 060646652 HEALTHCARE SERVICES CT 501C3 LINE 3 YALE NEW HAVEN HEALTH SERVICES CORP 0 YALE-NEW HAVEN CARE CONTINUUM CORP 789 HOWARD AVE NEW HAVEN CT 06519 455235566 NURSING HOME CT 501C3 LINE 3 YALE NEW HAVEN HOSPITAL 1 L&M HEALTHCARE INC 365 MONTAUK AVENUE NEW LONDON CT 06320 222553031 SYSTEM SUPPORT SERVICES CT 501C3 LINE 11A, I LAWRENCE MEMORIAL CORPORATION 1 SHORELINE SURGERY CENTER LLC 111 GOOSE LANE GUILFORD CT 06437 900110459 HEALTHCARE SERVICES CT N/A SSC II LLC 111 GOOSE LANE GUILFORD CT 06437 261709382 HEALTHCARE SERVICES CT N/A ORTHOPAEDIC & NEUROSURGERY CENTER 55 HOLLY HILL LANE GREENWICH CT 06830 273477197 HEALTHCARE SERVICES CT N/A TOTAL HEALTH CONNECTICUT LLC 789 HOWARD AVENUE NEW HAVEN CT 06519 474070024 HEALTHCARE SERVICES CT N/A YALE NEW HAVEN HEALTH SYSTEM INVESTMENT 20 YORK STREET NEW HAVEN CT 06510 271374301 INVESTMENT DE N/A YNHHS-MSO INC 789 HOWARD AVE NEW HAVEN CT 06519 061467717 MANAGEMENT SERVICES CT N/A C 1 YALE NEW HAVEN AMBULATORY SERVICES 40 TEMPLE STREET NEW HAVEN CT 06510 061398526 HEALTHCARE SERVICES CT N/A C 1 MEDICAL CENTER REALTY INC 50 YORK STREET NEW HAVEN CT 06511 061110858 RENTAL SERVICES CT N/A C 1 GREENWICH FERTILITY & IVF PC 5 PERRYRIDGE ROAD GREENWICH CT 06830 300145464 HEALTHCARE SERVICES CT N/A C 1 YORK ENTERPRISES INC 50 YORK STREET NEW HAVEN CT 06511 061110937 TITLE HOLDING CT N/A C 1 YNHH-PHYSICIANS CORP 789 HOWARD AVE NEW HAVEN CT 06519 061202305 ADMINISTRATIVE SERVICES CT N/A C 1 MEDICAL CENTER PHARMACY INC 50 YORK STREET NEW HAVEN CT 06511 061087673 PHARMACY CT N/A C 1 GREENWICH OCCUPATIONAL HEALTH SERVICES OF NY PC 5 PERRYRIDGE ROAD GREENWICH CT 06830 061540101 HEALTHCARE SERVICES NY N/A C 1 GREENWICH OCCUPATIONAL HEALTH SERVICES OF NEW JERSEY 5 PERRYRIDGE ROAD GREENWICH CT 06830 453833883 HEALTHCARE SERVICES NJ N/A C 1 PRIMARYNET OF CONNECTICUT INC- TERMINATED 93016 789 HOWARD AVE NEW HAVEN CT 06519 061463534 HEALTHCARE SERVICES CT N/A C 1 CENTURY FINANCIAL SERVICES INC 23 MAIDEN LANE NORTH HAVEN CT 06473 061110797 DEBT COLLECTION SERVICES CT N/A C 1 CENTURY MANAGEMENT SERVICES INC 23 MAIDEN LANE NORTH HAVEN CT 06473 061303173 RECEIVABLE MANAGEMENT SERVICES CT N/A C 1 L & M SYSTEMS INC 365 MONTAUK AVENUE NEW LONDON CT 06320 222553037 HEALTHCARE RELATED SERVICES CT N/A C 1 L&M HOME CARE SERVICES INC 365 MONTAUK AVENUE NEW LONDON CT 06320 061389272 HOME THERAPY CT N/A C 1 LAWRENCE & MEMORIAL INDEMNITY COMPANY LTD PO BOX 1159 KY1-1102 GRAND CAYMAN CJ 981021436 INSURANCE CJ N/A C 1 LMW HEALTHCARE INC HAMILTON D SCHWARZ AGENCY 8814 WASHINGTON TRUST 365 MONTAUK AVENUE NEW LONDON CT 06320 CHARITABLE REMAINDER TRUST RI T 223910 1.00000 1 LMW HEALTHCARE INC COMMUNITY ENDOWMENT FUND AGENCY 8814 WASHINGTON TRUST 365 MONTAUK AVENUE NEW LONDON CT 06320 CHARITABLE REMAINDER TRUST RI T 1097360 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 1 THE WESTERLY HOSPITAL FOUNDATION INC M 153494 CASH THE WESTERLY HOSPITAL FOUNDATION INC S 278389 CASH LAWRENCE AND MEMORIAL HOSPITAL INC R 19977271 CASH LM PHYSICIANS ASSOCIATION INC R 3741000 CASH PART II, IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: NAME OF RELATED ORGANIZATION: GREENWICH HOSPITAL DIRECT CONTROLLING ENTITY: GREENWICH HEALTH CARE SERVICES, INC. THROUGH 5/12/16, AFTER YALE NEW HAVEN HEALTH SERVICES CORPORATION. NAME OF RELATED ORGANIZATION: PERRYRIDGE CORPORATION DIRECT CONTROLLING ENTITY: GREENWICH HEALTH CARE SERVICES, INC. THROUGH 5/12/16, AFTER GREENWICH HOSPTIAL. NAME OF RELATED ORGANIZATION: GREENWICH HOSPITAL ENDOWMENT FUND INC. DIRECT CONTROLLING ENTITY: GREENWICH HEALTH CARE SERVICES, INC. THROUGH 5/12/16, AFTER GREENWICH HOSPTIAL.