N H C C MEDICAL ASSOCIATES INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- N H C C MEDICAL ASSOCIATES INC (EIN 05-0472268)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-14
- IRS object ID
- 201742269349300114
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-14T07:14:29-07:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2 Financial Center 60 South Street | AddressLine1Txt |
| City | Boston | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02111 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050472268 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NHCC Medical Associates Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NHCC | BusinessNameControlTxt |
| Phone | 4018466400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 Friendship Street | AddressLine1Txt |
| City | Newport | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02840 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary A Wakefield | PersonNm |
| Person Title | EVP & CFO | PersonTitleTxt |
| Signature | 2017-08-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Tara D'Agostino | PreparerPersonNm |
| PTIN | P01245482 | PTIN |
| Phone | 6179881000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | John Murphy MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 593 Eddy Street | AddressLine1Txt |
| City | Providence | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02903 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,457,633 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | none | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | RI | LegalDomicileStateCd |
| Activity Or Mission | NHCC Medical Associates, Inc. (NHCCMA) provides comprehensive, integrated health care-related services through the employment of physicians and other health care practitioners. (See Schedule O) | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 137 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $8,765,857 | PYContributionsGrantsAmt |
| CY Contributions Grants | $12,080,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,344,533 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $371,632 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$3,185,396 | PYOtherRevenueAmt |
| CY Other Revenue | $6,001 | CYOtherRevenueAmt |
| PY Total Revenue | $9,924,994 | PYTotalRevenueAmt |
| CY Total Revenue | $12,457,633 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,154,645 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $468,882 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,596,352 | PYOtherExpensesAmt |
| CY Other Expenses | $10,538,267 | CYOtherExpensesAmt |
| PY Total Expenses | $11,750,997 | PYTotalExpensesAmt |
| CY Total Expenses | $11,007,149 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,826,003 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,450,484 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $167,535 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,105 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,250,710 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,649,796 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$9,083,175 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$7,632,691 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To support & encourage development of comprehensive, integrated health care services for the advancement and well-being of communities in Rhode Island and elsewhere, including those served by the hospitals affiliated with Lifespan Corporation. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $11,007,149 | ExpenseAmt |
| Revenue | $377,633 | RevenueAmt |
| Desc | As disclosed in NHCC Medical Associates, Inc.'s (NHCCMA) Form 990 filed for the year ended September 30, 2015, a significant portion of NHCCMA's assets were purchased and transferred during the year by a related organization, Lifespan Physician Group, Inc. (LPG). Almost all of the physicians previously employed by NHCCMA became employees of LPG. The activity remaining within NHCCMA is comprised of NHCCMA physicians and nurses who provide medical services to Salve Regina University's health services department located in Newport, Rhode Island. The expenses related to services provided amounted to $474,487 during the fiscal year ended September 30, 2016. (See Schedule O) | Desc |
| Total Program Service Expenses | $11,007,149 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 15 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 137 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary A Wakefield | PersonNm |
| Phone | 4014447093 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 593 Eddy Street | AddressLine1Txt |
| City | Providence | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02903 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Thomas Fantes MD | |||||||||
| Trustee- 7/16 | 40.00 | 0.00 | Yes (X) | $259,815 | $0 | $14,615 | |||
| Heather Hall MD | |||||||||
| Trustee | 40.00 | 0.00 | Yes (X) | $247,294 | $0 | $32,100 | |||
| Thomas E McGue MD | |||||||||
| Secty. & Treas. | 5.00 | 35.00 | Yes (X) | $0 | $260,484 | $30,873 | Yes (X) | ||
| John Murphy MD | |||||||||
| President | 2.00 | 38.00 | Yes (X) | $0 | $612,014 | $26,620 | Yes (X) | ||
| Mary A Wakefield | |||||||||
| CFO | 1.00 | 39.00 | $0 | $799,484 | $142,023 | Yes (X) | |||
| Triste Coulombe MD | |||||||||
| Physician | 40.00 | 0.00 | $385,641 | $0 | $26,194 | Yes (X) | |||
| Larry A Evans MD | |||||||||
| Physician | 40.00 | 0.00 | $482,535 | $0 | $41,076 | Yes (X) | |||
| Stephen D Groskin MD | |||||||||
| Physician | 40.00 | 0.00 | $209,290 | $0 | $25,765 | Yes (X) | |||
| Alessandro Papa MD | |||||||||
| Physician | 40.00 | 0.00 | $369,277 | $0 | $36,481 | Yes (X) | |||
| Eric B Radler MD | |||||||||
| Physician | 40.00 | 0.00 | $313,226 | $0 | $42,023 | Yes (X) | |||
| Kenneth E Arnold | |||||||||
| Secretary | 0.00 | 40.00 | $0 | $610,563 | $41,004 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,267,078 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,282,545 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $458,774 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| University Surgical Associates | |||||
| PO Box 16149 | Rumford | RI | 02916 | Physician Med Svs | $472,828 |
| Leaders For Today | |||||
| 981 Worcester Street Suite 1C | Wellesley | MA | 02482 | Contract Labor | $313,495 |
| Weatherby Locums | |||||
| PO Box 972633 | Dallas | TX | 753972633 | Physician Med Svs | $278,381 |
| University Orthopedics | |||||
| 345 Valley Road | Middletown | RI | 02842 | Physician Med Svs | $170,968 |
| South County Ortho & Phys Therapy | |||||
| 1 High Street | Wakefield | RI | 02879 | Physician Med Svs | $121,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $12,080,000 | RelatedOrganizationsAmt |
| Total Contributions | $12,080,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Health Care Services | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $371,632 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $371,632 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $371,632 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Lease Refund | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $6,001 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,001 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,001 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,457,633 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $377,633 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $404,988 | TotalAmt |
| Program Services | $404,988 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,903 | TotalAmt |
| Program Services | $4,903 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,387 | TotalAmt |
| Program Services | $35,387 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,604 | TotalAmt |
| Program Services | $23,604 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,377 | TotalAmt |
| Program Services | $2,377 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| LPG Joint Program Support | $10,526,661 | $10,526,661 |
| Medical Supplies | $4,670 | $4,670 |
| Professional & Other Expenses | $4,559 | $4,559 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,007,149 | TotalAmt |
| Program Services | $11,007,149 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,015 | BOYAmt |
| EOY | $14,602 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,122 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,398 | BOYAmt |
| EOY | $2,398 | EOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $105 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,535 | BOYAmt |
| EOY | $17,105 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $222,840 | BOYAmt |
| EOY | $151,163 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,027,870 | BOYAmt |
| EOY | $7,498,633 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,250,710 | BOYAmt |
| EOY | $7,649,796 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$9,083,175 | BOYAmt |
| EOY | -$7,632,691 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$9,083,175 | BOYAmt |
| EOY | -$7,632,691 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,535 | BOYAmt |
| EOY | $17,105 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,450,484 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $1,908,537 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,765,857 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,080,000 | CurrentTaxYearAmt |
| Total | $22,754,394 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,888,126 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,350,872 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,257,307 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,344,533 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $371,632 | CurrentTaxYearAmt |
| Total | $33,212,470 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,888,126 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,350,872 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,165,844 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,110,390 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,451,632 | CurrentTaxYearAmt |
| Total | $55,966,864 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $55,966,864 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,888,126 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,350,872 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,165,844 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,110,390 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,451,632 | CurrentTaxYearAmt |
| Total | $55,966,864 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Public Support PY509 | 1.00000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Due to Affiliates | Desc |
| Amt | $7,498,633 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,498,633 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X : FIN48 Footnote | FormAndLineReferenceDesc |
| Explanation | NHCC Medical Associates, 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. The organization 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. The organization did not recognize the effect of any income tax positions during the fiscal year ended September 30, 2016. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alessandro Papa MD | ||||||||||||
| Physician | $310,200 | $28,500 | $30,577 | $13,853 | $22,628 | $405,758 | ||||||
| Eric B Radler MD | ||||||||||||
| Physician | $293,378 | $18,496 | $1,352 | $13,655 | $28,368 | $355,249 | ||||||
| Heather Hall MD | ||||||||||||
| Trustee | $227,291 | $20,003 | $12,109 | $19,991 | $279,394 | |||||||
| John Murphy MD | ||||||||||||
| President | $506,930 | $105,084 | $6,625 | $19,995 | $638,634 | |||||||
| Kenneth E Arnold | ||||||||||||
| Secretary | $507,389 | $103,174 | $23,250 | $17,754 | $651,567 | |||||||
| Larry A Evans MD | ||||||||||||
| Physician | $440,069 | $42,466 | $15,275 | $25,801 | $523,611 | |||||||
| Mary A Wakefield | ||||||||||||
| CFO | $683,686 | $115,798 | $125,469 | $16,554 | $941,507 | $84,972 | ||||||
| Stephen D Groskin MD | ||||||||||||
| Physician | $196,137 | $13,153 | $10,575 | $15,190 | $235,055 | |||||||
| Thomas E McGue MD | ||||||||||||
| Secty. & Treas. | $249,304 | $11,180 | $30,849 | $24 | $291,357 | |||||||
| Thomas Fantes MD | ||||||||||||
| Trustee- 7/16 | $231,436 | $7,637 | $20,742 | $12,714 | $1,901 | $274,430 | ||||||
| Triste Coulombe MD | ||||||||||||
| Physician | $310,834 | $74,807 | $15,275 | $10,919 | $411,835 | |||||||
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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).Also, NHCCMA purchases professional liability prior acts coverage for certain newly-hired physicians. Premiums are paid to insurance carriers by the insureds on an after tax basis. The income associated with the premiums is grossed-up to cover the total cost of the benefit as provided in their employment contracts and is included in Medicare wages, more specifically on Schedule J, Part II, Column B (iii). |
| Part I, Line 7: Non-Fixed payments not listed above | Certain physicians and executives participate in incentive compensation plans arranged through individual contractual agreements which stipulate non-fixed payments based on meeting criteria based on various quality and productivity markers. |
| Part III, Additional Information | Included in the Schedule J, Part II, Line (B)(iii) calendar year 2015 compensation for Stephen D. Groskin, MD, a highly compensated employee, was a retention payment of $5,000 made by NHCCMA to Dr. Groskin in his capacity as a family practice physician. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 1a: Explanation of Delegated Broad Authority to Committee | Included among the NHCCMA Board of Trustees are two Lifespan Designees (Designees), physicians designated by Lifespan Corporation (Lifespan) who shall be licensed to practice medicine in the State of Rhode Island and shall serve at the pleasure of Lifespan. The Designees shall have the right, acting alone by concurrent approval of both Designees, to initiate action on and approve any of the following matters:(a) To approve and/or initiate the enumerated joint powers of the Trustees listed within NHCCMA's bylaws, except to the extent that under Rhode Island law a greater number of Trustees of the Corporation is required to affirmatively approve a joint power action. To the extent that Rhode Island law requires a greater number of Trustees to make a recommendation or resolution on a joint power matter before undertaking such joint power action, then all Trustees shall take such prior vote on such matter in accordance with the bylaws in the manner specified by concurrent approval of the Designees.(b) To initiate a joint power action listed in part (a) above, this ability can only be exercised by the Designees in the event of a Board deadlock on a matter first presented for action at a regular or special meeting of the Board of Trustees of NHCCMA. (c) NHCCMA shall cause the Designees authority to approve and initiate actions to be reserved to NHCCMA in the bylaws (or applicable organizational documents) of any subsidiary of which NHCCMA is the sole or controlling member, partner, trustee, or stockholder, or that NHCCMA otherwise owns or controls. |
| 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 NHCCMA'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 currently makes its 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. NHCCMA's financial statements are included in the audited consolidated financial statements of Lifespan Corporation and Affiliates. In addition, copies of NHCCMA's Articles of Incorporation, Bylaws, and Conflict of Interest Policy are available upon request from the office of the Lifespan Chief Financial Officer, either in person or by mail. |
| Form 990, Part I, Line 1: | NHCC Medical Associates, Inc. (NHCCMA) provides comprehensive, integrated health care-related services through the employment of physicians and other health care practitioners and through the provision of accountable patient-centered, high quality, efficient, value-based, and innovative care to serve the health care needs of the Rhode Island community and finally, as and when the opportunity presents itself, to promote and advance medical research, education and training in medicine, medical related sciences, and clinical practice. In elaboration of such mission, NHCCMA is established for the benefit of and to support the teaching, research, and patient care missions of the Emma Pendleton Bradley Hospital, Newport Hospital, Rhode Island Hospital, The Miriam Hospital, and the Alpert Medical School of Brown University. |
| Form 990, Part III, Line 4a: | The remaining program expenses recorded on NHCCMA's books during the fiscal year ended September 30, 2016 reflect transfers to LPG representing NHCCMA's support of LPG's joint program with other related organizations included within the Lifespan health system. Because of the nature of LPG's operations as an organization which employs various physician practices, the revenue LPG is able to bill represents billing directly related solely to its employed physicians and does not include billing for ancillary services provided by the Lifespan hospitals within which these services are provided. The revenue deficit at LPG caused by this relationship is supported by NHCCMA and the other related joint program organizations included within the Lifespan health system so that LPG's operations reach a break-even point in its statement of operations and changes in net assets. |
| Form 990, Part VI, Section B, Line 12c: | Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including NHCCMA, 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, Line 15 a/b: | The following applies to Lifespan and all of its affiliates, including NHCCMA: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. Base Salary Actions: The CEO recommends any salary adjustments for participants in the executive compensation program, using the results of the valuation study and his/her assessment of individual performance or other pertinent information, for the Committee's consideration.New Participants in Executive Compensation Program: With respect to compensation offers for individuals expected to participate in the executive compensation program, certain members of the Lifespan CEO's Council work with the Committee's independent compensation consultant or rely on information previously provided by the consultant to establish a range of reasonable cash compensation within which recruitment is expected to conclude through acceptance of a reasonable compensation offer. |
| Form 990, Part XII, Line 2: | NHCCMA did not produce an audited financial statement as of and for the year ended September 30, 2016, it was included in Lifespan Corporation's audited consolidated financial statements, in which one column is used for NHCCMA. There are no regulatory or creditor stipulations which require the preparation of a separate audited financial statement for NHCCMA.The Lifespan Audit and Compliance Committee assumes responsibility for oversight of the audit of Lifespan Corporation's consolidated financial statements and the selection of Lifespan Corporation's independent accountant. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (37 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alternative Living Concepts | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050442015 | Housing for Elderly and Mentally Ill | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| Bayberry Courts Inc | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 204590384 | Housing for Elderly and Mentally Ill | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| Bradley Hospital Foundation | |||||||||||||||
| 167 Point Street | Providence | RI | 02903 | 050500688 | Philanthropic Activities | RI | 501(c)(3) | 7 | Lifespan Corporation | false | |||||
| Capital City Community Centers Inc | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050259090 | Daycare Services | RI | 501(c)(3) | 7 | Gateway Healthcare Inc | false | |||||
| Emma Pendleton Bradley Hospital | |||||||||||||||
| 1011 Veterans Memorial Parkway | East Providence | RI | 02915 | 050258806 | Pediatric Psych. Health Care Services | RI | 501(c)(3) | 3 | Lifespan Corporation | false | |||||
| Families Reaching Into Each New Day Inc | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050504841 | Bereavement Services for Children | RI | 501(c)(3) | 7 | Gateway Healthcare Inc | false | |||||
| Gateway Foundation | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 464002163 | Philanthropic Activities | RI | 501(c)(3) | 7 | Lifespan Corporation | false | |||||
| Gateway Healthcare Inc | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050309043 | Subs. Abuse & Psych. Health Care Svcs. | RI | 501(c)(3) | 9 | Lifespan Corporation | false | |||||
| Hospital Properties Inc | |||||||||||||||
| 167 Point Street | Providence | RI | 02903 | 222869743 | Property Management | RI | 501(c)(4) | N/A | Lifespan Corporation | false | |||||
| Human Services Realty Inc | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050398161 | Housing for Elderly and Mentally Ill | RI | 501(c)(2) | N/A | Gateway Healthcare Inc | false | |||||
| JM Apartments Inc | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050435537 | Housing for Elderly and Mentally Ill | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| Lifespan Corporation | |||||||||||||||
| 167 Point Street | Providence | RI | 02903 | 222861978 | Holding Company/ Mgmnt Services | RI | 501(c)(3) | 11 | NA | false | |||||
| Lifespan Diversified Services Inc | |||||||||||||||
| 167 Point Street | Providence | RI | 02903 | 050258935 | Holding Company/ Mgmnt Services | RI | 501(c)(3) | 9 | Lifespan Corporation | false | |||||
| Lifespan Foundation | |||||||||||||||
| 167 Point Street | Providence | RI | 02903 | 050493219 | Philanthropic Activities | RI | 501(c)(3) | 7 | Lifespan Corporation | false | |||||
| Lifespan of Massachusetts Inc | |||||||||||||||
| c/o Archstone Law 245 Winter St | Waltham | MA | 02451 | 043408517 | Holding Company | MA | 501(c)(3) | 11 | Lifespan Corporation | false | |||||
| Lifespan Physician Group Inc | |||||||||||||||
| 167 Point Street | Providence | RI | 02903 | 050389801 | Health Care Services | RI | 501(c)(3) | 9 | Lifespan Corporation | false | |||||
| Lifespan School Solutions Inc | |||||||||||||||
| 225 Chapman Street | Providence | RI | 02905 | 464910847 | Educational Services | RI | 501(c)(3) | 2 | Emma Pendleton Bradley Hospital | false | |||||
| LJR Corporation | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 030508346 | Housing for Elderly and Mentally Ill | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| Mill River Community Housing Corporation | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050427152 | Housing for Elderly and Mentally Ill | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| Newport Health Care Corporation | |||||||||||||||
| 11 Friendship Street | Newport | RI | 02840 | 222535537 | Holding Company/ Mgmnt. Services | RI | 501(c)(3) | 7 | Lifespan Corporation | false | |||||
| Newport Health Property Management Inc | |||||||||||||||
| 11 Friendship Street | Newport | RI | 02840 | 222335539 | Property Management | RI | 501(c)(3) | 11 | Newport Health Care Corporation | false | |||||
| Newport Hospital | |||||||||||||||
| 11 Friendship Street | Newport | RI | 02840 | 050258914 | Health Care Services | RI | 501(c)(3) | 3 | Lifespan Corporation | false | |||||
| Newport Hospital Foundation Inc | |||||||||||||||
| 11 Friendship Street | Newport | RI | 02840 | 222535533 | Philanthropic Activities | RI | 501(c)(3) | 7 | Lifespan Corporation | false | |||||
| Obed Apartments Inc | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050422771 | Housing for Elderly and Mentally Ill | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| Pathways Inc | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050393004 | Housing for Elderly and Mentally Ill | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| Rhode Island Hospital | |||||||||||||||
| 593 Eddy Street | Providence | RI | 02903 | 050258954 | Health Care Services | RI | 501(c)(3) | 3 | Lifespan Corporation | false | |||||
| Rhode Island Hospital Foundation | |||||||||||||||
| 167 Point Street | Providence | RI | 02903 | 050468736 | Philanthropic Activities | RI | 501(c)(3) | 7 | Lifespan Corporation | false | |||||
| RIH Ventures | |||||||||||||||
| 593 Eddy Street | Providence | RI | 02903 | 050448686 | Parking Facilities/Phlebotomy Services | RI | 501(c)(3) | 9 | Lifespan Corporation | false | |||||
| Shore Courts Inc | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050504003 | Housing for Elderly and Mentally Ill | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| The Autism Project | |||||||||||||||
| 1516 Atwood Avenue | Johnston | RI | 02919 | 050512037 | Services for Children with Autism | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| The Miriam Hospital | |||||||||||||||
| 164 Summit Avenue | Providence | RI | 02906 | 050258905 | Health Care Services | RI | 501(c)(3) | 3 | Lifespan Corporation | false | |||||
| The Miriam Hospital Foundation | |||||||||||||||
| 167 Point Street | Providence | RI | 02903 | 050377502 | Philanthropic Activities | RI | 501(c)(3) | 7 | Lifespan Corporation | false | |||||
| TLR Realty | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 043742771 | Housing for Elderly and Mentally Ill | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| Wentworth Corporation | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050488520 | Housing for Elderly and Mentally Ill | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| Westerly Courts Inc | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 611439766 | Housing for Elderly and Mentally Ill | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| JRR Housing | |||||||||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 263121266 | Housing for Elderly and Mentally Ill | RI | 501(c)(3) | 9 | Gateway Healthcare Inc | false | |||||
| RI Sound Enterprises Insurance Co Ltd | |||||||||||||||
| Offshore Insurance Captive | N/A | N/A | Lifespan Corporation | false | 65 Front Street | Hamilton | BD | HM 12 | BD | ||||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Lifespan MSO Inc | |||||||||
| 167 Point Street | Providence | RI | 02903 | 050508717 | Mgmnt. Svcs. | RI | Lifespan Corp | C corp | false |
| Lifespan Risk Services Inc | |||||||||
| 167 Point Street | Providence | RI | 02903 | 050459767 | Risk Mgmnt. | RI | Lifespan Corp | C corp | false |
| VNA Technicare Inc | |||||||||
| 622 George Washington Highway | Lincoln | RI | 02865 | 050472710 | DME Sales | RI | LDS Inc | C corp | false |
| Gateway Professional Group Inc | |||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050498391 | Psychotherapy | RI | Gateway Healthcare | C Corp | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Comments