2014-08-15T06:11:19-07:00 2013-09-30 KPMG LLP 2 Financial Center 60 South St Boston MA 02111 990 2012-10-01 050258905 The Miriam Hospital MIRI 4017932500 164 Summit Avenue Providence RI 02906 Mary A Wakefield 2014-08-15 true P01245482 6179885805 2012 2015-11-30 17:44:51Z Arthur J Sampson 164 Summit Avenue Providence RI 02906 1172783097 false false X www.miriamhospital.org X 1926 RI The mission of The Miriam Hospital(TMH) is to inspire one another to improve the health and spirit of the lives we touch. 28 21 3013 865 1176638 27107 8435033 5286192 411609404 431935848 8701381 6724302 15532616 14996817 444278434 458943159 507193 550308 0 183243201 197954536 0 0 233040198 245734555 416790592 444239399 27487842 14703760 400605850 439298535 138226843 145909207 262379007 293389328 X The mission of The Miriam Hospital(TMH) is to inspire one another to improve the health and spirit of the lives we touch. false false 337208694 600308 418352859 Patient Care:TMH offers expertise in cardiology, oncology, orthopedics, men's health, and minimally invasive surgery and is home to the state's first Joint Commission- certified Stroke Center and robotic surgery program. Services and programs provided by TMH include general medicine; general surgery; emergency medicine; cardiovascular care; orthopedics; nuclear cardiology; radiology; laboratory; renal dialysis; urology; gastroenterology; endocrinology; gynecology; nephrology; neurology; ophthalmology; trauma care; computerized tomography; and magnetic resonance imaging (MRI). The Hospital is nationally known for its HIV/AIDS and behavioral and preventive medicine research, including weight control, physical activity, and smoking cessation. (Continued on Schedule O). 29120167 25416167 Research:Since 1969, the level of research has increased from seven projects totaling $127,000 involving nine investigators to 339 projects totaling $29.1 million involving 78 investigators and 157 employees. The following represents significant areas of research being conducted at the Hospital: cancer treatment and prevention, epidemiological research, clinical trials in AIDS and HIV infection (including vaccine development), coronary heart disease, nutrition, exercise, weight control, and lifestyle risk factors affecting health. TMH provided $3.7 million in support of research activities in fiscal year 2013. (Continued on Schedule O). 23285874 2830817 Medical Education:TMH provides the setting for and substantially supports medical education in various clinical training and nursing programs. TMH is designated as a major teaching affiliate of The Warren Alpert Medical School of Brown University. The total cost of direct medical education provided by the Hospital exceeded the reimbursement received from third-party payors by $20.5 million in fiscal year 2013. (Continued on Schedule O). 389614735 true true false true false false false false false true true true false true true true true true false false true true false false false false true true true false true true false false false false false false false false false true false false false false false true false false false false true 234 0 true 3013 true true false false false false false false 0 false false false false false false false false false false X 28 21 true false true false true true true true true false false true true true true true true true true false X Mary A Wakefield 4014447093 593 Eddy Street Providence RI 02903 X Brian J Zink MD 1.00 3.00 X 0 1000 0 Jane Williams 0.00 0.00 X 0 0 0 Shivan Subramaniam 0.60 3.40 X 0 0 0 Hon Bruce Selya 1.50 7.50 X 0 0 0 Fred J Schiffman MD 0.00 0.00 X 0 0 0 Lawrence Sadwin 1.00 7.00 X 0 0 0 Lloyd Robertson 1.00 20.00 X 0 0 0 James A Procaccianti 0.00 0.00 X 0 0 0 Michael J Perik 0.00 0.00 X 0 0 0 Steven Pare 2.00 10.50 X 0 0 0 Stephen P Massed 0.50 16.00 X 0 0 0 David A Marcoux MD 0.00 0.00 X 0 0 0 Alan H Litwin 4.00 16.00 X X 0 0 0 Bertram M Lederer 4.00 10.00 X X 0 0 0 Scott B Laurans 0.75 10.75 X X 0 0 0 Marie J Langlois 1.00 2.00 X 0 0 0 Mary Jo Kaplan 0.00 0.00 X X 0 0 0 Dayle Hunt Joseph 1.00 5.00 X 0 0 0 Pamela Harrop MD 0.25 3.75 X 0 0 0 Michael L Hanna 0.00 0.00 X X 0 0 0 David Gorelick MD 0.50 2.50 X 0 0 0 Jason Fowler 0.00 0.00 X 0 0 0 Edward D Feldstein 0.30 6.70 X 0 0 0 Jonathan D Fain 1.00 6.00 X 0 0 0 Jonathan L Elion MD 0.00 0.00 X 0 0 0 Michael Ehrlich MD 2.00 11.00 X 0 96726 0 Penelope H Dennehy MD 0.00 0.00 X 0 202523 20491 Ellen Collis 0.00 6.50 X 0 0 0 Peter Capodilupo 0.80 8.20 X 0 0 0 David A Brown 0.25 7.25 X 0 0 0 Roger N Begin CFP 0.00 0.00 X 0 0 0 Emanuel Barrows 0.30 1.70 X 0 0 0 Timothy J Babineau MD 3.00 37.00 X 0 1486727 205277 Lawrence Aubin 1.00 14.00 X X 0 0 0 Sr M Therese Antone 1.00 5.50 X 0 0 0 Thomas Anders MD 1.00 6.50 X 0 0 0 Mary A Wakefield 6.00 34.00 X 0 798078 297927 Arthur J Sampson 30.00 10.00 X 0 546786 90041 Kenneth A Arnold 6.00 34.00 X 0 3554467 29606 Maria P Ducharme 40.00 0.00 X 274415 0 65464 Michael P Carey PhD 40.00 0.00 X 323732 0 37636 Robert W Corwin MD 40.00 0.00 X 355133 0 21356 Silvia Degli Esposti MD 40.00 0.00 X 348557 0 35609 Rogers C Griffith MD 40.00 0.00 X 297500 0 38940 Rena R Wing 40.00 0.00 X 281713 0 23458 Kathleen Hittner MD 40.00 0.00 X 0 708269 894820 1881050 7394576 1760625 249 true true false University Surgical Associates 2 Dudley Street Providence RI 02905 Medical Services 2348870 University Medicine Foundation 593 Eddy Street Providence RI 02903 Medical Services 9735251 Sodexo Inc 25 Royal Little Drive Providence RI 02904 Dietary/Cafe Service 1274930 Quest Diagnostics 12436 Collections Center Drive Chicago IL 60693 Laboratory Services 1491005 Brown University 75 Waterman Street Providence RI 02912 Medical Services 2106025 33 5102285 31725 152182 5286192 Temp Restricted (SPFs) 900099 537755 537755 Patient Service Rev 900099 402981592 402981592 Laboratory 621500 1109929 1109929 Direct Rev from Research 900099 27306572 27306572 431935848 3576137 3576137 2116 2116 0 789182 515686 273496 273496 7383 266113 716470301 713324252 3146049 3146049 3146049 0 0 0 Joint Program Revenue 900099 5235463 5235463 Indirect Rev from Grants 900099 5565560 5565560 Cafeteria Revenue 722210 1213530 1213530 2708768 2649442 59326 14723321 458943159 445489914 1176638 6990415 541308 541308 0 9000 9000 0 345390 345390 0 155964221 150505742 5458479 6239368 6019740 219628 24173737 23453649 720088 11231820 10839426 392394 0 0 0 3353 3353 0 465207 465207 21557984 21471914 86070 192466 187355 5111 87666489 87350107 316382 0 0 10197243 9429276 767967 748451 727424 21027 0 516235 450104 66131 3435770 3435770 0 11941632 11941632 2912868 2912868 All Other Expenses 13368225 13075957 292268 License Fee 18044585 18044585 Provision for bad debts 27557181 27557181 Purch Svs & Equip Cont 47117733 16681223 30436510 9133 9133 444239399 389614735 54624664 0 0 14068133 14008834 1514332 1122854 41439931 46235752 0 0 318703 179793 5968500 4850604 3427774 1670024 348448295 173519177 158860039 174929118 73630205 76419159 35075511 37994435 0 0 66302722 81887962 400605850 439298535 30020939 35888519 63953017 61833734 11700000 44252887 36486954 138226843 145909207 X 223650887 248255042 25771614 27475203 12956506 17659083 262379007 293389328 400605850 439298535 X 14703760 73316 16233245 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 3353 3353 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description The Miriam Hospital pays membership fees to the Hospital Association of Rhode Island (HARI), a portion of which is allocated to HARI's lobbying efforts. 111167306 33540223 6309324 33581357 117435496 97696217 35666188 10411008 32606107 111167306 96830355 25953487 678572 25766197 97696217 73337707 40371010 8097713 24976075 96830355 77300591 22261170 -882788 25341266 73337707 0.85200 0.14800 false true true 4288981 4288981 207236243 80844784 126391459 124154669 92674393 31480276 12768402 12768402 174929118 37994435 Other 138303 Interest in net assets of TMH Foundation 59423773 Held by third parties under LTD Agrts. 17922795 Deferred financing costs 1381189 81887962 Third-party payor settlements 6662566 Post-retirement benefit liability 34100 Lease payable 117574 Health care benefit self-insurance 4060321 Due to affiliates 717613 Accrued pension liability 24714400 Abatement liability 180380 36486954 X 447743018 73316 16233245 16306561 431436457 465207 27041495 27506702 458943159 416732697 416732697 465207 27041495 27506702 444239399 Part XII, Line 4b Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S Debt-financed rental expenses $-13275 Non debt-financed rental expenses $-502411 Provision for bad debts $27557181 Part XI, Line 4b Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S Debt-financed rental expenses $-13275 Non debt-financed rental expenses $-502411 Provision for bad debts $27557181 Part XI, Line 2d Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990 Change in funded status of pension $10194800 Increase in net assets of TMHF $6038445 Part X Part X : FIN48 Footnote TMH, as a not-for-profit corporation, is recognized under Section 501(c)(3) of the Internal Revenue Code and is exempt from Federal income taxes. TMH recognizes the effect of income tax positions only if those positions are more likely than not to be sustained. Changes in measurement are reflected in the period in which the change in judgment occurs. TMH did not recognize the effect of any income tax positions during the fiscal year ended September 30, 2013. Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. The Miriam Hospital's (TMH) unrestricted endowment consists of designated assets set aside by TMH's Board for future capital improvements, over which the Board retains control and may at its discretion subsequently use for other purposes. The largest temporarily restricted funds held by TMH are used to support: (1) the Women's Medicine Collaborative, a comprehensive, multidisciplinary center dedicated to meeting the health care needs of women; (2) purchase of an upgraded surgical robot; (3) the advancement of patient care, research, and education related to cardiology; (4) the treatment and prevention of cancer, including the Cancer Patient Navigator Program, which assists cancer patients through the entire course of their care; (5) replacement of TMH's hybrid catheterization laboratory; (6) TMH's capital equipment and operating needs in providing services to patients; and (7) the Surgery Department's educational and investigational functions. true Middle East 0 0 Grant Recipient in Region Research 9000 Europe 0 0 Program Services Research 434 Sub-Saharan Africa 0 0 Program Services Research 307332 South Asia 0 0 Program Services Research 4929 East Asia & the Pacific 0 0 Program Services Research 230 321925 321925 Middle East Philanthropy 9000 Check FMV 1 false false false false false true Grantmaker's Description of How Grants are Used in Foreign Country When a foreign institution is the subrecipient of an award received by a Lifespan Affiliate, the following procedures are followed: A subrecipient agreement is prepared and executed between the foreign institution and the Lifespan affiliate. The agreement describes the funding source, terms and conditions of the award, statement of work, payment method and audit. The foreign institution prepares an invoice to the Lifespan affiliate for expenses incurred under the agreement. Once received, the invoice is approved by both the principal investigator at the Lifespan affiliate and the research administrator in the Office of Research Administration.Check requests and wire transfer forms are prepared by the principal investigator, approved by the research administrator and forwarded to the Finance Department, where payment is processed to the foreign institution.Additionally, when the award is a federal award, a questionnaire is completed by the appropriate subrecipient official supplying information about the institution's financial system and method of accounting for the award. A request is also made for audited financial statements. When a foreign individual is not associated with an institution, a Professional Services Agreement (PSA) is executed and the individual sends an invoice to the Lifespan affiliate principal investigator of the project or sponsored agreement that states the number of hours, dates of services, work performed, reimbursement for expenses and compensation amount. The same approval process and payment is used as described above. true true true X true X true true true false true true 17606538 2724652 14881886 0.03570 38708935 31118115 7590820 0.01820 56315473 33842767 22472706 0.05390 327592 47031 280561 0.00070 23285874 2830817 20455057 0.04910 12801881 5489217 7312664 0.01750 29120167 25416167 3704000 0.00890 193732 193732 0.00050 65729246 33783232 31946014 0.07670 122044719 67625999 54418720 0.13060 true 6288549 1250938 86750779 87508836 -758057 X true true 1 1 The Miriam Hospital

164 Summit Avenue Providence RI 02906

X X X X X The Miriam Hospital 1 true X X X X X X X X 13 true true true X X X X X X X X X X X true false false true true 200.0000 true 400.0000 true X X X X X X true true X X X X X X X true X X true X X X X X X true X false false 17 TMH Pre-admission Testing Center

208 Collyer Street 3rd Floor Providence RI 02904

Outpatient Pre-admission assessment and education TMH Behavioral Medicine Clinic

146 West River Street Providence RI 02904

Outpatient Clinic RISE TB Clinic

14 Third Street Providence RI 02906

TB Clinic TMH Immunology Center

1125 North Main Street Providence RI 02904

Outpatient Clinic TMH Laboratory

400 Bald Hill Road Warwick RI 02886

Phlebotomy Lab TMH Laboratory

1 Commerce Street Lincoln RI 02865

Phlebotomy Lab TMH Outpatient Rehabilitation

195 Collyer Street Providence RI 02904

Outpatient PT, OT and Speech Rehab TMH Cardiac RehabPulmonary Rehab

208 Collyer Street Providence RI 02904

Outpatient Cardiac Clinic TMH Laboratory

1 Hoppin Street Providence RI 02903

Phlebotomy Lab Cardiovascular Institute

1454 South County Trail Suite 2000 East Greenwich RI 02818

Outpatient Cardiac Clinic TMH Weight Control & Diabetes Research

196 Richmond Street Providence RI 02903

Outpatient Research & Education TMH Behavioral Medicine Research

1 Hoppin Street Providence RI 02903

Outpatient Research & Education Womens Medicine Collaborative

146 West River Street Providence RI 02904

Comprehensive Women's Outpatient Clinic Cardiovascular Institute

208 Collyer Street Suites 100 102 Providence RI 02904

Outpatient Cardiac Clinic Cardiovascular Institute

950 Warren Avenue East Providence RI 02914

Outpatient Cardiac Clinic TMH Immunology Research Center

14 Third Street 11 Fourth Street Providence RI 02906

Outpatient Counseling TMH Diagnostic Imaging Center

195 Collyer Street Suite 101 Providence RI 02904

Outpatient Radiology Part VI - States Where Community Benefit Report Filed RI Part VI - Affilated Health Care System Roles and Promotion Lifespan's mission is to deliver health with care through highly personalized medical expertise provided with kindness and empathy. Lifespan is an academically based healthcare system at the forefront of medical care, continually engaging in research that will lead to medical breakthroughs. Lifespan affiliates provide comprehensive inpatient and outpatient medical, surgical, and psychiatric services for adults and children. Lifespan and its affiliates employ more than 13,500 people. The Lifespan system has aproximately 2,400 physicians on the medical staffs of its affiliated hospitals, operates 1,155 licensed beds in four hospital complexes, and in 2013 generated approximately $1.7 billion in total operating revenue. By each of these measures, Lifespan is Rhode Island's largest health system, serving a population of over 1.5 million. Three of its hospital members, Rhode Island Hospital (RIH), The Miriam Hospital (TMH), and Bradley Hospital (EPBH), are teaching affiliates of The Warren Alpert Medical School of Brown University, with 77 percent of the residents and fellows in this program based at RIH, TMH, and EPBH.Lifespan is a Rhode Island nonprofit corporation that is community-based and community-governed. As a nonprofit organization, Lifespan is run by a voluntary Board of Directors who are community representatives. Lifespan and all of its nonprofit hospital affiliates have received written notification from the Internal Revenue Service that they have been recognized as being organized and operated as entities described in Internal Revenue Code (IRC) Section 501(c)(3) and are generally exempt from income taxes under IRC Section 501(a).As of September 30, 2013, Lifespan Corporation employed approximately 750 full-time and part-time personnel, most of whom are located in Providence, RI. Lifespan Corporation provides support services to its affiliates, such as information services, telecommunications, risk management, legal, communications and public affairs, fundraising, facility development, strategic planning, internal audit/compliance, human resources, finance, payor contracting, and investment management, for which each affiliate is charged a fee equivalent to the costs incurred by Lifespan in providing these services.Corporate Authority and RoleLifespan Corporation has no members and is governed by its Board of Directors. The Board has responsibility for planning, directing, and establishing policies intended to assure the development and delivery of quality health services, professional education, and biomedical research on an integrated, cost-effective basis. The Board's powers include the power to set accounting policies for its affiliates, develop, negotiate, and approve all managed care agreements, develop affiliations with other institutions for educational and research purposes, and approve human resource plans, executive compensation, and benefits for system affiliates. The bylaws of TMH confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination, and support of the system. Powers reserved to Lifespan as sole member include: to elect and remove trustees; to approve the election of and to remove certain officers; to approve the amendment of the Articles of Incorporation and Bylaws and other Charter documents; to approve strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness.For a complete listing of affiliated members of Lifespan's integrated healthcare delivery system, please refer to Schedule R. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose The Hospital is governed by a Board of Trustees, which is composed of leaders of the local community elected by Lifespan Corporation. The Hospital's purpose is to at all times be operated exclusively as a tax-exempt charitable hospital and, as such, shall dispense medical and surgical aid and care to the sick and disabled of any race, creed, or color in keeping with Jewish ethical aspirations; shall act in a fashion designed to further, improve, and advance the science or art of health care delivery, patient care, and the knowledge, practice, and teaching of medicine and nursing; and assist in the advancement of medical research and investigation and in the improvement of medical teaching facilities and methods. The Hospital works collaboratively with physicians, our employees, other health care organizations, and the community to create a measurably healthier community through the provision of high quality, cost-effective, customer-focused health care services in an environment that promotes patient safety. The Hospital monitors the healthcare needs of its service area to ensure alignment of its resources with its mission. The Hospital measures the results of the programs and services it provides based on the value added to the community as well as the financial health of each program and its impact on the Hospital. The Hospital is organized and operated for the benefit of the community it serves. Part VI - Community Building Activities The Hospital substantially subsidizes various health services including the following programs: oncology, tuberculosis, and certain other specialty services. The Hospital also provides numerous other services to the community for which charges are not generated. These services include certain emergency services, community health screenings for cardiac health, prostate cancer and other diseases, smoking cessation, immunization and nutrition programs, diabetes education, community health training programs, patient advocacy, foreign language translation, physician referral services, and charitable contributions. Part VI - Community Information The Miriam Hospital, located in Providence, Rhode Island, is a 247-bed nonprofit general acute care teaching hospital with university affiliation providing a comprehensive range of diagnostic and therapeutic services (excluding obstetrics) for the acute care of patients principally from Rhode Island and southeastern Massachusetts. As a complement to its role in service and education, the Hospital actively supports research. The Hospital is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and participates as a provider primarily in Medicare, Blue Cross, and Medicaid programs. The Hospital is also a member of Voluntary Hospitals of America, Inc. (VHA).In 1969, the Hospital and certain other Rhode Island hospitals entered into an affiliation agreement to participate jointly in various clinical training programs and research activities with The Warren Alpert Medical School of Brown University (Brown). The Hospital is designated as a major teaching affiliate of Brown. The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically.With respect to nursing education, the Hospital has developed formal and informal educational affiliations with a number of accredited New England colleges and universities. The Hospital does not receive any compensation from the various schools for providing a clinical setting for the student nurse training.The Hospital conducts extensive medical research and is in the forefront of biomedical health care delivery research and among the leaders nationally in National Institutes of Health programs. Part VI - Patient Education of Eligibility for Assistance The Miriam Hospital has multilingual signage in the Hospital's main lobby and waiting areas which provides information on financial aid contacts. The Registration Department meets with patients at the outset of care to discuss eligibility for assistance. The Registration staff provides interested patients with a "Welcome" booklet which includes information on patient rights and responsibilities. The signage and booklets contain a telephone number which connects patients with Registration staff who can answer any additional questions that may arise after the patient has left the Hospital. Assistance eligibility is also summarized on the Hospital's website. Part VI - Needs Assessment Lifespan's Office of Strategic Planning and Analysis performs population-based studies for the Hospital regarding the need for inpatient medical and surgical services for both adults and children and a wide range of outpatient services including: primary care office visits, specialty care, emergency services, imaging, ambulatory surgery, and specific high technology services such as radiation therapy and bone marrow transplantation. A population-based study examines the growth and changes in the population, the resources in the community, and the changing prevalence of diseases. In addition to this approach, Lifespan Strategic Planning also examines experience with wait times, the level of staffing, and the changing standards of care. All of this information is used to assess the demand for additional services to provide access to high quality care.In addition to population approaches to assessing and estimating need, all specialties and services monitor demand at the service-specific level by considering changing patterns of care and methods of treatment for the specific medical problem, wait times for visits/queues, and community resources. The service leadership then goes through a review process to add staff, expanded hours, and/or new sub-components to round out core services on an as-needed basis. At times, expansion requires more space, equipment, and staff, but often accommodation of community demand is achieved through expanded hours. Facilities are added as needed to accommodate these expansions, but most often minor renovations of existing locations with better, more modern layouts and equipment allow for greater patient access.The RI State Certificate of Need program requires a focused study of need for all projects over $5.25 million, which is an important part of the program development process across Lifespan.Based on a broad understanding of community health needs, the Hospital provides a wide range of services to both its primary and secondary service areas. Lifespan and its hospital affiliates monitor health trends in Rhode Island in an effort to identify areas of unmet demands regarding clinical services. For example, in 2006, the Hospital was the first in the region to use a new technology to remove clots quickly, mitigating the debilitating effects of stroke. Over the past three years, the Hospital has expanded its groundbreaking robotic surgery program. The Hospital is also home to the state's first Joint Commission-Certified Stroke Center. Number of Hospital Faciltiy - 1 Part V, Line 20d - Other Billing Determination of Individuals Without Insurance Uninsured patients receive an automatic 50% Community Benefit discount on Hospital charges. Under Section 501(r)(5), the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care are the amounts generally billed to individuals who have insurance covering such care. In no case was there a situation where an uninsured patient paid more than amounts charged through Medicare or negotiated commercial insurance rates. Number of Hospital Faciltiy - 1 Part V, Line 17e - Other Collection Actions by Facility or Third Party Engaged The Hospital engages third parties to perform certain collection actions on its behalf. A pre-collect company is used for all self-pay accounts. Additionally, a collection agency is used if there is no payment activity on such accounts after 120 days. The collection process is explained in further detail in the response to Question 16e above. Number of Hospital Faciltiy - 1 Part V, Line 16e - Other Collection Actions Against a Patient Once an account balance or a portion thereof is classified as self-pay, it is placed with the Hospital's pre-collect company until the balance is paid in full, a monthly payment plan is in place, or insurance information is provided for billing.After 120 days, if there is no payment activity, the account qualifies for bad debt and the pre-collect company returns the account to Patient Financial Services, which in turn forwards it to a collection agency.The collection agency sends 3 to 5 notices to the patient requesting payment. If there are no responses after the notices are sent, collection calls are made. If there is no response after 120 days, the account is reviewed for legal action in the appropriate court.If there are no assets to pursue, the collection agency deems the account uncollectible and returns it to Patient Financial Services for writeoff.Note: In accordance with Center for Medicare and Medcaid Services mandates, Medicare patient accounts are held 130 days from last payment, after which if there has been no activity, the account is referred to collection. Number of Hospital Faciltiy - 1 Part V, Line 14g - Other Means Hospital Facility Publicized the Policy An abbreviated version of the Hospital's financial assistance policy is posted in various admitting and outpatient areas of the Hospital. Additionally, registration personnel refer uninsured and/or low income patients to Patient Financial Counselors to discuss the policy and/or answer any questions they might have. Number of Hospital Faciltiy - 1 Part V, Line 5c - Description of Making Needs Assessment Widely Available A copy of the Community Health Needs Assessment report issued for The Miriam Hospital as of September 30, 2013 can be obtained by visiting: http://www.lifespan.org/Lifespan-Community-Health-Needs-Assessment-Reports.aspx Number of Hospital Faciltiy - 1 Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment Rhode Island HospitalEmma Pendleton Bradley HospitalNewport Hospital Number of Hospital Faciltiy - 1 Part V, Line 3 - Account Input from Person Who Represent the Community The CHNA encompassed intensive data collection and analysis, as well as qualitative research in the forms of interviews with and surveys of more than 100 internal and external stakeholders, including hospital-based physicians, nurses, social workers, administrators, and other professionals, as well as community-based stakeholders representing constituencies served by The Miriam Hospital and Lifespans three other hospitals. The Miriam Hospitals leadership team shaped the CHNA by recommending institutional and community leaders for participation, offering observations about community need, and providing insight about existing and planned programs.Qualitative data collected during the CHNA consist of: 1) interviews completed with both internal (i.e. hospital- and Lifespan-based); 2) nearly two dozen key informant interviews with community leaders, representing an array of constituencies; and 3) a Community Stakeholder Survey of 54 organizations statewide.Interviews with leaders of organizations encompassed a wide range of issues and populations including historically underserved communities, such as minority populations, children and youth, immigrant and refugee populations, and included leaders of organizations with specific interest in or expertise about key issues such as obesity, cancer, and asthma. In a few cases, organizations submitted a completed questionnaire in lieu of participating in an interview. Leaders of organizations with a statewide focus on policy, advocacy, and social service provisions were interviewed, covering a broad range of social issue areas. A standard format and questionnaire was used for each interview.To ensure representation from a broad cross-section of the community, a statewide survey of 54 key community stakeholders was conducted. Those surveyed included members of medically underserved, low-income, and minority populations in the community; representatives of organizations that had knowledge, information, or relevant experience to the health needs of the community (including the Brown University School of Public Health, Warren Alpert Medical School of Brown University, the Economic Progress Institute, the United Way, and others); and representatives of the Rhode Island Department of Health. The survey was a 19-question instrument designed to elicit information about the general health and social needs of the community. Over 75% of those surveyed self-reported that they serve constituencies spanning the entire state of Rhode Island and/or the entire state of Rhode Island with the addition of southeastern Massachusetts. Community Stakeholder Survey Respondents:1. AARP, Executive Director2. African Alliance of RI, President3. Aids Project RI, Executive Director4. American Cancer Society5. American Lung Association of the Northeast, Director of Health Education6. Blue Cross/Blue Shield7. Brown School of Public Health8. Camp Street Community Ministries9. Center for Prisoner Health and Human Rights, The Miriam Hospital/Brown University Medical School, Executive Director10. Chinese Nursing Association11. Community Asthma Program12. Community Health Workers Association of Rhode Island, Brown Medical School13. Crossroads of Rhode Island, Director of Social Services14. Rhode Island Department of Health, Manager, Safe Rhode Island/Rhode Island Youth Suicide15. Rhode Island Department of Health16. Gateway Healthcare17. Goodwill Industries of Rhode Island, Case Manager / Employment Services Coordinator18. Health Centric Advisors, Senior Scientist19. Health Leads Providence, Executive Director20. Injury Prevention Center at Rhode Island Hospital21. James L. Maher Center, CEO22. Jewish Alliance of Greater Rhode Island, Community Relations Director23. Martin Luther King Community Center, Executive Director24. McAuley House, Associate Director25. Mental Health Association of Rhode Island, Executive Director26. The Miriam Hospital, Ambulatory TB/Immunology Department, Clinical Manager27. Mount Hope Learning Center28. Mount Hope Neighborhood Association29. NAACP Providence, President30. National Association of Social Workers (NASW) RI Chapter, President31. Newport County Community Mental Health Center32. Overeaters Anonymous33. Parent Support Network of Rhode Island34. Partnership to Reduce Cancer in RI, Secretary35. Progreso Latino, Executive Director36. Project Night Vision, Founder37. Providence School Department38. Refugee Clinic at Hasbro Children's Hospital39. Rhode Island Division of Elderly Affairs, Director40. Rhode Island Health Center Association, President & CEO41. Rhode Island Parent Information Network42. Rhode Island Public Health Association, President43. Rhode Island Public Health Institute at Brown University, Executive Director44. Rhode Island Adult Education Professional Development Center, Director45. Rhode Island Breast Cancer Coalition46. Rhode Island Department of Corrections, Medical Program Director47. Rhode Island Free Clinic48. Samuels Sinclair Dental Center, Director49. Socio-Economic Development Center for Southeast Asians, Executive Director50. Taming Asthma51. TB & Immunology, the RISE Clinic (The Miriam Hospital)52. United Way of Rhode Island, Director of Annual Giving53. Visiting Nurses Services of Newport and Bristol Counties54. Women's Center of Rhode Island, Residential Supervisor Part III, Line 9b - Provisions On Collection Practices For Qualified Patients The Hospital uses an outside pre-collection agency for all self-pay receivables. The pre-collection agency attempts to collect the debt for 120 days. During this time, 3 letters are sent to the patient's address of record and, for balances in excess of $50, attempts are made to reach the patient by telephone. If the agency makes contact with the patient and the patient expresses an inability to pay, payment plans and/or Community Free Service are offered (Please refer to the Charity Care Eligibility Criteria and Additional Information sections for further detail on those processes). If the pre-collection agency is unsuccessful in contacting the patient or no response is received within 120 days, the account is forwarded to a collection agency.The collection agency also sends statements and attempts to reach the patient via telephone. Again, if the agency makes contact with the patient and the patient expresses an inability to pay, payment plans and/or Community Free Service are offered. If no response is received, the claim is referred to small claims court and the patient is summoned to appear. If the patient does not appear, the Hospital will receive a judgment in its favor. If the Hospital learns that the claim has a related settlement, i.e., an automobile accident, the Hospital can put a lien on such settlement. Alternatively, if the collection agency deems the account uncollectible, it will be written off. Part III, Line 8 - Explanation Of Shortfall As Community Benefit Medicare shortfall has not been treated as a community benefit.The source of the Medicare allowable costs reported on Part III, Section B, Line 6 is the Medicare cost report, Form 2552-10. Part III, Line 4 - Bad Debt Expense Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the ability to collect accounts receivable, the Hospital analyzes its past history and identifies its revenue trends for each of its major payors to estimate the appropriate allowance for doubtful accounts and the associated provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant allowance for doubtful accounts and provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates, if applicable) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.The Hospital's allowance for doubtful accounts for self-pay patients increased from 79% of self-pay accounts receivable at September 30, 2012 to 81% of self-pay accounts receivable at September 30, 2013. The Hospital's self-pay writeoffs for the years ended September 30, 2013 and 2012 amounted to approximately $23,542,000 and $21,191,000, respectively. The Hospital did not change its charity care or uninsured discount policies during the years ended September 30, 2013 and 2012, respectively. The Hospital does not maintain a material allowance for doubtful accounts from third-party payors, nor did it have significant writeoffs from third-party payors in either 2013 or 2012.The Hospital provided $27,557,181 for uncollectible patient accounts during the year ended September 30, 2013. The associated cost reported on Line 2 of Part III was determined by applying an operating cost to charge ratio (exclusive of community benefit costs and charges) to the provision amount.Schedule H, Part III, Section A, Line 2The amount reported as bad debt expense is determined by applying the ratio of cost to charges (RCC) to the total charges written off to bad debt. The RCC rate is determined using data from the Hospital's cost accounting system and is adjusted for medical education, internally funded research, subsidized health services, community services, and charitable contributions. Discounts and payments are applied to patient accounts before such account balances are transferred to bad debt.Schedule H, Part III, Section A, Line 3Accounts pending transfer to bad debt are reviewed by the Hospital's patient advocate staff to determine qualification for financial assistance under the Hospital's policy. Accounts with insufficient information to determine eligibility are assigned a separate identifying code. These accounts are ultimately transferred to bad debt if the appropriate qualifying documentation is not received. The amount reported on Schedule H, Part III, Section A, Line 3 represents the account balances at charge written off to bad debt from the pending code, which are in turn converted to cost by applying the RCC rate as identified in Schedule H, Part III, Section A, Line 2. Part I, Line 7, Column F - Explanation of Bad Debt Expense The calculation of percentages disclosed for Schedule H, Part I, Line 7, column (f) "percent of total expense", does not include bad debt expense. Form 990, Part IX, Line 25 includes bad debt expense of $27,557,181. Part I, Line 7 - Explanation of Costing Methodology The Hospital's costing methodology used to calculate the amounts reported in Part I, Line 7 is as follows:a) Financial Assistance at cost- involves utilization of a ratio derived from dividing patient costs, as defined, by patient charges, as defined, and applying that percentage to total charity care charges.Patient costs reported in the cost accounting system are calculated based on Medicare principles of reimbursement by reducing total operating expenses by items such as bad debt expense, the cost of medical education, internally funded research, subsidized health services, community services, charitable contributions, and other operating revenue. Patient costs are then divided by patient charges to determine a ratio of cost to charges (RCC). This RCC is applied as the costing methodology for determining charity care expense.b) Medicaid- Medicaid expense is determined at cost as calculated by the Hospital's cost accounting system. The system applies historical costing methods applied to all patient segments based on various patient demographics and utilizations. These costing standards exclude bad debt, charity care, and the Medicaid portion of costs of health profession education which are reported on other areas of Line 7. These expenses include Medicaid provider taxes. Direct offsetting revenue is reported as amounts received from Medicaid, as well as other payments which include reimbursement under Federal "Upper Payment Limit" (UPL) and "Disproportionate Share Hospital" (DSH) programs.e) Community health improvement services and community benefit operations- Community benefit operations expenses are recorded as direct expenses incurred as reported by the Hospital's Community Health Services Department. Revenue received for these services is reported as direct offsetting revenue. f) Health profession education- Health profession education expenses represent direct costs related to amounts associated with resident and intern programs utilized at the Hospital. These costs are determined by reporting actual direct costs taken from the Medicare cost report. Direct offsetting revenue is reported as any direct Medicare reimbursements received for such services provided, as reported on the Hospital's Medicare cost report.g) Subsidized health services- Subsidized health services' community benefit expense is determined by the cost accounting system. These subsidized health services are recorded at cost in the Hospital's cost accounting system for all qualified subsidized health service divisions. This expense is adjusted to remove all related Graduate Medical Education (GME) expenses, as well as bad debt, Medicaid, and charity costs already reported in the applicable sections of Line 7. Net patient service revenue is recorded as amounts received from various payer types related to these services. Revenue associated with Medicare GME and Medicaid is excluded from the amount disclosed for subsidized health services.h) Research- The Hospital conducts extensive medical research focused on the prevention and treatment of HIV/AIDS, obesity, cancer, diabetes, cardiac disease, and mental health concerns. For all internal and external research conducted, the costs associated with these activities is calculated by combining the direct and indirect costs as reported within the Hospital's cost accounting system. Revenue received for these services is reported as direct offsetting revenue. i) Cash and in-kind contributions for community benefit- Expenses for cash and in-kind contributions for community benefit are determined by using direct costs recorded in the general ledger and including an allocation of contributions made by Lifespan Corporation on the Hospital's behalf. Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) The Miriam Hospital (the Hospital) uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at the Hospital is intended to define probable eligibility for public assistance (Medicaid or Community Free Service ("CFS")) for those patients who do not have the means to pay for hospital services rendered, as follows:1. Upon patient indication of an inability to pay required monies, the patient is offered the financial screening option to determine eligibility for public assistance (Medicaid, CFS).2. The application for CFS is completed and includes information relative to income, expense, and other available resources and requires proof of such information which may include:- most recently filed Federal income tax return and W-2 form(s)- copies of most recent savings and/or checking account statements- two most recently received payroll check stubs- copy of rent receipts for the last six months for proof of residency- copy of utility bills for the last month for proof of residency3. If the patient's financial situation falls within the guidelines for eligibility for Medicaid, RIte Care, or CFS, or if the patient has a long-term disability, the appropriate application process is completed. (Assistance to complete such applications is available from the Patient Financial Advocates (PFA) Office at the Hospital.)4. Uninsured patients receive an automatic 50% deduction at the Hospital.5. Eligibility for CFS above the 50% discount is provided for those applicants whose family gross income is at or below twice the Federal Poverty Guidelines, with a sliding scale for individuals up to four times the poverty level in effect at the time of application. Full charity care applicants with assets of more than $9,400 for an individual (or $14,100 for a family) may not qualify for care without charge, but may qualify for discounted care. While the maximum 100% discount may not be available to all charity care applicants based on the results of their asset test, all uninsured patients who receive care are eligible for, at a minimum, the 50% charity care discount. 6. For patients who qualify for less than 100% of the financial assistance program, a payment schedule is determined and agreed upon (discussed further below). Payment arrangements are established prior to service for non-urgent care. 7. In either case, the final results of the financial screening are recorded in the comments section of the Hospital's billing system.Requests for Payment Arrangements:Patient Financial Advocates (PFA) will qualify patients that are receiving non-urgent, medically indicated procedures prior to services. The PFA will request 75% to 100% of estimated charges (net of the automatic 50% discount) if the balance is under $5,000 and 50% to 100% of estimated charges (net of the automatic 50% discount) if the estimated bill equals or exceeds $5,000.For elective or non-urgent cases, the policy will require financial clearance prior to services or an exception from the Medical Director based on the clinical circumstances if the patient cannot meet the above payment agreement.Patients who do not qualify for total or partial CFS but who have difficulty in paying their bills after services are rendered may request enrollment in a payment plan. Eligibility for the payment plan includes the following guidelines:1. Immediate payment in full will result in financial hardship to the patient or the patient's family.2. Deposit of one-half of the estimated total bill is requested prior to admission.3. The minimum monthly payment of $50.00.4. The maximum length of the payment plan is twenty-four months.The Customer Service staff will set up the payment plan using the above guidelines as well as complete the necessary information on the "Payment Agreement" form and mail to the patient for signature.Account documentation will be done online. The pre-collect agency will be sent a copy of the payment agreement and all forms will be scanned into the PFS Optical Imaging System. true Thundermist Health Center 191 Social Street Woonsocket RI 02895 050355097 501(c)(3) 49500 0 Health Program Support RI Free Clinic 655 Broad Street Providence RI 02907 050501276 501(c)(3) 35110 0 General Support Ready To Learn Providence 945 Westminster Street Providence RI 02903 050467353 501(c)(3) 8000 0 General Support Mt Hope Neighborhood Assoc 199 Camp Street Providence RI 02906 222599257 501(c)(3) 8490 0 General Support Mt Hope Learning Center 140 Cypress Street Providence RI 02906 050502405 501(c)(3) 15000 0 General Support Groundwork Providence 8 Third Street Providence RI 02906 050397766 501(c)(3) 15000 0 General Support Festival Ballet Providence 825 Hope Street Providence RI 02906 050377245 501(c)(3) 7700 0 FMV General Support Downtown 5K Inc 183 Purgatory Road Exeter RI 02822 223047066 501(c)(3) 10000 0 General Support City of Providence 25 Dorrance Street Providence RI 02903 056000329 Gov't Org. 216000 0 Payment in lieu of taxes Brown University 164 Angell Street Providence RI 02912 050258809 501(c)(3) 151758 0 General Support 10 0 Additional Supplemental Information The Miriam Hospital is committed to community programs and provides support to various charitable organizations in Rhode Island. Donations are made to organizations recognized by the IRS as being described in IRC Section 501(c)(3). All contributions are approved by management and are made to organizations whose missions and goals align with those of the Hospital.In 2012, Lifespan, on behalf of Rhode Island Hospital and The Miriam Hospital, reached an agreement with the City of Providence to make voluntary payments to help stabilize the city's financial health. Lifespan has always maintained a strong commitment to Providence through its many community-based programs, as well as through the charity care it provides. As an organization, Lifespan understands that Providence's fiscal health is vital to the economic health of the entire State of Rhode Island. The agreement is a groundbreaking partnership that demonstrates Lifespan's commitment to help ensure a strong and vital Providence. X X true true X X X X X true true false false false false false true false false Timothy J Babineau MD 811918 282352 392457 182032 23245 1692004 87782 Silvia Degli Esposti MD 317634 27841 3082 14495 21114 384166 Rogers C Griffith MD 285274 12226 14495 24445 336440 Robert W Corwin MD 244210 57000 53923 5000 16356 376489 Rena R Wing 274247 7466 14458 9000 305171 Penelope H Dennehy MD 191709 6318 4496 10312 10179 223014 Michael P Carey PhD 321735 1997 14495 23141 361368 Mary A Wakefield 531513 175000 91565 281479 16448 1096005 68467 Maria P Ducharme 209483 50000 14932 45032 20432 339879 Kenneth A Arnold 451707 145000 2957760 12500 17106 3584073 2094059 Kathleen Hittner MD 388655 120000 199614 875273 19547 1603089 Arthur J Sampson 372859 104000 69927 73481 16560 636827 45784 Sch J, Part I, Line 7 Part I, Line 7: Non-Fixed payments not listed above The Lifespan Annual Incentive Compensation Plan provides a financial award opportunity for designated members of management, based on quantified objectives that are approved in advance by the Compensation Committee of the Lifespan Corporation Board of Directors. A specified level of financial performance must be met before any award is earned. The objectives vary from year to year and generally include various aspects of financial measures in addition to non-financial performance measures. For certain participants in the Lifespan Annual Incentive Compensation Plan, the award opportunity is divided into two pools. The first pool represents 80% of any earned incentive award, based on the achievement of the team performance objectives. The remaining 20% pool is distributed on an individual basis to participants at the discretion of the CEO, in each case subject to approval by the Compensation Committee of the Lifespan Corporation Board of Directors. Sch J, Part I, Line 1a 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).Social Club Dues:The job responsibilities of certain executives include development of relationships with business leaders and donors. Those relationships are facilitated by the ability to meet in private sessions during which focused business discussions take place. The Hope and University Clubs, which require individual memberships, are places in Providence where businessmen and women, civic, community, and social leaders can gather in a businesslike atmosphere. The cost of membership is considered by Lifespan to be reasonable and necessary and thus a qualified business expense not taxable to the employee. IRS regulations regarding documentation requirements are followed for any payments made for meetings held at the respective club, including the business purpose and nature of the business benefit derived; the nature of the business discussion or activity; and the identity and business relationship of attendees. B RI Health & Ed Bldg Corp 521300173 762243K36 2009-03-30 19582506 See Part V false false true A RI Health & Ed Bldg Corp 521300173 762243SS3 2006-02-14 40725126 See Part V false false true B 19582506 1954827 288639 339121 10798852 6201067 false false false true A 6525610 37924625 40725126 348652 968829 39407645 2006 false true true true B false false false true true 0.00500 0.00500 false false true A false true false true true 0.00330 0.00670 0.01000 false false true B false false false true false false false true A false false false true false false false true B true A true Supplemental Information Part VI Schedule K, Part I, Lines A & B, Column (f) - see description of purpose on Schedule O.Schedule K, Part IV, Line 2c:For the 2006 Lifespan Obligated Group bond issuance, a rebate computation was performed on May 31, 2013 in which the calculation reflected no rebate due.For the 2009 Lifespan Obligated Group bond issuance, a rebate computation was performed on May 15, 2013 in which the calculation reflected no rebate due. Lawrence Investments Vice Chair 124892 Property Lease false Lawrence Aubin, Vice Chair, is the owner of Lawrence Investments, LLC, which owns the West Bay Medical Center Building which leases space to The Miriam Hospital. In fiscal year 2013, The Miriam Hospital paid Lawrence Investments $124,892 for such leased space. Form 990, Schedule K, Part I, Line B, Column (f) The proceeds of the Series 2009A Bonds are being used for the purposes of financing projects consisting of: (i) the acquisition, construction, renovation, expansion and equipping of certain hospital and related health care facilities owned and operated or to be owned and operated by one or more of Rhode Island, The Miriam, or Emma Pendleton Bradley Hospitals, located at and in the vicinity of the Hospital Campuses; (ii) equipping, furnishing, and improving facilities and other depreciable assets used in health care operations on the Hospital Campuses; (iii) the funding of a debt service reserve fund for the Bonds; and (iv) and the payment of certain expenses of issuance with respect to the Bonds. Form 990, Schedule K, Part I, Line A, Column (f) The proceeds of the Series 2006A Bonds were used: (i) to advance refund a portion of the $214,585,000 Hospital Financing Revenue Bonds, Lifespan Obligated Group Issue, Series 1996; (ii) to advance refund a portion of the $78,000,000 Hospital Financing Revenue Bonds, Lifespan Obligated Group Issue, Series 2002 and (iii) to pay certain expenses incurred in connection with the issuance of the Series 2006A Bonds. Form 990, Part VI, Section B, Lines 15 a&b cont. Base Salary Actions: The CEO recommends any salary adjustments for participants in the executive compensation program, using the results of the valuation study and his/her assessment of individual performance or other pertinent information, for the Committee's consideration.New Participants in Executive Compensation Program: With respect to compensation offers for individuals expected to participate in the executive compensation program, the Office of the President works with the Committee's independent compensation consultant or relies on information previously provided by the consultant to establish a range of reasonable cash compensation within which recruitment is expected to conclude with acceptance of a reasonable compensation offer. Form 990, Part VI, Section B, Lines 15 a&b The following applies to Lifespan and all of its affiliates, including The Miriam Hospital:EXECUTIVE COMPENSATIONLifespan's executive compensation philosophy balances appropriate stewardship of resources and the need to be competitive in recruiting and retaining talented individuals. It incorporates market-competitive and performance-related principles, and covers the President and CEO of Lifespan as well as other officers, senior management, and key employees. Lifespan's executive compensation program complies both with law and with contemporary ethical norms, and is administered consistent with the organization's tax-exempt status under Section 501(c)(3) of the Internal Revenue Code (IRC) and the avoidance of transactions subject to intermediate sanctions under Section 4958 of the IRC. Executive compensation is also administered consistent with Lifespan's Corporate Compliance Policy on Excess Benefit Transactions.The Compensation Committee of the Lifespan Corporation Board of Directors (the Committee), comprised of disinterested Lifespan and affiliate Board members, is responsible for diligent oversight of executive compensation to ensure compliance with IRC requirements. Its duties include:* Approving eligibility for participation in the executive compensation program * Approving changes in compensation for existing executive participants * Approving guidelines, such as salary ranges and contract terms, on appropriate levels of compensation for other key employees* Approving new, and modifying or terminating existing, executive compensation plans including, but not limited to, annual incentive and executive benefit plans* Approving performance objectives associated with Lifespan's annual incentive plan, including measuring points, and using audited actual performance relative to these objectives as a precondition to approving the payment of any awards under the plan* Authorizing periodic performance benchmark studies to be conducted for purposes of assessing Lifespan's performance within the healthcare industry and the degree to which total remuneration levels at Lifespan are generally commensurate with Lifespan performance relative to healthcare industry performance* Conducting an annual performance review of Lifespan's Chief Executive Officer. The Chair of the Committee conducts and documents this review, based on his/her observations and interpretation of feedback from members of the Board of Directors* Selecting and engaging qualified, independent, third party compensation valuation consultants that the Committee charges with rendering opinions with respect to the reasonableness and comparability of compensation as well as the comparative organizations against which compensation is assessed, in accordance with relevant sections of the IRC and Lifespan's executive compensation philosophy. The independent consultants are not engaged by management to perform any services for Lifespan without prior approval by the Committee.Lifespan's Chief Executive Officer works closely with the Committee to make recommendations on the above topics and keep the Committee informed about contemplated compensation changes for executives and other key employees, as well as candidates for these roles. The CEO also provides periodic updates to the Committee regarding Lifespan's performance relative to compensation-related performance objectives. The Committee's deliberations and actions are documented in minutes prepared for each meeting.PROCESS FOR DETERMINING COMPENSATION Valuation of Total Cash and Total Remuneration: No less frequently than annually, the Committee receives and reviews a total cash compensation valuation of all existing executive compensation program participants prepared by its independent compensation consultant. Annually, the Committee also receives and reviews a total remuneration valuation of all existing executive compensation participants. Form 990, Part VI, Section B, Line 12c Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including The Miriam Hospital, 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 A, Line 1b: Edward Feldstein, Trustee, is a partner in Roberts, Carroll, Feldstein, and Peirce, a law firm that provides legal services to Lifespan Risk Services, Inc.David Gorelick, Trustee, is an officer of Aquidneck Medical Associates, a physician practice which has a professional service contract with Newport Hospital.Shivan Subramaniam, Trustee, is the Chairman and CEO of FM Global. Lifespan purchases property insurance coverage from Factory Mutual Insurance Company, a member of FM Global. During calendar year 2012, Brian Zink, Trustee, received taxable tuition reimbursement paid for by Rhode Island Hospital. Form 990, Part III, 4c TMH conducts extensive medical research and is in the forefront of biomedical health care delivery research and among the leaders nationally in National Institutes of Health programs.Major areas of research include:Cancer - TMH conducts clinical and behavioral research focusing on the many facets of cancer including prevention, education, and therapeutics which are supported by the National Cancer Institute, CALGB, and NSABP. TMH is a participating hospital in the Brown University-sponsored Cancer Oncology Group (BrUCOG).HIV - At TMH, research focuses on the treatment and prevention of HIV infections, especially in hard-to-reach populations, both in the U.S. and abroad. There are international sites located in Cambodia, India, Kenya, Indonesia, The Philippines, and South Africa. The Lifespan/Tufts/Brown Center for AIDS Research conducts clinical, basic, and translational research programs. The TB Clinic performs research in the area of co-infections of HIV and tuberculosis. Depression - The Center for Behavioral and Preventive Medicine (CBPM) is comprised of major centers including: (1) Weight Control and Diabetes, (2) Nicotine & Tobacco Research, and (3) Physical Activity Research.The Weight Control and Diabetes Center conducts research programs that focus on diet, exercise, maintenance strategies, home environment, adolescent issues, and pediatric obesity.The Physical Activity Research Center conducts research in the workplace, community settings, and health care facilities, involving all age groups and focusing on the effects of exercise in disease prevention and treatment. Form 990, Part III, 4b In 1969, TMH and certain other Rhode Island hospitals entered into an affiliation agreement to participate jointly in various clinical training programs and research activities with Brown Medical School, renamed The Warren Alpert Medical School of Brown University (Brown). The goals of the partnership are to facilitate the expansion of joint educational and research programs to compete both clinically and academically.The Hospital participates in Brown programs in internal medicine and medicine subspecialties, general surgery and surgical subspecialties, psychiatry, emergency medicine, orthopedics, and dermatology. The Hospital provides stipends to residents and physician fellows while in training.The Hospital is also a participating clinical training site for residents from other programs in anesthesiology, pediatric dentistry, family medicine, infectious disease, obstetrics/gynecology (OB/Gyn) and OB/Gyn subspecialties, otolaryngology, podiatry, psychiatry, geriatric psychiatry, orthopedics, rheumatology, and radiation oncology. In addition, TMH Behavioral Medicine, in collaboration with Brown, sponsors research and clinical psychology training programs for interns, postdoctoral fellows, and faculty trainees.With respect to nursing education, the Hospital has developed educational affiliations with the University of Rhode Island College of Nursing; Rhode Island College School of Nursing; Community College of Rhode Island (CCRI); Salve Regina University; Boston College; Yale University; Regis College; Simmons College; St. Josephs Health Services School of Nursing; the University of Massachusetts campuses at Dartmouth, Boston, Amherst, and Worcester; the University of Connecticut; New England Technical Institute; Northeastern University; Walden University; and the University of Pennsylvania, as well as other Schools of Nursing, pursuant to which their nursing students obtain clinical training and experience at the Hospital. The Hospital does not receive any compensation from the various schools for providing a clinical setting for the student nurse training.The Hospital sponsors training programs for a variety of allied health care professionals including required clinical and fieldwork experiences in physical, speech, and occupational therapy to university students in each discipline through contracts with the various universities. The Hospital serves as a clinical training site for students from CCRI for the vascular and cardiology ultrasound programs and also provides training experiences for students in diagnostic radiology, medical technology, phlebotomy, and social work. The Hospital serves as a clinical training site for students from The Nuclear Medicine Institute of the University of Findlay (Ohio). The Hospital has clinical affiliations/student clinical training programs for pharmacy students provided through contracts with a number of colleges and universities. Form 990, Part III, 4a, continued TMH is licensed to operate 247 acute care beds by the Rhode Island Department of Health. Notable medical accomplishments of TMH include performance of Rhode Island's first lung operation, first kidney transplant and first aortic valvuloplasty (a procedure to clear blocked heart valves). In 2013, TMH discharged 15,002 inpatients, logged more than 60,500 visits in its emergency department, and performed nearly 11,000 inpatient and outpatient surgical procedures. Services provided in 2013 represent nearly 61,600 inpatient days and more than 105,000 clinic visits. TMH is staffed by more than 1,000 affiliated physicians, approximately 50 full-time house staff (medical school graduates), a nursing staff of 500 and more than 1,100 health care employees. In total, TMH employs more than 2,600 people. TMH is a major teaching affiliate for The Warren Alpert Medical School of Brown University, providing clinical rotations for residents.TMH provides full charity care for individuals at or below twice the federal poverty level, with a sliding scale for individuals up to four times the poverty level. In addition, a substantial discount is offered to all other uninsured patients. The Hospital determines the cost associated with providing charity care by aggregating the applicable direct and indirect costs, including compensation and benefits, supplies, and other operating expenses, based on data from its costing system. The total cost, excluding medical education and research, incurred by the Hospital to provide charity care amounted to $14,881,886 in fiscal 2013. Charges forgone, based on established rates, amounted to $49,616,544.TMH substantially subsidized various health services including oncology, HIV, tuberculosis and men's health clinics at a cost of $7,312,664 in fiscal year 2013. TMH also provides numerous other services to the community for which charges are not generated. These services include certain emergency services, community health screenings for cardiac health, prostate cancer and other diseases, smoking cessation, immunization and nutrition programs, diabetes education, community health training programs, patient advocacy, foreign language translation, physicianreferral services, and charitable contributions. The cost of these services amounted to $280,561 in fiscal year 2013.TMH subsidizes the cost of treating patients who receive government assistance where reimbursement is below cost. Medicaid is a means-tested health insurance program, jointly funded by state and federal governments. States administer the program and set rules for eligibility, benefits, and provider payments within broad federal guidelines. The program provides health care coverage to low-income children and families, pregnant women, long-term unemployed adults, seniors, and persons with disabilities. Eligibility is determined by a variety of factors, which include income relative to the federal poverty line, age and immigration status, and assets. Form 990, Part I, Line 6 Volunteers support and contribute to the mission of TMH every day. They are able to learn, meet other dedicated volunteers, better understand the healthcare environment, and gain personal satisfaction knowing they are making a difference to patients, families, visitors, and vendors alike. Volunteer opportunities are available for both teens and adults in a wide variety of positions, including greeters, family liaisons, emergency room support, gift shop support, nurse aides, office support, pet therapy, physical therapy, patient visitors, recovery room support, art therapy, and central transporters. Volunteers also transport students and serve as guides, escorts, and interpreter aides. TMH's surgeons are leaders in their field. TMH, as part of an academic medical center, prizes the mastery of new technologies in order to improve the quality of life for patients. TMH surgeons have successfully performed over 1,000 procedures using the da Vinci surgical system and have made its use a cornerstone of cancer treatment at TMH. The Comprehensive Cancer Center brings together world-renowned physicians and a group of specialists from TMH, Rhode Island Hospital, and Newport Hospital, forming a multidisciplinary team whose level of knowledge and experience are unparalleled in Rhode Island.The Hospital's Adult Outpatient Behavioral Medicine Services help individuals improve health through behavior change. Services are offered to help patients adjust to chronic medical conditions, including their associated physical and emotional distress; modify unhealthy ways of living (for example, smoking cessation) to help prevent the onset or progression of disease; and treat mood and anxiety disorders that interfere with management of medical conditions. Services are available to help individuals with behavioral and psychosocial management of medical conditions such as headache, pain, cancer, heart disease (including those with implanted cardiac devices), pulmonary disease, and diabetes. The Weight Management Program provides comprehensive, medically supervised treatment for mild, moderate, and severely overweight adults. Specialized programs are also available for adolescents and diabetics. Treatment combines medical monitoring, behavioral therapy, exercise instruction, three levels of calorie reduction and nutrition education. The Hospital's clinicians include surgical oncologists, medical oncologists, radiation oncologists, hematologists, pathologists, physical therapists, radiologists, nurses, clinical social workers, patient advocates, pharmacists, and nutritionists. These dedicated specialists work with patients every step of the way, from diagnosis to treatment to follow-up care.To help patients and their families cope with breast cancer, TMH offers the Breast Health Navigator Program. The program assists breast cancer patients through the entire course of their cancer care with breast health navigators, registered nurses trained in oncology who possess an in-depth understanding of breast cancer and theprocess undergone by patients. They guide patients through diagnosis, treatment, andrecovery, while helping them make informed decisions and cope with the variety of issues they face.TMH and Rhode Island Hospital were named Blue Distinction Centers for Complex and Rare Cancers by Blue Cross and Blue Shield of Rhode Island. TMH and Rhode Island Hospital are the only two hospitals in the State to receive this distinction. Blue Distinction Centers for Complex and Rare Cancers are facilities within participating Blue Cross and Blue Shield network service areas that offer comprehensive inpatient cancer care programs for adults, delivered by multidisciplinary teams with subspecialty training and distinguished clinical expertise in treating complex and rare subtypes of cancer. TMH and Rhode Island Hospital have both been recognized for excellence in treating esophageal, gastric, liver, pancreatic, rectal, and thyroid cancer.The division of gastrointestinal and liver pathology is committed to providing high quality diagnostic services for gastrointestinal and liver diseases in patients.Collectively, gastrointestinal cancers are among the most common form of malignancies suffered today, affecting nearly a quarter of a million Americans each year. To address this, the Comprehensive Cancer Center has brought together nationally recognized leaders in the treatment and research of gastrointestinal cancers. TMH has been named among the nation's 100 top hospitals for cardiovascular care by Thompson Healthcare. Thompson's annual study identifies hospitals that are setting benchmark levels of performance for cardiovascular services throughout the nation. It recognizes the hospitals and their management teams for superior clinical, operational, and financial performance in the area of cardiovascular service.TMH's cardiac surgery department is led by four board certified cardiothoracic surgeons, each able to perform a wide variety of cardiac, thoracic, and peripheral vascular procedures. They represent more than ninety years of cumulative experience.Anesthesiologists dedicated to the management of complex cardiothoracic and vascular procedures provide each patient with the latest measures of intraoperative therapy and assessment. Every patient is monitored with a transesophageal echocardiogram (sonogram). TMH's team of surgeons, anesthesiologists and cardiologists works closely together. This cooperative approach has led to outstanding results at all levels of complexity.Thanks to the latest evolution in surgical technology, physicians now have an effective alternative to traditional open surgery and laparoscopy that allows them to provide patients with the best of both approaches. This alternative is the da Vinci Surgical System and TMH uses this technology to treat different types of cancer. The Total Joint CenterThe Total Joint Center at The Miriam Hospital is dedicated to providing the most technologically advanced and specialized procedures focused on the replacement of joints and rehabilitation and care in treating diseases of, or injuries to, hips, knees, and shoulders. The Miriam Hospital is a Blue Cross Blue Shield Blue Distinction Center for Knee and Hip Replacement, which is a designation given to hospitals that demonstrate an expertise in quality care by meeting objective clinical measures, resulting in better outcomes for patients.Medical and surgical services at the Total Joint Center are provided in a personalized, caring environment within the context of an academic medical center. All services focus on the patient experience from initial consultation through recovery.Multidisciplinary medical teams include many dedicated specialists - surgeons, internal medicine specialists, anesthesiologists, nurses, rehabilitation therapists, and social workers who work with patients from diagnosis to treatment to follow-up care. The physical therapy and nursing teams work together after surgery to get patients moving for faster recovery, and physicians, nurses and therapists work collaboratively to follow up care.Each patient benefits from individualized treatment plans and rehabilitation to aid recovery and restore functionality as quickly as possible. Whenever possible, minimally invasive surgery techniques are used to perform surgery. These techniques have dramatically improved the quality of the post-operative and recovery experience for the patient. In some cases and when appropriate, computer navigation technology is used for knee and hip replacement surgeries. Computer navigation can assist the surgeon and improve the level of accuracy, bringing the precision of bone cuts and implant alignment in joint replacement surgery to a whole new level of accuracy, reliability, and longevity.During 2013, in addition to new leaders and new services, Lifespan also brought new treatments to Rhode Island, invested in technology that enhanced its surgical capabilities, and extended its services beyond the walls of its hospitals. TMH became the first hospital in Rhode Island to perform thoracic surgery using minimally invasive robotic technology and opened the Kidney Stone Center, the only center of its kind in the state, bringing together a team of nephrologists, urologists, and dietitians all under one roof.Award-Winning CareIn 2013, TMH was named the top hospital in Rhode Island and southeastern Massachusetts for the second consecutive year, according to U.S. News & World Report. The Hospital was recognized as high performing in eight medical specialties, including cancer, diabetes/endocrinology, gastroenterology and surgery, geriatrics, nephrology, neurology and neurosurgery, pulmonology, and urology.Blue Distinction Center Recognition for Knee and Hip ReplacementAlso in 2013, TMH was named a "Blue Distinction Center in Knee and Hip Replacement" by Blue Cross and Blue Shield of Rhode Island. The Blue Distinction Centers for Specialty Care program is a national designation awarded to medical facilities that have demonstrated expertise in delivering quality specialty care.Award-Winning Stroke CareTMH received a 2013 "Get With The GuidelinesStroke Gold Plus Quality Achievement Award" from the American Heart Association, recognizing the hospitals commitment and success in implementing a higher standard of care by ensuring that stroke patients receive treatment according to nationally accepted guidelines.Environmental Partnership AwardTMH has received the "Partner Recognition Award" from Practice Greenhealth, a health care membership community that promotes efficiency and environmental stewardship while improving patient safety and care. National Stroke Center CertificationIn 2012, TMH's Stroke Center received a Gold Plus Performance Achievement Award from the American Heart Association/American Stroke Association. This is the association's highest honor for stroke care.Also in 2012, TMH earned the elite Gold Seal of Approval from The Joint Commission for Primary Stroke Centers, a national honor awarded to the country's top stroke programs. TMH, which was the first hospital in Rhode Island to be certified a Primary Stroke Center, holds distinction as the only facility in the state to be certified four times.Outstanding Achievement Award from the Commission on Cancer The Leonard and Adele R. Decof Family Comprehensive Cancer Center at The Miriam Hospital was presented with the 2012 Outstanding Achievement Award by the American College of Surgeons (ACS) Commission on Cancer (CoC). TMH is one of only 79 health care facilities in the country and the only in Rhode Island to receive this national honor based on excellence in providing quality care to cancer patients. Center of Excellence DesignationTMH was named an American Society for Metabolic and Bariatric Surgery (ASMBS) Bariatric Surgery Center of Excellence. The designation recognizes surgical programs with a demonstrated track record of excellence in providing superior and comprehensive bariatric surgery care.AACVPR Program Certification During 2011, The Miriam Hospital pulmonary rehabilitation program was awarded certification from the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). Certified AACVPR programs are recognized as leaders in the field of cardiovascular and pulmonary rehabilitation because they offer the most advanced practices available.Magnet Hospital DesignationIn 2010, for the fourth consecutive time, TMH received Magnet designation for overall nursing care and excellence from the American Nurses Credentialing Center (ANCC). Only three other facilities in the United States have been designated a Magnet hospital four times, and TMH is the only hospital in New England to earn this honor. The program provides a framework to recognize excellence in the managementphilosophy and practice of nursing services, adherence to standards for improving the quality of patient care, and continued competence of nursing personnel. In addition, recipient hospitals must demonstrate attention to the cultural and ethnic diversity of patients and their significant others, as well as the care providers in the system. The Magnet Award for Nursing Excellence is the highest level of recognition the American Nurses Credentialing Center can bestow upon organized nursing services in health care organizations. The Center's team-based approach provides state-of-the-art care for patients who have or are at risk for cancers of the upper gastrointestinal tract, such as pancreatic cancer, cancer of the esophagus, and tumors involving the liver.The gastrointestinal cancer care services available through the Comprehensive Cancer Center provide care for patients who have or are at risk for the following types of cancer: bile duct, esophagus, gallbladder, endocrine, and cystic tumors of the pancreas, liver, and stomach. TMH also offers medical nutrition therapy on an outpatient basis designed to help prevent and control gastrointestinal disorders. Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Increases Increase in Net Assets of TMHF = $6038445 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Increases Change in Funded Status of Pension & Other Postretirement = $10194800 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Lifespan and the Lifespan Obligated Group, which consists of The Miriam Hospital, RIH and Affiliates, Emma Pendleton Bradley Hospital, Rhode Island Hospital Foundation, and The Miriam Hospital Foundation, currently make their annual and quarterly consolidated financial statements available to the public via DAC (Digital Assurance Certification LLC), a disclosure dissemination agent for issues of tax-exempt bonds which electronically posts and transmits Lifespan's financial information to repositories and investors alike. In addition, copies of TMH's Articles of Incorporation, Bylaws, and Conflict of Interest Policy are available upon request from the office of the Lifespan Chief Financial Officer, either in person or by mail. Form 990, Part VI, Line 11b 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 Chief Financial Officer and Lifespan's Finance Department, with review by Lifespan's tax advisors, KPMG, LLP. The Form 990 is prepared by the accounting staff upon completion of The Miriam Hospital's annual independent audit for initial review by the Director of Finance and the Vice President of Finance - Corporate Services. Once the draft 990 is complete, the Director of Finance forwards it with all supporting worksheets to KPMG, which then reviews the completed form in detail. The Director of Finance answers questions as they arise and provides additional information as needed. Any recommended changes are incorporated into the return. The draft Form 990 is then provided to the Chief Financial Officer 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 Hospital'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 Chief Financial Officer 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 Chief Financial Officer is authorized to file the Form 990. Form 990, Part VI, Line 7b Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders Lifespan has the responsibility for planning, directing and establishing policies intended to assure the development and delivery of quality health services on an integrated, cost-effective basis. Powers reserved to Lifespan, in addition to those noted above, include: to approve amendment of the Articles of Incorporation and Bylaws and other Charter documents; to approve strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness. Form 990, Part VI, Line 7a Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body The bylaws of The Miriam Hospital (TMH) confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination and support of the system. Powers reserved to Lifespan include: to elect and remove trustees and to approve the election of and to remove certain officers. At each annual meeting of the TMH Board of Trustees, a list is compiled of the names of those persons selected to serve as Trustees of TMH so that it can be approved and submitted to Lifespan for ratification and election. Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Lifespan Corporation is the sole corporate member of The Miriam Hospital. Form 990, Part VI, Line 4 Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents Effective October 23, 2012, the Board of Directors of Lifespan and the Boards of Trustees of Rhode Island Hospital, The Miriam Hospital, Newport Health Care Corporation, Newport Hospital, and Emma Pendleton Bradley Hospital approved a restructuring of their governance. The restructuring has increased governance effectiveness and has streamlined governance operation, as well as provided a single strategic perspective for the Lifespan system hospitals. Pursuant to the restructuring, the Bylaws of Lifespan were amended such that the composition of the Boards of Trustees of each of the hospitals and of Newport Health Care Corporation is defined as those persons serving from time to time as the directors of Lifespan. As a result, the Boards of each entity are comprised of the same individuals. The Board of each entity retains its responsibilities and authorities notwithstanding the revision in its composition. The Board of Directors of Lifespan consists of not less than fourteen nor more than thirty-one directors, including the President and CEO of Lifespan, who serves ex-officio with vote, and the following ex-officio voting directors: the chair of each of Rhode Island Hospital Foundation, The Miriam Hospital Foundation, Newport Hospital Foundation, Bradley Hospital Foundation, and Gateway Foundation. Form 990, Part VI, Line 2 Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Kenneth E. Arnold, Secretary, Timothy J. Babineau, MD, President, and Mary A. Wakefield, CFO, are officers of related for-profit corporations. Mr. Arnold and Ms. Wakefield are officers of Lifespan Management Services Organization, Inc (MSO) and Lifespan Risk Services, Inc. Dr. Babineau and Ms. Wakefield are officers of VNA Technicare, Inc. (VNA). Additionally, Scott B. Laurans, Chair, is an officer of VNA.Jonathan Fain, Trustee, is the CEO of Teknor Apex Co. Bertram Lederer, Trustee, is also a Director of Teknor Apex Co. RI Sound Enterprises Insurance Co Ltd 65 Front Street Hamilton BD HM 12 Offshore Insurance Captive BD N/A N/A Lifespan Corporation 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 Wentworth Corporation 249 Roosevelt Avenue Pawtucket RI 02860 050488520 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 Gateway Healthcare Inc 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 The Miriam Hospital Womens Assoc 164 Summit Avenue Providence RI 02906 050268165 Patient Support RI 501(c)(3) 11 Lifespan Corporation false The Miriam Hospital Foundation 167 Point Street Providence RI 02903 050377502 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation 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 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 RIH Ventures 593 Eddy Street Providence RI 02903 050448686 Parking Facilities/Phlebotomy Services RI 501(c)(3) 11 Lifespan Corporation false Rhode Island Hospital Foundation 167 Point Street Providence RI 02903 050468736 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false Rhode Island Hospital 593 Eddy Street Providence RI 02903 050258954 Health Care Services RI 501(c)(3) 3 Lifespan Corporation 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 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 NHCC Medical Associates Inc 11 Friendship Street Newport RI 02840 050472268 Health Care Services RI 501(c)(3) 11 Newport Health Care Corporation false Newport Hospital Foundation Inc 11 Friendship Street Newport RI 02840 222535533 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false Newport Hospital 11 Friendship Street Newport RI 02840 050258914 Health Care Services RI 501(c)(3) 3 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 Health Care Corporation 11 Friendship Street Newport RI 02840 222535537 Holding Company/ Mgmnt Services RI 501(c)(3) 7 Lifespan Corporation 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 LJR Corporation 249 Roosevelt Avenue Pawtucket RI 02860 030508346 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 Gateway Healthcare Inc false Lifespan School Solutions Inc 167 Point Street Providence RI 02903 464910847 Educational Services RI Applied For Emma Pendleton Bradley Hospital false Lifespan Physician Group Inc 167 Point Street Providence RI 02903 050389801 Health Care Services RI 501(c)(3) 9 Lifespan Corporation false Lifespan of Massachusetts Inc c/o Archstone Law 245 Winter St Waltham MA 02451 043408517 Holding Company RI 501(c)(3) 11 Lifespan Corporation false Lifespan Foundation 167 Point Street Providence RI 02903 050493219 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false Lifespan Diversified Services Inc 167 Point Street Providence RI 02903 050258935 Holding Company/ Mgmnt Services RI 501(c)(3) 11 Lifespan Corporation false Lifespan Corporation 167 Point Street Providence RI 02903 222861978 Holding Company/ Mgmnt Services RI 501(c)(3) 11 NA 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 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 Hospital Properties Inc 167 Point Street Providence RI 02903 222869743 Property Management RI 501(c)(4) N/A 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 Gateway Foundation 249 Roosevelt Avenue Pawtucket RI 02860 464002163 Philanthropic Activities RI Applied For 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 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 Capital City Community Centers Inc 249 Roosevelt Avenue Pawtucket RI 02860 050259090 Daycare Services RI 501(c)(3) 7 Gateway Healthcare Inc false Bradley Hospital Foundation 167 Point Street Providence RI 02903 050500688 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation 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 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 Gateway Professional Group Inc 249 Roosevelt Avenue Pawtucket RI 02860 050498391 Psychotherapy RI Gateway Healthcare C Corp false VNA Technicare Inc 622 George Washington Highway Lincoln RI 02865 050472710 DME Sales RI LDS Inc C Corp false Lifespan Risk Services Inc 167 Point Street Providence RI 02903 050459767 Risk Mgmnt RI Lifespan Corp C Corp false Lifespan MSO Inc 167 Point Street Providence RI 02903 050508717 Mgmnt Services RI Lifespan Corp C Corp false false false true false false false false false false true true true true true true true true false false