2014-08-15T06:09:06-07:00 2013-09-30 KPMG LLP 2 Financial Center 60 South St Boston MA 02111 990 2012-10-01 050258914 Newport Hospital NEWP 4018466400 11 Friendship Street Newport RI 02840 Mary A Wakefield 2014-08-15 true P01245482 6179885805 2012 2015-11-30 17:44:51Z Mary A Wakefield 593 Eddy Street Providence RI 02903 624690577 false false X www.lifespan.org/newport/ X 1873 RI Newport Hospital (NH) is a 129-bed nonprofit acute care hospital providing inpatient, outpatient and emergency care services to the southern Rhode Island community. 28 21 917 200 145067 6050576 7590690 107495676 108585251 6102830 3926263 0 119649082 120102204 113880 0 0 51575158 53802107 0 0 57656308 61469375 109345346 115271482 10303736 4830722 325683730 325236038 45245598 42203382 280438132 283032656 X Newport Hospital (NH) is a 129-bed nonprofit acute care hospital providing inpatient, outpatient, and emergency care services to the southern Rhode Island community. (See Schedule O, Part III, Line 1) false false 46458215 48358605 During the fiscal year ended September 30, 2013, Newport Hospital (NH) reported 22,544 inpatient days, 4,392 discharges, 502 newborn deliveries and 1,258 inpatient surgeries. NH provides a range of diagnostic therapeutic healthcare services including: behavioral medicine, cardiac services, childbirth, orthopedics, and pulmonary medicine. (See Schedule O, Part III, Line 4a) 44983335 57283366 NH also provides healthcare services on an outpatient basis. In fiscal year 2013, NH experienced outpatient volume of 43,985 equivalent outpatient days and performed 4,470 outpatient surgeries. Outpatient services are also provided in the hospital emergency department. The hospital emergency department had 30,666 patient visits in fiscal 2013. (See Schedule O, Part III, Line 4b) 3334490 2943280 The Noreen Stonor Drexel Birthing Center (the Center) at NH delivered 502 births during the fiscal year ended September 30, 2013. The birthing center is a separate unit at NH for labor and delivery so patients can remain in the same location for labor, delivery, recovery, and post-partum care. The Center staff includes board-certified obstetricians, pediatricians, family practitioners, anesthesiologists, a certified nurse mid-wife, and registered nurses who have received national certifications in obstetrical nursing. The Center at NH has received the "Baby Friendly" designation from the World Health Organization and UNICEF. 94776040 true true false true false false false false false true true true false true true true true true false false false false false false false false true true false false true false false false false false false false false false false true false false false false false true false false false false true 68 0 true 917 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 0.08 3.92 X 0 1000 0 Leonard C Taddei MD 0.00 0.00 X 0 0 0 Shivan Subramaniam 0.22 3.78 X 0 0 0 Charles Stengel 0.00 0.00 X 0 0 0 Hon Bruce Selya 0.50 8.50 X 0 0 0 Suzette D Schochet 0.00 0.00 X X 0 0 0 Fred J Schiffman 0.00 0.00 X 0 0 0 Lawrence Sadwin 0.33 7.67 X 0 0 0 Kathleen H Ross 0.00 0.00 X 0 0 0 Lloyd Robertson 0.33 20.67 X 0 0 0 James A Purviance 0.00 0.00 X 0 0 0 Steven Pare 0.67 11.83 X 0 0 0 Christopher S Ottiano MD 0.00 0.00 X 0 0 0 Stephen P Massed 0.33 16.17 X X 0 0 0 Alan H Litwin 0.67 19.33 X 0 0 0 Bertram M Lederer 0.00 14.00 X 0 0 0 Scott B Laurans 0.50 11.00 X X 0 0 0 Marie J Langlois 0.00 3.00 X 0 0 0 Dayle Hunt Jospeh 0.30 5.70 X 0 0 0 Pamela Harrop MD 0.10 3.90 X 0 0 0 Michael L Hanna 0.00 0.00 X 0 0 0 David Gorelick MD 0.20 2.80 X 0 0 0 David S Gordon 0.00 0.00 X 0 0 0 Christine A Gill 0.00 0.00 X X 0 0 0 Rita B Gewirz 0.00 0.00 X 0 0 0 M Lynne Francis 0.00 0.00 X 0 0 0 Jason Fowler 0.00 0.00 X 0 0 0 Edward D Feldstein 0.11 6.89 X 0 0 0 Alan R Feinberg DMD 0.00 0.00 X 0 0 0 Jonathan D Fain 0.17 6.83 X 0 0 0 Michael Ehrlich MD 0.17 12.83 X 0 96726 0 Peter M DiBari 0.00 0.00 X 0 0 0 Ellen Collis 0.00 6.50 X 0 0 0 Peter Capodilupo 0.28 8.72 X 0 0 0 David A Brown 0.08 7.42 X 0 0 0 David G Bazarsky 0.00 0.00 X 0 0 0 Emanuel Barrows 0.11 1.89 X 0 0 0 Timothy J Babineau MD 1.00 39.00 X 0 1486727 205277 Lawrence Aubin Sr 0.33 14.67 X X 0 0 0 Sr Therese M Antone 0.33 6.17 X 0 0 0 Thomas Anders MD 0.33 7.17 X 0 0 0 Mary A Wakefield 1.00 39.00 X 0 798078 297927 August B Cordeiro 25.00 15.00 X 0 425713 78729 Kenneth E Arnold 1.00 39.00 X 0 3554467 29606 Paula M Gillette 40.00 0.00 X 272282 0 43461 Frank J Byrne 25.00 15.00 X 0 214338 43499 Bartholomew Grimes 40.00 0.00 X 176784 0 34575 David R Harriman 40.00 0.00 X 115279 0 11121 Marielen Maguire 40.00 0.00 X 120657 0 16150 Terrence R McWilliams MD 40.00 0.00 X 341249 0 32978 Denise Sullivan 40.00 0.00 X 121222 0 14984 Arthur J Sampson 0.00 40.00 X 0 546786 90041 Cathy E Duquette 0.00 40.00 X 0 334014 61861 Todd A Cipriani 0.00 40.00 X 0 246639 51465 1147473 7704488 1011674 32 true true false APG Security 171 Service Avenue Warwick RI 02886 Security services 526936 University Surgical Associates 2 Dudley Street Providence RI 02903 Medical, health care 566082 Providence Anesthesiologists 75 Newman Avenue Rumford RI 02916 Medical services 366250 NHCC Medical Associates 11 Friendship Street Newport RI 02840 Medical, health care 440599 Newport Emergency Physicians 11 Friendship Street Newport RI 02840 Medical, health care 3220200 15 7437252 30135 123303 7590690 Lifespan Laboratory 621150 145067 145067 Inpatient Service Revenue 622110 51301886 51301886 Cafe./Misc Pharm. sales 622110 17558 17558 Ancillary OP Service Rev. 622110 57120740 57120740 622110 108585251 992416 992416 0 0 0 507522220 504588373 2933847 2933847 2933847 0 0 0 0 120102204 108440184 145067 3926263 0 0 0 0 360609 277669 82940 0 42527493 35506378 7021115 1218499 1017772 200727 6727737 5618853 1108884 2967769 2478087 489682 0 0 0 2305 2305 0 395336 395336 5664820 5664820 22586 22586 173792 147723 26069 0 0 6426550 5526833 899717 80259 74641 5618 0 0 1169244 1169244 0 6564738 6564738 1087659 1000646 87013 State license fee 5205354 5205354 Provision for bad debts 7929474 7929474 Purchased services 12818688 10639511 2179177 Medical & surgical supplies 13207764 13075686 132078 720806 587702 133104 115271482 94776040 20495442 0 4188098 4676273 0 0 14340227 13693774 0 0 0 1653688 1370731 388894 318030 155975144 96482447 61488920 59492697 52177174 53297703 27308893 27972482 0 1330893 164137836 163083455 325683730 325236038 7363695 8594729 21985000 21150000 15896903 12458653 45245598 42203382 X 214111477 214298264 55598031 57921940 10728624 10812452 280438132 283032656 325683730 325236038 X 4830722 199037 -2435235 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 2305 2305 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description Newport Hospital pays membership dues to the Hospital Association of Rhode Island (HARI), a portion of which is allocated to HARI's lobbying efforts. 82940259 740577 3772004 2337971 85114869 79227445 1852434 7437381 5577001 82940259 76534229 7867456 1187929 6362169 79227445 73235178 238489 6505097 3444535 76534229 78583362 1585979 -1569783 5337380 73262178 0.19000 0.13000 0.68000 true true true 1406761 1406761 94184665 50185414 43999251 1184053 1148391 35662 59199665 45148642 14051023 59492697 27972482 Trustee-held funds-bond indenture 497566 Outside trusts 1267527 Master lease escrow fund 3677330 Interest in Net Assets of NH Foundation 150913401 Intercorporate financing 3587066 Deferred financing costs & other assets 563408 Cash and short-term investments 2577157 163083455 Third-party liabilities 2338293 Postretirement life insurance 582700 Other Long-term Liabilities 18486 Note Payable to Affiliate 3888581 Health care benefit self-insurance 133393 Accrued pension 5497200 12458653 X 109540257 199037 8398651 8597688 100942569 395336 18764299 19159635 120102204 106945733 106945733 395336 7930413 8325749 115271482 Part XII, Line 4b Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S Provision for Bad Debts $7929474 Auxiliary $939 Part XI, Line 4b Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S Provision for bad debts $7929474 Interco forgiveness NHCCMA $10834825 Part XI, Line 2d Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990 Increase in interest in net assets- NHF $1146451 Change in funded status of pension plan $7252200 Part X Part X : FIN48 Footnote NH, 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. NH recognizes the effect of income tax positions only if those positions are more likely than not to be sustained. Recognized income tax positions are measured at the largest amount of benefit that is greater than fifty percent to be realized upon settlement. Changes in measurement are reflected in the period in which the change in judgment occurs. NH 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. Newport Hospital's (NH's) endowment funds were established for a variety of purposes, including both donor-restricted endowment funds and funds designated by NH to function as endowments. NH's largest permanently restricted endowment funds support its emergency department, as well as promoting athletic activity and wellness among youth and families of Newport County. Other endowments of NH support patient care, including a comprehensive range of diagnostic and therapeutic health care services, as well as providing financial aid for persons requiring medical and nursing services.NH's largest board-designated endowment is used to support and maintain its facilities. Significant temporarily restricted funds held by NH are used for the purposes of: (1) interventional radiology; (2) supporting the operations of NH's Emergency Department; (3) the purchase of medical equipment; (4) rehabilitation services; and (5) support of NH's Birthing Center. true true true X true X true true true false true true 5528138 1850302 3677836 0.03430 12924170 10989850 1934320 0.01800 18452308 12840152 5612156 0.05230 187887 16945 170942 0.00160 15136940 10952152 4184788 0.03900 48624 48624 0.00050 15373451 10969097 4404354 0.04110 33825759 23809249 10016510 0.09340 true 2823686 320819 22348169 26980899 -4632730 X true true 1 1 Newport Hospital

11 Friendship Street Newport RI 02840

X X X Newport 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 8 XRA Medical Imaging

345 Valley Road Middletown RI 02842

Diagnostic Imaging Services Newport Hand Surgery

77 Turnpike Avenue Portsmouth RI 02871

Orthopedic Medicine Newport Dermatology

79 Turnpike Avenue Portsmouth RI 02871

Specialty Medicine Jamestown Family Practice Center

20 Southwest Avenue Jamestown RI 02835

Primary Care Offices Family Physicians of Newport

19 Friendship Street Suite 130 Newport RI 02840

Primary Care Offices Family Physicians of Tiverton & Little Compton

1800 Main Road Tiverton RI 02878

Primary Care Offices NHCC Medical Associates Inc

19 Friendship Street Suite 150-160 Newport RI 02840

General & Specialty Medicine Portsmouth Imaging Center

69 Turnpike Avenue Portsmouth RI 02871

Diagnostic Imaging Services 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 approximately 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 RI'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, 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 Bradley Hospital.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 the Hospital 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 Newport Hospital is governed by a Board of Trustees, which is composed of community members who are elected by Lifespan Corporation. The Hospital's vision is to work collaboratively with physicians, our employees, other health care organizations, and the community to create a measurably healthier Newport County 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 Newport Hospital connects with the community in several ways, both within the Hospital walls and at other venues. More than a dozen monthly support groups are held at the Hospital, some facilitated by medical professionals and others by community members. An annual health fair provides hundreds of screenings for diseases and health conditions, and the Hospital follows up with individuals whose tests identify a problem. Screenings for breast and prostate cancers are conducted free of charge at various times during the year.Several Hospital committees exist to provide interaction between the Hospital and the community. The Hospital supports community initiatives such as Rebuilding Together, the Newport Partnership for Families, a full-time physician with a nonprofit practice, a local mentoring program, and a program to identify middle school children who require help. In addition, the Hospital has partnered with a local philanthropist to form a committee to oversee a grant funded by the Hospital to help children become active and healthy. The committee began distributing grants in 2011. Parenting and breastfeeding support are available through the Hospital's birthing center, and a series of bimonthly presentations and lectures on relevant health topics is scheduled for the community to attend free of charge. Part VI - Community Information Newport Hospital is the only hospital on Aquidneck Island and in Newport County, which comprises a population of approximately 100,000. Located in Newport, the southernmost town in Newport County, the Hospital is approximately 20 miles from other hospitals; bridges link Newport and Aquidneck Island with the rest of the State of Rhode Island (two bridges to the west, one to the northwest, and one to the north). The community includes people on government assistance, working-class and middle-class constituents, U.S. Navy personnel and retirees, students from three colleges, and a small percentage of families of significant wealth. Part VI - Patient Education of Eligibility for Assistance Newport Hospital does not deny necessary medical treatment to anyone, regardless of insurance status or ability to pay. Financial counselors of Newport Hospital inform patients personally about their potential eligibility for payment assistance. In addition, at such public events as health fairs, the Hospital actively promotes financial assistance programs. When patients believe they might be eligible, financial counselors set up appointments to talk with them privately to determine their eligibility. Applications for financial assistance are provided in the registration office, the Emergency Department, the financial counseling office, and other departments providing care.Uninsured patients receive an automatic 50% reduction of charges. Medicare patients may receive waivers of cost-sharing amounts if they qualify based on financial need; qualification is determined through an application for charity care. Further discounts may apply, depending on a patient's income level. Part VI - Needs Assessment Newport Hospital continually assesses community needs in several ways. The Hospital has a formal survey process for patient feedback but more importantly, the Hospital uses a physician liaison position to facilitate physician communication with the Hospital. Doctors in the community provide information on what services patients need. Recent examples of the usefulness of this information include Newport Hospital's establishment of a wound care service, a dermatology practice, and a hand surgery practice. In addition, the Hospital reviews volumes in service areas to glean information on the utilization of various types of care. Newport Hospital functions as the first line of defense against illness, injury, and disease for its communities. With an Emergency Department that is open and staffed 24 hours a day with the ability to evaluate and treat everything from minor conditions to urgent care and stroke, as well as a dedicated, award-winning nursing staff that provides care for inpatients, the Hospital's importance to the community cannot be overstated. Newport Hospital is the designated disaster planning leader for its region of the State of Rhode Island and as such holds regular meetings and drills with first responders from the various municipalities within the region, as well as representatives from other facilities (e.g., nursing homes, hotels, and physician groups).Newport's significant seasonal employee population and large numbers of uninsured patients present financial challenges that the Hospital strives to deal with each year as part of its mission. Uncompensated care provided to members of the community signals commitment to the residents and visitors of Newport County and its surrounding towns.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. 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 Newport 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 HospitalThe Miriam HospitalEmma Pendleton Bradley 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 Newport Hospital and Lifespans three other hospitals. Newport 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 Newport Hospital does not bill for the excess of charges over agreed upon reimbursement amounts from third-party payors. Rather, such differences are recorded as a reduction of revenue through contractual adjustments. Collection efforts are focused on co-payments, deductibles and amounts denied by insurers. After all collection attempts are exhausted, any remaining balances, including any co-payments and deductibles, are written off as a bad debt. The Hospital classifies its bad debts as uncompensated care. This does not apply to Medicaid, however, as there are no associated co-payments or deductibles for this payor.The Hospital does not require collateral or other security in extending credit to patients; however, it routinely obtains assignment of patients' benefits payable under their health insurance programs, plans or policies. Uninsured patients are offered Community Free Service and/or payment plan options.Lifespan's Patient Financial Services Department (PFS) has the responsibility for administering collection policies and procedures to all patient accounts. PFS engages the services of various pre-collect agencies as necessary. The following are highlights of the overall collection effort:* If a patient presents for admission who is not insured, staff assists the family with a Medicaid application.* If the patient is ineligible for Medicaid, a financial screening is performed to determine status of qualification for Community Free Service.* If the patient does not qualify for Community Free Service, PFS or the pre-collect agency attempts at least four contacts with the responsible party within the first 120 days.* If the third-party carrier denies in writing any responsibility for payment, arrangements regarding an extended payment plan are discussed with the patient.* At 120 days, if there is no payment activity or no hold placed on the account, the account is transferred to the appropriate collection agency. Part 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 whether an accounts receivable will be collectible, 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 72% of self-pay accounts receivable at September 30, 2012 to 74% 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 $7,109,000 and $6,469,000, 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 $7,929,474 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 per the Hospital's audited financial statements.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 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 in 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 $7,929,474. 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 and charity care, which are reported on other areas of Line 7. These expenses include Medicaid provider taxes. Direct offsetting revenue is reported as amounts received from Medicaid, as well as other payments which include reimbursement under Federal "Upper Payment Limit" (UPL) and "Disproportionate Share Hospital" (DSH) programs.e) Community health improvement services and community benefit operations- Community benefit operations expense is recorded as direct expenses incurred as reported by the Hospital's Community Health Services Department. Revenue received for these services is reported as direct offsetting revenue. 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 bad debt, Medicaid, and charity costs already reported in 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 Medicaid is excluded from the amount disclosed for subsidized health services.i) Cash and in-kind contributions for community benefit- Expenses for cash and in-kind contributions for community benefit are calculated by using direct costs as recorded within the general ledger for the total amount of cash and in-kind contributions made by the Hospital, 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) Newport 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 Care ("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 or CFS, 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 worth 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 to enroll 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. X X true true X X X X X false true false false false false false true false false Todd A Cipriani 179918 39350 27371 34259 17206 298104 18060 Timothy J Babineau MD 811918 282352 392457 182032 23245 1692004 87782 Terrence R McWilliams MD 255618 54640 30991 32219 759 374227 22491 Paula M Gillette 214202 50826 7254 28190 15271 315743 Mary A Wakefield 531513 175000 91565 281479 16448 1096005 68467 Kenneth E Arnold 451707 145000 2957760 12500 17106 3584073 2094059 Frank J Byrne 157482 37964 18892 23086 20413 257837 14774 Cathy E Duquette 246873 52000 35141 45204 16657 395875 17728 Bartholomew Grimes 163280 13504 10887 23688 211359 August B Cordeiro 278745 100000 46968 58985 19744 504442 27360 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 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. Newport Emerg Physicians Trustee 3263911 Med. staffing servic false Aquidneck Medical Assoc Trustee 250688 Prof. Medical Svcs. false David Gorelick, Trustee, is an officer of Aquidneck Medical Associates, a for-profit physician practice which has a professional services contract with Newport Hospital. Newport Hospital paid Aquidneck Medical Associates $250,688 for such services in fiscal year 2013.Charles L. Stengel, MD, Trustee of Newport Hospital until October 23, 2012, is the Vice President of Newport Emergency Physicians, a for-profit corporation that provides staffing services to Newport Hospital. In fiscal year 2013 Newport Hospital paid Newport Emergency Physicians $3,263,911 for such services. Form 990, Part VI, Section B, Lines 15a and b, cont. * Selecting and engaging qualified, independent, third party compensation valuation consultants that the Committee charges with rendering opinions with respect to the reasonableness and comparability of compensation as well as the comparative organizations against which compensation is assessed, in accordance with relevant sections of the IRC and Lifespan's executive compensation philosophy. The independent consultants are not engaged by management to perform any services for Lifespan without prior approval by the Committee.Lifespan's Chief Executive Officer works closely with the Committee to make recommendations on the above topics and keep the Committee informed about contemplated compensation changes for executives and other key employees, as well as candidates for these roles. The CEO also provides periodic updates to the Committee regarding Lifespan's performance relative to compensation-related performance objectives. The Committee's deliberations and actions are documented in minutes prepared for each meeting.PROCESS FOR DETERMINING COMPENSATION Valuation of Total Cash and Total Remuneration: No less frequently than annually, the Committee receives and reviews a total cash compensation valuation of all existing executive compensation program participants prepared by its independent compensation consultant. Annually, the Committee also receives and reviews a total remuneration valuation of all existing executive compensation participants. Base Salary Actions: The CEO recommends any salary adjustments for participants in the executive compensation program, using the results of the valuation study and his/her assessment of individual performance or other pertinent information, for the Committee's consideration.New Participants in Executive Compensation Program: With respect to compensation offers for individuals expected to participate in the executive compensation program, 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 through acceptance of a reasonable compensation offer. Form 990, Part VI, Section B, Lines 15a and b The following applies to Lifespan and all of its affiliates, including Newport 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 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. Form 990, Part VI, Section B, Line 12c Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including Newport 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: Lawrence Aubin, Vice Chair, is the owner of Lawrence Investments, LLC, which owns West Bay Medical Center Building and leases space to The Miriam Hospital. Edward Feldstein, Trustee, is a partner in Roberts, Carroll, Feldstein, and Peirce, a law firm that provides legal services to Lifespan Risk Services, Inc.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, Line 4b Outpatient services include an emergency department, diagnostic medical imaging, laboratory, Vanderbilt Rehabilitation, and wound care, among others. The emergecy department is open and staffed 24 hours a day, 365 days a year, with emergency medicine physicians and specially trained physician assistants and nurses. The emergency department in accordance with the hospital's mission and civic obligations, treats every person who seeks care, regardless of their ability to pay. The Hospital substantially subsidizes various health services including adult psychiatry, Vanderbilt Rehabilitation, occupational health, and certain other specialty services. Form 990, Part III, Line 4a Newport Hospital received Magnet designation from the American Nurses Credentialing Center (ANCC) in 2004. Of more than 5,000 hospitals in the United States, only about 4 percent have achieved Magnet status. Magnet hospitals must demonstrate that their nursing services function beyond the level of excellence. Standards for Magnet status are rigorous and include not only outstanding patient care but also best practices in nursing, management philosophy, national standards for quality improvement, leadership by the chief nursing officer, nurse education levels, and professional models of care. The Magnet process is continuous; Magnet redesignated Newport Hospital in 2009.The Noreen Stonor Drexel Birthing Center at Newport Hospital has received the prestigious Baby Friendly designation from the World Health Organization and UNICEF. Newport Hospital is recognized for providing an optimal environment for the promotion, protection, and support of breastfeeding. Hospitals are awarded this status only when trained, independent evaluators have determined that all hospital practices meet the rigorous Baby Friendly standards. The Hospital has developed formal and informal educational affiliations with the University of Rhode Island College of Nursing; Community College of Rhode Island; Salve Regina University; and the University of Massachusetts-Dartmouth, pursuant to which their nursing students obtain clinical training and experience at the Hospital, which does not receive any compensation from the various schools for providing a clinical setting for the student nurse training.The Hospital 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 $3,677,836 in fiscal 2013. Charges forgone, based on established rates, amounted to $10,004,000.The Hospital substantially subsidized various health services including adult psychiatry, Vanderbilt Rehabilitation, and occupational health at a cost of $4,184,788 in fiscal year 2013.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. The cost of these services amounted to $170,942 in fiscal year 2013.The Hospital 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 III, Line 1 -Organization's Mission The mission of Newport Hospital is to provide acute and outpatient health services to Newport County, Rhode Island and to work in collaboration 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. Newport Hospital is established for the care of persons suffering from illnesses or disabilities which require that the patient receive inpatient or outpatient hospital care or rehabilitation services, to carry on any educational activities related to the healthcare field, and to promote charitable, scientific and educational purposes. Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Decreases Interco forgiveness NHCCMA = -$10834825 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Increases Increase in interest in net assets- NHF = $1146451 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Increases Change in funded status of pension plan = $7252200 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Increases Auxiliary = $939 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Lifespan, as well as NHCC and Affiliates (NHCC), currently make their annual and quarterly consolidated/combined financial statements available to the public via DAC (Digital Assurance Certification LLC), a disclosure dissemination agent for issuers of tax-exempt bonds which electronically posts and transmits Lifespan's and NHCC's financial information to repositories and investors alike. Newport Hospital's financial statements are included in NHCC's combined financial statements. In addition, copies of Newport Hospital'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 Lifespan's annual independent audit and reviewed by the Corporate Services Tax Compliance Manager. Further review is performed by the Director of Finance and the Vice President of Finance - Corporate Services. Once the draft Form 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. KPMG provides the Director of Finance with any recommended changes which are reviewed, and if agreed upon, are incorporated into the return. The draft Form 990 is then provided to the 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. Lifespan holds these powers with respect to NHCC; NHCC holds identical powers with respect to the Affiliate, which it may exercise with the authorization of Lifespan. Form 990, Part VI, Line 7a Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body The bylaws of Newport Hospital (the Affiliate) 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 Affiliate Board of Trustees, a list is compiled of the names of those persons selected to serve as Trustees of the Affiliate 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 Through October 22, 2012, Lifespan Corporation was sole corporate member of Newport Health Care Corporation ("NHCC"), which in turn was sole corporate member of Newport Hospital. Effective October 23, 2012, Lifespan Corporation replaced NHCC as sole corporate member of Newport 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.Also effective October 23, 2012, Lifespan replaced NHCC as sole corporate member of Newport Hospital and Newport Hospital Foundation, Inc. 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. 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