2013-08-14T13:53:56-07:00 2012-09-30 KPMG LLP Two Financial Center 60 South St Boston MA 02111 990 2011-10-01 050258954 Rhode Island Hospital RHOD 4014444000 593 Eddy Street Providence RI 02903 Mary A Wakefield 2013-08-14 true 6179881000 2011 2016-02-24 21:20:13Z Timothy J Babineau MD 593 Eddy Street Providence RI 02903 1262597828 false false X www.rhodeislandhospital.org X 1863 RI The mission of Rhode Island Hospital (RIH) is to be at the forefront of patient care by creating, applying and sharing the most advanced knowledge in health care. 19 16 8480 845 7228874 549563 9233076 9607808 1029306980 1053129634 14793122 40980195 26332667 14769459 1079665845 1118487096 217124 1864959 0 537816239 528885497 0 0 539568353 553415144 1077601716 1084165600 2064129 34321496 1237237170 1265159851 556839476 577763350 680397694 687396501 The mission of Rhode Island Hospital (RIH) is to be at the forefront of patient care by creating, applying and sharing the most advanced knowledge in health care. false false 800935813 1829959 1008025273 Patient Care:RIH, the principal teaching hospital of The Warren Alpert Medical School of Brown University, provides a comprehensive range of diagnostic and therapeutic health care services to inpatients and outpatients. RIH has particular expertise in cardiology, hematology/oncology, neurology, burn care, neurosurgery, orthopedics, pediatric care at RIH's pediatric division, Hasbro Children's Hospital, and emergency medicine, with RIH being the designated Level I Trauma Center for Rhode Island. Licensed to operate 719 acute care beds, RIH is the largest of the state's general acute care teaching hospitals, employing 6,387 full-time equivalents and providing comprehensive health services to most of Rhode Island and southeastern Massachusetts. (Cont. on Schedule O) 96656693 12806460 Medical Education:RIH provides the setting for and substantially supports medical education in various clinical training and nursing programs. The total cost of direct medical education provided by the Hospital exceeded the reimbursement received from third-party payors by $83.9 million in fiscal year 2012.(Continued on Schedule O) 51010375 39692991 Research:RIH conducts extensive medical research and is in the forefront of biomedical health care delivery research and among the leaders nationally in the National Institutes of Health programs. In addition, the Hospital sponsors many clinical trials, which provide valuable research information as well as cutting edge treatment for patients in the region. Federal support accounts for approximately 68% of all externally funded research at the Hospital. Researchers focus on clinical trials which investigate prevention and treatment of HIV/AIDS, obesity, cancer, diabetes, cardiac issues, neurological problems, orthopedic advancements, and mental health concerns. RIH provided $11.3 million in support of research activities in fiscal year 2012.(Cont. on Schedule O) 948602881 true true false true false false false false false true true true false true true true false true false false true false false false false false true true true true true true false false false false false false false false false true false false false false false true true true false false true 534 0 true 8480 true true true false false false false false false false false false 0 false false false false false false false false false false false X 19 16 true false false false true true true true true false false false true true true true true true true true true true X Mary A Wakefield 4014447093 167 Point Street Providence RI 02903 X Brian J Zink MD 3.00 X 0 0 0 Jane Williams RN PhD 5.00 X X 0 0 0 Fred J Schiffman MD 1.20 X 0 0 0 Lawrence B Sadwin 2.00 X 0 0 0 James A Procaccianti 2.00 X 0 0 0 Michael J Perik 1.00 X 0 0 0 David A Marcoux MD 2.00 X 0 0 0 Joseph J MarcAurele 4.00 X 0 0 0 Alan H Litwin 2.00 X 0 0 0 Bertram M Lederer 2.00 X X 0 0 0 Phillip Kydd 2.50 X 0 0 0 Mary Jo Kaplan 0.50 X 0 0 0 Dayle H Joseph MS EdD 4.00 X 0 0 0 Michael L Hanna 4.00 X X 0 0 0 Brian Goldner 0.50 X 0 0 0 Edward D Feldstein 2.00 X 0 0 0 Jonathan J Elion MD 2.00 X 0 0 0 Penelope H Dennehy MD 2.00 X 199992 0 21912 Ellen A Collis 1.50 X 0 0 0 Jeffrey G Brier 1.00 X 0 0 0 Edmund C Bennett 2.00 X X 0 0 0 Roger N Begin 2.00 X 0 0 0 Emanuel Barrows 1.50 X 0 0 0 Timothy J Babineau MD 23.00 X X 0 833462 145667 Lawrence A Aubin Sr 5.00 X X 0 0 0 Mary A Wakefield 16.00 X 0 677833 101701 Frederick J Macri 40.00 X 0 516954 84267 Barbara Riley RN 40.00 X 321908 0 63639 John B Murphy MD 40.00 X 361980 0 70957 Garth Cosgrove MD 40.00 X 1222811 0 38540 Robert B Klein MD 40.00 X 429223 0 33045 Paul Y Liu MD 40.00 X 394999 0 27487 Latha R Pisharodi MD 40.00 X 483955 0 37743 Murray B Resnick MD 40.00 X 513035 0 35486 George A Vecchione 0.00 X 0 7847928 28548 3927903 9876177 688992 630 true true false University Surgical Associates 72 Newman Avenue Rumford RI 02916 Medical Services 7409464 University Medicine Foundation 17 Virginia Ave Providence RI 02905 Medical Services 20714150 Neurology Foundation 34 Parsonage Street Providence RI 02903 Medical Services 4150126 Brown University 75 Waterman Street Providence RI 02912 Subcontracted Svcs. 3411016 APG Security Services 171 Service Avenue Warwick RI 02886 Security Services 4185015 80 7884627 1219845 503336 9607808 Temp Restricted (SPF's) 900099 9825726 9825726 Rental 531120 3294318 3294318 Patient Service Revenue 900099 984129248 984129248 Laboratory 621500 5399010 5399010 Direct Rev from Research 900099 50481332 50481332 1053129634 5998960 5998960 2287 2287 0 3523963 1882741 1641222 1641222 1641222 177206939 142227991 34978948 34978948 34978948 0 0 0 Linen Services 812300 1987106 1612062 375044 Indirect Rev from Grants 900099 11034629 11034629 Cafeteria Revenue 722210 3879717 3879717 -3773215 -5251601 1454820 23566 13128237 1118487096 1055125714 7228874 46524700 1829959 1829959 35000 35000 0 0 1059288 219589 839699 0 403436782 399738335 3698447 22928069 22679077 248992 71619136 70895749 723387 29842222 29518145 324077 0 0 0 12251 7055 5196 0 1683643 1683643 65092691 65083524 9167 302298 242298 60000 170976156 172163599 -1187443 0 0 16933246 14788066 2145180 1611677 1596824 14853 0 1495414 1458964 36450 13865339 7182 13858157 0 34849327 34849327 7987690 7987690 All Other Expenses 21707629 21035393 672236 License Fee 46344396 46344396 Provision for bad debts 61996757 61996757 Purch Svs & Equip Cont 108339136 30757785 77581351 217494 217494 1084165600 948602881 135562719 0 20326272 5311680 145 21574 4598112 3894294 127316769 137974046 0 0 0 12282409 13478601 1962588 2222685 1075946047 582132711 488332581 493813336 294393085 327750511 151291701 156413408 0 0 136733508 124279716 1237237170 1265159851 64386872 63992879 262912704 254889799 229539900 258880672 556839476 577763350 X 390119508 375532685 218428494 238460723 71849692 73403093 680397694 687396501 1237237170 1265159851 X 34321496 -27322689 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 12251 12251 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description Rhode Island Hospital pays membership fees to the Hospital Association of Rhode Island, the National Association of Children's Hospitals, and the Trauma Center Association of America. A portion of the membership dues paid to these organizations is allocated to their lobbying efforts. 478839711 70020787 50634789 91803606 507691681 475612207 72081127 11034904 79888527 478839711 402076328 106066104 42054008 74584234 475612206 0.48390 0.07720 0.43890 true false false 20125023 20125023 667344795 321753056 345591739 356442456 260379655 96062801 32033773 32033773 493813336 156413408 Other Receivables 14808048 Other Non-Current Assets 4501506 Interest in Net Assets of RIH Foundation 53892136 Intercompany Receivables 3940697 Deferred Financing Costs 5833519 124279716 Third-party Payor Settlements 39922103 Post-retirement Benefit Liability 23077400 Other Liabilities 27836874 Health Care Benefit Self-insurance 3693495 Accrued Pension Liability 164350800 258880672 Part X Part X : FIN48 Footnote Rhode Island Hospital (the Hospital), as a not-for-profit corporation, is recognized under Section 501(c)(3) of the Internal Revenue Code and is exempt from Federal income taxes. The Hospital recognizes the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount of benefit that is greater than fifty percent likely to be realized upon settlement. Changes in measurement are reflected in the period in which the change in judgment occurs. The Hospital did not recognize the effect of any income tax positions during the fiscal year ended September 30, 2012. Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Increase in Net Assets of RIHF $2048615 Transfer from Hospital Properties, Inc. $114316 Change in funded status of pension and other postretirement $ -40877452 Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. Rhode Island Hospital's (RIH's) endowment funds consist of both donor-restricted endowment funds and funds designated by RIH to function as endowments. RIH's largest permanently restricted endowments support patient care, particularly cardiology, hematology/oncology, and neurology, as well as pediatric care at RIH's pediatric division, Hasbro Children's Hospital (HCH), research, and charity care. RIH's unrestricted endowment includes designated assets set aside by RIH's Board for future capital improvements, over which the Board retains control and may at its discretion subsequently use for other purposes.Significant temporarily restricted funds held by RIH are used for the purposes of: (1) pediatric orthopedic research; (2) the care and treatment of crippled children; (3) the advancement of cardiac patient care, research and education; (4) pediatric and adult oncology; and (5) HCH's Palliative Care and Pain Program and other pediatric needs. Sub-Saharan Africa 0 0 Program Services Research 5975 Europe 0 0 Program Services Research 43768 East Asia & the Pacific 0 0 Program Services Research 140664 190407 190407 X false false false false false true true true true X true X true true false false true true 62937003 14924271 48012732 0.04700 178689072 179637022 -947950 241626075 194561293 47064782 0.04700 361467 56679 304788 0.00030 96656693 12806460 83850233 0.08200 29221298 20223652 8997646 0.00880 51010375 39692991 11317384 0.01110 647225 647225 0.00060 177897058 72779782 105117276 0.10280 419523133 267341075 152182058 0.14980 true 17712196 1968155 172223301 157426599 14796702 X true true Orthopedic MRI of RI LLC Imaging Services 0.33333 0.13333 1 0 Rhode Island Hospital

593 Eddy Street Providence RI 02903

X X X X X X Rhode Island Hospital 1 false true true 200.0000 true 400.0000 true X X X X X X true true X X X X X X true X X true X X X X X X true X false false 24 MRICT of Providence LLC

695 Eddy Street Providence RI 02903

Diagnostic Imaging Facility RIH Outpatient Psychiatry

146 West River Street Providence RI 02904

Outpatient Psychiatric and Behavioral Health Services Ophthalmology Clinic

1 Hoppin Street Suite 200 Providence RI 02903

General and Specialty Ophthalmic Examinations, Testing and Procedures Orthopedic MRI of RI LLC

100 Butler Drive Providence RI 02906

Medical Imaging Services RIH Outpatient Rehabilitation Services

765 Allens Avenue 1st Floor Suite 1 Providence RI 02905

Adult Physical and Occupational Therapy Southern New England Rehabilitation Ptr

200 High Service Avenue North Providence RI 02904

Rehabilitation Services RIH Lab at the Office of Louis Moran MD

1035 Post Road Warwick RI 02886

Outpatient Phlebotomy Pediatric and Adult Medicine

900 Warren Avenue 2nd Floor East Providence RI 02914

Pediatric and Adult Medicine Rhode Island Hospital Child Research Center

1 Hoppin Street Providence RI 02903

Outpatient Psychiatric Services RIH Pediatric and Adolescent Health Care Center

One Hoppin Street Suite 3055 Providence RI 02903

Outpatient Adolescent Services Radiosurgery Center of RI LLC

593 Eddy Street Providence RI 02903

Radiosurgery Services RI Hospital Molecular Laboratory

167 Point Street Coro East 3rd Floo Providence RI 02903

Molecular Diagnostic Testing General Internal Medicine Research Group

111 Plain Street Providence RI 02903

Research Studies Hallett Center for Diabetes & Endocrinology

900 Warren Avenue East Providence RI 02914

Multidisciplinary Care Treating Diabetes and Other Endocrine Disorders Respiratory and Immunology Center

593 Eddy Street - Hasbro Lower Leve Providence RI 02903

O/P Pedi Asthma/Allergy, Cystic Fibrosis, Immunology, Pulmonology and Rheumatology RIH Outpatient Psychiatry

235 Plain Street Providence RI 02905

Outpatient Psychiatric Services Audiology and Speech Pathology Department

115 Georgia Avenue Providence RI 02903

Speech Language Pathology and Audiology Services RIH Lab at the Office of Hugo Yamada MD

6 Blackstone Valley Place Lincoln RI 02865

Outpatient Phlebotomy RI Hospital Hasbro Childrens Outpatient Rehab Services

765 Allens Avenue 2nd Floor Suite 2 Providence RI 02905

Children's Physical and Occupational Therapy RIH Sleep Disorders Center

70 Catamore Boulevard East Providence RI 02914

Outpatient Professional & Technical Evaluation of Sleep Disorders RI Hospital Outpatient Rehabilitation Services

1 Hoppin Street Coro West 1 Providence RI 02903

Physical Therapy and Occupational Therapy RIH Pediatric Heart Center

1 Hoppin Street Suite 304 Providence RI 02903

Outpatient Pediatric Cardiology Services Rhode Island Hospital Surgery Center at Wayland Square

17 Seekonk Street Providence RI 02906

Outpatient Surgery Dialysis Center of Rhode Island Hospital

22 Baker Street Providence RI 02905

Hemodialysis, Peritoneal Dialysis, Home Hemodialysis (and Training) Part VI - Affilated Health Care System Roles and Promotion Lifespan's mission is to improve the health status of the people it serves in RI and in southern New England through the provision of customer friendly, geographically accessible, high value services in the environment of an integrated academic health system. Lifespan affiliates provide comprehensive inpatient and outpatient medical, surgical and psychiatric services for adults and children. Lifespan and its affiliates employ more than 12,500 people. The Lifespan system has over 2,300 physicians on the medical staffs of its affiliated hospitals, operates 1,155 licensed beds in four hospital complexes, and in 2012 generated approximately $1.6 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 (EPBH), are teaching affiliates of The Warren Alpert Medical School of Brown University with 78 percent of the residents and fellows in this program based at RIH, TMH, and EPBH.Lifespan is a RI 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, 2012, Lifespan Corporation employed approximately 700 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, and investment management, for which each affiliate is charged a fee equivalent to the costs incurred by Lifespan in providing these services.Corporate Authority and RoleLifespan Corporation has no members and is governed by its Board of Directors. The Board has responsibility for planning, directing and establishing policies intended to assure the development and delivery of quality health services, professional education and biomedical research on an integrated, cost-effective basis. The Board's powers include the power to set accounting policies for its affiliates, develop, negotiate and approve all managed care agreements, develop affiliations with other institutions for educational and research purposes, and approve human resource plans, executive compensation and benefits for system affiliates. The bylaws of RIH confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination and support of the system. Powers reserved to Lifespan as sole member include: to elect and remove trustees; to approve the election of and to remove certain officers; to approve the amendment of the Articles of Incorporation and Bylaws and other Charter documents; to approve strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness.For a complete listing of affiliated members of Lifespan's integrated healthcare delivery system, please refer to Schedule R. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose Rhode Island Hospital is governed by a Board of Trustees, which is composed of 20 voting members; 17 who are elected by Lifespan Corporation as sole member of the Hospital, and three who serve ex officio. Lifespan approves the elected Trustees to serve one-year terms, until his/her successor is duly authorized and elected at the next Annual Meeting. The ex officio members of the Board with a vote are the President and Chief Executive Officer of the Hospital along with the Chair of Rhode Island Hospital Foundation and the Chair of The Miriam Hospital Foundation. Additionally, the Chairman and the President and CEO of Lifespan Corporation are ex officio members of the Board without a vote. The Hospital's Board prescribes the duties and powers of committees appointed by the Chair and appoints members of the Medical Staff. The physicians on the Hospital's medical staff are both hospital-based and community-based. Part VI - Community Building Activities The Hospital substantially subsidizes various health services including the following programs: adult psychiatry, dental, adolescent, and Alzheimer's, as well as the Center for Special Children, early intervention, 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, stroke and burn survivor support groups, community health training programs, patient advocacy, foreign language translation, physician referral services, and charitable contributions. Part VI - Community Information Rhode Island Hospital, located in Providence, Rhode Island, is a 719-bed nonprofit general acute care teaching hospital with university affiliation providing a comprehensive range of diagnostic and therapeutic services (excluding obstetrics) for the acute care of patients principally from RI 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). In 2010, Brown named the Hospital its Principal Teaching Hospital. The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically. The Hospital currently sponsors 46 graduate medical education programs accredited by or under the auspices of the Accreditation Council for Graduate Medical Education (ACGME), while also sponsoring another 26 hospital-approved residency and fellowship programs.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 is among the leaders nationally in National Institutes of Health programs. Part VI - Patient Education of Eligibility for Assistance Rhode Island 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 areas. Lifespan and its hospital affiliates monitor health trends in Rhode Island in an effort to identify areas of unmet demands regarding clinical services. For example, over the past decade, the Hospital added a new state-of-the-art emergency department and opened the 110-room Bridge Building expansion, with three new floors dedicated to the care of cardiac, medical, and surgical patients. The Hospital's pediatric division, Hasbro Children's Hospital, is the state's only facility dedicated to pediatric care. The Hospital has continued its pioneering work on treatments for inoperable tumors as well as radiofrequency ablation. Also of note is Hasbro's Medical/Psychiatric Program. This program is expressly designed for children and adolescents with both challenging mental health and medical conditions who require hospitalization. A collaboration with Bradley Hospital, it is the only program in the region created to meet the complex needs of these children. Children ages 6 to 18 are treated in a newly renovated, secure 8-bed unit located on the 6th floor of Hasbro Children's Hospital. The unit was designed with input from both pediatrics and psychiatry to provide the very best care for children with psychiatric and medical illness. The safe, comfortable environment offers both private and semi-private rooms and areas for family, group and milieu therapy. Number of Hospital Faciltiy - 0 Part V, Line 19d - Other Billing Determination of Individuals Without Insurance Uninsured patients receive an automatic 50% Community Benefit discount on Hospital charges. 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 - 0 Part V, Line 16e - 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 15e above. Number of Hospital Faciltiy - 0 Part V, Line 15e - 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 - 0 Part V, Line 13g - 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. 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 collectibility of 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 decreased from 81% of self-pay accounts receivable at September 30, 2011 to 79% of self-pay accounts receivable at September 30, 2012. The Hospital's self-pay writeoffs for the years ended September 30, 2012 and 2011 amounted to approximately $53,361,000 and $55,880,000, respectively. The Hospital did not change its charity care or uninsured discount policies during the years ended September 30, 2012 and 2011, 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 2012 or 2011.The Hospital provided $61,996,757 for uncollectible patient accounts during the year ended September 30, 2012. 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 $61,996,757. 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 expense.Patient costs 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 by 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 professions education which are reported on other areas of Line 7. These expenses include Medicaid provider taxes. Direct offsetting revenue is reported as amounts received from Medicaid, as well as other payments which include reimbursement under Federal "Upper Payment Limit" (UPL) and "Disproportionate Share Hospital" (DSH) programs.e) Community health improvement services and community benefit operations- Community benefit operations expense is recorded as direct expenses incurred as reported by the Hospital's Community Health Services department. Revenue received for these services is reported as direct offsetting revenue. f) Health professions education- Health professions education expenses represent direct costs related to amounts associated with resident and intern programs utilized at 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 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, neurological problems, orthopedic advancements, and mental health concerns. For all internal and external research conducted, the costs associated with these activities is calculated by combining the direct and indirect costs as reported within 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 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) Rhode Island 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, has a long term disability, RIte Care 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 $8,500 for an individual (or $13,500 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 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 the 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 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 UNAPRIH Education Trust Fund 375 Branch Avenue Providence RI 02904 412139381 501(c)(3) 150000 0 Employee Education Support Thundermist Health Center 191 Social Street Woonsocket RI 02895 050355097 501(c)(3) 75375 0 Health Pgm Support Rhode Island Medical Society 235 Promenade Street Providence RI 02908 050250010 501(c)(6) 5500 0 Health Pgm Support Health Leads 2 Oliver Street 10th Floor Boston MA 02109 450484533 501(c)(3) 134500 0 Health Pgm Support City of Providence 25 Dorrance Street Providence RI 02903 056000329 Gov't Org. 584000 0 Payment in lieu of taxes Brown University 164 Angell Street Providence RI 02912 050258809 501(c)(3) 848984 0 General Support 6 0 Educational Assistance 10 35000 Grantmaker's Description of How Grants are Used Rhode Island Hospital is committed to community programs and provides support to various charitable organizations in Rhode Island and southeastern Massachusetts. Donations are made to organizations recognized by the IRS as being described in IRC Section 501(c)(3). All contributions are approved by management and are made to organizations whose missions and goals align with those of the Hospital.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.Individual scholarships are awarded annually to applicants by a joint decision making body comprised of both IBT (International Brotherhood of Teamsters) and RIH representatives. Payments are made directly to qualified educational institutions on behalf of scholarship recipients. X X X true true X X X X X false true false false false false false false false false Timothy J Babineau MD 670179 113906 49377 123194 22473 979129 21386 Robert B Klein MD 412688 5250 11285 16966 16079 462268 Penelope H Dennehy MD 193064 2470 4458 12594 9318 221904 Paul Y Liu MD 393083 1916 10695 16792 422486 Murray B Resnick MD 496994 13000 3041 16953 18533 548521 Mary A Wakefield 499573 84291 93969 85853 15848 779534 67780 Latha R Pisharodi MD 470819 9000 4136 16973 20770 521698 John B Murphy MD 305350 56630 51212 19745 432937 32493 George A Vecchione 928502 390234 6529192 7350 21198 7876476 3456806 Garth Cosgrove MD 1194096 28715 15485 23055 1261351 Frederick J Macri 371719 63669 81566 66803 17464 601221 55012 Barbara Riley RN 228557 39108 54243 43922 19717 385547 34117 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).Housing Allowances or Residences for Personal Use:A temporary housing allowance may be provided on a case-by-case basis as part of the recruitment of key executives. The allowance is documented in the individual employment contract or employment offer. In calendar year 2011 Lifespan provided this benefit to one new executive and the taxable amounts paid for the temporary housing resulting from relocation are included in Medicare wages, more specifically on Schedule J, Part II, column B (iii).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 business-like 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. Rhode Island Health and Education Building Corporation 521300173 762243K36 2009-03-30 72570461 see Schedule K, Part V false false true Rhode Island Health and Education Building Corporation 521300173 762243SS3 2006-02-14 160884410 see Schedule K, Part V false false true 72570461 7247455 1069664 1256743 53246921 9749678 false false false true 18393900 150795375 160884410 1377349 3827355 155679706 2006 false true true true false false false true true 0.00500 0.00500 true false false false true true 0.00500 0.00500 true false false false false false false false false false false false false X Roberts Carroll Feldstein Peirce Partner 196017 Legal Services false * Edward Feldstein, Trustee, is a partner in Roberts, Carroll, Feldstein and Peirce, a law firm that provides legal services to a sister company, Lifespan Risk Services. The common parent of RIH and Lifespan Risk Services is Lifespan Corporation. During fiscal year 2012, Lifespan Risk Services paid Roberts, Carroll, Feldstein and Peirce $196,017 for services regarding RIH matters. Form 990, Schedule K, Part V The Hospital has in place written post-issuance tax compliance procedures for tax-exempt obligations. To ensure that its bonds continue to qualify for tax-exempt status, the Hospital consults with bond counsel and other legal counsel and advisors, as needed, to ensure that all applicable post-issuance requirements are met. The Hospital has not identified any non-compliance with the requirements of its tax-exempt bonds. 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) 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 XII, Line 2 While the Hospital did not produce a separate audited financial statement as of and for the year ended September 30, 2012, it was included in Rhode Island Hospital and Affiliates' consolidated audited financial statements, which include Rhode Island Hospital, RIH Ventures, and Radiosurgery Center of Rhode Island, LLC. There are no regulatory or creditor stipulations which require the preparation of a separate audited financial statement for the organization.The Lifespan Audit and Compliance Committee assumes responsibility for oversight of the audit of RIH's consolidated financial statements and the selection of Lifespan's independent accountant. 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 Senior Vice President of Human Resources 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 Rhode Island 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 with both law and contemporary ethical norms, and is administered consistent with the organization's tax-exempt status under Section 501(c)(3) of the Internal Revenue Code (IRC) and the avoidance of transactions subject to intermediate sanctions under Section 4958 of the IRC. Executive compensation is also administered consistent with Lifespan's Corporate Compliance Policy on Excess Benefit Transactions.The Compensation Committee of the Lifespan Corporation Board of Directors (the Committee), comprised of disinterested Lifespan and affiliate Board members, is responsible for diligent oversight of executive compensation to ensure compliance with IRC requirements. Its duties include:* Approving eligibility for participation in the executive compensation program * Approving changes in compensation for existing executive participants * Approving guidelines, such as salary ranges and contract terms, on appropriate levels of compensation for other key employees* Approving new, and modifying or terminating existing, executive compensation plans including, but not limited to, annual and long-term incentive and executive benefit plans* Approving performance objectives associated with Lifespan's annual and long-term incentive plans, 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(s)* 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 Rhode Island 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. (For the bulk of Lifespan management staff knowledge of 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 III, Line 4c, continued Major areas of research include:Cancer: RIH participates in clinical trials of new therapeutic agents in both adult and pediatric medicine. These trials are supported by the National Cancer Institute and include the Cancer and Leukemia Group B (CALGB), Pediatric Oncology Group (POG), and National Surgical Adjuvant Breast and Bowel Project (NSABP). RIH is a participating hospital in the Brown University-sponsored Cancer Oncology group (BrUCOG).The Liver Research Center: The Liver Research Center emphasizes studies relating to the molecular biology of liver diseases such as Hepatitis B and C and cellular carcinoma.Heart Disease: Clinical research continues in antithrombolytic therapy and anticoagulant therapy. General research continues in areas of invasive therapy, such as angioplasty, artherectomy, coronary stenting, and laser treatment of coronary artery disease.Neurological Illness: The Alzheimer's Disease and Memory Disorder combines high quality neurological, neuropsychologic, and psychiatric services, thus creating a comprehensive diagnostic and treatment center for patients with memory disorders.Stroke: The Stroke Center at Rhode Island Hospital provides services to more than 900 adult and geriatric patients with suspected transient ischemic attack (TIA) or stroke annually in Rhode Island and Southeastern Massachusetts. As the region's only primary stroke center located within a Level 1 trauma center, Rhode Island Hospital is uniquely qualified to provide the most advanced clinical care to acute stroke patients. Other major research areas included multiple sclerosis, epilepsy, Parkinson's disease, and other movement disorders. Form 990, Part III, Line 4b, continued Under an affiliation agreement with The Warren Alpert Medical School of Brown University (Brown), RIH participates jointly in various clinical training programs and research activities. In 2010, Brown named RIH its Principal Teaching Hospital. The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically. The Hospital currently sponsors 46 graduate medical education programs accredited by or under the auspices of the Accreditation Council for Graduate Medical Education (ACGME), while also sponsoring another 26 hospital-approved residency and fellowship programs. The Hospital serves as the principal setting for these clinical training programs, which encompass the following disciplines: internal medicine and medicine subspecialties, including hematology and oncology; orthopedics and orthopedic subspecialties; clinical neurosciences; general surgery and surgical specialties; pediatrics and pediatric specialties, including hematology and oncology; dermatology; radiology; pathology; child psychiatry; emergency medicine and emergency medicine specialties; dentistry; and medical physics. In 2012, Brown University enrolled 455 students in undergraduate medical education programs. All medical students at Brown receive training at RIH. The Hospital teaching faculty help to ensure that the experience for both undergraduate and graduate medical education trainees remains transformative - transforming novice practitioners into physicians able to think, act, and keep their focus on the ultimate goal of providing the best and most appropriate care for patients no matter what the setting or circumstances. The Hospital is also a participating clinical training site for another 200 residents and fellows based at other institutions in anesthesiology, general surgery, family medicine, infectious disease, pulmonary medicine, rheumatology, obstetrics/gynecology (OB/Gyn) and OB/Gyn subspecialties, otolaryngology, podiatry, psychiatry, geriatric psychiatry, orthopedics, pediatric dentistry, colorectal surgery, and radiation oncology programs.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; Salve Regina University; Boston College; Yale University; Regis College; Simmons College; St. Joseph's Health Services' School of Nursing; the University of Massachusetts campuses at Dartmouth, Boston, Amherst and Worcester; the University of Connecticut; New England Technical Institute; 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.RIH sponsors training programs in the following medical fields: medical technology; diagnostic medical sonography; nuclear medicine technology; radiologic technology; mammography; computed tomography; and magnetic resonance imaging. At RIH, clinical affiliations/student clinical training programs are provided through contracts with a number of colleges and universities in the professional areas of speech-language pathology and audiology, physical therapy, physical therapy assistants, occupational therapy, and certified occupational therapy assistants. In addition, RIH serves as the clinical setting for training programs in histology, cytology, phlebotomy, child development and social work. RIH also has clinical affiliations/student clinical training programs for pharmacy students provided through contracts with a number of colleges and universities. Form 990, Part III, Line 4a, continued In 2012, RIH discharged 34,089 inpatients with total inpatient days of 179,378, treated 149,867 patients in its emergency departments, performed 22,354 inpatient and outpatient surgical procedures, and cared for 174,892 patients in outpatient clinics.Special services, facilities and programs provided by RIH include the Comprehensive Cancer Center for adults; Cardiovascular Institute, comprised of cardiac catheterization, balloon angioplasty and open heart surgery; critical care services; microvascular surgery; nuclear cardiology; radiology; laboratory; renal dialysis; computerized tomography; orthopedics, including minimally invasive carpal tunnel surgery and cartilage transplants for knee defects; and magnetic resonance imaging (MRI). RIH is the designated Level I Trauma Center for the State of Rhode Island and southeastern Massachusetts, with a state-of-the-art emergency department (ED) and a dedicated pediatric ED. RIH's adult ED includes a dedicated radiology unit, including 4-slice and 16-slice CT scanners, ultrasound and x-ray machines; an all-inclusive chest pain center; a critical care unit for the most seriously injured and ill; and private treatment rooms. In 2007, RIH was the first hospital in New England to place a cardiac catheterization lab in its ED, providing faster care and preserving heart muscle function for acute cardiac patients. RIH provides a full range of services to patients, with particular expertise in diagnostic imaging, cardiology, oncology (both medical and radiation), neurosciences and orthopedics. RIH offers imaging with the PET/CT technology for cancer staging, while cardiac MRI and 64-slice cardiac CT scanners are powerful tools for evaluating heart disease and function. The Anne C. Pappas Center for Breast Imaging is the only facility in the state to be designated a Breast Imaging Center of Excellence by the American College of Radiologists. In the area of cancer services, RIH pioneered image-guided tumor ablation, which shrinks or eliminates tumors by destroying them with heat (microwave ablation and radiofrequency ablation) or by freezing them (cryoablation). In addition, radiation oncology services include a linear accelerator for image-guided radiotherapy and stereotactic radiosurgery, as well as electronic brachytherapy for early-stage breast cancer patients, which reduces average treatment times from eight weeks to five days. In the area of surgical oncology, RIH is the only hospital in the state and one of only a few hospitals in New England to offer hyperthermic intraperitoneal chemoperfusion (HIPEC) for patients with advanced cancer of the abdomen. In the sphere of neurosurgery, RIH features one of the first gamma knife surgical centers in the United States, which offers intracranial stereotactic radiosurgery for the non-invasive treatment of brain lesions previously inaccessible or unsuccessfully treated by conventional therapies.Rhode Island Hospital provides a wide-range of adult, adolescent, and child behavioral health services. Related behavioral health services programs and research provided include: psychiatry emergency services for adults, adolescents, and children; psychiatry consultation liaison services; correctional psychiatry program; inpatient and geriatric psychiatry programs; mood disorders program; gambling treatment program; anxiety disorders program; body dysmorphic disorder program; behavioral sleep medicine program; substance abuse treatment program; neuropsychiatric services; adult and pediatric neuropsychology services; adult and pediatric partial hospitalization programs; family research program; and Bradley/ Hasbro Children's Research Center. Form 990, Part I, Line 6 Volunteers support and contribute to the mission of RIH and HCH every day, giving their time, energy and enthusiasm. Throughout the hospital, they are able to learn, meet other dedicated volunteers, better understand the healthcare environment, and gain personal satisfaction knowing they are making a difference to patients, families and visitors alike.Volunteer positions 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. RIH also offers pediatric services through its pediatric division, Hasbro Children's Hospital (HCH). HCH's specialties include cardiology, orthopedics, and hematology/oncology. HCH also has the area's only center for pediatric imaging, as well as the area's only pediatric intensive care unit, pediatric oncology and outpatient cardiac programs, pediatric emergency department, and pediatric surgical unit. It operates specialty clinics treating children ranging in age from newborn to 18 years. Services and programs include adolescent medicine, the Asthma and Allergy Center, the Children's Neurodevelopment Center, the Child Life Program, the Child Protection Program, dermatology, gastroenterology, infectious disease, the Injury Prevention Center, the Kidney Transplant Center, nephrology, neurosurgery, nutrition, the Partial Hospitalization Program, surgery, plastic surgery, primary care clinic, rehabilitation services, Sickle Cell Clinic, and urology.Additional special services, facilities and programs furnished by RIH include: the endovascular hybrid operating room suite (the only one of its kind in Rhode Island, the suite's design provides vascular surgeons with the flexibility to perform minimally invasive procedures and traditional open surgeries simultaneously with limited anesthesia); adult and pediatric kidney and pancreas transplant center; Alzheimer's disease and memory disorders center; an adult and pediatric hemostasis and thrombosis center; an adult and pediatric diabetes and endocrinology center; colorectal care center; and the transfusion-free medicine and surgery program, one of only two such formalized programs in New England. RIH also holds designation or certification as a bariatric surgery center of excellence; adult and pediatric burn center; breast imaging center of excellence, primary stroke center; and the distinction center for spine surgery, knee and hip replacement, and complex and rare cancers.RIH 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 costs associated with providing charity care by aggregating the applicable direct and indirect costs, including compensation and benefits, supplies, and other operating expenses, based on data from its costing system. The total cost, excluding medical education and research, incurred by the Hospital to provide charity care amounted to $48,012,732 in fiscal 2012. Charges forgone, based on established rates, amounted to $175,109,000.RIH substantially subsidized various health services including the following programs: adult psychiatry, dental, adolescent, and Alzheimer's, as well as the Center for Special Children, early intervention, and certain other specialty services at a cost of $8,997,646 in fiscal year 2012. RIH also provides numerous other services to the community for which charges are not generated. These services include certain emergency services, community health screenings for cardiac health, prostate cancer and other diseases, smoking cessation, immunization and nutrition programs, diabetes education, stroke and burn survivor support groups, community health training programs, patient advocacy, foreign language translation, physician referral services, and charitable contributions. The cost of these services amounted to $304,788 in fiscal 2012.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 of $800,000 a year for three years, for a total of $2.4 million to help stabilize the city's financial health. RIH's share of the voluntary payment is $584,000 a year, for a total of $1,752,000. Lifespan has always maintained a strong commitment to Providence through its many community-based programs, as well as through the charity care it provides. Community programs provide support to the city through various clinics, community health programs, employment training initiatives, youth employment and mentoring programs, and substantial financial support to various city programs. As an organization, Lifespan understands that the fiscal health of the City of Providence 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.RIH is accredited by The Joint Commission, the Accreditation Council for Graduate Medical Education for residency and fellowship training, the Accreditation Council for Continuing Medical Education of the Rhode Island Medical Society, the American College of Surgeons' Commission on Cancer, the Joint Review Committees on Educational Programs in Nuclear Medicine Technology and Radiologic Technology, the Commission of Accreditation of Allied Health Education Programs, and the National Accrediting Agency for Clinical Laboratory Sciences.In 2012, Rhode Island Hospital's adult cardiothoracic intensive care unit received its second Beacon Award for Critical Care Excellence. Rhode Island Hospital's diagnostic imaging department was awarded Healthcare Technology Management's first Best Practices in Healthcare Technology Management Award. The award recognizes the Hospital's effort to establish and sustain a culture of safety. The Comprehensive Cancer Center at Rhode Island Hospital was recognized by the Quality Oncology Practice Initiative (QOPI) Certification Program for delivering high-quality patient care. The QOPI Certification Program, an affiliate of the American Society of Clinical Oncology, provides a three-year certification for outpatient hematology-oncology practices that meet the highest standards for quality cancer care. In addition, RIH was named one of the 25 best hospitals to work for in the U.S. by Healthcare Business & Technology. 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 RIH, The Miriam Hospital, Emma Pendleton Bradley Hospital, Rhode Island Hospital Foundation, and The Miriam Hospital Foundation, currently make their annual and quarterly consolidated financial statements available to the public via DAC (Digital Assurance Certification LLC), a disclosure dissemination agent for issuers of the tax-exempt bonds which electronically posts and transmits Lifespan's financial information to repositories and investors alike. In addition, copies of the 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 11 Form 990, Part VI, Line 11: 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 is sent to Rhode Island Hospital's Board of Trustees in advance of its next Board meeting, at which the Chief Financial Officer discusses the highlights of the Form. 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 a 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 Rhode Island Hospital (RIH) confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination and support of the system. Powers reserved to Lifespan include: to elect and remove trustees and to approve the election of and to remove certain officers. At each annual meeting of the RIH Board of Trustees, a list is compiled of the names of those persons selected to serve as Trustees of RIH 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 Rhode Island Hospital. Form 990, Part VI, Line 2 Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Timothy J. Babineau, M.D., President, and Mary A. Wakefield, CFO, are employed by and officers of Lifespan Corporation. Ms. Wakefield is also an officer VNA Technicare, Inc.(VNA). Frederick J. Macri, Officer, is employed by Lifespan Corporation and an officer of VNA. Penelope H. Dennehy is employed by Rhode Island Hospital. 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