2012-08-14T13:20:00-07:00 2011-09-30 KPMG LLP 2 Financial Center 60 South Street Boston MA 02111 990 2010-10-01 050258914 Newport Hospital NEWP 4018466400 11 Friendship Street Newport RI 02840 Mary A Wakefield 2012-08-14 2010 2016-02-24 21:20:13Z August B Cordeiro 11 Friendship Street Newport RI 02840 152451254 false false X www.lifespan.org/newport/ X 1873 RI Newport Hospital (the Hospital) is a 129-bed nonprofit acute care hospital providing inpatient, outpatient and emergency care services to the southern Rhode Island community. 16 14 944 205 175226 238489 7867456 105896467 111214526 2981701 1716939 0 109116657 120798921 0 0 52979538 56356833 0 0 56169524 57930378 109149062 114287211 -32405 6511710 304235611 307062130 52934898 42404165 251300713 264657965 Newport Hospital (the Hospital) 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 47568859 55069200 During the year ended September 30, 2011, the Hospital reported 25,333 inpatient days, 4,903 discharges, 583 newborn deliveries and 1,632 inpatient surgeries. The Hospital 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 32819864 41999439 The Hospital also provides healthcare services on an outpatient basis. In fiscal year 2011, the Hospital experienced 42,888 equivalent outpatient days and performed 4,906 outpatient surgeries. See Schedule O, Part III, Line 4b 8296841 14145887 The Emergency Department at Newport Hospital had 31,188 patient visits in fiscal year 2011. The Emergency Department is responsible for treating everything from minor injuries and illnesses to urgent and life-threatening medical needs. It is open and staffed 24 hours a day, 365 days a year, with emergency medicine physicians and specially trained physician assistants, nurses, and nursing assistants. 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. It is often used as a primary care facility by people who do not have their own primary care physician. 88685564 true true false true false false false false false true true true false true true false 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 67 0 true 944 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 16 14 true false false false true true true true true false false false true true true true true true true true false false X Mary A Wakefield 4014447093 167 Point Street Providence RI 02903 X Valerie Martin 40.00 X 126325 0 27691 Todd Cipriani 40.00 X 240388 0 55071 Terrence R McWilliams MD 40.00 X 293386 0 37038 Suzette D Schochet 6.00 X X 0 0 0 Stephen P Massed 8.00 X X 0 0 0 Rita B Gewirz 2.50 X 0 0 0 Peter M DiBari 1.50 X 0 0 0 Mary A Wakefield 3.00 X 0 726687 103289 Marielen Maguire 40.00 X 122093 0 10341 M Lynne Francis 2.00 X 0 0 0 Louis A Fazzano 2.00 X 0 0 0 Leonard C Taddei DMD 4.00 X 0 0 0 Kathleen H Ross 4.00 X 0 0 0 Karen L Smith RN 40.00 X 118568 0 15767 John H Ellis 2.00 X 0 0 0 James A Purviance 3.00 X 0 0 0 Frank J Byrne 40.00 X 0 204408 43456 David S Gordon 3.00 X 0 0 0 David G Bazarsky Esq 2.00 X 0 0 0 Christopher Luttman MD 1.00 X 0 0 0 Christine A Gill MD 1.50 X X 0 0 0 Charles L Stengel MD 2.00 X 0 0 0 Cathy E Duquette 40.00 X 243404 0 51659 Bruce G Tucker 3.00 X 0 0 0 Bartholomew Grimes 40.00 X 154882 0 33986 August B Cordeiro 28.00 X X 0 374488 73367 Arthur J Sampson 0.00 X 0 501738 88638 Ann M Kashmanian 0.00 X 0 342875 59315 Alan R Feinberg DMD 2.00 X 0 0 0 1299046 2150196 599618 17 true true false Apollo Security 262 Washington Street Boston MA 02111 Security services 429004 University Surgical Associates 2 Dudley Street Providence RI 02903 Medical, health care 675236 Providence Anesthesiologists 75 Newman Avenue Rumford RI 02916 Medical services 340000 NHCC Medical Associates 11 Friendship Street Newport RI 02840 Medical, health care 1124647 Newport Emergency Physicians 11 Friendship Street Newport RI 02840 Medical, health care 3120891 12 7748919 118537 7867456 Lifespan Laboratory 621150 175226 175226 Inpatient Service Revenue 622110 55069200 55069200 Cafe./ Misc Pharm sales 622110 17961 17961 Auxiliary 622110 20581 20581 Ancillary OP Service Rev. 622110 55931558 55931558 111214526 1183374 1183374 0 0 0 32185898 31652333 533565 533565 533565 0 0 0 0 120798921 111039300 175226 1716939 0 0 0 0 303961 245389 58572 0 41366053 38211874 3154179 2989600 2765380 224220 8567519 7924955 642564 3129700 2910621 219079 0 0 0 0 0 293724 293724 5638724 5638724 36640 36640 244067 216487 27580 0 0 6417064 5582846 834218 71710 66690 5020 0 0 1225910 1225910 0 6453963 6453963 634707 583930 50777 State license fee 4995682 4995682 Purchased services 12444162 10441062 2003100 Provision for bad debts 6687829 1571640 5116189 Other program expenses 1190697 1015665 175032 Medical & surgical supplies 11538386 11423002 115384 57113 50659 6454 114287211 88685564 25601647 0 0 3866314 6089009 0 11757666 10800251 0 0 0 1627157 1617996 248744 237082 148401159 85970831 65459651 62430328 46470114 47336457 24090928 26750744 0 0 150715037 151800263 304235611 307062130 8092560 7744246 23535000 22780000 21307338 11879919 52934898 42404165 X 190651784 200437618 53896929 53683698 6752000 10536649 251300713 264657965 304235611 307062130 X 6511710 6845542 X false true true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 2475 2475 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. 76534229 7867456 1187929 6362169 79227445 73235178 238489 6505097 3444535 76534229 78583362 1585979 -1569783 5337380 73262178 0.20860 0.12590 0.66550 true false false 1470585 1470585 91687052 45978198 45708854 55243522 39992633 15250889 62430328 26750744 Trustee-held funds-bond indenture 497587 Outside trusts 1083508 Interest in Net Assets of NH Foundation 139717380 Intercorporate financing 5349788 Deferred financing costs & other assets 1094701 Cash and short-term investments 4057299 151800263 Third-party liabilities 2837000 Postretirement life ins. liability 859078 Health care benefit self-insurance 185241 Accrued pension liability 7998600 11879919 120798921 114287211 6511710 7524577 7524577 14036287 112391595 -296481 -361926 -658407 113050002 7748919 7748919 120798921 114287211 114287211 114287211 Part XII, Line 4b Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S Transfers from Newport Hospital Foundtn $7748919 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Funded status of pension plan $7524577 $ -0 $ -0 Auxiliary $ -20628 Interest in Foundation Net Assets $ -361926 Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. The Hospital's endowment consists of many funds established for a variety of purposes, including both donor-restricted endowment funds and funds designated by the Hospital to function as endowments. The majority of Newport Hospital's endowments are intended to be used in the areas of patient care, which includes a comprehensive range of diagnostic and therapeutic health care services to inpatients and outpatients. The endowment funds are used to maintain and support the Hospital and to provide care to patients suffering from illnesses or disabilities.The largest board-designated endowment held by the Hospital is used to support and maintain the facilities of the Hospital. Three large funds are used for the purchase and replacement of medical equipment, to offset the cost of charity care, and to support the operations of the Emergency Department, respectively. The Hospital's largest permanently restricted endowment funds support the Hospital's emergency department, as well as promote athletic activity and wellness among youth and families of Newport County. true true true X true X true true true false true true 5428246 1605215 3823031 0.03350 12573238 11041735 1531503 0.01340 18001484 12646950 5354534 0.04690 325826 6759 319067 0.00280 15113417 10982324 4131093 0.03610 33450 33450 0.00030 15472693 10989083 4483610 0.03920 33474177 23636033 9838144 0.08610 true 2538700 1158015 22517572 28511487 -5993915 X true true 1 0 Newport Hospital

11 Friendship Street Newport RI 02840

X X X Newport 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 7 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 - 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 12,400 people. The Lifespan system has over 2,200 physicians on the medical staffs of its affiliated hospitals, operates 1,155 licensed beds in four hospital complexes, and in 2011 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 79 percent of the residents and fellows in this program based at RIH, TMH and Bradley Hospital.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, 2011, Lifespan Corporation employed approximately 700 full-time and part-time personnel, most of whom are located at Lifespan's headquarters in Providence, RI. Lifespan Corporation provides support services to its affiliates, such as information services, telecommunications, risk management, legal, communications and public affairs, fundraising, payor contracting, 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 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 Newport Health Care 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 and to the organization. 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 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 (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 assistance with Hospital charges. In addition, at such public events as health fairs the Hospital actively promotes this service so that anyone who might qualify can easily learn about the 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, emergency department, financial counseling office, and in 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 where a patient falls in the income guidelines. 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 use 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 to urgent care and stroke, to 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 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, 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. 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. 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. The account remains with them until 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 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 then returns it to Patient Financial Services for writeoff.Note: In accordance with Center for Medicare and Medicaid Services mandates, Medicare patient accounts are held 130 days from last payment, after which if no activity, the account is then 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 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, primarily Medicaid. 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 shortfalls are not treated as community benefits because most Medicare patients are not indigent. The source of the Medicare allowable costs reported on Part III, Section B, Line 6 is the Medicare cost report, Form 2552-96. Part III, Line 4 - Bad Debt Expense The Hospital grants credit without collateral to its patients, most of whom are local residents and are insured under third party payor arrangements. Additions to the allowance for doubtful accounts are made by means of the provision for bad debts. Accounts deemed uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for bad debts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in federal and state governmental health care coverage, and other collection indicators.The Hospital provided $6,688,000 for uncollectible patient accounts during the year ended September 30, 2011. 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. Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) Newport Hospital uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at Newport Hospital (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 income tax return- most recently received payroll check stub- copy of rent receipts for the last six months- copy of utility bills for the last month4. 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.)5. Uninsured patients receive an automatic 50% deduction at the Hospital.6. 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 $8,855 for an individual (or $13,281 for a family) may not qualify for care without charge, but may qualify for discounted care. Partial charity care applicants are subject to the same asset test and may not qualify for the highest discount on care, but may be eligible for a lesser discount. 7. 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. 8. 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 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 $50.004. 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. X true true X X X X X false true false false false false false true false false Valerie Martin 118626 7699 10362 17329 154016 Todd Cipriani 172455 39957 27976 37379 17692 295459 17771 Terrence R McWilliams MD 222901 38536 31949 34766 2272 330424 22511 Mary A Wakefield 495892 132000 98795 88238 15051 829976 66367 Frank J Byrne 156933 27994 19481 24716 18740 247864 14778 Cathy E Duquette 176114 38577 28713 33680 17979 295063 17748 Bartholomew Grimes 142974 11908 12702 21284 188868 August B Cordeiro 262761 68000 43727 54584 18783 447855 23293 Arthur J Sampson 347763 84000 69975 72974 15664 590376 45014 Ann M Kashmanian 254658 56433 31784 39791 19524 402190 22671 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). Newport Emerg Physicians Officer 3021258 Med. staffing services false Charles L. Stengel, MD, a trustee of Newport Hospital, is the Vice President of Newport Emergency Physicians, a for-profit corporation that provides staffing services to Newport Hospital. In fiscal year 2011 Newport Hospital paid Newport Emergency Physicians $3,021,258 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 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 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 with contemporary ethical norms, and is administered consistent with the organization's tax-exempt status under Section 501(c)(3) of the Internal Revenue Code (IRC) and the avoidance of transactions subject to intermediate sanctions under Section 4958 of the IRC. Executive compensation is also administered consistent with Lifespan's Corporate Compliance Policy on Excess Benefit Transactions.The Compensation Committee of the Lifespan Corporation Board of Directors (the Committee), comprised of disinterested Lifespan and affiliate Board members, is responsible for diligent oversight of executive compensation to ensure compliance with IRC requirements. Its duties include:* Approving eligibility for participation in the executive compensation program * Approving changes in compensation for existing executive participants * Approving guidelines, such as salary ranges and contract terms, on appropriate levels of compensation for other key employees* Approving new, and modifying or terminating existing, executive compensation plans including, but not limited to, annual 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. 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. (For the bulk of Lifespan management staff awareness 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 4b Outpatient services include diagnostic medical imaging, laboratory, Vanderbilt Rehabilitation, wound care, and other notable services. The Hospital substantially subsidizes various health services including adult psychiatry, Vanderbilt Rehabilitation, occupational health, and certain other specialty services. The Hospital also provides numerous other services to the community for which charges are not generated. These services include certain emergency services, community health screenings for cardiac health, prostate cancer and other diseases, smoking cessation, immunization, and nutrition programs, diabetes education, community health training, patient advocacy, foreign language translation, physician referral services, and charitable contributions. 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; University of Massachusetts-Dartmouth and Yale University, 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. Form 990, Part III, Line 1 -Organization's Mission The mission of Newport Hospital is to provide acute and outpatient health services to all the people of 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 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 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 and NHCC's financial information to repositories and investors alike. Newport Hospital's financial statements are included in NHCC's consolidated 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 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 for initial review 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. Any recommended changes are incorporated into the return. The draft Form 990 is then provided to the Chief Financial Officer for final management review. Prior to filing the return with the Internal Revenue Service, a copy of the entire form is sent to the 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 as appropriate. The Chief Financial Officer is authorized to file the Form 990. 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), including the bylaws of NHCC, 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 Lifespan Corporation is the sole corporate member of Newport Health Care Corporation ("NHCC") which in turn is the sole corporate member of Newport Hospital. Form 990, Part VI, Line 2 Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Mary A. Wakefield is an officer of Lifespan Corporation. The following officer, former officer and key employee, respectively, of Newport Hospital are employed by Lifespan: August B. Cordeiro, Arthur J. Sampson and Frank J. Byrne. RI Sound Enterprises Insurance Co Ltd 65 Front Street Hamilton BD HM 12 Offshore Insurance Captive BD NA false RIH Ventures 593 Eddy Street Providence RI 02903 050448686 Parking Facilities/ Phlebotomy Services RI 501(c)(3) 11 NA false The Miriam Hospital Foundation 167 Point Street Providence RI 02903 050377502 Philanthropic Activities RI 501(c)(3) 7 NA false The Miriam Hospital 164 Summit Avenue Providence RI 02906 050258905 Health Care Services RI 501(c)(3) 3 NA false Rhode Island Hospital Foundation 167 Point Street Providence RI 02903 050468736 Philanthropic Activities RI 501(c)(3) 7 NA false Rhode Island Hospital 593 Eddy Street Providence RI 02903 050258954 Health Care Services RI 501(c)(3) 3 NA false NHCC Medical Associates Inc 11 Friendship Street Newport RI 02840 050472268 Health Care Services RI 501(c)(3) 11 NA false Newport Hospital Foundation Inc 11 Friendship Street Newport RI 02840 222535533 Philanthropic Activities RI 501(c)(3) 7 NA false Newport Health Property Management Inc 11 Friendship Street Newport RI 02840 222335539 Property Management RI 501(c)(3) 11 NA false Newport Health Care Corportaion 11 Friendship Street Newport RI 02840 222535537 Holding Company/ Mgmnt Services RI 501(c)(3) 7 NA false Lifespan of Massachusetts Inc c/o Archstone Law 245 Winter St Waltham MA 02451 043408517 Holding Company MA 501(c)(3) 11 NA false Lifespan Foundation 167 Point Street Providence RI 02903 050493219 Philanthropic Activities RI 501(c)(3) 7 NA false Lifespan Diversified Services 167 Point Street Providence RI 02903 050258935 Holding Company/ Mgmnt Services RI 501(c)(3) 11 NA false Lifespan Corporation 167 Point Street Providence RI 02903 222861978 Holding Company/ Mgmnt Services RI 501(c)(3) 11 NA false Hospital Properties Inc 593 Eddy Street Providence RI 02903 222869743 Property Mangement RI 501(c)(4) NA false Emma Pendleton Bradley Hospital 1011 Veterans Memorial Parkway East Providence RI 02915 050258806 Pediatric Psychiatric Health Care Services RI 501(c)(3) 3 NA false Bradley Hospital Foundation 167 Point Street Providence RI 02903 050500688 Philanthropic Activities RI 501(c)(3) 7 N A false VNA Technicare Inc 622 George Washington Highway Lincoln RI 02865 050472710 DME Sales RI NA C corp Lifespan Risk Services Inc 167 Point Street Providence RI 02903 050459767 Risk Mgmnt RI NA C corp Lifespan MSO Inc 167 Point Street Providence RI 02903 050508717 Mgmnt Services RI NA C corp false false true true true false false false true false false true false true false false false true