2012-08-14T15:30:57-07:00 2011-09-30 KPMG LLP 2 Financial Center 60 South St Boston MA 02111 990 2010-10-01 050258905 The Miriam Hospital MIRI 4017932500 164 Summit Avenue Providence RI 02906 Mary A Wakefield 2012-08-14 2010 2016-02-24 21:20:13Z Timothy J Babineau MD 164 Summit Avenue Providence RI 02906 445387674 false false X www.miriamhospital.org X 1926 RI The mission of The Miriam Hospital(TMH) is to inspire one another to improve the health and spirit of the lives we touch. 23 19 2750 872 2350176 48096 3051477 3004364 376274529 391208224 3691557 1825832 8027487 8994542 391045050 405032962 31075 0 0 168554688 179893033 0 0 211809727 220130266 380395490 400023299 10649560 5009663 376984402 372660071 139754581 135106742 237229821 237553329 The mission of The Miriam Hospital(TMH) is to inspire one another to improve the health and spirit of the lives we touch. false false 305946438 372601674 Patient Care:Services and programs provided by TMH include general medicine; general surgery; emergency medicine; cardiovascular care; orthopedics; nuclear cardiology; radiology; laboratory; renal dialysis; urology; gastroenterology; endocrinology; gynecology; nephrology; neurology; ophthalmology; trauma care; computerized tomography; and magnetic resonance imaging (MRI). (Continued on Schedule O). 24502572 21310805 Research:Since 1969, the level of research has increased from seven projects totaling $127,000 involving nine investigators to 393 projects totaling $24.5 million involving 71 investigators and 171 employees. The following represents significant areas of research being conducted at the Hospital: cancer treatment and prevention, epidemiological research, clinical trials in AIDS and HIV infection (including vaccine development), coronary heart disease, nutrition, exercise, weight control and lifestyle risk factors affecting health. TMH provided $3.2 million in support of research activities in fiscal year 2011. (Continued on Schedule O). 20138999 2611285 Medical Education:TMH provides the setting for and substantially supports medical education in various clinical training and nursing programs. TMH is designated as a major teaching affiliate of The Warren Alpert Medical School of Brown University. The total cost of direct medical education provided by the Hospital exceeded the reimbursement received from third-party payors by $17.5 million in fiscal year 2011. (Continued on Schedule O). 350588009 true true false true false false false false false true true true false true true false true true false false true false false false false false true true false false true true false false false false false false false false true true false false false false false true false false false false true 191 0 true 2750 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 23 19 true false true 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 Timothy J Babineau MD 13.00 X X 0 876509 144417 Sandra Cheng 40.00 X 256723 0 44536 Rogers C Griffith MD 40.00 X 282096 0 38192 Robert W Corwin MD 40.00 X 313397 0 56150 Rena R Wing 40.00 X 265402 0 26764 Rebecca L Burke 40.00 X 0 150977 15529 Phillip Kydd 1.00 X 0 0 0 Penelope H Dennehy MD 2.00 X 0 210412 22890 Michael L Hanna 2.00 X 0 0 0 Michael J Perik 1.00 X 0 0 0 Mary Jo Kaplan 3.00 X X 0 0 0 Mary A Wakefield 12.00 X 0 726687 103289 Maria Ducharme 40.00 X 190478 0 42333 Lawrence A Aubin Sr 4.00 X 0 0 0 Kathleen Hittner MD 0.00 X 0 678411 103821 Joseph J MarcAurele 2.00 X 0 0 0 Jonathan J Elion MD 2.00 X 0 0 0 Jeffrey M Burock MD 40.00 X 247140 0 35731 Jeffrey G Brier 5.00 X 0 0 0 Jane Williams RN PhD 1.00 X 0 0 0 James A Procaccianti 4.00 X 0 0 0 Fred J Schiffman MD 2.00 X 0 0 0 Emanuel Barrows 1.00 X 0 0 0 Ellen A Collis 1.00 X 0 0 0 Edward D Feldstein 10.00 X X 0 0 0 Edmund C Bennett 3.00 X 0 0 0 Dayle H Joseph MSEdD 4.00 X 0 0 0 David A Marcoux MD 2.50 X 0 0 0 Brian J Zink MD 3.00 X 0 0 0 Brian Goldner 1.00 X 0 0 0 Bertram M Lederer 3.00 X X 0 0 0 Arthur J Sampson 40.00 X 0 501738 88638 Alan H Litwin 8.00 X X 0 0 0 1555236 3144734 722290 152 true true false University Medicine Foundation 17 Virginia Ave Providence RI 02905 Medical Services 8334001 University Cardiovascular Surgical Assoc 2 Dudley St Ste 190 Providence RI 02905 Medical Services 2219730 Quest Diagnostics 12436 Collections Center Drive Chicago IL 60693 Laboratory Services 1662676 Narragansett Bay Anesthesia 164 Summit Avenue Providence RI 02906 Medical Services 1111417 Brown University 75 Waterman Street Providence RI 02912 Medical Services 1674732 32 2897400 32806 74158 3004364 Temp Restricted (SPFs) 900099 743536 743536 Patient Service Rev 900099 364805246 364805246 Laboratory 621500 2266038 2266038 Direct Rev from Research 900099 23393404 23393404 391208224 3227779 3227779 1700 1700 0 719529 505339 214190 214190 7249 206941 38445726 39849373 -1403647 -1403647 -1403647 0 0 0 State DSH Revenue 900099 1131939 1131939 Indirect Rev from Grants 900099 4253196 4253196 Cafeteria Revenue 722210 1119871 1119871 2275346 2195407 76889 3050 8780352 405032962 396522728 2350176 3155694 0 0 0 0 286491 286491 0 137714578 132806819 4907759 6113700 5896179 217521 26112295 25272476 839819 9665969 9322061 343908 0 0 0 3445 3445 0 129170 129170 17543668 17467228 76440 210159 195307 14852 84805925 84405377 400548 0 0 8227365 7503463 723902 680132 598770 81362 0 393704 355250 38454 3588870 3588870 0 10338516 10338516 2499665 2499665 Unrelated Business Income Tax 16353 16353 Purch Svs & Equip Cont 42525095 15388405 27136690 Provision for bad debts 18242417 18242417 License Fee 17153962 17153962 All Other Expenses 13771820 13174341 597479 0 400023299 350588009 49435290 0 0 13284083 14168190 1245050 1464558 38386570 36464708 0 0 550000 508141 3916035 4956106 3188072 888645 313201444 158306679 154295227 154894765 70121300 61584178 22282008 31534911 0 0 69716057 66195869 376984402 372660071 28247085 26928215 68064107 66056166 43443389 42122361 139754581 135106742 X 204340397 205353302 21499537 19575215 11389887 12624812 237229821 237553329 376984402 372660071 X 5009663 -4686155 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 3445 3445 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description The Miriam Hospital pays membership fees to the Hospital Association of Rhode Island (HARI), a portion of which is allocated to HARI's lobbying efforts. 96830355 25953487 678572 25766197 97696217 73337707 40371010 8097713 24976075 96830355 77300591 22261170 -882788 25341266 73337707 0.86900 0.13100 false false false 4288032 4288032 183532151 68788450 114743701 114544345 89518229 25026116 10836916 10836916 154894765 31534911 Trustee-held funds-bond indenture 10496052 Other 138445 Interest in NA of TMH Foundation 49382246 Deferred financing costs 1601998 66195869 Third-party payor settlements 9650372 Post-retirement benefit liability 145200 Lease payable 448146 Health care benefit self-insurance 2098884 Due to affiliates 3953291 Accrued pension liability 25617300 Abatement liability 209168 42122361 405032962 400023299 5009663 -910177 -3775978 -4686155 323508 400722976 -910177 -3775978 -4686155 405409131 129170 -505339 -376169 405032962 400399468 400399468 129170 -505339 -376169 400023299 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Change in funded status of pension and other postretirement $ -2933576 Decrease in Net Assets of TMHF $ -842402 Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. Endowment funds primarily include designated assets set aside by The Miriam Hospital's Board for future capital improvements, over which the Board retains control and may at its discretion subsequently use for other purposes, and assets whose use by the Hospital has been limited by grantors or donors to a specific purpose. The largest term endowments held by the Hospital are used to support: (1) the treatment and prevention of cancer, including the Cancer Patient Navigator Program, which assists cancer patients through the entire course of their care; and (2) the Hospital's capital equipment and operating needs in providing services to patients. Sub-Saharan Africa 0 0 Program Services Research 135148 South Asia 0 0 Program Services Research 114238 East Asia & the Pacific 0 0 Program Services Research 8286 257672 257672 X false false false false false true true true true X true X true true true false true true 18870894 5218490 13652404 0.03410 33415683 29973047 3442636 0.00860 52286577 35191537 17095040 0.04270 350869 54069 296800 0.00070 20138999 2611285 17527714 0.04380 11307987 9211075 2096912 0.00520 24502572 21310805 3191767 0.00800 77000 77000 0.00020 56377427 33187234 23190193 0.05790 108664004 68378771 40285233 0.10060 true 4482162 2600255 77627960 85668808 -8040848 X true true 1 0 The Miriam Hospital

164 Summit Avenue Providence RI 02906

X X X X X The Miriam 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 14 TMH Pre-admission Testing Center

208 Collyer Street 3rd Floor Providence RI 02904

Outpatient Pre-admission assessment and education TMH Behavioral Medicine Clinic

146 West River Street Providence RI 02904

Outpatient Clinic Womens Medicine Collaborative

146 West River Street Providence RI 02904

Comprehensive Women's Outpatient Clinic RISE TB Clinic

14 Third Street Providence RI 02906

TB Clinic TMH Laboratory

1 Commerce Street Lincoln RI 02865

Phlebotomy Lab TMH Outpatient Rehabilitation

195 Collyer Street Providence RI 02904

Outpatient PT, OT and Speech Rehab TMH Cardiac RehabPulmonary Rehab

208 Collyer Street Providence RI 02904

Outpatient Cardiac Clinic TMH Laboratory

400 Bald Hill Road Warwick RI 02886

Phlebotomy Lab TMH Laboratory

1 Hoppin Street Providence RI 02903

Phlebotomy Lab TMH Immunology Research

11 Fourth Street Providence RI 02906

Outpatient Research & Education TMH Immunology Research Center

14 Third Street Providence RI 02906

Outpatient Counseling TMH Weight Control & Diabetes Research

196 Richmond Street Providence RI 02903

Outpatient Research & Education Behavioral Medicine Research

1 Hoppin Street Providence RI 02903

Outpatient Research & Education TMH Diagnostic Imaging Center

195 Collyer Street Suite 101 Providence RI 02904

Outpatient Radiology 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 (EPBH), 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 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, 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 TMH confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination and support of the system. Powers reserved to Lifespan as sole member include: to elect and remove trustees; to approve the election of and to remove certain officers; to approve the amendment of the Articles of Incorporation and Bylaws and other Charter documents; to approve strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness.For a complete listing of affiliated members of Lifespan's integrated healthcare delivery system please refer to Schedule R. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose The Miriam Hospital is governed by a Board of Trustees, which is composed of 20 voting members who are elected by Lifespan Corporation as sole member of the Hospital, and five who serve ex officio. 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 The Miriam Hospital Foundation and the Chair of Rhode Island Hospital Foundation. The Chair and the President and CEO of Lifespan Corporation are ex officio members of the Board without a vote. Elected Board members serve one-year terms. 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: oncology, tuberculosis, and certain other specialty services. The Hospital also provides numerous other services to the community for which charges are not generated. These services include certain emergency services, community health screenings for cardiac health, prostate cancer and other diseases, smoking cessation, immunization, and nutrition programs, diabetes education, community health training programs, patient advocacy, foreign language translation, physician referral services and charitable contributions. Part VI - Community Information The Miriam Hospital, located in Providence, Rhode Island, is a 247-bed nonprofit general acute care teaching hospital with university affiliation providing a comprehensive range of diagnostic and therapeutic services (excluding obstetrics) for the acute care of patients principally from 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). The Hospital is designated as a major teaching affiliate of Brown. The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically.With respect to nursing education, the Hospital has developed formal and informal educational affiliations with a number of accredited New England colleges and universities. The Hospital does not receive any compensation from the various schools for providing a clinical setting for the student nurse training.The Hospital conducts extensive medical research and is in the forefront of biomedical health care delivery research and among the leaders nationally in National Institutes of Health programs. Part VI - Patient Education of Eligibility for Assistance The Miriam Hospital has multilingual signage in the Hospital's main lobby and waiting areas which provides information on financial aid contacts. The Registration Department meets with patients at the outset of care to discuss eligibility for assistance. The Registration staff provides interested patients with a "Welcome" booklet which includes information on patient rights and responsibilities. The signage and booklets contain a telephone number which connects patients with Registration staff who can answer any additional questions that may arise after the patient has left the Hospital. Assistance eligibility is also summarized on the Hospital's website. Part VI - Needs Assessment Lifespan's Office of Strategic Planning and Analysis performs population-based studies for the Hospital regarding the need for inpatient medical and surgical services for both adults and children and a wide range of outpatient services including: primary care office visits, specialty care, emergency services, imaging, ambulatory surgery, and specific high technology services such as radiation therapy and bone marrow transplantation. A population-based study examines the growth and changes in the population, the resources in the community, and the changing prevalence of diseases. Added to this population-based 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, in 2006, the Hospital was the first in the region to use a new technology to remove clots quickly, mitigating the debilitating effects of stroke. Over the past three years, the Hospital has expanded its groundbreaking robotic surgery program. The Hospital is home to the state's first Joint Commission-Certified Stroke Center and the only Women's Cardiac Center in Rhode Island. 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 The Hospital uses an outside pre-collection agency for all self-pay receivables, with the exception of self-pay after Medicare which is handled by the Hospital's Patient Financial Services Department. 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 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 $18,242,417 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) The Miriam Hospital (the Hospital) uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at the Hospital is intended to define probable eligibility for public assistance (Medicaid or Community Free Service ("CFS")) for those patients who do not have the means to pay for hospital services rendered, as follows:1. Upon patient indication of an inability to pay required monies, the patient is offered the financial screening option to determine eligibility for public assistance. (Medicaid, CFS)2. The application for CFS is completed and includes information relative to income, expense, and other available resources and requires proof of such information which may include:- most recently filed 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 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. X X true true X X X X X false true false false false false false true false false Timothy J Babineau MD 670588 172500 33421 123367 21050 1020926 Sandra Cheng 186389 44347 25987 36787 7749 301259 17952 Rogers C Griffith MD 271610 6500 3986 19160 19032 320288 Robert W Corwin MD 239655 58096 15646 41180 14970 369547 Rena R Wing 258517 6885 18705 8059 292166 Rebecca L Burke 93231 57746 9291 6238 166506 29280 Penelope H Dennehy MD 207645 2767 14465 8425 233302 Mary A Wakefield 495892 132000 98795 88238 15051 829976 66367 Maria Ducharme 170132 20346 24915 17418 232811 Kathleen Hittner MD 467757 110000 100654 84671 19150 782232 70604 Jeffrey M Burock MD 198997 40000 8143 15736 19995 282871 Arthur J Sampson 347763 84000 69975 72974 15664 590376 45014 Sch J, Part I, Line 7 Part I, Line 7: Non-Fixed payments not listed above The Lifespan Annual Incentive Compensation Plan provides a financial award opportunity for designated members of management, based on quantified objectives that are approved in advance by the Compensation Committee of the Lifespan Corporation Board of Directors. A specified level of financial performance must be met before any award is earned. The objectives vary from year to year and generally include various aspects of financial measures in addition to non-financial performance measures. For certain participants in the Annual Incentive Compensation Plan, the award opportunity is divided into two pools. The first pool represents 80% of any earned incentive award, based on the achievement of the team performance objectives. The remaining 20% pool is distributed on an individual basis to participants at the discretion of the CEO, in each case subject to approval by the Compensation Committee of the Lifespan Corporation Board of Directors. Sch J, Part I, Line 1a Part I, Line 1a: Relevant information in regards to selections on 1a. Tax Indemnification and Gross-up Payments:The Lifespan Executive Long Term Disability program provides financial protection to designated Lifespan executives in the event that they become disabled. Premiums are paid to the insurance carrier by the insureds on an after tax basis to allow for income replacement at a reasonable cost. The income associated with the premiums is grossed-up to cover the total cost of the benefit as provided in the Lifespan Executive Benefit Plan and is included in Medicare wages, more specifically on Schedule J, Part II, Column B (iii).Social Club Dues:The job responsibilities of certain executives include development of relationships with business leaders and donors. Those relationships are facilitated by the ability to meet in private sessions during which focused business discussions take place. The Hope and University Clubs, which require individual memberships, are places in Providence where businessmen and women, civic, community and social leaders can gather in a 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. RI Health & Ed Bldg Corp 521300173 762243K36 2009-03-30 19582506 See Part V false false true RI Health & Ed Bldg Corp 521300173 762243SS3 2006-02-14 40725126 See Part V false false true 19582506 1955452 288639 339121 8740761 8308509 false false false true 37924625 40725126 348652 968829 39407645 2006 false true true true false false false true true true false true false true true 0.00970 0.00970 true false false false false false false false false false false false false Schedule K, Part I, Lines A & B, Column (f) - see description of purpose on Schedule O. Jessica Brier Employee 104257 Employee Compensation false Roberts Carroll Feldstein & Peirce Partner 112456 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 TMH and Lifespan Risk Services is Lifespan Corporation. During fiscal year 2011, Lifespan Risk Services paid Roberts, Carroll, Feldstein and Peirce $112,456 for services regarding TMH matters.* The wife of Jeffrey Brier is employed by The Miriam Hospital as a Cardiovascular Clinical Nurse Specialist. In fiscal year 2011, The Miriam Hospital paid Jessica Brier $104,257 for her services. Form 990, Schedule K, Part I, Line B, Column (f) The proceeds of the Series 2009A Bonds are being used for the purposes of financing projects consisting of: (i) the acquisition, construction, renovation, expansion and equipping of certain hospital and related health care facilities owned and operated or to be owned and operated by one or more of Rhode Island, The Miriam, or Emma Pendleton Bradley Hospitals, located at and in the vicinity of the Hospital Campuses; (ii) equipping, furnishing, and improving facilities and other depreciable assets used in health care operations on the Hospital Campuses; (iii) the funding of a debt service reserve fund for the Bonds; and (iv) and the payment of certain expenses of issuance with respect to the Bonds. Form 990, Schedule K, Part I, Line A, Column (f) The proceeds of the Series 2006A Bonds were used: (i) to advance refund a portion of the $214,585,000 Hospital Financing Revenue Bonds, Lifespan Obligated Group Issue, Series 1996; (ii) to advance refund a portion of the $78,000,000 Hospital Financing Revenue Bonds, Lifespan Obligated Group Issue, Series 2002 and (iii) to pay certain expenses incurred in connection with the issuance of the Series 2006A Bonds. Form 990, Part VI, Section B, Lines 15 a&b cont. Base Salary Actions: The CEO recommends any salary adjustments for participants in the executive compensation program, using the results of the valuation study and his/her assessment of individual performance or other pertinent information, for the Committee's consideration.New Participants in Executive Compensation Program: With respect to compensation offers for individuals expected to participate in the executive compensation program, the office of the 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 The Miriam Hospital:EXECUTIVE COMPENSATIONLifespan's executive compensation philosophy balances appropriate stewardship of resources and the need to be competitive in recruiting and retaining talented individuals. It incorporates market-competitive and performance-related principles, and covers the President and CEO of Lifespan as well as other officers, senior management and key employees. Lifespan's executive compensation program complies both with law and with contemporary ethical norms, and is administered consistent with the organization's tax-exempt status under Section 501(c)(3) of the Internal Revenue Code (IRC) and the avoidance of transactions subject to intermediate sanctions under Section 4958 of the IRC. Executive compensation is also administered consistent with Lifespan's Corporate Compliance Policy on Excess Benefit Transactions.The Compensation Committee of the Lifespan Corporation Board of Directors (the Committee), comprised of disinterested Lifespan and affiliate Board members, is responsible for diligent oversight of executive compensation to ensure compliance with IRC requirements. Its duties include:* Approving eligibility for participation in the executive compensation program * Approving changes in compensation for existing executive participants * Approving guidelines, such as salary ranges and contract terms, on appropriate levels of compensation for other key employees* Approving new, and modifying or terminating existing, executive compensation plans including, but not limited to, annual 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 The Miriam Hospital, and administered by Lifespan's Corporate Compliance Department as follows: Each designated person subject to Lifespan's conflict of interest policy is required to provide Lifespan with an initial disclosure statement and thereafter an annual statement attesting that (i) the designated person has read and is familiar with this policy, and (ii) the designated person and, to the best of his/her knowledge, family members, have not in the past engaged in, are not presently engaging in, or plan to engage in, any activity which contravenes this policy.If, at any time during the course of employment or association, a designated person has reason to believe that an existing or contemplated activity may contravene this policy, the person shall submit a full written description of the activity to the Lifespan Compliance Officer or the Office of the General Counsel to seek a determination as to whether the contemplated activity does or does not contravene this policy. (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, 4c TMH conducts extensive medical research and is in the forefront of biomedical health care delivery research and among the leaders nationally in National Institutes of Health programs.Major areas of research include:Cancer. TMH conducts clinical and behavioral research focusing on the many facets of cancer including prevention, education and therapeutics which are supported by the National Cancer Institute, CALGB and NSABP. TMH is a participating hospital in the Brown University-sponsored Cancer Oncology Group (BrUCOG).HIV. At TMH, research focuses on the treatment and prevention of HIV infections, especially in hard-to-reach populations, both in the U.S. and abroad. There are international sites located in Cambodia, India, Kenya, Indonesia, The Philippines and South Africa. The Lifespan/Tufts/Brown Center for AIDS Research conducts clinical, basic and translational research programs. The TB Clinic performs research in the area of co-infections of HIV and tuberculosis. Depression. The Center for Behavioral and Preventive Medicine (CBPM) is comprised of major centers including: (1) Weight Control and Diabetes, (2) Nicotine & Tobacco Research, and (3) Physical Activity Research.The Weight Control and Diabetes Center conducts research programs that focus on diet, exercise, maintenance strategies, home environment, adolescent issues and pediatric obesity.The Physical Activity Research Center conducts research in the workplace, community settings and health care facilities, involving all age groups and focusing on the effects of exercise in disease prevention and treatment. Form 990, Part III, 4b In 1969, TMH and certain other Rhode Island hospitals entered into an affiliation agreement to participate jointly in various clinical training programs and research activities with Brown Medical School, renamed The Warren Alpert Medical School of Brown University (Brown). The goals of the partnership are to facilitate the expansion of joint educational and research programs to compete both clinically and academically.TMH participates in Brown programs in internal medicine and medicine subspecialties, general surgery and surgical subspecialties, psychiatry, emergency medicine, orthopedics, and dermatology and provides stipends to residents and physician fellows while in training. The Hospital is also a participating clinical training site for residents from other programs in infectious disease, OB/Gyn subspecialties, podiatry, psychiatry, geriatric psychiatry, colorectal surgery and cardiothoracic surgery. In addition, TMH Behavioral Medicine, in collaboration with Brown, sponsors research and clinical psychology training programs for interns, postdoctoral fellows and faculty trainees. OTHER EDUCATIONAL AFFILIATIONS AND PROGRAMS:Nursing. TMH has developed formal and informal educational affiliations with the University of Rhode Island College of Nursing; Rhode Island College; Community College of Rhode Island (CCRI); 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, pursuant to which their nursing students obtain clinical training and experience at TMH. TMH does not receive any compensation from the various schools for providing a clinical setting for the student nurse training.Sponsored Training Programs and Clinical Site Affiliations. TMH sponsors training programs for a variety of allied health care professionals including required clinical and fieldwork experienceS in physical, speech, and occupational therapy to university students in each discipline through contracts with the various universities. TMH serves as a clinical training site for students from CCRI for the vascular and cardiology ultrasound programs and also provides training experiences for students in diagnostic radiology, nuclear medicine technology, pathology, laboratory medicine and phlebotomy. Training programs are also provided for students in medical technology and social work. TMH has clinical affiliations/student clinical training programs for pharmacy students provided through contracts with a number of colleges and universities. Form 990, Part III, 4a, continued TMH is licensed to operate 247 acute care beds by the Rhode Island Department of Health. Notable medical accomplishments of TMH include performance of Rhode Island's first lung operation, first kidney transplant and first aortic valvuloplasty (a procedure to clear blocked heart valves). In 2011, TMH discharged 14,614 inpatients, logged nearly 55,000 visits in its emergency department and performed over 10,000 inpatient and outpatient surgical procedures. Services provided in 2011 represent more than 168,500 inpatient days and nearly 45,000 clinic visits. More than 900 physicians are affiliated with TMH and the Hospital employs nearly 2,500 people. TMH is a major teaching hospital for The Warren Alpert Medical School of Brown University, providing clinical rotations for residents.TMH provides full charity care for individuals at or below twice the federal poverty level, with a sliding scale for individuals up to four times the poverty level. In addition, a substantial charity allowance is offered to all other uninsured patients. The Hospital determines the cost associated with providing charity care by aggregating the applicable direct and indirect costs, including compensation and benefits, supplies, and other operating expenses, based on data from its costing system. The total cost, excluding medical education and research, incurred by the Hospital to provide charity care amounted to $13,652,404 in fiscal 2011. Charges forgone, based on established rates, amounted to $46,116,244.TMH substantially subsidized various health services including oncology, HIV, tuberculosis and men's health clinics at a cost of $2,096,912 in fiscal year 2011. TMH also provides numerous other services to the community for which charges are not generated. These services include certain emergency services, community health Form 990, Part III, 4a, page 2screenings for cardiac health, prostate cancer and other diseases, smoking cessation, immunization, and nutrition programs, diabetes education, community health training programs, patient advocacy, foreign language translation, physicianreferral services, and charitable contributions. The cost of these services amounted to $296,800 in fiscal year 2011.TMH subsidizes the cost of treating patients who receive government assistance where reimbursement is below cost. Medicaid is a means-tested health insurance program, jointly funded by state and federal governments. States administer the program and set rules for eligibility, benefits and provider payments within broad federal guidelines. The program provides health care coverage to low-income children and families, pregnant women, long-term unemployed adults, seniors and persons with disabilities. Eligibility is determined by a variety of factors, which include income relative to the federal poverty line, age and immigration status, and assets. Form 990, Part I, Line 6 Volunteers support and contribute to the mission of TMH every day. They are able to learn, meet other dedicated volunteers, better understand the healthcare environment, and gain personal satisfaction knowing they are making a difference to patients, families, visitors, and vendors alike. Volunteer 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. TMH's surgeons are leaders in their field. TMH, as part of an academic medical center, prizes the mastery of new techologies in order to improve the quality of life for patients. TMH surgeons have successfully performed over 1,000 procedures using the da Vinci surgical system and have made its use a cornerstone of cancer treatment at TMH. The Comprehensive Cancer Center brings together world-renowned physicians and a group of specialists from TMH, Rhode Island Hospital and Newport Hospital, forming a multidisciplinary team whose level of knowledge and experience are unparalleled in Rhode Island.Form 990, Part III, 4a, page 6The Hospital's Adult Outpatient Behavioral Medicine Services help individuals improve health through behavior change. Services are offered to help patients adjust to chronic medical conditions, including their associated physical and emotional distress; modify unhealthy ways of living (for example, smoking cessation) to help prevent the onset or progression of disease; and treat mood and anxiety disorders that interfere with management of medical conditions. Services are available to help individuals with behavioral and psychosocial management of medical conditions such as headache, pain, cancer, heart disease (including those with implanted cardiac devices), pulmonary disease, and diabetes. The Weight Management Program provides comprehensive, medically supervised treatment for mild, moderate and severely overweight adults. Specialized programs are also available for adolescents and diabetics. Treatment combines medical monitoring, behavioral therapy, exercise instruction, three levels of calorie reduction and nutrition education. The Hospital's clinicians include surgical oncologists, medical oncologists, radiation oncologists, hematologists, pathologists, physical therapists, radiologists, nurses, clinical social workers, patient advocates, pharmacists and nutritionists. These dedicated specialists work with patients every step of the way, from diagnosis to treatment to follow-up care.To help patients and their families cope with breast cancer, TMH offers the Breast Health Navigator Program. The program assists breast cancer patients through the entire course of their cancer care with breast health navigators, registered nurses trained in oncology who possess an in-depth understanding of breast cancer and theForm 990, Part III, 4a, page 7process undergone by patients. They guide patients through diagnosis, treatment andrecovery, while helping them make informed decisions and cope with the variety of issues they face.TMH and Rhode Island Hospital were named Blue Distinction Centers for Complex and Rare Cancers by Blue Cross and Blue Shield of Rhode Island. TMH and Rhode Island Hospital are the only two hospitals in the State to receive this distinction. Blue Distinction Centers for Complex and Rare Cancers are facilities within participating Blue Cross and Blue Shield network service areas that offer comprehensive inpatient cancer care programs for adults, delivered by multidisciplinary teams with subspecialty training and distinguished clinical expertise in treating complex and rare subtypes of cancer. TMH and Rhode Island Hospital have both been recognized for excellence in treating esophageal, gastric, liver, pancreatic, rectal and thyroid cancer.The division of gastrointestinal and liver pathology is committed to providing high quality diagnostic services for gastrointestinal and liver diseases in patients.Collectively, gastrointestinal cancers are among the most common form of malignancies suffered today, affecting nearly a quarter of a million Americans each year. To address this, the Comprehensive Cancer Center has brought together nationally recognized leaders in the treatment and research of gastrointestinal cancers. TMH has been named among the nation's 100 top hospitals for cardiovascular care by Thompson Healthcare. Thompson's annual study identifies hospitals that are setting benchmark levels of performance for cardiovascular services throughout the nation. It recognizes the hospitals and their management teams for superior clinical, operational and financial performance in the area of cardiovascular service.Form 990, Part III, 4a, page 5TMH's cardiac surgery department is led by four board certified cardiothoracic surgeons, each able to perform a wide variety of cardiac, thoracic and peripheral vascular procedures. They represent more than ninety years of cumulative experience.Anesthesiologists dedicated to the management of complex cardiothoracic and vascular procedures provide each patient with the latest measures of intraoperative therapy and assessment. Every patient is monitored with a transesophageal echocardiogram (sonogram). TMH's team of surgeons, anesthesiologists and cardiologists works closely together. This cooperative approach has led to outstanding results at all levels of complexity.Thanks to the latest evolution in surgical technology, physicians now have an effective alternative to traditional open surgery and laparoscopy that allows them to provide patients with the best of both approaches. This alternative is the da Vinci Surgical System and TMH uses this technology to treat different types of cancer. The Center's team-based approach provides state-of-the-art care for patients who have or are at risk for cancers of the upper gastrointestinal tract, such as pancreatic cancer, cancer of the esophagus, and tumors involving the liver.Form 990, Part III, 4a, page 8The gastrointestinal cancer care services available through the Comprehensive Cancer Center provide care for patients who have or are at risk for the following types of cancer: bile duct, esophagus, gallbladder, endocrine, and cystic tumors of the pancreas, liver and stomach.TMH also offers medical nutrition therapy on an outpatient basis designed to help prevent and control gastrointestinal disorders. National Stroke Performance Award In both 2011 and 2010, TMH received the American Heart Association/American Stroke Associations Get With The Guidelines Stroke (GWTG-Stroke) Gold Plus Performance Achievement Award. The award recognizes TMH's commitment and success in providing the highest standard of stroke care for patients, according to evidence-based guidelines. This is the Associations highest honor for stroke care. Outstanding Achievement Award from the Commission on Cancer Also in 2011, The Leonard and Adele R. Decof Family Comprehensive Cancer Center at TMH earned the Outstanding Achievement Award from the Commission on Cancer (CoC) of the American College of Surgeons. Among only 90 programs nationwide to receive thisForm 990, Part III, 4a, page 3honor, this award recognizes the significant commitment by medical staff,administration and support staff to providing high-quality cancer care to their patients, as well as meeting and exceeding the standards set by the CoC. Center of Excellence DesignationTMH was named an American Society for Metabolic and Bariatric Surgery (ASMBS) Bariatric Surgery Center of Excellence. The designation recognizes surgical programs with a demonstrated track record of excellence in providing superior and comprehensive bariatric surgery care.Blue Distinction Center RecognitionIn 2011, TMH was named a Blue Distinction Center for Bariatric Surgery by Blue Cross and Blue Shield of Rhode Island. TMH was named a Blue Distinction Center in 2010 by Blue Cross and Blue Shield of Rhode Island following a comprehensive review of its spine surgery and knee and hip replacement services. The Blue Distinction program recognizes facilities that meet objective, evidence-based thresholds for clinical quality, developed in collaboration with expert physicians and medical organizations.AACVPR Program Certification During 2011, The Miriam Hospital pulmonary rehabilitation program was awarded certification from the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). Certified AACVPR programs are recognized as leaders in the field of cardiovascular and pulmonary rehabilitation because they offer the most advanced practices available.Form 990, Part III, 4a, page 4Magnet Hospital DesignationIn 2010, for the fourth consecutive time, TMH received Magnet designation for overall nursing care and excellence from the American Nurses Credentialing Center (ANCC). Only three other facilities in the United States have been designated a Magnet hospital four times, and TMH is the only hospital in New England to earn this honor. The program provides a framework to recognize excellence in the managementphilosophy and practice of nursing services, adherence to standards for improving the quality of patient care, and continued competence of nursing personnel. In addition, recipient hospitals must demonstrate attention to the cultural and ethnic diversity of patients and their significant others, as well as the care providers in the system. The Magnet Award for Nursing Excellence is the highest level of recognition the American Nurses Credentialing Center can bestow upon organized nursing services in health care organizations. In 2010, TMH earned the elite Gold Seal of Approval from The Joint Commission for Primary Stroke Centers, a national honor awarded to the country's top stroke programs. TMH, which was the first hospital in Rhode Island to be certified as a Primary Stroke Center, holds distinction as the only facility in the state to be certified three times. Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Lifespan and the Lifespan Obligated Group, which consists of The Miriam Hospital, RIH and Affiliates, Emma Pendleton Bradley Hospital, Rhode Island Hospital Foundation, and The Miriam Hospital Foundation, currently make their annual and quarterly consolidated financial statements available to the public via DAC (Digital Assurance Certification LLC), a disclosure dissemination agent for issues of the tax-exempt bonds which electronically posts and transmits Lifespan's financial information to repositories and investors alike. In addition, copies of TMH's Articles of Incorporation, Bylaws, and Conflict of Interest Policy are available upon request from the office of the Lifespan Chief Financial Officer, either in person or by mail. Form 990, Part VI, Line 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 The Miriam Hospital's annual independent audit for initial review by the Director of Finance and the Vice President of Finance - Corporate Services. Once the draft 990 is complete, the Director of Finance forwards it with all supporting worksheets to KPMG, which then reviews the completed form in detail. The Director of Finance answers questions as they arise and provides additional information as needed. Any recommended changes are incorporated into the return. The draft Form 990 is then provided to the Chief Financial Officer for final management review.Prior to filing the return with the Internal Revenue Service, a copy of the entire form is sent to The Miriam 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. 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 The Miriam Hospital (TMH) confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination and support of the system. Powers reserved to Lifespan include: to elect and remove trustees and to approve the election of and to remove certain officers. At each annual meeting of the TMH Board of Trustees, a list is compiled of the names of those persons selected to serve as Trustees of TMH so that it can be approved and submitted to Lifespan for ratification and election. Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Lifespan Corporation is the sole corporate member of The Miriam Hospital. Form 990, Part VI, Line 4 Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents Revised Article III - Board of TrusteesSection 2, Number and Election, reflects a revision in the number of elected trustees from 16 to 20. 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 and key employees, respectively, are employed by Lifespan Corporation: Timothy J. Babineau, MD, Arthur J. Sampson and Rebecca L. Burke. RI Sound Enterprises Insurance Co Ltd 65 Front Street Hamilton BD HM 12 Offshore Insurance Captive NA false The Miriam Hospital Womens Assoc 164 Summit Avenue Providence RI 02906 050268165 Patient Support RI 501(c)(3) 11 N/A false The Miriam Hospital Foundation 167 Point Street Providence RI 02903 050377502 Philanthropic Activities RI 501(c)(3) 11 NA false RIH Ventures 593 Eddy Street Providence RI 02903 050448686 Parking Facilities/ Phlebotomy Services RI 501(c)(3) 11 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 N/A false Newport Hospital Foundation 11 Friendship Street Newport RI 02840 222535533 Philanthropic Activities RI 501(c)(3) 7 NA false Newport Hospital 11 Friendship Street Newport RI 02840 050258914 Health Care Services RI 501(c)(3) 3 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 Corporation 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 Management 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 NA 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 false false false false false false true true true false true true true false false