2011-08-11T16:57:20-07:00 2010-09-30 KPMG LLP 2 Financial Center 60 South Street Boston MA 02111 990 2009-10-01 050258905 The Miriam Hospital MIRI 4017932500 164 Summit Avenue Providence RI 02906 Mary A Wakefield 2011-08-11 2009 2016-02-24 21:20:13Z Timothy J Babineau MD 164 Summit Avenue Providence RI 02906 415479742 false false X www.lifespan.org/partners/tmh 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. 12 10 2697 919 2340927 67460 4105341 3051477 355601744 376274529 -1120647 3691557 7235294 8027487 365821732 391045050 105512 31075 0 159894522 168554688 0 0 204333836 211809727 364333870 380395490 1487862 10649560 354877512 376984402 135993470 139754581 218884042 237229821 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 290297417 31075 358075475 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). 23174000 20167000 Research:Since 1969, the level of research has increased from seven projects totaling $127,000 involving nine investigators to 270 projects totaling $22.4 million involving 69 investigators and 183 employees. The following is a selection of research being conducted at the Hospital: cancer treatment and prevention, epidemiological research and 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 million in support of research activities in 2010. (Continued on Schedule O). 20865000 2489000 Medical Education:TMH provides the setting for and substantially supports medical education in various clinical training and nursing programs. The total cost of direct medical education provided by the Hospital exceeded the reimbursement received from third-party payors by $10.4 million in 2010. (Continued on Schedule O). 334336417 true true false true false false false false false true true true true false false true false false false false false true true false true true false false false false false false false false false false false false false false false true false false false true 192 0 true 2697 true true true false false false false false false false false false 0 false false false false false false false false 12 10 true false true false true true true true true false false false true true true true true true true true false false X X Mary A Wakefield 4014447914 167 Point Street Providence RI 02903 Timothy J Babineau MD 13.00 X X 0 1022149 109707 Samuel K Suls 2.00 X 0 0 0 Ronald A DeLellis MD 2.00 X 0 0 0 Rogers C Griffith MD 40.00 X 310628 0 37406 Robert W Corwin MD 40.00 X 270028 0 47616 Robert L Bahr MD 1.00 X 0 0 0 Richard L Gold MD 5.00 X 0 0 0 Rena R Wing MD 0. X 252626 0 25710 Rebecca L Burke 40.00 X 0 368958 66491 Phillip Kydd 1.00 X 0 0 0 Paari Gopalakrishnan MD 40.00 X 258326 0 34127 Neil R Greenspan MD 1.00 X 0 0 0 Mary Jo Kaplan 5.00 X X 0 0 0 Mary A Wakefield 12.00 X 0 703615 93428 Marie J Langlois 1.00 X 0 0 0 Maria Ducharme 40.00 X 165219 0 16765 Marc A Crisafulli 1.00 X 0 0 0 Kathleen Hittner MD 0. X 0 698871 99231 Judith B Levitt 0. X 0 0 0 Jonathan L Elion MD 2.00 X 0 0 0 Jeffrey M Burock MD 40.00 X 239604 0 33534 Jeffrey G Brier 2.00 X 0 0 0 Frederick S Crisafulli MD 0. X 0 0 0 Frederick N Levinger 1.50 X 0 0 0 Fred J Schiffman MD 10.00 X 0 0 0 Edward D Feldstein 10.00 X 0 0 0 Dayle Hunt Joseph 4.00 X 0 0 0 David L Edmonds 3.00 X 0 0 0 David A Marcoux MD 2.00 X 0 0 0 Brian Goldner 1.00 X 0 0 0 Bertram M Lederer 5.00 X 0 0 0 Arthur J Sampson 40.00 X 0 469715 77334 Alan H Litwin 5.00 X X 0 0 0 1496431 3263308 641349 122 true true false University Surgical Assosicates PO 16149 Rumford RI 02916 Medical Services 1372479 University Medicine Foundation 178 Norwood Avenue Cranston RI 02905 Medical Services 7429505 Now Delivery PO Box 6945 Providence RI 02940 Delivery Services 1112730 Narragansett Bay Anesthesia 164 Summit Avenue Providence RI 02906 Medical Services 2221308 Brown University PO Box 1911 Providence RI 02912 Medical Services 1204536 19 2724498 142258 184721 3051477 Temp Restricted (SPFs) 900099 326963 326963 Patient Service Rev 900099 351249330 351249330 Laboratory 621500 2277764 2277764 Direct Rev from Research 900099 22420472 22420472 376274529 3237037 3237037 106279 106279 0 611505 485583 125922 125922 16457 109465 24297350 23949109 348241 348241 348241 0 0 0 State DSH Revenue 900099 1600000 1600000 Indirect Rev from Grants 900099 4163950 4163950 Cafeteria Revenue 900099 1109935 1109935 1027680 970760 46706 10214 7901565 391045050 380731475 2340927 4921171 31075 31075 0 0 0 212475 212475 0 128737720 124752373 3985347 7365200 7137520 227680 23137481 22511496 625985 9101812 8820449 281363 0 0 0 3425 3425 0 259886 259886 18580747 18504307 76440 114272 111550 2722 83503877 83090452 413425 0 0 7604598 6852399 752199 679692 633922 45770 0 265082 219773 45309 3681611 3681611 0 10461597 10461597 1890628 1890628 Unrelated Business Income Tax 22936 22936 Purch Svs & Equip Cont 39136694 14393501 24743193 Provision for bad debts 20154618 20154618 License Fee 15591837 15591837 All Other Expense 9858227 9401681 456546 0 380395490 334336417 46059073 0 0 20554812 13284083 1165849 1245050 34800345 38386570 0 0 550000 550000 3704858 3916035 2815745 3188072 302399293 148104066 155408130 154295227 54329794 70121300 18775138 22282008 0 0 62772841 69716057 354877512 376984402 28813367 28247085 69995486 68064107 37184617 43443389 135993470 139754581 X 192478600 204340397 19752885 21499537 6652557 11389887 218884042 237229821 354877512 376984402 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 3425 3425 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. This organization engages in lobbying activities on behalf of the Hospital. 73337707 40371010 8097713 24976075 96830355 77300591 22261170 -882788 25341266 73337707 0.85900 0.14100 false false false 4288032 4288032 184665243 63215774 121449469 108853919 84888292 23965627 4592099 4592099 154295227 22282008 Other 143854 Interest in the NA of TMH Foundation 50224648 Deferred financing costs 1739083 69716057 Third-party payor settlements 16061727 Lease payable 134186 Est. health benefit self-ins. costs 2293574 Due to affiliates 157710 Construction loan payable 70371 Accrued post-retirement benefit liab 263300 Accrued pension liability 24254000 Abatement liability 208521 43443389 391045050 380395490 10649560 4775384 2920835 7696219 18345779 398966966 4775384 2920835 7696219 391270747 259886 -485583 -225697 391045050 380621187 380621187 259886 -485583 -225697 380395490 Part XII, Line 2d Part XII, Line 2d: Other revenue amounts included in F/S but not included on form 990 Chng in fnd status of pension & postret $-3132652 Increase in Net Assets of TMHF $6053487 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 $0 Increase in Net Assets of TMHF $6053487 Change in funded status of pension and other postretirement $ -3132652 Effect of changing pension and postret. measurement date $ -0 Decrease in Net Assets of TMHF $ -0 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 general healthcare activities and research at the discretion of Hospital management. Sub-Saharan Africa 0 0 Program Services Research 151725 South Asia 0 0 Program Services Research 91495 Europe 0 0 Program Services Research 6439 East Asia & the Pacific 0 0 Program Services Research 14565 0 0 264224 X true true true X false true true true false true true 16334000 3871000 12463000 0.03280 32143000 32182000 -39000 48477000 36053000 12424000 0.03270 273000 38000 235000 0.00060 20865000 2489000 18376000 0.04830 9962000 7598000 2364000 0.00620 23174000 20167000 3007000 0.00790 116000 116000 0.00030 54390000 30292000 24098000 0.06330 102867000 66345000 36522000 0.09600 true 4954829 78498330 82123074 -3624744 X true true TMH Pre-admission Testing Cntr

208 Collyer St 3rd Floor Providence RI 02904

Outpatient Pre-admission assessmt & educ TMH Diagnostic Imaging Center

195 Collyer St Suite 101 Providence RI 02904

Outpatient Radiology TMH Cardiac RehabPulm Rehab

208 Collyer Street Providence RI 02904

Outpatient Cardiac Clinic TMH Outpatient Rehabilitation

195 Collyer Street Providence RI 02904

Outpatient Rehab PT, OT, Speech TMH Wgt Cntrl & Diabetes Res

196 Richmond Street Providence RI 02903

Outpatient Research & Education TMH Immunology Research Center

14 Third St and 11 Third St Providence RI 02906

Outpatient Counseling TMH Behavioral Medicine Clinic

1 Hoppin St Coro West 3 Providence RI 02903

Outpatient Clinic RISE TB Clinic

14 Third Street Providence RI 02906

TB Clinic TMH Laboratory

400 Bald Hill Road Warwick RI 02886

Phlebotomy Lab TMH Laboratory

1 Commerce Street Lincoln RI 02865

Phlebotomy Lab TMH Laboratory

1 Hoppin Street Providence RI 02903

Phlebotomy Lab The Miriam Hospital

164 Summit Avenue Providence RI 02906

X X X X X 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% is provided for those applicants whose family gross income is at or below the Federal Poverty Guidelines 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.Continued under "Additional Information".... 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 provision for bad debts, based on charges net of contractual allowances, was $20,154,618. The cost associated with the provision was $4,954,829 and is based on the ratio of cost to charges. 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. 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 I, Line 3c continued: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 if the balance is under $5,000 and 50% to 100% of estimated charges 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. 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. Lifespan's Office of Strategic Planning and Analysis performs population-based studies 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 for the Hospital. A population based study examines not only the growth and changes in the population, but the resources in the community, and the changing prevalence of diseases. Added to this population-based approach, Lifesfpan Strategic Planning also examines experience with wait times and crowding, 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 good 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 looking at: 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 go 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 in all projects over $2 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. The Miriam Hospital has multilingual signage in the Hospital's main lobby and waiting areas which provide 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. 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.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 Brown Medical School, renamed 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. The Hospital substantially subsidizes various health services including a tuberculosis clinic. 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 and weight loss programs, diabetes education, patient advocacy, foreign language translation, physician referral services and charitable contributions. The Miriam Hospital is governed by a Board of Trustees, which is composed of 10 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 Chairman of The Miriam Hospital Foundation. The Chairman and the President and CEO of Lifespan Corporation, as well as the Chairman of Rhode Island Hospital, 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. 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 12,300 people. The Lifespan system has over 2,100 physicians on the medical staffs of its affiliated hospitals, operates 1,155 licensed beds in four hospital complexes, and in 2010 generated approximately $1.6 billion in total operating revenue. By each of these measures, Lifespan is RI's largest health system, serving a population of over 1.5 million. Three of its hospital members, Rhode Island Hospital (RIH), The Miriam Hospital (TMH) and Bradley Hospital (EPBH), are teaching affiliates of the Warren Alpert Medical School of Brown University with 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, 2010, 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. true Jewish Community Center of RI 401 Elmgrove Ave Providence RI 02906 050258887 6000 0 Sponsorship of community event 1 0 Grantmaker's Description of How Grants are Used The Miriam Hospital (TMH) is committed to community programs and provides support to many charitable organizations in Southern New England. All contributions are approved by management and are made to non-profit, typically 501(c)(3) organizations, whose missions and goals align with those of TMH. During 2010, TMH sponsored the following: An award luncheon for Phoenix Houses of New England, a drug treatment and substance abuse agency; the Memory Walk to benefit Alzheimers Association, RI Chapter; the CVS/Caremark Downtown 5K Road Race to support nonprofit organizations and schools from Rhode Island and Massachusetts; the annual road race and charity golf tournament for the Jewish Community Center of RI; an Awards for Excellence dinner for Hope Funds for Cancer Research; program support for the RI Free Clinic; an end-of-year pizza party for the Dr. Martin Luther King Elementary School of Providence, RI, and various other community programs. X X X true true X X X X X false true false false false false false true false false Timothy J Babineau MD 573675 379376 69098 92035 17672 1131856 Rogers C Griffith MD 263568 43055 4005 19147 18259 348034 Robert W Corwin MD 222910 35816 11302 33286 14330 317644 Rena R Wing MD 248976 3650 17974 7736 278336 Rebecca L Burke 246118 74830 48010 52301 14190 435449 29633 Paari Gopalakrishnan MD 176637 40295 41394 16387 17740 292453 Mary A Wakefield 442966 168351 92298 79018 14410 797043 67165 Maria Ducharme 150324 14895 11732 5033 181984 Kathleen Hittner MD 451016 145651 102204 79234 19997 798102 71454 Jeffrey M Burock MD 191445 47561 598 14876 18658 273138 Arthur J Sampson 297218 104001 68496 61817 15517 547049 45555 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 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). Housing allowance or residences for personal use:A temporary housing allowance may be provided on a case-by-case basis as part of the recruitment of key executives. The allowance is documented in the individual employment contract or employment offer. In calendar year 2009 Lifespan provided this benefit to one new executive and the taxable amounts paid for relocation are included in Medicare wages, more specifically on Schedule J, Part II, column B (iii).Social Club Dues:The job responsibilities of certain executives include development of relationships with business leaders and donors. Those relationships are facilitated by the ability to meet in a setting where 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 Schedule O false false RI Health & Ed Bldg Corp 521300173 762243SS3 2006-02-14 40725126 See Schedule O false false 19547450 1955172 10940711 288639 6107175 false false false true 38811270 348652 2006 false true true true false false false true true true false true false true true 0.01760 true false false false false false false false false false false false false North Main Radiation Oncology Mary Jo Kaplan, Tr 162762 Outside Testing false Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Lifespan currently makes its 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. TMH's articles of incorporation, by laws, 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 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 Article III - GovernorsArticle III Governors was eliminated in its entirety. Previously, the Governors of the Hospital approved the nomination of individuals to the Member (Lifespan Corporation) for election to the Board of Trustees and to specific offices.Revised Article III - Board of TrusteesSection 2 Number and Election was revised to include the Chair of The Miriam Hospital Foundation or his/her designee as an ex-officio voting member of the Board of Trustees. The Chair of the Rhode Island Hospital Board of Trustees was made an ex-officio nonvoting member of the Hospital's Board of Trustees.Section 3 Terms was revised to change from staggered classes of trustees with three-year appointments to one-year appointments for all trustees. 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 key employees are employed by Lifespan: Rebecca L. Burke and Arthur J. Sampson.Frederick S. Crisafulli, trustee, is the father of Marc A. Crisafulli, trustee. RI Sound Enterprises Insurance Co Ltd 65 Front Street Hamilton BD HM 12 Offshore Insurance Captive NA The Miriam Hospital Foundation 167 Point Street Providence RI 02903 050377502 Philanthropic Activities RI 501(c)(3) 11 NA RIH Ventures 593 Eddy Street Providence RI 02903 050448686 Parking and Phlebotomy Services RI 501(c)(3) 11 NA Rhode Island Hospital Foundation 167 Point Street Providence RI 02903 050468736 Philanthropic Activities RI 501(c)(3) 7 NA Rhode Island Hospital 593 Eddy Street Providence RI 02903 050258954 Health Care Services RI 501(c)(3) 3 NA NHCC Medical Associates Inc 11 Friendship Street Newport RI 02840 050472268 Health Care Services 11 N/A N/A Newport Hospital Foundation 11 Friendship Street Newport RI 02840 222535533 Philanthropic Activities RI 501(c)(3) 11 NA Newport Hospital 11 Friendship Street Newport RI 02840 050258914 Health Care Services RI 501(c)(3) 3 NA Newport Health Property Management Inc 11 Friendship Street Newport RI 02840 222335539 Property Management RI 501(c)(3) 11 NA Newport Health Care Corporation 11 Friendship Street Newport RI 02840 222535537 Holding Company/Mgmnt Services RI 501(c)(3) 7 NA Lifespan of Massachusetts Inc c/o EAPD 111 Huntington Avenue Boston MA 02199 043408517 Holding Company MA 501(c)(3) 11 NA Lifespan Foundation 167 Point Street Providence RI 02903 050493219 Philanthropic Activities RI 501(c)(3) 7 NA Lifespan Diversified Services 167 Point Street Providence RI 02903 050258935 Holding Company/Mgmnt Services RI 501(c)(3) 11 NA Lifespan Corporation 167 Point Street Providence RI 02903 222861978 Holding Company/Mgmnt Services RI 501(c)(3) 11 NA Hospital Properties Inc 593 Eddy Street Providence RI 02903 222869743 Property Management RI 501(c)(4) NA Emma Pendleton Bradley Hospital 1011 Veterans Memorial Parkway East Providence RI 02915 050258806 Pediatric Psychiatric Health Care Services RI 501(c)(3) 3 NA Bradley Hospital Foundation 167 Point Street Providence RI 02903 050500688 Philanthropic Activities RI 501(c)(3) 7 NA VNA Technicare Inc 622 George Washington Highway Lincoln RI 02865 050472710 DME Sales RI NA C Lifespan Risk Services Inc 167 Point Street Providence RI 02903 050459767 Risk Mgmnt RI NA C Lifespan MSO Inc 167 Point Street Providence RI 02903 050508717 Mgmnt Services RI NA C false false true false false false false false false true true true false true true true false false