2026-08-17T15:51:21-07:00 2025-09-30 990 2024-10-01 050258905 THE MIRIAM HOSPITAL MIRI 4017932500 164 Summit Avenue Providence RI 02906 Kevin Bickerstaff Director of Finance 4014447035 2026-08-17 1 2024 2025-03-06 01:10:19Z John Fernandez 15 LaSalle Square Providence RI 02903 880827175 0 X www.miriamhospital.org X 1926 RI As a founding hospital in the Brown University Health system, The Miriam Hospital (TMH) is committed to its mission: Delivering health with care. 17 12 4283 250 3097083 114352 7087083 16669718 695247024 727629930 28765082 37171375 24723455 35518141 755822644 816989164 204430 269102 0 0 311463090 311612625 0 0 0 411022850 411636633 722690370 723518360 33132274 93470804 800046092 1066262318 297813505 459782774 502232587 606479544 As a founding hospital in the Brown University Health system, TMH is committed to its mission: Delivering health with care. 0 0 533762908 269102 695132096 Patient Care: TMH offers expertise in cardiology, oncology, orthopedics, men's health, and minimally invasive surgery, and is home to the State's first Joint Commission- certified Stroke Center and robotic surgery program. Services and programs provided by TMH also include anesthesiology; general medicine; general surgery; psychiatry; emergency medicine; cardiovascular care; orthopedics; dermatology; nuclear cardiology; radiology; laboratory; renal dialysis; urology; gastroenterology; endocrinology; gynecology; nephrology; neurology; and ophthalmology. 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 balloon valvuloplasty (a procedure to clear blocked heart valves). In 2025, TMH discharged 16,687 inpatients, logged more than 73,000 visits in its Emergency Department, and performed 12,378 inpatient and outpatient surgical procedures. Services provided in 2025 represent 69,832 inpatient days and more than 130,000 clinic visits. TMH is staffed by 1,298 privileged physicians, approximately 92 full-time house staff (medical school graduates), and a nursing staff of 927. In total, TMH employs more than 3,500 people. TMH is a major teaching affiliate of 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 three times the poverty level, as set by the Department of Health and Human Services. In addition, a substantial discount consistent with Medicare program reimbursement is offered to all other uninsured patients. TMH determines the costs associated with providing charity care by aggregating the applicable direct and indirect costs, including compensation and benefits, supplies, and other operating expenses, based on data from its costing system. The total cost, excluding medical education and research, incurred by TMH to provide charity care amounted to $14,176,405 in fiscal 2025. Charges forgone, based on established rates, amounted to $37,514,988. TMH substantially subsidized various health services including the following programs: adult psychiatry, tuberculosis, and certain other specialty services at a net cost of $4,997,246 in fiscal year 2025. TMH also provides numerous other services to the community for which charges are not generated. These services include certain emergency services, community health screenings for cardiac health, prostate cancer and other diseases, smoking cessation, immunization and nutrition programs, diabetes education, community health training programs, patient advocacy, foreign language translation, physician referral services, and charitable contributions. The net cost of these services amounted to $277,492 in fiscal year 2025. 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. TMH offers expertise in total joint replacement, minimally invasive and robotic surgery, and bariatric surgery, among many other specialties. The Leonard and Adele R. Decof Family Comprehensive Cancer Center at TMH brings together world-renowned physicians and a team of specialists from TMH, Rhode Island Hospital (RIH), and Newport Hospital (NH), forming a multidisciplinary team whose level of knowledge and experience are unparalleled in the State of Rhode Island. TMH, as a part of the Brown University Health Cancer Institute, provides state-of-the-art care for patients with cancer. Award-Winning Care: Through the years, TMH has received numerous distinctions and awards. TMH is one of an elite group of hospitals nationwide and internationally to achieve Magnet designation for nursing excellence six times from the American Nurses Credentialing Center (ANCC), with a current designation through 2025. This is the highest nursing credential, earned after an extensive application process is conducted every four years, in a hospital where nurses participate at all levels of care, making clinical and systems decisions to improve patient outcomes and experience. The Magnet Model promotes the critical role of nurses in achieving improved empirical outcomes through transformational leadership, structural empowerment, exemplary professional practice and new knowledge, innovations and improvements. A Magnet designated hospitals must possess high level nurse-to-patient ratios above non-magnet hospitals and demonstrate improved patient outcomes with superb nursing care for retaining this credential. TMH earned the "Top Hospital in Rhode Island" designation from US News & World Report for the 14th year in a row in its 2025 to 2026 report on the best hospitals in the country. The Miriam also ranked as the Top Hospital in the Providence metro area, which includes Providence, Pawtucket, Rhode Island, Fall River, Massachusetts, and New Bedford, Massachusetts. Additionally, US News & World Report awarded TMH a "high performing," rating for treatment of 8 conditions and adult specialty areas including hip and knee replacements, hip fractures, back surgery spinal fusion, colon cancer surgery, heart attack, stroke, pneumonia and chronic obstructive pulmonary disease. In 2025, TMH made Becker's 2025 list of 100 "Great Hospitals in America". The hospital has been recognized for delivering excellent clinical care, prioritizing patient safety, and driving innovation through research, education and continuous improvement. The Spine Center at TMH has earned an Advanced Certification in Spine Surgery (ACSS) from The Joint Commission, making it the first program in the region to earn an advanced certification, after a rigorous two-day survey by The Joint Commission resulting in "zero findings", making it an accredited Spine Center of Excellence. In 2025, the Total Joint Center at TMH continued to meet the rigorous performance standards of The Joint Commission when it earned its fifth Gold Seal of Approval for Advanced Total Hip and Knee Replacement. The Gold Seal is a symbol of quality that reflects a healthcare organization's commitment to providing safe and quality patient care. This recertification recognizes the ongoing commitment to the highest standards of care and outcomes by all the members of the team at the Total Joint Center. TMH has earned American College of Emergency Physicians (ACEP) Geriatric Emergency Department Accreditation (GEDA). This milestone reflects the ongoing commitment to providing high-quality, compassionate care, particularly for a growing geriatric population. This accreditation reflects The Miriam's implementation of evidence-based best practices in geriatric emergency care including specialized screening tools, careful prescribing to avoid high-risk medications, integration of palliative care and geriatric psychiatry consults, reduction in urinary catheter use, and improved access to transportation and transitional care services including pathways to both short- and long-term rehabilitation. TMH was named one of Avant-Garde Health's Healthcare Research All-Stars for 2025, placing it among the top one percent for orthopedic surgery research hospitals in the nation. Alan Daniels, MD, chief, division of spine surgery, and director, adult spinal deformity service, Rhode Island and The Miriam Hospitals, Eren O. Kuris, MD, spine surgeon, Bassel Diebo, MD, spine and scoliosis surgeon, and Brett D. Owens, MD, division chief, sports medicine were among the 2025 Avant Garde Health's Research All-Stars. The Healthcare Research All-Stars 2025 list recognizes top surgeons and hospitals across 22 specialties, including spine surgery and sports medicine. Top hospitals and surgeons are identified by procedural volumes, peer-reviewed publications, and publication weight. TMH Received Castle Connolly's Top Hospital 2025 award for excellence in cancer care (mastectomy) and gastroenterology and bariatrics (colon surgery). In the spring of 2025, TMH earned a Leapfrog Hospital Safety Grade of "A." The Leapfrog Group is a national nonprofit upholding the standard of patient safety in hospitals and ambulatory surgery centers. TMH received this national distinction for its achievements in prioritizing patient safety by protecting patients from preventable harm and errors. 57410773 0 57408292 Research: TMH has 428 research projects with total expenses of $57.4 million in fiscal year 2025 (106 investigators and 179 employees). 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. TMH also sponsors a significant level of these research activities. Federal support accounts for approximately 41% of all externally funded research at TMH. Researchers focus on clinical trials which investigate prevention and treatment of HIV/AIDS, obesity, cancer, diabetes, cardiac disease, and mental health concerns. TMH provided $2,481,000 in support of research activities in fiscal year 2025. 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, the Cancer and Leukemia Group B, and the National Surgical Adjuvant Breast and Bowel Project. TMH is a participating hospital in the Brown University-sponsored Cancer Oncology Group. HIV/AIDS - The Brown Health/Tufts/Brown Center for AIDS Research (CFAR) is a joint research effort among Brown University and Tufts University and their affiliated hospitals and centers. It is one of 20 centers located at academic medical centers throughout the United States that are part of the national CFAR program of the National Institutes of Health. The program emphasizes the importance of interdisciplinary collaboration, especially between basic and clinical investigators, and also encourages training and mentoring of young investigators as well as an inclusion of women and minorities. As part of the CFAR, division researchers engage in clinical, basic, and translational research designed to improve the prevention and treatment of HIV/AIDS, with a major focus on women, racial and ethnic minorities, and individuals with substance abuse problems. 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. TMH's TB Clinic performs research in the area of co-infections of HIV and tuberculosis. The Centers for Behavioral and Preventive Medicine aims to improve health through behavioral change and the integration of behavioral and biomedical science using clinical, community, and laboratory-based research. The Centers' research bridges biomedical, sociobehavioral, and population/public health scientific disciplines. Faculty members are committed to both basic research on discovering the mechanisms underlying behavioral factors in health and illness (e.g., examining the stress response among children and adolescents, neuroimaging of AIDS, and other medical conditions), and to applied research on the translation of these discoveries for clinical and community health improvement. Programs range from those that focus on primary prevention (e.g., promoting smoking cessation, preventing weight gain, increasing physical activity, and HIV/AIDS prevention) to improving the effectiveness of treatment and enhancing quality of life in populations such as cancer survivors and patients enrolled in cardiac rehabilitation programs. 28484125 0 6611331 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 TMH exceeded the reimbursement received from third-party payors by $21.9 million in fiscal year 2025. TMH provides the setting for and substantially supports medical education in various clinical training and nursing programs. The total cost of medical education provided by TMH exceeded the reimbursement received from third-party payors by $21,872,794 in 2025. 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 enable competition both clinically and academically. TMH participates in Brown programs in anesthesiology, internal medicine and medicine subspecialties, general surgery and surgical subspecialties, psychiatry, emergency medicine and emergency medicine subspecialties, orthopedics and orthopedic subspecialties, and dermatology. TMH provides stipends to residents and physician fellows while in training. In addition, TMH is a participating clinical training site for residents from other programs in anesthesiology, family medicine, internal medicine, emergency medicine, hematology/oncology, obstetrics/gynecology (OB/Gyn) and OB/Gyn subspecialties, dermatology, dermatopathology and pediatric pathology, otolaryngology, pediatric dentistry, podiatry, psychiatry and its subspecialties of forensic psychiatry, consult liaison psychiatry and geriatric psychiatry, orthopedics, rheumatology, and radiation oncology. Various departments and specialties at TMH serve as clinical sites for the physician assistant schools of Johnson & Wales University, Bryant University, and the Massachusetts College of Pharmacy. In addition, Behavioral Medicine at TMH, in collaboration with Brown, sponsors research and clinical psychology training programs for interns, postdoctoral fellows, and faculty trainees. With respect to nursing education, TMH has developed educational affiliations with the University of Rhode Island College of Nursing; Community College of Rhode Island (CCRI); Salve Regina University; Boston College; Yale University; Regis College; Simmons College; the University of Massachusetts campuses at Dartmouth, Boston, Amherst, and Worcester; Framingham State University; the University of Connecticut; The New England Institute of Technology; Northeastern University; Drexel University; Walden University; Georgetown University School of Nursing and Health Studies; Duke University School of Nursing; and the University of Pennsylvania, as well as other Schools of Nursing, 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. The Brown Health School of Medical Imaging collaborates with Rhode Island College in the following programs: diagnostic medical sonography; nuclear medicine technology; radiography; and magnetic resonance imaging. Students complete educational experiences at the Hospital, as well as other outpatient sites. TMH sponsors training programs for a variety of allied health care professionals, including required clinical and fieldwork experiences in physical, speech, and occupational therapy, which are provided to university students in each discipline through contracts with the various universities. TMH acts as a clinical training site for students from CCRI in its vascular and cardiology ultrasound programs and provides training experiences for both phlebotomy students and physical therapy assistant students. TMH serves as a clinical training site for students from The Nuclear Medicine Institute of the University of Findlay (Ohio) and has educational affiliations with the respiratory programs at both CCRI and The New England Institute of Technology. TMH's EEG Department provides clinical training to neurodiagnostic technology students from Laboure College (Massachusetts). TMH has clinical affiliations/student clinical training programs for pharmacy students provided through contracts with various colleges and universities. Most of the pharmacy students attend the University of Rhode Island, Massachusetts College of Pharmacy and Health Sciences, and Northeastern University. TMH has clinical social work student contracts with Rhode Island College, Boston University, Boston College, Smith College, Simmons College, and Bridgewater State University. 0 0 0 619657806 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 1 1 0 0 0 0 0 1 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 206 0 1 4283 1 1 1 0 0 0 0 0 0 0 X 17 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 RI X Peter K Markell 4014447914 15 LaSalle Square Providence RI 02903 John Fernandez Trustee 3 70 X 0 1651362 365361 Ziya L Gokaslan MD Trustee 0.5 45 X 0 1671733 46216 Peter K Markell Treasurer 0.5 59.5 X 0 1464555 40760 Timothy J Babineau MD Former Trustee 0 0 X 0 1335765 0 Paul J Adler Secretary 2 48 X 0 879367 149013 Maria Ducharme President 38 12 X 0 694877 135722 Vanzetta V James DNP Fmr CNO 0 0 X 367313 0 327587 Eva Greenwood Fmr Treasurer 0 60 X 0 539491 116060 Mark Deitch MD CMO 40 0 X 486975 0 105793 Janine Lairmore VP- Cardiovascular Institute 40 0 X 401315 0 98099 Laura R Stroud Director Center of 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0.25 5.25 X 0 0 0 Angel Tavares Trustee 0.5 2.5 X 0 0 0 2499113 8237150 1556434 550 1 1 0 Brown Medicine 110 Elm Street Providence RI 02903 Medical Services 9507698 Brown Surgical Associates Inc 2 Dudley Street Ste 470 Providence RI 02905 Medical Services 4182088 Brown Emergency Medicine 125 Whipple Street Providence RI 02908 Medical Services 2825662 O'Grady Peyton International USA Inc 12400 High Bluff Drive San Diego CA 92130 Contracted Labor 2360153 AMN Healthcare Inc 2735 Collection Center Drive Chicago IL 60693 Contracted Labor 2296827 33 0 0 0 9281386 7372504 15828 0 16669718 Program Service Revenue 622110 670430073 670430073 0 0 Direct Revenue from Research 541710 57408292 57408292 0 0 Special Purpose Funds 900099 -208435 -208435 0 0 0 0 0 0 727629930 9824464 0 0 9824464 0 0 0 0 0 0 0 0 2707568 0 1808299 0 899269 0 899269 0 0 899269 89376623 0 62029712 0 27346911 0 27346911 0 0 27346911 0 Joint Program Revenue 900099 18783330 18783330 0 0 Indirect Revenue from Grants 900099 5098011 5098011 0 0 Lab Revenue 621500 3050548 0 3050548 0 7686983 7640448 46535 0 34618872 816989164 759151719 3097083 38070644 269102 269102 0 0 0 0 0 0 899196 0 899196 0 0 0 0 0 245095917 242457505 2638412 0 11855575 11779389 76186 0 36726292 36403329 322963 0 17035645 16852259 183386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 458133 0 458133 0 28942518 28849173 93345 0 47457 47457 0 0 3533956 3350420 183536 0 0 0 0 0 0 0 0 0 14478738 14478738 0 0 418198 416856 1342 0 0 0 0 0 964017 958698 5319 0 2713183 0 2713183 0 0 0 0 0 24038570 0 24038570 0 6530798 6530798 0 0 Medical & Surgical Supplies 89752450 17704060 72048390 0 Purchased Services and Equipment Contracts 86163505 86162531 974 0 License Fee 63136912 63136912 0 0 Provision for Bad Debt 24860001 24860001 0 0 65598197 65400578 197619 0 723518360 619657806 103860554 0 295010 302086 18172422 4768453 1992823 7182366 53193910 60136446 0 0 0 0 0 0 7482268 6555291 47435807 251261485 419754339 243154606 165358998 176599733 176882471 213625022 233306839 239170097 0 0 0 0 95925544 106661339 800046092 1066262318 63103901 54679548 0 0 17465 0 42488297 38268917 0 0 0 0 0 0 157850000 157850000 34353842 208984309 297813505 459782774 X 405172822 476380465 97059765 130099079 502232587 606479544 800046092 1066262318 X 93470804 5017079 0 0 0 5759074 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 410189310 79773677 41730321 0 78898189 0 452795119 267125223 177110435 44708426 0 78754774 0 410189310 268275493 62653282 22867528 0 86671080 0 267125223 295359050 66302197 -34132762 0 59252992 0 268275493 218566531 94109929 45013085 0 62330495 0 295359050 0.8453 0 0.1547 0 1 1 0 3683785 3683785 0 247294258 161016357 86277901 0 0 0 0 0 147951084 82138249 65812835 0 20825212 0 20825212 176599733 0 0 Cash Equivalents 120265829 F Interest in Brown Investment Pool 61505220 F Collective Investment Funds and Limited Partnerships 54369978 F Marketable Alternatives 3029070 F 239170097 Interest in TMH Foundation 92726561 Right-of-Use Assets, Operating Leases 12487945 Deferred Financing Costs 1220114 Other Assets 226719 106661339 0 Due to Affiliates 184231990 Non-current Operating Lease Liabilities 12077222 Third-party Payor Liabilities 5355917 Healthcare Benefit Self-Insurance Liabilities 3451377 Non-current Arbitrage Bond Liabilities 2479528 Accrued Pension Liability 960200 Other Liabilities 286375 Post-retirement Benefit Liability 141700 208984309 X 801325671 5017079 0 0 5759073 10776152 790549519 458133 25981512 26439645 816989164 697078714 0 0 0 1808299 1808299 695270415 458133 27789812 28247945 723518360 Schedule D, Part V, Line 4 TMH's unrestricted endowment consists of designated assets set aside by TMH's Board for future capital improvements, over which the Board retains control and may at its discretion subsequently use for other purposes. The largest temporarily restricted funds held by TMH are used to support: (1) recruitment for the Director of the Weight Control & Diabetes Center; (2) clinical care, research, and education to develop treatment for pelvic floor disorders; (3) general hospital programs; (4) support of Cardiology labs and programs; (5) the Surgery Department's educational and investigational functions; (6) operational support to the Women's Cardiac Program and physical space; (7) expand the Mobile Integrated Healthcare (MIH) program at TMH; (8) student loan repayment and tuition assistance in Nursing; (9) the Department of Psychiatry's operations, education, research, and capital needs; (10) general support to community populations in need; (11) neuroscience research; (12) Medical Staff Association needs; (13) growth and enhancement for metastatic cancer clinical research trials; (14)multidisciplinary program support for diagnosing and evaluating of lung modules; (15) TMH's staff and patient wellness program, including supplies and equipment, wellness training, development, and educational workshops. Schedule D, Part X, Line 2 The organization is included in the consolidated financial statements of Brown University Health system which includes the following footnote regarding uncertain tax positions: Brown Health and substantially all its affiliates are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and are exempt from federal income taxes pursuant to Section 501(a) of the Code. Brown Health MSO, Inc., Lifespan Risk Services, Inc.(d/b/a Brown University Health Risk Services), and VNA Technicare, Inc. (d/b/a Brown Health Home Medical) are taxable corporations. TMH recognizes the effect of income tax positions only if those positions are more likely than not to be sustained. Recognized income tax positions are measured at the largest amount of benefit that is greater than fifty percent likely to be realized upon settlement. Changes in measurement are reflected in the period in which the change in judgment occurs. TMH did not recognize the effect of any income tax positions in either 2025 or 2024. Schedule D, Part XI, Line 2d Inter-affiliate net asset transfer- $1.480,779. Change in funded status of pension & post-retirement: $1,951,228. Joint Venture loss: ($13.116.557). Increase in net assets of TMH Foundation: $15,443,623. Schedule D, Part XI, Line 4b Provision for bad debts- contractuals: $23,316,470. Misc. non-operating gains & losses: $4,471,289. Interest expense on line-of-credit: $2,052. Rental expenses:($1,808,299). Schedule D, Part XII, Line 2d Rental Expenses: $1,808,299. Schedule D, Part XII, Line 4b Provision for bad debts- contractuals: $23,316,470. Misc. non-operating gains & losses: $4,471,289. Interest expense on line-of-credit: $2,053. 1 Sub-Saharan Africa 0 5 Program Services Research 252733 Europe (including Iceland and Greenland) 0 3 Program Services Research 6785 East Asia and the Pacific 0 1 Program Services Research 1837 Middle East and North Africa 0 1 Program Services Research 1800 Central America and the Caribbean 0 2 Program Services Research 1074 0 12 264229 0 0 0 0 0 0 Schedule F, Part I, Line 2 When a foreign institution is the subrecipient of an award received by a Brown Health affiliate, the following procedures are adhered to: A subrecipient agreement is prepared and executed between the foreign institution and the Brown Health affiliate. The agreement describes the funding source, terms and conditions of the award, statement of work, payment method, and audit process. The foreign institution prepares an invoice to the Brown Health affiliate for expenses incurred under the agreement. Once received, the invoice is reviewed and approved by both the principal investigator at the Brown Health affiliate and the responsible research administrator in the Brown Health Office of Research Administration. Check requests and wire transfer forms are prepared by the principal investigator, approved by the responsible research administrator, and forwarded to the Brown Health Finance Department, where payment is processed to the foreign institution. Additionally, when the award is a federal award, a questionnaire is completed by the appropriate subrecipient official supplying information about the foreign institution's financial system and method of accounting for the award. A request is also made for the institution's audited financial statements. When a foreign individual is not associated with an institution, a Professional Services Agreement (PSA) is executed and the individual sends an invoice to the Brown Health affiliate principal investigator associated with the project or sponsored agreement that states the number of hours, dates of services, work performed, expense reimbursement request, and compensation amount. The same approval and payment process is used as described above. Expenditures related to foreign activities are recorded on the accrual basis of accounting. 1 1 1 X 1 X 1 1 1 0 1 1 0 0 17918671 3742266 14176405 0.0203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17918671 3742266 14176405 0.0203 0 0 361668 84176 277492 0.0004 0 0 28484125 6611331 21872794 0.0313 0 0 11332427 6335182 4997245 0.0072 0 0 63774 61293 2481 0.00 0 0 155204 0 155204 0.0002 0 0 40397198 13091982 27305216 0.0391 0 0 58315869 16834248 41481621 0.0594 1 6043466 4214 92456518 97846031 -5389513 X 1 1 1 1 The Miriam Hospital 164 Summit Avenue Providence RI 02906 www.miriamhospital.org HOS00122 X X X X X The Miriam Hospital 1 0 0 1 X X X X X X X X X X 25 1 1 0 1 X https://www.brownhealth.org/sites/default/files/2025-10/Brown-University-Health-The-Miriam-Hospital- X 1 25 1 https://www.brownhealth.org/sites/default/files/2026-06/2026-2028_TMH_BUH_CHNA-CHIP_IS.pdf 0 0 1 X 200 300 X X X X X X 1 1 X X X X 1 X https://brownhealth-corporate.policystat.com/policy/token_access/404f8d95-a8e9-4104-9cfe-4ad1b8fff8b X https://www.brownhealth.org/sites/default/files/2026-05/Brown-University-Health-Financial-Assistance X https://brownhealth-corporate.policystat.com/policy/token_access/e4da701f-e2a0-472a-b2d0-d2c426ca603 X X X X X X X 1 X 0 X X X X 1 X 0 0 Schedule H, Part V, Section B, Line 2-The Miriam Hospital The amount reported as bad debt expense is determined by applying the ratio of cost to charges (RCC) to the total charges written off to bad debt. The RCC rate is determined using data from TMH's cost accounting system and is adjusted for medical education, internally funded research, subsidized health services, community services, and charitable contributions. Discounts and payments are applied to patient accounts before such account balances are transferred to bad debt. Schedule H, Part V, Section B, Line 3-The Miriam Hospital The CHNA process involved the integration of information from a range of data sources to identify the significant health needs of the community served by The Miriam Hospital, prioritize those needs, and identify the resources, facilities, and programs to address them. In order to identify the significant health needs of this community, primary quantitative and qualitative data and secondary quantitative data were collected. Regarding the significant needs that were identified in TMH's 9/30/2025 CHNA, they have been prioritized in order of significant needs of the community, as determined by a steering committee comprised of the Community Liaisons, TMH liaison, Brown Health Community Health Institute (BUHHI) leadership, TMH leadership, and Brown Health leadership. Schedule H, Part V, Section B, Line 5-The Miriam Hospital The 2025 Community Health Needs Assessment (CHNA) was conducted from October 2024 through June 2025 using a mixed methods approach that integrated primary research and secondary data analysis. This design ensured that both quantitative indicators and lived community experience informed the identification of health needs, disparities, and opportunities for improvement across Rhode Island. The primary data sources included community engagement, individual surveys, and key informant interviews. Secondary data were analyzed at multiple geographic levels to identify localized health needs and disparities. These sources varied in sample size, method of data collection and measures reported, but all are publicly available sources, and in each case, the most recent publicly accessible data was presented. The data sources are described in more detail below. Community Engagement: Community engagement served as a foundational component of the CHNA. Working in collaboration with community based organizations throughout Rhode Island, the assessment sought input from a broad cross section of residents, with intentional outreach to diverse populations, under resourced communities, and groups that have been historically marginalized. These engagements ensured representation across regions, age groups, and community sectors. Participants contributed perspectives on: Unmet health and social needs; Availability and adequacy of community resources; Barriers to accessing services; Gaps in service delivery; Recommendations to improve health and wellbeing. Key Stakeholder Survey: An online stakeholder survey was administered to 120 individuals representing organizations that serve diverse communities statewide. The survey collected insights on local health needs, client experiences with service access, system level challenges, and opportunities for collective impact and collaboration. Key Stakeholder Survey participants overwhelmingly identified behavioral health as the most pressing set of health concerns affecting the populations they serve. Behavioral health issues cited included mental health challenges, substance use disorders, trauma, and chronic stress. Stakeholders emphasized that these concerns are both widespread and increasingly complex, affecting individuals across age groups, communities, and service settings. In addition to behavioral health, stakeholders highlighted significant concerns related to older adult health and chronic conditions, including heart disease, diabetes, and cancer. These conditions were described as persistent drivers of poor health outcomes and contributors to long term healthcare needs. Stakeholder perceptions were consistent with the secondary data analyzed for the CHNA, which similarly showed high prevalence and disproportionate impact of behavioral health conditions and chronic diseases across Rhode Island. This alignment reinforces the validity of stakeholder insights and underscores the importance of prioritizing these issues in community health planning. Community perspectives and statewide public health data indicate that many priority health concerns have intensified in recent years, driven by both the lingering effects of the COVID 19 pandemic and persistent social determinants of health (SDoH) challenges. Stakeholders described how pandemic related factors-such as prolonged isolation, delayed or forgone healthcare, and developmental delays among children-continue to shape community health needs. These impacts are compounded by structural issues including the rising cost of living, housing instability, and declining access to care. Determining Community Health Priorities To improve community health, it is imperative to prioritize resources and activities toward the most pressing and cross-cutting health needs. In determining health priorities on which to focus its efforts over the next three-year cycle, Brown University Health leadership reviewed findings from the CHNA and sought to align with its health improvement programs and population health management strategies. Brown University Health applied the following rationale and criteria to define priorities: Prevalence of disease and number of community members affected; Rate of disease compared to state and national benchmarks; Health differences between community members; Existing programs, resources, and expertise to address the issue; Input from community partners and representatives; Alignment with concurrent public health and social service organization initiatives. Based on the CHNA findings, Brown University Health and Saint Anne's Hospital will focus on the following priority areas, addressing underlying Social Drivers of Health and the needs of distinct population groups as cross-cutting strategies: 1. Access to Care 2. Behavioral Health 3. Chronic Diseases 4. Maternal and Child Health 5. Older Adult Health and Wellbeing 6. Social Drivers of Health Other health issues identified as significant health needs for the state include affordable housing, maternal and child health, and older adult health and wellbeing. While these areas are not named priorities for Brown University Health due to the need to prioritize resources, the system is committed to collaborating with and supporting other community agencies focused on these needs. Brown University Health will also consider these areas when developing nuanced and whole-person strategies to improve access to care, behavioral health, and chronic disease. Schedule H, Part V, Section B, Line 6a-The Miriam Hospital Facility: Rhode Island Hospital Emma Pendleton Bradley Hospital Newport Hospital Schedule H, Part V, Section B, Line 11-The Miriam Hospital TMH's Community Health Needs Assessment issued for the fiscal year ended September 30, 2025 identified five significant health issue areas requiring a further implementation strategy. Those significant health issue areas include: (1) access to care and services; (2) behavioral health; (3)chronic disease prevention and mmanagement;(4) maternal and child health; and 5) older adult health and wellbeing. The implementation strategy to address those significant health needs outlined between October 1, 2025 - September 30, 2028 is available at: https://www.brownhealth.org/sites/default/files/2026-06/2026-2028_TMH_BUH_CHNA-CHIP_IS.pdf Schedule H, Part V, Section B, Line 16j-The Miriam Hospital An abbreviated version of TMH's Financial Assistance Policy is posted in various admitting and outpatient areas of TMH. 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. 21 Cardiovascular Institute 950 Warren Avenue East Providence RI 02914 Outpatient Cardiac Clinic TMH Immunology Research Center 14 Third St and 11 Fourth St Providence RI 02906 Outpatient Counseling Cardiovascular Institute 1454 South County Trail Suite 2000 East Greenwich RI 02818 Outpatient Cardiac Clinic Cardiovascular Institute 208 Collyer St Stes 100 and 102 Providence RI 02904 Outpatient Cardiac Clinic Women's Medicine Collaborative 146 West River St 2nd Fl Ste 11 Providence RI 02904 Comprehensive Women's Outpatient Clinic TMH Diagnostic Imaging Center 195 Collyer Street Suite 101 Providence RI 02904 Outpatient Radiology TMH Cardiac Rehab-Pulmonary Rehab 208 Collyer Street 2nd Flr Providence RI 02904 Outpatient Cardiac Clinic TMH Weight Control and Diabetes Research 196 Richmond Street Providence RI 02903 Outpatient Research & Education Intensive Cardiac Rehab Program 1454 South County Trail Suite 1100 East Greenwich RI 02818 Outpatient Cardiac Clinic TMH Outpatient Rehabilitation 195 Collyer Street Providence RI 02904 Outpatient PT, OT, and Speech Rehab Men's Health & Infectious Disease 180 Corliss St Stes C-E-F Providence RI 02904 Comprehensive Men's Outpatient Clinic TMH Laboratory 1 Commerce Street Lincoln RI 02865 Phlebotomy Lab Blackstone Valley Community Health Cente 1000 Broad Street Central Falls RI 02863 Outpatient Rehab Clinic Adult and Pediatric Rehabilitation Service 1 Commerce Street 2nd Floor Lincoln RI 02865 Outpatient Rehab Clinic Women's and Men's Health Pelvic Rehab 148 West River Street Suite 1D Providence RI 02904 Outpatient Rehabilitation Services TMH Laboratory 1180 Hope Street Basement Floor Bristol RI 02809 Phlebotomy Lab RISE TB Clinic 14 Third Street Providence RI 02906 TB Clinic TMH Laboratory 400 Bald Hill Road Warwick RI 02886 Phlebotomy Lab East Providence Imaging 375 Wampanoag Trail Suite 101B Riverside RI 02915 Outpatient Diagnostic Imaging TMH Pre-admission Test Center 208 Collyer Street Third Floor Providence RI 02904 Outpatient Pre-admission Assessment & Education Brown University Health Medical Imaging 900 Warren Avenue Suite 100 East Providence RI 02914 Outpatient Radiology Schedule H, Part I, Line 3c The Miriam Hospital (TMH) uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test. The financial screening process at TMH is intended to define probable eligibility for public assistance (Medicaid or Community Free Service ("CFS")) for those patients who do not have the means to pay for hospital services rendered, as follows: 1. Upon patient indication of an inability to pay required monies, the patient is offered the financial screening option to determine eligibility for public assistance (Medicaid, CFS). 2. The application for CFS is completed and includes information relative to income, expense, and other available resources, and requires proof of such information which may include: - most recently filed Federal income tax return and W-2 form(s) - copies of most recent savings and/or checking account statements - two most recently received payroll check stubs - copy of rent receipts for the last six months for proof of residency - copy of utility bills for the last month for proof of residency 3. If the patient's financial situation falls within the guidelines for eligibility for Medicaid, RIte Care, or CFS, or if the patient has a long-term disability, the appropriate application process is completed. (Assistance to complete such applications is available from the Patient Financial Advocates (PFA) Office at TMH.) 4. Uninsured patients receive a discount equal to the discount received by Medicare beneficiaries on TMH charges using the prospective method. Under Section 501(r)(5), the maximum amounts that can be charged to Financial Assistance Policy (FAP)-eligible individuals for emergency or other medically necessary care are the amounts generally billed to individuals who have Medicare insurance covering such care. In no case was there a situation where an uninsured patient paid more than amounts reimbursed from Medicare. 5. Eligibility for CFS above the 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 three times the poverty level in effect at the time of application. Full charity care applicants with assets worth more than $9,400 for an individual (or $14,100 for a family) may not qualify for care without charge, but will qualify for discounted care. While the maximum 100% discount may not be available to all charity care applicants based on the results of their asset test, all uninsured patients who receive care are eligible for, at a minimum, the charity care discount as provided by the Medicare program. 6. For patients who qualify for less than 100% of the financial assistance program, a payment schedule is determined and agreed upon (discussed further below). Payment arrangements are established prior to service for non-urgent care. 7. In either case, the final results of the financial screening are recorded in the comments section of TMH's billing system. Requests for Payment Arrangements: Patient Financial Advocates (PFAs) will qualify patients that are receiving non-urgent, medically indicated procedures prior to services. The PFAs will request 75% to 100% of estimated discounted charges if the balance is under $5,000 and 50% to 100% of estimated discounted charges if the estimated bill equals or exceeds $5,000. For elective or non-urgent cases, the policy requires financial clearance prior to services or an exception from the Medical Director based on the clinical circumstances if the patient cannot meet the above payment agreement. Patients who do not qualify for total or partial CFS, but who have difficulty in paying their bills after services are rendered, may request 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 the patient for signature. Account documentation will be done online. The pre-collect agency will be sent a copy of the payment agreement and all forms will be scanned into the PFS Optical Imaging System. Schedule H, Part I, Line 6a The community benefit report for all Brown University Health affiliated hospitals (The Miriam Hospital (TMH), Rhode Island Hospital (RIH), Emma Pendleton Bradley Hospital (EPBH), and Newport Hospital (NH)) is maintained by Brown Health and included in Brown Health's annual report. The annual report for the year ended September 30, 2025 is available at the following link. https://www.brownhealth.org/sites/default/files/2025-07/Annual-Report-2024_250709.pdf Schedule H, Part I, Line 7 TMH's costing methodology used to calculate the amounts reported in Part I, Line 7 is as follows: a) Financial assistance at cost- involves utilization of a ratio derived from dividing patient costs, as defined, by patient charges, as defined, and applying that percentage to total charity care charges. Patient costs reported in the cost accounting system are calculated based on Medicare principles of reimbursement by reducing total operating expenses (as calculated by Form 990 requirements) by items such as bad debt expense, the cost of medical education, internally funded research, subsidized health services, community services, charitable contributions, and other operating revenue. Patient costs are then divided by patient charges to determine a ratio of cost to charges (RCC). This RCC is applied as the costing methodology for determining charity care expense. b) Medicaid- Medicaid expense is determined at cost as calculated by TMH's cost accounting system. The system uses historical costing methods applied to all patient segments based on various patient demographics and utilizations. These costing standards exclude bad debt, charity care, and the Medicaid portion of costs of health professions education, which are reported on other areas of Line 7. These expenses include Medicaid provider taxes. Direct offsetting revenue is reported as amounts received from Medicaid, as well as other payments which include reimbursement under Federal "Upper Payment Limit" (UPL) and "Disproportionate Share Hospital" (DSH) programs. e) Community health improvement services and community benefit operations- Community benefit operations expense is recorded as direct expenses incurred as reported by TMH's Community Health Services Department. Revenue received for these services is reported as direct offsetting revenue. f) Health professions education- Health professions education expenses represent direct costs related to amounts associated with resident and intern programs utilized at TMH. These costs are determined by reporting actual direct costs taken from the Medicare cost report. Direct offsetting revenue is reported as any direct Medicare reimbursements received for such services provided, as reported in TMH's Medicare cost report. g) Subsidized health services- Subsidized health services' community benefit expense is determined by TMH's cost accounting system. These subsidized health services are recorded at cost in TMH's cost accounting system for all qualified subsidized health service divisions. This expense is adjusted to remove all related Graduate Medical Education (GME) expenses, as well as bad debt, Medicaid, and charity costs already reported in the applicable sections of Line 7. Net patient service revenue is recorded as amounts received from various payer types related to these services. Revenue associated with Medicare GME and Medicaid is excluded from the amount disclosed for subsidized health services. h) Research- TMH conducts extensive medical research focused on the prevention and treatment of HIV/AIDS, obesity, cancer, diabetes, cardiac disease, neurological problems, orthopedic advancements, and mental health concerns. For all internal and external research conducted, the costs associated with these activities are calculated by combining the direct and indirect costs as reported within TMH's cost accounting system. Revenue received for these services is reported as direct offsetting revenue. i) Cash and in-kind contributions for community benefit- Expenses for cash and in-kind community benefit contributions are incurred by TMH, including an allocation of contributions made by Brown University Health on TMH's behalf. Schedule H, Part I, Line 7, Column f The calculation of percentages disclosed for Schedule H, Part I, Line 7, column (f) "percent of total expense", does not include bad debt expense. Form 990, Part IX, Line 25 includes provision for bad debts of $24,860,001. Schedule H, Part III, Section A, Line 4 Due to the adoption of ASU No. 2014-09 in 2019 - Revenue From Contracts With Customers (Topic 606), bad debt expense is no longer reported in the audited financial statements as a separate line item, but rather is treated as a price concession. TMH's adoption of the ASU did not materially change the timing or amount of revenue recognized. However, the ASU requires that patient service revenue be presented in the statement of operations and changes in net assets at the transaction price, i.e., net of any provision for bad debts. Schedule H, Part III, Section B, Line 8 The Medicare shortfall for fiscal year 2025 was not treated as a community benefit. The source of the Medicare allowable costs reported on Part III, Section B, Line 6 is the Medicare cost report, Form 2552-10. Schedule H, Part III, Section C, Line 9b TMH does not bill for the excess of charges over agreed upon reimbursement amounts from third-party payors. Rather, such differences are recorded as a reduction of revenue through contractual adjustments. Collection efforts are focused on copayments, deductibles and amounts denied by insurers. After all collection attempts are exhausted, any remaining balances, including any copayments and deductibles, are written off as a bad debt. TMH classifies its bad debts as uncompensated care. This does not apply to Medicaid, however, as there are no associated copayments or deductibles for this payor. TMH generally does not require collateral or other security in extending credit to patients; however, it routinely obtains assignment of patients' benefits payable under their health insurance programs, plans, or policies. Uninsured patients are offered Community Free Service and/or payment plan options. Brown Health's Patient Financial Services Department (PFS) has the responsibility for communicating and administering collection policies and procedures to all patient accounts. PFS engages the services of various pre-collect agencies as necessary. The following are highlights of the overall collection effort: * If a patient presents for admission who is not insured, staff assists the family with a Medicaid application. * If the patient is ineligible for Medicaid, a financial screening is performed to determine status of qualification for charity care. All patients without medical insurance receive at a minimum a self-pay discount calculated using the Prospective Method of amounts generally billed. * If the patient does not qualify for charity care, PFS or the pre-collect agency attempts at least four contacts with the responsible party within the first 120 days. * At 120 days, if there is no payment activity or no hold placed on the account, the account is transferred to the appropriate collection agency. Schedule H, Part VI, Line 2 Brown Health's Office of Strategic Planning and Analysis performs population-based studies for TMH regarding the need for inpatient medical and surgical services 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. Brown Health 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 subcomponents 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 Rhode Island 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 Brown Health. Based on a broad understanding of community health needs, TMH provides a wide range of services to both its primary and secondary service areas. Brown Health and its hospital affiliates monitor health trends in Rhode Island in an effort to identify areas of unmet demand regarding clinical services. Schedule H, Part VI, Line 3 TMH has multilingual signage in its 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 TMH. Assistance eligibility is also summarized on TMH's website, http://miriamhospital.org. As part of TMH's inpatient intake process, TMH provides a summary of its Financial Assistance Policy, along with all assistance applications and the Patient Financial Services contact number, to all self-pay patients. The same process is also used for patients seen during the outpatient discharge process. Attempts are made to contact patients prior to their visit to screen for financial assistance and to inform them what documents are required for their financial assistance determination or to set up an appointment to see a "Patient Financial Advocate" (PFA) prior to service. PFAs discuss with patients the various government programs that might be available to them for financial assistance. PFAs also offer assistance with the financial application process and/or understanding the qualification factors for Medicaid, the Affordable Care Act, Medicare, Social Security Disability, the Supplemental Nutrition Assistance Program (SNAP), and Rhode Island Temporary Disability Insurance and Unemployment. This is done for both inpatient and outpatient services. Schedule H, Part VI, Line 4 TMH, 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 Rhode Island and southeastern Massachusetts. As a complement to its role in service and education, the Hospital actively supports research. TMH 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. TMH is also a member of the formerly-named Voluntary Hospitals of America, Inc., which has partnered with UHC Alliance NewCo, Inc. to become Vizient, Inc., the largest member-owned health care company in the United States. Schedule H, Part VI, Line 5 TMH is governed by a Board of Trustees, which is composed of leaders of the local community elected by Brown Health. TMH's purpose is to at all times be operated exclusively as a tax-exempt charitable hospital and, as such, shall dispense medical and surgical aid and care to the sick and disabled of any race, creed, or color in keeping with Jewish ethical aspirations; shall act in a fashion designed to further, improve, and advance the science or art of health care delivery, patient care, and the knowledge, practice, and teaching of medicine and nursing; and assist in the advancement of medical research and investigation and in the improvement of medical teaching facilities and methods. TMH works collaboratively with physicians, its employees, other health care organizations, and the community to create a measurably healthier community through the provision of high quality, cost-effective, customer-focused health care services in an environment that promotes patient safety. TMH monitors the healthcare needs of its service area to ensure alignment of its resources with its mission. TMH measures the results of the programs and services it provides based on the value added to the community as well as the financial health of each program and its impact on TMH. TMH is organized and operated for the benefit of the community it serves. Schedule H, Part VI, Line 6 Brown Health's mission is delivering health with care. Brown Health is an academically based healthcare system at the forefront of medical care, continually engaging in research that will lead to medical breakthroughs. Brown Health affiliates provide comprehensive inpatient and outpatient medical, surgical, and psychiatric services for adults and children. Brown Health and its affiliates employ approximately 19,500 people. The Brown Health system has approximately 5,500 physicians on the medical staffs of its affiliated hospitals, operates 1,473 licensed beds in six hospital complexes, and in 2025 generated approximately $4.4 billion in total operating revenue. By each of these measures, Brown Health is Rhode Island's largest health system, serving a population of about 1.1 million. Three of its hospital members, Rhode Island Hospital (RIH), The Miriam Hospital (TMH), and Emma Pendleton Bradley Hospital (EPBH), are teaching affiliates of The Warren Alpert Medical School of Brown University. Brown Health is a Rhode Island nonprofit corporation that is community-based and community-governed. As a nonprofit organization, Brown Health is run by a voluntary Board of Directors who are community representatives. Brown Health 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, 2025, Brown Health employed approximately 1,300 full-time and part-time personnel, most of whom are located in Providence, Rhode Island. Brown Health provides support services to its affiliates, such as information services, risk management, legal, communications and public affairs, fundraising, facility development, strategic planning, internal audit/compliance, human resources, finance, payor contracting, and investment management, for which each affiliate is charged a fee equivalent to the estimated costs incurred by Brown Health in providing these services. CORPORATE AUTHORITY AND ROLE Brown Health 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, approve all managed care agreements, negotiate, develop, and approve 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 Brown Health to provide it with the means of effective oversight, coordination, and support of the system. Powers specifically reserved to Brown Health as sole member of TMH include: to approve the amendment of the Articles of Incorporation and Bylaws and other Charter documents; to develop and approve strategic plans; to approve 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 Brown Health's integrated healthcare delivery system, please refer to Schedule R. 1 Brown University 75 Waterman Street Providence RI 02912 050258809 501(c)(3) 269102 FMV Shared Chair Support 1 0 Schedule I, Part I, Line 2 TMH is committed to community programs and provides support to various charitable organizations in Rhode Island. Donations are made to organizations recognized by the IRS as being described in IRC Section 501(c). All contributions are approved by management and are made to organizations whose missions and goals align with those of TMH. X 1 1 X X X X X 1 1 0 0 0 0 0 1 0 John Fernandez Trustee 0 1550583 0 0 0 100779 0 334533 0 30828 0 2016723 0 0 Ziya L Gokaslan MD Trustee 0 1513096 0 144400 0 14237 0 20700 0 25516 0 1717949 0 0 Peter K Markell Treasurer 0 1221588 0 242967 0 0 0 18975 0 21785 0 1505315 0 0 Timothy J Babineau MD Former Trustee 0 0 0 0 0 1335765 0 0 0 0 0 1335765 0 1335765 Paul J Adler Secretary 0 757627 0 0 0 121740 0 127377 0 21636 0 1028380 0 89854 Maria Ducharme President 0 604168 0 0 0 90709 0 105125 0 30597 0 830599 0 67740 Vanzetta V James DNP Fmr CNO 236145 0 0 0 131168 0 317354 0 10233 0 694900 0 0 0 Eva Greenwood Fmr Treasurer 0 516279 0 0 0 23212 0 91782 0 24278 0 655551 0 0 Mark Deitch MD CMO 446568 0 0 0 40407 0 84029 0 21764 0 592768 0 20780 0 Janine Lairmore VP- Cardiovascular Institute 360426 0 0 0 40889 0 67327 0 30772 0 499414 0 28947 0 Laura R Stroud Director Center of Behavior 338067 0 0 0 3314 0 18576 0 36219 0 396176 0 0 0 Rena Wing Senior Researcher 340076 0 0 0 7416 0 18576 0 27423 0 393491 0 0 0 Wenliang Song Research Scientist 288953 0 0 0 979 0 4182 0 41131 0 335245 0 0 0 Jill Underwood Registered Nurse 264136 0 0 0 569 0 14330 0 11386 0 290421 0 0 0 Schedule J, Part I, Line 1a Tax Indemnification and Grossed Up Payments: The Brown Health Executive Long Term Disability program provides financial protection to designated Brown Health physicians and 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 Brown Health Executive Benefit Plan and is included in Medicare wages, more specifically on Schedule J, Part II, Column B (iii). Schedule J, Part I, Line 3 Compensation of the TMH President is determined by the Compensation Committee of Brown University Health. This committee's determination process utilizes a combination of an independent compensation consultant, written employment contracts, and compensation studies/surveys, along with approval by the Brown Health Board of Directors. Schedule J, Part I, Line 4 Line 4a: The following individual received severance and/or a change of control payment during the calendar year ending December 31, 2024: Timothy J. Babineau, MD, former trustee: $1,335,765. Vanzetta V. James, DNP, CNO through 9/30/2024: $82,085. Line 4b: Brown Health offers a non-qualified supplemental employee retirement plan (SERP) to certain executives. The following individuals were credited with the non-vested amounts indicated during calendar year 2024 and such amounts are included in deferred compensation on Schedule J, Part II, Column C: Paul J. Adler - $106,677. Mark A. Deitch, MD - $69,035. Maria P. Ducharme - $84,425. John Fernandez - $313,833. Eva Greenwood - $73,257. Janine Lairmore - $48,800. In 2024, the following individuals became vested in and were paid a 2021 non-qualified supplemental employee retirement plan (SERP) amount and such amounts are included in Medicare wages, more specifically on Schedule J, Part II, Column B(iii): Paul J. Adler - $89,854. Mark Deitch - $20,780. Maria P. Ducharme - $67,740. Vanzetta V. James, DNP - $41,787. Janine Lairmore - $28,947. Peter K. Markell - $158,521. The portion of the above payments that was reported as deferred compensation in prior years is reflected on Schedule J, Part II, Column F. Participants included in Brown Health's SERP are awarded plan contributions on a quarterly basis. Contributions and interest earned during a plan year vest after three years and are paid to plan participants at that time. SERP payments earned during the calendar year which have not yet vested are disclosed on Schedule J, Part II, Column C. Vested SERP payments received during the year are disclosed on Schedule J, Part II, Column B(iii) (as well as Column F if reported on Schedule J, Part II, Column C of a previously filed Form 990). Plan contributions awarded to participants who have reached age 62 become vested as of the beginning of the following calendar year. Schedule J, Part I, Line 7 Certain physicians and executives participate in incentive compensation plans arranged through individual contractual agreements which stipulate non-fixed payments based on meeting criteria comprised of various quality and productivity markers. A RIHEBC Series 2016 521300173 762244FP1 2016-08-11 57000732 Refund 1996, 2006 Bonds 0 0 1 B RIHEBC Series 2024 521300173 762244LW9 2024-02-14 120479012 Capital Improvements 0 0 0 A 3040475 0 57000732 0 0 0 419512 0 0 0 56581220 0 1 1 1 1 B 0 0 121610650 0 0 0 966648 0 0 0 8138064 112505938 0 0 0 1 A 0 0 0 1 1 0 0 0 0 0 1 B 0 0 0 1 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 Schedule K, Part I, Column a-02/14/2024 120,479,012 RIHEBC Series 2024 The bond proceeds listed in line 3a & 3b differ from the bond issue disclosed per IRS Form 8038 due to the fact that TMH is part of the BHOG previously mentioned in Part I, Line A(f). Of the $308,112,067 disclosed in Form 8038 for the RIHEBC Series 2016 Bonds, TMH was allocated $57,000,732 of the total issuance proceeds disclosed in line 3a. Of the $332,814,949 disclosed in Form 8038 for the RIHEBC Series 2024 Bonds, TMH was allocated $120,479,012 of the total issuance proceeds disclosed in line 3b. Schedule K, Part I, Column b-08/11/2016 57,000,732 RIHEBC Series 2016 The total proceeds shown in Part II, Line 3 differs from the issue price shown in Part I(e) due to interest earnings on invested proceeds. Form 990, Part VI, Section A, Line 2 Lawrence A. Aubin, Sr., Chairman, and Michael L. Hanna, Trustee, are partners in the same for-profit organization. Form 990, Part VI, Section A, Line 6 Brown University Health is the sole member of TMH. Form 990, Part VI, Section A, Line 7a The sole member of TMH is Brown University Health, a non-profit corporation organized and existing under the Rhode Island Nonprofit Corporation Act. Additionally, the bylaws of TMH confer certain reserved powers upon Brown Health to provide it with the means of effective oversight, coordination, and support of the system. Powers reserved to Brown Health include: to elect and remove TMH trustees and to approve the election/removal of certain officers. Form 990, Part VI, Section A, Line 7b The TMH Board is comprised of the same individuals who serve on the Brown Health Board. Brown Health has the responsibility for planning, directing, and establishing policies intended to assure the development and delivery of quality health services on an integrated, cost-effective basis. Powers reserved to Brown Health, in addition to those noted above, include: to approve amendment of the Articles of Incorporation and Bylaws and other charter documents; to approve strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness. Form 990, Part VI, Section B, Line 11b The preparation and filing of the Form 990 and supporting schedules is the responsibility of the Executive Vice President & Chief Financial Officer (EVP/CFO)and Brown Health's Finance Department. The Form 990 is prepared by the accounting staff upon completion of Brown Health's annual independent audit and is reviewed by the Corporate Services Tax Compliance Manager and the Director of Finance. The draft Form 990 is then provided to the EVP/CFO for final management review. Prior to filing the return with the Internal Revenue Service, a copy of the entireform is posted to TMH's Board of Trustees website portal in advance of its next Board meeting. At the time of the Board Meeting the 990 is presented by the Brown Health Director of Finance and EVP/CFO, at which time all questions and concerns of the members of the Board are addressed by the EVP/CFO and incorporated into the Form 990 when appropriate. Once the Form 990 is complete and ready to be filed, the members of the Board are notified via email that a copy of the final version of the Form 990 is accessible through the same password-protected website portal. The EVP/CFO is authorized to file the Form 990. Form 990, Part VI, Section B, Line 12c Brown University Health has a Conflict of Interest Policy that is applicable to all affiliates, including TMH, and administered by Brown Health's Corporate Compliance Department as follows: Each designated person subject to Brown Health's conflict of interest policy is required to provide Brown Health 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 Brown Health 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. 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 Brown University Health. Annually, the Brown Health Compliance Officer shall review and report to the Brown Health Executive Corporate Compliance Committee and to the Brown Health 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 Brown Health. Form 990, Part VI, Section B, Line 15 The following applies to Brown Health and all of its affiliates, including TMH: EXECUTIVE COMPENSATION Brown Health'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 Brown Health as well as other officers, senior management, and key employees. Brown Health'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 Brown Health's Corporate Compliance Policy on Excess Benefit Transactions. The Compensation Committee of the Brown University Health Board of Directors (the Committee), comprised of disinterested Brown Health Board members, is responsible for diligent oversight of executive compensation to ensure compliance with IRC requirements. Its duties include: * Approving eligibility for participation in the executive compensation program. * Approving changes in compensation for existing executive participants. * Approving guidelines, such as salary ranges and contract terms, on appropriate levels of compensation for other key employees. * Approving new, and modifying or terminating existing, executive compensation plans including, but not limited to, annual incentive and executive benefit plans. * Approving performance objectives associated with Brown Health's annual incentive plan, including measuring points, and using verified actual performance relative to these objectives as a precondition to approving the payment of any awards under the plan. * Authorizing periodic performance benchmark studies to be conducted for purposes of assessing Brown Health's performance within the healthcare industry and the degree to which total remuneration levels at Brown Health are generally commensurate with Brown Health performance relative to healthcare industry performance. * Conducting an annual performance review of Brown Health'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 Brown Health's executive compensation philosophy. Brown Health'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 Brown Health's performance relative to compensation-related performance objectives. The Committee's deliberations and actions are documented in minutes prepared for each meeting. PROCESS FOR DETERMINING COMPENSATION Valuation of Total Cash and Total Remuneration: No less frequently than annually, the Committee receives and reviews a total cash compensation valuation of all existing executive compensation program participants prepared by its independent compensation consultant. Annually, the Committee also receives and reviews a total remuneration valuation of all existing executive compensation participants. Base Salary Actions: The CEO recommends any salary adjustments for participants in the executive compensation program, using the results of the valuation study and his/her assessment of individual performance or other pertinent information, for the Committee's consideration. New Participants in Executive Compensation Program: With respect to compensation offers for individuals expected to participate in the executive compensation program, certain members of the Brown Health CEO's leadership team work with the Committee's independent compensation consultant or rely 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 C, Line 19 Brown Health and the Brown Health Obligated Group, which consists of TMH, RIH, Emma Pendleton Bradley Hospital, Rhode Island Hospital Foundation, and The Miriam Hospital Foundation, currently make their annual and quarterly consolidated financial statements available to the public via DAC (Digital Assurance Certification, LLC), a disclosure dissemination agent for issuers of tax-exempt bonds which electronically posts and transmits Brown Health'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 Brown Health EVP/CFO, either in person or by mail. Form 990, Part XI, Line 9 Increase in Interest in TMH Foundation: $5,759,074. Form 990, Part XII, Line 2b TMH was included in the Brown Health and Affiliates audited consolidated financial statements as of and for the fiscal year ended September 30, 2025. Included in the amounts reported for TMH include activity of TMH and VNA Technicare, Inc., d/b/a Brown University Health Home Medical. The Brown Health Audit and Compliance Committee assumes responsibility for oversight of the audit of TMH's consolidated financial statements and the selection of Brown Health's independent accountant. 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