THE MIRIAM HOSPITAL: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: THE MIRIAM HOSPITAL (EIN 05-0258905)
Tax period: 2021-10-01 to 2022-09-30
Filed: 2023-08-11
IRS object ID: 202302239349301785
Schema version: 2021v4.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-08-11T11:37:38-07:00	ReturnTs
Tax Period End	2022-09-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	050258905	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	The Miriam Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MIRI	BusinessNameControlTxt
Phone	4017932500	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	164 Summit Avenue	AddressLine1Txt
City	Providence	CityNm
State Abbreviation	RI	StateAbbreviationCd
ZIP	02906	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Peter K Markell	PersonNm
Person Title	Treasurer	PersonTitleTxt
Signature	2023-08-11	SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	Peter K	PersonFirstNm
Person Last	Markell	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd
Federated Assurance Level	FAL1	FederatedAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Maria P Ducharme	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	164 Summit Avenue	AddressLine1Txt
City	Providence	CityNm
State Abbreviation	RI	StateAbbreviationCd
ZIP	02906	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$679,747,226	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.miriamhospital.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1926	FormationYr
Legal Domicile State	RI	LegalDomicileStateCd
Activity Or Mission	As a founding hospital in the Lifespan health system, The Miriam Hospital (TMH) is committed to its mission: Delivering health with care.	ActivityOrMissionDesc
Voting Members Governing Body	16	VotingMembersGoverningBodyCnt
Voting Members Independent	14	VotingMembersIndependentCnt
Total Employee	4319	TotalEmployeeCnt
Total Volunteers	459	TotalVolunteersCnt
Total Gross UBI	$383,717	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$4,685	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$34,975,575	PYContributionsGrantsAmt
CY Contributions Grants	$12,107,116	CYContributionsGrantsAmt
PY Program Service Revenue	$524,838,274	PYProgramServiceRevenueAmt
CY Program Service Revenue	$543,588,684	CYProgramServiceRevenueAmt
PY Investment Income	$22,129,247	PYInvestmentIncomeAmt
CY Investment Income	-$4,717,555	CYInvestmentIncomeAmt
PY Other Revenue	$16,981,147	PYOtherRevenueAmt
CY Other Revenue	$24,318,189	CYOtherRevenueAmt
PY Total Revenue	$598,924,243	PYTotalRevenueAmt
CY Total Revenue	$575,296,434	CYTotalRevenueAmt
PY Grants And Similar Paid	$430,881	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$431,030	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$252,946,848	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$276,477,003	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$305,206,170	PYOtherExpensesAmt
CY Other Expenses	$306,115,549	CYOtherExpensesAmt
PY Total Expenses	$558,583,899	PYTotalExpensesAmt
CY Total Expenses	$583,023,582	CYTotalExpensesAmt
PY Revenues Less Expenses	$40,340,344	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$7,727,148	CYRevenuesLessExpensesAmt
Total Assets BOY	$711,733,403	TotalAssetsBOYAmt
Total Assets EOY	$609,336,095	TotalAssetsEOYAmt
Total Liabilities BOY	$241,856,044	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$194,202,855	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$469,877,359	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$415,133,240	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	As a founding hospital in the Lifespan health system, TMH is committed to its mission: Delivering health with care.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$436,967,103	ExpenseAmt
Grant	$431,030	GrantAmt
Revenue	$519,331,301	RevenueAmt
Desc	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. (Continued on Schedule O).	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$45,905,434	ExpenseAmt
Revenue	$42,114,434	RevenueAmt
Desc	Research:TMH has 381 research projects with total expenses of $45.9 million in fiscal year 2022 (94 investigators and 152 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 60% 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. Included in total program expenses and revenue are $x.xx million of research grants from for-profit organizations that are not reported in Schedule H.(See Schedule O).	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$21,696,408	ExpenseAmt
Revenue	$5,313,319	RevenueAmt
Desc	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 $16.4 million in fiscal year 2022. (Continued on Schedule O).	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$504,568,945	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	173	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	4319	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Form8282 Filed	0	Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind	false	Form8899Filedind
Form1098 C Filed	false	Form1098CFiledInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	16	GoverningBodyVotingMembersCnt
Independent Voting Member	14	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (true)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	RI	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	Peter K Markell	PersonNm
Phone	4014447093	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	167 Point Street	AddressLine1Txt
City	Providence	CityNm
State Abbreviation	RI	StateAbbreviationCd
ZIP	02903	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd
Timothy J Babineau MD
Trustee- 6/22	8.00	40.00	Yes (X)	$0	$2,336,252	$1,293,210
Ziya L Gokaslan MD
Trustee	0.50	42.50	Yes (X)	$0	$1,633,725	$49,275
Mary A Wakefield
Treasurer	0.00	0.00		$0	$1,273,303	$125,549
Paul J Adler
Secretary	5.00	35.00		$0	$828,234	$146,676	Yes (X)
Maria P Ducharme
President	40.00	0.00		$575,014	$0	$116,908	Yes (X)
Michael P Carey MD
Physician	40.00	0.00		$416,175	$0	$40,011
Lara R Stroud
Dir. Ctr Behav.	40.00	0.00		$360,590	$0	$50,766
G Alan Kurose MD
Trustee-11/21	0.25	50.00	Yes (X)	$0	$380,737	$18,433
David A Kirshner
Treasurer	2.00	38.00		$0	$390,974	$7,478	Yes (X)
Janine Lairmore
VP- CVI	40.00	0.00		$303,232	$0	$72,511
Rena R Wing
Sr. Research	40.00	0.00		$309,615	$0	$30,087
Eirini Apostolidou
Physician	40.00	0.00		$228,750	$0	$17,977
Anne Schmidt DNP APRN-BC CENP CPHQ
Chief Nursing Officer	40.00	0.00		$229,917	$0	$80
Mark A Deitch MD
Chief Medical Officer	40.00	0.00		$152,424	$0	$18,859
Arthur J Sampson
Pres.- 12/20	0.00	2.50		$0	$70,928	$3,282	Yes (X)
Lawrence A Aubin Sr
Chair	0.50	7.50	Yes (X)	$0	$0	$0	Yes (X)
Emanuel Barrows
Trustee	1.50	6.10	Yes (X)	$0	$0	$0
Roger N Begin
Trustee	0.50	7.50	Yes (X)	$0	$0	$0
Peter Capodilupo
Vice Chair	0.50	4.00	Yes (X)	$0	$0	$0	Yes (X)
Sarah T Dowling JD LLM
Trustee	0.00	11.00	Yes (X)	$0	$0	$0
Jonathan D Fain
Trustee-11/21	1.00	1.50	Yes (X)	$0	$0	$0
Edward D Feldstein Esq
Trustee	1.00	9.50	Yes (X)	$0	$0	$0
Michael L Hanna
Trustee	1.50	4.80	Yes (X)	$0	$0	$0
Phillip Kydd
Trustee	0.50	1.00	Yes (X)	$0	$0	$0
Alan H Litwin
Vice Chair	1.50	9.75	Yes (X)	$0	$0	$0	Yes (X)
Martha B Mainiero MD
Trustee	0.00	3.50	Yes (X)	$0	$0	$0
Steven Pare
Trustee	1.00	11.00	Yes (X)	$0	$0	$0
Lawrence B Sadwin
Trustee	0.50	13.25	Yes (X)	$0	$0	$0
Shivan Subramaniam
Trustee	0.25	5.25	Yes (X)	$0	$0	$0
Jane Williams PhD RN
Trustee	0.25	6.50	Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,575,717	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$6,914,153	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,991,102	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	322	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Brown Medicine
110 Elm Street	Providence	RI	02903	Medical Services	$7,871,478
Huffmaster Crisis Response Inc
1055 W Maple Road	Clawson	MI	48017	Contract Labor	$4,106,648
AMN Healthcare Inc
2735 Collection Ctr Dr	Chicago	IL	60693	Contract Labor	$4,099,435
Brown Surgical Associates Inc
75 Newman Ave	Rumford	RI	02916	Medical Services	$3,885,596
Brown Emergency Medicine
125 Whipple St	Providence	RI	02908	Medical Services	$3,023,735

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	36	CntrctRcvdGreaterThan100KCnt
Related Organizations	$5,292,726	RelatedOrganizationsAmt
Government Grants	$6,804,019	GovernmentGrantsAmt
All Other Contributions	$10,371	AllOtherContributionsAmt
Total Contributions	$12,107,116	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Direct Rev from Research	900099	$42,114,434	$42,114,434
Patient Service Rev	900099	$498,542,595	$498,542,595
Special Purpose Funds	900099	$2,931,655	$2,931,655

Field	Value	IRS element (for citing)
Total Program Service Revenue	$543,588,684	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,698,062	TotalRevenueColumnAmt
Exclusion	$8,698,062	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$2,176,689	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,412,587	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$764,102	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$764,102	TotalRevenueColumnAmt
Exclusion	$764,102	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$89,622,588	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$103,038,205	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$13,415,617	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$13,415,617	TotalRevenueColumnAmt
Exclusion	-$13,415,617	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Indirect Rev from Grants	900099	$4,498,445	$4,498,445
Joint Program Revenue	900099	$14,976,802	$14,976,802
Weight Management Revenue	900099	$1,106,915	$1,106,915

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,971,925	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,588,208	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$383,717	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$23,554,087	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$575,296,434	TotalRevenueColumnAmt
Related Or Exempt Func Income	$566,759,054	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$383,717	UnrelatedBusinessRevenueAmt
Exclusion	-$3,953,453	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$431,030	TotalAmt
Program Services	$431,030	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,517,184	TotalAmt
Program Services	$720,619	ProgramServicesAmt
Management And General	$796,565	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$222,333,351	TotalAmt
Program Services	$220,862,113	ProgramServicesAmt
Management And General	$1,471,238	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$9,807,093	TotalAmt
Program Services	$9,729,267	ProgramServicesAmt
Management And General	$77,826	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$28,595,349	TotalAmt
Program Services	$28,339,085	ProgramServicesAmt
Management And General	$256,264	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$14,224,026	TotalAmt
Program Services	$14,081,217	ProgramServicesAmt
Management And General	$142,809	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$1,347	TotalAmt
Program Services	$1,347	ProgramServicesAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$702,409	TotalAmt
Management And General	$702,409	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$30,787,320	TotalAmt
Program Services	$30,710,927	ProgramServicesAmt
Management And General	$76,393	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$136,010	TotalAmt
Program Services	$136,010	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$49,688,275	TotalAmt
Program Services	$47,023,723	ProgramServicesAmt
Management And General	$2,664,552	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$14,353,319	TotalAmt
Program Services	$12,530,008	ProgramServicesAmt
Management And General	$1,823,311	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$379,853	TotalAmt
Program Services	$379,853	ProgramServicesAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$355,583	TotalAmt
Program Services	$355,042	ProgramServicesAmt
Management And General	$541	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$2,698,251	TotalAmt
Management And General	$2,698,251	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$19,216,678	TotalAmt
Management And General	$19,216,678	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$5,031,290	TotalAmt
Program Services	$5,031,290	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical & Surgical Supplies	$67,573,482	$67,573,482
Purch Svs & Equip Contracts	$63,939,060	$15,955,238	$47,983,822
License Fee	$23,023,420	$23,023,420
Provision for Bad Debts	$17,704,354	$17,704,354

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$10,524,898	TotalAmt
Program Services	$9,980,920	ProgramServicesAmt
Management And General	$543,978	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$583,023,582	TotalAmt
Program Services	$504,568,945	ProgramServicesAmt
Management And General	$78,454,637	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$6,737,618	BOYAmt
EOY	$188,454	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$95,676,660	BOYAmt
EOY	$18,071,006	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,312,511	BOYAmt
EOY	$1,312,511	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$43,521,185	BOYAmt
EOY	$49,341,010	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$5,895,819	BOYAmt
EOY	$6,511,173	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$3,839,383	BOYAmt
EOY	$15,632,307	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$350,799,858	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$182,026,527	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$169,235,956	BOYAmt
EOY	$168,773,331	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$171,678,285	BOYAmt
EOY	$144,314,793	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$70,300,264	BOYAmt
EOY	$78,428,211	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$143,535,722	BOYAmt
EOY	$126,763,299	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$711,733,403	BOYAmt
EOY	$609,336,095	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$56,356,909	BOYAmt
EOY	$51,133,614	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$37,208	BOYAmt
EOY	$27,945	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$41,167,492	BOYAmt
EOY	$37,875,796	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$49,250,000	BOYAmt
EOY	$49,250,000	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$95,044,435	BOYAmt
EOY	$55,915,500	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$241,856,044	BOYAmt
EOY	$194,202,855	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$391,930,253	BOYAmt
EOY	$341,470,364	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$77,947,106	BOYAmt
EOY	$73,662,876	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$469,877,359	BOYAmt
EOY	$415,133,240	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$711,733,403	BOYAmt
EOY	$609,336,095	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$7,727,148	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$29,369,759	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$17,647,212	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Form4720 Filed Section4955 Tax	false	Form4720FiledSection4955TaxInd
Correction Made	false	CorrectionMadeInd
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$1,347	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$1,347	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind
Form4720 Filed4912 Tax	false	Form4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part II-B, Line 1i - Other Activities Description	TMH pays membership fees to the Association of American Medical Colleges and the Greater New York Hospital Association. A portion of the membership dues paid to these organizations is allocated to their lobbying efforts.
Part IV - Additional Information

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$295,359,050	BeginningYearBalanceAmt
Contributions	$66,302,197	ContributionsAmt
Investment Earnings Or Losses	-$34,132,762	InvestmentEarningsOrLossesAmt
Other Expenditures	$59,252,992	OtherExpendituresAmt
End Year Balance	$268,275,493	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$218,566,531	BeginningYearBalanceAmt
Contributions	$94,109,929	ContributionsAmt
Investment Earnings Or Losses	$45,013,085	InvestmentEarningsOrLossesAmt
Other Expenditures	$62,330,495	OtherExpendituresAmt
End Year Balance	$295,359,050	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$176,284,901	BeginningYearBalanceAmt
Contributions	$56,090,522	ContributionsAmt
Investment Earnings Or Losses	$16,290,611	InvestmentEarningsOrLossesAmt
Other Expenditures	$30,099,503	OtherExpendituresAmt
End Year Balance	$218,566,531	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$173,570,529	BeginningYearBalanceAmt
Contributions	$28,474,665	ContributionsAmt
Investment Earnings Or Losses	$3,727,695	InvestmentEarningsOrLossesAmt
Other Expenditures	$29,487,988	OtherExpendituresAmt
End Year Balance	$176,284,901	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$161,149,968	BeginningYearBalanceAmt
Contributions	$28,824,519	ContributionsAmt
Investment Earnings Or Losses	$7,989,653	InvestmentEarningsOrLossesAmt
Other Expenditures	$24,393,611	OtherExpendituresAmt
End Year Balance	$173,570,529	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.84420	BoardDesignatedBalanceEOYPct
Term Endowment Balance EOY	0.15580	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,683,785	OtherCostOrOtherBasisAmt
Book Value	$3,683,785	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$243,636,502	OtherCostOrOtherBasisAmt
Depreciation	$138,366,214	DepreciationAmt
Book Value	$105,270,288	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$94,388,156	OtherCostOrOtherBasisAmt
Depreciation	$43,660,313	DepreciationAmt
Book Value	$50,727,843	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,091,415	OtherCostOrOtherBasisAmt
Book Value	$9,091,415	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$168,773,331	TotalBookValueLandBuildingsAmt
Total Book Value Securities	$78,428,211	TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
Deferred financing costs	$510,116
Interest in net assets of TMH Foundation	$62,061,719
Other assets	$138,503
Right of use leased assets	$18,520,472

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$126,763,299	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
Accrued pension liability	$14,768,603
Due to affiliates	$7,699,448
Health Care Benefit Self-insurance	$2,797,662
Non-current operating lease.	$18,621,336
Other Liabilities	$1,410,942
Post-retirement benefit liability	$134,800
Third-party payor settlements	$10,482,709

Field	Value	IRS element (for citing)
Total Liability	$55,915,500	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$512,052,511	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$29,369,760	NetUnrealizedGainsInvstAmt
Other Revenue	-$17,647,212	OtherRevenueAmt
Revenue Not Reported	-$47,016,972	RevenueNotReportedAmt
Revenue Subtotal	$559,069,483	RevenueSubtotalAmt
Investment Expenses Not Incld	$702,409	InvestmentExpensesNotIncldAmt
Other Revenues Not Included	$15,524,542	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$16,226,951	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$575,296,434	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$566,796,631	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$1,412,587	OtherExpensesIncludedAmt
Expenses Not Reported	$1,412,587	ExpensesNotReportedAmt
Expenses Subtotal	$565,384,044	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$702,409	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$16,937,129	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$17,639,538	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$583,023,582	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part V, Line 4: Intended uses of the endowment fund.	The Miriam Hospital's (TMH) 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) staff facilitating patient access to treatment of sexually transmitted infections; (3) clinical care, research, and education to develop treatment for pelvic floor disorders; (4) student loan repayment and tuition assistance in Nursing; (5) the Department of Psychiatry's operations, education, research, and capital needs; (6) the advancement of patient care in Cardiology; (7) the Surgery Department's educational and investigational functions; (8) research and program development for genitourinary cancer care; (9) operational support to the Womens Medicine Collaborative; (10) support of Cardiology labs and programs; (11) multidisciplinary program support for diagnosing and evaluating of lung modules; (12) the expansion of TMH's plastic surgery service line; (13) the treatment and prevention of cancer; and (14) support for equipment needs at TMH's Women's Association. (15) genitourinary reconstruction at the Department of Urology;
Part X : FIN48 Footnote	TMH is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and is exempt from Federal income taxes pursuant to Section 501(a) of the Code. 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 2022 or 2021.
Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S	Non-UBI debt-financed rental expenses $-133654 Non-debt-financed rental expenses $-1278933 Provision for bad debts $16850265 Miscellanous non-operating loss $86864
Part XII, Line 2d: Other expenses and losses per audited F/S	Non-UBI debt-financed rental expenses $133654 Non-debt-financed rental expenses $1278933
Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S	Provision for Bad Debts $16850265 Miscellanous non-operating loss $86864

Schedule F IRS990ScheduleF

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp (8 entries)

RegionRegionTxt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Specific Services ProvidedSpecificServicesProvidedTxt	Region Total ExpendituresRegionTotalExpendituresAmt
Sub-Saharan Africa	Program Services	Research	$453,362
North America	Program Services	Research	$51,250
Russia & Newly Independ States	Program Services	Research	$33,981
Central America and Caribbean	Program Services	Research	$19,847
East Asia and the Pacific	Program Services	Research	$16,349
Middle East and North Africa	Program Services	Research	$10,855
Europe	Program Services	Research	$6,709
South America	Program Services	Reserach	$500

Field	Value	IRS element (for citing)
Subtotal Spent	$592,853	SubtotalSpentAmt
Total Spent	$592,853	TotalSpentAmt
Transfer To Foreign Corp	false	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	false	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	false	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2 - Grantmakers Explanation For Monitoring Use of Funds Outside US	FormAndLineReferenceDesc
Explanation	When a foreign institution is the subrecipient of an award received by a Lifespan affiliate, the following procedures are adhered to: A subrecipient agreement is prepared and executed between the foreign institution and the Lifespan 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 Lifespan affiliate for expenses incurred under the agreement. Once received, the invoice is reviewed and approved by both the principal investigator at the Lifespan affiliate and the responsible research administrator in the Lifespan 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 Lifespan 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 Lifespan 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.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,892,917	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$827,372	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,065,545	NetCommunityBenefitExpnsAmt
Total Expense	0.01230	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$101,448,101	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$83,735,553	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,712,548	NetCommunityBenefitExpnsAmt
Total Expense	0.03090	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$109,341,018	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$84,562,925	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$24,778,093	NetCommunityBenefitExpnsAmt
Total Expense	0.04320	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$217,681	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,801	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$204,880	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,696,408	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,313,319	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$16,383,089	NetCommunityBenefitExpnsAmt
Total Expense	0.02860	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$18,527,444	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,609,798	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,917,646	NetCommunityBenefitExpnsAmt
Total Expense	0.01910	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$45,878,954	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$42,087,954	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,791,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00660	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$96,148	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$96,148	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$86,416,635	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$55,023,872	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$31,392,763	NetCommunityBenefitExpnsAmt
Total Expense	0.05490	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$195,757,653	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$139,586,797	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$56,170,856	NetCommunityBenefitExpnsAmt
Total Expense	0.09810	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$4,808,502	BadDebtExpenseAmt
Bad Debt Expense Attributable	$798,972	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$86,679,037	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$86,262,352	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$416,685	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	The Miriam Hospital	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	164 Summit Avenue	AddressLine1Txt
City	Providence	CityNm
State Abbreviation	RI	StateAbbreviationCd
ZIP	02906	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.miriamhospital.org	WebsiteAddressTxt
State License	HOS00122	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Research Facility	Yes (X)	ResearchFacilityInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	The Miriam Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
Other	Yes (X)	OtherInd
CHNA Conducted	22	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	See Schedule H, Part V, Section C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	22	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	See Schedule H, Part V, Section C	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.0000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	See Schedule H, Part V, Section C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	See Schedule H, Part V, Section C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	See Schedule H, Part V, Section C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Facility: The Miriam Hospital - Part V, Section B, Line 3j	Part V, Line 3e:On February 27, 2020, the first COVID-19 patient in Rhode Island was admitted to TMH, moving the nations smallest state onto the worldwide coronavirus map. After that date, cases began to increase quickly throughout the state. The first stay-at-home order was issued on March 20, 2020, requiring all Rhode Island residents to stay at home unless getting food, medicine, or other essentials. Originally scheduled to remain in effect until April 13, the order also banned gatherings of more than five individuals and required out-of-state visitors to quarantine for 14 days. As cases increased, Governor Gina Raimondo announced on April 23 that schools would remain closed for the rest of the academic year. Many hospitals also postponed elective and non-emergent procedures until a later date. By April 28, 2020, COVID hospitalization rates were at their first all-time high at 373, with 88 of these patients in the ICU and 59 on ventilators. Eventually, hospitalization rates and case numbers began to decrease, reaching a low on July 7, 2020 with only 58 Rhode Islanders hospitalized due to COVID.During the month of July, the state started to slowly re-open allowing some beaches, restaurants, and entertainment businesses to resume operations (with minimum capacity), and hospitals to begin performing elective procedures again. By fall, most schools were also able to open up again. After an increase in COVID cases in November 2020, Governor Raimondo announced a statewide pause reclosing many bars, gyms, and recreational venues. By December 15, 2020, hospitalization rates reached a high of 514 in-patients. After this COVID peak, rates slowed for a period, partly due to the distribution of vaccines that started in February 2021 with doses initially being offered to individuals aged 75 and older. After first distributing the vaccine to those most at risk, Rhode Island gradually allowed other groups of residents to register.On July 20, 2021, hospitalization rates hit another low when only 23 patients were admitted with a diagnosis of COVID. However, as the season changed to winter, rates spiked again with a new all-time high of 618 inpatients on January 17, 2022. Despite this being the highest record of hospitalizations, the greatest number of COVID-related fatalities still occurred at the beginning of the pandemic.Since the beginning of 2022, COVID rates have decreased, with a slight increase as of the drafting of this report (June, 2022). Overall, the town of Central Falls has the highest rate of COVID cases in the state, followed by Pawtucket, East Greenwich, and Providence (respectively at 2nd, 3rd, and 4th place). In contrast, the towns of Little Compton and Jamestown have the lowest COVID rates and related hospitalizations. Across the state of Rhode Island, over 8 million COVID tests have been administered; approximately 400,000 positive cases have been reported; and over 3,500 COVID-related deaths have occurred. As of the June 2022, 98.5% of the Rhode Island population is at least partially vaccinated; 83% have completed their primary series; and 41.2% have received boosters. These statistics vary depending on age, gender, and race. For example, 99% of residents between the ages of 70 and 79 have received their primary COVID-19 vaccine series while those between 19 and 24 have a lower primary vaccination rate of 62.2%. Specifically at TMH, visitation was suspended on March 9, 2020, the same day the Governor declared a state of emergency. By March 18, 2020, elective procedures at TMH were suspended. April 27, 2020 marked the day the Lifespan Alternative Hospital Site, operated by RIH and one of two alternative hospitals stood up in Rhode Island, was ready for operations. Just two days later, the state experienced the largest one-day volume of COVID positive inpatients (241), as the first wave crested. With COVID cases declining, restrictions on elective procedures were lifted on May 11, 2020. Six months later, on December 14, 2020, the second COVID wave peaked just as the alternative hospital site began admitting patients. TMH began vaccinating frontline workers with the Pfizer COVID-19 vaccine in midDecember 2020 and by October 1, 2021, 98% of Lifespans workforce was vaccinated against COVID-19. TMH clinical and research milestones include: Lifespan researchers were at the forefront of investigating the potential of remdesivir, the experimental antiviral drug from Gilead Sciences, Inc., to shorten the course of COVID-19 illness in patients being treated at TMH, NH and RIH. Rhode Island is one of only three sites in the nation to be selected by the CDC for a study involving widespread antibody testing for the COVID virus. The National Institute of Allergy and Infectious Diseases awarded Karen Tashima, MD, an immunologist based at TMH, a grant of approximately $1.7 million to study the efficacy of a Novavax vaccine candidate to prevent COVID-19. Lifespan is one of about 115 sites in the United States and Mexico participating in the trial. TMH was named a clinical trial site for the National Institutes of Health ACTIV-2 study, testing potential breakthrough treatments for COVID-19 outpatients. As part of its continued response to the COVID-19 pandemic, TMH physician, Jennie Johnson, MD, opened a clinic for patients afflicted with long-COVID. This condition occurs when patients have ongoing COVID symptoms for a month or more after the initial infection Regarding the significant needs that were identified in TMH's 9/30/2022 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, Lifespan Community Health Institute (LCHI) leadership, TMH leadership, and Lifespan leadership.
Facility: The Miriam Hospital - Part V, Section B, Line 5	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 TMH, prioritization of those needs, and identification of resources, facilities, and programs to address the prioritized needs. Both qualitative primary data and secondary quantitative data were gathered to identify the significant health needs of the community. Additionally, the ongoing COVID-19 pandemic has impacted the health concerns of the communities served by TMH as well as the hospitals provision of health services.The primary data sources included community health forums, individual surveys, and key informant interviews. Secondary data sources included national and local publications of state-specific data. 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 Health Forums:Qualitative data was collected through Community Health Forums (CHF) to solicit input from individuals representing the broad interests and perspectives of the community. Community forums are a standard qualitative social science data collection method, used in community-based or participatory action research. Participants in the CHFs included members of the medically underserved, low-income, and minority populations in the TMH service area.Two CHF were held on May 10, 2022 and May 14, 2022 in the TMH service area, with 23 participants. Participants were recruited using social media, electronic newsletter, email, and word of mouth. Virtual (Zoom) forums were scheduled at various times of the day. All CHF were open to the public and participants were fully engaged throughout the 90-minute discussion.Staff from the LCHI served as a hospital liaison to help plan and facilitate the CHF. The hospital liaison was a critical link between the LCHI as the coordinating body, the expertise and resources within the hospital, and the Community Liaisons described below.An important and unique component of the CHF was the involvement of Community Liaisons. Two people representing the diverse populations served by TMH were hired as consultants to assist with the CHNA. These Community Liaisons helped plan the CHF, recruited participants, and co-facilitated the forums. Community Liaisons were chosen through a competitive selection process and completed a 90-minute training prior to leading the CHF. The training included project planning tips, role-playing activities, conflict management tips, and logistical expectations. Community Liaisons were responsible for co-facilitating the discussion at the CHF with their hospital liaison.Each CHF was 90 minutes in duration and was co-facilitated by the hospital and Community Liaison. Discussion began with a brief presentation of TMHs 2019 CHNA priorities and examples of activities the hospital has performed in response. Participants were invited to share their reactions to what was presented as well as their current health concerns. Through discussion, the facilitators generated consensus on the participants health concerns, their prioritization of those concerns, and their ideas for how TMH could respond to those concerns. The input gathered during the CHF was assessed qualitatively to extract themes and quantitatively to determine the frequency with which those themes were cited. Community Liaisons also met with the LCHI hospital liaison to debrief the forums and offer their interpretation of the findings to ensure all input was captured and that priorities were appropriately aligned.Hiring, training, and empowering community members to serve as Community Liaisons in the CHNA process enriched the quantity and quality of community input. It also allowed TMH to build relationships with communities that might not otherwise have become aware of or engaged in the needs assessment process.Individual Surveys:To broaden the reach of community input, an online survey was promoted, and paper surveys were distributed and collected by LCHI staff at community events they attended in June 2022. The surveys addressed the same questions as the CHFs. Twenty individual surveys were received for TMH.Key Informant Interviews:Public health and health policy leaders who could inform the 2022 CHNA process and had knowledge, information, or expertise about the community that TMH serves were invited to be interviewed as part of the CHNA. Key informant interviews were conducted with these leaders to supplement the other quantitative and qualitative data collected. Key informants included: Chief Strategy Officer, Executive Office of Health and Human Services, State of Rhode Island Director of Policy, Planning and Research, Executive Office of Health and Human Services, State of Rhode Island Director, Health Equity Institute and Maternal and Child Health, Rhode Island Department of Health Vice President and Chief Medical Officer, Providence Community Health Centers Executive Director, Rhode Island Parent Information Network Director, Community Health Worker Association of Rhode Island Executive Vice President and Chief Medical Officer, Blue Cross Blue Shield Rhode IslandThe key informants identified the following statewide health priorities, with the first three named by multiple leaders: Apply hospital resources to address the social determinants of health, including housing, food, transportation, and employment, among other barriers to care. Improve access to behavioral health care for children and adults, especially noting access challenges for children and the burden of substance misuse among adults. Ensure the provision of equitable care with particular attention to ensuring equal access to high quality care for persons regardless of their race, ethnicity, language spoken or disability status. They noted that equitable care also required a workforce representative of the patients and implementation of the principles of anti-racism. Improve access to primary and specialty care locally. Grow the healthcare and behavioral health workforces through career pathways, higher reimbursement rates, and increased compensation. Improve access to community-based services including home-based therapeutic services for children with special needs. Reduce racial and ethnic disparities in maternal and child health.The interviewed leaders noted several opportunities for hospitals to contribute to efforts to address these goals including: innovate around care delivery models for behavioral health services for adults; invest in systems and technology to facilitate improved care coordination between primary and specialty care, as well as hospital and community-based providers; partner with state and community-based agencies on workforce development pathways for high-demand roles- notably behavioral health providers and community health workers; provide assistance to patients to help them navigate the healthcare system; and sustain access to telemedicine that was made available during the peak of the COVID-19 pandemic.
Facility: The Miriam Hospital - Part V, Section B, Line 6a	Rhode Island HospitalEmma Pendleton Bradley HospitalNewport Hospital
Facility: The Miriam Hospital - Part V, Section B, Line 11	TMH's Community Health Needs Assessment issued for the fiscal year ended September 30, 2022 identified six significant health issue areas requiring a further implementation strategy. Those significant health issue areas include: (1) access to healthcare service; (2) chronic disease management; (3) mental and behavioral health services for patients and caregivers; (4) grow and diversify the workforce; (5) community-based access to health information; and (6) navigation supports in hospital and community settings. The implementation strategy to address those significant health needs outlined between October 1, 2022 - September 30, 2025 is available at: https://www.lifespan.org/sites/default/files/2023-04/2022-TMH-CHNA-Implementation-Plan.pdfFor implementation actions that TMH took between October 1, 2019 and September 30, 2022, refer to the 2022 Community Healths Needs Assessment The Miriam Hospital, pages 13 - 30, which can be found at https://www.lifespan.org/sites/default/files/2022-09/TMHCommunityHealthNeedsAssessment2022.pdf
Facility: The Miriam Hospital - Part V, Section B, Line 16j	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.

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (23 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
Cardiovascular Institute
950 Warren Avenue	East Providence	RI	02914	Outpatient Cardiac Clinic
TMH Immunology Research Center
14 Third Street 11 Fourth Street	Providence	RI	02906	Outpatient Counseling
Cardiovascular Institute
1454 South County Trail Suite 2000	East Greenwich	RI	02818	Outpatient Cardiac Clinic
Cardiovascular Institute
208 Collyer Street Suites 100 102	Providence	RI	02904	Outpatient Cardiac Clinic
Womens Medicine Collaborative
146 West River Street	Providence	RI	02904	Comprehensive Women's Outpatient Clinic
TMH Diagnostic Imaging Center
195 Collyer Street SUite 101	Providence	RI	02904	Outpatient Radiology
TMH Cardiac RehabPulmonary Rehab
208 Collyer Street	Providence	RI	02904	Outpatient Cardiac Clinic
Mens Health & Infectious Disease
180 Corliss Street Suites C E	East Providence	RI	02904	Comprehensive Men's Outpatient Clinic
TMH Weight Control & Diabetes Research
196 Richmond Street	Providence	RI	02903	Outpatient Research & Education
Intensive Cardiac Rehab Program
1454 South County Trail	East Greenwich	RI	02818	Outpatient Cardiac Clinic
TMH Outpatient Rehabilitation
195 Collyer Street	Providence	RI	02904	Outpatient PT, OT, and Speech Rehab
Womens and Mens Health Rehabilitation Services
148 West River Street Suite 1D	Providence	RI	02904	Outpatient Rehabilitation Services
TMH Laboratory
1 Commerce Street	Lincoln	RI	02865	Phlebotomy Lab
Adult & Pediatric Rehabilitation Services
1 Commerce Street 2nd Floor	Lincoln	RI	02865	Outpatient Rehab Clinic
Blackstone Valley Community Health Center
1000 Broad Street	Central Falls	RI	02863	Outpatient Rehab Clinic
TMH Laboratory
1180 Hope Street Basement Floor	Bristol	RI	02809	Phlebotomy Lab
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
RISE TB Clinic
14 Third Street	Providence	RI	02906	TB Clinic
The Center for Weight & Wellness
1377 South County Trail	East Greenwich	RI	02818	Outpatient Clinic
TMH Pre-admission Test Center
208 Collyer Street Third Floor	Providence	RI	02904	Outpatient Pre-Admission Assessment & Education
TMH Behavioral Medicine Clinic
146 West River Street	Providence	RI	02904	Outpatient Clinic
Lifespan Medical Imaging
900 Warren Avenue Suite 100	East Providence	RI	02914	Outpatient Radiology

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used)	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 residency3. 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.
Part I, Line 6a - Related Organization Community Benefit Report	The community benefit report for all Lifespan affiliated hospitals (The Miriam Hospital, Rhode Island Hospital, Emma Pendleton Bradley Hospital, and Newport Hospital) is maintained by Lifespan Corporation and included in Lifespan's Annual Report. The annual report for the year ended September 30, 2021 is available at the following link. https://www.lifespan.org/sites/default/files/2022-05/LS-Annual-Report-2021-22-05-26.pdfPlease see pages 5-6, 10, 30, and 38-39 of the Lifespan Annual Report for community benefit information.The annual report for the year ended September 30, 2022 is not yet available for publication at the time of the filings of this tax return.
Part I, Line 7 - Explanation of Costing Methodology	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 Lifespan Corporation on TMH's behalf.
Part I, Line 7, Column F - Explanation of Bad Debt Expense	The calculation of percentages disclosed for Schedule H, Part I, Line 7, column (f) "percent of total expense", does not include bad debt expense. Form 990, Part IX, Line 25 includes provision for bad debts of $17,704,354.
Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense	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.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit	Accounts pending transfer to bad debt are reviewed by TMH's Patient Financial Advocate staff to determine qualification for financial assistance under TMH's policy. Accounts with insufficient information to determine eligibility are assigned a separate identifying code. These accounts are ultimately transferred to bad debt if the appropriate qualifying documentation is not received. The amount reported on Schedule H, Part III, Section A, Line 3 represents the account balances at charge written off to bad debt from the pending code, which are in turn converted to cost by applying the RCC rate as identified in Schedule H, Part III, Section A, Line 2.
Part III, Line 4 - Bad Debt Expense	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. TMHs 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.
Part III, Line 8 - Explanation Of Shortfall As Community Benefit	There is no Medicare shortfall for fiscal year 2022. If there was, it would not be treated as a community benefit.The source of the Medicare allowable costs reported on Part III, Section B, Line 6 is the Medicare cost report, Form 2552-10.
Part III, Line 9b - Provisions On Collection Practices For Qualified Patients	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.Lifespan'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.
Part VI, Line 2 - Needs Assessment	Lifespan'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. Lifespan Strategic Planning also examines experience with wait times, the level of staffing, and the changing standards of care. All of this information is used to assess the demand for additional services to provide access to high quality care.In addition to population approaches to assessing and estimating need, all specialties and services monitor demand at the service-specific level by considering changing patterns of care and methods of treatment for the specific medical problem, wait times for visits/queues, and community resources. The service leadership then goes through a review process to add staff, expanded hours, and/or new 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 Lifespan.Based on a broad understanding of community health needs, TMH provides a wide range of services to both its primary and secondary service areas. Lifespan and its hospital affiliates monitor health trends in Rhode Island in an effort to identify areas of unmet demand regarding clinical services.
Part VI, Line 3 - Patient Education of Eligibility for Assistance	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.
Part VI, Line 4 - Community Information	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.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 The Warren Alpert Medical School of Brown University (Brown). TMH 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, TMH has developed formal and informal educational affiliations with a number of accredited New England colleges and universities. TMH does not receive any compensation from the various schools for providing a clinical setting for the student nurse training.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.
Part VI, Line 4 - Community Building Activities	TMH substantially subsidizes various health services including clinics and certain other specialty services. 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.
Part VI, Line 5 - Promotion of Community Health	TMH is governed by a Board of Trustees, which is composed of leaders of the local community elected by Lifespan Corporation. 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.
Part VI, Line 6 - Affilated Health Care System	Lifespan's mission is delivering health with care. Lifespan is an academically based healthcare system at the forefront of medical care, continually engaging in research that will lead to medical breakthroughs. Lifespan affiliates provide comprehensive inpatient and outpatient medical, surgical, and psychiatric services for adults and children. Lifespan and its affiliates employ approximately 16,500 people. The Lifespan system has approximately 3,900 physicians on the medical staffs of its affiliated hospitals, operates 1,165 licensed beds in four hospital complexes, and in 2022 generated approximately $2.8 billion in total operating revenue. By each of these measures, Lifespan is Rhode Island's largest health system, serving a population of about 1.1 million. Three of its hospital members, The Miriam Hospital (TMH), Rhode Island Hospital (RIH), and Emma Pendleton Bradley Hospital (EPBH), are teaching affiliates of The Warren Alpert Medical School of Brown University.Lifespan is a Rhode Island 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, 2022, Lifespan Corporation employed approximately 1,100 full-time and part-time personnel, most of whom are located in Providence, Rhode Island. Lifespan Corporation 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 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, 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 Lifespan to provide it with the means of effective oversight, coordination, and support of the system. Powers specifically reserved to Lifespan 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 Lifespan's integrated healthcare delivery system, please refer to Schedule R.
Part VI, Line 7 - States Filing of Community Benefit Report	RI
Part VI - Additional Information	Form 990, Schedule H, Part V, Line 7: The website which makes TMH's CHNA report widely available is located at the following URL:https://www.lifespan.org/sites/default/files/2022-09/TMHCommunityHealthNeedsAssessment2022.pdfForm 990, Schedule H, Part V, Line 10a: The URL to view TMH's most recently adopted CHNA implementation strategy is below:https://www.lifespan.org/sites/default/files/2023-04/2022-TMH-CHNA-Implementation-Plan.pdfForm 990, Schedule H, Part V, Line 16a: The URL to view and download TMH's Financial Assistance Policy is below:https://www.lifespan.org/sites/default/files/2023-04/2023_04_23_Lifespan-Financial-Assistance-Policy.pdfForm 990, Schedule H, Part V, Line 16b: The URL to view and download TMH's Financial Assistance Policy application form is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/cfs-english_051920.pdfForm 990, Schedule H, Part V, Line 16c: The URL to view TMH's plain language summary of its Financial Assistance Policy is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/Lifespan-Financial-Assistance-Summary_052020.pdf

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt
Brown University
164 Angell St	Providence	RI	02912	050258809	501(c)(3)	$179,530	$0	General Support
City of Providence
25 Dorrance St	Providence	RI	02903	056000329	Government Entity	$135,000	$0	General Support
Jewish Alliance of Greater RI
41 Elmgrove Ave	Providence	RI	02906	274127671	501(c)(3)	$6,500	$0	General Support
Miriam Hospital Foundation
167 Point St	Providence	RI	02903	050377502	501(c)(3)	$110,000	$0	General Support

Field	Value	IRS element (for citing)
Total501c3 Org	4	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Additional Supplemental Information	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Anne Schmidt DNP APRN-BC CENP CPHQ
Chief Nursing Officer	$172,097	$40,592	$17,228	$80	$229,997
David A Kirshner
Treasurer						$336,420	$25,000	$29,554	$7,478	$398,452
Eirini Apostolidou
Physician	$167,673	$60,744	$333	$7,412	$246,727						$10,565
G Alan Kurose MD
Trustee-11/21						$373,985		$6,752	$18,433	$399,170
Janine Lairmore
VP- CVI	$241,964	$47,825	$13,443	$27,635	$375,743						$44,876
Lara R Stroud
Dir. Ctr Behav.	$339,221	$19,575	$1,794	$33,366	$411,356						$17,400
Maria P Ducharme
President	$425,823	$86,118	$63,073	$27,847	$691,922						$89,061	$42,232
Mark A Deitch MD
Chief Medical Officer	$100,001	$50,000	$2,423	$45	$171,283						$18,814
Mary A Wakefield
Treasurer						$586,633	$154,239	$532,431	$16,088	$1,398,852			$109,461	$417,777
Michael P Carey MD
Physician	$388,418	$21,903	$5,854	$22,544	$456,186						$17,467
Paul J Adler
Secretary						$539,785	$175,000	$113,449	$28,225	$974,910			$118,451	$75,373
Rena R Wing
Sr. Research	$299,961	$1,200	$8,454	$12,687	$339,702						$17,400
Timothy J Babineau MD
Trustee- 6/22						$1,327,997	$500,000	$508,255	$31,117	$3,629,462			$1,262,093	$395,062
Ziya L Gokaslan MD
Trustee						$1,511,202	$115,000	$7,523	$31,875	$1,683,000			$17,400

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Part I, Line 1a: Relevant information in regards to selections on 1a.

Tax Indemnification and Grossed Up Payments:The Lifespan Executive Long Term Disability program provides financial protection to designated Lifespan 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 Lifespan Executive Benefit Plan and is included in Medicare wages, more specifically on Schedule J, Part II, Column B (iii).

Part I, Line 7: Non-Fixed payments not listed above

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.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	RIHEBC Series 2016	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	521300173	BondIssuerEIN
CUSIP	762244FP1	CUSIPNum
Bond Issued	2016-08-11	BondIssuedDt
Issue Price	$57,000,732	IssuePriceAmt
Purpose	Refund 1996, 2006, 2009 Bonds	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	Yes (true)	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$2,627,925	RetiredAmt
Total Proceeds	$57,000,732	TotalProceedsAmt
Issuance Costs From Proceeds	$419,512	IssuanceCostsFromProceedsAmt
Other Spent Proceeds	$56,581,220	OtherSpentProceedsAmt
Refunding Tax Exempt Bonds	Yes (true)	RefundingTaxExemptBondsInd
Refunding Taxable Bonds	Yes (true)	RefundingTaxableBondsInd
Final Allocation Made	Yes (true)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Any Lease Arrangements	false	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	false	MgmtContractBondFincdPropInd
Any Research Agreements	Yes (true)	AnyResearchAgreementsInd
Engage Bond Counsel Research	Yes (true)	EngageBondCounselResearchInd
Bond Iss Meet Prvt Sec Pymt Test	false	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	Yes (true)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Rebate Not Due Yet	Yes (true)	RebateNotDueYetInd
Exception To Rebate	false	ExceptionToRebateInd
No Rebate Due	false	NoRebateDueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	false	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (true)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (true)	ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part VI	FormAndLineReferenceDesc
Explanation	Schedule K, Part I, Line A(f):On August 11, 2016, the Rhode Island Health and Educational Building Corporation (RIHEBC) issued, on behalf of the Lifespan Obligated Group, which consists of The Miriam Hospital, Rhode Island Hospital, Emma Pendleton Bradley Hospital, Rhode Island Hospital Foundation, and The Miriam Hospital Foundation, $265,470,000 of tax-exempt fixed rate serial and term bonds (the 2016 Bonds) used for the purpose of refunding existing bonds issued to the Lifespan Obligated Group, as well as to pay certain expenses of issuance with respect to the 2016 Bonds. The portion of the 2016 Bonds' proceeds allocable to TMH is $57,000,732. For purposes of TMH, the 2016 issuance resulted in the complete refinancing of its RIHEBC Series 1996, 2006A, and 2009A Bonds. Schedule K, Part I, Line 3:The bond proceeds listed in line 3 differ from the bond issue price disclosed per IRS Form 8038 due to the fact that TMH is part of the Lifespan Obligated Group previously mentioned in Part I, line A(f). Of the $308,112,067 disclosed in Form 8038, TMH was allocated $57,000,732 of the total issuance proceeds.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et	Lawrence A. Aubin, Sr., Chairman, and Michael L. Hanna, Trustee, are partners in the same for-profit organization.
Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents	During the fiscal year ended September 30, 2022, TMH amended its bylaws to change the composition of some sub-committees authorized by the hospital. Committees added by TMH include the Credentials Committee. The Bylaws were also amended to clarify that the TMH Board of Trustees is authorized to dissolve any non-joint committee, sub-committee, or task force.
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder	Lifespan Corporation is the sole member of TMH.
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body	Effective October 23, 2012, the Board of Directors of Lifespan and the Boards of Trustees of TMH, Rhode Island Hospital, Newport Health Care Corporation, Newport Hospital, and Emma Pendleton Bradley Hospital approved a restructuring of their governance. Gateway Healthcare, Inc. joined the Lifespan health system on July 1, 2013 and adopted this restructured governance. The restructuring has increased governance effectiveness and has streamlined governance operation, as well as provided a single strategic perspective for the Lifespan system hospitals. Pursuant to the restructuring, the bylaws of each of the affiliates were amended such that the composition of the Boards of Trustees of each of the hospitals and Newport Health Care Corporation is defined as those persons serving from time to time as the directors of Lifespan. As a result, the Boards of each entity are comprised of the same individuals. The Board of each entity retains its responsibilities and authorities notwithstanding the revision in its composition. The Board of Directors of Lifespan consists of not less than fourteen nor more than thirty-one directors, including the President & CEO of Lifespan, who serves ex-officio with vote.Additionally, the bylaws of TMH confer certain reserved powers upon 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 TMH trustees and to approve the election/removal of certain officers.
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders	The TMH Board is comprised of the same individuals who serve on the Lifespan Board. Lifespan has the responsibility for planning, directing, and establishing policies intended to assure the development and delivery of quality health services on an integrated, cost-effective basis. Powers reserved to Lifespan, in addition to those noted above, include: to approve amendment of the Articles of Incorporation and Bylaws and other charter documents; to approve strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness.
Form 990, Part VI, Line 11b: Form 990 Review Process	The preparation and filing of the Form 990 and supporting schedules is the responsibility of the Lifespan Executive Vice President & Chief Financial Officer (EVP/CFO) and Lifespan's Finance Department. The Form 990 is prepared by the accounting staff upon completion of Lifespan's annual independent audit and is reviewed by the Corporate Services Tax Compliance Manager, the Director of Finance, and the Vice President of Finance - Corporate Services. 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 entire form 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 Lifespan 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, Line 19: Other Organization Documents Publicly Available	Lifespan and the Lifespan 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 Lifespan's financial information to repositories and investors alike. In addition, copies of TMH's Articles of Incorporation, Bylaws, and Conflict of Interest Policy are available upon request from the office of the Lifespan EVP/CFO, either in person or by mail.
Other Changes In Net Assets Or Fund Balances - Other Decreases	Interest in Net assets of TMHF = -$17647212
.	TMH's multidisciplinary medical teams include many dedicated specialists - surgeons, internal medicine specialists, anesthesiologists, nurses, rehabilitation therapists, and social workers who work with patients from diagnosis to treatment to follow-up care. The physical therapy and nursing teams work together after surgery to get patients moving for faster recovery, and physicians, nurses, and therapists work collaboratively to follow-up care.Each patient benefits from individualized treatment plans and rehabilitation to aid recovery and restore functionality as quickly as possible. Whenever possible, minimally invasive surgical techniques are used to perform surgery, which have dramatically improved the quality of the post-operative and recovery experience for the patient. In certain cases, computer navigation technology is used for knee and hip replacement surgeries. Computer navigation can assist the surgeon and improve the level of accuracy, bringing the precision of bone cuts and implant alignment in joint replacement surgery to a whole new level of accuracy, reliability, and longevity.Thanks to the latest evolution in surgical technology, physicians now have an effective alternative to traditional open surgery and laparoscopy that allows them to provide patients with the best of both approaches. This alternative is the da Vinci Surgical System, which TMH uses to treat different types of cancer.TMH's surgeons are leaders in their respective fields. TMH, as part of an academic medical center, prizes the mastery of new technologies in order to improve the quality of life for patients. TMH surgeons have successfully performed over 1,000 procedures using the da Vinci Surgical System and have made its use a cornerstone of cancer treatment at TMH. TMH's Adult Outpatient Behavioral Medicine Services help individuals improve health through behavior change. Services are offered to help patients adjust to chronic medical conditions, including their associated physical and emotional distress; modify unhealthy ways of living (for example, smoking cessation) to help prevent the onset or progression of disease; and treat mood and anxiety disorders that interfere with management of medical conditions. Services are available to help individuals with behavioral and psychosocial management of medical conditions such as headache, pain, cancer, heart disease (including those with implanted cardiac devices), pulmonary disease, and diabetes. The Weight Management Program provides comprehensive, medically supervised treatment for mild, moderate, and severely overweight adults. Specialized programs are also available for adolescents and diabetics. Treatment combines medical monitoring, behavioral therapy, exercise instruction, three levels of calorie reduction, and nutrition education. TMH's clinicians also include surgical oncologists, medical oncologists, radiation oncologists, hematologists, pathologists, physical therapists, radiologists, patient advocates, pharmacists, and nutritionists.To help patients and their families cope with breast cancer, TMH offers the Breast Health Navigator Program, which assists breast cancer patients through the entire course of their cancer care by providing breast health navigators, registered nurses trained in oncology who possess an in-depth understanding of breast cancer and theprocess undergone by patients. These navigators guide patients through diagnosis, treatment, and recovery, while helping them make informed decisions and cope with the variety of issues they face.TMH and RIH were named Blue Distinction Centers for Complex and Rare Cancers by Blue Cross and Blue Shield of Rhode Island. TMH and RIH are the only two hospitals in the State to receive this distinction. Blue Distinction Centers for Complex and Rare Cancers are facilities within participating Blue Cross and Blue Shield network service areas that offer comprehensive inpatient cancer care programs for adults, delivered by multidisciplinary teams with subspecialty training and distinguished clinical expertise in treating complex and rare subtypes of cancer. TMH and RIH have both been recognized for excellence in treating esophageal, gastric, liver, pancreatic, rectal, and thyroid cancer.TMH's division of gastrointestinal and liver pathology is committed to providing high quality diagnostic services for gastrointestinal and liver diseases in patients. Collectively, gastrointestinal cancers are among the most common form of malignancies suffered today, affecting nearly a quarter of a million Americans each year. To address this, the Lifespan Cancer Institute has brought together a team of nationally recognized leaders in the treatment and research of gastrointestinal cancers.The gastrointestinal cancer care services available through the Lifespan Cancer Institute at TMH provide state-of-the-art care for patients who have or are at risk for the following types of cancer: bile duct, esophagus, gallbladder, endocrine, and cystic tumors of the pancreas, liver, and stomach. TMH also offers medical nutrition therapy on an outpatient basis designed to help prevent and control gastrointestinal disorders.
Form 990, Part I, Line 6	Volunteers support and contribute to the mission of TMH every day. They are able to learn, meet other dedicated volunteers, better understand the healthcare environment, and gain personal satisfaction knowing they are making a difference to patients, families, visitors, and vendors alike. Volunteer opportunities are available for both teens and adults in a wide variety of positions, including greeters, family liaisons, emergency room support, gift shop support, nurse aides, office support, pet therapy, physical therapy, patient visitors, recovery room support, art therapy, and central transporters. Volunteers also transport students and serve as guides, escorts, and interpreter aides.
Form 990, Part III, 4a:	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 2022, TMH discharged 15,516 inpatients, logged more than 65,000 visits in its Emergency Department, and performed 10,834 inpatient and outpatient surgical procedures. Services provided in 2022 represent 68,241 inpatient days and more than 144,000 clinic visits. TMH is staffed by 1,154 privileged physicians, approximately 83 full-time house staff (medical school graduates), and a nursing staff of 893. In total, TMH employs more than 3,400 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 $7,065,545 in fiscal 2022. Charges forgone, based on established rates, amounted to $21,250,340.TMH substantially subsidized various health services including the following programs: adult psychiatry, tuberculosis, and certain other specialty services at a net cost of $10,917,646 in fiscal year 2022. 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 $204,880 in fiscal year 2022.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 Lifespan Cancer Institute, provides state-of-the-art care for patients with cancer.Award-Winning Care:Through the years, The Miriam Hospital 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 2024. 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.The Miriam Hospital was ranked Best Regional Hospital in 2022-2023 by US News & World Report, and earned the title of Top Hospital in the Providence metro area. The hospital received a high performing ranking in areas of hip replacement, knee replacement, chronic obstructive pulmonary disease (COPD), colon cancer surgery, heart attack, heart failure, stroke, kidney failure, and in the specialty of diabetes.The Center for Bariatric Surgery, a program of Rhode Island and The Miriam hospitals, has been designated an Aetna Institute of Quality Bariatric Surgery Facility for 2022-2024. The program recognizes high-performing healthcare facilities that offer specialized care and meet high standards of quality and cost-efficiency.The American Heart Association/American Stroke Association presented The Miriam Hospital, a primary stroke center, with the Get with the Guidelines - Stroke Gold Plus award in 2022 including the Type 2 Diabetes Honor Roll as well as the Stroke Honor Roll. Receiving the Gold Plus award means that The Miriam continues to reach an aggressive goal of treating patients with 85 percent or higher compliance to core standard levels of care outlined by the AHA for 24 consecutive months or more.In late 2021, The Leapfrog Group named The Miriam Hospital a Top Hospital in the United States. The Miriam was one of just 149 hospitals to make the list and was grouped among the top 72 teaching hospitals in the country. The hospital received an A from Leapfrog Hospital Safety Grade, an independent national watchdog organization that assesses hospitals achievements in protecting patients from harm and error in the hospital.The Miriam Hospital ranked as one of Americas 100 Best Gastrointestinal Care hospitals and has earned the Gastrointestinal Surgery Excellence Award for 2022 and 2021, according to Healthgrades, the leading online resource for comprehensive information about physicians and hospitals.The Antimicrobial Stewardship Program at The Miriam Hospital was designated in 2021 as a Center of Excellence by the Infectious Diseases Society of America.In 2021, the obesity medicine program in the Center for Bariatric Surgery at The Miriam Hospital became the first and only program of its kind in Rhode Island to earn national Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) accreditation. The adult program was accredited in 2015, 2017, and 2021. The adolescent program earned accreditation initially in 2017 and again in 2021. With this voluntary yet rigorous accreditation, the center meets all criteria according to national quality standards established to deliver safe, high-quality metabolic and bariatric patient care
Form 990, Part III, 4b:	TMH provided $3,791,000 in support of research activities in fiscal year 2022. 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 Lifespan/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.
Form 990, Part III, 4c:	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 $16,383,089 in 2022.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 Lifespan 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. TMHs 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.
Form 990, Part VI, Section A, Line 1b:	Lawrence A. Aubin, Sr., Chair, is the owner of Lawrence Investments, LLC, with which Lifespan entered into a ten-year operating lease of certain health care facilities in July 2015. During fiscal year 2022, Lifespan paid rent to Lawrence Investments, LLC under the terms of this lease. Terms of the rent expense related to this lease have been established at fair market value.Phillip Kydd, Trustee has a family relationship with a principal owner of The Gemini Group. During fiscal year 2022, RIH paid The Gemini Group to provide business consulting and advisory services to RIH.
Form 990, Part VI, Section B, Line 12c:	Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including TMH, and administered by Lifespan's Corporate Compliance Department as follows: Each designated person subject to Lifespan's conflict of interest policy is required to provide Lifespan with an initial disclosure statement and thereafter an annual statement attesting that: (i) the designated person has read and is familiar with this policy, and (ii) the designated person and, to the best of his/her knowledge, family members, have not in the past engaged in, are not presently engaging in, or plan to engage in, any activity which contravenes this policy.If, at any time during the course of employment or association, a designated person has reason to believe that an existing or contemplated activity may contravene this policy, the person shall submit a full written description of the activity to the Lifespan Compliance Officer or the Office of the General Counsel to seek a determination as to whether the contemplated activity does or does not contravene this policy. If the activity in question involves either the Chief Executive Officer, the Senior Vice President and General Counsel, or a Trustee, a full written disclosure must be made to, and a determination sought from, the Chairman of the Board of Directors of Lifespan Corporation.Annually, the Lifespan Compliance Officer shall review and report to the Lifespan Executive Corporate Compliance Committee and to the Lifespan Audit and Compliance Committee on the administration of this policy.Failure on the part of any designated person to comply with this policy, including failure to submit in a timely fashion the conflict of interest disclosure statement, will be grounds for removal from his/her position and/or termination of his/her employment with Lifespan.
Form 990, Part VI, Section B, Lines 15 a&b:	The following applies to Lifespan and all of its affiliates, including TMH:EXECUTIVE COMPENSATIONLifespan's executive compensation philosophy balances appropriate stewardship of resources and the need to be competitive in recruiting and retaining talented individuals. It incorporates market-competitive and performance-related principles, and covers the President and CEO of Lifespan as well as other officers, senior management, and key employees. Lifespan's executive compensation program complies both with law and with contemporary ethical norms, and is administered consistent with the organization's tax-exempt status under Section 501(c)(3) of the Internal Revenue Code (IRC) and the avoidance of transactions subject to intermediate sanctions under Section 4958 of the IRC. Executive compensation is also administered consistent with Lifespan's Corporate Compliance Policy on Excess Benefit Transactions.The Compensation Committee of the Lifespan Corporation Board of Directors (the Committee), comprised of disinterested Lifespan 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 Lifespan'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 Lifespan's performance within the healthcare industry and the degree to which total remuneration levels at Lifespan are generally commensurate with Lifespan performance relative to healthcare industry performance* Conducting an annual performance review of Lifespan's Chief Executive Officer. The Chair of the Committee conducts and documents this review, based on his/her observations and interpretation of feedback from members of the Board of Directors.* Selecting and engaging qualified, independent, third-party compensation valuation consultants that the Committee charges with rendering opinions with respect to the reasonableness and comparability of compensation as well as the comparative organizations against which compensation is assessed, in accordance with relevant sections of the IRC and Lifespan's executive compensation philosophy.Lifespan's Chief Executive Officer works closely with the Committee to make recommendations on the above topics and keep the Committee informed about contemplated compensation changes for executives and other key employees, as well as candidates for these roles. The CEO also provides periodic updates to the Committee regarding Lifespan's performance relative to compensation-related performance objectives. The Committee's deliberations and actions are documented in minutes prepared for each meeting.PROCESS FOR DETERMINING COMPENSATION Valuation of Total Cash and Total Remuneration: No less frequently than annually, the Committee receives and reviews a total cash compensation valuation of all existing executive compensation program participants prepared by its independent compensation consultant. Annually, the Committee also receives and reviews a total remuneration valuation of all existing executive compensation participants.Base Salary Actions: The CEO recommends any salary adjustments for participants in the executive compensation program, using the results of the valuation study and his/her assessment of individual performance or other pertinent information, for the Committee's consideration.New Participants in Executive Compensation Program: With respect to compensation offers for individuals expected to participate in the executive compensation program, certain members of the Lifespan CEO's Council 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 XII, Line 2:	TMH was included in the Lifespan Corporation and Affiliates audited consolidated financial statements as of and for the fiscal year ended September 30, 2022. Included in the amounts reported for TMH include activity of TMH and VNA Technicare, Inc., d/b/a Lifespan Home Medical. The Lifespan Audit and Compliance Committee assumes responsibility for oversight of the audit of TMH's consolidated financial statements and the selection of Lifespan's independent accountant.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (35 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
ALC dba HSR
1 Virginia Avenue Suite 200	Providence	RI	02905	050442015	Housing for Elderly and Mentally Ill	RI	501(c)(3)	10	Gateway Healthcare Inc	false
Bayberry Courts Inc
1 Virginia Avenue Suite 200	Providence	RI	02905	204590384	Housing for Elderly and Mentally Ill	RI	501(c)(3)	10	Gateway Healthcare Inc	false
Bradley Hospital Foundation
167 Point Street	Providence	RI	02903	050500688	Philanthropic Activities	RI	501(c)(3)	7	Lifespan Corporation	false
Capital City Community Centers Inc
1 Virginia Avenue Suite 200	Providence	RI	02905	050259090	Daycare Services	RI	501(c)(3)	7	Gateway Healthcare Inc	false
Emma Pendleton Bradley Hospital
1011 Veterans Memorial Parkway	East Providence	RI	02915	050258806	Pediatric Psych. Health Care Services	RI	501(c)(3)	3	Lifespan Corporation	false
Families Reaching Into Each New Day Inc
1 Virginia Avenue Suite 200	Providence	RI	02905	050504841	Bereavement Services for Children	RI	501(c)(3)	7	Gateway Healthcare Inc	false
Gateway Healthcare Inc
1 Virginia Avenue Suite 200	Providence	RI	02905	050309043	Subs. Abuse & Psych. Health Care Svcs.	RI	501(c)(3)	10	Lifespan Corporation	false
Hospital Properties Inc
167 Point Street	Providence	RI	02903	222869743	Property Management	RI	501(c)(4)	N/A	Lifespan Corporation	false
JM Apartments Inc
1 Virginia Avenue Suite 200	Providence	RI	02905	050435537	Housing for Elderly and Mentally Ill	RI	501(c)(3)	10	Gateway Healthcare Inc	false
Lifespan Corporation
167 Point Street	Providence	RI	02903	222861978	Holding Company/ Mgmnt Services	RI	501(c)(3)	12(II)	NA	false
Lifespan Foundation
167 Point Street	Providence	RI	02903	050493219	Philanthropic Activities	RI	501(c)(3)	7	Lifespan Corporation	false
Lifespan of Massachusetts Inc
45 Baker Street 2nd Floor	Providence	RI	02905	043408517	Holding Company	RI	501(c)(3)	12(I)	Lifespan Corporation	false
Lifespan Physician Group Inc
167 Point Street	Providence	RI	02903	050389801	Physician Health Care Services	RI	501(c)(3)	10	Lifespan Corporation	false
Lifespan School Solutions Inc
140 Broadway	Providence	RI	02903	464910847	Educational Services	RI	501(c)(3)	2	Emma Pendleton Bradley Hospital	false
LJR Corporation
1 Virginia Avenue Suite 200	Providence	RI	02905	030508346	Housing for Elderly and Mentally Ill	RI	501(c)(3)	10	Gateway Healthcare Inc	false
Mill River Community Housing Corporation
1 Virginia Avenue Suite 200	Providence	RI	02905	050427152	Housing for Elderly and Mentally Ill	RI	501(c)(3)	10	Gateway Healthcare Inc	false
Newport Health Care Corporation
11 Friendship Street	Newport	RI	02840	222535537	Holding Company/ Mgmnt Services	RI	501(c)(3)	7	Lifespan Corporation	false
Newport Health Property Management Inc
11 Friendship Street	Newport	RI	02840	222335539	Property Management	RI	501(c)(3)	12(I)	Newport Health Care Corporation	false
Newport Hospital
11 Friendship Street	Newport	RI	02840	050258914	Health Care Services	RI	501(c)(3)	3	Lifespan Corporation	false
Newport Hospital Foundation Inc
11 Friendship Street	Newport	RI	02840	222535533	Philanthropic Activities	RI	501(c)(3)	7	Lifespan Corporation	false
NHCC Medical Associates Inc
11 Friendship Street	Newport	RI	02840	050472268	Health Care Services	RI	501(c)(3)	10	Lifespan Corporation	false
Obed Apartments Inc
1 Virginia Avenue Suite 200	Providence	RI	02905	050422771	Housing for Elderly and Mentally Ill	RI	501(c)(3)	10	Gateway Healthcare Inc	false
Pathways Inc
1 Virginia Avenue Suite 200	Providence	RI	02905	050393004	Housing for Elderly and Mentally Ill	RI	501(c)(3)	10	Gateway Healthcare Inc	false
Rhode Island Hospital
593 Eddy Street	Providence	RI	02903	050258954	Health Care Services	RI	501(c)(3)	3	Lifespan Corporation	false
Rhode Island Hospital Foundation
167 Point Street	Providence	RI	02903	050468736	Philanthropic Activities	RI	501(c)(3)	7	Lifespan Corporation	false
RIH Ventures
593 Eddy Street	Providence	RI	02903	050448686	Parking Facilities/Phlebotomy Services	RI	501(c)(3)	10	Lifespan Corporation	false
Shore Courts Inc
1 Virginia Avenue Suite 200	Providence	RI	02905	050504003	Housing for Elderly and Mentally Ill	RI	501(c)(3)	10	Gateway Healthcare Inc	false
The Autism Project
1516 Atwood Avenue	Johnston	RI	02919	050512037	Services for Children with Autism	RI	501(c)(3)	10	Gateway Healthcare Inc	false
The Miriam Hospital Foundation
167 Point Street	Providence	RI	02903	050377502	Philanthropic Activities	RI	501(c)(3)	7	Lifespan Corporation	false
The Miriam Hospital Womens Assoc
164 Summit Avenue	Providence	RI	02906	050268165	Patient Support	RI	501(c)(3)	12(II)	NA	false
TLR Realty
1 Virginia Avenue Suite 200	Providence	RI	02905	043742771	Housing for Elderly and Mentally Ill	RI	501(c)(3)	10	Gateway Healthcare Inc	false
Wentworth Corporation
1 Virginia Avenue Suite 200	Providence	RI	02905	050488520	Housing for Elderly and Mentally Ill	RI	501(c)(3)	10	Gateway Healthcare Inc	false
Westerly Courts Inc
1 Virginia Avenue Suite 200	Providence	RI	02905	611439766	Housing for Elderly and Mentally Ill	RI	501(c)(3)	10	Gateway Healthcare Inc	false
Coastal Medical Physicians Inc
10 Davol Square	Providence	RI	02903	844944884	Physician Health Care Services	RI	501(c)(3)	10	Lifespan Corporation	false
RI Sound Enterprises Insurance Co Ltd
					Offshore Insurance Captive		N/A	N/A	Lifespan Corporation	false	65 Front Street	Hamilton	BD	HM 12	BD

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	Lifespan Health Alliance LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	167 Point Street	AddressLine1Txt
City	Providence	CityNm
State Abbreviation	RI	StateAbbreviationCd
ZIP	02903	ZIPCd

Field	Value	IRS element (for citing)
EIN	812732225	EIN
Primary Activities	Account. Care Org.	PrimaryActivitiesTxt
Legal Domicile State	RI	LegalDomicileStateCd
Direct Controlling NA	N/A	DirectControllingNACd
Disproportionate Allocations	false	DisproportionateAllocationsInd
General Or Managing Partner	false	GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Share Of EOY AssetsShareOfEOYAssetsAmt
Lifespan MSO Inc
167 Point Street	Providence	RI	02903	050508717	Mgmnt Services	RI	Lifespan Corp	C Corp	false
Lifespan Risk Services Inc
167 Point Street	Providence	RI	02903	050459767	Risk Mgmnt	RI	Lifespan Corp	C Corp	false
VNA Technicare Inc
200 Corliss Street	Providence	RI	02904	050472710	DME Sales	RI	TMH	C Corp	Yes (true)	$3,660,261

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	VNA Technicare Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	q	TransactionTypeTxt
Involved	$565,084	InvolvedAmt
Method Of Amount Determination	Cash	MethodOfAmountDeterminationTxt