2022-08-12T06:33:45-07:00 2021-09-30 990 2020-10-01 050258806 Emma Pendleton Bradley Hospital EMMA 4014321000 1011 Veterans Memorial Parkway East Providence RI 02915 David A Kirshner Treasurer 2022-08-12 David A Kirshner 999009999 2 AAL1 IAL1 FAL1 2020 2022-09-23 18:48:47Z Henry T Sachs III MD 103827046 false X www.lifespan.org X 1957 RI As a member hospital in the Lifespan health system, Emma Pendleton Bradley Hospital (EPBH) is committed to its mission: Delivering health with care. 18 14 1118 14 0 5666661 4385187 82443251 84611034 2470518 5210910 2055424 898064 92635854 95105195 3500 0 0 51852431 54534921 0 307979 32085501 33843464 83941432 88378385 8694422 6726810 138024623 158328172 38172088 40740496 99852535 117587676 X As a member hospital in the Lifespan health system, EPBH is committed to its mission: Delivering health with care. false false 63718660 79956385 EPBH provides inpatient treatment for children ages 2 to 18 years suffering from serious behavioral disorders and/or developmental conditions such as mental retardation or autism who are in need of stabilization, assessment, and treatment for suicidal, destructive, self-injurious, or other dangerous or aggressive behaviors. EPBH also offers residential treatment providing intensive, family-centered services to children with emotional and behavioral problems which prevent them from living safely at home. (See also Schedule O) 7401427 6401427 The Bradley Hasbro Children's Research Center is devoted to the study and treatment of children at risk for serious mental disorders and behavior processes that support the intergenerational transmission of illness. The research areas are broad and include: Child and Adolescent Psychiatric Disorders, Pediatric Behavioral Health, Biological Basis of Psychiatric Disorders, Prevention and Early Intervention, Health Services Research, Pediatric Mood, Imaging & Neurodevelopment, Developmental Disorders Genetics Research, and Neuroplasticity/Autism Disorders. Included in total program expenses and revenue are approximately $143,000 of research grants from for-profit organizations that are not reported in Schedule H. 2428741 1447701 Home-based intensive behavioral treatment is for children who have been diagnosed with Autism Spectrum Disorder (ASD) or who have varying degrees of chronic behavior disorders that, if left untreated, would worsen and require more intensive treatment, including psychiatric hospitalization or out-of-home residential placement. Staff members visit a family's home and deliver clinical services to the child on a one-on-one basis. The treatment plan is family-oriented, as it includes all family members in the treatment process. (See also Schedule O) 73548828 true true false false false false false true false true true false true true true true false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true true true false false true 76 0 true 1118 true false false false false false false false 0 false false false false false false false X 18 14 true false false false true true true true true false false true true true true true true true true false RI X David A Kirshner 4014447914 593 Eddy Street Providence RI 02903 X Timothy J Babineau MD Trustee 2.00 38.00 X 0 2572012 1324073 Ziya L Gokaslan MD Trustee 0.50 43.50 X 0 1574942 50206 Mary A Wakefield Treas.- 6/21 3.00 37.00 X 0 1107285 192804 Paul J Adler Secretary 2.50 37.50 X 0 718440 127072 Henry T Sachs III MD Pres. & CMO 27.70 12.30 X 0 455612 101813 Mary Sullivan Chief Nursing Officer 40.00 0.00 199871 0 40432 Mary A Carskadon PhD Physician 40.00 0.00 184397 0 22322 Margaret R Paccione-Dyslewski PHD Dir. Behav. Ed. 40.00 0.00 174300 0 31634 Vareen Domaleski RN Fmr. Chief Nursing Officer 0.00 0.00 203748 0 0 Karyn J Horowitz MD Chief Medical Officer 40.00 0.00 151634 0 46561 Stephanie H D'Atri Dir. Early Child. 40.00 0.00 151563 0 37598 Daniel J Wall Fmr. President 0.00 0.00 0 181776 0 Raymond Bastow Nurse Supervisor 40.00 0.00 145543 0 19721 Shelley Grant Dir. Nursing 40.00 0.00 146664 0 9121 Lawrence A Aubin Sr Chair 1.00 16.00 X X 0 0 0 Emanuel Barrows Trustee 0.60 3.00 X 0 0 0 Roger N Begin Trustee 0.25 5.75 X 0 0 0 Peter Capodilupo Vice Chair 0.20 6.70 X X 0 0 0 Sarah T Dowling JD LLM Trustee 0.25 9.00 X 0 0 0 Jonathan D Fain Trustee 0.10 1.95 X 0 0 0 Edward D Feldstein Esq Trustee 0.50 10.50 X 0 0 0 Michael L Hanna Trustee 2.00 8.75 X 0 0 0 Phillip Kydd Trustee 0.25 2.50 X 0 0 0 G Alan Kurose Trustee 0.25 41.25 X 0 0 0 Alan H Litwin Vice Chair 0.50 9.60 X X 0 0 0 Martha B Mainiero MD Trustee 0.25 5.25 X 0 0 0 Steven Pare Trustee 2.00 11.50 X 0 0 0 Lawrence B Sadwin Trustee 3.50 9.85 X 0 0 0 Shivan Subramaniam Trustee 0.25 5.50 X 0 0 0 Jane Williams PhD RN Trustee 0.00 0.00 X 0 0 0 David A Kirshner Treasurer 10.00 30.00 X 0 0 0 1357720 6610067 2003357 46 true true false Aramark Services Inc PO Box 978839 Dallas TX 75397 Food Service 1386568 Brown University PO Box 1911 Providence RI 02912 Shared Chair 901639 Butler Hospital 350 Duncan Drive Providence RI 02906 Residency Rotations 527485 3 2026353 2358415 419 4385187 Inpatient Routine 622210 46307841 46307841 Partial Hospitalization 622210 18369034 18369034 Research 541700 6544312 6544312 Residential 623220 13459086 13459086 -69239 -69239 84611034 1958417 1958417 0 0 0 11974344 8721851 3252493 3252493 3252493 0 0 0 Joint Program Revenue 621300 898064 898064 898064 95105195 85509098 5210910 X 0 0 0 0 683595 683595 0 41685968 39911772 1774196 2060169 1962743 97426 7087959 6836429 251530 3017230 2877527 139703 0 0 0 0 0 99629 99629 9768797 9791035 -22238 20083 20083 2838918 2121999 716919 0 0 1397617 933837 463780 31139 30288 851 0 134038 78400 55638 589148 32492 556656 0 3016556 717 3015839 1142870 1142870 Purchased services 10217016 2890014 7327002 Other expenses 3889226 3844579 44647 Provision for bad debts 390448 390448 Fundraising expenses 307979 307979 0 88378385 73548828 14521578 307979 242160 2266927 11459562 14083103 807997 1076578 9160611 10937863 0 0 0 189226 165618 1515499 1567242 78355928 43325975 35799901 35029953 16056129 16849113 5882309 6898985 21854211 23265211 0 35057018 46187579 138024623 158328172 6204502 8767921 18706886 17357105 3000000 13260700 11615470 38172088 40740496 X 33012835 41469622 66839700 76118054 99852535 117587676 138024623 158328172 X 6726810 9573977 1434354 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8140 X false 77657734 10830772 13230965 11733006 89986465 70079480 13349949 1707082 7478777 77657734 71532423 8706364 -680240 9479067 70079480 68789160 7684105 3607791 8548633 71532423 64900265 7347959 4894415 8353479 68789160 0.18200 0.69900 0.11900 true true true 4000 4000 53386815 26459614 26927201 23520179 16866361 6653818 1444934 1444934 35029953 Limited Ptr'ships held inside Pool 4178659 F 23265211 Deferred Financing Costs 122338 Donated Art 8140 Interest in NA of Bradley Hospital Fndtn 1379195 Other non-current Leases 24361 Participation in HBCS Net Assets 23440 Right-of-Use Assets,Net Operating Leases 1656949 46187579 Accrued Pension Liability 4564500 Cares Act Deferred Emp Payroll Tax 887019 Health Care Benefit Self-insurance 747215 Intercompany Liabilities 2973439 Lease Liabilities 1681310 Other Long-term Liabilities 69900 Third-party Payor Liabilities 692087 11615470 X Part III, Line 4: Description of organization's collections and how it furthers its purpose. EPBH's collection of artwork consists of paintings, a sculpture, and a vase. The works of art are displayed throughout EPBH for the viewing pleasure of patients, visitors, and employees. Part V, Line 4: Intended uses of the endowment fund. EPBH's endowment funds consist of both donor-restricted endowment funds and funds designated by EPBH to function as endowments. EPBH receives support from various irrevocable outside trusts within its endowment funds, most notably The Helen Bradley Trust and The George L. Bradley Trust (the Trusts), which were established under the wills of the late Helen and George L. Bradley. At September 30, 2021, the market value of the Trusts was approximately $40.1 million (not including land and the original Laufer Building in East Providence, Rhode Island where EPBH is located). As a result of a court order in 2007, the Trusts were authorized to make annual distributions to EPBH based on the trailing twelve-quarter average fair market value of the Trusts' investment assets in amounts equal to 7% of the average market value of the Trusts in 2007, decreasing by one-quarter of one percent per year to 4.5% in 2017 and beyond.EPBH's largest temporarily restricted fund at September 30, 2021 consisted of $379,292 that supports the OCD Intensive Program, providing support for the needs of EPBH's intensive program for children with obsessive compulsive disorders.EPBH also holds a Family Support Fund that is used for emergency needs of its patients and their families.An additional temporarily restricted fund supports the operations and capital needs of EPBH's Compass Residential Program, which provides comprehensive mental health services guided by Dialectical Behavior Therapy for adolescents who are struggling with severe mood problems and/or behavior dysregulations.Another fund, provided by a donation of $200,000 by CVS Health, is supporting the treatment of co-occurring substance addiction and mental health disorders at EPBH. Part X : FIN48 Footnote EPBH and its affiliate, Lifespan School Solutions, Inc., are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and are exempt from Federal income taxes pursuant to Section 501(a) of the Code. EPBH 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. EPBH did not recognize the effect of any income tax positions in either 2021 or 2020. true true true X true X true true true false true true 103225 15026 88199 0.00100 45572064 40697086 4874978 0.05554 45675289 40712112 4963177 0.05654 208703 15876 192827 0.00219 2807084 290000 2517084 0.02861 3093724 1337205 1756519 0.01996 7401427 6401427 1000000 0.01137 7143 7143 0.00008 13518081 8044508 5473573 0.06221 59193370 48756620 10436750 0.11875 true 198547 X true true 1 1 Emma Pendleton BradleyHospital 1011 Veterans Memorial Parkway East Providence RI 02915 https://www.bradleyhospital.or HOS00123 X X X Emma Pendleton BradleyHospital 1 false false true X X X X X X X X X X 19 true true false true X See Schedule H, Part V, Section C X true 19 true See Schedule H, Part V, Section C false false true X 200.0000 300.0000 X X X X X X true true X X X X true X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X X X X X X X true X false X X X X true X false false Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 3j Part V, Line 3e- The significant needs identified in EPBH's 9/30/2019 CHNA have been prioritized in order of significant needs of the community, as determined by the organization.Another significant health need which impacted EPBH's community during 2021 was the COVID-19 pandemic. While this need was not outlined in EPBH's 9/30/19 CHNA Implementation Strategy, EPBH stepped to the forefront of caring for children adversely impacted by COVID-19 by offering vital care and services to address the stress, fear, grief, isolation, uncertainty, and other mental health issues created by COVID-19. Facility: Emma Pendleton BradleyHospital - 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 EPBH, 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.The primary data sources included community health forums, key informant interviews, and individual surveys. 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 (CHFs) to solicit input from individuals representing the broad interests and perspectives of the community. Participants in the CHFs included members of the medically underserved, low-income, and minority populations in the EPBH service area.Community forums are a standard qualitative social science data collection method, used in community-based or participatory action research. Six CHFs were held between May 22 and June 14, 2019 across the EPBH service area. Participants were recruited using social media, posted flyers, email, and word of mouth. Locations were selected to be easily accessible to the public and hospital patients, and forums were held at various times of the day on weekdays and weekends. EPBH forums were held at a community health center, a senior center, an elementary school, a parent support organization, a public library, and at EPBH. At each forum, a meal was provided, along with child care and interpretation if requested in advance. All CHFs were open to the public and participants were fully engaged throughout the 90-minute discussions.A representative of EPBH served as a hospital liaison to help plan and facilitate the CHFs. The EPBH liaison was a critical link between the Lifespan Community Health Institute (LCHI) as the coordinating body, the expertise and resources within EPBH, and the Community Liaisons described below.An important and unique component of the CHFs was the involvement of Community Liaisons. Three people representing the diverse populations served by EPBH were hired as consultants to assist with the CHNA. These Community liaisons helped plan the CHFs, recruited participants, and co-facilitated the forums. All Community Liaisons were chosen through a competitive selection process and completed a two-hour training prior to leading the CHFs. The training included project planning tips, role-playing activities, conflict management strategies, and logistical expectations. Community Liaisons were responsible for identifying an accessible venue for each forum, selecting a food vendor and menu that would be appealing to the target audience, and co-facilitating the discussion at the CHF with their hospital liaison.Each CHF was two hours in duration and followed a similar format that began with a meal, followed by a 90-minute discussion, co-facilitated by EPBH and Community Liaison. The discussion generated consensus on the participants health concerns, their prioritization of those concerns, and their ideas for how EPBH could respond to those concerns. Discussion began with a brief presentation of EPBHs 2016 CHNA priorities and examples of activities EPBH has performed in response. Participants were invited to share their reactions to what was presented as well as their current health concerns. The input gathered during the CHFs 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 and the hospital liaison to debrief the forums and offer their interpretation of the findings to ensure all input was captured and that priorities were appropriately ranked.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 EPBH 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, surveys were distributed and collected by LCHI staff at events they attended in May and June 2019, such as the annual Pride Festival. The surveys addressed the same questions as the CHFs. Two individual surveys were received for EPBH.Key Informant Interviews:The director of the LCHI identified public health and health policy leaders who could inform the 2019 CHNA process and who had knowledge, information, or expertise about the community that EPBH serves. Key informant interviews were conducted with state leaders to supplement the other quantitative and qualitative data collected. Key informants include the: Acting Chief of Staff, Executive Office of Health and Human Services, State of Rhode Island and Policy Director, Rhode Island Childrens Cabinet Director of Policy, Planning, and Research, Executive Office of Health and Human Services, State of Rhode Island Director, Health Equity Institute and Special Needs Director, Rhode Island Department of Health Physician Lead, Health Equity Institute, Rhode Island Department of HealthWhen crafting the EPBH implementation strategy, EPBH reflected upon the key themes that emerged from these conversations. The statewide priorities and recommendations of the key informants included: incorporate health equity targets; generate and monitor data on health disparities, especially by race, ethnicity and income; build strategies that incorporate the social determinants of health; go beyond individual interventions to family/household level interventions; make investments in early childhood; consider comorbidities, especially between behavioral health and chronic diseases; confront racism and bias to improve care; provide personalized care; be sensitive to misalignments within healthcare; and continue to address substance misuse and behavioral health conditions.To ensure representation from a broad cross-section of the community, CHF's were held in the following locations:- Blackstone Valley Neighborhood Health Center, 39 East Avenue, Pawtucket, RI 02860; - Park Holm Senior Center, 1 Parkholm Road, Newport, RI 02840;- Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI 02915;- Parent Support Network of Rhode Island, 535 Centerville Road, Suite 202, Warwick, RI 02886;- Bradley School South County, 4781 Tower Hill Road, South Kingstown, RI 02879;- Woonsocket Harris Public Library, 303 Clinton Street, Woonsocket, RI 02895. Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 6a Newport HospitalRhode Island HospitalThe Miriam Hospital Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 11 EPBH's Community Health Needs Assessment issued for the fiscal year ended September 30, 2019 identified four significant health issue areas requiring a further implementation strategy. Those significant health issue areas include: (1) access to services; (2) systems of care; (3) outreach and education; and (4) substance use prevention. The implementation strategy to address those significant health needs outlined between October 1, 2019 - September 30, 2022 is available at: https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/EPBH-CHNA-Implementation-Plan.pdfDuring the fiscal year ended September 30, 2021, EPBH implemented the specific actions listed below in order to address the significant community health needs outlined in its CHNA Implementation Strategy issued on February 11, 2020.Significant Health Need #1- Access to Services: -Promote the Pediatric Psychiatry Resource Network (PediPRN) to family physicians and KIDS Link (a hotline for children in emotional crisis) to parents: EPBH continued to outreach pediatricians and family practices to promote PediPRN and telephonic consultation. Efforts continue and EPBH is confident that outreach can be expanded to successfully promote the resources available. During FY '21 EPBH offered a variety of articles focused on assisting children and parents related to the promotion of mental health. Topics included "Going Back to School: How to Help Children Feel Safe During the Pandemic", "Children and Grief", "Teens, Stress and How Parents Can Help", and "Pros and Cons of Social Media".-During FY '21 EPBH opened the Bradley Hospital REACH program for children and teens, which was designed to reduce or eliminate self-harm and maladaptive behaviors, improve depressive and anxiety-related symptoms, help kids build coping skills, and decrease the need for hospitalization. All these needs existed prior to the pandemic, but the pandemic brought them to light.-The EPBH Sleep Research Laboratory led nationwide research into the effects of COVID-19 on childrens sleep schedules, gathering data through a Facebook survey with over 5000 respondents from all 50 states.-EPBH, Hasbro Children's Hospital (a division of RIH), and Boston Childrens hospitals joined forces to present the second Pediatric Healthcare Summit, held virtually on December 8, 2020. The course presentation featured such topics as adolescent eating disorders, transgender medicine, feeding dificulties, and the COVID-19 vaccine.Significant Health Need #2- Systems of care:-Provide transition supports to adult care/services: The EPBH Verrecchia Clinic now includes eight members as part of its clinical team. EPBH is also partnered with social work staff, which has allowed services to families with children and adolescents who have autism/developmental disabilities to be expanded to include adult-care services.-Optimize discharge planning to home and school-based services: EPBH has successfully implemented a multi-faceted network for communication and identification of available resources in the community to assist with discharge planning. Weekly e-mails are exchanged with Gateway Healthcare, Inc., a Lifespan affiliate, and other community-based mental health providers. Hasbro Childrens Hospital (a division of Rhode Island Hospital) providers routinely participate in the EPBH "Daily Huddle". EPBH, through the Pediatric Psychiatric Response Network, has ongoing consultation arrangements with community pediatricians and has recruited an Educational Coordinator to advocate for patients and liaison with Local Education Agencies (LEAs) during inpatient stays and post-discharge transitioning.Significant Health Need #3- Outreach and education: -EPBH has continued to enhance the computer-based continuing education offered to professionals in a variety of disciplines, including psychologists, social workers, certified counselors, physicians, nurses, speech/language and occupational therapists, and teachers. Courses are available through EPBH's computer learning management system (TRAIN) complete with self-registration, post test function, evaluation and certificate download. Powered by the Public Health Foundation, the TRAIN Learning Network brings together agencies and organizations in the public health, healthcare, and preparedness sectors to disseminate, track, and share trainings for the health workforce on a single national online learning management system platform. The system is utilized by the VHA, the CDC, and multiple other federal and state agencies. Moving to TRAIN has created a more user-friendly and mobile-friendly experience for our remote learners and has enhanced the visibility of courses available on TRAIN and via the EPBH website. The content created by EPBH clinicians is distributed regionally, nationally, and internationally to any English language user with web access. All courses are approved for continuing education credits across clinical disciplines. Examples of educational offerings include: "Autism in Infancy: Advances and Implications for Clinical Practice", "Considering the Children of Parents with Mental Illness: Impact on Behavioral and Social Functioning", "DSM 5 Updates for Eating Disorders: Implications for Diagnosis and Clinical Practice", "Foundations for Infant/Toddler Social Emotional Health and Development: Designed for Providers", and "Psychiatric, Reproductive, and Relationship Health in Adolescent and Young Adult Women".-During FY '21, EPBH offered its 21st annual Parenting Matters conference, a half-day event offering parents, childcare providers and teachers a unique opportunity to learn from top child development and behavior professionals in a casual setting. Internationally renowned parenting and Attention Deficit Disorder expert Thomas Phelan, Ph.D., was the conferences keynote speaker. Phelan, the author of the best-selling 1-2-3 Magic Parenting Program, presented Parenting Solutions for Dealing with Difficult Behavior in Toddlers, Children and Teens. The father of an ADD child, Phelan has also served on the boards of directors for two national organizations for parents of children with ADD, and authors a blog with tips and advice on the subject.Workshops offered throughout the event included topics such as Sibling Rivalry, Bullying in School and Online, Ready for Kindergarten, and Helping Overweight Children and Teens Manage Their Weight, which are designed to help parents deal with 21st century challenges.-EPBH offered its annual Bradley Conference fall series, held virtually, which focused on the issue of suicide prevention, with workshops on screening, response training, and the latest suicide risk assessments. The clinicians at EPBH designed this training program specifically for individuals who do not have a background in mental health. This class is offered to anyone who may wish to learn more about suicide prevention. Educators, public safety personnel, family members, health care workers, faith leaders, transportation workers, food service employees, community members anyone who interacts with children or adults will benefit.-EPBH received a $10 million award from the NIH to establish the Center for Sleep and Circadian Rhythms in Child and Adolescent Mental Health. The first of its kind in the U.S., the center will study the links between sleep, circadian rhythms, and mental illness.Significant Health Need #4- Substance use prevention:-Offered educational programs for youth focused on increasing protective factors and reducing risk factors for substance use: The EPBH Wave Clinic is piloting a parent education group for parents of adolescents who are struggling with both mental health and substance use conditions. The adolescents at the Wave Clinic receive evidence-based treatments including motivational enhancement therapy and cognitive behavioral therapies tailored to meet the needs of each youth and his or her family. The Wave Clinic treatment may encompass individual therapy, family therapy, and/or group therapy for teens, as well as a skills group for the parent(s) or caregiver. Treatment is provided by our multidisciplinary team, which may include a psychologist, a licensed mental health counselor, and a child and adolescent psychiatrist. Substance use monitoring is part of treatment. Because the Wave Clinic is an outpatient program, teens can continue their schooling and practice their newly acquired skills in their daily lives. The length of the program varies depending on the treatment goals of the adolescent and his or her family.The EPBH Outpatient Department also developed support groups during FY '21 for parents and teenagers with substance use disorders and co-occurring mental health diagnoses. These groups provide parents with strategies for effectively supporting teenagers during the stages of behavioral change and substance abuse reduction. Topics include relapse prevention, coping with relapse, and positive parenting practices. Each session emp Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 16j An abbreviated version of EPBH's Financial Assistance Policy is posted in various admitting and outpatient areas of EPBH. 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. Bradley Research Center 1 Hoppin Street Providence RI 02903 Research Facility The Bradley Center Proprietary Cranston RI 02920 Residential Program Hill House Proprietary Exeter RI 02911 Residential Program Compass Lincoln House Proprietary Lincoln RI 02865 Residential Program Rumford House Proprietary East Providence RI 02916 Residential Program Exeter House Proprietary North Providence RI 02911 Residential Program Heritage House Proprietary Warwick RI 02888 Residential Program Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) EPBH uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at EPBH is intended to define probable eligibility for public assistance (Medicaid or Community Free Care ("CFS")) for those patients who do not have the means to pay for hospital services rendered, as follows:1. Upon patient indication of an inability to pay required monies, the patient is offered the financial screening option to determine eligibility for public assistance (Medicaid, CFS).2. The application for CFS is completed and includes information relative to income, expense, and other available resources, and requires proof of such information which may include:- most recently filed Federal income tax return and any supporting W-2 form(s)- copies of most recent savings and/or checking account statements- two most recently received payroll check stubs3. If the patient's financial situation falls within the guidelines for eligibility for Medicaid or CFS, the appropriate application process is completed. (Assistance to complete such applications is available from the Patient Financial Advocates (PFA) Office at EPBH.)4. Uninsured patients receive an automatic deduction at EPBH equal to the amount calculated using the prospective method, referred to as amounts generally billed by Medicaid.5. Eligibility for CFS above amounts generally billed 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 may 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, a charity care discount equal to or more favorable than Amounts Generally Billed (AGB), which is the maximum amount EPBH would bill a patient qualifying for assistance under EPBH's Financial Assistance Policy (FAP). 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 EPBH's billing system.Requests for Payment Arrangements:Patient Financial Advocates (PFA) will qualify patients that are receiving non-urgent, medically indicated procedures prior to services. The PFA will request 75% to 100% of estimated charges (net of the AGB discount) if the balance is under $5,000 and 50% to 100% of estimated charges (net of the AGB discount) if the estimated bill equals or exceeds $5,000.Patients who do not qualify for total or partial CFS, but who have difficulty in paying their bills after services are rendered, may request to enroll in a payment plan. Eligibility for the payment plan includes the following guidelines:1. Immediate payment in full will result in financial hardship to the patient or the patient's family.2. Deposit of one-half of the estimated total bill is requested prior to admission.3. The minimum monthly payment of $50.00.4. 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 (EPBH, The Miriam Hospital, Rhode Island 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. Part I, Line 7 - Explanation of Costing Methodology EPBH'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 per 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.e) Community health improvement services and community benefit operations- Community benefit operations expense is recorded as direct expenses incurred as reported by EPBH'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 EPBH. g) Subsidized health services- Subsidized health services' community benefit expense is determined by EPBH's internally developed allocation model based on the general ledger whereby overhead costs are applied to all direct care departments using a historically determined basis. This expense is adjusted to remove all related 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.h) Research- EPBH conducts extensive medical research focused on child and adolescent mental health concerns and brain science. For all internal and external research conducted, the costs associated with these activities are calculated by combining the direct and indirect costs as calculated by EPBH's internally derived methodology. 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 EPBH, including an allocation of contributions made by Lifespan Corporation on EPBH'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 $390,448. 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 EPBH'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 EPBH's Patient Financial Advocate staff to determine qualification for financial assistance under EPBH'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. During the year ended September 30, 2021, there was no bad debt attributable to patients whose eligibility for financial assistance could not be determined. 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. EPBHs 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 9b - Provisions On Collection Practices For Qualified Patients EPBH 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 bad debts. EPBH 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.EPBH 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, primarily Medicaid. Uninsured patients are offered Community Free Service and/or payment plan options.Lifespan's Patient Financial Services Department (PFS) has the responsibility for 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.* 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.* If the third-party carrier denies in writing any responsibility for payment, arrangements regarding an extended payment plan are discussed with the patient's guardian. Part VI, Line 2 - Needs Assessment EPBH is the nation's first children's psychiatric hospital, providing services for children and adolescents not only from Rhode Island, but also from all over the country. EPBH is designated as a major teaching affiliate for The Warren Alpert Medical School of Brown University, with a focus in areas of child and adolescent psychiatric treatment.In recent years, EPBH has increased the number of physicians on staff in response to a heightened demand for outpatient services.As a psychiatric and behavioral health center, EPBH offers specialized services for children and adolescents. Such care begins with an evaluation designed to meet the unique needs of each child and family. This initial assessment provides an understanding of the problem, identifies the child's needs, and determines the best and least restrictive treatment approach. Once a child is admitted, a treatment plan is tailored to the child's needs.EPBH actively participates with community mental health centers and the Rhode Island Department of Health to understand the mental health needs of children and families in Rhode Island and its surrounding communities. EPBH is also a participant in Kids Count", which is a publicly funded agency that uses questionnaires with pediatricians, schools, and other providers to identify the mental health needs of the population that it serves. In addition, EPBH staff work collaboratively with administration and staff at various schools throughout the State of Rhode Island. There is a multidisciplinary team at each school site, led by a clinical psychologist. This team guides the treatment and education plan for each student. Each classroom is staffed by a teacher certified in special education and a classroom behavior specialist, both professionals with degrees in their fields.EPBH respects the roles of parents/guardians as partners in their child's care. EPBH's Family Liaison Program helps parents with questions, problems, or special concerns regarding their child's treatment by appointment or via telephone. The Family Liaison Program sponsors support groups and educational meetings on a regular schedule. Notices are posted in EPBH's main lobby, outpatient waiting room, and at the various unit entrances.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. Part VI, Line 3 - Patient Education of Eligibility for Assistance EPBH provides each patient with a "Patient and Family Information" booklet which includes information on patient rights and responsibilities. There is also multilingual signage in EPBH's main lobby and waiting area which provides information on financial aid contacts. The Registration Department meets with the patient's family at the outset of care to discuss eligibility for assistance, which is also summarized on EPBH's website. Part VI, Line 4 - Community Information EPBH, whose primary location is in East Providence, Rhode Island, is a 70-bed, nonprofit teaching hospital with university affiliation providing for the psychiatric treatment of adolescents and children, including some with severe developmental disabilities. EPBH operates several major programs including acute, partial hospitalization, residential, and outpatient. EPBH also operates five other secondary sites which furnish residential and research services. EPBH is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). EPBH currently participates as a provider in Rhode Island Medicaid, various out-of-state Medicaid programs, and the State of Rhode Island's Department of Children, Youth and Families programs, as well as providing care for patients covered by private health insurers. EPBH 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, EPBH 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). In 2010, Brown named Rhode Island Hospital its Principal Teaching Hospital. EPBH and The Miriam Hospital continue to be designated as major teaching affiliates. The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically. EPBH participates in the Child and Adolescent Psychiatry Fellowship as well as the Triple Board Residency Program (Pediatrics/Psychiatry/Child and Adolescent Psychiatry).EPBH has a diverse service area which is not defined solely by a contiguous geographic grouping of municipalities. The combined service area of EPBH includes all of the cities and towns in Rhode Island and the neighboring states of New England. EPBH, which receives referrals from all regions of the United States, has established itself as the national center for training and research in child and adolescent psychiatry. Part VI, Line 5 - Promotion of Community Health EPBH is governed by a Board of Trustees, which is composed of leaders of the local community elected by Lifespan Corporation. EPBH's purpose is to be staffed, equipped, and ready to serve the pediatric health needs of the community and its people from all walks of life. EPBH 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. EPBH monitors the healthcare needs of its service area to ensure alignment of its resources with its mission. EPBH 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 EPBH. EPBH 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 2021 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, Rhode Island Hospital (RIH), The Miriam Hospital (TMH), and Emma Pendleton Bradley Hospital (EPBH), are teaching affiliates of The Warren Alpert Medical School of Brown University, with 79 percent of the residents and fellows in this program based at RIH, TMH, and EPBH.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, 2021, 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 EPBH 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 EPBH 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 7a: The website which makes EPBH's CHNA report widely available is located at the following URL:https://www.lifespan.org/sites/default/files/lifespan-files/documents/centers/lifespan-community-health/9-30-2019-EPBH-CHNA.pdfForm 990, Schedule H, Part V, Line 10a: The URL to view EPBH's most recently adopted implementation strategy is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/EPBH-CHNA-Implementation-Plan.pdfForm 990, Schedule H, Part V, Line 16a: The URL to view and download EPBH's Financial Assistance Policy form is below:https://www.lifespan.org/sites/default/files/2021-11/FAP-eng_10-1-21-2.pdfForm 990, Schedule H, Part V, Line 16b: The URL to view and download EPBH'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 EPBH's plain language summary of the Financial Assistance Policy is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/Lifespan-Financial-Assistance-Summary_052020.pdf X true true X X X X X true true false false false false false true false Daniel J Wall Fmr. President 181776 181776 Henry T Sachs III MD Pres. & CMO 327035 78579 49998 74533 27280 557425 33885 Karyn J Horowitz MD Chief Medical Officer 109204 41879 551 17100 29461 198195 Margaret R Paccione-Dyslewski PHD Dir. Behav. Ed. 155518 14598 4184 10278 21356 205934 Mary A Carskadon PhD Physician 165236 14663 4498 10759 11563 206719 Mary A Wakefield Treas.- 6/21 730104 223806 153375 173498 19306 1300089 112130 Mary Sullivan Chief Nursing Officer 171443 27298 1130 12034 28398 240303 Paul J Adler Secretary 494175 125112 99153 99723 27349 845512 63837 Raymond Bastow Nurse Supervisor 130438 14455 650 8492 11229 165264 Shelley Grant Dir. Nursing 133784 12205 675 8583 538 155785 Stephanie H D'Atri Dir. Early Child. 138511 12900 152 9309 28289 189161 Timothy J Babineau MD Trustee 1328621 768085 475306 1292096 31977 3896085 371011 Vareen Domaleski RN Fmr. Chief Nursing Officer 203748 203748 Ziya L Gokaslan MD Trustee 1421018 146400 7524 17100 33106 1625148 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. A RIHEBC Series 2016 521300173 762244FP1 2016-08-11 24032741 Refund 2009 Bond false false true A 1054950 24032741 176876 23855865 2016 true true true true A false false false true true false false true A false true false false false false false true A false Part VI 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 EPBH, Rhode Island Hospital, The Miriam 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 EPBH is $24,032,741. For purposes of EPBH, the 2016 issuance resulted in the complete refinancing of its RIHEBC Series 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 EPBH is part of the Lifespan Obligated Group previously mentioned in Part I, line A(f). Of the $308,112,067 disclosed in Form 8038, EPBH was allocated $24,032,741 of the total issuance. Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Timothy J. Babineau, MD, Lifespan President & CEO, and David A. Kirshner, Lifespan Treasurer/EVP/CFO, are board members of VNA Technicare, Inc. (VNA), a related for-profit corporation. Dr. Babineau is a director and Mr. Kirshner is an officer of VNA. Additionally, Mr. Kirshner and Paul J. Adler, Lifespan Secretary, are board members of Lifespan MSO, Inc. (MSO) and Lifespan Risk Services, Inc. (LRS), separate related for-profit organizations. Mr. Adler is a director of MSO and LRS while Mr. Kirshner is an officer of those two organizations.Lawrence A. Aubin, Sr., Chairman, and Michael L. Hanna, Trustee, are partners in the same for-profit organization. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Lifespan is the sole member of EPBH. 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 Rhode Island Hospital, The Miriam Hospital, Newport Health Care Corporation, Newport Hospital, and EPBH approved a restructuring of their governance. Effective July 1, 2013, 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 and CEO of Lifespan, who serves ex-officio with vote.Additionally, the bylaws of EPBH 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 EPBH trustees and to approve the election or removal of certain officers. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The EPBH 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 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, along with a video presentation detailing form highlights, are posted to EPBH's Board of Trustees' website portal in advance of the next Board meeting, at which 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 EPBH, Rhode Island Hospital, The Miriam 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 EPBH'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 Increases Change in Funded Status of Pension Plan = $1092600 Other Changes In Net Assets Or Fund Balances - Other Increases Net Change in Foundation Assets = $341754 Form 990, Part III, Line 4a: EPBH provides inpatient treatment for children ages 2 to 18 years suffering from serious behavioral disorders and/or developmental conditions such as mental retardation or autism who are in need of stabilization, assessment, and treatment for suicidal, destructive, self-injurious, or other dangerous or aggressive behaviors.Residential treatment provides intensive, family-centered services to children with emotional and behavioral problems which prevent them from living safely at home.EPBH's partial programs furnish treatment alternatives to inpatient hospitalization or traditional outpatient services for children from infancy to adolescence with serious emotional, behavioral, eating, sleeping, anxiety, or obsessive-compulsive disorders, as well as relationship problems or a wide variety of other mental health issues co-occuring with substance use issues.The Center for Autism and Developmental Disabilities (CADD) has a highly specialized day program for children and adolescents who have autism or developmental disabilities with coexisting emotional and/or behavioral disorders. Form 990, Part III, Line 4c: Home-based intensive behavioral treatment is for children who have been diagnosed with Autism Spectrum Disorder (ASD) or have varying degrees of chronic behavior disorders that, if left untreated, would worsen and require more intensive treatment, including psychiatric hospitalization or out-of-home residential placement. Staff members visit a family's home and deliver clinical services to the child on a one-on-one basis. The treatment plan is family-oriented, as it includes all family members in the treatment process. The Mindful Teen Program, a six-month outpatient treatment program for adolescents who display signs of suicidality, nonsuicidal self-injury, or other self-destructive behaviors, offers dialectical behavior therapy for adolescents (DBT-A), an empirically validated treatment designed to help eliminate life-threatening and self-destructive behaviors by developing alternative skills to manage emotions and tolerate distress.EPBH also offers a hospital diversion program to children and adolescents with mental retardation. Those admitted to this home-based program present with chronic mild to moderate behavior disorders that, if left untreated, would worsen and require more intensive treatment, including hospitalization or residential placement. This service, which is also a resource for children recently discharged from EPBH, is used as a preventive measure against the future need for an out-of-home placement.EPBH's outpatient treatment programs are administered by a multidisciplinary staff of psychiatrists, psychologists, nurses, and qualified trainees, who provide comprehensive mental health evaluation and treatment to children, adolescents, and families for a wide range of clinical conditions. Patients may be treated with a variety of modalities including individual, group and family therapy, and psychopharmacologic management. Treatment is often coordinated with other agencies such as mental health centers, schools, or community-based organizations. 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 2021, 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. Form 990, Part VI, Section B, Line 12c: Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including EPBH, 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 EPBH: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 through acceptance of a reasonable compensation offer. 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