THE MIRIAM HOSPITAL: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- THE MIRIAM HOSPITAL (EIN 05-0258905)
- Tax period
- 2019-10-01 to 2020-09-30
- Filed
- 2021-08-13
- IRS object ID
- 202102259349302455
- Schema version
- 2019v5.0
- 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 | 2021-08-13T12:04:17-07:00 | ReturnTs |
| Tax Period End | 2020-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-10-01 | 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 | Mary A Wakefield | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Signature | 2021-08-13 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Maria P Ducharme | PrincipalOfficerNm |
| Gross Receipts | $654,470,762 | 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 | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 4135 | TotalEmployeeCnt |
| Total Volunteers | 459 | TotalVolunteersCnt |
| Total Gross UBI | $1,084,776 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$6,643 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,174,512 | PYContributionsGrantsAmt |
| CY Contributions Grants | $36,338,691 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $503,366,987 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $469,468,009 | CYProgramServiceRevenueAmt |
| PY Investment Income | $9,286,604 | PYInvestmentIncomeAmt |
| CY Investment Income | $9,545,039 | CYInvestmentIncomeAmt |
| PY Other Revenue | $24,289,663 | PYOtherRevenueAmt |
| CY Other Revenue | $19,681,439 | CYOtherRevenueAmt |
| PY Total Revenue | $540,117,766 | PYTotalRevenueAmt |
| CY Total Revenue | $535,033,178 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $279,915 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $259,857 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $240,435,661 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $240,418,904 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $275,889,328 | PYOtherExpensesAmt |
| CY Other Expenses | $281,671,314 | CYOtherExpensesAmt |
| PY Total Expenses | $516,604,904 | PYTotalExpensesAmt |
| CY Total Expenses | $522,350,075 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $23,512,862 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $12,683,103 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $503,803,275 | TotalAssetsBOYAmt |
| Total Assets EOY | $610,276,986 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $137,082,511 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $222,493,827 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $366,720,764 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $387,783,159 | 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 | $392,442,213 | ExpenseAmt |
| Grant | $259,857 | GrantAmt |
| Revenue | $455,656,677 | 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 | $30,914,653 | ExpenseAmt |
| Revenue | $27,364,653 | RevenueAmt |
| Desc | Research:TMH has 408 research projects with total expenses of $30.9 million in fiscal year 2020 (75 investigators and 130 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 73% 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 $1.95 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 | $20,473,104 | ExpenseAmt |
| Revenue | $4,412,405 | 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 $16.1 million in fiscal year 2020. (Continued on Schedule O). | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $443,829,970 | 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 | Yes (true) | 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 | 206 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 4135 | 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 | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | 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 | Mary A Wakefield | PersonNm |
| Phone | 4014447093 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 593 Eddy 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 (29 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 | 8.00 | 40.00 | Yes (X) | $0 | $1,761,978 | $1,423,050 | |
| Ziya L Gokaslan MD | |||||||
| Trustee | 0.50 | 43.50 | Yes (X) | $0 | $1,494,856 | $57,956 | |
| Mary A Wakefield | |||||||
| Treasurer | 5.70 | 34.30 | $0 | $870,016 | $242,111 | Yes (X) | |
| Paul J Adler | |||||||
| Secretary | 5.00 | 35.00 | $0 | $559,976 | $126,299 | Yes (X) | |
| Arthur J Sampson | |||||||
| President | 31.00 | 9.00 | $0 | $547,435 | $36,992 | Yes (X) | |
| G Dean Roye MD | |||||||
| Chief Medical Officer | 40.00 | 0.00 | $422,069 | $0 | $102,191 | ||
| Michael P Carey MD | |||||||
| Physician | 40.00 | 0.00 | $386,051 | $0 | $41,050 | ||
| Maria P Ducharme | |||||||
| Chief Nursing Officer | 40.00 | 0.00 | $307,791 | $0 | $85,647 | ||
| Rogers C Griffith MD | |||||||
| Physician | 40.00 | 0.00 | $312,252 | $0 | $44,253 | ||
| Joseph D Sweeney MD | |||||||
| Physician | 40.00 | 0.00 | $305,517 | $0 | $42,804 | ||
| Rena R Wing MD | |||||||
| Physician | 40.00 | 0.00 | $306,965 | $0 | $30,055 | ||
| Eirini Apostolidou MD | |||||||
| Physician | 40.00 | 0.00 | $304,702 | $0 | $22,129 | ||
| Lawrence A Aubin Sr | |||||||
| Chair | 1.00 | 15.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Emanuel Barrows | |||||||
| Trustee | 0.60 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| Roger N Begin | |||||||
| Trustee | 0.25 | 5.75 | Yes (X) | $0 | $0 | $0 | |
| Peter Capodilupo | |||||||
| Vice Chair | 0.20 | 3.70 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Sarah T Dowling JD LLM | |||||||
| Trustee | 0.25 | 4.75 | Yes (X) | $0 | $0 | $0 | |
| Jonathan D Fain | |||||||
| Trustee | 0.25 | 1.50 | Yes (X) | $0 | $0 | $0 | |
| Edward D Feldstein Esq | |||||||
| Trustee | 1.00 | 10.50 | Yes (X) | $0 | $0 | $0 | |
| Michael L Hanna | |||||||
| Trustee | 2.00 | 5.50 | Yes (X) | $0 | $0 | $0 | |
| Pamela A Harrop MD | |||||||
| Trustee- 10/19 | 0.25 | 2.25 | Yes (X) | $0 | $0 | $0 | |
| Phillip Kydd | |||||||
| Trustee | 0.50 | 2.50 | Yes (X) | $0 | $0 | $0 | |
| Alan H Litwin | |||||||
| Vice Chair | 1.00 | 9.10 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Martha B Mainiero MD | |||||||
| Trustee | 0.25 | 3.25 | Yes (X) | $0 | $0 | $0 | |
| Joseph J MarcAurele | |||||||
| Trustee- 10/19 | 0.25 | 2.50 | Yes (X) | $0 | $0 | $0 | |
| Steven Pare | |||||||
| Trustee | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | |
| Lawrence B Sadwin | |||||||
| Trustee | 1.00 | 11.70 | Yes (X) | $0 | $0 | $0 | |
| Shivan Subramaniam | |||||||
| Trustee | 0.25 | 5.25 | Yes (X) | $0 | $0 | $0 | |
| Jane Williams PhD RN | |||||||
| Trustee | 0.20 | 3.60 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,345,347 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,234,261 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,254,537 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 228 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | 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 | $7,111,559 |
| University Surgical Associates Inc | |||||
| PO Box 16149 | Rumford | RI | 02916 | Medical Services | $3,697,186 |
| Sodexo Inc | |||||
| 9801 Washingtonian Blvd | Gaithersburg | MD | 20878 | Dietary / Cafe Service | $2,939,960 |
| Quest Diagnostics Inc | |||||
| 500 Plaza Drive | Secaucus | NJ | 07094 | Lab Services | $2,593,295 |
| Brown Emergency Medicine | |||||
| 125 Whipple St 3rd | Providence | RI | 02908 | Medical Services | $2,583,456 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 33 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $3,362,144 | RelatedOrganizationsAmt |
| Government Grants | $32,941,006 | GovernmentGrantsAmt |
| All Other Contributions | $35,541 | AllOtherContributionsAmt |
| Noncash Contributions | $6,499 | NoncashContributionsAmt |
| Total Contributions | $36,338,691 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Direct Rev from Research | 900099 | $27,364,653 | $27,364,653 |
| Patient Service Rev | 900099 | $440,944,164 | $440,944,164 |
| Special Purpose Funds | 900099 | $1,159,192 | $1,159,192 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $469,468,009 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,126,812 | TotalRevenueColumnAmt |
| Exclusion | $6,126,812 | 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 | $2,801,043 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,170,106 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $630,937 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $630,937 | TotalRevenueColumnAmt |
| Exclusion | $630,937 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $120,685,705 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $117,267,478 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,418,227 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,418,227 | TotalRevenueColumnAmt |
| Exclusion | $3,418,227 | 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 | $4,432,569 | $4,432,569 |
| Joint Program Revenue | 900099 | $6,419,109 | $6,419,109 |
| Other Revenue | $3,624,095 | $3,624,095 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,574,729 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,489,953 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,084,776 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $19,050,502 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $535,033,178 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $487,433,735 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,084,776 | UnrelatedBusinessRevenueAmt |
| Exclusion | $10,175,976 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $259,857 | TotalAmt |
| Program Services | $259,857 | 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 | $860,713 | TotalAmt |
| Program Services | $860,713 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,996,250 | TotalAmt |
| Program Services | $181,373,132 | ProgramServicesAmt |
| Management And General | $7,623,118 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,143,848 | TotalAmt |
| Program Services | $10,694,818 | ProgramServicesAmt |
| Management And General | $449,030 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,909,756 | TotalAmt |
| Program Services | $25,931,781 | ProgramServicesAmt |
| Management And General | $977,975 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,508,337 | TotalAmt |
| Program Services | $12,005,875 | ProgramServicesAmt |
| Management And General | $502,462 | 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 | $256 | TotalAmt |
| Program Services | $256 | 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 | $955,429 | TotalAmt |
| Management And General | $955,429 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,511,364 | TotalAmt |
| Program Services | $27,127,093 | ProgramServicesAmt |
| Management And General | $384,271 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,307 | TotalAmt |
| Program Services | $106,632 | ProgramServicesAmt |
| Management And General | $9,675 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,064,826 | TotalAmt |
| Program Services | $33,470,325 | ProgramServicesAmt |
| Management And General | $2,594,501 | 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 | $15,446,168 | TotalAmt |
| Program Services | $13,619,756 | ProgramServicesAmt |
| Management And General | $1,826,412 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $437,469 | TotalAmt |
| Program Services | $437,460 | ProgramServicesAmt |
| Management And General | $9 | ManagementAndGeneralAmt |
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 | $266,824 | TotalAmt |
| Program Services | $266,824 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,422,948 | TotalAmt |
| Management And General | $1,422,948 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,382,969 | TotalAmt |
| Management And General | $19,382,969 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,475,798 | TotalAmt |
| Program Services | $5,475,798 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical & Surgical Supplies | $57,326,237 | $57,326,237 | |
| Purch Svs & Equip Contracts | $55,096,535 | $14,130,199 | $40,966,336 |
| License Fee | $25,924,198 | $25,924,198 | |
| Provision for Bad Debts | $19,464,003 | $19,464,003 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,779,983 | TotalAmt |
| Program Services | $15,355,013 | ProgramServicesAmt |
| Management And General | $1,424,970 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $522,350,075 | TotalAmt |
| Program Services | $443,829,970 | ProgramServicesAmt |
| Management And General | $78,520,105 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $486,823 | BOYAmt |
| EOY | $494,392 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,237,664 | BOYAmt |
| EOY | $101,174,155 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,662,641 | BOYAmt |
| EOY | $1,695,919 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,109,882 | BOYAmt |
| EOY | $44,201,465 | 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 | $5,820,820 | BOYAmt |
| EOY | $5,921,557 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,000,711 | BOYAmt |
| EOY | $4,155,199 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $440,619,064 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $267,085,917 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,883,436 | BOYAmt |
| EOY | $173,533,147 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,397,741 | BOYAmt |
| EOY | $153,265,057 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,048,044 | BOYAmt |
| EOY | $56,146,880 | 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 | $60,155,513 | BOYAmt |
| EOY | $69,689,215 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $503,803,275 | BOYAmt |
| EOY | $610,276,986 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,731,457 | BOYAmt |
| EOY | $47,098,600 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,823 | BOYAmt |
| EOY | $30,946,506 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,482,721 | BOYAmt |
| EOY | $44,368,896 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,755,452 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,065,058 | BOYAmt |
| EOY | $100,079,825 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,082,511 | BOYAmt |
| EOY | $222,493,827 | 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 | $315,876,031 | BOYAmt |
| EOY | $326,473,521 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,844,733 | BOYAmt |
| EOY | $61,309,638 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $366,720,764 | BOYAmt |
| EOY | $387,783,159 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $503,803,275 | BOYAmt |
| EOY | $610,276,986 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $12,683,103 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $7,941,202 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $438,090 | 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| 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 | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $256 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $256 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1i - Other Activities Description | FormAndLineReferenceDesc |
| Explanation | TMH pays membership fees to the American College of Surgeons. A portion of the membership dues paid to this organization is allocated to its lobbying efforts. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| 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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| 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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| 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 |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $130,155,405 | BeginningYearBalanceAmt |
| Contributions | $41,953,120 | ContributionsAmt |
| Investment Earnings Or Losses | $13,531,256 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $24,489,813 | OtherExpendituresAmt |
| End Year Balance | $161,149,968 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $122,853,669 | BeginningYearBalanceAmt |
| Contributions | $26,598,596 | ContributionsAmt |
| Investment Earnings Or Losses | $6,425,189 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $25,722,049 | OtherExpendituresAmt |
| End Year Balance | $130,155,405 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.86020 | BoardDesignatedBalanceEOYPct |
| Term Endowment Balance EOY | 0.13980 | 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 | $5,125,675 | OtherCostOrOtherBasisAmt |
| Book Value | $5,125,675 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $245,720,332 | OtherCostOrOtherBasisAmt |
| Depreciation | $134,310,770 | DepreciationAmt |
| Book Value | $111,409,562 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $184,517,742 | OtherCostOrOtherBasisAmt |
| Depreciation | $132,775,147 | DepreciationAmt |
| Book Value | $51,742,595 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,255,315 | OtherCostOrOtherBasisAmt |
| Book Value | $5,255,315 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $173,533,147 | TotalBookValueLandBuildingsAmt |
| Total Book Value Securities | $56,146,880 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Deferred financing costs | $272,974 |
| Interest in net assets of TMH Foundation | $60,257,720 |
| Other assets | $3,927 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $69,689,215 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| Accrued pension liability | $30,978,800 |
| CARES Act-Deferred FICA taxes | $4,929,768 |
| Due to affiliates | $3,369,412 |
| Health Care Benefit Self-insurance | $3,303,262 |
| Other Liabilities | $960,184 |
| Post-retirement benefit liability | $161,500 |
| Third-party payor settlements | $56,376,899 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $100,079,825 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $526,004,781 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $7,941,202 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $438,090 | OtherRevenueAmt |
| Revenue Not Reported | $8,379,292 | RevenueNotReportedAmt |
| Revenue Subtotal | $517,625,489 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $955,429 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $16,452,260 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $17,407,689 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $535,033,178 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $504,942,386 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $2,170,106 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $2,170,106 | ExpensesNotReportedAmt |
| Expenses Subtotal | $502,772,280 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $955,429 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $18,622,366 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $19,577,795 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $522,350,075 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 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) clinical care, research, and education to develop treatment for pelvic floor disorders; (3) staff facilitating patient access to treatment of sexually transmitted infections; (4) lab training for Immunology staff; (5) genitourinary reconstruction at the Department of Urology; (6) the Department of Psychiatry's operations, education, research, and capital needs; (7) the advancement of patient care in Cardiology; (8) research and program development for genitourinary cancer care; (9) the Surgery Department's educational and investigational functions; (10) the Palliative Care Program for cancer patients; (11) support of Cardiology labs and programs; (12) the expansion of the Colorectal Cancer Program; (13) the expansion of TMH's plastic surgery service line; (14) the treatment and prevention of cancer; and (15) support for equipment needs at TMH's Women's Association. |
| 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 2020 or 2019. |
| Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990 | Plant Donated Equipment $6499 Change in Funded Status of Pension Plan $-1860516 Increase Interest in Net Assets of TMHF $2292107 |
| Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S | Non-UBI debt-financed rental expenses $-5750 Non-debt-financed rental expenses $-2164356 Provision for bad debts $18622366 |
| Part XII, Line 2d: Other expenses and losses per audited F/S | Non-debt-financed rental expenses $2164356 Non-UBI debt-financed rental expenses $5750 |
| Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S | $0 $0 Provision for bad debts $18622366 |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Account Activities Outside US AccountActivitiesOutsideUSGrp (5 entries)
| RegionRegionTxt | OfficesOfficesCnt | EmployeeEmployeeCnt | Type Of Activities ConductedTypeOfActivitiesConductedTxt | Specific Services ProvidedSpecificServicesProvidedTxt | Region Total ExpendituresRegionTotalExpendituresAmt |
|---|---|---|---|---|---|
| Sub-Saharan Africa | 0 | 0 | Program Services | Research | $202,392 |
| Central America and Caribbean | 0 | 0 | Program Services | Research | $6,814 |
| Europe | 0 | 0 | Program Services | Research | $6,313 |
| Russia & Newly Independ States | 0 | 0 | Program Services | Research | $3,899 |
| Middle East and North Africa | 0 | 0 | Program Services | Research | $3,160 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Spent | $222,578 | SubtotalSpentAmt |
| Total Spent | $222,578 | 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 | $9,769,090 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,596,237 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,172,853 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01630 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $91,532,913 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $70,594,520 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,938,393 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04160 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $101,302,003 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $72,190,757 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $29,111,246 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05790 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $237,271 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,040 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $223,232 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,473,104 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,412,405 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,060,699 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03190 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,512,426 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,301,341 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,211,085 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02230 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,964,984 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $25,414,984 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,550,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00710 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $131,988 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $131,988 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $71,319,773 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $40,142,770 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $31,177,004 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06200 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $172,621,776 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $112,333,527 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $60,288,250 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11990 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,023,756 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $282,222 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $90,974,105 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $85,279,159 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $5,694,946 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 19 | 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 | 19 | 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 (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Facility: - Part V, Section B, Line 3j | Part V, Line 3e:In January 2020, the Secretary of HHS declared a national public health emergency due to a novel strain of coronavirus (COVID-19) and in March 2020, the World Health Organization announced the spread of the virus to be a pandemic. Also, in coordination with State of Rhode Island health authorities, in March 2020 TMH initiated emergency measures, expanded critical care bed capacity, acquired personal protective equipment, expanded testing capabilities, and created a redeployment process for clinical and non-clinical staff to work in areas where the need was most urgent.The Lifespan Alternative Hospital Site (the Site), was constructed within the Rhode Island Convention Center in Providence, Rhode Island in response to the anticipated need for surge capacity during the COVID-19 Pandemic.In partnership with the State, including the Governors office, the Rhode Island Department of Health, and the Rhode Island National Guard, Lifespan leadership brought to fruition a 600-bed facility under RIH's license with a full complement of hospital-level care capabilities.In a matter of weeks, the group engineered and executed a complex construction project, including negative pressure ventilation, electrical service throughout the cavernous space, walls erected to mimic the corridors and curtains of a hospital, and finishing touches like walkways named for familiar streets throughout the States communities.Completed in April 2020, the Site stood at the ready through the first peak of COVID-19 cases in Rhode Island, but was not operationalized until the second peak, in the fall of 2020. On December 1, 2020, the Site welcomed its first patients, caring for 516 patients over twelve weeks. In this second wave, in contrast to the first, the Site played an important role in enabling the Lifespan Hospitals to continue normal operations, serving the everyday health care needs of their patients, despite the Pandemic.The Site's presence decompressed busy emergency departments and allowed COVID patients meeting certain criteria to be cared for in its dedicated COVID-only warm space, reserving more hospital beds for their usual purposes.While fortunately the Site never neared its massive capacity, it served between 30 and 40 inpatients on most days, a significant relief to the stressed hospitals. The dedicated corps of Site staff included those who stepped up from all corners of the Lifespan organization. Physicians, nurses, respiratory therapists, nursing assistants, social workers, pharmacists, phlebotomists, EMS personnel, food service staff, environmental services specialists, chaplains and others put in countless hours of service, many of them beyond their ordinary working hours. As of September 30, 2020, 1,462 COVID-19 positive patients were discharged from Lifespan hospitals since the system accepted its first patient on February 17, 2020.Lifespan is working in partnership with the Rhode Island Department of Health (RIDOH) to ensure that the COVID-19 vaccine is offered to all eligible patients and in all the communities we serve. TMH is following RIDOH guidance on vaccine eligibility, depending on age and underlying health conditions. Regarding the significant needs that were identified in TMH's 9/30/2019 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: - 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.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 TMH 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 April 30 and June 21, 2019 across the TMH service area. Participants were recruited using social media, posted fliers, 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. TMH forums were held at community centers, places of worship, a high school, a homeless shelter, local non-profit agencies, and TMH. 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 TMH served as a hospital liaison to help plan and facilitate the CHFs. 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 CHFs was the involvement of Community Liaisons. Three people representing the diverse populations served by TMH 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 TMH and the Community Liaison. The discussion generated consensus on the participants health concerns, their prioritization of those concerns, and their ideas for how TMH could respond to those concerns. Discussion began with a brief presentation of TMHs 2016 CHNA priorities and examples of activities TMH 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 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, 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. Six individual surveys were received for TMH.Key Informant Interviews:The director of the LCHI identified public health and health policy leaders who could inform the 2019 CHNA process and had knowledge, information, or expertise about the community that TMH serves. Key informant interviews were conducted with state leaders to supplement the other quantitative and qualitative data collected. Key informants included 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 TMH implementation strategy, TMH 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:-IBG Studios, 199 Camp Street, Providence, RI 02906;-Pregreso Latino, 626 Broad Street, Central Falls, RI 02863;-Pawtucket YMCA, 20 Summer Street, Pawtucket, RI 02860;-The Jewish Alliance, 401 Elmgrove Avenue, Providence, RI 02906;-East Side Apartments, 83 Doyle Avenue, Providence, RI 02906; and-Hurvitz Conference Room, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906. |
| Facility: - Part V, Section B, Line 6a | Rhode Island HospitalEmma Pendleton Bradley HospitalNewport Hospital |
| Facility: - Part V, Section B, Line 11 | TMH's Community Health Needs Assessment issued for the fiscal year ended September 30, 2019 identified five significant health issue areas requiring a further implementation strategy. Those significant health issue areas include: (1) access to care; (2) healthy weight and nutrition; (3) cancer; (4) community-based education and outreach; (5) and mental and behavioral health. 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/TMH-CHNA-Implementation-Plan.pdfDuring the fiscal year ended September 30, 2020, TMH 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 care:- During the fiscal year ended September 30, 2020, TMH's Cardiac and Pulmonary Rehabilitation (CPR) program managed by the Lifespan Cardiovascular Institute (CVI) created a virtual/hybrid Cardiac and Pulmonary Rehab platform in conjunction with an organization called Chanl Health. This platform is staffed by the CVI and increases the enrollment of non-captured patients. It also increases utilization of CPR services, which improves a patient's clinical, psychosocial, and quality of life outcomes;-CPR also began implementing a "Home-Based Plan of Care" while the CVI locations at TMH, Rhode Island Hospital, and Newport Hospital were closed for eight weeks during FY '20 due to measures taken as a result of the COVID-19 Pandemic;-In conjunction with Lifespan's Communications and Marketing Department, TMH created a YouTube channel for improved access to exercise, meditation, and nutritional options for patients. This feature allows patients to improve adherence to healthier lives and provides them with increased flexibility to exhibit healthy living practices;-TMH and RIH began working with Nationwide Transportation to coordinate the transportation to/from rehabilitation appointments for individuals who do not drive. This partnership has allowed for increased access to cardiac rehab programs and services.-In coordination with the hospital affiliates, the Lifespan PhysicianGroup, Inc. (LPG) will actively recruit primary care physicians, medicalspecialists, and advanced practice providers to fill vacancies and matchcommunity needs: During fiscal year 2020 LPG hired more than 30 full time providers to fulfill various vacancies within primary care and other specialties.-In coordination with LPG, explore new models of care delivery with afocus on primary care and lowest cost: During FY '20 LPG continued to explore new models of care delivery, including traveling to visit innovative primary locations in areas outside of our service region. We are further evaluating the feasibility of such a practice in our area.-Implementation and expansion of technology in interpreterservices, including Interpreter on Wheels. Where appropriate,interpreter services will be made available using laptops and otherelectronic devices: TMH has expanded the use of Video Remote Interpreting (VRI), also known as "Interpreter on Wheels", by deploying 20 VRI machines which provide language interpretation in over 200 languages, including American Sign Language, Spanish, and Portuguese. All together Lifespan as a health system has deployed over 120 VRI machines to its various affiliates during FY '20.Significant Health Need #2- Healthy weight and nutrition:-The Center for Weight & Wellness (CWW) converted to a virtual program at the onset of the Pandemic, with all in-person groups and fitness classes having been temporarily discontinued during the Pandemic. These groups and classes will be re-established once in-person groups are able to resume. The Weight and Wellness Academies were offered prior to COVID-19. They include topics related to meal prep, stress management, skill building, and embracing the new you post-weight loss. CWWs first venture to deliver on-site weight and wellness programs to employees has been successful. Feedback was positive from both the employer and employees who engaged in the program. Program leadership continues to meet with other interested businesses to develop on-site and wellness programs for employees. Significant health need #3- Cancer: -Implementation of a colorectal multidisciplinary clinic at TMH: During FY '20 TMH opened a colorectal cancer multidisciplinary clinic within its Norman & Rosalie Fain Health Centers. TMH's colorectal specialists work in collaboration with the multidisciplinary care teams at the Lifespan Cancer Institute. As dedicated clinical researchers with national recognition, they seek to develop pioneering breakthrough treatments for colon and related cancers through ongoing clinical trials that are accessible to all qualified patients. Significant health need #4- Community-based education and outreach:- Lifespan Community Health Institute (LCHI) held 23 Diabetes Prevention Program (DPP) sessions during FY '20. DPP started with 20 participants and ended with 7 who completed the program on 7/27/20. LCHI also ran a DPP cohort in partnership with the RIH Center for Primary Care in FY '20. That class also had 23 sessions. 18 participants started and 3 finished by the end of FY '20. LCHI opened The Transitions Clinic (TTC) in FY '20. TTC is a primary care clinic with wrap-around supports, including community health workers for patients who have multiple chronic conditions and were released by the State of Rhode Island Department of Corrections in the previous year. TCC at RIH served 118 patients in FY '20. LCHI also offered a free community lecture series during FY '20 available to the public which included a Financial Literacy course, two "Food is Medicine" series (4 week sessions), 10 cooking demonstrations to almost 100 participants, 18 Safe Sitter lectures (136 participants) and 9 events on becoming a Lifespan Community Health Ambassador to promote health in the community (131 participants).Significant health need #5- Mental and behavioral health:-The Buprenorphine (Suboxone) Induction Hotline, a Rhode Island Department of Health-funded outreach project, went live on April 13, 2020. The project offers emergency/urgent suboxone induction and bridge prescriptions over the phone, until the patient is scheduled with an appointment at the Lifespan Recovery Center (LRC). The on-call Buprenorphine Induction Hotline is staffed by several TMH ED doctors consisting of emergency medicine, medical toxicology, internal medicine, and addiction medicine trained physicians. The goal is harm reduction by reducing the risk of overdose through street drug use or unsupervised withdrawal. The LRC clinicians also provide consultation with community providers in Providence to increase awareness and educate medical professionals about the availability and effectiveness of treatment.-Lifespan providers have been involved in several social media pieces to describe the nature of substance use disorders and the availability of treatment in order to educate the public and reduce stigma. The LRC recently hired a full-time social worker. The goal of this position is to ensure that patients' full spectrum of biopsychosocial needs are being met, with an emphasis on addressing social determinants of health that may negatively impact the ability to engage in treatment.-In response to the COVID-19 Pandemic, the LRC has been offering telehealth appointments to patients, which has improved access to care. For patients with certain hardships, TMH has provided Kindle Fires in order to engage in virtual appointments.The Lifespan Psychiatry and Behavioral Health Access Center continues to provide a streamlined way to make an appointment or be referred to the appropriate resource for all adult outpatient programs for mental, emotional, and behavioral health issues. We expanded our capabilities to provide a Telehealth Technical Support Line (TTSL). As TMH continued to build its telehealth capabilities this past year, TMH recognized the need to have technical support readily available to patients during the day, evening, and weekend hours. Researchers across Lifespan are committed to advancing the science and practice of the treatment of substance use disorders. Recent grant submissions have included investigating the role of mobile peer support for Opioid Use Disorder, evaluating changes to buprenorphine treatment in the context of COVID-19, and feasibility/acceptability/safety of completing buprenorphine inductions through pharmacy-based care.-Same day appointments for urgent evaluations are available at RIH's/TMH's East Providence and East Greenwich Outpatient Programs. In addition, on 5/3/2021 RIH/TMH will go live with their inpatient bridge clinic. Through this bridge clinic, patients being discharged from the RIH and NH psychiatric inpatient units will be sche |
| Facility: - 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. |
| Facility: - Part V, Section B, Line 22d | TMH uses the prospective method in determining amounts generally billed. Internal Revenue Code Section 501(r) defines the prospective method as the amount Medicare would reimburse TMH for billed care (including both the amount that would be reimbursed by Medicare and the amount the beneficiary would be personally responsible for paying in the form of copayments, coinsurance, and deductibles) if the patient was a Medicare fee-for-service beneficiary. |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (25 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 |
| 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 |
| Cardiovascular Institute | ||||
| 208 Collyer Street Suites 100 102 | Providence | RI | 02904 | Outpatient Cardiac Clinic |
| Cardiovascular Institute | ||||
| 1454 South County Trail Suite 2000 | East Greenwich | RI | 02818 | Outpatient Cardiac Clinic |
| TMH Weight Control & Diabetes Research | ||||
| 196 Richmond Street | Providence | RI | 02903 | Outpatient Research & Education |
| TMH Cardiac RehabPulmonary Rehab | ||||
| 208 Collyer Street | Providence | RI | 02904 | Outpatient Cardiac Clinic |
| Mens Health & Infectious Disease | ||||
| 180 Corliss Street Suites C E | Providence | RI | 02904 | Comprehensive Men's Outpatient Clinic |
| TMH Behavioral Medicine Research | ||||
| 1 Hoppin Street | Providence | RI | 02903 | Outpatient Research & Education |
| Intensive Cardiac Rehab Program | ||||
| 1454 South County Trail | East Greenwich | RI | 02818 | Outpatient Cardiac Clinic |
| TMH Laboratory | ||||
| 1 Hoppin Street | Providence | RI | 02903 | Phlebotomy Lab |
| TMH Laboratory | ||||
| 1 Commerce Street | Lincoln | RI | 02865 | Phlebotomy Lab |
| TMH Immunology Center | ||||
| 1125 North Main Street | Providence | RI | 02904 | Outpatient Clinic |
| TMH Outpatient Rehabilitation | ||||
| 195 Collyer Street | Providence | RI | 02904 | Outpatient PT, OT, and Speech Rehab |
| TMH Laboratory | ||||
| 1180 Hope Street Basement Floor | Bristol | RI | 02809 | Phlebotomy Lab |
| TMH Laboratory | ||||
| 400 Bald Hill Road | Warwick | RI | 02886 | Outpatient Clinic |
| Womens & Mens Health Rehabilitation Services | ||||
| 148 West River Street Suite 1D | Providence | RI | 02904 | Outpatient Rehab Clinic |
| Adult & Pediatric Rehabilitation Services | ||||
| 1 Commerce Street 2nd Floor | Lincoln | RI | 02865 | Outpatient Rehab Clinic |
| The Center for Weight & Wellness | ||||
| 1377 South County Trail | East Greenwich | RI | 02818 | Outpatient Clinic |
| RISE TB Clinic | ||||
| 14 Third Street | Providence | RI | 02906 | TB Clinic |
| East Providence Imaging | ||||
| 375 Wampanoag Trail Suite 101B | Riverside | RI | 02915 | Outpatient Diagnostic Imaging |
| Blackstone Valley Community Health Center | ||||
| 1000 Broad Street | Central Falls | RI | 02863 | Outpatient Rehab Clinic |
| TMH Behavioral Medicine Clinic | ||||
| 146 West River Street | Providence | RI | 02904 | Outpatient Clinic |
| TMH Pre-Admission Testing Center | ||||
| 208 Collyer Street Third Floor | Providence | RI | 02904 | Outpatient Pre-Admission Assessment & Education |
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, 2020 is available at the following link. https://issuu.com/lifespanmc/docs/ls-annual-report-2020-210527?fr=sYjZhOTM3NDAwMDAPlease see pages 5-17 and 39-40 of the Lifespan Annual Report for community benefit information. |
| 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 $19,464,003. |
| 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 2020. 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 16,000 people. The Lifespan system has approximately 3,700 physicians on the medical staffs of its affiliated hospitals, operates 1,165 licensed beds in four hospital complexes, and in 2020 generated approximately $2.5 billion in total operating revenue. By each of these measures, Lifespan is Rhode Island's largest health system, serving a population of over 1.0 million. Three of its hospital members, TMH, Rhode Island Hospital (RIH), 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 TMH, RIH, 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, 2020, 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/lifespan-files/documents/centers/lifespan-community-health/9-30-2019-TMH-CHNA.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/lifespan-files/documents/lifespan-main/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/lifespan-files/documents/lifespan-main/pfs/financial-assistance-policy-en_052020.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 (9 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 Street | Providence | RI | 02912 | 050258809 | 501(c)(3) | $165,334 | $0 | General Support |
| Community Health Innovations | ||||||||
| 250 Doyle Avenue | Providence | RI | 02906 | 833018929 | 501(c)(3) | $10,500 | $0 | General Support |
| Groundwork Providence | ||||||||
| 1005 Main Street | Pawtucket | RI | 02860 | 050397766 | 501(c)(3) | $10,500 | $0 | General Support |
| Jewish Alliance of Greater RI | ||||||||
| 401 Elmgrove Avenue | Providence | RI | 02906 | 274127671 | 501(c)(3) | $6,000 | $0 | General Support |
| Mt Hope Neighborhood Assoc | ||||||||
| 199 Camp Street | Providence | RI | 02906 | 222599257 | 501(c)(3) | $9,900 | $0 | General Support |
| Prov After School Alliance | ||||||||
| 81 Carpenter Street | Providence | RI | 02903 | 260319193 | 501(c)(3) | $10,000 | $0 | General Support |
| Summit Neighborhood Assn | ||||||||
| 25 Lauriston Street | Providence | RI | 02906 | 050465260 | 501(c)(3) | $5,873 | $0 | General Support |
| The Miriam HospitalFoundation | ||||||||
| 167 Point Street | Providence | RI | 02903 | 050377502 | 501(c)(3) | $25,000 | $0 | General Support |
| YMCA | ||||||||
| 438 Hope Street | Providence | RI | 02906 | 050258878 | 501(c)(3) | $10,500 | $0 | General Support |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 9 | 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 (12 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Arthur J Sampson | ||||||||||||||
| President | $450,709 | $96,726 | $16,800 | $20,192 | $584,427 | |||||||||
| Eirini Apostolidou MD | ||||||||||||||
| Physician | $272,102 | $32,100 | $500 | $9,201 | $12,928 | $326,831 | ||||||||
| G Dean Roye MD | ||||||||||||||
| Chief Medical Officer | $400,470 | $21,599 | $77,347 | $24,844 | $524,260 | |||||||||
| Joseph D Sweeney MD | ||||||||||||||
| Physician | $297,172 | $8,345 | $16,800 | $26,004 | $348,321 | |||||||||
| Maria P Ducharme | ||||||||||||||
| Chief Nursing Officer | $252,529 | $55,262 | $60,862 | $24,785 | $393,438 | $37,362 | ||||||||
| Mary A Wakefield | ||||||||||||||
| Treasurer | $725,836 | $144,180 | $222,120 | $19,991 | $1,112,127 | $105,275 | ||||||||
| Michael P Carey MD | ||||||||||||||
| Physician | $381,024 | $5,027 | $16,800 | $24,250 | $427,101 | |||||||||
| Paul J Adler | ||||||||||||||
| Secretary | $482,452 | $77,524 | $100,931 | $25,368 | $686,275 | $46,564 | ||||||||
| Rena R Wing MD | ||||||||||||||
| Physician | $298,523 | $8,442 | $16,800 | $13,255 | $337,020 | |||||||||
| Rogers C Griffith MD | ||||||||||||||
| Physician | $303,507 | $8,745 | $16,800 | $27,453 | $356,505 | |||||||||
| Timothy J Babineau MD | ||||||||||||||
| Trustee | $1,325,243 | $436,735 | $1,391,844 | $31,206 | $3,185,028 | $334,018 | ||||||||
| Ziya L Gokaslan MD | ||||||||||||||
| Trustee | $1,340,498 | $5,608 | $16,800 | $41,156 | $1,552,812 | $148,750 | ||||||||
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 | $2,382,800 | 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 (18 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | Timothy J. Babineau, MD, Lifespan President & CEO, and Mary A. Wakefield, Lifespan Treasurer/EVP/CFO, are board members of VNA Technicare, Inc. (VNA), a related for-profit corporation. Dr. Babineau is a director and Ms. Wakefield is an officer of VNA. Additionally, Ms. Wakefield 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 Ms. Wakefield is an officer of those two organizations. |
| 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, along with a video presentation detailing form highlights, are posted to TMH's Board of Trustees website portal in advance of its 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 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 | Change in funded status of pension and other postretirement = -$1860516 |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Increase in Interest in Net Assets of TMHF = $2292107 |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Plant Donated Equipment = $6499 |
| . | 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 2020, TMH discharged 16,996 inpatients, logged more than 67,000 visits in its Emergency Department, and performed 10,646 inpatient and outpatient surgical procedures. Services provided in 2020 represent 65,095 inpatient days and more than 139,000 clinic visits. TMH is staffed by 1,066 privileged physicians, approximately 77 full-time house staff (medical school graduates), and a nursing staff of 907. In total, TMH employs more than 3,300 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 $8,172,853 in fiscal 2020. Charges forgone, based on established rates, amounted to $23,839,880.TMH substantially subsidized various health services including the following programs: adult psychiatry, tuberculosis, and certain other specialty services at a net cost of $11,211,085 in fiscal year 2020. 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 $223,232 in fiscal year 2020.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, TMH has received numerous distinctions and awards. It is certified by the Joint Commission as a Primary Stroke Center, and was the first hospital in Rhode Island to be designated as such. The American Heart Association/American Stroke Association presented TMH, the "Get With the Guidelines - Stroke Gold Plus Quality Achievement Award" for 2020 by reaching an aggressive goal of treating patients with 85 percent or higher compliance to core standard levels of care outlined by the American Heart Assocation, as well as meeting seven out of ten stroke quality measures during the preceding twelve month period. TMH has been honored by the American Heart Association virtually every year for more than a decade.Through 2024, TMH is one of only a few hospitals nationwide to achieve its sixth consecutive Magnet designation for nursing excellence from the American Nurses Credentialing Center (ANCC). The Magnet status is a four-year designation and the highest nursing credential given, and is the leading source of successful nursing practice and strategy worldwide. It recognizes excellence in quality patient care and innovation in professional nursing practice. The Magnet Model Framework for Excellence incorporates strategic planning for clinical and systems decisions, for improved patient outcomes, nurse to patient ratios, and patient satisfaction. Magnet hospitals demonstrate superb nursing care in order to retain this credential.For the sixth time in a row, U.S. News & World Report named TMH "Tops in Rhode Island" on its Best Regional Hospitals list as well as the number one hospital in the Providence metro area for 2020-2021. For the second consecutive year, urology services earned TMH a place among the 50 hospitals deemed to have the best urology services in the country. U.S. News & World Report also designated TMH as a "high performer" in the areas of chronic obstructive pulmonary disease (COPD) treatment, colon cancer surgery, heart failure, hip replacement, and knee replacement, as well as in the specialties of geriatrics, nephrology, neurology, and neurosurgery.In 2020, Blue Cross and Blue Shield of Rhode Island named TMH a Blue Distinction Center+ for cardio care and a Blue Distinction Center for cancer care. In 2018, TMH was named a Blue Distinction Center for knee and hip replacement, and a Blue Distinction Center+ for bariatric surgery. Such designations recognize expertise in delivering quality care and improved patient safety.The Total Joint Center at TMH (the Center) is dedicated to providing the most technologically advanced and specialized procedures focused on the replacement of joints as well as rehabilitation and care in treating diseases of, or injuries to, hips, knees, and shoulders. TMH is a Blue Cross Blue Shield Blue Distinction Center for Knee and Hip Replacement, which is a designation given to hospitals that demonstrate an expertise in quality care by meeting objective clinical measures, resulting in better outcomes for patients. In 2019, the Gold Seal of Approval for Advanced Certification for Total Hip and Total Knee Replacement was awarded to the Center. TMH received this advanced designation for the third time, recognizing quality, consistency, and safety of services and patient care. The Medical and surgical services at the Center are provided in a personalized, caring environment within the context of an academic medical center. All services focus on the patient experience from initial consultation through recovery. The Center is the only Rhode Island program to achieve advanced certification.TMHs Center for Bariatric Surgery has been a Center of Excellence in Bariatric Surgery since 2011 and was accredited in 2014 and re-accredited in 2017 by the American College of Surgeons' Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program as an adult and adolescent center for weight loss surgery.TMH was included on the IBM Watson Health list of the Top 100 Hospitals for 2019. Divided into four categories, the list grouped TMH among the top 15 major teaching hospitals in the nation. Top performing hospitals acheive better risk-adjusted outcomes, delivering consistently better care at a lower cost.In late 2019, The Leapfrog Group named TMH a "Top Hospital" in the United States. TMH was one of just 120 hospitals to make the list and was grouped among the top 55 teaching hospitals in the country. In November 2019 TMH won its eighth semi-annual "A" grade for hospital safety from the Leapfrog Group.The Intensive Care Unit at TMH was recognized in 2019 with the Gold Beacon Award for Excellence, the highest designation conferred by The American Association of Critical-Care Nurses (AACN). |
| Form 990, Part III, 4b: | TMH provided $3,550,000 in support of research activities in fiscal year 2020. 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 $16,060,699 in 2020.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 2020, 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.*Pamela A. Harrop, MD, Trustee through October 2019, is the President of Medical Associates of Rhode Island, Inc. (MARI). Beginning in 2020, Lifespan and MARI engaged for Dr. Harrop to provide physician consulting services to the Lifespan hospitals. During fiscal year 2020, Lifespan paid MARI $54,000 as part of this consulting contract. |
| 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 TMH and Affiliate audited consolidated financial statements as of and for the fiscal year ended September 30, 2020, which consist 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 (34 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 | |||||||||||||||
| 225 Carolina Avenue Suite 100 | 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 | 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 | |||||
| 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 Total IncomeShareOfTotalIncomeAmt | 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) | -$998,771 | $918,890 |
| 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 | $139,071 | InvolvedAmt |
| Method Of Amount Determination | Cash | MethodOfAmountDeterminationTxt |