2025-08-15T07:32:09-05:00 2024-09-30 WithumSmithBrown PC 200 Jefferson Park Suite 400 Whippany NJ 079811070 990 2023-10-01 050258812 BUTLER HOSPITAL % JOHN E BRONHARD II CPA BUTL 4014556267 4 RICHMOND SQUARE 4TH FLOOR PROVIDENCE RI 02906 TODD CONKLIN CAO 4014556267 2025-08-13 true true Scott J Mariani P00642486 9738989494 2023 2025-03-06 01:10:19Z MARY MARRAN 4 RICHMOND SQUARE 4TH FLOOR PROVIDENCE RI 02906 171224447 false X WWW.BUTLER.ORG X 1844 RI TO PROVIDE TREATMENT OF PSYCHIATRIC ILLNESS IN AN ATMOSPHERE OF DIGNITY & RESPECT; TO CONTRIBUTE KNOWLEDGE THROUGH EDUCATION & RESEARCH. 14 11 1334 107 765650 261938 930236 1406579 128282942 164135088 1342209 1098835 4495855 4583945 135051242 171224447 10500 8000 0 0 68068044 73970358 0 0 0 60518152 84545121 128596696 158523479 6454546 12700968 81067680 97462925 24221419 25927086 56846261 71535839 X TO PROVIDE TREATMENT OF PSYCHIATRIC ILLNESS IN AN ATMOSPHERE OF DIGNITY AND RESPECT AND TO CONTRIBUTE KNOWLEDGE THROUGH EDUCATION AND RESEARCH WHILE CONTINUOUSLY IMPROVING THE WAYS THE HOSPITAL SERVICES ITS PATIENTS AND THE COMMUNITY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. false false 142671932 8000 164900738 EXPENSES INCURRED IN PROVIDING VARIOUS MEDICALLY NECESSARY PSYCHIATRIC SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. 142671932 true true false true false false false true false true true false true true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false true true true true false false true 0 0 1334 true true true false false false false true true false false false false false false X 14 11 false true false false true true true true true false false true true true true true true true true true true X JOHN E BRONHARD II CPA 4014556267 4 RICHMOND SQUARE 4TH FLOOR PROVIDENCE RI 02906 X MICHAEL E WAGNER MD DIRECTOR - PRESIDENT/CEO/CNE 55.0 0.0 X X 0 1688410 32601 JAMES E FANALE MD FORMER OFFICER 0.0 0.0 X 0 1317641 140001 F JOSEPH IANNONI FORMER OFFICER 0.0 0.0 X 0 806929 83899 MARY MARRAN PRESIDENT & COO 55.0 0.0 X 706462 0 83575 TODD A CONKLIN ASST. TREAS./EVP/CFO/CNE 55.0 0.0 X 0 707222 26659 GHULAM SURTI MD SVP & CMO 55.0 0.0 X 0 661001 58485 KEVIN BAILL MD DIRECTOR - MED DIR OP SVCS/BH 55.0 0.0 X 0 582758 52549 ANA TUYA FULTON MD DIR-CHIEF POP HLTH OFF/CNE 55.0 0.0 X 0 590920 21160 ASHLEY M TAYLOR ESQ ASST. SEC./GEN. COUNSEL/CNE 55.0 0.0 X 0 542295 17484 STEPHEN E BURKE VP FINANCE 55.0 0.0 X 0 324242 16266 DIANE FERREIRA RN SVP/CNO 55.0 0.0 X 242494 0 36220 PETER S VAN STEEDEN VP OF OPERATIONS 55.0 0.0 X 246647 0 28442 JAMES CARROLL JR Sr. Director of Facilities 55.0 0.0 X 180713 0 39610 LEILA ZAKI RN STAFF NURSE 55.0 0.0 X 198921 0 11085 CHLOE MORGAN PHARM D PHARMACIST SPECIALIST 55.0 0.0 X 176785 0 27710 CHRISTINE DIXON RN Staff Nurse 55.0 0.0 X 191208 0 10557 BREANNE COTE RN STAFF NURSE 55.0 0.0 X 174376 0 11096 GARY E FURTADO CHAIRMAN - DIRECTOR 1.0 0.0 X X 0 0 0 R STEPHEN MANTY VICE CHAIR/TREASURER-DIRECTOR 1.0 0.0 X X 0 0 0 JAMES A BOTVIN SECRETARY - DIRECTOR 1.0 0.0 X X 0 0 0 SHARON CONARD-WELLS DIRECTOR 1.0 0.0 X 0 0 0 CAROLYN MASTERS PHD RN DIRECTOR 1.0 0.0 X 0 0 0 JOSEPH J MCGAIR ESQ DIRECTOR 1.0 0.0 X 0 0 0 PATRICK J MURRAY JR DIRECTOR 1.0 0.0 X 0 0 0 PETER PHILIPS DIRECTOR 1.0 0.0 X 0 0 0 JUDITH REMONDI DIRECTOR 1.0 0.0 X 0 0 0 CHARLES R REPPUCCI ESQ DIRECTOR 1.0 0.0 X 0 0 0 MARIBETH Q WILLIAMSON DIRECTOR 1.0 0.0 X 0 0 0 2117606 7221418 697399 82 true true false CARE NEW ENGLAND HEALTH SYSTEM 4 RICHMOND SQUARE 4TH FLOOR PROVIDENCE RI 02906 MANAGEMENT 20478965 1 64499 1342080 1406579 NET PATIENT SERVICE REVENUE 541900 119855293 119855293 OTHER HEALTHCARE RELATED REVENUE 541900 34875371 34875371 MANAGEMENT FEES; TAX-EXEMPT AFFILIATE 900099 9404424 9404424 164135088 455186 455186 0 0 4009418 4009418 0 4009418 744402 3265016 625619 18030 625619 18030 643649 643649 0 0 0 0 0 0 0 0 0 CAFETERIA SALES 900099 553279 553279 VENDOR SALES 900099 21248 21248 574527 171224447 164135088 765650 4917130 8000 8000 0 0 0 1343839 1209455 134384 0 54959797 49463817 5495980 0 3236806 2913125 323681 10007861 9007075 1000786 4422055 3979850 442205 20478965 18431069 2047896 0 0 0 0 0 218291 196462 21829 33131 29818 3313 4344743 3910269 434474 57829 52046 5783 0 1334108 1200697 133411 79584 71626 7958 0 0 709149 638234 70915 0 2619721 2357749 261972 3085700 2777130 308570 RESEARCH EXPENSES 18898689 17008820 1889869 DUES & SUBSCRIPTIONS 18396194 16556575 1839619 PURCHASED SERVICES 10285511 9256960 1028551 MEDICAL SUPPLIES 1999286 1799357 199929 2004220 1803798 200422 158523479 142671932 15851547 0 2120 2120 15989064 12356797 224002 488652 8188737 11134688 0 0 0 0 0 0 266485 427076 270758 405567 103902150 79805824 15870901 24096326 0 0 0 0 32155465 38071346 0 0 8100148 10480353 81067680 97462925 8337161 10694875 0 0 265467 344880 0 0 0 0 0 0 2122391 1937284 0 0 13496400 12950047 24221419 25927086 X 33879650 56949135 22966611 14586704 56846261 71535839 81067680 97462925 X 12700968 1803852 184758 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true false SCHEDULE C, PART II-B; LINE 1I CARE NEW ENGLAND HEALTH SYSTEM, THE TAX-EXEMPT PARENT OF CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES, INCURS VARIOUS LOBBYING EXPENSES ON BEHALF OF THE SYSTEM; INCLUDING THIS ORGANIZATION. PLEASE REFER TO THE FORM 990 FILED BY CARE NEW ENGLAND HEALTH SYSTEM (FEIN: 05-0490997). false 28724038 4050 6164126 982428 33909786 25893995 84755 3597188 851900 28724038 33473341 11500 -6665858 924988 25893995 28205332 6500 6129449 867940 33473341 27121918 9201 1916036 841823 28205332 0.66260 0.33740 false false 52218460 45830493 6387967 31466 11275 20191 34881744 29932072 4949672 16770480 4031984 12738496 24096326 ENDOWMENT FUNDS 11439897 F BOARD-DESIGNATED FUNDS 22469887 F TRUSTEE-HELD FUNDS 3945328 F OTHER ASSETS - LT 216234 F 38071346 OTHER RECEIVABLES 9900646 RIGHT-OF-USE ASSETS 579707 10480353 0 OTHER LIABILITIES 1522332 PENSION LIABILITY 1323559 DUE TO THIRD PARTY PAYORS 7964732 SELF-INSURANCE RESERVES 98659 POST RETIREMENT LIABILITIES 1431682 CAPITAL LEASE LIABILITY 609083 12950047 FORM 990, SCHEDULE D, PART III, LINE 1A BUTLER HOSPITAL HOLDS VARIOUS WORKS OF ART THAT WERE DONATED TO THE ORGANIZATION IN THE EARLY TO MID-1900'S. AT THE TIME OF THE DONATION, THE WORKS OF ART WERE ADDED TO THE HOSPITAL'S COLLECTIONS AND WERE HELD FOR PUBLIC EXHIBITION AND FOR PRESERVATION FOR FUTURE GENERATIONS. IN ACCORDANCE WITH STATEMENT OF FINANCIAL ACCOUNTING STANDARDS NO. 116, ACCOUNTING FOR CONTRIBUTIONS RECEIVED AND CONTRIBUTIONS MADE, THE HOSPITAL DOES NOT RECOGNIZE OR CAPITALIZE ITS COLLECTIONS FOR FINANCIAL STATEMENT PURPOSES. THE VALUE OF THE HOSPITAL'S COLLECTIONS IS NOT CONSIDERED MATERIAL TO THE HOSPITAL'S FINANCIAL STATEMENTS. THEREFORE, THE EXISTENCE OF THESE COLLECTIONS IS NOT SEPARATELY DISCLOSED IN THE FOOTNOTES TO THE HOSPITAL'S FINANCIAL STATEMENTS. SCHEDULE D, PART V, QUESTION 4 THE HOSPITAL'S ENDOWMENTS CONSIST OF NUMEROUS INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE PURPOSES INCLUDE GENERAL PURPOSE, HEALTHCARE SERVICES, INDIGENT CARE, HEALTH EDUCATION AND FOR USE IN FURTHERING THE TAX-EXEMPT CHARITABLE PURPOSE OF THIS ORGANIZATION. SCHEDULE D, PART X THE ORGANIZATION IS AN AFFILIATE WITHIN CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S PARENT ENTITY IS CARE NEW ENGLAND HEALTH SYSTEM. AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTING ("CPA") FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CARE NEW ENGLAND HEALTH SYSTEM AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED SEPTEMBER 30, 2024 AND SEPTEMBER 30, 2023; RESPECTIVELY AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CERTAIN CONSOLIDATING SCHEDULES. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE DISCLOSURE RELATED TO THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48. THE ORGANIZATION COMPLETED AN ASSESSMENT OF THE ESTIMATED LIABILITY FOR UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2024 AND CONCLUDED THAT THE ESTIMATED LIABILITY WAS NOT MATERIAL TO THE ORGANIZATION'S FINANCIAL STATEMENTS. true true X true X true X true true true false false 2734919 2186982 547937 0.00350 60177506 60658570 0 0.00000 62912425 62845552 547937 0.00350 323992 323992 0.00200 6298808 831386 5467422 0.03450 16950130 11366713 5583416 0.03520 16325405 11733926 4591479 0.02900 127786 127786 0 0.00000 40026121 24059811 15966309 0.10070 102938546 86905363 16514246 0.10420 false 2727846 644721 5385481 8363805 -2978324 X true true 1 1 BUTLER HOSPITAL 345 BLACKSTONE BOULEVARD PROVIDENCE RI 02906 WWW.BUTLER.ORG HOS00124 X X X 1 BUTLER HOSPITAL 1 false false true X X X X X X X X X 21 true true true true X WWW.CARENEWENGLAND.ORG X true 21 true WWW.CARENEWENGLAND.ORG false true X 200. 300. X X X true true X X X X true X WWW.CARENEWENGLAND.ORG X WWW.CARENEWENGLAND.ORG X WWW.CARENEWENGLAND.ORG X X X X X X true X false X X X X true X false false SCH H, PART V, SEC B, Q'S 3J,7D,13B,13H,15E,16J,18E,19E,20E,21C,21D,23&24 NOT APPLICABLE. SCHEDULE H, PART V, SECTION B, QUESTION 5 THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INCLUDED WIDE PARTICIPATION OF PUBLIC HEALTH EXPERTS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS. THE RI DEPARTMENT OF HEALTH (DOH) AND HEALTH EQUITY ZONE (HEZ) PARTNERS WERE INCLUDED THROUGHOUT THE PROCESS TO COLLECT INSIGHTS AND PROVED ACCESS TO UNDERSERVED POPULATIONS. PARTNER FORUMS WHICH INCLUDED MORE THAN 40 PARTICIPANTS WERE HELD IN PROVIDENCE AND PAWTUCKET. INPUT FROM THESE FORUMS WAS USED TO DEVELOP PRIORITIES FOR THE PLAN. SCHEDULE H, PART V, SECTION B, QUESTIONS 6A & 6B CARE NEW ENGLAND HEALTH SYSTEM (CNE) PARTICIPATED IN A STATEWIDE COMMUNITY HEALTH NEEDS ASSESSMENT, LED BY THE HOSPITAL ASSOCIATION OF RHODE ISLAND (HARI), AND ITS MEMBER HOSPITALS (OUR LADY OF FATIMA HOSPITAL, ROGER WILLIAMS MEDICAL CENTER, LANDMARK MEDICAL CENTER, SOUTH COUNTY HOSPITAL AND THE WESTERLY HOSPITAL). HARI CHNA PARTNERS JOINTLY CONDUCTED A PRIORITIZATION TO IDENTIFY KEY STATEWIDE COMMUNITY HEALTH NEEDS. CARE NEW ENGLAND HEALTH SYSTEM'S HOSPITALS: BUTLER HOSPITAL, KENT HOSPITAL, AND WOMEN & INFANTS HOSPITAL IDENTIFIED SYSTEM PRIORITIES AND DEVELOPED A SYSTEM-WIDE IMPLEMENTATION PLAN WHICH ALIGNED WITH THE PRIORITIZED STATEWIDE HEALTH ISSUES. EACH HOSPITAL ALSO CONDUCTED ITS OWN NEEDS ASSESSMENT. SCHEDULE H, PART V, SECTION B, QUESTION 7A THE ORGANIZATION IS AN AFFILIATE WITHIN CARE NEW ENGLAND HEALTH SYSTEM; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: https://www.carenewengland.org/community-health-needs-assessment SCHEDULE H, PART V, SECTION B, QUESTION 8 THE FACILITY, WITH LIMITED RESOURCES, PRIORITIZED HEALTH NEEDS THAT WERE IDENTIFIED AND DEVELOPED AN IMPLEMENTATION PLAN TO ADDRESS THESE PRIORITY HEALTH NEED AREAS. THE SYSTEM AND FACILITY STRATEGIC PLAN MAPS TO IMPROVED COMMUNITY HEALTH AND THE CHNA IMPLEMENTATION PLAN. THE CHNA IMPLEMENTATION PLAN INCLUDES RESOURCES, ACTION AND GOALS (MEASURABLE). SCHEDULE H, PART V, SECTION B, QUESTION 10A THE ORGANIZATION IS AN AFFILIATE WITHIN CARE NEW ENGLAND HEALTH SYSTEM; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTION 10A, IS THE HOME PAGE FOR THE SYSTEM. THE IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: https://www.carenewengland.org/community-health-needs-assessment SCHEDULE H, PART V, SECTION B, QUESTION 11 THE HARI CHNA STEERING COMMITTEE CORRELATED QUANTITATIVE AND QUALITATIVE DATA FROM THE 2022 CHNA AND COMPARED WITH FINDINGS FROM THE 2019 CHNA AND RI DOH COMMUNITY HEALTH IMPROVEMENT PLAN TO DEFINE STATEWIDE HEALTH PRIORITIES. IN LINE WITH THE 2019 CHNA AND THE RI DOH, THE FOLLOWING COMMUNITY HEALTH ISSUES WERE IDENTIFIED AS PRIORITIES ACROSS THE STATE. - BEHAVIORAL HEALTH; - CHRONIC DISEASE: DIABETES & HEART DISEASE; AND - MATERNAL & CHILD HEALTH. CARE NEW ENGLAND ADOPTED THE FOLLOWING PRIORITIES AND ASSIGNED EXECUTIVE SPONSORS FOR EACH OF THE STATEWIDE GOALS. BEHAVIORAL HEALTH - PREVENT OPIOID USE ADDICTION AND OPIOID ADDICTION IN CONJUNCTION WITH OTHER SUBSTANCES; AND - DECREASE MORBIDITY AND MORTALITY FROM OPIOID USE AND OPIOID USE WITH OTHER SUBSTANCES. CHRONIC DISEASE: DIABETES - REDUCE THE NUMBER OF NEW CASES OF DIABETES; AND - DECREASE MORBIDITY AND MORTALITY FROM TYPE 2 DIABETES AND DIABETES-RELATED CONDITIONS. MATERNAL AND CHILD HEALTH - INCREASE HEALTH PREGNANCIES AND IMPROVE BIRTH OUTCOMES FOR AT-RISK MOTHERS AND BABIES; AND - REDUCE THE DISPARITY IN PRENATAL CARE, PRETERM BIRTHS, LOW BIRTHWEIGHT, AND INFANT MORTALITY AMONG AT-RISK BLACK/AFRICAN AMERICAN FAMILIES. SCHEDULE H, PART V, SECTION B, QUESTION 16 THE ORGANIZATION IS AN AFFILIATE WITHIN CARE NEW ENGLAND HEALTH SYSTEM; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTIONS 16A, 16B AND 16C, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY CAN BE ACCESSED AT THE FOLLOWING URL WHICH IS INCLUDED IN THE SYSTEM'S WEBSITE: https://www.carenewengland.org/patient-resources/ SCHEDULE H, PART I, LINE 3C NOT APPLICABLE. SCHEDULE H, PART I, LINE 6A NOT APPLICABLE. SCHEDULE H, PART I, LINE 7G NO COSTS RELATING TO SUBSIDIZED HEALTHCARE SERVICES ARE ATTRIBUTABLE TO ANY PHYSICIAN CLINICS. SCHEDULE H, PART I, LINE 7 WORKSHEET 2, "RATIO OF PATIENT CARE COST-TO-CHARGES" WAS USED TO COMPLETE THE COST-TO-CHARGE RATIO USED IN PART 1, LINE 7, UTILIZING DATA FROM THE FINANCIAL STATEMENTS AND MEDICARE COST REPORT FOR FY 2024. SCHEDULE H, PART II BUTLER HOSPITAL HAS DIRECT INVOLVEMENT IN NUMEROUS COMMUNITY BUILDING ACTIVITIES THAT PROMOTE AND IMPROVE THE HEALTH STATUS AND GENERAL BETTERMENT OF THE COMMUNITIES SERVED BY THE HOSPITAL. THIS IS ACCOMPLISHED THROUGH SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS, AND PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE ROOT CAUSES OF HEALTH CONCERNS. THIS ORGANIZATION PROVIDES EDUCATIONAL MATERIALS, CONDUCTS COMMUNITY HEALTH FAIRS AND HOLDS HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS AND FOR COMMUNITY PROVIDERS. PRESENTATIONS ARE PROVIDED BY PHYSICIANS, NURSES AND OTHER HEALTHCARE PROFESSIONALS. SCHEDULE H, PART III, SECTION A, LINE 4 PROVISION FOR BAD DEBT WAS CALCULATED USING THE ORGANIZATION'S BAD DEBT EXPENSE FROM ITS AUDITED FINANCIAL STATEMENTS, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. The System determines the transaction price based on standard charges for goods and service provided, reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients in accordance with the System's policy, and implicit price concessions provided to uninsured patients. The System determines its estimates of contractual adjustments and discounts based on contractual agreements, its discount policies, and historical experience. The System determines its estimate of implicit price concessions based on its historical collection experience. SCHEDULE H, PART III, SECTION B; QUESTION 8 THE INPATIENT MEDICARE ALLOWABLE COSTS WERE DETERMINED FROM THE SUBMITTED FY 2024 MEDICARE COST REPORT, WORKSHEET D-1, LINE 49. WORKSHEET D-1, LINE 49 DOES NOT INCLUDE DIRECT GME COSTS. THE OUTPATIENT ALLOWABLE COSTS COME FROM WORKSHEET E, PART B. MEDICARE UNDERPAYMENTS AND BAD DEBT IS COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE ORGANIZATION DID NOT INCLUDE MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT IN THE CALCULATION OF THEIR COMMUNITY BENEFIT PERCENTAGE. HOWEVER, THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW, THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM "CHARITABLE", A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT "[T]HE TERM CHARITABLE IS USED IN 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE,PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM "CHARITABLE" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE "CHARITY CARE STANDARD." UNDER THE STANDARD, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR IT. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY, AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH "REMOVE[D]" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE "COMMUNITY BENEFIT STANDARD," HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM "CHARITABLE," AS REQUIRED BY TREAS. REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. THE ORGANIZATION BELIEVES THAT MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA POSITION. AS OUTLINED IN THE AHA LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS. - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES HOSPITALS ONLY 92 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10-YEAR LOW AT NEGATIVE 5.4 PERCENT. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED ELIGIBLES." THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR FINANCIAL ASSISTANCE PROGRAMS. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOME BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY SCHEDULE H, PART III, SECTION C; QUESTION 9B BUTLER HOSPITAL DOES NOT PURSUE COLLECTION FOR THOSE PATIENTS WHO QUALIFY FOR 100% FINANCIAL ASSISTANCE, BUT OUR NORMAL COLLECTION POLICY WOULD APPLY FOR PATIENTS RECEIVING PARTIAL FINANCIAL ASSISTANCE (DISCOUNTED BY REASON OF INCOME/ASSETS ON THE FPG BETWEEN 200% AND 300%) OR EXTREME MEDICAL EXPENSES. SCHEDULE H, PART VI; QUESTION 2 IN ADDITION TO THE INTERNAL REVENUE CODE 501(R) COMMUNITY HEALTH NEEDS ASSESSMENT INFORMATION OUTLINED IN FORM 990, SCHEDULE H, PART V, SECTION B, CARE NEW ENGLAND HEALTH SYSTEM CONDUCTS A REVIEW OF KEY MARKET FACTORS FOR BUTLER HOSPITAL ANNUALLY WHICH INCLUDES: THE ORGANIZATION CONTINUALLY REVIEWS AND EVALUATES CURRENT AND PROPOSED PROGRAMS TO ENSURE THAT PROGRAMS OFFERING THE MOST BENEFIT WILL CONTINUE TO BE SUPPORTED BY THE HOSPITAL. THE HOSPITAL ALIGNS ITS COMMUNITY PROGRAMS IN SUPPORT OF THE RHODE ISLAND DEPARTMENT OF HEALTH HEALTHY PEOPLE 2010 INITIATIVES. OBJECTIVE 1: PHYSICAL ACTIVITY, OBJECTIVE 3: TOBACCO, OBJECTIVE 4: SUBSTANCE ABUSE AND OBJECTIVE 6: MENTAL HEALTH. PLEASE REFER TO SCHEDULE O FOR A DETAILED COMMUNITY BENEFIT STATEMENT. RHODE ISLAND DEPARTMENT OF HEALTH HEALTHY PEOPLE 2010 INITIATIVES. OBJECTIVE 1: PHYSICAL ACTIVITY, OBJECTIVE 3: TOBACCO, OBJECTIVE 4: SUBSTANCE ABUSE AND OBJECTIVE 6: MENTAL HEALTH. PLEASE REFER TO SCHEDULE O FOR A DETAILED COMMUNITY BENEFIT STATEMENT. SCHEDULE H, PART VI, QUESTION 3 AS A NOT FOR-PROFIT ENTITY, BUTLER HOSPITAL'S FIRST CONSIDERATION IN THE ADMISSION AND PLACEMENT OR TREATMENT OF ANY PATIENT IS THE PATIENT'S MEDICAL NEEDS. SOME PATIENTS HESITATE TO OBTAIN NECESSARY CARE BECAUSE OF THEIR FINANCIAL CONCERNS.A NOTICE OF FINANCIAL AID APPEARS ON ALL STATEMENTS SENT TO PATIENTS. ALSO, IT IS PROMINENTLY POSTED IN THE PATIENT ASSESSMENT DEPARTMENT, ADMISSION AREAS, OUTPATIENT CARE AREAS AND ON THE ORGANIZATION'S WEBSITE. ALSO, THE NOTICE IS AVAILABLE IN THE THREE MOST COMMON LANGUAGES USED BY THE PATIENT POPULATION IN ACCORDANCE WITH THE APPLICABLE "STANDARDS FOR CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES IN HEALTHCARE" (STANDARDS 4 AND 7, BASED ON TITLE VI OF THE CIVIL RIGHTS ACT OF 1964). SCHEDULE H, PART VI, QUESTION 4 BUTLER HOSPITAL SERVES THE ENTIRE STATE OF RHODE ISLAND AS A PROVIDER OF SPECIALIZED ASSESSMENT AND TREATMENT FOR ALL MAJOR PSYCHIATRIC ILLNESSES AND SUBSTANCE ABUSE AMONG ADULTS, SENIORS, AND ADOLESCENTS. THE POPULATION ACROSS RHODE ISLAND IS PRIMARILY WHITE; HOWEVER, 19.5% OF THE POPULATION IDENTIFIES AS ANOTHER RACE AND 15.4% OF THE POPULATION IDENTIFIES AS HISPANIC/LATINO. THE MEDIAN AGE OF RESIDENTS IS 39.9%. THE MEDIAN HOUSEHOLD INCOME, IN AGGREGATE, IS HIGHER AMONG WHITES AND ASIANS COMPARED TO BLACKS/AFRICAN AMERICANS AND HISPANICS/LATINOS. THE STATE ENCOMPASSES 416,126 HOUSING UNITS, 60.8% ARE OWNER-OCCUPIED AND 39.2% ARE RENTER-OCCUPIED. THE MEDIAN HOME VALUE FOR OWNER-OCCUPIED UNITS IS $261,900. THE MEDIAN HOUSEHOLD INCOME IN THE STATE IS $67,167; HOWEVER, INCOME VARIES NOTABLY BY RACE AND ETHNICITY. THE MEDIAN INCOME FOR BLACKS/ AFRICAN AMERICANS AND HISPANICS/LATINOS IS $36,627 AND $33,970 RESPECTIVELY. THE PERCENTAGE OF ALL FAMILIES LIVING IN POVERTY IS 12.4%; THE PERCENTAGE OF FAMILIES WITH CHILDREN LIVING IN POVERTY IS 17%. SCHEDULE H, PART VI; QUESTION 5 THE ORGANIZATION AND THE ENTIRE CARE NEW ENGLAND HEALTH SYSTEM PROMOTE THE HEALTH OF THE COMMUNITY ON A DAILY BASIS THROUGHOUT THE YEAR. THE SYSTEM COORDINATES AND OFFERS NUMEROUS COMMUNITY BENEFIT PROGRAMS, ACTIVITIES AND SUPPORT GROUPS TO THE COMMUNITY. PLEASE REFER TO SCHEDULE O FOR A DETAILED COMMUNITY BENEFIT STATEMENT. SCHEDULE H, PART VI; QUESTION 6 OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE THE CARE NEW ENGLAND HEALTH SYSTEM. NOT FOR-PROFIT CARE NEW ENGLAND HEALTH SYSTEM ENTITIES: CARE NEW ENGLAND HEALTH SYSTEM CARE NEW ENGLAND HEALTH SYSTEM IS THE TAX-EXEMPT PARENT OF THE CARE NEW ENGLAND HEALTH SYSTEM ("CNE"). THIS TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THIS ORGANIZATION IS THE SOLE MEMBER OR STOCKHOLDER OF EACH AFFILIATED ENTITY. CNE IS AN INTEGRATED SYSTEM OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF RHODE ISLAND. CARE NEW ENGLAND HEALTH SYSTEM IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). AS THE PARENT ORGANIZATION, CARE NEW ENGLAND HEALTH SYSTEM STRIVES TO CONTINUALLY DEVELOP AND OPERATE A MULTI-HOSPITAL HEALTHCARE SYSTEM WHICH PROVIDES SUBSTANTIAL COMMUNITY BENEFIT THROUGH THE PROVISION OF A COMPREHENSIVE SPECTRUM OF HEALTHCARE SERVICES TO THE RESIDENTS OF RHODE ISLAND AND SURROUNDING COMMUNITIES. CARE NEW ENGLAND HEALTH SYSTEM ENSURES THAT ITS SYSTEM PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. NO INDIVIDUALS ARE DENIED NECESSARY MEDICAL CARE, TREATMENT OR SERVICES. CNE'S ACTIVE HOSPITALS INCLUDE BUTLER HOSPITAL, WOMEN & INFANTS HOSPITAL OF RHODE ISLAND AND KENT COUNTY MEMORIAL HOSPITAL. EACH OF THESE HOSPITALS OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. EACH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. EACH OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. EACH MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF EACH RESTS WITH THE COMMON BOARD OF DIRECTORS OF CARE NEW ENGLAND HEALTH SYSTEM. THE BOARD IS COMPRISED OF A MAJORITY OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. BUTLER HOSPITAL BUTLER HOSPITAL IS A 117-BED NON-PROFIT PRIVATE, NON-PROFIT PSYCHIATRIC AND SUBSTANCE ABUSE HOSPITAL FOR ADULTS, ADOLESCENTS, CHILDREN, AND SENIORS LOCATED IN PROVIDENCE, RHODE ISLAND. BUTLER HOSPITAL IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, BUTLER HOSPITAL OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. KENT COUNTY MEMORIAL HOSPITAL KENT COUNTY MEMORIAL HOSPITAL IS A 359-BED NON-PROFIT ACUTE CARE HOSPITAL LOCATED IN WARWICK, RHODE ISLAND. KENT COUNTY MEMORIAL HOSPITAL IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, KENT COUNTY MEMORIAL HOSPITAL OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. WOMEN & INFANTS HOSPITAL OF RHODE ISLAND WOMEN & INFANTS HOSPITAL OF RHODE ISLAND IS A 247-BED AND 60-BASSINET NON-PROFIT SPECIALTY HOSPITAL FOR WOMEN AND NEWBORNS LOCATED IN PROVIDENCE, RHODE ISLAND. WOMEN & INFANTS CORPORATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, WOMEN & INFANTS CORPORATION OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. THE MEMORIAL HOSPITAL THE MEMORIAL HOSPITAL UNTIL ITS CLOSURE PREVIOUSLY OPERATED AS A 294-BED NON-PROFIT ACUTE CARE HOSPITAL LOCATED IN PAWTUCKET, RHODE ISLAND. THE MEMORIAL HOSPITAL IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, THE ORGANIZATION PROVIDED MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY PRIOR TO ITS CLOSURE. MOREOVER, THE MEMORIAL HOSPITAL OPERATED CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. BUTLER HOSPITAL FOUNDATION BUTLER HOSPITAL FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF BUTLER HOSPITAL; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. KENT COUNTY VISITING NURSE ASSOCIATION KENT COUNTY VISITING NURSE ASSOCIATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. KENT HOSPITAL FOUNDATION KENT HOSPITAL FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF KENT COUNTY MEMORIAL HOSPITAL; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. WOMEN & INFANTS DEVELOPMENT FOUNDATION WOMEN & INFANTS DEVELOPMENT FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF WOMEN & INFANTS HOSPITAL OF RHODE ISLAND; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. THE MEMORIAL HOSPITAL FOUNDATION THE MEMORIAL HOSPITAL FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION IS CURRENTLY INACTIVE. VNA OF CARE NEW ENGLAND FOUNDATION VNA OF CARE NEW ENGLAND FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS KENT COUNTY VISITING NURSE ASSOCIATION THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF KENT COUNTY VISITING NURSE ASSOCIATION; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. WOMEN & INFANTS CORPORATION WOMEN & INFANTS CORPORATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION IS THE PARENT ENTITY OF WOMEN & INFANTS HOSPITAL OF RHODE ISLAND AND ITS AFFILIATES, WHICH PROVIDE MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. WIH FACULTY PHYSICIANS, INC. WIH FACULTY PHYSICIANS, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION PROVIDES ME SCHEDULE H, PART VI, QUESTION 7 NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN RHODE ISLAND. NO COMMUNITY BENEFIT REPORT IS FILED WITH THE STATE OF RHODE ISLAND. X X X X true true false false false true true true false MICHAEL E WAGNER MD DIRECTOR - PRESIDENT/CEO/CNE 0 1100638 0 585000 0 2772 0 0 0 32601 0 1721011 0 0 JAMES E FANALE MD FORMER OFFICER 0 62631 0 0 0 1255010 0 140001 0 0 0 1457642 0 0 F JOSEPH IANNONI FORMER OFFICER 0 159737 0 0 0 647192 0 80500 0 3399 0 890828 0 0 MARY MARRAN PRESIDENT & COO 503690 0 200000 0 2772 0 72174 0 11401 0 790037 0 0 0 TODD A CONKLIN ASST. TREAS./EVP/CFO/CNE 0 562041 0 143722 0 1459 0 0 0 26659 0 733881 0 0 GHULAM SURTI MD SVP & CMO 0 546441 0 113698 0 862 0 26100 0 32385 0 719486 0 0 KEVIN BAILL MD DIRECTOR - MED DIR OP SVCS/BH 0 478300 0 98993 0 5465 0 20300 0 32249 0 635307 0 0 ANA TUYA FULTON MD DIR-CHIEF POP HLTH OFF/CNE 0 505920 0 85000 0 0 0 20300 0 860 0 612080 0 0 ASHLEY M TAYLOR ESQ ASST. SEC./GEN. COUNSEL/CNE 0 452025 0 90000 0 270 0 14500 0 2984 0 559779 0 0 STEPHEN E BURKE VP FINANCE 0 232977 0 89950 0 1315 0 6773 0 9493 0 340508 0 0 DIANE FERREIRA RN SVP/CNO 205092 0 36550 0 852 0 19824 0 16396 0 278714 0 0 0 PETER S VAN STEEDEN VP OF OPERATIONS 215257 0 31251 0 139 0 8400 0 20042 0 275089 0 0 0 JAMES CARROLL JR Sr. Director of Facilities 180104 0 0 0 609 0 13199 0 26411 0 220323 0 0 0 LEILA ZAKI RN STAFF NURSE 198421 0 500 0 0 0 0 0 11085 0 210006 0 0 0 CHLOE MORGAN PHARM D PHARMACIST SPECIALIST 176785 0 0 0 0 0 0 0 27710 0 204495 0 0 0 CHRISTINE DIXON RN Staff Nurse 191208 0 0 0 0 0 0 0 10557 0 201765 0 0 0 BREANNE COTE RN STAFF NURSE 174376 0 0 0 0 0 0 0 11096 0 185472 0 0 0 PART VII AND SCHEDULE J IN ACCORDANCE WITH INTERNAL REVENUE SERVICE FORM 990 RULES, REGULATIONS AND INSTRUCTIONS, THE COMPENSATION REPORTED IN CORE FORM, PART VII AND SCHEDULE J, PART II OF THIS FORM 990 IS DERIVED FROM 2023 FORMS W-2 AND FORMS 1099 (IF APPLICABLE). SCHEDULE J, PART I; QUESTION 4A THE FOLLOWING INDIVIDUAL INCLUDED IN SCHEDULE J, PART II RECEIVED SEVERANCE DURING CALENDAR YEAR 2023 WHICH WAS INCLUDED IN THE INDIVIDUAL'S 2023 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JAMES E. FANALE, M.D, $766,978. SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES VESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) AS THE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN THE INDIVIDUAL'S 2023 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JAMES E. FANALE, M.D., $488,032 AND F. JOSEPH IANNONI, $642,662. The deferred compensation amount in column c for the following individuals includes unvested benefits in an internal revenue code section 457(f) plan (non-qualified deferred compensation plan) which ARE subject to a substantial risk of complete forfeiture. Accordingly, these individuals may never actually receive these unvested benefit amounts. The amounts outlined herein were not included IN their 2023 form w-2, box 5, as taxable medicare wages: james e. fanale, m.d., $125,501; F. Joseph Iannoni, $66,000 AND MARY MARRAN, $49,999. SCHEDULE J, PART I; QUESTION 6A & 6B THE EXECUTIVE COMPENSATION PACKAGE FOR VARIOUS INDIVIDUALS REPORTED ON THIS FORM 990 CONSISTS OF BOTH A FIXED SALARY AND ADDITIONAL AT-RISK COMPENSATION THAT IS BASED ON SEVERAL QUALITATIVE AND QUANTITATIVE COMPONENTS. THE AT-RISK COMPENSATION IS COMPRISED OF BOTH SHORT-TERM AND LONG-TERM FACTORS AS FOLLOWS. THE SHORT-TERM INCENTIVE PROGRAM PROVIDES AN OPPORTUNITY FOR PROGRAM PARTICIPANTS TO EARN AN INCENTIVE AWARD BASED ON THE ACHIEVEMENT OF CRITICAL STRETCH GOALS THAT RECOGNIZE PERFORMANCE ABOVE EXPECTATIONS. THESE GOALS ARE MEASURED FOR EACH FISCAL PERIOD IN THE FOLLOWING CRITICAL AREAS: QUALITY, FINANCIAL AND PATIENT SATISFACTION. THE LONG-TERM INCENTIVE PROGRAM PROVIDES AN OPPORTUNITY FOR PROGRAM PARTICIPANTS TO EARN AN INCENTIVE AWARD BASED ON THE ACCOMPLISHMENT OF CRITICAL MULTI-YEAR SYSTEM PERFORMANCE OBJECTIVES. AWARDS ARE EARNED BY MEASURING SYSTEM PERFORMANCE OVER THREE-YEAR OVERLAPPING PERFORMANCE PERIODS AND ARE MEASURED IN REFERENCE TO GOALS IN THE FOLLOWING CRITICAL AREAS: NET INCOME FROM OPERATIONS, MARKET SHARE, PATIENT SATISFACTION AND STRATEGIC OBJECTIVE. SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2023 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2023 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS BUTLER HOSPITAL ("BUTLER") IS A NON-PROFIT PSYCHIATRIC AND ADDICTIONS HOSPITAL. BUTLER IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, BUTLER PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF AGE, SEX, RACE, COLOR, RELIGION, NATIONAL ORIGIN, ETHNICITY, CULTURE, LANGUAGE, DISABILITY, MARITAL STATUS, EDUCATION, SEXUAL ORIENTATION, GENDER IDENTITY OR EXPRESSION, INCOME, OR ABILITY TO PAY BILL. MOREOVER, BUTLER OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. BUTLER PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF- PAY, MEDICARE AND MEDICAID PATIENTS; 2. BUTLER OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. BUTLER MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF BUTLER RESTS WITH THE BOARD OF DIRECTORS OF CARE NEW ENGLAND HEALTH SYSTEM AND IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. THE OPERATIONS OF BUTLER, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THAT THE HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT AND THAT THE USE AND CONTROL OF BUTLER IS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. HISTORY ======= BUTLER IS AN AFFILIATE WITHIN THE CARE NEW ENGLAND HEALTH SYSTEM ("CARE NEW ENGLAND"). CARE NEW ENGLAND HEALTH SYSTEM IS THE TAX-EXEMPT PARENT OF THE HEALTH SYSTEM. THIS TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. FOUNDED IN 1844, BUTLER IS RHODE ISLAND'S ONLY PRIVATE, NON-PROFIT PSYCHIATRIC AND ADDICTIONS HOSPITAL FOR ADULTS, ADOLESCENTS, AND SENIORS. BUTLER IS AFFILIATED WITH THE WARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY AND IS THE FLAGSHIP HOSPITAL FOR ITS DEPARTMENT OF PSYCHIATRY, WHICH HAS BEEN RECOGNIZED BY ITS PEERS AS ONE OF THE TOP TEN IN THE UNITED STATES. A NATIONAL LEADER IN THE DEVELOPMENT OF ACUTE PSYCHIATRIC AND SUBSTANCE ABUSE TREATMENT, BUTLER IS INVOLVED IN A VARIETY OF RESEARCH EFFORTS WHICH HAS EARNED IT A NATIONAL REPUTATION AS A MAJOR TEACHING AND RESEARCH FACILITY. CARE NEW ENGLAND HEALTH SYSTEM WAS FORMED IN FEBRUARY 1996 BY FOUNDING MEMBERS BUTLER HOSPITAL, KENT COUNTY MEMORIAL HOSPITAL AND WOMEN & INFANTS HOSPITAL OF RHODE ISLAND. THESE THREE HOSPITALS ARE ALL INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATIONS. IN JUNE 1999, KENT COUNTY VISITING NURSE ASSOCIATION BECAME A MEMBER OF THE CARE NEW ENGLAND FAMILY, AND LATER THAT YEAR ANNOUNCED ITS NAME CHANGE TO VNA OF CARE NEW ENGLAND. IN 2000, HEALTHTOUCH, INC., A PRIVATE DUTY NURSING SERVICE, JOINED THE DIVISION. AS OF SEPTEMBER 3, 2013, SOUTHEASTERN HEALTHCARE SYSTEM, INC. ("SHS"), AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION LOCATED IN RHODE ISLAND AND SOUTHEASTERN MASSACHUSETTS, BECAME A SUBSIDIARY OF CARE NEW ENGLAND HEALTH SYSTEM ("CNE"); AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION AND THE PARENT ENTITY OF A RHODE ISLAND BASED TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CNE BECAME THE PARENT ORGANIZATION AND SOLE MEMBER OF SHS AS A RESULT OF THIS ACQUISITION. CNE AND SHS BELIEVE THAT THE ACQUISITION WILL GREATLY IMPROVE COMPREHENSIVE HEALTHCARE SERVICES. THE CARE NEW ENGLAND HEALTH SYSTEM WAS FOUNDED ON THE VISION THAT WE CAN BUILD A BETTER SYSTEM OF HEALTHCARE FOR THE PEOPLE AND COMMUNITIES OF SOUTHEASTERN NEW ENGLAND. THE SYSTEM OFFERS THE LATEST ADVANCES IN MEDICINE, SPECIALTY-TRAINED DOCTORS, AND RESPECTED SERVICES AND CARE. AN INTEGRATED HEALTH SYSTEM THAT OFFERS A CONTINUUM OF QUALITY CARE, CARE NEW ENGLAND IS MOVING HEALTHCARE FORWARD AND REINVENTING THE WAY HEALTHCARE IS DELIVERED. THIS APPROACH PUTS A BROAD SPECTRUM OF CARE - ADDRESSING PRIMARY CARE, MEDICAL CARE, SURGERY, WOMEN'S HEALTH, CARDIOLOGY AND BEHAVIORAL HEALTH AND AN ARRAY OF SPECIALTY AND SUBSPECIALTY PROGRAMS - ALL UNDER ONE UMBRELLA SO THEY ARE EASILY ACCESSIBLE TO PATIENTS AND FAMILIES. CARE NEW ENGLAND IS CURRENTLY COMPRISED OF SIX MEMBERS: BUTLER HOSPITAL, RHODE ISLAND'S ONLY PRIVATE, NONPROFIT PSYCHIATRIC AND ADDICTIONS HOSPITAL FOR ADULTS, YOUNG ADULTS, ADOLESCENTS AND SENIORS; KENT COUNTY MEMORIAL HOSPITAL, THE LARGEST COMMUNITY HOSPITAL IN THE STATE, PROVIDING A FULL SPECTRUM OF PRIMARY AND SECONDARY ACUTE CARE SERVICES; WOMEN & INFANTS HOSPITAL OF RHODE ISLAND, ONE OF THE NATION'S BUSIEST OBSTETRICAL FACILITIES WITH ONE OF THE NATION'S LARGEST SINGLE-FAMILY ROOM NEONATAL INTENSIVE CARE UNITS, THE AREA'S ONLY TERTIARY LEVEL NEONATAL FACILITY, AND VARIOUS SPECIALTY SERVICES; THE MEMORIAL HOSPITAL, UNTIL ITS CLOSURE ON MAY 1, 2018, WAS A COMMUNITY HOSPITAL BASED IN PAWTUCKET, RI, LENDING PRIMARY CARE EXPERTISE TO THE SYSTEM AND THE SYSTEM'S ONLY PATIENT CENTERED MEDICAL HOME MODEL OF CARE; THE VNA OF CARE NEW ENGLAND, WHICH PROVIDES A BROAD SPECTRUM OF HOME HEALTH AND HOSPICE; AND THE PROVIDENCE CENTER, PROVIDING OUTPATIENT MENTAL HEALTH AND SUBSTANCE USE SERVICES IN PATIENTS' HOMES, SCHOOLS AND NEIGHBORHOODS. THE SYSTEM INCLUDES A SOLID, DIVERSE COMBINATION OF PHYSICIAN SPECIALISTS AND GENERALISTS AND A STRONG COMMITMENT TO EDUCATION. BUTLER, MEMORIAL AND WOMEN & INFANTS HOSPITALS ARE MAJOR TEACHING AFFILIATES OF THE WARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY, WHILE KENT IS A TEACHING SITE FOR THE UNIVERSITY OF NEW ENGLAND COLLEGE OF OSTEOPATHIC MEDICINE. IN ADDITION, CARE NEW ENGLAND IS COMMITTED TO ADVANCE THE FIELD OF KNOWLEDGE IN MEDICINE THROUGH NATIONAL AND INTERNATIONALLY-FUNDED AND RECOGNIZED RESEARCH PROJECTS. CARE NEW ENGLAND PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN THE ESTABLISHED RATES. BECAUSE CARE NEW ENGLAND DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. CHARITY CARE INCLUDES SERVICES TO UNINSURED PATIENTS WHO CARE NEW ENGLAND HAS DETERMINED QUALIFY FOR CHARITY CARE UNDER CARE NEW ENGLAND POLICIES. SERVICES TO UNINSURED PATIENTS WHO ARE NOT ELIGIBLE FOR CHARITY CARE OR FOR WHOM CARE NEW ENGLAND WAS NOT ABLE TO DETERMINE THEIR ELIGIBILITY ARE NOT REPORTED AS CHARITY CARE BUT REPORTED IN THE PROVISION FOR BAD DEBTS. ADDITIONALLY, CARE NEW ENGLAND SPONSORS CERTAIN OTHER PROGRAMS WHICH PROVIDE SUBSTANTIAL BENEFIT TO THE BROADER COMMUNITY. SUCH PROGRAMS INCLUDE SERVICES TO NEEDY POPULATIONS, INCLUDING COMMUNITY SERVICE PROGRAMS AND SERVICES FOR SCHOOL-AGED CHILDREN AND THE ELDERLY. CARE NEW ENGLAND ALSO ACTIVELY SPONSORS PROGRAMS ON HEALTH EDUCATION AND WELLNESS. CARE NEW ENGLAND MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE AND COMMUNITY SERVICE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE BASED ON ESTABLISHED RATES FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY AND COMMUNITY SERVICE POLICIES. MISSION ======= BUTLER IS COMMITTED TO: - PROVIDING TREATMENT FOR PSYCHIATRIC AND ADDICTION ILLNESSES IN AN ATMOSPHERE OF DIGNITY AND RESPECT. - CONTRIBUTING TO KNOWLEDGE THROUGH EDUCATION AND RESEARCH. - CONTINUOUSLY IMPROVING THE WAYS WE SERVE OUR PATIENTS AND OUR COMMUNITY. VISION ====== AS A MEMBER OF CARE NEW ENGLAND HEALTH SYSTEM AND THE WARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY TEACHING HOSPITAL, WE SHALL MAINTAIN AND ENHANCE BUTLER'S LEADERSHIP ROLE IN BEHAVIORAL HEALTH SERVICES, TEACHING AND RESEARCH. WE SHALL RESPOND TO THE DEMANDS OF THIS RAPIDLY CHANGING HEALTHCARE ENVIRONMENT THROUGHOUT RHODE ISLAND AND SOUTHEASTERN MASSACHUSETTS. WE SHALL DISTINGUISH OURSELVES BY PROVIDING INDIVIDUALS AND FAMILIES OF ALL AGES AND BACKGROUNDS WITH A FULL CONTINUUM OF QUALITY, COST-EFFECTIVE SERVICES, WHILE CONTINUING OUR COMMITMENT AS AN ACADEMIC CENTER OF EXCELLENCE. CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS VALUES ====== AT BUTLER, WE PUT THE PATIENT AND THEIR FAMILIES AT THE CENTER OF ALL WE DO. IN OUR DAY-TO-DAY INTERACTIONS WITH PATIENTS AND EACH OTHER, OUR ACTIONS AND DECISIONS ARE GUIDED BY THE FOLLOWING CORE VALUES: - ACCOUNTABILITY, - CARING, AND - TEAMWORK. OVERVIEW ======== BUTLER IS THE ONLY ADOLESCENT, ADULT AND GERIATRIC PSYCHIATRIC TREATMENT HOSPITAL SERVING RHODE ISLAND AND SOUTHEASTERN NEW ENGLAND. IT PROVIDES ASSESSMENT AND TREATMENT FOR ALL MAJOR PSYCHIATRIC ILLNESSES AND SUBSTANCE USE DISORDERS. BUTLER'S INPATIENT PROGRAM HAS SEVEN TREATMENT UNITS WITH SPECIALTY PROGRAMS FOR ADOLESCENTS, YOUNG ADULTS AND SENIORS, PEOPLE WITH SUBSTANCE USE PROBLEMS, AND PATIENTS NEEDING INTENSIVE CARE. BUTLER'S PARTIAL HOSPITAL DAY PROGRAM HAS SEPARATE PROGRAMS FOR PSYCHIATRIC DISORDERS AND SUBSTANCE USE DISORDERS, INCLUDING AN AMBULATORY DETOXIFICATION PROGRAM. THE HOSPTIAL'S NEUROLOGY DEPARTMENT PROVIDES OUTPATIENT CARE IN ITS MEMORY AND AGING PROGRAM AND ITS MOVEMENT DISORDERS PROGRAM. BUTLER IS A MEMBER OF THE CARE NEW ENGLAND HEALTH SYSTEM AND IS A MAJOR TEACHING AFFILIATE OF THE WARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY. IT IS THE FLAGSHIP HOSPITAL FOR BROWN'S DEPARTMENT OF PSYCHIATRY WHICH HAS BEEN RECOGNIZED AS ONE OF THE TOP TEN IN THE UNITED STATES. IT IS ALSO A TRAINING FACILITY FOR RESIDENTS, MEDICAL STUDENTS, INTERNS, AND STUDENTS IN ADULT PSYCHIATRY AND PSYCHOLOGY AT BROWN UNIVERSITY AS WELL AS NURSING, PHARMACY, SOCIAL WORK AND OCCUPATIONAL THERAPY STUDENTS AND INTERNS FROM OTHER COLLEGES AND UNIVERSITIES IN THE REGION AND ACROSS THE COUNTRY. A NATIONALLY AND INTERNATIONALLY RECOGNIZED RESEARCH CENTER, BUTLER LEADS CUTTING-EDGE RESEARCH INITIATIVES WHICH INCLUDE STUDIES IN DEPRESSION, OBSESSIVE COMPULSIVE DISORDER, ALZHEIMER'S DISEASE AND OTHER MEMORY DISORDERS, MOVEMENT DISORDERS, ANXIETY, CAREGIVER STRESS, SUBSTANCE ABUSE AND FAMILY VIOLENCE, RISK-TAKING BEHAVIORS, AND SMOKING CESSATION. BUTLER EMPLOYS APPROXIMATELY 900 FULL-TIME AND PART-TIME CLINICAL AND NON-CLINICAL STAFF. MORE THAN 145 VOLUNTEERS ASSIST THE STAFF IN NEARLY ALL AREAS OF THE HOSPITAL. AS A REGIONAL CENTER IN PSYCHIATRY, BUTLER PROVIDES SERVICES TO PEOPLE DEALING WITH A WIDE RANGE OF PSYCHIATRIC AND SUBSTANCE USE PROBLEMS INCLUDING BUT NOT LIMITED TO: - DEPRESSION - BIPOLAR DISORDER - SUICIDAL BEHAVIOR - SUBSTANCE USE DISORDERS - PSYCHOTIC DISORDERS - OBSESSIVE COMPULSIVE DISORDER - MOVEMENT DISORDERS - MEMORY DISORDERS - ALZHEIMER'S DISEASE - ANXIETY DISORDERS COMPREHENSIVE SERVICES ====================== BUTLER PROVIDES COMPREHENSIVE PSYCHIATRIC EVALUATIONS AND TREATMENT IN THESE PRIMARY SETTINGS: PATIENT ASSESSMENT SERVICES - 24-HOUR EVALUATIONS AND ASSESSMENTS FOR PEOPLE WITH PSYCHIATRIC ILLNESSES, SUCH AS MAJOR DEPRESSION, ANXIETY, OR ADDICTION DISORDERS. INPATIENT CARE - PROVIDES 24-HOUR TREATMENT FOR MAJOR PSYCHIATRIC ILLNESSES INCLUDING DEPRESSION, MANIC-DEPRESSIVE ILLNESS, PSYCHOTIC DISORDERS AND SUBSTANCE ABUSE DETOXIFICATION. THE HOSPITAL ALSO PROVIDES SPECIALIZED PROGRAMS FOR ADOLESCENTS, SENIORS AFFECTED BY ALZHEIMER'S DISEASE, MEMORY LOSS AND OTHER PROBLEMS ASSOCIATED WITH AGING. PARTIAL HOSPITAL PROGRAMS - COMBINES HOSPITAL TREATMENT WITH A PATIENT'S LIFE AT HOME AND IN THE COMMUNITY. THE PARTIAL HOSPITAL HAS SPECIALIZED SERVICES INCLUDING ABUSED WOMEN, YOUNG ADULT AND ADULT PSYCHIATRIC ILLNESSES AND BEHAVIORAL PROBLEMS, AND ADULT SUBSTANCE ABUSE. OUTPATIENT SERVICES - THE HOSPITAL PROVIDES SPECIALIZED SERVICES THROUGH ITS MEMORY AND AGING PROGRAM AND MOVEMENT DISORDERS PROGRAM AS WELL AS INTENSIVE OUTPATIENT SERVICES FOR OBESSIVE-COMPULSIVE AND ANXIETY DISORDERS. COMMUNITY SERVICE ================= THE HOSPITAL SUPPORTS THE FOLLOWING ORGANIZATIONS IN A VARIETY OF WAYS INCLUDING COMMUNITY EDUCATION AND AWARENESS PROGRAMS, PROVIDING MEETING AND CONFERENCE AND OFFICE SPACE, AND PARTICIPATION ON VARIOUS BOARDS AND COMMITTEES WORKING TO IMPROVE THE MENTAL HEALTH STATUS OF PEOPLE AND FAMILIES. ALCOHOLICS ANONYMOUS ALPERT SCHOOL OF MEDICINE OF BROWN UNIVERSITY AMERICAN OCCUPATIONAL THERAPY ASSOCIATION AUTISM PROJECT BEHAVIORAL HEALTH COUNCIL OF COMMUNITY MENTAL HEALTH CENTERS DEPARTMENT OF BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND HOSPITALS DEPARTMENT OF HEALTH DEPARTMENT OF CHILDREN, YOUTH AND FAMILIES (DCYF) GAMBLERS ANONYMOUS IVY LEAGUE PSYCHIATRIC HOSPITALS LATINO PUBLIC RADIO MANIC DEPRESSIVE AND DEPRESSIVE ASSOCIATION MENTAL HEALTH ASSOCIATION OF RHODE ISLAND NATIONAL ALLIANCE FOR THE MENTALLY ILL, RHODE ISLAND NATIONAL ASSOCIATION OF PSYCHIATRIC HEALTH SYSTEMS NARCOTICS ANONYMOUS OCD RHODE ISLAND, OCD INTERNATIONAL FOUNDATION RHODE ISLAND PARENTING INFORMATION NETWORK NATIONAL ASSOCIATION OF SOCIAL WORKERS RHODE ISLAND STATE NURSES ASSOCIATION RHODE ISLAND BLOOD CENTER RHODE ISLAND PSYCHOTHERAPY SOCIETY UNITED WAY PUBLIC AND PROFESSIONAL EDUCATION PROGRAMS ========================================== BUTLER HOSPITAL BELIEVES COMMUNITY EDUCATION AND INFORMATION IS CRITICAL TO REDUCING STIGMA AND IMPROVING TREATMENT OUTCOMES THROUGH EARLY RECOGNITION OF A POSSIBLE PROBLEM. ANNUALLY, THE HOSPITAL SPONSORS PUBLIC AND PROFESSIONAL EDUCATION PROGRAMS INCLUDING THE ANNUAL ANTONIO CAPONE, MD CONFERENCE ON THE AGING BRAIN AND OCD MONTHLY EDUCATION LECTURE SERIES. IN ADDITION, THE HOSPITAL IS A YEARLY SPONSOR OF THE ANNUAL MAY IS MENTAL HEALTH MONTH PROGRAMS OFFERED BY THE MENTAL HEALTH ASSOCIATION OF RHODE ISLAND. THE HOSPITAL ALSO PARTICIPATES IN ONGOING HEALTH EDUCATION ACTIVITIES OFFERED BY ITS CARE NEW ENGLAND PARTNERS. PATIENT FAMILY EDUCATION CENTER & ON-LINE MENTAL HEALTH SCREENINGS ================================================================== THE BUTLER HOSPITAL PATIENT/FAMILY EDUCATION CENTER PROVIDES FREE INFORMATION ON BEHAVIORAL DISORDERS, ADDICTION, AND OTHER MEDICAL ISSUES. COMPUTER SEARCHES ARE PROVIDED ON REQUEST. DEVELOPED IN ASSOCIATION WITH THE ALLIANCE FOR THE MENTALLY ILL AND THE MANIC DEPRESSIVE AND DEPRESSIVE ILLNESS ASSOCIATION, THE CENTER IS THE LARGEST HOSPITAL-BASED INFORMATION CENTER OF ITS TYPE IN THE AREA. IN ADDITION, THE HOSPITAL SUPPORTS AN ON-LINE MENTAL HEALTH SCREENING FOR DEPRESSION, BIPOLAR DISORDER, EATING DISORDERS, GENERALIZED ANXIETY DISORDER, POST-TRAUMATIC STRESS DISORDER, SUBSTANCE ABUSE. SUPPORT GROUPS ============== IN ADDITION TO PROVIDING MEETING SPACE TO MANY MENTAL HEALTH AND ADDICTION SUPPORT GROUPS IN THE COMMUNITY, THE HOSPITAL PROVIDES THE FOLLOWING FREE SUPPORT GROUPS: - WEEKLY SELF-HELP GROUP FOR PATIENTS AND FORMER PATIENTS OF THE ALCOHOL & DRUG PROGRAM - FIVE DIFFERENT WEEKLY ADDICTION RECOVERY GROUPS - MONTHLY SUPPORT GROUP FOR PEOPLE SUFFERING FROM COMPULSIVE HOARDING - BI-WEEKLY ANXIETY AND DEPRESSION SUPPORT GROUP - BI-WEEKLY DEPRESSION AND BIPOLAR SUPPORT GROUP - WEEKLY COGNITIVE BEHAVIORAL THERAPY SKILLS SUPPORT GROUP FOR FORMER PATIENTS OF THE PARTIAL HOSPITAL PROGRAMS - WEEKLY DIALECTICAL BEHAVIOR THERAPY SKILLS TRAINING AND SELF-HELP SUPPORT GROUP FOR FORMER PATIENTS OF THE PARTIAL HOSPITAL WOMEN'S PROGRAM - MONTHLY SUICIDE SUPPORT GROUP CORE FORM, PART V, QUESTION 1A & CORE FORM, PART VII; SECTION B THE ORGANIZATION IS AN AFFILIATE WITHIN CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE ORGANIZATION'S FORM 990 REFLECTS ONE TOP FIVE INDEPENDENT CONTRACTOR FOR SERVICES AND REPORTS THAT NO FORMS 1099 WERE FILED WITH THE INTERNAL REVENUE SERVICE ("IRS"). CARE NEW ENGLAND HEALTH SYSTEM, A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION PAYS ALL OUTSTANDING ACCOUNTS PAYABLE INVOICES ON BEHALF OF THIS ORGANIZATION. IN CONJUNCTION WITH THIS SERVICE, CARE NEW ENGLAND HEALTH SYSTEM ALSO PREPARES AND ISSUES FORMS 1099 TO THESE VENDORS RECEIVING PAYMENTS WHERE APPLICABLE AND FILES THESE FORMS 1099 WITH THE IRS. CARE NEW ENGLAND HEALTH SYSTEM ALLOCATES THESE PAYMENTS TO THE ORGANIZATION VIA AN INTERCOMPANY ACCOUNT. CORE FORM, PART V, QUESTION 15 JAMES E. FANALE, M.D. IS A FORMER OFFICER/VOTING MEMBER OF THIS ORGANIZATION'S GOVERNING BODY. DR. FANALE WAS NOT INVOLVED WITH THIS ORGANIZATION IN ANY OTHER CAPACITY; HE PROVIDED NO SERVICES TO OR FOR THIS ORGANIZATION AND WAS NOT INVOLVED IN THE MANAGEMENT OF THIS ORGANIZATION. DR. FANALE SERVED AS THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF CARE NEW ENGLAND HEALTH SYSTEM. ACCORDINGLY, HIS COMMON LAW EMPLOYER/EMPLOYEE RELATIONSHIP WAS WITH CARE NEW ENGLAND HEALTH SYSTEM (EIN: 05-0490997). CARE NEW ENGLAND HEALTH SYSTEM FILED A 2023 FORM 4720 WHICH INCLUDED A REMITTANCE OF EXCISE TAX RELATED TO DR. FANALE'S COMPENSATION IN EXCESS OF $1M. MICHAEL E. WAGNER, M.D. SERVES AS A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS; AN UNCOMPENSATED POSITION. DR. WAGNER IS EMPLOYED BY A RELATED ORGANIZATION. ACCORDINGLY, HIS COMMON LAW EMPLOYER/EMPLOYEE RELATIONSHIP WAS WITH CARE NEW ENGLAND HEALTH SYSTEM (EIN: 05-0490997). CARE NEW ENGLAND HEALTH SYSTEM FILED A 2023 FORM 4720 WHICH INCLUDED A REMITTANCE OF EXCISE TAX RELATED TO DR. WAGNER'S COMPENSATION IN EXCESS OF $1M. CORE FORM, PART VI, SECTION A; QUESTION 3 THE ORGANIZATION IS AN AFFILIATE WITHIN CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). CARE NEW ENGLAND HEALTH SYSTEM ("CNE") IS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION AND SERVES AS THE PARENT ORGANIZATION OF THE SYSTEM. AS THE PARENT ORGANIZATION OF THE SYSTEM CNE PROVIDES VARIOUS CORPORATE RELATED SERVICES FOR THE BENEFIT OF VARIOUS SYSTEM ENTITIES; INCLUDING THIS ORGANIZATION. THESE CORPORATE SERVICES, INCLUDE, BUT ARE NOT LIMITED TO, EXECUTIVE, LEGAL AND RISK MANAGEMENT, COMPLIANCE AND GOVERNANCE, HUMAN RESOURCES AND FINANCE. CNE ALLOCATES A PERCENTAGE OF ITS TOTAL CORPORATE RELATED SERVICES COSTS TO VARIOUS SYSTEM ENTITIES, INCLUDING THIS ORGANIZATION, AS REIMBURSEMENT FOR THESE CORPORATE RELATED SERVICES. THE REIMBURSEMENT TO CNE IS REFLECTED AS AN EXPENSE FOR THESE ORGANIZATIONS. THE ORGANIZATION ENGAGES SODEXHO MANAGEMENT, INC. TO BE AN AGENT OF THE ORGANIZATION AND DELEGATES CONTROL TO SODEXHO IN THE MANAGEMENT OF DAILY OPERATIONS OF ITS FOOD AND NUTRITION DEPARTMENT. THE SODEXHO MANAGEMENT EMPLOYEE FUNCTIONS AND IS RECOGNIZED AS A DEPARTMENT MANAGER WHO PERFORMS IN ACCORDANCE WITH THE ORGANIZATION'S DEPARTMENT MANAGEMENT PRACTICES AND IN ACCORDANCE WITH ITS WRITTEN POLICIES AND PROCEDURES. THE POSITION REPORTS TO AN OFFICER/KEY EMPLOYEE OF THE ORGANIZATION. CORE FORM, PART VI, SECTION A; QUESTIONS 6 AND 7 CARE NEW ENGLAND HEALTH SYSTEM ("CNE") IS THE SOLE MEMBER OF THIS ORGANIZATION. CNE HAS THE ULTIMATE AUTHORITY TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE WITHIN CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CARE NEW ENGLAND HEALTH SYSTEM IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF ITS GOVERNING BODY (ITS BOARD OF DIRECTORS) PRIOR TO THE FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). THE CARE NEW ENGLAND HEALTH SYSTEM BOARD OF DIRECTORS HAS DELEGATED TO THE FINANCE COMMITTEE THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR THE TAX-EXEMPT AFFILIATES OF THE SYSTEM. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CERTIFIED PUBLIC ACCOUNTING ("CPA") FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE DEPARTMENT LEADERSHIP ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR THEIR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. THEREAFTER, THE FINAL FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO THE FILING WITH THE IRS. CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY WITH WHICH IT REGULARLY MONITORS AND ENFORCES COMPLIANCE. THE POLICY REQUIRES THAT A CONFLICT OF INTEREST DISCLOSURE FORM CONSISTENT WITH BEST GOVERNANCE PRACTICES AND INTERNAL REVENUE SERVICE GUIDELINES BE CIRCULATED TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY. IF AN INDIVIDUAL DISCLOSES AN INTEREST THAT COULD GIVE RISE TO A CONFLICT, THE INDIVIDUAL'S POTENTIAL CONFLICT IS REFERRED TO THE BOARD OF DIRECTORS, WHICH EVALUATES THE CONFLICT AND ITS POTENTIAL IMPACT ON THE INDIVIDUAL'S PARTICIPATION ON THE BOARD OR ON CERTAIN ISSUES THAT MAY COME BEFORE THE BOARD. AFTER CONSULTATION WITH THE ORGANIZATION'S GENERAL COUNSEL, THE BOARD WILL TAKE ANY NECESSARY MITIGATING ACTION, IF APPROPRIATE AND NECESSARY, TO ADDRESS ANY SUCH CONFLICT IN A MANNER CONSISTENT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. CORE FORM, PART VI, SECTION B; QUESTION 15 THE BOARD OF DIRECTORS OF CARE NEW ENGLAND HEALTH SYSTEM ("CNE") HAS A COMMITTEE OF DIRECTORS KNOWN AS THE CNE COMPENSATION COMMITTEE ("THE COMMITTEE"). THE COMMITTEE IS RESPONSIBLE FOR DISCHARGING THE BOARD'S RESPONSIBILITIES REGARDING THE TOTAL COMPENSATION PROGRAM FOR EXECUTIVES AND KEY PHYSICIANS IN CONJUNCTION WITH THE BUTLER HOSPITAL PRESIDENT AND CHIEF OPERATING OFFICER. THE COMMITTEE AT ALL TIMES CONDUCTS ITSELF FREE FROM EXECUTIVE MANAGEMENT IN ITS DECISION MAKING PROCESS EXCEPT WITH RESPECT TO DECISIONS RELATING TO THE PRESIDENT AND CHIEF OPERATING OFFICER WHICH ARE MADE IN CONJUNCTION WITH THE CARE NEW ENGLAND HEALTH SYSTEM CHIEF EXECUTIVE OFFICER. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THIS ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF BUTLER HOSPITAL SENIOR MANAGEMENT TEAM, INCLUDING, BUT NOT LIMITED TO, THE BUTLER HOSPITAL PRESIDENT/CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF DIRECTORS; EACH OF WHOM ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILARLY SIZED HEALTHCARE SYSTEMS AND HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING, BUT NOT LIMITED TO, THE PRESIDENT/CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE CNE COMPENSATION COMMITTEE. IN ADDITION, THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE BUTLER HOSPITAL PRESIDENT/CHIEF OPERATING OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION HAS BEEN ALLOCATED A PORTION OF TAX-EXEMPT BONDS (THROUGH ITS TAX-EXEMPT PARENT CARE NEW ENGLAND HEALTH SYSTEM) TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. THE ORGANIZATION HAS REFLECTED THIS AMOUNT AS A DUE TO AFFILIATE LIABILITY ON ITS BALANCE SHEET. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE SYSTEM'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. IN ADDITION, THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF RHODE ISLAND SECRETARY OF STATE. CORE FORM, PART VII AND SCHEDULE J CORE FORM, PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME OR PART-TIME EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR A RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF DIRECTORS. CORE FORM, PART VII, SECTION A, COLUMN B THE ORGANIZATION IS AN AFFILIATE WITHIN CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF DIRECTOR MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION. CORE FORM, PART X; LINE 25 THE ORGANIZATION IS AN AFFILIATE WITHIN CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM HAS A NUMBER OF OUTSTANDING LONG-TERM OBLIGATED GROUP DEBT LIABILITIES, INCLUDING THE FOLLOWING BOND ISSUANCES: - RHODE ISLAND HEALTH AND EDUCATIONAL BUILDING CORPORATION BONDS SERIES 2016B. THE BONDS OUTLINED ABOVE AND VARIOUS OTHER LONG-TERM BORROWINGS ARE ALLOCATED BY CARE NEW ENGLAND HEALTH SYSTEM; THE TAX-EXEMPT PARENT OF THE SYSTEM, TO THE FOLLOWING SYSTEM MEMBER HOSPITALS AND CERTAIN OTHER AFFILIATES. THE BALANCE SHEET OF THESE RESPECTIVE MEMBER HOSPITALS AND CERTAIN OTHER AFFILIATES REFLECTS A OBLIGATED GROUP LIABILITY. ACCORDINGLY, THIS CARE NEW ENGLAND HEALTH SYSTEM OBLIGATED GROUP LIABILITY IS REFLECTED ON THE BALANCE SHEET OF THE FOLLOWING SUBSIDIARY ORGANIZATIONS: - BUTLER HOSPITAL, EIN: 05-0258812 - KENT COUNTY MEMORIAL HOSPITAL, EIN: 05-0258896 - SHS VENTURES, INC., EIN: 05-0510341 - THE MEMORIAL HOSPITAL, EIN: 05-0259004 - THE PROVIDENCE CENTER, INC., EIN: 05-0316969 - VNA OF CARE NEW ENGLAND, EIN: 05-0242659 - WOMEN AND INFANTS CORPORATION, EIN: 02-2885807 - WOMEN & INFANTS HOSPITAL OF RHODE ISLAND, EIN: 05-0258937 SCHEDULE K WAS PREPARED ON A CONSOLIDATED BASIS AND IS INCLUDED IN THE FORM 990 OF CARE NEW ENGLAND HEALTH SYSTEM, EIN: 05-0490997. CORE FORM, PART XI; LINE 9 OTHER CHANGES IN FUND BALANCE INCLUDE: - PENSION AND POSTRETIREMENT ADJUSTMENT - ($1,543,159); - NET ASSETS RELEASED FROM RESTRICTIONS USED FOR PURCHASE OF PP&E - $9,506,607; - NET ASSETS RELEASED FROM RESTRICTIONS - $601,217; AND - OTHER CHANGES IN NET ASSETS WITH DONOR RESTRICTIONS - ($8,379,907). CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S PARENT ENTITY IS CARE NEW ENGLAND HEALTH SYSTEM. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CARE NEW ENGLAND HEALTH SYSTEM AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED SEPTEMBER 30, 2024 AND SEPTEMBER 30, 2023; RESPECTIVELY. AN UNMODIFIED OPINION WAS ISSUED EACH YEAR BY THE INDEPENDENT CPA FIRM. CARE NEW ENGLAND HEALTH SYSTEM'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. CORE FORM, PART XII; QUESTION 3 THE ORGANIZATION IS AN AFFILIATE WITHIN CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED AUDIT UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 AUDIT. CARRIAGE HOUSE LLC 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 208277056 RENTAL ESTATE RI 712230 2921554 BH BUTLER HOSPITAL ALLIED MEDICAL SVCS LLC 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 453034297 HEALTHCARE RI 0 0 BH BLACKSTONE HEALTH INC 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050427007 HEALTHCARE RI 501(C)(3) 509(A)(1) KCVNA false BUTLER HOSPITAL FOUNDATION 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 454530540 SUPPORT ORG RI 501(C)(3) 509(A)(3) BH true CARE NEW ENGLAND HEALTH SYSTEM 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050490997 HEALTHCARE RI 501(C)(3) 509(A)(3) NA false GRANDVIEW REALTY CORPORATION 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050384362 TITLE HLDG. RI 501(C)(3) 509(A)(2) TPC false GRANDVIEW SECOND CORPORATION 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 222812929 TITLE HLDG. RI 501(C)(3) 509(A)(2) TPC false HEALTHTOUCH INC 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050514949 HEALTHCARE RI 501(C)(3) 509(A)(2) KCVNA false KENT COUNTY MEMORIAL HOSPITAL 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050258896 HEALTHCARE RI 501(C)(3) HOSPITAL CNE false KENT COUNTY VNA DBA VNA OF CNE 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050242659 HEALTHCARE RI 501(C)(3) 509(A)(1) CNE false KENT HOSPITAL FOUNDATION 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050514640 SUPPORT ORG RI 501(C)(3) 509(A)(3) KCMH false NASHUA STREET CORPORATION 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050509674 TITLE HLDG. RI 501(C)(3) 509(A)(2) TPC false SHS VENTURES INC 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050510341 HEALTHCARE RI 501(C)(3) 509(A)(2) TMH false SOUTHEASTERN HEALTHCARE SYSTEM INC 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 061476858 HEALTHCARE RI 501(C)(3) 509(A)(3) CNE false STANDARD REALTY INC 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 222479719 INACTIVE RI 501(C)(3) 509(A)(2) TPC false THE MEMORIAL HOSPITAL 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050259004 HEALTHCARE RI 501(C)(3) HOSPITAL SEHCS false THE MEMORIAL HOSPITAL FOUNDATION 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 463246618 HEALTHCARE RI 501(C)(3) 509(A)(3) TMH false THE PROVIDENCE CENTER INC 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050316969 HEALTHCARE RI 501(C)(3) 509(A)(2) CNE false TPC SOCIAL VENTURES INC 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050441980 TRAINING RI 501(C)(3) 509(A)(2) TPC false VNA OF CARE NEW ENGLAND FOUNDATION 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 462293974 SUPPORT ORG RI 501(C)(3) 509(A)(3) KCVNA false WIH FACULTY PHYSICIANS INC 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 043579432 HEALTHCARE MA 501(C)(3) 509(A)(2) WIH false WILSON STREET APARTMENTS 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050520857 TITLE HLDG. RI 501(C)(3) 509(A)(2) TPC false WOMEN AND INFANTS CORPORATION 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 022885807 HEALTHCARE RI 501(C)(3) 509(A)(3) CNE false WOMEN AND INFANTS DEVELOPMENT FOUNDATION 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 222885815 HEALTHCARE RI 501(C)(3) 509(A)(3) WIC false WOMEN & INFANTS HOSPITAL OF RHODE ISLAND 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050258937 HEALTHCARE RI 501(C)(3) HOSPITAL WIC false CARE NEW ENGLAND AMBULATORY SURGERY CTR 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 871378551 INACTIVE RI 501(C)(3) 509(A)(2) CNE false TOLL GATE INDEMNITY LTD 23 LIME TREE BAY AVE PO BOX 1051 GRAND CAYMAN CJ KY1-11 342028514 FINANCIAL VEHICLE CJ NA C CORP. false W & I INDEMNITY LTD 23 LIME TREE BAY AVE PO BOX 1051 GRAND CAYMAN CJ KY1-11 980159342 FINANCIAL VEHICLE CJ NA C CORP. false BOULEVARD MEDICAL CONDO ASSOCIATION 4 RICHMOND SQUARE 4TH FL PROVIDENCE RI 02906 050497862 REAL ESTATE RI NA C CORP. false false false false true true false false false false true true false true true true true false true true BUTLER HOSPITAL FOUNDATION C 64499 COST SCHEDULE R, PART V THIS ORGANIZATION IS A MEMBER OF CARE NEW ENGLAND HEALTH SYSTEM; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. FUNDS ARE ROUTINELY TRANSFERRED BETWEEN AFFILIATES AND BUSINESS ACTIVITIES ARE COMMON ON BEHALF OF THE SYSTEM'S AFFILIATES, INCLUDING THIS ORGANIZATION. THESE TRANSACTIONS MAY BE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND OTHER AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY COST EFFECTIVE HEALTHCARE AND WELLNESS SERVICES TO THEIR COMMUNITIES REGARDLESS OF ABILITY TO PAY AND IN FURTHERANCE OF CHARITABLE TAX-EXEMPT PURPOSES.