2016-08-12T07:41:40-07:00 2015-09-30 KPMG LLP 2 Financial Center 60 South St Boston MA 02111 990 2014-10-01 050258914 Newport Hospital NEWP 4018466400 11 Friendship Street Newport RI 02840 Mary A Wakefield Treasurer 2016-08-12 true Tara D'Agostino P01245482 6179881000 2014 2016-09-27 15:27:22Z Crista F Durand 11 Friendship Street Newport RI 02840 195485724 false false X www.lifespan.org/newport/ X 1873 RI As a member hospital in the Lifespan health system, Newport Hospital (NH) is committed to its mission: Delivering health with care. 20 14 950 215 -176415 -1618 5070084 8817112 104302891 98569263 3816731 3469861 0 113189706 110856236 54300 0 51965700 53114806 0 0 58274442 52581954 110240142 105751060 2949564 5105176 331502653 308039967 48211259 52785269 283291394 255254698 X As a member hospital in the Lifespan health system, NH is committed to its mission: Delivering health with care. false false 42098691 44656215 During the fiscal year ended September 30, 2015, NH reported 22,018 inpatient days, 4,521 discharges, 406 newborn deliveries, and 952 inpatient surgeries. NH provides a range of diagnostic therapeutic healthcare services including: behavioral medicine, cardiac services, childbirth, orthopedics, and pulmonary medicine. (See Schedule O, Part III, Line 4a) 35830321 50865044 NH provides certain healthcare services on an outpatient basis. In fiscal year 2015, NH experienced outpatient volume of 42,261 equivalent outpatient days and performed 3,876 outpatient surgeries. Outpatient services are also provided in NH's Emergency Department, which had 30,965 patient visits in fiscal 2015. (See Schedule O, Part III, Line 4b) 4063015 2947214 The Noreen Stonor Drexel Birthing Center (the Center) at NH delivered 406 newborns during the fiscal year ended September 30, 2015. The Center is a separate unit at NH for labor and delivery, enabling patients to remain in the same location for labor, delivery, recovery, and post-partum care. The Center's staff includes board-certified obstetricians, pediatricians, family practitioners, anesthesiologists, a certified nurse mid-wife, and registered nurses who have received national certifications in obstetrical nursing. The Center at NH has received the "Baby Friendly" designation from the World Health Organization and UNICEF. 81992027 true true false false false false false false false true true true false true true true true true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true false false false false true 64 0 true 950 true true true false false false false false false 0 false false false false false false false false false false X 20 14 true false true false true true true true true false false true true true true true true true true false X Mary A Wakefield 4014447914 593 Eddy Street Providence RI 02903 X Thomas Anders MD Trustee 0.50 3.75 X 0 0 0 Lawrence Aubin Sr Chair 4.00 16.00 X X 0 0 0 Timothy J Babineau MD Trustee 1.00 39.00 X 0 2097376 308492 Emanuel Barrows Trustee 0.50 1.50 X 0 0 0 Roger Begin Trustee 0.00 0.00 X 0 0 0 David A Brown Trustee 0.50 4.50 X 0 0 0 Peter Capodilupo Trustee 0.50 3.00 X 0 0 0 Ellen Collis Trustee 0.50 4.50 X 0 0 0 Michael G Ehrlich MD Trustee 0.50 3.00 X 0 6439 0 Jonathan D Fain Trustee 0.30 1.85 X 0 0 0 Edward D Feldstein Trustee 0.50 3.00 X 0 0 0 David Gorelick MD Trustee 0.25 3.75 X 0 0 0 Michael L Hanna Trustee 0.50 4.00 X 0 0 0 Pamela Harrop MD Trustee 0.75 4.75 X 0 0 0 Marie J Langlois Trustee 0.25 5.75 X 0 0 0 Jerrold Lavine Trustee 0.00 14.00 X 0 0 0 Alan H Litwin Vice Chair 1.00 6.00 X X 0 0 0 Steven Pare Trustee 4.00 14.50 X 0 0 0 Lloyd Robertson Trustee 0.25 4.35 X 0 0 0 Lawrence Sadwin Trustee 2.00 11.00 X 0 0 0 Fred J Schiffman Trustee 0.50 3.00 X 0 0 0 Shivan Subramaniam Trustee 0.75 7.75 X 0 0 0 Jane Williams MD Trustee 0.00 0.00 X 0 0 0 Brian J Zink MD Trustee 0.50 2.00 X 0 1000 0 Kenneth E Arnold Secretary 1.00 39.00 X 0 732566 30234 Crista F Durand President 35.00 5.00 X 0 150773 26614 Mary A Wakefield Treasurer 1.25 38.75 X 0 1667207 124092 Frank J Byrne VP of Finance 25.00 15.00 X 0 278091 50092 Thomas McGue MD Chief Medical Officer 40.00 0.00 X 294970 0 29728 Denise Sullivan Chief Nursing Officer 40.00 0.00 X 208868 0 45676 Bartholomew L Grimes Admin. Director 40.00 0.00 X 203107 0 216988 David R Harriman Quality Measuremnt 40.00 0.00 X 117584 0 11207 Christina S Loulan Dir. Surgical Svcs 40.00 0.00 X 120447 0 8805 Pamela McLaughlin Dir.- Patient Exp. 40.00 0.00 X 118308 0 32336 Paul Parchesky Pharmacy Mgr. 40.00 0.00 X 121327 0 23819 Todd A Cipriani VP of Professional Svcs 0.00 40.00 X 0 276911 54168 August B Cordeiro President 0.00 40.00 X 0 300411 28154 Cathy E Duquette VP Nursing Svcs 0.00 40.00 X 0 533009 76523 Paula M Gillette Chief Nursing Officer 0.00 0.00 X 104916 0 0 Terrence McWilliams Chief Medical Officer 0.00 40.00 X 224597 8819 144 Arthur J Sampson President 0.00 40.00 X 0 798579 32314 1514124 6851181 1099386 27 true true false Sodexo Inc PO Box 360170 Pittsburgh PA 15251 Food services 648352 APG Security 171 Service Avenue Warwick RI 02886 Security services 549861 Providence Anesthesiologists 245 Chapman Street Providence RI 02905 Medical, health care 351602 RINGO LLC 445 Broadhollow Road Melville NY 11747 Personnel staffing 337408 Aquidneck Radiologists 11 Friendship Street Newport RI 02840 Medical, health care 275000 9 8735826 20500 60786 8817112 Ancillary OP Service Rev. 622110 50865044 50865044 Cafe./Misc Pharm. sales 622110 15135 15135 Inpatient Service Revenue 622110 44641080 44641080 Lifespan Laboratory 621150 100790 100790 Obstetrics - Birthing Ctr 622110 2947214 2947214 98569263 1016758 1016758 0 0 0 87082591 84352283 277205 2730308 -277205 2453103 -277205 2730308 0 0 0 Laboratory 621500 0 110856236 98468473 -176415 3747066 54300 54300 0 0 0 515071 386303 128768 0 41302232 37308250 3993982 1346279 1217361 128918 6916785 6243477 673308 3034439 2738633 295806 0 0 0 0 0 551712 551712 2797145 2797145 166420 166420 158927 135088 23839 0 0 7261385 6172177 1089208 29433 27373 2060 0 0 683331 683331 0 6566158 6566158 1488210 1264978 223232 Purchased services 11961259 2692159 9269100 Medical & surgical supplies 10465151 10461059 4092 State license fee 5307802 5307802 Provision for bad debts 4422669 4422669 722352 596833 125519 105751060 81992027 23759033 0 8046669 5312790 0 0 10189799 7940036 0 0 0 1559608 1520440 363003 533712 168653912 107505277 59425881 61148635 55102072 52309929 30300770 29315853 0 1330893 1330893 165183958 148627679 331502653 308039967 9450007 8932110 20275000 19096723 18486252 24756436 48211259 52785269 X 211654645 186753778 60766728 57733228 10870021 10767692 283291394 255254698 331502653 308039967 X 5105176 -5713881 -27427991 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 88297544 677962 -2508607 2187605 84279294 85114869 1040214 4555691 2413230 88297544 82940259 740577 3772004 2337971 85114869 79227445 1852434 7437381 5577001 82940259 76534229 7867456 1187929 6362169 79227445 0.18830 0.68390 0.12780 true true true 1406761 1406761 97590767 56340223 41250544 1147603 1104965 42638 68508781 50060089 18448692 61148635 29315853 Cash and short-term investments 1490642 Deferred financing costs & other assets 155628 Intercorporate financing 11766563 Interest in Net Assets of NH Foundation 134051976 Outside trusts 1162870 148627679 Accrued pension 19517400 Accrued Post Retirement Liab 557500 Health care benefit self-insurance 718210 Note Payable to Affiliate 2635000 Other Liabilities 66437 Third-party liabilities 1261889 24756436 X 72739983 -5713881 -27427991 -33141872 105881855 551712 4422669 4974381 110856236 100776679 100776679 551712 4422669 4974381 105751060 Part V, Line 4: Intended uses of the endowment fund. Newport Hospital's (NH's) endowment funds were established for a variety of purposes, including both donor-restricted endowment funds and funds designated by NH to function as endowments. NH's largest permanently restricted endowment funds support its emergency department, as well as promoting athletic activity and wellness among youth and families of Newport County. Other endowments of NH support patient care, including a comprehensive range of diagnostic and therapeutic health care services, as well as providing financial aid for persons requiring medical and nursing services.NH's largest board-designated endowment is used to support and maintain its facilities. Significant temporarily restricted funds held by NH are used for the purposes of: (1) interventional radiology; (2) supporting the operations of NH's Emergency Department; (3) the purchase of medical equipment; (4) rehabilitation services; and (5) support of NH's Birthing Center. Part X : FIN48 Footnote NH, as a not-for-profit corporation, is recognized under Section 501(c)(3) of the Internal Revenue Code and is exempt from Federal income taxes pursuant to Section 501(a) of the Code. NH 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 to be realized upon settlement. Changes in measurement are reflected in the period in which the change in judgment occurs. NH did not recognize the effect of any income tax positions during the fiscal year ended September 30, 2015. Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S Provision for bad debts $4422669 Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S Provision for Bad Debts $4422669 true true true X true X true true true false true true 2483106 1690341 792765 0.00780 17748468 14244109 3504359 0.03460 20231574 15934450 4297124 0.04240 259078 9932 249146 0.00250 14805220 11654301 3150919 0.03110 37124 37124 0.00037 15101422 11664233 3437189 0.03397 35332996 27598683 7734313 0.07637 true 1425868 127505 20793964 25446213 -4652249 X true true 1 1 Newport Hospital 11 Friendship Street Newport RI 02840 X X X Newport Hospital 1 false false true X X X X X X X X 13 true true false true X http://www.newporthospital.org X X true 13 true Please refer to Schedule O supplemental info for full URL. false false true X 200.0000 300.0000 X X X X X X true true X X X X true X see Schedule O X see Schedule O X X X X X X true X X true X X X X X X true X false false Part V, Line 5 - Account Input from Persons Who Represent the Community The CHNA encompassed intensive data collection and analysis, as well as qualitative research in the forms of interviews with and surveys of more than 100 internal and external stakeholders, including hospital-based physicians, nurses, social workers, administrators, and other professionals, as well as community-based stakeholders representing constituencies served by Newport Hospital (NH) and Lifespans three other hospitals. NHs leadership team shaped the CHNA by recommending institutional and community leaders for participation, offering observations about community need, and providing insight about existing and planned programs.Qualitative data collected during the CHNA consist of: (1) interviews completed with internal stakeholders (i.e., hospital-based and Lifespan-based); (2) nearly two dozen key informant interviews with community leaders, representing an array of constituencies; and (3) a Community Stakeholder Survey of 54 organizations statewide.Interviews with leaders of organizations encompassed a wide range of issues and populations, including historically underserved communities, such as minority populations, children and youth, and immigrant/refugee populations, and also included leaders of organizations with specific interest or expertise in key issues such as obesity, cancer, and asthma. In a few cases, organizations submitted a completed questionnaire in lieu of participating in an interview. Leaders of organizations with a statewide focus on policy, advocacy, and social service provisions were interviewed, covering a broad range of social issue areas. A standard format and questionnaire were used for each interview.To ensure representation from a broad cross-section of the community, a statewide survey of 54 key community stakeholders was conducted. Those surveyed included members of medically underserved, low-income, and minority populations in the community; representatives of organizations that had knowledge, information, or relevant experience re: the health needs of the community (including the Brown University School of Public Health, The Warren Alpert Medical School of Brown University, the Economic Progress Institute, the United Way, and others); and representatives of the Rhode Island Department of Health. The survey was a 19-question instrument designed to elicit information about the general health and social needs of the community. Over 75% of those surveyed self-reported that they serve constituencies spanning either the entire State of Rhode Island or the entire State of Rhode Island and southeastern Massachusetts. Community Stakeholder Survey Respondents:1. AARP, Executive Director2. African Alliance of RI, President3. Aids Project RI, Executive Director4. American Cancer Society5. American Lung Association of the Northeast, Director of Health Education6. Blue Cross/Blue Shield7. Brown School of Public Health8. Camp Street Community Ministries9. Center for Prisoner Health and Human Rights, Miriam Hospital/Brown University Medical School, Executive Director10. Chinese Nursing Association11. Community Asthma Program12. Community Health Workers Association of Rhode Island, Brown Medical School13. Crossroads of Rhode Island, Director of Social Services14. Rhode Island Department of Health, Manager, Safe Rhode Island/Rhode Island Youth Suicide15. Rhode Island Department of Health16. Gateway Healthcare17. Goodwill Industries of Rhode Island, Case Manager / Employment Services Coordinator18. Health Centric Advisors, Senior Scientist19. Health Leads Providence, Executive Director20. Injury Prevention Center at Rhode Island Hospital21. James L. Maher Center, CEO22. Jewish Alliance of Greater Rhode Island, Community Relations Director23. Martin Luther King Community Center, Executive Director24. McAuley House, Associate Director25. Mental Health Association of Rhode Island, Executive Director26. The Miriam Hospital, Ambulatory TB/Immunology Department, Clinical Manager27. Mount Hope Learning Center28. Mount Hope Neighborhood Association29. NAACP Providence, President30. National Association of Social Workers (NASW) RI Chapter, President31. Newport County Community Mental Health Center32. Overeaters Anonymous33. Parent Support Network of Rhode Island34. Partnership to Reduce Cancer in RI, Secretary35. Progreso Latino, Executive Director36. Project Night Vision, Founder37. Providence School Department38. Refugee Clinic at Hasbro Children's Hospital39. Rhode Island Division of Elderly Affairs, Director40. Rhode Island Health Center Association, President & CEO41. Rhode Island Parent Information Network42. Rhode Island Public Health Association, President43. Rhode Island Public Health Institute at Brown University, Executive Director44. Rhode Island Adult Education Professional Development Center, Director45. Rhode Island Breast Cancer Coalition46. Rhode Island Dept of Corrections, Medical Program Director47. Rhode Island Free Clinic48. Samuels Sinclair Dental Center, Director49. Socio-Economic Development Center for Southeast Asians, Executive Director50. Taming Asthma51. TB & Immunology, The RISE Clinic (The Miriam Hospital)52. United Way of Rhode Island, Director of Annual Giving53. Visiting Nurses Services of Newport and Bristol Counties54. Women's Center of Rhode Island, Residential Supervisor Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment Rhode Island HospitalThe Miriam HospitalEmma Pendleton Bradley Hospital Part V, Line 7d - Description of Making Needs Assessment Widely Available A copy of the Community Health Needs Assessment report issued for NH as of September 30, 2013 can be obtained by visiting: http://www.lifespan.org/Lifespan-Community-Health-Needs-Assessment-Reports.aspx or http://www.newporthospital.org. Part V, Line 16i - Other Means Hospital Facility Publicized the Policy An abbreviated version of NH's financial assistance policy is posted in various admitting and outpatient areas of NH. 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. Part V, Line 18d - Other Collection Actions Against a Patient Once an account balance or a portion thereof is classified as self-pay, it is placed with NH's pre-collect company until the balance is paid in full, a monthly payment plan is in place, or insurance information is provided for billing.After 120 days, if there is no payment activity, the account qualifies for bad debt and the pre-collect company returns the account to Patient Financial Services, which in turn forwards it to a collection agency.The collection agency sends 3 to 5 notices to the patient requesting payment. If there are no responses after the notices are sent, collection calls are made. If there is no response after 120 days, the account is reviewed for legal action in the appropriate court.If there are no assets to pursue, the collection agency deems the account uncollectible and returns it to Patient Financial Services for write-off.Note: In accordance with Center for Medicare and Medicaid Services mandates, Medicare patient accounts are held 130 days from last payment, after which if there has been no activity, the account is referred to collection. Part V, Line 19d - Other Actions Took Before Any Collection Actions NH engages third parties to perform certain collection actions on its behalf. A pre-collect company is used for all self-pay accounts. Additionally, a collection agency is used if there is no payment activity on such accounts after 120 days. The collection process is explained in further detail in the response to Question 18d above. 8 Portsmouth Imaging Center 69 Turnpike Avenue Portsmouth RI 02871 Diagnostic Imaging Services NHCC Medical Associates Inc 19 Friendship Street Suite 150-160 Newport RI 02840 General & Specialty Medicine Family Physicians of Tiverton & Little Compton 1800 Main Road Tiverton RI 02878 Primary Care Offices Family Physicians of Newport 19 Friendship Street Suite 130 Newport RI 02840 Primary Care Offices Jamestown Family Practice Center 20 Southwest Avenue Jamestown RI 02835 Primary Care Offices Newport Dermatology 79 Turnpike Avenue Portsmouth RI 02871 Specialty Medicine Womens Health Services 77 Turnpike Avenue Portsmouth RI 02871 OB/GYN Newport Hospital Medical Imaging 345 Valley Road Middletown RI 02842 Diagnostic Imaging Services Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) Newport Hospital (NH) uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at NH 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 the Hospital.)4. Uninsured patients receive a discount equal to the discount received by Medicare beneficiaries on NH charges. Under Section 501(r)(5), the maximum amounts that can be charged to 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 same 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 NH's billing system.Requests for Payment Arrangements:Patient Financial Advocates (PFA) will qualify patients that are receiving non-urgent, medically indicated procedures prior to services. The PFA will request 75% to 100% of estimated 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 will require 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 7 - Explanation of Costing Methodology NH's costing methodology used to calculate the amounts reported in Part I, Line 7 is as follows:a) Financial assistance at cost- involves utilization of a ratio derived from dividing patient costs, as defined, by patient charges, as defined, and applying that percentage to total charity care charges. Patient costs reported in the cost accounting system are calculated based on Medicare principles of reimbursement by reducing total operating expenses (as calculated per Form 990 requirements) by items such as bad debt expense, 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 NH's cost accounting system. The system applies historical costing methods applied to all patient segments based on various patient demographics and utilizations. These costing standards exclude bad debt and charity care, 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 NH's Community Health Services Department. Revenue received for these services is reported as direct offsetting revenue. g) Subsidized health services- Subsidized health services' community benefit expense is determined by NH's cost accounting system. These subsidized health services are recorded at cost in NH's cost accounting system for all qualified subsidized health service divisions. This expense is adjusted to remove all related bad debt, Medicaid, and charity costs already reported in the applicable sections of Line 7. Net patient service revenue is recorded as amounts received from various payer types related to these services. Revenue associated with Medicaid is excluded from the amount disclosed for subsidized health services.i) Cash and in-kind contributions for community benefit- Expenses for cash and in-kind contributions for community benefit are made by NH, including an allocation of contributions made by Lifespan Corporation on NH's behalf. Part I, Line 7, Column F - Explanation of Bad Debt Expense The calculation of percentages disclosed in 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 bad debt expense of $4,422,669. 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 NH's cost accounting system and is adjusted for, 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 NH's patient advocate staff to determine qualification for financial assistance under NH'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 Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the ability to collect an accounts receivable, NH analyzes its past history and identifies its revenue trends for each of its major payors to estimate the appropriate allowance for doubtful accounts and the associated provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, NH analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), NH records a significant allowance for doubtful accounts and provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates, if applicable) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.NH's allowance for doubtful accounts for self-pay patients decreased from 72% of self-pay accounts receivable at September 30, 2014 to 71% of self-pay accounts receivable at September 30, 2015. NH's self-pay writeoffs for the years ended September 30, 2015 and 2014 amounted to approximately $4,889,000 and $6,646,000, respectively. NH did not change its charity care or uninsured discount policies during the years ended September 30, 2015 and 2014, respectively. Part III, Line 8 - Explanation Of Shortfall As Community Benefit Medicare shortfall has not been 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 For patients who've been identified as qualifying for financial assistance, NH 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 co-payments, deductibles and amounts denied by insurers. After all collection attempts are exhausted, any remaining balances, including any co-payments and deductibles, are written off as a bad debt. NH classifies its bad debts as uncompensated care. This does not apply to Medicaid, however, as there are no associated co-payments or deductibles for this payor.NH 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 Community Free Service.* If the patient does not qualify for Community Free Service, PFS or the pre-collect agency attempts at least four contacts with the responsible party within the first 120 days.* If the third-party carrier denies in writing any responsibility for payment, arrangements regarding an extended payment plan are discussed with the patient.* 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 - Needs Assessment NH continually assesses community needs in several ways. NH has a formal survey process for patient feedback but more importantly, NH uses a physician liaison position to facilitate physician communication with NH. Doctors in the community provide information on what services patients need. Recent examples of the usefulness of this information include NH's establishment of a wound care service, a dermatology practice, and a hand surgery practice. In addition, NH reviews volumes in service areas to glean information on the utilization of various types of care. Newport Hospital functions as the first line of defense against illness, injury, and disease for its communities. With an Emergency Department that is open and staffed 24 hours a day with the ability to evaluate and treat everything from minor conditions to urgent care and stroke, as well as a dedicated, award-winning nursing staff that provides care for inpatients, the Hospital's importance to the community cannot be overstated. Newport Hospital is the designated disaster planning leader for its region of the State of Rhode Island and as such holds regular meetings and drills with first responders from the various municipalities within the region, as well as representatives from other facilities (e.g., nursing homes, hotels, and physician groups).Newport's significant seasonal employee population and large numbers of uninsured patients present financial challenges that the Hospital strives to deal with each year as part of its mission. Uncompensated care provided to members of the community signals commitment to the residents and visitors of Newport County and its surrounding towns.The RI State Certificate of Need program requires a focused study of need for all projects over $5.25 million, which is an important part of the program development process across Lifespan. Part VI - Patient Education of Eligibility for Assistance NH does not deny necessary medical treatment to anyone, regardless of insurance status or ability to pay. Financial counselors of NH inform patients personally about their potential eligibility for payment assistance. In addition, at such public events as health fairs, NH actively promotes financial assistance programs. When patients believe they might be eligible, financial counselors set up appointments to talk with them privately to determine their eligibility. Applications for financial assistance are provided in the registration office, the Emergency Department, the financial counseling office, and other departments providing care. As part of NH's inpatient intake process, NH provides a summary of the 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. PFA's discuss with patients the various government programs that might be available to them for financial assistance. PFA's also offer assistance with the financial application process and/or understanding the qualification factors for Medicaid, the Affordable Care Act, Medicare, Social Security Disability, Supplemental Nutrition Assistance Program (SNAP), and Rhode Island Temporary Disability Insurance and Unemployment. This is done for both inpatient and outpatient services.Uninsured patients receive a discount on charges equal to that received by Medicare beneficiaries. Medicare patients may receive waivers of cost-sharing amounts if they qualify based on financial need; qualification is determined through an application for charity care. Further discounts may apply, depending on a patient's income level. Part VI - Community Information NH is the only hospital on Aquidneck Island and in Newport County, which comprises a population of approximately 100,000. Located in Newport, the southernmost town in Newport County, NH is approximately 20 miles from other hospitals; bridges link Newport and Aquidneck Island with the rest of the State of Rhode Island (two bridges to the west, one to the northwest, and one to the north). The community includes people on government assistance, working-class and middle-class constituents, U.S. Navy personnel and retirees, students from three colleges, and a small percentage of families of significant wealth. Part VI - Community Building Activities NH connects with the community in several ways, both within the Hospital walls and at other venues. More than a dozen monthly support groups are held at NH, some facilitated by medical professionals and others by community members. An annual health fair provides hundreds of screenings for diseases and health conditions, and the Hospital follows up with individuals whose tests identify a problem. Screenings for breast and prostate cancers are conducted free of charge at various times during the year.Several NH committees exist to provide interaction between NH and the community. NH supports community initiatives such as Rebuilding Together, the Newport Partnership for Families, a full-time physician with a nonprofit practice, a local mentoring program, and a program to identify middle school children who require help. In addition, NH has partnered with a local philanthropist to form a committee to oversee a grant funded by NH to help children become active and healthy. The committee began distributing grants in 2011. Parenting and breastfeeding support are available through NH's birthing center, and a series of bimonthly presentations and lectures on relevant health topics is scheduled for the community to attend free of charge. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose NH is governed by a Board of Trustees, which is composed of community members who are elected by Lifespan Corporation. NH's vision is to work collaboratively with physicians, our employees, other health care organizations, and the community to create a measurably healthier Newport County through the provision of high quality, cost-effective, customer-focused health care services in an environment that promotes patient safety. NH monitors the healthcare needs of its service area to ensure alignment of its resources with its mission. NH 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 NH. NH is organized and operated for the benefit of the community it serves. Part VI - Affilated Health Care System Roles and Promotion 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 14,000 people. The Lifespan system has approximately 2,400 physicians on the medical staffs of its affiliated hospitals, operates 1,155 licensed beds in four hospital complexes, and in 2015 generated approximately $1.9 billion in total operating revenue. By each of these measures, Lifespan is Rhode Island's largest health system, serving a population of over 1.5 million. Three of its hospital members, Rhode Island Hospital (RIH), The Miriam Hospital (TMH), and Emma Pendleton Bradley Hospital (EPBH), are teaching affiliates of The Warren Alpert Medical School of Brown University with 69 percent of the residents and fellows in this program based at RIH, TMH, and EPBH.Lifespan is a Rhode Island nonprofit corporation that is community-based and community-governed. As a nonprofit organization, Lifespan is run by a voluntary Board of Directors who are community representatives. Lifespan and all of its nonprofit hospital affiliates have received written notification from the Internal Revenue Service that they have been recognized as being organized and operated as entities described in Internal Revenue Code (IRC) Section 501(c)(3) and are generally exempt from income taxes under IRC Section 501(a).As of September 30, 2015, Lifespan Corporation employed approximately 940 full-time and part-time personnel, most of whom are located in Providence, RI. Lifespan Corporation provides support services to its affiliates, such as information services, telecommunications, 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 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, develop, negotiate, and approve all managed care agreements, develop affiliations with other institutions for educational and research purposes, and approve human resource plans, executive compensation, and benefits for system affiliates. The bylaws of the Hospital confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination and support of the system. Powers reserved to Lifespan as sole member include: to elect and remove trustees; to approve the election of and to remove certain officers; to approve the 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.For a complete listing of affiliated members of Lifespan's integrated healthcare delivery system, please refer to Schedule R. Part VI - States Where Community Benefit Report Filed RI true The Miriam Hospital 164 Summit Avenue Providence RI 02906 050258905 501(c)(3) 54300 0 Philanthropic Program Services 1 0 Additional Supplemental Information NH 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)(3). All contributions are approved by management and are made to organizations whose missions and goals align with those of NH. X true true X X X X X true true false false false false false true false false Arthur J Sampson President 433050 132000 233529 15600 16714 830893 171029 August B Cordeiro President 107065 193346 9208 18946 328565 127692 Bartholomew L Grimes Admin. Director 145580 12547 44980 191810 25178 420095 Cathy E Duquette VP Nursing Svcs 352288 120000 60721 59810 16713 609532 35167 Crista F Durand President 118236 25000 7537 19016 7598 177387 Denise Sullivan Chief Nursing Officer 166366 32000 10502 27356 18320 254544 Frank J Byrne VP of Finance 208140 46000 23951 29386 20706 328183 18040 Kenneth E Arnold Secretary 479128 155561 97877 13000 17234 762800 Mary A Wakefield Treasurer 645835 221000 800372 107538 16554 1791299 526051 Pamela McLaughlin Dir.- Patient Exp. 108332 8304 1672 7487 24849 150644 Paula M Gillette Chief Nursing Officer 104916 104916 104916 Terrence McWilliams Chief Medical Officer 8819 224597 139 5 224597 8963 224597 Thomas McGue MD Chief Medical Officer 239325 45969 9676 29704 24 324698 Timothy J Babineau MD Trustee 1037312 616410 443654 285101 23391 2405868 123313 Todd A Cipriani VP of Professional Svcs 199167 43666 34078 36746 17422 331079 20849 Part I, Line 1a: Relevant information in regards to selections on 1a. Tax Indemnification and Gross-up Payments:The Lifespan Executive Long Term Disability program provides financial protection to designated Lifespan 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 The Lifespan Annual Incentive Compensation Plan provides a financial award opportunity for designated members of management, based on quantified objectives that are approved in advance by the Compensation Committee of the Lifespan Corporation Board of Directors. A specified level of financial and non-financial performance must be met before any award is earned. The objectives vary from year to year and generally include various aspects of financial measures in addition to non-financial performance measures. For certain participants in the Annual Incentive Compensation Plan, the award opportunity is divided into two pools. The first pool represents 70% of any earned incentive award, based on the achievement of the team performance objectives. The remaining 30% pool is distributed on an individual basis to participants at the discretion of the CEO, in each case subject to approval by the Compensation Committee of the Lifespan Corporation Board of Directors. Additionally, 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. Part III, Additional Information Included in the Schedule J, Part II, Line (B)(iii) calendar year 2014 compensation for Timothy J. Babineau, MD, President & Chief Executive Officer, was a retention payment of $250,000 (earned during the transition to a new Lifespan CEO) made by Lifespan Corporation to Dr. Babineau in his capacity as President & CEO of the Lifespan health system.Included in the Schedule J, Part II, Line (B)(iii) calendar year 2014 compensation for Mary A. Wakefield, Executive Vice President & Chief Financial Officer, was a one-time retention payment in the amount of $700,000 (earned during the transition to a new Lifespan CEO) made by Lifespan Corporation to Ms. Wakefield in her capacity as EVP & CFO of the Lifespan health system. A RIHEBC 521300173 2014-11-05 20390000 See Schedule K, Part VI false false false A 20887660 154000 20732994 666 true false true true A false false false false false false true A false false false false false false false false A false Part VI Schedule K, Part I, Line A, Column (f) - The proceeds of the Series 2014 Bonds are being used for the purposes of the full redemption of Newport Hosptial's February 1, 1999 Bonds.Schedule K, Part V:Because the proceeds of the 2014 bond funding were used solely for the purpose of retirement and redemption of Newport Hospital's 1999 series bond placement, Newport Hospital does not have in place written post-issuance tax compliance procedures for tax-exempt obligations. Newport Hospital did not use the funds from this bond issue to fund any other projects associated with Newport Hospital or any of its other affiliates. Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Kenneth E. Arnold, Secretary, Timothy J. Babineau, MD, Trustee, and Mary A. Wakefield, Treasurer, are officers of related for-profit corporations. Mr. Arnold and Ms. Wakefield are officers of Lifespan Management Services Organization, Inc. (MSO) and Lifespan Risk Services, Inc. Dr. Babineau and Ms. Wakefield are officers of VNA Technicare, Inc. (VNA).Lawrence Aubin, Chair, and Shivan Subramaniam, Trustee, are Directors of Citizens Bank. Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents Changes made to the orgnization's bylaws during the fiscal year ended September 30, 2015 include:(1) the Chairs of each of Rhode Island Hospital Foundation, The Miriam Hospital Foundation, Newport Hospital Foundation, Bradley Hospital Foundation, and Gateway Foundation are no longer considered ex-officio voting directors of Lifespan Corporation; and(2) the number of elected directors of the Board has been changed to a minimum of fourteen, from nine, and a maximum of thirty-one, from twenty-six. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Lifespan Corporation is the sole corporate member of NH. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body Effective October 23, 2012, the Board of Directors of Lifespan and the Boards of Trustees of Rhode Island Hospital, The Miriam Hospital, Newport Health Care Corporation, NH, and Emma Pendleton Bradley Hospital approved a restructuring of their governance. The restructuring has increased governance effectiveness and has streamlined governance operation, as well as provided a single strategic perspective for the Lifespan system hospitals. Pursuant to the restructuring, the bylaws of each of the affiliates were amended such that the composition of the boards of trustees of each of the hospitals and Newport Health Care Corporation is defined as those persons serving from time to time as the directors of Lifespan. As a result, the Boards of each entity are comprised of the same individuals. The Board of each entity retains its responsibilities and authorities notwithstanding the revision in its composition. The Board of Directors of Lifespan consists of not less than fourteen nor more than thirty-one directors, including the President and CEO of Lifespan, who serves ex-officio with vote.Additionally, the bylaws of NH 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 NH trustees and to approve the election of and to remove certain officers. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders As noted above, the NH Board is comprised of the same individuals who serve on the Lifespan Board. Lifespan has the responsibility for planning, directing, and establishing policies intended to assure the development and delivery of quality health services on an integrated, cost-effective basis. Powers reserved to Lifespan, in addition to those noted above, include: to approve amendment of the Articles of Incorporation and Bylaws and other charter documents; to approve strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness. Form 990, Part VI, Line 11b: Form 990 Review Process The preparation and filing of the Form 990 and supporting schedules is the responsibility of the Executive Vice President & Chief Financial Officer (EVP/CFO) and Lifespan's Finance Department, with review by Lifespan's tax advisors, KPMG LLP (KPMG). The Form 990 is prepared by the accounting staff upon completion of Lifespan's annual independent audit and reviewed by the Corporate Services Tax Compliance Manager, the Director of Finance, and the Vice President of Finance - Corporate Services. The Form 990 is forwarded to KPMG for further review. KPMG provides the Tax Compliance Manager with any recommended changes which are reviewed, and if agreed upon, are incorporated into the return. 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 NH's Board of Directors 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, as well as NHCC and Affiliates (NHCC), currently make their annual and quarterly consolidated/combined 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 and NHCC's financial information to repositories and investors alike. Newport Hospital's financial statements are included in NHCC's combined financial statements. NH'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 plan = -$8100400 Other Changes In Net Assets Or Fund Balances - Other Decreases Decrease in Net Assets of NHF = -$19209678 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfer to Affiliates = -$117913 Form 990, Part III, Line 1 -Organization's Mission The mission of Newport Hospital (NH) is to provide acute and outpatient health services to Newport County, Rhode Island and to work in collaboration with physicians, our 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. NH is established for the care of persons suffering from illnesses or disabilities which require that the patient receive inpatient or outpatient hospital care or rehabilitation services, to carry on any educational activities related to the healthcare field, and to promote charitable, scientific, and educational purposes. Form 990, Part III, Line 4a NH first received the Magnet designation from the American Nurses Credentialing Center (ANCC) in 2004. Of more than 5,000 hospitals in the United States, only about 4 percent have achieved Magnet status. Magnet hospitals must demonstrate that their nursing services function beyond the level of excellence. Standards for Magnet status are rigorous and include not only outstanding patient care but also best practices in nursing, management philosophy, national standards for quality improvement, leadership by the chief nursing officer, nurse education levels, and professional models of care. The Magnet process is continuous; Magnet once again redesignated RI in 2009 and 2014.The Noreen Stonor Drexel Birthing Center at NH has received the prestigious Baby Friendly designation from the World Health Organization and UNICEF. NH is recognized for providing an optimal environment for the promotion, protection, and support of breastfeeding. Hospitals are awarded this status only when trained, independent evaluators have determined that all hospital practices meet the rigorous Baby Friendly standards.NH was tied for first place, with The Miriam Hospital, in the U.S News & World Report's best regional hospitals ranking, one of only two hospitals in Rhode Island to make the list.NH was selected as a Guardian of Excellence Award for the quality of its inpatient rehabilitation. Deemed to be in the top 95th percentile or above by the awarding group, Press Ganey Associates, NH recently expanded its rehabilitation capacity with the creation of a physiatry service line and the addition of two physiatrists. The new staff work closely with NHs Vanderbilt Rehabilitation Center staff, providing medical support, enhanced services and continuum of care after discharge. NH has developed formal and informal educational affiliations with the University of Rhode Island College of Nursing; Community College of Rhode Island; Salve Regina University; and the University of Massachusetts-Dartmouth, pursuant to which their nursing students obtain clinical training and experience at NH, which does not receive any compensation from the various schools for providing a clinical setting for the student nurse training.NH 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. In addition, a substantial discount is offered to all other uninsured patients equal to the Medicare program. NH determines the cost 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 net cost incurred by NH to provide charity care amounted to $792,795 in fiscal 2015. Charges forgone, based on established rates, amounted to $4,194,898.NH substantially subsidized various health services including adult psychiatry, Vanderbilt Rehabilitation, and obstetrics at a net cost of $3,150,919 in fiscal year 2015.NH 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 $249,146 in fiscal year 2015.NH 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. Form 990, Part III, Line 4b Outpatient services include an emergency department, diagnostic medical imaging, laboratory, Vanderbilt Rehabilitation, and wound care, among others. The Emergency Department (ED) is open and staffed 24 hours a day, 365 days a year, with emergency medicine physicians and specially trained physician assistants and nurses. The ED, in accordance with the hospital's mission and civic obligations, treats every person who seeks care, regardless of their ability to pay. NH substantially subsidizes various health services including adult psychiatry, Vanderbilt Rehabilitation, occupational health, and certain other specialty services. Form 990, Part VI, Section A, Line 1b: *Lawrence Aubin, Chair, is a Director of Citizens Bank (Citizens). In 2013, Rhode Island Hospital (RIH), The Miriam Hospital (TMH), and Emma Pendleton Bradley Hospital (EPBH) entered into a master lease and loan and security agreement with Citizens Asset Finance, an affiliate of Citizens, to which RIH, TMH, and EPBH made debt service and interest payments during the fiscal year ended September 30, 2015. Additionally, Mr. Aubin 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 2015, Lifespan paid rent to Lawrence Investments, LLC under the terms of this lease. Lastly, Lifespan entered into a credit agreement with Citizens Bank in April 2015 for a line of credit facility to finance working capital requirements. During fiscal year 2015, RIH and EPBH paid Citizens interest payments on the outstanding facility balance.*Edward Feldstein, Trustee, is a partner in Roberts, Carroll, Feldstein, and Peirce, a law firm that provides legal services to Lifespan Risk Services, Inc. on behalf of various Lifespan affiliates.*The spouse of Pamela Harrop, Trustee, is employed as a cardiologist by TMH. *Shivan Subramaniam, Trustee, is the Chairman of FM Global and served as CEO of FM Global through December 31, 2014. Lifespan purchases property insurance coverage from Factory Mutual Insurance Company, a member of FM Global. Additionally, Mr. Subramaniam is a Director of Citizens. In 2013, RIH, TMH, and EPBH entered into a master lease and loan and security agreement with Citizens Asset Finance, an affiliate of Citizens, to which RIH, TMH, and EPBH made debt service and interest payments during the fiscal year ended September 30, 2015. Also, Lifespan entered into a credit agreement with Citizens Bank in April 2015 for a line of credit facility to finance working capital requirements. During fiscal year 2015, RIH and EPBH paid Citizens interest payments on the outstanding facility balance.*Brian J. Zink, MD, Trustee, received taxable tuition reimbursement from RIH. Form 990, Part VI, Section B, Line 12c Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including Newport Hospital, 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. This requirement shall be acknowledged as part of the annual performance evaluation process. 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 15a and b The following applies to Lifespan and all of its affiliates, including Newport Hospital: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 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 and affiliate 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 audited 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. The independent consultants are not engaged by management to perform any services for Lifespan without prior approval by the Committee.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 relies on information previously provided by the consultant to establish a range of reasonable cash compensation within which recruitment is expected to conclude through acceptance of a reasonable compensation offer. Form 990, Part XII, Line 2: NH produced audited financial statements as of and for the year ended September 30, 2015. Additionally, it was included in Newport Health Care Corporation's audited combined financial statements as well as Lifespan Corporation's audited consolidated financial statements, in which one column is used for the Newport Hospital Obligated Group, which includes Newport Hospital and Newport Hospital Foundation. The Lifespan Audit and Compliance Committee assumes responsibility for oversight of the audit of Lifespan Corporation's consolidated financial statements and the selection of Lifespan Corporation's independent accountant. Schedule H, Part V, Line 10a: The URL to view NH's most recently adopted implementation strategy is below:http://www.newporthospital.org/uploadedFiles/NH/Content/About_Us/NewportCHNA_2013.pdfPlease refer to page 43 of the CHNA to view the implementation strategy. Schedule H, Part V, Line 16b: The URL to view and download NH's FAP application form is below:http://www.lifespan.org/uploadedFiles/Lifespan/Content/Patient_Financial_Services/Lifespan-FAF-ENG.pdf Schedule H, Part V, Line 16c: The URL to view NH's plain language summary of the FAP is below:http://www.lifespan.org/lifespan-customer-service.html Alternative Living Concepts 249 Roosevelt Avenue Pawtucket RI 02860 050442015 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 Gateway Healthcare Inc false Bayberry Courts Inc 249 Roosevelt Avenue Pawtucket RI 02860 204590384 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 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 249 Roosevelt Avenue Pawtucket RI 02860 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 249 Roosevelt Avenue Pawtucket RI 02860 050504841 Bereavement Services for Children RI 501(c)(3) 7 Gateway Healthcare Inc false Gateway Foundation 249 Roosevelt Avenue Pawtucket RI 02860 464002163 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false Gateway Healthcare Inc 249 Roosevelt Avenue Pawtucket RI 02860 050309043 Subst. Abuse & Psych. Health Care Svcs RI 501(c)(3) 9 Lifespan Corporation false Hospital Properties Inc 167 Point Street Providence RI 02903 222869743 Property Management RI 501(c)(4) N/A Lifespan Corporation false Human Services Realty Inc 249 Roosevelt Avenue Pawtucket RI 02860 050398161 Housing for Elderly and Mentally Ill RI 501(c)(2) N/A Gateway Healthcare Inc false JM Apartments Inc 249 Roosevelt Avenue Pawtucket RI 02860 050435537 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 Gateway Healthcare Inc false Lifespan Corporation 167 Point Street Providence RI 02903 222861978 Holding Company/ Mgmnt Services RI 501(c)(3) 11 N/A false Lifespan Diversified Services Inc 167 Point Street Providence RI 02903 050258935 Holding Company/ Mgmnt Services RI 501(c)(3) 11 Lifespan Corporation false Lifespan Foundation 167 Point Street Providence RI 02903 050493219 Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation false Lifespan of Massachusetts Inc c/o Archstone Law 245 Winter St Waltham MA 02451 043408517 Holding Company MA 501(c)(3) 11 Lifespan Corporation false Lifespan Physician Group Inc 167 Point Street Providence RI 02903 050389801 Health Care Services RI 501(c)(3) 9 Lifespan Corporation false Lifespan School Solutions Inc 225 Chapman Street Providence RI 02905 464910847 Educational Services RI 501(c)(3) 2 Emma Pendleton Bradley Hospital false LJR Corporation 249 Roosevelt Avenue Pawtucket RI 02860 030508346 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 Gateway Healthcare Inc false Mill River Community Housing Corporation 249 Roosevelt Avenue Pawtucket RI 02860 050427152 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 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) 11 Newport Health Care 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) 9 Lifespan Corporation false Obed Apartments Inc 249 Roosevelt Avenue Pawtucket RI 02860 050422771 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 Gateway Healthcare Inc false Pathways Inc 249 Roosevelt Avenue Pawtucket RI 02860 050393004 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 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) 9 Lifespan Corporation false Shore Courts Inc 249 Roosevelt Avenue Pawtucket RI 02860 050504003 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 Gateway Healthcare Inc false The Autism Project 1516 Atwood Avenue Johnston RI 02919 050512037 Services for Children with Autism RI 501(c)(3) 9 Gateway Healthcare Inc false The Miriam Hospital 164 Summit Avenue Providence RI 02906 050258905 Health Care Services RI 501(c)(3) 3 Lifespan Corporation false The Miriam Hospital Foundation 167 Point Street Providence RI 02903 050377502 Philanthropic Activities AL 501(c)(3) 7 Lifespan Corporation false TLR Realty 249 Roosevelt Avenue Pawtucket RI 02860 043742771 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 Gateway Healthcare Inc false Wentworth Corporation 249 Roosevelt Avenue Pawtucket RI 02860 050488520 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 Gateway Healthcare Inc false Westerly Courts Inc 249 Roosevelt Avenue Pawtucket RI 02860 611439766 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 Gateway Healthcare Inc false JRR Housing 249 Roosevelt Avenue Pawtucket RI 02860 263121266 Housing for Elderly and Mentally Ill RI 501(c)(3) 9 Gateway Healthcare Inc false RI Sound Enterprises Insurance Co Ltd 65 Front Street Hamilton HM BD 12 Offshore Insurance Captive BD Lifespan Corporation false Lifespan MSO Inc 167 Point Street Providence RI 02903 050508717 Mgmnt Svcs 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 622 George Washington Highway Lincoln RI 02865 050472710 DME Sales RI LDS Inc C corp false Gateway Professional Group Inc 249 Roosevelt Avenue Pawtucket RI 02860 050498391 Psychotherapy RI Gateway Healthcare C Corp false false false true true true false false false false true true false true false true true true false false