2015-08-14T12:20:48-05:00 2014-09-30 WithumSmithBrown PC 465 South St Ste 200 Morristown NJ 079606497 990 2013-10-01 050258812 BUTLER HOSPITAL % KATHY TOPOR BUTL 4019217602 345 BLACKSTONE BOULEVARD Suite PROVIDENCE RI 02906 JOSEPH IANNONI CFO 9738989494 2015-08-13 true Scott J Mariani P00642486 9738989494 2013 2016-04-25 22:37:26Z LAWRENCE H PRICE MD 345 BLACKSTONE BOULEVARD PROVIDENCE RI 02906 106309387 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. 21 15 1059 131 1002232 261505 1593500 1412932 90247935 100861710 1890148 974649 2754290 2814363 96485873 106063654 276000 525000 0 0 65168660 69724363 0 0 0 32084544 36795733 97529204 107045096 -1043331 -981442 87976525 87420773 49035641 52102486 38940884 35318287 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 96393087 525000 101759942 EXPENSES INCURRED IN PROVIDING VARIOUS MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. 96393087 true true false true false false false true false true true false true true true false false true false false false false false false true false true true true false true false false false false false false false false false false false false true true true false false false true 131 0 true 1059 true true true false false false false true true false false false false X 21 15 true true false false true true true true true false false true true true true true true true true true true X KATHY TOPOR 4019217602 C/O CNE ACCTING DEPT 345 BLACKSTONE PROVIDENCE RI 02906 X GEORGE W SHUSTER CHAIRMAN - DIRECTOR 1.0 X X 0 1936 0 CHARLES R REPPUCCI ESQ VICE CHAIRMAN - DIRECTOR 1.0 X X 0 0 0 CYNTHIA B PATTERSON SECRETARY - DIRECTOR 1.0 X X 0 0 0 DOUGLAS JACOBS TREASURER - DIRECTOR 1.0 X X 0 0 0 HERBERT BRENNAN MD DIRECTOR 1.0 X 0 0 0 DAVID A CARCIERI MD DIRECTOR 25.0 X 0 93065 13645 ALLEN H CICCHITELLI DIRECTOR 1.0 X 0 0 0 ESTHER EMARD DIRECTOR 1.0 X 0 0 0 ROBERT G FLANDERS JR ESQ DIRECTOR 1.0 X 0 0 0 GARY E FURTADO DIRECTOR 1.0 X 0 0 0 JOHN R GALVIN DIRECTOR 1.0 X 0 0 0 KENT W GLADDING DIRECTOR 1.0 X 0 0 0 WILLIAM M KAPOS DIRECTOR 1.0 X 0 0 0 DENNIS D KEEFE DIRECTOR - PRESIDENT/CEO/CNE 55.0 X X 0 1165268 130379 DIANE LIPSCOMBE PHD DIRECTOR 1.0 X 0 0 0 SUSANNA MAGEE MD DIRECTOR 1.0 X 0 0 0 JOSEPH J MCGAIR ESQ DIRECTOR 1.0 X 0 0 0 PATRICK J MURRAY JR DIRECTOR 1.0 X 0 0 0 ROBERT G PADULA DIRECTOR 1.0 X 0 0 0 GHULAM MUSTAFA SURTI MD DIRECTOR - UNIT CHIEF BH 55.0 X 405552 0 36507 MARIBETH WILLIAMSON DIRECTOR 1.0 X 0 0 0 ALYSSA V BOSS ESQ ASST SEC/SVP & GENERAL COUNSEL 55.0 X 0 396972 69983 JOSEPH IANNONI EFF 814 ASST. TREAS./SVP/CFO/CNE 55.0 X 0 0 0 JOHN M SUTHERLAND III SVP/CFO/CNE (TERM 8/14) 55.0 X 0 587861 51235 PATRICIA R RECUPERO JD MD PRESIDENT AND CEO (TERM 7/14) 55.0 X 600520 0 369992 LAWRENCE H PRICE MD PRESIDENT AND COO (EFF 7/14) 55.0 X 398139 0 28440 MICHAEL A FIORI MD PRESIDENT BH MED STAFF ASSOC 55.0 X 384111 0 17394 BONNIE BAKER CPA FHFMA VICE PRESIDENT/CFO 55.0 X 0 359800 50773 WALTER DIAS VICE PRESIDENT/COO 55.0 X 356947 0 46875 LINDA DAMON RN ARNP VICE PRESIDENT/CNO 55.0 X 293032 0 43954 JULIE FORREST MD PSYCHIATRIST 55.0 X 468436 0 19521 MARTIN J FURMAN ASSOCIATE MEDICAL DIRECTOR 55.0 X 448392 0 43869 ALVARO J OLIVARES MD UNIT CHIEF 55.0 X 381930 0 40166 MICHAEL D STEIN MD DIRECTOR GENERAL MED RESEARCH 55.0 X 336181 0 38985 JAMES K SULLIVAN MD DEPUTY MEDICAL DIRECTOR CS 55.0 X 331102 0 22100 4404342 2604902 1023818 105 false true false EW BURMAN INC 33 VERMONT AVENUE WARWICK RI 02888 MAINTENANCE 2605849 SODEXO INC AFFILIATES PO BOX 360170 PITTSBURGH PA 152516170 DIETARY 1825942 BROWN UNIVERSITY 164 ANGELL STREET PROVIDENCE RI 02912 STAFFING 1083581 PHALANX ENGINEERING INC 110A BYFIELD STREET WARWICK RI 02888 BUILDING 609957 WARZYCHA CONSTRUCTION COMPANY INC 51 ENFIELD STREET PAWTUCKET RI 02861 CONSTRUCTION 229379 10 X 122291 1290641 2395 1412932 NET PATIENT SERVICE REVENUE 541900 73963397 73963397 OTHER HEALTHCARE RELATED REVENUE 541900 18346974 18242974 104000 MANAGEMENT FEES 900099 8551339 8551339 100861710 465173 465173 0 0 2322408 199060 2123348 0 2123348 889283 1234065 509476 509476 509476 509476 46673 122291 46673 0 0 0 CAFETERIA SALES 900099 612638 612638 GIFT SHOP SALES 453220 69428 69428 VENDOR SALES 900099 8949 8949 691015 106063654 100757710 1002232 2890780 525000 525000 0 0 0 2981462 2683316 298146 0 0 52391536 47152382 5239154 2968084 2671276 296808 7501532 6751379 750153 3881749 3493574 388175 0 0 0 1950 1755 195 0 0 2388961 2150065 238896 25334 22801 2533 2660581 2394523 266058 0 0 1041843 937659 104184 235454 211909 23545 0 0 729422 656480 72942 0 3761280 3385152 376128 2596898 2337208 259690 RESEARCH EXPENSES 11336422 10202780 1133642 0 PURCHASED SERVICES 8561612 7705451 856161 0 MEDICAL SUPPLIES 2676734 2409061 267673 0 DUES AND SUBSCRIPTION 256870 231183 25687 0 522372 470133 52239 107045096 96393087 10652009 0 X 5325 5325 12053227 12932641 795419 556034 8409152 8018897 0 0 0 0 0 0 271905 308659 545053 415235 82973314 50430872 33015694 32542442 0 0 0 0 26301653 26677740 0 0 6579097 5963800 87976525 87420773 12943834 9879543 0 0 1478185 0 0 0 0 0 0 0 3629219 3528207 0 0 30984403 38694736 49035641 52102486 X 18624477 13772668 17895566 19106234 2420841 2439385 38940884 35318287 87976525 87420773 X -981442 826307 -3467462 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 1950 1950 false SCHEDULE C, PART II-B; LINE 1I THE ORGANIZATION IS A MEMBER OF THE NATIONAL ASSOCIATION OF PSYCHIATRIC HEALTH SYSTEMS ("NAPHS"). THE ORGANIZATION PAID $1,950 TO THE NAPHS AS THE PORTION OF MEMBERSHIP DUES ALLOCATED TO LOBBYING. THE NAPHS PROVIDES BOTH ADVOCACY AND REPRESENTATION FOR ITS MEMBERS. THE NAPHS ADVOCATES FOR BEHAVIORAL HEALTH AND REPRESENTS PROVIDER SYSTEMS THAT ARE COMMITTED TO THE DELIVERY OF RESPONSIVE, ACCOUNTABLE, AND CLINICALLY EFFECTIVE TREATMENT AND PREVENTION PROGRAMS FOR CHILDREN, ADOLESCENTS, ADULTS, AND OLDER ADULTS WITH MENTAL AND SUBSTANCE ABUSE DISORDERS. THE NAPHS'S ADVOCACY AGENDA CAN BE VIEWED AT THEIR WEBSITE: WWW.NAPHS.ORG. IN ADDITION, THIS ORGANIZATION IS AN AFFILIATE IN THE CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CARE NEW ENGLAND HEALTH SYSTEM PAYS MOST LOBBYING EXPENDITURES ON BEHALF OF ALL AFFILIATES WITHIN THE SYSTEM AND REPORTS THESE COSTS ON ITS RESPECTIVE FORM 990, SCHEDULE C, ANNUALLY. 21306274 0 2794060 640460 23459874 20436461 0 1480707 610894 21306274 17912872 167662 3060057 704130 20436461 18252809 592078 -230849 701166 17912872 17008598 225771 1775372 756932 18252809 false false 48371219 28831335 19539884 0 0 0 29994133 18973299 11020834 4607962 2626238 1981724 32542442 MARKET INVESTMENT 0 F ENDOWMENT FUNDS 17942013 F BOARD-DESIGNATED FUNDS 5517861 F TRUSTEE-HELD FUNDS 2860107 F OTHER ASSETS - LT 357759 F 26677740 DEPOSITS 128734 OTHER RECEIVABLES 2475973 DEFERRED FINANCING COST 51443 DUE FROM AFFILIATES 3307650 5963800 0 OTHER LIABILITIES 2903188 PENSION LIABILITY 1715000 DUE TO AFFILIATES 22891335 DUE TO THIRD PARTY PAYORS 3126836 SELF-INSURANCE RESERVES 2411409 POST RETIREMENT LIABILITIES 5646968 38694736 FORM 990, SCHEDULE D, PART III, LINE 1A SCHEDULE D, PART V, QUESTION 4 SCHEDULE D, PART X THE ORGANIZATION IS AN AFFILIATE OF 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 BIG FOUR 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, 2014 AND SEPTEMBER 30, 2013; RESPECTIVELY AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CERTAIN CONSOLIDATING SCHEDULES. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN 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, 2014 AND CONCLUDED THAT THE ESTIMATED LIABILITY WAS NOT MATERIAL TO THE ORGANIZATION'S FINANCIAL STATEMENTS. 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SCHEDULE H, PART V, SECTION B, QUESTION 3 Care New England sought community input through interviews and key informant surveys with 49 key community stakeholders, focus groups with healthcare providers, and inclusion of partner hospital representatives as well as public health officials in the prioritization and implementation planning process. SCHEDULE H, PART V, SECTION B, QUESTION 4 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, Memorial Hospital of Rhode Island, 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 has its own Needs Assessment. SCHEDULE H, PART V, SECTION B, QUESTION 5D In addition to the organization's website, www.butler.org, the CHNA is available at www.rihealthcarematter.org. SCHEDULE H, PART V, SECTION B, QUESTION 7 By adopting the statewide priorities, Mental Health and Substance Abuse, Heart Disease, and Diabetes, Care New England will take a comprehensive approach to addressing the most urgent needs in the communities it serves. Care New England will continue to monitor community needs and adjust programming and services accordingly. The Community Health Needs Assessment covered 3 priority areas, Mental Health Substance Abuse, Diabetes and Heart Disease. With these priorities we included strategies across these priorities, Overweight and Obesity, Access to Care and Heart Disparities. The following represents our status of these priorities and strategies: Mental Health Substance Abuse Goal 1: Decrease morbidity from diabetes and heart disease among persons with mental illness/substance use disorders Key Initiatives: - Refer psychiatric patients without primary care physician (PCP) to a PCP practice - Include mental health screening in coronary heart failure (CHF) program - Provide medication continuity in emergency department (ED) for patients with diabetes/heart disease (Safe Transitions) Key Measure Accomplishment: - Butler Hospital Patients have been accepted from PCP referrals Goal 2: Increase access to appropriate, quality mental health/substance abuse services Key Initiatives: - Develop patient-centered medical home model with integrated mental/physical health (Affinity) - Provide for online mental health screenings - Integrate TPC psychiatric services into CNE emergency departments Key Measure Accomplishments: - Butler patient evaluations increased FY12-14 period; - Post-partum depression education for WIH patients increased FY13-14 period: 2,328 families educated in FY14 Diabetes Goal 1: Increase the number of people who are aware of the risk factors for diabetes Key Measure Accomplishments: - About 1500 CNE employees screened for diabetes in 2013; > 600 in 2014 (through CNE Wellness) Goal 2: Increase diabetes self-management education for people living with diabetes Key Initiatives: - Develop standardized screening across CNE, implement RN review, and share results with patients/PCPs - Develop diabetes support groups diabetes management - Continue diabetes awareness education and offer screening Heart Disease Goal 1: Increase the number of women who are aware of their risk for heart disease Key Initiatives: - Conduct Women's Health Fair, including cardiac/diabetes screening and nutrition/exercise education - Increase breastfeeding and obtain Baby Friendly designation for birthing services Key Measure Accomplishments: - Since 2012, the number of women leaving WIH breastfeeding increased from about 25% to over 60%, surpassing project average - Women & Infants designated a Baby-Friendly Hospital Goal 2: Reduce heart disease through early identification, and early and appropriate treatment/management Key Initiatives: - Conduct CHF education to manage patient symptoms - Develop partnerships with PCPs and area skilled nursing facilities - Hold Spirit of Women Day of Dance (Feb. 2014) to educate about heart disease risk (screenings for BP, cholesterol, etc.) Key Measure Accomplishments - CNE engaged in developing post-acute partnerships with skilled nursing facilities Key Measure Accomplishments - CNE engaged in developing post-acute partnerships with skilled nursing facilities SCHEDULE H, PART V, SECTION B, QUESTION 20D THE FACILITY HAS A LONGSTANDING POLICY OF PROVIDING UNINSURED PATIENTS A 30% DISCOUNT FROM CHARGES. THIS PERCENTAGE WAS AN APPROXIMATION OF THE AVERAGE PAYMENT RATES FOR NONGOVERNMENTAL PAYORS ACROSS THE SYSTEM. ADDITIONAL DISCOUNTS ARE PROVIDED FOR ADVANCE OR PROMPT PAYMENTS. 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 A COST-TO-CHARGE RATIO WAS USED, THE SOURCE BEING THE MEDICARE COST REPORT FOR FY 2012, ADJUSTED FOR CERTAIN COSTS WHICH ARE PARTICULAR TO MEDICARE COST REPORTING, BUT NOT APPROPRIATE FOR PART 1, LINE 7. E.G. REMOVING THE REASONABLE COST EQUIVALENT FOR PHYSICIAN SERVICES IN W/S A-8-2, ADJUSTING PENSION EXPENSE TO GAAP, ADJUSTMENTS FOR USEFUL LIVES OF CERTAIN SOFTWARE, AND REMOVING THE RELATED PARTY COSTS (OTHER THAN HOME OFFICE). WORKSHEET 2, "RATIO OF PATIENT CARE COST-TO-CHARGES" WAS USED TO COMPLETE THE COST-TO-CHARGE RATIO USED IN PART 1, LINE 7. 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 ORGANIZATION AND ITS AFFILIATES PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM'S ALLOWANCE FOR DOUBTFUL ACCOUNTS (PROVISION FOR BAD DEBT) METHODOLOGY AND CHARITY CARE POLICIES ARE CONSISTENTLY APPLIED ACROSS ALL HOSPITAL AFFILIATES. THE ATTACHED TEXT WAS OBTAINED FROM THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS OF THE ORGANIZATION. NET PATIENT SERVICE REVENUE THE HOSPITALS AND THE AGENCY HAVE INDIVIDUAL AGREEMENTS WITH MANY THIRD-PARTY PAYORS THAT PROVIDE PAYMENTS AT AMOUNTS DIFFERENT FROM THEIR ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER-DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, AND INCLUDES ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS DUE TO SUCH THINGS AS FUTURE AUDITS AND REVIEWS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN, OR AS YEARS ARE NO LONGER SUBJECT TO SUCH ADJUSTMENTS. CHARITY CARE THE HEALTH SYSTEM PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR CHARITY CARE POLICIES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. BECAUSE THE HEALTH SYSTEM DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT REVENUE. SCHEDULE H, PART III, SECTION B; QUESTION 8 THE INPATIENT MEDICARE ALLOWABLE COSTS WERE DETERMINED FROM THE SUBMITTED FY 2014 MEDICARE COST REPORT, WORKSHEET D-1, LINE 49, LESS PARA-MED COSTS, WHICH ARE INCLUDED IN PART I, LINE 7(F). WORKSHEET D-1, LINE 49 DOES NOT INCLUDE DIRECT GME COSTS. THE OUTPATIENT ALLOWABLE COSTS COME FROM WORKSHEET E, PART B. BAD DEBT IS COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. 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, RELIGION 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 "THE TERM CHARITABLE IS USED IN 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE," AND 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 "DUAL 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, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BA 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 ALL COMMUNITY BENEFIT PROGRAMS UNDERTAKEN BY THE HOSPITAL ARE ALIGNED WITH THE MISSION OF THE HOSPITAL: TO IMPROVE THE HEALTH STATUS AND WELL-BEING OF INDIVIDUALS AND FAMILIES IN ITS SERVICE AREA. RECOGNIZING THAT COMMUNITY NEEDS MAY OUTPACE RESOURCES, THE HOSPITAL 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. 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'S PRIMARY SERVICE AREA CONSISTS OF RHODE ISLAND WITH A TOTAL POPULATION OF 1,048,683. THE AVERAGE HOUSEHOLD INCOME IS $74,085 AND 13.6 PERCENT OF THE POPULATION HAS INCOME BELOW THE POVERTY LEVEL. THIRTEEN HOSPITALS SERVE THE PRIMARY SERVICE AREA AND A SIGNIFICANT PERCENT OF HOSPITAL DISCHARGES ARE MEDICARE, MEDICAID AND UNINSURED PATIENTS. DATA FROM TRUVEN HEALTH ANALYTICS, INC. FOR 2014 INDICATED THAT THODE ISLAND CONSISTED OF THE FOLLOWING GROUPS: 74.5% OF THE POPULATION WERE CAUCASIAN, 13.8% OF THE POPULATION WERE HISPANICS AND LATINOS OF ANY RACE, 5.0% WERE BLACK OR AFRICAN AMERICANS AND 6.7% REPORTED OTHER ETHNICITIES. 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 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, RELIGION 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, KENT COUNTY MEMORIAL HOSPITAL AND THE 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, RELIGION 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, RELIGION 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 CORPORATION 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, RELIGION OR ABILITY TO PAY. MOREOVER, WOMEN & INFANTS CORPORATION OPERATES 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, RELIGION 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 170(B)(1)(A)(VI). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION 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, RELIGION 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, RELIGION 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, RELIGION 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 MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. HEALTH TOUCH, INC. HEALTH TOUCH, 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 MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. AFFINITY PHYSICIANS, L.L.C. AND KENT ANCILLARY SERVICES, L.L.C. ARE SINGLE MEMBER LIMITED LIABILITY COMPANIES OF KENT COUNTY MEMORIAL HOSPITAL. INTEGRA COMMUNITY CARE NETWORK, L.L.C. IS A SINGLE MEMBER LIMITED LIABILITY COMPANY OF CARE NEW ENGLAND HEALTH SYSTEM. Memorial hospital Memorial hospital is a 294-bed non-profit acute care hospital located in pawtucket, rhode island. 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, religion or ability to pay. Moreover, memorial hospital operates consistently with the criteria outlined in irs revenue ruling 69-545. Blackstone health, inc. Blackstone health, inc. Is an organization recognized by the internal revenue service as tax-exempt pursuant to internal revenue code 501( 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. true BROWN UNIVERSITY CONTROLLERS OFC BOX J PROVIDENCE RI 02912 050258809 501(C)(3) 525000 PROGRAM SUPPORT 1 0 SCHEDULE I, PART I; QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS. X X X X false true false false false true true true false DENNIS D KEEFE DIRECTOR - PRESIDENT/CEO/CNE 0 851008 0 264000 0 50260 0 107126 0 23253 0 1295647 0 0 GHULAM MUSTAFA SURTI MD DIRECTOR - UNIT CHIEF BH 403842 0 0 0 1710 0 17850 0 18657 0 442059 0 0 0 ALYSSA V BOSS ESQ ASST SEC/SVP & GENERAL COUNSEL 0 296312 0 76858 0 23802 0 48000 0 21983 0 466955 0 0 JOHN M SUTHERLAND III SVP/CFO/CNE (TERM 8/14) 0 446220 0 104346 0 37295 0 28050 0 23185 0 639096 0 0 PATRICIA R RECUPERO JD MD PRESIDENT AND CEO (TERM 7/14) 442202 0 125307 0 33011 0 346833 0 23159 0 970512 0 0 0 LAWRENCE H PRICE MD PRESIDENT AND COO (EFF 7/14) 314339 0 66300 0 17500 0 25500 0 2940 0 426579 0 0 0 MICHAEL A FIORI MD PRESIDENT BH MED STAFF ASSOC 306211 0 57970 0 19930 0 15300 0 2094 0 401505 0 0 0 BONNIE BAKER CPA FHFMA VICE PRESIDENT/CFO 0 288647 0 59845 0 11308 0 28050 0 22723 0 410573 0 0 WALTER DIAS VICE PRESIDENT/COO 288225 0 58767 0 9955 0 28050 0 18825 0 403822 0 0 0 LINDA DAMON RN ARNP VICE PRESIDENT/CNO 230521 0 51904 0 10607 0 25500 0 18454 0 336986 0 0 0 JULIE FORREST MD PSYCHIATRIST 449689 0 0 0 18747 0 15300 0 4221 0 487957 0 0 0 MARTIN J FURMAN ASSOCIATE MEDICAL DIRECTOR 410598 0 19237 0 18557 0 25500 0 18369 0 492261 0 0 0 ALVARO J OLIVARES MD UNIT CHIEF 381930 0 0 0 0 0 20400 0 19766 0 422096 0 0 0 MICHAEL D STEIN MD DIRECTOR GENERAL MED RESEARCH 334467 0 0 0 1714 0 17850 0 21135 0 375166 0 0 0 JAMES K SULLIVAN MD DEPUTY MEDICAL DIRECTOR CS 305756 0 21600 0 3746 0 19125 0 2975 0 353202 0 0 0 PART VII AND SCHEDULE J TAXABLE COMPENSATION REPORTED HEREIN IS DERIVED FROM 2013 FORMS W-2 AND 1099 (IF APPLICABLE). SCHEDULE J, PART I; QUESTION 4B THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUAL INCLUDES UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUAL MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN THE INDIVIDUAL'S 2013 FORM W-2, AS TAXABLE WAGES: PATRICIA R. RECUPERO, JD, M.D., $318,783. 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, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2013 FORM W-2, AS TAXABLE WAGES: DENNIS D. KEEFE, $88,001 AND ALYSSA V. BOSS, ESQ., $32,024. 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 2013 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2013 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 substance abuse 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 race, color, creed, sex, national origin, religion or ability to pay. 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 substance abuse 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 comprised of six members: butler hospital, rhode island's only private, nonprofit psychiatric and substance abuse hospital for adults, adolescents and seniors; kent 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; Memorial Hospital, 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, hospice and private duty nursing services for new mothers, the elderly and the terminally ill; and the care new england wellness center, which offers an array of rehabilitation, wellness, fitness and educational programs. 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 illness 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. 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 - teamwork CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS Overview ======== Butler is the only adolescent, and adult psychiatric treatment hospital serving rhode island and southeastern new england. It provides assessment and treatment for all major psychiatric illnesses and substance abuse. Butler's inpatient program has eighttreatment units with specialty programs for adolescents, seniors, people with substance abuse problems, and patients needing intensive care . Butler's partial hospital day program has separate programs for psychiatric disorders and substance abuse. 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 abuse problems including but not limited to: - depression - bipolar disorder- suicidal behavior - alcohol and substance abuse - 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, 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. 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. Al anon 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 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 irving m. Rosen, md, memorial spiritual program which celebrated its 20th anniversary, the annual Antonio Capone, MD conference on the Aging Brain. 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, substance, abuse, 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 substance abuse supports 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 -weekly substance abuse recovery group -monthly support group for people suffering from compulsive hoarding - 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 VI, SECTION A; QUESTION 2 CHARLES R. REPPUCCI, ESQ. AND ROBERT G. FLANDERS, JR., ESQ. - BUSINESS RELATIONSHIP. CORE FORM, PART VI, SECTION A; QUESTION 3 THE HOSPITAL ENGAGES SODEXHO MANAGEMENT, INC. TO BE AN AGENT OF THE HOSPITAL 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 HOSPITAL'S DEPARTMENT MANAGEMENT PRACTICES AND IN ACCORDANCE WITH ITS WRITTEN POLICIES AND PROCEDURES. THE POSITION REPORTS TO AN OFFICER/KEY EMPLOYEE OF THE HOSPITAL. 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 IN THE CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CARE NEW ENGLAND HEALTH SYSTEM IS THE PARENT ENTITY OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF DIRECTORS) PRIOR TO THE FILING WITH THE IRS. IN ADDITION THE CARE NEW ENGLAND HEALTH SYSTEM FINANCE COMMITTEE ALSO PERFORMED A REVIEW OF THE FEDERAL FORM 990 PRIOR TO MAKING IT AVAILABLE TO EACH VOTING MEMBER OF ITS BOARD OF DIRECTORS. 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 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 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 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, INCLUDING, BUT NOT LIMITED TO, THE INDIVIDUALS OUTLINED ABOVE, FOR THEIR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP AND OTHER INDIVIDUALS 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 AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL PRIOR TO PRESENTATION OF THE FEDERAL FORM 990 TO THE MEMBERS OF THE CARE NEW ENGLAND HEALTH SYSTEM FINANCE COMMITTEE. FOLLOWING THE FINANCE COMMITTEE'S REVIEW 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 AND REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH THAT POLICY. 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 A DIRECTOR DISCLOSES AN INTEREST THAT COULD GIVE RISE TO A CONFLICT, THE DIRECTOR'S POTENTIAL CONFLICT IS REFERRED TO THE BOARD OR THE COMMITTEE, WHICH EVALUATES THE CONFLICT AND ITS POTENTIAL IMPACT ON THE DIRECTOR'S PARTICIPATION ON THE BOARD OR ON CERTAIN ISSUES THAT MAY COME BEFORE THE BOARD. AFTER CONSULTATION WITH COUNSEL, THE COMMITTEE WILL TAKE 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 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 THE 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 CARE NEW ENGLAND HEALTH SYSTEM 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 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 IN THE 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, REPRESENTS 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 ONE HOUR. THE HOURS REFLECTED ON 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 VII AND SCHEDULE J PATRICIA R. RECUPERO, JD, M.D., PRESIDENT AND CHIEF EXECUTIVE OFFICER FOR THIS ORGANIZATION FOR THE PERIOD 10/1/2013 - 7/1/2014 WAS TRANSFERRED TO CARE NEW ENGLAND HEALTH SYSTEM; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, ON 7/2/2014 WHERE SHE SERVED AS THE SENIOR VICE PRESIDENT FOR EDUCATION AND TRAINING THROUGH THE ORGANIZATION'S YEAR END OF 9/30/2014. LAWRENCE H. PRICE, M.D., MEDICAL DIRECTOR FOR THIS ORGANIZATION FOR THE PERIOD 10/1/2013 - 7/1/2014 BECAME THE PRESIDENT AND CHIEF OPERATING OFFICER FOR THIS ORGANIZATION STARTING 7/2/2014 THROUGH THE ORGANIZATION'S YEAR END OF 9/30/2014. CORE FORM, PART XI; LINE 9 OTHER CHANGES IN FUND BALANCE INCLUDE: - PENSION AND POSTRETIREMENT ADJUSTMENT; ($2,929,993); - NET ASSETS RELEASED FROM RESTRICTIONS USED FOR PURCHASE OF PROPERTY, PLANT AND EQUIPMENT; $206,110; AND - NET ASSETS RELEASED FROM RESTRICTIONS; ($743,579). CORE FORM, PART XII; QUESTION 2 THIS ORGANIZATION IS AN AFFILIATE OF 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 BIG FOUR 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, 2014 AND SEPTEMBER 30, 2013; RESPECTIVELY AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNQUALIFIED 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 IN THE CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES ("SYSTEM"). THE SYSTEM ENGAGES AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED A-133 AUDIT. THIS ORGANIZATION WAS INCLUDED IN THE SYSTEM WIDE A-133 AUDIT. 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RI C CORP. false false false true true true false false false false false false false true true true true true false false SCHEDULE R, PART V AS OUTLINED IN SCHEDULE O, CARE NEW ENGLAND HEALTH SYSTEM IS THE TAX-EXEMPT PARENT OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. THIS ORGANIZATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) ORGANIZATION. THE SYSTEM ALSO INCLUDES KENT COUNTY MEMORIAL HOSPITAL, WOMEN & INFANTS HOSPITAL OF RHODE ISLAND AND THE MEMORIAL HOSPITAL; EACH IS ALSO RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL. CARE NEW ENGLAND HEALTH SYSTEM ROUTINELY PAYS EXPENSES FOR VARIOUS AFFILIATES WITHIN THE CARE NEW ENGLAND HEALTH SYSTEM IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.