N H C C MEDICAL ASSOCIATES INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- N H C C MEDICAL ASSOCIATES INC (EIN 05-0472268)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-15
- IRS object ID
- 201422279349300742
- Schema version
- 2012v2.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-15T06:09:43-07:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2 Financial Center 60 South St | AddressLine1 |
| City | Boston | City |
| State | MA | State |
| ZIP Code | 02111 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050472268 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NHCC Medical Associates Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NHCC | NameControl |
| Phone | 4018466400 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 Friendship Street | AddressLine1 |
| City | Newport | City |
| State | RI | State |
| ZIP Code | 02840 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Mary A Wakefield | Name |
| Title | EVP & CFO | Title |
| Date Signed | 2014-08-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P01245482 | PTIN |
| Phone | 6179885805 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Mary A Wakefield | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 593 Eddy Street | AddressLine1 |
| City | Providence | City |
| State | RI | State |
| ZIP Code | 02903 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 10350872 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | none | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1993 | YearFormation |
| State Legal Domicile | RI | StateLegalDomicile |
| Activity Or Mission Description | The mission of NHCC Medical Associates is to employ physicians and other healthcare practitioners to provide integrated, comprehensive healthcare services to the community. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 28 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 21 | NbrIndependentVotingMembers |
| Total Nbr Employees | 105 | TotalNbrEmployees |
| Total Nbr Volunteers | 22 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 7888126 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 10350872 | ProgramServiceRevenueCY |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7888126 | TotalRevenuePriorYear |
| Total Revenue Current Year | 10350872 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 118768 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 36062 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9153936 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12683020 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1915650 | OtherExpensePriorYear |
| Other Expenses Current Year | 3033360 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 11188354 | TotalExpensesPriorYear |
| Total Expenses Current Year | 15752442 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3300228 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -5401570 | RevenuesLessExpensesCY |
| Total Assets BOY | 671095 | TotalAssetsBOY |
| Total Assets EOY | 934971 | TotalAssetsEOY |
| Total Liabilities BOY | 9277256 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4107877 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -8606161 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -3172906 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | The mission of NHCC Medical Associates is to employ physicians and other healthcare practitioners to provide integrated, comprehensive healthcare services to the community. (See Schedule O) | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 15752442 | Expense |
| Grants | 36062 | Grants |
| Revenue | 10350872 | Revenue |
| Description | The purpose of NHCC Medical Associates, a Newport-based group practice of internal and family medicine specialists, is to employ physicians and other healthcare practitioners to provide integrated, comprehensive healthcare services to the community. | Description |
| Total Program Service Expense | 15752442 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 13 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 105 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 28 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 21 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Mary A Wakefield | NamePerson |
| Telephone Number | 4014447093 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 593 Eddy Street | AddressLine1 |
| City | Providence | City |
| State | RI | State |
| ZIP Code | 02903 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (50 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| Brian J Zink MD | |||||||||
| Trustee | 0.08 | 3.92 | X | 0 | 1000 | 0 | |||
| Leonard C Taddei DMD | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Shivan Subramaniam | |||||||||
| Trustee | 0.22 | 3.78 | X | 0 | 0 | 0 | |||
| Charles Stengel | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Hon Bruce Selya | |||||||||
| Trustee | 0.50 | 8.50 | X | 0 | 0 | 0 | |||
| Suzette D Schochet | |||||||||
| Secr.- 10/1 | 0.00 | 0.00 | X | 0 | 0 | 0 | X | ||
| Fred J Schiffman | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Lawrence Sadwin | |||||||||
| Trustee | 0.33 | 7.67 | X | 0 | 0 | 0 | |||
| Kathleen H Ross | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Lloyd Robertson | |||||||||
| Trustee | 0.33 | 20.67 | X | 0 | 0 | 0 | |||
| James A Purviance | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Steven Pare | |||||||||
| Trustee | 0.67 | 11.83 | X | 0 | 0 | 0 | |||
| Christopher S Ottiano MD | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Stephen P Massed | |||||||||
| Chair- 10/12 | 0.33 | 16.17 | X | 0 | 0 | 0 | X | ||
| Alan H Litwin | |||||||||
| Trustee | 0.67 | 19.33 | X | 0 | 0 | 0 | |||
| Bertram M Lederer | |||||||||
| Trustee | 0.00 | 14.00 | X | 0 | 0 | 0 | |||
| Scott B Laurans | |||||||||
| Chairman | 0.25 | 11.25 | X | 0 | 0 | 0 | X | ||
| Marie J Langlois | |||||||||
| Trustee | 0.00 | 3.00 | X | 0 | 0 | 0 | |||
| Dayle Hunt Joseph | |||||||||
| Trustee | 0.30 | 5.70 | X | 0 | 0 | 0 | |||
| Pamela Harrop MD | |||||||||
| Trustee | 0.10 | 3.90 | X | 0 | 0 | 0 | |||
| Michael L Hanna | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| David Gorelick MD | |||||||||
| Trustee | 0.20 | 2.80 | X | 0 | 0 | 0 | |||
| David S Gordon | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Christine A Gill | |||||||||
| V. Chair- 10/12 | 0.00 | 0.00 | X | 0 | 0 | 0 | X | ||
| Rita B Gewirz | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| M Lynne Francis | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Jason Fowler | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Edward D Feldstein | |||||||||
| Trustee | 0.11 | 6.89 | X | 0 | 0 | 0 | |||
| Alan R Feinberg DMD | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Jonathan D Fain | |||||||||
| Trustee | 0.17 | 6.83 | X | 0 | 0 | 0 | |||
| Michael Ehrlich MD | |||||||||
| Trustee | 0.17 | 12.83 | X | 0 | 96726 | 0 | |||
| Peter M DiBari | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Ellen Collis | |||||||||
| Trustee | 0.00 | 6.50 | X | 0 | 0 | 0 | |||
| Peter Capodilupo | |||||||||
| Trustee | 0.28 | 8.72 | X | 0 | 0 | 0 | |||
| David A Brown | |||||||||
| Trustee | 0.08 | 7.42 | X | 0 | 0 | 0 | |||
| David G Bazarsky | |||||||||
| Trustee | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Emanuel Barrows | |||||||||
| Trustee | 0.11 | 1.89 | X | 0 | 0 | 0 | |||
| Timothy J Babineau MD | |||||||||
| Trustee | 1.00 | 39.00 | X | 0 | 1486727 | 205277 | |||
| Lawrence Aubin Sr | |||||||||
| Vice Chairman | 0.33 | 14.67 | X | 0 | 0 | 0 | X | ||
| Sr Therese M Antone | |||||||||
| Trustee | 0.33 | 6.17 | X | 0 | 0 | 0 | |||
| Thomas Anders MD | |||||||||
| Trustee | 0.33 | 7.17 | X | 0 | 0 | 0 | |||
| Mary A Wakefield | |||||||||
| Treasurer | 1.00 | 39.00 | 0 | 798078 | 297927 | X | |||
| August B Cordeiro | |||||||||
| President & CEO | 5.00 | 35.00 | 0 | 425713 | 78729 | X | |||
| Kenneth E Arnold | |||||||||
| Secretary | 0.50 | 39.50 | 0 | 3554467 | 29606 | X | |||
| Larry A Evans MD | |||||||||
| Physician | 40.00 | 0.00 | 368707 | 0 | 37643 | X | |||
| Mohammad Y Hmadeh MD | |||||||||
| Physician | 40.00 | 0.00 | 340803 | 0 | 23409 | X | |||
| Donald MacDougall MD | |||||||||
| Physician | 40.00 | 0.00 | 240700 | 0 | 35402 | X | |||
| Alexis J Markowski MD | |||||||||
| Physician | 40.00 | 0.00 | 298214 | 0 | 30665 | X | |||
| Eric B Radler MD | |||||||||
| Physician | 40.00 | 0.00 | 263452 | 0 | 28576 | X | |||
| Arthur J Sampson | |||||||||
| President & CEO | 0.00 | 40.00 | 0 | 546786 | 90041 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1511876 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 6909497 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 857275 | TotalOtherCompensation |
| Number Individuals GT100 K | 39 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| University Surgical Associates Inc | |||||
| PO Box 16149 | Rumford | RI | 02916 | Physician Med. Svc | 309178 |
| South County Orthopedics and Therapy | |||||
| 1 High St | Wakefield | RI | 02879 | Physician Med. Svc | 184850 |
| Barton Associates Inc | |||||
| 10 Dearborn Road | Peabody | MA | 01960 | Physician Med. Svc | 221360 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Health Care Services | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 10350872 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10350872 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 10350872 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10350872 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10350872 | RelatedOrExemptFunctionIncome |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36062 | Total |
| Program Services | 36062 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11115690 | Total |
| Program Services | 11115690 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 331910 | Total |
| Program Services | 331910 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 696808 | Total |
| Program Services | 696808 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 538612 | Total |
| Program Services | 538612 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 385739 | Total |
| Program Services | 385739 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21238 | Total |
| Program Services | 21238 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 189058 | Total |
| Program Services | 189058 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 779852 | Total |
| Program Services | 779852 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42535 | Total |
| Program Services | 42535 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 370578 | Total |
| Program Services | 370578 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Professional & Other Expenses | 118271 | 118271 |
| Medical Supplies | 240023 | 240023 |
| Provision for Bad Debts | 442247 | 442247 |
| Collection & Billing Fees | 443819 | 443819 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15752442 | Total |
| Program Services | 15752442 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 182657 | BOY |
| EOY | 173233 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 385128 | BOY |
| EOY | 486359 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4589 | BOY |
| EOY | 159311 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 414802 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 298734 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 98721 | BOY |
| EOY | 116068 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 671095 | BOY |
| EOY | 934971 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 912686 | BOY |
| EOY | 1199511 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8364570 | BOY |
| EOY | 2908366 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9277256 | BOY |
| EOY | 4107877 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -8606161 | BOY |
| EOY | -3172906 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -8606161 | BOY |
| EOY | -3172906 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 671095 | BOY |
| EOY | 934971 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -5401570 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 10834825 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type2 | X | SupportingOrg509a3Type2 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Newport Hosp | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050258914 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Supported Organization Notified | false | SupportedOrganizationNotified |
| Organized In US | false | OrganizedInUS |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 414802 | OtherCostOrOtherBasis |
| Depreciation | 298734 | Depreciation |
| Book Value | 116068 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 116068 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Due to Affiliates | Description |
| Amount | $2,908,366 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2908366 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part X | Identifier |
| Return Reference | Part X : FIN48 Footnote | ReturnReference |
| Explanation | NHCC Medical Associates, 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. The organization recognizes the effect of income tax positions only if those positions are more likely than not to be sustained. Changes in measurement are reflected in the period in which the change in judgment occurs. The organization did not recognize the effect of any income tax positions during the fiscal year ended September 30, 2013. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | East Bay Community Action Health Clinic | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19 Broadway | AddressLine1 |
| City | Newport | City |
| State | RI | State |
| ZIP Code | 02840 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 050310024 | EINOfRecipient |
| IRC Section | 501 (c)(3) | IRCSection |
| Amount Of Cash Grant | 36062 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 0 | AmountOfNonCashAssistance |
| Purpose Of Grant | Charitable Support | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Grantmaker's Description of How Grants are Used | Identifier |
| Explanation | To ensure that grant funds are used for primary care health services, NHCC Medical Associates reviews the monthly financial records of the East Bay Community Action Program's Primary Care Health Clinic, as the grant recipient. NHCC Medical Associates reviews billings, collections, and program expenses to ensure that the grant is used in accordance with its intended purpose. In addition, NHCC Medical Associates' Director of Physician Practices periodically meets with East Bay Community Action Program management and reviews the primary care practice's patient volumes to determine compliance with the terms of the grant. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| TitleTitle | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Timothy J Babineau MD | |||||||||||||
| Trustee | 811918 | 282352 | 392457 | 182032 | 23245 | 1692004 | 87782 | ||||||
| Mohammad Y Hmadeh MD | |||||||||||||
| Physician | 258321 | 81982 | 500 | 13800 | 9609 | 364212 | |||||||
| Mary A Wakefield | |||||||||||||
| Treasurer | 531513 | 175000 | 91565 | 281479 | 16448 | 1096005 | 68467 | ||||||
| Larry A Evans MD | |||||||||||||
| Physician | 304994 | 61667 | 2046 | 14495 | 23148 | 406350 | |||||||
| Kenneth E Arnold | |||||||||||||
| Secretary | 451707 | 145000 | 2957760 | 12500 | 17106 | 3584073 | 2094059 | ||||||
| Eric B Radler MD | |||||||||||||
| Physician | 239236 | 23425 | 791 | 13426 | 15150 | 292028 | |||||||
| Donald MacDougall MD | |||||||||||||
| Physician | 236895 | 3805 | 12841 | 22561 | 276102 | ||||||||
| August B Cordeiro | |||||||||||||
| President & CEO | 278745 | 100000 | 46968 | 58985 | 19744 | 504442 | 27360 | ||||||
| Arthur J Sampson | |||||||||||||
| President & CEO | 372859 | 104000 | 69927 | 73481 | 16560 | 636827 | 45784 | ||||||
| Alexis J Markowski MD | |||||||||||||
| Physician | 297363 | 851 | 14495 | 16170 | 328879 | ||||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Sch J, Part I, Line 7 | 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 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 80% of any earned incentive award, based on the achievement of the team performance objectives. The remaining 20% 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. |
| Sch J, Part I, Line 1a | 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).Social Club Dues:The job responsibilities of certain executives include development of relationships with business leaders and donors. Those relationships are facilitated by the ability to meet in private sessions during which focused business discussions take place. The Hope and University Clubs, which require individual memberships, are places in Providence where businessmen and women, civic, community, and social leaders can gather in a businesslike atmosphere. The cost of membership is considered by Lifespan to be reasonable and necessary and thus a qualified business expense not taxable to the employee. IRS regulations regarding documentation requirements are followed for any payments made for meetings held at the respective club, including the business purpose and nature of the business benefit derived; the nature of the business discussion or activity; and the identity and business relationship of attendees. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (14 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Section B, Line 15a & b, cont | * 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, the Office of the President works 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 | While the organization did not produce an audited financial statement as of and for the year ended September 30, 2013, it was included in NHCC and Affiliates' audited combined financial statements, in which one column is used for the organization individually. The NHCC and Affiliates audited combined financial statements are included in the Lifespan audited consolidated financial statements. There are no regulatory or creditor stipulations which require the preparation of a separate audited financial statement for NHCC Medical Associates, Inc.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. | |
| Form 990, Part VI, Section B, Line 15a and b | The following applies to Lifespan and all of its affiliates, including NHCC Medical Associates: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 with both 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. | |
| Form 990, Part VI, Section B, Line 12c | Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including NHCC Medical Associates, 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, Line 1b: | Lawrence Aubin, Vice Chair, is the owner of Lawrence Investments, LLC, which owns West Bay Medical Center Building and leases space to The Miriam Hospital. Edward Feldstein, Trustee, is a partner in Roberts, Carroll, Feldstein, and Peirce, a law firm that provides legal services to Lifespan Risk Services, Inc.David Gorelick, Trustee, is an officer of Aquidneck Medical Associates, a physician practice which has a professional service contract with Newport Hospital.Shivan Subramaniam, Trustee, is the Chairman and CEO of FM Global. Lifespan purchases property insurance coverage from Factory Mutual Insurance Company, a member of FM Global. During calendar year 2012, Brian Zink, Trustee, received taxable tuition reimbursement paid for by Rhode Island Hospital. | |
| Form 990, Part III, Line 1 -Organization's Mission | NHCC Medical Associates is operated to ensure that the necessary physicians are available to the community to meet its healthcare needs.NHCC Medical Associates' medical practices include: dermatology, family medicine, hand surgery, hospitalists, neurology, pathology, psychiatry, physiatry, pulmonology, and rheumatology. Physicians are recruited and employed based on the healthcare needs of the community. | |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Intercompany Forgiveness = $10834825 | Form 990, Part XI, Line 9 |
| 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. NHCC Medical Associates is included in the audited combined financial statements of NHCC and Affiliates. In addition, copies of NHCC Medical Associates' Articles of Incorporation, Bylaws, and Conflict of Interest Policy are available upon request from the office of the Lifespan Chief Financial Officer, either in person or by mail. | Form 990, Part VI, Line 19 |
| 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 Chief Financial Officer and Lifespan's Finance Department, with review by Lifespan's tax advisors, KPMG LLP. 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. Further review is performed by the Director of Finance and the Vice President of Finance - Corporate Services. Once the draft Form 990 is complete, the Director of Finance forwards it with all supporting worksheets to KPMG, which then reviews the completed form in detail. The Director of Finance answers questions as they arise and provides additional information as needed. KPMG provides the Director of Finance 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 Chief Financial Officer 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 the Hospital's Board of Trustees website portal in advance of its next Board meeting, at which all questions and concerns of the members of the Board are addressed by the Chief Financial Officer 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 Chief Financial Officer is authorized to file the Form 990. | Form 990, Part VI, Line 11b |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | 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. Lifespan holds these powers with respect to NHCC; NHCC holds identical powers with respect to the Affiliate, which it may exercise with the authorization of Lifespan. | Form 990, Part VI, Line 7b |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | The bylaws of NHCC Medical Associates (the Affiliate), including the bylaws of NHCC, 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 include: to elect and remove trustees and to approve the election of and to remove certain officers. At each annual meeting of the Affiliate Board of Trustees, a list is compiled of the names of those persons selected to serve as Trustees of the Affiliate so that it can be approved and submitted to Lifespan for ratification and election. | Form 990, Part VI, Line 7a |
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | Lifespan Corporation is the sole corporate member of Newport Health Care Corporation ("NHCC"), which in turn is the sole corporate member of NHCC Medical Associates, Inc. | Form 990, Part VI, Line 6 |
| Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents | Effective October 23, 2012, the Board of Directors of Lifespan and the Boards of Trustees of Rhode Island Hospital, The Miriam Hospital, Newport Health Care Corporation, Newport Hospital, and 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 Lifespan were amended such that the composition of the Boards of Trustees of each of the hospitals and of 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, and the following ex-officio voting directors: the chair of each of Rhode Island Hospital Foundation, The Miriam Hospital Foundation, Newport Hospital Foundation, Bradley Hospital Foundation, and Gateway Foundation. | Form 990, Part VI, Line 4 |
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | Kenneth E. Arnold, Secretary, Timothy J. Babineau, MD, President, and Mary A. Wakefield, CFO, 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). Additionally, Scott B. Laurans, Chair, is an officer of VNA.Jonathan Fain, Trustee, is the CEO of Teknor Apex Co. Bertram Lederer, Trustee, is also a Director of Teknor Apex Co. | Form 990, Part VI, Line 2 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (36 entries)
| Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Primary ActivitiesPrimaryActivities | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Legal Domicile StateLegalDomicileState |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RI Sound Enterprises Insurance Co Ltd | |||||||||||||||
| 65 Front Street | Hamilton | BD | HM 12 | Offshore Insurance Captive | BD | N/A | N/A | Lifespan Corporation | false | ||||||
| Westerly Courts Inc | |||||||||||||||
| Housing for Elderly and Mentally Ill | 501(c)(3) | 9 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 611439766 | RI | |||||
| Wentworth Corporation | |||||||||||||||
| Housing for Elderly and Mentally Ill | 501(c)(3) | 9 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050488520 | RI | |||||
| TLR Realty | |||||||||||||||
| Housing for Elderly and Mentally Ill | 501(c)(3) | 9 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 043742771 | RI | |||||
| The Miriam Hospital Foundation | |||||||||||||||
| Philanthropic Activities | 501(c)(3) | 7 | Lifespan Corporation | false | 167 Point Street | Providence | RI | 02903 | 050377502 | RI | |||||
| The Miriam Hospital | |||||||||||||||
| Health Care Services | 501(c)(3) | 3 | Lifespan Corporation | false | 164 Summit Avenue | Providence | RI | 02906 | 050258905 | RI | |||||
| The Autism Project | |||||||||||||||
| Services for Children with Autism | 501(c)(3) | 9 | Gateway Healthcare Inc | false | 1516 Atwood Avenue | Johnston | RI | 02919 | 050512037 | RI | |||||
| Shore Courts Inc | |||||||||||||||
| Housing for Elderly and Mentally Ill | 501(c)(3) | 9 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050504003 | RI | |||||
| RIH Ventures | |||||||||||||||
| Parking Facilities/Phlebotomy Services | 501(c)(3) | 11 | Lifespan Corporation | false | 593 Eddy Street | Providence | RI | 02903 | 050448686 | RI | |||||
| Rhode Island Hospital Foundation | |||||||||||||||
| Philanthropic Activities | 501(c)(3) | 7 | Lifespan Corporation | false | 167 Point Street | Providence | RI | 02903 | 050468736 | RI | |||||
| Rhode Island Hospital | |||||||||||||||
| Health Care Services | 501(c)(3) | 3 | Lifespan Corporation | false | 593 Eddy Street | Providence | RI | 02903 | 050258954 | RI | |||||
| Pathways Inc | |||||||||||||||
| Housing for Elderly and Mentally Ill | 501(c)(3) | 9 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050393004 | RI | |||||
| Obed Apartments Inc | |||||||||||||||
| Housing for Elderly and Mentally Ill | 501(c)(3) | 9 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050422771 | RI | |||||
| Newport Hospital Foundation Inc | |||||||||||||||
| Philanthropic Activities | 501(c)(3) | 7 | Lifespan Corporation | false | 11 Friendship Street | Newport | RI | 02840 | 222535533 | RI | |||||
| Newport Hospital | |||||||||||||||
| Health Care Services | 501(c)(3) | 3 | Lifespan Corporation | false | 11 Friendship Street | Newport | RI | 02840 | 050258914 | RI | |||||
| Newport Health Property Management Inc | |||||||||||||||
| Property Management | 501(c)(3) | 11 | Newport Health Care Corporation | false | 11 Friendship Street | Newport | RI | 02840 | 222335539 | RI | |||||
| Newport Health Care Corporation | |||||||||||||||
| Holding Company/ Mgmnt. Services | 501(c)(3) | 7 | Lifespan Corporation | false | 11 Friendship Street | Newport | RI | 02840 | 222535537 | RI | |||||
| Mill River Community Housing Corporation | |||||||||||||||
| Housing for Elderly and Mentally Ill | 501(c)(3) | 9 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050427152 | RI | |||||
| LJR Corporation | |||||||||||||||
| Housing for Elderly and Mentally Ill | 501(c)(3) | 9 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 030508346 | RI | |||||
| Lifespan School Solutions Inc | |||||||||||||||
| Educational Services | Applied For | Emma Pendleton Bradley Hospital | false | 167 Point Street | Providence | RI | 02903 | 464910847 | RI | ||||||
| Lifespan Physician Group Inc | |||||||||||||||
| Health Care Services | 501(c)(3) | 9 | Lifespan Corporation | false | 167 Point Street | Providence | RI | 02903 | 050389801 | RI | |||||
| Lifespan of Massachusetts Inc | |||||||||||||||
| Holding Company | 501(c)(3) | 11 | Lifespan Corporation | false | c/o Archstone Law 245 Winter St | Waltham | MA | 02451 | 043408517 | MA | |||||
| Lifespan Foundation | |||||||||||||||
| Philanthropic Activities | 501(c)(3) | 7 | Lifespan Corporation | false | 167 Point Street | Providence | RI | 02903 | 050493219 | RI | |||||
| Lifespan Diversified Services Inc | |||||||||||||||
| Holding Company/ Mgmnt Services | 501(c)(3) | 11 | Lifespan Corporation | false | 167 Point Street | Providence | RI | 02903 | 050258935 | RI | |||||
| Lifespan Corporation | |||||||||||||||
| Holding Company/ Mgmnt Services | 501(c)(3) | 11 | NA | false | 167 Point Street | Providence | RI | 02903 | 222861978 | RI | |||||
| JM Apartments Inc | |||||||||||||||
| Housing for Elderly and Mentally Ill | 501(c)(3) | 9 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050435537 | RI | |||||
| Human Services Realty Inc | |||||||||||||||
| Housing for Elderly and Mentally Ill | 501(c)(2) | N/A | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050398161 | RI | |||||
| Hospital Properties Inc | |||||||||||||||
| Property Management | 501(c)(4) | N/A | Lifespan Corporation | false | 167 Point Street | Providence | RI | 02903 | 222869743 | RI | |||||
| Gateway Healthcare Inc | |||||||||||||||
| Subs. Abuse & Psych. Health Care Svcs. | 501(c)(3) | 9 | Lifespan Corporation | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050309043 | RI | |||||
| Gateway Foundation | |||||||||||||||
| Philanthropic Activities | Applied For | Lifespan Corporation | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 464002163 | RI | ||||||
| Families Reaching Into Each New Day Inc | |||||||||||||||
| Bereavement Services for Children | 501(c)(3) | 7 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050504841 | RI | |||||
| Emma Pendleton Bradley Hospital | |||||||||||||||
| Pediatric Psych. Health Care Services | 501(c)(3) | 3 | Lifespan Corporation | false | 1011 Veterans Memorial Parkway | Veterans Memorial | RI | 02915 | 050258806 | RI | |||||
| Capital City Community Centers Inc | |||||||||||||||
| Daycare Services | 501(c)(3) | 7 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050259090 | RI | |||||
| Bradley Hospital Foundation | |||||||||||||||
| Philanthropic Activities | 501(c)(3) | 7 | Lifespan Corporation | false | 167 Point Street | Providence | RI | 02903 | 050500688 | RI | |||||
| Bayberry Courts Inc | |||||||||||||||
| Housing for Elderly and Mentally Ill | 501(c)(3) | 9 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 204590384 | RI | |||||
| Alternative Living Concepts | |||||||||||||||
| Housing for Elderly and Mentally Ill | 501(c)(3) | 9 | Gateway Healthcare Inc | false | 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050442015 | RI | |||||
Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| Gateway Professional Group Inc | |||||||||
| 249 Roosevelt Avenue | Pawtucket | RI | 02860 | 050498391 | Psychotherapy | RI | Gateway Healthcare | C Corp | false |
| VNA Technicare Inc | |||||||||
| 644 George Washington Highway | Lincoln | RI | 02865 | 050472710 | DME Sales | RI | LDS Inc | C corp | false |
| Lifespan Risk Services Inc | |||||||||
| 167 Point Street | Providence | RI | 02903 | 050459767 | Risk Mgmnt. | RI | Lifespan Corp | C corp | false |
| Lifespan MSO Inc | |||||||||
| 167 Point Street | Providence | RI | 02903 | 050508717 | Mgmnt. Svcs. | RI | Lifespan Corp | C corp | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |