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ST JOSEPH HEALTH SERVICES OF RI: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ST JOSEPH HEALTH SERVICES OF RI (EIN 05-0259026)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-13
IRS object ID
201442259349300824
Schema version
2012v2.3
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

FieldValueIRS element (for citing)
Timestamp2014-08-13T08:10:49-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line160 South StreetAddressLine1
CityBostonCity
StateMAState
ZIP Code02111ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN050259026EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST JOSEPH HEALTH SERVICES OF RIBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% KATHLEEN MOOREInCareOfName
Name ControlSTJONameControl
Phone4014563312Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 HIGH SERVICE AVENUEAddressLine1
Address Line2SuiteAddressLine2
CityNORTH PROVIDENCECity
StateRIState
ZIP Code02904ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL CONKLIN JRName
TitleCFO/TREASURERTitle
Date Signed2014-08-07DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone6179881000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKENNETH BELCHERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1200 HIGH SERVICE AVENUEAddressLine1
CityNORTH PROVIDENCECity
StateRIState
ZIP Code02904ZIPCode
FieldValueIRS element (for citing)
Gross Receipts143815881GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SAINTJOSEPHRI.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1946YearFormation
State Legal DomicileRIStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF ST. JOSEPH HEALTH SERVICES OF RI IS TO PRESERVE, RESTORE AND ENHANCE THE HEALTH OF INDIVIDUALS AND FAMILIES WE SERVE WITHIN OUR COMMUNITIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees1602TotalNbrEmployees
Total Nbr Volunteers35TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year283550ContributionsGrantsPriorYear
Contributions Grants Current Year448375ContributionsGrantsCurrentYear
Program Service Revenue Prior Year143703182ProgramServiceRevenuePriorYear
Program Service Revenue CY140750185ProgramServiceRevenueCY
Investment Income Prior Year417051InvestmentIncomePriorYear
Investment Income Current Year490049InvestmentIncomeCurrentYear
Other Revenue Prior Year2989557OtherRevenuePriorYear
Other Revenue Current Year2127272OtherRevenueCurrentYear
Total Revenue Prior Year147393340TotalRevenuePriorYear
Total Revenue Current Year143815881TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year82971703SalariesEtcPriorYear
Salaries Etc Current Year80873097SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year69107644OtherExpensePriorYear
Other Expenses Current Year66736950OtherExpensesCurrentYear
Total Expenses Prior Year152079347TotalExpensesPriorYear
Total Expenses Current Year147610047TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-4686007RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-3794166RevenuesLessExpensesCY
Total Assets BOY87918744TotalAssetsBOY
Total Assets EOY77002711TotalAssetsEOY
Total Liabilities BOY154113252TotalLiabilitiesBOY
Total Liabilities EOY126904477TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-66194508NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-49901766NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF ST. JOSEPH HEALTH SERVICES OF RI IS TO PRESERVE,RESTORE AND ENHANCE THE HEALTH OF INDIVIDUALS AND FAMILIES WE SERVE WITHIN OUR COMMUNITIES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense97127836Expense
Revenue142506534Revenue
DescriptionPATIENT HEALTHCARE SERVICES - ST. JOSEPH HEALTH SERVICES OF RI IS DEDICATED TO PROVIDING PATIENT CARE SERVICES, LABORATORY AND TEACHING SERVICES WITHIN THE COMMUNITY. *SEE SCHEDULE O*Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense12089802Expense
Revenue0Revenue
DescriptionFREE CARE - PER ST. JOSEPH'S PUBLIC NOTICE, ST. JOSEPH HEALTH SERVICES OF RI IS PROUD OF ITS COMMITMENT TO PROVIDE QUALITY CARE TO ALL INDIVIDUALS WHO NEED IT. ST. JOSEPH HEALH SERVICES OF RI PROVIDES FINANCIAL AID TO PATIENTS WITHOUT INSURANCE AND WHO MAY NOT BE ABLE TO PAY FOR THE CARE PROVIDED. *SEE SCHEDULE O*Description
FieldValueIRS element (for citing)
Total Program Service Expense109217638TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096116NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1602NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKATHLEEN MOORENamePerson
Telephone Number4014563322TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 HIGH SERVICE AVENUEAddressLine1
CityNORTH PROVIDENCECity
StateRIState
ZIP Code02904ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
KENNETH BELCHER
PRESIDENT AND CEO CCHP0.040.0XX042865225282
JOSEPH SAMARTANO JR DDS
TRUSTEE1.0X119041019270
ELLEN MCCARTY PHD
BOARD MEMBER1.0X000
JOSEPH P MAZZA MD
BOARD MEMBER1.0X000
LESLIE MARTINEAU
BOARD MEMBER1.0X000
NANCY ROGERS
BOARD MEMBER1.0X000
REV PAUL D THEROUX
BOARD MEMBER1.0X000
REV WILLIAM I VARSANYI
BOARD MEMBER1.0X000
REVEREND ROBERT FORCIER
BOARD MEMBER1.0X000
ROBERTO ORTIZ MD
BOARD MEMBER1.0X000
STEVEN COLAGIOVANNI MD
BOARD MEMBER1.0X000
MICHAEL CONKLIN JR
CFO/TREASURER CCHP0.040.0X032867124393
KIMBERLY O'CONNELL
SENIOR VP0.040.0X026678522713
PATRICIA NADLE
CNO40.0250758019296X
SUSAN CERRONE-ABELY
VP CIO0.040.0024288824719X
DARLEEN SOUZA
VP HUMAN RESOURCES40.0020134219849X
DANIEL KANE
DENTIST40.0295103018653X
MAUREEN L HARKAVY
PHYSICIAN40.0310545013759X
WAJAHAT FAHEEM
PHYSICIAN40.0338676028096X
TODD H CARRANZA
PHYSICIAN40.034288009391X
MAGDI L SALMON
PHYSICIAN40.023650009817X
JOHN M FOGARTY
FORMER COO0.015230400X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2045807TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1468338TotalReportableCompFrmRltdOrgs
Total Other Compensation235238TotalOtherCompensation
Number Individuals GT100 K43NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CLAFLIN CO
PO BOX 7830WARWICKRI028877830MEDICAL SUPPLIES2119131
SODEXO INC AFFILIATES
PO BOX 360170PITTSBURGHPA15251FOOD SERVICE1175330
UNIVERSITY PATHOLOGISTS
300 CENTERVILLE ROAD STE 215WARWICKRI02886LABORATORY SERVICES724200
ASSOCIATES IN ANESTHESIA
200 HIGH SERVICE AVENUENORTH PROVIDENCERI02904MEDICAL SERVICES694290
MAYO COLLABORATIVE SERVICES INC
PO BOX 9146MINNEAPOLISMN554809146LABORATORY SERVICES633250
FieldValueIRS element (for citing)
Number Of Contractors GT100 K32NumberOfContractorsGT100K
Government Grants61931GovernmentGrants
All Other Contributions386444AllOtherContributions
Total Contributions448375TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE621400136516901136516901
OTHER PROGRAM SERVICE REVENUE54190039098443909844
CAFETERIA722320323440323440
FieldValueIRS element (for citing)
Total Program Service Revenue140750185TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column369346TotalRevenueColumn
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$369,346ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column75703TotalRevenueColumn
Exclusion$75,703ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real370923Real
Personal0Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real370923Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column370923TotalRevenueColumn
Exclusion$370,923ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities0Securities
Other45000Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other45000Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column45000TotalRevenueColumn
Exclusion$45,000ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events0GrossIncomeFundraisingEvents

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Gaming0GrossIncomeGaming

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
MEANINGFUL USE RECEIPTS900099164255216425520
TRANSFER FROM CCHP FOUNDATION900099113797113797
FieldValueIRS element (for citing)
Total Other Revenue1756349TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column143815881TotalRevenueColumn
Related Or Exempt Function Income142506534RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$860,972ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1577081Total
Management And General1577081ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total57620875Total
Program Services51446534ProgramServices
Management And General6174341ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total855409Total
Program Services639590ProgramServices
Management And General215819ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total16545082Total
Program Services12368086ProgramServices
Management And General4176996ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4274650Total
Program Services3196159ProgramServices
Management And General1078491ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total10162165Total
Management And General10162165ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1022920Total
Management And General1022920ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total303554Total
Management And General303554ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total2116Total
Program Services2116ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6995552Total
Program Services5359176ProgramServices
Management And General1636376ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total78254Total
Management And General78254ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total999594Total
Program Services355674ProgramServices
Management And General643920ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2000681Total
Program Services1635206ProgramServices
Management And General365475ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2465453Total
Program Services437224ProgramServices
Management And General2028229ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total26272Total
Program Services24227ProgramServices
Management And General2045ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total42390Total
Program Services33744ProgramServices
Management And General8646ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1045574Total
Program Services1045574ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5775430Total
Program Services4620344ProgramServices
Management And General1155086ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total-117352Total
Program Services-117352ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES1399060814108530-1179220
BAD DEBT EXPENSE1113733411137334
HOSPITAL LICENSING FEE71538477153847
FOOD727324727324

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2925234Total
Program Services2198148ProgramServices
Management And General727086ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total147610047Total
Program Services109217638ProgramServices
Management And General38392409ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY655BOY
EOY655EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5250579BOY
EOY7364844EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY3225BOY
EOY2675EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15230073BOY
EOY14745257EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY177576BOY
EOY266367EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY178121BOY
EOY129398EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1535001BOY
EOY1668626EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY546466BOY
EOY665440EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis142058837LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec110122301LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY35574946BOY
EOY31936536EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY29422102BOY
EOY20222913EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY87918744BOY
EOY77002711EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY16785654BOY
EOY17494279EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY677814BOY
EOY6402EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY17108210BOY
EOY16531868EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1194008BOY
EOY1293510EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY118347566BOY
EOY91578418EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY154113252BOY
EOY126904477EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-74311981BOY
EOY-58501685EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY842349BOY
EOY1101168EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7275124BOY
EOY7498751EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-66194508BOY
EOY-49901766EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY87918744BOY
EOY77002711EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-3794166ReconcilationRevenueExpenses
Reconciliation Unrealized Invest39880ReconciliationUnrealizedInvest
Reconcilation Other Changes20047028ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$2,116OtherActivitiesAmount
Total Lobbying Expenditures IIB2116TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLOBBYING EXPENSEIdentifier
Return ReferencePART II-B, LINE 1IReturnReference
ExplanationST. JOSEPH HEALTH SERVICES OF RI PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION OF RHODE ISLAND. THE PORTION OF DUES ALLOCATED TO LOBBYING EFFORTS FOR THE YEAR ENDED 9/30/2013 WAS $2,116.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1251348BeginningOfYearBalance
Contributions7211Contributions
Investment Earnings Or Losses44120InvestmentEarningsOrLosses
Other Expenditures704OtherExpenditures
End Of Year Balance1301975EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1479931BeginningOfYearBalance
Contributions10990Contributions
Investment Earnings Or Losses138InvestmentEarningsOrLosses
Other Expenditures109630OtherExpenditures
Administrative Expenses130081AdministrativeExpenses
End Of Year Balance1251348EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1412982BeginningOfYearBalance
Contributions82754Contributions
Investment Earnings Or Losses245InvestmentEarningsOrLosses
Administrative Expenses16050AdministrativeExpenses
End Of Year Balance1479931EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1407395BeginningOfYearBalance
Contributions14982Contributions
Investment Earnings Or Losses199InvestmentEarningsOrLosses
Administrative Expenses9594AdministrativeExpenses
End Of Year Balance1412982EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1341680BeginningOfYearBalance
Contributions45250Contributions
Investment Earnings Or Losses29065InvestmentEarningsOrLosses
Administrative Expenses8600AdministrativeExpenses
End Of Year Balance1407395EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.92000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.08000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis624770OtherCostOrOtherBasis
Book Value624770BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis71565443OtherCostOrOtherBasis
Depreciation50676327Depreciation
Book Value20889116BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1105332OtherCostOrOtherBasis
Depreciation301801Depreciation
Book Value803531BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis68446315OtherCostOrOtherBasis
Depreciation59144173Depreciation
Book Value9302142BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis316977OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value316977BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings31936536TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
TRUSTEE UNDER LOAN INDENTURE2734955
BENEFICIAL INTEREST PERP TRUST6299046
TRUSTEE FOR WORKERS COMP/PROF743475
ENDOWMENT FUNDS1301400
OTHER ASSETS2208604
MALPRACTICE INSUR. RECEIVABLE6225191
DUE TO/FROM RELATED PARTIES710242
FieldValueIRS element (for citing)
Total Book Value Other Assets20222913TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
ESTIMATED SETTLEMENTS TO 3RD PARTY$2,987,204
INSURANCE RESERVES$10,529,305
PENSION LIABILITY$73,115,483
ASSET RETIREMENT OBLIGATION$3,527,549
DUE TO/FROM RELATED PARTIES$1,380,669
OTHER LIABILITIES$38,208
FieldValueIRS element (for citing)
Total Of Amounts91578418TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ENDOWMENT FUNDSPART V, LINE 4THE ORGANIZATION'S ENDOWMENT CONSISTS OF SEVERAL INDIVIDUAL FUNDS ESTABLISHED BY DONORS FOR A VARIETY OF PURPOSES INCLUDING BUT NOT LIMITED TO SCHOLARSHIPS. DISTRIBUTIONS ARE MADE IN ACCORDANCE WITH SPECIFIC DONOR RESTRICTED GUIDELINES.
FIN 48 (ASC 740) FOOTNOTEPART X, LINE 2ST. JOSEPH HEALTH SERVICES OF RI IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)3 OF THE INTERNAL REVENUE CODE AND IS GENERALLY EXEMPT FROM INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. ST. JOSEPH HEALTH SERVICES OF RI RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. SJSHRI DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITION IN EITHER 2013 OR 2012.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense6930527TotalCommunityBenefitExpense
Direct Offsetting Revenue3367948DirectOffsettingRevenue
Net Community Benefit Expense3562579NetCommunityBenefitExpense
Percent Of Total Expense0.02610PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense20889050TotalCommunityBenefitExpense
Direct Offsetting Revenue17564844DirectOffsettingRevenue
Net Community Benefit Expense3324206NetCommunityBenefitExpense
Percent Of Total Expense0.02440PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense27819577TotalCommunityBenefitExpense
Direct Offsetting Revenue20932792DirectOffsettingRevenue
Net Community Benefit Expense6886785NetCommunityBenefitExpense
Percent Of Total Expense0.05050PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense2916216TotalCommunityBenefitExpense
Direct Offsetting Revenue1533736DirectOffsettingRevenue
Net Community Benefit Expense1382480NetCommunityBenefitExpense
Percent Of Total Expense0.01010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2916216TotalCommunityBenefitExpense
Direct Offsetting Revenue1533736DirectOffsettingRevenue
Net Community Benefit Expense1382480NetCommunityBenefitExpense
Percent Of Total Expense0.01010PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense30735793TotalCommunityBenefitExpense
Direct Offsetting Revenue22466528DirectOffsettingRevenue
Net Community Benefit Expense8269265NetCommunityBenefitExpense
Percent Of Total Expense0.06060PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$3,589,106BadDebtExpenseAmount
Amount Attributable To2848244AmountAttributableTo
Amount Reimbursed By Medicare33293995AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare41010876CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-7716881MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1St Joseph Health Services of RIBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1200 High Service AvenueAddressLine1
CityNorth Providence RICity
StateRIState
ZIP Code02904ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST JOSEPH HEALTH SERVICES OF RIBusinessNameLine1
FieldValueIRS element (for citing)
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedtrueAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent300.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities12NumberOfOtherFacilities

Other Facilities OtherFacilities (12 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
PEDIATRIC DENTAL
21 PEACE STREETPROVIDENCERI02907DENTAL
ST JOSEPH ADULT PRIMARY CARE CLINIC
21 PEACE STREETPROVIDENCERI02907PRIMARY CARE
ST JOSEPH OUTPATIENT REHABILITATION
1637 MINERAL SPRING AVENUENORTH PROVIDENCERI02094GENERAL MEDICAL & SURGICAL
ST JOSEPH WALK-IN CLINIC
21 PEACE STREETPROVIDENCERI02907GENERAL MEDICAL & SURGICAL
ST JOSEPH OBGYN CLINIC
21 PEACE STREETPROVIDENCERI02907GENERAL MEDICAL & SURGICAL
ST JOSEPH PEDIATRIC CLINIC
21 PEACE STREETPROVIDENCERI02907GENERAL MEDICAL & SURGICAL
ST JOSEPH OUTPATIENT REHABILITATION
21 PEACE STREETPROVIDENCERI02907GENERAL MEDICAL & SURGICAL
APPLE VALLEY RADIOLOGY & PHLEBOTOMY
466 PUTNAM PIKEGREENVILLERI02828RADIOLOGY & PHLEBOTOMY LAB
JOHNSTON DENTAL
1524 ATWOOD AVENUE SUITE 125JOHNSTONRI02904DENTAL
PEDIATRIC DENTAL
40 BROAD STREETPAWTUCKETRI02860DENTAL
FATIMA HEALTH CENTER
40 BROAD STREETPAWTUCKETRI02860HEALTH CENTER
WOUND CARE CLINIC
2 WAKE ROBINLINCOLNRI02884WOUND CARE CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PERCENT OF TOTAL EXPENSEPART I, LINE 7(F)THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE FOR LINE 7 COLUMN(F) IS $11,137,334. PART I, LINE 7 THE COSTING METHODOLOGY USED TO DERIVE THE AMOUNTS ARE FROM WORKSHEET 2 AND IS BASED ON PATIENT CARE COST TO CHARGES. METHODOLOGY TO DETERMINE BAD DEBT AT COST PART III, LINE 2 THE AMOUNT REPORTED ON PART III LINE 2 IS THE ACTUAL BAD DEBT EXPENSE REPORTED ON THE FINANCIAL STATEMENTS SCALED TO COST. THE COSTING METHODOLOGY IS THE SAME UTILIZED IN PART I, LINE 7. THE HOSPITAL QUALIFIES PATIENTS BASED ON THE MEDICARE PROGRAM 120 DAY RULE WHICH ENTAILS EACH PATIENT ACCOUNT RECEIVING THREE BILLING STATEMENTS. IF NO PAYMENT IS RECEIVED, THE PATIENT ACCOUNT IS PLACED WITH A COLLECTOR 120 DAYS AFTER THE INITIAL STATEMENT IS MAILED. BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE POLICY PART III, LINE 3 SJHSRI INTERNALLY TRACKS THE ACCOUNTS TRANSFERRED TO BAD DEBT AND IS ABLE TO DISTINGUISH THE PATIENTS WITH NO INSURANCE COVERAGE. OF THE ACCOUNTS WITH NO COVERAGE, THE BUSINESS OFFICE PROVIDES AN ESTIMATED PERCENTAGE OF THE ACCOUNTS THAT WOULD QUALITY FOR CHARITY IF THEY COMPLETED THE FREE CARE APPLICATION.
BAD DEBT EXPENSEPART III, LINE 4SJHSRL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE CHARITY CARE POLICIES WITHOUT CHARGE OR AT AMOUNTS LESS THAN THE ESTABLISHED RATES. BECAUSE SJHSRI DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, SJHSRI ANALYZES ITS PAST HISTORY AND IDENTIFIES ITS REVENUE TRENDS FOR EACH OF ITS MAJOR PAYORS TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND THE ASSOCIATED PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, SJHSRI ANALYZES CONTRACTUALLY DUE A.'1LOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), SJHSRI RECORDS A SIGNIFICANT ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF APPLICABLE) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SJHSRL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS DECREASED FROM 77.31 % OF SELF-PAY ACCOUNTS RECEIVABLE AT SEPTEMBER 30,2012 TO 72.45% OF SELF-PAY ACCOUNTS RECEIVABLE AT SEPTEMBER 30,2013. SJHSRL'S SELF-PAY WRITEOFFS FOR THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012 AMOUNTED TO $10,475,214 AND $9,297,845, RESPECTIVELY. SJHSRI DID NOT CHANGE ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012, RESPECTIVELY. SJHSRI DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITEOFFS FROM THIRD-PARTY PAYORS IN EITHER 2013 OR 2012.
EXPLANATION OF SHORTFALL AS COMMUNITY BENEFITPART III, LINE 8NONE OF THE MEDICARE SHORTFALL HAS BEEN TREATED AS A COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS IS BASED UPON THE MEDICARE COST REPORT USING RCC (RATIO OF COST CHARGE) METHODOLOGY.
COLLECTION PRACTICES FOR QUALIFIED PATIENTSPART III, LINE 9BST JOSEPH HEALTH SERVICES OF RI PROVIDES CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. OUR COLLECTION PROCESS PROVIDES PATIENTS WITH FOUR PROGRESSIVE BILLING NOTICES. ALL STATEMENTS INCLUDE A NOTICE OF AVAILABLE FINANCIAL AID. UNRESOLVED DEBTS ARE TRANSFERRED TO BAD DEBT (WITH NO PAYMENT ACTIVITY) AT DAY 120. AN OUTSIDE COLLECTION AGENCY IS USED FOR ADDITIONAL COLLECTION ACTIVITY. CLIENTS THAT QUALIFY FOR DISCOUNT/FREE-CARE WRITE-OFFS (BASED ON 200-300% OF FEDERAL POVERTY GUIDELINES AND LIMITED ASSETS) HAVE BALANCES REDUCED/WRITTEN-OFF BASED ON INFORMATION DOCUMENTED IN THE APPLICATION PROCESS. ANY BALANCES NOT COVERED BY THE FREE CARE PROCESS ARE BILLED FOLLOWING OUR STANDARD COLLECTION PROCESS.
ST. JOSEPH HEALTH SERVICES OF RI (1)INPUT FROM PERSONS WHO REPRESENT INTERESTS OF THE COMMUNITYPART V, SECTION B, QUESTION 3 ST. JOSEPH HEALTH SERVICES OF RI AND ITS CHNA PARTNERS SOUGHT COMMUNITY INPUT THROUGH INTERVIEWS WITH 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. CHNA CONDUCTED WITH ONE OR MORE HOSPITAL FACILITIES PART V, SECTION B, QUESTION 4 ST. JOSEPH HEALTH SERVICES OF RI PARTICIPATED IN A STATEWIDE COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), LED BY THE HOSPITAL ASSOCIATION OF RHODE ISLAND (HARI), AND ITS MEMBER HOSPITALS: BUTLER HOSPITAL, KENT HOSPITAL, LANDMARK MEDICAL CENTER, MEMORIAL HOSPITAL, OUR LADY OF FATIMA HOSPITAL (ST. JOSEPH'S HEALTH SERVICES OF RI), PROVIDENCE VA MEDICAL CENTER, SOUTH COUNTY HOSPITAL, THE WESTERLY HOSPITAL, AND WOMEN AND INFANTS HOSPITAL. URL FOR CHNA PART V, SECTION B, LINE 5A HTTP://WWW.FATIMAHOSPITAL.COM/FOR-PATIENTS/FATIMA%20CHNA%202013.PDF AMOUNTS BILLED TO INDIVIDUALS WITH NO INSURANCE, PART V, SEC. B, LINE 20D PATIENTS WHO DO NOT HAVE INSURANCE ARE BILLED BASED ON THE HOSPITAL CHARGE MASTER. PATIENTS WHO QUALIFY FOR FULL OR PARTIAL FREE CARE WILL BE DISCOUNTED APPROPRIATELY.
ST. JOSEPH HEALTH SERVICES OF RI (1)GROSS CHARGE FOR SERVICES, PART V, SECTION B, LINE 22THE HOSPITAL BILLS A LIMITED NUMBER OF PATIENTS WITH ADEQUATE FINANCIAL RESOURCES THE GROSS CHARGE RATE FOR UNINSURED MEDICARE SERVICES.
COMMUNITY HEALTH NEEDS ASSESSMENTPART VI, LINE 2ST. JOSEPH HEALTH SERVICES OF RI PARTICIPATED IN A STATEWIDE COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), LED BY THE HOSPITAL ASSOCIATION OF RHODE ISLAND (HARI), AND ITS MEMBER HOSPITALS. THE CHNA WAS CONDUCTED FROM SEPTEMBER 2012 TO MAY 2013. THE ASSESSMENT WAS CONDUCTED IN A TIMELINE TO COMPLY WITH REQUIREMENTS SET FORTH IN THE AFFORDABLE CARE ACT, AS WELL AS TO FURTHER THE HOSPITAL'S COMMITMENT TO COMMUNITY HEALTH AND POPULATION HEALTH MANAGEMENT. THE FINDINGS FROM THE ASSESSMENT WILL BE UTILIZED BY OUR LADY OF FATIMA HOSPITAL TO GUIDE ITS COMMUNITY BENEFIT INITIATIVES AND TO ENGAGE PARTNERS TO ADDRESS THE IDENTIFIED HEALTH NEEDS. THE PURPOSE OF THE CHNA WAS TO GATHER INFORMATION ABOUT LOCAL HEALTH NEEDS AND HEALTH BEHAVIORS IN AN EFFORT TO ENSURE HOSPITAL COMMUNITY HEALTH IMPROVEMENT INITIATIVES AND COMMUNITY BENEFIT ACTIVITIES ARE ALIGNED WITH COMMUNITY NEED. THE ASSESSMENT EXAMINED A VARIETY OF COMMUNITY, HOUSEHOLD AND HEALTH STATISTICS TO PORTRAY A FULL PICTURE OF THE HEALTH AND SOCIAL DETERMINANTS OF HEALTH IN THE OUR LADY OF FATIMA HOSPITAL SERVICE AREA. THE FINDINGS FROM THE CHNA WERE UTILIZED BY OUR LADY OF FATIMA HOSPITAL TO PRIORITIZE PUBLIC HEALTH ISSUES AND DEVELOP A COMMUNITY HEALTH IMPLEMENTATION STRATEGY. OUR LADY OF FATIMA HOSPITAL IS COMMITTED TO THE PEOPLE IT SERVES AND THE COMMUNITIES THEY LIVE IN. HEALTHY COMMUNITIES LEAD TO LOWER HEALTH CARE COSTS, ROBUST COMMUNITY PARTNERSHIPS, AND AN OVERALL ENHANCED QUALITY OF LIFE.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VI, LINE 3INFORMATION ON THE ST. JOSEPH HEALTH SERVICES OF RI FINANCIAL ASSISTANCE PROGRAM IS COMMUNICATED TO THE PATIENT AT THE POINT OF REGISTRATION THROUGH SIGNAGE WITHIN THE HOSPITAL AND ON THE HOSPITAL'S WEBSITE HTTP://WWW.FATIMAHOSPITAL.COM. FURTHERMORE, THE HOSPITAL HAS PATIENT FINANCIAL COUNSELORS' ONSITE TO EDUCATE PATIENTS ON THE FINANCIAL PROGRAMS THAT ARE AVAILABLE.
COMMUNITY INFORMATIONPART VI, LINE 4St. Joseph Health Services of RI defines its service area as northwest Providence and the surrounding communities of North Providence, Johnston, Cranston, Smithfield, Lincoln and bordering communities to those cities and towns.
PROMOTION OF COMMUNITY HEALTHPART VI, LINE 5IN ADDITION TO ITS ACTIVITIES IN DELIVERING HEALTH CARE SERVICES TO THE COMMUNITY AS DESCRIBED ELSEWHERE IN THIS FILING, ST. JOSEPH HEALTH SERVICES OF RI (SJHSRI) FURTHERS ITS EXEMPT PURPOSES THROUGH THE FOLLOWING MEANS: A) SJHSRI IS MANAGED BY A COMMUNITY BOARD OF TRUSTEES, ON WHICH A SUBSTANTIAL MAJORITY OF TRUSTEES ARE RESIDENTS OF THE HOSPITAL'S EFFECTIVE MARKET AREA AND WHO ARE NEITHER EMPLOYEES OR CONTRACTORS OF THE HOSPITAL. B) WITH THE EXCEPTION OF CERTAIN DEPARTMENTS WHICH, IN THE INTERESTS OF EFFICIENCY, QUALITY AND PROPER ADMINISTRATION, ARE TRADITIONALLY RESERVED TO A SINGLE PHYSICIAN GROUP HAVING AN EXCLUSIVE ARRANGEMENT WITH RESPECT TO THE DEPARTMENT (IE RADIOLOGY, ANESTHESIA, AND PATHOLOGY), SJHSRI MAINTAINS AN OPEN MEDICAL STAFF THAT EXTENDS PRIVILEGES TO ALL QUALIFIED PHYSICIAN APPLICANTS WHO EXHIBIT THE PROPER TRAINING AND EXPERTISE TO SERVE THE HOSPITAL'S PATIENTS. C) THE ORGANIZATION TRADITIONALLY APPLIES ALL SURPLUS FUNDS TO ENSURING FINANCIALLY PRUDENT AVAILABLE FUNDS, CAPITAL MAINTENANCE AND IMPROVEMENTS, AND THE ADDITION OF SERVICES THAT BENEFIT THE COMMUNITY. RWMC AND ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND AFFILIATED IN JANUARY 2010 UNDER CHARTERCARE HEALTH PARTNERS. THE AFFILIATION PARTNERS BELIEVE THAT BY COMBINING THEIR COMPLEMENTARY STRENGTHS, THEY CAN SIGNIFICANTLY IMPROVE THEIR ABILITY TO MEET THE HEALTHCARE NEEDS OF THE REGION THROUGH MORE COORDINATION, IMPROVED EFFICIENCY, REDUCED FRAGMENTATION OF CARE, AND IMPROVED ACCESS FOR THE POOR AND UNDERSERVED PEOPLE IN CHARTERCARE'S EFFECTIVE MARKET AREA AND BEYOND. THE PARTIES RECOGNIZED THAT WHETHER THEY AFFILIATED OR NOT, CHANGE WILL AND MUST OCCUR IN THEIR ORGANIZATIONS IN LIGHT OF EMERGING CHANGES IN HEALTHCARE DELIVERY, AND CHANGES IN PUBLIC AND PRIVATE SYSTEMS FOR PAYING FOR HEALTH CARE. THE AFFILIATION BETTER POSITIONED THE TWO ORGANIZATIONS TO ADDRESS THE CHALLENGES AND TO MEET THE NEEDS OF THEIR COMMUNITIES.
AFFILIATED HEALTH CARE SYSTEMPART VI, LINE 6ST. JOSEPH HEALTH SERVICES OF RI (SJHSRI) IS PART OF CHARTERCARE HEALTH PARTNERS (CCHP), A COMMUNITY HEALTH SYSTEM THAT SERVES THE CENTRAL AND NORTHWESTERN SEGMENTS OF RHODE ISLAND. THE AFFILIATION OF ROGER WILLIAMS MEDICAL CENTER (RWMC) AND ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND (SJHSRI) IN JANUARY 2010 TO FORM CCHP, ALLOWED BOTH HERITAGE HOSPITALS THE ABILITY TO COMBINE THEIR COMPLEMENTARY STRENGTHS, AND ALLOW THEM TO SIGNIFICANTLY IMPROVE THEIR ABILITY TO MEET THE HEALTHCARE NEEDS OF THE REGION THROUGH MORE COORDINATION, IMPROVED EFFICIENCY, REDUCED FRAGMENTATION OF CARE, AND IMPROVED ACCESS FOR THE POOR AND UNDERSERVED PEOPLE IN CHARTERCARE'S EFFECTIVE MARKET AREA AND BEYOND. SJHSRI'S AFFILIATION ALSO ALLOWS THEM TO WORK CLOSELY WITH RWMC IN THE CREATION OF DEFINED STATE RECOGNIZED CENTERS OF EXCELLENCE IN GERIATRICS, CANCER CARE, GASTROENTEROLOGY AND BEHAVIORAL MEDICINE. THE AFFILIATION OF THE TWO HERITAGE HOSPITALS HAS ALLOWED THEM TO INTEGRATE THE MENTIONED EXISTING SERVICES BETWEEN THE TWO HOSPITALS IN A MANNER THAT BEST SERVES THE EVER EVOLVING COMMUNITIES NEEDS AND IN A MORE INTEGRATED AND MORE EFFICIENT MANNER. IN ADDITION TO SHARING POLICIES AND PROCEDURES FOR BEST OPERATIONAL AND MANAGEMENT PRACTICES, SYSTEM HOSPITALS PARTICIPATE IN A CHARTERCARE QUALITY COMMITTEE. THE CHARTERCARE QUALITY COMMITTEE OVERSEES WORK DONE BY THE HOSPITAL QUALITY COMMITTEES AND HELPS PROMOTE THE WEALTH OF PERFORMANCE IMPROVEMENT AND QUALITY INITIATIVES IN EACH OF THE TWO HOSPITALS (OUR LADY OF FATIMA HOSPITAL AND ROGER WILLIAMS MEDICAL CENTER), ELMHURST EXTENDED CARE (AN EDEN ALTERNATIVE NURSING HOME), ROGER WILLIAMS HOME CARE AND THE SJHSRI CENTER OF HEALTH AND HUMAN SERVICES. THE QUALITIES COMMITTEES THAT OVERSEE CLINICAL PRACTICES WITHIN THE SYSTEM HAVE COMMUNITY REPRESENTATIVES OF THE BOARD OF TRUSTEE AS WELL AS REPRESENTATIVES FROM THE MEDICAL STAFF, NURSING, ADMINISTRATION AND THE QUALITY DEPARTMENTS. STATE FILING OF COMMUNITY BENEFIT REPORT RHODE ISLAND

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KENNETH BELCHER
PRESIDENT AND CEO CCHP04018950002675706406018876045393400
MICHAEL CONKLIN JR
CFO/TREASURER CCHP032843500023604900019493035306400
JOHN M FOGARTY
FORMER COO000015230400000152304000
DANIEL KANE
DENTIST295103000009093095600313756000
MAUREEN L HARKAVY
PHYSICIAN310545000004298094610324304000
WAJAHAT FAHEEM
PHYSICIAN3386760000073500207460366772000
TODD H CARRANZA
PHYSICIAN342880000000093910352271000
MAGDI L SALMON
PHYSICIAN236500000000098170246317000
PATRICIA NADLE
CNO2487300002028000192960270054000
SUSAN CERRONE-ABELY
VP CIO02185890002429905441019278026760700
DARLEEN SOUZA
VP HUMAN RESOURCES0197316000402605277014572022119100
KIMBERLY O'CONNELL
SENIOR VP02448440002194105106017607028949800

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
GROSS-UP PAYMENT AND HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USEPART I, LINE 1APATRICIA NADLE IS A CHARTERCARE HEALTH PARTNERS EMPLOYEE WHO IS THE CNO FOR ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND. SHE BEGAN HER EMPLOYMENT IN OCTOBER 2010 AND RENTS ONE OF THE PROPERTIES OWNED BY THE ST. JOSEPH HEALTH SERVICES OF RI. SHE RECEIVES IN HER PAY CHECK A GROSS-UP IN ORDER FOR HER TO PAY THE RENT FOR THE PROPERTY. IN CALENDAR YEAR 2012, SHE RECEIVED A TOTAL GROSS-UP FOR RENT OF $22,315.
ESTABLISH COMPENSATIONPART I, LINE 3EXECUTIVE SALARIES AND BENEFITS ARE PAID BY CHARTERCARE HEALTH PARTNERS BEGINNING JANUARY 2012. EMPLOYEE SALARIES ARE ESTABLISHED UNDER THE COMPENSATION POLICIES OF THE ORGANIZATION'S MANAGEMENT COMPANY - CHARTERCARE HEALTH PARTNERS.
SEVERANCE PAYMENTPART I, LINE 4AJOHN M FOGARTY RECEIVED A SEVERANCE PAYMENT OF $152,304.
NONQUALIFIED SUPPLEMENTAL RETIREMENT PLANPART I, LINE 4BTHE FOLLOWING INDIVIDUALS PARTICIPATE IN A NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN AND RECEIVED THE FOLLOWING DISTRIBUTIONS UNDER THE 457(F) PLAN: KENNETH BELCHER - $21,809 MICHAEL CONKLIN - $0 KIMBERLY O'CONNELL - $19,388 SUSAN CERRONE-ABELY - $15,329 THE FOLLOWING INDIVIDUALS PARTICIPATE IN A SPLIT DOLLAR LIFE INSURANCE PLAN AND INCLUDED THE FOLLOWING IMPUTED INCOME IN TAXABLE WAGES IN CALENDAR YEAR 2012: KENNETH BELCHER - $4,947 MICHAEL CONKLIN - $236 KIMBERLY O'CONNELL - $129 SUSAN CERRONE-ABELY - $239 DARLEEN SOUZA - $64

Schedule L IRS990ScheduleL

Loan Table LoanTable (6 entries)

Relationship With OrganizationRelationshipWithOrganizationPurpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
K BELCHER
OFFICERSPLIT DOLLAR PREMIUMX$19,39458181falsetruetrue
S ABELY
KEY EMPLOYEESPLIT DOLLAR PREMIUMX$6,45819373falsetruetrue
K O'CONNELL
OFFICERSPLIT DOLLAR PREMIUMX$3,50710520falsetruetrue
M CONKLIN
OFFICERSPLIT DOLLAR PREMIUMX$30,68892063falsetruetrue
D SOUZA
KEY EMPLOYEESPLIT DOLLAR PREMIUMX$8,83226495falsetruetrue
P NADLE
KEY EMPLOYEESPLIT DOLLAR PREMIUMX$19,91259735falsetruetrue
FieldValueIRS element (for citing)
Total Balance Due266367TotalBalanceDue

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierLOANS TO INTERESTED PERSONSIdentifier
Return ReferencePART IIReturnReference
ExplanationCHARTERCARE HEALTH PARTNERS HAS DEVELOPED A COMPENSATION AND BENEFIT PROGRAM TO RETAIN EXPERIENCED HEALTHCARE PROFESSIONALS. UNDER THE PROGRAM CERTAIN EMPLOYEES HAVE BEEN ENROLLED IN A SPLIT DOLLAR LIFE INSURANCE PROGRAM THAT PROVIDES PRE AND POST EMPLOYMENT LIFE INSURANCE BENEFITS. THE LIFE INSURANCE PREMIUMS FOR THIS POLICY HAVE BEEN PAID BY THE HOSPITAL AND IN RETURN THE HOSPITAL HAS RECEIVED A COLLATERAL INTEREST IN THE PROCEEDS OF THE POLICY. UPON THE DEATH OR TERMINATION OF EMPLOYMENT OF THE INSURED, THE HOSPITAL WILL BE REPAID THE AMOUNTS THAT HAVE BEEN ADVANCED. THE AMOUNTS REPORTED AS LOANS REPRESENT THE AGGREGATE PREMIUMS THAT HAVE BEEN PAID TO DATE. INTEREST HAS BEEN COMPUTED ON THESE ADVANCES AND INCLUDED IN TAXABLE COMPENSATION PAID TO EACH EMPLOYEE AS REFLECTED IN FORM W-2.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSION AND PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART I LINE 1 AND PART III, LINE 4AST. JOSEPH HOSPITAL WAS ESTABLISHED IN 1892 AS A 175-BED GENERAL HOSPITAL. IT OPERATED AS AN ACUTE CARE HOSPITAL UNTIL 1990, WHEN IT WAS CONVERTED TO A SPECIALTY HOSPITAL THAT HOSTS COMPREHENSIVE PSYCHIATRIC CARE, THE SOUTHERN NEW ENGLAND REHABILITATION CENTER AND THE CENTER FOR HEALTH AND HUMAN SERVICES, AN AWARD-WINNING CLINIC PROVIDING PRIMARY CARE TO THE POOR AND DISADVANTAGED OF SOUTH PROVIDENCE. OUR LADY OF FATIMA HOSPITAL WAS OPENED IN 1954 AS A 175-BED ACUTE CARE HOSPITAL, AND ADDED AN ADDITIONAL 100 BEDS IN 1960. THE HOSPITAL IS A NON-PROFIT, GENERAL ACUTE CARE FACILITY OPERATING UNDER THE SPONSORSHIP OF THE DIOCESE OF PROVIDENCE. TODAY, ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND IS PART OF CHARTERCARE HEALTH PARTNERS (CCHP), A COMMUNITY HEALTH SYSTEM THAT SERVES THE CENTRAL AND NORTHWESTERN SEGMENTS OF RHODE ISLAND. CCHP WAS FORMED IN JANUARY OF 2010 BY THE AFFILIATION OF TWO HOSPITALS: ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND AND ROGER WILLIAMS MEDICAL CENTER. THE INDIVIDUAL HOSPITALS OF CCHP ARE DEEPLY ROOTED IN THEIR COMMUNITIES, EACH WITH A LONG TRADITION OF PROVIDING HIGH QUALITY CARE AND SERVICES. ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND (SJHSRI) OFFERS TREATMENT IN 28 MEDICAL AND SURGICAL SPECIALTIES AND HAS A NATIONALLY RECOGNIZED AMBULATORY CARE CENTER AND ONE OF THE STATE'S BUSIEST SURGICAL PROGRAMS. THE HOSPITAL HAS ACKNOWLEDGED EXCELLENCE IN SEVERAL SURGICAL SUBSPECIALTIES INCLUDING NEUROSURGERY, ORTHOPEDICS, AND UROLOGY. FATIMA ALSO OPERATES THE STATE'S ONLY HOSPITAL-BASED SCHOOL OF NURSING, AND ALSO RUNS SCHOOLS OF MEDICAL TECHNOLOGY, CYTO-TECHNOLOGY AND HISTO-TECHNOLOGY. THE FOLLOWING ARE SELECTED 2013 HIGHLIGHTS FROM SJHSRI: -THIRTY NINE PHYSICIANS AFFILIATED WITH ST. JOSEPH PARENT COMPANY CHARTERCARE HEALTH PARTNERS WERE RECOGNIZED IN RHODE ISLAND MONTHLY AS "TOP DOCTORS" AS VOTED BY THEIR PEERS. -FATIMA HOSPITAL AND ROGER WILLIAMS MEDICAL CENTER OFFICIALLY OPENED THE STATE'S FIRST SENIOR-FRIENDLY EMERGENCY DEPARTMENTS ON MARCH 25. FOR NEARLY A YEAR, BOTH EMERGENCY DEPARTMENTS HAVE UNDERGONE PHYSICAL RENOVATIONS AND MODIFICATIONS, WHILE PROVIDING ENHANCED TRAINING AND ASSESSMENT TOOLS FOR STAFF. -FATIMA HOSPITAL WAS DESIGNATED AS A BLUE DISTINCTION CENTER FOR SPINE SURGERY BY BLUE CROSS & BLUE SHIELD OF RHODE ISLAND FOR DEMONSTRATING BETTER OVERALL QUALITY OF CARE AND PATIENT RESULTS IN THIS SPECIALTY. BLUE DISTINCTION CENTERS FOR SPINE SURGERY HAVE DEMONSTRATED THEIR COMMITMENT TO QUALITY CARE, RESULTING IN BETTER OVERALL OUTCOMES FOR SPINE SURGERY PATIENTS. -FATIMA HOSPITAL WAS ONE OF ONLY 11 HOSPITAL ACROSS THE COUNTRY CHOSEN FOR THE SOCIETY OF HOSPITAL MEDICINE'S 2013-2014 GLYCEMIC CONTROL AND INNOVATIVE CARE COORDINATION PROGRAM. THE PROGRAM'S GOAL IS TO HELP SITES IMPROVE DIABETES CARE PROCESSES, INTERDISCIPLINARY TEAM STRATEGIES, ORDER SETS AND PROTOCOLS AND TRANSITIONS OF CARE. FATIMA IS A JOINT COMMISSION-CERTIFIED SITE FOR ADVANCED DIABETES CARE. COLLABORATION WITH NATIONALLY RECOGNIZED MENTORS PROVIDED BY THE SOCIETY OF HOSPITAL MEDICINE PROGRAM AND THE ACCOMPANYING DATA ANALYSIS WILL ASSIST THE DIABETES TEAM IN ACHIEVING THE GOALS SET FOR CONTINUED JOINT COMMISSION CERTIFICATION, IN ADDITION TO INSURING CONSISTENT, BEST PRACTICE CARE FOR OUR DIABETIC PATIENTS. -THE LABORATORY AT FATIMA HOSPITAL UNDERWENT A SUCCESSFUL INSPECTION BY THE COLLEGE OF AMERICAN PATHOLOGISTS ON JUNE 25. THE ON-SITE LABORATORY INSPECTION WAS CONDUCTED BY A GROUP OF LABORATORY PROFESSIONALS FROM CAPE COD HOSPITAL AND FALMOUTH HOSPITAL. THE ONE DAY INSPECTION IS BASED ON AN EDUCATIONAL PEER REVIEW PROCESS USING NUMEROUS LABORATORY STANDARDS. -ST. JOSEPH SERVICES PARENT COMPANY -- CHARTERCARE HEALTH PARTNERS -- WAS AGAIN RECOGNIZED BY PROVIDENCE BUSINESS NEWS AS ONE OF RHODE ISLAND'S "HEALTHIEST EMPLOYERS." THE HEALTHIEST COMPANIES WERE CHOSEN BASED ON SCORES IN SIX WELLNESS CATEGORIES. -ON DECEMBER 18, PHASE 3 OF THE LABORATORY CONSOLIDATION PROJECT WITH THE IMPLEMENTATION OF "TOTAL LABORATORY AUTOMATION" WAS COMPLETED. THIS COMPLETES THE TRANSITION OF THE CORE LAB IN CHEMISTRY/HEMATOLOGY TO FATIMA. PHASE 3 OF THE CONSOLIDATION INCLUDED WORK FLOW REDESIGN, EQUIPMENT STANDARDIZATION, AND AUTOMATION TO ALLOW FOR IMPROVED QUALITY, A REDUCTION IN TURNAROUND TIMES, AND IMPROVED PRODUCTIVITY. -ONE HUNDRED PERCENT OF THE 2013 GRADUATING CLASS OF THE ST. JOSEPH SCHOOL OF NURSING PASSED THE NATIONAL LICENSURE EXAM (NCLEX-RN.) OUR GRADUATES COLLECTIVELY REGISTERED THE HIGHEST PASS RATE IN THE STATE, OUTPERFORMING THE GRADUATES OF ALL OTHER NURSING PROGRAMS INCLUDING CCRI, URI, RIC, SALVE REGINA, AND NEIT. -THE ST. JOSEPH SCHOOL OF NURSING HELD GRADUATION CEREMONIES FOR ITS 111TH CLASS ON MAY 17 WITH 26 DIPLOMAS AND PINS PRESENTED TO THE GRADUATING CLASS OF 2013. -IN 2013, SIX STUDENTS GRADUATED FROM THE SCHOOL OF MEDICAL TECHNOLOGY AT FATIMA HOSPITAL, COMPLETING A YEAR-LONG LABORATORY INTERNSHIP PROGRAM. THE SCHOOL IS A MEMBER INSTITUTION OF THE BOARD OF RHODE ISLAND SCHOOLS OF ALLIED HEALTH, A CONSORTIUM OF THREE COLLEGE/UNIVERSITY CLINICAL LABORATORY SCIENCE PROGRAMS AND TWO SCHOOLS OF MEDICAL TECHNOLOGY IN THE STATE. FREE CARE PER THE HOSPITAL'S PUBLIC NOTICE, SJHSRI IS PROUD OF ITS COMMITMENT TO PROVIDE QUALITY CARE TO ALL INDIVIDUALS WHO NEED IT. THE HOSPITAL PROVIDES FINANCIAL AID TO PATIENTS WITHOUT INSURANCE AND WHO MAY NOT BE ABLE TO PAY FOR THE CARE PROVIDED. SJHSRI WILL PROVIDE FULL CHARITY CARE TO UNINSURED BASED ON INCOME LIMITS AND FAMILY SIZE. FURTHERMORE, SJHSRI OFFERS PARTIAL CHARITY CARE BASED ON A SLIDING SCALE. THE CENTER FOR HEALTH & HUMAN SERVICES ONE OF THE MOST SIGNIFICANT WAYS IN WHICH SJHSRI GIVES BACK TO THE COMMUNITY IS THROUGH ITS CONTINUED OPERATION OF THE CENTER FOR HEALTH & HUMAN SERVICES, LOCATED IN SOUTH PROVIDENCE. THE CENTER OPERATES A NUMBER OF SERVICES, WHICH MIGHT OTHERWISE BE UNAVAILABLE TO INDIVIDUALS AND FAMILIES IN THE COMMUNITY. THE SERVICES ARE AVAILABLE TO A RANGE OF PEOPLE, FROM INFANTS TO ADULTS. IN 2013, TOTAL HEALTH CENTER VISITS (INCLUDING SATELLITE OFFICES) WERE 25,501.
ORGANIZATION'S MISSION AND PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)FORM 990, PART I LINE 1 AND PART III, LINE 4AAMONG THE SERVICES OFFERED AT THE CENTER: -PEDIATRIC DENTAL CENTER: THE CENTER OPERATES A HIGHLY SUCCESSFUL PEDIATRIC DENTAL CLINIC SERVICING LOW INCOME AND IMMIGRANT CHILDREN IN PROVIDENCE. THE CENTER HAS EXPANDED BY OPERATING A SATELLITE CENTER IN PAWTUCKET AND JOHNSTON. ALL THREE CENTERS OFFER A FULL RANGE OF PREVENTATIVE AND RESTORATIVE DENTAL SERVICES AND SCHOOL-BASED DENTAL PROGRAMS. THE CENTER HAS RECEIVED NATIONAL RECOGNITION AND ACCLAIM FOR ITS HIGH QUALITY SERVICES. IN 2013, VISITS TO THE PEDIATRIC DENTAL CENTER, INCLUDING SATELLITE OFFICES, TOTALED 44,230. -PEDIATRIC CLINIC: PROVIDES PRIMARY CARE SERVICES FROM BIRTH TO ADOLESCENCE, INCLUDING WELL/SICK VISITS, CHECK-UPS, IMMUNIZATIONS, VISION/HEARING SCREENINGS, HEALTH/NUTRITION EDUCATION AND CHRONIC ILLNESSES LIKE ASTHMA AND DIABETES. MORE THAN 200 EMPLOYEES PARTICIPATED IN PATIENT SAFETY DAY, LEARNING MORE ABOUT A VARIETY OF SAFETY INITIATIVES INCLUDING SAFE MEDICATION PRACTICE, INFECTION CONTROL, AND STROKE RECOGNITION AND RESPONSE. -WOMEN, INFANTS & CHILDREN: PROVIDES HEALTH FOOD & NUTRITION ADVICE TO CHILDREN, PREGNANT WOMEN AND NEW MOTHERS INCLUDING BREASTFEEDING ADVICE AND SUPPORT AS WELL AS REFERRALS TO DOCTORS AND DENTISTS. -LEAD AND IMMUNIZATION CLINICS: PROVIDES LEAD TESTING AND TREATMENT FOR CHILDREN DIAGNOSED WITH LEAD POISONING, AS WELL AS IMMUNIZATIONS TO ANY CHILD (UP TO AGE 19) LIVING IN RHODE ISLAND, REGARDLESS OF INSURANCE STATUS. -ADULT PRIMARY CARE CLINIC: PROVIDES ANNUAL PHYSICALS, SICK VISITS, CARE FOR CHRONIC ILLNESSES, INCLUDING ASTHMA AND DIABETES, IMMUNIZATIONS, AND MEDICAL EDUCATION. -WALK-IN CLINIC: PROVIDES TREATMENT FOR NON-EMERGENT CONDITIONS AND ILLNESSES SUCH AS COMMON COLD SYMPTOMS, INFECTIONS, EARACHES, FEVERS, SCHOOL AND WORK PHYSICALS, AND IMMUNIZATIONS. -SOCIAL SERVICES: PROVIDES MENTAL HEALTH AND PSYCHOSOCIAL ASSESSMENTS, AS WELL AS INDIVIDUAL AND GROUP COUNSELING, CASE MANAGEMENT AND ADVOCACY SERVICES, CRISIS INTERVENTION, PARENTING & HEALTH EDUCATION. -DIABETES RESOURCE CENTER: PROVIDES DIABETES CASE MANAGEMENT, EDUCATION AND PRIMARY CARE REFERRALS FOR ADULTS WITH DIABETES WHO ARE UNINSURED, UNDERINSURED, OR HOMELESS. OPERATES A SATELLITE CENTER IN PAWTUCKET. SERVICE TO THE COMMUNITY SJHSRI HAS A LONG HISTORY AS A LEADER IN SUPPORTING OUR COMMUNITY THROUGH PARTNERSHIPS, EDUCATION, OUTREACH, CHARITY, AND VOLUNTEERISM. THE FOLLOWING IS A BRIEF OVERVIEW OF THE PROGRAMS AND PROJECTS THAT THE STAFF AND VOLUNTEERS WERE INVOLVED WITH IN 2013. 2013 COMMUNITY EDUCATION/HEALTH FAIRS/SCREENINGS -MARCH 7: MORE THAN 200 EMPLOYEES PARTICIPATED IN PATIENT SAFETY DAY, LEARNING MORE ABOUT A VARIETY OF SAFETY INITIATIVES INCLUDING SAFE MEDICATION PRACTICE, INFECTION CONTROL, AND STROKE RECOGNITION AND RESPONSE. -MAY 8: FATIMA HOSPTIAL HOSTED A COMMUNITY HEALTH FAIR FOCUSED ON STROKE SIGNS AND PREVENTION. MORE THAN 200 PEOPLE ATTENDED. -JUNE 19: THE DIABETES OUTREACH TEAM AT FATIMA HOSTED A GUIDED SUPERMARKET TOUR TO INFORM PARTICIPANTS OF BETTER FOOD SHOPPING HABITS WHEN DIAGNOSED WITH DIABETES. 21 PEOPLE PARTICIPATED. -AUGUST 6: FATIMA HOSPITAL AND ROGER WILLIAMS MEDICAL CENTER PARTICIPATED IN THE FIRST-EVER NATIONAL NIGHT OUT, HOSTED BY THE NORTH PROVIDENCE POLICE DEPARTMENT. MORE THAN 500 PEOPLE ATTENDED AND HAD THE OPPORTUNITY TO PARTAKE IN OUR SCREENING/PREVENTION PROJECTS INCLUDING SKIN CANCER SCREENING, SMOKING CESSATION/PREVENTION, DENTAL HYGIENE, AND STROKE CARE. -SEPTEMBER 27: SOUTHERN NEW ENGLAND REHABILITATION CENTER HOSTED A CONFERENCE FOCUSED ON BRAIN INJURY WITH MORE THAN 100 PARTICIPANTS. -MONTH OF OCTOBER: CHARTERCARE HOME HEALTH SERVICES CONDUCTED 30 FLU CLINICS AT VARIOUS ASSISTED LIVINGS : TOTAL 1407 FLU SHOTS GIVEN -OCTOBER 2: 43 MEN WERE SCREENED AT THE ANNUAL PROSTATE CANCER SCREENING. -OCTOBER 7: SOUTHERN NEW ENGLAND REHABILITATION CENTER HELD AN EVENT TO CELEBRATE THE PROGRESS OF REHABILITATION PATIENTS WITH 25 PARTICIPANTS. -OCTOBER 17: FATIMA HOSTED PROGRAM ON PALLIATIVE CARE AND END-OF-LIFE DECISIONS THAT WAS ATTENDED BY 75 PARTICIPANTS. -OCTOBER 19: ST. JOSEPH HEALTH CENTER HOSTED A HEALTH FAIR TO PROVIDE FREE SCREENINGS AND INFORMATION ABOUT A VARIETY OF TOPICS INCLUDING THE SERVICES OFFERED AT THE CENTER'S CLINICS. MORE THAN 200 PEOPLE ATTENDED. -THE WEEK OF OCTOBER 21: FATIMA HOSPITAL HELD A WEEK LONG PROMOTION OF BREAST HEALTH AWARENESS IN THE BREAST CARE CENTER WHICH INCLUDED FREE MAMMOGRAMS, STAFF AVAILABLE TO ANSWER QUESTIONS, AND A VISIT FROM THE GLORIA GEMMA BREAST BUS. -NOVEMBER 2: THE DIABETES EDUCATION TEAM FROM FATIMA HOSPITAL, ALONG WITH DOZENS OF OTHER MEDICAL PROFESSIONALS FROM THE COMMUNITY, DELIVERED SCREENINGS, INFORMATION AND EDUCATIONAL LECTURES RELATED TO DIABETES ON NOVEMBER 2 AT RHODE ISLAND COLLEGE. THIS WAS THE 5TH ANNUAL DIABETES FAIR HOSTED BY FATIMA, A REGIONAL LEADER IN DIABETES CARE. LESS THAN A YEAR AGO, FATIMA BECAME THE FIRST HOSPITAL IN NEW ENGLAND CERTIFIED BY THE JOINT COMMISSION FOR ADVANCED INPATIENT DIABETES CARE. -NOVEMBER 4: OUR LADY OF FATIMA HOSPITAL TEAMED WITH THE AMERICAN CANCER SOCIETY TO HOST A SESSION OF LOOK GOODFEEL BETTER. LGFB IS A HANDS-ON WORKSHOP LEAD BY TRAINED VOLUNTEER COSMETOLOGISTS TO HELP WOMEN UNDERGOING CANCER TREATMENT WITH COSMETICS, SKIN CARE AND HEAD COVERING OPTIONS. -NOVEMBER 23: BONE DAY INCLUDED AN INFORMATIONAL BOOTH WHERE PARTICIPANTS LEARNED ABOUT OSTEOPOROSIS AND THE IMPORTANCE OF STRONG BONES. -DECEMBER 13: MORE THAN 700 CHILDREN GOT IN THE HOLIDAY SPIRIT AT THE 31ST ANNUAL CHRISTMAS PARTY AT THE ST. JOSEPH CENTER FOR HEALTH AND HUMAN SERVICES. THIS EVENT, FOR FAMILIES THAT RECEIVE MEDICAL AND DENTAL CARE AT THE CENTER, INCLUDES GIFTS FROM SANTA, ENTERTAINMENT, CRAFTS AND REFRESHMENTS. COMMUNITY SUPPORT FATIMA HOSPITAL OFFERS SUPPORT GROUPS FOR INDIVIDUALS FACING A VARIETY OF MEDICAL CHALLENGE FROM STROKE TO DIABETES. COMMUNITY PARTNERSHIPS SJHSRI ACTIVELY COLLABORATES WITH SCHOOLS, FELLOW HEALTH CARE PROVIDERS AND OTHERS TO MAXIMIZE OUR CONTRIBUTIONS TO THE COMMUNITY. IN 2013, ST. JOSEPH HEALTH SERVICES ALONG WITH ITS OTHER CCHP-AFFILIATED EMPLOYEES, HELPED RAISE FUNDS FOR A NUMBER OF CHARITABLE CAUSES INCLUDING: -MARTIN LUTHER KING (MLK) DAY: ST. JOSEPH EMPLOYEES VOLUNTEERED AS PART OF OUR MLK DAY EVENT FOR HABITAT FOR HUMANITY, HELPING TO BUILD HOUSES FOR LOW-INCOME FAMILIES IN PAWTUCKET AND PROVIDENCE. -CLOTHING DRIVE: ST. JOSEPH HEALTH SERVICES COLLECTED COATS, MITTENS, AND OTHER GENTLY USED ITEMS FOR THE RHODE ISLAND FURNITURE BANK. -"DAFFODIL DAYS": RAISED MONEY FOR THE AMERICAN CANCER SOCIETY. -THE REHAB RIDERS, A TEAM OF FATIMA EMPLOYEES AND THEIR FRIENDS, AGAIN TOOK PART IN THE MS 150 MILE BIKE RIDE. THE TEAM HAS RAISED OVER $50,000 SINCE ITS FORMATION. -BLOOD DRIVES: ST. JOSEPH'S EMPLOYEES DONATED BLOOD AT QUARTERLY BLOOD DRIVES HELD AT FATIMA HOSPITAL. -SCHOOL OF NURSING RAISED MONEY FOR THANKSGIVING BASKETS FOR THE NEEDY. -SCHOOL OF NURSING RAISED MONEY FOR THANKSGIVING BASKETS FOR THE NEEDY. -SCHOOL OF NURSING RAISED MONEY FOR THANKSGIVING BASKETS FOR THE NEEDY. -CLOTHING DRIVE: ST. JOSEPH HEALTH SERVICES COLLECTED COATS, MITTENS, AND OTHER GENTLY USED ITEMS FOR THE RHODE ISLAND FURNITURE BANK. -"DAFFODIL DAYS": RAISED MONEY FOR THE AMERICAN CANCER SOCIETY. -THE REHAB RIDERS, A TEAM OF FATIMA EMPLOYEES AND THEIR FRIENDS, AGAIN TOOK PART IN THE MS 150 MILE BIKE RIDE. THE TEAM HAS RAISED OVER $50,000 SINCE ITS FORMATION. -BLOOD DRIVES: ST. JOSEPH'S EMPLOYEES DONATED BLOOD AT QUARTERLY BLOOD DRIVES HELD AT FATIMA HOSPITAL. -SCHOOL OF NURSING RAISED MONEY FOR THANKSGIVING BASKETS FOR THE NEEDY.
BUSINESS RELATIONSHIPSPART VI, SECTION A, LINE 2KENNETH BELCHER AND MICHAEL CONKLIN HAVE A BUSINESS RELATIONSHIP. THEY ARE OFFICERS/DIRECTORS OF ST. JOSEPH HEALTH SERVICES OF RI AND OFFICERS/DIRECTORS OF RELATED FOR PROFIT ENTITIES ROSEBANK CORPORATION, ELMHURST HEALTH ASSOCIATES AND OUR LADY OF FATIMA ANCILLARY SERVICES.
MANAGEMENT FUNCTIONSPART VI, SECTION A, LINE 3EFFECTIVE JANUARY 4, 2010, THE PRINCIPAL MANAGEMENT FUNCTIONS OF RWMC AND SJHSRI ARE CONDUCTED UNDER THE DIRECTION OF CHARTERCARE HEALTH PARTNER'S OFFICERS, TRUSTEES, AND KEY EMPLOYEES. CONSEQUENTLY, THERE ARE NO KEY EMPLOYEES DISCLOSED FOR THE EXECUTIVE OR FINANCIAL MANAGEMENT FUNCTIONS AFTER JANUARY 2010.
MEMBERS OF THE ORGANIZATIONPART VI, SECTION A, LINES 6-7BCHARTERCARE HEALTH PARTNERS IS THE SOLE MEMBER OF ST. JOSEPH HEALTH SERVICES OF RI. CHARTERCARE HEALTH PARTNERS AS THE SOLE MEMBER RESERVES THE POWER TO AMEND THE ARETICLES AND BYLAWS OF THE ENTITY, APPOINT OR REMOVE A MEMBER OF THE BOARD OF TRUSTEES, ENTER INTO CONTRACTS, AND EFFECT ANY DISSOLUTION, ALLILIATION, MERGER, OR REORGANIZATION, AND HAS THE EXCLUSIVE POWER TO APPOINT OR REMOVE THE CEO, CFO AND THE COO (IF ANY).
REVIEW PROCESSPART VI, SECTION B, LINE 11ATHE COMPLETION OF THE FORM 990 BEGINS WITH AN OPENING MEETING ATTENDED BY THE CONTROLLER OF CCHP AND KPMG LLP, AN INDEPENDENT TAX CONSULTANT. THE MEETING CONSISTS OF A REVIEW OF THE ORGANIZATIONAL STRUCTURE, SIGNAIFICANT CHANGES IN OPERATIONS OR PROGRAM ACTIVITITES FROM THE PRIOR YEAR, AND OVERVIEW OF CHANGES IN THE FORM 990. THE FINANCE DEPARTMENT GATHERS THE REQUIRED INFORMATION AND POPULATES THE FORM 990 IN CONJUNCTION WITH KPMG LLP. ONCE COMPLETED, THE DRAFT FORM 990 IS REVIEWED WITH SENIOR MANAGEMNT TO ENSURE INDIVIDUALS ARE PROVIDED TIME TO REVIEW AND APPROVE THE FORM 990 PRIOR TO THE DEADLINE. AFTER THE INTERNAL REVIEW IS COMPLETED, THE FORM 990 IS PROVIDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW AND COMMENTS. A MEETING IS HELD TO REVIEW THE FORM 990 AND DISCUSS ANY QUESTIONS AND COMMENTS. UPON FINANCE COMMITTEE APPROVAL, A FINAL COPY OF THE FORM 990 IS DISTRIBUTED TO EACH VOTING BOARD MEMBER AND FILED WITH THE TAXING AUTHORITY.
CONFLICT OF INTERESTPART VI, SECTION B, LINE 12THE CONFLICT OF INTEREST POLICY INCLUDED IN THE BY-LAWS IS TO PROTECT THE COPRORATION'S INTEREST WHEN IT IS COTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR TRUSTEE OF THE CORPORATION. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND ALL MATERIAL FACTS TO THE OFFICERS, TRUSTEES AND MEMBERS OF ANY COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. ON AN ANNUAL BASIS, EACH MEMBER OF THE BOARD IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT AND ALL RESPONSES ARE SUBMITTED AND REVIEWED BY LEGAL COUNSEL. ANY ACTUAL AND POSSIBLE CONFLICTS OF INTEREST ARE REVIEWED WITH THE BOARD OF TRUSTEES.
COMPENSATION POLICYPART VI, SECTION B, LINE 15EXECUTIVE COMPENATION PHILOSOPHY: THE EXECUTIVE MANAGEMNT MEMBERS OF ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND (SJHSRI) ARE ACCOUNTABLE FOR ENSURING THAT THE MISSION, VISION, AND VALUES ARE CARRIED OUT AT THE HIGHEST LEVELS OF QUALITY, SERVICE AND EFFICIENCY WITHIN THE COMMUNITIES SERVED. THE PROCESS TO DETERMINE ANNUAL EXECUTIVE COMPENSATION IS REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. THE COMMITTEE IS COMPRISED OF INDIVIDUALS WHO ARE INDEPENDENT OF SJHSRI MANAGEMENT, HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS, ARE NOT RELATED TO OR UNDER THE CONTROL OF ANY INDIVIDUAL, WHO'S COMPENSATION ARRANGEMENT IS BEING REVIEWED, HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH SJHSRI AND ARE NOT PAID FOR THEIR SERVICES AS BOARD MEMBERS. THE COMMITTEE MAY RETAIN AN INDEPENDENT CONSULTANT TO CONDUCT AN ANNUAL COMPENSATION ANALYSIS AND OR TO PROVIDE ADVISORY SERVICES RELATED TO COMPENSATION. TO ATTRACT AND RETAIN THE HIGHEST CALIBER OF HEATLHCARE PROGESSIONALS NEEDED TO SUSTAIN THE QUALITY OF THE INSTITUTION; COMPENSATION MUST BE COMPETITIVE WITH THAT PROVIDED BY THE ORGANIZATIONS WITH WHICH THE INSTITUTION COMPETES WITHIN THE JOB MARKET. SJHSRI BENCHMARKS EXECUTIVE POSITIONS AGAINST ORGANIZATIONS OF COMPARABLE SIZE AND MISSION ON BOTH A NATIONAL AND REGIONAL LEVEL. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EXPERIENCE AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. IT IS THE OBLIGATION OF THE COMMITTEE TO ASSESS THE PERFORMANCE OF SJHSRI'S CEO, DETERMINE HIS/HER COMPENSATION AND REPORT IT'S FINDING IN THE REGARD TO THE BOARD. THE COMMITTEE IS ALSO RESPONSIBLE FOR REVIEWING THE PERFORMANCE ASSESSMENTS AND COMPENSATION RECOMMENDATIONS FOR THE EXECUTIVE MANAGEMENT MEMBERS. COMPENSATION DECISIONS ARE MADE IN A MANNER THAT IS CONSISTENT WITH THE EXECUTIVE COMPENSATION GUIDELINES AS PUT FORWARD: EXECUTIVE LEVEL COMPENSATION ADMINSTRATION GUIDELINE: EXECUTIVE PAY SHOULD BE COMMENSURATE WITH THE INDIVIDUAL'S SKILLS, KNOWLEDGE AND EXPERIENCE AS IT RELATES TO THEIR POSITION. THE MINIMUM AND 1ST QUARTILE OF THE COMPETITIVE MARKET COMPOSITE MAY BE APPROPRIATE FOR NEWLY HIRED INDIVIDUALS WITH LIMITED EXPERIENCE IN A COMPARABLE POSITION. FULLY EXPERIENCED INDIVIDUALS WITH A DEMONSTRATED RECORD OF CONSISTENTLY MEETING PERFORMANCE EXPECTATIONS FOR THE POSITION SHOULD GENERALLY BE PAID WITHIN 90% TO 110% OF THE MIDPOINT. HIGHLY EXPERIENCED INDIVIDUALS WITH A DEMOSTRATED RECORD OF CONSISTENLY EXCEEDING PERFORMANCE EXPECTATIONS IN ALL AREAS OF ACCOUNTABILITY, OR AN INDIVIDUAL WITH SPECIAL SKILLS AND EXPERTISE BEYOND THOSE NORMALLY ASSOCIATED WITH THE POSITION TYPICALLY HAVE A PAY TARGET BETWEEN MIDPOINT AND THE 3RD QUARTILE OF THE COMPETITIVE MARKET COMPOSITE. THE MAXIMUM OF THE MARKET COMPOSITE REPRESENTS THE HIGHEST SALARY LEVEL WHICH SJHSRI BELIEVES IS APPROPRIATE FOR THE POSITION. AN INDIVIDUAL WHOSE SALRY IS NEAR THE MAXIMUM OF THE MARKET COMPOSITE WILL BE ELIGIBLE FOR SALARY INCREASE OF NO MORE THAN THE AMOUNT REQUIRED TO REACH THE MAXIMUM MARKET PAY LEVEL.
PUBLIC DISCLOSUREPART VI, LINE 19ST. JOSEPH HEALTH SERVICES OF RI MAKES ITS TAX RETURN, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE TAX RETURN IS ALSO POSTED ON HTTP://WWW.GUIDESTAR.ORG.
OTHER CHANGES IN NET ASSETSPART XI, LINE 5ADJUSTMENT TO PENSION LIABILITY $ 19,846,971 CHANGE IN MARKET VALUE OF PERPETUAL TRUSTS $ 200,911 UNRESTRICTED NET ASSET TRANSFER $ (854) -------------- TOTAL $ 20,047,028

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
CHARTERCARE HEALTH PARTNERS FOUNDATION
200 HIGH SERVICE AVENUENORTH PROVIDENCERI02908260236669FUNDRAISINGRI501(C)(3)7CCHPfalse
ROGER WILLIAMS MEDICAL CENTER
825 CHALKSTONE AVENUEPROVIDENCERI02908050258959HEALTHCARERI501(C)(3)3CCHPfalse
ROGER WILLIAMS REALTY CORPORATION
825 CHALKSTONE AVENUEPROVIDENCERI02908050423855RENTAL MGMTRI501(C)(3)11CCHPfalse
RWGH PHYSICIANS OFFICE BUILDING
825 CHALKSTONE AVENUEPROVIDENCERI02908050398588BLDG MGMTRI501(C)(3)11CCHPfalse
ELMHURST EXTENDED CARE FACILITIES INC
50 MAUDE STREETPROVIDENCERI02908222723407NURSING HOMERI501(C)(3)3CCHPfalse
ROGER WILLIAMS MEDICAL ASSOCIATES
825 CHALKSTONE AVENUEPROVIDENCERI02908203346936PHY PRACTICERI501(C)(3)11CCHPfalse
CHARTERCARE HEALTH PARNERS
825 CHALKSTONE AVENUEPROVIDENCERI02908264235815MANAGEMENTRI501(C)(3)11NAfalse
ST JOSEPH HOSPITAL WORKERS COMP TRUST
200 HIGH SERVICE AVENUENORTH PROVIDENCERI02904056106574TRUSTRI501(C)(3)11SJHSRItrue

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsControlled OrgControlledOrg
ELMHURST HEALTH ASSOCIATES
825 CHALKSTONE AVENUEPROVIDENCERI02908050437610LABORATORYRICCHPC Corp00false
OUR LADY OF FATIMA ANCILLARY SERVICES
200 HIGH SERVICE AVENUENORTH PROVIDENCERI02908050519862LABORATORYRICCHPC Corp00false
ROSEBANK CORPORATION
825 CHALKSTONE AVENUEPROVIDENCERI02908050342046REAL ESTATERICCHPC Corp00false
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetstrueExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg