2013-08-14T12:10:08-05:00 2012-09-30 WithumSmithBrown PC 465 South St Ste 200 Morristown NJ 079606497 990 2011-10-01 050258812 BUTLER HOSPITAL % BONNIE BAKER CPA BUTL 4016811150 345 BLACKSTONE BOULEVARD PROVIDENCE RI 02906 BONNIE BAKER 2013-08-09 true 9738989494 2011 2016-02-25 16:41:14Z PATRICIA R RECUPERO JD MD 345 BLACKSTONE BOULEVARD PROVIDENCE RI 02906 107218603 false X WWW.BUTLER.ORG X 1844 RI TO PROVIDE TREATMENT OF PSYCHIATRIC ILLNESS IN AN ATMOSPHERE OF DIGNITY AND RESPECT; TO CONTRIBUTE KNOWLEDGE THROUGH EDUCATION AND RESEARCH WHILE IMPROVING SERVICES TO PATIENTS AND THE COMMUNITY. 19 10 1067 111 261507 216517 1046779 1010474 90813298 91278917 1084894 6221566 2452715 2640742 95397686 101151699 455250 337500 0 0 63515803 63272986 0 0 0 30984871 31002056 94955924 94612542 441762 6539157 86220162 86078959 51505605 55751124 34714557 30327835 TO PROVIDE TREATMENT OF PSYCHIATRIC ILLNESS IN AN ATMOSPHERE OF DIGNITY AND RESPECT AND TO CONTRIBUTE KNOWLEDGE THROUGH EDUCATION AND RESEARCH WHILE CONTINUOUSLY IMPROVING THE WAYS THE HOSPITAL SERVICES ITS PATIENTS AND THE COMMUNITY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. false false 85184837 337500 91540424 EXPENSES INCURRED IN PROVIDING VARIOUS MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. 85184837 true true false true false false true false true true false true true true false false true false false true false false false true false true true true false true false false false false false false false true false false false false true true true false false false true 116 0 true 1067 true true true false false false false true true false false false false X 19 10 true true true false true true true true true false false true true true true true true true true true true X BONNIE BAKER CPA 4016811150 345 BLACKSTONE BOULEVARD PROVIDENCE RI 02906 X GEORGE W SHUSTER 1.0 X X 0 2189 0 CHARLES R REPPUCCI ESQ 1.0 X X 0 0 0 CYNTHIA B PATTERSON 1.0 X X 0 0 0 DOUGLAS JACOBS 1.0 X X 0 0 0 ALLEN H CICCHITELLI 1.0 X 0 0 0 EDWARD J COONEY DECEASED 1.0 X 0 0 0 ESTHER EMARD 1.0 X 0 0 0 ROBERT G FLANDERS JR ESQ 1.0 X 0 0 0 JOHN R GALVIN 1.0 X 0 0 0 KENT W GLADDING 1.0 X 0 0 0 DUANE T GOLOMB MD 5.0 X 0 10600 0 DENNIS D KEEFE 55.0 X X 0 362570 215857 JOSEPH J MCGAIR ESQ 1.0 X 0 0 0 ROBERT G PADULA 1.0 X 0 0 0 PATRICIA R RECUPERO JD MD 55.0 X X 660666 0 341493 LISA B SHEA MD 55.0 X 265030 0 21248 SANTINA L SIENA MD 10.0 X 0 31510 8403 JOSEPH W SPINALE DO FACC FACP 55.0 X 0 176296 17832 MARIBETH WILLIAMSON 1.0 X 0 0 0 ALYSSA BOSS ESQ 55.0 X 0 270485 74583 JOHN M SUTHERLAND III 55.0 X 0 903656 162299 MICHAEL A FIORI MD 55.0 X 153331 0 10722 BONNIE BAKER CPA FHFMA 55.0 X 0 402674 105964 WALTER DIAS 55.0 X 392007 0 113742 LINDA DAMON RN ARNP 55.0 X 298597 0 78232 STEVEN A RASMUSSEN MD 55.0 X 454727 0 106940 JULIE FORREST MD 55.0 X 443525 0 12828 LAWRENCE PRICE MD 55.0 X 358288 0 79918 MICHAEL STEIN MD 55.0 X 333727 0 37326 GHULAM SURTI MD 55.0 X 329270 0 33491 ALVARO OLIVARES MD 55.0 X 326954 0 37089 4016122 2159980 1457967 104 false true false YODER TIDWELL LTD 333 SMITH STREET PROVIDENCE RI 02908 ARCHITECTURAL 410325 FALL RIVER NEW BEDFORD MRI LP 313 FAUNCE CORNER ROAD NORTH DARTMOUTH MA 02747 MEDICAL SERVICES 142330 HINCKLEY ALLEN SNYDER LLP 50 KENNEDY PLAZA SUITE 1500 PROVIDENCE RI 02903 LEGAL 124628 3 99087 911387 1010474 NET PATIENT SERVICE REVENUE 541900 63526932 63526932 OTHER HEALTHCARE RELATED REVENUE 541900 27751985 27751985 91278917 4888256 -35133 4923389 0 0 2137230 132939 2004291 2004291 292495 1711796 7237464 5904154 1333310 1333310 1333310 29811 99087 29811 0 0 0 CAFETERIA SALES 722210 554404 554404 GIFT SHOP SALES 453220 77902 77902 VENDOR SALES 900099 4145 4145 636451 101151699 91278917 261507 8600801 337500 337500 0 0 0 2896734 2607060 289674 0 0 45862870 41276583 4586287 1090913 981822 109091 9852558 8867302 985256 3569911 3212920 356991 0 227082 204374 22708 952 857 95 9243 8319 924 0 0 2093322 1883990 209332 100711 90640 10071 2058909 1853018 205891 0 0 26496 23846 2650 137476 123728 13748 0 0 433047 389742 43305 0 3483331 3134798 348533 2035040 1831536 203504 PURCHASED SERVICES 10130254 9117229 1013025 0 MEDICAL SUPPLIES 1737946 1564151 173795 0 UTILITIES 768313 691482 76831 0 REPAIRS & MAINTENANCE 411164 370048 41116 0 7348770 6613892 734878 94612542 85184837 9427705 0 21752 15688 16361744 14039975 557731 420366 5687440 5746873 0 0 0 0 4071228 4368186 262561 281082 471650 499015 66826358 43871809 21815094 22954549 0 0 0 0 34331232 32998508 0 0 2639730 4754717 86220162 86078959 10004744 9661008 0 0 1210287 1439100 0 0 0 0 0 0 5231806 3804764 0 0 35058768 40846252 51505605 55751124 X 15461497 11946775 16823913 15958566 2429147 2422494 34714557 30327835 86220162 86078959 X 6539157 -10925879 X X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 9243 9243 false LOBBYING ACTIVITIES SCHEDULE C, PART II-B; LINE 1I THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION ("AHA"). THE ORGANIZATION PAID $3,515 TO THE AHA AS THE PORTION OF MEMBERSHIP DUES ALLOCATED TO LOBBYING. THE AHA PROVIDES BOTH ADVOCACY AND REPRESENTATION FOR ITS MEMBERS. AHA'S ADVOCACY IS GENERALLY ABOUT HOSPITALS AS THE CORNERSTONE OF THE COMMUNITY, PROTECTING THE HEALTHCARE SAFETY NET AND IMPROVING CARE, AFFORDABILITY AND COVERAGE. THE AHA'S ADVOCACY AGENDA CAN BE VIEWED AT THEIR WEBSITE: WWW.AHA.ORG. THE ORGANIZATION IS A MEMBER OF THE NATIONAL ASSOCIATION OF PSYCHIATRIC HEALTH SYSTEMS ("NAPHS"). THE ORGANIZATION PAID $1,800 TO THE NAPHS AS THE PORTION OF MEMBERSHIP DUES ALLOCATED TO LOBBYING. THE NAPHS PROVIDES BOTH ADVOCACY AND REPRESENTATION FOR ITS MEMBERS. THE NAPHS ADVOCATES FOR BEHAVIORAL HEALTH AND REPRESENTS PROVIDER SYSTEMS THAT ARE COMMITTED TO THE DELIVERY OF RESPONSIVE, ACCOUNTABLE, AND CLINICALLY EFFECTIVE TREATMENT AND PREVENTION PROGRAMS FOR CHILDREN, ADOLESCENTS, ADULTS, AND OLDER ADULTS WITH MENTAL AND SUBSTANCE ABUSE DISORDERS. THE NAPHS'S ADVOCACY AGENDA CAN BE VIEWED AT THEIR WEBSITE: WWW.NAPHS.ORG. THE ORGANIZATION IS A MEMBER OF THE RI COUNCIL OF COMMUNITY MENTAL HEALTH ORGANIZATIONS, INC. ("RICCMHO"). THE ORGANIZATION PAID $3,081 TO THE RICCMHO AS THE PORTION OF MEMBERSHIP DUES ALLOCATED TO LOBBYING. THE RICCMHO PROVIDES ADVOCACY AND REPRESENTATION TO ITS MEMBERS. THE PURPOSE OF THE RICCMHO'S ADVOCACY IS TO BROADEN THE BASE OF MENTAL HEALTH AMBASSADORS IN THE RHODE ISLAND COMMUNITY. THE RICCMHO'S ADVOCACY AGENDA CAN BE VIEWED AT THEIR WEBSITE: WWW.RICCMHO.ORG. THE ORGANIZATION IS A MEMBER OF THE HOSPITAL ASSOCIATION OF RHODE ISLAND ("HARI"). THE ORGANIZATION PAID $847 TO THE HARI AS THE PORTION OF MEMBERSHIP DUES ALLOCATED TO LOBBYING. THE HARI PROVIDES ADVOCACY AND REPRESENTATION TO ITS MEMBERS. HARI'S ADVOCACY IS GENERALLY ABOUT HOSPITALS AS THE CORNERSTONE OF THE COMMUNITY, PROTECTING THE HEALTHCARE SAFETY NET AND IMPROVING CARE, AFFORDABILITY AND COVERAGE. THE HARI'S ADVOCACY AGENDA CAN BE VIEWED AT THEIR WEBSITE: WWW.HARI.ORG. 17912872 167662 3060057 704130 20436461 18252809 592078 -230849 701166 17912872 17008598 225771 1775372 756932 18252809 18436605 192208 -816844 803371 17008598 0.22890 0.11250 0.65860 false false 0 0 36932011 25285372 11646639 3394924 2355426 1039498 23674309 16231011 7443298 2825114 0 2825114 22954549 MARKET INVESTMENT 517028 F ENDOWMENT FUNDS 15592995 F BOARD-DESIGNATED FUNDS 4555654 F TRUSTEE-HELD FUNDS 10442511 F OTHER ASSETS - LT 1890320 F INVESTMENTS 0 F 32998508 DEPOSITS 93494 OTHER RECEIVABLES 4590032 DEFERRED FINANCING COST 71191 4754717 0 OTHER LIABILITIES 2988576 PENSION LIABILITY 16181725 DUE TO AFFILIATES 16830328 DUE TO THIRD PARTY PAYORS 2597200 SELF-INSURANCE RESERVES 2248423 40846252 WORKS OF ART FORM 990, SCHEDULE D, PART III, LINE 1A BUTLER HOSPITAL HOLDS VARIOUS WORKS OF ART THAT WERE DONATED TO THE ORGANIZATION IN THE EARLY TO MID-1900'S. AT THE TIME OF THE DONATION, THE WORKS OF ART WERE ADDED TO THE HOSPITAL'S COLLECTIONS AND WERE HELD FOR PUBLIC EXHIBITION AND FOR PRESERVATION FOR FUTURE GENERATIONS. IN ACCORDANCE WITH STATEMENT OF FINANCIAL ACCOUNTING STANDARDS NO. 116, ACCOUNTING FOR CONTRIBUTIONS RECEIVED AND CONTRIBUTIONS MADE, THE HOSPITAL DOES NOT RECOGNIZE OR CAPITALIZE ITS COLLECTIONS FOR FINANCIAL STATEMENT PURPOSES. THE VALUE OF THE HOSPITAL'S COLLECTIONS IS NOT CONSIDERED MATERIAL TO THE HOSPITAL'S FINANCIAL STATEMENTS. THEREFORE, THE EXISTENCE OF THESE COLLECTIONS IS NOT SEPARATELY DISCLOSED IN THE FOOTNOTES TO THE HOSPITAL'S FINANCIAL STATEMENTS. ENDOWMENT FUNDS FORM 990, SCHEDULE D, PART V, LINE 4 BUTLER HOSPITAL HOLDS VARIOUS WORKS OF ART THAT WERE DONATED TO THE ORGANIZATION IN THE EARLY TO MID-1900'S. THE WORKS OF ART INCLUDE WATERCOLORS ON PAPER AND OILS ON CANVAS BY VARIOUS ARTISTS. THE COLLECTION ALSO INCLUDES A SIMON WILLARD CLOCK. THE DONATED ITEMS WERE ADDED TO THE HOSPITAL'S COLLECTIONS AND ARE HELD FOR CHARITABLE PURPOSES, FURTHERING THE ORGANIZATION'S EXEMPT PURPOSES. THE MOST SIGNIFICANT USES OF THE HOSPITAL'S COLLECTIONS ARE PUBLIC EXHIBITION AND THE PRESERVATION FOR FUTURE GENERATIONS. MANY OF THE OILS ON CANVAS ARE PORTRAITS OF THE ORIGINAL FOUNDERS OF THE HOSPITAL AND ARE THEREFORE, ALSO HISTORICALLY RELEVANT TO THE ORGANIZATION. TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE SCHEDULE D, PART X THE ORGANIZATION IS AN AFFILIATE OF CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT, INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S PARENT ENTITY IS CARE NEW ENGLAND HEALTH SYSTEM. AN INDEPENDENT BIG FOUR CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CARE NEW ENGLAND HEALTH SYSTEM AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED SEPTEMBER 30, 2012 AND SEPTEMBER 30, 2011; RESPECTIVELY AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CERTAIN CONSOLIDATING SCHEDULES. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN FOOTNOTE DISCLOSURE RELATED TO THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48. THE ORGANIZATION COMPLETED AN ASSESSMENT OF THE ESTIMATED LIABILITY FOR UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2012 AND CONCLUDED THAT THE ESTIMATED LIABILITY WAS NOT MATERIAL TO THE ORGANIZATION'S FINANCIAL STATEMENTS. true North America 0 0 Program Services RESEARCH,STUDY & CONS. 32238 0 0 0 0 32238 32238 false false false false false false ORGANIZATION'S PROCEDURES FOR MONITORING USE OF GRANT FUNDS OUTSIDE THE US SCHEDULE F, PART I; QUESTION 2 THE HOSPITAL OBTAINS AN INDEPENDENT CONTRACTOR AGREEMENT FOR ALL CONSULTANTS WORKING ON RESEARCH STUDIES. THE INDEPENDENT CONTRACTOR AGREEMENT DESCRIBES WORK TO BE PERFORMED BY THE CONSULTANT AND THE PAYMENT TERMS. THE PRINCIPAL INVESTIGATOR OF THE STUDY, A BUTLER HOSPITAL EMPLOYEE, MONITORS THE WORK PERFORMED BY THE CONSULTANT PER THE TERMS OF THE INDEPENDENT CONTRACTOR AGREEMENT. UPON SATISFACTORY COMPLETION OF THE WORK PERFORMED, THE PRINCIPAL INVESTIGATOR APPROVES PAYMENT TO THE CONSULTANT BY GENERATING A REQUEST FOR PAYMENT AND SUBMITTING THE REQUEST TO THE ACCOUNTS PAYABLE DEPARTMENT OF THE HOSPITAL. FUND EVENT 128898 99087 29811 8244 12594 8973 0 128898 99087 29811 8244 12594 8973 29811 true true true X true X true true true false false 2208675 8828 2199847 0.02330 2208675 8828 2199847 0.02330 302865 0 302865 0.00320 2243309 839067 1404242 0.01480 10211424 8606048 1605376 0.01700 10332494 9860624 471870 0.00500 33882 0 33882 0.00040 23123974 19305739 3818235 0.04040 25332649 19314567 6018082 0.06370 false 2853983 448075 14502444 18440262 -3937818 X true true 1 1 BUTLER HOSPITAL

345 BLACKSTONE BOULEVARD PROVIDENCE RI 02906

X X X BUTLER HOSPITAL 1 true true 200. true 300. true X X true true X X X X X true false true X false false ELIGIBILITY FOR DISCOUNTED CARE SCHEDULE H, PART I, LINE 3C NOT APPLICABLE. COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A NOT APPLICABLE. SUBSIDIZED HEALTH SERVICES SCHEDULE H, PART I, LINE 7 NO COSTS RELATING TO SUBSIDIZED HEALTHCARE SERVICES ARE ATTRIBUTABLE TO ANY PHYSICIAN CLINICS. CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFIT COST SCHEDULE H, PART I, LINE 7 A COST-TO-CHARGE RATIO WAS USED, THE SOURCE BEING THE MEDICARE COST REPORT FOR FY 2012, ADJUSTED FOR CERTAIN COSTS WHICH ARE PARTICULAR TO MEDICARE COST REPORTING, BUT NOT APPROPRIATE FOR PART 1, LINE 7. E.G. REMOVING THE REASONABLE COST EQUIVALENT FOR PHYSICIAN SERVICES IN W/S A-8-2, ADJUSTING PENSION EXPENSE TO GAAP, ADJUSTMENTS FOR USEFUL LIVES OF CERTAIN SOFTWARE, AND REMOVING THE RELATED PARTY COSTS (OTHER THAN HOME OFFICE). WORKSHEET 2, "RATIO OF PATIENT CARE COST-TO-CHARGES" WAS USED TO COMPLETE THE COST-TO-CHARGE RATIO USED IN PART 1, LINE 7. COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II BUTLER HOSPITAL HAS DIRECT INVOLVEMENT IN NUMEROUS COMMUNITY BUILDING ACTIVITIES THAT PROMOTE AND IMPROVE THE HEALTH STATUS AND GENERAL BETTERMENT OF THE COMMUNITIES SERVED BY THE HOSPITAL. THIS IS ACCOMPLISHED THROUGH SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS, AND PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE ROOT CAUSES OF HEALTH CONCERNS. THIS ORGANIZATION PROVIDES EDUCATIONAL MATERIALS, CONDUCTS COMMUNITY HEALTH FAIRS AND HOLDS HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS AND FOR COMMUNITY PROVIDERS. PRESENTATIONS ARE PROVIDED BY PHYSICIANS, NURSES AND OTHER HEALTHCARE PROFESSIONALS. BAD DEBT EXPENSE SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE WAS CALCULATED USING THE ORGANIZATION'S BAD DEBT EXPENSE FROM ITS AUDITED FINANCIAL STATEMENTS, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. THE ORGANIZATION AND ITS AFFILIATES PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM'S ALLOWANCE FOR DOUBTFUL ACCOUNTS (BAD DEBT EXPENSE) METHODOLOGY AND CHARITY CARE POLICIES ARE CONSISTENTLY APPLIED ACROSS ALL HOSPITAL AFFILIATES. THE ATTACHED TEXT WAS OBTAINED FROM THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS OF THE ORGANIZATION. NET PATIENT SERVICE REVENUE THE HOSPITALS AND THE AGENCY HAVE INDIVIDUAL AGREEMENTS WITH MANY THIRD-PARTY PAYORS THAT PROVIDE PAYMENTS AT AMOUNTS DIFFERENT FROM THEIR ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER-DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, AND INCLUDES ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS DUE TO SUCH THINGS AS FUTURE AUDITS AND REVIEWS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN, OR AS YEARS ARE NO LONGER SUBJECT TO SUCH ADJUSTMENTS. CHARITY CARE THE HEALTH SYSTEM PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR CHARITY CARE POLICIES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. BECAUSE THE HEALTH SYSTEM DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT REVENUE. COMMUNITY BENEFIT SCHEDULE H, PART III, SECTION B; QUESTION 8 THE INPATIENT MEDICARE ALLOWABLE COSTS WERE DETERMINED FROM THE SUBMITTED FY 2012 MEDICARE COST REPORT, WORKSHEET D-1, LINE 49, LESS PARA-MED COSTS, WHICH ARE INCLUDED IN PART I, LINE 7(F). WORKSHEET D-1, LINE 49 DOES NOT INCLUDE DIRECT GME COSTS. THE OUTPATIENT ALLOWABLE COSTS COME FROM WORKSHEET E, PART B. BAD DEBT IS COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW, THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM "CHARITABLE", A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT "[T]HE TERM CHARITABLE IS USED IN 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE," AND PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE: IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM "CHARITABLE" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE "CHARITY CARE STANDARD." UNDER THE STANDARD, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR IT. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY, AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH "REMOVE[D]" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE "COMMUNITY BENEFIT STANDARD," HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM "CHARITABLE," AS REQUIRED BY TREAS. REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. THE ORGANIZATION BELIEVES THAT MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA POSITION. AS OUTLINED IN THE AHA LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS. - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES HOSPITALS ONLY 92 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10-YEAR LOW AT NEGATIVE 5.4 PERCENT. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED "DUAL ELIGIBLES." THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR FINANCIAL ASSISTANCE PROGRAMS. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOME BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF COLLECTION POLICY SCHEDULE H, PART III, SECTION C; QUESTION 9B BUTLER HOSPITAL DOES NOT PURSUE COLLECTION FOR THOSE PATIENTS WHO QUALIFY FOR 100% FINANCIAL ASSISTANCE, BUT OUR NORMAL COLLECTION POLICY WOULD APPLY FOR PATIENTS RECEIVING PARTIAL FINANCIAL ASSISTANCE (DISCOUNTED BY REASON OF INCOME/ASSETS ON THE FPG BETWEEN 200% AND 300%) OR EXTREME MEDICAL EXPENSES. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTIONS 1J, 3, 4, 5C, 6I & 7 NOT APPLICABLE. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QS 9,10,11H,13G,15E,16E,17E,18D,20&21 NOT APPLICABLE. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 19D THE FACILITY HAS A LONGSTANDING POLICY OF PROVIDING UNINSURED PATIENTS A 30% DISCOUNT FROM CHARGES. THIS PERCENTAGE WAS AN APPROXIMATION OF THE AVERAGE PAYMENT RATES FOR NONGOVERNMENTAL PAYORS ACROSS THE SYSTEM. ADDITIONAL DISCOUNTS ARE PROVIDED FOR ADVANCE OR PROMPT PAYMENTS. NEEDS ASSESSMENT SCHEDULE H, PART VI; QUESTION 2 ALL COMMUNITY BENEFIT PROGRAMS UNDERTAKEN BY THE HOSPITAL ARE ALIGNED WITH THE MISSION OF THE HOSPITAL: TO IMPROVE THE HEALTH STATUS AND WELL-BEING OF INDIVIDUALS AND FAMILIES IN ITS SERVICE AREA. RECOGNIZING THAT COMMUNITY NEEDS MAY OUTPACE RESOURCES, THE HOSPITAL CONTINUALLY REVIEWS AND EVALUATES CURRENT AND PROPOSED PROGRAMS TO ENSURE THAT PROGRAMS OFFERING THE MOST BENEFIT WILL CONTINUE TO BE SUPPORTED BY THE HOSPITAL. THE HOSPITAL ALIGNS ITS COMMUNITY PROGRAMS IN SUPPORT OF THE RHODE ISLAND DEPARTMENT OF HEALTH HEALTHY PEOPLE 2010 INITIATIVES: OBJECTIVE 1: PHYSICAL ACTIVITY, OBJECTIVE 3: TOBACCO, OBJECTIVE 4: SUBSTANCE ABUSE AND OBJECTIVE 6: MENTAL HEALTH. PLEASE REFER TO SCHEDULE O FOR A DETAILED COMMUNITY BENEFIT STATEMENT. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI; QUESTION 3 AS A NOT FOR-PROFIT ENTITY, BUTLER HOSPITAL'S FIRST CONSIDERATION IN THE ADMISSION AND PLACEMENT OR TREATMENT OF ANY PATIENT IS THE PATIENT'S MEDICAL NEEDS. SOME PATIENTS HESITATE TO OBTAIN NECESSARY CARE BECAUSE OF THEIR FINANCIAL CONCERNS. A NOTICE OF FINANCIAL AID APPEARS ON ALL STATEMENTS SENT TO PATIENTS. ALSO, IT IS PROMINENTLY POSTED IN THE PATIENT ASSESSMENT DEPARTMENT, ADMISSION AREAS, OUTPATIENT CARE AREAS AND ON THE ORGANIZATION'S WEBSITE. ALSO, THE NOTICE IS AVAILABLE IN THE THREE MOST COMMON LANGUAGES USED BY THE PATIENT POPULATION IN ACCORDANCE WITH THE APPLICABLE "STANDARDS FOR CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES IN HEALTHCARE" (STANDARDS 4 AND 7, BASED ON TITLE VI OF THE CIVIL RIGHTS ACT OF 1964). COMMUNITY INFORMATION SCHEDULE H, PART VI; QUESTION 4 BUTLER HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF A SUBURBAN POPULATION IN PROVIDENCE, RHODE ISLAND WITH A TOTAL POPULATION OF 178,042. THE AVERAGE HOUSEHOLD INCOME IS $36,925 AND 26.3 PERCENT OF THE POPULATION HAS INCOME BELOW THE POVERTY LEVEL. TWENTY FOUR HOSPITALS SERVE THE PRIMARY SERVICE AREA AND A SIGNIFICANT PERCENT OF HOSPITAL DISCHARGES ARE MEDICARE, MEDICAID AND UNINSURED PATIENTS. AS OF THE 2010 AMERICAN COMMUNITY SURVEY CONDUCTED BY THE U.S. CENSUS BUREAU, PROVIDENCE CONSISTED OF THE FOLLOWING GROUPS: 37.6% OF THE POPULATION WERE CAUCASIAN, 38.1% OF THE POPULATION WERE HISPANICS AND LATINOS OF ANY RACE AND 13.1% WERE BLACK OR AFRICAN AMERICAN. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI; QUESTION 5 THE ORGANIZATION AND THE ENTIRE CARE NEW ENGLAND HEALTH SYSTEM PROMOTE THE HEALTH OF THE COMMUNITY ON A DAILY BASIS THROUGHOUT THE YEAR. THE SYSTEM COORDINATES AND OFFERS NUMEROUS COMMUNITY BENEFIT PROGRAMS, ACTIVITIES AND SUPPORT GROUPS TO THE COMMUNITY. PLEASE REFER TO SCHEDULE O FOR A DETAILED COMMUNITY BENEFIT STATEMENT. AFFILIATED HEALTHCARE SYSTEM SCHEDULE H, PART VI; QUESTION 6 OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE THE CARE NEW ENGLAND HEALTH SYSTEM. NOT FOR-PROFIT CARE NEW ENGLAND HEALTH SYSTEM ENTITIES: CARE NEW ENGLAND HEALTH SYSTEM CARE NEW ENGLAND HEALTH SYSTEM IS THE TAX-EXEMPT PARENT OF THE CARE NEW ENGLAND HEALTH SYSTEM ("CNE"). THIS INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THIS ORGANIZATION IS THE SOLE MEMBER OR STOCKHOLDER OF EACH AFFILIATED ENTITY. CNE IS AN INTEGRATED SYSTEM OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF RHODE ISLAND. CARE NEW ENGLAND HEALTH SYSTEM IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). AS THE PARENT ORGANIZATION, CARE NEW ENGLAND HEALTH SYSTEM STRIVES TO CONTINUALLY DEVELOP AND OPERATE A MULTI-HOSPITAL HEALTHCARE SYSTEM WHICH PROVIDES SUBSTANTIAL COMMUNITY BENEFIT THROUGH THE PROVISION OF A COMPREHENSIVE SPECTRUM OF HEALTHCARE SERVICES TO THE RESIDENTS OF RHODE ISLAND AND SURROUNDING COMMUNITIES. CARE NEW ENGLAND HEALTH SYSTEM ENSURES THAT ITS SYSTEM PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. NO INDIVIDUALS ARE DENIED NECESSARY MEDICAL CARE, TREATMENT OR SERVICES. CNE'S ACTIVE HOSPITALS INCLUDE BUTLER HOSPITAL, WOMEN & INFANTS HOSPITAL OF RHODE ISLAND AND KENT COUNTY MEMORIAL HOSPITAL. EACH OF THESE HOSPITALS OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. EACH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. EACH OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. EACH MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF EACH RESTS WITH ITS BOARD OF DIRECTORS AND THE BOARD OF DIRECTORS OF CARE NEW ENGLAND HEALTH SYSTEM. BOTH BOARDS ARE COMPRISED OF A MAJORITY OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. BUTLER HOSPITAL BUTLER HOSPITAL IS A 117-BED NON-PROFIT PRIVATE, NON-PROFIT PSYCHIATRIC AND SUBSTANCE ABUSE HOSPITAL FOR ADULTS, ADOLESCENTS, CHILDREN, AND SENIORS LOCATED IN PROVIDENCE, RHODE ISLAND. BUTLER HOSPITAL IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MOREOVER, BUTLER HOSPITAL OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. KENT COUNTY MEMORIAL HOSPITAL KENT COUNTY MEMORIAL HOSPITAL IS A 359-BED NON-PROFIT ACUTE CARE HOSPITAL LOCATED IN WARWICK, RHODE ISLAND. KENT COUNTY MEMORIAL HOSPITAL IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MOREOVER, KENT COUNTY MEMORIAL HOSPITAL OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. WOMEN & INFANTS HOSPITAL OF RHODE ISLAND WOMEN & INFANTS CORPORATION IS A 247-BED AND 60-BASSINET NON-PROFIT SPECIALTY HOSPITAL FOR WOMEN AND NEWBORNS LOCATED IN PROVIDENCE, RHODE ISLAND. WOMEN & INFANTS CORPORATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MOREOVER, WOMEN & INFANTS CORPORATION OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. BUTLER HOSPITAL FOUNDATION BUTLER HOSPITAL FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF BUTLER HOSPITAL; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. KENT COUNTY VISITING NURSE ASSOCIATION KENT COUNTY VISITING NURSE ASSOCIATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 170(B)(1)(A)(VI). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. KENT HOSPITAL FOUNDATION KENT HOSPITAL FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF KENT COUNTY MEMORIAL HOSPITAL; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. WOMEN & INFANTS DEVELOPMENT FOUNDATION WOMEN & INFANTS DEVELOPMENT FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF WOMEN & INFANTS HOSPITAL OF RHODE ISLAND; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. WOMEN & INFANTS CORPORATION WOMEN & INFANTS CORPORATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION IS THE PARENT ENTITY OF WOMEN & INFANTS HOSPITAL OF RHODE ISLAND AND ITS AFFILIATES, WHICH PROVIDE MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PALOMAR GROUP, INC. PALOMAR GROUP, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. WIH FACULTY PHYSICIANS, INC. WIH FACULTY PHYSICIANS, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. HEALTH TOUCH, INC. HEALTH TOUCH, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. AFFINITY PHYSICIANS, L.L.C. AND KENT ANCILLARY SERVICES, L.L.C. ARE SINGLE MEMBER LIMITED LIABILITY COMPANIES OF KENT COUNTY MEMORIAL HOSPITAL. FOR-PROFIT CARE NEW ENGLAND HEALTH SYSTEM ENTITIES: W&I INDEMNITY LTD. AN ENTITY 100% OWNED BY WOMEN & INFANTS HOSPITAL OF RHODE ISLAND. THIS ENTITY IS A FINANCIAL VEHICLE AND FOREIGN CORPORATION LOCATED IN GRAND CAYMAN. TOLL GATE INDEMNITY LTD. AN ENTITY 100% OWNED BY KENT COUNTY MEMORIAL HOSPITAL. THIS ENTITY IS A FINANCIAL VEHICLE AND FOREIGN CORPORATION LOCATED IN GRAND CAYMAN. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, QUESTION 7 NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN RHODE ISLAND. NO COMMUNITY BENEFIT REPORT IS FILED WITH THE STATE OF RHODE ISLAND. true BROWN UNIVERSITY CONTROLLERS OFC BOX J PROVIDENCE RI 02912 050258809 501(C)(3) 337500 PROGRAM SUPPORT GRANT FUND MONITORING SCHEDULE I, PART I; QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS. X X X X false true false false false true true true false DENNIS D KEEFE 0 324669 0 10000 0 27901 0 200000 0 15857 0 578427 0 0 PATRICIA R RECUPERO JD MD 430705 0 100100 0 129861 0 307915 0 33578 0 1002159 0 92982 0 LISA B SHEA MD 259411 0 5280 0 339 0 18309 0 2939 0 286278 0 0 0 JOSEPH W SPINALE DO FACC FACP 0 78210 0 0 0 98086 0 0 0 17832 0 194128 0 0 ALYSSA BOSS ESQ 0 207760 0 51645 0 11080 0 56540 0 18043 0 345068 0 0 JOHN M SUTHERLAND III 0 436565 0 130200 0 336891 0 140207 0 22092 0 1065955 0 283459 MICHAEL A FIORI MD 152470 0 0 0 861 0 10338 0 384 0 164053 0 0 0 BONNIE BAKER CPA FHFMA 0 281845 0 51885 0 68944 0 81877 0 24087 0 508638 0 54103 WALTER DIAS 282068 0 51812 0 58127 0 97588 0 16154 0 505749 0 49778 0 LINDA DAMON RN ARNP 228194 0 39755 0 30648 0 65148 0 13084 0 376829 0 25761 0 STEVEN A RASMUSSEN MD 344666 0 54026 0 56035 0 91378 0 15562 0 561667 0 54462 0 JULIE FORREST MD 425866 0 0 0 17659 0 12266 0 562 0 456353 0 0 0 LAWRENCE PRICE MD 311488 0 46800 0 0 0 77950 0 1968 0 438206 0 0 0 MICHAEL STEIN MD 331968 0 0 0 1759 0 15925 0 21401 0 371053 0 0 0 GHULAM SURTI MD 327598 0 0 0 1672 0 14878 0 18613 0 362761 0 0 0 ALVARO OLIVARES MD 326954 0 0 0 0 0 18375 0 18714 0 364043 0 0 0 COMPENSATION INFORMATION PART VII AND SCHEDULE J TAXABLE COMPENSATION REPORTED HEREIN IS DERIVED FROM 2011 FORMS W-2 AND 1099 (IF APPLICABLE). COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES VESTED BENEFITS IN A LONG-TERM INCENTIVE PLAN WHICH ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: PATRICIA R. RECUPERO, J.D., M.D., $92,982; JOHN M. SUTHERLAND III, $283,459; BONNIE BAKER, CPA, FHFMA, $54,103; WALTER DIAS, $49,778; LINDA DAMON, R.N., ARNP, $25,761; AND STEVEN A. RASMUSSEN, M.D., $54,462. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN A LONG-TERM INCENTIVE PLAN WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THE UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN THE INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE WAGES: PATRICIA R. RECUPERO, J.D., M.D., $134,415; ALYSSA BOSS, ESQ., $41,840; JOHN M. SUTHERLAND III, $115,707; BONNIE BAKER, CPA, FHFMA, $54,927; WALTER DIAS, $70,638; LINDA DAMON, R.N., ARNP, $43,098; STEVEN A. RASMUSSEN, M.D., $64,428 AND LAWRENCE PRICE, M.D., $55,900. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUAL INCLUDES UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUAL MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN THE INDIVIDUAL'S 2011 FORM W-2, AS TAXABLE WAGES: PATRICIA R. RECUPERO, JD, M.D., $146,550. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUAL INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUAL MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN THE INDIVIDUAL'S 2011 FORM W-2, AS TAXABLE WAGES: DENNIS D. KEEFE, $200,000. COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 6A & 6B THE EXECUTIVE COMPENSATION PACKAGE FOR VARIOUS INDIVIDUALS REPORTED ON THIS FORM 990 CONSISTS OF BOTH A FIXED SALARY AND ADDITIONAL AT-RISK COMPENSATION THAT IS BASED ON SEVERAL QUALITATIVE AND QUANTITATIVE COMPONENTS. THE AT-RISK COMPENSATION IS COMPRISED OF BOTH SHORT-TERM AND LONG-TERM FACTORS AS FOLLOWS. THE SHORT-TERM INCENTIVE PROGRAM PROVIDES AN OPPORTUNITY FOR PROGRAM PARTICIPANTS TO EARN AN INCENTIVE AWARD BASED ON THE ACHIEVEMENT OF CRITICAL STRETCH GOALS THAT RECOGNIZE PERFORMANCE ABOVE EXPECTATIONS. THESE GOALS ARE MEASURED FOR EACH FISCAL PERIOD IN THE FOLLOWING CRITICAL AREAS: QUALITY, FINANCIAL AND PATIENT SATISFACTION. THE LONG-TERM INCENTIVE PROGRAM PROVIDES AN OPPORTUNITY FOR PROGRAM PARTICIPANTS TO EARN AN INCENTIVE AWARD BASED ON THE ACCOMPLISHMENT OF CRITICAL MULTI-YEAR SYSTEM PERFORMANCE OBJECTIVES. AWARDS ARE EARNED BY MEASURING SYSTEM PERFORMANCE OVER THREE-YEAR OVERLAPPING PERFORMANCE PERIODS AND ARE MEASURED IN REFERENCE TO GOALS IN THE FOLLOWING CRITICAL AREAS: NET INCOME FROM OPERATIONS, MARKET SHARE, PATIENT SATISFACTION AND STRATEGIC OBJECTIVE. COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2011 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. COMPENSATION INFORMATION SCHEDULE J, PART II; COLUMN F THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUALS INCLUDES VESTED BENEFITS IN A LONG TERM INCENTIVE PLAN BECAUSE THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THIS AMOUNT WAS TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: PATRICIA R. RECUPERO, J.D., M.D., $92,982; JOHN M. SUTHERLAND III, $283,459; BONNIE BAKER, CPA, FHFMA, $54,103; WALTER DIAS, $49,778; LINDA DAMON, R.N., ARNP, $25,761 AND STEVEN A. RASMUSSEN, M.D., $54,462. THESE AMOUNTS WERE REPORTED ON PRIOR YEAR FORMS 990 AS AT-RISK NON-TAXABLE DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C. HINCKLEY ALLEN SNYDER LLP PLEASE REFER TO PART V 149175 PROFESSIONAL SERVICES false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV CHARLES R. REPPUCCI, ESQ. AND ROBERT G. FLANDERS, JR., ESQ.; DIRECTORS OF THIS ORGANIZATION ARE PARTNERS IN THE LAW FIRM OF HINCKLEY, ALLEN & SNYDER, L.L.P. THIS ORGANIZATION UTILIZED THE SERVICES OF THIS FIRM DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2012. TOTAL FEES PAID BY THE ORGANIZATION TO THIS FIRM TOTALED $149,175. SERVICES WERE RENDERED AT FAIR MARKET VALUE RATES PURSUANT TO ARMS-LENGTH NEGOTIATIONS. COMMUNITY BENEFIT STATEMENT CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS BUTLER HOSPITAL ("BUTLER") IS A NON-PROFIT PSYCHIATRIC AND SUBSTANCE ABUSE HOSPITAL. BUTLER IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, BUTLER PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MOREOVER, BUTLER OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. BUTLER PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF- PAY, MEDICARE AND MEDICAID PATIENTS; 2. BUTLER OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. BUTLER MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF BUTLER RESTS WITH THE BOARD OF DIRECTORS OF CARE NEW ENGLAND HEALTH SYSTEM AND IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. THE OPERATIONS OF BUTLER, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THAT THE HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT AND THAT THE USE AND CONTROL OF BUTLER IS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. HISTORY ======= BUTLER IS AN AFFILIATE WITHIN THE CARE NEW ENGLAND HEALTH SYSTEM ("CARE NEW ENGLAND"). CARE NEW ENGLAND HEALTH SYSTEM IS THE TAX-EXEMPT PARENT OF THE HEALTH SYSTEM. THIS TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. FOUNDED IN 1844, BUTLER IS RHODE ISLAND'S ONLY PRIVATE, NON-PROFIT PSYCHIATRIC AND SUBSTANCE ABUSE HOSPITAL FOR ADULTS, ADOLESCENTS, AND SENIORS. BUTLER IS AFFILIATED WITH THE WARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY AND IS THE FLAGSHIP HOSPITAL FOR ITS DEPARTMENT OF PSYCHIATRY, WHICH HAS BEEN RECOGNIZED BY ITS PEERS AS ONE OF THE TOP TEN IN THE UNITED STATES. A NATIONAL LEADER IN THE DEVELOPMENT OF ACUTE PSYCHIATRIC AND SUBSTANCE ABUSE TREATMENT, BUTLER IS INVOLVED IN A VARIETY OF RESEARCH EFFORTS WHICH HAS EARNED IT A NATIONAL REPUTATION AS A MAJOR TEACHING AND RESEARCH FACILITY. CARE NEW ENGLAND HEALTH SYSTEM WAS FORMED IN FEBRUARY 1996 BY FOUNDING MEMBERS BUTLER HOSPITAL, KENT COUNTY MEMORIAL HOSPITAL AND WOMEN & INFANTS HOSPITAL OF RHODE ISLAND. THESE THREE HOSPITALS ARE ALL INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATIONS. IN JUNE 1999, KENT COUNTY VISITING NURSE ASSOCIATION BECAME A MEMBER OF THE CARE NEW ENGLAND FAMILY, AND LATER THAT YEAR ANNOUNCED ITS NAME CHANGE TO VNA OF CARE NEW ENGLAND. IN 2000, HEALTHTOUCH, INC., A PRIVATE DUTY NURSING SERVICE, JOINED THE DIVISION. TODAY, VNA OF CARE NEW ENGLAND PROVIDES A BROAD SPECTRUM OF HOME HEALTH AND HOSPICE SERVICES. THE CARE NEW ENGLAND HEALTH SYSTEM WAS FOUNDED IN 1996 BY MEMBERS COMMITTED TO THE VISION THAT WE CAN BUILD A BETTER SYSTEM OF HEALTHCARE FOR THE PEOPLE AND COMMUNITIES OF SOUTHEASTERN NEW ENGLAND. THE SYSTEM OFFERS THE LATEST ADVANCES IN MEDICINE, SPECIALTY-TRAINED DOCTORS, AND RENOWNED SERVICES AND CARE. AN INTEGRATED HEALTH SYSTEM THAT OFFERS A CONTINUUM OF QUALITY CARE, CARE NEW ENGLAND IS MOVING HEALTHCARE FORWARD AND REINVENTING THE WAY HEALTHCARE IS DELIVERED. THIS APPROACH PUTS A BROAD SPECTRUM OF CARE - ADDRESSING CANCER, CARDIAC REHABILITATION, HYPERBARIC MEDICINE, PARKINSON'S DISEASE, MATERNAL-FETAL MEDICINE AND FETAL SURGERY, ADVANCED LAPAROSCOPIC AND ROBOTIC SURGERY, STROKE AND ADDICTION TREATMENT - ALL UNDER ONE UMBRELLA SO THEY ARE EASILY ACCESSIBLE TO PATIENTS AND FAMILIES. CARE NEW ENGLAND IS COMPRISED OF FIVE MEMBERS: BUTLER HOSPITAL, RHODE ISLAND'S ONLY PRIVATE, NONPROFIT PSYCHIATRIC AND SUBSTANCE ABUSE HOSPITAL FOR ADULTS, ADOLESCENTS, CHILDREN AND SENIORS; KENT HOSPITAL, THE LARGEST COMMUNITY HOSPITAL IN THE STATE, PROVIDING A FULL SPECTRUM OF PRIMARY AND SECONDARY ACUTE CARE SERVICES; WOMEN & INFANTS HOSPITAL OF RHODE ISLAND, ONE OF THE NATION'S BUSIEST OBSTETRICAL FACILITIES WITH ONE OF THE NATION'S LARGEST SINGLE-FAMILY ROOM NEONATAL INTENSIVE CARE UNITS, THE AREA'S ONLY TERTIARY LEVEL NEONATAL FACILITY, AND VARIOUS SPECIALTY SERVICES; THE VNA OF CARE NEW ENGLAND, WHICH PROVIDES A BROAD SPECTRUM OF HOME HEALTH, HOSPICE AND PRIVATE DUTY NURSING SERVICES FOR NEW MOTHERS, THE ELDERLY AND THE TERMINALLY ILL; AND THE CARE NEW ENGLAND WELLNESS CENTER, WHICH OFFERS AN ARRAY OF REHABILITATION, WELLNESS, FITNESS AND EDUCATIONAL PROGRAMS. THE SYSTEM INCLUDES A SOLID, DIVERSE COMBINATION OF PHYSICIAN SPECIALISTS AND GENERALISTS AND A STRONG COMMITMENT TO EDUCATION. BUTLER AND WOMEN & INFANTS HOSPITALS ARE MAJOR TEACHING AFFILIATES OF THE WARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY, WHILE KENT IS A TEACHING SITE FOR THE UNIVERSITY OF NEW ENGLAND COLLEGE OF OSTEOPATHIC MEDICINE. IN ADDITION, CARE NEW ENGLAND IS COMMITTED, THROUGH NATIONAL AND INTERNATIONALLY-FUNDED AND RECOGNIZED RESEARCH PROJECTS, TO FINDING ANSWERS TO MANY OF TODAY'S MEDICAL QUESTIONS. CARE NEW ENGLAND PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN THE ESTABLISHED RATES. BECAUSE CARE NEW ENGLAND DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. CHARITY CARE INCLUDES SERVICES TO UNINSURED PATIENTS WHO CARE NEW ENGLAND HAS DETERMINED QUALIFY FOR CHARITY CARE UNDER CARE NEW ENGLAND POLICIES. SERVICES TO UNINSURED PATIENTS WHO ARE NOT ELIGIBLE FOR CHARITY CARE OR WHO CARE NEW ENGLAND WAS NOT ABLE TO DETERMINE THEIR ELIGIBILITY ARE NOT REPORTED AS CHARITY CARE BUT REPORTED IN THE PROVISION FOR BAD DEBTS. ADDITIONALLY, CARE NEW ENGLAND SPONSORS CERTAIN OTHER PROGRAMS WHICH PROVIDE SUBSTANTIAL BENEFIT TO THE BROADER COMMUNITY. SUCH PROGRAMS INCLUDE SERVICES TO NEEDY POPULATIONS INCLUDING COMMUNITY SERVICE PROGRAMS AND SERVICES FOR SCHOOL-AGED CHILDREN AND THE ELDERLY. CARE NEW ENGLAND ALSO ACTIVELY SPONSORS PROGRAMS ON HEALTH EDUCATION AND WELLNESS. CARE NEW ENGLAND MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE AND COMMUNITY SERVICE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE BASED ON ESTABLISHED RATES FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY AND COMMUNITY SERVICE POLICIES. MISSION ======= BUTLER IS COMMITTED TO: - PROVIDING TREATMENT FOR PSYCHIATRIC ILLNESS IN AN ATMOSPHERE OF DIGNITY AND RESPECT. - CONTRIBUTING TO KNOWLEDGE THROUGH EDUCATION AND RESEARCH. - CONTINUOUSLY IMPROVING THE WAYS WE SERVE OUR PATIENTS AND OUR COMMUNITY. VISION ====== AS A MEMBER OF CARE NEW ENGLAND HEALTH SYSTEM AND BROWN UNIVERSITY TEACHING HOSPITAL, WE SHALL MAINTAIN AND ENHANCE BUTLER'S LEADERSHIP ROLE IN BEHAVIORAL HEALTH SERVICES, TEACHING AND RESEARCH. WE SHALL RESPOND TO THE DEMANDS OF THIS RAPIDLY CHANGING HEALTHCARE ENVIRONMENT THROUGHOUT RHODE ISLAND AND SOUTHEASTERN MASSACHUSETTS. WE SHALL DISTINGUISH OURSELVES BY PROVIDING INDIVIDUALS AND FAMILIES OF ALL AGES AND BACKGROUNDS WITH A FULL CONTINUUM OF QUALITY, COST-EFFECTIVE SERVICES, WHILE CONTINUING OUR COMMITMENT AS AN ACADEMIC CENTER OF EXCELLENCE. COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS VALUES ====== AT BUTLER, WE PUT THE PATIENT AND THEIR FAMILIES AT THE CENTER OF ALL WE DO. IN OUR DAY-TO-DAY INTERACTIONS WITH PATIENTS AND EACH OTHER, OUR ACTIONS AND DECISIONS ARE GUIDED BY THE FOLLOWING CORE VALUES: - KINDNESS: WE TREAT EVERYONE WITH UNDERSTANDING AND CARING. - EXCELLENCE: WE DEMONSTRATE UNPARALLELED QUALITY IN ALL WE DO. - NEW IDEAS: WE ENCOURAGE LIFELONG LEARNING, CONTINUAL IMPROVEMENT AND INNOVATION. - TRUST: WE CAN BE COUNTED ON TO ALWAYS PLACE OUR PATIENTS' INTERESTS FIRST. - COLLABORATION: WE WORK IN PARTNERSHIPS WITH THOSE AROUND US, INCLUDING OUR PATIENTS. - ACCOUNTABILITY: WE HOLD OURSELVES ACCOUNTABLE FOR THE IMPACT OF OUR DECISIONS. - RESPECT: WE TREAT EACH PERSON WITH DIGNITY, RESPECTING THE DIVERSE NEEDS OF THOSE WE SERVE. - ETHICS: WE HOLD OURSELVES TO THE HIGHEST ETHICAL STANDARDS. OVERVIEW ======== BUTLER IS THE ONLY ADOLESCENT, AND ADULT PSYCHIATRIC TREATMENT HOSPITAL SERVING RHODE ISLAND AND SOUTHEASTERN NEW ENGLAND. IT PROVIDES ASSESSMENT AND TREATMENT FOR ALL MAJOR PSYCHIATRIC ILLNESSES AND SUBSTANCE ABUSE. BUTLER'S INPATIENT PROGRAM HAS SEVEN TREATMENT UNITS WITH SPECIALTY PROGRAMS FOR ADOLESCENTS, SENIORS, PEOPLE WITH SUBSTANCE ABUSE PROBLEMS, AND PEOPLE SUFFERING FROM MOOD AND PSYCHOTIC DISORDERS. BUTLER'S PARTIAL HOSPITAL DAY PROGRAM HAS SEPARATE PROGRAMS FOR PSYCHIATRIC DISORDERS AND SUBSTANCE ABUSE. BUTLER IS A MEMBER OF THE CARE NEW ENGLAND HEALTH SYSTEM AND IS A MAJOR TEACHING AFFILIATE OF THE WARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY. IT IS THE FLAGSHIP HOSPITAL FOR BROWN'S DEPARTMENT OF PSYCHIATRY WHICH HAS BEEN RECOGNIZED AS ONE OF THE TOP TEN IN THE UNITED STATES. IT IS ALSO A TRAINING FACILITY FOR RESIDENTS, MEDICAL STUDENTS, INTERNS, AND STUDENTS IN ADULT PSYCHIATRY AT BROWN UNIVERSITY AS WELL AS STUDENTS AND INTERNS FROM OTHER COLLEGES AND UNIVERSITIES IN THE REGION. A NATIONALLY AND INTERNATIONALLY RECOGNIZED RESEARCH CENTER, BUTLER IS AN ACTIVE PARTICIPANT IN A VARIETY OF RESEARCH INITIATIVES WHICH INCLUDE STUDIES IN MAJOR DEPRESSION, OBSESSIVE COMPULSIVE DISORDER, ALZHEIMER'S DISEASE AND OTHER MEMORY DISORDERS, MOVEMENT DISORDERS, DEPRESSION AND ANXIETY IN DEMENTIA CAREGIVERS, SUBSTANCE ABUSE AND FAMILY VIOLENCE, ROLE OF FORGIVENESS IN FAMILIES, SMOKING CESSATION. BUTLER EMPLOYS APPROXIMATELY 900 FULL-TIME AND PART-TIME CLINICAL AND NON-CLINICAL STAFF. MORE THAN 50 VOLUNTEERS ASSIST THE STAFF IN NEARLY ALL AREAS OF THE HOSPITAL. AS A REGIONAL CENTER IN PSYCHIATRY, BUTLER PROVIDES SERVICES TO PEOPLE DEALING WITH A WIDE RANGE OF PSYCHIATRIC AND SUBSTANCE ABUSE PROBLEMS INCLUDING BUT NOT LIMITED TO: - DEPRESSION - MANIC DEPRESSIVE ILLNESS - SUICIDAL BEHAVIOR - ALCOHOL AND SUBSTANCE ABUSE - PSYCHOTIC DISORDERS - OBSESSIVE COMPULSIVE DISORDER - MOVEMENT DISORDERS - MEMORY DISORDERS - ALZHEIMER'S DISEASE - ANXIETY DISORDERS COMPREHENSIVE SERVICES ====================== BUTLER PROVIDES COMPREHENSIVE PSYCHIATRIC EVALUATIONS AND TREATMENT IN THESE PRIMARY SETTINGS: PATIENT ASSESSMENT SERVICES - 24-HOUR EVALUATIONS AND ASSESSMENTS FOR PEOPLE WITH PSYCHIATRIC ILLNESSES, SUCH AS MAJOR DEPRESSION, ANXIETY, OR ADDICTION DISORDERS. INPATIENT CARE- PROVIDES 24-HOUR TREATMENT FOR MAJOR PSYCHIATRIC ILLNESSES INCLUDING DEPRESSION, MANIC-DEPRESSIVE ILLNESS, PSYCHOTIC DISORDERS AND SUBSTANCE ABUSE DETOXIFICATION. THE HOSPITAL ALSO PROVIDES SPECIALIZED PROGRAMS FOR ADOLESCENTS, SENIORS AFFECTED BY ALZHEIMER'S DISEASE, MEMORY LOSS AND OTHER PROBLEMS ASSOCIATED WITH AGING. PARTIAL HOSPITAL PROGRAMS - COMBINES HOSPITAL TREATMENT WITH A PATIENT'S LIFE AT HOME AND IN THE COMMUNITY. THE PARTIAL HOSPITAL HAS SPECIALIZED SERVICES INCLUDING ABUSED WOMEN, ADULT BEHAVIORAL PROBLEMS, AND ADULT SUBSTANCE ABUSE. OUTPATIENT SERVICES- THE HOSPITAL PROVIDES SPECIALIZED SERVICES THROUGH ITS MEMORY AND AGING PROGRAM AND MOVEMENT DISORDERS PROGRAM. COMMUNITY SERVICE ================= THE HOSPITAL SUPPORTS THE FOLLOWING ORGANIZATIONS IN A VARIETY OF WAYS INCLUDING COMMUNITY EDUCATION AND AWARENESS PROGRAMS, PROVIDING MEETING AND CONFERENCE AND OFFICE SPACE, AND PARTICIPATION ON VARIOUS BOARDS AND COMMITTEES WORKING TO IMPROVE THE MENTAL HEALTH STATUS OF PEOPLE AND FAMILIES. AL ANON ALCOHOLICS ANONYMOUS ALPERT SCHOOL OF MEDICINE OF BROWN UNIVERSITY BEHAVIORAL HEALTH COUNCIL OF COMMUNITY MENTAL HEALTH CENTERS DEPARTMENT OF BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND HOSPITALS DEPARTMENT OF HEALTH DEPARTMENT OF CHILDREN, YOUTH AND FAMILIES (DCYF) GAMBLERS ANONYMOUS IVY LEAGUE PSYCHIATRIC HOSPITALS MANIC DEPRESSIVE AND DEPRESSIVE ASSOCIATION MENTAL HEALTH ASSOCIATION OF RHODE ISLAND NATIONAL ALLIANCE FOR THE MENTALLY ILL, RHODE ISLAND NATIONAL ASSOCIATION OF PSYCHIATRIC HEALTH SYSTEMS NARCOTICS ANONYMOUS RHODE ISLAND PARENTING INFORMATION NETWORK RECOVERY ROOM - NURSING SUPPORT GROUP NATIONAL ASSOCIATION OF SOCIAL WORKERS RHODE ISLAND STATE NURSES ASSOCIATION RHODE ISLAND BLOOD BANK RHODE ISLAND PSYCHOTHERAPY SOCIETY UNITED WAY PUBLIC AND PROFESSIONAL EDUCATION PROGRAMS ========================================== BUTLER HOSPITAL BELIEVES COMMUNITY EDUCATION AND INFORMATION IS CRITICAL TO REDUCING STIGMA AND IMPROVING TREATMENT OUTCOMES THROUGH EARLY RECOGNITION OF A POSSIBLE PROBLEM. ANNUALLY, THE HOSPITAL SPONSORS PUBLIC AND PROFESSIONAL EDUCATION PROGRAMS INCLUDING THE ANNUAL IRVING M. ROSEN, MD, MEMORIAL SPIRITUAL PROGRAM WHICH CELEBRATED ITS 17TH ANNIVERSARY IN 2013. IN ADDITION, THE HOSPITAL IS A YEARLY SPONSOR OF THE ANNUAL MAY IS MENTAL HEALTH MONTH PROGRAMS OFFERED BY THE MENTAL HEALTH ASSOCIATION OF RHODE ISLAND. THE HOSPITAL ALSO PARTICIPATES IN ONGOING HEALTH EDUCATION ACTIVITIES OFFERED BY ITS CARE NEW ENGLAND PARTNERS. PATIENT FAMILY EDUCATION CENTER & ON-LINE MENTAL HEALTH SCREENINGS ================================================================== THE BUTLER HOSPITAL PATIENT/FAMILY EDUCATION CENTER PROVIDES FREE INFORMATION ON BEHAVIORAL DISORDERS, SUBSTANCE, ABUSE, AND OTHER MEDICAL ISSUES. COMPUTER SEARCHES ARE PROVIDED ON REQUEST. DEVELOPED IN ASSOCIATION WITH THE ALLIANCE FOR THE MENTALLY ILL AND THE MANIC DEPRESSIVE AND DEPRESSIVE ILLNESS ASSOCIATION, THE CENTER IS THE LARGEST HOSPITAL-BASED INFORMATION CENTER OF ITS TYPE IN THE AREA. IN ADDITION, THE HOSPITAL SUPPORTS AN ON-LINE MENTAL HEALTH SCREENING FOR DEPRESSION, BIPOLAR DISORDER, GENERALIZED ANXIETY DISORDER, POST-TRAUMATIC STRESS DISORDER, AND SUBSTANCE ABUSE. SUPPORT GROUPS ============== IN ADDITION TO PROVIDING MEETING SPACE TO MANY MENTAL HEALTH AND SUBSTANCE ABUSE SUPPORTS GROUPS IN THE COMMUNITY, THE HOSPITAL PROVIDES THE FOLLOWING FREE SUPPORT GROUPS: -MONTHLY SUPPORT GROUPS FOR TEENAGERS WITH OCD AS WELL AS FOR PATIENTS, AND FAMILIES AND FRIENDS OF PEOPLE WITH OCD -WEEKLY SELF-HELP GROUP FOR PATIENTS AND FORMER PATIENTS OF THE ALCOHOL & DRUG PROGRAM -WEEKLY SUBSTANCE ABUSE RECOVERY GROUP -MONTHLY SUPPORT GROUP FOR PEOPLE SUFFERING FROM COMPULSIVE HOARDING DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTION 2 CHARLES R. REPPUCCI, ESQ. AND ROBERT G. FLANDERS, JR., ESQ. - BUSINESS RELATIONSHIP. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTION 3 THE HOSPITAL ENGAGES SODEXHO MANAGEMENT, INC. TO BE AN AGENT OF THE HOSPITAL AND DELEGATES CONTROL TO SODEXHO IN THE MANAGEMENT OF DAILY OPERATIONS OF ITS FOOD AND NUTRITION DEPARTMENT. THE SODEXHO MANAGEMENT EMPLOYEE FUNCTIONS AND IS RECOGNIZED AS A DEPARTMENT MANAGER WHO PERFORMS IN ACCORDANCE WITH THE HOSPITAL'S DEPARTMENT MANAGEMENT PRACTICES AND IN ACCORDANCE WITH ITS WRITTEN POLICIES AND PROCEDURES. THE POSITION REPORTS TO AN OFFICER/KEY EMPLOYEE OF THE HOSPITAL. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTION 4 THE ORGANIZATION IS AN AFFILIATE IN A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH HAS AS ITS PARENT CARE NEW ENGLAND HEALTH SYSTEM; AN INTERNAL REVENUE CODE SECTION 501(C)(3) ORGANIZATION. EFFECTIVE ON OCTOBER 1, 2011 TO COINCIDE WITH THE BEGINNING OF THIS ORGANIZATION'S FISCAL YEAR CERTAIN ORGANIZATIONAL DOCUMENTS WERE AMENDED, INCLUDING ITS CORPORATE BY-LAWS, TO PROVIDE THAT THE VOTING MEMBERS OF THE BOARD OF DIRECTORS SHALL BE THE VOTING MEMBERS OF THE CARE NEW ENGLAND HEALTH SYSTEM'S BOARD OF DIRECTORS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTIONS 6 AND 7 CARE NEW ENGLAND HEALTH SYSTEM ("CNE") IS THE SOLE MEMBER OF THIS ORGANIZATION. CNE HAS THE ULTIMATE AUTHORITY TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE IN THE CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CARE NEW ENGLAND HEALTH SYSTEM IS THE PARENT ENTITY OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF DIRECTORS) PRIOR TO THE FILING WITH THE IRS. IN ADDITION THE CARE NEW ENGLAND HEALTH SYSTEM FINANCE COMMITTEE ALSO PERFORMED A REVIEW OF THE FEDERAL FORM 990 PRIOR TO MAKING IT AVAILABLE TO EACH VOTING MEMBER OF ITS BOARD OF DIRECTORS. THE CARE NEW ENGLAND HEALTH SYSTEM BOARD OF DIRECTORS HAS DELEGATED TO THE FINANCE COMMITTEE THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION AND FILING PROCESS FOR THE TAX-EXEMPT AFFILIATES OF THE SYSTEM. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S DIRECTOR OF ACCOUNTING AND VARIOUS OTHER INDIVIDUALS TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP, INCLUDING, BUT NOT LIMITED TO, THE INDIVIDUAL OUTLINED ABOVE, FOR HER REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP AND OTHER INDIVIDUALS REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL PRIOR TO PRESENTATION OF THE FEDERAL FORM 990 TO THE MEMBERS OF THE CARE NEW ENGLAND HEALTH SYSTEM FINANCE COMMITTEE. FOLLOWING THE FINANCE COMMITTEE'S REVIEW THE FINAL FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO THE FILING WITH THE IRS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY AND REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH THAT POLICY. THE POLICY REQUIRES THAT A CONFLICT OF INTEREST DISCLOSURE FORM CONSISTENT WITH BEST GOVERNANCE PRACTICES AND INTERNAL REVENUE SERVICE GUIDELINES BE CIRCULATED TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY. IF A DIRECTOR DISCLOSES AN INTEREST THAT COULD GIVE RISE TO A CONFLICT, THE DIRECTOR'S POTENTIAL CONFLICT IS REFERRED TO THE BOARD OR THE COMMITTEE, WHICH EVALUATES THE CONFLICT AND ITS POTENTIAL IMPACT ON THE DIRECTOR'S PARTICIPATION ON THE BOARD OR ON CERTAIN ISSUES THAT MAY COME BEFORE THE BOARD. AFTER CONSULTATION WITH COUNSEL, THE COMMITTEE WILL TAKE ACTION, IF APPROPRIATE AND NECESSARY, TO ADDRESS ANY SUCH CONFLICT IN A MANNER CONSISTENT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 15 THE BOARD OF DIRECTORS OF CARE NEW ENGLAND HEALTH SYSTEM ("CNE") HAS A COMMITTEE OF DIRECTORS KNOWN AS THE CNE COMPENSATION COMMITTEE ("THE COMMITTEE"). THE COMMITTEE IS RESPONSIBLE FOR DISCHARGING THE BOARD'S RESPONSIBILITIES REGARDING THE TOTAL COMPENSATION PROGRAM FOR EXECUTIVES AND KEY PHYSICIANS IN CONJUNCTION WITH THE BUTLER PRESIDENT AND CHIEF EXECUTIVE OFFICER. THE COMMITTEE AT ALL TIMES CONDUCTS ITSELF FREE FROM EXECUTIVE MANAGEMENT IN ITS DECISION MAKING PROCESS EXCEPT WITH RESPECT TO DECISIONS RELATING TO THE PRESIDENT AND CHIEF EXECUTIVE OFFICER WHICH ARE MADE IN CONJUNCTION WITH THE CARE NEW ENGLAND HEALTH SYSTEM CHIEF EXECUTIVE OFFICER. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THIS ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE BUTLER HOSPITAL SENIOR MANAGEMENT TEAM, INCLUDING, BUT NOT LIMITED TO, THE BUTLER HOSPITAL PRESIDENT/CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND CHIEF OPERATING OFFICER. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF AT LEAST 7 DIRECTORS, ALL OF WHOM ARE INDEPENDENT, AT LEAST ONE MEMBER OF THE BOARD FROM EACH OF THE OPERATING ENTITIES (KENT COUNTY MEMORIAL HOSPITAL, WOMEN & INFANTS HOSPITAL OF RHODE ISLAND, BUTLER HOSPITAL AND THE KENT COUNTY VNA) AS WELL AS FROM THE CNE BOARD, SERVE ON THE COMMITTEE. THE CNE PRESIDENT/CHIEF EXECUTIVE OFFICER PARTICIPATES IN COMPENSATION COMMITTEE MEETINGS, EXCEPT AS THE COMMITTEE'S DELIBERATIONS CONCERN THE CNE PRESIDENT/CHIEF EXECUTIVE OFFICER. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILARLY SIZED HEALTHCARE SYSTEMS AND HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS APPLIES TO CERTAIN BUTLER HOSPITAL SENIOR MANAGEMENT PERSONNEL, INCLUDING, BUT NOT LIMITED TO, THE BUTLER HOSPITAL PRESIDENT/CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND CHIEF OPERATING OFFICER. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY EITHER THE COMPENSATION COMMITTEES OF KENT COUNTY MEMORIAL HOSPITAL OR WOMEN & INFANTS HOSPITAL OF RHODE ISLAND OR BY BUTLER HOSPITAL'S PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION HAS BEEN ALLOCATED A PORTION OF TAX-EXEMPT BONDS (THROUGH ITS TAX-EXEMPT PARENT CARE NEW ENGLAND HEALTH SYSTEM) TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. THE ORGANIZATION HAS REFLECTED THIS AMOUNT AS A DUE TO AFFILIATE LIABILITY ON ITS BALANCE SHEET. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE SYSTEM'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. IN ADDITION, THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF RHODE ISLAND SECRETARY OF STATE. COMPENSATION INFORMATION DISCLOSURE CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME OR PART-TIME EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR A RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF DIRECTORS. RELATED HOURS DISCLOSURE CORE FORM, PART VII, SECTION A, COLUMN B THE ORGANIZATION IS AN AFFILIATE IN THE CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF DIRECTOR MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY ONE HOUR. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION. OTHER CHANGES IN FUND BALANCE CORE FORM, PART XI; LINE 5 OTHER CHANGES IN FUND BALANCE INCLUDE: - CHANGE IN NET UNREALIZED LOSSES ON INVESTMENTS; ($654,825); - NONOPERATING EXPENDITURES; ($314,360); - PENSION AND POSTRETIREMENT ADJUSTMENT; ($7,272,127); - NET ASSETS RELEASED FROM RESTRICTIONS USED FOR PURCHASE OF PROPERTY, PLANT AND EQUIPMENT; $137,970; - TRANSFERS; $26,000; - TRANSFER FROM DEFERRED REVENUE; $19,619; - NET UNREALIZED LOSSES FROM INVESTMENTS; ($2,408,985); AND - NET ASSETS RELEASED FROM RESTRICTIONS; ($459,171). AUDITED FINANCIAL STATEMENTS CORE FORM, PART XII; QUESTION 2 THIS ORGANIZATION IS AN AFFILIATE OF CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT, INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S PARENT ENTITY IS CARE NEW ENGLAND HEALTH SYSTEM. AN INDEPENDENT BIG FOUR CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CARE NEW ENGLAND HEALTH SYSTEM AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED SEPTEMBER 30, 2012 AND SEPTEMBER 30, 2011; RESPECTIVELY AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNQUALIFIED OPINION WAS ISSUED EACH YEAR BY THE INDEPENDENT CPA FIRM. CARE NEW ENGLAND HEALTH SYSTEM'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. FINANCIAL STATEMENTS AND REPORTING CORE FORM, PART XII; QUESTION 3 THE ORGANIZATION IS AN AFFILIATE IN THE CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES ("SYSTEM"). THE SYSTEM ENGAGES AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED A-133 AUDIT. THIS ORGANIZATION WAS INCLUDED IN THE SYSTEM WIDE A-133 AUDIT. 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W & I INDEMNITY LTD 23 LIME TREE AVE PO BOX 1051 GRAND CAYMAN CJ KY1-11 980159342 FINANCIAL VEH CJ C CORP. false false true true true false false false false false false true true true true true false false TRANSACTIONS WITH RELATED ORGANIZATIONS SCHEDULE R, PART V AS OUTLINED IN SCHEDULE O, CARE NEW ENGLAND HEALTH SYSTEM IS THE TAX-EXEMPT PARENT OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. THIS ORGANIZATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) ORGANIZATION. THE SYSTEM ALSO INCLUDES BUTLER HOSPITAL, KENT COUNTY MEMORIAL HOSPITAL AND WOMEN & INFANTS HOSPITAL OF RHODE ISLAND; EACH IS ALSO RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL. THIS ORGANIZATION ROUTINELY PAYS EXPENSES FOR VARIOUS AFFILIATES WITHIN THE CARE NEW ENGLAND HEALTH SYSTEM IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.