2013-08-14T13:42:35-07:00 2012-09-30 KPMG LLP Two Financial Center 60 South St Boston MA 02111 990 2011-10-01 050258806 Emma Pendleton Bradley Hospital EMMA 4014321000 1011 Veterans Memorial Parkway East Providence RI 02915 Mary A Wakefield 2013-08-14 true 6179881000 2011 2016-02-24 21:20:13Z Daniel J Wall 1011 Veterans Memorial Parkway East Providence RI 02915 80864747 false false X www.lifespan.org X 1957 RI Emma Pendleton Bradley Hospital's mission is to provide a range of family-focused, high quality mental health care to infants, children, adolescents, and young adults with emotional disorders and/or developmental disabilities. 19 16 1061 125 0 949799 1157676 68232489 70248004 2060084 2577581 1484514 1647222 72726886 75630483 12805 0 53381577 54967520 0 185410 21633720 17796440 75015297 72776765 -2288411 2853718 113965188 123687845 39052635 41955481 74912553 81732364 X Emma Pendleton Bradley Hospital's mission is to provide a range of family-focused, high quality mental health care to infants, children, adolescents, and young adults with emotional disorders and/or developmental disabilities. false false 38165210 12805 43317667 Inpatient treatment for children ages 2 to 18 years who suffer from serious behavioral disorders in addition to developmental conditions such as mental retardation or autism and who are in need of stabilization, assessment, and treatment for suicidal, destructive, self-injurious, or other dangerous or aggressive behaviors.Residential treatment which provides intensive, family-centered services to children who have emotional and behavioral problems that prevent them from living safely at home.Partial programs provide treatment alternatives to inpatient hospitalization or traditional outpatient services, to children from infancy to adolescence with serious emotional, behavioral, eating, sleeping, or relationship problems. 15629735 20127926 The Bradley Schools are private, municipal district-funded, day treatment programs for children and adolescents whose psychiatric and behavioral needs cannot be met in a public school setting. Bradley Schools provide special education services to school-age children and adolescents with chronic behavior disorders and additional developmental disabilities, who often present with oppositional and disruptive classroom behaviors, as well as social and life skill difficulties. 4724376 3786578 The Bradley Hasbro Children's Research Center is devoted to the study and treatment of children at risk for serious mental disorders and behavior processes that support the intergenerational transmission of illness. The research areas are broad and include: Child and Adolescent Psychiatric Disorders, Forensic & Juvenile Justice, Pediatric Behavioral Health, Biological Basis of Psychiatric Disorders, Prevention and Early Intervention, Health Services Research, Pediatric Mood, Imaging & Neurodevelopment, and Developmental Disorders Genetics Research. 3707107 4663055 62226428 true true false false false false false false false true true false true true true true true true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true false false false false true 50 0 true 1061 true false false false false false false false false false false false 0 false false false false false false false false false false false X 19 16 true false false false true true true true true false false false true true true true true true true true false false X Mary A Wakefield 4014447093 167 Point Street Providence RI 02903 X Kenneth W Washburn 3.00 X 0 0 0 Daniel J Wall 40.00 X X 0 508720 31131 Gary Serby 0.00 X 0 0 0 Thomas H Quill Jr 2.50 X 0 0 0 Carol A Peterson 2.00 X X 0 0 0 Stephen O Meredith 2.00 X X 0 0 0 Jozy A Mainelli 3.00 X 0 0 0 Bruce N Leonard 1.40 X 0 0 0 David Kohlhammer 1.00 X 0 0 0 Patrick J Kennedy 0.50 X 0 0 0 Jeffrey Hirsh 4.00 X 0 0 0 Donald P Galamaga 1.00 X 0 0 0 Gregory K Fritz MD 2.50 X 0 293734 33279 Patricia J FlanaganMD 1.50 X 0 224853 34779 Lynne Barry Dolan 1.50 X 0 0 0 David A Brown 4.00 X X 0 0 0 Charles H Boisseau 8.00 X X 0 0 0 Michael J Benes 2.50 X 0 0 0 Jonathan A Barnes 2.50 X X 0 0 0 Mary A Wakefield 4.00 X 0 677833 101701 Henry Sachs MD 40.00 X 251608 0 59414 Dale F Radka MD 40.00 X 272501 0 37182 Rowland P Barrett MD 40.00 X 209776 0 36226 Jeffrey Hunt MD 40.00 X 233622 0 35129 Margaret G Klitzke MD 40.00 X 204011 0 33313 Jarle Z Meservey MD 40.00 X 201948 0 20411 Kevin P Myers MD 40.00 X 253884 0 33414 Laura A Ruoff MD 40.00 X 195303 0 21295 Susan V Eagleson 0.00 X 129200 0 14838 1951853 1705140 492112 49 true true false T & I Solutions PO Box 7976 Cumberland RI 02864 Interpreters 128546 Partners Interpreting 500 E Washington St34 North Attleboro MA 02760 Interpreters 165839 Jackson & Coker PO Box 277638 Atlanta GA 30384 Contract Physician 224139 Butler Hospital 345 Blackstone Boulevard Providence RI 02906 Residency Rotations 304548 Brown University PO Box 1911 Providence RI 02912 Shared Chair 234904 6 1150642 7034 1157676 School 611110 20127926 20127926 Residential 623220 8132280 8132280 Research 541700 4187353 4187353 Partial Hospitalization 622210 5371194 5371194 Inpatient Routine 622210 29413418 29413418 3015833 3015833 70248004 1737140 1737140 289 289 0 0 6074416 5234264 840152 840152 840152 0 0 0 School Lunch Program 611110 224170 224170 Grant Indirect Revenue 622210 701754 701754 All Other 622210 599099 599099 122199 122199 1647222 75630483 71895226 2577581 12805 12805 0 0 0 912284 912284 0 41761962 40875743 886219 1590589 1555226 35363 7704842 7551121 153721 2997843 2931193 66650 0 0 0 0 0 43174 43174 1491214 1491214 693 393 300 3009853 2916892 92961 0 0 1085842 959696 126146 153130 149761 3369 0 104776 83977 20799 1587847 1587847 0 2099650 2099650 85049 85049 Fundraising 185410 185410 Bad Debt Expense 278079 278079 Equipment contracts & all othr 1511972 1436822 75150 Purchased services 6159751 986173 5173578 0 72776765 62226428 10364927 185410 3625408 4762662 0 527689 502753 9406639 9598270 0 0 0 154681 129290 162016 395598 60987097 22113696 39020463 38873401 6568168 11227773 3363628 5348264 18500000 18500000 0 32636496 34349834 113965188 123687845 4780381 5399188 23034282 23032697 11237972 13523596 39052635 41955481 X 24662622 27735577 4226819 4947794 46023112 49048993 74912553 81732364 113965188 123687845 X 2853718 3966093 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 56382024 10362656 4285722 5090984 65939418 55928526 7257140 -1905627 4898014 56382024 52929583 6659882 1495682 5156621 55928526 0.19430 0.74340 0.06230 true false false 379599 379599 48658353 13728413 34929940 10918217 8385283 2532934 1030928 1030928 38873401 Limited Partnerships held inside Pool 2186102 F Commodities-Various 301947 F 18500000 Participation in HBCS Net Assets 78180 Interest in NA of Bradley Foundation 453166 Deferred Financing Costs 654326 34349834 Third Party Liabilities 1283918 Other Long-term Liabilities 126400 Intercompany Liabilities 275038 Health Care Benefit Self-insurance 695040 Accrued Pension Liability 11143200 13523596 75630483 72776765 2853718 3328323 637770 3966093 6819811 79089913 3328323 174281 3502604 75587309 43174 43174 75630483 76270102 76270102 43174 -3536511 -3493337 72776765 Part X Part X : FIN48 Footnote Emma Pendleton Bradley Hospital (the Hospital), as a not-for-profit corporation, is recognized under Section 501(c)(3) of the Internal Revenue Code and is exempt from Federal income taxes. The Hospital 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 of benefit that is greater than fifty percent likely to be realized upon settlement. Changes in measurement are reflected in the period in which the change in judgment occurs. The Hospital did not recognize the effect of any income tax positions during the fiscal year ended September 30, 2012. Part XII, Line 2d Part XII, Line 2d: Other revenue amounts included in F/S but not included on form 990 Interest in Foundation Net Assets $-491409 Funded Status of Pension Plan $-2870821 Fundraising Expenses $-185410 Other Non-Operating Losses $0 Bad Debt Recovery $3721921 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Bad Debt Recovery $4000000 Funded Status of Pension Plan $ -2870821 Interest in Foundation Net Assets $ -491409 Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. Bradley Hospital's (BH's) endowment funds were established for a variety of purposes including both donor-restricted endowment funds and funds designated by BH to function as endowments. BH receives support from various irrevocable trusts within its endowment funds, including The Helen Bradley Trust and The George L. Bradley Trust (the Trusts), which were established under the wills of the late Helen and George L. Bradley. At September 30, 2012, the market value of the Trusts held by unrelated entities was approximately $30.5 million (not including the land and the original Laufer Building in East Providence, Rhode Island where BH is located). As a result of a court order in 2007, the Trusts were authorized to make annual distributions to BH based on the trailing twelve-quarter average fair market value of the Trusts' investment assets in amounts equal to 7% of the average market value of the Trusts in 2007, decreasing by one-quarter of one percent per year to 4.5% in 2017.The largest temporarily restricted endowment held by BH is used to support the Pedi-MIND (Pediatric Mood, Imaging, and Neuro Development) Program for bipolar disorder, including equipment. The goal of the Pedi-MIND Program is to identify biological and behavioral markers of psychiatric illness in children and adolescents in order to improve diagnosis, treatment, and prevention of these conditions. Another large fund is used for renovation and upkeep of the Samuel Swan House, which is the location of the Children's Residential and Family Therapy Program. The van Beuren Newport Child Psychiatry Fund supports the establishment of an outpatient pediatric psychiatry clinic at Newport Hospital, collaboratively overseen by BH's Outpatient Services Department. Finally, BH's Sensory, Speech, and Occupational Therapy Clinic (the Clinic), is supported by a term endowment. The Clinic is for children with sensory, speech, and other disorders that impact their ability to function and communicate; therapists work directly with patients, families, clinicians, and teachers to develop a plan of care and therapy, setting goals and priorities, and measuring outcomes. true true true X true X true true false false true true 627612 80053 547559 0.00760 627612 80053 547559 0.00760 93363 14170 79193 0.00110 1862415 1862415 0.02570 17177583 13243929 3933654 0.05430 4724376 3786578 937798 0.01290 29200 29200 0.00040 23886937 17044677 6842260 0.09440 24514549 17124730 7389819 0.10200 true 176024 6160 23666 -17506 X true true 1 0 Emma Pendleton BradleyHospital

1011 Veterans Memorial Parkway East Providence RI 02915

X X Emma Pendleton BradleyHospital 1 false true true 200.0000 true 400.0000 true X X X X X X true true X X X X X X true X X true X X X X X X false X X false false 14 Whiteknact Elementary School- E Providence Pship

261 Grosvenor Avenue East Providence RI 02914

Special Education Facility East Providence High School- E Providence Pship

2000 Pawtucket Avenue East Providence RI 02914

Special Education Facility Rumford House

PROPRIETARY East Providence RI 02916

Residential Program Heritage House

PROPRIETARY Warwick RI 02888

Residential Program Silver Spring Elementary School - E Prov Pship

120 Silver Spring Avenue East Providence RI 02914

Special Education Facility Exeter House

PROPRIETARY Exeter RI 02822

Residential Program Hill House

PROPRIETARY North Providence RI 02911

Residential Program The Bradley School - Westerly

93 Tower Street Westerly RI 02891

Special Education Facility Martin Middle School - E Providence Partnership

111 Brown Street East Providence RI 02914

Special Education Facility Bradley Research Center

1 Hoppin Street Providence RI 02903

Research Facility The Center for Autism&Developmental Disabilities School

1011 Veterans Memorial Parkway East Providence RI 02915

Special Education Facility The Bradley School - South County

4781 Tower Hill Road Wakefield RI 02879

Special Education Facility The Bradley School - Portsmouth

2820 East Main Road Portsmouth RI 02871

Special Education Facility The Bradley School - Campus

1011 Veterans Memorial Parkway East Providence RI 02915

Special Education Facility Part VI - Affilated Health Care System Roles and Promotion Lifespan's mission is to improve the health status of the people it serves in RI and in southern New England through the provision of customer friendly, geographically accessible, high value services in the environment of an integrated academic health system. Lifespan affiliates provide comprehensive inpatient and outpatient medical, surgical and psychiatric services for adults and children. Lifespan and its affiliates employ more than 12,500 people. The Lifespan system has over 2,300 physicians on the medical staffs of its affiliated hospitals, operates 1,155 licensed beds in four hospital complexes, and in 2012 generated approximately $1.6 billion in total operating revenue. By each of these measures, Lifespan is RI's largest health system, serving a population of over 1.5 million. Three of its hospital members, Rhode Island Hospital (RIH), The Miriam Hospital (TMH), and Bradley Hospital, are teaching affiliates of the Warren Alpert Medical School of Brown University with 78 percent of the residents and fellows in this program based at RIH, TMH, and Bradley Hospital.Lifespan is a RI nonprofit corporation that is community-based and community-governed. As a nonprofit organization, Lifespan is run by a voluntary Board of Directors who are community representatives. Lifespan and all of its nonprofit hospital affiliates have received written notification from the Internal Revenue Service that they have been recognized as being organized and operated as entities described in Internal Revenue Code (IRC) Section 501(c)(3) and are generally exempt from income taxes under IRC Section 501(a).As of September 30, 2012, Lifespan Corporation employed approximately 700 full-time and part-time personnel, most of whom are located in Providence, RI. Lifespan Corporation provides support services to its affiliates, such as information services, telecommunications, risk management, legal, communications and public affairs, fundraising, facility development, strategic planning, internal audit/compliance, human resources, finance, and investment management, for which each affiliate is charged a fee equivalent to the costs incurred by Lifespan in providing these services.CORPORATE AUTHORITY AND ROLELifespan Corporation has no members and is governed by its board of directors. The Board has responsibility for planning, directing and establishing policies intended to assure the development and delivery of quality health services, professional education and biomedical research on an integrated, cost-effective basis. The Board's powers include the power to set accounting policies for its affiliates, develop, negotiate and approve all managed care agreements, develop affiliations with other institutions for educational and research purposes, and approve human resource plans, executive compensation, and benefits for system affiliates. The bylaws of the Hospital confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination and support of the system. Powers reserved to Lifespan as sole member include: to elect and remove trustees; to approve the election of and to remove certain officers; to approve the amendment of the Articles of Incorporation and Bylaws and other Charter documents; to approve strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness.For a complete listing of affiliated members of Lifespan's integrated healthcare delivery system please refer to Schedule R. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose Bradley Hospital is governed by a Board of Trustees, which is composed of up to 23 voting members who are elected by Lifespan Corporation as sole member of the Hospital and three who serve ex officio. The ex officio member of the Board with a vote is the President and Chief Executive Officer of the Hospital. The Chairman and the President of Lifespan Corporation are ex officio members of the Board without a vote. The Hospital's Board, which meets six times a year, prescribes the duties and powers of committees appointed by the Chair and appoints members of the Medical Staff. Elected Board members serve one-year terms.The physicians and psychologists on the Hospital's medical staff are either hospital-based or community based. Part VI - Community Information The Hospital, whose primary location is East Providence, Rhode Island, is a 60-bed, nonprofit teaching hospital with university affiliation providing for the psychiatric treatment of adolescents and children including some with severe developmental disabilities. The Hospital operates several major programs including acute, partial hospitalization, residential, and outpatient, as well as The Bradley School, which provides special education services to children from preschool through high school. The Hospital also operates nine other secondary sites which furnish residential and special education services. As a complement to its role in service and education, the Hospital actively supports research. The Hospital is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The Hospital currently participates as a provider in Rhode Island Medicaid, various out of state Medicaid programs, and State of Rhode Island Department of Children, Youth and Families programs, as well as providing care for patients covered by private health insurers and municipal school departments. The Hospital is also a member of Voluntary Hospitals of America, Inc. (VHA).In 1969, the Hospital and certain other RI hospitals entered into an affiliation agreement to participate jointly in various clinical training programs and research activities with Brown Medical School, renamed The Warren Alpert Medical School of Brown University (Brown). In 2010, Brown named Rhode Island Hospital its Principal Teaching Hospital. The Hospital and The Miriam Hospital continue to be designated as major teaching affiliates. The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically. The Hospital participates in the Brown residency program in psychiatry and in the Child and Adolescent Psychiatry Fellowship.The Hospital has a diverse service area which is not defined solely by a contiguous geographic grouping of municipalities. The combined service area of the Hospital includes all of the cities and towns in Rhode Island and the neighboring states of New England. The Hospital, which receives referrals from all regions of the United States, has established itself as the national center for training and research in child and adolescent psychiatry. Part VI - Patient Education of Eligibility for Assistance Bradley Hospital provides each patient with a "Patient and Family Information" booklet which includes information on patient rights and responsibilities. There is also multilingual signage in the Hospital's main lobby and waiting area which provides information on financial aid contacts. The Registration Department meets with the patient's family at the outset of care to discuss eligibility for assistance, which is also summarized on the Hospital's website. Part VI - Needs Assessment Bradley Hospital is the nation's first children's psychiatric hospital, providing services for children and adolescents not only from Rhode Island, but also from all over the country. The Hospital is the principal child and adolescent psychiatric teaching hospital for The Warren Alpert Medical School of Brown University.Based on an increase in the demand for adolescent services, in 2009 the Hospital transferred 6 additional beds into its adolescent unit, moving them from its developmental disabilities unit, which has achieved an offsetting reduction in its average length of stay. In recent years the Hospital has also increased the number of physicians on staff in response to a heightened demand for outpatient services.As a psychiatric and behavioral health center, the Hospital offers specialized services for children and adolescents. Such care begins with an evaluation designed to meet the unique needs of each child and family. This initial assessment provides an understanding of the problem, identifies the child's needs, and determines the best and least restrictive treatment approach. Once a child is admitted, a treatment plan is tailored to the child's needs.The Hospital actively participates with community mental health centers and the Rhode Island Department of Health to understand the mental health needs of children and families in RI and its surrounding communities. The Hospital is also a participant in Kids Count", which is a publicly funded agency that uses questionnaires with pediatricians, schools, and other providers to identify the mental health needs of the population that it serves. In addition, Hospital staff work collaboratively with administration and staff at various schools throughout the State of Rhode Island. There is a multidisciplinary team at each school site, led by a clinical psychologist. This team guides the treatment and education plan for each student. Each classroom is staffed by a teacher certified in special education and a classroom behavior specialist, both professionals with degrees in their fields.The Hospital respects the role of parents/guardians as partners in their child's care. The Hospital's Family Liaison Program helps parents with questions, problems or special concerns regarding their child's treatment by appointment or via telephone. The Family Liaison Program sponsors support groups and educational meetings on a regular schedule. Notices are posted in the Hospital's main lobby, outpatient waiting room, and at the various unit entrances.The RI State Certificate of Need program requires a focused study of need for all projects over $5.25 million, which is an important part of the program development process across Lifespan. Number of Hospital Faciltiy - 0 Part V, Line 19d - Other Billing Determination of Individuals Without Insurance Uninsured patients receive an automatic 25% Community Benefit discount on Hospital charges. In no case was there a situation where an uninsured patient paid more than amounts charged through Medicare or negotiated commercial insurance rates. Number of Hospital Faciltiy - 0 Part V, Line 16e - Other Collection Actions by Facility or Third Party Engaged The Hospital engages third parties to perform certain collection actions on its behalf. A pre-collect company is used for all self-pay accounts. Additionally, a collection agency is used if there is no payment activity on such accounts after 120 days. The collection process is explained in further detail in the response to Question 15e above. Number of Hospital Faciltiy - 0 Part V, Line 15e - Other Collection Actions Against a Patient Once an account balance or a portion thereof is classified as self-pay, it is placed with the Hospital's pre-collect company. The account remains with them until balance is paid in full, a monthly payment plan is in place, or insurance information is provided for billing.After 120 days, if there is no payment activity, the account qualifies for bad debt and the pre-collect company returns the account to Patient Financial Services, which in turn forwards to a collection agency.The collection agency sends 3 to 5 notices to the patient requesting payment. If there are no responses after letters are sent, collection calls are made. If there is no response after 120 days, the account is reviewed for legal action in the appropriate court.If there are no assets to pursue, the collection agency deems the account uncollectible and then returns it to Patient Financial Services for writeoff.Note: In accordance with Center for Medicare and Medicaid Services mandates, Medicare patient accounts are held 130 days from last payment, after which if no activity, the account is then referred to collection. Number of Hospital Faciltiy - 0 Part V, Line 13g - Other Means Hospital Facility Publicized the Policy An abbreviated version of the Hospital's financial assistance policy is posted in various admitting and outpatient areas of the Hospital. Additionally, registration personnel refer uninsured and/or low income patients to Patient Financial Counselors to discuss the policy and/or answer any questions they might have. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Bradley Hospital does not bill for the excess of charges over agreed upon reimbursement amounts from third-party payors. Rather, such differences are recorded as a reduction of revenue through contractual adjustments. Collection efforts are focused on co-payments, deductibles and amounts denied by insurers. After all collection attempts are exhausted, any remaining balances, including any co-payments and deductibles, are written off as a bad debt. The Hospital classifies its bad debts as uncompensated care. This does not apply to Medicaid, however, as there are no associated co-payments or deductibles for this payor.The Hospital does not require collateral or other security in extending credit to patients; however, it routinely obtains assignment of patients' benefits payable under their health insurance programs, plans or policies, primarily Medicaid. Uninsured patients are offered Community Free Service and/or payment plan options.Lifespan's Patient Financial Services Department (PFS) has the responsibility for administering collection policies and procedures to all patient accounts. PFS engages the services of various pre-collect agencies as necessary. The following are highlights of the overall collection effort:* If a patient presents for admission who is not insured, staff assists the family with a Medicaid application.* If the patient is ineligible for Medicaid, a financial screening is performed to determine status of qualification for Community Free Service.* If the patient does not qualify for Community Free Service, PFS or the pre-collect agency attempts at least four contacts with the responsible party within the first 120 days.* If the third-party carrier denies in writing any responsibility for payment, arrangements regarding an extended payment plan are discussed with the patient.* At 120 days, if there is no payment activity or no hold placed on the account, the account is transferred to the appropriate collection agency. Part III, Line 8 - Explanation Of Shortfall As Community Benefit Medicare shortfall has not been treated as a community benefit.The source of the Medicare allowable costs reported on Part III, Section B, Line 6 is the Medicare cost report, Form 2552-10. Part III, Line 4 - Bad Debt Expense Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectibility of accounts receivable, the Hospital 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, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital 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.The Hospital's allowance for doubtful accounts decreased from $5,150,000 at September 30, 2011 to $850,000 at September 30, 2012. In 2011 the allowance for doubtful accounts was increased by $4,000,000 as a result of past due receivables from the eighty-seven municipal school departments served by the Hospital. In 2012, as a result of subsequent collections, the allowance for doubtful accounts was decreased by $4,000,000. The Hospital's self-pay writeoffs for the years ended September 30, 2012 and 2011 amounted to $405,000 and $293,000, respectively. The Hospital did not change its charity care or uninsured discount policies during the years ended September 30, 2012 and 2011, respectively. The Hospital did not have significant writeoffs from third-party payors in either 2012 or 2011.Schedule H, Part III, Section A, Line 2The amount reported as bad debt expense is determined by applying the ratio of cost to charges (RCC) to the total charges written off to bad debt. The RCC rate is determined using data from the Hospital's cost accounting system and is adjusted for medical education, internally funded research, subsidized health services, community services, and charitable contributions. Discounts and payments are applied to patient accounts before such account balances are transferred to bad debt.Schedule H, Part III, Section B, Line 6The amount reported as allowable Medicare costs is determined by applying a RCC to total charges incurred by Medicare patients treated. The RCC rate is determined using data from the Hospital's cost accounting system and is adjusted for medical education, internally funded research, subsidized health services, community services, and charitable contributions. Part I, Line 7, Column F - Explanation of Bad Debt Expense The calculation of percentages disclosed for Schedule H, Part I, Line 7, column (f) "percent of total expense", does not include bad debt expense. Form 990, Part IX, Line 25 includes bad debt expense of $278,079. Part I, Line 7 - Explanation of Costing Methodology The Hospital's costing methodology used to calculate the amounts reported in Part I, Line 7 is as follows:a) Financial Assistance at cost- involves utilization of a ratio derived from dividing patient costs, as defined, by patient charges, as defined, and applying that percentage to total charity care expense.Patient costs are calculated based on Medicare principles of reimbursement by reducing total operating expenses by items such as bad debt expense, the cost of medical education, internally funded research, subsidized health services, community services, charitable contributions, and other operating revenue. Patient costs are then divided by patient charges to determine a ratio of cost to charges (RCC). This RCC is applied as the costing methodology for determining charity care expense.e) Community health improvement services and community benefit operations- Community benefit operations expense is recorded as direct expenses incurred as reported by the Hospital's Community Health Services department. Revenue received for these services is reported as direct offsetting revenue. g) Subsidized health services- Subsidized health services' community benefit expense is determined by the Hospital's internally developed allocation model based on the general ledger whereby overhead costs are applied using a historically determined basis to all direct care departments. This expense is adjusted to remove all related bad debt, Medicaid, and charity costs already reported in applicable sections of Line 7. Net patient service revenue is recorded as amounts received from various payer types related to these services. Revenue associated with Medicare GME is excluded from the amount disclosed for subsidized health services.h) Research- The Hospital conducts extensive medical research focused on child and adolescent health concerns and brain science. For all internal and external research conducted, the costs associated with these activities is calculated by combining the direct and indirect costs as calculated by the Hospital's internally derived methodology. Revenue received for these services is reported as direct offsetting revenue. i) Cash and in-kind contributions for community benefit- Expenses for cash and in-kind contributions for community benefit are direct costs as recorded in the general ledger, including an allocation of contributions made by Lifespan Corporation on the Hospital's behalf. Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) Emma Pendleton Bradley Hospital (the Hospital) uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at the Hospital is intended to define probable eligibility for public assistance (Medicaid or Community Free Care ("CFS")) for those patients who do not have the means to pay for hospital services rendered, as follows:1. Upon patient indication of an inability to pay required monies, the patient is offered the financial screening option to determine eligibility for public assistance. (Medicaid, CFS)2. The application for CFS is completed and includes information relative to income, expense, and other available resources and requires proof of such information which may include:- most recently filed Federal income tax return and any supporting W-2 form(s)- copies of most recent savings and/or checking account statements- two most recently received payroll check stubs3. If the patient's financial situation falls within the guidelines for eligibility for Medicaid or CFS, the appropriate application process is completed. (Assistance to complete such applications is available from the Patient Financial Advocates (PFA) Office at the Hospital.)4. Uninsured patients receive an automatic 25% deduction at the Hospital.5. Eligibility for CFS above the 25% discount is provided for those applicants whose family gross income is at or below twice the Federal Poverty Guidelines, with a sliding scale for individuals up to four times the poverty level in effect at the time of application. Full charity care applicants with assets worth more than $8,855 for an individual (or $13,281 for a family) may not qualify for care without charge, but may qualify for discounted care. While the maximum 100% discount may not be available to all charity care applicants based on the results of their asset test, all uninsured patients who receive care are eligible for, at a minimum, the 50% charity care discount. 6. For patients who qualify for less than 100% of the financial assistance program, a payment schedule is determined and agreed upon (discussed further below). Payment arrangements are established prior to service for non-urgent care. 7. In either case, the final results of the financial screening are recorded in the comments section of the Hospital's billing system.Requests for Payment Arrangements:Patient Financial Advocates (PFA) will qualify patients that are receiving non-urgent, medically indicated procedures prior to services. The PFA will request 75% to 100% of estimated charges (net of the automatic 25% discount) if the balance is under $5,000 and 50% to 100% of estimated charges (net of the automatic 25% discount) if the estimated bill exceeds $5,000.Patients who do not qualify for the total or partial CFS, but who have difficulty in paying their bills after services are rendered, may request to enroll in a payment plan. Eligibility for the payment plan includes the following guidelines:1. Immediate payment in full will result in financial hardship to the patient or the patient's family.2. Deposit of one-half of the estimated total bill is requested prior to admission.3. The minimum monthly payment of $50.004. The maximum length of the payment plan is twenty-four months.The Customer Service staff will set up the payment plan using the above guidelines as well as complete the necessary information on the "Payment Agreement" form and mail to patient for signature.Account documentation will be done online. The pre-collect agency will be sent a copy of the payment agreement and all forms will be scanned into the PFS Optical Imaging System. Brown University 164 Angell Street Providence RI 02912 050258809 501(c)(3) 12805 0 General Support 1 0 X true true X X X X X true true false false false false false false false false Susan V Eagleson 129200 14838 144038 Rowland P Barrett MD 206242 3534 13654 22572 246002 Patricia J FlanaganMD 220802 2814 1237 14794 19985 259632 Mary A Wakefield 499573 84291 93969 85853 15848 779534 67780 Margaret G Klitzke MD 200723 3288 13226 20087 237324 Laura A Ruoff MD 194660 643 12149 9146 216598 Kevin P Myers MD 143504 110380 17150 16264 287298 Jeffrey Hunt MD 224521 9101 15040 20089 268751 Jarle Z Meservey MD 201001 947 11980 8431 222359 Henry Sachs MD 240478 11130 39698 19716 311022 Gregory K Fritz MD 287371 6363 17097 16182 327013 Daniel J Wall 282756 48094 177870 14700 16431 539851 121074 Dale F Radka MD 260461 12040 17088 20094 309683 Sch J, Part I, Line 1a Part I, Line 1a: Relevant information in regards to selections on 1a. Tax Indemnification and Gross-up Payments:The Lifespan Executive Long Term Disability program provides financial protection to designated Lifespan executives in the event that they become disabled. Premiums are paid to the insurance carrier by the insureds on an after tax basis to allow for income replacement at a reasonable cost. The income associated with the premiums is grossed-up to cover the total cost of the benefit as provided in the Lifespan Executive Benefit Plan and is included in Medicare wages, more specifically on Schedule J, Part II, Column B (iii). RI Health & Education Bldg Corp 521300173 762243K36 2009-03-30 19582506 See Schedule O false false true 23038242 2300779 339576 398966 19927384 71537 2012 false false true true false false false true true 0.00500 0.00500 true false false false false false false X Schedule K, Part I, Line A, Column (f) The proceeds of the bonds have been used for the purposes of financing projects consisting of the acquisition, construction, renovation, expansion and equipping of certain hospital facilities owned and operated or to be owned and operated by the Hospital. More specifically, the construction of an approximately 51,640 square foot, two-story addition located on the west side of the Hospital's existing Laufer Building and the renovation of approximately 18,000 square feet in the vacated space of Bradley's Laufer Building and Swan House for patient and residential school uses. Form 990, Schedule K, Part V: The Hospital has in place written post-issuance tax compliance procedures for tax-exempt obligations. To ensure that its bonds continue to qualify for tax-exempt status, the Hospital consults with bond counsel and other legal counsel and advisors, as needed, to ensure that all applicable post-issuance requirements are met. The Hospital has not identified any non-compliance with the requirements of its tax-exempt bonds. Form 990, Part XII, Line 2C The Lifespan Audit and Compliance Committee assumes responsibility for the oversight of the audit of Bradley Hospital's financial statements and the selection of Lifespan's independent accountant. Form 990, Part VI, Section B, Q15, cont * Selecting and engaging qualified, independent, third party compensation valuation consultants that the Committee charges with rendering opinions with respect to the reasonableness and comparability of compensation as well as the comparative organizations against which compensation is assessed, in accordance with relevant sections of the IRC and Lifespan's executive compensation philosophy. The independent consultants are not engaged by management to perform any services for Lifespan without prior approval by the Committee.Lifespan's Chief Executive Officer works closely with the Committee to make recommendations on the above topics and keep the Committee informed about contemplated compensation changes for executives and other key employees, as well as candidates for these roles. The CEO also provides periodic updates to the Committee regarding Lifespan's performance relative to compensation-related performance objectives. The Committee's deliberations and actions are documented in minutes prepared for each meeting.PROCESS FOR DETERMINING COMPENSATION Valuation of Total Cash and Total Remuneration: No less frequently than annually, the Committee receives and reviews a total cash compensation valuation of all existing executive compensation program participants prepared by its independent compensation consultant. Annually, the Committee also receives and reviews a total remuneration valuation of all existing executive compensation participants. Base Salary Actions: The CEO recommends any salary adjustments for participants in the executive compensation program, using the results of the valuation study and his/her assessment of individual performance or other pertinent information, for the Committee's consideration.New Participants to Executive Compensation Program: With respect to compensation offers for individuals expected to participate in the executive compensation program: the office of the Senior Vice President of Human Resources works with the Committee's independent compensation consultant or relies on information previously provided by the consultant to establish a range of reasonable cash compensation within which recruitment is expected to conclude through acceptance of a reasonable compensation offer. Form 990, Part VI, Section B, Q15 a & b The following applies to Lifespan and all of its affiliates, including Emma Pendleton Bradley Hospital:EXECUTIVE COMPENSATIONLifespan's executive compensation philosophy balances appropriate stewardship of resources and the need to be competitive in recruiting and retaining talented individuals. It incorporates market-competitive and performance-related principles, and covers the President and CEO of Lifespan as well as other officers, senior management and key employees. Lifespan's executive compensation program complies with both law and contemporary ethical norms, and is administered consistent with the organization's tax-exempt status under Section 501(c)(3) of the Internal Revenue Code (IRC) and the avoidance of transactions subject to intermediate sanctions under Section 4958 of the IRC. Executive compensation is also administered consistent with Lifespan's Corporate Compliance Policy on Excess Benefit Transactions.The Compensation Committee of the Lifespan Corporation Board of Directors (the Committee), comprised of disinterested Lifespan and affiliate Board members, is responsible for diligent oversight of executive compensation to ensure compliance with IRC requirements. Its duties include:* Approving eligibility for participation in the executive compensation program * Approving changes in compensation for existing executive participants * Approving guidelines, such as salary ranges and contract terms, on appropriate levels of compensation for other key employees* Approving new, and modifying or terminating existing, executive compensation plans including, but not limited to, annual and long-term incentive and executive benefit plans* Approving performance objectives associated with Lifespan's annual and long-term incentive plans, including measuring points, and using audited actual performance relative to these objectives as a precondition to approving the payment of any awards under the plan(s)* Authorizing periodic performance benchmark studies to be conducted for purposes of assessing Lifespan's performance within the healthcare industry and the degree to which total remuneration levels at Lifespan are generally commensurate with Lifespan performance relative to healthcare industry performance* Conducting an annual performance review of Lifespan's Chief Executive Officer. The Chair of the Committee conducts and documents this review, based on his/her observations and interpretation of feedback from members of the Board of Directors. Form 990, Part VI, Section B, Q12C Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including Emma Pendleton Bradley Hospital, and administered by Lifespan's Corporate Compliance Department as follows: Each designated person subject to Lifespan's conflict of interest policy is required to provide Lifespan with an initial disclosure statement and thereafter an annual statement attesting that (i) the designated person has read and is familiar with this policy, and (ii) the designated person and, to the best of his/her knowledge, family members, have not in the past engaged in, are not presently engaging in, or plan to engage in, any activity which contravenes this policy.If, at any time during the course of employment or association, a designated person has reason to believe that an existing or contemplated activity may contravene this policy, the person shall submit a full written description of the activity to the Lifespan Compliance Officer or the Office of the General Counsel to seek a determination as to whether the contemplated activity does or does not contravene this policy. (For the bulk of Lifespan management staff awareness of this requirement shall be acknowledged as part of the annual performance evaluation process.) If the activity in question involves either the Chief Executive Officer, the Senior Vice President and General Counsel, or a Trustee, a full written disclosure must be made to, and a determination sought from, the Chairman of the Board of Directors of Lifespan Corporation.Annually, the Lifespan Compliance Officer shall review and report to the Lifespan Executive Corporate Compliance Committee and to the Lifespan Audit and Compliance Committee on the administration of this policy.Failure on the part of any designated person to comply with this policy, including failure to submit in a timely fashion the conflict of interest disclosure statement, will be grounds for removal from his/her position and/or termination of his/her employment with Lifespan. Form 990, Part III, line 4a: EPBH provides full charity care for individuals at or below twice the federal poverty level, with a sliding scale for individuals up to four times the poverty level. In addition, a substantial discount is offered to all other uninsured patients. The Hospital determines the cost associated with providing charity care by aggregating the applicable direct and indirect costs, including compensation and benefits, supplies, and other operating expenses, based on data from its costing system. The total cost, excluding medical education and research, incurred by the Hospital to provide charity care amounted to $991,000 in fiscal 2012. Charges forgone, based on established rates, amounted to $547,559. Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Lifespan currently makes its annual and quarterly consolidated financial statements available to the public via DAC (Digital Assurance Certification LLC), a disclosure dissemination agent for issuers of tax-exempt bonds which electronically posts and transmits Lifespan's financial information to repositories and investors alike. In addition, copies of the Hospital's articles of incorporation, bylaws, and conflict of interest policy are available upon request from the office of the Lifespan Chief Financial Officer, either in person or by mail. Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process The preparation and filing of the Form 990 and supporting schedules is the responsibility of the Chief Financial Officer and Lifespan's Finance Department, with review by Lifespan's tax advisors, KPMG LLP. The Form 990 is prepared by the accounting staff upon completion of Lifespan's annual independent audit and reviewed by the Corporate Services Tax Compliance Manager. Further review is performed by the Director of Finance and the Vice President of Finance - Corporate Services. Once the draft Form 990 is complete, the Director of Finance forwards it with all supporting worksheets to KPMG, which then reviews the completed form in detail. The Director of Finance answers questions as they arise and provides additional information as needed. KPMG provides the Director of Finance with any recommended changes which are reviewed, and if agreed upon, are incorporated into the return. The draft Form 990 is then provided to the Chief Financial Officer for final management review. Prior to filing the return with the Internal Revenue Service, a copy of the entire form is sent to the Hospital's Board of Trustees in advance of its next Board meeting, at which the Chief Financial Officer discusses the highlights of the Form. All questions and concerns of the members of the Board are addressed by the Chief Financial Officer and incorporated into the Form 990 when appropriate. Once the Form 990 is complete and ready to be filed, the members of the Board are notified via email that a copy of the final version of the Form 990 is accessible through a password protected website portal. The Chief Financial Officer is authorized to file the Form 990. Form 990, Part VI, Line 7b Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders Lifespan has the responsibility for planning, directing and establishing policies intended to assure the development and delivery of quality health services on an integrated, cost-effective basis. Powers reserved to Lifespan, in addition to those noted above, include: to approve amendment of the Articles of Incorporation and Bylaws and other Charter documents; to approve strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness. Form 990, Part VI, Line 7a Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body The bylaws of Emma Pendleton Bradley Hospital (the Hospital) confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination and support of the system. Powers reserved to Lifespan include: to elect and remove trustees and to approve the election of and to remove certain officers. At each annual meeting of the Hospital Board of Trustees, a list is compiled of the names of those persons selected to serve as Trustees of the Hospital so that it can be approved and submitted to Lifespan for ratification and election. Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Lifespan is the sole corporate member of Emma Pendleton Bradley Hospital. Form 990, Part VI, Line 2 Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et Daniel J. Wall, President, and Mary A. Wakefield, CFO, are both employed by Lifespan Corporation. Ms. Wakefield is also an officer of Rhode Island Hospital.Patricia J. Flanagan and Gregory K. Fritz, Trustees, are employed by Rhode Island Hospital. Form 990, Part III, Line 4d Form 990, Part III, Line 4d : Other Program Services Description OTHER PROGRAM SERVICES 4: HOME-BASED TREATMENT SERVICES AND OUTPATIENT CLINICSHome-based intensive behavioral treatment is for children who have been diagnosed with autism spectrum disorder and have varying degrees of chronic behavior disorders that, if left untreated, would worsen and require more intensive treatment, including psychiatric hospitalization or out-of-home residential placement. Staff members visit a family's home and deliver clinical services to the child on a one-on-one basis. The treatment plan is family-oriented, as it includes all family members in the treatment process.Bradley also offers a hospital diversion program to children and adolescents with mental retardation. Those admitted to this home-based program present with chronic mild to moderate behavior disorders that, if left untreated, would worsen and require more intensive treatment, including hospitalization or residential placement. This service, which is also a resource for children recently discharged from the Hospital, is used as a preventive measure against the future need for an out-of-home placement.Bradley's outpatient treatment programs are administered by a multidisciplinary staff of psychiatrists, psychologists, nurses, and qualified trainees, who provide comprehensive mental health evaluation and treatment for children, adolescents, and families for a wide range of clinical conditions. Patients may be treated with a variety of modalities including individual, group and family therapy, and psychopharmacologic management. Treatment is often coordinated with other agencies such as mental health centers, schools, or community-based organizations. 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