2024-08-14T10:43:54-07:00 2023-09-30 990 2022-10-01 050258806 Emma Pendleton Bradley Hospital EMMA 4014321000 1011 Veterans Memorial Parkway East Providence RI 02915 Peter K Markell EVP/CFO 2024-08-14 true 2022 2024-08-08 14:25:15Z Henry T Sachs III MD 106326001 false X www.lifespan.org X 1957 RI As a member hospital in the Lifespan health system, Emma Pendleton Bradley Hospital (EPBH) is committed to its mission: Delivering health with care. 16 10 1149 14 0 4877341 1852448 88920226 96069486 -405351 3967075 0 93392216 101889009 2500 0 59086934 65168706 0 328892 35421958 39163266 94508892 104334472 -1116676 -2445463 144574684 146724385 36233370 36588710 108341314 110135675 X As a member hospital in the Lifespan health system, EPBH is committed to its mission: Delivering health with care. false false 75353181 85773333 EPBH provides inpatient treatment for children ages 2 to 18 years suffering from serious behavioral disorders and/or developmental conditions such as mental retardation or autism who are in need of stabilization, assessment, and treatment for suicidal, destructive, self-injurious, or other dangerous or aggressive behaviors. EPBH also offers residential treatment providing intensive, family-centered services to children with emotional and behavioral problems which prevent them from living safely at home. (See also Schedule O) 9010910 7443910 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, Pediatric Behavioral Health, Biological Basis of Psychiatric Disorders, Prevention and Early Intervention, Health Services Research, Pediatric Mood, Imaging & Neurodevelopment, Developmental Disorders Genetics Research, and Neuroplasticity/Autism Disorders. Included in total program expenses and revenue are approximately $339,000 of research grants from for-profit organizations that are not reported in Schedule H. 2906362 3197635 Home-based intensive behavioral treatment is for children who have been diagnosed with Autism Spectrum Disorder (ASD) or who 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. (See also Schedule O) 87270453 true true false false false false false true false true true true true true true true false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true true true false false true 102 0 true 1149 true false false false false false false false 0 false false false false false false false X 16 10 true false false false true true true true true false false true true true true true true true true false RI X Peter K Markell 4014447914 167 Point Street Providence RI 02903 X Timothy J Babineau Fmr Trustee 0.00 0.00 0 6453503 383339 Ziya L Gokaslan MD Trustee 0.50 42.50 X 0 1671096 49960 Paul J Adler Secretary 2.50 37.50 X 0 744106 145044 David A Kirshner Treasurer-11/22 0.00 0.00 X 0 857218 20609 G Alan Kurose Fmr Trustee 0.00 50.00 0 636825 63815 Henry T Sachs III MD Pres. & CMO 45.00 3.00 X 0 454323 107767 Karyn J Horowitz MD Chief Medical Officer 40.00 0.00 377071 0 79591 Arthur J Sampson Trustee 0.00 8.00 X 0 417696 18300 Eva Greenwood Treasurer 0.50 39.50 X 0 198973 34915 Mary A Carskadon PhD Physician 40.00 0.00 183706 0 22567 Margaret R Paccione-Dyslewski PHD Dir. Behav. Ed. 40.00 0.00 167801 0 31583 Susan Lantz Interim CNO 40.00 0.00 178032 0 21262 Nicole A Nappe Clinical Mgr 40.00 0.00 152670 0 38360 Stephanie H D'Atri Dir. Early Child. 40.00 0.00 152598 0 38383 Ellen M Hallsworth Dir. REACH 40.00 0.00 159945 0 5491 Lawrence A Aubin Sr Chair 0.50 7.50 X X 0 0 0 Emanuel Barrows Trustee 0.50 6.50 X 0 0 0 Roger N Begin Trustee 2.00 10.50 X 0 0 0 Peter Capodilupo Vice Chair 0.00 5.00 X X 0 0 0 Sarah T Dowling JD LLM Trustee 0.00 13.00 X 0 0 0 Edward D Feldstein Esq Trustee 0.10 2.00 X 0 0 0 John Fernandez Trustee 2.00 48.00 X 0 0 0 Philip Kydd Trustee 0.50 6.00 X 0 0 0 Alan H Litwin Vice Chair 0.50 9.00 X X 0 0 0 Martha B Mainiero MD Trustee 0.25 2.85 X 0 0 0 Steven Pare Trustee 0.00 3.00 X 0 0 0 Lawrence B Sadwin Trustee 5.00 12.00 X 0 0 0 Shivan Subramaniam Trustee 0.25 5.25 X 0 0 0 Jane Williams PhD RN Trustee 5.00 27.00 X 0 0 0 Michael L Hanna Trustee 0.25 6.05 X 0 0 0 Peter K Markell EVP & CFO 0.00 0.00 X 0 0 0 1371823 11433740 1060986 56 true true false Aramark Services Inc PO Box 978839 Dallas TX 75397 Food Service 1614106 AMN Healthcare Inc 2735 Collection Center Dr Chicago IL 60693 Contract Labor 799342 Butler Hospital 350 Duncan Drive Providence RI 02906 Residency Rotations 658385 Brown University PO Box 1911 Providence RI 02906 Shared Chair 560424 EI US LLC PO Box 4110 Woburn MA 01888 Academics 201440 6 1506548 345900 1852448 Inpatient Routine 622210 48823614 48823614 Partial Hospitalization 622210 22298970 22298970 Research 541700 8956206 8956206 Residential 623220 14179285 14179285 Special Purpose Funds 622210 995475 995475 815936 815936 96069486 1804915 1804915 0 0 0 6599152 4436992 2162160 2162160 2162160 0 0 0 0 101889009 96069486 3967075 X 2500 2500 0 0 0 583060 583060 0 50384924 48328985 2055939 2757623 2629749 127874 7886695 7631883 254812 3556404 3394944 161460 0 0 0 0 0 49453 49453 13788862 13795950 -7088 31628 31374 254 3303091 2323942 979149 0 0 1996926 1248866 748060 194101 186304 7797 0 234643 192914 41729 565688 90017 475671 0 3193438 2082 3191356 751932 751932 Purchased services 11398799 2874652 8524147 Other expenses 3222224 3097710 124514 Fundraising expenses 328892 328892 Bad Debt Expense 103589 103589 0 104334472 87270453 16735127 328892 175622 197137 2356750 3677536 1441783 1220955 11794817 11245445 0 0 0 170435 185532 4984019 3775199 63487825 28459630 34287582 35028195 13476748 15270434 7323970 7579248 23265211 23265211 0 45297747 45279493 144574684 146724385 6285484 6017254 15969255 14541058 3000000 3000000 10978631 13030398 36233370 36588710 X 42916377 42686048 65424937 67449627 108341314 110135675 144574684 146724385 X -2445463 2556137 265956 1417731 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8140 X false 86248062 13574492 4437729 15443527 88816756 89986465 21483958 -11091876 14130485 86248062 77657734 10830772 13230965 11733006 89986465 70079480 13349949 1707082 7478777 77657734 71532423 8706364 -680240 9479067 70079480 true true true 4000 4000 45802592 20708351 25094241 13500830 7751279 5749551 4180403 4180403 35028195 7579248 23265211 Deferred Financing Costs 95351 Donated Art 8140 Interest in NA of Bradley Hospital Fndtn 1485326 Other non-current Leases 35772 Participation in HBCS Net Assets 7800 Right-of-Use Assets,Net Operating Leases 945243 45279493 Accrued Pension Liability 1995900 Health Care Benefit Self-insurance 734471 Intercompany Liabilities 9190782 Lease Liabilities 981015 Other Long-term Liabilities 53500 Third-party Payor Liabilities 74730 13030398 X Part III, Line 4: Description of organization's collections and how it furthers its purpose. EPBH's collection of artwork consists of paintings, a sculpture, and a vase. The works of art are displayed throughout EPBH for the viewing pleasure of patients, visitors, and employees. Part V, Line 4: Intended uses of the endowment fund. EPBH's endowment funds consist of both donor-restricted endowment funds and funds designated by EPBH to function as endowments. EPBH receives support from various irrevocable outside trusts within its endowment funds, most notably 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, 2022, the market value of the Trusts was approximately $32.9 million (not including land and the original Laufer Building in East Providence, Rhode Island where EPBH is located). As a result of a court order in 2007, the Trusts were authorized to make annual distributions to EPBH 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 and beyond.EPBH's largest temporarily restricted fund as of September 30, 2022 consisted of a $600,000 donation from Bradley Hospital Foundations yearly gala, that will support the creation of a splash pad and play area on the EPBH campus. EPBH's second largest fund of $451,335 supports the Healing Arts program that provides creative and therapeutic activities that improve and enhance the physical, mental and emotional well-being of patients by offering a wide variety of visual art projects, performance arts and musical programs.EPBH also has a Childrens Psychiatry Directors fund that has $420,565 available for staff recruitment and academic support for Childrens Psychiatry programs.The Samuel Swan Trust supports a fund of $412,220 that has been established for the maintenance and repair of the Swan House and general support for EPBHs programs. And another of EPBHs temporarily restricted funds, The Family Support fund has $375,617 dedicated to helping with emergency needs of EPBH patients families. Part X : FIN48 Footnote EPBH and its affiliate, Lifespan School Solutions, Inc., are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and are exempt from Federal income taxes pursuant to Section 501(a) of the Code. EPBH recognizes the effect of income tax positions only if those positions are more likely than not to be 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. EPBH did not recognize the effect of any income tax positions in either 2023 or 2022. true true true X true X true true true false true true 32951 41949 -8998 55613671 48118841 7494830 0.08598 55646622 48160790 7485832 0.08598 114597 13032 101565 0.00117 2553525 276891 2276634 0.02612 9700001 6892012 2807989 0.03221 9010910 7443910 1567000 0.01798 11952 11952 0.00014 21390985 14625845 6765140 0.07761 77037607 62786635 14250972 0.16359 true 55959 X true true 1 1 Emma Pendleton BradleyHospital 1011 Veterans Memorial Parkway East Providence RI 02915 https://www.bradleyhospital.or HOS00123 X X X Emma Pendleton BradleyHospital 1 false false true X X X X X X X X X X 22 true true false true X See Schedule H, Part V, Section C X true 22 true See Schedule H, Part V, Section C false false true X 200.0000 300.0000 X X X X X X true true X X X X true X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X X X X X X X true X false X X X X true X false false Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 3j Part V, Line 3e- The significant needs identified in EPBH's 9/30/2022 CHNA have been prioritized in order of significant needs of the community, as determined by the organization.On February 27, 2020, the first case of COVID-19 was confirmed in Rhode Island, moving the nations smallest state onto the worldwide coronavirus map. After that date, cases began to increase quickly throughout the state. The first stay-at-home order was issued on March 20, 2020, requiring all Rhode Island residents to stay at home unless getting food, medicine, or other essentials. Originally scheduled to remain in effect until April 13, the order also banned gatherings of more than five individuals and required out-of-state visitors to quarantine for 14 days. As cases increased, Governor Gina Raimondo announced on April 23 that schools would remain closed for the rest of the academic year. Many hospitals also postponed elective and non-emergent procedures until a later date. By April 28, 2020 hospitalization rates were at their first all-time high at 373, with 88 of these patients in the ICU and 59 on ventilators. Eventually, hospitalization rates and case numbers began to decrease, reaching a low on July 7, 2020 with only 58 Rhode Islanders hospitalized due to COVID.During the month of July 2020 the state started to slowly re-open allowing some beaches, restaurants, and entertainment businesses to resume operations (with minimum capacity), and hospitals to begin performing elective procedures again. By fall, most schools were also able to open again. After an increase in COVID-19 cases in November 2020, Raimondo announced a statewide pause reclosing many bars, gyms, and recreational venues.30 By December 15, 2020, hospitalization rates reached a high of 514 in-patients.After this peak, rates slowed for a period, partly due to the distribution of vaccines that started in February 2021 with doses initially being offered to individuals aged 75 and older. After first distributing the vaccine to those most at risk, Rhode Island gradually allowed other groups of residents to register. As of the writing of this report (June 2022), 98.5% of the Rhode Island population is at least partially vaccinated; 83% have completed their primary series; and 41.2% have received boosters. These statistics vary depending on age, gender, and race. For example, 99% of residents between the ages of 70 and 79 have received their primary COVID-19 vaccine series while those between 19 and 24 have a lower primary vaccination rate of 62.2%. As of April 10, 2021, approximately 68.5% of the states partially vaccinated population identified as white and less than 5% identified as Black.On July 20, 2021, hospitalization rates hit another low when only 23 patients were inflicted with COVID. However, as the season changed to winter, rates spiked again with a new all-time high of 618 inpatients on January 17, 2022. Despite this being the highest record of hospitalizations, the greatest number of COVID-related fatalities still occurred at the beginning of the pandemic.Since the beginning of 2022, COVID-related rates have decreased, with a slight increase as of the drafting of this report (June 2022). Overall, the town of Central Falls has the highest rate of COVID cases in the state, ahead of Pawtucket, East Greenwich, and Providence (respectively at 2nd, 3rd, and 4th place). In contrast, the towns of Little Compton and Jamestown have the lowest COVID rates and related hospitalizations. Across the state of Rhode Island, over 8 million COVID tests have been administered; approximately 400,000 positive cases have been reported; and over 3,500 COVID-related deaths have occurred. Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 5 The CHNA process involved the integration of information from a range of data sources to identify the significant health needs of the community served by EPBH, prioritization of those needs, and identification of resources, facilities, and programs to address the prioritized needs. Both qualitative primary data and secondary quantitative data were gathered to identify the significant health needs of the community.Primary data sources used for this report include community health forums, individual surveys, and key informant interviews. Secondary data sources include national and local publications of data that is specific to the state of Rhode Island and the EPBH service area.Community Health ForumsQualitative data was collected through Community Health Forums (CHF) to solicit input from individuals representing the broad interests and perspectives of the community. Community forums are a standard qualitative social science data collection method, used in community-based or participatory action research. Participants in the CHF included members of the medically underserved, low-income, and minority populations in the EPBH service area.Four CHF were held between May 3 and June 1, 2022, across the EPBH service area, with 71 participants. Participants were recruited using social media, electronic newsletter, email, and word of mouth. A mix of in-person and virtual (Zoom) forums were scheduled at easily accessible locations and at various times of the day. In-person EPBH forums were held at a public library and a substance use treatment and support center. At each in-person forum, a full meal was provided, along with childcare and interpretation if requested in advance. All CHF were open to the public and participants were engaged in a 90-minute discussion. In lieu of the provision of a meal, five $25 grocery store gift cards were raffled off as an appreciation of participation at each virtual forum.A community outreach representative of EPBH served as a hospital liaison to help plan and facilitate the CHF. The hospital liaison was a critical link between the LCHI as the coordinating body, the expertise and resources within the hospital, and the Community Liaisons described below.An important and unique component of the CHF was the involvement of Community Liaisons. Two people representing the diverse populations served by EPBH were hired as consultants to assist with the CHNA. These Community Liaisons helped plan the CHF, recruited participants, and co-facilitated the forums. Community Liaisons were chosen through a competitive selection process and completed a 90-minute training prior to leading the CHF. The training included project planning tips, role-playing activities, conflict management tips, and logistical expectations. Community Liaisons were responsible for identifying an accessible community venue for each forum, selecting a food vendor and menu that would be appealing to the target audience, and co-facilitating the discussion at the CHF with their hospital liaison.Each in-person CHF was two hours in duration and began with a meal, followed by a 90-minute discussion, co-facilitated by the hospital and Community Liaison, that generated consensus on the participants health concerns, their prioritization of those concerns, and their ideas for how EPBH could respond to those concerns. Discussion began with a brief presentation of EPBHs 2019 CHNA priorities and examples of activities the hospital has performed in response. Participants were invited to share their reactions to what was presented as well as their current health concerns. Virtual forums were 90 minutes in duration and followed the same discussion format as the in-person CHF. The input gathered during the CHF was assessed qualitatively to extract themes and quantitatively to determine the frequency with which those themes were cited. Community Liaisons also met with the LCHI and the hospital liaison to debrief the forums and offer their interpretation of the findings to ensure all input was captured and that priorities were appropriately aligned.Hiring, training, and empowering community members to serve as Community Liaisons in the CHNA process enriched the quantity and quality of community input. It also allowed EPBH to build relationships with communities that might not otherwise have become aware of or engaged in the needs assessment process.Individual SurveysTo broaden the reach of community input, an online survey was promoted, and paper surveys were distributed and collected by LCHI staff at community events they attended in June 2022. The surveys addressed the same questions as the CHF. Eleven individual surveys were received for EPBH. Key Informant InterviewsPublic health and health policy leaders who could inform the 2022 CHNA process and had knowledge, information, or expertise about the community that EPBH serves were invited to be interviewed as part of the CHNA. Key informant interviews were conducted with these leaders to supplement the other quantitative and qualitative data collected. Key informants included: Chief Strategy Officer, Executive Office of Health and Human Services, State of Rhode Island; Director of Policy, Planning and Research, Executive Office of Health and Human Services, State of Rhode Island; Director, Health Equity Institute and Maternal and Child Health, Rhode Island Department of Health; Vice President and Chief Medical Officer, Providence Community Health Centers; Executive Director, Rhode Island Parent Information Network; Director, Community Health Worker Association of Rhode Island; and Executive Vice President and Chief Medical Officer, Blue Cross Blue Shield Rhode IslandThe key informants identified the following statewide health priorities, with the first three named by multiple leaders: Apply hospital resources to address the social determinants of health, including housing, food, transportation, and employment, among other barriers to care. Improve access to behavioral health care for children and adults, especially noting access challenges for children and the burden of substance misuse among adults. Ensure the provision of equitable care with particular attention to ensuring equal access to high quality care for persons regardless of their race, ethnicity, language spoken or disability status. They noted that equitable care also required a workforce representative of the patients and implementation of the principles of anti-racism. Improve access to primary and specialty care locally. Grow the healthcare and behavioral health workforces through career pathways, higher reimbursement rates, and increased compensation. Improve access to community-based services including home-based therapeutic services for children with special needs. Reduce racial and ethnic disparities in maternal and child health.The interviewed leaders noted several opportunities for hospitals to contribute to efforts to address these goals including: innovate around care delivery models for behavioral health services for adults; invest in systems and technology to facilitate improved care coordination between primary and specialty care, as well as hospital and community-based providers; partner with state and community-based agencies on workforce development pathways for high-demand roles- notably behavioral health providers and community health workers; provide assistance to patients to help them navigate the healthcare system; and sustain access to telemedicine that was made available during the peak of the COVID-19 pandemic.EPBH Patient Data, Calendar Year 2021Lifespans Planning Department analyzed EPBH patient data on patients, admissions, and encounters was disaggregated by town of residence, age, race, ethnicity, language spoken, gender, and payor mix for calendar year 2021. This inpatient and outpatient data is important for understanding trends in utilization of hospital services. Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 6a Newport HospitalRhode Island HospitalThe Miriam Hospital Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 11 EPBH's Community Health Needs Assessment issued for the fiscal year ended September 30, 2022 identified four significant health issue areas requiring a further implementation strategy. Those significant health issue areas include: (1) community education and prevention; (2) access to treatment services; (3) navigation assistance and referrals to community services; and (4) parent training on mental health topics. The implementation strategy to address those significant health needs outlined between October 1, 2022 - September 30, 2025 is available at: https://www.lifespan.org/sites/default/files/2023-04/2022-EPBH-CHNA-Implementation-Plan.pdfDuring the fiscal year ended September 30, 2020, EPBH implemented the specific actions listed below in order to address the significant community health needs outlined in its CHNA Implementation Strategy issues February 11, 2020.Offer Mental Health First Aid in English and Spanish to the general population and school staff: A total of 55 classes (27 adult; 28 youth) were offered in the community, resulting in 775 people certified in Mental Health First Aid. Providence Public Schools and Mentor Rhode Island trained the required minimum 10% staff in Youth MHFA to begin implementing teen MHFA. Mentor RI held their first teen MHFA class in October 2023, certifying 8 youth from their Juvenile Justice Initiative program.Continue to offer annual Parenting Matters Conference and Workshops: A Parenting Matters Workshop was held on December 15, 2022; The Annual Bradley Hospital Parenting Matters Conference was held Saturday, April 1, 2023. The Parenting Matters Conference also included several additional workshops related to sections of Community Education and Prevention, Transition Support, Navigation Assistance and Referral to Community Resources, and Parent Training on Mental Health Topics. On July 13th, 2023 the Bradley Hospital Parent Support Group Special Education Workshop was held. Bradley offers monthly Hospital Parent Support Group Meetings and the Bradley Hospital Family Liaison Program Referral and Resource Information. All workshops are free and open to the public.Offer educational programs on behavioral health topics identified in EPBHs CHNA for professionals who work with school age children: BLE presented 113 Professional development trainings for over 30 different school districts, community health centers, colleges and organizations throughout RI, CT & MA. The BLE trained approximately 2,300 individuals. Some of the most frequently requested trainings/topics were: Trauma Informed Care/Trauma Sensitive Schools; De-Escalation training; The Hidden Message: Understanding Challenging Behavior /Managing Transitions Creating a Softer Classroom/Calming Corner; Autism Thinking and Autism focused trainingsIncrease access to suicide prevention programming through schools: BLE presented 38 Suicide Prevention trainings in 15 different school districts, community health centers, Colleges and organizations throughout RI & MA. BLE trained approximately 2100 individuals in Suicide Prevention.Collaborate with Newport Hospital (NH) to increase supports for adolescents on Aquidneck Island: Bradley Access continues to coordinate with the NH Emergency Department when they have patients in need of inpatient admission. We monitor availability of inpatient beds and facilitate transfers from NH to Bradley as quickly as possible. KidsLink received 113 calls from Aquidneck Island during fiscal year 2023 (based on callers who gave location information). We maintain a statewide Community Resource list that staff use for referrals. We currently have 6 providers from Aquidneck Island on the list.Promote the Pediatric Psychiatry Resource Network (PediPRN) to family physicians and KIDS Link (a hotline for children in emotional crisis) to parents: 49% of PediPRN consultations included assisting PCPs with assessing LOC and referral resources for appropriate LOC for their patients with BH concerns. PediPRN fielded 222 consultations and participated in training approximately 89 pediatric primary care providers and 19 other pediatric providers (affiliated with pediatric practices on BH related topics to facilitate their confidence and competence in addressing the BH needs of their patients over the course of 12 trainings. Provision of mental and behavioral health services to children and parents without requiring in person appointments. PediPRN consultations addressed BH service needs of over 170 children via their primary care provider. PediPRN has a video library on child BH topics on its website. We also have additional valuable resource information for PCPs on childrens behavioral health.Increase utilization of Bradley REACH (Remote E-therapy for Adolescents and Children) Program), a groundbreaking program to expand virtual access to psychiatric programs for children & adolescents: Bradley REACH virtual PHP program treated 134 patients in four states: RI, MA, CT & FL. The REACH program opened in FL in spring 2023, marking the first time that Bradley Hospital has provided care to patients located outside New England. The Apalachee Center, our partner organization in FL is located in an area of extremely high behavioral health workforce shortage (only 3 child and adolescent psychiatrists in the counties they serve) meaning that the high-quality virtual workforce we provide is of huge value to these communities. Attendance in the program was 95.3% which testifies to the fact that the accessibility of Bradley REACH means that patients are getting a higher dose of treatment because the program makes care accessible in their own homes and communities. Youth Outcomes Questionnaire (YOQ) data shows that the REACH program is taking children from a level of acuity where they might need inpatient care, to close to the average level of acuity for outpatient care. This is supported by the fact that 86.6% of patients discharged to outpatient or home-based services in this period. Only 5.2% of patients discharged to the ED or inpatient care, demonstrating that Bradley REACH is keeping acute adolescents out of higher levels of care. In FY23 Bradley REACH grew its profile by launching a website which had over 10,000 page views since January 2023. In April 2023 we launched a blog with information on mental health aimed at families. By the end of September 2023, we had published 21 blogs on topics including social media, parenting teens, autism, telehealth, trauma and suicide. We also launched our social media platform where the information is targeted at families. In FY23 Bradley REACH also facilitated consultations with 9 hospitals or health care providers who visited or consulted with our teams virtually to learn more about the quality care that Bradley provides and our continuum of care. These providers came from as far away as Australia, Kansas, Utah, Michigan and Missouri. Five of these consultations focused on Bradleys Center for Autism and Developmental Disabilities (CADD) and 4 focused on the medical psychiatric program at Hasbro.Improve access to language interpretation to facilitate access for patients who speak a language other than English: In the last fiscal year, we have hired one social worker who can provide clinical care in Spanish. MiGente Program has hired 2 research assistants and 1 Post-Doctoral Psychologist who are also Spanish speaking. Provide transition supports to adult care/services: Clinic social worker leads our transition services. She spends approximately 30% of her time assisting families with the transition process. Primary role is meeting with families who have children with ASD and other developmental challenges who receive care at Bradley, to review transition planning needs, and providing ongoing assistance, as needed, to families as their children transition into adult services. While initial meetings with families can often be billed, much of the follow up is funded by Verrecchia clinic through the familys generous philanthropy. The Social worker provides training and support to clinicians throughout the hospital when they have questions or need guidance regarding transition services and supports; accepts referrals from providers outside of Bradley and will meet with the families to introduce considerations for all the above.; serves as liaison to many agencies who provide home based care, to identify available services for children/young adults and their families; and provides education to psychiatry trainees regarding the transition process.Offer a menu of web-based, distance learning, and in-person educational programs through Bradley Learning Exchange: Currently there are more than 30 courses available online provided by Bradley faculty. All courses and CME/CEUs are free of charge. Courses have been completed by learners in all 50 states, 44 international countries representing 1,000 learners. In FY23 there were 6 Presentations with approximately 200 participants mostly regionally. The most pop Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 16j An abbreviated version of EPBH's Financial Assistance Policy is posted in various admitting and outpatient areas of EPBH. 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. Bradley Research Center 1 Hoppin Street Providence RI 02903 Research Facility The Bradley Center Proprietary Cranston RI 02920 Residential Program Compass Lincoln House Proprietary Lincoln RI 02865 Residential Program Exeter House Proprietary North Providence RI 02911 Residential Program Heritage House Proprietary Warwick RI 02888 Residential Program Hill House Proprietary Exeter RI 02911 Residential Program Rumford House Proprietary East Providence RI 02916 Residential Program Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) EPBH uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at EPBH 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 EPBH.)4. Uninsured patients receive an automatic deduction at EPBH equal to the amount calculated using the prospective method, referred to as amounts generally billed by Medicaid.5. Eligibility for CFS above amounts generally billed 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 three times the poverty level in effect at the time of application. Full charity care applicants with assets worth more than $9,400 for an individual (or $14,100 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, a charity care discount equal to or more favorable than Amounts Generally Billed (AGB), which is the maximum amount EPBH would bill a patient qualifying for assistance under EPBH's Financial Assistance Policy (FAP). 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 EPBH'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 AGB discount) if the balance is under $5,000 and 50% to 100% of estimated charges (net of the AGB discount) if the estimated bill equals or exceeds $5,000.Patients who do not qualify for 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 $50.00.4. 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 the 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. Part I, Line 6a - Related Organization Community Benefit Report The community benefit report for all Lifespan affiliated hospitals (EPBH, The Miriam Hospital, Rhode Island Hospital, and Newport Hospital) is maintained by Lifespan Corporation and included in Lifespan's annual report. The annual report for the year ended September 30, 2022 is available at the following link. https://www.lifespan.org/sites/default/files/2023-08/LS-Annual-Report-2022-230816.pdfPlease see pages 5-6, 10, 30, and 38-39 of the Lifespan Annual Report for community benefit information.The annual report for the year ended September 30, 2023 is not yet available at:https://www.lifespan.org/sites/default/files/2024-08/LS-Annual-Report-2023-final-8-6-2024.pdf Part I, Line 7 - Explanation of Costing Methodology EPBH'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 charges.Patient costs reported in the cost accounting system are calculated based on Medicare principles of reimbursement by reducing total operating expenses (as calculated per Form 990 requirements) 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 EPBH's Community Health Services Department. Revenue received for these services is reported as direct offsetting revenue. f) Health professions education- Health professions education expenses represent direct costs related to amounts associated with resident and intern programs utilized at EPBH. g) Subsidized health services- Subsidized health services' community benefit expense is determined by EPBH's internally developed allocation model based on the general ledger whereby overhead costs are applied to all direct care departments using a historically determined basis. This expense is adjusted to remove all related bad debt, Medicaid, and charity costs already reported in the applicable sections of Line 7. Net patient service revenue is recorded as amounts received from various payer types related to these services.h) Research- EPBH conducts extensive medical research focused on child and adolescent mental health concerns and brain science. For all internal and external research conducted, the costs associated with these activities are calculated by combining the direct and indirect costs as calculated by EPBH'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 community benefit contributions are incurred by EPBH, including an allocation of contributions made by Lifespan Corporation on EPBH's behalf. 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 $103,589. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense The 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 EPBH'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. There was $103,589 of bad debt recorded by EPBH during the fiscal year ending September 30, 2023. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit Accounts pending transfer to bad debt are reviewed by EPBH's Patient Financial Advocate staff to determine qualification for financial assistance under EPBH's policy. Accounts with insufficient information to determine eligibility are assigned a separate identifying code. These accounts are ultimately transferred to bad debt if the appropriate qualifying documentation is not received. During the year ended September 30, 2023, there was no bad debt attributable to patients whose eligibility for financial assistance could not be determined. Part III, Line 4 - Bad Debt Expense Due to the adoption of ASU No. 2014-09 in 2019 - Revenue From Contracts With Customers (Topic 606), bad debt expense is no longer reported in the audited financial statements as a separate line item, but rather is treated as a price concession. EPBHs adoption of the ASU did not materially change the timing or amount of revenue recognized. However, the ASU requires that patient service revenue be presented in the statement of operations and changes in net assets at the transaction price, i.e., net of any provision for bad debts. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients EPBH 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 copayments, deductibles, and amounts denied by insurers. After all collection attempts are exhausted, any remaining balances, including any copayments and deductibles, are written off as bad debts. EPBH classifies its bad debts as uncompensated care. This does not apply to Medicaid, however, as there are no associated copayments or deductibles for this payor.EPBH generally 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 communicating and 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 charity care.* If the patient does not qualify for charity care, 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's guardian. Part VI, Line 2 - Needs Assessment EPBH 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. EPBH is designated as a major teaching affiliate for The Warren Alpert Medical School of Brown University, with a focus in areas of child and adolescent psychiatric treatment.In recent years, EPBH has increased the number of physicians on staff in response to a heightened demand for outpatient services.As a psychiatric and behavioral health center, EPBH 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.EPBH 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 Rhode Island and its surrounding communities. EPBH 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, EPBH 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.EPBH respects the roles of parents/guardians as partners in their child's care. EPBH'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 EPBH's main lobby, outpatient waiting room, and at the various unit entrances.The Rhode Island 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. Part VI, Line 3 - Patient Education of Eligibility for Assistance EPBH provides each patient with a "Patient and Family Information" booklet which includes information on patient rights and responsibilities. There is also multilingual signage in EPBH'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 EPBH's website. Part VI, Line 4 - Community Information EPBH, whose primary location is in East Providence, Rhode Island, is a 70-bed, nonprofit teaching hospital with university affiliation providing for the psychiatric treatment of adolescents and children, including some with severe developmental disabilities. EPBH operates several major programs including acute, partial hospitalization, residential, and outpatient. EPBH also operates five other secondary sites which furnish residential and research services. EPBH is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). EPBH currently participates as a provider in Rhode Island Medicaid, various out-of-state Medicaid programs, and the State of Rhode Island's Department of Children, Youth and Families programs, as well as providing care for patients covered by private health insurers. EPBH is also a member of the formerly-named Voluntary Hospitals of America, Inc., which has partnered with UHC Alliance NewCo, Inc. to become Vizient, Inc., the largest member-owned health care company in the United States.In 1969, EPBH and certain other Rhode Island hospitals entered into an affiliation agreement to participate jointly in various clinical training programs and research activities with The Warren Alpert Medical School of Brown University (Brown). In 2010, Brown named Rhode Island Hospital its Principal Teaching Hospital. EPBH 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. EPBH participates in the Child and Adolescent Psychiatry Fellowship as well as the Triple Board Residency Program (Pediatrics/Psychiatry/Child and Adolescent Psychiatry).EPBH has a diverse service area which is not defined solely by a contiguous geographic grouping of municipalities. The combined service area of EPBH includes all of the cities and towns in Rhode Island and the neighboring states of New England. EPBH, 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, Line 5 - Promotion of Community Health EPBH is governed by a Board of Trustees, which is composed of leaders of the local community elected by Lifespan Corporation. EPBH's purpose is to be staffed, equipped, and ready to serve the pediatric health needs of the community and its people from all walks of life. EPBH works collaboratively with physicians, its employees, other health care organizations, and the community to create a measurably healthier community through the provision of high quality, cost-effective, customer-focused health care services in an environment that promotes patient safety. EPBH monitors the healthcare needs of its service area to ensure alignment of its resources with its mission. EPBH measures the results of the programs and services it provides based on the value added to the community as well as the financial health of each program and its impact on EPBH. EPBH is organized and operated for the benefit of the community it serves. Part VI, Line 6 - Affilated Health Care System Lifespan's mission is delivering health with care. Lifespan is an academically based healthcare system at the forefront of medical care, continually engaging in research that will lead to medical breakthroughs. Lifespan affiliates provide comprehensive inpatient and outpatient medical, surgical, and psychiatric services for adults and children. Lifespan and its affiliates employ approximately 16,500 people. The Lifespan system has approximately 3,900 physicians on the medical staffs of its affiliated hospitals, operates 1,165 licensed beds in four hospital complexes, and in 2022 generated approximately $2.8 billion in total operating revenue. By each of these measures, Lifespan is Rhode Island's largest health system, serving a population of about 1.1 million. Three of its hospital members, Rhode Island Hospital (RIH), The Miriam Hospital (TMH), and Emma Pendleton Bradley Hospital (EPBH), are teaching affiliates of The Warren Alpert Medical School of Brown University.Lifespan is a Rhode Island 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, 2022, Lifespan Corporation employed approximately 1,100 full-time and part-time personnel, most of whom are located in Providence, Rhode Island. Lifespan Corporation provides support services to its affiliates, such as information services, risk management, legal, communications and public affairs, fundraising, facility development, strategic planning, internal audit/compliance, human resources, finance, payor contracting, and investment management, for which each affiliate is charged a fee equivalent to the estimated 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, approve all managed care agreements, negotiate, develop, and approve affiliations with other institutions for educational and research purposes, and approve human resource plans, executive compensation, and benefits for system affiliates. The bylaws of EPBH confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination, and support of the system. Powers specifically reserved to Lifespan as sole member of EPBH include: to approve the amendment of the Articles of Incorporation and Bylaws and other Charter documents; to develop and approve strategic plans; to approve 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, Line 7 - States Filing of Community Benefit Report RI Part VI - Additional Information Form 990, Schedule H, Part V, Line 7a: The website which makes EPBH's CHNA report widely available is located at the following URL:https://www.lifespan.org/sites/default/files/2022-09/EPBHCommunityHealthNeedsAssessment2022.pdfForm 990, Schedule H, Part V, Line 10a: The URL to view EPBH's most recently adopted implementation strategy is below:https://www.lifespan.org/sites/default/files/2023-04/2022-EPBH-CHNA-Implementation-Plan.pdfForm 990, Schedule H, Part V, Line 16a: The URL to view and download EPBH's Financial Assistance Policy form is below:https://www.lifespan.org/sites/default/files/2023-04/2023_04_23_Lifespan-Financial-Assistance-Policy.pdfForm 990, Schedule H, Part V, Line 16b: The URL to view and download EPBH's Financial Assistance Policy application form is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/cfs-english_051920.pdfForm 990, Schedule H, Part V, Line 16c: The URL to view EPBH's plain language summary of the Financial Assistance Policy is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/Lifespan-Financial-Assistance-Summary_052020.pdf X true true X X X X X true true false false false false false true false Arthur J Sampson Trustee 412504 5192 18300 435996 David A Kirshner Treasurer-11/22 662492 194726 12141 8468 877827 Ellen M Hallsworth Dir. REACH 149830 10000 115 5491 165436 Eva Greenwood Treasurer 134109 50000 14864 27186 7729 233888 G Alan Kurose Fmr Trustee 589012 36227 11586 39196 24619 700640 Henry T Sachs III MD Pres. & CMO 382245 72078 79920 27847 562090 50060 Karyn J Horowitz MD Chief Medical Officer 304000 52896 20175 49009 30582 456662 Margaret R Paccione-Dyslewski PHD Dir. Behav. Ed. 162670 5131 10063 21520 199384 Mary A Carskadon PhD Physician 179083 4623 10877 11690 206273 Nicole A Nappe Clinical Mgr 152464 206 9560 28800 191030 Paul J Adler Secretary 616787 127319 116284 28760 889150 86715 Stephanie H D'Atri Dir. Early Child. 152403 195 9561 28822 190981 Susan Lantz Interim CNO 177521 511 10778 10484 199294 Timothy J Babineau Fmr Trustee 1010777 3000000 2442726 358564 24775 6836842 4007802 Ziya L Gokaslan MD Trustee 1511572 152000 7524 18300 31660 1721056 Part I, Line 1a: Relevant information in regards to selections on 1a. Tax Indemnification and Grossed Up Payments:The Lifespan Executive Long Term Disability program provides financial protection to designated Lifespan physicians and 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). Part I, Line 7: Non-Fixed payments not listed above Certain physicians and executives participate in incentive compensation plans arranged through individual contractual agreements which stipulate non-fixed payments based on meeting criteria comprised of various quality and productivity markers. A RIHEBC Series 2016 521300173 762244FP1 2016-08-11 24032741 Refund 2009 Bond false false true A 1162980 24032741 176876 23855865 2016 true true true true A false false false true true false false true A false true false false false false false true A false Part VI Schedule K, Part I, Line A(f):On August 11, 2016, the Rhode Island Health and Educational Building Corporation (RIHEBC) issued, on behalf of the Lifespan Obligated Group, which consists of EPBH, Rhode Island Hospital, The Miriam Hospital, Rhode Island Hospital Foundation, and The Miriam Hospital Foundation, $265,470,000 of tax-exempt fixed rate serial and term bonds (the 2016 Bonds) used for the purpose of refunding existing bonds issued to the Lifespan Obligated Group, as well as to pay certain expenses of issuance with respect to the 2016 Bonds. The portion of the 2016 Bonds' proceeds allocable to EPBH is $24,032,741. For purposes of EPBH, the 2016 issuance resulted in the complete refinancing of its RIHEBC Series 2009A Bonds. Schedule K, Part I, Line 3:The bond proceeds listed in line 3 differ from the bond issue price disclosed per IRS Form 8038 due to the fact that EPBH is part of the Lifespan Obligated Group previously mentioned in Part I, line A(f). Of the $308,112,067 disclosed in Form 8038, EPBH was allocated $24,032,741 of the total issuance. Form 990, Part VI, Section A, Line 2 Lawrence A. Aubin, Sr., Chairman, and Michael L. Hanna, Trustee, are partners in the same for-profit organization. Form 990, Part VI, Section A, Line 6 Lifespan is the sole member of EPBH. Form 990, Part VI, Section A, Line 7a Effective October 23, 2012, the Board of Directors of Lifespan and the Boards of Trustees of Rhode Island Hospital, The Miriam Hospital, Newport Health Care Corporation, Newport Hospital, and EPBH approved a restructuring of their governance. Effective July 1, 2013, Gateway Healthcare, Inc. joined the Lifespan health system on July 1, 2013 and adopted this restructured governance. The restructuring has increased governance effectiveness and has streamlined governance operation, as well as provided a single strategic perspective for the Lifespan system hospitals. Pursuant to the restructuring, the bylaws of each of the affiliates were amended such that the composition of the boards of trustees of each of the hospitals and Newport Health Care Corporation is defined as those persons serving from time to time as the directors of Lifespan. As a result, the Boards of each entity are comprised of the same individuals. The Board of each entity retains its responsibilities and authorities notwithstanding the revision in its composition. The Board of Directors of Lifespan consists of not less than fourteen nor more than thirty-one directors, including the President and CEO of Lifespan, who serves ex-officio with vote.Additionally, the bylaws of EPBH confer certain reserved powers upon 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 EPBH trustees and to approve the election or removal of certain officers. Form 990, Part VI, Section A, Line 7b The EPBH Board is comprised of the same individuals who serve on the Lifespan Board. 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, Section B, Line 11b The preparation and filing of the Form 990 and supporting schedules is the responsibility of the Executive Vice President & Chief Financial Officer (EVP/CFO) and Lifespan's Finance Department. The Form 990 is prepared by the accounting staff upon completion of Lifespan's annual independent audit and is reviewed by the Corporate Services Tax Compliance Manager and the Director of Finance. The draft Form 990 is then provided to the EVP/CFO for final management review. Prior to filing the return with the Internal Revenue Service, a copy of the entire form is posted to EPBH's Board of Trustees website portal in advance of its next Board meeting. At the time of the Board Meeting the 990 is presented by the Lifespan Director of Finance and EVP/CFO, at which time all questions and concerns of the members of the Board are addressed by the EVP/CFO and incorporated into the Form 990 when appropriate. Once the Form 990 is complete and ready to be filed, the members of the Board are notified via email that a copy of the final version of the Form 990 is accessible through the same password-protected website portal. The EVP/CFO is authorized to file the Form 990 Form 990, Part VI, Section C, Line 19 Lifespan and the Lifespan Obligated Group, which consists of EPBH, Rhode Island Hospital, The Miriam Hospital, Rhode Island Hospital Foundation, and The Miriam Hospital Foundation, currently make their 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 EPBH's Articles of Incorporation, Bylaws, and Conflict of Interest Policy are available upon request from the office of the Lifespan EVP/CFO, either in person or by mail. Form 990, Part XI, Line 9 Change in Funded Status of Pension Plan = $1353167 Form 990, Part XI, Line 9 Joint venture transfer = $152644 Form 990, Part XI, Line 9 Net Change in Foundation Assets = $0 Form 990, Part XI, Line 9 Net Change in Foundation Assets = -$88080 Form 990, Part III, Line 4a: EPBH provides inpatient treatment for children ages 2 to 18 years suffering from serious behavioral disorders and/or developmental conditions such as mental retardation or autism who are in need of stabilization, assessment, and treatment for suicidal, destructive, self-injurious, or other dangerous or aggressive behaviors.Residential treatment provides intensive, family-centered services to children with emotional and behavioral problems which prevent them from living safely at home.EPBH's partial programs furnish treatment alternatives to inpatient hospitalization or traditional outpatient services for children from infancy to adolescence with serious emotional, behavioral, eating, sleeping, anxiety, or obsessive-compulsive disorders, as well as relationship problems or a wide variety of other mental health issues co-occuring with substance use issues.The Center for Autism and Developmental Disabilities (CADD) has a highly specialized day program for children and adolescents who have autism or developmental disabilities with coexisting emotional and/or behavioral disorders. Form 990, Part III, Line 4c: Home-based intensive behavioral treatment is for children who have been diagnosed with Autism Spectrum Disorder (ASD) or 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. The Mindful Teen Program, a six-month outpatient treatment program for adolescents who display signs of suicidality, nonsuicidal self-injury, or other self-destructive behaviors, offers dialectical behavior therapy for adolescents (DBT-A), an empirically validated treatment designed to help eliminate life-threatening and self-destructive behaviors by developing alternative skills to manage emotions and tolerate distress.EPBH 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 EPBH, is used as a preventive measure against the future need for an out-of-home placement.EPBH'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 to 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. Form 990, Part VI, Section A, Line 1b: *Shivan S. Subramaniam, Trustee, is the Lead Director on the Board of Directors at Citizens Bank, N.A. During fiscal year 2023, Lifespan paid Citizens Bank, N.A.,in its normal course of business as part of Lifespan's accounts payable function.*Lawrence A. Aubin, Sr., Chair, and Michael Hanna, Trustee, are owners of New England Real Estate Holding Group, LLC (NEREHG), with which Lifespan has entered into an operating lease of a health care facility. During fiscal year 2023, Lifespan paid rent to NEREHG under the terms of its lease. Terms of the rent expense related to the lease have been established at fair market value.*Phillip Kydd, Trustee, has a family relationship with a principal owner of The Gemini Group. During fiscal year 2023, RIH paid The Gemini Group to provide business consulting and advisory services to RIH. Form 990, Part VI, Section B, Line 12c: Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including EPBH, 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. If the activity in question involves either the Chief Executive Officer, the Senior Vice President and General Counsel, or a Trustee, a full written disclosure must be made to, and a determination sought from, the Chairman of the Board of Directors of Lifespan Corporation.Annually, the Lifespan Compliance Officer shall review and report to the Lifespan Executive Corporate Compliance Committee and to the Lifespan Audit and Compliance Committee on the administration of this policy.Failure on the part of any designated person to comply with this policy, including failure to submit in a timely fashion the conflict of interest disclosure statement, will be grounds for removal from his/her position and/or termination of his/her employment with Lifespan. Form 990, Part VI, Section B, Lines 15 a&b: The following applies to Lifespan and all of its affiliates, including EPBH: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 both with law and with 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 Board members, is responsible for diligent oversight of executive compensation to ensure compliance with IRC requirements. Its duties include:* Approving eligibility for participation in the executive compensation program * Approving changes in compensation for existing executive participants * Approving guidelines, such as salary ranges and contract terms, on appropriate levels of compensation for other key employees* Approving new, and modifying or terminating existing, executive compensation plans including, but not limited to, annual incentive and executive benefit plans* Approving performance objectives associated with Lifespan's annual incentive plan, including measuring points, and using verified actual performance relative to these objectives as a precondition to approving the payment of any awards under the plan* Authorizing periodic performance benchmark studies to be conducted for purposes of assessing Lifespan's performance within the healthcare industry and the degree to which total remuneration levels at Lifespan are generally commensurate with Lifespan performance relative to healthcare industry performance* Conducting an annual performance review of Lifespan's Chief Executive Officer. The Chair of the Committee conducts and documents this review, based on his/her observations and interpretation of feedback from members of the Board of Directors.* 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. Lifespan's Chief Executive Officer works closely with the Committee to make recommendations on the above topics and keep the Committee informed about contemplated compensation changes for executives and other key employees, as well as candidates for these roles. The CEO also provides periodic updates to the Committee regarding Lifespan's performance relative to compensation-related performance objectives. The Committee's deliberations and actions are documented in minutes prepared for each meeting.PROCESS FOR DETERMINING COMPENSATION Valuation of Total Cash and Total Remuneration: No less frequently than annually, the Committee receives and reviews a total cash compensation valuation of all existing executive compensation program participants prepared by its independent compensation consultant. Annually, the Committee also receives and reviews a total remuneration valuation of all existing executive compensation participants. Base Salary Actions: The CEO recommends any salary adjustments for participants in the executive compensation program, using the results of the valuation study and his/her assessment of individual performance or other pertinent information, for the Committee's consideration.New Participants in Executive Compensation Program: With respect to compensation offers for individuals expected to participate in the executive compensation program, certain members of the Lifespan CEO's leadership team work with the Committee's independent compensation consultant or rely 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. 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