Community Benefit Insight - Tax-exempt hospital

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Roger Williams Medical Center F/k/a Roger Williams Hospital

Roger Williams Medical Center

825 Chalkstone Avenue
Providence, RI 02908

Bed count	220	Medicare provider number	410004	Member of the Council of Teaching Hospitals	YES	Children's hospital	NO

EIN: 050258959

Display data for year:

Community Benefit Spending- 2013
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

8.95%

Spending by Community Benefit Category- 2013
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2013

Additional data

Community Benefit Expenditures: 2013

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 1,447,860 1.32 %
Medicaid as % of operating expenses	$ 5,642,499 5.13 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 2,758,100 2.51 %
Subsidized health services as % of operating expenses	$ 0 0 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 0 0 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2013

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 2,378,540 2.16 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2022 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 1,755,601 73.81 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:

Reported to credit agency	YES
Filed lawsuit	Not available
Placed liens on residence	Not available
Issue body attachments? (an order by the court commanding a sheriff or other official to physically bring before the court a person who is guilty of contempt of court)	Not available

Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2013

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES
Did the tax-exempt hospital execute the implementation strategy?	YES
Did the tax-exempt hospital participate in the development of a community-wide plan?	YES

Supplemental Information: 2013

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 105950914 including grants of $ 0) (Revenue $ 154258643)
PATIENT HEALTHCARE SERVICES - ROGER WILLIAMS MEDICAL CENTER PROVIDES MEDICAL CARE TO PATIENTS, A MULTI-DISCIPLINARY APPROACH TO THE TREATMENT OF CANCER, SURGICAL SERVICES, DERMATOLOGY, DIAGNOSTIC IMAGING, LABORATORY SERVICES, GASTROENTEROLOGY, EMERGENCY ROOM FACILITIES AND OTHER ANCILLARY SERVICES PRIMARILY TO THE RHODE ISLAND COMMUNITY. *SEE SCHEDULE O*

4B (Expenses $ 0 including grants of $ 0) (Revenue $ 2488848)
DIRECT RESEARCH - ROGER WILLIAMS MEDICAL CENTER IS HOME TO SCIENTISTS, RESEARCHERS, AND INVESTIGATORS ACTIVELY INVOLVED IN A VARIETY OF MEDICAL RESEARCH ACTIVITIES. RESEARCH PROGRAMS ARE SUPPORTED BY FEDERAL FUNDS, EXTERNAL INSTITUTION GRANTS, AND OTHER SOURCES. AWARDS RECEIVED BY ROGER WILLIAMS MEDICAL CENTER AND ITS FACULTY INCLUDE PEER-REVIEWED GRANTS FROM THE NATIONAL INSTITUTES OF HEALTH AND OTHERS. CURRENT RESEARCH INCLUDES A MULTITUDE OF BASIC AND CLINICAL STUDIES IN CANCER, WHICH IS A PRIMARY INTEREST OF THE HOSPITAL. CURRENTLY, THERE ARE ONGOING TRIALS FOR A VARIETY OF CANCERS INCLUDING HEAD, NECK, BREAST, PROSTATE, GI, HEMATOLOGICAL MALIGNANCIES, AND OTHERS.

4C (Expenses $ 0 including grants of $ 0) (Revenue $ 0)
FREE CARE - PER THE MEDICAL CENTER'S PUBLIC NOTICE, ROGER WILLIAMS MEDICAL CENTER IS PROUD OF ITS COMMITMENT TO PROVIDE QUALITY CARE TO ALL INDIVIDUALS WHO NEED IT. THE MEDICAL CENTER PROVIDES FINANCIAL AID TO PATIENTS WITHOUT INSURANCE AND WHO MAY NOT BE ABLE TO PAY FOR THE CARE PROVIDED. *SEE SCHEDULE O*

Supplemental Information

Schedule H (Form 990) Part VI

part i, line 7
the costing methodology used to derive the amounts is from workesheet 2 and is based on patienr care cost to charges part iii, line 2 THE AMOUNT REPORTED ON PART III IS THE ACTUAL BAD DEBT EXPENSE REPORTED ON THE FINANCIAL STATEMENTS SCALED TO COST. THE COSTING METHODOLOGY IS THE SAME UTILIZED IN PART I, LINE 7. THE HOSPITAL QUALIFIES PATIENTS BASED ON THE MEDICARE PROGRAM 120 DAY RULE WHICH ENTAILS EACH PATIENT ACCOUNT RECEIVING THREE BILLING STATEMENTS. IF NO PAYMENT IS RECEIVED, THE PATIENT ACCOUNT IS PLACED WITH A COLLECTOR 120 DAYS AFTER THE INITIAL STATEMENT IS MAILED. BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE POLICY PART III, LINE 3 RWMC INTERNALLY TRACKS THE ACCOUNTS TRANSFERRED TO BAD DEBT AND IS ABLE TO DISTINGUISH THE PATIENTS WITH NO INSURANCE COVERAGE. OF THE ACCOUNTS WITH NO COVERAGE, THE BUSINESS OFFICE PROVIDES AN ESTIMATED PERCENTAGE OF THE ACCOUNTS THAT WOULD QUALITY FOR CHARITY IF THEY COMPLETED THE FREE CARE APPLICATION. BAD DEBT EXPENSE PART III, LINE 4 THE MEDICAL CENTER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE CHARITY CARE POLICIES WITHOUT CHARGE OR AT AMOUNTS LESS THAN THE ESTABLISHED RATES. BECAUSE THE MEDICAL CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE MEDICAL CENTER 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 MEDICAL CENTER 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-PATTY 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 MEDICAL CENTER 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.

PART III, LINE 8
NONE OF THE MEDICARE SHORTFALL HAS BEEN TREATED AS A COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS IS BASED UPON THE MEDICARE COST REPORT USING RCC (RATIO OF COST CHARGE) METHODOLOGY.

PART III, LINE 9B
ROGER WILLIAMS MEDICAL CENTER PROVIDES CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. OUR COLLECTION PROCESS PROVIDES PATIENTS WITH FOUR PROGRESSIVE BILLING NOTICES. ALL STATEMENTS INCLUDE A NOTICE OF AVAILABLE FINANCIAL AID. UNRESOLVED DEBTS ARE TRANSFERRED TO BAD DEBT (WITH NO PAYMENT ACTIVITY) AT DAY 120. AN OUTSIDE COLLECTION AGENCY IS USED FOR ADDITIONAL COLLECTION ACTIVITY. CLIENTS THAT QUALIFY FOR DISCOUNT/FREE-CARE WRITE-OFFS (BASED ON 200-300% OF FEDERAL POVERTY GUIDELINES AND LIMITED ASSETS) HAVE BALANCES REDUCED/WRITTEN-OFF BASED ON INFORMATION DOCUMENTED IN THE APPLICATION PROCESS. ANY BALANCES NOT COVERED BY THE FREE CARE PROCESS ARE BILLED FOLLOWING OUR STANDARD COLLECTION PROCESS.

INPUT FROM PERSONS WHO REPRESENT INTERESTS OF THE COMMUNITY
PART V, SECTION B, QUESTION 3 ROGER WILLIAMS MEDICAL CENTER AND ITS CHNA PARTNERS SOUGHT COMMUNITY INPUT THROUGH INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS, FOCUS GROUPS WITH HEALTHCARE PROVIDERS, AND INCLUSION OF PARTNER HOSPITAL REPRESENTATIVES AS WELL AS PUBLIC HEALTH OFFICIALS IN THE PRIORITIZATION AND IMPLEMENTATION PLANNING PROCESS. CHNA CONDUCTED WITH ONE OR MORE HOSPITAL FACILITIES PART V, SECTION B, QUESTION 3 ROGER WILLIAMS MEDICAL CENTER PARTICIPATED IN A STATEWIDE COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), LED BY THE HOSPITAL ASSOCIATION OF RHODE ISLAND (HARI), AND ITS MEMBER HOSPITALS: BUTLER HOSPITAL, KENT HOSPITAL, LANDMARK MEDICAL CENTER, MEMORIAL HOSPITAL, OUR LADY OF FATIMA HOSPITAL (ST. JOSEPH'S HEALTH SERVICES OF RI), PROVIDENCE VA MEDICAL CENTER, SOUTH COUNTY HOSPITAL, THE WESTERLY HOSPITAL, AND WOMEN AND INFANTS HOSPITAL. URL FOR CHNA PART V, SECTION B, LINE 5A HTTP://WWW.RWMC.ORG/FOR-PATIENTS/RWMC%20CHNA%20FINAL%20REPORT%202013.PDF AMOUNTS BILLED TO INDIVIDUALS WITH NO INSURANCE, PART V, SEC. B, LINE 20D PATIENTS WHO DO NOT HAVE INSURANCE ARE BILLED BASED ON THE HOSPITAL CHARGE MASTER. PATIENTS WHO QUALIFY FOR FULL OR PARTIAL FREE CARE WILL BE DISCOUNTED APPROPRIATELY.

GROSS CHARGE FOR SERVICES, PART V, SECTION B, LINE 22
THE HOSPITAL BILLS A LIMITED NUMBER OF PATIENTS WITH ADEQUATE FINANCIAL RESOURCES THE GROSS CHARGE RATE FOR UNINSURED MEDICARE SERVICES.

PART VI, LINE 2
ROGER WILLIAMS MEDICAL CENTER PARTICIPATED IN A STATEWIDE COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), LED BY THE HOSPITAL ASSOCIATION OF RHODE ISLAND (HARI), AND ITS MEMBER HOSPITALS. THE CHNA WAS CONDUCTED FROM SEPTEMBER 2012 TO MAY 2013. THE ASSESSMENT WAS CONDUCTED IN A TIMELINE TO COMPLY WITH REQUIREMENTS SET FORTH IN THE AFFORDABLE CARE ACT, AS WELL AS TO FURTHER THE HOSPITAL'S COMMITMENT TO COMMUNITY HEALTH AND POPULATION HEALTH MANAGEMENT. THE FINDINGS FROM THE ASSESSMENT WILL BE UTILIZED BY ROGER WILLIAMS MEDICAL CENTER TO GUIDE ITS COMMUNITY BENEFIT INITIATIVES AND TO ENGAGE PARTNERS TO ADDRESS THE IDENTIFIED HEALTH NEEDS. THE PURPOSE OF THE CHNA WAS TO GATHER INFORMATION ABOUT LOCAL HEALTH NEEDS AND HEALTH BEHAVIORS IN AN EFFORT TO ENSURE HOSPITAL COMMUNITY HEALTH IMPROVEMENT INITIATIVES AND COMMUNITY BENEFIT ACTIVITIES ARE ALIGNED WITH COMMUNITY NEED. THE ASSESSMENT EXAMINED A VARIETY OF COMMUNITY, HOUSEHOLD AND HEALTH STATISTICS TO PORTRAY A FULL PICTURE OF THE HEALTH AND SOCIAL DETERMINANTS OF HEALTH IN THE ROGER WILLIAMS MEDICAL CENTER SERVICE AREA. THE FINDINGS FROM THE CHNA WERE UTILIZED BY ROGER WILLIAMS MEDICAL CENTER TO PRIORITIZE PUBLIC HEALTH ISSUES AND DEVELOP A COMMUNITY HEALTH IMPLEMENTATION STRATEGY. ROGER WILLIAMS MEDICAL CENTER IS COMMITTED TO THE PEOPLE IT SERVES AND THE COMMUNITIES THEY LIVE IN. HEALTHY COMMUNITIES LEAD TO LOWER HEALTH CARE COSTS, ROBUST COMMUNITY PARTNERSHIPS, AND AN OVERALL ENHANCED QUALITY OF LIFE.

PART VI, LINE 3
INFORMATION ON THE ROGER WILLIAMS MEDICAL CENTER FINANCIAL ASSISTANCE PROGRAM IS COMMUNICATED TO THE PATIENT AT THE POINT OF REGISTRATION THROUGH SIGNAGE WITHIN THE HOSPITAL AND ON THE HOSPITAL'S WEBSITE HTTP//RWMC.ORG. FURTHERMORE, THE HOSPITAL HAS PATIENT FINANCIAL COUNSELORS' ONSITE TO EDUCATE PATIENTS ON THE FINANCIAL PROGRAMS THAT ARE AVAILABLE.

PART VI, LINE 4
ROGER WILLIAMS MEDICAL CENTER DEFINES ITS SERVICE AREA AS PROVIDENCE, NORTH PROVIDENCE, CRANSTON, LINCOLN, PAWTUCKET, EAST PROVIDENCE. IN THE MIDST OF ONE OF THE CITY'S OLDEST NEIGHBORHOODS, ROGER WILLIAMS MEDICAL CENTER IS A COMMUNITY-OWNED AND GOVERNED HEALTH CARE ORGANIZATION THAT PROVIDES SOME OF THE MOST ADVANCED SPECIALTY CARE AVAILABLE TODAY. THAT CARE IS ADMINISTERED ACROSS A VARIETY OF SETTINGS, BOTH ON AND OFF OF OUR CAMPUS: - IN THE EMERGENCY ROOM - IN OUR LABORATORY AND DIAGNOSTIC IMAGING CENTERS - IN THE HOSPITAL SETTING THROUGH INPATIENT AND OUTPATIENT SERVICES - AT YOUR RESIDENCE THROUGH OUR HOME CARE PROGRAMS - IN COMMUNITY PHYSICIAN OFFICES THROUGH OUR STATEWIDE CONTINUCARE PROGRAM - IN LONG-TERM CARE FACILITIES THROUGH OUR AFFILIATION WITH ELMHURST EXTENDED CARE - IN LOCAL NEIGHBORHOODS, BUSINESSES AND SCHOOLS THROUGH OUR COMMUNITY OUTREACH OVER THE YEARS, THE QUALITY OF OUR CARE HAS EARNED US MANY DISTINCTIONS. ONE OF THE MOST RECENT AND NOTEWORTHY IS OUR FORMAL AFFILIATION WITH BOSTON UNIVERSITY SCHOOL OF MEDICINE. THAT DESIGNATION GIVES US THE PRIVILEGE AND HONOR OF TEACHING FUTURE GENERATIONS OF PHYSICIANS IN THE LATEST MEDICAL PRACTICES. OUR ACADEMIC AFFILIATION ALSO ENSURES THAT INDIVIDUALS AND FAMILIES IN RHODE ISLAND HAVE ACCESS TO THE MOST UP-TO-DATE MEDICAL KNOWLEDGE, DIAGNOSTIC AND TREATMENT PROCEDURES. PARTICULARLY IN THE AREA OF CANCER CARE, OUR ACADEMIC RESEARCH EFFORTS, OUR EXPERTISE AND OUR MEDICAL PRACTITIONERS ARE ON A PAR WITH THE BEST IN THE COUNTRY. IN ALL SPECIALTIES, OUR COMMITMENT TO ADVANCING MEDICAL RESEARCH, APPLYING WHAT WE LEARN IN THE PATIENT SETTING, ADHERING TO THE STRICTEST PROTOCOLS, AND MEASURING CLINICAL OUTCOMES ENSURE THAT AS A PATIENT HERE, YOU RECEIVE THE HIGHEST STANDARD OF MEDICAL CARE.

PART VI, LINE 5
IN ADDITION TO ITS ACTIVITIES IN DELIVERING HEALTH CARE SERVICES TO THE COMMUNITY AS DESCRIBED ELSEWHERE IN THIS FILING, ROGER WILLIAMS MEDICAL CENTER (RWMC) FURTHERS ITS EXEMPT PURPOSES THROUGH THE FOLLOWING MEANS: A) RWMC IS MANAGED BY A COMMUNITY BOARD OF TRUSTEES, ON WHICH A SUBSTANTIAL MAJORITY OF TRUSTEES ARE RESIDENTS OF THE HOSPITAL'S EFFECTIVE MARKET AREA AND WHO ARE NEITHER EMPLOYEES OR CONTRACTORS OF THE HOSPITAL. B) WITH THE EXCEPTION OF CERTAIN DEPARTMENTS WHICH, IN THE INTERESTS OF EFFICIENCY, QUALITY AND PROPER ADMINISTRATION, ARE TRADITIONALLY RESERVED TO A SINGLE PHYSICIAN GROUP HAVING AN EXCLUSIVE ARRANGEMENT WITH RESPECT TO THE DEPARTMENT (IE RADIOLOGY, ANESTHESIA, AND PATHOLOGY), RWMC MAINTAINS AND OPEN MEDICAL STAFF THAT EXTENDS PRIVILEGES TO ALL QUALIFIED PHYSICIAN APPLICANTS WHO EXHIBIT THE PROPER TRAINING AND EXPERTISE TO SERVE THE HOSPITAL'S PATIENTS. C) THE ORGANIZATION TRADITIONALLY APPLIES ALL SURPLUS FUNDS TO ENSURING FINANCIALLY PRUDENT AVAILABLE FUNDS, CAPITAL MAINTENANCE AND IMPROVEMENTS, AND THE ADDITION OF SERVICES THAT BENEFIT THE COMMUNITY. RWMC AND ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND AFFILIATED IN JANUARY 2010 UNDER CHARTERCARE HEALTH PARTNERS. THE AFFILIATION PARTNERS BELIEVE THAT BY COMBINING THEIR COMPLEMENTARY STRENGTHS, THEY CAN SIGNIFICANTLY IMPROVE THEIR ABILITY TO MEET THE HEALTHCARE NEEDS OF THE REGION THROUGH MORE COORDINATION, IMPROVED EFFICIENCY, REDUCED FRAGMENTATION OF CARE, AND IMPROVED ACCESS FOR THE POOR AND UNDERSERVED PEOPLE IN CHARTERCARE'S EFFECTIVE MARKET AREA AND BEYOND. THE PARTIES RECOGNIZED THAT WHETHER THEY AFFILIATED OR NOT, CHANGE WILL AND MUST OCCUR IN THEIR ORGANIZATIONS IN LIGHT OF EMERGING CHANGES IN HEALTHCARE DELIVERY, AND CHANGES IN PUBLIC AND PRIVATE SYSTEMS FOR PAYING FOR HEALTH CARE. THE AFFILIATION BETTER POSITIONED THE TWO ORGANIZATIONS TO ADDRESS THE CHALLENGES AND TO MEET THE NEEDS OF THEIR COMMUNITIES.

PART VI, LINE 6
ROGER WILLIAMS MEDICAL CENTER (RWMC) IS PART OF CHARTERCARE HEALTH PARTNERS (CCHP), A COMMUNITY HEALTH SYSTEM THAT SERVES THE CENTRAL AND NORTHWESTERN SEGMENTS OF RHODE ISLAND. THE AFFILIATION OF RWMC AND ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND (SJHSRI) IN JANUARY 2010 TO FORM CCHP, ALLOWED BOTH HERITAGE HOSPITALS THE ABILITY TO COMBINE THEIR COMPLEMENTARY STRENGTHS, AND ALLOW THEM TO SIGNIFICANTLY IMPROVE THEIR ABILITY TO MEET THE HEALTHCARE NEEDS OF THE REGION THROUGH MORE COORDINATION, IMPROVED EFFICIENCY, REDUCED FRAGMENTATION OF CARE, AND IMPROVED ACCESS FOR THE POOR AND UNDERSERVED PEOPLE IN CHARTERCARE'S EFFECTIVE MARKET AREA AND BEYOND. RWMC'S AFFILIATION ALSO ALLOWS THEM TO WORK CLOSELY WITH SJHSRI IN THE CREATION OF DEFINED STATE RECOGNIZED CENTERS OF EXCELLENCE IN GERIATRICS, CANCER CARE, GASTROENTEROLOGY AND BEHAVIORAL MEDICINE. THE AFFILIATION OF THE TWO HERITAGE HOSPITALS HAS ALLOWED THEM TO INTEGRATE THE MENTIONED EXISTING SERVICES BETWEEN THE TWO HOSPITALS IN A MANNER THAT BEST SERVES THE EVER EVOLVING COMMUNITIES NEEDS AND IN A MORE INTEGRATED AND MORE EFFICIENT MANNER. IN ADDITION TO SHARING POLICIES AND PROCEDURES FOR BEST OPERATIONAL AND MANAGEMENT PRACTICES, SYSTEM HOSPITALS PARTICIPATE IN A CHARTERCARE QUALITY COMMITTEE. THE CHARTERCARE QUALITY COMMITTEE OVERSEES WORK DONE BY THE HOSPITAL QUALITY COMMITTEES AND HELPS PROMOTE THE WEALTH OF PERFORMANCE IMPROVEMENT AND QUALITY INITIATIVES IN EACH OF THE TWO HOSPITALS (OUR LADY OF FATIMA HOSPITAL AND ROGER WILLIAMS MEDICAL CENTER), ELMHURST EXTENDED CARE (AN EDEN ALTERNATIVE NURSING HOME), ROGER WILLIAMS HOME CARE AND THE SJHSRI CENTER OF HEALTH AND HUMAN SERVICES. THE QUALITIES COMMITTEES THAT OVERSEE CLINICAL PRACTICES WITHIN THE SYSTEM HAVE COMMUNITY REPRESENTATIVES OF THE BOARD OF TRUSTEE AS WELL AS REPRESENTATIVES FROM THE MEDICAL STAFF, NURSING, ADMINISTRATION AND THE QUALITY DEPARTMENTS. STATE FILING OF COMMUNITY BENEFIT REPORT RHODE ISLAND

Operating expenses	$ 109,983,169
Total amount spent on community benefits as % of operating expenses	$ 9,848,459 8.95 %