4A (Expenses $ 56747357 including grants of $ 0) (Revenue $ 62818157)
During the fiscal year ended September 30, 2022, NH reported 29,979 inpatient days, 4,995 discharges, 425 newborn deliveries, and 931 inpatient surgeries. NH provides a range of diagnostic therapeutic healthcare services including: behavioral medicine, cardiac services, obstetrics, orthopedics, pulmonary medicine, and cancer care. (See also Schedule O, Part III, Line 4a)

4B (Expenses $ 43378733 including grants of $ 0) (Revenue $ 62265702)
NH provides certain healthcare services on an outpatient basis. In fiscal year 2022, NH experienced outpatient volume of 32,088 equivalent outpatient days and performed 4,742 outpatient surgeries. Outpatient services are also provided in NH's Emergency Department, which had 29,254 patient visits in fiscal year 2022.(See also Schedule O, Part III, Line 4b)

4C (Expenses $ 4643263 including grants of $ 0) (Revenue $ 4633060)
"The Noreen Stonor Drexel Birthing Center (the Center) at NH delivered 425 newborns during the fiscal year ended September 30, 2022. The Center is a separate unit at NH for labor and delivery, enabling patients to remain in the same location for labor, delivery, recovery, and postpartum care. The Center's staff includes board-certified obstetricians, pediatricians, family practitioners, anesthesiologists, a certified nurse midwife, and registered nurses who have received national certifications in obstetrical nursing. The Center at NH has received the ""Baby Friendly"" designation from the World Health Organization and UNICEF."

Facility: Newport Hospital - Part V, Section B, Line 3j
Part V, Line 3e- 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 Newport Hospital, prioritize those needs, and identify the resources, facilities, and programs to address them. In order to identify the significant health needs of this community, primary quantitative and qualitative data and secondary quantitative data were collected. In addition, it is critical to highlight the context of the ongoing COVID-19 pandemic which has impacted the health concerns of the communities served by NH as well as the hospitals provision of health services.On March 1, 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 up again. After an increase in COVID cases in November, 2020, Raimondo announced a statewide pause reclosing many restaurants, gyms, and recreational venues. By December 15, 2020, hospitalization rates reached a high of 514 in-patients.After this COVID 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. In February 2021, NH offered a vaccination clinic to members of the general public. To assist with access and potential transportation issues, the vaccination clinic was held in the hospitals Borden Carey building, which is on a bus route and is accessible to public. 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.Like hospitals across the country, NH had to restrict or cancel services during the peak months of the pandemic and continues to experience staffing challenges. At NH and across the Lifespan system, several initiatives to recruit and retain talented team members were implemented, including sign-on bonuses and market adjustments for select positions, expanding our employee referral program, and introducing new resources to support employees total wellbeing. NH is also assessing the ways patients access care and how it can best meet the needs of our community into the future, while maintaining the hospitals financial stability. Following are examples of service line modifications as a result of the COVID-19 pandemic: NH outpatient cardiac and pulmonary rehabilitation, pulmonary medicine and dermatology programs discontinued operations. NHs acute inpatient Vanderbilt rehabilitation program expanded with the addition of 15 new patient rooms for a total of 28 newly renovated inpatient rooms. NHs new pharmacy not only provides prescription medications, but also offers over-the-counter medications. This new on-site pharmacy makes it convenient for patients to fill prescription when leaving the hospital for inpatient and outpatient visits. The newly renovated Lifespan Cancer Institute was conveniently relocated to the first floor of the hospital; the newly constructed area provides cancer patients with four new exam rooms and nine outpatient infusion bays.

Facility: Newport Hospital - 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 NH, 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 NH 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 CHFs included members of the medically underserved, low-income, and minority populations in the NH service area.Six CHF were held between May 9 and June 7, 2022 across the NH service area, with 86 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 NH forums were held at a senior center and two community centers. 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 fully engaged throughout the 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 NH 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 NH 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 2-hour 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 followed a similar format that 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 NH could respond to those concerns. Discussion began with a brief presentation of NHs 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 NH 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 (See Appendix E for the survey). Eight individual surveys were received for NH. 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 NH 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 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.NH Patient Data, Fiscal Years 2020-2022Lifespans Planning Department analyzed NH patient data on patients, discharges, and encounters was disaggregated by town of residence, age, race, ethnicity, and language spoken for fiscal years ending September 30, 2019 through September 30, 2021. This inpatient, outpatient and ED data is important for understanding trends in utilization of hospital services.

Facility: Newport Hospital - Part V, Section B, Line 6a
Rhode Island HospitalThe Miriam HospitalEmma Pendleton Bradley Hospital

Facility: Newport Hospital - Part V, Section B, Line 11
NH's Community Health Needs Assessment issued for the fiscal year ended September 30, 2022 identified five significant health issue areas requiring a further implementation strategy. Those significant health issue areas include: (1) access to primary care and specialty services; (2) access to mental and behavioral health; (3) outreach, education and navigation assistance to address health and social services;(4) establish a patient-family advisory committee; and (5) healthy aging. 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-NH-CHNA-Implementation-Plan.pdfFor implementation actions that NH took between October 1, 2019 and September 30, 2022, refer to the 2022 Community Healths Needs Assessment Newport Hospital, pages 13 - 22, which can be found at https://www.lifespan.org/sites/default/files/2022-09/NH2022CommunityHealthNeedsAssessment.pdf

Facility: Newport Hospital - Part V, Section B, Line 16j
An abbreviated version of NH's Financial Assistance Policy is posted in various admitting and outpatient areas of NH. Additionally, registration personnel refer uninsured and/or low-income patients to Patient Financial Counselors to discuss the policy and/or answer any questions they might have.

Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used)
"Newport Hospital (NH) uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at NH is intended to define probable eligibility for public assistance (Medicaid or Community Free Service (""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 W-2 form(s)- copies of most recent savings and/or checking account statements- two most recently received payroll check stubs- copy of rent receipts for the last six months for proof of residency- copy of utility bills for the last month for proof of residency3. If the patient's financial situation falls within the guidelines for eligibility for Medicaid, RIte Care, or CFS, or if the patient has a long-term disability, the appropriate application process is completed. (Assistance to complete such applications is available from the Patient Financial Advocates (PFA) Office at the Hospital.)4. Uninsured patients receive a discount equal to the discount received by Medicare beneficiaries on NH charges using the prospective method. Under Section 501(r)(5), the maximum amounts that can be charged to Financial Assistance Policy (FAP)-eligible individuals for emergency or other medically necessary care are the amounts generally billed to individuals who have Medicare insurance covering such care. In no case was there a situation where an uninsured patient paid more than amounts reimbursed from Medicare.5. Eligibility for CFS above the discount is provided for those applicants whose family gross income is at or below twice the Federal Poverty Guidelines, with a sliding scale for individuals up to 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 will qualify for discounted care. While the maximum 100% discount may not be available to all charity care applicants based on the results of their asset test, all uninsured patients who receive care are eligible for, at a minimum, the same charity care discount as provided by the Medicare program. 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 services for non-urgent care. 7. In either case, the final results of the financial screening are recorded in the comments section of NH'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 discounted charges if the balance is under $5,000 and 50% to 100% of estimated discounted charges if the estimated bill equals or exceeds $5,000.For elective or non-urgent cases, the policy will require financial clearance prior to services or an exception from the Medical Director based on the clinical circumstances if the patient cannot meet the above payment agreement.Patients who do not qualify for total or partial CFS, but who have difficulty in paying their bills after services are rendered, may request enrollment 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 (NH), Rhode Island Hospital (RIH), The Miriam Hospital (TMH), and Emma Pendleton Bradley Hospital (EPBH), is maintained by Lifespan Corporation and included in Lifespan's annual report. The annual report for the year ended September 30, 2021 is available at the following link. https://www.lifespan.org/sites/default/files/2022-05/LS-Annual-Report-2021-22-05-26.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, 2022 is not yet available for publication at the time of the filings of this tax return.

Part I, Line 7, Column F - Explanation of Bad Debt Expense
"The calculation of percentages disclosed in 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 provision for bad debts of $3,762,515."

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 NH's cost accounting system and is adjusted for 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.

Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit
Accounts pending transfer to bad debt are reviewed by NH's Patient Financial Advocate staff to determine qualification for financial assistance under NH'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. The amount reported on Schedule H, Part III, Section A, Line 3 represents the account balances at charge written off to bad debt from the pending code, which are in turn converted to cost by applying the RCC rate as identified in Schedule H, Part III, Section A, Line 2.

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. NHs 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 I, Line 7 - Explanation of Costing Methodology
"NH'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 NH's 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, 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.b) Medicaid- Medicaid expense is determined at cost as calculated by NH's cost accounting system. The system uses historical costing methods applied to all patient segments based on various patient demographics and utilizations. These costing standards exclude bad debt expense and charity care, which are reported on other areas of Line 7. These expenses include Medicaid provider taxes. Direct offsetting revenue is reported as amounts received from Medicaid, as well as other payments which include reimbursement under Federal ""Upper Payment Limit"" (UPL) and ""Disproportionate Share Hospital"" (DSH) programs.e) Community health improvement services and community benefit operations- Community benefit operations expense is recorded as direct expenses incurred as reported by NH's Community Health Services Department. Revenue received for these services is reported as direct offsetting revenue. g) Subsidized health services- Subsidized health services' community benefit expense is determined by NH's cost accounting system. These subsidized health services are recorded at cost in NH's cost accounting system for all qualified subsidized health service divisions. 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. Revenue associated with Medicaid is excluded from the amount disclosed for subsidized health services.i) Cash and in-kind contributions for community benefit- Expenses for cash and in-kind community benefit contributions are incurred by NH, including an allocation of contributions made by Lifespan Corporation on NH's behalf."

Part III, Line 8 - Explanation Of Shortfall As Community Benefit
Medicare shortfall has not been treated as a community benefit. The source of the Medicare allowable costs reported on Part III, Section B, Line 6 is the Medicare cost report, Form 2552-10.

Part III, Line 9b - Provisions On Collection Practices For Qualified Patients
NH 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 a bad debt. NH 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.NH 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. 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 Community Free Service.* If the patient does not qualify for Community Free Service, PFS or the pre-collect agency attempts at least four contacts with the responsible party within the first 120 days.* If the third-party carrier denies in writing any responsibility for payment, arrangements regarding an extended payment plan are discussed with the patient.* At 120 days, if there is no payment activity or no hold placed on the account, the account is transferred to the appropriate collection agency.

Part VI, Line 4 - Community Information
NH is the only hospital on Aquidneck Island and in Newport County, which comprises a population of approximately 82,000. Located in Newport, the southernmost town in Newport County, NH is approximately 20 miles from other hospitals; bridges link Newport and Aquidneck Island with the rest of the State of Rhode Island (two bridges to the west, one to the northwest, and one to the north). The community includes people on government assistance, working-class and middle-class constituents, U.S. Navy personnel and retirees, students from three colleges, and a small percentage of families of significant wealth. NH is also a member of Vizient, Inc., the largest member-owned health care company in the United States.

Part VI, Line 7 - States Filing of Community Benefit Report
RI

Part VI, Line 2 - Needs Assessment
NH continually assesses community needs in several ways. NH has a formal survey process for patient feedback but more importantly, NH uses a physician liaison position to facilitate physician communication with NH. Doctors in the community provide information on what services patients need. Recent examples of the usefulness of this information include NH's establishment of a wound care service, a dermatology practice, and a hand surgery practice. In addition, NH reviews volumes in service areas to glean information on the utilization of various types of care. NH functions as the first line of defense against illness, injury, and disease for its communities. With an Emergency Department that is open and staffed 24 hours a day with the ability to evaluate and treat everything from minor conditions to urgent care and stroke, as well as a dedicated, award-winning nursing staff that provides care for inpatients, NH's importance to the community cannot be overstated. NH is the designated disaster planning leader for its region of the State of Rhode Island and as such holds regular meetings and drills with first responders from the various municipalities within the region, as well as representatives from other facilities (e.g., nursing homes, hotels, and physician groups).Newport's significant seasonal patient population and large numbers of uninsured patients present financial challenges that NH strives to deal with each year as part of its mission. Uncompensated care provided to members of the community signals commitment to the residents and visitors of Newport County and its surrounding towns.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
"NH does not deny necessary medical treatment to anyone, regardless of insurance status or ability to pay. Financial counselors of NH inform patients personally about their potential eligibility for payment assistance. In addition, at such public events as health fairs, NH actively promotes financial assistance programs. When patients believe they might be eligible, financial counselors set up appointments to talk with them privately to determine their eligibility. Applications for financial assistance are provided in the registration office, the Emergency Department, the financial counseling office, and other departments providing care. As part of NH's inpatient intake process, NH provides self-pay patients with a summary of its Financial Assistance Policy, along with all assistance applications and the Patient Financial Services contact number. The same steps are used for patients seen during the outpatient discharge process. Attempts are made to contact patients prior to their visit to screen for financial assistance and to inform them what documents are required for their financial assistance determination, or to set up an appointment to see a ""Patient Financial Advocate"" (PFA) prior to service. PFAs discuss with patients the various government programs that might be available to them for financial assistance. PFAs also offer assistance with the financial application process and/or understanding the qualification factors for Medicaid, the Affordable Care Act, Medicare, Social Security Disability, the Supplemental Nutrition Assistance Program (SNAP), and Rhode Island Temporary Disability Insurance and Unemployment. This is done for both inpatient and outpatient services.Uninsured patients receive a discount on charges equal to the amount calculated using the Prospective Method, which is the amount that Medicare or Medicaid would allow for the care. Medicare patients may receive waivers of cost-sharing amounts if they qualify based on financial need; qualification is determined through an application for charity care. Further discounts may apply, depending on a patient's income level."

Part VI, Line 4 - Community Building Activities
NH connects with the community in several ways, both within NH's walls and at other venues. More than a dozen monthly support groups are held at NH, some facilitated by medical professionals and others by community members. An annual health fair provides hundreds of screenings for diseases and health conditions, and NH follows up with individuals whose tests identify a problem. Screenings for breast and prostate cancers are conducted free of charge at various times during the year.Several NH committees exist to provide interaction between NH and the community. NH supports community initiatives such as Rebuilding Together, an organization dedicated to helping those who are in dire need of home rehabilitation, and the Newport Partnership for Families, which coordinates community services that prevent child abuse and neglect for children at risk. In addition, NH has partnered with a major philanthropist to form a committee to oversee grants funded by NH to help children become active and healthy. The committee began distributing grants in 2011. Parenting and breastfeeding support are available through NH's Birthing Center, and a series of bimonthly presentations and lectures on relevant health topics is scheduled for the community to attend free of charge.

Part VI, Line 5 - Promotion of Community Health
NH is governed by a Board of Trustees, which is comprised of leaders of the local community elected by Lifespan Corporation. NH works collaboratively with physicians, its employees, other health care organizations, and the community to create a measurably healthier Newport County through the provision of high quality, cost-effective, customer-focused health care services in an environment that promotes patient safety. NH monitors the healthcare needs of its service area to ensure alignment of its resources with its mission. NH 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 NH. NH 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 NH 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 NH 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 - Additional Information
Schedule H, Part V, Line 7: The NH website which makes NH's CHNA report widely available is located at the following URL:https://www.lifespan.org/sites/default/files/2022-09/NH2022CommunityHealthNeedsAssessment.pdfSchedule H, Part V, Line 10a: The URL to view NH's most recently adopted CHNA implementation strategy is below:https://www.lifespan.org/sites/default/files/2023-04/2022-NH-CHNA-Implementation-Plan.pdfForm 990, Schedule H, Part V, Line 16a: The URL to view and download NH's Financial Assistance Policy 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 NH'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 NH's plain language summary of its Financial Assistance Policy is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/Lifespan-Financial-Assistance-Summary_052020.pdf