TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) CHARLES R REPPUCCI ESQ CHAIR - DIRECTOR	5.0	X	X	0	0
(2) ALLEN H CICCHITELLI VICE CHAIR - DIRECTOR	1.0	X	X	0	0
(3) STANLEY M ARONSON MD VICE CHAIR - DIRECTOR	1.0	X	X	0	0
(4) KEKIN A SHAH SECRETARY - DIRECTOR	1.0	X	X	0	0
(5) ROBERT G PADULA TREASURER - DIRECTOR	1.0	X	X	0	0
(6) PHYLLIS C FIELD ASST SECRETARY - DIRECTOR	1.0	X	X	0	0
(7) DEAN T HOLT ASST TREASURER - DIRECTOR	1.0	X	X	0	0
(8) WILLIAM J ALLEN DIRECTOR	1.0	X		0	0
(9) EARL D CHAMBERS DIRECTOR	1.0	X		0	0
(10) ROBERT E DEBLOIS DIRECTOR	1.0	X		0	0
(11) MARGARET D FARRELL ESQ DIRECTOR	1.0	X		0	0
(12) MICHAEL A FIORI MD DIRECTOR - PRESIDENT MED STAFF	25.0	X		75,536	2,526
(13) MICHAEL FOLLICK PHD DIRECTOR	1.0	X		0	0
(14) RABBI LESLIE Y GUTTERMAN DIRECTOR	1.0	X		0	0
(15) DENNIS B LANGLEY DIRECTOR	1.0	X		0	0
(16) DIANE LIPSCOMBE PHD DIRECTOR	1.0	X		0	0
(17) LEWIS P LIPSITT PHD DIRECTOR	1.0	X		0	0

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) MICHAEL M MATONE DIRECTOR	1.0	X			0	0
(19) MARY B OLENN DIRECTOR	1.0	X			0	0
(20) PATRICIA R RECUPERO JD MD DIRECTOR - PRESIDENT/CEO	55.0	X	X		688,067	305,680
(21) ARTHUR S ROBBINS DIRECTOR	1.0	X			0	0
(22) GARY R ST PETER ESQ DIRECTOR	1.0	X			0	0
(23) BONNIE BAKER CPA VICE PRESIDENT FINANCE/CFO	55.0		X		448,769	121,662
(24) WALTER DIAS VICE PRESIDENT/COO	55.0		X		415,255	96,562
(25) LINDA DAMON RN ARNP VICE PRESIDENT/CNO	55.0		X		313,560	65,561
(26) STEVEN A RASMUSSEN MD MEDICAL DIRECTOR	55.0		X		544,232	71,163
(27) JULIE FORREST MD PSYCHIATRIST	55.0			X	448,847	1,500
(28) LAWRENCE PRICE MD CLINICAL DIRECTOR	55.0			X	400,176	1,166
(29) MICHAEL STEIN DIRECTOR	55.0			X	342,372	18,952
(30) ALVARO OLIVARES MD UNIT CHIEF	55.0			X	331,292	18,252
(31) GHULAM SURTI MD UNIT CHIEF	55.0			X	324,099	16,752

(A) Name and business address	(B) Description of services	(C) Compensation
BROWN UNIVERSITY 24 CHARLESFIELD ST BOX T PROVIDENCE,RI02912	MEDICAL SERVICES	1,625,777
RHODE ISLAND HOSPITAL 1 HOPPIN STREET PROVIDENCE,RI02903	MEDICAL SERVICES	436,543
SODEXO INC AFFILIATES PO BOX 81049 WOBURN,MA01813	PROF. SERVICES	329,217
BOSTON MEDICAL CENTER 38 EAST NEWTON STREET BOSTON,MA02118	MEDICAL SERVICES	263,076
WARZYCHA CONSTRUCTION CO INC 51 ENFIELD STREET PAWTUCKET,RI02861	CONSTRUCTION	240,995
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 21

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21	455,250	455,250
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	3,148,573	2,833,715	314,858	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	46,552,466	41,591,190	4,621,243	340,033
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	1,940,911	1,746,820	194,091
9	Other employee benefits .......	8,202,452	7,326,738	814,082	61,632
10	Payroll taxes ...........	3,671,401	3,304,261	367,140
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	217,420	195,678	21,742
c	Accounting ...........	35,763	32,187	3,576
d	Lobbying ...........	6,044	5,440	604
e	Professional fundraising. See Part IV, line 17..	0
f	Investment management fees ......	0
g	Other ..........	1,872,796	1,672,249	185,804	14,743
12	Advertising and promotion ....	199,719	174,101	19,345	6,273
13	Office expenses .......	4,243,287	3,796,691	421,855	24,741
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	23,754	21,379	2,375
17	Travel ............	129,377	112,330	12,481	4,566
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	429,729	386,756	42,973
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	3,324,998	2,992,498	332,500
23	Insurance ..............	1,790,359	1,611,323	179,036
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	PURCHASED SERVICES	9,004,027	8,099,955	899,995	4,077
b	PROVISION FOR BAD DEBT	1,796,158	1,796,158	0	0
c	UTILITIES	765,888	689,299	76,589	0
d	DUES & SUBSCRIPTIONS	235,428	211,253	23,472	703
e	BANK FEES	44,704	40,234	4,470	0
f	All other expenses	6,865,420	6,178,878	686,542
25	Total functional expenses. Add lines 1 through 24f	94,955,924	85,274,383	9,224,773	456,768
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	9,737	1	21,752
2	Savings and temporary cash investments .......	16,044,271	2	16,361,744
3	Pledges and grants receivable, net .........	237,683	3	557,731
4	Accounts receivable, net .........	5,069,207	4	5,687,440
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............	3,222,898	7	4,071,228
8	Inventories for sale or use ..............	246,448	8	262,561
9	Prepaid expenses and deferred charges ............	458,165	9	471,650
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	64,478,506
b	Less: accumulated depreciation. .....	10b	42,663,412	22,172,744	10c	21,815,094
11	Investments—publicly traded securities ..........		11
12	Investments—other securities. See Part IV, line 11 ......		12
13	Investments—program-related. See Part IV, line 11 ..	26,878,222	13	34,331,232
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	2,320,592	15	2,639,730
16	Total assets. Add lines 1 through 15 (must equal line 34)...	76,659,967	16	86,220,162
	17	Accounts payable and accrued expenses .	10,403,530	17	10,004,744
18	Grants payable ..........		18
19	Deferred revenue ..........	246,142	19	1,210,287
20	Tax-exempt bond liabilities ..........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	5,527,234	23	5,231,806
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities. Complete Part X of Schedule D.....	20,577,437	25	35,058,768
26	Total liabilities. Add lines 17 through 25.....	36,754,343	26	51,505,605
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	20,287,343	27	15,461,497
28	Temporarily restricted net assets .....	17,195,224	28	16,823,913
29	Permanently restricted net assets .....	2,423,057	29	2,429,147
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	39,905,624	33	34,714,557
34	Total liabilities and net assets/fund balances .....	76,659,967	34	86,220,162

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

BUTLER HOSPITAL

Employer identification number

05-0258812

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2010

Name of organization

BUTLER HOSPITAL

Employer identification number

05-0258812

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization BUTLER HOSPITAL
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization BUTLER HOSPITAL
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
BUTLER HOSPITAL

Employer identification number

05-0258812

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below.
SchCMd Bullet

Attach to Form 990 or Form 990-EZ. SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

BUTLER HOSPITAL

Employer identification number

05-0258812

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities .................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2010

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check if the filing organization belongs to an affiliated group.
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated Group Totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots non-taxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2010

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? If "Yes," describe in Part IV ..........................

Yes

6,044

Total. lines 1c through 1i ...................................

6,044

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
LOBBYING ACTIVITIES	SCHEDULE C, PART II-B; LINE 1I	THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION ("AHA"). THE ORGANIZATION PAID $2,665 TO THE AHA AS THE PORTION OF MEMBERSHIP DUES ALLOCATED TO LOBBYING. THE AHA PROVIDES BOTH ADVOCACY AND REPRESENTATION FOR ITS MEMBERS. AHA'S ADVOCACY IS GENERALLY ABOUT HOSPITALS AS THE CORNERSTONE OF THE COMMUNITY, PROTECTING THE HEALTHCARE SAFETY NET AND IMPROVING CARE, AFFORDABILITY AND COVERAGE. THE AHA'S ADVOCACY AGENDA CAN BE VIEWED AT THEIR WEBSITE: WWW.AHA.ORG. THE ORGANIZATION IS A MEMBER OF THE NATIONAL ASSOCIATION OF PSYCHIATRIC HEALTH SYSTEMS ("NAPHS"). THE ORGANIZATION PAID $900 TO THE NAPHS AS THE PORTION OF MEMBERSHIP DUES ALLOCATED TO LOBBYING. THE NAPHS PROVIDES BOTH ADVOCACY AND REPRESENTATION FOR ITS MEMBERS. THE NAPHS ADVOCATES FOR BEHAVIORAL HEALTH AND REPRESENTS PROVIDER SYSTEMS THAT ARE COMMITTED TO THE DELIVERY OF RESPONSIVE, ACCOUNTABLE, AND CLINICALLY EFFECTIVE TREATMENT AND PREVENTION PROGRAMS FOR CHILDREN, ADOLESCENTS, ADULTS, AND OLDER ADULTS WITH MENTAL AND SUBSTANCE ABUSE DISORDERS. THE NAPHS'S ADVOCACY AGENDA CAN BE VIEWED AT THEIR WEBSITE: WWW.NAPHS.ORG. THE ORGANIZATION IS A MEMBER OF THE RI COUNCIL OF COMMUNITY MENTAL HEALTH ORGANIZATIONS, INC. ("RICCMHO"). THE ORGANIZATION PAID $2,479 TO THE RICCMHO AS THE PORTION OF MEMBERSHIP DUES ALLOCATED TO LOBBYING. THE RICCMHO PROVIDES ADVOCACY AND REPRESENTATION TO ITS MEMBERS. THE PURPOSE OF THE RICCMHO'S ADVOCACY IS TO BROADEN THE BASE OF MENTAL HEALTH AMBASSADORS IN THE RHODE ISLAND COMMUNITY. THE RICCMHO'S ADVOCACY AGENDA CAN BE VIEWED AT THEIR WEBSITE: WWW.RICCMHO.ORG.

Schedule C (Form 990 or 990EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

BUTLER HOSPITAL

Employer identification number

05-0258812

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back
1a	Beginning of year balance ....	18,252,809	17,008,598	18,436,605
b	Contributions ........	592,078	225,771	192,208
c	Investment earnings or losses ...	-230,849	1,775,372	-816,844
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	701,166	756,932	803,371
f	Administrative expenses ....
g	End of year balance ......	17,912,872	18,252,809	17,008,598

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

22.470 %

Permanent endowment: SchDMd Bullet

12.450 %

Term endowment: SchDMd Bullet

65.080 %

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................
b	Buildings ................	4,132,336	41,666,962	29,637,217	16,162,081
c	Leasehold improvements ............
d	Equipment ................	154,202	14,337,504	10,507,209	3,984,497
e	Other .................	309,738	3,877,763	2,518,985	1,668,516
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........					21,815,094

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) MARKET INVESTMENT	816,698	F
(2) ENDOWMENT FUNDS	13,944,405	F
(3) BOARD-DESIGNATED FUNDS	3,965,894	F
(4) TRUSTEE-HELD FUNDS	12,164,645	F
(5) OTHER ASSETS - LT	1,793,847	F
(6) INVESTMENTS	1,645,743	F



Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)	34,331,232

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes		0
OTHER LIABILITIES		2,470,656
PENSION LIABILITY		10,039,127
ASSET RETIREMENT OBLIGATION		0
DUE TO AFFILIATES		17,603,786
DUE TO THIRD PARTY PAYORS		2,876,733
SELF-INSURANCE RESERVES		2,068,466



Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		35,058,768
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3
4	Net unrealized gains (losses) on investments ..........................	4
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8
9	Total adjustments (net). Add lines 4 - 8 .............................	9
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV): ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......		5

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV): ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......		5

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
WORKS OF ART	FORM 990, SCHEDULE D, PART III, LINE 1A	BUTLER HOSPITAL HOLDS VARIOUS WORKS OF ART THAT WERE DONATED TO THE ORGANIZATION IN THE EARLY TO MID-1900'S. AT THE TIME OF THE DONATION, THE WORKS OF ART WERE ADDED TO THE HOSPITAL'S COLLECTIONS AND WERE HELD FOR PUBLIC EXHIBITION AND FOR PRESERVATION FOR FUTURE GENERATIONS. IN ACCORDANCE WITH STATEMENT OF FINANCIAL ACCOUNTING STANDARDS NO. 116, ACCOUNTING FOR CONTRIBUTIONS RECEIVED AND CONTRIBUTIONS MADE, THE HOSPITAL DOES NOT RECOGNIZE OR CAPITALIZE ITS COLLECTIONS FOR FINANCIAL STATEMENT PURPOSES. THE VALUE OF THE HOSPITAL'S COLLECTIONS IS NOT CONSIDERED MATERIAL TO THE HOSPITAL'S FINANCIAL STATEMENTS. THEREFORE, THE EXISTENCE OF THESE COLLECTIONS IS NOT SEPARATELY DISCLOSED IN THE FOOTNOTES TO THE HOSPITAL'S FINANCIAL STATEMENTS. DURING FISCAL YEAR 2009, THE HOSPITAL'S DIRECTORS VOTED TO SELL TWO OF THE HOSPITAL'S WORKS OF ART. THESE TWO WORKS OF ART REPRESENTED APPROXIMATELY NINETY PERCENT OF THE VALUE OF THE HOSPITAL'S COLLECTION. IN APRIL 2009, THE HOSPITAL ENTERED INTO A MEMORANDUM OF UNDERSTANDING TO SELL THESE TWO WORKS OF ART TO A NEW YORK GALLERY FOR $500,000. IN JANUARY 2010, THE SALE OF THE FIRST WORK OF ART WAS COMPLETED. DURING OCTOBER 2010 AND FISCAL YEAR 2011, THE SALE OF THE SECOND WORK OF ART WAS COMPLETED, RESULTING IN A $231,350 GAIN ON SALE OF ASSETS WHICH IS INCLUDED IN FORM 990, PART VIII, LINE 7.
ENDOWMENT FUNDS	FORM 990, SCHEDULE D, PART V, LINE 4	BUTLER HOSPITAL HOLDS VARIOUS WORKS OF ART THAT WERE DONATED TO THE ORGANIZATION IN THE EARLY TO MID-1900'S. THE WORKS OF ART INCLUDE WATERCOLORS ON PAPER AND OILS ON CANVAS BY VARIOUS ARTISTS. THE COLLECTION ALSO INCLUDES A SIMON WILLARD CLOCK. THE DONATED ITEMS WERE ADDED TO THE HOSPITAL'S COLLECTIONS AND ARE HELD FOR CHARITABLE PURPOSES, FURTHERING THE ORGANIZATION'S EXEMPT PURPOSES. THE MOST SIGNIFICANT USES OF THE HOSPITAL'S COLLECTIONS ARE PUBLIC EXHIBITION AND THE PRESERVATION FOR FUTURE GENERATIONS. MANY OF THE OILS ON CANVAS ARE PORTRAITS OF THE ORIGINAL FOUNDERS OF THE HOSPITAL AND ARE THEREFORE, ALSO HISTORICALLY RELEVANT TO THE ORGANIZATION.
TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE	SCHEDULE D, PART X	THE ORGANIZATION IS AN AFFILIATE OF CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT, INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S PARENT ENTITY IS CARE NEW ENGLAND HEALTH SYSTEM. AN INDEPENDENT BIG FOUR CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CARE NEW ENGLAND HEALTH SYSTEM AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED SEPTEMBER 30, 2011 AND SEPTEMBER 30, 2010; RESPECTIVELY AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CERTAIN CONSOLIDATING SCHEDULES. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN FOOTNOTE DISCLOSURE RELATED TO THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48. THE ORGANIZATION COMPLETED AN ASSESSMENT OF THE ESTIMATED LIABILITY FOR UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2011 AND CONCLUDED THAT THE ESTIMATED LIABILITY WAS NOT MATERIAL TO THE ORGANIZATION'S FINANCIAL STATEMENTS.

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F
(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,
Part IV, line 14b, 15, or 16.
Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization
BUTLER HOSPITAL

Employer identification number

05-0258812

Part I

General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of the grants or

assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award

the grants or assistance? ...................................

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside the
United States.

Activites per Region. (Use Part V if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees or agents in region or independent contractors	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for region/investments in region
	North America	0	0	Program Services	RESEARCH,STUDY & CONS.	15,559
	Europe (Including Iceland and Greenland)	0	0	Program Services	RESEARCH,STUDY & CONS.	4,099















3a	Sub-total .....	0	0			19,658
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	0	0			19,658

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2010

Schedule F (Form 990) 2010

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,

Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet

Use Part V if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ..... MediumBullet

Enter total number of other organizations or entities ........................ MediumBullet

Schedule F (Form 990) 2010

Schedule F (Form 990) 2010Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Use Part V if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2010

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2010

Page 5

Part V

Supplemental Information
Complete this part to provide the information (see instructions) required in Part I, line 2, and any additional information.

Identifier	ReturnReference	Explanation
ORGANIZATION'S PROCEDURES FOR MONITORING USE OF GRANT FUNDS OUTSIDE THE US	SCHEDULE F, PART I; QUESTION 2	THE HOSPITAL OBTAINS AN INDEPENDENT CONTRACTOR AGREEMENT FOR ALL CONSULTANTS WORKING ON RESEARCH STUDIES. THE INDEPENDENT CONTRACTOR AGREEMENT DESCRIBES WORK TO BE PERFORMED BY THE CONSULTANT AND THE PAYMENT TERMS. THE PRINCIPAL INVESTIGATOR OF THE STUDY, A BUTLER HOSPITAL EMPLOYEE, MONITORS THE WORK PERFORMED BY THE CONSULTANT PER THE TERMS OF THE INDEPENDENT CONTRACTOR AGREEMENT. UPON SATISFACTORY COMPLETION OF THE WORK PERFORMED, THE PRINCIPAL INVESTIGATOR APPROVES PAYMENT TO THE CONSULTANT BY GENERATING A REQUEST FOR PAYMENT AND SUBMITTING THE REQUEST TO THE ACCOUNTS PAYABLE DEPARTMENT OF THE HOSPITAL.

Schedule F (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization
BUTLER HOSPITAL

Employer identification number

05-0258812

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and e-mail solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.

(i) Name and address of individual or entity (fundraiser)	(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
	(ii) Activity	Yes	No	(iv) Gross receipts from activity		(vi) Amount paid to (or retained by) organization
Total .................

List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2010

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.

		(a) Event #1 GOLF TOURNAMENT (event type)	(b) Event #2 SILENT AUCTION (event type)	(d) Total Events (Add col. (a) through col. (c))
1	Gross receipts . . .	97,651	32,513	130,164
2	Less: Charitable contributions . . .	68,609	32,513	101,122
3	Gross income (line 1 minus line 2) . . .	29,042		29,042
4	Cash prizes . . .
5	Non-cash prizes . .
6	Rent/facility costs . .	22,799		22,799
7	Food and beverages . .
8	Entertainment . . .
9	Other direct expenses .	6,243		6,243
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........			29,042
11	Net income summary. Combine lines 3 and 10 in column (d)............

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (Add col. (a) through col. (c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes
	No

	Yes
	No

	Yes
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," Explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," Explain:

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ...........................

YesNo

Schedule G (Form 990 or 990-EZ) 2010

Page 3

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Provide the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)

Identifier	ReturnReference	Explanation

Schedule G (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

BUTLER HOSPITAL

Employer identification number

05-0258812

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

If "Yes," is it a written policy? .......................

Yes

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low

income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If

"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....

Yes

200% 250% 300% 350% 400% Other

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Yes

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............

Does the organization prepare an annual community benefit report?.............

If "Yes," does the organization make it available to the public? ..............

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Charity Care and Certain Other Community Benefits at Cost

	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Charity care at cost (from Worksheets 1 and 2) ..	1,884,011	8,828	1,875,183	2.010 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....
dTotal Charity Care and Means-Tested Government Programs .....	1,884,011	8,828	1,875,183	2.010 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	339,014	18,100	320,914	0.340 %
f Health professions education (from Worksheet 5) ..	2,587,080	763,486	1,823,594	1.960 %
g Subsidized health services (from Worksheet 6) ..	9,671,196	7,834,018	1,837,177	1.970 %
h Research (from Worksheet 7)	11,812,085	9,860,624	1,951,461	2.090 %
i Cash and in-kind contributions to community groups (from Worksheet 8) ..	20,146	1,185	18,961	0.020 %
jTotal Other Benefits ...	24,429,521	18,477,413	5,952,107	6.380 %
kTotal. Add lines 7d and 7j. ..	26,313,532	18,486,241	7,827,290	8.390 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense (at cost).....

866,192

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

77,957

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

13,948,045

Enter Medicare allowable costs of care relating to payments on line 5.....

17,470,541

Subtract line 6 from line 5. This is the surplus or (shortfall)........

-3,522,496

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......

Yes

Part IV

Management Companies and Joint Ventures

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2010

Page 3

Part VFacility Information

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
1	BUTLER HOSPITAL 345 BLACKSTONE BOULEVARD PROVIDENCE,RI02906	X	X	X

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:BUTLER HOSPITAL

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9
	If “Yes,” indicate the FPG family income limit for eligibility for free care: %

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: %
11	Explained the basis for calculating amounts charged to patients?.................		11
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 7

Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, measured by total revenue per facility, from largest to smallest) How many non-hospital facilities did the organization operate during the tax year?
Name and address		Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2010

Page 8

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2	Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
Eligibility for Discounted Care	Schedule H, Part I, Line 3c	Not applicable.
Community Benefit Report	Schedule H, Part I, Line 6a	Not applicable.
Subsidized Health Services	Schedule H, Part I, Line 7g	No costs relating to subsidized healthcare services are attributable to any physician clinics.
Percent of Total Expense	Schedule H, Part I, Line 7, Column (F)	The bad debt expense included on form 990, Part IX, Line 25, Column (a), but subtracted for purposes of calculating the percentage in this column is $1,796,158.
Financial Assistance and Certain Other Community Benefits at Cost	Schedule H, Part I, Line 7	A cost-to-charge ratio was used, the source being the Medicare Cost Report for FY 2011, adjusted for certain costs which are particular to Medicare cost reporting, but not appropriate for Part 1, Line 7. E.g. removing the Reasonable Cost Equivalent for physician services in W/S A-8-2, adjusting pension expense to GAAP, adjustments for useful lives of certain software, and removing the related party costs (other than home office). Worksheet 2, "Ratio of Patient Care Cost-to-Charges" was used to complete the cost-to-charge ratio used in Part 1, line 7.
Community Building Activities	Schedule H, Part II	Butler Hospital has direct involvement in numerous community building activities that promote and improve the health status and general betterment of the communities served by the hospital. This is accomplished through service on state and regional advocacy committees and boards, volunteerism with local community-based non-profit advocacy groups, and participation in conferences and other educational activities to promote understanding of the root causes of health concerns. This organization provides educational materials, conducts community health fairs and holds health education seminars and outreach sessions for its patients and for community providers. Presentations are provided by physicians, nurses and other healthcare professionals.
Bad Debt Expense	Schedule H, Part III, Section A, Line 4	Bad debt expense was calculated using the organization's bad debt expense from its audited financial statements, net of accounts written off at charges and multiplied by its cost to charge ratio. The organization and its affiliates prepare and issue audited consolidated financial statements. The system's allowance for doubtful accounts (bad debt expense) methodology and charity care policies are consistently applied across all hospital affiliates. The attached text was obtained from the footnotes to the audited financial statements of the organization. Net Patient Service Revenue The Hospitals and the Agency have individual agreements with many third-party payors that provide payments at amounts different from their established rates. Payment arrangements include prospectively determined rates per discharge, reimbursed costs, discounted charges, and per-diem payments. Net patient service revenue is reported at estimated net realizable amounts from patients, third-party payors, and others for services rendered, and includes estimated retroactive revenue adjustments due to such things as future audits and reviews. Retroactive adjustments are considered in the recognition of revenue on an estimated basis in the period the related services are rendered, and such amounts are adjusted in future periods as adjustments become known, or as years are no longer subject to such adjustments. Charity care The Health System provides care to patients who meet certain criteria under their charity care policies without charge or at amounts less than established rates. Because the Health System does not pursue collection of amounts determined to qualify as charity care, they are not reported as net patient revenue.
Medicare Shortfall	Schedule H, Part III, Line 8	The Inpatient Medicare allowable costs were determined from the submitted FY 2011 Medicare Cost Report, Worksheet D-1, Line 49, less para-med costs, which are included in Part I, Line 7(f). Worksheet D-1, Line 49 does not include direct GME costs. The outpatient allowable costs come from Worksheet E, Part B. Bad debt is community benefit and associated costs are includable on the Form 990, Schedule H, Part I. The organization feels that Medicare underpayments (shortfall) and bad debt are community benefit and associated costs are includable on the Form 990, Schedule H, Part I. As outlined more fully below, the organization believes that these services and related costs promote the health of the community as a whole and are rendered in conjunction with the organization's charitable tax-exempt purposes and mission in providing medically necessary healthcare services to all individual's in a non-discriminatory manner without regard to race, color, creed, sex, national origin, religion or ability to pay and consistent with the community benefit standard promulgated by the IRS. The community benefit standard is the current standard for a hospital for recognition as a tax-exempt and charitable organization under Internal Revenue Code ("IRC") 501(c)(3). The organization is recognized as a tax-exempt entity and charitable organization under 501(c)(3) of the IRC. Although there is no definition in the tax code for the term "charitable", a regulation promulgated by the Department of the Treasury provides some guidance and states that "[t]he term charitable is used in 501(c)(3) in its generally accepted legal sense," and provides examples of charitable purposes, including the relief of the poor or unprivileged; the promotion of social welfare; and the advancement of education, religion, and science. Note: it does not explicitly address the activities of hospitals. In the absence of explicit statutory or regulatory requirements applying the term "charitable" to hospitals, it has been left to the IRS to determine the criteria hospitals must meet to qualify as IRC 501(c)(3) charitable organizations. The original standard was known as the charity care standard. This standard was replaced by the IRS with the community benefit standard which is the current standard. Charity care standard In 1956, the IRS issued Revenue Ruling 56-185, which addressed the requirements hospitals needed to meet in order to qualify for IRC 501(c)(3) status. One of these requirements is known as the "charity care standard." under the standard, a hospital had to provide, to the extent of its financial ability, free or reduced-cost care to patients unable to pay for it. A hospital that expected full payment did not, according to the ruling, provide charity care based on the fact that some patients ultimately failed to pay. The ruling emphasized that a low level of charity care did not necessarily mean that a hospital had failed to meet the requirement since that level could reflect its financial ability to provide such care. The ruling also noted that publicly supported community hospitals would normally qualify as charitable organizations because they serve the entire community, and a low level of charity care would not affect a hospital's exempt status if it was due to the surrounding community's lack of charitable demands. Community benefit standard In 1969, the IRS issued Revenue Ruling 69-545, which "remove[d]" from Revenue Ruling 56-185 "the requirements relating to caring for patients without charge or at rates below cost." Under the standard developed in Revenue Ruling 69-545, which is known as the "community benefit standard," hospitals are judged on whether they promote the health of a broad class of individuals in the community. The ruling involved a hospital that only admitted individuals who could pay for the services (by themselves, private insurance, or public programs such as Medicare), but operated a full-time emergency room that was open to everyone. The IRS ruled that the hospital qualified as a charitable organization because it promoted the health of people in its community. The IRS reasoned that because the promotion of health was a charitable purpose according to the general law of charity, it fell within the "generally accepted legal sense" of the term "charitable," as required by Treas. Reg. 1.501(c)(3)-1(d)(2). The IRS ruling stated that the promotion of health, like the relief of poverty and the advancement of education and religion, is one of the purposes in the general law of charity that is deemed beneficial to the community as a whole even though the class of beneficiaries eligible to receive a direct benefit from its activities does not include all members of the community, such as indigent members of the community, provided that the class is not so small that its relief is not of benefit to the community. The IRS concluded that the hospital was "promoting the health of a class of persons that is broad enough to benefit the community" because its emergency room was open to all and it provided care to everyone who could pay, whether directly or through third-party reimbursement. Other characteristics of the hospital that the IRS highlighted included the following: its surplus funds were used to improve patient care, expand hospital facilities, and advance medical training, education, and research; it was controlled by a board of trustees that consisted of independent civic leaders; and hospital medical staff privileges were available to all qualified physicians. The organization believes that Medicare underpayments and bad debt are community benefit and associated costs are includable on the Form 990, Schedule H, Part I. The American Hospital Association ("AHA") feels that Medicare underpayments (shortfall) and bad debt are community benefit and thus includable on the Form 990, Schedule H, Part I. This organization agrees with the AHA position. As outlined in the AHA letter to the IRS dated August 21, 2007 with respect to the first published draft of the new Form 990 and Schedule H, the AHA felt that the IRS should incorporate the full value of the community benefit that hospitals provide by counting Medicare underpayments (shortfall) as quantifiable community benefit for the following reasons. - providing care for the elderly and serving Medicare patients is an essential part of the Community Benefit Standard. - Medicare, like Medicaid, does not pay the full cost of care. Recently, Medicare reimburses hospitals only 92 cents for every dollar they spend to take care of Medicare patients. The Medicare Payment Advisory Commission ("MEDPAC") in its March 2007 report to Congress cautioned that underpayment will get even worse, with margins reaching a 10-year low at negative 5.4 percent. - many Medicare beneficiaries, like their Medicaid counterparts, are poor. More than 46 percent of Medicare spending is for beneficiaries whose income is below 200 percent of the Federal poverty level. Many of those Medicare beneficiaries are also eligible for Medicaid -- so called "dual eligibles." There is every compelling public policy reason to treat Medicare and Medicaid underpayments similarly for purposes of a hospital's community benefit and include these costs on Form 990, Schedule H, Part I. Medicare underpayment must be shouldered by the hospital in order to continue treating the community's elderly and poor. These underpayments represent a real cost of serving the community and should count as a quantifiable community benefit. Both the AHA and this organization also feel that patient bad debt is a community benefit and thus includable on the Form 990, Schedule H, Part I. Like Medicare underpayment (shortfalls), there also are compelling reasons that patient bad debt should be counted as quantifiable community benefit as follows: - A significant majority of bad debt is attributable to low-income patients, who, for many reasons, decline to complete the forms required to establish eligibility for hospitals' charity care or financial assistance programs. A 2006 congressional budget office ("CBO") report, nonprofit hospitals and the provision of community benefits, cited two studies indicating that "the great majority of bad debt was attributable to patients with income below 200% of the Federal poverty line." - the report also noted that a substantial portion of bad debt is pending charity care. Unlike bad debt in other industries, hospital bad debt is complicated by the fact that hospitals follow their mission to the community and treat every patient that comes through their emergency department, regardless of ability to pay. Patients who have outstanding bills are not turned away, unlike other industries. Bad debt is further complicated by the auditing industry's standards on reporting charity care. Many patients cannot or do not provide the necessary, extensive documentation required to be deemed charity care by auditors. As a result, roughly 40% of
Debt Collection Policy	Schedule H, Part III, Line 9b	Butler Hospital does not pursue collection for those patients who qualify for 100% financial assistance, but our normal collection policy would apply for patients receiving partial financial assistance (discounted by reason of income/assets on the FPG between 200% and 300%) or extreme medical expenses.
Facility Policies and Practices	Schedule H, Part V	Not applicable.
Needs Assessment	Schedule H, Part VI, Question 2	All Community Benefit programs undertaken by the hospital are aligned with the mission of the hospital: to improve the health status and well-being of individuals and families in its service area. Recognizing that community needs may outpace resources, the hospital continually reviews and evaluates current and proposed programs to ensure that programs offering the most benefit will continue to be supported by the hospital. The hospital aligns its community programs in support of the Rhode Island Department of Health Healthy People 2010 Initiatives: Objective 1: Physical Activity, Objective 3: Tobacco, Objective 4: Substance Abuse and Objective 6: Mental Health. Please refer to Schedule O for a detailed community benefit statement.
Patient Education of Eligibility for Assistance	Schedule H, Part VI, Question 3	As a not for-profit entity, Butler Hospital's first consideration in the admission and placement or treatment of any patient is the patient's medical needs. Some patients hesitate to obtain necessary care because of their financial concerns. A notice of financial aid appears on all statements sent to patients. Also, it is prominently posted in the patient assessment department, admission areas, outpatient care areas and on the organization's website. Also, the notice is available in the three most common languages used by the patient population in accordance with the applicable "standards for culturally and linguistically appropriate services in healthcare" (Standards 4 and 7, based on Title VI of the Civil Rights Act of 1964).
Community information	Schedule H, Part VI, Question 4	Butler Hospital's primary service area consists of a suburban population in Providence, Rhode Island with a total population of 178,042. The average household income is $36,925 and 26.3 percent of the population has income below the poverty level. Twenty four hospitals serve the primary service area and a significant percent of hospital discharges are Medicare, Medicaid and uninsured patients. As of the 2008 American Community Survey conducted by the U.S. Census Bureau, Providence consisted of the following groups: 49.8% of the population were Caucasian, 38.1% of the population were Hispanics and Latinos of any race and 16% were Black or African American.
Promotion of Community Health	Schedule H, Part VI, Question 5	The organization and the entire Care New England Health System promote the health of the community on a daily basis throughout the year. The system coordinates and offers numerous community benefit programs, activities and support groups to the community. Please refer to schedule O for a detailed community benefit statement.
Affiliated Health Care System	Schedule H, Part VI, Question 6	Outlined below is a summary of the entities which comprise the Care New England Health System. Not for-profit Care New England Health System entities: Care New England Health System Care New England Health System is the tax-exempt parent of the Care New England Health System ("CNE"). This integrated healthcare delivery system consists of a group of affiliated healthcare organizations. This organization is the sole member or stockholder of each affiliated entity. CNE is an integrated system of healthcare providers throughout the state of Rhode Island. Care New England Health System is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). As the parent organization, Care New England Health System strives to continually develop and operate a multi-hospital healthcare system which provides substantial community benefit through the provision of a comprehensive spectrum of healthcare services to the residents of Rhode Island and surrounding communities. Care New England Health System ensures that its system provides medically necessary healthcare services to all individuals regardless of race, color, creed, sex, national origin, religion or ability to pay. No individuals are denied necessary medical care, treatment or services. CNE's active hospitals include Butler Hospital, Women & Infants Hospital of Rhode Island and Kent County Memorial Hospital. Each of these hospitals operates consistently with the following criteria outlined in IRS Revenue Ruling 69-545: 1. Each provides medically necessary healthcare services to all individuals regardless of ability to pay, including charity care, self-pay, Medicare and Medicaid patients; 2. Each operates an active emergency room for all persons; which is open 24 hours a day, 7 days a week, 365 days per year; 3. Each maintains an open medical staff, with privileges available to all qualified physicians; 4. Control of each rests with its board of directors and the board of directors of Care New England Health System. Both boards are comprised of a majority of independent civic leaders and other prominent members of the community; and 5. Surplus funds are used to improve the quality of patient care, expand and renovate facilities and advance medical care; programs and activities. Women & Infants Hospital of Rhode Island Women & Infants Corporation is a 247-bed and 60-bassinet non-profit specialty hospital for women and newborns located in Providence, Rhode Island. Women & Infants Corporation is recognized by the Internal Revenue Service as an Internal Revenue Code 501(c)(3) tax-exempt organization. Pursuant to its charitable purposes, the organization provides medically necessary healthcare services to all individuals regardless of race, color, creed, sex, national origin, religion or ability to pay. Moreover, Women & Infants Corporation operates consistently with the criteria outlined in IRS Revenue Ruling 69-545. Kent County Memorial Hospital Women & Infants Corporation is a 359-bed non-profit acute care hospital located in Warwick, Rhode Island. Kent County Memorial Hospital is recognized by the Internal Revenue Service as an Internal Revenue Code 501(c)(3) tax-exempt organization. Pursuant to its charitable purposes, the organization provides medically necessary healthcare services to all individuals regardless of race, color, creed, sex, national origin, religion or ability to pay. Moreover, Kent County Memorial Hospital operates consistently with the criteria outlined in IRS Revenue Ruling 69-545. Kent County Visiting Nurse Association Kent County Visiting Nurse Association is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 170(b)(1)(A)(vi). The organization provides medically necessary healthcare services to all individuals regardless of race, color, creed, sex, national origin, religion or ability to pay. Kent Hospital Foundation Kent Hospital Foundation is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). Through fundraising activities the organization supports the charitable purposes, programs and services of Kent County Memorial Hospital; a related internal Revenue Code 501(c)(3) tax-exempt organization, that provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, religion or ability to pay. Women & Infants Development Foundation Women & Infants Development Foundation is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). Through fundraising activities the organization supports the charitable purposes, programs and services of Women & Infants Hospital of Rhode Island; a related internal Revenue Code 501(c)(3) tax-exempt organization, that provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, religion or ability to pay. Women & Infants Corporation Women & Infants Corporation is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). The organization is the parent entity of Women & Infants Hospital of Rhode Island and its affiliates, which provide medically necessary healthcare services to all individuals regardless of race, color, creed, sex, national origin, religion or ability to pay. Palomar Group, Inc. Palomar Group, Inc. is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(2). The organization provides medically necessary healthcare services to all individuals regardless of race, color, creed, sex, national origin, religion or ability to pay. WIH Faculty Physicians, Inc. WIH Faculty Physicians, Inc. is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(2). The organization provides medically necessary healthcare services to all individuals regardless of race, color, creed, sex, national origin, religion or ability to pay. Health Touch, Inc. Health Touch, Inc. is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(2). The organization provides medically necessary healthcare services to all individuals regardless of race, color, creed, sex, national origin, religion or ability to pay. Carriage House, L.L.C. and Butler Hospital Allied Medical Services, L.L.C. are single member limited liability companies of Butler Hospital. For-Profit Care New England Health System Entities: W&I Indemnity Ltd. An entity 100% owned by Women & Infants Hospital of Rhode Island. This entity is a financial vehicle and foreign corporation located in Grand Cayman. Toll Gate Indemnity Ltd. An entity 100% owned by Kent County Memorial Hospital. This entity is a financial vehicle and foreign corporation located in Grand Cayman.
State Filing of Community Benefit Report	Schedule H, Part VI, Question 7	Not applicable. The entity and related provider organizations are located in Rhode Island. No community benefit report is filed with the state of Rhode Island.

Schedule H (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
BUTLER HOSPITAL

Employer identification number
05-0258812

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) BROWN UNIVERSITYCONTROLLERS OFC BOX J PROVIDENCE,RI02912	05-0258809	501(C)(3)	455,250	PROGRAM SUPPORT

Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image

Enter total number of other organizations ................................ . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2010

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
GRANT FUND MONITORING	SCHEDULE I, PART I; QUESTION 2	GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS.

Schedule I (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

BUTLER HOSPITAL

Employer identification number

05-0258812

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Yes

Any related organization? .........................

Yes

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported in prior Form 990 or Form 990-EZ
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) PATRICIA R RECUPERO JD MD	(i) (ii)	408,778 0	147,000 0	132,289 0	268,747 0	36,933 0	993,747 0	100,416 0
(2) BONNIE BAKER CPA	(i) (ii)	275,900 0	106,613 0	66,256 0	95,539 0	26,123 0	570,431 0	57,385 0
(3) WALTER DIAS	(i) (ii)	277,345 0	79,317 0	58,593 0	91,444 0	5,118 0	511,817 0	52,627 0
(4) LINDA DAMON RN ARNP	(i) (ii)	228,764 0	68,989 0	15,807 0	52,279 0	13,282 0	379,121 0	11,846 0
(5) STEVEN A RASMUSSEN MD	(i) (ii)	373,285 0	105,891 0	65,056 0	54,462 0	16,701 0	615,395 0	62,371 0
(6) JULIE FORREST MD	(i) (ii)	447,744 0	0 0	1,103 0	0 0	1,500 0	450,347 0	0 0
(7) LAWRENCE PRICE MD	(i) (ii)	315,692 0	84,484 0	0 0	0 0	1,166 0	401,342 0	0 0
(8) MICHAEL STEIN	(i) (ii)	340,861 0	0 0	1,511 0	0 0	18,952 0	361,324 0	0 0
(9) ALVARO OLIVARES MD	(i) (ii)	331,292 0	0 0	0 0	0 0	18,252 0	349,544 0	0 0
(10) GHULAM SURTI MD	(i) (ii)	322,872 0	0 0	1,227 0	0 0	16,752 0	340,851 0	0 0

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
COMPENSATION INFORMATION	PART VII AND SCHEDULE J	TAXABLE COMPENSATION REPORTED HEREIN IS DERIVED FROM 2010 FORMS W-2 AND 1099 (IF APPLICABLE).
COMPENSATION INFORMATION	SCHEDULE J, PART I; QUESTION 4B	THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES VESTED BENEFITS IN A LONG-TERM INCENTIVE PLAN WHICH ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2010 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: PATRICIA R. RECUPERO, J.D., M.D., $100,416; BONNIE BAKER, CPA, $57,385; WALTER DIAS, $52,627; LINDA DAMON, R.N., ARNP, $11,846 AND STEVEN A. RASMUSSEN, M.D., $62,371. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUAL INCLUDES UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUAL MAY NEVER ACTUALLY RECEIVE THE UNVESTED BENEFIT AMOUNT. THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN THE INDIVIDUAL'S 2010 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: PATRICIA R. RECUPERO, J.D., M.D., $138,254. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN A LONG-TERM INCENTIVE PLAN WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THE UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN THE INDIVIDUAL'S 2010 FORM W-2, BOX 5, AS TAXABLE WAGES: PATRICIA R. RECUPERO, J.D., M.D., $92,982; BONNIE BAKER, CPA, $54,103; WALTER DIAS, $49,788; LINDA DAMON, R.N., ARNP, $25,761 AND STEVEN A. RASMUSSEN, M.D., $54,462.
COMPENSATION INFORMATION	SCHEDULE J, PART I; QUESTION 6A & 6B	THE EXECUTIVE COMPENSATION PACKAGE FOR VARIOUS INDIVIDUALS REPORTED ON THIS FORM 990 CONSISTS OF BOTH A FIXED SALARY AND ADDITIONAL AT-RISK COMPENSATION THAT IS BASED ON SEVERAL QUALITATIVE AND QUANTITATIVE COMPONENTS. THE AT-RISK COMPENSATION IS COMPRISED OF BOTH SHORT-TERM AND LONG-TERM FACTORS AS FOLLOWS. THE SHORT-TERM INCENTIVE PROGRAM PROVIDES AN OPPORTUNITY FOR PROGRAM PARTICIPANTS TO EARN AN INCENTIVE AWARD BASED ON THE ACHIEVEMENT OF CRITICAL STRETCH GOALS THAT RECOGNIZE PERFORMANCE ABOVE EXPECTATIONS. THESE GOALS ARE MEASURED FOR EACH FISCAL PERIOD IN THE FOLLOWING CRITICAL AREAS: QUALITY, FINANCIAL AND PATIENT SATISFACTION. THE LONG-TERM INCENTIVE PROGRAM PROVIDES AN OPPORTUNITY FOR PROGRAM PARTICIPANTS TO EARN AN INCENTIVE AWARD BASED ON THE ACCOMPLISHMENT OF CRITICAL MULTI-YEAR SYSTEM PERFORMANCE OBJECTIVES. AWARDS ARE EARNED BY MEASURING SYSTEM PERFORMANCE OVER THREE-YEAR OVERLAPPING PERFORMANCE PERIODS AND ARE MEASURED IN REFERENCE TO GOALS IN THE FOLLOWING CRITICAL AREAS: NET INCOME FROM OPERATIONS, MARKET SHARE, PATIENT SATISFACTION AND STRATEGIC OBJECTIVE.
COMPENSATION INFORMATION	SCHEDULE J, PART I; QUESTION 7	CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2010 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2010 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.
COMPENSATION INFORMATION	SCHEDULE J, PART II; COLUMN F	THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUALS INCLUDES VESTED BENEFITS IN A LONG TERM INCENTIVE PLAN BECAUSE THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THIS AMOUNT WAS TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S 2010 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: PATRICIA R. RECUPERO, J.D., M.D., $100,416; BONNIE BAKER, CPA, $57,385; WALTER DIAS, $52,627; LINDA DAMON, R.N., ARNP, $11,846 AND STEVEN A. RASMUSSEN, M.D., $62,371. THESE AMOUNTS WERE REPORTED ON PRIOR YEAR FORMS 990 AS AT-RISK NON-TAXABLE DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C.

Schedule J (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

BUTLER HOSPITAL

Employer identification number

05-0258812

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(b) Description of transaction	(c) Corrected?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.

(a) Name of interested person and purpose	(b) Loan to or from the organization?		(c)Original principal amount	(d)Balance due	(e) In default?		(f) Approved by board or committee?		(g)Written agreement?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b)Relationship between interested person and the organization	(c)Amount of grant or type of assistance

For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2010

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) HINCKLEY ALLEN SNYDER LLP	PLEASE REFER TO PART V	210,964	PROFESSIONAL SERVICES		No

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule L (see instructions).

Identifier	Return Reference	Explanation
BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS	SCHEDULE L, PART IV	CHARLES R. REPPUCCI, ESQ. AND MARGARET D. FARRELL, ESQ.; DIRECTORS OF THIS ORGANIZATION ARE PARTNERS IN THE LAW FIRM OF HINCKLEY, ALLEN & SNYDER, L.L.P. THIS ORGANIZATION UTILIZED THE SERVICES OF THIS FIRM DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2011. TOTAL FEES PAID BY THE ORGANIZATION TO THIS FIRM TOTALED $210,964. SERVICES WERE RENDERED AT FAIR MARKET VALUE RATES PURSUANT TO ARMS-LENGTH NEGOTIATIONS.

Schedule L (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

BUTLER HOSPITAL

Employer identification number

05-0258812

Identifier	Return Reference	Explanation
COMMUNITY BENEFIT STATEMENT	CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	BUTLER HOSPITAL ("BUTLER") IS A NON-PROFIT PSYCHIATRIC AND SUBSTANCE ABUSE HOSPITAL. BUTLER IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, BUTLER PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MOREOVER, BUTLER OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. BUTLER PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF- PAY, MEDICARE AND MEDICAID PATIENTS; 2. BUTLER OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. BUTLER MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF BUTLER RESTS WITH ITS BOARD OF TRUSTEES AND THE BOARD OF TRUSTEES OF CARE NEW ENGLAND HEALTH SYSTEM. BOTH BOARDS ARE COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. THE OPERATIONS OF BUTLER, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THAT THE HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT AND THAT THE USE AND CONTROL OF BUTLER IS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. HISTORY ======= BUTLER IS AN AFFILIATE WITHIN THE CARE NEW ENGLAND HEALTH SYSTEM ("CARE NEW ENGLAND"). CARE NEW ENGLAND HEALTH SYSTEM IS THE TAX-EXEMPT PARENT OF THE HEALTH SYSTEM. THIS TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. FOUNDED IN 1844, BUTLER IS RHODE ISLAND'S ONLY PRIVATE, NON-PROFIT PSYCHIATRIC AND SUBSTANCE ABUSE HOSPITAL FOR ADULTS, ADOLESCENTS, CHILDREN, AND SENIORS. BUTLER IS AFFILIATED WITH THE WARREN ALERT MEDICAL SCHOOL OF BROWN UNIVERSITY AND IS THE FLAGSHIP HOSPITAL FOR ITS DEPARTMENT OF PSYCHIATRY, WHICH HAS BEEN RECOGNIZED BY ITS PEERS AS ONE OF THE TOP TEN IN THE UNITED STATES. A NATIONAL LEADER IN THE DEVELOPMENT OF ACUTE PSYCHIATRIC AND SUBSTANCE ABUSE TREATMENT, BUTLER IS INVOLVED IN A VARIETY OF RESEARCH EFFORTS WHICH HAS EARNED IT A NATIONAL REPUTATION AS A MAJOR TEACHING AND RESEARCH FACILITY. CARE NEW ENGLAND HEALTH SYSTEM WAS FORMED IN FEBRUARY 1996 BY FOUNDING MEMBERS BUTLER HOSPITAL, KENT COUNTY MEMORIAL HOSPITAL AND WOMEN & INFANTS HOSPITAL OF RHODE ISLAND. THESE THREE HOSPITALS ARE ALL INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATIONS. IN JUNE 1999, KENT COUNTY VISITING NURSE ASSOCIATION BECAME A MEMBER OF THE CARE NEW ENGLAND FAMILY, AND LATER THAT YEAR ANNOUNCED ITS NAME CHANGE TO VNA OF CARE NEW ENGLAND. IN 2000, HEALTHTOUCH, INC., A PRIVATE DUTY NURSING SERVICE, JOINED THE DIVISION. TODAY, VNA OF CARE NEW ENGLAND PROVIDES A BROAD SPECTRUM OF HOME HEALTH AND HOSPICE SERVICES. CARE NEW ENGLAND'S STRENGTHS ARE BASED ON COMPLEMENTARY PROGRAMS AND DISTINCTIVE COMPETENCIES OF OUR PARTNER HOSPITALS AND AGENCIES. BUTLER OFFERS EXPERTISE IN BEHAVIORAL HEALTH AND SUBSTANCE ABUSE. KENT PROVIDES A FULL CADRE OF PRIMARY AND SECONDARY ACUTE CARE SERVICES. WOMEN & INFANTS SPECIALIZES IN THE HEALTH NEEDS OF WOMEN AND NEWBORN CHILDREN. VNA OF CARE NEW ENGLAND PROVIDES A SPECTRUM OF HOME HEALTH, HOSPICE AND PRIVATE DUTY NURSING SERVICES. CARE NEW ENGLAND WELLNESS CENTER OFFERS AN ARRAY OF REHABILITATION, WELLNESS, FITNESS AND EDUCATIONAL PROGRAMS. AS A RESULT, CARE NEW ENGLAND IS WELL POSITIONED TO TRANSITION INTO THE NEW ERA OF HEALTHCARE DELIVERY WITH A HIGH QUALITY CONTINUUM OF CARE. CARE NEW ENGLAND IS DEDICATED TO THE ADVANCEMENT OF MEDICAL EDUCATION AND RESEARCH. BUTLER HOSPITAL SERVES AS THE PRINCIPAL TEACHING AFFILIATE FOR PSYCHIATRY AND HUMAN BEHAVIOR FOR WARREN ALERT MEDICAL SCHOOL OF BROWN UNIVERSITY, WOMEN & INFANTS IS BROWN'S PRIMARY AFFILIATE IN OBSTETRICS, GYNECOLOGY AND NEWBORN PEDIATRICS, AND KENT IS AFFILIATED WITH THE UNIVERSITY OF NEW ENGLAND COLLEGE OF OSTEOPATHIC MEDICINE. CARE NEW ENGLAND PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN THE ESTABLISHED RATES. BECAUSE CARE NEW ENGLAND DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. CHARITY CARE INCLUDES SERVICES TO UNINSURED PATIENTS WHO CARE NEW ENGLAND HAS DETERMINED QUALIFY FOR CHARITY CARE UNDER CARE NEW ENGLAND POLICIES. SERVICES TO UNINSURED PATIENTS WHO ARE NOT ELIGIBLE FOR CHARITY CARE OR WHO CARE NEW ENGLAND WAS NOT ABLE TO DETERMINE THEIR ELIGIBILITY ARE NOT REPORTED AS CHARITY CARE BUT REPORTED IN THE PROVISION FOR BAD DEBTS. ADDITIONALLY, CARE NEW ENGLAND SPONSORS CERTAIN OTHER PROGRAMS WHICH PROVIDE SUBSTANTIAL BENEFIT TO THE BROADER COMMUNITY. SUCH PROGRAMS INCLUDE SERVICES TO NEEDY POPULATIONS INCLUDING COMMUNITY SERVICE PROGRAMS AND SERVICES FOR SCHOOL-AGED CHILDREN AND THE ELDERLY. CARE NEW ENGLAND ALSO ACTIVELY SPONSORS PROGRAMS ON HEALTH EDUCATION AND WELLNESS. CARE NEW ENGLAND MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE AND COMMUNITY SERVICE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE BASED ON ESTABLISHED RATES FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY AND COMMUNITY SERVICE POLICIES. MISSION ======= BUTLER IS COMMITTED TO: - PROVIDING TREATMENT FOR PSYCHIATRIC ILLNESS IN AN ATMOSPHERE OF DIGNITY AND RESPECT. - CONTRIBUTING TO KNOWLEDGE THROUGH EDUCATION AND RESEARCH. - CONTINUOUSLY IMPROVING THE WAYS WE SERVE OUR PATIENTS AND OUR COMMUNITY. VISION ===== AS A MEMBER OF CARE NEW ENGLAND HEALTH SYSTEM AND BROWN UNIVERSITY TEACHING HOSPITAL, WE SHALL MAINTAIN AND ENHANCE BUTLER'S LEADERSHIP ROLE IN BEHAVIORAL HEALTH SERVICES, TEACHING AND RESEARCH. WE SHALL RESPOND TO THE DEMANDS OF THIS RAPIDLY CHANGING HEALTHCARE ENVIRONMENT THROUGHOUT RHODE ISLAND AND SOUTHEASTERN MASSACHUSETTS. WE SHALL DISTINGUISH OURSELVES BY PROVIDING INDIVIDUALS AND FAMILIES OF ALL AGES AND BACKGROUNDS WITH A FULL CONTINUUM OF QUALITY, COST-EFFECTIVE SERVICES, WHILE CONTINUING OUR COMMITMENT AS AN ACADEMIC CENTER OF EXCELLENCE. VALUES ====== AT BUTLER, WE PUT THE PATIENT AND THEIR FAMILIES AT THE CENTER OF ALL WE DO. IN OUR DAY-TO-DAY INTERACTIONS WITH PATIENTS AND EACH OTHER, OUR ACTIONS AND DECISIONS ARE GUIDED BY THE FOLLOWING CORE VALUES: - KINDNESS: WE TREAT EVERYONE WITH UNDERSTANDING AND CARING. - EXCELLENCE: WE DEMONSTRATE UNPARALLELED QUALITY IN ALL WE DO. - NEW IDEAS: WE ENCOURAGE LIFELONG LEARNING, CONTINUAL IMPROVEMENT AND INNOVATION. - TRUST: WE CAN BE COUNTED ON TO ALWAYS PLACE OUR PATIENTS' INTERESTS FIRST. - COLLABORATION: WE WORK IN PARTNERSHIPS WITH THOSE AROUND US, INCLUDING OUR PATIENTS. - ACCOUNTABILITY: WE HOLD OURSELVES ACCOUNTABLE FOR THE IMPACT OF OUR DECISIONS. - RESPECT: WE TREAT EACH PERSON WITH DIGNITY, RESPECTING THE DIVERSE NEEDS OF THOSE WE SERVE. - ETHICS: WE HOLD OURSELVES TO THE HIGHEST ETHICAL STANDARDS.
COMMUNITY BENEFIT STATEMENT CONTINUED	CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	OVERVIEW ======== BUTLER IS THE ONLY CHILD, ADOLESCENT, AND ADULT PSYCHIATRIC TREATMENT HOSPITAL SERVING RHODE ISLAND AND SOUTHEASTERN NEW ENGLAND. IT PROVIDES ASSESSMENT AND TREATMENT FOR ALL MAJOR PSYCHIATRIC ILLNESSES AND SUBSTANCE ABUSE. BUTLER'S INPATIENT PROGRAM HAS EIGHT TREATMENT UNITS WITH SPECIALTY PROGRAMS FOR CHILDREN, ADOLESCENTS, SENIORS, PEOPLE WITH SUBSTANCE ABUSE PROBLEMS, AND PEOPLE SUFFERING FROM MOOD AND PSYCHOTIC DISORDERS. BUTLER'S PARTIAL HOSPITAL DAY PROGRAM HAS SEPARATE PROGRAMS FOR PSYCHIATRIC DISORDERS AND SUBSTANCE ABUSE. BUTLER IS A MEMBER OF THE CARE NEW ENGLAND HEALTH SYSTEM AND IS AFFILIATED WITH THE WARREN ALERT MEDICAL SCHOOL OF BROWN UNIVERSITY. IT IS THE FLAGSHIP HOSPITAL FOR BROWN'S DEPARTMENT OF PSYCHIATRY WHICH HAS BEEN RECOGNIZED AS ONE OF THE TOP TEN IN THE UNITED STATES. IT IS ALSO A TRAINING FACILITY FOR RESIDENTS, MEDICAL STUDENTS, INTERNS, AND STUDENTS IN ADULT PSYCHIATRY AT BROWN UNIVERSITY AS WELL AS STUDENTS AND INTERNS FROM OTHER COLLEGES AND UNIVERSITIES IN THE REGION. A NATIONALLY AND INTERNATIONALLY RECOGNIZED RESEARCH CENTER, BUTLER IS AN ACTIVE PARTICIPANT IN A VARIETY OF RESEARCH INITIATIVES WHICH INCLUDE STUDIES IN MAJOR DEPRESSION, OBSESSIVE COMPULSIVE DISORDER, ALZHEIMER'S DISEASE AND OTHER MEMORY DISORDERS, DEPRESSION AND ANXIETY IN DEMENTIA CAREGIVERS, SUBSTANCE ABUSE AND FAMILY VIOLENCE, ROLE OF FORGIVENESS IN FAMILIES, SMOKING CESSATION, AND BODY DYSMORPHIC DISORDER IN CHILDREN, ADOLESCENTS, AND ADULTS. BUTLER EMPLOYS APPROXIMATELY 850 FULL-TIME AND PART-TIME CLINICAL AND NON-CLINICAL STAFF. MORE THAN 50 VOLUNTEERS ASSIST THE STAFF IN NEARLY ALL AREAS OF THE HOSPITAL. THE BOARD OF TRUSTEES REPRESENTS A CROSS-SECTION OF THE BUSINESS COMMUNITY. CHAIRMAN OF THE BOARD IS CHARLES R. REPPUCCI, AND PRESIDENT AND CHIEF EXECUTIVE OFFICER IS PATRICIA RYAN RECUPERO, JD, MD. AS A REGIONAL CENTER IN PSYCHIATRY, BUTLER PROVIDES SERVICES TO PEOPLE DEALING WITH A WIDE RANGE OF PSYCHIATRIC AND SUBSTANCE ABUSE PROBLEMS INCLUDING BUT NOT LIMITED TO: - DEPRESSION - MANIC DEPRESSIVE ILLNESS - SUICIDAL BEHAVIOR - ALCOHOL AND SUBSTANCE ABUSE - PSYCHOTIC DISORDERS - OBSESSIVE COMPULSIVE DISORDER - BODY DYSMORPHIC DISORDER - MEMORY DISORDERS - ALZHEIMER'S DISEASE - EATING DISORDERS - ANXIETY DISORDERS COMPREHENSIVE SERVICES ---------------------- BUTLER PROVIDES COMPREHENSIVE PSYCHIATRIC EVALUATIONS AND TREATMENT IN THREE PRIMARY SETTINGS: - INPATIENT PROGRAM - PARTIAL HOSPITAL PROGRAM - ALCOHOL & DRUG TREATMENT SERVICES (ADTS) LIMITED OUTPATIENT TREATMENT MAY BE AVAILABLE IN THE FOLLOWING PROGRAMS: - SENIOR TREATMENT PROGRAM - CULTURAL PSYCHIATRY PROGRAM (HISPANIC AND PORTUGUESE) - VARIOUS RESEARCH PROGRAMS
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION A; QUESTION 2	CHARLES R. REPPUCCI, ESQ. AND MARGARET D. FARRELL, ESQ. - BUSINESS RELATIONSHIP.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION A; QUESTION 3	THE HOSPITAL ENGAGES SODEXHO MANAGEMENT, INC. TO BE AN AGENT OF THE HOSPITAL AND DELEGATES CONTROL TO SODEXHO IN THE MANAGEMENT OF DAILY OPERATIONS OF ITS FOOD AND NUTRITION DEPARTMENT. THE SODEXHO MANAGEMENT EMPLOYEE FUNCTIONS AND IS RECOGNIZED AS A DEPARTMENT MANAGER WHO PERFORMS IN ACCORDANCE WITH THE HOSPITAL'S DEPARTMENT MANAGEMENT PRACTICES AND IN ACCORDANCE WITH ITS WRITTEN POLICIES AND PROCEDURES. THE POSITION REPORTS TO AN OFFICER/KEY EMPLOYEE OF THE HOSPITAL.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7	CARE NEW ENGLAND HEALTH SYSTEM ("CNE") IS THE SOLE MEMBER OF THIS ORGANIZATION. CNE HAS THE ULTIMATE AUTHORITY TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION B; QUESTION 11B	THE ORGANIZATION IS AN AFFILIATE IN THE CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CARE NEW ENGLAND HEALTH SYSTEM IS THE PARENT ENTITY OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS MADE AVAILABLE TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF DIRECTORS) PRIOR TO THE FILING WITH THE IRS. IN ADDITION THE CARE NEW ENGLAND HEALTH SYSTEM FINANCE COMMITTEE ALSO PERFORMED A REVIEW OF THE FEDERAL FORM 990 PRIOR TO MAKING IT AVAILABLE TO EACH VOTING MEMBER OF ITS BOARD OF DIRECTORS. THE CARE NEW ENGLAND HEALTH SYSTEM BOARD OF DIRECTORS HAS DELEGATED TO THE FINANCE COMMITTEE THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION AND FILING PROCESS FOR THE TAX-EXEMPT AFFILIATES OF THE SYSTEM. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S DIRECTOR OF ACCOUNTING AND VARIOUS OTHER INDIVIDUALS TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP, INCLUDING, BUT NOT LIMITED TO, THE INDIVIDUAL OUTLINED ABOVE, FOR HER REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP AND OTHER INDIVIDUALS REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL PRIOR TO PRESENTATION OF THE FEDERAL FORM 990 TO THE MEMBERS OF THE CARE NEW ENGLAND HEALTH SYSTEM FINANCE COMMITTEE. FOLLOWING THE FINANCE COMMITTEE'S REVIEW THE FINAL FEDERAL FORM 990 WAS MADE AVAILABLE TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO THE FILING WITH THE IRS.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION B; QUESTION 12	THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY AND REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH THAT POLICY. THE POLICY REQUIRES THAT A CONFLICT OF INTEREST DISCLOSURE FORM CONSISTENT WITH BEST GOVERNANCE PRACTICES AND INTERNAL REVENUE SERVICE GUIDELINES BE CIRCULATED TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY. IF A DIRECTOR DISCLOSES AN INTEREST THAT COULD GIVE RISE TO A CONFLICT, THE DIRECTOR'S POTENTIAL CONFLICT IS REFERRED TO THE BOARD OR THE COMMITTEE, WHICH EVALUATES THE CONFLICT AND ITS POTENTIAL IMPACT ON THE DIRECTOR'S PARTICIPATION ON THE BOARD OR ON CERTAIN ISSUES THAT MAY COME BEFORE THE BOARD. AFTER CONSULTATION WITH COUNSEL, THE COMMITTEE WILL TAKE ACTION, IF APPROPRIATE AND NECESSARY, TO ADDRESS ANY SUCH CONFLICT IN A MANNER CONSISTENT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION B; QUESTION 15	THE BOARD OF DIRECTORS OF CARE NEW ENGLAND HEALTH SYSTEM ("CNE") HAS A COMMITTEE OF DIRECTORS KNOWN AS THE CNE COMPENSATION COMMITTEE ("THE COMMITTEE"). THE COMMITTEE IS RESPONSIBLE FOR DISCHARGING THE BOARD'S RESPONSIBILITIES REGARDING THE TOTAL COMPENSATION PROGRAM FOR CNE'S EXECUTIVES. IN ADDITION, THE COMMITTEE IS ALSO RESPONSIBLE FOR DISCHARGING THE BUTLER HOSPITAL'S BOARD OF DIRCTORS RESPONSIBILITIES REGARDING THE TOTAL COMPENSATION PROGRAM FOR BUTLER HOSPITAL EXECUTIVES. THE COMMITTEE AT ALL TIMES CONDUCTS ITSELF FREE FROM EXECUTIVE MANAGEMENT IN ITS DECISION MAKING PROCESS. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THIS ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE BUTLER HOSPITAL SENIOR MANAGEMENT TEAM, INCLUDING, BUT NOT LIMITED TO, THE BUTLER HOSPITAL PRESIDENT/CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND CHIEF OPERATING OFFICER. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF AT LEAST 7 DIRECTORS, ALL OF WHOM ARE INDEPENDENT, AT LEAST ONE MEMBER OF THE BOARD FROM EACH OF THE OPERATING ENTITIES (KENT COUNTY MEMORIAL HOSPITAL, WOMEN & INFANTS HOSPITAL OF RHODE ISLAND, BUTLER HOSPITAL AND THE KENT COUNTY VNA) AS WELL AS FROM THE CNE BOARD, SERVE ON THE COMMITTEE. THE CNE PRESIDENT/CHIEF EXECUTIVE OFFICER PARTICIPATES IN COMPENSATION COMMITTEE MEETINGS, EXCEPT AS THE COMMITTEE'S DELIBERATIONS CONCERN THE CNE PRESIDENT/CHIEF EXECUTIVE OFFICER. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILARLY SIZED HEALTHCARE SYSTEMS AND HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS APPLIES TO CERTAIN BUTLER HOSPITAL SENIOR MANAGEMENT PERSONNEL, INCLUDING, BUT NOT LIMITED TO, THE BUTLER HOSPITAL PRESIDENT/CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND CHIEF OPERATING OFFICER. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY EITHER THE COMPENSATION COMMITTEES OF KENT COUNTY MEMORIAL HOSPITAL OR WOMEN & INFANTS HOSPITAL OF RHODE ISLAND OR BY BUTLER HOSPITAL'S PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION C; QUESTION 19	THE ORGANIZATION HAS BEEN ALLOCATED A PORTION OF TAX-EXEMPT BONDS (THROUGH ITS TAX-EXEMPT PARENT CARE NEW ENGLAND HEALTH SYSTEM) TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. THE ORGANIZATION HAS REFLECTED THIS AMOUNT AS A DUE TO AFFILIATE LIABILITY ON ITS BALANCE SHEET. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE SYSTEM'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. IN ADDITION, THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF RHODE ISLAND SECRETARY OF STATE.
COMPENSATION INFORMATION DISCLOSURE	CORE FORM, PART VII AND SCHEDULE J	PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME OR PART-TIME EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR A RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF DIRECTORS.
OTHER CHANGES IN FUND BALANCE	CORE FORM, PART XI; LINE 5	OTHER CHANGES IN FUND BALANCE INCLUDE: NET PAYMENTS ON INTEREST RATE SWAPS; ($138,416); CHANGE IN NET UNREALIZED LOSSES ON INVESTMENTS; ($354,523); NONOPERATING EXPENDITURES; ($321,469); PENSION AND POSTRETIREMENT ADJUSTMENT; ($3,118,755); NET ASSETS RELEASED FROM RESTRICTIONS USED FOR PURCHASE OF PROPERTY, PLANT AND EQUIPMENT; $351,935; TRANSFERS; ($8,618); TRANSFER TO DEFERRED REVENUE; ($807,390); NET UNREALIZED LOSSES FROM INVESTMENTS; (368,517); AND NET ASSETS RELEASED FROM RESTRICTIONS; ($867,076).
AUDITED FINANCIAL STATEMENTS	CORE FORM, PART XII; QUESTION 2	THIS ORGANIZATION IS AN AFFILIATE OF CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT, INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S PARENT ENTITY IS CARE NEW ENGLAND HEALTH SYSTEM. AN INDEPENDENT BIG FOUR CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CARE NEW ENGLAND HEALTH SYSTEM AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED SEPTEMBER 30, 2011 AND SEPTEMBER 30, 2010; RESPECTIVELY AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNQUALIFIED OPINION WAS ISSUED EACH YEAR BY THE INDEPENDENT CPA FIRM. CARE NEW ENGLAND HEALTH SYSTEM'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR.
FINANCIAL STATEMENTS AND REPORTING	CORE FORM, PART XII; QUESTION 3	THE ORGANIZATION IS AN AFFILIATE IN THE CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES ("SYSTEM"). THE SYSTEM ENGAGES AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED A-133 AUDIT. THIS ORGANIZATION WAS INCLUDED IN THE SYSTEM WIDE A-133 AUDIT.
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:CHARLES R REPPUCCI ESQ TITLE:CHAIR - DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:ALLEN H CICCHITELLI TITLE:VICE CHAIR - DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:STANLEY M ARONSON MD TITLE:VICE CHAIR - DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:KEKIN A SHAH TITLE:SECRETARY - DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:ROBERT G PADULA TITLE:TREASURER - DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:PHYLLIS C FIELD TITLE:ASST SECRETARY - DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:DEAN T HOLT TITLE:ASST TREASURER - DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:WILLIAM J ALLEN TITLE:DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:EARL D CHAMBERS TITLE:DIRECTOR HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:ROBERT E DEBLOIS TITLE:DIRECTOR HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:MARGARET D FARRELL ESQ TITLE:DIRECTOR HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:MICHAEL A FIORI MD TITLE:DIRECTOR - PRESIDENT MED STAFF HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:MICHAEL FOLLICK PHD TITLE:DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:RABBI LESLIE Y GUTTERMAN TITLE:DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:DENNIS B LANGLEY TITLE:DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:DIANE LIPSCOMBE PHD TITLE:DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:LEWIS P LIPSITT PHD TITLE:DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:MICHAEL M MATONE TITLE:DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:MARY B OLENN TITLE:DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:PATRICIA R RECUPERO JD MD TITLE:DIRECTOR - PRESIDENT/CEO HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:ARTHUR S ROBBINS TITLE:DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:GARY R ST PETER ESQ TITLE:DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:BONNIE BAKER CPA TITLE:VICE PRESIDENT FINANCE/CFO HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:WALTER DIAS TITLE:VICE PRESIDENT/COO HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:LINDA DAMON RN ARNP TITLE:VICE PRESIDENT/CNO HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:STEVEN A RASMUSSEN MD TITLE:MEDICAL DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:JULIE FORREST MD TITLE:PSYCHIATRIST HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:LAWRENCE PRICE MD TITLE:CLINICAL DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:MICHAEL STEIN TITLE:DIRECTOR HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:ALVARO OLIVARES MD TITLE:UNIT CHIEF HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:GHULAM SURTI MD TITLE:UNIT CHIEF HOURS:

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

BUTLER HOSPITAL

Employer identification number

05-0258812

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) CARRIAGE HOUSE LLC 345 BLACKSTONE BOULEVARD PROVIDENCE,RI02906 20-8277056	RENTAL ESTATE	RI	775,504	3,760,667	BUTLER HOSP
(2) BUTLER HOSPITAL ALLIED MEDICAL SVCS LLC 345 BLACKSTONE BOULEVARD PROVIDENCE,RI02906 45-3034297	HEALTHCARE	RI	0	0	BUTLER HOSP

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) CARE NEW ENGLAND HEALTH SYSTEM 45 WILLARD AVENUE PROVIDENCE,RI02905 05-0490997	HEALTHCARE	RI	501(C)(3)	509(A)(3)	NA
(2) WOMEN AND INFANTS CORPORATION 300 RICHMOND STREET PROVIDENCE,RI02903 02-2885807	HEALTHCARE	RI	501(C)(3)	509(A)(3)	CNE
(3) WOMEN & INFANTS HOSPITAL OF RHODE ISLAND 300 RICHMOND STREET PROVIDENCE,RI02903 05-0258937	HEALTHCARE	RI	501(C)(3)	509(A)(1)	WIC
(4) WOMEN AND INFANTS DEVELOPMENT FOUNDATION 300 RICHMOND STREET PROVIDENCE,RI02903 22-2885815	HEALTHCARE	RI	501(C)(3)	509(A)(3)	WIC
(5) PALOMAR GROUP INC 300 RICHMOND STREET PROVIDENCE,RI02903 05-0462378	PARKING FAC.	RI	501(C)(3)	509(A)(2)	WIC
(6) WIH FACULTY PHYSICIANS INC 67 BRIGHAM STREET NEW BEDFORD,MA02740 04-3579432	HEALTHCARE	MA	501(C)(3)	509(A)(2)	WIH
(7) KENT COUNTY MEMORIAL HOSPITAL 455 TOLL GATE ROAD WARWICK,RI02886 05-0258896	HEALTHCARE	RI	501(C)(3)	HOSPITAL	CNE
(8) KENT HOSPITAL FOUNDATION 455 TOLL GATE ROAD WARWICK,RI02886 05-0514640	SUPPORT ORG	RI	501(C)(3)	509(A)(3)	KCMH
(9) KENT COUNTY VNA DBA VNA OF CNE 51 HEALTH LANE WARWICK,RI02886 05-0242659	HEALTHCARE	RI	501(C)(3)	170B1AVI	CNE
(10) HEALTHTOUCH INC 51 HEALTH LANE WARWICK,RI02886 05-0514949	HEALTHCARE	RI	501(C)(3)	509(A)(2)	KCVNA

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2010

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Type of entity (C corp, S corp, or trust)
(1) TOLL GATE INDEMNITY LTD 23 LIME TREE BAY AVE PO BOX 1051 GRAND CAYMAN KY1-11 CJ 34-2028514	FINANCIAL VEHICLE	CJ	C CORP.
(2) W & I INDEMNITY LTD 23 LIME TREE AVE PO BOX 1051 GRAND CAYMAN KY1-11 CJ 98-0159342	FINANCIAL VEHICLE	CJ	C CORP.

Schedule R (Form 990) 2010

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

Yes

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)

Schedule R (Form 990) 2010

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Are all partners section 501(c)(3) organizations?		(e) Share of end-of-year assets	(f) Disproprtionate allocations?		(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2010

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE TREATMENT OF PSYCHIATRIC ILLNESS IN AN ATMOSPHERE OF DIGNITY AND RESPECT; TO CONTRIBUTE KNOWLEDGE THROUGH EDUCATION AND RESEARCH WHILE IMPROVING SERVICES TO PATIENTS AND THE COMMUNITY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	22
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	18
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	1,074
6	Total number of volunteers (estimate if necessary) ....	6	145
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	227,010
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	171,763

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	734,144	1,046,779
9	Program service revenue (Part VIII, line 2g) .........	91,304,728	90,813,298
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,185,389	1,084,894
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	754,208	2,452,715
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	93,978,469	95,397,686
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	450,000	455,250
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	68,010,054	63,515,803
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 456,768
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	22,758,374	30,984,871
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	91,218,428	94,955,924
19	Revenue less expenses. Subtract line 18 from line 12......	2,760,041	441,762
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	76,659,967	86,220,162
21	Total liabilities (Part X, line 26)............	36,754,343	51,505,605
22	Net assets or fund balances. Subtract line 21 from line 20 .....	39,905,624	34,714,557

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	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 85,274,383 including grants of $ 455,250 ) (Revenue $ 91,040,308 )
	EXPENSES INCURRED IN PROVIDING VARIOUS MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services. (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 85,274,383

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	4,332,205	0	719,776

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c		101,122
d	Related organizations...1d
e	Government grants (contributions)1e		24,232

f	All other contributions, gifts, grants, and similar amounts not included above1f		921,425
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			1,046,779
			Business Code
2a	NET PATIENT SERVICE REVENUE		541,900	64,309,852	64,309,852
b	OTHER HEALTHCARE RELATED REVENUE		541,900	26,503,446	26,503,446
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			90,813,298
3	Investment income (including dividends, interest
	and other similar amounts).....			686,558			686,558
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross Rents	2,137,317
b	Less: rental expenses	243,056
c	Rental income or (loss)	1,894,261
d	Net rental income or (loss).......			1,894,261		224,021	1,670,240
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	3,177,392	250,000
b	Less: cost or other basis and sales expenses	3,010,406	18,650
c	Gain or (loss)	166,986	231,350
d	Net gain or (loss)..........			398,336			398,336
8a	Gross income from fundraising events (not including $ 101,122 of contributions reported on line 1c). See Part IV, line 18 ...
	a		29,042
b	Less: direct expenses ...b		29,042
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	CAFETERIA SALES		722,210	482,686			482,686
b	GIFT SHOP SALES		453,220	71,962			71,962
c	VENDOR SALES		900,099	3,806		2,989	817
d	All other revenue ....
e	Total. Add lines 11a–11d ......			558,454
12	Total revenue. See Instructions....			95,397,686	90,813,298	227,010	3,310,599


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			9,737	1	21,752
2	Savings and temporary cash investments .......			16,044,271	2	16,361,744
3	Pledges and grants receivable, net .........			237,683	3	557,731
4	Accounts receivable, net .........			5,069,207	4	5,687,440
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............			3,222,898	7	4,071,228
8	Inventories for sale or use ..............			246,448	8	262,561
9	Prepaid expenses and deferred charges ............			458,165	9	471,650
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	64,478,506
b	Less: accumulated depreciation. .....	10b	42,663,412	22,172,744	10c	21,815,094
11	Investments—publicly traded securities ..........				11
12	Investments—other securities. See Part IV, line 11 ......				12
13	Investments—program-related. See Part IV, line 11 ..			26,878,222	13	34,331,232
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			2,320,592	15	2,639,730
16	Total assets. Add lines 1 through 15 (must equal line 34)...			76,659,967	16	86,220,162
17	Accounts payable and accrued expenses .			10,403,530	17	10,004,744
18	Grants payable ..........				18
19	Deferred revenue ..........			246,142	19	1,210,287
20	Tax-exempt bond liabilities ..........				20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			5,527,234	23	5,231,806
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities. Complete Part X of Schedule D.....			20,577,437	25	35,058,768
26	Total liabilities. Add lines 17 through 25.....			36,754,343	26	51,505,605
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			20,287,343	27	15,461,497
28	Temporarily restricted net assets .....			17,195,224	28	16,823,913
29	Permanently restricted net assets .....			2,423,057	29	2,429,147
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			39,905,624	33	34,714,557
34	Total liabilities and net assets/fund balances .....			76,659,967	34	86,220,162

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................	Yes	No