Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 10-01-2013 , 2013, and ending 09-30-2014
BCheck if applicable:
CName of organization
KENT COUNTY MEMORIAL HOSPITAL
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
455 TOLL GATE ROAD
Suite
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WARWICK, RI02886
D Employer identification number

05-0258896
E Telephone number

G Gross receipts $ 324,331,518
F Name and address of principal officer:
MICHAEL DACEY MD
455 TOLL GATE ROAD
WARWICK,RI02886
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.KENTRI.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1951
M State of legal domicile: RI
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE ORGANIZATION IS DEVOTED TO CONTINUALLY IMPROVING THE HEALTH IMPROVING THE HEALTH & WELL-BEING OF THE PEOPLE & COMMUNITIES WE SERVE OFFERING OUR ESSENTIAL SERVICES WITHOUT REGARD FOR ABILITY TO PAY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 21
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 15
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 2,378
6 Total number of volunteers (estimate if necessary) ............. 6 282
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,475,432
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -474,256
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,243,080 3,636,374
9 Program service revenue (Part VIII, line 2g) ......... 310,548,917 317,993,243
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,611,935 1,065,009
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 461,878 725,457
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 313,865,810 323,420,083
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 250,000 277,636
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) 168,091,577 175,817,207
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 317,230 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet2,089    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 144,889,961 139,459,558
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 313,548,768 315,554,401
19 Revenue less expenses. Subtract line 18 from line 12....... 317,042 7,865,682
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 169,139,183 175,521,958
21 Total liabilities (Part X, line 26)............. 101,090,135 104,364,993
22 Net assets or fund balances. Subtract line 21 from line 20..... 68,049,048 71,156,965
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: KENT COUNTY MEMORIAL HOSPITAL IS DEVOTED TO CONTINUALLY IMPROVING THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITIES WE SERVE, OFFERING OUR ESSENTIAL SERVICES WITHOUT REGARD FOR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 284,024,896 including grants of $ 277,636 ) (Revenue $ 317,993,243 )
EXPENSES INCURRED IN PROVIDING VARIOUS OTHER 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 expensesMediumBullet284,024,896
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
Yes
 
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions).... Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II.................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
208
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
2,378
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
21
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
15
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletKATHY TOPORC/O CNE ACCTING DEPT 345 BLACKSTONEPROVIDENCERI02906 (401) 921-7602
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) GEORGE W SHUSTER........................................................................
CHAIRMAN - DIRECTOR
 1.0
.......................   		X   X       1,936 0 0
(2) CHARLES R REPPUCCI ESQ........................................................................
VICE CHAIRMAN - DIRECTOR
 1.0
.......................   		X   X       0 0 0
(3) CYNTHIA B PATTERSON........................................................................
SECRETARY - DIRECTOR
 1.0
.......................   		X   X       0 0 0
(4) DOUGLAS JACOBS........................................................................
TREASURER - DIRECTOR
 1.0
.......................   		X   X       0 0 0
(5) HERBERT BRENNAN MD........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(6) DAVID A CARCIERI MD........................................................................
DIRECTOR
 25.0
.......................   		X           0 93,065 13,645
(7) ALLEN H CICCHITELLI........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(8) ESTHER EMARD........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(9) ROBERT G FLANDERS JR ESQ........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(10) GARY E FURTADO........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(11) JOHN R GALVIN........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(12) KENT W GLADDING........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(13) WILLIAM M KAPOS........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(14) DENNIS D KEEFE........................................................................
DIRECTOR - PRESIDENT/CEO/CNE
 55.0
.......................   		X   X       0 1,165,268 130,379
(15) DIANE LIPSCOMBE PHD........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(16) SUSANNA MAGEE MD........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(17) JOSEPH J MCGAIR ESQ........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) PATRICK J MURRAY JR........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(19) ROBERT G PADULA........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(20) GHULAM MUSTAFA SURTI MD........................................................................
DIRECTOR - UNIT CHIEF BH
 55.0
.......................   		X           0 405,552 36,507
(21) MARIBETH WILLIAMSON........................................................................
DIRECTOR
 1.0
.......................   		X           0 0 0
(22) ALYSSA V BOSS ESQ........................................................................
ASST SEC/SVP & GENERAL COUNSEL
 55.0
.......................   		    X       0 396,972 69,983
(23) JOSEPH IANNONI EFF 814........................................................................
ASST. TREAS./SVP/CFO/CNE
 55.0
.......................   		    X       0 0 0
(24) JOHN M SUTHERLAND III........................................................................
SVP/CFO/CNE (TERM 8/14)
 55.0
.......................   		    X       0 587,861 51,235
(25) SANDRA L COLETTA........................................................................
PRESIDENT & CEO (TERM 7/1/14)
 55.0
.......................   		    X       848,067 0 22,455
(26) MICHAEL DACEY MD........................................................................
PRESIDENT & COO (EFF 7/2/14)
 55.0
.......................   		    X       409,600 0 28,492
(27) JOSEPH W SPINALE DO FACC FACP........................................................................
SR VP /CH MEDICAL OFFICER GME
 55.0
.......................   		    X       478,132 0 36,956
(28) PAUL A BEAUDOIN........................................................................
SR VP/FINANCE/KH
 55.0
.......................   		    X       0 406,924 39,313
(29) RENE E FISCHER RN........................................................................
SR VP-PAT CARE SVCS(TERM 3/14)
 55.0
.......................   		    X       336,577 0 37,497
(30) REBECCA BURKE........................................................................
SR VP-PAT CARE SVCS (EFF 3/14)
 55.0
.......................   		    X       0 0 0
(31) FRANCES FALSEY........................................................................
SR VP/CAO
 55.0
.......................   		    X       194,072 0 25,355
(32) JAMES M BURKE........................................................................
VP - FINANCE (EFF 5/2/14)
 55.0
.......................   		    X       0 216,293 35,789
(33) JEAN M BUTLER........................................................................
VP - PATIENT CARE SERVICES
 55.0
.......................   		    X       200,259 0 16,429
(34) DEAN R CARLSON........................................................................
VP HUMAN RESOURCES
 55.0
.......................   		    X       0 122,564 27,901
(35) PAUL MCKENNEY MD........................................................................
ASST CHIEF MEDICAL OFFICER
 55.0
.......................   		    X       304,316 0 45,530
(36) DUANE T GOLOMB MD........................................................................
PRESIDENT-AFFINITY PHYSICIANS
 55.0
.......................   		    X       271,840 0 27,138
(37) RICHARD J RENEHAN........................................................................
EXECUTIVE DIR CNE PHYS ORG.
 55.0
.......................   		    X       0 269,560 19,530
(38) GUY LANCELLOTTI MD........................................................................
CHIEF OF SURGERY
 55.0
.......................   		        X   444,853 0 33,040
(39) GEORGE A PERDRIZET MD........................................................................
DIR-WOUND&CR HYPER(TERM 11/14)
 55.0
.......................   		        X   382,606 0 29,732
(40) DIANE M REALIMARINI MD........................................................................
ASST. CHIEF - EMERGENCY DEPT.
 55.0
.......................   		        X   372,192 0 17,301
(41) CANDACE DYER MD........................................................................
PHYSICIAN COMM BREAST HEALTH
 55.0
.......................   		        X   370,307 0 15,973
(42) PETER F GRAVES MD........................................................................
DIRECTOR - EMERGENCY DEPT.
 55.0
.......................   		        X   366,320 0 15,991
(43) JOSEPH A DIPIETRO........................................................................
FORMER OFFICER
 0.0
.......................   		          X 419,095 0 42,498
(44) HELEN M REED........................................................................
FORMER VP - REVENUE CYCLE
 55.0
.......................   		          X 0 311,245 43,688
(45) JOHN ISAAC MD........................................................................
FORMER PRES-AFFINITY PHYS
 55.0
.......................   		          X 256,794 0 19,125
(46) DAVID B CAMPBELL........................................................................
FORMER OFFICER
 0.0
.......................   		          X 0 233,392 34,228
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 5,656,966 4,208,696 915,710
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet191
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
REHABCARE GROUP INC, PO BOX 502096ST LOUISMO631502096 MEDICAL 3,982,543
BRIGHAM WOMENS PHYSICIAN ORGANIZA, 75 FRANCIS STREETBOSTONMA021156106 MEDICAL SUPPORT SVCS 2,354,319
PURITY SERVICES, 405 MYRTLE STREETNEW BEDFORDMA02746 LAUNDRY 1,243,599
X-RAY ASSOCIATES INC, 65 SOCKANOSSET CROSSROADCRANSTONRI02920 RADIOLOGY 908,385
ANESTHESIA ASSOCIATES OF KENT COUNT, PO BOX 7032WARWICKRI02887 ANESTHESIA 735,655
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet40
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b 60,275
c Fundraising events....1c 242,159
d Related organizations...1d 3,271,693
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		62,247
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 3,636,374
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 541900 309,457,993 309,457,993    
b OTHER HEALTHCARE RELATED REVENUE 541900 8,535,250 7,059,818 1,475,432  
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 317,993,243
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 1,022,688     1,022,688
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 563,141  
b Less: rental expenses    
c Rental income or (loss) 563,141 0
d Net rental income or (loss).......MediumBullet 563,141     563,141
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 389,893  
b Less: cost or other basis and sales expenses 347,572  
c Gain or (loss) 42,321  
d Net gain or (loss)..........MediumBullet 42,321     42,321
8a Gross income from fundraising events (not including
$ 242,159
of contributions reported on line 1c). See Part IV, line 18 ..
a 30,026
b Less: direct expenses ...b 30,026
c Net income or (loss) from fundraising events..MediumBullet 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...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a 686,863
b Less: cost of goods sold ..b 533,837
c Net income or (loss) from sales of inventory..MediumBullet 153,026     153,026
Miscellaneous Revenue Business Code
11a CAFETERIA 900003 9,290     9,290
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 9,290
12 Total revenue. See Instructions......MediumBullet 323,420,083 316,517,811 1,475,432 1,790,466
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
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 United States. See Part IV, line 21 277,636 277,636
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. 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 .... 3,284,652 2,956,186 328,466 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 134,775,839 121,298,255 13,477,584  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 6,704,429 6,033,986 670,443  
9 Other employee benefits ....... 22,136,608 19,922,949 2,213,659  
10 Payroll taxes ........... 8,915,679 8,024,111 891,568  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 0      
c Accounting ........... 0      
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 9,873,307 8,885,976 987,331  
12 Advertising and promotion .... 31 28 3  
13 Office expenses ....... 3,713,159 3,341,843 371,316  
14 Information technology ...... 11,506 10,355 1,151  
15 Royalties .. 0      
16 Occupancy ........... 6,103,502 5,493,152 610,350  
17 Travel ............ 32,552 29,297 3,255  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 0      
20 Interest ........... 1,215,363 1,093,827 121,536  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 9,944,176 8,949,758 994,418  
23 Insurance .............. 10,167,558 9,150,802 1,016,756  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a PURCHASED SERVICES 45,244,998 40,720,498 4,524,500 0
b MEDICAL SUPPLIES 34,518,782 31,066,904 3,451,878 0
c LICENSURE FEE 14,583,914 13,125,523 1,458,391 0
d CONTRACTED SERVICES 2,150,722 1,935,650 215,072 0
e All other expenses 1,899,988 1,708,160 189,739 2,089
25 Total functional expenses. Add lines 1 through 24e 315,554,401 284,024,896 31,527,416 2,089
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 0 1 63,020
2 Savings and temporary cash investments ......... -2,654,687 2 14,194,236
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 42,502,779 4 35,915,776
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 4,335,017 8 4,326,812
9 Prepaid expenses and deferred charges .......... 1,076,881 9 1,204,676
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 215,047,619
b Less: accumulated depreciation ..... 10b 140,325,000 77,154,828 10c 74,722,619
11 Investments—publicly traded securities .......... 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 ..... 40,397,618 13 41,488,002
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 6,326,747 15 3,606,817
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 169,139,183 16 175,521,958
Liabilities 17 Accounts payable and accrued expenses ......... 35,436,249 17 36,407,636
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 0
20 Tax-exempt bond liabilities ............. 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 1,416,935 23 481,323
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 64,236,951 25 67,476,034
26 Total liabilities. Add lines 17 through 25......... 101,090,135 26 104,364,993
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 52,128,481 27 54,915,862
28 Temporarily restricted net assets ........... 3,116,998 28 3,397,545
29 Permanently restricted net assets ........... 12,803,569 29 12,843,558
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet 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 ........... 68,049,048 33 71,156,965
34 Total liabilities and net assets/fund balances ........ 169,139,183 34 175,521,958
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
323,420,083
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
315,554,401
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
7,865,682
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
68,049,048
5
Net unrealized gains (losses) on investments ...............
5
18,873
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-4,776,638
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
71,156,965
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
KENT COUNTY MEMORIAL HOSPITAL
 
Employer identification number

05-0258896
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.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of 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)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (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 monetary support
Yes No Yes No Yes No
Total  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Name of the organization
KENT COUNTY MEMORIAL HOSPITAL
 
Employer identification number

05-0258896
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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
Special Rules
......................... 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 on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 2
Name of organization
KENT COUNTY MEMORIAL HOSPITAL
  		Employer identification number

05-0258896
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

   
RESTRICTED
RESTRICTED
RESTRICTED, RESTRICTEDRESTRICTED

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 3
Name of organization
KENT COUNTY MEMORIAL HOSPITAL
  		Employer identification number

05-0258896
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 4
Name of organization
KENT COUNTY MEMORIAL HOSPITAL
  		Employer identification number

05-0258896
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2013)

Additional Data


Software ID:  
Software Version:  
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.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
KENT COUNTY MEMORIAL HOSPITAL
 
Employer identification number

05-0258896
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
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 Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2013

Schedule C (Form 990 or 990-EZ) 2013
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(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? ......................................

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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2013


Schedule C (Form 990 or 990-EZ) 2013
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)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
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:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
 
j
Total. Add lines 1c through 1i ...............................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
SCHEDULE C, PART II-B; LINE 1I THIS 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 PAYS MOST LOBBYING EXPENDITURES ON BEHALF OF ALL AFFILIATES WITHIN THE SYSTEM AND REPORTS THESE COSTS ON ITS RESPECTIVE FORM 990, SCHEDULE C, ANNUALLY.
Schedule C (Form 990 or 990EZ) 2013

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
KENT COUNTY MEMORIAL HOSPITAL
 
Employer identification number

05-0258896
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 ........    
5
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? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the 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, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, 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.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), 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 $  
2
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 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?........
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 30,107,645 28,531,093 25,180,750 25,866,548 23,976,800
b Contributions ........ 0 0 0 2,794 0
c Net investment earnings, gains, and losses 1,997,861 2,358,421 4,019,207 -284,526 2,234,701
d Grants or scholarships ..... 0 0 0 0 0
e Other expenditures for facilities
and programs ........ 		852,793 699,402 590,807 333,968 279,440
f Administrative expenses .... 72,850 82,467 78,057 70,098 65,513
g End of year balance ...... 31,179,863 30,107,645 28,531,093 25,180,750 25,866,548
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet47.000 %
b
Permanent endowment SchDMd Bullet53.000 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
Yes
 
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   532,468 532,468
b Buildings ................ 1,185,781 103,776,482 53,764,076 51,198,187
c Leasehold improvements ............        
d Equipment ................   102,822,583 83,792,351 19,030,232
e Other .................   6,730,305 2,768,573 3,961,732
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 74,722,619
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) INVESTMENT IN SUBSIDIARY 855,488 F
(2) ENDOWMENT FUNDS 11,583,136 F
(3) ENDOWMENT FUND - TRUST FUND 14,842,965 F
(4) EF TRUST FUND - VALUATION 3,579,559 F
(5) INVESTMENT - PHO 122,340 F
(6) OTHER INVESTMENTS 10,183,990 F
(7) CASH AND CASH EQUIVALENTS 184,831 F
(8) TRUSTEE HELD PROJECT FUNDS 135,693 F

Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 41,488,002
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
DUE TO THIRD PARTY PAYORS; CURRENT -133,476
DUE TO THIRD PARTY PAYORS; NON-CURRENT 5,766,063
LONG-TERM BENEFITS PAYABLE 677,725
OTHER LIABILITIES 379,000
ASSET RETIREMENT OBLIGATION 929,847
PENSION LIABILITY 19,763,792
DUE TO AFFILIATES; CURRENT 11,872,076
DUE TO AFFILIATES; NON-CURRENT 28,221,007
UNEARNED PREMIUM 0
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 67,476,034
2. Liability for uncertain tax positions In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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 XIII.) ............ 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 XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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 XIII.) ............ 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 XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
SCHEDULE D, PART V, QUESTION 4 THE HOSPITAL'S ENDOWMENTS CONSIST OF NUMEROUS INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE PURPOSES INCLUDE GENERAL PURPOSE, HEALTHCARE SERVICES, INDIGENT CARE, HEALTH EDUCATION AND PROPERTY AND EQUIPMENT.
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 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, 2014 AND SEPTEMBER 30, 2013; 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, 2014 AND CONCLUDED THAT THE ESTIMATED LIABILITY WAS NOT MATERIAL TO THE ORGANIZATION'S FINANCIAL STATEMENTS.
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image 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.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
KENT COUNTY MEMORIAL HOSPITAL
 
Employer identification number

05-0258896
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers.Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? ...............................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (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 and investments
in region
Central America and the Caribbean 1 1 Program Services FINANCIAL VEHICLE 8,171,964
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 1 1 8,171,964
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 1 1 8,171,964
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
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. Part II can be duplicated 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 non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 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
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013Page 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.
Part III can be duplicated 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) 2013
Schedule F (Form 990) 2013
Page 4
Part IV
Foreign Forms
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, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
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, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................
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)..............................
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, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
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)....................................
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)................................................
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2013
Additional Data


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Software Version:  



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 arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
KENT COUNTY MEMORIAL HOSPITAL
 
Employer identification number

05-0258896
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
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?
b
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.
(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
Yes No
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
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 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

GOLF OUTING
(event type) 		(b) Event #2

GALA
(event type) 		(c) Other events

8
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 63,491 9,018 199,676 272,185
2 Less: Contributions . . 43,099 8,634 190,426 242,159
3 Gross income (line 1
minus line 2) . . . 		20,392 384 9,250 30,026
VerticalDirectExpenses 4 Cash prizes . . . 1,520     1,520
5 Noncash prizes . .        
6 Rent/facility costs . . 7,500     7,500
7 Food and beverages . 6,884     6,884
8 Entertainment . . .        
9 Other direct expenses . 4,488 384 9,250 14,122
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 30,026
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow  
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.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
%
%
%
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 3
11
Does the organization operate gaming activities with nonmembers? .................
12
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? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
%
b
An outside facility ........................
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
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 $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
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
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2013
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
KENT COUNTY MEMORIAL HOSPITAL
 
Employer identification number

05-0258896
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
 
No
b
If "Yes," did the organization make it available to the public? ..............
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    12,520,455 5,653,498 6,866,958 2.180 %
b Medicaid (from Worksheet 3,
column a) .... 		    46,755,434 44,573,916 2,181,518 0.690 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    59,275,889 50,227,414 9,048,476 2.870 %
Other Benefits
     269,591 0 269,591 0.090 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    9,289,936 2,388,299 6,901,637 2.190 %
g Subsidized health services
(from Worksheet 6) .. 		    36,527,520 25,920,796 10,606,723 3.360 %
h Research (from Worksheet 7)     0 0 0 0 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    5,000 0 5,000  
j Total. Other Benefits ..     46,092,047 28,309,095 17,782,951 5.640 %
k Total. Add lines 7d and 7j .     105,367,936 78,536,509 26,831,427 8.510 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(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
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
14,148,112
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
3,916,900
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
67,024,716
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
78,963,847
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-11,939,131
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(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) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 KENT COUNTY MEMORIAL HOSPITAL
455 TOLL GATE ROAD
WARWICK,RI02886
WWW.KENTRI.ORG
HOS00125 		X X   X     X      
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
KENT COUNTY MEMORIAL HOSPITAL
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 300.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
SCH H, PT V, SECT B, Q'S 1J,6I,10,11,12I,14G,16E,17E,18E,19C,19D,21&22 NOT APPLICABLE.
SCHEDULE H, PART V, SECTION B, QUESTION 3 Care New England sought community input through interviews and key informant surveys with 49 key community stakeholders, focus groups with healthcare providers, and inclusion of partner hospital representatives as well as public health officials in the prioritization and implementation planning process.
SCHEDULE H, PART V, SECTION B, QUESTION 4 Care New England Health System (CNE) participated in a statewide Community Health Needs Assessment, led by the Hospital Association of Rhode Island (HARI), and its member hospitals (Our Lady of Fatima Hospital, Roger Williams Medical Center, Landmark Medical Center, South County Hospital and The Westerly Hospital). HARI CHNA partners jointly conducted a prioritization to identify key statewide community health needs. Care New England Health System's hospitals: Butler Hospital, Kent Hospital, Memorial Hospital of Rhode Island, and Women & Infants Hospital identified system priorities and developed a system-wide Implementation Plan which aligned with the prioritized statewide health issues. Each hospital also has its own Needs Assessment.
SCHEDULE H, PART V, SECTION B, QUESTION 5D In addition to the organization's website, www.kenthospital.org, the CHNA is available at www.rihealthcarematter.org.
SCHEDULE H, PART V, SECTION B, QUESTION 7 By adopting the statewide priorities, Mental Health and Substance Abuse, Heart Disease, and Diabetes, Care New England will take a comprehensive approach to addressing the most urgent needs in the communities it serves. Care New England will continue to monitor community needs and adjust programming and services accordingly. The Community Health Needs Assessment covered 3 priority areas, Mental Health Substance Abuse, Diabetes and Heart Disease. With these priorities we included strategies across these priorities, Overweight and Obesity, Access to Care and Heart Disparities. The following represents our status of these priorities and strategies: Mental Health Substance Abuse Goal 1: Decrease morbidity from diabetes and heart disease among persons with mental illness/substance use disorders Key Initiatives: - Refer psychiatric patients without primary care physician (PCP) to a PCP practice - Include mental health screening in coronary heart failure (CHF) program - Provide medication continuity in emergency department (ED) for patients with diabetes/heart disease (Safe Transitions) Key Measure Accomplishment: - Butler Hospital Patients have been accepted from PCP referrals Goal 2: Increase access to appropriate, quality mental health/substance abuse services Key Initiatives: - Develop patient-centered medical home model with integrated mental/physical health (Affinity) - Provide for online mental health screenings - Integrate TPC psychiatric services into CNE emergency departments Key Measure Accomplishments: - Butler patient evaluations increased FY12-14 period; - Post-partum depression education for WIH patients increased FY13-14 period: 2,328 families educated in FY14 Diabetes Goal 1: Increase the number of people who are aware of the risk factors for diabetes Key Measure Accomplishments: - About 1500 CNE employees screened for diabetes in 2013; > 600 in 2014 (through CNE Wellness) Goal 2: Increase diabetes self-management education for people living with diabetes Key Initiatives: - Develop standardized screening across CNE, implement RN review, and share results with patients/PCPs - Develop diabetes support groups diabetes management - Continue diabetes awareness education and offer screening Heart Disease Goal 1: Increase the number of women who are aware of their risk for heart disease Key Initiatives: - Conduct Women's Health Fair, including cardiac/diabetes screening and nutrition/exercise education - Increase breastfeeding and obtain Baby Friendly designation for birthing services Key Measure Accomplishments: - Since 2012, the number of women leaving WIH breastfeeding increased from about 25% to over 60%, surpassing project average - Women & Infants designated a Baby-Friendly Hospital Goal 2: Reduce heart disease through early identification, and early and appropriate treatment/management Key Initiatives: - Conduct CHF education to manage patient symptoms - Develop partnerships with PCPs and area skilled nursing facilities - Hold Spirit of Women Day of Dance (Feb. 2014) to educate about heart disease risk (screenings for BP, cholesterol, etc.) Key Measure Accomplishments - CNE engaged in developing post-acute partnerships with skilled nursing facilities Key Measure Accomplishments - CNE engaged in developing post-acute partnerships with skilled nursing facilities
SCHEDULE H, PART V, SECTION B, QUESTION 20D THE FACILITY HAS A LONGSTANDING POLICY OF PROVIDING UNINSURED PATIENTS A 30% DISCOUNT FROM CHARGES. THIS PERCENTAGE WAS AN APPROXIMATION OF THE AVERAGE PAYMENT RATES FOR NONGOVERNMENTAL PAYORS ACROSS THE SYSTEM. ADDITIONAL DISCOUNTS ARE PROVIDED FOR ADVANCE OR PROMPT PAYMENTS.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?34
Name and address Type of Facility (describe)
1 KENT OUTPATIENT THERAPY
1351 SOUTH COUNTY TRAIL
EAST GREENWICH,RI02818 		OUTPATIENT PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH
2 SURGERY PAWTUCKET
333 SCHOOL STREET
PAWTUCKET,RI02860 		PHYSICIAN PRACTICE
3 AFFINITY - KENT SURGICAL
470 TOLL GATE ROAD
WARWICK,RI02886 		PHYSICIAN PRACTICE
4 AFFINITY - WEST BAY
390 TOLL GATE ROAD
WARWICK,RI02886 		PHYSICIAN PRACTICE
5 DR GOLOMB OFFICE
766 WASHINGTON STREET
COVENTRY,RI02816 		PHYSICIAN PRACTICE
6 ARCAND FAMILY PRACTICE
1079 MAIN STREET
WEST WARWICK,RI02983 		PHYSICIAN PRACTICE
7 KENT HOSPITAL OUTPATIENT LAB
227 CENTERVILLE ROAD
WARWICK,RI02886 		VASCULAR LAB
8 WOMEN'S CARE FAMILY PRACTICE
42 PARK PLACE
PAWTUCKET,RI02860 		PHYSICIAN PRACTICE
9 KENT HOSPITAL OUTPATIENT LAB
166 TOLL GATE ROAD
WARWICK,RI02886 		LAB
10 AFFINITY - TROMBATORE
300 TOLL GATE ROAD
WARWICK,RI02886 		PHYSICIAN PRACTICE
11 KENT HOSPITAL OUTPATIENT LAB
982 TIOGUE AVENUE
COVENTRY,RI02816 		LAB
12 KENT HOSPITAL OUTPATIENT LAB
390 TOLL GATE ROAD
WARWICK,RI02886 		LAB
13 KENT HOSPITAL OUTPATIENT LAB
905 PONTIAC AVENUE
CRANSTON,RI02920 		LAB
14 KENT HOSPITAL OUTPATIENT LAB
1620 NOOSENECK HILL ROAD
COVENTRY,RI02816 		LAB
15 MRI ON CENTERVILLE ROAD
227 CENTERVILLE ROAD
WARWICK,RI02886 		MRI FACILITY
16 KENT HOSPITAL OUTPATIENT LAB
1051 TEN ROD ROAD
NORTH KINGSTON,RI02852 		LAB
17 KENT HOSPITAL OUTPATIENT LAB
308 CALLAHAN ROAD
NORTH KINGSTON,RI02852 		LAB
18 AFFINITY - PRIMARY CARE WARWICK
215 TOLL GATE ROAD
WARWICK,RI02886 		PHYSICIAN PRACTICE
19 AFFINITY - SPORTS MEDICINE
5750 POST ROAD
EAST GREENWICH,RI02818 		PHYSICIAN PRACTICE
20 KENT HOSPITAL OUTPATIENT LAB
190 COMMERCE DRIVE
WARWICK,RI02886 		LAB
21 KENT HOSPITAL OUTPATIENT LAB
250 CENTERVILLE ROAD
WARWICK,RI02886 		LAB
22 KENT HOSPITAL OUTPATIENT LAB
595 WASHINGTON STREET
COVENTRY,RI02816 		LAB
23 EG SPINE AND SPORT
1351 SO COUNTY TRAIL
EAST GREENWICH,RI02818 		PHYSICIAN PRACTICE
24 KENT HOSPITAL OUTPATIENT LAB
688 FRENCHTOWN ROAD
EAST GREENWICH,RI02818 		LAB
25 KENT HOSPITAL OUTPATIENT LAB
1079 MAIN STREET
WEST WARWICK,RI02983 		LAB
26 KENT HOSPITAL OUTPATIENT LAB
215 TOLL GATE ROAD
WARWICK,RI02886 		LAB
27 KENT HOSPITAL OUTPATIENT LAB
750 RESERVOIR AVENUE
CRANSTON,RI02910 		LAB
28 KENT HOSPITAL OUTPATIENT LAB
227 CENTERVILLE ROAD
WARWICK,RI02886 		LAB
29 KENT HOSPITAL OUTPATIENT LAB
215 TOLL GATE ROAD SUITE 201
WARWICK,RI02886 		LAB
30 DR REEDER OFFICE
1351 SOUTH COUNTY TRAIL
EAST GREENWICH,RI02818 		PHYSICIAN PRACTICE
31 AFFINITY - PRIMARY CARE EAST SIDE
100 RAY DRIVE
PROVIDENCE,RI02906 		PHYSICIAN PRACTICE
32 KENT HOSPITAL OUTPATIENT LAB
5750 POST ROAD
EAST GREENWICH,RI02818 		LAB
33 KENT HOSPITAL OUTPATIENT LAB
75 MINNESOTA AVENUE
WARWICK,RI02888 		LAB
34 CARDIOLOGY PLAIN STREET
90 PLAIN STREET
PROVIDENCE,RI02903 		PHYSICIAN PRACTICE
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
SCH H, PT V, SECT B, Q'S 1J,6I,10,11,12I,14G,16E,17E,18E,19C,19D,21&22 NOT APPLICABLE.
SCHEDULE H, PART V, SECTION B, QUESTION 3 Care New England sought community input through interviews and key informant surveys with 49 key community stakeholders, focus groups with healthcare providers, and inclusion of partner hospital representatives as well as public health officials in the prioritization and implementation planning process.
SCHEDULE H, PART V, SECTION B, QUESTION 4 Care New England Health System (CNE) participated in a statewide Community Health Needs Assessment, led by the Hospital Association of Rhode Island (HARI), and its member hospitals (Our Lady of Fatima Hospital, Roger Williams Medical Center, Landmark Medical Center, South County Hospital and The Westerly Hospital). HARI CHNA partners jointly conducted a prioritization to identify key statewide community health needs. Care New England Health System's hospitals: Butler Hospital, Kent Hospital, Memorial Hospital of Rhode Island, and Women & Infants Hospital identified system priorities and developed a system-wide Implementation Plan which aligned with the prioritized statewide health issues. Each hospital also has its own Needs Assessment.
SCHEDULE H, PART V, SECTION B, QUESTION 5D In addition to the organization's website, www.kenthospital.org, the CHNA is available at www.rihealthcarematter.org.
SCHEDULE H, PART V, SECTION B, QUESTION 7 By adopting the statewide priorities, Mental Health and Substance Abuse, Heart Disease, and Diabetes, Care New England will take a comprehensive approach to addressing the most urgent needs in the communities it serves. Care New England will continue to monitor community needs and adjust programming and services accordingly. The Community Health Needs Assessment covered 3 priority areas, Mental Health Substance Abuse, Diabetes and Heart Disease. With these priorities we included strategies across these priorities, Overweight and Obesity, Access to Care and Heart Disparities. The following represents our status of these priorities and strategies: Mental Health Substance Abuse Goal 1: Decrease morbidity from diabetes and heart disease among persons with mental illness/substance use disorders Key Initiatives: - Refer psychiatric patients without primary care physician (PCP) to a PCP practice - Include mental health screening in coronary heart failure (CHF) program - Provide medication continuity in emergency department (ED) for patients with diabetes/heart disease (Safe Transitions) Key Measure Accomplishment: - Butler Hospital Patients have been accepted from PCP referrals Goal 2: Increase access to appropriate, quality mental health/substance abuse services Key Initiatives: - Develop patient-centered medical home model with integrated mental/physical health (Affinity) - Provide for online mental health screenings - Integrate TPC psychiatric services into CNE emergency departments Key Measure Accomplishments: - Butler patient evaluations increased FY12-14 period; - Post-partum depression education for WIH patients increased FY13-14 period: 2,328 families educated in FY14 Diabetes Goal 1: Increase the number of people who are aware of the risk factors for diabetes Key Measure Accomplishments: - About 1500 CNE employees screened for diabetes in 2013; > 600 in 2014 (through CNE Wellness) Goal 2: Increase diabetes self-management education for people living with diabetes Key Initiatives: - Develop standardized screening across CNE, implement RN review, and share results with patients/PCPs - Develop diabetes support groups diabetes management - Continue diabetes awareness education and offer screening Heart Disease Goal 1: Increase the number of women who are aware of their risk for heart disease Key Initiatives: - Conduct Women's Health Fair, including cardiac/diabetes screening and nutrition/exercise education - Increase breastfeeding and obtain Baby Friendly designation for birthing services Key Measure Accomplishments: - Since 2012, the number of women leaving WIH breastfeeding increased from about 25% to over 60%, surpassing project average - Women & Infants designated a Baby-Friendly Hospital Goal 2: Reduce heart disease through early identification, and early and appropriate treatment/management Key Initiatives: - Conduct CHF education to manage patient symptoms - Develop partnerships with PCPs and area skilled nursing facilities - Hold Spirit of Women Day of Dance (Feb. 2014) to educate about heart disease risk (screenings for BP, cholesterol, etc.) Key Measure Accomplishments - CNE engaged in developing post-acute partnerships with skilled nursing facilities Key Measure Accomplishments - CNE engaged in developing post-acute partnerships with skilled nursing facilities
SCHEDULE H, PART V, SECTION B, QUESTION 20D THE FACILITY HAS A LONGSTANDING POLICY OF PROVIDING UNINSURED PATIENTS A 30% DISCOUNT FROM CHARGES. THIS PERCENTAGE WAS AN APPROXIMATION OF THE AVERAGE PAYMENT RATES FOR NONGOVERNMENTAL PAYORS ACROSS THE SYSTEM. ADDITIONAL DISCOUNTS ARE PROVIDED FOR ADVANCE OR PROMPT PAYMENTS.
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
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
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
KENT COUNTY MEMORIAL HOSPITAL
 
Employer identification number
05-0258896
Part I
General Information on Grants and Assistance
1
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? ....................................
2
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. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) KENT HOSPITAL FOUNDATION
455 TOLL GATE ROAD
WARWICK,RI02886 		05-0514640 501(C)(3) 225,000       GENERAL SUPPORT






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2013

Schedule I (Form 990) 2013
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.
Part III can be duplicated 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. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
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, PART II; COLUMN D THE 2013 FORM 990 FOR KENT COUNTY MEMORIAL HOSPITAL INCLUDES THE KENT COUNTY MEMORIAL HOSPITAL AUXILIARY; A DIVISION OF KENT COUNTY MEMORIAL HOSPITAL. THE KENT COUNTY MEMORIAL HOSPITAL AUXILIARY'S BOOKS AND RECORDS ARE ACCOUNTED FOR ON THE CASH BASIS METHOD. THE AMOUNT OF $225,000 LISTED IN SCHEDULE I, PART II; COLUMN D IS THE AMOUNT OF CASH SUPPORT PROVIDED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2014.
Schedule I (Form 990) 2013


Additional Data


Software ID:  
Software Version:  


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, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
KENT COUNTY MEMORIAL HOSPITAL
 
Employer identification number

05-0258896
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
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:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
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:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
Yes
 
If "Yes," to line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (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 as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)DENNIS D KEEFEDIRECTOR - PRESIDENT/CEO/CNE (i)
(ii)		 0
851,008 		0
264,000 		0
50,260 		0
107,126 		0
23,253 		0
1,295,647 		0
0
(2)GHULAM MUSTAFA SURTI MDDIRECTOR - UNIT CHIEF BH (i)
(ii)		 0
403,842 		0
0 		0
1,710 		0
17,850 		0
18,657 		0
442,059 		0
0
(3)ALYSSA V BOSS ESQASST SEC/SVP & GENERAL COUNSEL (i)
(ii)		 0
296,312 		0
76,858 		0
23,802 		0
48,000 		0
21,983 		0
466,955 		0
0
(4)JOHN M SUTHERLAND IIISVP/CFO/CNE (TERM 8/14) (i)
(ii)		 0
446,220 		0
104,346 		0
37,295 		0
28,050 		0
23,185 		0
639,096 		0
0
(5)SANDRA L COLETTAPRESIDENT & CEO (TERM 7/1/14) (i)
(ii)		 647,664
0 		155,250
0 		45,153
0 		17,850
0 		4,605
0 		870,522
0 		0
0
(6)MICHAEL DACEY MDPRESIDENT & COO (EFF 7/2/14) (i)
(ii)		 322,592
0 		61,506
0 		25,502
0 		19,125
0 		9,367
0 		438,092
0 		0
0
(7)JOSEPH W SPINALE DO FACC FACPSR VP /CH MEDICAL OFFICER GME (i)
(ii)		 390,156
0 		68,001
0 		19,975
0 		17,850
0 		19,106
0 		515,088
0 		0
0
(8)PAUL A BEAUDOINSR VP/FINANCE/KH (i)
(ii)		 0
328,357 		0
71,288 		0
7,279 		0
20,400 		0
18,913 		0
446,237 		0
0
(9)RENE E FISCHER RNSR VP-PAT CARE SVCS(TERM 3/14) (i)
(ii)		 267,930
0 		43,725
0 		24,922
0 		19,125
0 		18,372
0 		374,074
0 		0
0
(10)FRANCES FALSEYSR VP/CAO (i)
(ii)		 151,561
0 		32,890
0 		9,621
0 		14,651
0 		10,704
0 		219,427
0 		0
0
(11)JAMES M BURKEVP - FINANCE (EFF 5/2/14) (i)
(ii)		 0
177,915 		0
36,899 		0
1,479 		0
15,620 		0
20,169 		0
252,082 		0
0
(12)JEAN M BUTLERVP - PATIENT CARE SERVICES (i)
(ii)		 165,568
0 		33,055
0 		1,636
0 		14,872
0 		1,557
0 		216,688
0 		0
0
(13)DEAN R CARLSONVP HUMAN RESOURCES (i)
(ii)		 0
108,006 		0
14,250 		0
308 		0
7,066 		0
20,835 		0
150,465 		0
0
(14)PAUL MCKENNEY MDASST CHIEF MEDICAL OFFICER (i)
(ii)		 232,480
0 		52,004
0 		19,832
0 		22,950
0 		22,580
0 		349,846
0 		0
0
(15)DUANE T GOLOMB MDPRESIDENT-AFFINITY PHYSICIANS (i)
(ii)		 269,435
0 		0
0 		2,405
0 		17,850
0 		9,288
0 		298,978
0 		0
0
(16)RICHARD J RENEHANEXECUTIVE DIR CNE PHYS ORG. (i)
(ii)		 0
207,328 		0
44,200 		0
18,032 		0
17,850 		0
1,680 		0
289,090 		0
0
(17)GUY LANCELLOTTI MDCHIEF OF SURGERY (i)
(ii)		 439,049
0 		0
0 		5,804
0 		14,025
0 		19,015
0 		477,893
0 		0
0
(18)GEORGE A PERDRIZET MDDIR-WOUND&CR HYPER(TERM 11/14) (i)
(ii)		 326,804
0 		35,000
0 		20,802
0 		14,025
0 		15,707
0 		412,338
0 		0
0
(19)DIANE M REALIMARINI MDASST. CHIEF - EMERGENCY DEPT. (i)
(ii)		 303,959
0 		67,500
0 		733
0 		15,300
0 		2,001
0 		389,493
0 		0
0
(20)CANDACE DYER MDPHYSICIAN COMM BREAST HEALTH (i)
(ii)		 345,985
0 		0
0 		24,322
0 		14,025
0 		1,948
0 		386,280
0 		0
0
(21)PETER F GRAVES MDDIRECTOR - EMERGENCY DEPT. (i)
(ii)		 316,347
0 		32,001
0 		17,972
0 		14,025
0 		1,966
0 		382,311
0 		0
0
(22)JOSEPH A DIPIETROFORMER OFFICER (i)
(ii)		 199,127
0 		53,680
0 		166,288
0 		28,050
0 		14,448
0 		461,593
0 		0
0
(23)HELEN M REEDFORMER VP - REVENUE CYCLE (i)
(ii)		 0
252,950 		0
52,116 		0
6,179 		0
22,950 		0
20,738 		0
354,933 		0
0
(24)JOHN ISAAC MDFORMER PRES-AFFINITY PHYS (i)
(ii)		 236,437
0 		0
0 		20,357
0 		19,125
0 		0
0 		275,919
0 		0
0
(25)DAVID B CAMPBELLFORMER OFFICER (i)
(ii)		 0
133,464 		0
0 		0
99,928 		0
18,946 		0
15,282 		0
267,620 		0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
PART VII AND SCHEDULE J TAXABLE COMPENSATION REPORTED HEREIN IS DERIVED FROM 2013 FORMS W-2 AND 1099 (IF APPLICABLE).
SCHEDULE J, PART I; QUESTION 4A CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A SEVERANCE PAYMENT WHICH AMOUNTS WERE INCLUDED ON EACH INDIVIDUAL'S 2013 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES; JOSEPH A. DIPIETRO, $78,954 AND DAVID B. CAMPBELL, $44,901.
SCHEDULE J, PART I; QUESTION 4B THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION 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 EACH INDIVIDUAL'S 2013 FORM W-2, AS TAXABLE WAGES: DENNIS D. KEEFE, $88,001 AND ALYSSA V. BOSS, ESQ., $32,024.
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.
SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2013 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2013 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.
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet 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, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
KENT COUNTY MEMORIAL HOSPITAL
 
Employer identification number

05-0258896
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) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
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 assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2013
Schedule L (Form 990 or 990-EZ) 2013
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?
Yes No
(1) WEST BAY SURGICAL ASSOCIATES INC PLEASE REFER TO PART V 436,894 PRACTICE SUPPORT AGREEMENT   No
(2) DUANE T GOLOMB MD INC PLEASE REFER TO PART V 536,364 PRACTICE SUPPORT AGREEMENT   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCHEDULE L, PART IV JOHN ISAAC, M.D. IS A FORMER OFFICER OF THE ORGANIZATION. THE ORGANIZATION MADE PAYMENTS TO AN ENTITY IN WHICH HE HAS AN OWNERSHIP INTEREST, WEST BAY SURGICAL ASSOCIATES, INC. DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2014. PRACTICE SUPPORT AGREEMENT REIMBURSEMENTS MADE TO WEST BAY SURGICAL ASSOCIATES, INC. WERE $436,894. COSTS WERE REIMBURSED BASED UPON FAIR MARKET VALUE ANALYSIS AND PURSUANT TO ARM'S LENGTH NEGOTIATIONS. DUANE T. GOLOMB, M.D. IS AN OFFICER OF THE ORGANIZATION. THE ORGANIZATION MADE PAYMENTS TO AN ENTITY IN WHICH HE HAS AN OWNERSHIP INTEREST, DUANE T. GOLOMB, M.D., INC. DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2014. PRACTICE SUPPORT AGREEMENT REIMBURSEMENTS MADE TO DUANE T. GOLOMB, M.D., INC. WERE $536,364. COSTS WERE REIMBURSED BASED UPON FAIR MARKET VALUE ANALYSIS AND PURSUANT TO ARM'S LENGTH NEGOTIATIONS.
Schedule L (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  




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.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
KENT COUNTY MEMORIAL HOSPITAL
 
Employer identification number

05-0258896
Return Reference Explanation
CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS KENT HOSPITAL ("KENT") IS A GENERAL MEDICAL AND SURGICAL TEACHING HOSPITAL. KENT IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, KENT 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, KENT OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. KENT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF- PAY, MEDICARE AND MEDICAID PATIENTS; 2. KENT OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. KENT MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF KENT RESTS WITH THE BOARD OF DIRECTORS OF CARE NEW ENGLAND HEALTH SYSTEM AND IS 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 KENT, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THE HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT AND THAT THE USE AND CONTROL OF KENT 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 ======= KENT IS AN AFFILIATE WITHIN THE CARE NEW ENGLAND HEALTH SYSTEM ("CARE NEW ENGLAND"). CARE NEW ENGLAND IS THE TAX-EXEMPT PARENT OF THE HEALTH SYSTEM. THIS TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. KENT IS A 359-BED, NON-PROFIT, ACUTE CARE HOSPITAL SERVING APPROXIMATELY 300,000 RESIDENTS OF WARWICK, WEST WARWICK, EAST GREENWICH, WEST GREENWICH, COVENTRY AND PARTS OF NORTH KINGSTOWN, EXETER AND CRANSTON, RHODE ISLAND. KENT IS LOCATED ON 57 ACRES IN THE TOLL GATE SECTION OF WARWICK (11 MILES SOUTH OF PROVIDENCE) AND IS THE SECOND LARGEST SINGLE-SITE HOSPITAL IN THE STATE. CHARTERED BY THE STATE OF RHODE ISLAND IN 1946, KENT OPENED WITH 90 BEDS IN 1951 AND EXPANDED IN 1960, 1973 AND 1981 TO KEEP PACE WITH COMMUNITY GROWTH. TODAY, KENT PROVIDES A FULL COMPLEMENT OF INPATIENT SERVICES INCLUDING CARDIOLOGY AND EXTENDED CORONARY CARE, INFECTIOUS DISEASE, PRIMARY CARE, ONCOLOGY, ORTHOPEDICS, OBSTETRICS AND GYNECOLOGY, PEDIATRICS, REHABILITATION AND SURGERY. IN ADDITION, THE HOSPITAL OFFERS A COMPREHENSIVE RANGE OF OUTPATIENT SERVICES INCLUDING CARDIAC CATHETERIZATION, INFUSION, DIAGNOSTIC IMAGING AND SURGERY. THE HOSPITAL ALSO OPERATES A WOMEN'S DIAGNOSTIC IMAGING CENTER AND A WOUND RECOVERY CENTER, AND PROVIDES LABORATORY AND PRIMARY CARE SERVICES AT VARIOUS SITES THROUGHOUT THE COMMUNITY. KENT HAS MORE THAN 2,200 EMPLOYEES, A MEDICAL STAFF OF MORE THAN 600, A VOLUNTEER CORPS OF 500 AND 350 AUXILIANS. KENT'S EMERGENCY SERVICES DEPARTMENT SERVES SOME 70,000 ANNUAL VISITS. THIS VOLUME RANKS KENT'S EMERGENCY DEPARTMENT AMONG THE TOP 10-PERCENT NATIONALLY. 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. As of september 3, 2013, southeastern healthcare system, inc. ("shs"), an internal revenue code section 501(c)(3) tax-exempt organization located in rhode island and southeastern massachusetts, became a subsidiary of care new england health system ("cne"); an internal revenue code section 501(c)(3) tax-exempt organization and the parent entity of a rhode island based tax-exempt integrated healthcare delivery system. Cne became the parent organization and sole member of shs as a result of this acquisition. Cne and shs believe that the acquisition will greatly improve comprehensive healthcare services. THE CARE NEW ENGLAND HEALTH SYSTEM WAS FOUNDED ON THE VISION THAT WE CAN BUILD A BETTER SYSTEM OF HEALTHCARE FOR THE PEOPLE AND COMMUNITIES OF SOUTHEASTERN NEW ENGLAND. THE SYSTEM OFFERS THE LATEST ADVANCES IN MEDICINE, SPECIALTY-TRAINED DOCTORS, AND RESPECTED SERVICES AND CARE. AN INTEGRATED HEALTH SYSTEM THAT OFFERS A CONTINUUM OF QUALITY CARE, CARE NEW ENGLAND IS MOVING HEALTHCARE FORWARD AND REINVENTING THE WAY HEALTHCARE IS DELIVERED. THIS APPROACH PUTS A BROAD SPECTRUM OF CARE - ADDRESSING PRIMARY CARE, MEDICAL CARE, SURGERY, WOMEN'S HEALTH, CARDIOLOGY AND BEHAVIORAL HEALTH AND AN ARRAY OF SPECIALTY AND SUBSPECIALTY PROGRAMS - ALL UNDER ONE UMBRELLA SO THEY ARE EASILY ACCESSIBLE TO PATIENTS AND FAMILIES. CARE NEW ENGLAND IS COMPRISED OF SIX MEMBERS: BUTLER HOSPITAL, RHODE ISLAND'S ONLY PRIVATE, NONPROFIT PSYCHIATRIC AND SUBSTANCE ABUSE HOSPITAL FOR ADULTS, ADOLESCENTS, CHILDREN AND SENIORS; KENT HOSPITAL, THE SECOND LARGEST COMMUNITY HOSPITAL IN THE STATE, PROVIDING A FULL SPECTRUM OF PRIMARY AND SECONDARY ACUTE CARE SERVICES; MEMORIAL HOSPITAL, A COMMUNITY HOSPITAL BASED IN PAWTUCKET, RI, LENDING PRIMARY CARE EXPERTISE TO THE SYSTEM AND THE SYSTEM'S ONLY PATIENT CENTERED MEDICAL HOME MODEL OF CARE; WOMEN & INFANTS HOSPITAL OF RHODE ISLAND, ONE OF THE NATION'S BUSIEST OBSTETRICAL FACILITIES WITH ONE OF THE NATION'S LARGEST SINGLE-FAMILY ROOM NEONATAL INTENSIVE CARE UNITS, THE AREA'S ONLY TERTIARY LEVEL NEONATAL FACILITY, AND VARIOUS SPECIALTY SERVICES; THE VNA OF CARE NEW ENGLAND, WHICH PROVIDES A BROAD SPECTRUM OF HOME HEALTH, HOSPICE AND PRIVATE DUTY NURSING SERVICES FOR NEW MOTHERS, THE ELDERLY AND THE TERMINALLY ILL; AND THE CARE NEW ENGLAND WELLNESS CENTER, WHICH OFFERS AN ARRAY OF REHABILITATION, WELLNESS, FITNESS AND EDUCATIONAL PROGRAMS. THE SYSTEM INCLUDES A SOLID, DIVERSE COMBINATION OF PHYSICIAN SPECIALISTS AND GENERALISTS AND A STRONG COMMITMENT TO EDUCATION. BUTLER, MEMORIAL AND WOMEN & INFANTS HOSPITALS ARE MAJOR TEACHING AFFILIATES OF THE WARREN ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY, WHILE KENT IS A TEACHING SITE FOR THE UNIVERSITY OF NEW ENGLAND COLLEGE OF OSTEOPATHIC MEDICINE. IN ADDITION, CARE NEW ENGLAND IS COMMITTED TO ADVANCE THE FIELD OF KNOWLEDGE IN MEDICINE THROUGH NATIONAL AND INTERNATIONALLY-FUNDED AND RECOGNIZED RESEARCH PROJECTS. CARE NEW ENGLAND PROVIDES MEDICALLY NECESSARY CARE 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 FOR WHOM 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 ======= KENT IS DEVOTED TO CONTINUALLY IMPROVING THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITIES WE SERVE, OFFERING OUR ESSENTIAL SERVICES WITHOUT REGARD FOR ABILITY TO PAY. VISION ====== KENT WILL BE ONE OF THE BEST REGIONAL HOSPITALS IN NEW ENGLAND, PREFERRED BY PATIENTS, STAFF AND PHYSICIANS FOR ITS QUALITY, SAFETY AND SERVICE.
CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS VALUES ===== KENT PUTS THE PATIENTS 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: - ACCOUNTABILITY - CARING - TEAMWORK AWARDS & RECOGNITIONS ===================== IN A REPORT RELEASED BY HEALTHGRADES, KENT'S WOMEN'S CARE CENTER HAS ACHIEVED THE HEALTHGRADES, MATERNITY CARE EXCELLENCE AWARD FOR THREE CONSECUTIVE YEARS, RECOGNIZING HOSPITALS THAT PROVIDE CONSISTENT HIGH-QUALITY CARE FOR WOMEN DURING PREGNANCY IN CHILDBIRTH. KENT ALSO RECEIVED THE HEALTHGRADES PATIENT SAFETY AWARD IN 2012. KENT IS ALSO RECOGNIZED AS A CERTIFIED STROKE CENTER AND IS THE RECIPIENT OF THE AMERICAN HEART/STROKE ASSOCIATION'S GET WITH THE GUIDELINES - GOLD ACHIEVEMENT AWARD. WOMEN'S CARE CENTER =================== QUALIFIED STAFF --------------- KENT OFFERS THE COMMUNITY PRIVATE PRACTICE OBSTETRICIANS, MIDWIVES AND PEDIATRICIANS WHO BRING A WEALTH OF EXPERIENCE. KENT MATERNITY PATIENTS RECEIVE INDIVIDUALIZED CARE FROM OUR EXPERIENCED OB NURSING TEAM. LABOR & DELIVERY ---------------- THE WOMEN'S CARE CENTER INCLUDES SIX PRIVATE LABOR AND DELIVERY ROOMS AND A SURGICAL DELIVERY SUITE WITH ANESTHESIA SERVICES AND THE LATEST TECHNOLOGY IN FETAL MONITORING. IN ADDITION, COMPREHENSIVE DIAGNOSTIC AND TREATMENT RESOURCES FROM THE STATE'S LARGEST COMMUNITY HOSPITAL ARE IMMEDIATELY AVAILABLE. POSTPARTUM ---------- KENT OFFERS ALL SINGLE, LARGE AND COMFORTABLE POSTPARTUM ROOMS WITH PRIVATE SHOWERS. MOST ROOMS ARE ALSO SET ASIDE AS FAMILY ROOMS WITH A SLEEP SOFA AND MINI-DINING AREA. THE PEACE OF MIND OF OUR PATIENTS AND FAMILIES IS ALSO OF PRIME IMPORTANCE. THAT'S WHY KENT'S WOMEN'S CARE CENTER IS EQUIPPED WITH ADVANCED SECURITY TECHNOLOGY AND CONTINUOUS ATTENTION TO THE PRIVACY AND COMFORT OF PATIENTS AND FAMILY MEMBERS. SPECIAL CARE NURSERY -------------------- KENT IS PROUD TO BE THE SITE OF THE ONLY COMMUNITY HOSPITAL BASED SPECIAL CARE NURSERY IN RHODE ISLAND. A SKILLED NURSING TEAM IS UNDER THE MEDICAL DIRECTION OF A NEONATOLOGIST, A PHYSICIAN SPECIALIZING IN THE CARE OF NEWBORNS, WHO IS AVAILABLE AT ALL TIMES. THE SPECIAL CARE NURSERY IS OPERATED IN COLLABORATION WITH OUR CARE NEW ENGLAND PARTNER, WOMEN & INFANTS HOSPITAL, AND OFFERS COMPREHENSIVE AND INDIVIDUALIZED CARE FOR NEWBORNS NEEDING THIS ADDITIONAL LEVEL OF SERVICE. EDUCATION AND CHILDBIRTH CLASSES -------------------------------- OUR FAMILY-CENTERED CHILDBIRTH PROGRAM INCLUDES A HOST OF EDUCATION AND SUPPORT CLASSES FROM PRE-PREGNANCY TO POSTPARTUM, SUCH AS OUR POPULAR MOTHER'S CLUB. AND, WE MAKE SURE THAT PROSPECTIVE DADS, BROTHERS AND SISTERS AND OTHER FAMILY MEMBERS ARE INCLUDED ALONG THE WAY. CLASSES ARE SCHEDULED AT CONVENIENT TIMES AND LED BY EXPERIENCED, INFORMATIVE WOMEN'S CARE PROFESSIONALS. OUR CERTIFIED CHILDBIRTH EDUCATORS CAN EVEN ARRANGE INDIVIDUAL PROGRAMS. FOR WOMEN CHOOSING TO BREAST FEED, LACTATION SERVICES ARE AVAILABLE DURING PRENATAL EDUCATION AND AFTER THE BABY IS BORN. ANTENATAL TESTING SERVICES ARE ALSO OFFERED RIGHT IN THE WOMEN'S CARE CENTER IN A COMFORTABLE, WELL-EQUIPPED AREA STAFFED BY A KNOWLEDGEABLE AND RESPONSIVE STAFF. IN ADDITION TO OBSTETRICS AND GYNECOLOGICAL CARE, THE WOMEN'S CARE CENTER OFFERS SERVICES TO FEMALE AESTNETIC PATIENTS WITH THE SAME FOCUS ON PERSONALIZED, QUALITY NURSING CARE IN COMFORTABLE, MODERN SURROUNDINGS. EMERGENCY MEDICINE ================== STAFFED BY BOARD CERTIFIED PHYSICIANS AND EXPERIENCED EMERGENCY NURSES, KENT'S EMERGENCY DEPARTMENT (ED) IS THE SECOND LARGEST IN THE STATE. CARING FOR SOME 70,000 PATIENTS ANNUALLY, THE ED OFFERS 24 HOUR A DAY COMPREHENSIVE, CRITICAL CARE FOR ALL TYPES OF MEDICAL PROBLEMS IN A STATE-OF-THE-ART FACILITY BACKED BY THE LATEST CLINICAL INFORMATION AND DIAGNOSTIC SYSTEMS. KENT HOSPITAL OPENED THE RAPID ASSESSMENT PROGRAM IN ITS EMERGENCY DEPARTMENT IN 2011 WHICH DRAMATICALLY REDUCED WAITING TIMES FROM UP TO TWO HOURS TO JUST MINUTES. IN ADDITION, OVERALL VISIT TIME HAS DRAMATICALLY BEEN REDUCED. KENT HOSPITAL WAS ALSO THE FIRST HOSPITAL IN THE STATE TO ELIMINATE THE PRACTICE OF AMBULANCE DIVERSION. THE KENT EMERGENCY DEPARTMENT OFFERS: ------------------------------------- - INCREASED SPACE AND CAPACITY TO RESPOND TO COMMUNITY GROWTH AND DEMAND - ENHANCED PATIENT CONFIDENTIALITY, COMFORT AND PRIVACY - IMPROVED PATIENT FLOW AND DECREASED WAITING TIMES - ENLARGED WAITING AREAS AND IMPROVED SPACE FOR FAMILIES TO VISIT WITH PATIENTS - GRADE LEVEL AMBULANCE ENTRANCE WITH OVERHEAD SHELTER FOR MULTIPLE ARRIVING EMS UNITS - ENLARGED PATIENT CARE SPACES - DEDICATED ISOLATION AND BEHAVIOR HEALTHCARE ROOMS - STATE-OF-THE-ART DECONTAMINATION FACILITY AND A MOBILE UNIT FOR ADDITIONAL CAPACITY - SEPARATE WALK-IN ENTRANCE AND REGISTRATION AREAS - DIGITAL RADIOLOGY TO ENHANCE DIAGNOSTIC SERVICES AND SPEED DIAGNOSES - A DESIGN THAT CAN ACCOMMODATE UP TO 90,000 PATIENTS ANNUALLY EXPANSION OF THE ED WAS GENEROUSLY SUPPORTED BY THE COMMUNITY THROUGH THE CAMPAIGN FOR KENT. INTENSIVE CARE UNIT =================== INTENSIVE MEDICAL-SURGICAL SERVICES ARE PROVIDED IN KENT'S 15-BED INTENSIVE CARE UNIT (ICU). THE ICU IS UNDER THE DIRECTION OF AN INTENSIVIST, A PHYSICIAN WHO IS BOARD-CERTIFIED IN THE SPECIALIZED CARE OF CRITICALLY ILL PATIENTS. THE UNIT IS STAFFED BY A MULTIDISCIPLINARY HEALTHCARE TEAM, WHICH INCLUDES A PHYSICIAN, NURSE, PHYSICAL THERAPIST, RESPIRATORY THERAPIST, SOCIAL WORKER, NUTRITIONIST AND PASTORAL CARE. PATIENTS BENEFIT FROM ADVANCED TECHNOLOGY AND A PERSONALIZED APPROACH TO MEET THE NEEDS OF EACH INDIVIDUAL AND THEIR FAMILIES. DUE TO THE SEVERITY OF THE PATIENT CONDITIONS ON THIS UNIT, SPECIAL VISITATION GUIDELINES ARE NECESSARY. CARDIOLOGY ========== KENT OFFERS A RESPECTED REGIONAL RESOURCE FOR THE DIAGNOSIS AND MEDICAL MANAGEMENT OF HEART DISEASE. FROM OUTPATIENT CONSULTATION TO TREATMENT IN KENT'S CONGESTIVE HEART FAILURE CLINIC OR COUNSELING FOR HEART TRANSPLANTATION, BRIGHAM AND WOMEN'S CARDIOVASCULAR ASSOCIATES AT KENT HOSPITAL IS STRUCTURED TO SERVE YOU EVERY STEP OF THE WAY FROM DIAGNOSIS TO TREATMENT. A TEAM OF CARDIOLOGISTS, WORKING IN COLLABORATION WITH BRIGHAM AND WOMEN'S HOSPITAL OF BOSTON, BRING UNCOMPROMISED CARE TO THE LOCAL COMMUNITY. SPECIALISTS PROVIDE A BROAD SPECTRUM OF CARDIAC SERVICES INCLUDING CARDIAC CATHETERIZATION; ARRHYTHMIA SERVICES; AN ADVANCED VALVULAR HEART DISEASE CLINIC; TESTING AND EVALUATION; AS WELL AS PACEMAKER AND DEFIBRILLATOR DEVICES. PSYCHIATRY ========== KENT'S 11-BED UNIT CARES FOR PATIENTS NEEDING MENTAL HEALTH SERVICES. THIS DEDICATED UNIT IS STAFFED BY BOARD-CERTIFIED PSYCHIATRISTS AND CERTIFIED PSYCHIATRIC NURSES BACKED BY THE FULL MEDICAL RESOURCES OF THE HOSPITAL. KENT BELIEVES IN THE COMMUNITY ============================== KENT HOSPITAL WORKS TO SUPPORT THE COMMUNITY IN MANY WAYS. AS A CENTRAL LOCATION IN THE REGION, KENT PROVIDES MEETING SPACE TO COMMUNITY ORGANIZATIONS THROUGHOUT THE COURSE OF THE YEAR FOR SUCH ACTIVITIES AS ALCOHOLICS ANONYMOUS, OVEREATERS ANONYMOUS, PARKINSON'S, CHILDBIRTH EDUCATION, BREAST FEEDING CLASSES, ADOPT A FAMILY HOLIDAY ACTIVITIES, BLOOD DRIVES AND FLU CLINICS. FURTHER, KENT STAFF GIVES OF THEIR TIME BACK TO SUCH ACTIVITIES AS STATEWIDE MENTORING PROGRAMS FOR HIGH SCHOOL STUDENTS, RI ACADEMIC DECATHLON, YMCA BOARD OF DIRECTORS AND RESPIRATORY THERAPY PRESENTATIONS FOR AREA VOCATIONAL SCHOOLS. KENT ALSO OFFERS ANNUAL SCREENING PROGRAMS FOR BREAST CANCER, SKIN CANCER AND COLON CANCER.
CORE FORM, PART VI, SECTION A; QUESTION 2 CHARLES R. REPPUCCI, ESQ. AND ROBERT G. FLANDERS, JR., ESQ. - BUSINESS RELATIONSHIP.
CORE FORM, PART VI, SECTION A; QUESTION 3 THE ORGANIZATION ENGAGES SODEXO HEALTH CARE ("SODEXO") TO BE AN AGENT OF THE ORGANIZATION AND DELEGATES CONTROL TO SODEXO IN THE MANAGEMENT OF DAILY OPERATIONS OF ITS FOOD AND NUTRITION DEPARTMENT AND ENVIRONMENTAL SERVICES. THE SODEXO MANAGEMENT EMPLOYEES FUNCTION AND ARE RECOGNIZED AS DEPARTMENT MANAGERS WHO PERFORM IN ACCORDANCE WITH THE ORGANIZATION'S DEPARTMENT MANAGEMENT PRACTICES AND IN ACCORDANCE WITH ITS WRITTEN POLICIES AND PROCEDURES. EACH POSITION REPORTS TO AN OFFICER/KEY EMPLOYEE OF THE ORGANIZATION. THE ORGANIZATION ENGAGES REHABCARE GROUP, INC. TO BE AN AGENT OF THE ORGANIZATION AND DELEGATES CONTROL TO REHABCARE GROUP, INC. IN THE MANAGEMENT OF DAILY OPERATIONS OF ITS INPATIENT AND OUTPATIENT REHABILITATION DEPARTMENTS. THE REHABCARE GROUP, INC. MANAGEMENT EMPLOYEE FUNCTIONS AND IS RECOGNIZED AS A DEPARTMENT MANAGER WHO PERFORMS IN ACCORDANCE WITH THE ORGANIZATION'S DEPARTMENT MANAGEMENT PRACTICES AND IN ACCORDANCE WITH ITS WRITTEN POLICIES AND PROCEDURES. THE POSITION REPORTS TO AN OFFICER/KEY EMPLOYEE OF THE ORGANIZATION.
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.
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 PROVIDED 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 FINANCE DEPARTMENT LEADERSHIP 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 INDIVIDUALS OUTLINED ABOVE, FOR THEIR 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 PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO THE FILING WITH THE IRS.
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.
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 EXECUTIVES AND KEY PHYSICIANS IN CONJUNCTION WITH THE KCMH PRESIDENT AND CHIEF OPERATING OFFICER. THE COMMITTEE AT ALL TIMES CONDUCTS ITSELF FREE FROM EXECUTIVE MANAGEMENT IN ITS DECISION MAKING PROCESS EXCEPT WITH RESPECT TO DECISIONS RELATING TO THE PRESIDENT AND CHIEF OPERATING OFFICER WHICH ARE MADE IN CONJUNCTION WITH THE CARE NEW ENGLAND HEALTH SYSTEM CHIEF EXECUTIVE OFFICER. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE 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 SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT AND COO. 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 MEMBERS OF THE BOARD OF DIRECTORS EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. 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 SENIOR MANAGEMENT PERSONNEL, INCLUDING, BUT NOT LIMITED TO, THE PRESIDENT AND COO. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE ALSO REVIEWED BY THE CARE NEW ENGLAND HEALTH SYSTEM COMPENSATION COMMITTEE. IN ADDITION, THE KENT COUNTY MEMORIAL HOSPITAL PRESIDENT AND COO, WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT, ALSO REVIEWS THE COMPENSATION AND BENEFITS OF OTHER PEOPLE INCLUDED IN THIS FORM 990 IN CONJUNCTION WITH EACH 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.
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.
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. IN ADDITION, HELEN M. REED, FORMER VICE PRESIDENT REVENUE CYCLE OF THE ORGANIZATION, IS STILL EMPLOYED BY CARE NEW ENGLAND HEALTH SYSTEM, AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION AND PARENT ENTITY OF THE CARE NEW ENGLAND HEALTH SYSTEM. MS. REED WORKS 55 HOURS PER WEEK AS THE VICE PRESIDENT REVENUE CYCLE OF CARE NEW ENGLAND HEALTH SYSTEM.
CORE FORM, PART VII, SECTION A, COLUMN B THE ORGANIZATION IS AN AFFILIATE IN THE CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF DIRECTOR MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY ONE HOUR. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION.
CORE FORM, PART VII AND SCHEDULE J SANDRA L. COLETTA, PRESIDENT AND CHIEF EXECUTIVE OFFICER FOR THIS ORGANIZATION FOR THE PERIOD 10/1/2013 - 7/1/2014 WAS TRANSFERRED TO CARE NEW ENGLAND HEALTH SYSTEM; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, ON 7/2/2014 WHERE SHE SERVED AS THE CHIEF OPERATING OFFICER THROUGH THE ORGANIZATION'S YEAR END OF 9/30/2014. MICHAEL DACEY, M.D., SENIOR VICE PRESIDENT MEDICAL AFFAIRS FOR THIS ORGANZIATION FOR THE PERIOD 10/1/2013 - 7/1/2014 BECAME THE PRESIDENT AND CHIEF OPERATING OFFICER OF THIS ORGANIZATION ON 7/2/2014 THROUGH THE ORGANIZATION'S YEAR END OF 9/30/2014. JAMES M. BURKE, VICE PRESIDENT OF FINANCE FOR THIS ORGANIZATION, WAS FORMERLY THE VICE PRESIDENT ACCOUNTING AT CARE NEW ENGLAND HEALTH SYSTEM; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, FOR THE PERIOD 10/1/2013 - 5/1/2014. HE BECAME THE VICE PRESIDENT OF FINANCE OF THIS ORGANIZATION EFFECTIVE ON 5/2/2014 THROUGH THE ORGANIZATION'S YEAR END OF 9/30/2014.
CORE FORM, PART XI; LINE 9 OTHER CHANGES IN FUND BALANCE INCLUDE: - PENSION AND POST RETIREMENT ADJUSTMENT; ($5,741,845); - NET ASSETS RELEASED FROM RESTRICTIONS USED FOR EQUIPMENT PURCHASE; $1,403,240; AND - OTHER DECREASES IN FUND BALANCE; ($438,033).
CORE FORM, PART XII; QUESTION 2 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 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, 2014 AND SEPTEMBER 30, 2013; 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.
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.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
KENT COUNTY MEMORIAL HOSPITAL
 
Employer identification number

05-0258896
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) 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) KENT ANCILLARY SERVICES LLC
455 TOLL GATE ROAD
WARWICK,RI02886
56-2420959 		HEALTHCARE RI 5,008,574 0 KCMH
 
(2) AFFINITY PHYSICIANS LLC
455 TOLL GATE ROAD
WARWICK,RI02886
27-2557996 		HEALTHCARE RI 26,330,100 2,574,015 KCMH
 








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 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
 
 
No
(2) BUTLER HOSPITAL

345 BLACKSTONE BLVD

PROVIDENCE,RI02906
05-0258812 		HEALTHCARE RI 501(C)(3) HOSPITAL CNE
 
 
No
(3) WOMEN AND INFANTS CORPORATION

300 RICHMOND STREET

PROVIDENCE,RI02903
02-2885807 		HEALTHCARE RI 501(C)(3) 509(A)(3) CNE
 
 
No
(4) WOMEN & INFANTS HOSPITAL OF RHODE ISLAND

300 RICHMOND STREET

PROVIDENCE,RI02903
05-0258937 		HEALTHCARE RI 501(C)(3) HOSPITAL WIC
 
 
No
(5) WOMEN AND INFANTS DEVELOPMENT FOUNDATION

300 RICHMOND STREET

PROVIDENCE,RI02903
22-2885815 		HEALTHCARE RI 501(C)(3) 509(A)(3) WIC
 
 
No
(6) WIH FACULTY PHYSICIANS INC

67 BRIGHAM STREET

NEW BEDFORD,MA02740
04-3579432 		HEALTHCARE MA 501(C)(3) 509(A)(2) WIH
 
 
No
(7) KENT HOSPITAL FOUNDATION

455 TOLL GATE ROAD

WARWICK,RI02886
05-0514640 		SUPPORT ORG RI 501(C)(3) 509(A)(3) KCMH
 
Yes
 
(8) KENT COUNTY VNA DBA VNA OF CNE

51 HEALTH LANE

WARWICK,RI02886
05-0242659 		HEALTHCARE RI 501(C)(3) 170B1AVI CNE
 
 
No
(9) HEALTHTOUCH INC

51 HEALTH LANE

WARWICK,RI02886
05-0514949 		HEALTHCARE RI 501(C)(3) 509(A)(2) KCVNA
 
 
No
(10) BUTLER HOSPITAL FOUNDATION

345 BLACKSTONE BOULEVARD

PROVIDENCE,RI02906
45-4530540 		SUPPORT ORG RI 501(C)(3) 509(A)(3) BH
 
 
No
(11) SOUTHEASTERN HEALTHCARE SYSTEM INC

111 BREWSTER STREET

PAWTUCKET,RI02860
06-1476858 		HEALTHCARE RI 501(C)(3) 509(A)(3) CNE
 
 
No
(12) THE MEMORIAL HOSPITAL

111 BREWSTER STREET

PAWTUCKET,RI02860
05-0259004 		HEALTHCARE RI 501(C)(3) HOSPITAL SEHCS
 
 
No
(13) BLACKSTONE HEALTH INC

420 MAIN STREET

PAWTUCKET,RI02860
05-0457007 		HEALTHCARE RI 501(C)(3) 509(A)(1) SEHCS
 
 
No
(14) SHS VENTURES INC

111 BREWSTER STREET

PAWTUCKET,RI02860
05-0510341 		HEALTHCARE RI 501(C)(3) 509(A)(2) TMH
 
 
No
(15) VNA OF CARE NEW ENGLAND FOUNDATION

51 HEALTH LANE

WARWICK,RI02886
46-2293974 		SUPPORT ORG RI 501(C)(3) 509(A)(3) KCVNA
 
 
No
(16) THE MEMORIAL HOSPITAL FOUNDATION

111 BREWSTER STREET

PAWTUCKET,RI02860
46-3246618 		HEALTHCARE RI 501(C)(3) 509(A)(3) TMH
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
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



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No 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)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) TOLL GATE INDEMNITY LTD

23 LIME TREE BAY AVE PO BOX 1051
GRAND CAYMAN   KY1-11
CJ
34-2028514 		FINANCIAL VEHICLE CJ KCMH
  		C CORP. 9,594,135 35,486,595 100.000 %   No
(2) W & I INDEMNITY LTD

23 LIME TREE AVE PO BOX 1051
GRAND CAYMAN   KY1-11
CJ
98-0159342 		FINANCIAL VEHICLE CJ N/A
 C CORP.         No
(3) BOULEVARD MEDICAL CONDO ASSOCIATION

111 BREWSTER STREET
PAWTUCKET,RI02860
05-0497862 		REAL ESTATE RI N/A
 C CORP.         No
(4) PRIMARY CARE CENTER OF NEW ENGLAND INC

111 BREWSTER STREET
PAWTUCKET,RI02860
05-0423957 		HEALTHCARE SVCS. RI N/A
 C CORP.         No






Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) KENT HOSPITAL FOUNDATION

 B 225,000 COST
(2) KENT HOSPITAL FOUNDATION

 C 3,271,693 COST




Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
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)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V?UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
SCHEDULE R, PART V AS OUTLINED IN SCHEDULE O, CARE NEW ENGLAND HEALTH SYSTEM IS THE TAX-EXEMPT PARENT OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. THIS ORGANIZATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) ORGANIZATION. THE SYSTEM ALSO INCLUDES BUTLER HOSPITAL, WOMEN & INFANTS HOSPITAL OF RHODE ISLAND AND THE MEMORIAL HOSPITAL; EACH IS ALSO RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL. CARE NEW ENGLAND HEALTH SYSTEM ROUTINELY PAYS EXPENSES FOR VARIOUS AFFILIATES WITHIN THE CARE NEW ENGLAND HEALTH SYSTEM IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.
Schedule R (Form 990) 2013
Additional Data


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