Form990


Department of the TreasuryInternal 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.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 10-01-2022 , and ending 09-30-2023
BCheck if applicable:
CName of organization
Emma Pendleton Bradley Hospital
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1011 Veterans Memorial Parkway
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
East Providence, RI02915
D Employer identification number

05-0258806
E Telephone number

G Gross receipts $ 106,326,001
F Name and address of principal officer:
Henry T Sachs III MD
 
 
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.lifespan.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: 1957
M State of legal domicile: RI
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: As a member hospital in the Lifespan health system, Emma Pendleton Bradley Hospital (EPBH) is committed to its mission: Delivering health with care.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 16
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 10
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 1,149
6 Total number of volunteers (estimate if necessary) ............. 6 14
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 4,877,341 1,852,448
9 Program service revenue (Part VIII, line 2g) ......... 88,920,226 96,069,486
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -405,351 3,967,075
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)   0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 93,392,216 101,889,009
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...   2,500
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 59,086,934 65,168,706
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet328,892    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 35,421,958 39,163,266
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 94,508,892 104,334,472
19 Revenue less expenses. Subtract line 18 from line 12....... -1,116,676 -2,445,463
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 144,574,684 146,724,385
21 Total liabilities (Part X, line 26)............. 36,233,370 36,588,710
22 Net assets or fund balances. Subtract line 21 from line 20..... 108,341,314 110,135,675
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
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Type or print name and title
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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 (2021)
Form 990 (2021)
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: As a member hospital in the Lifespan health system, EPBH is committed to its mission: Delivering health with care.
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 $ 75,353,181 including grants of $   ) (Revenue $ 85,773,333 )
EPBH provides inpatient treatment for children ages 2 to 18 years suffering from serious behavioral disorders and/or developmental conditions such as mental retardation or autism who are in need of stabilization, assessment, and treatment for suicidal, destructive, self-injurious, or other dangerous or aggressive behaviors. EPBH also offers residential treatment providing intensive, family-centered services to children with emotional and behavioral problems which prevent them from living safely at home. (See also Schedule O)
4b (Code:   ) (Expenses $ 9,010,910 including grants of $   ) (Revenue $ 7,443,910 )
The Bradley Hasbro Children's Research Center is devoted to the study and treatment of children at risk for serious mental disorders and behavior processes that support the intergenerational transmission of illness. The research areas are broad and include: Child and Adolescent Psychiatric Disorders, Pediatric Behavioral Health, Biological Basis of Psychiatric Disorders, Prevention and Early Intervention, Health Services Research, Pediatric Mood, Imaging & Neurodevelopment, Developmental Disorders Genetics Research, and Neuroplasticity/Autism Disorders. Included in total program expenses and revenue are approximately $339,000 of research grants from for-profit organizations that are not reported in Schedule H.
4c (Code:   ) (Expenses $ 2,906,362 including grants of $   ) (Revenue $ 3,197,635 )
Home-based intensive behavioral treatment is for children who have been diagnosed with Autism Spectrum Disorder (ASD) or who have varying degrees of chronic behavior disorders that, if left untreated, would worsen and require more intensive treatment, including psychiatric hospitalization or out-of-home residential placement. Staff members visit a family's home and deliver clinical services to the child on a one-on-one basis. The treatment plan is family-oriented, as it includes all family members in the treatment process. (See also Schedule O)
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet87,270,453
Form 990 (2021)
Form 990 (2021)
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
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
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 I.............
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 II.........
4
 
No
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 Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III..
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
List of Attached Documents:
// Content
.........................
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
List of Attached Documents:
// Content
....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment
List of Attached Documents:
// Content
..............
8
Yes
 
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
List of Attached Documents:
// Content
..............
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
List of Attached Documents:
// Content
......
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
List of Attached Documents:
// Content
...................
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
List of Attached Documents:
// Content
.......
11b
Yes
 
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
List of Attached Documents:
// Content
.......
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
List of Attached Documents:
// Content
............
11d
Yes
 
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
11f
Yes
 
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
List of Attached Documents:
// Content
......................
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
List of Attached Documents:
// Content
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.........
14b
 
No
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 IV.....
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...
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. ....
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............
18
 
No
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...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
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
List of Attached Documents:
// Content
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...............Click to see attachment
List of Attached Documents:
// Content
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
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
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
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.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
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
List of Attached Documents:
// Content
33
 
No
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
35b
Yes
 
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
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
102
b
Enter the number of Forms W-2G included on 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
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
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
1,149
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
 
No
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
 
 
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
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
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
0
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
 
No
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
No
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring 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
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
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
16
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
10
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
 
No
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 on 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 on 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 on 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
RI
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 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, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletPeter K Markell167 Point Street   Providence,RI02903 (401) 444-7914
Form 990 (2021)
Form 990 (2021)
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 the 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, Form 1099-MISC, and/or box 1 of Form 1099-NEC) 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.

See the instructions for the order in which to list the persons above.
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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(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) Timothy J Babineau......................................................................
Fmr Trustee
0.00
.................
0.00
            0 6,453,503 383,339
(2) Ziya L Gokaslan MD......................................................................
Trustee
0.50
.................
42.50
X           0 1,671,096 49,960
(3) Paul J Adler......................................................................
Secretary
2.50
.................
37.50
    X       0 744,106 145,044
(4) David A Kirshner......................................................................
Treasurer-11/22
0.00
.................
0.00
X           0 857,218 20,609
(5) G Alan Kurose......................................................................
Fmr Trustee
0.00
.................
50.00
            0 636,825 63,815
(6) Henry T Sachs III MD......................................................................
Pres. & CMO
45.00
.................
3.00
    X       0 454,323 107,767
(7) Karyn J Horowitz MD......................................................................
Chief Medical Officer
40.00
.................
0.00
            377,071 0 79,591
(8) Arthur J Sampson......................................................................
Trustee
0.00
.................
8.00
X           0 417,696 18,300
(9) Eva Greenwood......................................................................
Treasurer
0.50
.................
39.50
X           0 198,973 34,915
(10) Mary A Carskadon PhD......................................................................
Physician
40.00
.................
0.00
            183,706 0 22,567
(11) Margaret R Paccione-Dyslewski PHD......................................................................
Dir. Behav. Ed.
40.00
.................
0.00
            167,801 0 31,583
(12) Susan Lantz......................................................................
Interim CNO
40.00
.................
0.00
            178,032 0 21,262
(13) Nicole A Nappe......................................................................
Clinical Mgr
40.00
.................
0.00
            152,670 0 38,360
(14) Stephanie H D'Atri......................................................................
Dir. Early Child.
40.00
.................
0.00
            152,598 0 38,383
(15) Ellen M Hallsworth......................................................................
Dir. REACH
40.00
.................
0.00
            159,945 0 5,491
(16) Lawrence A Aubin Sr......................................................................
Chair
0.50
.................
7.50
X   X       0 0 0
(17) Emanuel Barrows......................................................................
Trustee
0.50
.................
6.50
X           0 0 0
Form 990 (2021)
Form 990 (2021)
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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(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) Roger N Begin........................................................................
Trustee
2.00
.......................10.50
X           0 0 0
(19) Peter Capodilupo........................................................................
Vice Chair
0.00
.......................5.00
X   X       0 0 0
(20) Sarah T Dowling JD LLM........................................................................
Trustee
0.00
.......................13.00
X           0 0 0
(21) Edward D Feldstein Esq........................................................................
Trustee
0.10
.......................2.00
X           0 0 0
(22) John Fernandez........................................................................
Trustee
2.00
.......................48.00
X           0 0 0
(23) Philip Kydd........................................................................
Trustee
0.50
.......................6.00
X           0 0 0
(24) Alan H Litwin........................................................................
Vice Chair
0.50
.......................9.00
X   X       0 0 0
(25) Martha B Mainiero MD........................................................................
Trustee
0.25
.......................2.85
X           0 0 0
(26) Steven Pare........................................................................
Trustee
0.00
.......................3.00
X           0 0 0
(27) Lawrence B Sadwin........................................................................
Trustee
5.00
.......................12.00
X           0 0 0
(28) Shivan Subramaniam........................................................................
Trustee
0.25
.......................5.25
X           0 0 0
(29) Jane Williams PhD RN........................................................................
Trustee
5.00
.......................27.00
X           0 0 0
(30) Michael L Hanna........................................................................
Trustee
0.25
.......................6.05
    X       0 0 0
(31) Peter K Markell........................................................................
EVP & CFO
0.00
.......................0.00
    X       0 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 1,371,823 11,433,740 1,060,986
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet56
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
Aramark Services Inc

PO Box 978839
Dallas,TX75397
Food Service 1,614,106
AMN Healthcare Inc

2735 Collection Center Dr
Chicago,IL60693
Contract Labor 799,342
Butler Hospital

350 Duncan Drive
Providence,RI02906
Residency Rotations 658,385
Brown University

PO Box 1911
Providence,RI02906
Shared Chair 560,424
EI US LLC

PO Box 4110
Woburn,MA01888
Academics 201,440
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet6
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 1,506,548
e Government grants (contributions)1e 345,900
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 1,852,448
 Program Service RevenueAmt Business Code
2a Inpatient Routine 622210 48,823,614 48,823,614    
b Partial Hospitalization 622210 22,298,970 22,298,970    
c Research 541700 8,956,206 8,956,206    
d Residential 623220 14,179,285 14,179,285    
e Special Purpose Funds 622210 995,475 995,475    
f All other program service revenue. 815,936 815,936    
g Total. Add lines 2a–2f .....MediumBullet 96,069,486
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 1,804,915     1,804,915
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents     6a
b Less: rental expenses     6b
c Rental income or (loss)     6c
d Net rental income or (loss).......MediumBullet 0      
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   6,599,152 7a
b Less: cost or other basis and sales expenses   4,436,992 7b
c Gain or (loss)   2,162,160 7c
d Net gain or (loss).........MediumBullet 2,162,160     2,162,160
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 0
12 Total revenue. See instructions.....MediumBullet 101,889,009 96,069,486   3,967,075
Form 990 (2021)
Form 990 (2021)
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 domestic organizations and domestic governments. See Part IV, line 21 .... 2,500 2,500
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. 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 ........... 583,060 583,060    
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........ 50,384,924 48,328,985 2,055,939  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 2,757,623 2,629,749 127,874  
9 Other employee benefits ....... 7,886,695 7,631,883 254,812  
10 Payroll taxes ........... 3,556,404 3,394,944 161,460  
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 ...... 49,453   49,453  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 13,788,862 13,795,950 -7,088  
12 Advertising and promotion .... 31,628 31,374 254  
13 Office expenses ....... 3,303,091 2,323,942 979,149  
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 1,996,926 1,248,866 748,060  
17 Travel ............ 194,101 186,304 7,797  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 234,643 192,914 41,729  
20 Interest ........... 565,688 90,017 475,671  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 3,193,438 2,082 3,191,356  
23 Insurance ... 751,932 751,932    
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 11,398,799 2,874,652 8,524,147  
b Other expenses 3,222,224 3,097,710 124,514  
c Fundraising expenses 328,892     328,892
d Bad Debt Expense 103,589 103,589    
e All other expenses 0      
25 Total functional expenses. Add lines 1 through 24e 104,334,472 87,270,453 16,735,127 328,892
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 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 175,622 1 197,137
2 Savings and temporary cash investments ......... 2,356,750 2 3,677,536
3 Pledges and grants receivable, net ...... 1,441,783 3 1,220,955
4 Accounts receivable, net ............. 11,794,817 4 11,245,445
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6 0
7 Notes and loans receivable, net ...........   7 0
8 Inventories for sale or use ............ 170,435 8 185,532
9 Prepaid expenses and deferred charges ...... 4,984,019 9 3,775,199
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 63,487,825
b Less: accumulated depreciation 10b 28,459,630 34,287,582 10c 35,028,195
11 Investments—publicly traded securities . 13,476,748 11 15,270,434
12 Investments—other securities. See Part IV, line 11 ..... 7,323,970 12 7,579,248
13 Investments—program-related. See Part IV, line 11 .. 23,265,211 13 23,265,211
14 Intangible assets ...............   14 0
15 Other assets. See Part IV, line 11 ........... 45,297,747 15 45,279,493
16 Total assets. Add lines 1 through 15 (must equal line 33)... 144,574,684 16 146,724,385
Liabilities 17 Accounts payable and accrued expenses ..... 6,285,484 17 6,017,254
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities ......... 15,969,255 20 14,541,058
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties .. 3,000,000 23 3,000,000
24 Unsecured notes and loans payable to unrelated third parties ..   24  
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 10,978,631 25 13,030,398
26 Total liabilities. Add lines 17 through 25.. 36,233,370 26 36,588,710
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 42,916,377 27 42,686,048
28 Net assets with donor restrictions ........... 65,424,937 28 67,449,627
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 108,341,314 32 110,135,675
33 Total liabilities and net assets/fund balances ........ 144,574,684 33 146,724,385
Form 990 (2021)
Form 990 (2021)
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
101,889,009
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
104,334,472
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-2,445,463
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
108,341,314
5
Net unrealized gains (losses) on investments ...............
5
2,556,137
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
265,956
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
1,417,731
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
110,135,675
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 on
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 (2021)
Form 990 (2021)
Additional Data


Software ID: 22015553
Software Version: 2022v5.0
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
Emma Pendleton Bradley Hospital
 
Employer identification number

05-0258806
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 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
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 failed 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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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 VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization .......................right arrow
b
33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow
17a
10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
b
10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
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) 2022

Schedule A (Form 990) 2022
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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 on 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 VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow
b
33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow
20
Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2022 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2022
(iii)
Distributable
Amount for 2022
1 Distributable amount for 2022 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2022:
a From 2017.......  
b From 2018.......  
c From 2019.......  
d From 2020.......  
e From 2021.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2022 distributable amount  
i Carryover from 2017 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2022 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2022 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2022, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.
 
6 Remaining underdistributions for 2022. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.
 
7 Excess distributions carryover to 2023. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2018.....  
b Excess from 2019.....  
c Excess from 2020.....  
d Excess from 2021.....  
e Excess from 2022.....  
Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990) 2022


Additional Data


Software ID: 22015553
Software Version: 2022v5.0
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Name of the organization
Emma Pendleton Bradley Hospital
 
Employer identification number

05-0258806
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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2022)
Schedule B (Form 990) (2022) Page 2
Name of organization
Emma Pendleton Bradley Hospital
 
Employer identification number
05-0258806
Part I
Contributors
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


(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) (2022)
Schedule B (Form 990) (2022)
Page 3
Name of organization
Emma Pendleton Bradley Hospital
 
Employer identification number

05-0258806
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) (2022)
Schedule B (Form 990) (2022)
Page 4
Name of organization
Emma Pendleton Bradley Hospital
 
Employer identification number

05-0258806
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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) (2022)
Additional Data


Software ID: 22015553
Software Version: 2022v5.0
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on 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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Emma Pendleton Bradley Hospital
 
Employer identification number

05-0258806
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of 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" on 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 7/25/06, 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB 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 FASB 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)
Revenue included on 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 FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $ 8,140
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
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" on 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, for escrow or custodial account liability? ...
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" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance .... 86,248,062 89,986,465 77,657,734 70,079,480 71,532,423
b Contributions ... 13,574,492 21,483,958 10,830,772 13,349,949 8,706,364
c Net investment earnings, gains, and losses 4,437,729 -11,091,876 13,230,965 1,707,082 -680,240
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
15,443,527 14,130,485 11,733,006 7,478,777 9,479,067
f Administrative expenses ....          
g End of year balance ...... 88,816,756 86,248,062 89,986,465 77,657,734 70,079,480
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on 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)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
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" on 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 .....   4,000 4,000
b Buildings ....   45,802,592 20,708,351 25,094,241
c Leasehold improvements        
d Equipment ....   13,500,830 7,751,279 5,749,551
e Other .....   4,180,403   4,180,403
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 35,028,195
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on 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........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 7,579,248
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on 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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 23,265,211
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)Deferred Financing Costs 95,351
(2)Donated Art 8,140
(3)Interest in NA of Bradley Hospital Fndtn 1,485,326
(4)Other non-current Leases 35,772
(5)Participation in HBCS Net Assets 7,800
(6)Right-of-Use Assets,Net Operating Leases 945,243
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 45,279,493
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 13,030,398
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) 2021

Schedule D (Form 990) 2021
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on 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 (losses) 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' on 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
Part III, Line 4: Description of organization's collections and how it furthers its purpose. EPBH's collection of artwork consists of paintings, a sculpture, and a vase. The works of art are displayed throughout EPBH for the viewing pleasure of patients, visitors, and employees.
Part V, Line 4: Intended uses of the endowment fund. EPBH's endowment funds consist of both donor-restricted endowment funds and funds designated by EPBH to function as endowments. EPBH receives support from various irrevocable outside trusts within its endowment funds, most notably The Helen Bradley Trust and The George L. Bradley Trust (the Trusts), which were established under the wills of the late Helen and George L. Bradley. At September 30, 2022, the market value of the Trusts was approximately $32.9 million (not including land and the original Laufer Building in East Providence, Rhode Island where EPBH is located). As a result of a court order in 2007, the Trusts were authorized to make annual distributions to EPBH based on the trailing twelve-quarter average fair market value of the Trusts' investment assets in amounts equal to 7% of the average market value of the Trusts in 2007, decreasing by one-quarter of one percent per year to 4.5% in 2017 and beyond.EPBH's largest temporarily restricted fund as of September 30, 2022 consisted of a $600,000 donation from Bradley Hospital Foundations yearly gala, that will support the creation of a splash pad and play area on the EPBH campus. EPBH's second largest fund of $451,335 supports the Healing Arts program that provides creative and therapeutic activities that improve and enhance the physical, mental and emotional well-being of patients by offering a wide variety of visual art projects, performance arts and musical programs.EPBH also has a Childrens Psychiatry Directors fund that has $420,565 available for staff recruitment and academic support for Childrens Psychiatry programs.The Samuel Swan Trust supports a fund of $412,220 that has been established for the maintenance and repair of the Swan House and general support for EPBHs programs. And another of EPBHs temporarily restricted funds, The Family Support fund has $375,617 dedicated to helping with emergency needs of EPBH patients families.
Part X : FIN48 Footnote EPBH and its affiliate, Lifespan School Solutions, Inc., are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and are exempt from Federal income taxes pursuant to Section 501(a) of the Code. EPBH recognizes the effect of income tax positions only if those positions are more likely than not to be sustained. Recognized income tax positions are measured at the largest amount of benefit that is greater than fifty percent likely to be realized upon settlement. Changes in measurement are reflected in the period in which the change in judgment occurs. EPBH did not recognize the effect of any income tax positions in either 2023 or 2022.
Schedule D (Form 990) 2021


Additional Data


Software ID: 22015553
Software Version: 2022v5.0




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
Emma Pendleton Bradley Hospital
 
Employer identification number

05-0258806
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 criteria used 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
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
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) . . .
    32,951 41,949 -8,998  
b Medicaid (from Worksheet 3, column a) . . . . .     55,613,671 48,118,841 7,494,830 8.598 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     55,646,622 48,160,790 7,485,832 8.598 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     114,597 13,032 101,565 0.117 %
f Health professions education (from Worksheet 5) . . .     2,553,525 276,891 2,276,634 2.612 %
g Subsidized health services (from Worksheet 6) . . . .     9,700,001 6,892,012 2,807,989 3.221 %
h Research (from Worksheet 7) .     9,010,910 7,443,910 1,567,000 1.798 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     11,952   11,952 0.014 %
j Total. Other Benefits . .     21,390,985 14,625,845 6,765,140 7.761 %
k Total. Add lines 7d and 7j .     77,037,607 62,786,635 14,250,972 16.359 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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 Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
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
55,959
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
 
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
 
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
 
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
 
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) 2022
Schedule H (Form 990) 2022
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?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Emma Pendleton BradleyHospital
1011 Veterans Memorial Parkway
East Providence,RI02915
https://www.bradleyhospital.or
HOS00123
X   X X            
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 4
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)
Emma Pendleton BradleyHospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 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 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 22
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): See Schedule H, Part V, Section C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, 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) 2022
Schedule H (Form 990) 2022
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Emma Pendleton BradleyHospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
See Schedule H, Part V, Section C
b
See Schedule H, Part V, Section C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 6
Part VFacility Information (continued)

Billing and Collections
Emma Pendleton BradleyHospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 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
f
19 Did the hospital facility or other authorized 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Emma Pendleton BradleyHospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 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
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 3j Part V, Line 3e- The significant needs identified in EPBH's 9/30/2022 CHNA have been prioritized in order of significant needs of the community, as determined by the organization.On February 27, 2020, the first case of COVID-19 was confirmed in Rhode Island, moving the nations smallest state onto the worldwide coronavirus map. After that date, cases began to increase quickly throughout the state. The first stay-at-home order was issued on March 20, 2020, requiring all Rhode Island residents to stay at home unless getting food, medicine, or other essentials. Originally scheduled to remain in effect until April 13, the order also banned gatherings of more than five individuals and required out-of-state visitors to quarantine for 14 days. As cases increased, Governor Gina Raimondo announced on April 23 that schools would remain closed for the rest of the academic year. Many hospitals also postponed elective and non-emergent procedures until a later date. By April 28, 2020 hospitalization rates were at their first all-time high at 373, with 88 of these patients in the ICU and 59 on ventilators. Eventually, hospitalization rates and case numbers began to decrease, reaching a low on July 7, 2020 with only 58 Rhode Islanders hospitalized due to COVID.During the month of July 2020 the state started to slowly re-open allowing some beaches, restaurants, and entertainment businesses to resume operations (with minimum capacity), and hospitals to begin performing elective procedures again. By fall, most schools were also able to open again. After an increase in COVID-19 cases in November 2020, Raimondo announced a statewide pause reclosing many bars, gyms, and recreational venues.30 By December 15, 2020, hospitalization rates reached a high of 514 in-patients.After this peak, rates slowed for a period, partly due to the distribution of vaccines that started in February 2021 with doses initially being offered to individuals aged 75 and older. After first distributing the vaccine to those most at risk, Rhode Island gradually allowed other groups of residents to register. As of the writing of this report (June 2022), 98.5% of the Rhode Island population is at least partially vaccinated; 83% have completed their primary series; and 41.2% have received boosters. These statistics vary depending on age, gender, and race. For example, 99% of residents between the ages of 70 and 79 have received their primary COVID-19 vaccine series while those between 19 and 24 have a lower primary vaccination rate of 62.2%. As of April 10, 2021, approximately 68.5% of the states partially vaccinated population identified as white and less than 5% identified as Black.On July 20, 2021, hospitalization rates hit another low when only 23 patients were inflicted with COVID. However, as the season changed to winter, rates spiked again with a new all-time high of 618 inpatients on January 17, 2022. Despite this being the highest record of hospitalizations, the greatest number of COVID-related fatalities still occurred at the beginning of the pandemic.Since the beginning of 2022, COVID-related rates have decreased, with a slight increase as of the drafting of this report (June 2022). Overall, the town of Central Falls has the highest rate of COVID cases in the state, ahead of Pawtucket, East Greenwich, and Providence (respectively at 2nd, 3rd, and 4th place). In contrast, the towns of Little Compton and Jamestown have the lowest COVID rates and related hospitalizations. Across the state of Rhode Island, over 8 million COVID tests have been administered; approximately 400,000 positive cases have been reported; and over 3,500 COVID-related deaths have occurred.
Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 5 The CHNA process involved the integration of information from a range of data sources to identify the significant health needs of the community served by EPBH, prioritization of those needs, and identification of resources, facilities, and programs to address the prioritized needs. Both qualitative primary data and secondary quantitative data were gathered to identify the significant health needs of the community.Primary data sources used for this report include community health forums, individual surveys, and key informant interviews. Secondary data sources include national and local publications of data that is specific to the state of Rhode Island and the EPBH service area.Community Health ForumsQualitative data was collected through Community Health Forums (CHF) to solicit input from individuals representing the broad interests and perspectives of the community. Community forums are a standard qualitative social science data collection method, used in community-based or participatory action research. Participants in the CHF included members of the medically underserved, low-income, and minority populations in the EPBH service area.Four CHF were held between May 3 and June 1, 2022, across the EPBH service area, with 71 participants. Participants were recruited using social media, electronic newsletter, email, and word of mouth. A mix of in-person and virtual (Zoom) forums were scheduled at easily accessible locations and at various times of the day. In-person EPBH forums were held at a public library and a substance use treatment and support center. At each in-person forum, a full meal was provided, along with childcare and interpretation if requested in advance. All CHF were open to the public and participants were engaged in a 90-minute discussion. In lieu of the provision of a meal, five $25 grocery store gift cards were raffled off as an appreciation of participation at each virtual forum.A community outreach representative of EPBH served as a hospital liaison to help plan and facilitate the CHF. The hospital liaison was a critical link between the LCHI as the coordinating body, the expertise and resources within the hospital, and the Community Liaisons described below.An important and unique component of the CHF was the involvement of Community Liaisons. Two people representing the diverse populations served by EPBH were hired as consultants to assist with the CHNA. These Community Liaisons helped plan the CHF, recruited participants, and co-facilitated the forums. Community Liaisons were chosen through a competitive selection process and completed a 90-minute training prior to leading the CHF. The training included project planning tips, role-playing activities, conflict management tips, and logistical expectations. Community Liaisons were responsible for identifying an accessible community venue for each forum, selecting a food vendor and menu that would be appealing to the target audience, and co-facilitating the discussion at the CHF with their hospital liaison.Each in-person CHF was two hours in duration and began with a meal, followed by a 90-minute discussion, co-facilitated by the hospital and Community Liaison, that generated consensus on the participants health concerns, their prioritization of those concerns, and their ideas for how EPBH could respond to those concerns. Discussion began with a brief presentation of EPBHs 2019 CHNA priorities and examples of activities the hospital has performed in response. Participants were invited to share their reactions to what was presented as well as their current health concerns. Virtual forums were 90 minutes in duration and followed the same discussion format as the in-person CHF. The input gathered during the CHF was assessed qualitatively to extract themes and quantitatively to determine the frequency with which those themes were cited. Community Liaisons also met with the LCHI and the hospital liaison to debrief the forums and offer their interpretation of the findings to ensure all input was captured and that priorities were appropriately aligned.Hiring, training, and empowering community members to serve as Community Liaisons in the CHNA process enriched the quantity and quality of community input. It also allowed EPBH to build relationships with communities that might not otherwise have become aware of or engaged in the needs assessment process.Individual SurveysTo broaden the reach of community input, an online survey was promoted, and paper surveys were distributed and collected by LCHI staff at community events they attended in June 2022. The surveys addressed the same questions as the CHF. Eleven individual surveys were received for EPBH. Key Informant InterviewsPublic health and health policy leaders who could inform the 2022 CHNA process and had knowledge, information, or expertise about the community that EPBH serves were invited to be interviewed as part of the CHNA. Key informant interviews were conducted with these leaders to supplement the other quantitative and qualitative data collected. Key informants included: Chief Strategy Officer, Executive Office of Health and Human Services, State of Rhode Island; Director of Policy, Planning and Research, Executive Office of Health and Human Services, State of Rhode Island; Director, Health Equity Institute and Maternal and Child Health, Rhode Island Department of Health; Vice President and Chief Medical Officer, Providence Community Health Centers; Executive Director, Rhode Island Parent Information Network; Director, Community Health Worker Association of Rhode Island; and Executive Vice President and Chief Medical Officer, Blue Cross Blue Shield Rhode IslandThe key informants identified the following statewide health priorities, with the first three named by multiple leaders: Apply hospital resources to address the social determinants of health, including housing, food, transportation, and employment, among other barriers to care. Improve access to behavioral health care for children and adults, especially noting access challenges for children and the burden of substance misuse among adults. Ensure the provision of equitable care with particular attention to ensuring equal access to high quality care for persons regardless of their race, ethnicity, language spoken or disability status. They noted that equitable care also required a workforce representative of the patients and implementation of the principles of anti-racism. Improve access to primary and specialty care locally. Grow the healthcare and behavioral health workforces through career pathways, higher reimbursement rates, and increased compensation. Improve access to community-based services including home-based therapeutic services for children with special needs. Reduce racial and ethnic disparities in maternal and child health.The interviewed leaders noted several opportunities for hospitals to contribute to efforts to address these goals including: innovate around care delivery models for behavioral health services for adults; invest in systems and technology to facilitate improved care coordination between primary and specialty care, as well as hospital and community-based providers; partner with state and community-based agencies on workforce development pathways for high-demand roles- notably behavioral health providers and community health workers; provide assistance to patients to help them navigate the healthcare system; and sustain access to telemedicine that was made available during the peak of the COVID-19 pandemic.EPBH Patient Data, Calendar Year 2021Lifespans Planning Department analyzed EPBH patient data on patients, admissions, and encounters was disaggregated by town of residence, age, race, ethnicity, language spoken, gender, and payor mix for calendar year 2021. This inpatient and outpatient data is important for understanding trends in utilization of hospital services.
Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 6a Newport HospitalRhode Island HospitalThe Miriam Hospital
Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 11 EPBH's Community Health Needs Assessment issued for the fiscal year ended September 30, 2022 identified four significant health issue areas requiring a further implementation strategy. Those significant health issue areas include: (1) community education and prevention; (2) access to treatment services; (3) navigation assistance and referrals to community services; and (4) parent training on mental health topics. The implementation strategy to address those significant health needs outlined between October 1, 2022 - September 30, 2025 is available at: https://www.lifespan.org/sites/default/files/2023-04/2022-EPBH-CHNA-Implementation-Plan.pdfDuring the fiscal year ended September 30, 2020, EPBH implemented the specific actions listed below in order to address the significant community health needs outlined in its CHNA Implementation Strategy issues February 11, 2020.Offer Mental Health First Aid in English and Spanish to the general population and school staff: A total of 55 classes (27 adult; 28 youth) were offered in the community, resulting in 775 people certified in Mental Health First Aid. Providence Public Schools and Mentor Rhode Island trained the required minimum 10% staff in Youth MHFA to begin implementing teen MHFA. Mentor RI held their first teen MHFA class in October 2023, certifying 8 youth from their Juvenile Justice Initiative program.Continue to offer annual Parenting Matters Conference and Workshops: A Parenting Matters Workshop was held on December 15, 2022; The Annual Bradley Hospital Parenting Matters Conference was held Saturday, April 1, 2023. The Parenting Matters Conference also included several additional workshops related to sections of Community Education and Prevention, Transition Support, Navigation Assistance and Referral to Community Resources, and Parent Training on Mental Health Topics. On July 13th, 2023 the Bradley Hospital Parent Support Group Special Education Workshop was held. Bradley offers monthly Hospital Parent Support Group Meetings and the Bradley Hospital Family Liaison Program Referral and Resource Information. All workshops are free and open to the public.Offer educational programs on behavioral health topics identified in EPBHs CHNA for professionals who work with school age children: BLE presented 113 Professional development trainings for over 30 different school districts, community health centers, colleges and organizations throughout RI, CT & MA. The BLE trained approximately 2,300 individuals. Some of the most frequently requested trainings/topics were: Trauma Informed Care/Trauma Sensitive Schools; De-Escalation training; The Hidden Message: Understanding Challenging Behavior /Managing Transitions Creating a Softer Classroom/Calming Corner; Autism Thinking and Autism focused trainingsIncrease access to suicide prevention programming through schools: BLE presented 38 Suicide Prevention trainings in 15 different school districts, community health centers, Colleges and organizations throughout RI & MA. BLE trained approximately 2100 individuals in Suicide Prevention.Collaborate with Newport Hospital (NH) to increase supports for adolescents on Aquidneck Island: Bradley Access continues to coordinate with the NH Emergency Department when they have patients in need of inpatient admission. We monitor availability of inpatient beds and facilitate transfers from NH to Bradley as quickly as possible. KidsLink received 113 calls from Aquidneck Island during fiscal year 2023 (based on callers who gave location information). We maintain a statewide Community Resource list that staff use for referrals. We currently have 6 providers from Aquidneck Island on the list.Promote the Pediatric Psychiatry Resource Network (PediPRN) to family physicians and KIDS Link (a hotline for children in emotional crisis) to parents: 49% of PediPRN consultations included assisting PCPs with assessing LOC and referral resources for appropriate LOC for their patients with BH concerns. PediPRN fielded 222 consultations and participated in training approximately 89 pediatric primary care providers and 19 other pediatric providers (affiliated with pediatric practices on BH related topics to facilitate their confidence and competence in addressing the BH needs of their patients over the course of 12 trainings. Provision of mental and behavioral health services to children and parents without requiring in person appointments. PediPRN consultations addressed BH service needs of over 170 children via their primary care provider. PediPRN has a video library on child BH topics on its website. We also have additional valuable resource information for PCPs on childrens behavioral health.Increase utilization of Bradley REACH (Remote E-therapy for Adolescents and Children) Program), a groundbreaking program to expand virtual access to psychiatric programs for children & adolescents: Bradley REACH virtual PHP program treated 134 patients in four states: RI, MA, CT & FL. The REACH program opened in FL in spring 2023, marking the first time that Bradley Hospital has provided care to patients located outside New England. The Apalachee Center, our partner organization in FL is located in an area of extremely high behavioral health workforce shortage (only 3 child and adolescent psychiatrists in the counties they serve) meaning that the high-quality virtual workforce we provide is of huge value to these communities. Attendance in the program was 95.3% which testifies to the fact that the accessibility of Bradley REACH means that patients are getting a higher dose of treatment because the program makes care accessible in their own homes and communities. Youth Outcomes Questionnaire (YOQ) data shows that the REACH program is taking children from a level of acuity where they might need inpatient care, to close to the average level of acuity for outpatient care. This is supported by the fact that 86.6% of patients discharged to outpatient or home-based services in this period. Only 5.2% of patients discharged to the ED or inpatient care, demonstrating that Bradley REACH is keeping acute adolescents out of higher levels of care. In FY23 Bradley REACH grew its profile by launching a website which had over 10,000 page views since January 2023. In April 2023 we launched a blog with information on mental health aimed at families. By the end of September 2023, we had published 21 blogs on topics including social media, parenting teens, autism, telehealth, trauma and suicide. We also launched our social media platform where the information is targeted at families. In FY23 Bradley REACH also facilitated consultations with 9 hospitals or health care providers who visited or consulted with our teams virtually to learn more about the quality care that Bradley provides and our continuum of care. These providers came from as far away as Australia, Kansas, Utah, Michigan and Missouri. Five of these consultations focused on Bradleys Center for Autism and Developmental Disabilities (CADD) and 4 focused on the medical psychiatric program at Hasbro.Improve access to language interpretation to facilitate access for patients who speak a language other than English: In the last fiscal year, we have hired one social worker who can provide clinical care in Spanish. MiGente Program has hired 2 research assistants and 1 Post-Doctoral Psychologist who are also Spanish speaking. Provide transition supports to adult care/services: Clinic social worker leads our transition services. She spends approximately 30% of her time assisting families with the transition process. Primary role is meeting with families who have children with ASD and other developmental challenges who receive care at Bradley, to review transition planning needs, and providing ongoing assistance, as needed, to families as their children transition into adult services. While initial meetings with families can often be billed, much of the follow up is funded by Verrecchia clinic through the familys generous philanthropy. The Social worker provides training and support to clinicians throughout the hospital when they have questions or need guidance regarding transition services and supports; accepts referrals from providers outside of Bradley and will meet with the families to introduce considerations for all the above.; serves as liaison to many agencies who provide home based care, to identify available services for children/young adults and their families; and provides education to psychiatry trainees regarding the transition process.Offer a menu of web-based, distance learning, and in-person educational programs through Bradley Learning Exchange: Currently there are more than 30 courses available online provided by Bradley faculty. All courses and CME/CEUs are free of charge. Courses have been completed by learners in all 50 states, 44 international countries representing 1,000 learners. In FY23 there were 6 Presentations with approximately 200 participants mostly regionally. The most pop
Facility: Emma Pendleton BradleyHospital - Part V, Section B, Line 16j An abbreviated version of EPBH's Financial Assistance Policy is posted in various admitting and outpatient areas of EPBH. Additionally, registration personnel refer uninsured and/or low-income patients to Patient Financial Counselors to discuss the policy and/or answer any questions they might have.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 9
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?  
Name and address Type of Facility (describe)
1 Bradley Research Center
1 Hoppin Street
Providence,RI02903
Research Facility
2 The Bradley Center
Proprietary
Cranston,RI02920
Residential Program
3 Compass Lincoln House
Proprietary
Lincoln,RI02865
Residential Program
4 Exeter House
Proprietary
North Providence,RI02911
Residential Program
5 Heritage House
Proprietary
Warwick,RI02888
Residential Program
6 Hill House
Proprietary
Exeter,RI02911
Residential Program
7 Rumford House
Proprietary
East Providence,RI02916
Residential Program
8
9
10
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 10
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
Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) EPBH uses a dual system for determining financial aid eligibility: federal poverty guidelines and an asset test.The financial screening process at EPBH is intended to define probable eligibility for public assistance (Medicaid or Community Free Care ("CFS")) for those patients who do not have the means to pay for hospital services rendered, as follows:1. Upon patient indication of an inability to pay required monies, the patient is offered the financial screening option to determine eligibility for public assistance (Medicaid, CFS).2. The application for CFS is completed and includes information relative to income, expense, and other available resources, and requires proof of such information which may include:- most recently filed Federal income tax return and any supporting W-2 form(s)- copies of most recent savings and/or checking account statements- two most recently received payroll check stubs3. If the patient's financial situation falls within the guidelines for eligibility for Medicaid or CFS, the appropriate application process is completed. (Assistance to complete such applications is available from the Patient Financial Advocates (PFA) Office at EPBH.)4. Uninsured patients receive an automatic deduction at EPBH equal to the amount calculated using the prospective method, referred to as amounts generally billed by Medicaid.5. Eligibility for CFS above amounts generally billed is provided for those applicants whose family gross income is at or below twice the Federal Poverty Guidelines, with a sliding scale for individuals up to three times the poverty level in effect at the time of application. Full charity care applicants with assets worth more than $9,400 for an individual (or $14,100 for a family) may not qualify for care without charge, but may qualify for discounted care. While the maximum 100% discount may not be available to all charity care applicants based on the results of their asset test, all uninsured patients who receive care are eligible for, at a minimum, a charity care discount equal to or more favorable than Amounts Generally Billed (AGB), which is the maximum amount EPBH would bill a patient qualifying for assistance under EPBH's Financial Assistance Policy (FAP). 6. For patients who qualify for less than 100% of the financial assistance program, a payment schedule is determined and agreed upon (discussed further below). Payment arrangements are established prior to service for non-urgent care. 7. In either case, the final results of the financial screening are recorded in the comments section of EPBH's billing system.Requests for Payment Arrangements:Patient Financial Advocates (PFA) will qualify patients that are receiving non-urgent, medically indicated procedures prior to services. The PFA will request 75% to 100% of estimated charges (net of the AGB discount) if the balance is under $5,000 and 50% to 100% of estimated charges (net of the AGB discount) if the estimated bill equals or exceeds $5,000.Patients who do not qualify for total or partial CFS, but who have difficulty in paying their bills after services are rendered, may request to enroll in a payment plan. Eligibility for the payment plan includes the following guidelines:1. Immediate payment in full will result in financial hardship to the patient or the patient's family.2. Deposit of one-half of the estimated total bill is requested prior to admission.3. The minimum monthly payment of $50.00.4. The maximum length of the payment plan is twenty-four months.The Customer Service staff will set up the payment plan using the above guidelines as well as complete the necessary information on the "Payment Agreement" form and mail to the patient for signature. Account documentation will be done online. The pre-collect agency will be sent a copy of the payment agreement and all forms will be scanned into the PFS Optical Imaging System.
Part I, Line 6a - Related Organization Community Benefit Report The community benefit report for all Lifespan affiliated hospitals (EPBH, The Miriam Hospital, Rhode Island Hospital, and Newport Hospital) is maintained by Lifespan Corporation and included in Lifespan's annual report. The annual report for the year ended September 30, 2022 is available at the following link. https://www.lifespan.org/sites/default/files/2023-08/LS-Annual-Report-2022-230816.pdfPlease see pages 5-6, 10, 30, and 38-39 of the Lifespan Annual Report for community benefit information.The annual report for the year ended September 30, 2023 is not yet available at:https://www.lifespan.org/sites/default/files/2024-08/LS-Annual-Report-2023-final-8-6-2024.pdf
Part I, Line 7 - Explanation of Costing Methodology EPBH's costing methodology used to calculate the amounts reported in Part I, Line 7 is as follows:a) Financial assistance at cost- involves utilization of a ratio derived from dividing patient costs, as defined, by patient charges, as defined, and applying that percentage to total charity care charges.Patient costs reported in the cost accounting system are calculated based on Medicare principles of reimbursement by reducing total operating expenses (as calculated per Form 990 requirements) by items such as bad debt expense, the cost of medical education, internally funded research, subsidized health services, community services, charitable contributions, and other operating revenue. Patient costs are then divided by patient charges to determine a ratio of cost to charges (RCC). This RCC is applied as the costing methodology for determining charity care expense.e) Community health improvement services and community benefit operations- Community benefit operations expense is recorded as direct expenses incurred as reported by EPBH's Community Health Services Department. Revenue received for these services is reported as direct offsetting revenue. f) Health professions education- Health professions education expenses represent direct costs related to amounts associated with resident and intern programs utilized at EPBH. g) Subsidized health services- Subsidized health services' community benefit expense is determined by EPBH's internally developed allocation model based on the general ledger whereby overhead costs are applied to all direct care departments using a historically determined basis. This expense is adjusted to remove all related bad debt, Medicaid, and charity costs already reported in the applicable sections of Line 7. Net patient service revenue is recorded as amounts received from various payer types related to these services.h) Research- EPBH conducts extensive medical research focused on child and adolescent mental health concerns and brain science. For all internal and external research conducted, the costs associated with these activities are calculated by combining the direct and indirect costs as calculated by EPBH's internally derived methodology. Revenue received for these services is reported as direct offsetting revenue. i) Cash and in-kind contributions for community benefit- Expenses for cash and in-kind community benefit contributions are incurred by EPBH, including an allocation of contributions made by Lifespan Corporation on EPBH's behalf.
Part I, Line 7, Column F - Explanation of Bad Debt Expense The calculation of percentages disclosed for Schedule H, Part I, Line 7, column (f) "percent of total expense", does not include bad debt expense. Form 990, Part IX, Line 25 includes bad debt expense of $103,589.
Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense The amount reported as bad debt expense is determined by applying the ratio of cost to charges (RCC) to the total charges written off to bad debt. The RCC rate is determined using data from EPBH's cost accounting system and is adjusted for medical education, internally funded research, subsidized health services, community services, and charitable contributions. Discounts and payments are applied to patient accounts before such account balances are transferred to bad debt. There was $103,589 of bad debt recorded by EPBH during the fiscal year ending September 30, 2023.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit Accounts pending transfer to bad debt are reviewed by EPBH's Patient Financial Advocate staff to determine qualification for financial assistance under EPBH's policy. Accounts with insufficient information to determine eligibility are assigned a separate identifying code. These accounts are ultimately transferred to bad debt if the appropriate qualifying documentation is not received. During the year ended September 30, 2023, there was no bad debt attributable to patients whose eligibility for financial assistance could not be determined.
Part III, Line 4 - Bad Debt Expense Due to the adoption of ASU No. 2014-09 in 2019 - Revenue From Contracts With Customers (Topic 606), bad debt expense is no longer reported in the audited financial statements as a separate line item, but rather is treated as a price concession. EPBHs adoption of the ASU did not materially change the timing or amount of revenue recognized. However, the ASU requires that patient service revenue be presented in the statement of operations and changes in net assets at the transaction price, i.e., net of any provision for bad debts.
Part III, Line 9b - Provisions On Collection Practices For Qualified Patients EPBH does not bill for the excess of charges over agreed upon reimbursement amounts from third-party payors. Rather, such differences are recorded as a reduction of revenue through contractual adjustments. Collection efforts are focused on copayments, deductibles, and amounts denied by insurers. After all collection attempts are exhausted, any remaining balances, including any copayments and deductibles, are written off as bad debts. EPBH classifies its bad debts as uncompensated care. This does not apply to Medicaid, however, as there are no associated copayments or deductibles for this payor.EPBH generally does not require collateral or other security in extending credit to patients; however, it routinely obtains assignment of patients' benefits payable under their health insurance programs, plans, or policies, primarily Medicaid. Uninsured patients are offered Community Free Service and/or payment plan options.Lifespan's Patient Financial Services Department (PFS) has the responsibility for communicating and administering collection policies and procedures to all patient accounts. PFS engages the services of various pre-collect agencies as necessary. The following are highlights of the overall collection effort:* If a patient presents for admission who is not insured, staff assists the family with a Medicaid application.* If the patient is ineligible for Medicaid, a financial screening is performed to determine status of qualification for charity care.* If the patient does not qualify for charity care, PFS or the pre-collect agency attempts at least four contacts with the responsible party within the first 120 days.* If the third-party carrier denies in writing any responsibility for payment, arrangements regarding an extended payment plan are discussed with the patient's guardian.
Part VI, Line 2 - Needs Assessment EPBH is the nation's first children's psychiatric hospital, providing services for children and adolescents not only from Rhode Island, but also from all over the country. EPBH is designated as a major teaching affiliate for The Warren Alpert Medical School of Brown University, with a focus in areas of child and adolescent psychiatric treatment.In recent years, EPBH has increased the number of physicians on staff in response to a heightened demand for outpatient services.As a psychiatric and behavioral health center, EPBH offers specialized services for children and adolescents. Such care begins with an evaluation designed to meet the unique needs of each child and family. This initial assessment provides an understanding of the problem, identifies the child's needs, and determines the best and least restrictive treatment approach. Once a child is admitted, a treatment plan is tailored to the child's needs.EPBH actively participates with community mental health centers and the Rhode Island Department of Health to understand the mental health needs of children and families in Rhode Island and its surrounding communities. EPBH is also a participant in Kids Count", which is a publicly funded agency that uses questionnaires with pediatricians, schools, and other providers to identify the mental health needs of the population that it serves. In addition, EPBH staff work collaboratively with administration and staff at various schools throughout the State of Rhode Island. There is a multidisciplinary team at each school site, led by a clinical psychologist. This team guides the treatment and education plan for each student. Each classroom is staffed by a teacher certified in special education and a classroom behavior specialist, both professionals with degrees in their fields.EPBH respects the roles of parents/guardians as partners in their child's care. EPBH's Family Liaison Program helps parents with questions, problems, or special concerns regarding their child's treatment by appointment or via telephone. The Family Liaison Program sponsors support groups and educational meetings on a regular schedule. Notices are posted in EPBH's main lobby, outpatient waiting room, and at the various unit entrances.The Rhode Island State Certificate of Need program requires a focused study of need for all projects over $5.25 million, which is an important part of the program development process across Lifespan.
Part VI, Line 3 - Patient Education of Eligibility for Assistance EPBH provides each patient with a "Patient and Family Information" booklet which includes information on patient rights and responsibilities. There is also multilingual signage in EPBH's main lobby and waiting area which provides information on financial aid contacts. The Registration Department meets with the patient's family at the outset of care to discuss eligibility for assistance, which is also summarized on EPBH's website.
Part VI, Line 4 - Community Information EPBH, whose primary location is in East Providence, Rhode Island, is a 70-bed, nonprofit teaching hospital with university affiliation providing for the psychiatric treatment of adolescents and children, including some with severe developmental disabilities. EPBH operates several major programs including acute, partial hospitalization, residential, and outpatient. EPBH also operates five other secondary sites which furnish residential and research services. EPBH is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). EPBH currently participates as a provider in Rhode Island Medicaid, various out-of-state Medicaid programs, and the State of Rhode Island's Department of Children, Youth and Families programs, as well as providing care for patients covered by private health insurers. EPBH is also a member of the formerly-named Voluntary Hospitals of America, Inc., which has partnered with UHC Alliance NewCo, Inc. to become Vizient, Inc., the largest member-owned health care company in the United States.In 1969, EPBH and certain other Rhode Island hospitals entered into an affiliation agreement to participate jointly in various clinical training programs and research activities with The Warren Alpert Medical School of Brown University (Brown). In 2010, Brown named Rhode Island Hospital its Principal Teaching Hospital. EPBH and The Miriam Hospital continue to be designated as major teaching affiliates. The goals of the partnership are to facilitate the expansion of joint educational and research programs in order to compete both clinically and academically. EPBH participates in the Child and Adolescent Psychiatry Fellowship as well as the Triple Board Residency Program (Pediatrics/Psychiatry/Child and Adolescent Psychiatry).EPBH has a diverse service area which is not defined solely by a contiguous geographic grouping of municipalities. The combined service area of EPBH includes all of the cities and towns in Rhode Island and the neighboring states of New England. EPBH, which receives referrals from all regions of the United States, has established itself as the national center for training and research in child and adolescent psychiatry.
Part VI, Line 5 - Promotion of Community Health EPBH is governed by a Board of Trustees, which is composed of leaders of the local community elected by Lifespan Corporation. EPBH's purpose is to be staffed, equipped, and ready to serve the pediatric health needs of the community and its people from all walks of life. EPBH works collaboratively with physicians, its employees, other health care organizations, and the community to create a measurably healthier community through the provision of high quality, cost-effective, customer-focused health care services in an environment that promotes patient safety. EPBH monitors the healthcare needs of its service area to ensure alignment of its resources with its mission. EPBH measures the results of the programs and services it provides based on the value added to the community as well as the financial health of each program and its impact on EPBH. EPBH is organized and operated for the benefit of the community it serves.
Part VI, Line 6 - Affilated Health Care System Lifespan's mission is delivering health with care. Lifespan is an academically based healthcare system at the forefront of medical care, continually engaging in research that will lead to medical breakthroughs. Lifespan affiliates provide comprehensive inpatient and outpatient medical, surgical, and psychiatric services for adults and children. Lifespan and its affiliates employ approximately 16,500 people. The Lifespan system has approximately 3,900 physicians on the medical staffs of its affiliated hospitals, operates 1,165 licensed beds in four hospital complexes, and in 2022 generated approximately $2.8 billion in total operating revenue. By each of these measures, Lifespan is Rhode Island's largest health system, serving a population of about 1.1 million. Three of its hospital members, Rhode Island Hospital (RIH), The Miriam Hospital (TMH), and Emma Pendleton Bradley Hospital (EPBH), are teaching affiliates of The Warren Alpert Medical School of Brown University.Lifespan is a Rhode Island nonprofit corporation that is community-based and community-governed. As a nonprofit organization, Lifespan is run by a voluntary Board of Directors who are community representatives. Lifespan and all of its nonprofit hospital affiliates have received written notification from the Internal Revenue Service that they have been recognized as being organized and operated as entities described in Internal Revenue Code (IRC) Section 501(c)(3) and are generally exempt from income taxes under IRC Section 501(a).As of September 30, 2022, Lifespan Corporation employed approximately 1,100 full-time and part-time personnel, most of whom are located in Providence, Rhode Island. Lifespan Corporation provides support services to its affiliates, such as information services, risk management, legal, communications and public affairs, fundraising, facility development, strategic planning, internal audit/compliance, human resources, finance, payor contracting, and investment management, for which each affiliate is charged a fee equivalent to the estimated costs incurred by Lifespan in providing these services.CORPORATE AUTHORITY AND ROLELifespan Corporation has no members and is governed by its Board of Directors. The Board has responsibility for planning, directing, and establishing policies intended to assure the development and delivery of quality health services, professional education, and biomedical research on an integrated, cost-effective basis. The Board's powers include the power to set accounting policies for its affiliates, approve all managed care agreements, negotiate, develop, and approve affiliations with other institutions for educational and research purposes, and approve human resource plans, executive compensation, and benefits for system affiliates. The bylaws of EPBH confer certain reserved powers on Lifespan to provide it with the means of effective oversight, coordination, and support of the system. Powers specifically reserved to Lifespan as sole member of EPBH include: to approve the amendment of the Articles of Incorporation and Bylaws and other Charter documents; to develop and approve strategic plans; to approve capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness.For a complete listing of affiliated members of Lifespan's integrated healthcare delivery system, please refer to Schedule R.
Part VI, Line 7 - States Filing of Community Benefit Report RI
Part VI - Additional Information Form 990, Schedule H, Part V, Line 7a: The website which makes EPBH's CHNA report widely available is located at the following URL:https://www.lifespan.org/sites/default/files/2022-09/EPBHCommunityHealthNeedsAssessment2022.pdfForm 990, Schedule H, Part V, Line 10a: The URL to view EPBH's most recently adopted implementation strategy is below:https://www.lifespan.org/sites/default/files/2023-04/2022-EPBH-CHNA-Implementation-Plan.pdfForm 990, Schedule H, Part V, Line 16a: The URL to view and download EPBH's Financial Assistance Policy form is below:https://www.lifespan.org/sites/default/files/2023-04/2023_04_23_Lifespan-Financial-Assistance-Policy.pdfForm 990, Schedule H, Part V, Line 16b: The URL to view and download EPBH's Financial Assistance Policy application form is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/cfs-english_051920.pdfForm 990, Schedule H, Part V, Line 16c: The URL to view EPBH's plain language summary of the Financial Assistance Policy is below:https://www.lifespan.org/sites/default/files/lifespan-files/documents/lifespan-main/pfs/Lifespan-Financial-Assistance-Summary_052020.pdf
Schedule H (Form 990) 2022
Additional Data


Software ID: 22015553
Software Version: 2022v5.0
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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
Emma Pendleton Bradley Hospital
 
Employer identification number

05-0258806
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 on 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 on 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
Yes
 
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 on Line 1a? ....
2
Yes
 
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 on 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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on 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" on 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) 2022

Schedule J (Form 990) 2022
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 on 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, 1099-MISC compensation, and/or 1099-NEC (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1Arthur J Sampson
Trustee
(i)

(ii)
 
-------------
412,504
 
-------------
 
 
-------------
5,192
 
-------------
18,300
 
-------------
 
 
-------------
435,996
 
-------------
 
2David A Kirshner
Treasurer-11/22
(i)

(ii)
 
-------------
662,492
 
-------------
 
 
-------------
194,726
 
-------------
12,141
 
-------------
8,468
 
-------------
877,827
 
-------------
 
3Ellen M Hallsworth
Dir. REACH
(i)

(ii)
149,830
-------------
 
10,000
-------------
 
115
-------------
 
 
-------------
 
5,491
-------------
 
165,436
-------------
 
 
-------------
 
4Eva Greenwood
Treasurer
(i)

(ii)
 
-------------
134,109
 
-------------
50,000
 
-------------
14,864
 
-------------
27,186
 
-------------
7,729
 
-------------
233,888
 
-------------
 
5G Alan Kurose
Fmr Trustee
(i)

(ii)
 
-------------
589,012
 
-------------
36,227
 
-------------
11,586
 
-------------
39,196
 
-------------
24,619
 
-------------
700,640
 
-------------
 
6Henry T Sachs III MD
Pres. & CMO
(i)

(ii)
 
-------------
382,245
 
-------------
 
 
-------------
72,078
 
-------------
79,920
 
-------------
27,847
 
-------------
562,090
 
-------------
50,060
7Karyn J Horowitz MD
Chief Medical Officer
(i)

(ii)
304,000
-------------
 
52,896
-------------
 
20,175
-------------
 
49,009
-------------
 
30,582
-------------
 
456,662
-------------
 
 
-------------
 
8Margaret R Paccione-Dyslewski PHD
Dir. Behav. Ed.
(i)

(ii)
162,670
-------------
 
 
-------------
 
5,131
-------------
 
10,063
-------------
 
21,520
-------------
 
199,384
-------------
 
 
-------------
 
9Mary A Carskadon PhD
Physician
(i)

(ii)
179,083
-------------
 
 
-------------
 
4,623
-------------
 
10,877
-------------
 
11,690
-------------
 
206,273
-------------
 
 
-------------
 
10Nicole A Nappe
Clinical Mgr
(i)

(ii)
152,464
-------------
 
 
-------------
 
206
-------------
 
9,560
-------------
 
28,800
-------------
 
191,030
-------------
 
 
-------------
 
11Paul J Adler
Secretary
(i)

(ii)
 
-------------
616,787
 
-------------
 
 
-------------
127,319
 
-------------
116,284
 
-------------
28,760
 
-------------
889,150
 
-------------
86,715
12Stephanie H D'Atri
Dir. Early Child.
(i)

(ii)
152,403
-------------
 
 
-------------
 
195
-------------
 
9,561
-------------
 
28,822
-------------
 
190,981
-------------
 
 
-------------
 
13Susan Lantz
Interim CNO
(i)

(ii)
177,521
-------------
 
 
-------------
 
511
-------------
 
10,778
-------------
 
10,484
-------------
 
199,294
-------------
 
 
-------------
 
14Timothy J Babineau
Fmr Trustee
(i)

(ii)
 
-------------
1,010,777
 
-------------
3,000,000
 
-------------
2,442,726
 
-------------
358,564
 
-------------
24,775
 
-------------
6,836,842
 
-------------
4,007,802
15Ziya L Gokaslan MD
Trustee
(i)

(ii)
 
-------------
1,511,572
 
-------------
152,000
 
-------------
7,524
 
-------------
18,300
 
-------------
31,660
 
-------------
1,721,056
 
-------------
 
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
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 I, Line 1a: Relevant information in regards to selections on 1a. Tax Indemnification and Grossed Up Payments:The Lifespan Executive Long Term Disability program provides financial protection to designated Lifespan physicians and executives in the event that they become disabled. Premiums are paid to the insurance carrier by the insureds on an after-tax basis to allow for income replacement at a reasonable cost. The income associated with the premiums is grossed up to cover the total cost of the benefit as provided in the Lifespan Executive Benefit Plan and is included in Medicare wages, more specifically on Schedule J, Part II, Column B (iii).
Part I, Line 7: Non-Fixed payments not listed above Certain physicians and executives participate in incentive compensation plans arranged through individual contractual agreements which stipulate non-fixed payments based on meeting criteria comprised of various quality and productivity markers.
Schedule J (Form 990) 2022

Additional Data


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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Emma Pendleton Bradley Hospital
 
Employer identification number
05-0258806
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A RIHEBC Series 2016
 
52-1300173 762244FP1 08-11-2016 24,032,741 Refund 2009 Bond   X   X X  
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 1,162,980      
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 24,032,741      
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 176,876      
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds .............        
11 Other spent proceeds ............. 23,855,865      
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2016
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........
X              
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........
X              
16 Has the final allocation of proceeds been made? .......... X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X              
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X            
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............   X            
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? ............. X              
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X              
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet        
6 Total of lines 4 and 5 .............        
7 Does the bond issue meet the private security or payment test? ...   X            
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X              
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X            
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? ....... X              
b Exception to rebate? ........   X            
c No rebate due? .........   X            
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....                
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X            
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X            
7 Has the organization established written procedures to monitor the requirements of section 148? ... X              
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?   X            
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Part VI Schedule K, Part I, Line A(f):On August 11, 2016, the Rhode Island Health and Educational Building Corporation (RIHEBC) issued, on behalf of the Lifespan Obligated Group, which consists of EPBH, Rhode Island Hospital, The Miriam Hospital, Rhode Island Hospital Foundation, and The Miriam Hospital Foundation, $265,470,000 of tax-exempt fixed rate serial and term bonds (the 2016 Bonds) used for the purpose of refunding existing bonds issued to the Lifespan Obligated Group, as well as to pay certain expenses of issuance with respect to the 2016 Bonds. The portion of the 2016 Bonds' proceeds allocable to EPBH is $24,032,741. For purposes of EPBH, the 2016 issuance resulted in the complete refinancing of its RIHEBC Series 2009A Bonds. Schedule K, Part I, Line 3:The bond proceeds listed in line 3 differ from the bond issue price disclosed per IRS Form 8038 due to the fact that EPBH is part of the Lifespan Obligated Group previously mentioned in Part I, line A(f). Of the $308,112,067 disclosed in Form 8038, EPBH was allocated $24,032,741 of the total issuance.
Schedule K (Form 990) 2021

Additional Data


Software ID: 22015553
Software Version: 2022v5.0

SCHEDULE O
(Form 990)

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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Emma Pendleton Bradley Hospital
 
Employer identification number

05-0258806
Return Reference Explanation
Form 990, Part VI, Section A, Line 2 Lawrence A. Aubin, Sr., Chairman, and Michael L. Hanna, Trustee, are partners in the same for-profit organization.
Form 990, Part VI, Section A, Line 6 Lifespan is the sole member of EPBH.
Form 990, Part VI, Section A, Line 7a Effective October 23, 2012, the Board of Directors of Lifespan and the Boards of Trustees of Rhode Island Hospital, The Miriam Hospital, Newport Health Care Corporation, Newport Hospital, and EPBH approved a restructuring of their governance. Effective July 1, 2013, Gateway Healthcare, Inc. joined the Lifespan health system on July 1, 2013 and adopted this restructured governance. The restructuring has increased governance effectiveness and has streamlined governance operation, as well as provided a single strategic perspective for the Lifespan system hospitals. Pursuant to the restructuring, the bylaws of each of the affiliates were amended such that the composition of the boards of trustees of each of the hospitals and Newport Health Care Corporation is defined as those persons serving from time to time as the directors of Lifespan. As a result, the Boards of each entity are comprised of the same individuals. The Board of each entity retains its responsibilities and authorities notwithstanding the revision in its composition. The Board of Directors of Lifespan consists of not less than fourteen nor more than thirty-one directors, including the President and CEO of Lifespan, who serves ex-officio with vote.Additionally, the bylaws of EPBH confer certain reserved powers upon Lifespan to provide it with the means of effective oversight, coordination, and support of the system. Powers reserved to Lifespan include: to elect and remove EPBH trustees and to approve the election or removal of certain officers.
Form 990, Part VI, Section A, Line 7b The EPBH Board is comprised of the same individuals who serve on the Lifespan Board. Lifespan has the responsibility for planning, directing, and establishing policies intended to assure the development and delivery of quality health services on an integrated, cost-effective basis. Powers reserved to Lifespan, in addition to those noted above, include: to approve amendment of the Articles of Incorporation and Bylaws and other charter documents; to approve strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness.
Form 990, Part VI, Section B, Line 11b The preparation and filing of the Form 990 and supporting schedules is the responsibility of the Executive Vice President & Chief Financial Officer (EVP/CFO) and Lifespan's Finance Department. The Form 990 is prepared by the accounting staff upon completion of Lifespan's annual independent audit and is reviewed by the Corporate Services Tax Compliance Manager and the Director of Finance. The draft Form 990 is then provided to the EVP/CFO for final management review. Prior to filing the return with the Internal Revenue Service, a copy of the entire form is posted to EPBH's Board of Trustees website portal in advance of its next Board meeting. At the time of the Board Meeting the 990 is presented by the Lifespan Director of Finance and EVP/CFO, at which time all questions and concerns of the members of the Board are addressed by the EVP/CFO and incorporated into the Form 990 when appropriate. Once the Form 990 is complete and ready to be filed, the members of the Board are notified via email that a copy of the final version of the Form 990 is accessible through the same password-protected website portal. The EVP/CFO is authorized to file the Form 990
Form 990, Part VI, Section C, Line 19 Lifespan and the Lifespan Obligated Group, which consists of EPBH, Rhode Island Hospital, The Miriam Hospital, Rhode Island Hospital Foundation, and The Miriam Hospital Foundation, currently make their annual and quarterly consolidated financial statements available to the public via DAC (Digital Assurance Certification, LLC), a disclosure dissemination agent for issuers of tax-exempt bonds which electronically posts and transmits Lifespan's financial information to repositories and investors alike. In addition, copies of EPBH's Articles of Incorporation, Bylaws, and Conflict of Interest Policy are available upon request from the office of the Lifespan EVP/CFO, either in person or by mail.
Form 990, Part XI, Line 9 Change in Funded Status of Pension Plan = $1353167
Form 990, Part XI, Line 9 Joint venture transfer = $152644
Form 990, Part XI, Line 9 Net Change in Foundation Assets = $0
Form 990, Part XI, Line 9 Net Change in Foundation Assets = -$88080
Form 990, Part III, Line 4a: EPBH provides inpatient treatment for children ages 2 to 18 years suffering from serious behavioral disorders and/or developmental conditions such as mental retardation or autism who are in need of stabilization, assessment, and treatment for suicidal, destructive, self-injurious, or other dangerous or aggressive behaviors.Residential treatment provides intensive, family-centered services to children with emotional and behavioral problems which prevent them from living safely at home.EPBH's partial programs furnish treatment alternatives to inpatient hospitalization or traditional outpatient services for children from infancy to adolescence with serious emotional, behavioral, eating, sleeping, anxiety, or obsessive-compulsive disorders, as well as relationship problems or a wide variety of other mental health issues co-occuring with substance use issues.The Center for Autism and Developmental Disabilities (CADD) has a highly specialized day program for children and adolescents who have autism or developmental disabilities with coexisting emotional and/or behavioral disorders.
Form 990, Part III, Line 4c: Home-based intensive behavioral treatment is for children who have been diagnosed with Autism Spectrum Disorder (ASD) or have varying degrees of chronic behavior disorders that, if left untreated, would worsen and require more intensive treatment, including psychiatric hospitalization or out-of-home residential placement. Staff members visit a family's home and deliver clinical services to the child on a one-on-one basis. The treatment plan is family-oriented, as it includes all family members in the treatment process. The Mindful Teen Program, a six-month outpatient treatment program for adolescents who display signs of suicidality, nonsuicidal self-injury, or other self-destructive behaviors, offers dialectical behavior therapy for adolescents (DBT-A), an empirically validated treatment designed to help eliminate life-threatening and self-destructive behaviors by developing alternative skills to manage emotions and tolerate distress.EPBH also offers a hospital diversion program to children and adolescents with mental retardation. Those admitted to this home-based program present with chronic mild to moderate behavior disorders that, if left untreated, would worsen and require more intensive treatment, including hospitalization or residential placement. This service, which is also a resource for children recently discharged from EPBH, is used as a preventive measure against the future need for an out-of-home placement.EPBH's outpatient treatment programs are administered by a multidisciplinary staff of psychiatrists, psychologists, nurses, and qualified trainees, who provide comprehensive mental health evaluation and treatment to children, adolescents, and families for a wide range of clinical conditions. Patients may be treated with a variety of modalities including individual, group and family therapy, and psychopharmacologic management. Treatment is often coordinated with other agencies such as mental health centers, schools, or community-based organizations.
Form 990, Part VI, Section A, Line 1b: *Shivan S. Subramaniam, Trustee, is the Lead Director on the Board of Directors at Citizens Bank, N.A. During fiscal year 2023, Lifespan paid Citizens Bank, N.A.,in its normal course of business as part of Lifespan's accounts payable function.*Lawrence A. Aubin, Sr., Chair, and Michael Hanna, Trustee, are owners of New England Real Estate Holding Group, LLC (NEREHG), with which Lifespan has entered into an operating lease of a health care facility. During fiscal year 2023, Lifespan paid rent to NEREHG under the terms of its lease. Terms of the rent expense related to the lease have been established at fair market value.*Phillip Kydd, Trustee, has a family relationship with a principal owner of The Gemini Group. During fiscal year 2023, RIH paid The Gemini Group to provide business consulting and advisory services to RIH.
Form 990, Part VI, Section B, Line 12c: Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including EPBH, and administered by Lifespan's Corporate Compliance Department as follows: Each designated person subject to Lifespan's conflict of interest policy is required to provide Lifespan with an initial disclosure statement and thereafter an annual statement attesting that: (i) the designated person has read and is familiar with this policy, and (ii) the designated person and, to the best of his/her knowledge, family members, have not in the past engaged in, are not presently engaging in, or plan to engage in, any activity which contravenes this policy.If, at any time during the course of employment or association, a designated person has reason to believe that an existing or contemplated activity may contravene this policy, the person shall submit a full written description of the activity to the Lifespan Compliance Officer or the Office of the General Counsel to seek a determination as to whether the contemplated activity does or does not contravene this policy. If the activity in question involves either the Chief Executive Officer, the Senior Vice President and General Counsel, or a Trustee, a full written disclosure must be made to, and a determination sought from, the Chairman of the Board of Directors of Lifespan Corporation.Annually, the Lifespan Compliance Officer shall review and report to the Lifespan Executive Corporate Compliance Committee and to the Lifespan Audit and Compliance Committee on the administration of this policy.Failure on the part of any designated person to comply with this policy, including failure to submit in a timely fashion the conflict of interest disclosure statement, will be grounds for removal from his/her position and/or termination of his/her employment with Lifespan.
Form 990, Part VI, Section B, Lines 15 a&b: The following applies to Lifespan and all of its affiliates, including EPBH:EXECUTIVE COMPENSATIONLifespan's executive compensation philosophy balances appropriate stewardship of resources and the need to be competitive in recruiting and retaining talented individuals. It incorporates market-competitive and performance-related principles, and covers the President and CEO of Lifespan as well as other officers, senior management, and key employees. Lifespan's executive compensation program complies both with law and with contemporary ethical norms, and is administered consistent with the organization's tax-exempt status under Section 501(c)(3) of the Internal Revenue Code (IRC) and the avoidance of transactions subject to intermediate sanctions under Section 4958 of the IRC. Executive compensation is also administered consistent with Lifespan's Corporate Compliance Policy on Excess Benefit Transactions.The Compensation Committee of the Lifespan Corporation Board of Directors (the Committee), comprised of disinterested Lifespan Board members, is responsible for diligent oversight of executive compensation to ensure compliance with IRC requirements. Its duties include:* Approving eligibility for participation in the executive compensation program * Approving changes in compensation for existing executive participants * Approving guidelines, such as salary ranges and contract terms, on appropriate levels of compensation for other key employees* Approving new, and modifying or terminating existing, executive compensation plans including, but not limited to, annual incentive and executive benefit plans* Approving performance objectives associated with Lifespan's annual incentive plan, including measuring points, and using verified actual performance relative to these objectives as a precondition to approving the payment of any awards under the plan* Authorizing periodic performance benchmark studies to be conducted for purposes of assessing Lifespan's performance within the healthcare industry and the degree to which total remuneration levels at Lifespan are generally commensurate with Lifespan performance relative to healthcare industry performance* Conducting an annual performance review of Lifespan's Chief Executive Officer. The Chair of the Committee conducts and documents this review, based on his/her observations and interpretation of feedback from members of the Board of Directors.* Selecting and engaging qualified, independent, third-party compensation valuation consultants that the Committee charges with rendering opinions with respect to the reasonableness and comparability of compensation as well as the comparative organizations against which compensation is assessed, in accordance with relevant sections of the IRC and Lifespan's executive compensation philosophy. Lifespan's Chief Executive Officer works closely with the Committee to make recommendations on the above topics and keep the Committee informed about contemplated compensation changes for executives and other key employees, as well as candidates for these roles. The CEO also provides periodic updates to the Committee regarding Lifespan's performance relative to compensation-related performance objectives. The Committee's deliberations and actions are documented in minutes prepared for each meeting.PROCESS FOR DETERMINING COMPENSATION Valuation of Total Cash and Total Remuneration: No less frequently than annually, the Committee receives and reviews a total cash compensation valuation of all existing executive compensation program participants prepared by its independent compensation consultant. Annually, the Committee also receives and reviews a total remuneration valuation of all existing executive compensation participants. Base Salary Actions: The CEO recommends any salary adjustments for participants in the executive compensation program, using the results of the valuation study and his/her assessment of individual performance or other pertinent information, for the Committee's consideration.New Participants in Executive Compensation Program: With respect to compensation offers for individuals expected to participate in the executive compensation program, certain members of the Lifespan CEO's leadership team work with the Committee's independent compensation consultant or rely on information previously provided by the consultant to establish a range of reasonable cash compensation within which recruitment is expected to conclude through acceptance of a reasonable compensation offer.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID: 22015553
Software Version: 2022v5.0
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 Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Emma Pendleton Bradley Hospital
 
Employer identification number

05-0258806
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











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)ALC dba HSR
1 Virginia Avenue Suite 200

Providence,RI02905
05-0442015
Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc
 
 
No
(2)Bayberry Courts Inc
1 Virginia Avenue Suite 200

Providence,RI02905
20-4590384
Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc
 
 
No
(3)Bradley Hospital Foundation
167 Point Street

Providence,RI02903
05-0500688
Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation
 
 
No
(4)Capital City Community Centers Inc
1 Virginia Avenue Suite 200

Providence,RI02905
05-0259090
Daycare Services RI 501(c)(3) 7 Gateway Healthcare Inc
 
 
No
(5)Families Reaching Into Each New Day Inc
1 Virginia Avenue Suite 200

Providence,RI02905
05-0504841
Bereavement Services for Children RI 501(c)(3) 7 Gateway Healthcare Inc
 
 
No
(6)Gateway Healthcare Inc
1 Virginia Avenue Suite 200

Providence,RI02905
05-0309043
Subst. Abuse & Psych.Health Care Svcs RI 501(c)(3) 10 Lifespan Corporation
 
 
No
(7)Hospital Properties Inc
167 Point Street

Providence,RI02903
22-2869743
Property Management RI 501(c)(4) N/A Lifespan Corporation
 
 
No
(8)JM Apartments Inc
1 Virginia Avenue Suite 200

Providence,RI02905
05-0435537
Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc
 
 
No
(9)Lifespan Corporation
167 Point Street

Providence,RI02903
22-2861978
Holding Company/ Mgmnt Services RI 501(c)(3) 12(II) NA
 
 
No
(10)Lifespan Foundation
167 Point Street

Providence,RI02903
05-0493219
Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation
 
 
No
(11)Lifespan of Massachusetts Inc
45 Baker Street 2nd Floor

Providence,RI02905
04-3408517
Holding Company MA 501(c)(3) 12(I) Lifespan Corporation
 
 
No
(12)Lifespan Physician Group Inc
167 Point Street

Providence,RI02903
05-0389801
Physician Health Care Services RI 501(c)(3) 10 Lifespan Corporation
 
 
No
(13)Lifespan School Solutions Inc
140 Broadway

Providence,RI02903
46-4910847
Education Services RI 501(c)(3) 2 Emma Pendleton Bradley Hospital
 
Yes
 
(14)LJR Corporation
1 Virginia Avenue Suite 200

Providence,RI02905
03-0508346
Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc
 
 
No
(15)Mill River Community Housing Corporation
1 Virginia Avenue Suite 200

Providence,RI02905
05-0427152
Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc
 
 
No
(16)Newport Health Care Corporation
11 Friendship Street

Newport,RI02840
22-2535537
Holding Company/ Mgmnt Services RI 501(c)(3) 7 Lifespan Corporation
 
 
No
(17)Newport Health Property Management Inc
11 Friendship Street

Newport,RI02840
22-2335539
Property Management RI 501(c)(3) 12(I) Newport Health Care Corporation
 
 
No
(18)Newport Hospital
11 Friendship Street

Newport,RI02840
05-0258914
Health Care Services RI 501(c)(3) 3 Lifespan Corporation
 
 
No
(19)Newport Hospital Foundation Inc
11 Friendship Street

Newport,RI02840
22-2535533
Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation
 
 
No
(20)NHCC Medical Associates Inc
11 Friendship Street

Newport,RI02840
05-0472268
Health Care Services RI 501(c)(3) 10 Lifespan Corporation
 
 
No
(21)Obed Apartments Inc
1 Virginia Avenue Suite 200

Providence,RI02905
05-0422771
Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc
 
 
No
(22)Pathways Inc
1 Virginia Avenue Suite 200

Providence,RI02905
05-0393004
Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc
 
 
No
(23)Rhode Island Hospital
593 Eddy Street

Providence,RI02903
05-0258954
Health Care Services RI 501(c)(3) 3 Lifespan Corporation
 
 
No
(24)Rhode Island Hospital Foundation
167 Point Street

Providence,RI02903
05-0468736
Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation
 
 
No
(25)RIH Ventures
593 Eddy Street

Providence,RI02903
05-0448686
Parking Facilities/ Phlebotomy Services RI 501(c)(3) 10 Lifespan Corporation
 
 
No
(26)Shore Courts Inc
1 Virginia Avenue Suite 200

Providence,RI02905
05-0504003
Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc
 
 
No
(27)The Autism Project
1516 Atwood Avenue

Johnston,RI02919
05-0512037
Services for Children with Autism RI 501(c)(3) 10 Gateway Healthcare Inc
 
 
No
(28)The Miriam Hospital
164 Summit Avenue

Providence,RI02906
05-0258905
Health Care Services RI 501(c)(3) 3 Lifespan Corporation
 
 
No
(29)The Miriam Hospital Foundation
167 Point Street

Providence,RI02903
05-0377502
Philanthropic Activities RI 501(c)(3) 7 Lifespan Corporation
 
 
No
(30)TLR Realty
1 Virginia Avenue Suite 200

Providence,RI02905
04-3742771
Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc
 
 
No
(31)Wentworth Corporation
1 Virginia Avenue Suite 200

Providence,RI02905
05-0488520
Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc
 
 
No
(32)Westerly Courts Inc
1 Virginia Avenue Suite 200

Providence,RI02905
61-1439766
Housing for Elderly and Mentally Ill RI 501(c)(3) 10 Gateway Healthcare Inc
 
 
No
(33)Coastal Medical Physicians Inc
10 Davol Square

Providence,RI02903
84-4944884
Physician Health Care Services RI 501(c)(3) 10 Lifespan Corporation
 
 
No
(34)RI Sound Enterprises Insurance Co Ltd
65 Front Street
Hamilton   HM 12
BD
Offshore Insurance Captive BD   N/A NA
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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
(1) Lifespan Health Alliance LLC

167 Point Street
Providence,RI02903
81-2732225
Account. Care Org. RI N/A
        No     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) Lifespan MSO Inc

167 Point Street
Providence,RI02903
05-0508717
Mgmnt Svcs RI Lifespan Corp
 
C corp         No
(2) Lifespan Risk Services

167 Point Street
Providence,RI02903
05-0459767
Risk Mgmnt RI Lifespan Corp
 
C corp         No
(3) VNA Technicare Inc

200 Corliss Street
Providence,RI02904
05-0472710
DME Sales RI The Miriam Hospital
 
C corp         No
(4) CRUT 2

c/o Bank of America PO Box 830269
Dallas,TX75283
Philanthropic CT N/A
Trust 1,502,117 54,767,095 100.000 % Yes  
(5) CRUT 2

c/o Bank of America PO Box 830269
Dallas,TX75283
Philanthropic RI N/A
Trust 67,687 2,043,886 100.000 % Yes  




Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
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
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
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
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
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) Lifespan School Solutions Inc

r 5,841,000 Cash
(2) Lifespan School Solutions Inc

s 1,396,000 Cash
(3) CRUT 2

c 1,502,117 FMV
(4) CRUT 2

c 67,687 FMV


Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

Additional Data


Software ID: 22015553
Software Version: 2022v5.0