The Miriam Hospital

What it reported doing in 2024

Patient Care: TMH offers expertise in cardiology, oncology, orthopedics, men's health, and minimally invasive surgery, and is home to the State's first Joint Commission- certified Stroke Center and robotic surgery program. Services and programs provided by TMH also include anesthesiology; general medicine; general surgery; psychiatry; emergency medicine; cardiovascular care; orthopedics; dermatology; nuclear cardiology; radiology; laboratory; renal dialysis; urology; gastroenterology; endocrinology; gynecology; nephrology; neurology; and ophthalmology. TMH is licensed to operate 247 acute care beds by the Rhode Island Department of Health. Notable medical accomplishments of TMH include performance of Rhode Island's first lung operation, first kidney transplant, and first aortic balloon valvuloplasty (a procedure to clear blocked heart valves). In 2025, TMH discharged 16,687 inpatients, logged more than 73,000 visits in its Emergency Department, and performed 12,378 inpatient and outpatient surgical procedures. Services provided in 2025 represent 69,832 inpatient days and more than 130,000 clinic visits. TMH is staffed by 1,298 privileged physicians, approximately 92 full-time house staff (medical school graduates), and a nursing staff of 927. In total, TMH employs more than 3,500 people. TMH is a major teaching affiliate of The Warren Alpert Medical School of Brown University, providing clinical rotations for residents. TMH provides full charity care for individuals at or below twice the federal poverty level, with a sliding scale for individuals up to three times the poverty level, as set by the Department of Health and Human Services. In addition, a substantial discount consistent with Medicare program reimbursement is offered to all other uninsured patients. TMH determines the costs associated with providing charity care by aggregating the applicable direct and indirect costs, including compensation and benefits, supplies, and other operating expenses, based on data from its costing system. The total cost, excluding medical education and research, incurred by TMH to provide charity care amounted to $14,176,405 in fiscal 2025. Charges forgone, based on established rates, amounted to $37,514,988. TMH substantially subsidized various health services including the following programs: adult psychiatry, tuberculosis, and certain other specialty services at a net cost of $4,997,246 in fiscal year 2025. TMH also provides numerous other services to the community for which charges are not generated. These services include certain emergency services, community health screenings for cardiac health, prostate cancer and other diseases, smoking cessation, immunization and nutrition programs, diabetes education, community health training programs, patient advocacy, foreign language translation, physician referral services, and charitable contributions. The net cost of these services amounted to $277,492 in fiscal year 2025. TMH subsidizes the cost of treating patients who receive government assistance where reimbursement is below cost. Medicaid is a means-tested health insurance program, jointly funded by state and federal governments. States administer the program and set rules for eligibility, benefits, and provider payments within broad federal guidelines. The program provides health care coverage to low-income children and families, pregnant women, long-term unemployed adults, seniors, and persons with disabilities. Eligibility is determined by a variety of factors, which include income relative to the federal poverty line, age and immigration status, and assets. TMH offers expertise in total joint replacement, minimally invasive and robotic surgery, and bariatric surgery, among many other specialties. The Leonard and Adele R. Decof Family Comprehensive Cancer Center at TMH brings together world-renowned physicians and a team of specialists from TMH, Rhode Island Hospital (RIH), and Newport Hospital (NH), forming a multidisciplinary te

Financial Efficiency

• Mission deployment rate: 78.7%; rating input score 79
• Program expense ratio: 85.6%; rating input score 86
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 68th percentile among comparable filings
• Pay-setting controls: 5 of 6 controls in place; rating input score 83
  • Compensation committee: Pass
  • Independent consultant: Pass
  • Other Form 990s reviewed: Missing
  • Written employment contract: Pass
  • Compensation survey or study: Pass
  • Board or committee approval: Pass
• Foreign activity oversight: Scored; rating input score 0
• Grant itemization coverage: 100%; rating input score 100; 77th percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Yes; rating input score 100

Accountability

• Independent voting board: 70.6%; rating input score 71; 21st percentile among comparable filings
• Governance controls: 9 of 9 controls in place; rating input score 100
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Pass
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: 11.4%; rating input score 76; 76th percentile among comparable filings
• Total-asset coverage ratio: 1.47; rating input score 53; 53rd percentile among comparable filings
• Liabilities to assets ratio: 0.43; rating input score 42; 42nd percentile among comparable filings
• Officer compensation ratio: 0.6%; rating input score 83; 83rd percentile among comparable filings

Growth

• Program expense growth: 5.3% per year; rating input score 100; 43rd percentile among comparable filings
• Revenue growth: 4.4% per year; rating input score 100; 37th percentile among comparable filings
• Asset growth: 6% per year; rating input score 100; 44th percentile among comparable filings