2024-10-15T15:24:52-05:00 2023-12-31 540737372 PBMARES LLP 725 JACKSON STREET SUITE 210 FREDERICKSBURG VA 22401 990 2023-01-01 201106426 MARY WASHINGTON HEALTHCARE GROUP RETURN MARY 5407412507 2300 FALL HILL AVENUE 418 FREDERICKSBURG VA 22401 SEAN T BARDEN EXECUTIVE VP AND CFO 5407412507 2024-10-08 1 1 JENNIFER N FRENCH CPA P00659678 5403713566 2024-10-08 X 2023 2024-10-15 13:58:12Z MICHAEL P MCDERMOTT MD 2300 FALL HILL AVENUE 418 FREDERICKSBURG VA 22401 976726659 1 1 4243 X WWW.MARYWASHINGTONHEALTHCARE.COM X 1983 VA OUR MISSION IS TO IMPROVE THE HEALTH OF PEOPLE IN THE COMMUNITIES WE SERVE. THROUGH OUR SUBSIDIARIES WE PROVIDE INPATIENT AND OUTPATIENT HOSPITAL SERVICES AND OTHER MEDICAL SERVICES. 15 13 4947 409 1599176 0 7178378 5525805 826815258 928978151 1512802 2476697 116946 189176 835623384 937169829 3100961 3680087 0 0 294858149 339718037 0 0 1464514 540787427 575602020 838746537 919000144 -3123153 18169685 461875065 518712725 249920659 249409729 211954406 269302996 OUR MISSION IS TO IMPROVE THE HEALTH OF PEOPLE IN THE COMMUNITIES WE SERVE. THROUGH OUR SUBSIDIARIES WE PROVIDE INPATIENT AND OUTPATIENT HOSPITAL SERVICES AND OTHER MEDICAL SERVICES. 0 0 863623280 3680087 927703502 PROVISION OF INPATIENT AND OUTPATIENT GENERAL ACUTE CARE HOSPITAL, PSYCHIATRIC HOSPITAL SERVICES, HOME HEALTH AND HOSPICE SERVICES, IMAGING AND AMBULATORY SURGERY SERVICES AND PHYSICIAN SERVICES. PRIMARY SERVICE AREAS ARE FREDERICKSBURG, ORANGE, PRINCE WILLIAM, STAFFORD, SPOTSYLVANIA, CAROLINE, KING GEORGE, AND WESTMORELAND COUNTIES IN VIRGINIA AND SECONDARY SERVICE AREAS INCLUDE MANASSAS, FAUQUIER, CULPEPER, LOUISA, HANOVER, ESSEX AND RICHMOND COUNTIES IN VIRGINIA. WE SERVED 126,150 PATIENTS IN OUR EMERGENCY ROOMS, 351,096 OUTPATIENTS, 20,321 SURGICAL CASES AND 25,401 PATIENT DISCHARGES. 863623280 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 2 0 1 4947 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 15 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X SANDRA W BROWN 5407412507 2300 FALL HILL AVENUE 418 FREDERICKSBURG VA 22401 MICHAEL P MCDERMOTT MD MBA PRESIDENT AND CEO 2.00 40.00 X X 0 1937224 43642 SAUSHEEN TAYLOR MD PHYSICIAN/TRUSTEE 2.00 40.00 X 0 390671 40456 RONALD W BRANSCOME MS BOARD CHAIR 2.00 2.00 X X 0 0 0 BRUCE L DAVIS BA BOARD VICE CHAIR 2.00 2.00 X X 0 0 0 CATHERINE M WACK BOARD SECRETARY/TREASURER 2.00 2.00 X X 0 0 0 MATTHEW D DUMONT MD BOARD TRUSTEE 2.00 2.00 X 0 0 0 MARGARET F HARDY RN MBA JD BOARD TRUSTEE 2.00 2.00 X 0 0 0 DERMAINE A LEWIS BACC BOARD TRUSTEE 2.00 2.00 X 0 0 0 RICHMOND MCDANIEL BS BOARD TRUSTEE 2.00 2.00 X 0 0 0 HOWARD C OWEN BS BOARD TRUSTEE 2.00 2.00 X 0 0 0 CHETAN B PAI DO BOARD TRUSTEE 2.00 2.00 X 0 0 0 CLARENCE A ROBINSON BS BOARD TRUSTEE 2.00 2.00 X 0 0 0 MARTIN A WILDER JR EDD BOARD TRUSTEE 2.00 2.00 X 0 0 0 LINDA D WORRELL CHPC BOARD TRUSTEE 2.00 2.00 X 0 0 0 KIMBERLY C YOUNG MBA BOARD TRUSTEE 2.00 2.00 X 0 0 0 CHRISTOPHER NEWMAN MD EVP, COO & CMO 2.00 40.00 X 0 1004837 43240 SEAN T BARDEN BSBA MBA EVP & CFO 2.00 40.00 X 0 918023 35351 TRAVIS TURNER BS MBA SVP & CPHO 2.00 40.00 X 0 671612 39729 XAVIER RICHARDSON BA MBA SVP & CDO 2.00 40.00 X 0 612300 21672 KATHRYN WALL BA MA SVP & CHRO (THRU 10/23) 2.00 40.00 X 0 600171 21025 STEPHEN MANDELL MD VICE PRESIDENT 40.00 2.00 X 573904 0 37403 ERIC FLETCHER MBA APR SVP & CSO 2.00 40.00 X 0 543835 44601 GEOFFREY LAWSON SVP & CIO 2.00 40.00 X 0 554663 26100 DAVID YI MD VICE PRESIDENT 2.00 40.00 X 0 533838 11744 STEPHANIE GOLDBERG VICE PRESIDENT 40.00 2.00 X 520089 0 11721 EILEEN DOHMANN RN BSN MBA NEA-BC SVP & CNO (THRU 5/23) 2.00 40.00 X 0 493822 6579 RICHARD LEWIS MD VICE PRESIDENT 2.00 40.00 X 0 437237 35284 CATHLEEN YABLONSKI BS MS SVP, CAOO 40.00 2.00 X 462320 0 36495 DANIEL WOODFORD VICE PRESIDENT 40.00 2.00 X 456382 0 39760 SCOTT SELL VICE PRESIDENT 40.00 2.00 X 415027 0 38956 LAUREN BLALOCK VICE PRESIDENT 2.00 40.00 X 0 400843 43058 SANDRA BROWN CPA VICE PRESIDENT 2.00 40.00 X 0 370992 33298 SARAH OGLE VICE PRESIDENT 2.00 40.00 X 0 355008 10849 SUMMER HUGHES VP & CHIEF OF STAFF 2.00 40.00 X 0 349048 8604 CODY BLANKENSHIP VICE PRESIDENT 2.00 40.00 X 0 352886 38290 ALAN EDWARDS VICE PRESIDENT 2.00 40.00 X 0 369487 40058 JOANDREW COUSINS VICE PRESIDENT (THRU 7/23) 2.00 40.00 X 0 233899 6989 RENUKA GUPTA VICE PRESIDENT 2.00 40.00 X 0 194031 4958 TONJA THIGPEN SVP & CNO 2.00 40.00 X 0 158247 5612 JOANNE HUBER-STURANS SVP & CHRO 2.00 40.00 X 0 93388 2649 ELIESE K BERNARD SVP & CHOO (THRU 1/23) 40.00 0.00 X 30799 0 2323 PARTAM MANALAI MD PHYSICIAN 40.00 0.00 X 1382111 0 33889 SANG HO NA MD PHYSICIAN 40.00 0.00 X 1115752 0 27834 AGOSTINO VISIONI MD PHYSICIAN 40.00 0.00 X 898320 0 45051 J T SHERWOOD MD PHYSICIAN 40.00 0.00 X 936057 0 47222 HONG NGUYEN MD PHYSICIAN 40.00 0.00 X 746231 0 11344 MARIE FREDRICK RT R CRA MJ FORMER VICE PRESIDENT (THRU 6/22) 2.00 40.00 X 0 127968 0 7536992 11704030 895786 740 1 1 0 FREDERICKSBURG ORTHOPAEDIC ASSOCIATES 3310 FALL HILL AVENUE FREDERICKSBURG VA 22401 PHYSICIAN SERVICES 16666527 ARMG LLC PO BOX 17125 FERNANDINA BEACH FL 32034 PROFESSIONAL SERVICES - PHYSICAL THERAPY 5138750 COMMONWEALTH SPINE & REHAB 4710 SPOTSYLVANIA PKWY STE 201 FREDERICKSBURG VA 22407 PHYSICIAN SERVICES 3081051 TEAM NET MEDICAL LLC 754 WARRENTON ROAD FREDERICKSBURG VA 22406 MEDICAL SERVICES 1771861 HICUITY HEALTH 1 CITYPLACE DRIVE STE 570 ST LOUIS MO 63141 MEDICAL SERVICES 1290634 31 432558 588651 640517 3864079 5525805 NET PATIENT SERVICES REVENUE 623000 886873231 886873231 OTHER OPERATING REVENUE 623000 26547089 26547089 PROGRAM RENTAL INCOME 531120 9021951 9021951 MANAGEMENT SERVICES 623000 3403189 3403189 LAB FEES 621500 1599176 1599176 1533515 1533515 928978151 2450131 2450131 39088269 359776 38892748 528731 195521 -168955 26566 26566 0 432558 135351 -135351 -135351 INCOME FROM PARTNERSHIPS/LLCS 623000 324527 324527 324527 937169829 927703502 1599176 2341346 X 3678087 3678087 2000 2000 2625061 2466245 154616 4200 286943072 269583016 16900947 459109 5280497 4961027 311021 8449 24756032 23258292 1458130 39610 20113375 18896516 1184678 32181 119691051 112449742 7049803 191506 278387 261545 16397 445 10975 10311 646 18 174462 163907 10276 279 150422641 141322070 8859894 240677 14241 13379 839 23 6462127 6071169 380619 10339 1829033 1718377 107730 2926 24587930 23100360 1448229 39341 2555600 2400986 150525 4089 549266 516035 32352 879 2060047 1935414 121337 3296 28234964 26526749 1663039 45176 4058382 3812850 239039 6493 MEDICAL AND HOSPITAL SU 141615517 133047778 8341154 226585 PROVIDER ASSESSMENT 44787223 42077596 2637967 71660 BAD DEBT EXPENSE 35963327 33787546 2118240 57541 OTHER MEDICAL AND HOSPI 6418650 6030322 378058 10270 5888197 5531961 346814 9422 919000144 863623280 53912350 1464514 946838 1378574 18925233 17955563 77067838 74978272 136141 136141 17629966 18793320 7143952 6829053 813312008 483609605 280039323 329702403 55735909 63991043 4239105 4562954 10760 385402 461875065 518712725 28256500 26274527 62886 23602 190975286 181334667 30625987 41776933 249920659 249409729 X 192716884 251358098 19237522 17944898 211954406 269302996 461875065 518712725 X 18169685 8595910 30582995 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7965346 223688 756672 7432362 7950546 500 164367 150067 7965346 7605785 383359 38598 7950546 6199920 1435446 29581 7605785 6017627 218934 36641 6199920 0.00000 1.00000 0.00000 0 0 33167620 33167620 396162939 217656456 178506483 23197649 18768616 4429033 282572683 217340621 65232062 78211117 29843912 48367205 329702403 ACCRUED LOSS-PROFESSIONAL LIABILIES 4625221 CAPITAL LEASE OBLIGATIONS 37151712 41776933 X PART V, LINE 4: THE INTEREST EARNED FROM THE ENDOWMENT FUNDS IS USED TO FUND SCHOLARSHIPS AND GRANTS IN FUTHERANCE OF OUR MISSION. PART X, LINE 2: MWHC WAS RECOGNIZED AS A PUBLIC CHARITY GENERALLY EXEMPT FROM FEDERAL INCOME TAXATION UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE PURSUANT TO A DETERMINATION LETTER ISSUED BY THE IRS IN MARCH 1992. MWHC IS ENTITLED TO RELY ON THIS DETERMINATION AS LONG AS THERE ARE NO SUBSTANTIAL CHANGES IN ITS CHARACTER, PURPOSES, OR METHODS OF OPERATION. MANAGEMENT HAS CONCLUDED THAT THERE HAVE BEEN NO SUCH CHANGES AND, THEREFORE, MWHC'S STATUS AS A PUBLIC CHARITY EXEMPT FROM FEDERAL INCOME TAXATION REMAINS IN EFFECT. THE STATE IN WHICH MWHC OPERATES ALSO PROVIDES GENERAL EXEMPTION FROM STATE INCOME TAXATION FOR ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAXATION. HOWEVER, MWHC IS SUBJECT TO BOTH FEDERAL AND STATE INCOME TAXATION AT CORPORATE TAX RATES ON ITS UNRELATED BUSINESS INCOME. EXEMPTION FROM OTHER STATE TAXES, SUCH AS REAL AND PERSONAL PROPERTY TAXES, IS SEPARATELY DETERMINED. CERTAIN ENTITIES UNDER MWHC ARE TAXABLE ENTITIES. MWHC HAD NO UNRECOGNIZED TAX BENEFITS OR LIABILITIES, OR SUCH AMOUNTS WERE IMMATERIAL DURING THE PERIODS PRESENTED. FOR TAX PERIODS WITH RESPECT TO WHICH NO UNRELATED BUSINESS INCOME WAS RECOGNIZED, NO TAX RETURN WAS REQUIRED. TAX PERIODS FOR WHICH NO RETURN IS FILED REMAIN OPEN FOR EXAMINATION INDEFINITELY. GENERALLY, TAX RETURNS FOR THE YEARS ENDED DECEMBER 31, 2020, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. ALL REQUIRED TAX FILINGS HAVE BEEN FILED ON A TIMELY BASIS. STAFFORD HOSPITAL CUP 220479 220479 3250 2796 13058 7610 24677 MWHF OPEN 119000 119000 900 15686 1388 6956 4 93079 93079 350 122 4100 19862 34595 432558 432558 4500 2918 32844 28860 66228 135350 -135350 1 1 X 1 X 1 X 500.000000000000 1 1 0 1 1 6198141 6198141 0.00680 6198141 6198141 0.00680 560112 560112 0.00060 6037386 176657 5860729 0.00640 168138142 112222407 55915735 0.06110 308851 36129 272722 0.00030 2699071 2699071 0.00290 177743562 112435193 65308369 0.07130 183941703 112435193 71506510 0.07810 841605 55600 786005 0.00090 841605 55600 786005 0.00090 1 14385646 3596411 287055572 374539401 -87483829 X 1 1 1 MEDICAL IMAGING OF FREDERICKSBURG OUTPATIENT IMAGING 0.51000 0.49000 2 FREDERICKSBURG AMBULATORY SURGERY CENTER AMBULATORY SERGICAL SERVICES 0.62130 0.37870 3 COWAN INVESTMENT PARTNERS MEDICAL OFFICE BUILDING 0.12500 0.37500 4 MEDICAL PLAZA AT COSNER CORNER MEDICAL OFFICE BUILDING 0.42780 0.57220 5 FREDERICKSBURG ENDOSCOPY CENTER HOLDINGS LLC OUTPATIENT ENDOSCOPY 0.51000 0.49000 2 1 MARY WASHINGTON HOSPITAL INC 1101 SAM PERRY BLVD FREDERICKSBURG VA 22401 X X X 471 BED ACUTE CARE HOSPITAL LEVEL 2 TRAUMA 2 STAFFORD HOSPITAL LLC 101 HOSPITAL CENTER BLVD STAFFORD VA 22554 X X X 100 BED HOSPITAL MARY WASHINGTON HOSPITAL INC 1 0 0 1 X X X X X X X X 22 1 1 0 1 X HTTPS://WWW.MARYWASHINGTONHEALTHCARE.COM/ABOUT-US/REGULATORY-DOCUMENTS/ X X 1 22 0 1 0 1 X 200.000000000000 500.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.MARYWASHINGTONHEALTHCARE.COM/ABOUT-US/REGULATORY-DOCUMENTS/ X HTTPS://WWW.MARYWASHINGTONHEALTHCARE.COM/ABOUT-US/REGULATORY-DOCUMENTS/ X HTTPS://WWW.MARYWASHINGTONHEALTHCARE.COM/ABOUT-US/REGULATORY-DOCUMENTS/ X X X X X X X 1 X 0 X X X 1 X 0 0 STAFFORD HOSPITAL LLC 2 0 0 1 X X X X X X X X 22 1 1 0 1 X HTTPS://WWW.MARYWASHINGTONHEALTHCARE.COM/ABOUT-US/REGULATORY-DOCUMENTS/ X X 1 22 0 1 0 1 X 200.000000000000 500.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.MARYWASHINGTONHEALTHCARE.COM/ABOUT-US/REGULATORY-DOCUMENTS/ X HTTPS://WWW.MARYWASHINGTONHEALTHCARE.COM/ABOUT-US/REGULATORY-DOCUMENTS/ X HTTPS://WWW.MARYWASHINGTONHEALTHCARE.COM/ABOUT-US/REGULATORY-DOCUMENTS/ X X X X X X X 1 X 0 X X X 1 X 0 0 MARY WASHINGTON HOSPITAL, INC. PART V, SECTION B, LINE 5: MWHC'S COMMITMENT AND LEADERSHIP IN INVESTING IN THE HEALTH OF THE COMMUNITIES IT SERVES ARE CENTERED AROUND AN OVERALL COMMUNITY BENEFIT STRATEGY. A KEY VALUE OF MWHC IS TO DIRECTLY UTILIZE COMMUNITY INPUT TO DRIVE INITIATIVES THAT WILL IMPROVE THE OVERALL HEALTH OF THE COMMUNITY. MWHC WORKED JOINTLY WITH THE RAPPAHANNOCK AREA HEALTH DISTRICT (RAHD), THE LOCAL HEALTH DEPARTMENT, TO CONDUCT THE NEEDS ASSESSMENT WHICH FURTHER ENSURED AND STRENGTHENED OUR ATTENTION TO PUBLIC HEALTH ISSUES. THEIR EXPERTISE IN PUBLIC HEALTH HAS ALSO BEEN EXTREMELY BENEFICIAL AS WE COLLABORATED IN THE DEVELOPMENT AND IMPLEMENTATION OF OUR COMMUNITY HEALTH IMPROVEMENT PLAN TO ADDRESS THE NEEDS IDENTIFIED IN THE CHNA, AND RAHD CONTINUES TO BE AN ACTIVE AND ENGAGED PARTNER THROUGHOUT THE PRESENT THREE-YEAR CHNA CYCLE.WE ALSO WORKED CLOSELY WITH BE WELL RAPPAHANNOCK (BWR) AS OUR CHNA STEERING COMMITTEE, AN IMPORTANT ROLE IN ENSURING OUR ABILITY TO TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE DIVERSE COMMUNITY WE SERVE.BWR IS A COLLABORATIVE COMPRISED OF A BROAD RANGE OF INDIVIDUALS FROM AGENCIES REPRESENTATIVE OF THE COMMUNITY, IN TERMS OF SOCIOECONOMICS, GEOGRAPHIC LOCATION AND SERVICE AREA, AND RACE AND ETHNICITY. THE MEMBERS HAVE A DEEP CONCERN FOR THE OVERALL HEALTH AND WELL-BEING OF THE RESIDENTS OF THE RAPPAHANNOCK REGION. THE PURPOSE OF THE COUNCIL IS TO IDENTIFY AND PRIORITIZE COMMUNITY NEEDS, PROVIDE GUIDANCE AND OVERSIGHT OVER PLANNED COMMUNITY IMPROVEMENTS, AND MONITOR PROGRESS ON PRIORITY HEALTH AND SOCIAL CONCERNS IMPACTING THE RAPPAHANNOCK REGION. BE WELL RAPPAHANNOCK REPRESENTATIVE ORGANIZATIONS INCLUDES THE FOLLOWING DIVERSE ORGANIZATIONS:-REGIONAL COMMUNITY COLLABORATIVE FOR YOUTH AND FAMILIES -DEPARTMENTS OF SOCIAL SERVICES -BUSINESS REPRESENTATIVE-LOCAL GOVERNMENT REPRESENTATIVE -HIGHER EDUCATION -MARY WASHINGTON HEALTHCARE -MARY WASHINGTON HOSPITAL FOUNDATION -MENTAL HEALTH AMERICA -PHYSICIAN REPRESENTATIVE -PUBLIC DEFENDER-RAPPAHANNOCK AREA COMMUNITY SERVICES BOARD -RAPPAHANNOCK AREA HEALTH DISTRICT -RAPPAHANNOCK UNITED WAY -SCHOOL ADMINISTRATOR -SCHOOL SYSTEMS (PUBLIC) MARY WASHINGTON HOSPITAL, INC. PART V, SECTION B, LINE 6A: STAFFORD HOSPITAL AND SPOTSYLVANIA REGIONAL MEDICAL CENTER STAFFORD HOSPITAL, LLC PART V, SECTION B, LINE 6A: MARY WASHINGTON HOSPITAL AND SPOTSYLVANIA REGIONAL MEDICAL CENTER MARY WASHINGTON HOSPITAL, INC. PART V, SECTION B, LINE 7D: PRESENTED AT NUMEROUS COMMUNITY MEETINGS, SUCH AS THE ROTARY CLUB, CHAMBER OF COMMERCE, AND FREDERICKSBURG CITY COUNCIL. STAFFORD HOSPITAL, LLC PART V, SECTION B, LINE 7D: PRESENTED AT NUMEROUS COMMUNITY MEETINGS, SUCH AS THE ROTARY CLUB, CHAMBER OF COMMERCE, AND FREDERICKSBURG CITY COUNCIL. MARY WASHINGTON HOSPITAL, INC. PART V, SECTION B, LINE 11: SEE IMPLEMENTATION STRATEGY ATTACHED TO THE RETURN STAFFORD HOSPITAL, LLC PART V, SECTION B, LINE 11: SEE IMPLEMENTATION STRATEGY ATTACHED TO THE RETURN. MARY WASHINGTON HOSPITAL, INC. PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY IS MADE AVAILABLE ON THE ORGANIZATION'S WEBSITE. SIGNS ARE POSTED IN ALL PATIENT REGISTRATION AREAS AND NOTES INCLUDED ON ALL PATIENT STATEMENTS INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND WHO TO CONTACT FOR MORE INFORMATION. BILLING OFFICE PERSONNEL EXPLAIN THE MATERIALS TO ALL PATIENTS REQUESTING ADDITIONAL INFORMATION. STAFFORD HOSPITAL, LLC PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY IS MADE AVAILABLE ON THE ORGANIZATION'S WEBSITE. SIGNS ARE POSTED IN ALL PATIENT REGISTRATION AREAS AND NOTES INCLUDED ON ALL PATIENT STATEMENTS INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND WHO TO CONTACT FOR MORE INFORMATION. BILLING OFFICE PERSONNEL EXPLAIN THE MATERIALS TO ALL PATIENTS REQUESTING ADDITIONAL INFORMATION. 6 1 - MEDICAL IMAGING OF FREDERICKSBURG 1201 SAM PERRY BLVD SUITE 102 ASC BUILD FREDERICKSBURG VA 224014490 IMAGING SERVICES 2 - FREDERICKSBURG AMBULATORY SURGERY CENTER 1201 SAM PERRY BLVD SUITE 101 FREDERICKSBURG VA 224014490 AMBULATORY SURGERY CENTER 3 - MARY WASHINGTON URGENT CARE 11131 JOURNAL PARKWAY SUITE A KING GEORGE VA 22485 URGENT CARE 4 - REGIONAL CANCER CENTER AT MONTROSS 15394 KINGS HIGHWAY MONTROSS VA 22520 RADIATION THERAPY 5 - MARY WASHINGTON EYE CARE CENTER 4710 SPOTSYLVANIA PARKWAY FREDERICKSBURG VA 22407 EYE CARE CENTER 6 - FREDERICKSBURG ENDOSCOPY CENTER LLC 1121 CENTRAL PARK BLVD FREDERICKSBURG VA 22401 ENDOSCOPY CENTER PART I, LN 7 COL(F): MWHC UTILIZED THE SERVICES OF SEARCHAMERICA TO IDENTIFYPFAP ELIGIBLE PATIENTS WHOSE ACCOUNTS HAD FALLEN INTO BAD DEBT.SEARCHAMERICA PROVIDED A LIST UTILIZING VARIOUS MARKET RESEARCH TOAPPROXIMATE THE FEDERAL POVERTY LEVEL OF EACH ACCOUNT HOLDER. WITH THISINFORMATION WE WERE ABLE TO DETERMINE ACCOUNTS THAT MAY HAVE BEEN ELIGIBLEFOR FREE CARE OR DISCOUNTED CARE UNDER OUR FINANCIAL ASSISTANCE POLICY. FORM 990, SCHEDULE H, PART I, LINE 7B. THE COMMONWEALTH OF VIRGINIA ELECTED TO EXPAND MEDICAID COVERAGE IN 2018 WITH 2019 BEING THE FIRST FULL YEAR OF IMPACT. THIS PROGRAM IS FUNDED THROUGH AN ASSESSMENT LEVIED ON ALL HOSPITALS IN THE COMMONWEALTH BASED ON THEIR TOTAL PATIENT SERVICE REVENUE. ADDITIONAL PROVIDER PAYMENTS ARE DISTRIBUTED BACK TO HOSPITALS WHICH PROVIDE SERVICES TO MEDICAID PATIENTS BASED ON THEIR PERCENTAGE OF NET PATIENT SERVICE REVENUE FROM THE MEDICAID PROGRAM. PART II, COMMUNITY BUILDING ACTIVITIES: IN FURTHERANCE OF ITS MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY IT SERVES THE ORGANIZATION PROMOTES WORKFORCE DEVELOPMENT FOR THE RECRUITMENT OF PHYSICIANS AND OTHER HEALTH PROFESSIONALS IN AREAS IDENTIFIED AS SHORTAGE AREAS THROUGH ITS COMMUNITY NEEDS ASSESSMENTS AND MEDICAL STAFF DEVELOPMENT PLANS. RECRUITMENT OF PHYSICIANS TO PRACTICE IN MWHC'S SERVICE AREA IMPROVES ACCESS TO CARE RESULTING IN GREATER AVAILABILITY OF PHYSICIAN SPECIALISTS, LESS TRAVEL TO OBTAIN CARE, AND SHORTER WAIT TIMES FOR APPOINTMENTS. RECRUITMENT EFFORTS ARE ENHANCED BY MWHC'S GRADUATE MEDICAL EDUCATION (GME) PROGRAM WHICH STARTED IN JULY 2023. THE MWHC GME PROGRAM ADDS SIGNIFICANT VALUE TO THE GREATER FREDERICKSBURG COMMUNITY BY ENHANCING ACCESS TO AND DELIVERY OF QUALITY CARE. IT ALSO PROVIDES A PIPELINE OF FUTURE PHYSICIANS AS THE REGION CONTINUES TO GROW AND HEALTHCARE NEEDS BECOME MORE COMPLEX. PART III, LINE 4: MWHC PROVIDES SERVICES TO UNINSURED PATIENTS AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT FROM STANDARD CHARGES. PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE. MWHC ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022, WAS NOT CONSIDERED MATERIAL.PATIENTS WHO MEET MWHC'S CRITERIA FOR CHARITY CARE ARE PROVIDED CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SUCH AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE ARE NOT REPORTED AS REVENUE. PART III, LINE 8: AS A NOT-FOR-PROFIT HOSPITAL IT IS OUR MISSION TO IMPROVE THE HEALTH STATUS OF ALL PEOPLE WITHIN OUR COMMUNITY AND TO PROVIDE HEALTHCARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE STATUS. MWHC ACCEPTS MEDICARE AND MEDICAID AND IT IS A WELL ESTABLISHED FACT THAT NOT-FOR-PROFIT FACILITIES DO NOT RECOUP THE COST OF CARING FOR THOSE PATIENTS UTILIZING THESE PROGRAMS. UNDER IRS GUIDELINES MEDICARE AND MEDICAID BENEFICIARIES ARE CONSIDERED TO BE MEMBERS OF A CHARITABLE CLASS, THEREFORE BY ASSISTING THESE PATIENTS AND ACCEPTING THE SHORTFALLS IN REPAYMENT, THE ORGANIZATION IS IN FACT RELIEVING GOVERNMENT BURDEN AND PROVIDING A SIGNIFICANT COMMUNITY BENEFIT TO OUR SERVICE AREA. PART III, LINE 9B: PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY POINT IN THE COLLECTION CYCLE AND MODIFICATIONS OF ABILITY TO PAY MAY BE ADJUSTED SHOULD FINANCIAL OR INSURANCE STATUS CHANGE SINCE THE FIRST DAY OF CARE. MWHC DOES NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE THEY HAVE MADE REASONABLE EFFORTS TO DETERMINE WHETHER THE INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS CONSTITUTE NOTIFICATION BY MWHC OF ITS FINANCIAL ASSISTANCE POLICY BY WRITTEN AND/OR ORAL COMMUNICATIONS TO ALL UNINSURED/UNDERINSURED PATIENTS AS WELL AS CONSIDERATION OF ELIGIBILITY BASED UPON THE PRESUMPTIVE ELIGIBILITY GUIDELINES DESCRIBED IN THE FINANCIAL ASSISTANCE POLICY. PART VI, LINE 2: MARY WASHINGTON HEALTHCARE AND ITS AFFILIATES (MARY WASHINGTON HOSPTIAL, MARY WASHINGTON HOSPITAL FOUNDATION, STAFFORD HOSPITAL, LLC, STAFFORD HOSPITAL FOUNDATION, MEDICORP PROPERTIES, INC., AND MARY WASHINGTON HEALTHCARE CLINICAL SERVICES, INC.) HAS AS ITS MISSION TO IMPROVE THE HEALTH OF MEMBERS OF THE COMMUNITIES IT SERVES: FREDERICKSBURG, VA AND THE SURROUNDING COUNTIES. THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THESE COMMUNITIES IN NUMEROUS WAYS INCLUDING: 1.) WORKING COLLABORATIVELY WITH BE WELL RAPPAHANNOCK (BWR). BWR IS A COLLABORATIVE COMPRISED OF AGENCIES REPRESENTATIVE OF THE COMMUNITY, WITH A DEEP CONCERN FOR THE HEALTH AND WELL-BEING OF THE RESIDENTS OF THE RAPPAHANNOCK REGION. THE PURPOSE OF THE COUNCIL IS TO IDENTIFY AND PRIORITIZE COMMUNITY NEEDS, PROVIDE GUIDANCE, AND OVERSIGHT OVER PLANNED COMMUNITY IMPROVEMENTS, AND MONITOR PROGRESS ON PRIORITY HEALTH AND SOCIAL CONCERNS IMPACTING THE RAPPAHANNOCK REGION. BE WELL RAPPAHANNOCK REPRESENTATIVE ORGANIZATIONS INCLUDE COMMUNITY COLLABORATIVE FOR YOUTH AND FAMILIES, DEPARTMENTS OF SOCIAL SERVICES, AREA BUSINESSES, LOCAL GOVERNMENT, HIGHER EDUCATION, RAPPAHANNOCK AREA HEALTH DISTRICT, RAPPAHANNOCK UNITED WAY, RAPPAHANNOCK COMMUNITY SERVICE BOARD, COMMUNITY MENTAL HEALTH, AND AREA SCHOOL DISTRICTS. 2.) RESPONDING TO INFORMATION GATHERED FROM AREA COMMUNITY-BASED ORGANIZATIONS. THE COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES A FOUNDATION FOR WORKING COLLABORATIVELY WITH KEY STAKEHOLDERS IN THE COMMUNITY TO IMPROVE HEALTH. SPECIAL ATTENTION HAS BEEN GIVEN TO IDENTIFY HEALTH DISPARITIES, NEEDS OF VULNERABLE POPULATIONS, AND UNMET HEALTH NEEDS OR GAPS IN SERVICES THROUGH COMMUNITY INPUT. PART VI, LINE 3: MARY WASHINGTON HEALTHCARE AFFILIATES PROVIDE INFORMATION TO PATIENTS ABOUT ITS FINANCIAL ASSISTANCE PROGRAMS THROUGH SIGNAGE AT INTAKE AREAS, FLYERS AT ADMISSIONS, NOTICES ON BILLS AND COLLECTION STATEMENTS. FINANCIAL COUNSELORS ARE ALSO AVAILABLE TO ASSIST PATIENTS IN OBTAINING FINANCIAL ASSISTANCE. PART VI, LINE 4: MARY WASHINGTON HEALTHCARE PROVIDES EXCEPTIONAL MEDICAL SERVICES TO THE CITY OF FREDERICKSBURG AND THE SURROUNDING "COMMUNITY" THAT CONSIST OF THE PRIMARY SERVICE AREA CITY OF FREDERICKSBURG AND COUNTIES OF STAFFORD, KING GEORGE, SPOTSYLVANIA, CAROLINE, WESTMORELAND, ORANGE, AND PRINCE WILLIAM, MWHC'S SECONDARY SERVICE AREA COUNTIES ARE MANASSAS, FAUQUIER, CULPEPER, LOUISA, ESSEX, AND RICHMOND. ESTABLISHED IN 1899, MARY WASHINGTON HOSPITAL (MWH), A 471 BED ACUTE CARE FACILITY, OFFERS COMPREHENSIVE HEALTHCARE AND MULTIPLE CENTERS OF EXCELLENCE INCLUDING CARDIOLOGY AND CARDIOVASCULAR SURGERY, ONCOLOGY, ORTHOPEDICS, NEUROLOGY AND NEUROSURGERY, BEHAVIORAL HEALTH, AND WOMEN AND INFANT HEALTH. STAFFORD HOSPITAL, LLC, A 100 BED ACUTE CARE FACILITY, ALSO OFFERS COMPREHENSIVE HEALTHCARE SERVICES. BOTH MWH AND SH ARE ACCREDITED BY THE JOINT COMMISSION AND LICENSED BY THE COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH AND THE DEPARTMENT OF MENTAL HEALTH, MENTAL RETARDATION AND SUBSTANCE ABUSE SERVICES. MWH ALSO PROVIDES ADVANCE RADIATION THERAPY AND HOME HEALTH SERVICES THROUGH MARY WASHINGTON HOME HEALTH.AS OF THE MOST RECENT CENSUS, THE PRIMARY SERVICE AREA IN WHICH BOTH HOSPITALS SERVE IS MADE UP OF ABOUT 1,796 SQUARE MILES OF SUBURBAN AND RURAL LAND. COMMUNITY RESIDENTS IN THE PRIMARY SERVICE AREA EARN A MEDIAN INCOME PER HOUSEHOLD OF $95,349/YEAR, WITH A COLLECTIVE AVERAGE OF 8.6% OF THE ENTIRE PRIMARY SERVICE AREA LIVING BELOW THE FEDERAL POVERTY GUIDELINES. THE PRIMARY SERVICE AREA HAS AN ESTIMATED POPULATION OF 477,221 INDIVIDUALS AND 165,393 HOUSEHOLDS. PART VI, LINE 5: MARY WASHINGTON HOSPITAL, INC. AND STAFFORD HOSPITAL, LLC EACH OPERATE EMERGENCY ROOMS THAT ARE OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY; HAVE OPEN MEDICAL STAFFS WITH PRIVILEGES TO ALL QUALIFIED PHYSICIANS WHO APPLY, HAVE A GOVERNING BODY WITH A MAJORITY OF INDEPENDENT TRUSTEES, AND PARTICIPATE IN MEDICAID, MEDICARE AND OTHER GOVERNMENT SPONSORED HEALTH CARE PROGRAMS. MARY WASHINGTON HEALTHCARE CLINICAL SERVICES, INC. THROUGH ITS SUBSIDIARIES, PROVIDES ANCILLARY HEALTH SERVICES INCLUDING PHYSICIAN PRACTICES, OUTPATIENT AND AMBULATORY SURGERY, AND HOME HEALTH/HOSPICE SERVICES.THE ORGANIZATION UTILIZES SURPLUS FUNDS TO EXPAND SERVICES PROVIDED TO THE COMMUNITY (IN RESPONSE TO THE COMMUNITY NEEDS ASSESSMENTS), UPGRADE FACILITIES AND EQUIPMENT TO ENHANCE CLINICAL CARE AND PHYSICIAN CONNECTIVITY TO PATIENT ELECTRONIC HEALTH RECORDS, AND HEALTH EDUCATION PROGRAMS. PART VI, LINE 6: MARY WASHINGTON HEALTHCARE AFFILIATES INCLUDE TWO (2) HOSPITALS, OTHER CLINICAL SERVICES THAT INCLUDE AN AMBULATORY SURGERY CENTER, AN ENDOSCOPY CENTER, HOSPICE/HOME HEALTH, INDEPENDENT DIAGNOSTIC TESTING FACILITIES, URGENT CARE CENTERS, OUTPATIENT PHYSICAL THERAPY CENTERS, OUTREACH LABORATORIES, OUTPATIENT INFUSION CENTERS OUTPATIENT RADIATION ONCOLOGY CENTERS AND PHYSICIAN PRACTICES; TWO (2) FOUNDATIONS AND A PROPERTY DIVISION. ALL ACTIVITIES OF THIS GROUP ARE COORDINATED AND OVERSEEN BY THE PARENT'S (MARY WASHINGTON HEALTHCARE) BOARD OF TRUSTEES. THE AFFILIATED GROUP'S ACTIVITIES ARE CLOSELY PLANNED/INTEGRATED THROUGH INTERLOCKING BOARDS TO ENSURE THE MOST EFFECTIVE DELIVERY OF CARE. EACH MEMBER OF THE AFFILIATED GROUP FOCUSES EFFORTS IN ITS PARTICULAR AREA OF RESPONSIBILITY AND IS ACCOUNTABLE TO THE PARENT'S BOARD FOR ACHIEVING ITS MISSION AND GOALS FOR THE PROVISION OF HEALTH CARE. THE DIVISION OF SERVICES ABOVE ALLOWS PATIENTS TO ACCESS CARE IN THE MOST APPROPRIATE SETTING. THE GOVERNANCE OVERSIGHT PROVIDED BY THE PARENT GUARANTEES OPTIMAL COORDINATION OF THE VARIOUS SEGMENTS OF CARE AND ENSURES HIGH QUALITY SERVICE AS ECONOMICALLY AS POSSIBLE. PART VI, LINE 7, REPORTS FILED WITH STATES VA 0 LLOYD F MOSS FREE CLINIC 1301 SAM PERRY BLVD STE 100 FREDERICKSBURG VA 22401 541677934 501(C)(3) 1084611 0 ACCESS TO CARE PROGRAMS MICAH ECUMENICAL MINISTRIES PO BOX 3277 FREDERICKSBURG VA 22402 204044884 501(C)(3) 135000 0 RESIDENTIAL RECOVERY PROGRAM FREDERICKSBURG CHRISTIAN HEALTH CENTER 1129 HEATHERSTONE DRIVE FREDERICKSBURG VA 22407 542061482 501(C)(3) 90000 0 ACCESS TO CARE PROGRAMS GUADALUPE FREE CLINIC OF COLONIAL BEACH PO BOX 275 COLONIAL BEACH VA 22443 510635977 501(C)(3) 75000 0 ACCESS TO CARE PROGRAMS RAPPAHANNOCK AREA COMMUNITY SERVICES 600 JACKSON STREET FREDERICKSBURG VA 22401 541183037 GOVERNMENT/LOCAL 84800 0 CHILDREN AND ADOLESCENT BEHAVIOURAL HEALTH SUPPORT PROGRAM CENTRAL VA HEALTH SERVICES PO BOX 220 NEW CANTON VA 25892 540887287 501(C)(3) 60000 0 ACCESS TO CARE PROGRAMS GERMANNA COMMUNITY COLLEGE EDUCATIONAL FOUNDATION PO BOX 1430 LOCUST GROVE VA 22508 541379348 501(C)(3) 50000 0 NURSING PROGRAM EXPANSION FREDERICKSBURG REGIONAL TRANSIT 1400 JEFFERSON DAVIS HWY FREDERICKSBURG VA 22401 546001293 115 40000 0 ACCESS TO CARE PROGRAMS VIRGINIA COMMUNITY FOOD CONNECTIONS PO BOX 7664 FREDERICKSBURG VA 22404 811346510 501(C)(3) 30000 0 FRESH FOOD ACCESS FOR COMMUNITY HEALTH STAFFORD SCHOOLS HEAD START 610 GAYLE ST FREDERICKSBURG VA 22405 546001628 115 35000 0 CHILDREN'S INSURANCE OUTREACH / NUTRITION CONSULTANT PROJECTS FREDERICKSBURG AREA FOOD BANK 3631 LEE HILL DR FREDERICKSBURG VA 22408 541255013 501(C)(3) 30000 0 ESTABLISHING HEALTHY EATING RESEARCH GUIDELINES RAPPAHANNOCK AREA AGENCY ON AGING INC 460 LENDALL LANE FREDERICKSBURG VA 22405 541027651 501(C)(3) 17000 0 INSURANCE COUNSELING ASSISTANCEACCESS TO CARE PROGRAMS GEORGE WASHINGTON REGIONAL COMMISSION 406 PRINCESS ANNE STREET FREDERICKSBURG VA 22401 540715969 115 74122 0 COMMUNITY HOUSINGCOMMUNITY BASED ELIGIBILITY WORKER GWYNETH'S GIFT FOUNDATION 2217 PRINCESS ANNE ST STE 101 FREDERICKSBURG VA 22401 474428397 501(C)(3) 21000 0 LIFE SAVING CPR EDUCATION AND AED ACCESS DOWNTOWN GREENS INC 206 CHARLES STREET FREDERICKSBURG VA 22401 541853889 501(C)(3) 10000 0 NUTRITION PROGRAMS STAFFORD JUNCTION INC 791 TRUSLOW ROAD FREDERICKSBURG VA 22406 203036072 501(C)(3) 18000 0 HEALTHY LIVING PROGRAMS STAFFORD COUNTY SOCIAL SERVICES PO BOX 7 STAFFORD VA 22554 546001626 115 21788 0 ACCESS TO CARE PROGRAMS HAZEL HILL HEALTHCARE PROJECT 225 BUTLER RD FREDERICKSBURG VA 22401 271744104 501(C)(3) 15000 0 ACCESS TO CARE PROGRAMS RX PARTNERSHIP 2924 EMERYWOOD PARKWAY 300 RICHMOND VA 23294 571186937 501(C)(3) 18150 0 ACCESS TO CARE PROGRAMS DISABILITY RESOURCE CENTER 409 PROGRESS ST FREDERICKSBURG VA 22401 541687677 501(C)(3) 12500 0 ACCESS TO CARE PROGRAMS MENTAL HEALTH AMERICA OF FREDERICKSBURG 2217 PRINCESS ANNE STSTE 104-1 FREDERICKSBURG VA 22401 540678704 501(C)(3) 44600 0 HELPLINE PROGRAM LOISANN'S HOPE HOUSE 902 LAFAYETTE BLVD FREDERICKSBURG VA 22401 521419314 501(C)(3) 25000 0 AFFORDABLE HOUSING THE HUB OF HOPE 5008 SOUTHPOINT PKWY FREDERICKSBURG VA 22407 852751588 501(C)(3) 12500 0 NUTRITION PROGRAMS THE ZOE LIFE CENTER (ZOE FREEDOM CENTER) 928 BRAGG ROAD FREDERICKSBURG VA 22407 824028300 501(C)(3) 7500 0 BEHAVIORAL HEALTH PROGRAMS VIRGINIA DEPARTMENT OF HEALTH RAPPAHANNOCK AREA HEALTH DISTRICT 608 JACKSON ST FREDERICKSBURG VA 22401 546001775 501(C)(3) 35000 0 ACCESS TO CARE PROGRAMS CITY OF FREDERICKSBURG PARKS RECREATION AND EVENTS DEPARTMENT PO BOX 967 FREDERICKSBURG VA 224040967 546001293 501(C)(3) 7500 0 ACCESS TO CARE PROGRAMS GREATER FREDERICKSBURG HABITAT FOR HUMANITY PO BOX 82665 FREDERICKSBURG VA 22404 541737851 501(C)(3) 25000 0 AFFORDABLE HOUSING 20 7 X X 1 1 X X X X X X 0 1 0 0 0 0 0 1 0 MICHAEL P MCDERMOTT MD MBA PRESIDENT AND CEO 0 1252999 0 593385 0 90840 0 9900 0 33742 0 1980866 0 0 PARTAM MANALAI MD PHYSICIAN 1241564 0 0 0 140547 0 2958 0 30931 0 1416000 0 0 0 SANG HO NA MD PHYSICIAN 1032512 0 83240 0 0 0 9900 0 17934 0 1143586 0 0 0 CHRISTOPHER NEWMAN MD EVP, COO & CMO 0 735756 0 261324 0 7757 0 9900 0 33340 0 1048077 0 0 J T SHERWOOD MD PHYSICIAN 790005 0 146052 0 0 0 9900 0 37322 0 983279 0 0 0 SEAN T BARDEN BSBA MBA EVP & CFO 0 653510 0 224107 0 40406 0 9900 0 25451 0 953374 0 0 AGOSTINO VISIONI MD PHYSICIAN 825011 0 73309 0 0 0 9288 0 35763 0 943371 0 0 0 HONG NGUYEN MD PHYSICIAN 255008 0 490003 0 1220 0 7650 0 3694 0 757575 0 0 0 TRAVIS TURNER BS MBA SVP & CPHO 0 489378 0 152468 0 29766 0 8555 0 31174 0 711341 0 0 XAVIER RICHARDSON BA MBA SVP & CDO 0 319731 0 94637 0 197932 0 9900 0 11772 0 633972 0 161732 KATHRYN WALL BA MA SVP & CHRO (THRU 10/23) 0 321487 0 121986 0 156698 0 9900 0 11125 0 621196 0 138805 STEPHEN MANDELL MD VICE PRESIDENT 415704 0 103615 0 54585 0 8272 0 29131 0 611307 0 46511 0 ERIC FLETCHER MBA APR SVP & CSO 0 400746 0 124857 0 18232 0 9900 0 34701 0 588436 0 0 GEOFFREY LAWSON SVP & CIO 0 408340 0 127468 0 18855 0 9900 0 16200 0 580763 0 0 DAVID YI MD VICE PRESIDENT 0 420183 0 104729 0 8926 0 9900 0 1844 0 545582 0 0 STEPHANIE GOLDBERG VICE PRESIDENT 409237 0 102000 0 8852 0 9900 0 1821 0 531810 0 0 0 EILEEN DOHMANN RN BSN MBA NEA-BC SVP & CNO (THRU 5/23) 0 156854 0 119910 0 217058 0 4883 0 1696 0 500401 0 207704 CATHLEEN YABLONSKI BS MS SVP, CAOO 347629 0 108308 0 6383 0 9167 0 27328 0 498815 0 0 0 DANIEL WOODFORD VICE PRESIDENT 354153 0 98892 0 3337 0 9167 0 30593 0 496142 0 0 0 RICHARD LEWIS MD VICE PRESIDENT 0 328144 0 81789 0 27304 0 9900 0 25384 0 472521 0 29668 SCOTT SELL VICE PRESIDENT 332504 0 82523 0 0 0 9900 0 29056 0 453983 0 0 0 LAUREN BLALOCK VICE PRESIDENT 0 300650 0 71349 0 28844 0 9245 0 33813 0 443901 0 0 SAUSHEEN TAYLOR MD PHYSICIAN/TRUSTEE 0 370804 0 19867 0 0 0 5757 0 34699 0 431127 0 0 ALAN EDWARDS VICE PRESIDENT 0 268560 0 66938 0 33989 0 7641 0 32417 0 409545 0 29743 SANDRA BROWN CPA VICE PRESIDENT 0 291029 0 73389 0 6574 0 9059 0 24239 0 404290 0 0 CODY BLANKENSHIP VICE PRESIDENT 0 278824 0 70038 0 4024 0 7647 0 30643 0 391176 0 0 SARAH OGLE VICE PRESIDENT 0 278170 0 69335 0 7503 0 8570 0 2279 0 365857 0 0 SUMMER HUGHES VP & CHIEF OF STAFF 0 273535 0 61302 0 14211 0 5765 0 2839 0 357652 0 0 JOANDREW COUSINS VICE PRESIDENT (THRU 7/23) 0 204624 0 10000 0 19275 0 5594 0 1395 0 240888 0 0 RENUKA GUPTA VICE PRESIDENT 0 128946 0 61000 0 4085 0 3989 0 969 0 198989 0 0 TONJA THIGPEN SVP & CNO 0 113370 0 40000 0 4877 0 0 0 5612 0 163859 0 0 MARIE FREDRICK RT R CRA MJ FORMER VICE PRESIDENT (THRU 6/22) 0 0 0 0 0 127968 0 0 0 0 0 127968 0 0 PART I, LINE 1A PART I, LINE 1A - TRUSTEES WHO ARE UNCOMPENSATED VOLUNTEERS TRAVELING FOR BUSINESS RELATED REASONS ON BEHALF OF THE ORGANIZATION ARE REIMBURSED FOR THE COST OF SPOUSAL TRAVEL. REIMBURSEMENTS PAID FOR SPOUSAL TRAVEL ARE REIMBURSED AND REPORTED AS INCOME ON A FORM 1099 IN THE YEAR PAID. EXECUTIVES WHO ARE TRAVELING FOR BUSINESS RELATED REASONS ON BEHALF OF THE ORGANIZATION ARE REIMBURSED FOR THE COST OF SPOUSAL MEALS PROVIDED AND THE AMOUNT IS REPORTED AS INCOME ON THE EXECUTIVE'S W-2. PART I, LINE 4B XAVIER RICHARDSON RECEIVED A 457(F) DISTRIBUTION OF $161,732. KATHRYN WALL RECEIVED A 457(F) DISTRIBUTION OF $138,805. STEPHEN MANDELL RECEIVED A 457(F) DISTRIBUTION OF $46,511. EILEEN DOHMANN RECEIVED A 457(F) DISTRIBUTION OF $207,704. RICHARD LEWIS RECEIVED A 457(F) DISTRIBUTION OF $20,396. LAUREN BLALOCK RECEIVED A 457(F) DISTRIBUTION OF $29,668. ALAN EDWARDS RECEIVED A 457(F) DISTRIBUTION OF $29,743. PART I, LINE 7 PART I, LINE 7 - ALL EXECUTIVES HAVE AS A PART OF THEIR COMPENSATION A VARIABLE COMPONENT SUCH THAT THEY ARE ELIGIBLE TO RECEIVE A PERCENTAGE OF THEIR BASE PAY AS AN INCENTIVE FOR THE ACHIEVEMENT OF INDIVIDUAL AND CORPORATE GOALS AND OBJECTIVES. SCHEDULE J INDEPENDENT BOARD TRUSTEES RECEIVE NO COMPENSATION. A ECONOMIC DEVELOPMENT AUTHORITY 521303430 355849AS9 2007-05-10 86868312 REFUNDING OF 1996 MWH BONDS 0 0 0 B ECONOMIC DEVELOPMENT AUTHORITY 521303430 355849BC3 2014-05-28 59254492 REFUNDING OF 2002 BONDS 0 0 0 C ECONOMIC DEVELOPMENT AUTHORITY 541244413 852431BM6 2016-05-02 128486132 REFUNDING OF 2006 BONDS 0 0 0 D ECONOMIC DEVELOPMENT AUTHORITY 521303430 2016-11-22 30405000 REFUNDING OF 2013 BONDS 0 0 0 A 81860000 86868312 583010 86285302 2007 1 0 1 1 B 59254492 630794 58623698 2014 1 0 1 1 C 4010000 128486132 2100667 126385465 2016 1 0 1 1 D 7465000 30405000 30405000 2016 1 0 1 1 A 0 0 1 1 0 0 0 1 B 0 0 1 1 0 0 0 1 C 0 0 1 1 0 0 0 1 D 0 1 1 1 0 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 0 1 0 1 0 0 1 1 A 1 B 1 C 1 D 1 A VIRGINIA SMALL BUSINESS FINANCING AUTHORITY 521300845 2023-11-20 50000000 CAPITAL PURCHASES 0 0 0 A 50000000 24611835 0 0 0 1 A 0 0 1 1 0 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT COMPLETES A DRAFT OF THE INTERNAL REVENUE SERVICE (IRS) FORM 990 INFORMATION RETURN FOR MARY WASHINGTON HEALTHCARE AND ITS SUBSIDIARIES. THIS DRAFT IS SUBMITTED TO THE FINANCE COMMITTEE OF THE ORGANIZATION'S BOARD OF TRUSTEES. THE FORM 990 AND UNDERLYING INFORMATION ARE PRESENTED TO AND REVIEWED BY THIS COMMITTEE. IF THE CONTENTS OF THE 990 RETURN ARE DEEMED ACCURATE AND ACCEPTABLE BY THE COMMITTEE, THIS BODY RECOMMENDS ACCEPTANCE OF THE RETURN BY THE FULL BOARD OF TRUSTEES. THE FORM 990 RETURN IS SUBSEQUENTLY PRESENTED TO AND REVIEWED BY THE ORGANIZATION'S BOARD OF TRUSTEES. IF DEEMED ACCURATE AND ACCEPTABLE THE BOARD ACCEPTS THE RETURN THROUGH A FORMAL MOTION. AS PART OF THIS PROCESS, THE DRAFT RETURN IS POSTED ON THE BOARD'S WEBSITE WHERE IT REMAINS AVAILABLE FOR REVIEW EVEN AFTER FORMAL ACCEPTANCE BY THE BOARD. THE FORM 990 RETURN IS ALSO AVAILABLE TO MEMBERS OF THE BOARD OF TRUSTEES AS WELL AS THE GENERAL PUBLIC ON MARY WASHINGTON HEALTHCARE'S WEBSITE (WWW.MARYWASHINGTONHEALTHCARE.COM). FORM 990, PART VI, SECTION B, LINE 12C EVERY TRUSTEE AND EXECUTIVE IS REQUIRED TO DISCLOSE ANY AND ALL CONFLICTS. THE DISCLOSURES ARE MADE ANNUALLY AND SUBMITTED TO THE MARY WASHINGTON HEALTHCARE CHIEF COMPLIANCE OFFICER (CCO). THE CCO PRESENTS ALL CONFLICTS TO THE ENTERPRISE RISK MANAGEMENT COMMITTEE OF THE BOARD OF TRUSTEES. THE CHAIRMAN OF THE ENTERPRISE RISK MANAGEMENT COMMITTEE REPORTS ALL CONFLICTS TO THE FULL BOARD. CONFLICTS ARE CONTINUALLY AND ACTIVELY MANAGED. AT EACH MEETING, THE CHAIR ASKS IF ANYONE AT THE MEETING HAS A CONFLICT TO DISCLOSE. INDIVIDUALS WITH CONFLICTS DISCLOSE THEIR CONFLICTS AND THE RELATED TOPIC. THE INDIVIDUAL THEN RECUSES HIM/HERSELF FROM ANY DECISION RELATED TO THAT TOPIC. THE CONFLICT OF INTERESTS POLICY IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 MARY WASHINGTON HEALTHCARE UTILIZES AN EXECUTIVE COMPENSATION COMMITTEE WITH THE PURPOSE AND AUTHORITY TO ESTABLISH PROCESSES TO ENSURE FAIR AND COMMERCIALLY REASONABLE COMPENSATION FOR THE CEO AND EXECUTIVE LEADERSHIP. IN ORDER TO ENSURE COMPENSATION PAID IS SET AT FAIR MARKET VALUE, THE EXECUTIVE COMPENSATION COMMITTEE UTILIZES COMPENSATION SURVEY DATA, FORM 990 INFORMATION FROM COMPARABLE HEALTH SYSTEMS, AND THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT. SUCH INDEPENDENT THIRD PARTY DATA POINTS PROVIDE ASSURANCE THAT EXECUTIVE COMPENSATION IS COMMERCIALLY REASONABLE AND AT A FAIR MARKET VALUE. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIALS STATEMENTS ARE POSTED ON THE MARY WASHINGTON HEALTHCARE WEBSITE FOR PUBLIC VIEW. FORM 990, PART IX, LINE 11G CONTRACT PERSONNEL: PROGRAM SERVICE EXPENSES 37,544,165. MANAGEMENT AND GENERAL EXPENSES 2,353,753. FUNDRAISING EXPENSES 63,939. TOTAL EXPENSES 39,961,857. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 61,696,520. MANAGEMENT AND GENERAL EXPENSES 3,867,935. FUNDRAISING EXPENSES 105,071. TOTAL EXPENSES 65,669,526. BILLING AND COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 117,552. MANAGEMENT AND GENERAL EXPENSES 7,370. FUNDRAISING EXPENSES 200. TOTAL EXPENSES 125,122. ASP SERVICES: PROGRAM SERVICE EXPENSES 127,982. MANAGEMENT AND GENERAL EXPENSES 8,024. FUNDRAISING EXPENSES 218. TOTAL EXPENSES 136,224. MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 7,674,957. MANAGEMENT AND GENERAL EXPENSES 481,165. FUNDRAISING EXPENSES 13,071. TOTAL EXPENSES 8,169,193. STORAGE SERVICES: PROGRAM SERVICE EXPENSES 114,903. MANAGEMENT AND GENERAL EXPENSES 7,204. FUNDRAISING EXPENSES 196. TOTAL EXPENSES 122,303. WASTE DISPOSAL: PROGRAM SERVICE EXPENSES 1,354,505. MANAGEMENT AND GENERAL EXPENSES 84,918. FUNDRAISING EXPENSES 2,307. TOTAL EXPENSES 1,441,730. MANAGEMENT CONTRACTS: PROGRAM SERVICE EXPENSES 32,691,486. MANAGEMENT AND GENERAL EXPENSES 2,049,525. FUNDRAISING EXPENSES 55,675. TOTAL EXPENSES 34,796,686. FORM 990, PART XI, LINE 9: UNCOLLECTED PLEDGES 436,910. ELIMINATION OF EQUITY FOR CONSOLIDATED ENTITIES 12,688,498. RELIEF FROM AFFILIATE LOANS 17,457,587. FORM 990, PART XII, LINE 2C THE COMPANIES IN THE GROUP RETURN ARE INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MWHC. RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AUDITORS RESTS WITH THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES. FORM 990, PART V, Q2A NO ENTITY WITHIN THE GROUP FILES W-2S WITH THE IRS. ALL PAYROLL IS PAID THROUGH AN AGENCY AGREEMENT WITH MARY WASHINGTON HEALTHCARE. FORM 990, SCHEDULE R ABBREVIATIONS: MWHC - MARY WASHINGTON HEALTHCARE MPI - MEDICORP PROPERTIES, INC. MWHC CLINICAL - MARY WASHINGTON HEALTHCARE CLINICAL SERVICES, INC. MWHC SERVICES, INC. - MARY WASHINGTON HEALTHCARE SERVICES, INC. MEDIDOCTORS H.C. - MEDIDOCTORS HOLDING COMPANY FORM 990, PART V, Q3A AND Q3B MARY WASHINGTON HOSPITAL AND MARY WASHINTON HOSPITAL FOUNDATON FILE SEPARATE 990T'S RELATED TO UNRELATED BUSINESS INCOME. MEDIDOCTORS LLC 2300 FALL HILL AVE STE 418 FREDERICKSBURG VA 22401 541990805 MEDICAL VA 431 -7003 MARY WASHINGTON HEALTHCARE CLINICAL SERVICES INC MARY WASHINGTON MEDICAL GROUP - HOSPITALIST SERVICES LLC 2300 FALL HILL AVE STE 418 FREDERICKSBURG VA 22401 571172752 MEDICAL VA 28875262 409144 MARY WASHINGTON HEALTHCARE CLINICAL SERVICES INC MARY WASHINGTON EYE CARE LLC 2300 FALL HILL AVE STE 418 FREDERICKSBURG VA 22401 271248032 MEDICAL VA 2746113 751974 MWHC URGENT CARE LLC 2300 FALL HILL AVE STE 418 FREDERICKSBURG VA 22401 834378864 MEDICAL VA 10589830 1183362 STAFFORD HOSPITAL AUXILIARY 2300 FALL HILL AVE SUITE 418 FREDERICKSBURG VA 22401 262704632 MEDICAL SERVICES VA 501(C)(3) LINE 12D, III-O 0 MARY WASHINGTON HOSPITAL AUXILIARY 2300 FALL HILL AVE SUITE 418 FREDERICKSBURG VA 22401 752985923 MEDICAL SERVICES VA 501(C)(3) LINE 12D, III-O 0 MARY WASHINGTON HEALTHCARE 2300 FALL HILL AVE SUITE 418 FREDERICKSBURG VA 22401 541240646 SUPPORT SERVICES VA 501(C)(3) LINE 12C, III-FI 0 FREDERICKSBURG AMBULATORY SURGERY CENTER 2300 FALL HILL AVE STE 418 FREDERICKSBURG VA 22401 562322548 SURGERY CTR VA MWHC CLINICAL SERVICES INC RELATED 2316213 356632 0 1 0.62130 MEDICAL IMAGING OF FREDERICKSBURG 2300 FALL HILL AVE STE 418 FREDERICKSBURG VA 22401 541364028 IMAGING VA MWHC CLINICAL SERVICES INC RELATED 8825480 3924144 0 1 0.51000 COWAN INVESTMENT PARTNERS LLC 2300 FALL HILL AVE STE 418 FREDERICKSBURG VA 22401 651294835 REAL ESTATE VA MEDICORP PROPERTIES INC RELATED 24627 40025 0 0 0.12500 SPOTSYLVANIA PARKWAY MEDICAL PLAZA LLC 2300 FALL HILL AVE STE 418 FREDERICKSBURG VA 22401 262656396 REAL ESTATE VA MEDICORP PROPERTIES INC RELATED 221602 -679633 0 0 0.42780 COMMONWEALTH IMAGING LLC 2300 FALL HILL AVE STE 418 FREDERICKSBURG VA 22401 050622704 IMAGING VA MWHC SERVICES INC RELATED 2924 40444 0 0 0.33330 MWHC ENDOSCOPY HOLDINGS LLC 2300 FALL HILL AVE STE 418 FREDERICKSBURG VA 22401 834407938 ENDOSCOPY VA MWHC CLINICAL SERVICES INC RELATED 1532862 304411 0 1 0.60000 FREDERICKSBURG ENDOSCOPY CENTER LLC 1211 CENTRAL PARK BLVD FREDERICKSBURG VA 22401 834398314 ENDOSCOPY VA MWHC ENDOSCOPY HOLDINGS LLC RELATED 2576655 508834 0 0 0.51000 FREDERICKSBURG PROFESSIONAL RISK EXCHANGE 2300 FALL HILL AVE SUITE 418 FREDERICKSBURG VA 22401 331095956 CAPTIVE INSURANCE VT MWHC C 1173339 14815420 1.00000 0 MARY WASHINGTON HEALTHCARE SERVICES INC 2300 FALL HILL AVE SUITE 418 FREDERICKSBURG VA 22401 541244509 RETAIL MEDICAL VA MWHC C -686850 712894 1.00000 0 MARY WASHINGTON HEALTH PLAN 2300 FALL HILL AVE SUITE 418 FREDERICKSBURG VA 22401 823693765 HEALTH MAINTENANCE VA MWHC C -3047471 14841834 1.00000 0 PINNACLE HEALTH CORPORATION 2300 FALL HILL AVE SUITE 418 FREDERICKSBURG VA 22401 311636492 HEALTH MANAGEMENT VA MWHA C 2327 305832 1.00000 0 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0