2023-05-12T18:51:59-05:00 2022-06-30 366055558 GRANT THORNTON LLP 1301 INTERNATIONAL PARKWAY SUITE 300 FORT LAUDERDALE FL 33323 990 2022-01-01 540696355 UVA PRINCE WILLIAM MEDICAL CENTER UVAP 5712841163 8700 SUDLEY ROAD MANASSAS VA 20110 CHARLES CODER CFO 5712841163 2023-05-12 1 CHARLES CODER XXX-XX-XXXX 0 STEPHANIE LARSEN P01981731 9547689900 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z X UVA HEALTH PRINCE WILLIAM MEDICAL CENTER ERIK SHANNON 8700 SUDLEY ROAD MANASSAS VA 20110 164019577 0 X HTTPS://UVAHEALTH.COM/LOCATION X 1964 VA SEE SCHEDULE O 17 10 0 394 2280 0 11478047 1270768 291466934 160901485 -4150684 48079 1065580 1029634 299859877 163249966 97520 58850 0 0 116287037 60900933 0 0 0 160651878 89607502 277036435 150567285 22823442 12682681 273629689 295890516 69547160 73624898 204082529 222265618 X SEE SCHEDULE O 0 0 134832135 154596676 TOGETHER, UVA PRINCE WILLIAM MEDICAL CENTER AND UVA HAYMARKET MEDICAL CENTER HAVE 190 LICENSED BEDS. DURING THE SHORT PERIOD JANUARY 1, 2022 - JUNE 30, 2022, THERE WERE 20,172 PATIENT DAYS, WITH AN AVERAGE LENGTH OF STAY OF 3.86 DAYS, AND AN AVERAGE DAILY CENSUS OF 111. THERE WERE 5,224 DISCHARGES, 2,516 INPATIENT AND OUTPATIENT SURGERIES, 69,073 OUTPATIENT ENCOUNTERS AND 33,769 EMERGENCY DEPARTMENT VISITS. 4081857 6302529 UVA CANCER CENTER GAINESVILLE, LLC IS NATIONALLY RECOGNIZED BY THE AMERICAN COLLEGE OF RADIOLOGY, AND IS A VITAL PART OF UVA HEALTH'S COMPREHENSIVE CANCER PROGRAM IN NORTHERN VIRGINIA. 138913992 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 17 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 VA X CHARLES CODER 5712841163 8700 SUDLEY ROAD MANASAS VA 20110 X STEPHEN SMITH MD PRES & COO / TRUSTEE (THRU 2/2022) 25.00 25.00 X X 0 0 0 STEVEN M DANZIGER CHAIR 0.20 1.00 X X 0 0 0 MATTHEW GUILFOYLE TRUSTEE 0.20 0.40 X 0 0 0 VIKRAM KHOT MD TRUSTEE 0.20 0.60 X 0 0 0 JACQUELINE KRICK TRUSTEE 0.20 0.40 X 0 0 0 STEPHEN NELSON TRUSTEE 0.20 0.40 X 0 0 0 ROSS SWITKES MD TRUSTEE 0.20 0.40 X 0 0 0 MARY FRANCES SOUTHERLAND TRUSTEE 0.20 0.80 X 0 0 0 KIRSTEN GREEN MD TRUSTEE 0.20 0.60 X 0 0 0 CHARLES BARRELL TRUSTEE 0.20 0.80 X 0 0 0 LISA ANN PEACOCK TRUSTEE 0.20 0.60 X 0 0 0 RICHARD HARRINGTON TRUSTEE 0.20 0.60 X 0 0 0 MICHELLE METZGAR TRUSTEE 0.20 0.60 X 0 0 0 CHRIS HEATON MD TRUSTEE 0.20 45.60 X 0 0 0 PAM KINCHELOE RN JD TRUSTEE 0.20 0.60 X 0 0 0 BEN WAMPLER MD TRUSTEE 0.20 0.60 X 0 0 0 SHIV KHANDELWAL MD TRUSTEE 0.20 0.60 X 0 0 0 CHARLES CODER CFO & TREASURER 0.20 50.20 X 0 0 0 ERIK SHANNON INT. CEO 0.20 50.80 X 0 0 0 0 0 0 0 0 0 0 0 1270768 1270768 NET PATIENT REVENUE 622110 160899205 160899205 PHARMACY 621111 2280 2280 160901485 35161 35161 963508 769611 193897 193897 193897 12918 0 12918 12918 12918 EQUITY IN SUB 900099 503142 503142 CAFETERIA MEALS 722514 277862 277862 VENDING MACHINE 454210 15144 15144 39589 39589 835737 163249966 160899205 2280 1077713 X 38850 38850 20000 20000 502065 502065 50693447 46637971 4055476 2023651 1861758 161893 4151895 3819744 332151 3529875 3247485 282390 71093 71093 2000 2000 35539686 32648984 2890702 13795 13795 1054239 760716 293523 977313 955840 21473 4188565 3568911 619654 21581 20330 1251 14726 13548 1178 2583883 2583883 9670533 7625235 2045298 865668 627885 237783 MEDICAL SUPPLIES 14198174 14198174 BAD DEBT 12190443 12190443 PHARMACEUTICALS 4104490 4104490 REPAIRS AND MAINTENANCE 2770816 2734278 36538 1340497 1241672 98825 150567285 138913992 11653293 0 36582970 49673327 126232 28337 51909306 67952550 2384306 2267992 6611965 6623301 863746 684272 450488245 313006523 143958067 137481722 731417 731417 6280838 6783980 15521078 15514628 8659764 8148990 273629689 295890516 44143032 52451806 2985305 2985305 22418823 18187787 69547160 73624898 X 201904775 220087864 2177754 2177754 204082529 222265618 273629689 295890516 X 12682681 5500408 X X 0 0 0 X 2177754 2177754 2177754 2177754 2177754 2177754 2177754 2177754 2177754 2177754 1.00000 0 0 4237615 4237615 214966187 122516355 92449832 5013719 2872458 2141261 183329787 152422716 30907071 42940937 35194994 7745943 137481722 OPERATING LEASE 6101076 THIRD PARTY PAYMENT PAYABLE 4641337 PATIENT REFUNDS 3317996 OTHER LIABILITIES 2993016 NON-QUALIFIED BENEFIT PLANS 731417 DUE TO AFFILIATES 402945 18187787 PART V, LINE 4: THE ENDOWMENT FUNDS' INTENDED USE IS FOR PATIENT FINANCIAL HARDSHIPS. 1 1 X 1 X 1 X 0 1 0 1 1 1046272 0 1046272 0.00760 27501161 27501161 28547433 27501161 1046272 0.00760 19589 0 19589 0.00010 297757 13046 284711 0.00210 7908993 3456078 4452915 0.03220 3660 3660 0.00000 8229999 3469124 4760875 0.03440 36777432 30970285 5807147 0.04200 1 12190443 0 58588284 36950995 21637289 X 1 1 1 NOVANTUVAUSP SURGERY CENTERS LLC HEALTHCARE 0.25000 0.00000 0.49000 2 1 UVAPWMC DBA UVA HEALTH PRINCE WILLIAM MEDICAL CENTER 8700 SUDLEY ROAD MANASSAS VA 20110 SEE SUPPLEMENTAL INFORMATION H1882 X X X A 2 UVAHMC DB UVA HEALTH HAYMARKET MEDICAL CENTER 15225 HEATHCOTE BLVD HAYMARKET VA 20169 SEE SUPPLEMENTAL INFORMATION H1938 X X X A UVA PRINCE WILLIAM MEDICAL CENTER 0 0 1 X X X X X X X X 19 1 0 0 1 X SEE SUPPLEMENTAL INFORMATION X 1 19 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION A: LINE 1: HOSPITAL FACILITIES INFORMATIONHTTPS://UVAHEALTH.COM/LOCATION/PRINCE-WILLIAM-MEDICAL-CENTER-5597282LINE 2: HOSPITAL FACILITIES INFORMATIONHTTPS://UVAHEALTH.COM/LOCATION/PRINCE-WILLIAM-MEDICAL-CENTER-5597282 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: UVAPWMC DBA UVA HEALTH PRINCE WILLIAM MEDICAL , - FACILITY 2: UVAHMC DB UVA HEALTH HAYMARKET MEDICAL CENTER UVA PRINCE WILLIAM MEDICAL CENTER PART V, SECTION B, LINE 3J: UVA PRINCE WILLIAM MEDICAL CENTERPART V, SECTION B, LINE 3E:SEVERAL SOCIAL, BEHAVIORAL, AND CLINICAL HEALTH NEEDS WERE IDENTIFIED IN THE NEEDS ASSESSMENT. ONCE THE HEALTH NEEDS WERE IDENTIFIED, SURVEYS AND COMMUNITY MEETINGS WERE CONDUCTED IN WHICH THE VARIOUS COMMUNITY STAKEHOLDERS RANKED THE HEALTH ISSUES ACCORDING TO THE YEARS OF POTENTIAL LIFE LOST AND MAGNITUDE OF IMPACT. THE INFORMATION GATHERED WAS THEN MATRIXED AND SCORED IN ORDER TO RANK THE FOCUS AREAS AND PRIORITIZE THE IDENTIFIED HEALTH NEEDS. THE PRIORITIZED IDENTIFIED HEALTH NEEDS AND SUPPORTING DATA ARE THEN REVIEWED AND DELIBERATED UPON FURTHER BY THE BOARD. AN IMPLEMENTATION PLAN IS CREATED FOR CERTAIN OF THE PRIORITIZED, IDENTIFIED HEALTH NEEDS AND ASSESSED REGULARLY THROUGHOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT LIFE CYCLE. COMMUNITY PARTNERS WHO ARE CURRENTLY DOING THE WORK ARE IDENTIFIED AS POTENTIAL PARTNERS FOR COLLABORATION ON THOSE IDENTIFIED NEEDS THAT ARE NOT PART OF THE IMPLEMENTATION PLAN. UVA PRINCE WILLIAM MEDICAL CENTER PART V, SECTION B, LINE 5: WHILE CONDUCTING THE CHNA, THE HOSPITAL FACILITY(IES) SOLICITED INPUT FROM, AND CONSULTED WITH, A VARIETY OF COMMUNITY REPRESENTATIVES INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES OF CITY AND COUNTY GOVERNMENT INCLUDING HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES/UNIVERSITIES, COMMUNITY COALITIONS AND OTHER SOCIAL SERVICE AGENCIES. INPUT WAS GATHERED THROUGH COMMUNITY MEETINGS, STAKEHOLDER'S INTERVIEWS, AND SOLICITED THROUGH WRITTEN COMMENTS THROUGHOUT THE SURVEY PERIOD UNTIL THE FINAL COMMUNITY PRIORITY SETTING MEETING(S) AND SURVEY. THE SCOPE OF EXPERTISE WAS BROAD AND INCLUDED SUCH AREAS AS PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES. DATA DERIVED FROM THESE EXERCISES IS BOTH QUANTITATIVE AND QUALITATIVE IN SCOPE. UVA PRINCE WILLIAM MEDICAL CENTER PART V, SECTION B, LINE 7D: UVA PRINCE WILLIAM MEDICAL CENTERPART V, SECTION B, LINE 7BHTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX#2019-2021-211UVA PRINCE WILLIAM MEDICAL CENTERPART V, SECTION B, LINE 10AHTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX#2019-2021-211 UVA PRINCE WILLIAM MEDICAL CENTER PART V, SECTION B, LINE 11: THE HOSPITAL FACILITY(IES) IS/ARE A PART OF UVA COMMUNITY HEALTH, INC., AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. THE FACILITY'S CHNA IDENTIFIED MULTIPLE NEEDS FOR THE COMMUNITY SERVED. THE NEEDS IDENTIFIED WERE REVIEWED AND PRIORITIZED BY THE CHNA RESOURCE GROUP AND SUBSEQUENTLY BY EACH FACILITY'S BOARD. THEY EVALUATED EACH DOCUMENTED NEED AND ITS INTERSECTION WITH THE ORGANIZATION'S VISION, COMMITMENTS, AND KEY STRENGTHS BEFORE FURTHER PRIORITIZING THE HEALTH NEEDS AND AGREEING UPON THE TOP HEALTH PRIORITIES TO BE ADDRESSED. WHERE POSSIBLE, WE HAVE LEVERAGED THE SYSTEM'S STRENGTHS AND RESOURCES TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES. UVA COMMUNITY HEALTH, INC. AND EACH OF ITS HOSPITAL FACILITIES HAVE ADOPTED AND EXECUTED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE PRIORITIZED COMMUNITY HEALTH NEEDS FROM THE CHNAS. THE IMPLEMENTATION STRATEGIES OUTLINE THE PLAN THAT THE HOSPITAL FACILITY(IES) WILL UNDERTAKE TO MEET THOSE HEALTH NEEDS IN EACH OF ITS COMMUNITIES. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. CERTAIN OF THE NEEDS NOT ADDRESSED FALL OUTSIDE OF THE SCOPE OF TRADITIONAL HEALTHCARE (IE. DENTAL WORK) AND OTHERS ARE CANDIDATES FOR COLLABORATIVE WORK AND HAVE OTHER RESOURCES IN THE COMMUNITY THAT CAN MORE APPROPRIATELY ADDRESS THESE NEEDS BASED ON SCOPE OF SERVICES AND SKILL SET. FOR MORE DETAILED INFORMATION, REFER TO THE PUBLICLY AVAILABLE IMPLEMENTATION PLAN AVAILABLE ON THE WEBSITE; REFER TO THE URL GIVEN PREVIOUSLY FOR THE POSTING OF THE PLAN.UVA PRINCE WILLIAM MEDICAL CENTERPART V, LINE 16A, FAP WEBSITE:HTTPS://UVAHEALTH.COM/SERVICES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-INFORMATIONUVA PRINCE WILLIAM MEDICAL CENTERPART V, LINE 16B, FAP APPLICATION:HTTPS://UVAHEALTH.COM/SERVICES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-INFORMATIONUVA PRINCE WILLIAM MEDICAL CENTERPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY:HTTPS://UVAHEALTH.COM/SITES/DEFAULT/FILES/2023-02/UVAHEALTH-NOVA-BILLING-POLICIES-2023.PDF 1 1 - HAYMARKET SURGERY CENTER LLC 15225 HEATHCOTE BLVD HAYMARKET VA 20169 AMBULATORY SURGERY CENTER PART I, LINE 3C: OTHER CRITERIA BESIDES INCOME AND FPG USED IN DETERMINING ELIGIBILITY FOR FREE CARE INCLUDE: (1) RESIDENCY - PATIENTS MUST RESIDE WITHIN THE SERVICE AREA OF THE HOSPITAL; (2) THE KIND OF SERVICE PROVIDED - ONLY MEDICALLY NECESSARY SERVICES ARE COVERED; (3) PATIENT STATUS - IN PROVIDER BASED PHYSICIAN CLINICS, PATIENTS MUST HAVE BEEN TREATED BY AN AFFILIATED MEDICAL GROUP PRIMARY CARE PHYSICIAN WITHIN THE PREVIOUS THREE YEARS; AND (4) ACCESS TO HEALTH CARE COVERAGE - PATIENTS MUST BE UNABLE TO ACCESS EMPLOYER SPONSORED HEALTH PLANS OR ENTITLEMENT PROGRAMS. LASTLY, THE PATIENT MUST BE WITHOUT SUBSTANTIAL LIQUID ASSETS (I.E. CASH-ON-HAND). ASSETS SUCH AS HOUSES, CARS, PENALIZED RETIREMENT SAVINGS FUNDS, ETC. ARE NOT CONSIDERED LIQUID ASSETS. SUBSTANTIAL ASSETS ARE DEFINED AS ENOUGH CASH-ON-HAND TO COVER THE MEDICAL EXPENSES WITHOUT PLACING A HARDSHIP ON THE PATIENT. PATIENTS WITH SPECIAL CIRCUMSTANCES SUCH AS BANKRUPTCY MAY ALSO BE ELIGIBLE FOR CHARITY CARE; DETERMINATION IS MADE ON A CASE BY CASE BASIS UNDER THESE CIRCUMSTANCES. PART I, LINE 6A: PART I, LINE 6A:THE COMMUNITY BENEFIT REPORT IS PREPARED BY A RELATED ORGANIZATION. NOVANT HEALTH, INC. IS A MEMBER ORGANIZATION OF THE NOVANT HEALTH UVA HEALTH SYSTEM. IT PRODUCES A COMMUNITY BENEFIT REPORT, REFERRED TO AS A COMMUNITY IMPACT REPORT, REPRESENTING THE HEALTH SYSTEM AS A WHOLE INCLUDING THE FILING ORGANIZATION. THE REPORT CAN BE FOUND AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPXPLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. PART I, LINE 7: COSTS REPORTED IN THE TABLE FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AMOUNTS ARE CALCULATED USING AN ENTITY SPECIFIC COST TO CHARGE RATIO BASED ON WORKSHEET 2 (CCR). PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 12,190,443. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES ADDRESS THE UNDERLYING CAUSES OF HEALTH PROBLEMS AND IMPACTS THE HEALTH OF OUR COMMUNITY THROUGH PARTNERSHIPS WITH LOCAL AGENCIES DEDICATED TO IMPROVING THE LIVES OF ALL INDIVIDUALS. OUTREACH INCLUDES PROVIDING SUPPORT TO ORGANIZATIONS SUCH AS LOCAL YMCA'S, UNITED WAY PARTNER AGENCIES, CHAMBERS OF COMMERCE AND OTHER LOCAL COMMUNITY ORGANIZATIONS, ASSISTING WITH COMMUNITY AND COUNTY COALITIONS, AND PROVIDING EDUCATION SEMINARS AND TRAINING FOR COMMUNITY WORKFORCES. THROUGH THESE OUTREACH METHODS WE ARE ABLE TO SUCCESSFULLY WORK TOWARDS BRIDGING THE GAP OF NEED WITHIN OUR IDENTIFIED IMPACTED COMMUNITIES. PART III, LINE 2: IMPLICIT PRICE CONCESSIONS (FORMERLY LABELED BAD DEBT EXPENSE) ARE DETERMINED BASED ON MANAGEMENT'S ASSESSMENT OF CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE. PART III, LINE 4: THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS (FORMERLY LABELED BAD DEBT EXPENSE, AT COST) ON LINE 2 IS CALCULATED USING THE SAME METHODOLOGY AS CHARITY CARE AND OTHER COMMUNITY BENEFITS USING AN ENTITY SPECIFIC COST TO CHARGE RATIO (CCR). FOOTNOTE 2 (ACCOUNTS RECEIVABLE) ON PAGE 8 OF THE AUDITED FINANCIAL STATEMENTS DESCRIBES PRICE CONCESSIONS. PART III, LINE 8: THE METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6 IS DETERMINED BY FOLLOWING THE MEDICARE PRINCIPLES OF ALLOWABLE COSTS. COST FOR THE OVERHEAD DEPARTMENTS ARE STEPPED DOWN TO THE REMAINING COST CENTERS BASED ON STATISTICS FOR EACH OVERHEAD COST CENTER. ONCE THE STEP-DOWN PROCESS IS COMPLETE, A COST TO CHARGE RATIO ("CCR") IS DEVELOPED FOR EACH COST CENTER. THE CCR IS THEN APPLIED TO THE MEDICARE REVENUE BY COST CENTER AND TOTALED. IT SHOULD BE NOTED THAT THE MEDICARE COST REPORTS DO NOT ADDRESS ANY MANAGED CARE MEDICARE REVENUES, COSTS, OR RELATED SHORTFALL. THE TOTAL REVENUES REPORTED AS RECEIVED FROM MEDICARE IN LINE 5 OF SECTION B ARE ONLY REPRESENTATIVE OF MEDICARE FEE FOR SERVICE PAYMENTS RECEIVED. THE ALLOWABLE COSTS ON LINE 6 ARE SIGNIFICANTLY LOWER THAN THE ACTUAL EXPENDITURES. AS SUCH, THE SHORTFALL IS UNDERESTIMATED. EVERY HOSPITAL TREATS MEDICARE PATIENTS. SOME HOSPITALS ARE LOCATED IN HIGH MEDICARE POPULATION AREAS; OTHERS PROVIDE SERVICES DISPROPORTIONATELY USED BY MEDICARE PATIENTS. MEDICARE RATES AND NUMBERS OF MEDICARE PATIENTS ARE NOT NEGOTIATED. AS REIMBURSEMENT RATES DECLINE RELATIVE TO COSTS OF CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THIS SERVICE THESE PATIENTS WOULD BECOME AN OBLIGATION ON THE GOVERNMENT. ANY UNREIMBURSED COSTS OF THIS CARE ARE A COMMUNITY BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT. PART III, LINE 9B: THE FILING ORGANIZATION HAS A POLICY THAT OUTLINES PROCEDURES THE HOSPITALMAY TAKE FOR NONPAYMENT INCLUDING INTERNAL AND EXTERNAL COLLECTIONPRACTICES AND REPORTING TO CREDIT AGENCIES. THE POLICY STATES THATREASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE MUSTBE MADE BEFORE THE ORGANIZATION, OR ANY EXTERNAL ORGANIZATION, ENGAGE INAN EXTRAORDINARY COLLECTION ACTION.FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AND WHO ARE COOPERATINGIN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, THE ORGANIZATIONMAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDECOLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS. PART VI, LINE 2: PART VI, LINE 2: NEEDS ASSESSMENTAT THE TIME THE CHNA WAS PERFORMED, THE ORGANIZATION WAS PART OF NOVANT HEALTH UVA HEALTH SYSTEM, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS OF JULY 1, 2021, UVA MEDICAL CENTER TOOK FULL OWNERSHIP OF NHUVAHS, AT WHICH TIME THE SYSTEM TRANSITIONED ITS NAME TO UVA COMMUNITY HEALTH, INC. AND BEGAN THE PROCESS TO REBRAND ALL FACILITIES AND ENTITIES UNDER THE "UVA HEALTH" BRAND. UVA COMMUNITY HEALTH, INC. HAS A COMMUNITY BENEFIT DEPARTMENT ("CBE DEPARTMENT") COMPRISED OF COMMUNITY BENEFIT PROFESSIONALS. THE CBE DEPARTMENT IS RESPONSIBLE FOR COORDINATING THE PREPARATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) FOR EACH HOSPITAL WITHIN THE SYSTEM, INCLUDING THE CHNAS REPORTED IN PART V, SECTION B. EACH HOSPITAL AND THE CBE DEPARTMENT WORK TOGETHER TO IDENTIFY ORGANIZATIONS AND RESOURCES WITHIN ITS COMMUNITY THAT CONTRIBUTE TO THE PROCESS. THESE ORGANIZATIONS AND RESOURCES INCLUDE PUBLIC HEALTH DEPARTMENTS, LOCAL COMMUNITY COALITIONS REPRESENTING THE MEDICALLY UNDERSERVED, UNITED WAY, LOCAL UNIVERSITIES, ETC. COMMUNITY HEALTH ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS IN THE COMMUNITY ARE USED IN COMBINATION WITH INTERNAL HOSPITAL DATA AND INFORMATION COLLECTED FROM LOCAL AGENCIES TO PREPARE THE HOSPITAL'S CHNA. THROUGH PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS WE ARE ABLE TO DRAW INFERENCE OF THE NEEDS NOT MET WITHIN THE IMMEDIATE COMMUNITIES WE SERVE, AND MEET AND EXCEED THOSE COMMUNITY MEMBER'S NEEDS. IN ADDITION TO ADDRESSING NEEDS IDENTIFIED THROUGH THE CHNA, EACH HOSPITAL MAY RESPOND TO REQUESTS FOR SPECIFIC COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS FROM PUBLIC AGENCIES OR COMMUNITY GROUPS. ORGANIZATIONAL PARTNERSHIPS ESTABLISHED BY THE COMMUNITY BENEFIT DEPARTMENT ARE OFTEN LEVERAGED TO ADDRESS NEEDS THAT WERE IDENTIFIED IN THE CHNA, BUT WERE UNADDRESSED BY THE FACILITY IMPLEMENTATION PLAN. PART VI, LINE 3: PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION IS COMMITTED TO PROVIDING OUTSTANDING HEALTHCARE TO ALL MEMBERS OF OUR COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY. OUR FINANCIAL COUNSELING TEAMS ARE CONSTANTLY WORKING WITH THE PATIENTS WITHIN OUR COMMUNITIES TO UNDERSTAND THEIR NEEDS AND ENSURE THAT OUR POLICIES AND PROCESSES ADDRESS THESE NEEDS. WE ALSO MAINTAIN CONTRACTS WITH MEDICAID ELIGIBILITY VENDORS AND THESE TEAMS OFFER ADDITIONAL SUPPORT IN PROCESSING AND ASSESSING HOW WE SERVE THE FINANCIAL NEEDS OF OUR PATIENTS. BASED ON THE ASSESSMENTS OF OUR COMMUNITIES, THE ORGANIZATION HAS DEVELOPED FINANCIAL ASSISTANCE POLICIES AND PROGRAMS THAT ADDRESS THE FINANCIAL NEEDS OF OUR PATIENTS. WE PRIDE OURSELVES ON THE TRANSPARENCY OF OUR PROGRAMS AND THE EDUCATION WE OFFER OUR PATIENTS AROUND OUR FINANCIAL ASSISTANCE POLICIES. OUR PROGRAMS ARE DOCUMENTED ON OUR WEBSITE, ALONG WITH CONTACT INFORMATION FOR OUR FINANCIAL COUNSELORS. ADDITIONALLY, OUR PROGRAMS ARE DOCUMENTED ON PATIENT FLYERS THROUGHOUT THE ORGANIZATION'S FACILITIES AND PHYSICIAN OFFICES. OUR PATIENT ACCESS SPECIALISTS, FINANCIAL COUNSELORS AND BUSINESS OFFICE TEAMS WORK WITH ALL ELIGIBLE PATIENTS TO EDUCATE THEM ON THE VARIOUS OPTIONS AVAILABLE VIA OUR FINANCIAL ASSISTANCE PROGRAMS OR GOVERNMENT SPONSORED CARE. THEY ALSO REFERENCE OUR FINANCIAL ASSISTANCE POLICY IN ALL CONVERSATIONS RELATED TO PATIENTS BILLS. FINALLY, WE WORK WITH LOCAL AREA FREE HEALTH CLINICS AND OTHER CHARITABLE ORGANIZATIONS TO PROVIDE CONTINUATION OF CARE FOR THEIR PATIENTS. IN ADDITION TO OUR FINANCIAL COUNSELING PROCESSES USED TO IDENTIFY CHARITY CARE PATIENTS, OUR COLLECTIONS PROCESSES WITHIN OUR BUSINESS OFFICES ALSO HELP IDENTIFY PATIENTS WHO ARE ALREADY ELIGIBLE FOR CHARITY OR WHO MAY BE ELIGIBLE BASED ON THEIR STATUS WITHIN THE FEDERAL POVERTY GUIDELINES ("FPG"). WE UTILIZE PREVIOUSLY SUBMITTED PATIENT DOCUMENTATION AND CREDIT AGENCY REPORTED FPG FOR DETERMINATION. SUPPORTING DOCUMENTS ARE VALID 6 MONTHS FROM THE DATE OF SUBMISSION. OUR POLICIES ARE CONSIDERED FLUID AND ARE UPDATED FREQUENTLY BASED ON LOCAL AND NATIONAL MARKET STANDARDS AND NATIONAL ECONOMIC CONDITIONS. ANY UPDATES TO OUR POLICIES REQUIRE MULTI-LEVEL LEADERSHIP APPROVAL AND ARE ULTIMATELY APPROVED BY THE ORGANIZATION'S BOARD. PART VI, LINE 4: PART VI, LINE 4: COMMUNITY INFORMATIONUVA PRINCE WILLIAM MEDICAL CENTER FORM 990 INCLUDES THE OPERATIONS OF TWO LICENSED HOSPITAL: UVAPWMC DBA UVA HEALTH PRINCE WILLIAM MEDICAL CENTER AND AS UVAHMC DBA UVA HEALTH HAYMARKET MEDICAL CENTER.UVAPWMC DBA UVA HEALTH PRINCE WILLIAM MEDICAL CENTERTHE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA. THE PRIMARY SERVICE AREA FOR UVA PRINCE WILLIAM MEDICAL CENTER IS DEFINED BY THE ZIP CODES THAT REPRESENT MORE THAN 75% OF THE HOSPITAL'S IN-PATIENT POPULATION. THIS INCLUDES THE CITY OF MANASSAS, BRISTOW, AND GAINESVILLE, ALL LOCATED WITHIN PRINCE WILLIAM COUNTY, MANASSAS CITY, AND MANASSAS PARK. THE SECONDARY SERVICE AREA FOR UVA PRINCE WILLIAM MEDICAL CENTER COVERS A FOUR-COUNTY RADIUS, INCLUDING: CULPEPER, FAIRFAX, FAUQUIER AND WARREN COUNTIES IN VIRGINIA.UVAHMC DBA UVA HEALTH HAYMARKET MEDICAL CENTERTHE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA. THE PRIMARY SERVICE AREA FOR UVA HAYMARKET MEDICAL CENTER IS DEFINED BY THE ZIP CODES THAT REPRESENT MORE THAN 75% OF THE HOSPITAL'S IN-PATIENT POPULATION. THIS INCLUDES THE CITY OF MANASSAS, BRISTOW, AND GAINESVILLE, HAYMARKET, NOKESVILLE, AND WARRENTON, ALL LOCATED WITHIN PRINCE WILLIAM COUNTY, MANASSAS CITY, AND FAUQUIER COUNTY. THE SECONDARY SERVICE AREA FOR UVA HAYMARKET MEDICAL CENTER COVERS FOUR COUNTIES, INCLUDING CULPEPER, FAIRFAX, LOUDOUN AND WARREN COUNTIES IN VIRGINIA.PRINCE WILLIAM COUNTY IS MORE URBAN IN NATURE. THE COUNTY CONSISTS OF A LARGE URBAN CENTER SURROUNDED BY SMALLER, MORE RURAL COMMUNITIES AND IS PART OF THE WASHINGTON ARLINGTON ALEXANDRIA METROPOLITAN STATISTICAL AREA. BASED ON 2018 ESTIMATES, PRINCE WILLIAM COUNTY REMAINED THE SECOND-MOST POPULOUS COUNTY IN THE STATE OF VIRGINIA WITH A LITTLE LESS THAN 500,000 RESIDENTS. THE CITY OF MANASSAS HAS AN ESTIMATED POPULATION OF 41,641 RESIDENTS. PRINCE WILLIAM COUNTY AND THE CITY OF MANASSAS HAVE EXPERIENCED STEADY POPULATION GROWTH OF (16.4%, AND 10.1%) RESPECTIVELY SINCE THE 2010 US CENSUS. CHILDREN AND ADOLESCENTS MAKE UP OVER ONE-THIRD (34.7%) OF THE POPULATION IN PRINCE WILLIAM COUNTY AND OVER ONE-THIRD (35.5%) OF THE POPULATION IN THE CITY OF MANASSAS. SENIORS MAKE UP 9.9% AND 10.4% OF THE POPULATION IN THE TWO COUNTIES, RESPECTIVELY. MEDIAN AGE CONTINUES TO INCREASE, AND WE CAN SEE A SHIFT IN THE POPULATION FROM ADOLESCENTS TO SENIORS AS OUR POPULATION CONTINUES TO AGE. THIS TREND MAY PUT A STRAIN ON HEALTHCARE SERVICES IN PRINCE WILLIAM COUNTY BECAUSE HEALTH CARE FOR OLDER INDIVIDUALS ARE DIFFERENT FROM THAT PROVIDED TO OTHER AGE GROUPS IN SEVERAL RESPECTS: GREATER RESOURCE DEMANDS, THE INTERTWINING OF PROFESSIONAL HEALTH SERVICES WITH SOCIAL SERVICES, THE FREQUENT OCCURRENCE OF IMPORTANT ETHICAL CONUNDRUMS, AND A HIGHER PREVALENCE OF PHYSICAL AND MENTAL DISABILITIES. NON-WHITE MINORITIES CURRENTLY MAKE UP 58.0% OF THE RACIAL DEMOGRAPHIC IN PRINCE WILLIAM COUNTY AND 59.8% OF THE RACIAL DEMOGRAPHIC IN THE CITY OF MANASSAS. THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS FOR PRINCE WILLIAM COUNTY: WHITE NON-HISPANIC 42.0%; BLACK/AFRICAN-AMERICAN 22.2%; HISPANIC OR LATINO 24.2%; OTHER 11.6%. THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS FOR CITY OF MANASSAS: WHITE NON-HISPANIC 40.2%; BLACK/AFRICAN-AMERICAN 15.3%; HISPANIC OR LATINO 37.8%; OTHER 6.7%.ACCORDING TO THE US CENSUS BUREAU DATA, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $101,059 IN PRINCE WILLIAM, $77,551 IN MANASSAS CITY, AND $94,775 IN FAUQUIER. THE POVERTY RATE FOR PRINCE WILLIAM COUNTY AND CITY OF MANASSAS ARE 6.1%, AND 8.7%, RESPECTIVELY.THERE ARE THREE ACUTE CARE HOSPITALS IN THE COMMUNITY, TWO OF WHICH ARE THE ORGANIZATION. THE OTHER IS ANOTHER NON-PROFIT HOSPITAL. STATISTICAL INFORMATION WAS GATHERED FROM VARIOUS STATE AND FEDERAL SOURCES BUT PRIMARILY THE US CENSUS BUREAU. SPECIFIC REFERENCES AND OTHER SUPPORTING INFORMATION CAN BE FOUND IN THE ORGANIZATION'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT AT: HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX#2019-2021-211 PART VI, LINE 5: PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTHE ORGANIZATION FURTHERS ITS EXEMPT PURPOSES BY DOING THE FOLLOWING:1. ADOPTING A FINANCIAL ASSISTANCE POLICY;2. REMAINING CERTIFIED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO PROVIDE SERVICES TO ALL BENEFICIARIES OF MEDICARE, MEDICAID, AND OTHER GOVERNMENT PAYMENT PROGRAMS, AND PROVIDING SERVICES IN A NONDISCRIMINATORY MANNER TO SUCH BENEFICIARIES;3. OPERATING A FULL-TIME EMERGENCY ROOM WHICH IS OPEN TO AND ACCEPTS ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY;4. MAINTAINING AN OPEN MEDICAL STAFF, SUBJECT TO EXCLUSIVE CONTRACTS FOR HOSPITAL-BASED SERVICES SUCH AS ANESTHESIOLOGY, RADIOLOGY, PATHOLOGY, HOSPITALIST, AND EMERGENCY DEPARTMENT SERVICES, TO THE EXTENT AN EXCLUSIVE CONTRACT FOR THOSE SERVICES IS REQUIRED TO OBTAIN PROPER STAFFING COVERAGE OR TO PERMIT A MORE EFFICIENT DELIVERY OF THOSE SERVICES WITHIN THE HOSPITAL FACILITY;5. MAINTAINING A GOVERNING BOARD CONSISTING PRIMARILY OF A BROAD CROSS-SECTION OF LEADERS IN THE COMMUNITY;6. ADOPTING AND APPLYING A CONFLICT OF INTEREST POLICY, WHICH APPLIES TO THE GOVERNING BOARD AND ORGANIZATION OFFICERS;7. PROVIDING HEALTH EDUCATION LECTURES AND WORKSHOPS;8. PROVIDING HEALTH FAIRS, EDUCATION ON SPECIFIC DISEASES OR CONDITIONS, AND HEALTH PROMOTION AND WELLNESS PROGRAMS TO THE COMMUNITIES IT SERVES;9. PROVIDING SUPPORT GROUPS AND SELF HELP PROGRAMS TO THE COMMUNITIES IT SERVES;10. PROVIDING COMMUNITY-BASED CLINICAL SERVICES, INCLUDING WITHOUT LIMITATION, HEALTH SCREENINGS AND CLINICS FOR UNINSURED OR UNDERINSURED PERSONS TO THE COMMUNITIES IT SERVES;11. PROVIDING HEALTHCARE SUPPORT SERVICES, INCLUDING WITHOUT LIMITATION, INFORMATION AND REFERRAL TO COMMUNITY SERVICES, CASE MANAGEMENT OF UNDERINSURED AND UNINSURED PERSONS, TELEPHONE INFORMATION SERVICES AND ASSISTANCE TO ENROLL IN PUBLIC PROGRAMS, SUCH AS STATE CHILDREN'S HEALTH INSURANCE PROGRAM (SCHIP) AND MEDICAID TO THE COMMUNITIES IT SERVES;12. PROVIDING SUBSIDIZED HEALTH SERVICES AND CLINICAL PROGRAMS TO THE COMMUNITIES IT SERVES;13. PROVIDING CASH AND IN-KIND CONTRIBUTIONS TO NONPROFIT COMMUNITY HEALTHCARE ORGANIZATIONS IN THE COMMUNITIES IT SERVES; AND14. GENERALLY PROMOTING THE HEALTH, WELLNESS, AND WELFARE OF THE COMMUNITIES IT SERVES BY PROVIDING QUALITY HEALTHCARE SERVICES AT REASONABLE COST.PLEASE SEE THE UVA HEALTH COMMUNITY BENEFIT REPORT, LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX#2019-2021-211PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. PART VI, LINE 6: PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMTHE ORGANIZATION IS AN INTEGRAL PART OF UVA COMMUNITY HEALTH AND THE UNIVERSITY OF VIRGINIA MEDICAL CENTER ('UVA MEDICAL CENTER'), BOTH ARE NOT-FOR-PROFIT INTEGRATED GROUPS OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. EACH HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITY IT SERVES, AS REPORTED INDIVIDUALLY ON EACH HOSPITAL'S FORM 990, SCHEDULE H. THE SYSTEM'S COMMUNITY BENEFIT AS A WHOLE IS DOCUMENTED IN A SYSTEM-WIDE COMMUNITY BENEFIT REPORT, LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPXPLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. THERE ARE SIGNIFICANT COMMUNITY BENEFIT ACTIVITIES WITHIN NOVANT HEALTH WHICH MAY NOT BE REPORTABLE ON A SCHEDULE H BECAUSE THEY ARE NOT CONDUCTED BY AN ENTITY WHICH OWNS OR OPERATES A HOSPITAL.IN ADDITION TO HOSPITALS, UVA COMMUNITY HEALTH INC. INCLUDES A PHYSICIAN ORGANIZATION WITH PRACTICES IN VIRGINIA AND A HOSPITAL FOUNDATION WHICH SUPPORTS AND ENHANCES THE ACTIVITIES IN THOSE HOSPITALS' COMMUNITIES. FURTHER, UVA COMMUNITY HEALTH INC. INCLUDES AMBULATORY SURGERY CENTERS, IMAGING CENTERS, REHABILITATION CENTERS, AND OTHER OUTPATIENT FACILITIES; ALL DEDICATED TO PROMOTING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES. PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT UVA PRINCE WILLIAM MEDICAL CENTER FILES A COMMUNITY BENEFIT REPORT WITH THE VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION IN ACCORDANCE WITH THEIR REPORTING GUIDELINES FOR PURPOSES OF ADVOCACY AND THE STATE'S REPORTING REQUIREMENTS. 1 AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVENUE DALLAS TX 75231 135613797 501(C)(3) 7650 0 COMMUNITY OUTREACH CODE OF SUPPORT FOUNDATION 4220 KING STREET ALEXANDRIA VA 22302 273485502 501(C)(3) 10000 0 COMMUNITY OUTREACH COMMUNITY HEALTH SOLUTIONS 4200 INNSLAKE DRIVE SUITE 103 GLEN ALLEN VA 23060 542031229 501(C)(3) 8500 0 COMMUNITY OUTREACH 3 0 SCHOLARSHIPS 13 20000 PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS THE FILING ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY THE UNIVERSITY OF VIRGINIA MEDICAL CENTER ('UVA MEDICAL CENTER'), THE PARENT ORGANIZATION. UVA COMMUNITY HEALTH INC'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. UVA COMMUNITY HEALTH INC. HAS ESTABLISHED A SYSTEM-WIDE CORPORATE POLICY WITH STANDARDIZED GUIDELINES THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE FILING ORGANIZATION MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS ARE MAINTAINED VIA THE GENERAL LEDGER. FUNDS ARE GENERALLY NOT TRACKED AFTER BEING GRANTED, AS THE ORIGINAL ELIGIBILITY AND SELECTION CRITERIA HAVE ALREADY BEEN MET. FORM 990, HEADER: CHANGE IN ACCOUNTING PERIOD FOR THE PERIOD 1/1/2022 - 6/30/2022. HURRICANE IAN DISASTER RELIEF DR-4673-FL. FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITES UVA PRINCE WILLIAM MEDICAL CENTER OUR MISSION TRANSFORMING HEALTH AND INSPIRING HOPE FOR ALL VIRGINIANS AND BEYOND OUR VISION TO BE THE NATION'S LEADING PUBLIC ACADEMIC HEALTH SYSTEM AND A BEST PLACE TO WORK WHILE TRANSFORMING PATIENT CARE, RESEARCH, EDUCATION, AND ENGAGEMENT WITH THE DIVERSE COMMUNITIES WE SERVE OUR VALUES: ASPIRE AT UVA HEALTH, WE PUT THE PATIENT AT THE CENTER OF EVERYTHING WE DO. WE ASPIRE TO CREATE A CULTURE OF EXCELLENCE, ENGAGEMENT, AND TRUST THROUGH OUR VALUES. - ACCOUNTABILITY: ACKNOWLEDGING AND ASSUMING RESPONSIBILITY FOR WHERE WE HAVE SUCCEEDED AND FAILED IN TERMS OF OUR ACTIONS, DECISIONS, POLICIES, AND RESULTS. - STEWARDSHIP: MANAGING OUR RESOURCES AND COMMITMENT TO CONTINUAL IMPROVEMENT AND LEARNING RESPONSIBLY AND CAREFULLY WHILE ACKNOWLEDGING SHORTCOMINGS OR PROBLEMS IN OUR QUEST. - PROFESSIONALISM: APPROACHING ALL THAT WE DO IN A COLLABORATIVE WAY AND DELIVERING EXCELLENT CARE THROUGH THE LENS OF HELPFULNESS, POSITIVITY, KINDNESS, AND COMPETENCY. - INTEGRITY: BEING HONEST, OPEN, AND FAIR THROUGH OUR BEHAVIORS, ATTITUDE, AND TREATMENT OF OTHERS. - RESPECT: VALUING EVERYONE THROUGH OUR COMPASSIONATE AND CARING WAYS. - EQUITY: FOSTERING AN ENVIRONMENT OF BELONGING THAT PROMOTES JUSTICE, EQUITY, DIVERSITY, INCLUSION, AND UNITY THROUGHOUT THE ORGANIZATION AND WITHIN THE COMMUNITIES WE SERVE. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION IS A NONPROFIT CORPORATION WITH MEMBERS (OR A MEMBER). THE SOLE MEMBER, UVA PRINCE WILLIAM HEALTH SYSTEM HAS CERTAIN RIGHTS AND POWERS WITH REGARD TO THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER OF THE ORGANIZATION, UVA PRINCE WILLIAM HEALTH SYSTEM HAS THE POWER TO APPOINT ALL MEMBERS OF THE GOVERNING BODY OF UVA PRINCE WILLIAM MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE MEMBER, UVA PRINCE WILLIAM HEALTH SYSTEM HAS THE POWER TO APPROVE CERTAIN TRANSACTIONS, ACTIONS AND CHANGES TO THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD HAS DELEGATED REVIEW OF THE FORM 990 TO UVA COMMUNITY HEALTH'S BOARD OF TRUSTEES' AUDIT AND COMPLIANCE COMMITTEE ("THE COMMITTEE"), WHICH OVERSEES TAX MATTERS FOR ENTITIES IN THE UVA COMMUNITY HEALTH SYSTEM. THE COMMITTEE IS THE REVIEW BODY FOR ALL OF THE FORM 990S FILED FOR ORGANIZATIONS WITHIN THE UVA COMMUNITY HEALTH SYSTEM. THE COMMITTEE MEETS BEFORE THE FORM 990S ARE FILED WITH THE IRS AND AFTER ALL BOARD MEMBERS HAVE BEEN PROVIDED A PAPER OR ELECTRONIC COPY OF THE FORM 990 AND A SUMMARY OF ITS CONTENTS. THE VICE PRESIDENT OF TAX AND LEGAL COUNSEL FOR UVA COMMUNITY HEALTH ATTEND THE MEETING TO ANSWER ANY QUESTIONS AND ADDRESS ANY SIGNIFICANT DISCLOSURES WITHIN THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S TRUSTEE CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES, PRINCIPAL OFFICERS OR MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS. ALL TRUSTEES ARE SENT AN ANNUAL DISCLOSURE QUESTIONNAIRE. THE BEGINNING OF EACH MEETING OF THE BOARD BEGINS WITH VOLUNTARY VERBAL SELF-DISCLOSURE OF ANY CONFLICTS WITH ANY ITEMS ON THE AGENDA. AS ADDITIONAL ISSUES ARISE DURING THE COURSE OF THE MEETING, A SIMILAR SELF-DISCLOSURE IS EXPECTED. CHALLENGES BY PARTICIPANTS ARE ENCOURAGED IF SELF-DISCLOSURES ARE NOT FORTH-COMING. DURING THE COURSE OF DOING BUSINESS, IF CONFLICTS ARE SUSPECTED BY ANYONE, THEY ARE ENCOURAGED TO NOTIFY THE CEO OF THEIR SUSPICIONS. THE CEO WILL INVESTIGATE, EMPLOYING LEGAL COUNSEL AS NECESSARY, AND WILL RESOLVE AS APPROPRIATE. ULTIMATELY IT IS THE RESPONSIBILITY OF THE CEO AND THE CHAIRMAN OF THE BOARD TO ENFORCE THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 FORM 990, PART VI, SECTION B, LINE 15A/15B: THE FILING ORGANIZATION IS AN INTEGRAL PART OF UVA COMMUNITY HEALTH INC. ("THE SYSTEM"). UVA COMMUNITY HEALTH INC.'S BOARD PROVIDES A COMPENSATION REVIEW AND APPROVAL PROCESS TO CERTAIN SYSTEM ENTITIES. THE PROCESS IS CONDUCTED BY AN INDEPENDENT AND DISINTERESTED THIRD PARTY. THE INDEPENDENT COMPENSATION CONSULTANT USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS TO ENSURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE FOR THAT EXECUTIVE'S POSITION. THE UVA COMMUNITY HEALTH BOARD APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN ALL ORGANIZATIONS IN THE UVA COMMUNITY HEALTH SYSTEM ARE AVAILABLE UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE EXTENT REQUIRED BY LAW. FORM 990, PART VII: COMPENSATION INFORMATION THE ORGANIZATION IS NOT REPORTING ANY COMPENSATION INFORMATION ON FORM 990, PART VII IN COMPLIANCE WITH THE IRS INSTRUCTIONS FOR SHORT-PERIOD FILERS. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 3,489,106. MANAGEMENT AND GENERAL EXPENSES 387,677. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,876,783. COLLECTION SERVICE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 609,277. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 609,277. CREDENTIALING FEES: PROGRAM SERVICE EXPENSES 14,428. MANAGEMENT AND GENERAL EXPENSES 1,254. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,682. RECRUITMENT: PROGRAM SERVICE EXPENSES 14,783. MANAGEMENT AND GENERAL EXPENSES 1,285. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,068. PROFESSIONAL PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 7,646,359. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,646,359. FOOD SERVICE: PROGRAM SERVICE EXPENSES 2,143,037. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,143,037. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 5,331,981. MANAGEMENT AND GENERAL EXPENSES 463,651. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,795,632. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 6,082,702. MANAGEMENT AND GENERAL EXPENSES 528,931. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,611,633. TSA ADMIN FEES: PROGRAM SERVICE EXPENSES 7,926,588. MANAGEMENT AND GENERAL EXPENSES 898,627. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,825,215. FORM 990, PART XI, LINE 9: AFFILIATE TRANSFER -1,372,844. MAAP PAYMENT 5,737,317. JUNE 2022 BANK OF AMERICA WIRE TRANSFER 1,135,935. FORM 990, PART XII: THE ORGANIZATION IS FILING THIS FORM 990 FOR THE SHORT-PERIOD JANUARY 1 THROUGH JUNE 30, 2022. THE ORGANIZATION DID NOT ISSUE AUDITED FINANCIAL STATEMENTS FOR THIS SHORT PERIOD, BUT THE ORGANIZATION WILL HAVE AUDITED FINANCIAL STATEMENTS FOR THE PERIOD JULY 1, 2021 - JUNE 30, 2022. SUCH FINANCIAL STATEMENTS ARE NOT AVAILABLE AT THE TIME OF FILING OF THIS RETURN. UVA CULPEPER MEDICAL CENTER 8700 SUDLEY RD STE 411 MANASSAS VA 20110 540622371 HEALTHCARE VA 501(C)(3) LINE 3 UVA COMMUNITY HEALTH INC 0 UVA CATON MERCHANT HOUSE ASSISTED LIVING 8700 SUDLEY RD STE 411 MANASSAS VA 20110 541291284 HEALTHCARE VA 501(C)(3) LINE 10 UVA PRINCE WILLIAM HEALTH SYSTEM 0 UVA PRINCE WILLIAM HEALTH SYSTEM 8700 SUDLEY RD STE 411 MANASSAS VA 20110 541278944 HEALTHCARE VA 501(C)(3) LINE 12C, III-FI UVA COMMUNITY HEALTH INC 0 UVA COMMUNITY HEALTH INC 8700 SUDLEY RD STE 411 MANASSAS VA 20110 810868533 HEALTHCARE VA 501(C)(3) LINE 12A, I UVA MEDICAL CENTER 0 UVA COMMUNITY HEALTH FOUNDATION 8700 SUDLEY RD STE 411 MANASSAS VA 20110 541307595 HEALTHCARE VA 501(C)(3) LINE 7 UVA PRINCE WILLIAM HEALTH SYSTEM 0 UNIVERSITY OF VIRGINIA MEDICAL CENTER 8700 SUDLEY RD STE 411 MANASSAS VA 20110 546001796 HEALTHCARE VA GOVERNMENTAL N/A 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 1 0 1 1