UVA CULPEPER MEDICAL CENTER: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- UVA CULPEPER MEDICAL CENTER (EIN 54-0622371)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-11
- IRS object ID
- 202113159349303861
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-11T11:05:59-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 366055558 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRANT THORNTON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 WILSON BOULEVARD SUITE 1400 | AddressLine1Txt |
| City | ARLINGTON | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22209 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540622371 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CULPEPER MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CULP | BusinessNameControlTxt |
| Phone | 3367182803 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 SUNSET LANE | AddressLine1Txt |
| City | CULPEPER | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22701 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DONNA STATON | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3367182803 | PhoneNum |
| Signature | 2021-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DONNA | PersonFirstNm |
| Person Last | STATON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARY TORRETTA | PreparerPersonNm |
| PTIN | P00847851 | PTIN |
| Phone | 7038477500 | PhoneNum |
| Preparation | 2021-11-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHARLES CODER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 28 BLACKWELL PARK SUITE 303 | AddressLine1Txt |
| City | WARRENTON | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 20186 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $116,183,075 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NOVANTHEALTHUVA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1956 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 888 | TotalEmployeeCnt |
| Total Volunteers | 176 | TotalVolunteersCnt |
| Total Gross UBI | $1,399 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $197,988 | PYContributionsGrantsAmt |
| CY Contributions Grants | $13,669,278 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $117,643,000 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $101,074,270 | CYProgramServiceRevenueAmt |
| PY Investment Income | $20,700 | PYInvestmentIncomeAmt |
| CY Investment Income | $157,248 | CYInvestmentIncomeAmt |
| PY Other Revenue | $986,964 | PYOtherRevenueAmt |
| CY Other Revenue | $1,128,321 | CYOtherRevenueAmt |
| PY Total Revenue | $118,848,652 | PYTotalRevenueAmt |
| CY Total Revenue | $116,029,117 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $606,522 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $577,208 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $48,776,792 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $50,053,711 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $67,125,951 | PYOtherExpensesAmt |
| CY Other Expenses | $61,841,504 | CYOtherExpensesAmt |
| PY Total Expenses | $116,509,265 | PYTotalExpensesAmt |
| CY Total Expenses | $112,472,423 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,339,387 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,556,694 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $116,694,297 | TotalAssetsBOYAmt |
| Total Assets EOY | $139,556,597 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,288,478 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,884,680 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $102,405,819 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $107,671,917 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER IS TO HELP PEOPLE ACHIEVE AND MAINTAIN OPTIMAL HEALTH BY PROVIDING THE BEST POSSIBLE HEALTH CARE SERVICES. WE WILL ALWAYS MAKE THE NEEDS OF OUR PATIENTS OUR TOP PRIORITY. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $89,636,372 | ExpenseAmt |
| Grant | $577,208 | GrantAmt |
| Revenue | $101,785,479 | RevenueAmt |
| Desc | CULPEPER MEMORIAL HOSPITAL, INC., DOING BUSINESS AS NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER ("NHUVACMC") PROVIDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTHCARE AND IMPROVE HEALTH IN OUR COMMUNITY. NHUVACMC IS A 70-BED NON-PROFIT, ACUTE CARE HOSPITAL LOCATED IN CULPEPER, VA WITH COMPREHENSIVE SERVICES PROVIDING A 24 HOUR, PHYSICIAN STAFFED EMERGENCY DEPARTMENT, FAMILY BIRTH CENTER, SURGICAL SERVICES, INTENSIVE CARE UNIT AND MORE. NHUVACMC PROVIDES MEDICAL AND OTHER HEALTHCARE SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. OUR MISSION IS TO HELP PEOPLE ACHIEVE AND MAINTAIN OPTIMAL HEALTH BY PROVIDING THE BEST POSSIBLE HEALTHCARE SERVICES. WE ALWAYS MAKE THE NEEDS OF OUR PATIENTS OUR TOP PRIORITY. (CONTINUED IN SCHEDULE O)WE ALSO PARTNER WITH LOCAL NON-PROFIT ORGANIZATIONS (THE CHAMBER OF COMMERCE AND LOCAL SCHOOLS), TO SUPPORT LOCAL EVENTS AND PROVIDE HEALTH AND WELLNESS PROGRAMS. ALL UNINSURED PATIENTS, REGARDLESS OF INCOME LEVEL OR COUNTY OF RESIDENCE, RECEIVE A 20% DISCOUNT ON HOSPITAL SERVICES AND AN ADDITIONAL 15% DISCOUNT FOR PAYMENT WITHIN 30 DAYS. NHUVACMC WORKS WITH LOCAL COMMUNITY COLLEGES TO PROVIDE TOURS, LECTURES, AND INTERNSHIPS FOR STUDENTS. NHUVACMC PUBLISHES TWO MAJOR COMMUNITY NEWSLETTERS. "SIMPLY HEALTH AND "AGING WELL" ARE PUBLISHED 3 TIMES A YEAR; THEY REACH 50,000 HOMES IN CULPEPER AND SURROUNDING COUNTIES. DURING 2020, THERE WERE 11,807 PATIENT DAYS, WITH AN AVERAGE LENGTH OF STAY OF 4 DAYS, AND AN AVERAGE DAILY CENSUS OF 32. THERE WERE 3,104 DISCHARGES, 2,000 INPATIENT AND OUTPATIENT SURGERIES, 93,830 OUTPATIENT ENCOUNTERS AND 29,441 EMERGENCY DEPARTMENT VISITS. | Desc |
| Total Program Service Expenses | $89,636,372 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 76 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 888 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES CODER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5712841163 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 28 BLACKWELL PARK SUITE 303 | AddressLine1Txt |
| City | WARRENTON | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 20186 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| ALFRED PILONG | |||||||||
| SVP & CEO NH-UVA HS | 0.00 | 50.00 | Yes (X) | $0 | $847,203 | $137,280 | |||
| JONATHAN D'SOUZA | |||||||||
| CHIEF MEDICAL OFFICER | 50.00 | 0.00 | $388,241 | $0 | $25,399 | Yes (X) | |||
| DONNA STATON | |||||||||
| PRESIDENT | 50.00 | 0.00 | Yes (X) | $257,869 | $0 | $12,726 | |||
| MINDI SHIFFLETT | |||||||||
| CHIEF NURSING OFFICER | 50.00 | 0.00 | $194,780 | $0 | $32,559 | Yes (X) | |||
| SUSAN EDWARDS | |||||||||
| CHIEF HUMAN RESOURCE OFFICER | 50.00 | 0.00 | $174,385 | $0 | $33,044 | Yes (X) | |||
| DENNIS SMITH | |||||||||
| PHARMACY MANAGER | 45.00 | 0.00 | $180,881 | $0 | $20,483 | Yes (X) | |||
| SARA WHITE | |||||||||
| ADMIN DIRECTOR OF FINANCE | 50.00 | 0.00 | Yes (X) | $175,623 | $0 | $22,126 | |||
| TEMPLE COATES | |||||||||
| DIR. PROF. & ANCILLARY SVC. | 45.00 | 0.00 | $164,778 | $0 | $32,328 | Yes (X) | |||
| STEVEN SPEELMAN | |||||||||
| ADMIN DIRECTOR INFORMATION SYS | 45.00 | 0.00 | $167,059 | $0 | $26,903 | Yes (X) | |||
| MARK UTZ | |||||||||
| DIR. OF PLANT ENGINEERING SVC. | 45.00 | 0.00 | $158,978 | $0 | $22,133 | Yes (X) | |||
| MARK CHANEY | |||||||||
| DIRECTOR OF NURSING | 45.00 | 0.00 | $156,742 | $0 | $22,608 | Yes (X) | |||
| MICHELLE STRIDER | |||||||||
| CHIEF QUALITY OFFICER | 50.00 | 0.00 | $153,869 | $0 | $22,078 | Yes (X) | |||
| CHARLES BARRELL | |||||||||
| CHAIR | 0.20 | 0.20 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| SALLY NAN BARBER | |||||||||
| VICE CHAIR | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| DOUG LISCHKE | |||||||||
| TREASURER | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| HORTENSE HINTON-JACKSON | |||||||||
| SECRETARY | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| RICHARD HARRINGTON | |||||||||
| TRUSTEE | 0.20 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| JAMES FERGUSON MD | |||||||||
| TRUSTEE | 0.20 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| THOMAS REYNOLDS | |||||||||
| TRUSTEE | 0.20 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| SCOTT SYVERUD MD | |||||||||
| TRUSTEE | 0.20 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,173,205 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $847,203 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $409,667 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 49 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| UNIVERSITY OF VIRGINIA PHYSICIANS GROUP | |||||
| 500 RAY C HUNT DR | CHARLOTTESVILLE | VA | 22903 | CLINICAL SUPPORT | $3,185,355 |
| OUTPATIENT IMAGING CULPEPER | |||||
| 840 CRESCENT CENTRE DR SUITE 200 | FRANKLIN | TN | 37067 | CLINICAL SUPPORT | $2,830,708 |
| UVA MEDICAL CENTER | |||||
| PO BOX 800778 | CHARLOTTESVILLE | VA | 22908 | CLINICAL SUPPORT | $2,339,460 |
| AMERICAN ANESTHESIOLOGY | |||||
| PO BOX 281034 | ATLANTA | GA | 30384 | PHYSICIAN SUPPORT | $1,749,625 |
| MOORE'S ELECTRICAL & MECHANICAL CONSTR | |||||
| 916 N POPLAR ST | CHARLOTTE | NC | 28206 | PURCHASED SERVICES | $826,147 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 21 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $13,636,253 | GovernmentGrantsAmt |
| All Other Contributions | $33,025 | AllOtherContributionsAmt |
| Total Contributions | $13,669,278 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 622110 | $104,392,768 | $104,392,768 |
| PASS-THRU PATIENT LOSS | 621111 | -$3,318,498 | -$3,318,498 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $101,074,270 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,939 | TotalRevenueColumnAmt |
| Exclusion | $9,939 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $216,806 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $216,806 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $216,806 | TotalRevenueColumnAmt |
| Exclusion | $216,806 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $301,267 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $153,958 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $147,309 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $147,309 | TotalRevenueColumnAmt |
| Exclusion | $147,309 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|---|
| MISCELLANEOUS REVENUE | 900099 | $711,209 | $711,209 | ||
| CAFETERIA MEALS | 722514 | $198,907 | $198,907 | ||
| CATERING | 722320 | $1,399 | $1,399 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $911,515 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $116,029,117 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $101,785,479 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,399 | UnrelatedBusinessRevenueAmt |
| Exclusion | $572,961 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $551,275 | TotalAmt |
| Program Services | $551,275 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,933 | TotalAmt |
| Program Services | $25,933 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,492,700 | TotalAmt |
| Management And General | $1,492,700 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,184,455 | TotalAmt |
| Program Services | $24,717,886 | ProgramServicesAmt |
| Management And General | $13,466,569 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,353,208 | TotalAmt |
| Program Services | $879,585 | ProgramServicesAmt |
| Management And General | $473,623 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,279,670 | TotalAmt |
| Program Services | $4,081,785 | ProgramServicesAmt |
| Management And General | $2,197,885 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,743,678 | TotalAmt |
| Program Services | $1,783,391 | ProgramServicesAmt |
| Management And General | $960,287 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $520,030 | TotalAmt |
| Management And General | $520,030 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,521,574 | TotalAmt |
| Program Services | $15,173,573 | ProgramServicesAmt |
| Management And General | $2,348,001 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,282 | TotalAmt |
| Program Services | $94,282 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,639,092 | TotalAmt |
| Program Services | $1,259,665 | ProgramServicesAmt |
| Management And General | $379,427 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,094,534 | TotalAmt |
| Program Services | $1,094,534 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,581,479 | TotalAmt |
| Program Services | $1,518,220 | ProgramServicesAmt |
| Management And General | $63,259 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,795 | TotalAmt |
| Program Services | $1,167 | ProgramServicesAmt |
| Management And General | $628 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,156 | TotalAmt |
| Program Services | $41,701 | ProgramServicesAmt |
| Management And General | $22,455 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,371,897 | TotalAmt |
| Program Services | $6,128,200 | ProgramServicesAmt |
| Management And General | $243,697 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,522 | TotalAmt |
| Program Services | $64,379 | ProgramServicesAmt |
| Management And General | $356,143 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACEUTICALS | $14,010,418 | $14,010,418 | |
| MEDICAL SUPPLIES | $9,059,717 | $9,014,797 | $44,920 |
| BAD DEBT | $5,825,525 | $5,825,525 | |
| REPAIRS AND MAINTENANCE | $1,983,614 | $1,959,243 | $24,371 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,652,869 | TotalAmt |
| Program Services | $1,410,813 | ProgramServicesAmt |
| Management And General | $242,056 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,472,423 | TotalAmt |
| Program Services | $89,636,372 | ProgramServicesAmt |
| Management And General | $22,836,051 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,831,182 | BOYAmt |
| EOY | $33,613,208 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,780,393 | BOYAmt |
| EOY | $15,064,646 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,693,244 | BOYAmt |
| EOY | $2,463,799 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,078,581 | BOYAmt |
| EOY | $1,004,429 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $78,910,928 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $21,490,875 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,321,558 | BOYAmt |
| EOY | $57,420,053 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,194,266 | BOYAmt |
| EOY | $3,404,716 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,795,073 | BOYAmt |
| EOY | $23,912,743 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,673,003 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,694,297 | BOYAmt |
| EOY | $139,556,597 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,160,314 | BOYAmt |
| EOY | $26,103,302 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,128,164 | BOYAmt |
| EOY | $5,781,378 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,288,478 | BOYAmt |
| EOY | $31,884,680 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,245,289 | BOYAmt |
| EOY | $107,511,485 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $160,530 | BOYAmt |
| EOY | $160,432 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,405,819 | BOYAmt |
| EOY | $107,671,917 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,694,297 | BOYAmt |
| EOY | $139,556,597 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,556,694 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $1,709,404 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $4,187 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,187 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LINE 1I DUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,192,309 | OtherCostOrOtherBasisAmt |
| Book Value | $6,192,309 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,969,580 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,015,438 | DepreciationAmt |
| Book Value | $13,954,142 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $114,364 | OtherCostOrOtherBasisAmt |
| Depreciation | $114,364 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $39,744,300 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,749,222 | DepreciationAmt |
| Book Value | $32,995,078 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,890,375 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,611,851 | DepreciationAmt |
| Book Value | $4,278,524 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $57,420,053 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| OPERATING LEASE | $2,687,179 |
| THIRD PARTY PAYMENT PAYABLE | $2,046,435 |
| DUE TO AFFILIATES | $1,000,000 |
| PATIENT REFUNDS | $47,753 |
| OTHER LIABILITIES | $11 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,781,378 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | LIABILITY UNDER FIN 48 (ASC 740) FOOTNOTE THE AUDIT FOR NOVANT HEALTH UVA HEALTH SYSTEM AND ITS AFFILIATES IS PREPARED ON A CONSOLIDATED BASIS. THE COMPANY IS REQUIRED TO EVALUATE UNCERTAIN TAX POSITIONS. THIS EVALUATION INCLUDES A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE COMPANY'S CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS FOR THE YEARS ENDED DECEMBER 31, 2020 AND 2019. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,739,516 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,739,516 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03510 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,070,796 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,558,992 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,511,804 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04230 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,810,312 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,558,992 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,251,320 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07740 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $45,333 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $45,333 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $500,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $500,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $545,333 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $545,333 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00510 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,355,645 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,558,992 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,796,653 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08250 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,300 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,300 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $22,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,825,525 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $36,195,044 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $50,291,867 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$14,096,823 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 CULPEPER SURGERY CENTER LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | OUTPATIENT SURGERY CENTER | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.62670 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.37330 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMH DBA NHUVAHS CULPEPER MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 SUNSET LANE | AddressLine1Txt |
| City | CULPEPER | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.NOVANTHEALTHUVA.ORG | WebsiteAddressTxt |
| State License | H1848 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CULPEPER MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 20 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE SECTION C | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B, LINE 3E: | CULPEPER MEMORIAL HOSPITALSEVERAL SOCIAL, BEHAVIORAL, AND CLINICAL HEALTH NEEDS WERE IDENTIFIED THROUGH A COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY. ONCE THE HEALTH NEEDS WERE IDENTIFIED, SURVEYS AND COMMUNITY MEETINGS WERE CONDUCTED TO ASK COMMUNITY MEMBERS AND STAKEHOLDERS TO RANK THE TOP HEALTH ISSUES ACCORDING TO YEARS OF POTENTIAL LIFE LOST AND MAGNITUDE OF THESE ISSUES. THE SCORES ARE CALCULATED TO RANK THE FOCUS AREAS AND PRIORITIZE THE IDENTIFIED HEALTH NEEDS. |
| PART V, SECTION B, LINE 5: | CULPEPER MEMORIAL HOSPITALWHILE CONDUCTING THE CHNA, THE HOSPITAL FACILITY 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, AND OTHER SOCIAL SERVICE AGENCIES. INPUT WAS GATHERED THROUGH A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY AND DATA FROM THE VIRGINIA DEPARTMENT OF HEALTH. THE SCOPE OF EXPERTISE WAS BROAD AND INCLUDED SUCH AREAS AS PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES. WHERE POSSIBLE, WE HAVE LEVERAGED THE RESOURCES OF THE ORGANIZATION TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES. |
| PART V, SECTION B, LINE 7B: | CULPEPER MEMORIAL HOSPITALHTTPS://WWW.NOVANTHEALTHUVA.ORG/ABOUT-US/COMMUNITY-ENGAGEMENT/COMMUNITY-BENEFIT.ASPX |
| PART V, SECTION B, LINE 10A: | CULPEPER MEMORIAL HOSPITALHTTPS://WWW.NOVANTHEALTHUVA.ORG/ABOUT-US/COMMUNITY-ENGAGEMENT/COMMUNITY-BENEFIT.ASPX |
| PART V, SECTION B, LINE 11: | CULPEPER MEMORIAL HOSPITALTHE HOSPITAL FACILITY IS A PART OF NOVANT HEALTH UVA HEALTH SYSTEM, 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 HOSPITAL LEADERSHIP AND BOARD OF TRUSTEE MEMBERS; AS WELL AS, THE UVA MEDICAL CENTER AND UNIVERSITY OF VIRGINIA PHYSICIANS GROUP. NEEDS WERE EVALUATED BASED ON THE FACILITY'S SCOPE OF SERVICE, EXPERTISE, AVAILABILITY OF RESOURCES, AND THE FACILITY'S ABILITY TO IMPACT OVERALL POPULATION HEALTH. THE HOSPITAL FACILITY HAS ADOPTED AND EXECUTED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE PRIORITIZED COMMUNITY HEALTH NEEDS FROM THE CHNA. THE IMPLEMENTATION STRATEGY OUTLINES THE PLAN THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET THOSE HEALTH NEEDS IN ITS COMMUNITY. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. IT WAS DETERMINED THAT THERE ARE 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. |
| PART V, LINE 16A, FAP WEBSITE: | CULPEPER MEMORIAL HOSPITALHTTPS://WWW.NOVANTHEALTHUVA.ORG/PATIENTS--VISITORS/FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPX |
| PART V, LINE 16B, FAP APPLICATION: | CULPEPER MEMORIAL HOSPITALHTTPS://WWW.NOVANTHEALTHUVA.ORG/PATIENTS--VISITORS/FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPX |
| PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY: | CULPEPER MEMORIAL HOSPITALHTTPS://WWW.NOVANTHEALTHUVA.ORG/PATIENTS--VISITORS/FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPX |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - CULPEPER SURGERY CENTER LLC | ||||
| 541 SUNSET LANE STE 201 | CULPEPER | VA | 22701 | AMBULATORY SURGERY CENTER |
| 1 - NHUVA HEALTH SYSTEM IMAGING CULPEPER | ||||
| 501 SUNSET LANE | CULPEPER | VA | 22701 | IMAGING CENTER |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | OTHER CRITERIA BESIDES INCOME AND FPG USED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE INCLUDE WHETHER THE PATIENT HAS ANY OF THE FOLLOWING ASSETS: CHECKING OR SAVINGS ACCOUNTS, STOCKS, BONDS, IRAS, 401KS, CDS, LIFE INSURANCE (CASH TO LOAN VALUE), REAL PROPERTY, OR PERSONAL PROPERTY SUCH AS VEHICLES, CAMPERS, OR MOBILE HOMES. |
| 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.ASPX. PLEASE 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: | THE COSTING METHODOLOGY USED TO CALCULATE AMOUNTS REPORTED IN LINE 7 WAS A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.PART I, LINE 7 COL(F):THE AMOUNT OF BAD DEBT REMOVED FROM TOTAL EXPENSES (DENOMINATOR) WAS$5,825,525. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES ADDRESS THE UNDERLYING CAUSES OF HEALTH PROBLEMS AND IMPACT 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 CHAMBERS OF COMMERCE AND OTHER LOCAL COMMUNITY ORGANIZATIONS, AND PROVIDING EDUCATION SEMINARS AND TRAINING FOR COMMUNITY WORKFORCES. |
| PART III, LINE 2: | IMPLICIT PRICE CONCESSIONS (ANALOGOUS TO BAD DEBT EXPENSE) ARE DETERMINED BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS, AND ECONOMIC CONDITIONS, THE AGE OF THE ACCOUNTS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. |
| PART III, LINE 4: | THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS (ANALOGOUS TO BAD DEBT EXPENSE) 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 6 OF THE AUDITED FINANCIAL STATEMENTS DESCRIBES THE BAD DEBT EXPENSE. |
| 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 EACHOVERHEAD 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. THEALLOWABLE 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 HOSPITAL MAY TAKE FOR NONPAYMENT INCLUDING INTERNAL AND EXTERNAL COLLECTION PRACTICES AND REPORTING TO CREDIT AGENCIES. THE POLICY STATES THAT REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE MUST BE MADE BEFORE THE ORGANIZATION, OR ANY EXTERNAL ORGANIZATION, ENGAGE IN AN EXTRAORDINARY COLLECTION ACTION.FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, THE ORGANIZATION MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS. |
| PART VI, LINE 2: | THE ORGANIZATION IS PART OF NOVANT HEALTH UVA HEALTH SYSTEM, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. NOVANT HEALTH, INC. IS A MEMBER ORGANIZATION OF THE NOVANT HEALTH UVA HEALTH SYSTEM. NOVANT HEALTH, INC. HAS A COMMUNITY BENEFIT DEPARTMENT ("CB DEPARTMENT") COMPRISED OF COMMUNITY BENEFIT PROFESSIONALS AND AN ASSOCIATED ADVISORY WORKING GROUP ("THE COMMUNITY BENEFIT GROUP") THAT INCLUDES REPRESENTATIVES FROM INTERNAL AUDIT, LEGAL, AND TAX. THE CB DEPARTMENT IS RESPONSIBLE FOR COORDINATING THE PREPARATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) REPORTED IN PART V, SECTION B, FOR EACH HOSPITAL WITHIN THE NOVANT HEALTH SYSTEM AS WELL AS FOR THE FILING ORGANIZATION. EACH HOSPITAL AND THE COMMUNITY BENEFIT GROUP 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. 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. |
| PART VI, LINE 3: | CULPEPER HOSPITAL HAS SEVERAL WAYS THAT IT INFORMS AND EDUCATES PATIENTS WHO MAY BE IN NEED AND ARE ELIGIBLE FOR ASSISTANCE. WHEN STAFF (CASHIER, FINANCIAL COUNSELOR, AND REGISTERS) ARE SPEAKING WITH A PATIENT THAT STATES THEY ARE NOT ABLE TO PAY, THE PATIENT IS ENCOURAGED TO APPLY FOR FINANCIAL ASSISTANCE. BROCHURES DESCRIBING THE FINANCIAL ASSISTANCE POLICY ARE PLACED IN OUR BILLING STATEMENTS, AS WELL AS THE APPLICABLE POVERTY GUIDELINES FOR QUALIFYING FOR FINANCIAL ASSISTANCE. IN ADDITION, FINANCIAL ASSISTANCE APPLICATIONS, AS WELL AS FAQS WITH RESPECT TO THE FINANCIAL ASSISTANCE POLICY, ARE HANDED OUT TO PATIENTS UPON REGISTRATION. THEHOSPITAL'S WEBSITE POSTS THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND GUIDELINES FOR APPLYING. |
| PART VI, LINE 4: | CULPEPER MEMORIAL HOSPITAL, INC. DBA NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTERTHE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA. THE PRIMARY SERVICE AREA FOR NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER IS DEFINED BY THE ZIP CODES THAT REPRESENT MORE THAN 75% OF THE HOSPITAL'S IN-PATIENT POPULATION. THESE ZIP CODES ALL FALL WITHIN CULPEPER COUNTY, VIRGINIA.BASED ON 2020 ESTIMATES, CULPEPER COUNTY IS THE 37TH OUT OF 133 COUNTIES IN THE STATE OF VIRGINIA WITH JUST OVER 53,428 RESIDENTS. SPREAD ACROSS THE FOOTHILLS OF THE BLUE RIDGE MOUNTAINS' FIELDS OF THE NORTH CENTRAL PIEDMONT REGION, CULPEPER COUNTY, VIRGINIA POSSESSES A RURAL CHARACTER DISPLAYING THE NATURAL SPLENDOR OF RUSTIC VIRGINIA. CULPEPER COUNTY HAS EXPERIENCED SMALL, BUT STEADY POPULATION GROWTH (12.7%) SINCE THE 2010 US CENSUS.CHILDREN AND ADOLESCENTS (AGE 0-18) MAKE UP AN ESTIMATE OF ONE-QUARTER (24%) OF THE POPULATION IN CULPEPER COUNTY AND SENIORS (AGE 65 AND OVER) MAKE UP 16% OF THE POPULATION. NONWHITE MINORITIES CURRENTLY MAKE UP 39% OF THE RACIAL DEMOGRAPHIC IN CULPEPER COUNTY. THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS: WHITE NON-HISPANIC 7.4%; BLACK/AFRICAN-AMERICAN 1.4%; HISPANIC OR LATINO 1.2%; OTHER 2%. DATA TAKEN FROM THE 2019 US CENSUS BUREAU INCLUDES INDIVIDUALS THAT IDENTIFIED WITH MULTIPLE RACES; THEREFORE, THE PERCENTAGES EXCEED 100%.ACCORDING TO THE US CENSUS BUREAU DATA, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $67,696. THE POVERTY RATE FOR CULPEPER COUNTY IS 8%. THIS IS THE ONLY ACUTE CARE FACILITY IN THE COMMUNITY. 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. |
| PART VI, LINE 5: | THE 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. PARTICIPATING IN HEALTH FAIRS, AND PROVIDING 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 MEDICAID TO THE COMMUNITIES IT SERVES;12. PROVIDING CASH AND IN-KIND CONTRIBUTIONS TO NONPROFIT COMMUNITY HEALTHCARE ORGANIZATIONS IN THE COMMUNITIES IT SERVES; AND13. GENERALLY PROMOTING THE HEALTH, WELLNESS, AND WELFARE OF THE COMMUNITIES IT SERVES BY PROVIDING QUALITY HEALTHCARE SERVICES AT REASONABLE COST.FOR SPECIFIC EXAMPLES OF THIS ORGANIZATION'S COMMUNITY BENEFIT ACTIVITIES, WHICH FURTHER THE ORGANIZATION'S EXEMPT PURPOSES (AND THOSE OF ALL HOSPITALS AND HEALTHCARE FACILITIES IN THE SAME HEALTHCARE SYSTEM), PLEASE SEE THE NOVANT HEALTH COMMUNITY BENEFIT REPORT, LOCATED ATHTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX.PLEASE 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: | THE ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH UVA HEALTH SYSTEM AND NOVANT HEALTH (COLLECTIVELY KNOWN AS "THE SYSTEM"), BOTH OF WHICH 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 HTTP://HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX.PLEASE 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. 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, NOVANT HEALTH UVA HEALTH SYSTEM INCLUDES A PHYSICIAN ORGANIZATION WITH PRACTICES IN VIRGINIA AND A HOSPITAL FOUNDATION WHICH SUPPORTS AND ENHANCES THE ACTIVITIES IN THOSE HOSPITALS' COMMUNITIES. FURTHER, NOVANT HEALTH UVA HEALTH SYSTEM INCLUDES AMBULATORY SURGERY CENTERS, IMAGING CENTERS, REHABILITATION CENTERS, AND OTHEROUTPATIENT FACILITIES; ALL DEDICATED TO PROMOTING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES. |
| PART VI, LINE 7: | STATE FILING OF COMMUNITY BENEFIT REPORTCULPEPER MEMORIAL HOSPITAL 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. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| CULPEPER WELLNESS FOUNDATION INC | |||||||
| 19002 CROSSROAD PKWY | CULPEPER | VA | 22701 | 521366700 | 501(C)(3) | $500,000 | COMMUNITY OUTREACH |
| ORANGE COUNTY FREE CLINIC INC | |||||||
| 101 C WOODMARK STREET | ORANGE | VA | 22960 | 251922019 | 501(C)(3) | $15,000 | COMMUNITY OUTREACH |
| THE BOYS & GIRLS CLUB OF FAUQUIER INC | |||||||
| 169 KEITH STREET | WARRENTON | VA | 20186 | 541815587 | 501(C)(3) | $10,000 | COMMUNITY OUTREACH |
| GIRLS ON THE RUN PIEDMONT | |||||||
| PO BOX 245 | WARRENTON | VA | 20186 | 463737841 | 501(C)(3) | $6,000 | COMMUNITY OUTREACH |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (5 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|---|
| EMPLOYEE EMERGENCY FUND | 2 | $2,319 | $0 | ||
| SCHOLARSHIPS | 4 | $2,000 | $0 | ||
| MAMMOGRAMS | 48 | $19,724 | $0 | ||
| PATIENT ASSISTANCE | 5 | $196 | $0 | ||
| PATIENT TRANSPORTATION | 32 | $0 | $1,694 | FMV | TRANSPORTATION |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS THE FILING ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), THE PARENT ORGANIZATION. NOVANT HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. NOVANT HEALTH 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALFRED PILONG | ||||||||||||||
| SVP & CEO NH-UVA HS | $0 | $524,656 | $0 | $281,458 | $0 | $41,089 | $0 | $97,672 | $0 | $39,608 | $0 | $984,483 | $0 | $0 |
| JONATHAN D'SOUZA | ||||||||||||||
| CHIEF MEDICAL OFFICER | $295,836 | $0 | $92,405 | $0 | $0 | $0 | $14,653 | $0 | $10,746 | $0 | $413,640 | $0 | $0 | $0 |
| DONNA STATON | ||||||||||||||
| PRESIDENT | $224,484 | $0 | $23,000 | $0 | $10,385 | $0 | $600 | $0 | $12,126 | $0 | $270,595 | $0 | $0 | $0 |
| MINDI SHIFFLETT | ||||||||||||||
| CHIEF NURSING OFFICER | $179,188 | $0 | $15,592 | $0 | $0 | $0 | $9,584 | $0 | $22,975 | $0 | $227,339 | $0 | $0 | $0 |
| SUSAN EDWARDS | ||||||||||||||
| CHIEF HUMAN RESOURCE OFFICER | $159,375 | $0 | $15,010 | $0 | $0 | $0 | $10,251 | $0 | $22,793 | $0 | $207,429 | $0 | $0 | $0 |
| DENNIS SMITH | ||||||||||||||
| PHARMACY MANAGER | $164,384 | $0 | $16,497 | $0 | $0 | $0 | $10,144 | $0 | $10,339 | $0 | $201,364 | $0 | $0 | $0 |
| SARA WHITE | ||||||||||||||
| ADMIN DIRECTOR OF FINANCE | $159,989 | $0 | $13,651 | $0 | $1,983 | $0 | $9,916 | $0 | $12,210 | $0 | $197,749 | $0 | $0 | $0 |
| TEMPLE COATES | ||||||||||||||
| DIR. PROF. & ANCILLARY SVC. | $148,796 | $0 | $14,004 | $0 | $1,978 | $0 | $9,513 | $0 | $22,815 | $0 | $197,106 | $0 | $0 | $0 |
| STEVEN SPEELMAN | ||||||||||||||
| ADMIN DIRECTOR INFORMATION SYS | $151,791 | $0 | $13,269 | $0 | $1,999 | $0 | $9,601 | $0 | $17,302 | $0 | $193,962 | $0 | $0 | $0 |
| MARK UTZ | ||||||||||||||
| DIR. OF PLANT ENGINEERING SVC. | $142,851 | $0 | $14,141 | $0 | $1,986 | $0 | $8,502 | $0 | $13,631 | $0 | $181,111 | $0 | $0 | $0 |
| MARK CHANEY | ||||||||||||||
| DIRECTOR OF NURSING | $141,647 | $0 | $13,095 | $0 | $2,000 | $0 | $8,848 | $0 | $13,760 | $0 | $179,350 | $0 | $0 | $0 |
| MICHELLE STRIDER | ||||||||||||||
| CHIEF QUALITY OFFICER | $139,074 | $0 | $12,795 | $0 | $2,000 | $0 | $8,928 | $0 | $13,150 | $0 | $175,947 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH UVA HEALTH SYSTEM ("THE SYSTEM") AND RELIES UPON NOVANT HEALTH, INC., A SUPPORTING ORGANIZATION OF THE SYSTEM, TO USE THE PROCESS DESCRIBED IN PART VI, LINE 15 OF THIS RETURN TO ESTABLISH COMPENSATION FOR CERTAIN EXECUTIVES. THIS PROCESS ADHERES TO THE REQUIREMENTS SET FORTH TO SECURE THE REBUTTABLE PRESUMPTION OF REASONABLENESS AND INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT AND DISINTERESTED MEMBERS OF A COMPENSATION COMMITTEE, CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, THE UTILIZATION OF THIRD-PARTY COMPARABILITY DATA SUCH AS PUBLISHED COMPENSATION SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. |
| PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: | THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. ELIGIBLE EXECUTIVES WILL BE NOMINATED BY THE CEO AND APPROVED BY THE NOVANT HEALTH COMPENSATION AND LEADERSHIP COMMITTEE ("THE COMMITTEE") TO PARTICIPATE. GENERALLY, ANNUAL CONTRIBUTIONS TO THE PLAN OR PAYMENTS TO PARTICIPANTS WILL BE BASED ON A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AS OF JANUARY 1ST OF THE PREVIOUS PLAN YEAR AND ARE REPORTED IN COLUMN (C) OF SCHEDULE J. PRIOR TO MAKING THE CONTRIBUTIONS OR PAYMENTS, THE COMMITTEE WILL APPROVE THE AMOUNTS AS TO REASONABLENESS, WHEN COMBINED WITH ALL OTHER ANNUAL COMPENSATION. A 3 YEAR CLASS-YEAR VESTING PERIOD WILL APPLY UP TO AGE 62, WHEN ALL MONEY WOULD BE VESTED AND PAID OUT TO THE PARTICIPANT. OTHERWISE, VESTING WILL OCCUR ON JANUARY 1ST OF EACH YEAR FOR THE APPROPRIATE CLASS-YEAR VESTING PERIOD. THE COMMITTEE REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | CULPEPER MEMORIAL HOSPITAL DOING BUSINESS AS NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER ("NHUVACMC") IS AN INTEGRAL PART OF THE NOVANT HEALTH UVA HEALTH SYSTEM ("NHUVAHS"). NHUVAHS WAS FORMED IN 2016 BY NOVANT HEALTH AND THE UNIVERSITY OF VIRGINIA HEALTH SYSTEM, AND IS A REGIONAL NONPROFIT, INTEGRATED HEALTHCARE NETWORK OF PHYSICIAN CLINICS, OUTPATIENT CENTERS, AND HOSPITALS THAT SERVES PATIENTS AND COMMUNITIES IN VIRGINIA. NHUVACMC RECEIVES STRATEGIC PLANNING, ADMINISTRATIVE AND OTHER SUPPORT FROM NOVANT HEALTH, INC., A MEMBER OF THE NOVANT HEATH UVA HEALTH SYSTEM. GENERAL INFORMATION NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER, LOCATED IN CULPEPER, VA, IS PART OF A JOINT OPERATING COMPANY KNOWN AS NOVANT HEALTH UVA HEALTH SYSTEM, WHICH WAS FORMED IN 2016 BETWEEN NOVANT HEALTH AND UVA HEALTH. THE HOSPITAL IS FOCUSED ON PROVIDING COMMUNITY SUPPORT, CONSISTENT QUALITY, EXCELLENT CARE AND A REMARKABLE WORK ENVIRONMENT FOR OUR TEAM MEMBERS. WE ARE COMMITTED TO MEETING THE HEALTH CARE NEEDS OF RESIDENTS OF CULPEPER, ORANGE, MADISON AND SURROUNDING COUNTIES IN VIRGINIA, ONE PERSON AT A TIME. IN ADDITION TO OUR QUALITY OF SERVICES AND COMPREHENSIVE CATEGORIES OF SERVICES, WE'RE VERY PROUD OF OUR PATIENT FINANCIAL SERVICES PROGRAM. WE WORK WITH CUSTOMERS TO HELP QUALIFY THEM FOR PUBLIC ASSISTANCE, ESTABLISH A REASONABLE PAYMENT PLAN, DISCOUNT THEIR BILL OR PROVIDE THEM WITH FREE CHARITY CARE. SOCIAL RESPONSIBILITY AND COMMUNITY OUTREACH COMMUNITY OUTREACH IS A CRITICAL COMPONENT TO THE MISSION OF NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER. BEYOND OUR PROVISION OF QUALITY HEALTHCARE SERVICES, WE SUPPORT OTHER COMMUNITY ORGANIZATIONS THAT PROVIDE HEALTH SERVICES, EDUCATION, AND ASSISTANCE TO UNINSURED AND VULNERABLE POPULATIONS, AS WELL AS THE OVERALL COMMUNITY. SOME RECIPIENT ORGANIZATIONS INCLUDE CULPEPER WELLNESS FOUNDATION, CULPEPER FREE CLINIC, ORANGE COUNTY FREE CLINIC, GIRLS ON THE RUN PIEDMONT, CULPEPER LITERACY COUNCIL, SAFE, GERMANNA FOUNDATION GUARANTEE, CRUSH AND TEAM JORDAN. IN 2020, CULPEPER MEDICAL CENTER HOSTED VIRTUAL EDUCATION SESSIONS FOR THE COMMUNITY WHICH INCLUDED THE FOLLOWING: - WHAT'S UP, DOC? - FALL PREVENTION - PEDIATRIC HEALTHY EATING AND WEIGHT MANAGEMENT - WOMEN'S HEALTH CULPEPER MEDICAL CENTER ALSO OFFERED VIRTUAL SUPPORT GROUPS FOR WOMEN WHO HAVE LOST A NEWBORN OR PREGNANCY AND CANCER PATIENTS AND THEIR CAREGIVERS. IT PROVIDED COMMUNITY EDUCATION ABOUT ACCESS TO HEALTHCARE SERVICES, CANCER SERVICES, HEART DISEASE, STROKE, DIABETES AND COVID-19. WE ALSO OFFERED A SUPPORT GROUP SESSION FOR THOSE SEEKING HELP WITH STRESS MANAGEMENT AND DEPRESSION. OTHER INITIATIVES INCLUDED: - TWO AMERICAN RED CROSS BLOOD DRIVES THAT RECEIVED DONATIONS - COVID-19 COMMUNITY TESTING PART OF OUR ONGOING COMMITMENT TO PATIENTS AND THE COMMUNITY IS OFFERING FREE HEALTH SCREENINGS AND PARTNERING WITH OUR PHYSICIAN SPECIALISTS IN THE FIELDS OF CARDIOLOGY, ORTHOPEDICS, AND WOMEN'S HEALTH TO PROVIDE FREE EDUCATION TO MEMBERS OF OUR COMMUNITY. MAMMOGRAPHY SCREENINGS FOR COMMUNITY MEMBERS IN NEED, REGARDLESS OF THEIR ABILITY TO PAY, IS MADE POSSIBLE THROUGH THE PAMPER ME PINK MAMMOGRAPHY FUND, BASED AT NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER. NEW TECHNOLOGY & SERVICES IN JANUARY 2020, CULPEPER MEDICAL CENTER OPENED A THIRD PHYSICAL THERAPY AND REHAB SERVICES LOCATION THAT SPECIALIZES IN TREATING ORTHOPEDIC CONDITIONS SUCH AS LOWER-BACK PAIN, SHOULDER PAIN, POST-SURGERY RECOVERY, JOINT REPLACEMENT AND ARTHRITIS. THE CLINIC ALSO INCLUDES SPORTS REHAB FOR SPRAINS AND STRAINS, POST-OPERATIVE LIGAMENT SURGERIES AND OTHER SPORTS INJURIES. IN ADDITION, THE NEW LOCATION OFFERS GENERAL PHYSICAL THERAPY SERVICES AND SPECIALTY SERVICES INCLUDING LSVT BIG FOR PARKINSON'S DISEASE AND DRY NEEDLING. IN AUGUST 2020, NOVANT HEALTH UVA HEALTH SYSTEM OUTPATIENT IMAGING CULPEPER OPENED IN THE HEART OF DOWNTOWN CULPEPER, SUPPORTING THE TOWN'S MAIN STREET REVITALIZATION PROJECT. THE NEW FREESTANDING IMAGING CENTER PROVIDES RESIDENTS OF CULPEPER AND SURROUNDING COUNTIES WITH INCREASED OPTIONS FOR IMAGING SERVICES. IN SEPTEMBER 2020, TWO NEW SURGEONS JOINED CULPEPER MEDICAL CENTER. UVA ORTHOPEDICS, A DEPARTMENT OF CULPEPER MEDICAL CENTER WELCOMED A NEW HAND AND UPPER EXTREMITY ORTHOPEDIST, SHERIFF AKINLEYE, MD. TREATMENTS INCLUDE JOINT REPLACEMENT, ARTHROSCOPY AND SOFT TISSUE MANAGEMENT. ALL SURGERY, REHABILITATION AND POSTOPERATIVE FOLLOW-UP VISITS ARE PERFORMED AT CULPEPER MEDICAL CENTER. DR. AKINLEYE IS THE FIRST PROVIDER IN MORE THAN 15 YEARS TO OFFER THIS LEVEL OF SPECIALIZED SERVICE TO THE CULPEPER AREA. UVA SURGICAL SERVICES, A DEPARTMENT OF CULPEPER MEDICAL CENTER, WELCOMED A NEW GENERAL SURGEON, TIFFANY STODDARD. EXPANDED TREATMENTS INCLUDE MINIMALLY INVASIVE SURGERY OPTIONS. AWARDS, RECOGNITIONS & CERTIFICATIONS/RECERTIFICATIONS - RECEIVED AN 'A' GRADE IN THE LEAPFROG GROUP'S FALL 2020 HOSPITAL SAFETY GRADE - BABY FRIENDLY DESIGNATION BY THE WORLD HEALTH ORGANIZATION AND THE UNITED NATIONS CHILDREN'S FUND - NAMED ONE OF THE 100 BEST "HOSPITALS FOR SPECIALTY CARE" BY HEALTHGRADES FOR TWO AREAS OF ORTHOPEDICS: JOINT REPLACEMENT AND ORTHOPEDIC SURGERY - NAMED BY NEWSWEEK (IN PARTNERSHIP WITH THE LEAPFROG GROUP) AS ONE OF THE NATION'S BEST MATERNITY HOSPITALS FOR 2020 - EARNED A PERFECT SCORE IN THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S MATERNITY PRACTICES IN INFANT NUTRITION AND CARE (MPINC) SURVEY ACCREDITATION NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER IS FULLY ACCREDITED BY THE JOINT COMMISSION, AN INDEPENDENT ORGANIZATION THAT EVALUATES A HEALTHCARE ORGANIZATION'S PERFORMANCE IN AREAS THAT MOST AFFECT PATIENT HEALTH AND SAFETY. NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER BREAST CENTER IS ACCREDITED BY THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS BY THE AMERICAN COLLEGE OF SURGEONS. ACCREDITATION IS GRANTED TO CENTERS THAT HAVE VOLUNTARILY COMMITTED TO PROVIDE THE HIGHEST QUALITY OF CARE TO PATIENTS WITH BREAST DISEASES AND THAT UNDERGO A RIGOROUS EVALUATION AND REVIEW OF ITS PERFORMANCE AND COMPLIANCE WITH THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS. NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER IS ACCREDITED BY THE INTERSOCIETAL COMMISSION FOR THE ACCREDITATION OF VASCULAR LABORATORIES, ENSURING QUALITY PATIENT CARE FOR VASCULAR TESTING. COMMUNITY BENEFIT REPORT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPA CT.ASPX THE COMMUNITY BENEFIT REPORT, REFERRED TO AS A COMMUNITY IMPACT REPORT, PREPARED BY NOVANT HEALTH IS A SYSTEM-WIDE REPORT THAT INCLUDES QUALITATIVE AND QUANTITATIVE INFORMATION. PLEASE 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. IN THIS REPORT, THE NOVANT HEALTH SYSTEM'S COMMUNITY BENEFIT WAS APPROXIMATELY $1,018,000,000, INCLUDING $179,000,000 IN FINANCIAL ASSISTANCE FOR 2020. |
| FORM 990, PART III, LINE 2 | SERVING COMMUNITY IN THE PANDEMIC LEARN ABOUT HOW WE ARE SERVING OUR COMMUNITIES IN THE PANDEMIC BY VISITING HTTPS://WWW.NOVANTHEALTH.ORG/PORTALS/92/ASSETS/DOCUMENTS/ANNUAL-FINANCIA L-INFORMATION/NOVANT-HEALTH-2020-ANNUAL-REPORT_RISING-UP.PDF. |
| FORM 990, PART VI, SECTION A, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS THE CORPORATION IS A NONPROFIT CORPORATION WITH MEMBERS (OR A MEMBER). THE CORPORATION HAS NOVANT HEALTH UVA HEALTH SYSTEM AS ITS SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | ELECTION OF MEMBERS AND THEIR RIGHTS THE BOARD OF NOVANT HEALTH UVA HEALTH SYSTEM APPOINTS THE BOARD OF CULPEPER MEMORIAL HOSPITAL, INC. |
| FORM 990, PART VI, SECTION B, LINE 11B | ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE REVIEW OF THE 990 IS PERFORMED BY THE CONTROLLER AND CHIEF FINANCIAL OFFICER AND THEN BY THE PRESIDENT; THE PRESIDENT BEING THE ONE RESPONSIBLE FOR SIGNING THE 990. A COPY OF THE 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING THE FORM 990 WITH IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING AND ENFORCEMENT OF CONFLICT OF INTEREST 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 | THE FILING ORGANIZATION IS AN INTEGRAL PART OF THE NOVANT HEALTH UVA HEALTH SYSTEM ("THE SYSTEM"), WHICH IS SUPPORTED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), ONE OF ITS MEMBERS. NOVANT HEALTH SUPPORTS THE SYSTEM BY PROVIDING A COMPENSATION REVIEW AND APPROVAL PROCESS TO CERTAIN SYSTEM ENTITIES. THE PROCESS IS CONDUCTED BY THE INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH, INC. BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) WHO REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR CERTAIN LEADERS AND EXECUTIVES ("EXECUTIVES") SERVING AS OFFICERS, INCLUDING THE TOP MANAGEMENT OFFICIAL, OR KEY EMPLOYEES FOR CERTAIN ENTITIES WITHIN THE SYSTEM. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT AND 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 COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, 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 | GOVERNING DOCUMENTS DISCLOSURE THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 5,079,254. MANAGEMENT AND GENERAL EXPENSES 1,106,376. TOTAL EXPENSES 6,185,630. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 140,368. MANAGEMENT AND GENERAL EXPENSES 5,849. TOTAL EXPENSES 146,217. COLLECTION SERVICES: MANAGEMENT AND GENERAL EXPENSES 194,782. TOTAL EXPENSES 194,782. PROFESSIONAL PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 8,020,675. TOTAL EXPENSES 8,020,675. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,933,276. MANAGEMENT AND GENERAL EXPENSES 1,040,994. TOTAL EXPENSES 2,974,270. |
| FORM 990, PART XI, LINE 9: | PARTNERSHIPS 3,116,794. NET ASSETS RELEASED FROM RESTRICTION 510,609. BOOK ADJUSTMENT -479,972. AFFILIATE TRANSFERS -1,438,027. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (24 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| AUXILIARY OF FORSYTH MEMORIAL HOSPITAL | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 560862112 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | FORSYTH MEMORIAL HOSPITAL INC | 0 | |
| BRUNSWICK NOVANT MEDICAL CENTER FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 274616751 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | BRUNSWICK COMMUNITY HOSPITAL LLC | 0 | |
| CAROLINA MEDICORP ENTERPRISES INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 581466368 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | NOVANT MEDICAL GROUP INC | 0 | |
| COMMUNITY GENERAL HEALTH PARTNERS INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 560636250 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH TRIAD REGION LLC | 0 | |
| COMMUNITY GENERAL HOSPITAL FOUNDATION INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561828629 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | COMMUNITY GENERAL HEALTH PARTNERS INC | 0 | |
| FORSYTH MEDICAL CENTER FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 562120959 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | FORSYTH MEMORIAL HOSPITAL INC | 0 | |
| FORSYTH MEMORIAL HOSPITAL INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 560928089 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH TRIAD REGION LLC | 0 | |
| FOUNDATION HEALTH SYSTEMS CORP | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561373175 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | NOVANT HEALTH INC | 0 | |
| MEDICAL PARK HOSPITAL INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561340424 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH TRIAD REGION LLC | 0 | |
| NOVANT HEALTH INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561376950 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | 0 | N/A | |
| NOVANT MEDICAL GROUP INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 581728803 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NMG SERVICES LLC | 0 | |
| PERSONAL CARE SERVICES | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 541291284 | HEALTHCARE | VA | 501(C)(3) | LINE 10 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| PRESBYTERIAN HOSPITAL FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 581413074 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC | 0 | |
| PRESBYTERIAN MEDICAL CARE CORPORATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561376368 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC | 0 | |
| PRINCE WILLIAM HEALTH SYSTEM | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 541278944 | HEALTHCARE | VA | 501(C)(3) | LINE 12C, III-FI | NOVANT HEALTH UVA HEALTH SYSTEM | 0 | |
| PRINCE WILLIAM HOSPITAL | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 540696355 | HEALTHCARE | VA | 501(C)(3) | LINE 3 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| PWHS FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 541307595 | HEALTHCARE | VA | 501(C)(3) | LINE 7 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| ROWAN HEALTH SERVICES CORPORATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561424814 | HEALTHCARE | NC | 501(C)(3) | LINE 12C, III-FI | NOVANT HEALTH INC | 0 | |
| ROWAN REGIONAL MEDICAL CENTER AUXILIARY | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 237022472 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | ROWAN REGIONAL MEDICAL CENTER INC | 0 | |
| ROWAN REGIONAL MEDICAL CENTER FOUNDATION INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561424818 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | ROWAN REGIONAL MEDICAL CENTER INC | 0 | |
| ROWAN REGIONAL MEDICAL CENTER INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 560547479 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | ROWAN HEALTH SERVICES CORPORATION | 0 | |
| SELF INSURANCE FUND - NOVANT HEALTH INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 581867242 | HEALTHCARE | NC | 501(C)(3) | LINE 12C, III-FI | NOVANT HEALTH INC | 0 | |
| THE PRESBYTERIAN HOSPITAL | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 560554230 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC | 0 | |
| NOVANT HEALTH UVA HEALTH SYSTEM | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 810868533 | HEALTHCARE | VA | 501(C)(3) | LINE 12A, I | NOVANT HEALTH INC | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CULPEPER SURGERY CENTER LLC | |||||||||||||
| 541 SUNSET LANE SUITE 201 | CULPEPER | VA | 22701 | 541975624 | HEALTHCARE | VA | CULPEPER MEMORIAL HOSPITAL INC | RELATED | $116,273 | $1,418,662 | 0 | 0 | 0.62670 |
| NH UVA HEALTH SYSTEM IMAGING CULPEPER LLC | |||||||||||||
| 840 CRESCENT CENTRE DR STE 200 | FRANKLIN | TN | 37076 | 843645484 | HEALTHCARE | TN | CULPEPER MEMORIAL HOSPITAL INC | RELATED | -$3,433,146 | $1,108,104 | 0 | Yes (1) | 0.80000 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| ADEPT HEALTH INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 562226937 | ADMIN SERVICES | NC | N/A | C | 0 |
| CHOICEHEALTH INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561896065 | MANAGED CARE | NC | N/A | C | 0 |
| COMMUNICARE INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561952950 | RENTAL REAL ESTATE | NC | N/A | C | 0 |
| KERNERSVILLE MEDICAL CENTER PARK OWNERS' ASSOCIATION | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 471511401 | RENTAL REAL ESTATE | NC | N/A | C | 0 |
| MEDQUEST INC & SUBSIDIARIES | |||||||||
| 3480 PRESTON RIDGE RD STE 600 | ALPHARETTA | GA | 30005 | 223860764 | DIAGNOSTIC IMAGING | DE | N/A | C | 0 |
| NOVANT HEALTH TRINOVA INSURANCE PROTECTED CELL INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 812963143 | INSURANCE | NC | N/A | C | 0 |
| SALEM DIAGNOSTICS INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561513621 | HEALTH RELATED | NC | N/A | C | 0 |
| SALEM HEALTH SERVICES INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561342654 | HEALTH RELATED | NC | N/A | C | 0 |
| THE PARK AT MONROE PROPERTY OWNERS ASSOCIATION INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 463910256 | RENTAL REAL ESTATE | NC | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| NOVANT HEALTH UVA HEALTH SYSTEM IMAGING CULPEPER LLC | ||
| R | $2,661,220 | CASH |
| CULPEPER SURGERY CENTER LLC | ||
| S | $250,689 | CASH |