2020-10-26T07:27:04-05:00 2019-12-31 346565596 ERNST & YOUNG US LLP 221 E 4TH ST SUITE 2900 CINCINNATI OH 45202 990 2019-01-01 541071867 INOVA HEALTH SYSTEM FOUNDATION INOV 7032892433 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 ALICE POPE CFO 7032892433 2020-10-19 1 JULIE L SPARKS P01268401 5136121400 167.201.243.109 2020-10-19 08:25:17 ED P 2C2748230AB9EBAEFF42548E528CDF4FEA525E48 115F918F5B3BFF6E5CFBECC689F621CD653AF3E4 2019 2021-01-29 14:40:06Z J STEPHEN JONES MD 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 839888813 0 X HTTPS://FOUNDATION.INOVA.ORG X 1977 VA IHSF, THE PARENT COMPANY OF INOVA HEALTH SYSTEM, OVERSEES AND COORDINATES THE ACTIVITIES OF INOVA HEALTH SYSTEM TO ENSURE THAT THEY FURTHER FOUNDATION'S AND SYSTEM'S TAX-EXEMPT PURPOSES AND SERVES AS A CHARITABLE FOUNDATION TO SUPPORT INOVA'S TAX-EXEMPT ENTITIES. 16 14 83 294 -10489938 -10570055 35854163 35038451 0 8593865 -187471546 757667868 16929392 20339210 -134687991 821639394 16033580 18453644 0 0 12019738 18947835 71910 281491 9839106 24649132 20979125 52774360 58662095 -187462351 762977299 4798487417 5727201448 2329865075 2404696208 2468622342 3322505240 X INOVA HEALTH SYSTEM FOUNDATION IS THE PARENT COMPANY OF INOVA HEALTH SYSTEM. INOVA HEALTH SYSTEM (INOVA) PROVIDES HEALTHCARE AND RELATED SERVICES THROUGHOUT NORTHERN VIRGINIA AND THE GREATER METROPOLITAN WASHINGTON, D.C. AREA, INCLUDING CERTAIN CONTIGUOUS COUNTIES OF VIRGINIA AND MARYLAND. 0 0 33287112 18453644 28426449 INOVA HEALTH SYSTEM FOUNDATION (IHSF), THE PARENT COMPANY OF INOVA HEALTH SYSTEM, IS A NON-STOCK, NOT-FOR-PROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. INOVA HEALTH SYSTEM (INOVA) PROVIDES HEALTHCARE AND RELATED SERVICES THROUGHOUT NORTHERN VIRGINIA AND THE GREATER METROPOLITAN WASHINGTON, D.C. AREA, INCLUDING CERTAIN CONTIGUOUS COUNTIES OF VIRGINIA AND MARYLAND.SINCE ITS INITIATION BY CITIZEN-VOLUNTEERS IN 1956, INOVA AND ITS AFFILIATES HAVE GROWN TO MEET THE CHANGING NEEDS OF A DIVERSE AND GROWING POPULATION. AS A NOT-FOR-PROFIT ORGANIZATION, INOVA DOES NOT HAVE SHAREHOLDERS. IT IS GOVERNED BY THE PEOPLE IT SERVES: MEMBERS OF THE COMMUNITY. THIS MODEL OF GOVERNANCE HELPS TO ENSURE THAT INOVA MEETS THE DIVERSE HEALTHCARE NEEDS OF THE COMMUNITY.IN KEEPING WITH INOVA'S COMMUNITY SERVICE MISSION, INOVA AND ITS AFFILIATES PROVIDE A WIDE RANGE OF PROGRAMS AND SERVICES WHICH DIRECTLY BENEFIT THE COMMUNITY THEY SERVE. THESE INCLUDE:PROVIDING THE HIGHEST QUALITY MEDICAL CARE TO ALL MEMBERS OF THE COMMUNITY, REGARDLESS OF THEIR FINANCIAL RESOURCES.PROVIDING FREE AND BELOW COST HEALTH SERVICES TO MEET THE IDENTIFIED NEEDS OF TARGETED COMMUNITY GROUPS, SUCH AS: THE INDIGENT AND ELDERLY; VICTIMS OF CANCER, HEART DISEASE, AND STROKE; PERSONS AFFECTED BY SUBSTANCE ABUSE; HIV-POSITIVE INDIVIDUALS; AND OTHERS. PROVIDING UNCOMPENSATED CARE IN ACCORDANCE WITH INOVA POLICIES WHICH ENSURE ACCESS TO MEDICALLY NECESSARY CARE FOR ALL INDIVIDUALS. CHARITY CARE IS DEFINED AS FREE OR DISCOUNTED HEALTHCARE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD TO PAY. INOVA HEALTH SYSTEM IS ONE OF THE LARGEST PROVIDERS OF UNCOMPENSATED CARE IN VIRGINIA. PROVIDING HEALTH EDUCATION AND A VARIETY OF OTHER SERVICES TO THE COMMUNITY.TRAINING HEALTH PROFESSIONALS AND PARTICIPATING IN MEDICAL RESEARCH ACTIVITIES. IHSF IS COMPRISED OF: INOVA HEALTH SYSTEM FOUNDATION (FOUNDATION), A PARENT COMPANY, WHICH ALSO SERVES AS A CHARITABLE FOUNDATION, RAISING FUNDS TO SUPPORT INOVA'S TAX-EXEMPT ENTITIES. THE FOUNDATION OPERATES IN ACCORDANCE WITH INOVA'S ARTICLES OF INCORPORATION, WHICH PROVIDE THAT ALL FUNDS RAISED, EXCEPT FOR THOSE REQUIRED FOR THE OPERATIONS OF THE FOUNDATION, BE DISTRIBUTED OR HELD IN SUPPORT OF THE CHARITABLE OBJECTIVES AND MISSION OF INOVA AND ITS TAX-EXEMPT SUBSIDIARIES. FUNDS RAISED ARE CHANNELED TO THE COMMUNITY IN THE FORM OF EXPANDED MEDICAL AND OTHER COMMUNITY SERVICES. DURING 2019, FOUNDATION FUNDS WERE USED TO SUPPORT INOVA'S CENTERS OF EXCELLENCE IN CANCER, CARDIOVASCULAR AND NEUROLOGICAL CARE, AS WELL AS THE LIFE WITH CANCER SUPPORT AND EDUCATIONAL PROGRAM AND THE FORENSIC ASSESSMENT CONSULTATION TEAM (FACT) PROGRAM. IN ADDITION, DONATED FUNDS WERE USED IN 2019 TO SUPPORT MANY OTHER INOVA PROGRAMS INCLUDING THE INOVA JUNIPER PROGRAM, INOVA CENTER FOR WELLNESS AND METABOLIC HEALTH, INOVACARES CLINICS FOR WOMEN AND CHILDREN, THE INOVA HEALTHY PLATE CLUB, THE INOVA KELLAR CENTER'S BEHAVIORAL SERVICES PROGRAM, SIMPLICITY HEALTH CLINICS, AND INOVA HEALTH ADVANTAGE PRIMARY CARE CLINICS.INOVA HEALTH CARE SERVICES (IHCS) IS A NOT-FOR-PROFIT CORPORATION THAT OPERATES HOSPITAL FACILITIES, PROGRAMS, AND OTHER SHARED SERVICE ARRANGEMENTS AND CARRIES ON EDUCATION AND RESEARCH ACTIVITIES. AS OF DECEMBER 31, 2019, IHCS OPERATED FOUR HOSPITALS, HAVING A TOTAL OF 1,669 LICENSED HOSPITAL BEDS IN FAIRFAX COUNTY, VIRGINIA - INOVA FAIRFAX HOSPITAL (FAIRFAX), INOVA MOUNT VERNON HOSPITAL (MOUNT VERNON), AND INOVA FAIR OAKS HOSPITAL (FAIR OAKS) AND IN ALEXANDRIA CITY - INOVA ALEXANDRIA HOSPITAL. EACH OF THESE HOSPITALS PROVIDES GENERAL ACUTE CARE SERVICES, INCLUDING EMERGENCY ROOM FACILITIES, INPATIENT AND OUTPATIENT SERVICES, AND A VARYING NUMBER OF ANCILLARY AND SPECIALIZED SERVICES BASED ON THE NEEDS OF THE COMMUNITY. IHCS AND ITS SUBSIDIARIES PROVIDE LONG-TERM CARE AND BEHAVIORAL HEALTH SERVICES. LONG TERM CARE IS PROVIDED THROUGH INOVA ASSISTED LIVING, A TRANSITIONAL LIVING FACILITIES PROVIDER AND THROUGH ELDERLINK, A COOPERATIVE PROGRAM PROVIDING CASE MANAGEMENT SERVICES TO OLDER ADULTS. INOVA HOUSE CALLS PROVIDES PRIMARY MEDICAL CARE TO HOMEBOUND PATIENTS ENSURING PATIENTS ARE ABLE TO AGE IN PLACE. IN ADDITION, COMPREHENSIVE ADDICTION TREATMENT SERVICES PROVIDES SERVICES TO ADULTS SUFFERING FROM ALCOHOL AND OTHER CHEMICAL DEPENDENCIES. THE KELLAR CENTER PROVIDES TREATMENT FOR CHILDREN AND ADOLESCENTS WITH SUBSTANCE ABUSE AND BEHAVIORAL AND EMOTIONAL PROBLEMS. IHCS IS ALSO THE PARENT COMPANY OF FOUR FREE-STANDING 24-HOUR EMERGENCY CENTERS, WHICH ARE AFFILIATED WITH ITS HOSPITALS, AND OPERATES THE INOVA RESEARCH CENTER, WHICH PROVIDES A QUALITY ARENA FOR PROFESSIONAL EDUCATION AND CLINICAL RESEARCH. IN ADDITION, IHCS OPERATES INOVA ALEXANDRIA FOUNDATION, A CHARITABLE FOUNDATION.LOUDOUN HOSPITAL CENTER (LHC) IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO PROMOTE THE HEALTH AND WELL-BEING OF LOUDOUN COUNTY, VIRGINIA, AND SURROUNDING AREAS. LHC OPERATES INOVA LOUDOUN HOSPITAL CENTER (A 183-BED HOSPITAL), LOUDOUN NURSING AND REHABILITATION CENTER, THE ASHBURN HEALTHPLEX, LOUDOUN HEALTHCARE FOUNDATION, AND OTHER HEALTHCARE RELATED FACILITIES.INOVA HOME HEALTH (IHH) TO PROVIDE HOME HEALTH SERVICES, INOVA HAS A JOINT VENTURE WITH ALTERNATE SOLUTIONS HEALTH NETWORK WHICH RESTRUCTURED THE MANAGEMENT OF THE INOVA VNA SERVICES. INOVA MAINTAINS 51% OWNERSHIP OF THE COMPANY, AND THE JOINT VENTURE IS NOW KNOWN AS INOVA HOME HEALTH (IHH).INTOTAL HEALTH, LLC WAS A MEDICAID MANAGED CARE HEALTH INSURANCE PLAN LICENSED BY THE COMMONWEALTH OF VIRGINIA. THE PLAN SERVED APPROXIMATELY 60,000 TEMPORARY ASSISTANCE FOR NEEDY FAMILIES, CHILDREN'S HEALTH INSURANCE PROGRAM RECIPIENTS, AND SUPPLEMENTAL SECURITY INCOME/AGED, BLIND AND DISABLED MEMBERS THROUGH THE MEDALLION 3.0 AND FAMILY ACCESS TO MEDICAL INSURANCE SECURITY PROGRAMS UNTIL THE PLAN WAS SOLD TO UNITED HEALTHCARE EFFECTIVE OCTOBER 31, 2017. THE PLAN VOLUNTARILY SURRENDERED ITS INSURANCE LICENSE EFFECTIVE DECEMBER 26, 2018 AND HAD NO MEMBERS AND NO ACTIVE BUSINESS DURING 2018 AND 2019.INOVA HOLDINGS, INC. (IHI) IS THE PARENT HOLDING COMPANY FOR VARIOUS TAXABLE ENTITIES WITHIN INOVA INCLUDING TECHNICAL DYNAMICS INC., A BIOMEDICAL EQUIPMENT MAINTENANCE AND ENGINEERING COMPANY. IHI AND ITS SUBSIDIARIES OPERATE FACILITIES PROVIDING A VARIETY OF HEALTH CARE AND SUPPORT SERVICES TO PATIENTS AND TO AFFILIATED HEALTH CARE PROVIDERS.PROGRAM SERVICESPHILANTHROPY IS CRITICAL TO INOVA'S MISSION. THERE ARE OVER 500 PHILANTHROPIC FUNDS IN INOVA'S FOUNDATION. THIS BROAD RANGE OF PHILANTHROPY HELPS INOVA STAY ON THE FOREFRONT OF MEDICAL ADVANCES, DEVELOP NEW PROGRAMS TO MEET CHANGING NEEDS, AND PROVIDE AFFORDABLE HEALTHCARE TO ALL WHO NEED IT. PROGRAMS SUPPORTED INCLUDE PARTNERSHIP FOR HEALTHIER COMMUNITIES (PHC), SERVING 21,000 CHILDREN AND FAMILIES IN 2019; THE INOVA JUNIPER PROGRAM SERVING OVER 1,700 PERSONS LIVING WITH HIV; AND THE LIFE WITH CANCER PROGRAM WITH 47,000 SERVICE HOURS SPENT WITH PATIENTS. FOUNDATION FUNDS ALSO SUPPORT MANY OTHER INOVA PROGRAMS INCLUDING THE INOVA CENTER FOR WELLNESS AND METABOLIC HEALTH, INOVACARES CLINICS FOR WOMEN AND CHILDREN, AND THE INOVA KELLAR CENTER'S BEHAVIORAL SERVICES PROGRAM.TOTAL SUPPORT PROVIDED IN 2019 TO THE COMMUNITY AND INOVA PROGRAMS WAS APPROXIMATELY $18.5 MILLION. 11722353 INVESTMENT MANAGEMENT FEES OF $11.7 MILLION ARE RELATED TO INVESTMENTS THAT INOVA HEALTH SYSTEM FOUNDATION UTILIZES TO PROVIDE HEALTHCARE AND RELATED SERVICES THROUGHOUT NORTHERN VIRGINIA AND THE GREATER WASHINGTON, D.C., METROPOLITAN AREA. THE FEES ARE CALCULATED BASED ON THE MARKET VALUE OF THE INVESTMENTS TIMES BASIS POINTS ESTABLISHED IN EACH CONTRACT. THE RATES ON THESE CONTRACTS APPLY UNTIL A NEW RATE IS NEGOTIATED. 2406194 THE FOUNDATION MAINTAINS AUXILIARY SERVICES AT THE HOSPITALS FOR THE PURPOSE OF OPERATING GIFT AND THRIFT SHOPS THAT PROVIDE SUPPORT TO THE HOSPITALS WITHIN THE SYSTEM. THE AUXILIARIES RECEIVE COMMISSIONS FROM VARIOUS FUNDRAISING ACTIVITIES. THE COST ASSOCIATED WITH THE AUXILIARIES WAS $2.4 MILLION IN 2019. 47415659 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 X 180 0 1 83 1 1 1 1 BR CA CI CO EZ DA FR HU GR IS JA MY HK PL KS TW TU MX EI UK 0 0 0 1 1 1 1 0 0 0 1 0 X 16 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X INOVA HEALTH SYSTEM FOUNDATION 7032892433 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 ANTHONY NADER CHAIRMAN 3.00 0.00 X X 0 0 0 PAUL SAVILLE TRUSTEE 3.00 0.00 X 0 0 0 NICHOLAS CAROSI TRUSTEE 4.00 0.00 X 0 0 0 SUDHAKAR KESAVAN TREASURER 3.00 0.00 X X 0 0 0 RENEE DESILVA TRUSTEE 3.00 0.00 X 0 0 0 WILLIAM DUDLEY SECRETARY 3.00 0.00 X X 0 0 0 ALAN DABBIERE TRUSTEE 3.00 0.00 X 0 0 0 MARK STAVISH TRUSTEE 3.00 0.00 X 0 0 0 DONNA MOREA TRUSTEE 3.00 0.00 X 0 0 0 MARK MOORE TRUSTEE 3.00 0.00 X 0 0 0 JACK EBELER TRUSTEE 2.00 2.00 X 0 0 0 KATE HANLEY TRUSTEE 3.00 0.00 X 0 0 0 PENELOPE GROSS TRUSTEE 3.00 0.00 X 0 0 0 WESLEY BUSH TRUSTEE 3.00 0.00 X 0 0 0 J STEPHEN JONES CEO, PRESIDENT 10.00 40.00 X X 3113435 0 278528 RICHARD MAGENHEIMER ASST TREASURER/CFO ENDING 6-4-19 7.00 43.00 X 2456488 0 60949 LORING FLINT EVP CHIEF MEDICAL OFFICER 5.00 45.00 X 1392340 0 63123 JOHN GAUL ASST SECRETARY/SVP GENERAL 6.00 44.00 X 0 1202570 182985 CONSUELO PILOT EVP CIO 10.00 40.00 X 1172857 0 35176 BENJAMIN FRANK COO CHIEF OF STAFF 10.00 40.00 X 1013873 0 89544 MARK STAUDER COO, ENDING 7/30/18 6.00 44.00 X 1061798 0 0 PETER JOBSE VP MANAGING DIRECTOR 40.00 0.00 X 873548 0 66051 TERRI FEELEY CHIEF PEOPLE OFFICER IHS 10.00 40.00 X 791363 0 129662 ALICE POPE ASST TREASURER/CFO BEGINNING 6-4-19 8.00 42.00 X 621102 0 21441 SAGE BOLTE PRESIDENT IHS FOUNDATION 40.00 10.00 X 0 444958 73224 TRICIA NGUYEN SVP CIN, FORMER, ENDING 9-30-18 40.00 0.00 X 502644 0 0 MADELINE ERARIO MD TRUSTEE 10.00 30.00 X 0 377472 60445 12999448 2025000 1061128 41 1 1 0 KILTEARN PARTNERS LLP 3 SEMPLE STREET EDINBURGH UK EH38BL INVESTMENT FEES 1503859 HARDING LOEVNER LP 400 CROSSING BLVD 4TH FLOOR BRIDGEWATER NJ 08807 INVESTMENT FEES 1192867 VULCAN VALUE PARTNERS LLC 2801 HWY 280 SOUTH SUITE 300 BIRMINGHAM AL 35223 INVESTMENT FEES 909809 TARGET MARKE TEAM 1200 ABERNATHY ROAD NE SUITE 1600 ATLANTA GA 30328 MARKETING 695877 NORTHERN TRUST 50 S LASALLE STREET CHICAGO IL 60603 INVESTMENT FEES 655282 25 X 3225 854052 34181174 1137098 35038451 MANAGEMENT FEE INCOME 541900 8593865 8593865 8593865 68080488 -10489938 78570426 705364752 66432 15843804 0 689520948 66432 689587380 689587380 1356945 854052 850319 506626 506626 14279418 1555296 12724122 12724122 INNOVATION HEALTH SEE SCHEDULE O 524298 7091846 7091846 INNOVATION HEALTH HOLDINGS LLC 524298 16616 16616 7108462 821639394 28426449 -10489938 768664432 18453644 18453644 6551945 6551945 10375160 5447177 552662 4375321 437802 262296 24766 150740 999574 570265 63059 366250 583354 234190 47588 301576 1060443 78426 52693 929324 182029 154886 25214 1929 281491 281491 11722353 11722353 2158606 1824040 296937 37629 116222 24899 4063 87260 686876 126394 20575 539907 277739 80251 13064 184424 1147217 972902 156499 17816 135836 64985 10579 60272 209638 31242 5086 173310 116 116 17752 14440 2351 961 22031 4438 723 16870 OTHER PURCHASED SERVICE 2434824 281606 47598 2105620 TAXES AND LICENSES 583937 490468 79847 13622 FOOD 112098 18793 3059 90246 INCOME TAX 95495 95495 15913 6019 967 8927 58662095 47415659 1407330 9839106 1047188 1145327 47128631 49448655 735328 843147 158225 189400 602732 180925 3805971 709294 2337762 3096677 1907437876 1910207951 2681409230 3589418992 157630445 172670374 4798487417 5727201448 2653254 4191406 2327211821 2400504802 2329865075 2404696208 X 2325569238 3158990019 143053104 163515221 2468622342 3322505240 4798487417 5727201448 X 762977299 100352559 -9446960 X X 0 1 X 1 0 X X 2 INOVA HEALTH CARE SERVICES 540620889 3 1 18453644 0 INOVA VNA HOME CARE INC 541277164 10 1 0 0 2 18453644 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25737576 406083 1591240 1941 187657 5700 27539601 26226400 151351 -390959 14077 122567 112572 25737576 21758119 2009250 2961353 431077 71245 26226400 19593177 1798279 840100 314405 159032 21758119 19921712 678087 -159295 86663 718276 42388 19593177 0.20000 0.80000 0.00000 0 0 2275486 2275486 40650 24888 15762 348714 327342 21372 665300 357064 308236 475821 475821 3096677 3589418992 F 3589418992 DUE TO SUBSIDIARIES AND AFFILIATES 2398381817 LEASE LIABILITY 2122985 2400504802 X PART V, LINE 4: THE INOVA HEALTH FOUNDATION MANAGES 47 INDIVIDUAL ENDOWMENT FUNDS. THE ENDOWED FUNDS PROVIDE STABLE FINANCIAL SUPPORT TO A WIDE VARIETY OF PROGRAMS AND INITIATIVES IN PERPETUITY, PLAYING A CRITICAL ROLE IN ENABLING INOVA TO ACHIEVE ITS MISSION. PROGRAMS AND INITIATIVES SUPPORTED BY ENDOWED FUNDS INCLUDE SCHOLARSHIPS FOR CLINICAL STAFF, PROFESSIONAL EDUCATION, PATIENT EDUCATION, RESEARCH, COMMUNITY OUTREACH PROGRAMS, AND OPERATIONAL AND CAPITAL NEEDS SUPPORT. PART X, LINE 2: FROM INOVA HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTS THAT INCLUDE INOVA HEALTH SYSTEM FOUNDATION: THE FOUNDATION, IHCS, AND LHC ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN DETERMINED TO BE EXEMPT FROM FEDERAL INCOME TAX UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. IHI AND ITS SUBSIDIARIES ARE TAXABLE ORGANIZATIONS. DEFERRED INCOME TAXES ARE PROVIDED FOR ALL SIGNIFICANT TIMING DIFFERENCES BETWEEN REVENUES AND EXPENSES REPORTED FOR FINANCIAL STATEMENT AND FOR TAX PURPOSES. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS. CENTRAL AMERICA AND THE CARIBBEAN INVESTMENT 1041682000 EUROPE/GUERNSEY INVESTMENT 21373000 EAST ASIA AND THE PACIFIC INVESTMENT 3720000 0 0 0 0 0 0 1066775000 0 1066775000 1 0 1 1 1 0 PART III ACCOUNTING METHOD: PART 1, LINE 3, COLUMN F ACCRUAL METHOD OF ACCOUNTING X X X X X X 1 MELISSA MCGEE 5478 ASHLEIGH ROAD FAIRFAX VA 22030 SPECIAL EVENT 0 889202 11770 861202 KATHY NEWMAN 6100 SADDLE HORN DRIVE FAIRFAX VA 22030 SPECIAL EVENT 0 889202 28000 877432 EXPERT EVENTS 123 S BROAD ST PHILADELPHIA PA 19109 SPECIAL EVENT 0 712845 232923 479922 ALLISON JOHNSON 19130 COTON HALL ST LEESBURG VA 20178 SPECIAL EVENT 0 215645 7311 208334 PATRICIA WATSON 19238 MILL SITE PLACE LEESBURG VA 20176 SPECIAL EVENT 0 215645 1487 214157 2922539 281491 2641047 VA MD DC FL WV INOVA HONORS 852845 309441 543404 59935 110609 27603 220427 LWC LOBSTER EXTRAVAGENZA 798856 245689 553167 72777 139991 26005 83749 4 559296 298922 260374 62152 1725 45346 2210997 854052 1356945 132712 312752 55333 349522 850319 506626 1 INOVA HEALTH CARE SERVICES 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 540620889 501(C)(3) 18453644 MULTIPLE GRANTS MADE TO FURTHER THE MISSION OF INOVA HEALTH CARE SERVICES OF PROVIDING QUALITY HEALTHCARE TO THE COMMUNITY. 1 0 PART I, QUESTION 2 THE FOUNDATION DONATED FUNDS TO ITS 501(C )(3) SUPPORTED ORGANIZATION, INOVA HEALTH CARE SERVICES, IN FURTHERANCE OF THE MISSION TO IMPROVE THE HEALTH OF THE DIVERSE COMMUNITY WE SERVE THROUGH EXCELLENCE IN PATIENT CARE, EDUCATION AND RESEARCH. EXPENDITURE OF SUCH FUNDS IS OVERSEEN BY THE FOUNDATION'S LEADERSHIP AND BOARD. X 0 0 X X X X X X 1 1 0 0 0 0 0 0 0 J STEPHEN JONES CEO, PRESIDENT 1653686 0 1440000 0 19749 0 253912 0 24616 0 3391963 0 240000 0 RICHARD MAGENHEIMER ASST TREASURER/CFO ENDING 6-4-19 439909 0 909995 0 1106584 0 58000 0 2949 0 2517437 0 1538308 0 LORING FLINT EVP CHIEF MEDICAL OFFICER 301911 0 978910 0 111519 0 58000 0 5123 0 1455463 0 498935 0 JOHN GAUL ASST SECRETARY/SVP GENERAL 0 663195 0 444754 0 94621 0 154406 0 28579 0 1385555 0 160177 CONSUELO PILOT EVP CIO 218248 0 553626 0 400983 0 32275 0 2901 0 1208033 0 349659 0 BENJAMIN FRANK COO CHIEF OF STAFF 264781 0 187840 0 561252 0 86398 0 3146 0 1103417 0 0 0 MARK STAUDER COO, ENDING 7/30/18 0 0 0 0 1061798 0 0 0 0 0 1061798 0 0 0 PETER JOBSE VP MANAGING DIRECTOR 512429 0 282694 0 78425 0 66051 0 0 0 939599 0 166798 0 TERRI FEELEY CHIEF PEOPLE OFFICER IHS 667310 0 120000 0 4053 0 98660 0 31002 0 921025 0 0 0 ALICE POPE ASST TREASURER/CFO BEGINNING 6-4-19 398650 0 141728 0 80724 0 3366 0 18075 0 642543 0 0 0 SAGE BOLTE PRESIDENT IHS FOUNDATION 0 323662 0 95704 0 25592 0 48733 0 24491 0 518182 0 6521 TRICIA NGUYEN SVP CIN, FORMER, ENDING 9-30-18 0 0 0 0 502644 0 0 0 0 0 502644 0 0 0 MADELINE ERARIO MD TRUSTEE 0 310176 0 65949 0 1347 0 57552 0 2893 0 437917 0 0 PART I, LINE 1A GROSS-UP PAYMENT MADE TO ALICE POPE FOR MOVING REIMBURSMENT TAXABLE AS COMPENSATION. PART I, LINE 3 THESE METHODS ARE PERFORMED BY INOVA HEALTH SYSTEM FOUNDAION, WHICH USED: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY FORM 990 OF OTHER ORGANIZATIONS APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINES 4A-B SEVERENCE: MARK STAUDER $1,061,798 BENJAMIN FRANK $555,296 CONSUELO PILOT $394,482 TRICIA NGUYEN $502,643 SEVERANCE AMOUNTS WERE PAID WITHIN 24 MONTHS AFTER SEPARATION FROM SERVICE. SERP PLAN PAYMENTS: RICHARD MAGENHEIMER - $108,398 SAGE BOLTE - $24,528 LORING FLINT - $106,145 JOHN GAUL - $90,845 PETER JOBSE - $50,901 THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP PLAN) IS A NONQUALIFIED RETIREMENT PLAN. EMPLOYEES ELIGIBLE TO PARTICIPATE ARE AT LEVEL OF ASSISTANT VICE PRESIDENT AND ABOVE. EACH YEAR, A CERTAIN PERCENTAGE OF EACH PARTICIPANT'S BASE SALARY IS CONTRIBUTED TO THE SERP PLAN. THIS AMOUNT RANGES FROM 5% TO 20%, DEPENDING ON POSITION. AFTER THREE YEARS OF CONTINUOUS PARTICIPATION, PARTICIPANTS VEST IN 50% OF THEIR BALANCE AT THAT TIME AND ARE PAID OUT THE VESTED BALANCE AS A TAXABLE EVENT. AFTER A TOTAL OF SIX YEARS PARTICIPATION, PARTICIPANTS ARE 100% VESTED AND ARE PAID OUT THEIR REMAINING BALANCE AS A TAXABLE EVENT. VESTING THEN REVERTS TO A THREE-YEAR ROLLING SCHEDULE UNTIL YEAR 12. THEREAFTER, THE ANNUAL CONTRIBUTION IS PAID OUT TO THE PARTICIPANT EACH YEAR AS A TAXABLE EVENT. X 7 2825 MARKET VALUE X 33862 RESALE VALUE X 463722 RESALE VALUE X 42 14391885 MARKET QUOTE X 11 2704 MARKET VALUE X 35 16719 MARKET VALUE X VACATION PACKAGE 19 48214 MARKET VALUE X GIFT CERTIFICATES 130 40353 MARKET VALUE X EVENT TICKETS 33 19926 MARKET VALUE 1 0 1 0 PART V, QUESTION 1A AND 2A - NUMBER OF FORMS 1099 AND EMPLOYEES THE ORGANIZATION FILES ITS FORMS 1099 UNDER A SUBSIDIARY ENTITY AND DOES NOT REPORT ANY EMPLOYEE COMPENSATION UNDER ITS OWN EIN. THE ORGANIZATION FALLS UNDER A MASTER PAY AGENT AND DOES NOT FILE ANY PAYROLL RETURNS UNDER ITS OWN EIN, HOWEVER ALL REQUIRED RETURNS HAVE BEEN FILED ON TIME. FORM 990, PART VI, SECTION A, LINE 1 WITH THE EXCEPTION OF THE DUTIES AND RESPONSIBILITIES THAT ARE RESERVED TO THE BOARD OF TRUSTEES AS REQUIRED BY LAW, THE EXECUTIVE COMMITTEE IS APPOINTED BY THE BOARD TO SUPPORT THE BOARD OF TRUSTEES IN THE PERFORMANCE OF ITS DUTIES AND RESPONSIBILITIES THAT ARE TIME-SENSITIVE AND MUST BE ADDRESSED BEFORE THE NEXT REGULARLY SCHEDULED MEETING OF THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED AND PROVIDED TO THE CHIEF ACCOUNTING OFFICER AND EXTERNAL TAX CONSULTANTS FOR INITIAL REVIEW. AFTER THE REVIEW IT IS GIVEN TO THE CFO OF INOVA HEALTH SYSTEM FOR REVIEW AND COMMENT. THE FORM 990 IS PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES FOR THEIR REVIEW. UPON COMPLETION OF THE EXECUTIVE COMMITTEE REVIEW, IT IS PROVIDED TO THE FULL BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C YES, ANNUALLY THE ORGANIZATION DISTRIBUTES THE CONFLICT OF INTEREST POLICY TO ALL DIRECTORS, OFFICERS, TRUSTEES, AND KEY EMPLOYEES. THE ORGANIZATION REQUIRES THAT EACH DIRECTOR, OFFICER, TRUSTEE, AND KEY EMPLOYEE ACKNOWLEDGE THAT THEY HAVE READ, UNDERSTOOD, AND WILL ABIDE BY THE POLICY. EACH DIRECTOR, OFFICER, TRUSTEE, AND KEY EMPLOYEE IS REQUIRED TO COMPLETE AND SUBMIT AN ANNUAL CONFLICT OF INTEREST DISCLOSURE. THESE DISCLOSURES ARE BROAD AND REQUIRE THAT THE INDIVIDUAL LIST ANY BUSINESS RELATIONSHIPS OR PERSONAL RELATIONSHIPS WITH OTHER DIRECTORS, OFFICERS, TRUSTEES, AND KEY EMPLOYEES, AS WELL AS ANY RELATIONSHIPS WITH COMPETITORS, OR CURRENT OR POTENTIAL VENDORS OR CONTRACTORS. DISCLOSURE STATEMENTS ARE REVIEWED BY SENIOR MANAGEMENT AND ANY POTENTIAL CONFLICTS ARE DISCUSSED WITH GOVERNING BODY CHAIRMAN TO ENSURE THAT ANY MEMBER WHO MAY HAVE A CONFLICT DISCLOSES THEIR POTENTIAL CONFLICT, AND IS DISMISSED FROM RELATED DISCUSSIONS AND RECUSED FROM PARTICIPATION IN APPLICABLE DECISIONS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF ALL SENIOR MANAGEMENT POSITIONS IS EVALUATED ANNUALLY IN CONSIDERATION OF EACH MANAGER'S JOB CONTENT, SCOPE AND COMPLEXITY. COMPENSATION LEVELS FOR EXECUTIVES ARE REVIEWED BY AN INDEPENDENT EXTERNAL CONSULTANT TO ENSURE THAT REMUNERATION IS CONSISTENT WITH THE ORGANIZATION'S COMPENSATION PHILOSOPHY AND OBJECTIVES AND COMPETITIVE WITH OTHER LARGE COMPLEX HEALTH SYSTEMS. THE INDEPENDENT COMPENSATION CONSULTANT MAINTAINS NATIONAL BENCHMARK COMPENSATION DATABASES AND SURVEYS AND ALSO REVIEWS FORMS 990 OF COMPARABLE HEALTHCARE SYSTEMS TO DETERMINE MARKET LEVELS OF COMPENSATION. IN ADDITION, THE INOVA HEALTH SYSTEM'S CEO'S COMPENSATION IS REVIEWED ALONG WITH CERTAIN OTHER SENIOR EXECUTIVES AND APPROVED ANNUALLY BY AN INDEPENDENT GOVERNING BOARD. THE JOB REQUIREMENTS AND COMPLEXITY OF ALL OTHER MANAGEMENT POSITIONS ARE EVALUATED ANNUALLY USING NATIONALLY RECOGNIZED THIRD-PARTY SALARY SURVEYS TO ASSURE THAT THE COMPENSATION FOR SUCH POSITIONS IS CONSISTENT WITH EXTERNAL MARKET COMPENSATION COMPARISONS. SALARY RANGES ARE DEVELOPED FOR EACH MANAGEMENT POSITION CLASSIFICATION TO ENSURE THAT THE COMPENSATION LEVELS FOR THESE POSITIONS ARE CONSISTENT WITH THE ORGANIZATION'S COMPENSATION PHILOSOPHY AND WITH COMPETITIVE MARKET COMPARISONS. COMPENSATION FOR EMPLOYED PHYSICIANS IS REVIEWED AND APPROVED BY THE PHYSICIAN SERVICES EXECUTIVE COMMITTEE. THE COMMITTEE IS COMPRISED OF EXECUTIVE MANAGEMENT OF THE PHYSICIAN SERVICES GROUP. THE FAIR MARKET VALUE (FMV) COMPENSATION IS BASED ON FOUR NATIONALLY RECOGNIZED INDUSTRY PHYSICIAN COMPENSATION BENCHMARK SURVEYS (MGMA, AMGA, SULLIVAN & COTTER, KORN FERRY HAY GROUP). THE COMMITTEE ALSO UTILIZES INDEPENDENT CONSULTANTS TO PROVIDE FMV OPINIONS FOR POSITIONS THAT ARE NOT READILY AVAILABLE IN THE FOUR PUBLISHED BENCHMARK SURVEYS. THE CONSULTANTS' OPINIONS AND COMPENSATION SURVEY DATA ARE PRESENTED TO THE PHYSICIAN COMPENSATION COMMITTEE FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 INOVA HEALTH SYSTEM MAKES CERTAIN INFORMATION PUBLICLY AVAILABLE. INOVA'S CONSOLIDATED FINANCIAL STATEMENTS ARE POSTED ON THE ELECTRONIC MUNICIPAL MARKET ACCESS'S (EMMA) WEBSITE ON A QUARTERLY BASIS. INOVA'S GOVERNING DOCUMENTS ARE NOT CURRENTLY PUBLICLY AVAILABLE. WHILE THE CONFLICT OF INTEREST POLICY IS NOT SPECIFICALLY PUBLICLY DISCLOSED, INOVA'S CODE OF CONDUCT IS ON THE PUBLIC WEBSITE. SECTION II OF THE CODE OF CONDUCT DESCRIBES WHAT CAN CONSTITUTE A CONFLICT AND REQUIRES THAT POTENTIAL CONFLICTS BE REPORTED TO MANAGEMENT OR THE CHIEF COMPLIANCE OFFICER AND/OR INOVA'S LEGAL DEPARTMENT. THE CODE OF CONDUCT CONTAINS THE CONFLICT OF INTEREST PRINCIPLES, IS PART OF INOVA'S ORIENTATION AND ANNUAL COMPLIANCE TRAINING, AND IS AVAILABLE TO TEAM MEMBERS AND PHYSICIANS ON INOVA'S INTRANET WEBSITE. PART VIII, LINE 11B THE INNOVATION HEALTH HOLDINGS, LLC FORM K-1 DOES NOT INCLUDE THE EARNINGS FROM TWO 100% OWNED CORPORATE ENTITIES: INNOVATION HEALTH INSURANCE COMPANY INNOVATION HEALTH PLAN, INC. THE NET LOSS RELATED TO THESE TWO ENTITIES HAS BEEN RECORDED ON THIS LINE AND AS A FUND BALANCE ADJUSTMENT. FORM 990, PART XI, LINE 9: EQUITY EARNINGS IN SUBS 2,647,726. TRANSFERS -4,986,224. INNOVATION PARTNERSHIP NET LOSS 0. INNOVATION HEALTH NET LOSS -7,108,462. PART XII, LINE 2B AND 2C - AUDITED FINANCIAL STATEMENTS THE COMPANY IS PART OF THE INOVA HEALTH SYSTEM, A NOT-FOR-PROFIT INTEGRATED HEALTH CARE DELIVERY SYSTEM SERVING NORTHERN VIRGINIA AND SURROUNDING AREAS. THE COMPANY'S FINANCIAL STATEMENTS ARE CONSOLIDATED IN THE INOVA HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTS. INOVA HEALTH SYSTEM IS AUDITED ON AN ANNUAL BASIS BY A "BIG FOUR" INDEPENDENT PUBLIC ACCOUNTING FIRM. IN ADDITION, THEY ARE RESPONSIBLE FOR THE ISSUANCE OF A MANAGEMENT LETTER ENCOMPASSING EACH MEMBER OF THE CONSOLIDATED GROUP. THE FINANCE AND AUDIT COMMITTEE OF THE BOARD OF TRUSTEES OF INOVA HEALTH SYSTEM IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT, INCLUDING THE HIRING OF THE AUDIT FIRM, REVIEW AND APPROVAL OF AUDITED FINANCIAL STATEMENTS AND COMMUNICATION WITH THE EXTERNAL AUDITORS AT LEAST TWICE A YEAR WITHOUT THE PRESENCE OF INTERNAL MANAGEMENT. PART XII, LINE 3A - A-133 AUDIT THE COMPANY IS A PART OF THE INOVA HEALTH SYSTEM (IHS), A NOT-FOR-PROFIT INTEGRATED HEALTH CARE DELIVERY SYSTEM SERVING NORTHERN VIRGINIA AND SURROUNDING AREAS. IHS RECEIVES VARIOUS FEDERAL GRANTS. THESE GRANTS AND AWARDS ARE AUDITED AS PART OF THE CONSOLIDATED INOVA HEALTH SYSTEM UNIFORM GUIDANCE COMPLIANCE AUDIT. THE INOVA HEALTH SYSTEM'S FEDERAL GRANTS ARE AUDITED ON AN ANNUAL BASIS BY A "BIG FOUR" INDEPENDENT PUBLIC ACCOUNTING FIRM AND A "REPORT OF INDEPENDENT AUDITORS ON COMPLIANCE FOR EACH MAJOR PROGRAM; REPORT ON INTERNAL CONTROL OVER COMPLIANCE AND REPORT ON SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS REQUIRED BY THE UNIFORM GUIDANCE" IS ISSUED ON A CONSOLIDATED BASIS. THE FINANCE AND AUDIT COMMITTEE OF THE BOARD OF TRUSTEES OF INOVA HEALTH SYSTEM IS RESPONSIBLE FOR THE OVERSIGHT OF THE UNIFORM GUIDANCE AUDIT, INCLUDING THE HIRING OF THE AUDIT FIRM, REVIEW AND APPROVAL OF AUDITED FINANCIAL STATEMENTS AND COMMUNICATIONS WITH THE EXTERNAL AUDITORS DURING THE YEAR WITHOUT THE PRESENCE OF INTERNAL MANAGEMENT. 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