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 540620889 INOVA HEALTH CARE SERVICES 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 08:26:28 ED P 2C2748230AB9EBAEFF42548E528CDF4FEA525E48 115F918F5B3BFF6E5CFBECC689F621CD653AF3E4 2019 2021-01-29 14:40:06Z J Stephen Jones MD 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 3265079822 0 X INOVA.ORG X 1956 VA IHCS's mission is to maintain and operate hospitals that provide quality care to the community. 15 8 19441 2655 1832367 0 25548975 23202955 2919258895 3107559782 2332208 3088850 111812372 99530299 3058952450 3233381886 0 0 0 0 1488996899 1624356280 0 0 0 1404878780 1450396101 2893875679 3074752381 165076771 158629505 5112809613 5237587498 2537343840 2506644998 2575465773 2730942500 X IHCS was specifically chartered for the purpose of serving the health care needs of the community by establishing, maintaining, and operating hospital facilities, programs, and other shared service arrangements; carrying on health-related education activities; promoting and carrying on health-related scientific research; and engaging in activities designed and carried on to promote the general health of the community. IHCS includes a centralized System Office and the various unincorporated and incorporated subsidiaries which are described below.The unincorporated divisions of IHCS include: Inova Fairfax Medical Campus, Inova Mount Vernon Hospital, Inova Fair Oaks Hospital, Inova Alexandria Hospital, ACCESS of Reston, ACCESS of Fairfax, Inova Research Center, Assisted Living Facilities, Inova Physical Rehabilitation Services, Inova Urgent Care Centers, Inova Employee Assistance, and Behavioral Health and Addiction Treatment. 0 0 2569965868 3179165326 Inova Health Care Services (IHCS) is part of the Inova Health System whose mission is to serve the needs of the community by establishing, maintaining, and operating hospital facilities, programs, and other shared service arrangements; carrying on health-related education activities; promoting and conducting scientific research; and engaging in activities designed to promote the general health of the community. All five of Inova Health System's hospitals have been rated with 5 out of 5 stars in the most recent Centers for Medicare & Medicaid Services (CMS) Five-Star Quality Rating System report. Inova is the only health system in the country comprised of more than three hospitals where all are 5-star rated. A CMS five-star quality rating is based on extensive data that measures patient experience, infection rates, readmissions and mortality.IHCS includes a centralized System Office and the various unincorporated and incorporated subsidiaries. The unincorporated subsidiaries of IHCS include: Inova Fairfax Medical Campus, Inova Mount Vernon Hospital, Inova Fair Oaks Hospital, Inova Alexandria Hospital, ACCESS of Reston, ACCESS of Fairfax, Inova Research Center, Assisted Living Facilities, Inova Physical Rehabilitation Services, Inova Urgent Care Centers, Inova Employee Assistance, and Behavioral Health and Addiction Treatment.PROGRAM SERVICESAcute care services are provided on three campuses in Fairfax County and one campus in the City of Alexandria in Virginia. Services provided include emergency and trauma facilities, inpatient and outpatient services, and a variety of ancillary and specialized services. During 2019, IHCS admissions and observations cases totaled 112,206, outpatient visits totaled 387,800, emergency visits totaled 337,461 (30,260 of the total ER visits were at the Springfield Healthplex and 16,265 at the Lorton Healthplex) and deliveries totaled 16,505. The acute care program services provided by these hospitals are described more fully below. Inova Fairfax Medical Campus (IFMC) includes the Inova Heart and Vascular Institute, Inova Women's Hospital, Inova Fairfax Hospital for Children, and the Inova Schar Cancer Institute. The hospital, located in Central Fairfax County is a 948-licensed bed tertiary care hospital providing comprehensive medical and surgical services which include emergency/trauma, cardiac, transplant, cancer, obstetric, pediatric, neonatal, stroke, and extensive outpatient services. Inova Fairfax Hospital is the home of Northern Virginia's only level one emergency and trauma center and the state-of-the-art Women's and Children's Center. In addition, Inova Fairfax Hospital is a teaching hospital providing clinical training through medical residency, nursing, and paramedical education programs.Inova Mount Vernon Hospital (IMVH) is a 237-licensed bed acute-care hospital serving Southeastern Fairfax County. Inova Mount Vernon Hospital provides a full-service, 24-hour emergency department; broad range of diagnostic, medical, and surgical services; inpatient psychiatric services; the Dorothea R. Fischer Wound Healing Center, and a specialized hyperbaric oxygen therapy program used to treat conditions requiring increased oxygen flow to body tissues (such as grafts and certain types of burns). Inova Mount Vernon Hospital also operates the Lorton Healthplex, a 24-hour free standing emergency facility and the Inova Center for Rehabilitation, a nationally-known accredited program providing inpatient and outpatient rehabilitative services.Inova Fair Oaks Hospital (IFOH) is a top-ranked 182-bed acute care community hospital serving the rapidly growing suburbs of Northern Virginia. Signature service lines include spine, weight loss, joint replacement, and minimally invasive surgery. State-of-the-art cancer care and maternity services are also signature offerings. Inova Fair Oaks Hospital is a fully accredited Comprehensive Center for Bariatric Surgery and a designated Center of Excellence in Minimally Invasive Gynecology.Inova Alexandria Hospital (IAH) is a 302-licensed bed general acute care hospital, which opened on January 23, 1873. Inova Alexandria Hospital provides a spectrum of diagnostic services, including full-body CT scanning, MRI, and a cardiac catheterization laboratory; a variety of inpatient medical, surgical, and orthopedic services; comprehensive outpatient services, including outpatient surgery, physical medicine, and rehabilitation; and a 24-hour emergency department as well as the Springfield Healthplex, a free standing emergency facility. In addition, specialized obstetric and pediatric services are provided by the hospital's Maternal and Infant Health Center and a children's unit. Specific acute care programs include:Cardiovascular Care: Inova Fairfax Medical Campus (IFMC) is the flagship campus for Inova Heart and Vascular Institute (IHVI). Inova Heart and Vascular Institute's clinical capabilities cover the full spectrum of complex cardiovascular and pulmonary care from medical evaluation and diagnostic testing to the most innovative minimally invasive surgical techniques and complex open surgeries. IHVI at IFMC houses 192 inpatient beds, five cardiovascular operating rooms, an 11-room cardiac catheterization / electrophysiology / interventional radiology suite, 64-slice CT scanner and other diagnostic testing, outpatient clinics, cardiac rehabilitation and educational facilities. Services offered include cardiac diagnostic services, cardiac imaging, cardiac catheterization, interventional cardiology, electrophysiology, cardiothoracic surgery and complex airway interventions, structural heart services, vascular surgery, vascular and interventional radiology, advanced lung disease and transplant program, cardiac and respiratory failure program, heart failure and transplant program and cardiac rehab. Additionally, in 2019 IHVI faculty had over 250+ publications in peer-reviewed journals in the past year, a high level of engagement and participation in major meetings and conferences throughout the world, and major growth in clinical trial enrollment. Finally, Inova's BioCore Laboratories were recently established for clinical and research testing. IHVI works with industry and a community of researchers to prioritize clinical problems in need of new treatments to help investigators expand the domain of in-vitro diagnostics. The Inova Heart & Vascular Institute had over 163,000 patient visits in 2019 at its 5 hospitals, 29 ambulatory offices, and 12 non-invasive cardiovascular imaging and diagnostic service locations. Women's Health: The Inova Women's Health program is the largest such program in the Mid-Atlantic region, providing services for over 16,000 births each year. Obstetric services provided include: delivery services, high risk prenatal services, inpatient and outpatient obstetrics/gynecologic surgery, and regular and specialty nursery care. Inova Fairfax Hospital was ranked 13th in the nation by U.S. News & World Report for Gynecology. IFMC provides obstetric services to low-income patients through the InovaCares Clinic for Women with 36,486 visits in 2019. In addition, IAH works with the Casey Clinic, a State health clinic jointly funded by the State of Virginia, the City of Alexandria and the Alexandria Health Department, providing obstetric services to low-income patients.Pediatrics: Inova Children's Hospital is Northern Virginia's only children's hospital, and a regional tertiary and quaternary referral center with 226 licensed acute care beds, providing the highest level of care. Inova Children's Hospital is home to the only Pediatric Intensive Care Unit and Pediatric Trauma Center in the region, as well as the region's only Level IV Neonatal ICU. In 2019, Inova Children's Hospital treated nearly 50,000 children in its Pediatric Emergency Department, more than 12,000 children in inpatient units, and performed more than 4,500 surgeries. Inova Children's provides a complete range of expert, subspecialized children's services in more than 40 subspecialties, including pediatric cardiac surgery, pediatric cancer care, pediatric orthopedics and sports medicine, pediatric spine surgery, pediatric neurology and neurosurgery. As of December 31, 2019, NICU bassinets numbered 108 and total bassinets was 143. Inova Children's provides a primary care medical home for children of low income families that are uninsured or on Medicaid through the InovaCares Clinic for Children which in 2019 provided 27,410 visits at an unreimbursed cost of $819,609. 37498326 19642682 Inova Research Center - Medical StudentsThe Inova Research Center (IRC), including research and academic activities, is centered on the Inova Fairfax Medical Campus. In 2019, the Inova campus of the Virginia Commonwealth University School of Medicine had a total of 27 third year and 30 fourth year medical students who spent their clerkship years at Inova Fairfax Medical Campus. In addition, 471 students came to Inova hospitals for a four week rotation in 2019. Pharmacy Students and ResidentsAlso located on the Inova campus is the VCU School of Pharmacy which partners with clinicians and practitioners across Inova and Northern Virginia to help educate and train an increasing number of pharmacy students each year. In 2019, 56 second, third and fourth year pharmacy students completed didactic and experiential learning experiences across Northern Virginia with the Inova Health System. Pharmacy practitioners precepted nearly 125 Introductory Pharmacy Practice Experiences (IPPEs) and Advanced Pharmacy Practice Experiences (APPEs), with the great majority of students from the VCU School of Pharmacy and a smaller contingent from other colleges of pharmacy. With the advent of the Shenandoah School of Pharmacy at the Inova Center for Personalized Health beginning in 2017, approximately 70 students completed over 100 experiential rotations across the Inova Health System during the 2018-19 academic year.In addition, there are pharmacy post-graduate training opportunities offered at three Inova institutions. Inova Fairfax Medical Campus offers 5 PGY-1 Pharmacy Practice Residency positons, as well as a PGY-2 Emergency Medicine Pharmacy Residency position and a PGY-2 Critical Care Residency position. Inova Alexandria and Inova Mount Vernon Hospitals each offer 2 PGY-1 Pharmacy Practice Residency positions, for a total of ten post-graduate training opportunities across Inova Health System. There was also one PGY-2 Ambulatory Care residency position.The Claude Moore Health Education CenterThe Claude Moore Health Education Center on the campus of Inova Fairfax Medical Campus features 11,000 square feet of space dedicated to the educational needs of medical and nursing students as well as residents and fellows. This state-of-the-art center includes both medical and surgical simulation centers, enabling students to learn through hands-on experience. The Center also features a dedicated research floor to support the extensive activities of the Inova Research Center, where there are numerous active clinical trials, ongoing translational research and outcomes projects, many in partnership with universities and other research entities. The unreimbursed cost of these programs in 2019 was $17.9 million.Residents/FellowsInova sponsors accredited residency training programs in: Pediatrics, General Surgery, Internal Medicine, OB/GYN, Neurosurgery and Podiatry. In addition, Inova also sponsors accredited fellowships in Surgical Critical Care, Pediatric Emergency Medicine, Cardiology, and Bariatric surgery. Inova supports training programs from affiliates in Emergency Medicine, Psychiatry, Orthopedics, Ophthalmology, Family Practice, and medical and surgical specialties. In all, Inova trained 709 residents/fellows from 19 specialties in 2019. As a teaching facility, Inova Fairfax Medical Campus incurs typical, additional expenses associated with teaching facilities including physician teaching costs and resident salaries, the cost of maintaining higher levels of technology required to support a teaching program and charges resulting from extra tests ordered for instructional purposes. The unreimbursed cost of these programs in 2019 was $12.4 million. Inova Translational Medicine InstituteIn 2010, the Inova Translational Medicine Institute (ITMI), a not-for-profit research institute was created for research activities related to the innovative field of personalized medicine. Personalized medicine is a medical model that emphasizes the customization of healthcare to individual patients. It involves the use of genetic information about an individual patient. In 2011, ITMI collaborated with physicians from Fairfax Neonatal Associates to investigate the genetic causes of pre-term delivery. Findings were used to build a reference database of genomic and clinical information which will empower clinical genomic discovery. In 2012, ITMI started the Fairfax Childhood Longitudinal Study, which is investigating the genomic basis for childhood wellness and disease over the duration of the childhoods of over 3,000 children living in Northern Virginia. Institute members provide Medical Genetics and Genetic Counseling to newborns with congenital abnormalities as well as cancer patients with a family history concerning for a genetic basis of their disease. Based upon reprioritization for the organization and focus on clinical research, the decision was made to discontinue the institute on December 31, 2019. Each year, IHCS designates funds for the development and continuation of identified, accessible direct care programs and services benefiting those most in need in the community. Many of these programs and services are not billed to the patient or are provided at a fee structure below the actual cost of the service. In addition to providing the direct care subsidized service, Inova also provides disease-prevention programs, health and exercise classes, health education and health screenings and other programs within the community in support of the IHCS mission. In 2019 Inova provided over 250,000 people with health education, prevention and wellness programs, health fairs and screenings, and clinically related services resulting in over 130,000, visits for direct health care services at an unreimbursed cost of approximately $28.6 million. These services and programs are described below.Inova Cares Clinic for Women and ChildrenThe Inova Cares Clinic for Women (ICCW) was created in 1960 to serve the uninsured women of Fairfax County, offering a wide range of OB/GYN services for those in need. This program is a service offered to the community in collaboration with the Fairfax County Health Department, serving uninsured and low-income patients up to 400% of the Federal Poverty Level (FPL). The clinic works in partnership with the Fairfax County Health Department and Inova Fairfax Hospital to promote early and continuous prenatal care for the culturally diverse population who are its patients. Inova Cares Clinic for Women provides comprehensive outpatient obstetrical services and gynecological care as well as non-stress testing, and LEEP and colposcopy procedures at little to no cost to the patient. The clinic provides specialty gynecological care service as well, including maternal fetal medicine, Gyn/Onc, and Uro/Gyn. In addition to medical services, the clinic also provides support services including radiology, laboratory, genetic testing, diabetes management, case management, social work, family planning, and nutritional counseling. In 2019, ICCW provided over 36,486 patient encounters for over 4,000 patients, 2,446 newly established. Additionally, ICCW supported over 2,000 deliveries at Inova medical campuses. The Inova Cares Clinic for Children (ICCC) was created in 1993 as a response to the inability of uninsured or Medicaid mothers to secure an affordable medical home for their children. ICCC is recognized as an accredited Patient Centered Medical Home by the National Committee for Quality Assurance, and serves as a medical home for newborns up to 21 years of age. The Inova Cares Clinic for Children provides comprehensive pediatric services that includes well-child care, immunizations, episodic care (sick visits), and school/sports physicals, immunizations, and nutritional counseling. In 2019, the InovaCares Clinic for Children provided 27,410 clinical services to over 7,700 patients, 2,492 newly established.Inova Alexandria Hospital (IAH) OB ClinicIAH donates space on the campus to the Casey Clinic, a community health center funded by the State of Virginia, Alexandria Health Department and the City Of Alexandria to provide primary healthcare services to low-income and uninsured children and adults that are residents of the City of Alexandria. IAH funds the clinic physicians who provide OB patient prenatal examinations and delivery at Inova Alexandria Hospital. Inova Juniper Program, HIV Clinical and Education ServicesInova Juniper Program (IJP) provides outpatient primary medical care, mental health therapy, substance abuse counseling, pharmaceutical assistance, and medical case management services to 1,740 Ryan White funded persons living with HIV disease in the suburban Virginia region. To maximize accessibility for clients, services are provided at the main location in Fairfax, as well as six satellite clinics (Dumfries, Manassas, Mt. Vernon, Falls Church, Leesburg and Herndon), hospitals, homes and other community locations throughout the region.Major accomplishments of IJP for 2019 include:Served 1,740 patients living with HIV, providing 46,100 services.Provided 5,428 case management services to 688 Ryan White funded clients living with HIV. Provided 395 clients with mental health services and 33 clients with substance abuse outpatient care.Conducted 311 hours of education and capacity building reaching 1,129 participants.Conducted 488 HIV tests with seroprevalence of 0.8% across Northern Virginia.Successfully implemented prevention programs to support, motivate and educate the public and people living with HIV. Programs are targeted to incarcerated men and women, men who have sex with men, youth, and the general population. HIV testing, outreach groups, and patient navigation services are also provided.Life with CancerThe purpose of Life with Cancer (LWC), the psychosocial program of the Inova Schar Cancer Institute, is to enhance the quality of life of those individuals in the community affected by cancer. The program addresses specific adjustment to illness needs by providing individual and family counseling, support groups, educational seminars, integrative therapies, workshops on managing side effects, fitness classes and nutrition classes and consults. Additionally, LWC provides Oncology Nurse Navigator consultations on understanding diagnosis, treatments, side effects and living with advanced disease. Life with Cancer is generously supported primarily by the community, therefore all services, except psychiatry and some of the acupuncture and massage services, are available at no charge.In 2019, Life with Cancer conducted 3,347 educational classes, groups, and wellness programs for adults, children and adolescents with 17,540 visits. In addition, 24,814 counseling or educational consultation sessions were provided by the Oncology Therapists and Oncology Nurse Navigators serving 18,331 people. The total number of participants in programs/classes, groups and counseling in 2019 was 40,929 and Life with Cancer staff provided 47,334 service hours. In 2019, the Life With cancer pediatric oncology clinic staff provided clinical and educational support (inpatient and outpatient) to 3,216 children, teens and parents and held 4,425 support and education group sessions and counseling sessions.The LWC Connect Line, a critical touch point for patients and families provided information and access to care for 3,462 individuals in 2019.Inova Lions Eye ClinicAdministered by Inova Health System (IHS), the Ophthalmology Clinic provides ophthalmic specialty services to the indigent including treatment of glaucoma, retina, and cataracts. IHS provides a part-time ophthalmologist, an ophthalmic technician, and a receptionist for the clinic. The remaining physicians volunteer their services. In 2019, Inova Lions Eye clinics provided services to 1,537 unique patients with a total of 4,935 visits.Inova Geriatrics and Advanced IllnessThe Medical House Calls program is designed to help patients successfully "age in place" while reducing readmissions and overall cost. An interdisciplinary team provides comprehensive primary care in patient homes and assisted living facilities. Patients are generally 65 years of age or older and they have difficulty leaving home for medical appointments. Commonly, patients need the most help with multiple chronic illnesses, changes in functional ability, polypharmacy and frailty/debility. These primary care services are "high-touch" with intensive patient management and care coordination with an emphasis on advance care planning. The program staff leverages strong relationships with inpatient teams, hospice agencies, skilled nursing staff, physical therapy staff, occupational therapy staff, mental health counselors and county services for high-quality patient outcomes. In 2019 the program served 810 patients and completed 5,286 physician/nurse practitioner house calls in 47 zip codes across Northern Virginia. Approximately 2,000 nursing/social work encounters were also provided to support the patient population.ElderLink ElderLink is a non-profit partnership between Inova and the Fairfax Area Agency on Aging. ElderLink provides case management, care coordination, health and wellness programming, and caregiver support to older adults and their caregivers. ElderLink provided service to approximately 722 older adults and their caregivers in 2019. 2607464194 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 0 1 X 2738 0 1 19441 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 15 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X Inova Health Care Services 7032892433 8110 Gatehouse Road Suite 400W Falls Church VA 22042 JACK EBELER CHAIRMAN 2.00 2.00 X X 0 0 0 CHARLES BEARD JR SECRETARY 3.00 0.00 X X 0 0 0 SCOTT HAMBERGER TRUSTEE 1.00 2.00 X 0 0 0 JOHN COOK TRUSTEE 3.00 0.00 X 0 0 0 J STEPHEN JONES CEO 35.00 15.00 X X 0 3113435 278531 NANCY TAYLOR TRUSTEE 3.00 0.00 X 0 0 0 JAY TYROLER MD TRUSTEE 3.00 0.00 X 115000 0 0 PHIL NOLAN TRUSTEE 3.00 0.00 X 0 0 0 JILL MCCABE MD TRUSTEE 1.00 2.00 X 0 0 0 ROBERT TSIEN TRUSTEE 3.00 0.00 X 0 0 0 RICHARD MAGENHEIMER TREASURER-CFO, Ending 6-4-19 35.00 15.00 X 0 2456488 60949 JAMES ECKLUND DEPT CHAIR NEUROSCIENCE 40.00 0.00 X 1554601 0 172740 JOHN HAMILTON PHYSICIAN 40.00 0.00 X 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STEPHEN MOTEW CHIEF CLINICAL ENTERPRISE 40.00 0.00 X 0 739256 28721 ALICE POPE TREASURER-CFO, Beginning 6-4-19 35.00 15.00 X 0 621102 21441 PATRICK CHRISTIANSEN EVP CEO IFMC, FORMER, ENDING 11-4-18 40.00 0.00 X 0 613824 0 TONI ARDEBELL ASSOC CHIEF CLINICAL ENTERPRISE 40.00 0.00 X 468754 0 55840 MADELINE ERARIO MD TRUSTEE 30.00 10.00 X 377472 0 60445 JANIS CARUSO MD TRUSTEE 40.00 0.00 X 0 315586 53425 JOHN FITZGERALD PRES IFOH, FORMER, ENDING 12-31-18 40.00 0.00 X 306592 0 2214 DAVID QUIRKE EVP CIO 40.00 0.00 X 0 181721 18583 RASHID NAYYAR MD TRUSTEE 3.00 0.00 X 172297 0 0 KEITH STERLING MD TRUSTEE 2.00 1.00 X 160000 0 0 15064984 14221883 2068149 2577 1 1 0 RANDSTAD HEALTHCARE PO BOX 742689 ATLANTA GA 30374 STAFFING 39330174 CROTHALL SERVICES GROUP 955 CHESTERBROOK BLVD SUITE 300 WAYNE PA 19087 TRANSPORT/CLEANING 35008375 HITT CONTRACTING INC 2900 FAIRVIEW PARK DRIVE FALLS CHURCH VA 22042 CONSTRUCTION 33139237 SIRIUS COMPUTER SOLUTIONS INC 10100 REUNION PLACE UNIT 500 SAN ANTONIO TX 78216 IT CONSULTING 25381315 MEDTRONIC USA INC PO BOX 409201 ATLANTA GA 30384 TECHNOLOGY 22475803 862 17279504 5923451 23202955 Net Patient Service Revenue 622110 3087554072 3087554072 Inova Reston MRI Center LLC 621400 6547600 6547600 Northern Virginia Surgery Center 621400 4043228 4043228 Franconia-Springfield Surgery Cen 621400 3906306 3906306 Technical Dynamics, LLC 811000 2797205 2797205 2711371 2711371 3107559782 -121553 -121553 2597132 2597132 27655040 954301 21205334 749650 6449706 204651 6654357 204651 6449706 10356223 9742952 613271 613271 613271 OTHER OPERATING REVENUE 900099 83624321 81996605 1627716 COMMUNITY BLOOD SERVICES 900099 9251621 9251621 92875942 3233381886 3198808008 1832367 9538556 7647927 7647927 1358882629 1168030671 190851958 49893222 40863934 9029288 120991111 100399567 20591544 86941391 73778281 13163110 3325896 2019761 1306135 2939936 47831 2892105 423406 423406 233398752 232346736 1052016 10742978 3892258 6850720 29916410 16231048 13685362 42627380 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2607040789 2607464194 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 483780 700409 368341 423405 1975935 250000 250000 250000 250000 1000000 1500000 183106287 183106287 1406132020 623079405 783052615 1118698418 543794483 574903935 1559196966 1220435484 338761482 347149918 157282443 189867475 2069691794 OTHER ASSETS 21702438 DUE FROM SUBSIDIARIES AND AFFILIATES 1995955083 LONG TERM RIGHT OF USE 85952323 2103609844 THIRD PARTY SETTLEMENTS 31991486 SELF INSURED LIABILITY 25250987 INTEREST RATE SWAP LIABILITY 2976771 LEASE LIABILITY 93021729 153240973 X Part X, Line 2: From Inova Health System consolidated financial statements including Inova Health Care Services: 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. 1 1 X 1 X 400.000000000000 1 X 1 1 0 1 1 84325687 84325687 0.02770 332801777 143172639 189629138 0.06240 417127464 143172639 273954825 0.09010 11438991 446296 10992695 0.00360 13002203 603838 12398365 0.00410 17137598 3655485 13482113 0.00440 37498326 19642682 17855644 0.00590 4126188 4126188 0.00140 83203306 24348301 58855005 0.01940 500330770 167520940 332809830 0.10950 1 14428892 0 496864966 643784495 -146919529 X 1 1 1 Franconia-Springfield Surgery Center LLC Surgical Services 0.58210 0.41790 2 Northern Virginia Surgery Center LLC Surgical Services 0.61390 0.38610 3 Inova Ambulatory Surgery Center at Lorton LLC Surgical Services 0.65080 0.34920 4 McLean Ambulatory Surgery LLC Surgical Services 0.57500 0.42500 4 1 INOVA FAIRFAX HOSPITAL 3300 GALLOWS ROAD FALLS CHURCH VA 22046 INOVA.ORG VA H1921 X X X X X X A 2 INOVA ALEXANDRIA HOSPITAL 4320 SEMINARY ROAD ALEXANDRIA VA 22304 INOVA.ORG VA H1859 X X X A 3 INOVA FAIR OAKS HOSPITAL 3600 JOSPEH SIEWICK DRIVE FAIRFAX VA 22033 INOVA.ORG VA H1922 X X X A 4 INOVA MOUNT VERNON HOSPITAL 2501 PARKER LANE ALEXANDRIA VA 22306 INOVA.ORG VA H1923 X X X A Facility Reporting Group - A 0 0 1 X X X X X X X X X 19 1 1 0 1 X See line 10a for CHNA website X 1 19 1 www.inova.org/inova-in-the-community/index.jsp 0 1 X 400.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X https://www.inova.org/patient-and-visitor-information/financial-assistance X https://www.inova.org/patient-and-visitor-information/financial-assistance X https://www.inova.org/patient-and-visitor-information/financial-assistance X X X X X X X 1 X 0 X X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: INOVA FAIRFAX HOSPITAL, - Facility 2: INOVA ALEXANDRIA HOSPITAL, - Facility 3: INOVA FAIR OAKS HOSPITAL, - Facility 4: INOVA MOUNT VERNON HOSPITAL Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL Part V, Section B, line 3j: Question 3eInova Fairfax Medical Campus (IFMC) completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Eight areas were identified as the most significant health needs for the IFMC community: Chronic Conditions; Economic Stability; Healthcare Access; Injuries and Violence; Mental Health; Neighborhood and Built Environment; Obesity, Nutrition, and Physical Activity; and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, IFMC developed a three-year implementation strategy to address its community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on hospital expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, Inova Fairfax Medical Campus has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova hospitals, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual hospital locales, but also through a system approach across the entire northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each hospital region. The hospital's 3-year implementation strategy was approved by the Inova Health Care Services Board. Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL Part V, Section B, line 5: For Inova Fairfax Hospital :The Inova Fairfax Hospital CHNA adopts knowledge gained during the Fairfax County Health Department's CHA, as well as additional community input. As a part of the collaborative process leading this CHNA, the Fairfax County Health Director and Strategic Planner provided valuable insight and knowledge, and input was received from diverse sources including the local health departments, hospital staff, representatives of key community groups and individual community members.The Fairfax CHA examined a variety of other community assessments to extrapolate significant health needs and themes. The main tool utilized in this process was an analysis of these community assessments produced by key groups and partners in the community. Some assessments examined a broad range of health-related indicators, and others studied a specific program area or health-related issue. Diverse sectors of the community were broadly represented, and together these assessments provide a comprehensive profile of the Fairfax community. The 12 assessments included in the Fairfax County CHA were the following: Community Health DashboardFairfax County Youth SurveyFairfax County Human Services Needs AssessmentInova Community Health Needs AssessmentKaiser Permanente Community Health Needs Assessment,Community Assessment for Public Health Emergency ResponseFairfax Food Council Community Food AssessmentCulturally and Linguistically Appropriate Services SurveyEquitable Growth Profile of Fairfax CountyA Study in Contrasts: Why Life Expectancy Varies in Northern VirginiaFairfax County Park Authority Needs Assessment, The State of the Health Care Workforce in Northern Virginia. For more information on the Fairfax County CHA, visit www.fairfaxcounty.gov/livehealthy.Additionally, Inova staff gathered feedback from the Partnership for a Healthier FairfaxSteering Committee and the Fairfax County Multicultural Advisory Council through targeted focus group questions.Inova and the health departments gathered community input through a public survey promoted to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese [Mandarin], English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics, as well as health department facilities. Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL Part V, Section B, line 6a: Inova Fair Oaks HospitalInova Mt. Vernon HospitalInova Loudoun HospitalInova Alexandria Hospital Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL Part V, Section B, line 11: As of December 31, 2019, the hospital facility had just finalized its 2019 implementation strategy and was preparing to address the significant needs identified in its 2019 CHNA report. (See response to Part VI, line 2 for a description of the three priority areas of significant community health needs identified in the 2019 CHNA report and how the hospital facility will focus on meeting these needs over the next three years.) Accordingly, the following is a description of how the hospital facility took action in 2019 to meet the significant needs identified in its 2016 CHNA report and implementation strategy.BackgroundInova Fairfax Medical Campus (IFMC) conducted a Community Health Needs Assessment (CHNA) in 2016 to identify the significant health needs in its community, and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2017-2019. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts and improve public health.The Inova Fairfax Medical Campus team selected the following priority areas for the 2017-19 Implementation Strategy: Improve the Care and Conditions of Aging Adults, Improve Care and Access to Care for Individuals with Mental Health and Substance Abuse Needs, and Improve Cultural Competency and Inclusion.Update - Year ThreeUpon board approval of the 2016 CHNA and Implementation Strategy, the IFMC CEO assigned members of the senior leadership team to lead the efforts and convene work teams around each of the Implementation Strategy focus areas. Members of the work teams include representatives from the hospital (clinical leadership, behavioral health, case management, community health, and human resources) as well as representatives from local government agencies and other related community services. The groups have met at different times to collaborate on potential action steps.Through the work and collaboration of the work teams, much progress has been made, as described below.1. Inova's Program Outreach Administrator was the co-chair for the Health Workforce team of the Partnership for a Healthier Fairfax. This team worked on a project to improve outcomes for the diverse population served through education and outreach to providers about the use and importance of CLAS standards. In 2019, a curriculum based on the facilitated discussion of video stories sharing the lived experiences of diverse individuals in the healthcare system was completed. The three training modules have all been tested and piloted and are available for use throughout the community.2. Additionally, in March 2019, Inova hosted Healthcare Disparities Conference: The Culture of Health. More than 150 physicians, nurses, clinicians, and other healthcare workers turned out for the half-day symposium, which addressed how sociocultural barriers impact care for culturally and ethnically diverse patients, how to recognize and address implicit bias, and the diversity of experience and health inequities in Northern Virginia. Keynote speakers, along with a panel of local safety net providers, reviewed local, regional, and national health disparities data. They also shared community resources, and offered strategies to improve awareness, overcome bias, and elevate health outcomes for these populations.3. Cultural Competency begins with diversity and understanding at all levels. To address this from within, Inova initiated a system-wide Inclusion Council. This diverse council, led by Vice President of Human Resources Dave Marks, will be responsible for coordinating and ensuring systemness of Inova's diversity and inclusion (D&I) initiatives. The intent is to strengthen team members' sense of belonging at Inova to ensure every team member has a voice.4. One way that Inova continues to work to fill the gap in services for child and adolescent mental health is through the REACH program. REACH is an educational program for providers to learn how to use psychiatric medications with the pediatric patients in their offices. Every year Inova provides this training opportunity to pediatricians and nurse practitioners.5. The Inova Medical House Calls program is designed to help patients successfully "age in place" while reducing readmissions and overall cost. An interdisciplinary team provides comprehensive primary care in patient homes and assisted living facilities. Patients are generally 65 years of age or older and they have difficulty leaving home for medical appointments. These primary care services are "high-touch" with intensive patient management and care coordination with an emphasis on advance care planning. The program staff leverages strong relationships with inpatient teams, hospice agencies, skilled nursing staff, physical therapy staff, occupational therapy staff, mental health counselors, and county services for high-quality patient outcomes. In 2019, the Inova Medical House Calls program served 810 unique patients and completed 5,286 MD or NP house calls in 47 zip codes across Northern Virginia.6. ElderLink is a non-profit partnership between Inova, the Fairfax Area Agency on Aging, and the Alzheimer's Association, National Capital Area Chapter. ElderLink provides case management, care coordination, health and wellness programming, as well as support to patients returning from the hospital back to their home in the community, and caregiver support to older adults and their caregivers.7. 2019 was also a year of growth for the system's Hospital Elder Life Program (HELP). The program expanded from Inova Fairfax Hospital to include Inova Alexandria and Inova Fair Oaks. As a result, from 2018 to 2019 the number of patients served increased by 78%.8. HELP began using the Simulation Lab at Inova Fairfax Hospital to train volunteers across the system. Inova is one of the first HELP programs in the country to use this training method. Additionally, HELP opened the Geriatric Resource Center, an interactive addition to the Jacob D. Zylman Health Sciences Library located inside Inova Fairfax Hospital. The center provides geriatric-related consumer health information to anyone in the community, as well as free ElderLink consultations for Fairfax County residents. 9. As part of its focus to promote community health and education, Inova's Department of Population/Community Health provides small grants to not-for-profit organizations. One of these grants was to Insight Memory Care Center, where funds will help support the organization's adult day respite care program. IMCC is the only licensed adult day center in Northern Virginia dedicated to enhancing the lives of individuals with Alzheimer's disease and related dementias as well as their caregivers and families.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's implementation strategy focuses on meeting the priority and specified community health needs described above. Certain issues, such as access to dental care, affordable housing, and the physical environment are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Other topics, such as diabetes, hypertension, obesity, and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system. Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL Part V, Section B, line 13h: Calculate family size Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL Part V, Section B, line 16j: Financial Aid Brochures explaining the charity policy are available through out the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website. Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL Part V, Section B, line 3j: Question 3eInova Alexandria Hospital (IAH) completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Ten areas were identified as the most significant health needs for the IAH community: Chronic Conditions; Economic Stability; Healthcare Access; Injuries and Violence; Mental Health; Neighborhood and Built Environment; Obesity, Nutrition, and Physical Activity; Oral Health; Sexual and Reproductive Health; and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, IAH developed a three-year implementation strategy to address its community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on hospital expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, Inova Alexandria Hospital has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova hospitals, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual hospital locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each hospital region. The hospital's 3-year implementation strategy was approved by the Inova Health Care Services Board. Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL Part V, Section B, line 5: For IAH:Throughout the CHNA/CHA, the Alexandria Health Department (AHD) and Inova worked with community partners and developed public meetings, pop-up events and targeted outreach plans to engage residents who are not always represented. Following are the core strategies AHD used to capture a wide variety of community perspectives and priorities. Inova was an active participant in these activities but relied on AHD core strength in community engagement to lead the process. Throughout the assessment, input was received from diverse sources including the local health department, hospital staff, representatives of key community groups and individual community members. The Community Health Assessment Steering Committee - comprised of community members - guided Alexandria's CHA focus, process and decision-making each step of the way. Through monthly meetings, this group advised AHD staff on outreach strategies, public meeting structure and how to prioritize data using equity as a primary lens. Organizations represented include:Alexandria Bicycle and Pedestrian Advisory CommitteeAlexandria City Public SchoolsAlexandria Commission for WomenAlexandria Commission on AgingAlexandria Commission on HIV/AIDSAlexandria Health DepartmentAlexandria Redevelopment and Housing AuthorityAlexandria School Health Advisory BoardCasa ChirilaguaEconomic Opportunities CommissionFriends of Alexandria Mental Health CenterFriends of Guest House Inova Health SystemMedical Reserve CorpsMotley FoolNeighborhood Health (FQHC)Northern Virginia Health FoundationPartnership for a Healthier AlexandriaTheater ChurchPublic MeetingsAHD hosted three community meetings to ensure transparency and engage community members in the CHA process. Meeting locations were selected deliberately for geographic diversity, proximity to public transit, and easy accessibility for those with limited mobility. AHD provided meals and interpreter services in Spanish, Arabic, and Amharic at all meetings. These public meetings were advertised through City of Alexandria media channels, local newspapers, Medical Reserve Corps volunteer flyer distribution, tabling at community events, and email outreach to various partners and other local government agencies.Kickoff and Creating a Vision for Health: April 26, 2018, First Baptist ChurchIntro to Data Collection: July 26, 2018, Durant Recreation CenterGathering Evidence and Examining Results: November 3, 2018, George Washington Middle SchoolBuilding a Healthier Alexandria Together: Community Health Assessment Report Release: June 26, 2019, Beth El Hebrew CongregationPhotoVoicePhotoVoice is a method to crowdsource information using pictures. AHD introduced the concept during the July 26, 2018 public meeting and asked attendees to submit photos that capture either what people are proud of in Alexandria or what could be improved. Participants could submit up to five photos with captions through email or text message. PhotoVoice participants submitted more than 70 pictures and captions. A subset of this group met on August 9, 2018 to discuss the images and sort them into categories. The resulting categories are: equitable access to green space, accessibility in our food system, community cohesion, children and youth, environment and mobility. A full gallery of the images are on Instagram@AlexHealthMatters.Public Health Pop-UpsDuring the Community Themes and Strengths Assessment (CTSA) public survey, AHD staff organized 26 public health pop-ups to collect surveys and promote the November 3, 2018 community meeting. These pop-up locations were selected to meet residents where they are and encourage survey participation from community members who may not be fully engaged in civic processes because of time, awareness, literacy, or language barriers. A combination of AHD employees and Medical Reserve Corps volunteers staffed all of the pop-ups, which were mostly held on evenings and weekends. Of the nearly 1,800 completed CTSA surveys, almost half were collected during public health pop-ups.In addition to the pop-ups, Inova and AHD staff worked with a number of local organizations to administer and collect surveys on their premises on an ongoing basis, such as the Department of Community and Human Services, the Alexandria Redevelopment and Housing Authority, Tenants and Workers United, and Casa Chirilagua. Finally, all AHD locations - 4480 King Street clinics and WIC, Teen Wellness Center at TC Williams, and the Casey Center - administered the survey to clients. Additionally, Inova promoted the online survey on its website and through community partners including safety net providers, social service agencies and others. Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL Part V, Section B, line 6a: Inova Fairfax HospitalInova Loudoun HospitalInova Fair Oaks HospitalInova Mt. Vernon Hospital Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL Part V, Section B, line 11: As of December 31, 2019, the hospital facility had just finalized its 2019 implementation strategy and was preparing to address the significant needs identified in its 2019 CHNA report. (See response to Part VI, line 2 for a description of the three priority areas of significant community health needs identified in the 2019 CHNA report and how the hospital facility will focus on meeting these needs over the next three years.) Accordingly, the following is a description of how the hospital facility took action in 2019 to meet the significant needs identified in its 2016 CHNA report and implementation strategy.BackgroundInova Alexandria Hospital (IAH) conducted a Community Health Needs Assessment (CHNA) in 2016 to identify the significant health needs in its community, and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2017-2019. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts, and improve public health.The Inova Alexandria Hospital team selected the following priority areas for the 2017-19 Implementation Strategy: Improve the Care and Conditions of Aging Adults and Improve Care and Access to Care for Individuals with Mental Health and/or Substance Abuse Needs.Update - Year ThreeMembers of the Community Health Services Division, IAH leadership, and community partners have been working diligently on the priority areas set forth in the 2016 CHNA Implementation Plan.Through the work and collaboration of diverse stakeholders, much progress has been made, as described below.1. As part of Inova's ongoing efforts to combat the opioid epidemic, Inova Alexandria Hospital's Emergency Department (ED) is partnering with the Alexandria Residential Treatment Center (ARTC) to help people struggling with opioid addiction. Physicians in the ED identify patients in acute opioid withdrawal and prescribe buprenorphine to alleviate the symptoms. The patient is then referred to ARTC to begin substance abuse treatment. Any Alexandria resident 18 or over is eligible to participate. ARTC provides round-the-clock structured clinical support to help end drug and alcohol addiction. In addition to sending opioid withdrawal patients directly to ARTC, the ED has referred many other opioid patients to the program.2. Additionally, IAH actively participates in an interagency opioid work group looking to coordinate efforts to address deterrence as well as treatment of opioid abuse across the City of Alexandria.3. Another way that Inova is working to fill the gap in services for child and adolescent mental health is through the REACH program. REACH is an educational program for providers to learn how to use psychiatric medications with the pediatric patients in their offices. Every year Inova provides this training opportunity to pediatricians and nurse practitioners.4. As part of its focus to promote community health and education, Inova's Department of Population/Community Health provides small grants to not-for-profit organizations. To further improve the health of the diverse communities that we serve, Inova provided one of these grants to the Carpenter Shelter to expand education opportunities for licensed mental health staff.5. The Inova Medical House Calls program is designed to help patients successfully "age in place" while reducing readmissions and overall cost. An interdisciplinary team provides comprehensive primary care in patient homes and assisted living facilities. Patients are generally 65 years of age or older and they have difficulty leaving home for medical appointments. These primary care services are "high-touch" with intensive patient management and care coordination with an emphasis on advance care planning. The program staff leverages strong relationships with inpatient teams, hospice agencies, skilled nursing staff, physical therapy staff, occupational therapy staff, mental health counselors, and city/county services for high-quality patient outcomes. In 2019, the Inova Medical House Calls program served 810 unique patients and completed 5,286 MD or NP house calls in 47 zip codes across Northern Virginia.6. 2019 was also a year of growth for the system's Hospital Elder Life Program (HELP). HELP offers assistance and activities at no charge that keep hospital patients mentally and physically active, which helps prevent confusion and preserves mental and physical functioning in older patients. This extra attention enhances patient comfort and helps them maintain their independence while hospitalized. It also lessens or prevents what is known as delirium. The program expanded from Inova Fairfax Hospital to include Inova Alexandria and Inova Fair Oaks. As a result, from 2018 to 2019 the total number of patients served by HELP increased by 78%.7. To better serve Northern Virginia's Medicaid population, Inova opened four new primary care clinics in the region. The Inova Health Advantage Clinics provide primary care services to adult Medicaid enrollees, including health maintenance and disease prevention, patient education and counseling, and treatment of acute and chronic medical conditions such as diabetes and hypertension. Extending medical insurance to low-income residents provides access to healthcare, earlier detection of serious illnesses, better care for existing health problems and improved ability to work, and the ability to attend school and live independently. It keeps patients healthy and out of the hospital, improving outcomes and reducing the overall cost of care. The new clinics are co-located with Inova's Simplicity Health Clinics in Alexandria, Annandale, and Sterling.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's implementation strategy focuses on meeting the priority and specified community health needs described above. Certain issues, such as access to dental care, are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Other topics, such as diabetes, hypertension, obesity, and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system. Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL Part V, Section B, line 13h: Calculate family size Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL Part V, Section B, line 16j: Financial Aid Brochures explaining the charity policy are available through out the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website. Group A-Facility 3 -- INOVA FAIR OAKS HOSPITAL Part V, Section B, line 3j: Question 3eInova Fair Oaks Hospital (IFOH) completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Seven areas were identified as the most significant health needs for the IFOH community: Chronic Conditions, Economic Stability, Healthcare Access, Injuries and Violence, Mental Health, Neighborhood and Built Environment, and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, IFOH developed a three-year implementation strategy to address its community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on hospital expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, Inova Fair Oaks Hospital has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova hospitals, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual hospital locales, but also through a system approach across the entire northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each hospital region. The hospital's 3-year implementation strategy was approved by the Inova Health Care Services Board. Group A-Facility 3 -- INOVA FAIR OAKS HOSPITAL Part V, Section B, line 5: For IFOH:The IFOH CHNA adopts knowledge gained during the Fairfax County Health Department's CHA, as well as additional community input. As a part of the collaborative process leading this CHNA, the Fairfax County Health Director and Strategic Planner provided valuable insight and knowledge, and input was received from diverse sources including the local health departments, hospital staff, representatives of key community groups and individual community members.The Fairfax CHA examined a variety of other community assessments to extrapolate significant health needs and themes. The main tool utilized in this process was an analysis of these community assessments produced by key groups and partners in the community. Some assessments examined a broad range of health-related indicators, and others studied a specific program area or health-related issue. Diverse sectors of the community were broadly represented, and together these assessments provide a comprehensive profile of the Fairfax community. The 12 assessments included in the Fairfax County CHA were the following: Community Health DashboardFairfax County Youth SurveyFairfax County Human Services Needs AssessmentInova Community Health Needs AssessmentKaiser Permanente Community Health Needs Assessment,Community Assessment for Public Health Emergency ResponseFairfax Food Council Community Food AssessmentCulturally and Linguistically Appropriate Services SurveyEquitable Growth Profile of Fairfax CountyA Study in Contrasts: Why Life Expectancy Varies in Northern VirginiaFairfax County Park Authority Needs Assessment, The State of the Health Care Workforce in Northern Virginia. For more information on the Fairfax County CHA, visit www.fairfaxcounty.gov/livehealthy.Additionally, Inova staff gathered feedback from the Partnership for a Healthier Fairfax Steering Committee and the Fairfax County Multicultural Advisory Council through targeted focus group questions.Inova and the health departments gathered community input through a public survey promoted to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese [Mandarin], English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics, as well as health department facilities. Group A-Facility 3 -- INOVA FAIR OAKS HOSPITAL Part V, Section B, line 6a: Inova Fairfax HospitalInova Mt. Vernon HospitalInova Alexandria HospitalInova Loudoun Hospital Group A-Facility 3 -- INOVA FAIR OAKS HOSPITAL Part V, Section B, line 11: As of December 31, 2019, the hospital facility had just finalized its 2019 implementation strategy and was preparing to address the significant needs identified in its 2019 CHNA report. (See response to Part VI, line 2 for a description of the three priority areas of significant community health needs identified in the 2019 CHNA report and how the hospital facility will focus on meeting these needs over the next three years.) Accordingly, the following is a description of how the hospital facility took action in 2019 to meet the significant needs identified in its 2016 CHNA report and implementation strategy.Inova Fair Oaks Hospital conducted a Community Health Needs Assessment (CHNA) in 2016 to identify the significant health needs in its community and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2017 - 2019. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts, and improve public health.The Inova Fair Oaks Hospital team selected the following priority areas for the 2017-19 Implementation Strategy: Increase Access to Dental Care and Decrease Childhood Obesity.Update - Year ThreeMembers of the Community Health Services Division, IFOH leadership and community partners have been working diligently on the priority areas set forth in the 2016 CHNA Implementation Plan.Through the work and collaboration of diverse stakeholders, much progress has been made, as described below.1. To prevent and reduce the incidence of nutrition-related diseases, Inova focused on several initiatives to reduce food insecurity and increase food literacy among community members. Specifically, Inova continued to match the purchases made by SNAP customers (formerly food stamps) at farmers markets, allowing low-income individuals to purchase more fresh produce.2. Inova continued to grow the Inova Healthy Plate Program, an 8-week school-based nutrition program provided to local Title I elementary schools and community programs. The Inova Healthy Plate Club (IHPC) aims to improve students' understanding of nutrition and the importance of healthy behaviors. In 2019, the Inova Healthy Plate Club graduated approximately 330 students from its 8-week cooking and nutrition class. IHPC also served more than 8,000 kids and parents through taste tests, parent classes, lessons during the school day, and more. In the IFOH community in particular, IHPC provided lessons during physical education classes at Centre Ridge Elementary School, and provided nutritional education activities at London Towne Elementary School throughout the day.3. As part of its focus to promote community health and education, Inova's Department of Population/Community Health provides small grants to not-for-profit organizations. One of these grants was to the Medical Care for Children Partnership Foundation, where funds will be used to provide uninsured children from birth to age 19 with comprehensive oral health and preventative care.4. Working with community partners to increase access and utilization of oral health services, Inova has several staff members in various roles on the Virginia Oral Health Coalition. Sub-groups are working on improving access, understanding the needs of children with special healthcare needs, and increasing education on the importance of oral health.5. To better serve Northern Virginia's Medicaid population, Inova opened four new primary care clinics in the region. The Inova Health Advantage Clinics provide primary care services to adult Medicaid enrollees, including health maintenance and disease prevention, patient education and counseling, and treatment of acute and chronic medical conditions such as diabetes and hypertension. Extending medical insurance to low-income residents improves access to healthcare, earlier detection of serious illnesses, better care for existing health problems, and improved ability to work, attend school, and live independently. It keeps patients healthy and out of the hospital, improving outcomes and reducing the overall cost of care. The new clinics are co-located with Inova's Simplicity Health Clinics in Alexandria, Annandale, and Sterling.6. Partnership for Healthier Communities (PHC) is Inova's longstanding initiative to connect children and adults to health insurance and quality healthcare services. PHC is located throughout the Northern Virginia region and works closely with local school systems, governments, and community outreach programs to provide comprehensive and culturally and linguistically appropriate assistance to a vulnerable population. To meet the needs of the increased population now eligible for Medicaid, PHC expanded outreach even further to help more people successfully enroll in Medicaid. In addition to expanded community outreach targeted at reaching previously ineligible adults, a PHC eligibility worker is now available at each Inova Health Advantage location to identify and assist individuals and families.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's implementation strategy focuses on meeting the priority and specified community health needs described above. Certain issues, such as lack of affordable housing and the physical environment are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Other topics, such as diabetes, heart disease, and hypertension are not covered individually as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system. Group A-Facility 3 -- INOVA FAIR OAKS HOSPITAL Part V, Section B, line 13h: Calculate family size Group A-Facility 3 -- INOVA FAIR OAKS HOSPITAL Part V, Section B, line 16j: Financial Aid Brochures explaining the charity policy are available through out the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website. Group A-Facility 4 -- INOVA MOUNT VERNON HOSPITAL Part V, Section B, line 3j: Question 3eInova Mount Vernon Hospital (IMVH) completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Eight areas were identified as the most significant health needs for the IMVH community: Chronic Conditions; Economic Stability; Healthcare Access; Injuries and Violence; Maternal, Infant, and Child Health; Mental Health; Neighborhood and Built Environment; and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, IMVH developed a three-year implementation strategy to address its community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on hospital expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, Inova Mount Vernon Hospital has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova hospitals, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual hospital locales, but also through a system approach across the entire northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each hospital region. The hospital's 3-year implementation strategy was approved by the Inova Health Care Services Board. Group A-Facility 4 -- INOVA MOUNT VERNON HOSPITAL Part V, Section B, line 5: For IMVH:The IMVH CHNA adopts knowledge gained during the Fairfax County Health Department's CHA, as well as additional community input. As a part of the collaborative process leading this CHNA, the Fairfax County Health Director and Strategic Planner provided valuable insight and knowledge, and input was received from diverse sources including the local health departments, hospital staff, representatives of key community groups and individual community members.The Fairfax CHA examined a variety of other community assessments to extrapolate significant health needs and themes. The main tool utilized in this process was an analysis of these community assessments produced by key groups and partners in the community. Some assessments examined a broad range of health-related indicators, and others studied a specific program area or health-related issue. Diverse sectors of the community were broadly represented, and together these assessments provide a comprehensive profile of the Fairfax community. The 12 assessments included in the Fairfax County CHA were the following: Community Health DashboardFairfax County Youth SurveyFairfax County Human Services Needs AssessmentInova Community Health Needs AssessmentKaiser Permanente Community Health Needs Assessment,Community Assessment for Public Health Emergency ResponseFairfax Food Council Community Food AssessmentCulturally and Linguistically Appropriate Services SurveyEquitable Growth Profile of Fairfax CountyA Study in Contrasts: Why Life Expectancy Varies in Northern VirginiaFairfax County Park Authority Needs Assessment, The State of the Health Care Workforce in Northern Virginia. For more information on the Fairfax County CHA, visit www.fairfaxcounty.gov/livehealthy.Additionally, Inova staff gathered feedback from the Partnership for a Healthier Fairfax Steering Committee and the Fairfax County Multicultural Advisory Council through targeted focus group questions.Inova and the health departments gathered community input through a public survey promoted to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese [Mandarin], English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics, as well as health department facilities. Group A-Facility 4 -- INOVA MOUNT VERNON HOSPITAL Part V, Section B, line 6a: Inova Loudoun HospitalInova Fairfax HospitalInova Fair Oaks HospitalInova Alexandria Hospital Group A-Facility 4 -- INOVA MOUNT VERNON HOSPITAL Part V, Section B, line 11: As of December 31, 2019, the hospital facility had just finalized its 2019 implementation strategy and was preparing to address the significant needs identified in its 2019 CHNA report. (See response to Part VI, line 2 for a description of the three priority areas of significant community health needs identified in the 2019 CHNA report and how the hospital facility will focus on meeting these needs over the next three years.) Accordingly, the following is a description of how the hospital facility took action in 2019 to meet the significant needs identified in its 2016 CHNA report and implementation strategy.Inova Mount Vernon Hospital (IMVH) conducted a Community Health Needs Assessment (CHNA) in 2016 to identify the significant health needs in its community, and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2017 - 2019. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts, and improve public health.The Inova Mount Vernon Hospital team selected the following priority areas for the 2017-19 Implementation Strategy: Improve the Care and Conditions of Aging Adults, Improve Care and Access to Care for Individuals with Mental Health and Substance Abuse Needs, and Decrease the Prevalence and Improve the Care of Individuals with Diabetes.Update - Year ThreeMembers of the Community Health Services Division, IMVH leadership, and community partners have been working diligently on the priority areas set forth in the 2016 CHNA Implementation Plan.Through the work and collaboration of diverse stakeholders, much progress has been made, as described below.1. One way that Inova is working to fill the gap in services for child and adolescent mental health is through the REACH program. REACH is an educational program for providers to learn how to use psychiatric medications with the pediatric patients in their offices. Every year Inova provides this training opportunity to pediatricians and nurse practitioners.2. To prevent and reduce the incidence of nutrition-related diseases, Inova focused on several initiatives to reduce food insecurity and increase food literacy among community members. Specifically, Inova continued to match the purchases made by SNAP customers (formerly food stamps) at farmers markets, allowing low-income individuals to purchase more fresh produce.3. Inova continued to grow the Inova Healthy Plate Program, an 8-week school-based nutrition program provided to local Title I elementary schools and community programs. The Inova Healthy Plate Club aims to improve students' understanding of nutrition and the importance of healthy behaviors. In 2018, the Inova Healthy Plate Club served over 270 students, including Hammond Middle School and a new program at John Adams Elementary Schools.4. Additionally, a community outreach initiative, the IMVH Continuum of Care Collaborative, was started in 2018. This team is comprised of partners who we interact with post-discharge (SNFs, home health, assisted living, Transitional Services Clinic, dialysis, hospice, etc.). The purpose is to provide for a smoother transition out of the hospital back to life and to reduce readmissions and mortality. 5. The Inova Medical House Calls program is designed to help patients successfully "age in place" while reducing readmissions and overall cost. An interdisciplinary team provides comprehensive primary care in patient homes and assisted living facilities. Patients are generally 65 years of age or older and they have difficulty leaving home for medical appointments. These primary care services are "high-touch" with intensive patient management and care coordination with an emphasis on advance care planning. The program staff leverages strong relationships with inpatient teams, hospice agencies, skilled nursing staff, physical therapy staff, occupational therapy staff, mental health counselors, and county services for high-quality patient outcomes.6. Additionally, one major issue in care for the growing older adult population has been a scarcity of options for primary care. To meet this need, Inova added a geriatrician in three of the Inova Medical Group primary care practices, one of which is in the IMVH community.7. ElderLink is a non-profit partnership between Inova, the Fairfax Area Agency on Aging, and the Alzheimer's Association, National Capital Area Chapter. ElderLink provides case management, care coordination, health and wellness programming, as well as support to patients returning from the hospital back to their home in the community, and caregiver support to older adults and their caregivers.8. To better serve Northern Virginia's Medicaid population, Inova opened four new primary care clinics in the region. The Inova Health Advantage Clinics provide primary care services to adult Medicaid enrollees, including health maintenance and disease prevention, patient education and counseling, and treatment of acute and chronic medical conditions such as diabetes and hypertension. Extending medical insurance to low-income residents improves access to healthcare, earlier detection of serious illnesses, better care for existing health problems, and improved ability to work, attend school, and live independently. It keeps patients healthy and out of the hospital, improving outcomes and reducing the overall cost of care. The new clinics are co-located with Inova's Simplicity Health Clinics in Alexandria, Annandale and Sterling.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's implementation strategy focuses on meeting the priority and specified community health needs described above. Certain issues, such as access to dental care and the physical environment are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Other topics, such as cultural competency, obesity, and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system. Group A-Facility 4 -- INOVA MOUNT VERNON HOSPITAL Part V, Section B, line 13h: Calculate family size Group A-Facility 4 -- INOVA MOUNT VERNON HOSPITAL Part V, Section B, line 16j: Financial Aid Brochures explaining the charity policy are available through out the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website. 46 1 - RADIOLOGY IMAGING ASSOCIATES LLC 19455 DEERFIELD AVENUE SUITE 102 LANSDOWNE VA 20176 IMAGING CENTER 2 - EMERGENCY CARE CENTER OF FAIRFAX 4315 CHAIN BRIDGE ROAD FAIRFAX VA 22030 EMERGENCY ROOM 3 - FRANCONIA SPRINGFIELD SURGERY CENTER LLC 6355 WALKER LANE SUITE 200 ALEXANDRIA VA 22310 OUTPATIENT SURGERY 4 - NORTHERN VIRGINIA SURGERY CENTER LLC 3620 JOSEPH SIEWICK DRIVE FAIRFAX VA 22033 OUTPATIENT SURGERY 5 - EMERGENCY CARE CENTER OF RESTON 11901 BARON CAMERON AVENUE RESTON VA 20190 EMERGENCY ROOM 6 - INOVA RESTON MRI CENTER LLC 2722 MERRILLE DRIVE SUITE 230 FAIRFAX VA 22031 MRI CENTER 7 - MCLEAN AMBULATORY SURGERY LLC 7601 LEWINSVILLE ROAD SUITE 440 MCLEAN VA 22102 OUTPATIENT SURGERY 8 - ASSISTED LIVING AT FAIR OAKS 3750 JOSEPH SIEWICK DRIVE FAIRFAX VA 22033 ASSISTED LIVING 9 - ASSISTED LIVING AT MCLEAN 8315 TURNING LEAF MCLEAN VA 22102 ASSISTED LIVING 10 - ASSISTED LIVING AT RESTON TOWN CENTER 1778 FOUNTAIN DRIVE RESTON VA 20190 ASSISTED LIVING 11 - KELLAR 11204 WAPLES MILL ROAD FAIRFAX VA 22030 BEHAVIORAL SERVICES 12 - ASSISTED LIVING AT MT VERNON 8033 HOLLAND ROAD ALEXANDRIA VA 22306 ASSISTED LIVING 13 - INOVA AMBULATORY SURGERY CTR AT LORTON 9321 SANGER STREET LORTON VA 22079 OUTPATIENT SURGERY 14 - ASSISTED LIVING AT GEORGE MASON 4300 CHAIN BRIDGE ROAD FAIRFAX VA 22030 ASSISTED LIVING 15 - INOVA URGENT CARE CTR - W SPRINGFIELD 6230 ROLLING ROAD SUITE J SPRINGFIELD VA 22152 URGENT CARE 16 - POTOMAC RADIATION ONCOLOGY 2296 OPITZ BLVD WOODBRIDGE VA 22191 RADIATION ONCOLOGY 17 - INSTITUTE OF RESEARCH AND EDUCATION 3300 GALLOWS ROAD FALLS CHURCH VA 22042 RESEARCH FACILITY 18 - INOVA URGENT CARE CTR - DULLES SOUTH 24801 PINEBROOK ROAD SUITE 110 CHANTILLY VA 20152 URGENT CARE 19 - ASHBURN OCCUPATIONAL HEALTH 21785 FILLAGREE CT SUITE 103 ASHBURN VA 20147 OCCUPATIONAL HEALTH 20 - INOVA URGENT CARE CTR - S ARLINGTON 3263 COLUMBIA PIKE ARLINGTON VA 22204 URGENT CARE 21 - INOVA URGENT CARE CENTER - VIENNA 180 MAPLE AVENUE WEST VIENNA VA 22180 URGENT CARE 22 - INOVA URGENT CARE CENTER - RESTON 1488 NORTH POINT VILLAGE CENTER RESTON VA 20194 URGENT CARE 23 - INOVA URGENT CARE CTR - CENTREVILLE 6201 CENTREVILLE ROAD SUITE 200 CENTREVILLE VA 20121 URGENT CARE 24 - INOVA URGENT CARE CTR - TYSONS CORNER 8357-E LEESBURG PIKE VIENNA VA 22182 URGENT CARE 25 - IAH OCCUPATIONAL HEALTH 4700 KING ST SUITE 201 ALEXANDRIA VA 22302 OCCUPATIONAL HEALTH 26 - INOVA PHYSICAL THERAPY - SPRINGFIELD 8348 TRAFORD LANE SUITE 100 SPRINGFIELD VA 22152 REHABILITATION 27 - INOVA PHYSICAL THERAPY CTR - VIENNA 8320 OLD COURTHOUSE ROAD SUITE 410 VIENNA VA 22182 REHABILITATION 28 - INOVA PHYSICAL THERAPY CTR- SPORTPLEX 6355 WALKER LANE SUITE 404 ALEXANDRIA VA 22310 REHABILITATION 29 - INOVA PHYSICAL THERAPY - CENTREVILLE 6201 CENTREVILLE ROAD SUITE 500 CENTREVILLE VA 20121 REHABILITATION 30 - INOVA PHYSICAL THERAPY CTR - ASHBURN 20905 PROFESSIONAL PLAZA SUITE 110 ASHBURN VA 20147 REHABILITATION 31 - INOVA PHYSICAL THERAPY CTR - FAIRFAX 8501 ARLINGTON BLVD SUITE 200 FAIRFAX VA 22031 REHABILITATION 32 - INOVA PHYSICAL THERAPY CTR - FAIROAKS 3620 JOSEPH SIEWICK DRIVE SUITE 101 FAIRFAX VA 22033 REHABILITATION 33 - INOVA URGENT CARE CTR - N ARLINGTON 4600-C LEE HIGHWAY ARLINGTON VA 22207 URGENT CARE 34 - INOVA PHYSICAL THERAPY - WOODBRIDGE 14605 POTOMAC BRANCH DRIVE SUITE 200 WOODBRIDGE VA 22191 REHABILITATION 35 - INOVA URGENT CARE CTR - PURCELLVILLE 7601 LEWINSVILLE ROAD SUITE 440 PURCELLVILLE VA 20132 URGENT CARE 36 - INOVA PHYSICAL THERAPY CTR - DULLES 24801 PINEBROOK ROAD SUITE 200 CHANTILLY VA 20152 REHABILITATION 37 - PRINCE WILLIAM OCCUPATIONAL HEALTH 8480 KAO CIRCLE MANASSAS VA 20110 OCCUPATIONAL HEALTH 38 - INOVA URGENT CARE CTR - DUNN LORING 2671 AVENIR PLACE SUITE A VIENNA VA 22180 URGENT CARE 39 - INOVA PHYSICAL THERAPY CTR-ALEXANDRIA 4700 KING ST SUITE 200 ALEXANDRIA VA 22302 REHABILITATION 40 - INOVA PHYSICAL THERAPY CTR- MT VERNON 8101 HINSON FARM ROAD SUITE 401 ALEXANDRIA VA 22306 REHABILITATION 41 - INOVA PHYSICAL THERAPY CTR - BALLSTON 1005 NORTH GLEBE ROAD SUITE 400 ARLINGTON VA 22201 REHABILITATION 42 - INOVA PHYSICAL THERAPY - VA SQUARE 3833 NORTH FAIRFAX DRIVE SUITE 300 ARLINGTON VA 22203 REHABILITATION 43 - INOVA URGENT CARE CENTER - MANASSAS 8051 SUDLEY ROAD MANASSAS VA 22109 URGENT CARE 44 - INOVA URGENT CARE CTR - WOODBRIDGE 14605 POTOMAC BRANCH DRIVE SUITE 200 WOODBRIDGE VA 22191 URGENT CARE 45 - CATS 3300 GALLOWS ROAD FALLS CHURCH VA 22042 BEHAVIORAL SERVICES 46 - INOVA PHYSICAL THERAPY - DUNN LORING 2740 PROSPERITY AVENUE SUITE 200 FAIRFAX VA 22033 REHABILITATION Part I, Line 3c: Catastrophic Financial Assistance: Catastrophic Financial Assistance is available for patients who do not qualify for free care based on the criteria above, who, due to the nature and extent of services provided, have significant care-related financial obligations in relation to household income and other potenally available resources. In such circumstances, the patient responsibility will be limited to the lesser of 30% of Family Income or the Amounts Generally Billed. Part I, Line 6a: THE COMMUNITY BENEFIT REPORT IS INCLUDED IN THE CONSOLIDATED INOVA HEALTH SYSTEM REPORT TO THE COMMUNITY ON INOVA.ORG WEBSITE. Part I, Line 7: Cost to charge ratio method is used based on table 2 in the instructions. Total operating expense is divided by Total Gross Revenue to arrive at the cost to charge ratio. Part I, Line 7g: Cost of Physician Clinic is $5,234,914. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 34,167,397. Part II, Community Building Activities: Inova's Office of Sustainability provides community building support focused on environmental improvements. Environmental Mission Statement:Inova Health System is committed to establishing an environmental program that is safer and healthier for patients, employees and the community.Community Building Environmental Improvements Waste ManagementInova has been focused on waste reduction strategies including recycling and segregation since 2008. Throughout the hospitals there is a single stream recycling process and there are focused efforts on reducing regulated medical waste. In 2019, Inova recycled or diverted approximately 2.5 million pounds of material from local landfills and waste to energy facilities.Specialized areas recycling/reuse: Inova has implemented specialized recycling programs to capture specific materials throughout the hospitals including a medical donation program that shipped 52,000 pounds of unused, unopened medical supplies and durable medical equipment to places in need both in local communities and to 29 countries across the globe.EnergyDuring 2019, Inova continued to make progress towards its energy goal of reducing energy use intensity (EUI) 20 percent by the year 2020 (baseline year 2012). A variety of projects including exterior lighting upgrades, specific interior lighting projects, HVAC improvements and energy monitoring, all continued throughout 2019. These efforts result in cost savings and improved resilience for the overall health of the community.WaterInova continues to maintain native plantings and low-impact irrigation systems for landscaping as well as reduce water consumption in our hospitals through the routine replacement of less efficient plumbing fixtures. BuildingsInova is currently working on a number of projects pursuing LEED certification including the Inova Center for Personalized Health along with Inova Fairfax Medical Campus. The goal of Inova's green building efforts is to ensure that our buildings are operated in the most efficient manner, leading to both operational savings as well as improved patient/employee outcomes. TransportationContinued collaboration with Fairfax County Department of Transportation to promote alternative commuting options for Inova employees resulting in fewer single-occupancy vehicle trips. The Inova Fairfax Medical Campus achieved the required mode-split again in 2019, with more than 18% of employees using some sort of alternative mode of transportation. Inova Mount Vernon hospital also has a mode-split requirement and 15% of employees there are using a form of alternative transportation. This is the result of employees taking public transportation, Employee Commuter Shuttles, carpools and some even biking or walking to work. These initiatives contribute to lower levels of air pollution and congestion as well as improvements to overall community health. FoodContinued to promote and serve local and sustainable foods throughout Inova hospitals with 21% of food spend categorized as sustainable. Inova hospitals continued to focus on purchasing meat without routine use of antibiotics. In 2019, 42% of meats served were certified as antibiotic free. These initiatives are important for the health of all patients and the community, and also support local farms. Sponsor of the Northern Virginia Chapter of Buy Fresh, Buy Local, a nationally recognized program that is dedicated to reintroducing Americans to their food - the seeds it grows from, the farmers who produce it, and the routes that carry it from the fields to their tables. In 2019, Inova launched a Community Supported Agriculture (CSA) Program to help our employee's access local and sustainable foods. Food is aggregated from local farmers and delivered directly to four hospital locations for weekly pick-ups.CommunityDistributed more than 500 native tree seedlings to be planted within the local community in 2019 in support of Earth Day.Mentored peer organizations locally and nationally as well as a variety of corporate clients on sustainable practices through a combination of formal speaking engagements, news article publications and informal discussions, helping them create safer environments for their patients, employees, and communities. Part III, Line 4: BAD DEBT FOOTNOTE FROM INOVA HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTSPatient accounts receivable include charges for amounts due from all patients less price concessions relating to allowances for the excess of established charges over the payments to be received on behalf of patients covered by Medicare, Medicaid and other insurers. The provision for price concessions is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the price concessions based upon historical experience of self-pay accounts receivable, including those balances after insurance payments and not covered by insurance. The results of this review are then used to make any modifications to the provision for price concessions. There have been no significant changes in the current year to the underlying assumptions used by IHS to estimate the allowance for price concessions. Patient accounts receivable are written off after collection efforts have been followed in accordance with IHS policies.All operating entities of IHS treat emergency patients and provide medically necessary treatment to patients regardless of their ability to pay. A patient is classified as a charity patient based upon established IHS' policies that consider patient income levels as well as other factors including credit histories and demographic information. Since IHS does not pursue collection of amounts that qualify as charity care, these amounts are deducted from gross revenue. Part III, Line 8: The organization does not treat any Medicare shortfall as community benefit. The amounts are taken directly from the Medicare Cost Reports as filed using a cost to charge ratio method. Part III, Line 9b: Patients who have not applied for Financial Assistance under this policy are subject to Inova's normal billing and collections processes.All patient responsibility portions of Inova's accounts will process through Inova's billing and collection systems for effective collections within federal guidelines. Patient responsibility portions will be processed through pre-billing, statement, and follow-up in automated and systematic steps. All collections actions will be in compliance with the Fair Debt Collection Practices Act and ACA International's Code of Ethics and Professional Responsibility.Patients will receive statements for 120 days. After 120 days, with no contact from the patient and without the establishment of acceptable payment terms, accounts will be transferred to a professional collection agency. If continued non-payment occurs beyond a reasonable period of time, Inova may take additional actions on the account.If a patient wishes to make payment arrangements and does not have resources to pay the account in full, the patient should make Inova aware of their situation and Inova will offer payment plans.No Inova entity or third-party collections agent will impose extraordinary collections actions ("ECAs") such as legal actions or adverse credit reporting against any patient, without first making reasonable efforts to determine whether that patient is eligible for Financial Assistance under this policy. These reasonable efforts include:Assuring that no ECAs are imposed for at least 120 days from the date of the first billing statement.Providing a 30-day written notice that includes information about Inova's Financial Assistance Policy and about any intended ECAs to be imposed in the event of nonpayment.Providing oral notification of any intended ECAs to be imposed in the event of nonpayment.If a patient is determined to be eligible for Financial Assistance after payment is received or after an ECA has been imposed, the account will be adjusted and the collections action will be reversed.The Vice President of Revenue Cycle Operations or his/her designee is responsible for determining whether Inova has made reasonable efforts to determine whether an individual is FAP-eligible and whether one or more ECAs may be imposed. PART III, LINE 2 AND 3 Actual bad debt expense is multiplied by the cost to charge ratio used in computing charity care expense in Part I. The provision for bad debts is recognized when providing an allowance for uncollectible accounts.There are no estimated amounts for bad debt expense attributable to patients under the organization's charity care policy. Part VI, Line 2: Inova Health System (IHS) completed a Community Health Needs Assessment (CHNA) in 2019 to identify priority health status and access issues for particular geographic areas and populations by focusing on the following questions: What are the biggest health challenges? Who is most affected? Where are the unmet needs for services? What are the health inequities?Inova's CHNA considers multiple data sources, including secondary data (regarding demographics, health status indicators, and measures of health care access), assessments prepared by other organizations in recent years, and primary data derived from a surveys of persons who represent the broad interests of the community, including those with expertise in public health.The following topics and data are assessed in Inova's CHNA report:Demographics, e.g., numbers and locations of vulnerable people;Economic issues, e.g., poverty and unemployment rates, and impacts of state or local budget changes;Community issues, e.g., homelessness, housing, environmental concerns, crime, and availability of social services;Health status indicators, e.g. morbidity rates for various diseases and conditions, and mortality rates for leading causes of death;Health access indicators, e.g., uninsured rates, discharges for ambulatory care sensitive conditions (ACSC), and use of emergency departments for non-emergent care;Health disparities indicators; andAvailability of healthcare facilities and resources. The assessment identifies a list of significant community health needs.As a result of this work and previous work, three priority areas will be the focus for the next three years. While the approach to addressing these areas may differ from one community to another, the system-wide selection of priority areas will add value to efforts in each region. The Director of Community Relations is coordinating plans with Inova and community leaders to ensure plans are implemented effectively and in partnership with existing frameworks and resources in each of the respective communities. The Director of Community Relations is centralized to the system under the Vice President of Population Health and thereby assures system coordinated efforts are centralized and reflective of Inova Health System's work across Northern Virginia.The various Public Health Departments also conduct community health assessments using the framework of the Mobilizing for Action through Planning and Partnerships (MAPP) process. Due to the timing of these processes, the information from the MAPP health needs assessments in the jurisdictions served by Inova Health System were incorporated differently into the community health needs assessment process and implementation plans in 2019. Fairfax and Arlington Health Departments conducted their own MAPP process and collaborated with Inova, Alexandria conducted its process jointly with Inova but reported separately, and the Loudoun MAPP process was conducted jointly with Inova. The MAPP process leads to an ongoing community-driven planning process that is designed to provide information for improving the community's delivery of the ten essential public health services. This process brings together a diverse group of key community stakeholders including local government, human service organizations, schools and universities, healthcare consumers, advocacy groups, hospitals, faith institutions, youth development organizations, economic and philanthropic groups, etc. to identify strengths and weaknesses in the ten essential areas to provide a foundation for community health planning. In addition to these activities, Inova is continually garnering feedback on existing safety net and community programs from participants through satisfaction surveys, focus groups, participating in regional and local health related groups such as the Northern Virginia Health Services Coalition, and meeting with various cultural and ethnic groups in the community. Internal utilization and outcomes data, review of best practices, regional and national benchmark data, and other external sources such as the Metropolitan Washington Council of Governments (COG) demographic data are used to develop strategic goals for health improvement activities. Collectively, all this information is utilized in assessing community health needs to guide strategic planning efforts. Part VI, Line 3: Inova Health System utilizes a multifaceted approach to educate and inform patients and the public about Inova's Financial Assistance Policy (FAP) or sometimes referred to as the charity care policy. Information regarding this policy is kept up to date on the Inova website and through signage. Upon admission to any Inova hospital or any visit to outpatient facilities or clinics including emergency departments, Inova has information posted regarding patient rights and responsibilities. In addition, Inova provides information about the charity care program and referrals to meet with Inova financial counselors who assist patients in completing Inova's charity care application. This financial information is reviewed by the Inova Patient Accounts Department with the patient contacted if additional information is required in order to make a determination. The patient is subsequently provided a letter, notifying them as to whether or not they qualify for charity care.Inova also has Medicaid eligibility workers on-site in all hospitals, in the Inova Cares Clinics (clinic for low income families) and in the community as part of the Partnership for Healthier Communities Access to Care program. Inova partners with schools across the jurisdiction to provide information about state funded health programs for children and contact information to meet with an eligibility worker responsible for enrolling families in state Medicaid programs. These eligibility workers also go out into the community attending community events such as health fairs, faith-based community activities and other family centered community events to proactively meet with families to encourage enrollment in programs for which they are eligible. Inova has a section of the public website dedicated to information about financial assistance resources. Part VI, Line 4: Inova Health Care Services (IHCS) is a not-for-profit corporation and a subsidiary of the parent organization, Inova Health System Foundation (Inova). 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. Northern Virginia is one of the fastest growing urban communities in the United States. With approximately 1,304 square miles, the region is the most densely populated in the Commonwealth of Virginia. Northern Virginia is comprised of several distinct communities, including the cities of Alexandria, Fairfax, Falls Church, Manassas and Manassas Park, and the counties of Arlington, Fairfax, Loudoun, and Prince William. The eastern sections are urbanized with attendant health problems of overcrowding and increasing demand for health services and public programs. Inova Health Care Services' service area is primarily the cities of Alexandria, Fairfax and Falls Church and Fairfax County.The region's population served by IHCS is forecasted to grow 9% over the next decade adding an estimated average of 12,000 persons a year. Population will be spurred by the long-term strength of the region's economy, high rates of in-migration and international immigration. The region's population that is 65 years of age and older is expected to grow 20% over the next 5 years, while the number of children will increase by about 4% during the same time period. (MWCOG and ESRI)Northern Virginia's racial and ethnic diversity is more pronounced than in the rest of the state. With increasing diversity, economically disadvantaged populations and multiple languages, the need for access to culturally appropriate, flexible health care continues to grow. The Northern Virginia geographic region in 2018 was 41% minority, up from 28% in 1990, while the nation as a whole reflects a 39% minority population (U.S. Census Bureau). Fairfax County, with more than one million residents, is the largest jurisdiction in Northern Virginia and also has the largest minority population. In Fairfax County in 2019, Asians, Hispanics, and African Americans represented 19.0%, 16.2%, and 9.4% of the county's population, respectively (Fairfax County Economic, Demographic and Statistical Research, 2019 data). One-quarter of the state's Hispanic population resides in Fairfax County (U.S. Census Bureau).According to the US Census Bureau Small Area Health Insurance Estimates (SAHIE) in 2017 approximately 9% of the total population under the age of 65 (about 90,000 people) in Fairfax County lacked healthcare insurance. Of the people living in Fairfax County whose family incomes are at or below 200% of the federal poverty level, SAHIE estimates that 28.2% (about 40,000 people) were uninsured in 2017.Area residents most likely to be uninsured are those whose family incomes are at or below 200% of the poverty level, young adults (age 18-44), people of racial backgrounds other than White, unemployed individuals, part-time workers, and people who work at companies with fewer than 50 employees. Serving this population poses significant cultural and linguistic challenges, and these uninsured citizens are widely distributed in terms of age, geographic region, and health status. Part VI, Line 5: Inova Health System's investment in the communities across Northern Virginia is evident through numerous targeted community programs. These programs provide access to care for low income, uninsured, underinsured and vulnerable populations; promote health & wellness; increase health literacy; provide the support and infrastructure for disaster preparedness; and provide programs to support development of our future healthcare workforce to meet the healthcare needs of the communities served. All Inova healthcare facilities have open medical staffs to provide the maximum access to qualified physicians. A Community Board of Trustees provides fiscal and quality oversight for Inova Health Care Services' facilities to ensure the vision and mission of the organization is achieved.Access to Care ProgramsInova's Population and Community Health Division is organized to address a wide-spectrum of community healthcare needs. In addition to the programs already described in the core form program, activities that provide infrastructure support and services focused on vulnerable populations to increase access to healthcare services for the communities served by Inova Health System include the following programs:Inova established a Safetynet Specialty Care Provider Network in partnership with Fairfax County. The physician leader engaged numerous Inova specialty care practices to accept referrals at Medicare rates from community primary care settings such as federally qualified health centers and free clinics. In order to ensure access to specialties not available at Inova, a specialty network including outside providers was then established with the same referral arrangement. With funding support from the county, Inova facilitates payment to the providers for patients otherwise unable to pay for those services. A program is being designed whereby an Inova coordinator will assist the referring clinic, the patient, and the specialty provider with scheduling and navigating the completion of required documentation.Inova's Partnership for Healthier Communities (PHC) provides individuals and families with comprehensive application and enrollment assistance to connect them with an appropriate and affordable source of health care services. In 2019, the program assisted over 21,000 children and adults with access to a source of comprehensive health care services such as Medicaid, FAMIS or local safety net providers. PHC expanded efforts in 2019 with the onset of Medicaid expansion in Virginia (including a name change from Partnership for Healthier Kids to reflect the updated mission and outreach activities).Care Connection for Children (CCC) is part of the Virginia Department of Health statewide network serving children and youth with special healthcare needs. Professional care coordinators partner with families to coordinate care and find the best healthcare and community resources in Northern Virginia. CCC is committed to helping children maximize their potential in a caring, innovative and culturally sensitive manner. In 2019, CCC served 907 families.Transitional Care Management Inova Transitional Services (ITS) is a comprehensive program designed to support medically vulnerable patients with a recent Inova hospitalization to ensure quality transitions of care outcomes and support the ambulatory physician community in managing this challenging population after discharge. ITS case managers provide 30 day post-acute telephonic case management designed to encourage patients to follow up with their Primary Care Physician (PCP) and follow instructions on medication reconciliation. ITS case managers also assist patients by providing education on their disease symptoms and empower them to take an active, preventative role, in their healthcare and wellness. ITS also offers Medicare Focused Coordinators for the Medicare 65+ focus diagnosis patients to ensure proper access and coordination of all discharge dispositions, post-acute care services, and assist with transitions throughout the 30-day post-hospitalization continuum by assisting patients and community service providers with follow up coordination, resource connection, problem solving, and communication. The ITS clinics are hospitalist-run post-acute clinics that provide immediate attention to medically complex patients who require intensive follow-up care. Patients are provided appointments to ensure that all hospital discharge instructions, medication reconciliation, and symptoms have been stabilized and resolved prior to transitioning back to their PCP or to a long-term medical home. Clinic services also include disease and medication education, prescription assistance, case management support, and community resource connection. In 2019, ITS case managers managed over 4,500 admissions, Medicare Coordinators managed almost 5,000 admissions, and the ITS clinics served over 3,700 patients with over 9,000 visit encounters. Inova Kellar CenterInova Kellar Center (IKC) is a community based behavioral health program and special education school founded by Inova in 1991 with a gift from Fairfax County residents, Art and Betty Kellar, to address a gap in mental health and substance abuse services for children and adolescents. Currently IKC offers a full continuum of mental health services from outpatient therapies and medication management to after school Intensive Outpatient Programs and a full day Partial Hospitalization Program. The Kellar School, a private special education day school for students with emotional, social, and behavioral needs provides academic instruction within a therapeutic environment. The Center provided 72,334 hours of programming, treatment, and education to children, adolescents, and families in 2019. Inova Ewing Forensic Assessment and Consultation Teams (FACT)The Inova Ewing FACT department is a comprehensive, outpatient forensic nursing program for children and adults. Established in the late 1990s, the Inova Ewing FACT department has provided specialized care for victims of sexual abuse, domestic violence, and child abuse. FACT serves all of Northern Virginia including Fairfax, Arlington, Loudoun, and Prince William counties, the cities of Alexandria and Falls Church, parts of Fauquier and Stafford counties, military installations, universities and the FBI. The department also performs courtesy exams for outlying jurisdictions including the District of Columbia, Maryland, and West Virginia. The program has grown significantly over the years and now provides services in the areas of sexual assault, intimate partner/domestic violence, physical child abuse, strangulation, and human sex trafficking. In 2019, the department had 1,031 patient encounters, reflecting a 10% increase from 2018 and a 53% increase from 2016. Health Promotion and Preventative Care ProgramsTo prevent and reduce the incidence of nutrition-related diseases, Inova focuses on several initiatives to reduce food insecurity and increase food literacy among community members. Specifically, Inova continued to match the purchases made by SNAP customers (formerly food stamps) at farmers markets, allowing low-income individuals to purchase more fresh produce.Inova also continued to grow the Inova Healthy Plate Program, which helps children and their families learn about the importance of healthy eating and physical activity. In 2019, the Inova Healthy Plate Club had about 330 kids graduate from its 8-week cooking and nutrition education class. The program also served more than 8,000 kids and parents through taste tests, parent classes, lessons during the school day, and more.Language and Disability ServicesThe Language and Disability Services Department is dedicated to ensuring equal access to Inova's services regardless of language preference or the need for special accommodations. In support of patient safety and satisfaction, language interpretation and document translations are provided at every Inova facility to facilitate communication with the 14% of Inova's patient population who are Limited English Proficient (LEP) and the 0.2% of clients who are Deaf or Hard of Hearing (D/HH). In 2019, phone, video, and in-person medical interpreters delivered 125,325 hours of interpretation in 350 languages, and 18,128 hours in American Sign Language. Additionally, 610 vital documents were translated into Inova's top languages. Part VI, Line 6: Organization is part of Inova Health System included in description under Line 5. PART VI, LINE 5 Continued Cash and In-Kind Contributions to Community GroupsInova donates space, cash, and in-kind support such as utilities, landscaping/grounds keeping, housekeeping, and donated staff time to a number of community groups and services. Inova supports NOVA Scripts, the Center for Multicultural Human Services, Shenandoah University, and the Nova Dental Clinic. Inova also provides financial support to The Loudoun Free Clinic and HealthWorks for Northern Virginia and Neighborhood Health, the local Federally Qualified Health Centers. In 2019, Inova donated over $3.9 million for these groups covering both cash and in-kind transactions.Additionally, as part of Inova's efforts to harness the collective power of community partners, agencies, and organizations to create positive social impact, Inova provided $60,000 in community grants. Applicants were required to present programs or projects addressing the population health needs described in the Inova Community Health Needs Assessments. The following programs were funded in 2019.Carpenter's Shelter - $5,000. Funds supported their mental health program serving emergency shelter residents. The funds will allow them to expand their program to accommodate a Masters of Social Work student intern and support additional continuing education opportunities to their licensed mental health care provider.Insight Memory Care Center - $10,000. Funds helped to support their adult day respite care program. IMCC is the only licensed adult day center in Northern Virginia dedicated to enhancing the lives of individuals with Alzheimer's disease and related dementias as well as their caregivers and families.Medical Care for Children Partnership Foundation - $15,000. Funds supported uninsured children from birth to age 19 with comprehensive oral health and preventative care. Project Mend-A-House Inc. - $10,000. Funds provided needed materials and supplies to enable volunteers to provide free home repair/construction services to improve the quality of life for low-income seniors, veterans and people with disabilities allowing them to age in place. The House, Inc. - $10,000. Funds supported The House Student Leadership Center's Office on Youth Mental Health and Wellness which aims to improve overall mental health with an integrative program approach for underserved and underinsured youth and families through evidence-based intervention strategies. The Ryan Bartel Foundation - $10,000. Funds supported the extension of the Sources of Strength (SOS) training - an evidence-led, youth suicide prevention and wellness program into the wider community, bridging the gap for the population who is not directly trained or exposed to SOS campaigns though Loudoun County Public Schools who has implemented the program in 20 schools. X 1 1 1 1 0 0 0 0 0 0 0 J STEPHEN JONES CEO 0 1653686 0 1440000 0 19749 0 253912 0 24619 0 3391966 0 240000 RICHARD MAGENHEIMER TREASURER-CFO, Ending 6-4-19 0 439909 0 909995 0 1106584 0 58000 0 2949 0 2517437 0 1538308 JAMES ECKLUND DEPT CHAIR NEUROSCIENCE 1133984 0 232722 0 187895 0 148235 0 24505 0 1727341 0 83556 0 JOHN HAMILTON PHYSICIAN 1471652 0 95951 0 1242 0 60058 0 27080 0 1655983 0 0 0 LORING FLINT EVP CMO, ENDING 6-1-19 0 301911 0 978910 0 111519 0 58000 0 5126 0 1455466 0 498935 JOHN GAUL ASST SECRETARY 663195 0 444754 0 94621 0 154406 0 28579 0 1385555 0 160177 0 HOMAYOUN A HASHEMI PHYSICIAN 1297268 0 0 0 3564 0 58244 0 16739 0 1375815 0 0 0 JOHN NIEDERHUBER EVP IHS & PRES ITMI, ENDING 4-1-19 284787 0 287349 0 755812 0 28510 0 315 0 1356773 0 0 0 HARVEY MCDUFFIE SVP PRESIDENT INOVA REALTY 558323 0 554427 0 19447 0 132603 0 21393 0 1286193 0 110886 0 CHRISTOPHER O'CONNOR PRESIDENT IHVI 901571 0 274065 0 29447 0 40459 0 13050 0 1258592 0 0 0 ALAN SPEIR PHYSICIAN SUPV 1029222 0 162304 0 4112 0 42089 0 20478 0 1258205 0 0 0 CONSUELO PILOT EVP CIO, ENDING 4-28-19 0 218248 0 553626 0 400983 0 32276 0 2901 0 1208034 0 349659 HPATRICK WALTERS INTERIM CHRO 478439 0 580030 0 77615 0 53331 0 12074 0 1201489 0 330080 0 BENJAMIN FRANK COO CHIEF OF STAFF, ENDING 4-12-19 0 264781 0 187840 0 561252 0 86398 0 3146 0 1103417 0 0 MARK STAUDER COO, FORMER, ENDING 9-30-18 0 0 0 0 0 1061798 0 0 0 0 0 1061798 0 0 SUSAN CARROLL SVP CLIN ENT SPPT OPS AND ADMIN 603109 0 303786 0 93972 0 28820 0 27917 0 1057604 0 131471 0 LUCAS COLLAZO MD TRUSTEE 837882 0 0 0 2322 0 58000 0 24190 0 922394 0 0 0 TERRI FEELY CHIEF PEOPLE OFFICER IHS 0 667310 0 120000 0 4053 0 98660 0 31002 0 921025 0 0 DEBORAH ADDO FORMER CEO ILH 0 465643 0 246245 0 36352 0 147147 0 2269 0 897656 0 99829 STEPHEN MOTEW CHIEF CLINICAL ENTERPRISE 0 561637 0 47602 0 130017 0 15678 0 13043 0 767977 0 0 ALICE POPE TREASURER-CFO, Beginning 6-4-19 0 398650 0 141728 0 80724 0 3366 0 18075 0 642543 0 0 PATRICK CHRISTIANSEN EVP CEO IFMC, FORMER, ENDING 11-4-18 0 0 0 0 0 613824 0 0 0 0 0 613824 0 0 TONI ARDEBELL ASSOC CHIEF CLINICAL ENTERPRISE 341283 0 42925 0 84546 0 46049 0 9791 0 524594 0 0 0 MADELINE ERARIO MD TRUSTEE 310176 0 65949 0 1347 0 57552 0 2893 0 437917 0 0 0 JANIS CARUSO MD TRUSTEE 0 185437 0 129544 0 605 0 38501 0 14924 0 369011 0 0 JOHN FITZGERALD PRES IFOH, FORMER, ENDING 12-31-18 19148 0 217061 0 70383 0 1942 0 272 0 308806 0 103278 0 DAVID QUIRKE EVP CIO 0 126116 0 50000 0 5605 0 0 0 18583 0 200304 0 0 RASHID NAYYAR MD TRUSTEE 172297 0 0 0 0 0 0 0 0 0 172297 0 0 0 KEITH STERLING MD TRUSTEE 160000 0 0 0 0 0 0 0 0 0 160000 0 0 0 Part I, Line 1a Gross-up payment made to the following for moving reimbursment taxable as compensation: Alice Pope Stephen Motew Toni Ardabell Part I, Line 3 The following methods were used by Inova Health System Foundation, a related organization, to establish the compensation of IHCS's CEO for the tax year: 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 Severance: Mark Stauder $1,061,798 Benjamin Frank $555,296 John Niederhuber $745,067 Consuelo Pilot $394,482 Patrick Christiansen $613,824 Severance amounts were paid within 24 months after separation from service. SERP Plan Payments: Richard Magenheimer - $108,398 Patrick Walters - $66,016 John Fitzgerald - $68,852 Susan Carroll - $87,647 James Ecklund - $167,112 Loring Flint - $106,145 John Gaul - $90,845 The Supplemental Executive Retirement plan (SERP Plan) is a nonqualified retirement plan. Employees eligible to participate are Executive Directors, Assistant Vice Presidents, Vice Presidents, Senior Vice Presidents, Executive Vice Presidents, CFO, COO, and CEO. 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 and after attaining age 45, participants are 100% vested and are paid out their remaining balance as a taxable event. Vesting then reverts to a 3 year rolling schedule until year 12. Thereafter, the annual contribution is paid out to the participant each year as a taxable event. A Industrial Development Authority of Fairfax County Virginia 911920228 303823FM5 2005-05-12 124000000 See Part VI 0 0 0 B Industrial Development Authority of Fairfax County Virginia 911920228 303823JJ8 2010-03-08 190000000 See Part VI 0 0 0 C Industrial Development Authority of Fairfax County Virginia 911920228 303823KE7 2012-08-23 382960937 See Part VI 0 0 0 D Industrial Development Authority of Fairfax County Virginia 911920228 303823KS6 2012-12-20 80991559 See Part VI 0 0 0 A 14270000 130441544 3604217 367125 126470203 2007 0 0 1 1 B 95000000 356022667 166022667 190000000 2016 1 0 1 1 C 28075000 385117977 385117977 2016 0 0 1 1 D 80991559 80991559 0 1 1 1 A 0 1 1 1 1 1 0.01100 0.01100 0 0 1 B 0 1 0 1 1 0.00930 0.01130 0.02060 0 0 1 C 0 0 0 1 1 0.00600 0.00600 0 0 1 D 0 1 0 1 1 0.00900 0.01100 0.02000 0 0 1 A 0 0 0 1 1 1 Morgan Stanley Capital Services 30.000000000000 0 1 0 0 1 B 0 0 0 1 1 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 05/12/2010 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 09/10/2017 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 10/12/2017 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 02/18/2018 Issuer Name: industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 07/14/2019 PART I, COLUMN E, ISSUE PRICE Part I, column E, 2005A bonds 2005A, B, D, E bond issue price per form 8038 476,700,000 2005B, D, E bonds refinanced by subsequent issues (352,700,000) Remaining 2005A issue price 124,000,000 PART I, COLUMN F, DESCRIPTION OF PURPOSE Bond A 1) Renovate and expand certain portions of Inova Alexandria Hospital (IAH), Inova Fairfax Hospital (IFH), Inova Fair Oaks Hospital (IFOH); 2) Acquire certain capital equipment for use in or in connection with IAH, IFH, IFOH, and Inova Mount Vernon Hospital (IMVH) and renovate any space necessary or incidental to the installation of such equipment; 3) Pay issuance costs for Series 2005 A and B; 4) Refund prior bonds issued by the Industrial Development Authority of Loudoun County, Virginia Hospital Revenue Bonds, Series 1995 issued 10/26/1995 and 2002A issued 6/27/2002, and pay issuance costs of Series 2005D; 5) Refund prior bonds Series 2001A, B, C, and D issued 12/11/2001 Bond B 1) Refund prior bonds - 2009B issued 4/16/2009; 2) Pay issuance costs of series 2010A bonds Bond C 1) Construct, renovate and expand certain portions of IFH, IMVH and IFOH Bond D 1) Advance refund a portion of 2009A bonds issued 4/16/2009 Bond E 1) Refund prior bonds - 1988A-D issued 8/4/1988; 2000 issued 3/23/2000; 2005A and 2005C issued 5/12/2005 Bond F 1) Construct, renovate and expand certain portions of IFH, IMVH and IFOH Bond G 1) Refund prior bonds - portion of 2009A issued 4/16/09 (advance) and portion of 2012C issued 8/23/12 (current) Bond H 1) Refund prior bonds - portion of 2012C issued 8/23/12 Bond I 1) Refunded prior bonds-2000 issued 03/23/2000; 2005C issued 05/12/2005;2017 issued 12/27/2017 2)Expansion of Inova Loudoun Hospital and a variety of projects at IFMC PART II, LINE 3, PROCEEDS Part II, line 3. 2005A bonds Issue price 124,000,000 Earnings 6,441,544 Total proceeds 130,441,544 Part II, line 3. 2010A bonds Issue price 190,000,000 Earnings 1,511,888 Transferred proceeds 164,510,779 Total proceeds 356,022,667 Part II, line 3. 2012AB bonds Issue price 382,960,937 Earnings 2,157,040 Total proceeds 385,117,977 Part II, line 3. 2014A bonds Issue price 209,030,800 Earnings 687,091 Total proceeds 209,717,891 Part II, line 3. 2016A bonds issue price 178,341,611 escrow earnings 2,835,082 total proceeds 181,176,693 Part II, line 3. 2018AB bonds issue price 484,976,577 escrow earnings 3,344,870 total proceeds 488,321,447 PART IV, LINE 2C, DATE OF REBATE COMPUTATION Part 4, line 2C. 2005A Rebate Computation for the bond issued 5/12/2010 was performed: 05/12/2010 Part 4, line 2C. 2010A Rebate Computation for the bond issued 9/10/2012 was performed: 09/10/2017 Part 4, line 2C. 2012AB Rebate Computation for the bond issued 10/12/2017 was performed: 10/12/2017 Part 4, line 2C. 2018AB Rebate Computation for the bond issued 07/31/18 was performed: 07/14/2019 A Industrial Development Authority of Fairfax County Virginia 911920228 2013-12-04 79530000 See Part VI 0 0 0 B Industrial Development Authority of Fairfax County Virginia 911920228 303823KX5 2014-12-17 209030800 See Part VI 0 0 0 C Industrial Development Authority of Fairfax County Virginia 911920228 303823LM8 2016-05-11 178341611 See Part VI 0 0 0 D Industrial Development Authority of Fairfax County Virginia 911920228 303823LR7 2016-05-11 99685000 See Part VI 0 0 0 A 25600000 79530000 79530000 1 0 1 1 B 209717891 209717891 2017 0 0 1 1 C 181714070 181714070 1 1 1 1 D 1120000 99685000 99685000 1 0 1 1 A 0 1 1 1 1 1 0.01100 0.01100 0 0 1 B 0 1 0 1 1 0.00700 0.00700 0 0 1 C 0 1 0 1 1 0.01000 0.02200 0.03200 0 0 1 D 0 1 0 1 1 0.03400 0.01100 0.04500 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 1 0 0 0 0 0 1 D 0 1 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 A industrial Development Authority of Fairfax County Virginia 911920228 303823MX3 2018-07-31 484976577 See Part VI 0 0 0 A 6820000 488321447 234549874 220051092 33720481 1 0 0 1 A 0 1 0 1 1 0.00800 0.01000 0.01800 0 0 1 A 0 0 0 1 1 0 0 0 1 A 1 0 0 0 Charles Beard Jr Trustee 66791 Family member employed under IHCS. Services provided at arm's length and customary rates. 0 PART III, LINE 4A Cancer Care: Inova Schar Cancer Institute (Inova Schar) is a state-of-the-art cancer care destination in the DC Metro area designed to meet the needs the evolving region and to bring healing and hope to patients. The Inova Schar team - 1,000+ doctors, researchers, nurses, cancer specialists and emotional support experts - delivers the nation's highest standard of compassionate, multi-disciplinary and holistic cancer care, customized to the needs of each patient. Inova Schar's coordinated model puts the patient at the center, allowing them to see their entire care team in one visit, at one location, improving communication and minimizing travel time. Nationally renowned specialists, surgeons, genetic counselors and leading researchers are backed by the latest in drug discovery, clinical trials, research and advanced treatments. Inova Schar Cancer Institute, a Department of Inova Fairfax Medical Campus, operates full-service, accredited, cancer centers at all five of Inova's hospitals - Inova Fairfax Medical Campus, Inova Alexandria Hospital, Inova Fair Oaks Hospital, Inova Loudoun Hospital, and Inova Mount Vernon Hospital. Inova Fairfax Medical Campus is designated by the American College of Surgeons Commission on Cancer as a Teaching Hospital Cancer Program, and Inova Alexandria Hospital has a Community Hospital Comprehensive Cancer Program designation. Other System Hospitals meet the American College of Surgeons Community Hospital Cancer Program standards. The System maintains several programs dedicated to different types of cancer, cancer care and cancer risk assessment, including the Inova Breast Care Program (certified at all 5 hospitals), the Cancer Genetic Counseling Program (hereditary conditions), the Inova Melanoma and Skin Cancer Program, the Inova Head and Neck Cancer Program, the Inova Gastrointestinal Multidisciplinary Clinic, the Inova Genitourinary Cancer Program, the Inova Molecular Tumor Board, and Life with Cancer (support and education to cancer patients). The Emergency and Trauma Center at Inova Fairfax Medical Campus, Northern Virginia's only Level I trauma center, is a state-of-the-art facility. Emergency medical specialists with expertise in trauma care, treat every type of illness, injury, or life-threatening trauma. Inova Center for Rehabilitation, located on the Inova Mount Vernon campus, is certified by The Joint Commission for Stroke Rehabilitation, and provides comprehensive inpatient and outpatient medical rehabilitation services to patients with traumatic and acquired brain injuries, spinal cord injuries, strokes, multiple sclerosis, and other orthopedic and neurological disabilities. These services are staffed by an interdisciplinary team representing psychiatry, neuropsychology, physical therapy, occupational therapy, rehabilitation nursing, therapeutic recreation and case management with treatment tailored to meet the specific needs of each patient. ACCESS of Fairfax, and ACCESS of Reston are 24-hour, free standing emergency centers located in Fairfax City, and Reston, Virginia, respectively. During 2019, ACCESS of Fairfax provided 14,337 emergency room visits and ACCESS of Reston reported 8,884 emergency room visits. Long Term Care Services Assisted Living Facilities: IHCS's assisted living facilities provide care and services for adults who need assistance with activities of daily living and 24 hour oversight with 408 units for accommodation. Each community has specialized memory care units and programs. A nursing staff is on-site 24 hours a day. IHCS maintains four assisted living facilities in Fairfax, Reston, Fair Oaks, and Mt. Vernon, Virginia. In addition, IHCS owns a 60% interest in an assisted living joint venture in McLean, Virginia. IHCS owns and Sunrise operates five assisted living facilities across Fairfax County with total assisted living days in 2019 of 145,187. Physical Therapy Services Inova Physical Therapy Centers: IHCS promotes and conducts specific research and educational activities related to the care of the sick and injured. In 2019, outpatient visits totaled 189,363 with services offered at eighteen outpatient centers located throughout Northern Virginia. Areas of specialty include: Physical Therapy (PT) and Occupational Therapy (OT). Urgent Care Centers Inova Urgent Care Centers: The IHCS mission includes serving the community as a not-for-profit organization through the provision of urgent medical care. In 2019, outpatient visits totaled 153,097 with services being provided seven days a week with no appointment necessary at eleven locations. Inova ended the year with ten locations, with one having closed in July. The centers provide services for medical conditions that require prompt attention but do not pose an immediate or serious threat to life. Treatment is provided for such ailments as sore throats, ear infections or minor cuts and bruises. Services offered also include treatment for work-related injuries and worker's compensation cases, physical exams including camp, sport, school, pre-employment, immigration medical examinations and travel medicine. Laboratory tests, X-rays, audiometry and vision screening, alcohol and drug testing, and flu shots are provided on-site. The centers are staffed by board-certified/board-eligible physicians licensed in Virginia. A physician, nurse, and radiology technologist are on duty at each center during hours of operation. Employee Assistance Programs Inova Employee Assistance (EAP) is part of IHCS providing counseling, work life services and resources to help improve the overall health and wellbeing of the employees of Inova Health System and the employer communities served by Inova and its affiliates. EAP was organized to promote health through referral to a wide range of behavioral health, financial, legal and other supportive services. In 2019, EAP supported 19,259 Inova employees and approximately 195,304 total employees/household members with the following services: Confidential Counseling: Short-term counseling services can help find solutions to problems ranging from family or workplace frustrations to alcohol or drug abuse. Financial & Legal Services: Employees and their household members can speak with a financial & legal professional at no charge regarding such issues as retirement planning, debt consolidation, funding a child's college education, mortgage loan options and a variety of other financial concerns. Work Life Referral Services: Work Life consultants help assess needs, pinpoint appropriate resources, and suggest guidelines for evaluating those resources. Consultants can locate resources in a variety of areas, including childcare, adoption, eldercare and convenience services. Behavioral Services IHCS's Behavioral Services are committed to providing intensive, personalized care to help people cope with, and overcome, addictions and emotional problems that prevent them from fully functioning in the community. Inova CATS Program (Comprehensive Addiction Treatment Services) is a leader in providing the highest quality addiction treatment services in Northern Virginia and surrounding areas. A series of structured programs offers effective, compassionate treatment for individuals dealing with all forms of substance abuse disorders, including addiction to alcohol, prescription drugs, heroin, cocaine and other drugs. Services are available to adults ages 18 and older. The range of services includes: Inpatient Medical Detoxification, Partial Hospitalization Program, Intensive Outpatient Program, Outpatient Groups, Medication Assisted Therapy and Substance Use Assessments. In 2019, the CATS Partial Hospitalization/Intensive Outpatient Program provided 10,573 encounters. PART III, LINE 4A Inova Kellar Center is a comprehensive, behavioral health treatment center and special education school for children, adolescents and their families. With locations in Fairfax and Loudoun counties, Inova Kellar Center provides a full continuum of outpatient services for psychiatric disorders, substance use disorders, and behavioral and emotional issues. Services include assessment, psychological testing, educational testing, psychiatric evaluation, medication management, individual, family and group therapy and Intensive In-Home services. For adolescents who require intense mental health interventions, the Center provides an afterschool Intensive Outpatient Program for mental health and co-occurring disorders and a full day Partial Hospitalization Program for adolescents who are in crisis and unable to attend school. The treatment services and programs are provided to children and families regardless of ability to pay. The Kellar School of Inova Kellar Center provides special education services to children and adolescents who have not been successful in the public school setting and may be at risk for being removed from the community and placed in more restrictive settings due to an emotional disability, learning disability, autism or other health impairment. During 2019, Inova Kellar Center provided 72,334 hours of programming, treatment and education to children, adolescents and families in the community. The total unreimbursed cost for 2019 was approximately $1.7 million dollars. Charity Care All Inova facilities, including the IHCS facilities with the exception of the assisted living facilities, provide charity care in accordance with Inova policies which ensures 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. These policies include the following key provisions: 1. Emergency care shall be provided to all persons regardless of their ability to pay. 2. Non-emergency medically necessary care, except for certain specialty or referral programs, shall be provided by all hospitals and access facilities to medically indigent patients. "Medically necessary" refers to conditions which, if not promptly treated, would lead to an adverse change in the health status of a patient. Free care is provided to uninsured or underinsured individuals with Family Incomes at or below 400% of the current Federal Poverty Guidelines (FPG). 3. In 2019, the FAP expanded eligible residency to all of Virginia, increased availability of catastrophic coverage, and raised underinsured coverage to up to 400% of the FPG. Inova Health System utilizes a multifaceted approach to educate and inform patients and the public about Inova's Financial Assistance Policy (FAP) or sometimes referred to as the charity care policy. Information regarding this policy is kept up to date on the Inova website and through signage. Upon admission to any Inova hospital or any visit to outpatient facilities or clinics including emergency departments, Inova has information posted regarding patient rights and responsibilities. In addition, Inova provides information about the charity care program and referrals to meet with Inova financial counselors who assist patients in completing Inova's charity care application. This financial information is reviewed by the Inova Patient Accounts Department with the patient contacted if additional information is required in order to make a determination. The patient is subsequently provided a letter, notifying them as to whether or not they qualify for charity care. In 2019 IHCS's unreimbursed cost of charity care, including free and discounted services, was $84.3 million. Medicaid Established under Title XIX of the Social Security Act, this program provides assistance for the medically indigent, including those who cannot pay for care despite being able to afford other living expenses. Also included under this program are the blind, disabled, pregnant women, very low income parents, children, and the elderly. While Virginia Medicaid coverage was expanded in 2019 to increase the number of eligible individuals, the reimbursement that IHCS facilities receive from the Medicaid program routinely falls below the actual cost of services provided. During 2019, IHCS provided care to Medicaid patients at an unreimbursed cost of 189.6 million. Participation in Governmental Programs for Those Without the Ability to Pay Various government programs provide for the indigent, including Medicaid recipients. These programs provide a percentage of reimbursement for qualifying patients; however, payment is typically below the cost of those services. In addition to federal and state programs, the Inova subsidiaries, including IHCS, work with various County governments and agencies in providing certain free services to those residents the County identifies as most in need. PART III, LINE 4D Inova Center for Wellness and Metabolic Health The Inova Center for Wellness and Metabolic Health (ICWMH) provides endocrinology medical visits, diabetes education and medical nutrition therapy. Endocrinology visits are provided by Board Certified Endocrinologists. The providers see patients for many endocrine issues, not limited to diabetes. The Center is recognized by the American Diabetes Association for diabetes education which is provided by Registered Nurses and Registered Dieticians. Staff members are either Certified Diabetes Educators or are in the process of achieving this designation. The Center has preliminary recognition from the CDC to provide the Diabetes Prevention Program (DPP) through telemedicine and in person or completely by telemedicine. This program is a year-long lifestyle modification program. This year the DPP provided 732 participant encounters. In addition, ICWMH staff participated in community events providing education about diabetes and pre-diabetes to approximately 120 people. In 2019, ICWMH provided a total of 10,930 outpatient participant encounters - 7,436 at the Fairfax centers (Alexandria, Fairfax and Fair Oaks) and 3,494 at the Loudoun site. Simplicity Health Simplicity Health is a group of primary care clinics that provide excellent healthcare at affordable fees. Simplicity Health serves working adults who may not currently receive regular primary care because they do not qualify for Medicaid, do not get health insurance through work, or have insurance with prohibitively high copays and deductibles. Simplicity Health clinics bring excellent care to convenient locations in high need communities, making healthcare not only affordable, but also accessible. Sites employ a team of providers and staff who are bilingual in a variety of languages, such as Korean, Vietnamese, Spanish, and Arabic. The primary goal of these clinics is to provide ongoing primary care, prevention and disease management for chronic illnesses like diabetes, hypertension and heart disease. Staff assist patients who need to arrange for additional services beyond primary care. In 2019, Simplicity Health clinics provided services to 4,833 unique patients with a total of 15,236 visits. Inova Health Advantage Inova Health Advantage (IHA) is a new service representing Inova's effort to increase access for primary care services following the decision to expand Medicaid coverage in Virginia. The clinic has four locations: Alexandria, Annandale, Manassas, and Sterling. In 2019, Inova Health Advantage clinics provided services to 545 unique patients with a total of 1,366 visits. IHCS and its subsidiaries provide many other non-billed and below margin patient services. Case management services are provided to the indigent and assistance is provided with financial paperwork. Inova Mount Vernon participates in the Health Information and Claims Assistance Program by providing assistance with health insurance paperwork problems. In addition, home IV therapy services are provided for the indigent. Transportation is provided for some indigent patients to and from IHCS facilities and programs. Inova Fairfax Medical Campus provides forensic and medical care to abused adults and children as well as blood alcohol testing for area police departments while coordinating the disposition of deaths with various community organizations. Other services include pastoral care, free living accommodations for out-of-town Inova Fairfax Medical Campus heart and lung transplant patients and their families, and emergency assistance to patients and their families needing medication or transportation. Community Health Education and Promotion As part of Inova's overall health promotion effort, IHCS and its subsidiaries are actively involved in sponsoring programs, activities, and services designed to improve community health and prevent the onset of disease. Inova Well serves the community as the premier provider of health education and wellness services. Knowing that each individual requires different kinds of support and services to meet their personal wellness needs, Inova Well offers a variety of wellness programming. Inova's wellness services include, but are not limited to, personal health coaching and prenatal support, childbirth education, life support re-certification and first aid, health fair screenings, seminars, health challenges, fitness classes and immunizations. In order to reach people where they are most comfortable, Inova Well holds programs in community settings, at employer worksites and other easily accessible locations throughout the Northern Virginia and the Greater Metropolitan Washington Area. During 2019, Inova Well served over 236,821 participants. Program highlights are described below. Employee Wellness Inova Well supports employees and spouses at all health and fitness levels through a comprehensive and supportive wellness program. Employees get tools, support and programs to help improve health or maintain healthy habits. Inova Well provides blood work, biometric screenings, in-person and telephonic wellness coaching, fitness classes and wellness events in Inova's operating units. In 2019, Inova Well had 16,710 touches within the Inova Health System. It is the goal of the wellness coaches to work with employees to establish realistic wellness goals and to support employees while they work towards optimal health. Influenza Vaccination The Inova Well Immunization Program provided 40,167 flu shots, Tdap & Hepatitis B vaccinations and TB screenings at 780 events. Inova Well provides immunizations for Inova employees and physicians, community members and workplaces throughout the metropolitan area. Number of flu shots (Quadrivalent, High-Dose & Peds): 39,144 3,071 shots at 18 clinics for Loudoun County Public School employees Number of TB plants/readings: 849 Number of Tdap and Hepatitis B vaccinations: 174 The Workplace and Community Program The Workplace and Community Program provided over 277 health events that included biometric screenings, seminars, and interactive education stations. The Respiratory Fit Testing program served over 8,145 participants. Clients were located throughout the Washington, DC, Metropolitan area and far west into Virginia. The Care Management Programs continued to provide personalized support and health coaching to encourage healthy behaviors related to weight management, tobacco cessation, back pain management, pregnancy and breastfeeding. Inova Well coaching supported Inova employees, their spouses and community members. Inova Well provides the Program Manager for The Prince William County Wellness Program, which delivers a full range of wellness services and programs for county employees. Programs include: health and wellness seminars and screenings, weekly meditation, a walking challenge, and a video tutorial around healthy supermarket strategies. In 2019, the Inova Well Program Manager provided services to over 1,800 employee lives in Prince William County. The Health Education Program Inova Well provided Life Support education classes for 14,523 students in community and worksite locations. The Inova Well Childbirth Education program served 5,448 community members through educational classes such as breastfeeding, baby care, and childbirth preparation. Additionally, the program offered over 190 free new mom support groups to 2,603 participants. Childbirth Education also served 11,390 individuals through complimentary maternity tours at IFMC, IAH and IFOH. The Inova WellBaby program, which provides personalized support and education to pregnant and breastfeeding women through email and telephonic outreach, supported around 174 Inova employees and spouses in 2019. The Inova Well Fitness program provided over 253 fitness classes to Inova employees and community members in 2019. The program offers classes at locations throughout the community and in a variety of different formats including multi-week series, workshops and drop-in classes. Class types offered include mind body classes (yoga, tai chi), cardio/strength building classes (body toning, Zumba), mommy fitness classes (bootcamp, prenatal yoga) and senior focused classes (strength training for seniors, seniorcize). Over 3,209 individuals took part in these fitness classes, multi-week session based classes and workshops. PART V, LINE 2A, NUMBER OF EMPLOYEES 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 A, line 6 The organization has a single member. The sole member is Inova Health System Foundation, a charitable 501(c)(3) tax-exempt organization which serves as the parent company of the integrated health care delivery system. Form 990, Part VI, Section A, line 7a The sole member of the organization, Inova Health System Foundation, is a charitable 501(c)(3) tax-exempt organization. The sole member elects the members of the governing body of the organization. Form 990, Part VI, Section A, line 7b The sole member of the organization, Inova Health System Foundation, is a charitable 501(c)(3) tax-exempt organization. The sole member holds reserved powers with respect to certain actions, including approval of borrowings, amendments of Articles of Incorporation and Bylaws. In addition to the reserved powers, under the laws of the Commonwealth of Virginia certain extraordinary actions require member approval, such as mergers, consolidations, liquidations and the sale of substantially all of the assets of the organization. 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 Completed by related entity, Inova Health System Foundation: 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. Form 990, Part XI, line 9: PARTNERSHIP INCOME -20,005,710. CHANGE IN INVESTMENTS BALANCE -15,278,252. EQUITY IN SUBS 17,573,642. CAPITAL REIMBURSEMENT 1,751,136. UNRECOGNIZED PENSION -337,000. transfers 13,366,044. PART XII, LINE 2B AND 2C, AUDITED FINANCIAL STATMENTS 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 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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