FHI SERVICES: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
FHI SERVICES (EIN 54-0573701)
Tax period
2015-10-01 to 2016-09-30
Filed
2017-08-11
IRS object ID
201732239349301383
Schema version
2015v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-08-11T13:58:17-05:00ReturnTs
Tax Period End2016-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN222428965PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CITRIN COOPERMAN & COMPANY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12 BETHESDA METRO CENTER 11TH FLOORAddressLine1Txt
CityBETHESDACityNm
State AbbreviationMDStateAbbreviationCd
ZIP20814ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN540573701EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FHI SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFHISBusinessNameControlTxt
Phone5406804100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line198 ALEXANDRIA PIKE NO 43AddressLine1Txt
CityWARRENTONCityNm
State AbbreviationVAStateAbbreviationCd
ZIP20186ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCHRISTINE M CONNOLLYPersonNm
Person TitlePRESIDENT & CEOPersonTitleTxt
Phone5406804100PhoneNum
Signature2017-08-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRIAN J GIGANTIPreparerPersonNm
PTINP00646609PTIN
Phone3016549000PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCHRISTINE M CONNOLLYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line198 ALEXANDRIA PIKE NO 43AddressLine1Txt
CityWARRENTONCityNm
State AbbreviationVAStateAbbreviationCd
ZIP20186ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$97,779,526GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FAUQUIERHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1954FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionOUR MISSION IS TO RESTORE, PROMOTE AND MAINTAIN THE HEALTH OF THE COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers15TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$3,779,894PYProgramServiceRevenueAmt
CY Program Service Revenue$8,812,189CYProgramServiceRevenueAmt
PY Investment Income$7,013,195PYInvestmentIncomeAmt
CY Investment Income$14,232,081CYInvestmentIncomeAmt
PY Other Revenue$265,284PYOtherRevenueAmt
CY Other Revenue$2,248,541CYOtherRevenueAmt
PY Total Revenue$11,058,373PYTotalRevenueAmt
CY Total Revenue$25,292,811CYTotalRevenueAmt
PY Grants And Similar Paid$359,700PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,860,398CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$246,275PYOtherExpensesAmt
CY Other Expenses$343,358CYOtherExpensesAmt
PY Total Expenses$605,975PYTotalExpensesAmt
CY Total Expenses$2,203,756CYTotalExpensesAmt
PY Revenues Less Expenses$10,452,398PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$23,089,055CYRevenuesLessExpensesAmt
Total Assets BOY$204,244,886TotalAssetsBOYAmt
Total Assets EOY$225,399,613TotalAssetsEOYAmt
Total Liabilities BOY$6,690,933TotalLiabilitiesBOYAmt
Total Liabilities EOY$5,313,224TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$197,553,953NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$220,086,389NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOUR MISSION IS TO RESTORE, PROMOTE AND MAINTAIN THE HEALTH OF THE COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,884,982ExpenseAmt
Grant$1,860,398GrantAmt
Revenue$11,060,730RevenueAmt
DescFHI SERVICES IS A 501C (3) NON-PROFIT CORPORATION. FHI SERVICES IS GOVERNED BY THE SAME BOARD AND MANAGEMENT TEAM AS ITS PARENT ORGANIZATION, FHS SERVICES, AND ITS BROTHER/SISTER ORGANIZATION, THE FAUQUIER HEALTH FOUNDATION (DBA THE PATH FOUNDATION. THE THREE ENTITIES, COLLECTIVELY, ARE REFERRED TO AS THE ORGANIZATION". THE ORGANIZATION'S" MISSION IS TO STRENGTHEN THE HEALTH AND VITALITY OF THE COMMUNITIES OF FAUQUIER, RAPPAHANNOCK AND NORTHERN CULPEPER COUNTIES. FAUQUIER HOSPITAL IS OPERATED BY A JOINT VENTURE (FAUQUIER HOLDING COMPANY) OWNED IN PART BY FHI SERVICES (20%) AND LIFEPOINT HEALTH (80%). FHI SERVICES APPOINTS 50% OF THE MEMBERS OF THE FAUQUIER HOLDING COMPANY LLC'S GOVERNING BOARD REQUIRES FHI SERVICES CONSENT AND FHI SERVICES HAS MAJORITY GOVERNANCE WITH RESPECT TO ITEMS/ISSUES IMPACTING THE TAX-EXEMPT PURPOSE OF FHI SERVICES (CHARITABLE OVERRIDE PROVISION).THE COMMUNITY BENEFIT CONTRIBUTION OF FHI SERVICES INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTHCARE AND IMPROVE HEALTH IN OUR COMMUNITIES. ORGANIZATIONAL COMMITMENT TO PROVIDING A COMMUNITY BENEFIT INCLUDES: FAUQUIER HEALTH (FH) IS A 97 BED NOT-FOR-PROFIT ACUTE CARE FACILITY THAT PROVIDES COMPREHENSIVE HEALTH CARE SERVICES FOR THE COMMUNITIES IT SERVES. THE MISSION IS TO RESTORE, PROMOTE AND MAINTAIN THE HEALTH OF THE COMMUNITY.FH IS THE ONLY HOSPITAL IN THE PRIMARY SERVICE AREA OF FAUQUIER COUNTY WITH A POPULATION OF 83,195. THE SERVICE AREA IS GROWING AND AGING, WITH OVERALL PROJECTED GROWTH BETWEEN 2013-2018 OF 3.8% AND WITH A 45+ POPULATION COMPRISING 47% OF THE TOTAL IN 2018.ALL PATIENTS AT FH SHALL HAVE IMPARTIAL ACCESS TO TREATMENT OR ACCOMMODATIONS THAT ARE AVAILABLE OR MEDICALLY INDICATED, REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, RELIGION, OR SOURCE OF PAYMENT FOR CARE. THE 24-HOUR EMERGENCY DEPARTMENT IS OPEN TO EVERYONE IN THE COMMUNITY, REGARDLESS OF ABILITY TO PAY. FH HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. THE MAJORITY OF THE MEMBERS OF OUR GOVERNING BODIES FOR FH ARE INDEPENDENT REPRESENTATIVES OF THE COMMUNITIES SERVED.FH PROVIDES MEDICAL OVERSIGHT, DIRECTION, AND ORDERS TO PARAMEDICS IN THE FIELD AND IN ROUTE TO THE HOSPITAL. OUR EMERGENCY DEPARTMENT OFFERS 24-HOUR ACCESS TO MEDICAL SERVICES AND HELICOPTER TRANSPORT FOR CRITICALLY ILL OR INJURED INDIVIDUALS.FH HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES FREE CARE FOR PATIENTS WITHIN 200% OF THE FEDERAL POVERTY GUIDELINES AND DISCOUNTED CARE FOR PATIENTS WITHIN 300% OF THE FEDERAL POVERTY GUIDELINES.IN ADDITION, THROUGH A CONTINUING CARE FUND, FAUQUIER HEALTH OFFERS ASSISTANCE TO INDIVIDUALS WHO HAVE INADEQUATE FINANCIAL MEANS TO COVER THE COST OF POST-HOSPITALIZATION HEALTH SERVICES, SUCH AS NURSING CARE. TO HELP TRAIN AND EDUCATE HEALTH CARE PROFESSIONALS, FH WORKS WITH LOCAL COMMUNITY COLLEGES TO PROVIDE TOURS, LECTURES, AND INTERNSHIPS FOR STUDENTS. FH PARTICIPATES IN MEDICARE, MEDICAID, AND CHAMPUS/TRICARE STANDARD.TO ADDRESS THE GROWING AND CHANGING HEALTH CARE NEEDS RESULTING FROM THESE POPULATION CHANGES, FAUQUIER HEALTH CONTINUES TO SUPPORT TWENTY-ONE PHYSICIANS, AN ENDOCRINOLOGIST, TWO OBSTETRICS/GYNECOLOGISTS, THREE FAMILY MEDICINE PHYSICIANS, A RHEUMATOLOGIST, A NEUROLOGIST, AN INFECTIOUS DISEASE SPECIALIST, SEVEN INTERNAL MEDICINE PHYSICIANS, TWO UROLOGISTS, A HEMATOLOGIST/ONCOLOGIST AND TWO GENERAL SURGEONS.IN ADDITION, PARTNERSHIPS HAVE BEEN ESTABLISHED WITH LOCAL NON-PROFIT ORGANIZATIONS (E.G. FAUQUIER FREE CLINIC, THE CHAMBER OF COMMERCE, SCHOOLS AND CHURCHES) AND NATIONAL ORGANIZATIONS (E.G. THE AMERICAN CANCER SOCIETY) TO SUPPORT LOCAL EVENTS AND PROVIDE COMMUNITY HEALTH AND WELLNESS PROGRAMS. THESE COMMUNITY BENEFIT ACTIVITIES ARE COORDINATED BY A FULL-TIME COMMUNITY OUTREACH STAFF PERSON, SUPPORTED BY ADMINISTRATIVE AND CLINICAL DEPARTMENTS, AND AUXILIARY VOLUNTEERS AS NEEDED.IN ADDITION TO THE CONTRIBUTIONS MADE BY THE HOSPITAL, FHI SERVICES INVESTS IN THE COMMUNITY BY PROVIDING GRANTS RELATED TO THE FOUR PRIORITY AREAS STEMMING FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT UNDERTAKEN BY FAUQUIER HEALTH OF CHILDHOOD WELLNESS, MENTAL HEALTH, SENIOR SERVICES AND ACCESS TO HEALTH. FHI SERVICES OFFERS SEVERAL GRANT CYCLES DURING THE YEAR TO HELP NONPROFITS AND GOVERNMENT AGENCIES BETTER THE COMMUNITIES IT SERVES. IN THE CURRENT YEAR, PROJECT AND PLANNING GRANTS WERE FUNDED. GENERAL OPERATIONS GRANTS ARE FUNDED ON A TWO YEAR CYCLE AND WERE NOT FUNDED IN FY2016.FHI SERVICES RECOGNIZES THAT FUNDING FOR PROJECTS AND PLANNING IS VERY IMPORTANT TO NONPROFITS. CAREFUL STRATEGIC PLANNING, BOARD CULTIVATION AND THE UNINTERRUPTED RUNNING OF CORE ORGANIZATIONAL ACTIVITIES ARE ESSENTIAL TO THE SUCCESS OF THRIVING COMMUNITY INSTITUTIONS. ANNUAL PLANNING GRANTS ARE OFFERED TO NONPROFITS AND PUBLIC AGENCIES WITH A TRACK RECORD OF COMMUNITY IMPACT AND SOUND FISCAL MANAGEMENT.THE KEY OBJECTIVES OF THE PROJECT AND PLANNING GRANTS ARE: - TO PROVIDE SUPPORT FOR EFFECTIVE AND ESSENTIAL PROGRAMS FOR NONPROFITS - TO ENCOURAGE NONPROFIT BOARDS AND STAFF TO ENGAGE IN CAPACITY BUILDING AND LEADERSHIP CULTIVATION. - TO FACILITATE CRITICAL, LONG-RANGE STRATEGIC PLANNING.Desc
Total Program Service Expenses$1,884,982TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related InvstYes (1)ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpYes (1)ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document7IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldVAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LORNA MAGILLBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5406804100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line198 ALEXANDRIA PIKE SUITE 43AddressLine1Txt
CityWARRENTONCityNm
State AbbreviationVAStateAbbreviationCd
ZIP20186ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
PATRICIA WOODWARD
TRUSTEE1.503.00Yes (X)$0$0$0
JOSHUA JAKUM MD
TRUSTEE1.503.00Yes (X)$0$0$0
KAREN WACHTMEISTER
TRUSTEE1.503.00Yes (X)$0$0$0
THOMAS TUCKER
TRUSTEE1.503.00Yes (X)$0$0$0
RICK GERHARDT
TRUSTEE1.503.00Yes (X)$0$0$0
SUSAN STRITTMATTER
TRUSTEE1.503.00Yes (X)$0$0$0
SUSAN RUBIN
TRUSTEE1.503.00Yes (X)$0$0$0
KEVIN CARTER
TRUSTEE1.503.00Yes (X)$0$0$0
MARSHALL DOELLER
TRUSTEE1.503.00Yes (X)$0$0$0
JANELLE DOWNES
TRUSTEE1.503.00Yes (X)$0$0$0
MARY LEIGN MCDANIEL
TRUSTEE1.503.00Yes (X)$0$0$0
MARK VAN DE WATER
TRUSTEE1.503.00Yes (X)$0$0$0
JOHN MCCARTHY
CHAIR1.503.00Yes (X)$0$0$0Yes (X)
ROBIN GULICK
VICE CHAIR1.503.00Yes (X)$0$0$0Yes (X)
RAYMOND KNOTT
SECRETARY/TREASURER1.503.00Yes (X)$0$0$0Yes (X)
CHRISTINE CONNOLLY
PRESIDENT & CEO8.0032.00$0$235,651$38,561Yes (X)
LORNA MAGILL
CFO11.0044.00$0$124,872$13,723Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$360,523TotReportableCompRltdOrgAmt
Total Other Compensation$52,284TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescINCOME FROM HOSPITAL VENTUREDesc
Business900003BusinessCd
Total Revenue Column$8,812,189TotalRevenueColumnAmt
Related Or Exempt Func Income$8,812,189RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$8,812,189TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,151,383TotalRevenueColumnAmt
Exclusion$3,151,383ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$83,567,413SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$72,486,715SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$11,080,698SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,080,698TotalRevenueColumnAmt
Exclusion$11,080,698ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCHANGE IN RESERVE LIABILITYDesc
Business900009BusinessCd
Total Revenue Column$2,248,541TotalRevenueColumnAmt
Related Or Exempt Func Income$2,248,541RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,248,541OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,292,811TotalRevenueColumnAmt
Related Or Exempt Func Income$11,060,730RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$14,232,081ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,860,398TotalAmt
Program Services$1,860,398ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$40,949TotalAmt
Management And General$40,949ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$24,390TotalAmt
Management And General$24,390ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$250,726TotalAmt
Management And General$250,726ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$20,925TotalAmt
Program Services$20,925ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$269TotalAmt
Management And General$269ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescTAXES AND LICENSESDesc
Total$6,099TotalAmt
Program Services$3,659ProgramServicesAmt
Management And General$2,440ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,203,756TotalAmt
Program Services$1,884,982ProgramServicesAmt
Management And General$318,774ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$30,302,891BOYAmt
EOY$17,237,509EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$28,431BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$8,955,914BOYAmt
EOY$8,955,914EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$11,708BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$126,290,743BOYAmt
EOY$151,466,887EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$9,064,881BOYAmt
EOY$9,546,239EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$27,234,415BOYAmt
EOY$33,046,604EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,355,903BOYAmt
EOY$5,146,460EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$204,244,886BOYAmt
EOY$225,399,613EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
EOY$46,179EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
EOY$564,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,690,933BOYAmt
EOY$4,703,045EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,690,933BOYAmt
EOY$5,313,224EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$188,458,835BOYAmt
EOY$210,527,098EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$30,237BOYAmt
EOY$13,052EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,064,881BOYAmt
EOY$9,546,239EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$197,553,953BOYAmt
EOY$220,086,389EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$204,244,886BOYAmt
EOY$225,399,613EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$23,089,055ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$556,619NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,064,881BeginningYearBalanceAmt
Investment Earnings Or Losses$481,358InvestmentEarningsOrLossesAmt
End Year Balance$9,546,239EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,546,225BeginningYearBalanceAmt
Investment Earnings Or Losses-$481,344InvestmentEarningsOrLossesAmt
End Year Balance$9,064,881EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,058,046BeginningYearBalanceAmt
Contributions$697ContributionsAmt
Investment Earnings Or Losses$751,271InvestmentEarningsOrLossesAmt
Other Expenditures$248,020OtherExpendituresAmt
Administrative Expenses$15,769AdministrativeExpensesAmt
End Year Balance$9,546,225EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,623,235BeginningYearBalanceAmt
Contributions$519ContributionsAmt
Investment Earnings Or Losses$689,130InvestmentEarningsOrLossesAmt
Other Expenditures$238,906OtherExpendituresAmt
Administrative Expenses$15,932AdministrativeExpensesAmt
End Year Balance$9,058,046EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,688,981BeginningYearBalanceAmt
Contributions$616ContributionsAmt
Investment Earnings Or Losses$1,188,611InvestmentEarningsOrLossesAmt
Other Expenditures$240,718OtherExpendituresAmt
Administrative Expenses$14,255AdministrativeExpensesAmt
End Year Balance$8,623,235EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescINVESTMENT IN FAUQUIER HOLDINGDesc
Book Value$33,046,604BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$33,046,604TotalBookValueProgramRltdAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescRESERVE LIABILITYDesc
Amt$4,703,045Amt
FieldValueIRS element (for citing)
Total Liability$4,703,045TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE FAUQUIER HOSPITAL ENDOWMENT FUND (THE TRUST) IS AN IRREVOCABLE TRUST CREATED BY THE CHICHESTER DUPONT FOUNDATION IN 1959. A LOCAL BANK WAS DESIGNATED AS THE TRUSTEE AND REMITS INCOME FROM THE TRUST TO THE HOSPITAL SEMIANNUALLY. THE INCOME MAY BE EMPLOYED BY THE HOSPITAL TO FURTHER ITS WORK IN SUCH MANNER AS THE BOARD OF TRUSTEES OF THE HOSPITAL DETERMINES.
PART X, LINE 2:THE FOLLOWING IS THE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. IN THE FOOTNOTE, FHS SERVICES REFERS TO THE CONSOLIDATED GROUP AS A WHOLE WHICH INCLUDES FHS SERVICES,FHI SERVICES, AND FAUQUIER HEALTH FOUNDATION. FHS SERVICES, FHI SERVICES AND THE FAUQUIER HEALTH FOUNDATION ARE ALL EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC AS A PUBLIC CHARITY PURSUANT TO IRC SECTION 509(A). FEDERAL TAX LAW REQUIRES THAT THESE ENTITIES BE OPERATED IN A MANNER CONSISTENT WITH THEIR INITIAL EXEMPTION APPLICATION TO MAINTAIN THEIR EXEMPT STATUS. MANAGEMENT HAS ANALYZED THE OPERATIONS OF THESE ENTITIES AND CONCLUDED THAT THESE ENTITIES REMAIN IN COMPLIANCE WITH THE REQUIREMENTS FOR EXEMPTION. THE STATE IN WHICH THESE ENTITIES OPERATE ALSO PROVIDES A GENERAL EXCEPTION FROM STATE INCOME TAXATION FOR ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAXATION. HOWEVER, THESE ENTITIES ARE SUBJECT TO BOTH FEDERAL AND STATE INCOME TAXATION AT CORPORATE TAX RATES ON THEIR UNRELATED BUSINESS INCOME. THESE ENTITIES HAVE NO UNRECOGNIZED TAX BENEFITS. MANAGEMENT HAS ALSO CONSIDERED THE IMPACT OF UNRELATED BUSINESS ACTIVITIES AND HAS CONCLUDED THAT THESE ENTITIES ARE NOT SUBJECT TO UNRELATED BUSINESS TAX OR ANY OTHER TAXES THAT COULD BE IMPOSED BY THE IRC OR STATE TAXING AUTHORITIES. AS SUCH, NO PROVISION IS MADE FOR INCOME TAXES AND NO ASSET OR LIABILITY HAS BEEN RECOGNIZED FOR DEFERRED TAXES.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically Indigent0FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$629,864TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$629,864NetCommunityBenefitExpnsAmt
Total Expense0.02820TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,365,227TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,365,962DirectOffsettingRevenueAmt
Net Community Benefit Expns-$735NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,995,091TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,365,962DirectOffsettingRevenueAmt
Net Community Benefit Expns$629,129NetCommunityBenefitExpnsAmt
Total Expense0.02820TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$213,740TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,138DirectOffsettingRevenueAmt
Net Community Benefit Expns$209,602NetCommunityBenefitExpnsAmt
Total Expense0.00940TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$100,386TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$100,386NetCommunityBenefitExpnsAmt
Total Expense0.00450TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,875,942TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,875,942NetCommunityBenefitExpnsAmt
Total Expense0.08400TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,190,068TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,138DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,185,930NetCommunityBenefitExpnsAmt
Total Expense0.09790TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,185,159TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,370,100DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,815,059NetCommunityBenefitExpnsAmt
Total Expense0.12610TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$564TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$564NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$298TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$298NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$862TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$862NetCommunityBenefitExpnsAmt
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$519,317BadDebtExpenseAmt
Bad Debt Expense Attributable$146,160BadDebtExpenseAttributableAmt
Reimbursed By Medicare$6,275,949ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$8,296,557CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$2,020,608MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE FAUQUIER HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 HOSPITAL DRIVEAddressLine1Txt
CityWARRENTONCityNm
State AbbreviationVAStateAbbreviationCd
ZIP20186ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.FAUQUIERHEALTH.ORGWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1THE FAUQUIER HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.FAUQUIERHEALTH.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt14ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.FAUQUIERHEALTH.ORGStrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.FAUQUIERHEALTH.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.FAUQUIERHEALTH.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.FAUQUIERHEALTH.ORGFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
THE FAUQUIER HOSPITALPART V, SECTION B, LINE 5: FAUQUIER HOSPITAL CONSULTED WITH COMMUNITY HEALTH SOLUTIONS OF RICHMOND, VIRGINIA, TO CONDUCT THE HEALTH NEEDS ASSESSMENT.INPUT WAS REQUESTED FROM 60 COMMUNITY STAKEHOLDERS VIA AN ONLINE SURVEY INCLUDING PUBLIC AND PRIVATE SCHOOLS, THE LOCAL HEALTH DEPARTMENT,EMS,THE UNITED WAY, FAUQUIER FREE CLINIC, FAUQUIER FISH,PEOPLE HELPING PEOPLE AND THE LOCAL HEAD START PROGRAM. INFORMATION WAS RECEIVED FROM ORGANIZATIONS AND COMMUNITY LEADERS WITH PUBLIC HEALTH KNOWLEDGE. THIS INFORMATION HELPED DETERMINE THE HEALTH NEEDS OF THE COMMUNITY AND THE FEEDBACK WAS INCLUDED IN THE IMPLEMENTATION STRATEGY.THE INFORMATION DISCUSSED INCLUDED COMMUNITY HEALTH CONCERNS, COMMUNITY SERVICE GAPS,VULNERABLE/AT-RISK POPULATIONS, HEALTH ASSETS IN THE COMMUNITY, SERIOUS HEALTH ISSUES ON THE HORIZON, AND WAYS TO PROMOTE BETTER HEALTH IN THE COMMUNITY.
THE FAUQUIER HOSPITALPART V, SECTION B, LINE 7D: IN ADDITION TO SHARING THE COMMUNITY HEALTH NEEDS ASSESSMENT ON THE FAUQUIER HEALTH WEBSITE, IT WAS DISTRIBUTED TO: THE COMMUNITY STAKEHOLDERS WHO WERE INVITED TO TAKE PART IN THE ONLINE SURVEY; THE WARRENTON OFFICE OF THE RAPPAHANNOCK RAPIDAN HEALTH DEPARTMENT AS WELL AS ANYONE WHO REQUESTS A COPY OF THE ASSESSMENT.
THE FAUQUIER HOSPITALPART V, SECTION B, LINE 11: FAUQUIER HEALTH'S HEALTH NEEDS ASSESSMENT IDENTIFIED AND EVALUATED THE GLOBAL COMMUNITY HEALTH NEEDS OF OUR PRIMARY SERVICE AREA OF FAUQUIER AND RAPPAHANNOCK COUNTIES. OF THE MANY COMMUNITY SERVICE GAPS AND HEALTH NEEDS IDENTIFIED, FAUQUIER HEALTH CHOSE THE AREA OF GREATEST NEED AND WHERE THE GREATEST IMPACT COULD BE MADE. THOSE TOPICS ARE TRANSPORTATION, HEALTH EDUCATION, AGING SERVICES AND EARLY DETECTION AND SCREENING IN ADDITION TO LEADING CAUSES OF DEATH, WHICH ARE: CANCER, HEART DISEASE, DIABETES AND ALZHEIMER'S. CHILDHOOD OBESITY, A COMMUNITY HEALTH CONCERN IS ALSO BEING ADDRESSED. TO ADDRESS HEALTH EDUCATION AND LEADING CAUSES OF DEATH, THE HOSPITAL HOSTS FREE, MONTHLY HEALTH LECTURES ON VARIOUS TOPICS IDENTIFIED IN THE ASSESSMENT SUCH AS CANCER, HEART DISEASE, LYME DISEASE, MENOPAUSE, OSTEOPOROSIS, DIABETES, CONGESTIVE HEART FAILURE AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE. THE ANNUAL HEALTH FAIR PROVIDES HEALTH SCREENINGS FOR B/P, CHOLESTEROL, BLOOD GLUCOSE, BMI, AND PSA SCREENINGS. FAUQUIER HEALTH ADDRESSES DIABETES, BY PROVIDING DIABETES EDUCATION INCLUDING SUPPORT GROUPS, SELF-MANAGEMENT CLASSES, SCREENINGS AND COUNSELING. FREE MAMMOGRAMS ARE PROVIDED TO WOMEN TURNING 40 TO PROVIDE BREAST CANCER SCREENINGS. TO ADDRESS AGING SERVICES, FAUQUIER HEALTH FACILITATES SUPPORT GROUPS FOR ALZHEIMER'S, DEMENTIA, CANCER, CAREGIVERS AND DIABETES. IN ADDITION, FAUQUIER PARTNERS WITH THE LOCAL COMMUNITY SERVICE BOARD AND AGING TOGETHER TO HOST MEDICARE/MEDICAID COUNSELING AND A FALLS SYMPOSIUM AND ALZHEIMER'S/DEMENTIA WORKSHOP. FAUQUIER HEALTH PARTNERED WITH FAUQUIER COMMUNITY CHILD CARE TO ADDRESS CHILDHOOD OBESITY THROUGH AN 8 WEEK SUMMER CAMP PROGRAM THAT HIGHLIGHTED PHYSICAL ACTIVITY AND NUTRITION. OTHER HEALTH NEEDS IDENTIFIED THAT THE HOSPITAL IS NOT ADDRESSING ARE HANDLED BY OTHER LOCAL ORGANIZATIONS OR GOVERNMENT ENTITIES. AM EXAMPLEIS SOCIAL SERVICES. DENTAL CARE IS NOT THE EXPERTISE OF THE HOSPITAL SO IT IS ADDRESSED BY THE LOCAL FREE CLINIC. BEHAVIORAL HEALTH IS CURRENTLY ADDRESSED BY THE LOCAL COMMUNITY SERVICES BOARD, HOWEVER THE HOSPITAL IS EXPLORING INITIATIVES TO ADDRESSTHE NEED IN THE COMMUNITY. THE HOSPITAL SUPPORTS THE LOCAL FREE CLINIC FINANCIALLY AND WITH DONATED LAB AND RADIOLOGY SERVICES TO PROVIDE CARE TO THE UNINSURED POPULATION. THE RESULTS OF THE HEALTH NEEDS ASSESSMENT ARE CONTINUALLY BEING REVIEWED AND CONSIDERED BY FAUQUIER HOSPITAL LEADERSHIP.
THE FAUQUIER HOSPITALPART V, SECTION B, LINE 16I: IN ADDITION TO PUBLISHING THE FINANCIAL ASSISTANCE POLICY ON THE HOSPITAL'S WEBSITE, SIGNAGE IS POSTED STRATEGICALLY THROUGHOUT THE HOSPITAL (INCLUDING ALL INPATIENT, OUTPATIENT, ANCILLARY AND EMERGENCY DEPARTMENT REGISTRATION OFFICES) WHICH INDICATES THAT FINANCIAL ASSISTANCE IS AVAILABLE AND PROVIDES CONTACT INFORMATION FOR FINANCIAL COUNSELORS WHO CAN HELP WITH THE APPLICATION PROCESS. NOTIFICATIONS REGARDING THE POLICY ARE AVAILABLE IN BOTH ENGLISH AND SPANISH, THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY FAUQUIER HOSPITAL. REPRESENTATIVES OF OUR FINANCIAL ASSISTANCE ELIGIBILITY PARTNERS, MEDASSIST, ALSO DIRECTS ALL PATIENTS WHO ARE SCREENED FOR STATE OR FEDERAL ASSISTANCE PROGRAMS BUT DO NOT QUALIFY TO THE HOSPITAL FINANCIAL COUNSELORS FOR HOSPITAL CHARITYSCREENING.
THE FAUQUIER HOSPITALPART V, SECTION B, LINE 22D: AMOUNTS CHARGED TO A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY WILL BE BASED ON THE APPLICABLE DISCOUNT STATED IN THE FINANCIAL ASSISTANCE DISCOUNT GUIDELINES TABLE MULTIPLIED BY THE GROSS CHARGES OTHERWISE BILLABLE TO THE PATIENT. THESE DISCOUNTS HAVE BEEN ESTABLISHED IN A MANNER THAT IS INTENDED TO ENSURE THAT, FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 501(R), A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY IS NOT CHARGED MORE THAN THE AMOUNT GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE ("AGB"). FAUQUIER HOSPITAL HAS INITIALLY ELECTED TO CALCULATE AGB USING THE "LOOK BACK METHOD" DESCRIBED IN APPLICABLE TREASURY REGULATIONS, BASED ON CLAIMS APPROVED BY MEDICARE AND PRIVATE INSURERS DURING A 12-MONTH MEASUREMENT PERIOD. FURTHER INFORMATION ABOUT THE AGB PERCENTAGE CURRENTLY IN USE AND A DESCRIPTION OF HOW SUCH AGB PERCENTAGE WAS CALCULATED MAY BE OBTAINED IN WRITING AND FREE OF CHARGE BY SENDING A WRITTEN REQUEST TO FAUQUIER HOSPITAL - PATIENT FINANCIAL SERVICES, 500 HOSPITAL DRIVE, WARRENTON , VA 20186 . THIS INFORMATION MAY ALSO BE DOWNLOADED AT WWW.FAUQUIERHEALTH.ORG .
FieldValueIRS element (for citing)
Facility14FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - THE VILLA AT SUFFIELD MEADOWS
6735 SUFFIELD LANEWARRENTONVA20187ASSISTED LIVING
2 - FAUQUIER HEALTH REHABILITATION AND NU
360 HOSPITAL DRIVEWARRENTONVA20186NURSING HOME
3 - FAUQUIER HEALTH WELLNESS CENTER
419 HOLIDAY COURT SUITE 200WARRENTONVA20186WELLNESS CENTER
4 - FAUQUIER HEALTH HOME CARE SERVICES
170 W SHIRLEY AVEWARRENTONVA20186HOME CARE
5 - FAUQUIER HEALTH SLEEP CENTER
493 BLACKWELL ROAD SUITE 317-AWARRENTONVA20186SLEEP CENTER
6 - WOUND HEALING CENTER
493 BLACKWELL ROAD SUITE 317-AWARRENTONVA20186WOUND CENTER
7 - FAUQUIER HOSPITAL-MEDICAL IMAGING SERVIC
493 BLACKWELL ROAD SUITE 119WARRENTONVA20186MEDICAL IMAGING
8 - HEMATOLOGYONCOLOGY
500 HOSPITAL DRIVEWARRENTONVA20186PHYSICIAN SERVICE
9 - INFECTIOUS DISEASES RHEUMATOLOGYENDO
550 HOSPITAL DRIVEWARRENTONVA20186PHYSICIAN SERVICE
10 - OBSTETRICS AND GYNECOLOGY
253 VETERNAS DRIVE SUITE 210WARRENTONVA20186PHYSICIAN SERVICE
11 - FAMILY PRACTICE AT BEALETON
6200 STATION DRIVEBEALETONVA22712PHYSICIAN SERVICE
12 - INTERNAL MEDICINE AT LAKE MANASSAS
7915 LAKE MANASSAS DR 101GAINESVILLEVA20155PHYSICIAN SERVICE
13 - NEUROLOGY
384 HOSPITAL DRIVEWARRENTONVA20186PHYSICIAN SERVICE
14 - PIEDMONT INTERNAL MEDICINE
419 HOLIDAY COURT SUITE 200WARRENTONVA20186PHYSICIAN SERVICE

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:ALL PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME LEVELS ARE AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG),ARE ELIGIBLE FOR FREE CARE. THIS PROCESS REQUIRES AN APPLICATION AND VERIFICATION OF ALL SOURCES OF INCOME. IN ADDITION,ALL PATIENTS WHOSE INCOME IS BETWEEN 200-300% OF FPG ARE ELIBLE FOR DISCOUNTED CARE. BEFORE FINAL COLLECTION ACTION, ACCOUNTS ARE PUT THROUGH CREDIT SCORING SOFTWARE TO HELP IDENTIFY THOSE PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAVE NOT CONTACTED OUR OFFICE UP TO THAT POINT. IF THE SOFTWARE INDICATES THAT THE PATIENT'S INCOME LEVEL MEETS FINANCIAL ASSISTANCE ELIGIBILITY, THE ACCOUNT IS PRESUMPTIVELY WRITTEN OFF TO CHARITY AND FURTHER COLLECTION ACTIVITY IS NOT PURSUED.PART I, LINE 7THE HOSPITAL FACILITY WAS CONTRIBUTED TO FAUQUIER HOLDING COMPANY, LLC AS PART OF THE LIFEPOINT TRANSACTION IN TAX YEAR 2013. FHI SERVICESRETAINS A 20% OWNERSHIP INTEREST IN FAUQUIER HOLDING COMPANY, LLC, AND APPOINTS 50% OF THE MEMBERS OF THE GOVERNING BOARD AND MAINTAINS RESERVE POWERS OVER EXEMPT ACTIVITIES OF THE JOINT VENTURE. FAUQUIER HOLDING COMPANY, LLC HAS A CALENDAR YEAR FISCAL YEAR AND ISSUES ITSFORM K-1 BASED UPON THE CALENDAR YEAR. AS A RESULT, THE INFORMATION PROVIDED IN PART I LINE 7 AND PART II REFLECTS THE OPERATIONS REFLECTED ON THE K-1 ISSUED BY FAUQUIER HOLDING COMPANY, LLC, WHICH IS 20% OF THE TOTAL COSTS INCURRED BY FAUQUIER HOSPITAL, FOR ITS YEAR ENDING WITHIN FHI SERVICES' FISCAL YEAR ( FROM JANUARY 1, 2015 THROUGH DECEMBER 31, 2015). FHI SERVICES' FISCAL YEAR WAS 10/1/2015 - 9/30/2016.
PART II, COMMUNITY BUILDING ACTIVITIES:COMMUNITY BUILDING ACTIVITIES SUPPORT THE HEALTH OF THE COMMUNITY BY OFFERING ENVIRONMENTAL IMPROVEMENTS AND COMMUNITY SUPPORT.ENVIRONMENTAL IMPROVEMENTS - FAUQUIER HEALTH'S ANNUAL MEDICATION AND SHARPS COLLECTION EVENTS HELPS TO SAFELY DISPOSE OF 300 GALLONS OF SHARPS AND 550 LBS OF MEDICATIONS. RATHER THAN COMMUNITY MEMBERS FLUSHING MEDICATIONS INTO THE GROUND WATER OR DISPOSING OF SHARPS AT THE LANDFILL, FAUQUIER HEALTH COLLECTS THEM AND WORKS WITH A MEDICAL WASTE MANAGEMENT COMPANY THAT DISPOSES OF THE ITEMS.COMMUNITY SUPPORT ACTIVITIES INCLUDED MED SHARPS,EMERGENCY DRUG SUPPLIES AND DISASTER ASSISTANCE.
PART III, LINE 2:THE AMOUNT OF ORGANIZATION'S BAD DEBT EXPENSE WAS ESTIMATED BY MULTIPLYING THE TOTAL BAD DEBT EXPENSE FOR FAUQUIER HEALTH BY THE COST-TO-CHARGE RATIO CALCULATED IN WORKSHEET II. THE AMOUNT REPORTED IS 20% OF THIS COST WHICH IS THE FHI SERVICES INTEREST IN THE FAUQUIER HOLDING COMPANY, LLC.
PART III, LINE 3:BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS ESTIMATED BY USING THE TOTAL BAD DEBT EXPENSE FOR FAUQUIER HEALTH MULTIPLIED BY THE COST-TO-CHARGE RATIO TO CALCULATE COST. THE BAD DEBT EXPENSE AT COST IS MULTIPLIED BY 29% WHICH IS THE ESTIMATED PERCENTAGE ATTRIBUTABLE TO PATIENTS THAT WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY. THE AMOUNT REPORTED IS 20% OF THIS COST WHICH IS THE FHI SERVICES INTEREST IN THE FAUQUIER HOLDING COMPANY, LLC.
PART III, LINE 4:ACCOUNTS RECEIVABLE ARE REPORTED NET OF ALLOWANCES FOR THE EXCESS OF CHARGES OVER THE PAYMENTS ON PATIENT ACCOUNTS TO BE RECEIVED FROM THIRD PARTY PAYERS AND ESTIMATES OF UNCOLLECTIBLE AMOUNTS. THE SYSTEM'S POLICY IS TO WRITE-OFF ALL PATIENT ACCOUNTS THAT HAVE BEEN IDENTIFIED AS UNCOLLECTABLE. ANY ALLOWANCE FOR DOUBTFUL ACCOUNTS IS RECORDED FOR ACCOUNTS NOT YET WRITTEN OFF THAT MAY BECOME UNCOLLECTABLE IN FUTURE PERIODS BASED ON MANAGMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS FOR EACH OF ITS MAJOR PAYERS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS , AND OTHERS FOR SERVICES RENDERED, AND INCLUDE ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGERSUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS. FAUQUIER HOSPITAL PERIODICALLY EMPLOYED CREDIT SCORING SOFTWARE TO HELP IDENTIFY PATIENTS THAT MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, WHICH HAD NOT COMPLETED A FINANCIAL ASSISTANCE APPLICATION. IF THE SOFTWARE INDICATED THAT THE PATIENT'S INCOME LEVEL MET FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THEN THE ACCOUNT WAS WRITTEN OFFTO CHARITY AND FURTHER COLLECTION ACTIVITY WAS NOT PURSUED. AS A RESULT OF THE PERIODIC USE OF SUCH CREDIT SCORING SOFTWARE THROUGHOUT THE YEAR, IT IS DIFFICULT TO ESTIMATE THE AMOUNT OF THE BAD DEBT EXPENSE ATTRIBUTABLETO PATIENTS THAT MIGHT QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.
PART III, LINE 8:THE SHORTFALL FOR MEDICARE IS NOT CURRENTLY INCLUDED/CONSIDERED IN COMMUNITY BENEFIT. HOWEVER, THE SHORTFALL IS DUE TO THE REIMBURSEMENT FROM MEDICARE FALLING SHORT OF THE COST INCURRED TO PROVIDE CARE TO THE MEDICARE POPULATION SERVED BY THE FAUQUIER HOSPITAL. AS WITH THE SHORTFALL EXPERIENCED FOR THE MEDICAID POPULATION, THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT AS WELL. IT IS PART OF THE ORGANIZATION'S MISSION TO PROVIDE THE BEST POSSIBLE CARE TO PATIENTS WITHIN OUR COMMUNITY, AND THE ORGANIZATION BELIEVES PROVIDING SUCH CARE HAS IMPROVED THE OVERALL HEALTH OF THE COMMUNITY. BY PROVIDING SUCH CARE TO MEDICARE PATIENTS, THE GOVERNMENT'S BURDEN FOR CARING FOR SUCH INDIVIDUALS IS LESSENED. THE MEDICARE COST REPORT WAS UTILIZED AS OUTLINED IN THE SCHEDULE H,PART III, SECTION B, WORKSHEET B, WHICH UTILIZES THE COST TO CHARGE RATIO DEVELOPED WITHIN THE MEDICARE COST REPORT TO DETERMINE THE ALLOWABLE COST.
PART III, LINE 9B:FAUQUIER HOSPITAL'S FINANCIAL ASSISTANCE POLICY CONTAINS THE FOLLOWING PROVISION ON COLLECTION PRACTICES FOR THOSE PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE: FAUQUIER HOSPITAL MANAGEMENT SHALL DEVELOP POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT,INCLUDING COLLECTIONS ACTION AND REPORTING TO CREDIT AGENCIES) THAT TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY CARE OR DISCOUNTED CARE; A PATIENT'S GOOD FAITH EFFORTS TO APPLY FOR GOVERNMENTALASSISTANCE PROGRAMS OR FINANCIAL ASSISTANCE FROM FAUQUIER HOSPITAL, AND APATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS OR HER PAYMENT AGREEMENTSWITH FAUQUIER HOSPITAL. FAUQUIER HOSPITAL WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS LAWSUITS, WAGE GARNISHMENTS, ARRESTS, BODY ATTACHMENTS, LIENS ON RESIDENCES, OR OTHER SIMILAR LEGAL ACTIONS AGAINSTANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHERTHAT PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS FINANCIAL ASSISTANCE POLICY. "REASONABLE EFFORTS" INCLUDE NOTIFICATIONS BY THE HOSPITAL OF THIS FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND IN WRITTEN AND ORAL COMMUNICATIONS WITH THE PATIENT REGARDING THE PATIENT'S BILL,INCLUDING INVOICES AND TELEPHONE CALLS BEFORE COLLECTION ACTION OR REPORTING TO CREDIT AGENCIES IS INITIATED. IF A PATIENT IS FOUND TO QUALIFY FOR FINANCIAL ASSISTANCE AFTER COLLECTION ACTIONS HAVE STARTED, ALL COLLECTION ACTIVITY IS IMMEDIATELY STOPPED, NOTIFICATIONS ARE SENT TO THE CREDIT BUREAU IF NECESSARY AND PATIENTS ARE NOT CHARGED FOR COLLECTION FEES.IF A PATIENT IS FOUND TO QUALIFY FOR FINANCIAL ASSISTANCE AFTER MAKING PAYMENTS TOWARDS THEIR BALANCE, THE PAYMENTS ARE REFUNDED TO THE PATIENT.
PART VI, LINE 2:FAUQUIER HEALTH ASSESSES THE HEALTH NEEDS OF THE COMMUNITY BY CONDUCTING A HEALTH NEEDS ASSESSMENT EVERY THREE YEARS AS WELL AS CONTINUALLY COMMUNICATING WITH THE COMMUNITY STAKEHOLDERS WHO ARE SERVING OUR AREAS RESIDENTS. FOR EXAMPLE, FAUQUIER HEALTH MEETS REGULARLY WITH THE FAUQUIER FREE CLINIC LEADERSHIP AND PROVIDES FINANCIAL AND IN-KIND ASSISTANCE TO THE CLINIC WHICH SERVES THE UNINSURED IN FAUQUIER AND RAPPAHANNOCK COUNTIES.
PART VI, LINE 3:NOTIFICATION OF FAUQUIER HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM IS DISSEMINATED BY VARIOUS MEANS, INCLUDING NOTIFICATION OF CONTACT INFORMATION FOR FINANCIAL COUNSELORS ON ALL OF OUR BILLING STATEMENTS AND SIGNAGE IN ALL OF OUR PATIENT REGISTRATIONS AREAS. THE POLICY ITSELF IS AVAILABLE ON THE HOSPITAL WEBSITE, WHICH ALSO PROVIDES CONTACT INFORMATION FOR OUR FINANCIAL COUNSELORS. REQUESTS FOR FINANCIAL ASSISTANCE MAY BE MADE AT ANY POINT IN THE COLLECTION CYCLE. EVERY BILLING STATEMENT RECEIVED BY A PATIENT INCLUDES THE FOLLOWING LANGUAGE:"IN MEETING YOUR FINANCIAL OBLIGATIONS FOR THE CARE PROVIDED BY FAUQUIER HOSPITAL WE ASK THAT YOU WORK WITH US ON ANY BILLS THAT YOU ARE HAVING DIFFICULTY PAYING.YOU WILL FIND OUR STAFF UNDERSTANDING AND EAGER ,TO HELP YOU." THIS MESSAGE IS FOLLOWED BY A LIST OF TELEPHONE NUMBERS THAT THE PATIENT MAY CALL TO REACH THE ORGANIZATION'S FINANCIAL COUNSELING STAFF, HOURS OF OPERATION,AND AN EMAIL ADDRESS. WHEN PATIENTS CALL THE FINANCIAL COUNSELING TELEPHONE NUMBER, THEY ARE PROMPTED TO SELECTIONS TO REACH THE STAFF MEMBER THAT IS MOST LIKELY ABLE TO HELP THEM I.E.: UNINSURED, SPANISH SPEAKING, BILLING QUESTIONS, ETC. IN ADDITION,UNINSURED INPATIENTS AND THOSE WITH MEDICARE INSURANCE AND NO SECONDARY CARRIER ARE CONTACTED USUALLY WITH A PERSONAL VISIT IN THEIR HOSPITAL ROOM) BY AN EMPLOYEE OF ONE OF OUR PARTNERS, MEDASSIST.THE MEDASSIST PERSONNEL SCREEN THESE PATIENTS FOR ELIGIBILITY FOR AVAILABLE STATE OR FEDERAL PROGRAMS. IF THESE PATIENTS DO NOT MEET CRITERIA FOR THESE PROGRAMS, THEY ARE THEN REFERRED TO A FINANCIAL COUNSELOR FOR SCREENING FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. UNINSURED PATIENTS WHO VISIT OUR EMERGENCY DEPARTMENT ARE ALSO GIVEN A PACKET OF INFORMATION THAT INCLUDES A FINANCIAL ASSISTANCE APPLICATION AND A BUSINESS CARD WITH THE NAME AND CONTACT INFORMATION FOR ONE OF OUR FINANCIAL COUNSELORS. LASTLY, WE DO USE CREDIT SCORING SOFTWARE TO HELP IDENTIFY PATIENTS WHO MIGHT QUALIFY FOR FINANCIAL ASSISTANCE BUT HAVE NOT CONTACTED OUR OFFICE. OUR FINANCIAL ASSISTANCE POLICY STATES THAT WE MAY USE THIS KIND OF SOFTWARE, WHICH USES INFORMATION FROM CREDIT BUREAUS AND SCREENS PATIENTS AGAINST THE CRITERIA OF OUR FINANCIAL ASSISTANCE POLICY.
PART VI, LINE 4:FAUQUIER HOSPITAL (FH)IS A 97-BED, NOT-FOR-PROFIT,ACUTE CARE FACILITY ESTABLISHED IN 1954 TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES TO THE RURAL COMMUNITIES IT SERVES. OUR MISSION IS TO RESTORE, PROMOTE AND MAINTAIN THE HEALTH OF OUR COMMUNITY. FAUQUIER HOSPITAL IS THE ONLY HOSPITAL IN OUR PRIMARY SERVICE AREA, WHICH INCLUDES FAUQUIER AND MINOR PORTIONS OF FIVE SURROUNDING COUNTIES. THE PRIMARY SERVICE AREA HAS A POPULATION OF 83,195.THE AVERAGE HOUSEHOLD INCOME IS $114,633.7.1% OF THE COMMUNITY RESIDENTS HAVE INCOMES BELOW THE FEDERAL POVERTY GUIDELINE. 17.2% OF FAUQUIER HOSPITAL'S PATIENTS ARE MEDICAID RECIPIENTS OR SELF-PAY. THE FOLLOWING DISTRICTS WITHIN FAUQUIER COUNTY ARE CONSIDERED MUA/P BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION(HRSA): LEE DISTRICT AND MARSHALL DISTRICT.
PART VI, LINE 5:FAUQUIER HEALTH PROMOTES THE HEALTH OF THE COMMUNITY BY: - ENSURING THAT THE MAJORITY (78%) OF THE INDIVIDUALS SERVING ON THE FAUQUIER HOSPITAL BOARD OF DIRECTORS RESIDE IN THE PRIMARY SERVICE AREA AND ARE NOT EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION.- EXTENDING MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY WHO ARE INTERESTED. - FAUQUIER HEALTH USES SURPLUS FUNDS TO IMPROVE PATIENT CARE BY UPGRADING THE TOOLS NEEDED TO CARE FOR PATIENTS AND PLANNING FOR IMPROVEMENTS. FAUQUIER HEALTH CONTINUES TO SUPPORT TWENTY-ONE EMPLOYED PHYSICIANS, AN ENDOCRINOLOGIST, TWO OBSTETRICS/GYNECOLOGISTS, THREE FAMILY MEDICINE PHYSICIANS, A RHEUMATOLOGIST, A NEUROLOGIST, AN INFECTIOUS DISEASE SPECIALIST, A HEMATOLOGIST/ONCOLOGIST, TWO UROLOGISTS, AND SEVEN INTERNISTS. A HOME HEALTH DISEASE MANAGEMENT TRAINING PROGRAM (TO INCLUDE CONGESTIVE HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND DIABETES) WAS IMPLEMENTED FOR PATIENTS. A TRANSITIONS TO HOME PROGRAM WAS DEVELOPED TO ADDRESS CHRONIC DISEASE MANAGEMENT AND READMISSION RATES FOR PATIENTS. PLANS DEVELOPED FOR A NEONATAL INTENSIVE CARE UNIT WERE ALSO PERFORMED.- FH PARTNERS WITH LOCAL NON-PROFIT ORGANIZATIONS(E.G. FAUQUIER FREE CLINIC, THE CHAMBER OF COMMERCE, SCHOOLS AND CHURCHES) AND NATIONAL ORGANIZATIONS (E.G. THE AMERICAN CANCER SOCIETY) TO SUPPORT LOCAL EVENTSAND PROVIDE COMMUNITY HEALTH AND WELLNESS PROGRAMS. THESE COMMUNITY BENEFITS ACTIVITIES ARE COORDINATED BY A FULL-TIME COMMUNITY OUTREACH STAFF PERSON, SUPPORTED BY ADMINISTRATIVE AND CLINICAL DEPARTMENTS, AND OUR AUXILIARY VOLUNTEERS AS NEEDED. - TO HELP TRAIN AND EDUCATE HEALTH CARE PROFESSIONALS, FH WORKS WITH LOCAL COMMUNITY COLLEGES TO PROVIDE TOURS, LECTURES, AND INTERNSHIPS FOR STUDENTS; FH STAFF PROVIDED APPROXIMATELY 29,487 HOURS AT A COST OF APPROXIMATELY $487.623. - ADDITIONALLY, THE ORGANIZATION PROVIDES ASSISTANCE TO THE FAUQUIER FREE CLINIC (FFC). FFC PROVIDES PRIMARY HEALTH AND DENTAL CARE TO UNINSURED RESIDENTS OF FAUQUIER AND RAPPAHANNOCK COUNTIES. FH PROVIDED LABORATORY, CARDIOLOGY/NEUROLOGY/PULMONARY SERVICES, AND RADIOLOGY SERVICES AT NO CHARGE TO FCC PATIENTS FOR A TOTAL COST OF $192,455. A TOTAL OF 708 HOURSOF FREE CLINICAL CARE WERE PROVIDED BY COMMUNITY PHYSICIANS AND CLINICAL STAFF. IN ADDITION, FH CONTRIBUTED $2,500 IN UNRESTRICTED FUNDS. COMMUNITY HEALTH EDUCATION, SCREENINGS AND OUTREACH PROGRAMS: FAUQUIER HEALTH PROVIDED 74 HEALTH EDUCATION SEMINARS (WHICH INCLUDE CLASSES AND LECTURES) AND HEALTH SCREENINGS AT 11 LOCAL EVENTS. FH ALSO PROVIDES SPEAKERS FOR LOCAL SCHOOLS AND COMMUNITY ORGANIZATIONS TO BUILD RELATIONSHIPS WITHIN THE COMMUNITY, PROMOTE COLLABORATION IN MANAGING HEALTH AND WELLNESS, AND EDUCATE THE COMMUNITY ON THE HEALTH SYSTEM.HEALTH EDUCATION THROUGH ADVERTISING, MEDIA, AND PUBLICATIONS: FH HAS TWO PUBLICATIONS, ONE IS A COMMUNITY NEWSLETTER, HEALTHY HAPPENINGS, INTENDED TO EDUCATE THE PUBLIC ABOUT HEALTH ISSUES AND HEALTH CARE AND HOSPITAL SERVICES. PUBLISHED QUARTERLY, IT REACHES 101,000 HOMES IN FAUQUIER AND SURROUNDING COUNTIES. THE SECOND IS A SENIOR LIVING PUBLICATION THAT IS PUBLISHED TWICE A YEAR AND REACHES 42,000 INDIVIDUALS WHO ARE AGE 55 AND OLDER. THE COST TO FH FOR PUBLICATION AND DISTRIBUTION OF THESE NEWSLETTERS IN FY15 WAS $426,225.EMERGENCY SERVICES. FH PROVIDES MEDICAL OVERSIGHT, DIRECTION, AND ORDERS TO PARAMEDICS IN THE FIELD AND IN ROUTE TO THE HOSPITAL. OUR EMERGENCY DEPARTMENT OFFERS 24-HOUR ACCESS TO MEDICAL SERVICES AND HELICOPTER TRANSPORT FOR CRITICALLY ILL OR INJURED INDIVIDUALS.SUPPORT GROUPS AND COMMUNITY GROUPS. FH SPONSORED, ASSISTED, OR PROVIDED MEETING SPACE FOR FIVE SUPPORT GROUPS THAT MET WEEKLY OR MONTHLY, AT A COST TO FH OF $11,681. ADDITIONALLY, FH PROVIDED MEETING SPACE OR CASH DONATIONS FOR SEVERAL NON-PROFIT COMMUNITY GROUPS, (E.G. THE AMERICAN RED CROSS, FAUQUIER FREE CLINIC AND AMERICAN CANCER SOCIETY FAUQUIER CHAPTER), WITH A FAIR MARKET VALUE OF $44,905 FOR THE MEETING SPACE AND TOTAL CASH DONATIONS IN THE AMOUNT OF $11,500. FH EMPLOYEES PROVIDED REPRESENTATION ON COMMUNITY BOARDS AND COALITIONS AT AN EXPENSE OF $8,820.PHYSICIAN REFERRAL. THE HOSPITAL ASSISTED 1,304 PEOPLE THROUGH THE PHYSICIAN REFERRAL PROGRAM, WHICH HELPS THE COMMUNITY WITH QUESTIONS ON PHYSICIANS, APPOINTMENTS, CLASSES AND PROGRAMS REGISTRATION, AND HEALTH RESOURCES AVAILABLE THROUGH THE HOSPITAL OR IN THE COMMUNITY.
PART VI, LINE 6:THE 80% OWNER OF FAUQUIER HOSPITAL IS LIFEPOINT HEALTH, A LEADING HEALTHCARE COMPANY DEDICATED TO MAKING COMMUNITIES HEALTHIER WITH FACILITIES IN 22 STATES. FHI SERVICES HAS A 20% OWNERSHIP INTEREST IN FAUQUIER HOLDING COMPANY, LLC, WHICH OPERATES FAUQUIER HOSPITAL ALONG WITH LIFEPOINT HEALTH WHICH MAINTAINS AN 80% OWNERSHIP INTEREST.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxtAddress Line2USAddress/AddressLine2Txt
AGING TOGETHER
PO BOX 367CULPEPERVA22701462046459501(C)(3)$25,000CAPACITY BUILDING FUNDING TO SUPOORT THE ORGANIZATION DURING A TRANSITION IN LEADERSHIP.
BOYS AND GIRLS CLUB OF FAUQUIER INC
169 KEITH STREETWARRENTONVA20186541815587501(C)(3)$40,000SUPPORT FOR THE SERVICE OFFERINGS AND OPERATING PLAN FOR A YOUTH AFTER SCHOOL PROGRAM.
COMMUNITY TOUCH INC
10499 JERICHO RDBEALETONVA22712201369506501(C)(3)$10,000FUNDING TO CREATE A STRATEGIC PLANNING GRANT TO CREATE A COMPREHENSIVE MARKETING PLAN. THE OBJECTIVE OF THE PLAN WAS TO ENHANCE THE ORGANIZATION'S VISIBILITY TO REACH THE TARGET CLIENT BASE AS WELL AS INCREASE FUTURE DONOR SUPPORT.
FAUQUIER COMMUNITY CHILD CARE INC
400 HOLIDAY CT SUITE 105WARRENTONVA20186541590790501(C)(3)$34,500FUNDING TO ASSIST IN IMPLEMENTING THE HEALTHY EATING AND PHYSICAL ACTIVITY STANDARDS IN ASSOCIATION WITH THE NATIONAL AFTER SCHOOL ASSOCIATION.
FAUQUIER COUNTY COMMUNITY DEVELOPMENT
29 ASHBY ST 3RD FLOORWARRENTONVA20186546001274FAUQUIER COUNTY$50,000FUNDING FOR THE COMMUNITY CONVERSATIONS STRATEGIC PLANNING PROCESS TO INVOLVE COMMUNITY MEMBERS IN UNDERSTANDING AND RESPONDING TO EXTERNAL FORCES AND INTERNAL CHANGES AFFECTING THE COUNTY OVER THE UPCOMING DECADES, AND INFORM THE COUNTY'S COMPREHENSIVE PLAN UPDATE.
FAUQUIER COUNTY PUBLIC LIBRARY
11 WINCHESTER STWARRENTONVA20186546001274FAUQUIER COUNTY$25,000FUNDING FOR A COMMUNITY ASSESSMENT TO ASSIST THE LIBRARY AND COUNTY IN PLANNING FOR FUTURE LIBRARY RESOURCES AND SERVICES.
FAUQUIER COUNTY PUBLIC SCHOOLS (FCPS)-VPI
430 E SHIRLEY AVEWARRENTONVA20186546001276FAUQUIER COUNTY$15,000SUPPORT FOR THE PLANNING OF A FOUR WEEK SUMMER PROGRAM TO BE OFFERED IN JULY 2017. RISING KINDERGARTENERS WHO ARE IDENTIFIED AS POTENTIALLY BEING AT RISK WILL BE IDENTIFIED TO PARTICIPATE.
FCPS- FAUQUIER REACHES FOR EXCELLENCE IN SOCIAL HEALTH
430 E SHIRLEY AVEWARRENTONVA20186546001276FAUQUIER COUNTY$100,000FUNDING FOR THE FRESH PROGRAM TO SUPPORT A CULTURE OF HEALTH AND FITNESS FOR STUDENTS ATTENDING FAUQUIER COUNTY PUBLIC SCHOOLS.
FAUQUIER EXCELLENCE IN EDUCATION FOUNDATION
PO BOX 512WARRENTONVA20188541433026501(C)(3)$96,500FUNDING TO IMPROVE THE BUILDING AND GROUNDS OF THE OUTDOOR LAB LOCATED AT FAUQUIER HIGH SCHOOL.
FAUQUIER FREE CLINIC INC
PO BOX 3138WARRENTONVA20188541669652501(C)(3)$370,000FUNDING TO SUPPORT THE IMPLEMENTATION OF INTEGRATED MENTAL HEALTH CARE SERVICES. IMPLEMENT A TELE-PSYCHIATRY PROGRAM AND PROVIDE REMOTE MENTAL HEALTH SERVICES TO FILL GAPS IN LOCAL RESOURCES.
FAUQUIER FREE CLINIC INC
PO BOX 3138WARRENTONVA20188541669652501(C)(3)$52,700FUNDING TO ADD NEW CAPACITY TO ADDRESS THE SHORTAGE OF ORAL HEALTH RESOURCES IN THE REGION.
FAUQUIER HABITAT FOR HUMANITY
PO BOX 3189WARRENTONVA20188541595774501(C)(3)$6,150FUNDING TO PROVIDE FINANCIAL AND NUTRITIONAL EDUCATION FOR FAMILIES.
LORD FAIRFAX COMMUNITY COLLEGE FOUNDATION
LFCC FOUNDATION CORRON 2013 173MIDDLETOWNVA22645510247624501(C)(3)$75,000FUNDING FOR AN ASSOCIATE OF APPLIED SCIENCE IN EMERGENCY MEDICAL SERVICES (EMS) DEGREE AND PARAMEDIC CAREER STUDIES CERTIFICATE PROGRAM.SKIRMISHER LN
MENTAL HEALTH ASSOCIATION OF FAUQUIER COUNTY
PO BOX 3549WARRENTONVA20188521215685501(C)(3)$33,000FUNDING TO ALLOW FOR PLANNING TO INTEGRATE BEHAVIORIAL HEALTH SERVICES INTO MEDICAL SERVICES.
MOUNTAIN VISTA GOVERNOR'S SCHOOL FOUNDATION
6480 COLLEGE STWARRENTONVA20187800367061501(C)(3)$60,000FUNDING FOR A 10TH GRADE COHORT TO INCREASE THE NUMBER AND ENHANCE THE OPPORTUNITIES FOR STUDENTS ATTENDING MVGS.
PIEDMONT ENVIRONMENTAL COUNCIL
PO BOX 460WARRENTONVA20188540935569501(C)(3)$64,336FUNDING TO ORGANIZE A COLLABORATIVE PLANNING EFFORT IN REMINGTON TO BUILD ON ITS COMMUNITY ASSETS AND OFFER TRANSPORTATION AND RECREATIONAL OPTIONS, SUCH AS TRAILS, SIDEWALKS, BIKE ROUTES, AND PARK PROJECTS THAT RECONNECT THE COMMUNITY TO ENCOURAGE ACTIVE LIVING.
RAPPHOME
PO BOX 193WASHINGTONVA22747475254378501(C)(3)$50,000FUNDING TO SUPPORT ACTIONS AND GOALS IDENTIFIED FOR THE EXPANSION OF A RURAL SENIOR VILLAGE PILOT PROGRAM.
RAPPAHANNOCK COUNTY PUBLIC SCHOOLS
6 SCHOOLHOUSE RDWASHINGTONVA22747546001554RAPPAHANNOCK COUNTY$10,550A GRANT TO PROVIDE ALL RCPS STAFF WITH HEALTH AND WELLNESS ORIENTED SUPPLIES AT THE 2016-2017 ACADEMIC YEAR CONVOCATION DAY TO LAUNCH THE COMMIT TO BE FIT INITIATIVE.
RAPPAHANNOCK COUNTY SCHOOLS
6 SCHOOLHOUSE RDWARRENTONVA22747546001554RAPPAHANNOCK COUNTY$100,000FUNDING FOR THE COMMIT TO BE FIT PROGRAM.
VOLTRAN
FAUQUIER DEPT OF SOCIAL SERVICESWARRENTONVA20186271352660501(C)(3)$15,000FUNDING FOR A STRATEGIC PLAN TO DEVELOP POLICIES AND PROCEDURES TO INCREASE CAPACITY AND SUSTAINABILITY OF THE ORGANIZATION.320 HOSPITAL HILL STE 11
WINDY HILL FOUNDATION
PO BOX 1593MIDDLEBURGVA20118541244012501(C)(3)$60,000FUNDING FOR THE CONSTRUCTION AND OUTFITTING OF FIVE FULLY-ACCESIBLE "RESIDENTIAL" UNITS.
FieldValueIRS element (for citing)
Total501c3 Org14Total501c3OrgCnt
Total Other Org2TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationORGANIZATIONS SEEKING GRANT FUNDING MUST SUBMIT A PROPOSAL BUDGET AND, IN MOST CASES, A BUDGET, DURING THE APPLICATION PROCESS. APPLICANTS TO 12-MONTH GRANTS MUST SUBMIT ORGANIZATION FINANCIALS AND A FORM 990. THE GRANT AGREEMENT SPECIFIES THAT FUNDS MAY ONLY BE USED IN CONFORMITY WITH THE ORIGINAL PROPOSAL AND ANY SUBSTANTIAL CHANGES MUST BE REQUESTED AND APPROVED IN WRITING. TWELVE MONTH COMPETITIVE GRANTS REQUIRE GRANTEES TO FILE A WRITTEN SIX-MONTH INTERIM REPORT AND/OR FINAL REPORTS DESCRIBING GRANT ACTIVITIES AND/OR EXPENDITURES, FOLLOWING THE END OF THE GRANT TERM. RECIPIENTS OF SHORT TERM "MAKE IT HAPPEN" GRANTS FILE A FINAL REPORT DESCRIBING GRANT ACTIVITY AND/OR EXPENDITURES WITHIN THIRTY DAYS OF GRANT CLOSURE. IN THE CASE OF A SUCCESSFUL PROPOSAL, THE PROJECT AND ITS BUDGET SUBMITTED AT THE TIME OF APPLICATION FORM THE BASIS OF THE GRANT AGREEMENT. THE REPORTING SUBMITTED IS REVIEWED AND EVALUATED BY THE ORGANIZATION'S PROGRAM STAFF.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonCHRISTINE CONNOLLYPersonNm
TitlePRESIDENT & CEOTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$203,151CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$30,000BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$2,500OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$24,206DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$14,355NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$274,212TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE CEO AND CFO ARE COMPENSATED BY THE FAUQUIER HEALTH FOUNDATION (DBA THE PATH FOUNDATION). THE ORGANIZATIONS" BOARD ADOPTED A COMPENSATION POLICY FOR ITS CEO AND CFO. AN EXECUTIVE COMPENSATION COMMITTEE OF INDEPENDENT DIRECTORS OF THE BOARD OF THE ORGANIZATION" WAS ESTABLISHED TO REVIEW THE COMPENSATION FOR ALL EMPLOYEES SPECIFIED AS HAVING A SUBSTANTIAL INFLUENCE OVER THE ORGANIZATION AND WHO RECEIVE REMUNERATION FROM THE ORGANIZATION". THE EXECUTIVE COMPENSATION COMMITTEE IS ADVISED BY AN INDEPENDENT COMPENSATION CONSULTANT, WHICH OPINES TO THE COMPENSATION COMMITTEE THAT THE LEVEL OF COMPENSATION PAID AND THE PROCESS BY WHICH COMPENSATION IS ESTABLISHED MEET APPLICABLE IRS REASONABLENESS AND "SAFE HARBOR' STANDARDS. THE OUTSIDE COMPENSATION CONSULTANT PROVIDES DATA OF COMPENSATION PROVIDED AT SIMILAR ORGANIZATIONS TO ENSURE THAT THE ORGANIZATION DOES NOT COMPENSATE IN EXCESS OF MARKET NORMS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 4THE BY-LAWS WERE AMENDED EFFECTIVE AUGUST 2016 AS FOLLOWS: ARTICLE IV - TRUSTEES: ADDED IN FIRST PARAGRAPH: EFFECTIVE AT THE 2016 ANNUAL MEETING, THE NUMBER OF TRUSTEES SHALL NOT EXCEED 15. SYSTEM BOARD IS REPLACED BY FHS BOARD. LAST SENTENCE FROM FIRST PARAGRAPH IS REDACTED. ARTICLE IX - JOINT COMMITTEE OF FHS SERVICES, FHI SERVICES AND FHF: ADDED IN FIRST PARAGRAPH: THE PRESIDENT OF FHS SERVICES, FHI SERVICES AND FHF SHALL SERVE EX OFFICIO AS A NON-VOTING MEMBER OF THIS COMMITTEE. THE CHAIR SHALL BE A DIRECTOR. INVESTMENT & FINANCE COMMITTEE: ADDED: SHOULD THE CHAIR BE ABSENT FROM A MEETING, A BOARD MEMBER SHALL CHAIR THE MEETING.
FORM 990, PART VI, SECTION A, LINE 6FHS SERVICES IS THE PARENT OF THE ORGANIZATION AND THE FAUQUIER HEALTH FOUNDATION (DBA THE PATH FOUNDATION) IS A BROTHER/SISTER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE FHS SERVICES BOARD OF DIRECTORS ELECTS THE MEMBERS OF FHI SERVICES.
FORM 990, PART VI, SECTION A, LINE 7BTHE FAUQUIER HEALTH FOUNDATION (DBA THE PATH FOUNDATION) REQUIRES THE APPROVAL OF THE FHS SERVICES BOARD, TO ELECT, APPOINT, OR REMOVE DIRECTORS AND IMPLEMENT AMENDMENTS TO THE ARTICLES OF INCORPORATION.
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION PREPARES THE FORM 990 WITH ASSISTANCE FROM AN OUTSIDE ACCOUNTING FIRM. ONCE A DRAFT OF THE FORM 990 IS COMPLETED, IT IS SUBMITTED TO MANAGEMENT OF THE ORGANIZATION FOR REVIEW AND COMMENTS. AFTER INCORPORATING CHANGES FROM MANAGEMENT, MATERIALLY COMPLETE DRAFT FORMS 990 ARE MADE AVAILABLE TO THE BOARD OF THE ORGANIZATION. COMMENTS OR QUESTIONS RECEIVED FROM THE BOARD ARE INCORPORATED INTO A FINAL FORM 990, WHICH IS SIGNED BY THE PRESIDENT/CEO, CHRISTINE CONNOLLY.
FORM 990, PART VI, SECTION B, LINE 12CUNDER THE CONFLICT OF INTEREST POLICY, ALL BOARD MEMBERS, MANAGEMENT, AND KEY EMPLOYEES COMPLETE AN ANNUAL DISCLOSURE FORM REGARDING BUSINESS RELATIONSHIPS THAT HE OR SHE, OR ANY FAMILY MEMBER, HAS WITH ANY OTHER COMPANY THAT DOES BUSINESS WITH THE ORGANIZATION, AS WELL AS ANY BUSINESS RELATIONSHIPS BETWEEN AND AMONG THE BOARD MEMBERS , MANAGEMENT , AND KEY EMPLOYEES. THE ANNUAL DISCLOSURE STATEMENTS ARE REVIEWED BY INDEPENDENT LEGAL COUNSEL, AND THE AUDIT AND COMPLIANCE COMMITTEE, WHO IS ULTIMATELY RESPONSIBLE IF A CONFLICT EXISTS. ANY SUCH CONFLICTS WOULD BE REPORTED TO THE FULL BOARD. IN ADDITION , ANY PERSON WHO IS COVERED BY THE CONFLICT OF INTEREST POLICY HAS AN ONGOING OBLIGATION TO DISCLOSE THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICT TO THE BOARD OR THE BOARD COMMITTEE IN WHICH THE MATTER ARISES. FINALLY, THE ORGANIZATION MONITORS BOARD MEMBER ELIGIBILITY FOR ANY POTENTIAL CONFLICTS , IN ORDER TO AVOID SUCH CONFLICTS FROM OCCURRING IN THE FIRST PLACE. AN OPPORTUNITY IS GIVEN AT THE START OF EACH MEETING TO DISCLOSE ANY CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15THE CEO AND CFO ARE COMPENSATED BY THE FAUQUIER HEALTH FOUNDATION (DBA THE PATH FOUNDATION). THE ORGANIZATIONS" BOARD ADOPTED A COMPENSATION POLICY FOR ITS CEO AND CFO. AN EXECUTIVE COMPENSATION COMMITTEE OF INDEPENDENT DIRECTORS OF THE BOARD OF THE ORGANIZATION" WAS ESTABLISHED TO REVIEW THE COMPENSATION FOR ALL EMPLOYEES SPECIFIED AS HAVING A SUBSTANTIAL INFLUENCE OVER THE ORGANIZATION AND WHO RECEIVE REMUNERATION FROM THE ORGANIZATION". THE EXECUTIVE COMPENSATION COMMITTEE IS ADVISED BY AN INDEPENDENT COMPENSATION CONSULTANT, WHICH OPINES TO THE COMPENSATION COMMITTEE THAT THE LEVEL OF COMPENSATION PAID AND THE PROCESS BY WHICH COMPENSATION IS ESTABLISHED MEET APPLICABLE IRS REASONABLENESS AND "SAFE HARBOR' STANDARDS. THE OUTSIDE COMPENSATION CONSULTANT PROVIDES DATA OF COMPENSATION PROVIDED AT SIMILAR ORGANIZATIONS TO ENSURE THAT THE ORGANIZATION DOES NOT COMPENSATE IN EXCESS OF MARKET NORMS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990 PART XII, LINE 2CTHE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS DURING TAX YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
FHS SERVICES
98 ALEXANDRIA PIKEWARRENTONVA20186541416705MANAGEMENT COORDINATIONVA501(C)(3)LINE 11C, III-F1NONE0
FAUQUIER HEALTH FOUNDATION (DBA PATH FOUNDATION)
98 ALEXANDRIA PIKEWARRENTONVA20186300219424COMMUNITY HEALTHVA501(C)(3)LINE 7FHS SERVICESYes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationYes (1)DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1FAUQUIER HEALTH FOUNDATION(DBA PATH FOUNDATION)BusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeRTransactionTypeTxt
Involved$2,480,000InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt

Unrelated Org Txbl Partnership UnrelatedOrgTxblPartnershipGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FAUQUIER HOLDING COMPANY LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1330 SEVEN SPRINGS WAYAddressLine1Txt
CityBRENTWOODCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37027ZIPCd
FieldValueIRS element (for citing)
EIN901001620EIN
Primary ActivitiesHEALTHCAREPrimaryActivitiesTxt
Legal Domicile StateTNLegalDomicileStateCd
Predominate IncomeRELATEDPredominateIncomeDesc
All Partners C3 SYes (1)AllPartnersC3SInd
Share Of Total Income$4,101,348ShareOfTotalIncomeAmt
Share Of EOY Assets$33,187,285ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
Ownership0.20000OwnershipPct

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART VIFormAndLineReferenceDesc
ExplanationTHE 2015 K-1 IS MARKED AS FINAL DUE TO A TECHNICAL TERMINATION AT 12/31/2015 WITH A CHANGE TO THE 80% PARTNER. THE PARTNERSHIP CONTINUES AT 1/1/2016 AS NORMAL.ExplanationTxt

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