2016-11-15T10:15:05-06:00 2015-12-31 ERNST & YOUNG US LLP 800 YARD STREET SUITE 200 COLUMBUS OH 43212 990 2015-01-01 901000718 Riverside Healthcare Association Inc Group % VP OF FINANCE RIVE 7578757838 608 Denbigh Blvd Suite 800 Newport News VA 23608 WALTER AUSTIN JR SR VP AND CFO 7578757838 2016-11-14 true Diane L Bean P00104972 6142325678 2015 2017-02-10 21:41:12Z WILLIAM DOWNEY CEOPRESIDENT 608 DENBIGH BLVD STE 800 NEWPORT NEWS VA 23608 1524910204 true true 5701 X RIVERSIDEONLINE.COM X PROVIDE GENERAL MEDICAL SERVICES TO THE COMMUNITY. 184 141 11129 798 259897 3066040 3426178 1034144648 1135098703 9012439 11523663 317947229 347569593 1364170356 1497618137 8189159 7600821 0 0 553545139 594112471 0 0 79135 790185207 882002764 1351919505 1483716056 12250851 13902081 870803594 895801617 355820625 355646528 514982969 540155089 TO CARE FOR OTHERS AS WE WOULD CARE FOR THOSE WE LOVE - TO ENHANCE THEIR WELL-BEING AND IMPROVE THEIR HEALTH. false false 1157990043 7600821 1470210045 General hospital services provided to the community: 2,520,069 persons were benefited in 2015 with quantifiable community benefits of $153,572,396. 1157990043 true true false true false false false false false true true false false false true false true true false false false false false false false false true true true false true true false false false false false false false false true true false false false false true true true true false false true X 935 0 true 11129 true true true false false false false false false false false false false X 184 141 true false false false true true true true true false false false true true true true true true true true true VA X VP OF FINANCE 7578757838 608 DENBIGH BLVD 800 NEWPORT NEWS VA 23608 ALAN WITT BOARD MEMBER 1.0 0.0 X 0 0 0 ALEXANDER DILLARD BOARD MEMBER 1.0 0.0 X 0 0 0 ALFRED POOLE CHAIRMAN 1.0 0.0 X 0 0 0 ALICE BURGESS BOARD MEMBER 1.0 0.0 X 0 0 0 BARBARA HAYWOOD BOARD MEMBER 1.0 0.0 X 0 0 0 BENJAMIN GARRETT BOARD MEMBER 1.0 0.0 X 0 0 0 BETTY BLEVINS VICE CHAIRMAN 1.0 0.0 X 0 0 0 BLAIR MARSTELLER BOARD MEMBER 40.0 0.0 X 231977 0 38903 CARAMINE KELLAM BOARD MEMBER 1.0 0.0 X 0 0 0 CAROLYN FELLING BOARD MEMBER 1.0 0.0 X 0 0 0 CARRIE MOSS BOARD MEMBER 40.0 0.0 X 559060 0 30816 CARRINGTON RANDOLPH BOARD MEMBER 1.0 0.0 X 0 0 0 CELIA ADOLPHI BOARD MEMBER 40.0 0.0 X 6668 0 0 CHANNING HALL VICE CHAIRMAN 1.0 0.0 X 0 0 0 CHARLES HIGGINS BOARD MEMBER 1.0 0.0 X 0 0 0 CHARLES MINTER BOARD MEMBER 1.0 0.0 X 0 0 0 CHARLES REVERE CHAIRMAN 1.0 0.0 X 0 0 0 CONWAY SMITH VICE CHAIRMAN 1.0 0.0 X 0 0 0 CONWAY SHEILD CHAIRMAN 1.0 0.0 X 0 0 0 DANIEL SHERLOCK VICE CHAIRMAN 1.0 0.0 X 0 0 0 DARRYL FISHER BOARD MEMBER 1.0 0.0 X 0 0 0 DAVID GORE BOARD MEMBER 40.0 0.0 X 541439 0 36636 DAVID JONES BOARD MEMBER 40.0 0.0 X 266904 0 48122 DAYTON RITT BOARD MEMBER 1.0 0.0 X 0 0 0 DEBRA BOYER BOARD MEMBER 40.0 0.0 X 276195 0 45630 DELORIS BECKER BOARD MEMBER 1.0 0.0 X 0 0 0 DENNIS LOFTUS SR VP, CHIEF INFORMATION OFFIC 40.0 0.0 X 405377 0 47963 DWAYNE BLAKE BOARD MEMBER 1.0 0.0 X 0 0 0 EMMELINE GASINK BOARD MEMBER 40.0 0.0 X 267046 0 21387 EUGENE JORDAN BOARD MEMBER 1.0 0.0 X 0 0 0 FRANCES ELLIS VICE CHAIRMAN 1.0 0.0 X 0 0 0 FREDRICK ARNOLD BOARD MEMBER/SERVICE LINE CHIE 40.0 0.0 X 119611 0 10226 GARY KAVIT BOARD MEMBER 40.0 0.0 X 500491 0 45642 GARY STARKEY FACILITY MEDICAL DIRECTOR 1.0 0.0 X 0 0 0 GEORGE GOODSON BOARD MEMBER 1.0 0.0 X 0 0 0 GEORGE KANNARKAT BOARD MEMBER 40.0 0.0 X 833145 0 49076 GORDON GENTRY CHAIRMAN 1.0 0.0 X 0 0 0 HALL HOWARD BOARD MEMBER 40.0 0.0 X 63125 0 2232 HERBERT KELLY BOARD MEMBER 1.0 0.0 X 0 0 0 IVY MITCHELL BOARD MEMBER 1.0 0.0 X 0 0 0 JAMES DUDLEY SERVICE LINE CHIEF 40.0 0.0 X 335764 0 56190 JAMES MCCORRY SERVICE LINE CHIEF, RDHW 40.0 0.0 X 406132 0 25558 JAMES MULLINS BOARD MEMBER 40.0 0.0 X X 291971 0 39336 JAMES THORN BOARD MEMBER 1.0 0.0 X 0 0 0 JARED BATES BOARD MEMBER 1.0 0.0 X 0 0 0 JEFFREY HASKINS BOARD MEMBER 40.0 0.0 X 212660 0 17101 JEFFREY HENKE BOARD MEMBER 40.0 0.0 X 468854 0 49806 JEROLD 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ROBERT CULLOM PHYSICIAN 40.0 0.0 X 1280206 0 25028 TYLER WIND PHYSICIAN 34.0 0.0 X 1046438 0 41808 TERRIS KENNEDY BOARD MEMBER 40.0 0.0 X 86777 0 6182 33798337 0 2843404 841 true true false Fisher Scientific Company LLC PO BOX 404705 ATLANTA GA 303844705 RADIOLOGY SERVICES 2209081 Crowe Horwath LLP PO Box 71570 CHICAGO IL 606941570 PROESSIONAL SERVICES 1690925 Covidien Kendall USS PO Box 120823 DALLAS TX 75312 ACCOUNTING SERVICES 930328 Radon Medical LLC 14983 Moneta Road MONETA VA 24121 HEALTHCARE SERVICES 860872 Escribe Management Services 469 Mclaws Circle WILLIAMSBURG VA 23185 PROFESSIONAL SVCS 721669 27 2524707 901471 3426178 PROGRAM SERVICE REVENUE 900099 1135098703 1135098703 1135098703 9031104 9031104 0 0 23514916 23127982 386934 0 386934 386934 6083558 573086 2434879 1729206 3648679 -1156120 2492559 2492559 0 0 0 SVCS TO AFFILIATES 900002 315032752 315032752 OPTICAL SALES 900004 8116641 8116641 OTHER FUNCTIONAL INCOME 900099 11523254 11523254 12510012 438695 259897 11811420 347182659 1497618137 1470210045 259897 23722017 7600821 7600821 0 0 0 30131797 30131797 230183 230183 469203328 428677828 40525500 32482496 17266174 15216322 32058625 29929160 2129465 30006042 26163155 3842887 312632 312632 992594 992594 626027 626027 149241 149241 0 106087 106087 32355419 32355419 5560040 357197 5202843 54024774 40061110 13884815 78849 35707096 3581084 32126012 0 66418237 66418237 3012847 2000212 1012635 0 33649 20263 13386 5787297 767807 5019490 217950774 127828814 90121960 37278621 28591374 8687247 79742505 8786952 70955553 PROFESSIONAL SERVICES 71730205 71730062 143 BAD DEBT EXPENSE 100189634 100189634 NET GAIN/LOSS DEBT FINANCE 5269268 5269268 TAXES -316246 207582 -523971 143 165072063 159808466 5263597 1483716056 1157990043 325646878 79135 30236335 28743084 538803289 470208879 0 0 -33346986 52978093 0 0 0 0 0 0 14786978 14558707 11595115 11422602 712434939 470632586 237605991 241802353 0 0 0 0 32063780 37022731 38915342 38935341 143750 129827 870803594 895801617 298492769 305069567 0 0 1938158 2176509 20950000 19485000 0 0 0 0 0 0 0 0 34439698 28915452 355820625 355646528 X 508155239 530945442 6727730 9109647 100000 100000 514982969 540155089 870803594 895801617 X 13902081 11270039 X false true X true false X RIVERSIDE HEALTHCARE ASSOCIATION INC 521241835 9 true 0 0 RIVERSIDE HOSPITAL INC 521245746 3 true 0 0 WALTER REED MEMORIAL HOSPITAL 521241836 3 true 0 0 EASTERN VA REHABILITATION HOSPITAL 521432269 3 true 0 0 4 0 0 true true false false false false false false false false false false false false false true true false false false 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PART IV, SECTION A, LINE 2 Riverside Healthcare Foundation has determined that its hospital supported organizations, which qualify under 170(b)(1)(A)(iii), also qualify as public charities under section 509(a)(2)). PART IV, SECTION B, LINE 2 Riverside Healthcare Foundation also supported its other supported organizations within the Riverside Health System. That support carried out the purposes of Riverside Healthcare Association, Inc. (RHA) by strengthening the ability of the Foundations supported organizations to provide quality health care and improve the health of citizens in RHAs community. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false true 46913 false false true 102328 149241 false Other Lobbying Activities Salary and Expenses $102,328. Dues $ 46,913. Lobbies on issues related to certificates of public need and all issues affecting healthcare such as hospitals, patients, physicians, and health insurance. 1186469 -11449 1175020 1269006 46463 129000 1186469 1305166 77915 114075 1269006 1208060 149106 52000 1305166 1356116 19944 168000 1208060 1.00000 false false 12511847 12511847 274998320 150829335 124168985 408287927 306815393 101472534 16636845 12987858 3648987 241802353 0 OTHER CURRENT LIABILITIES 3864313 OBLIGATION UNDER CAPITAL LEASE 24088945 NOTE PAYABLE-CURRENT 703710 CONTINGENT LIABILITY 258484 28915452 Schedule D Part V Line 4 Endowment funds are used for scholarships true true X true X 250. false false true false true true 5 33085 20021557 20021557 0.01450 13 41653 54755444 49441862 5313582 0.00380 18 74738 74777001 49441862 25335139 0.01830 32 3613 2421069 2421069 0.00180 9 374 21544130 11149481 10394649 0.00750 464206 464206 0.00030 105 1015 1434747 1434747 0.00100 146 5002 25864152 11149481 14714671 0.01060 164 79740 100641153 60591343 40049810 0.02890 true 100189632 243265476 251728226 -8462750 X true true 6 1 Riverside Regional Medical Center 500 J CLYDE MORRIS BLVD NEWPORT NEWS VA 23601 www.riversideonline.com/rrmc/ H-1887 RIVERSIDE HOSPITAL INC 521245746 X X X X X Inpat Psychiatric 1 2 Riverside Walter Reed Hospital 7519 HOSPITAL DRIVE GLOUCESTER VA 23061 www.riversideonline.com/rwrh/ H-1890 RIVERSIDE MIDDLE PENINSULA H 521241836 X X X 2 3 Riverside Tappahannock Hospital 618 HOSPITAL ROAD TAPPAHANNOCK VA 22560 www.riversideonline.com/rth/ H-1889 RIVERSIDE TAPPAHANNOCK HOSPI 541489410 X X X 3 4 Riverside Rehabilitation Institute 245 CHESAPEAKE AVENUE NEWPORT NEWS VA 23607 www.riversideonline.com/rri/ H-1888 THE REHABILITATION INSTITUTE 521432269 X Inpat Rehabilitation 4 5 Riverside Doctors Hosp Williamsburg 1500 Commonwealth Avenue Williamsburg VA 23185 www.riversideonline.com/rdhw/ H-1937 DOCTORS' HOSPITAL OF WILLIAM 271540267 X X X 6 6 Riverside Behavioral Health Center 2244 Executive Drive Hampton VA 23666 www.riversideonline.com/rbhc/ 399 Riverside Behavioral Center 541979321 X INPAT PSYCHIATRIC 5 Riverside Regional Medical Center 1 false false true X X X X X X X X X 13 true true false true X See Part V, Sec. C X true 13 true www.riversideonline.com/community_benefit/ false false true X 250. 0. X X X true true X X false true X false X X true X false false Riverside Walter Reed Hospital 2 false false true X X X X X X X X X 13 true false false true X See Part V, Sec. C X true 13 true www.riversideonline.com/community_benefit/ false false true X 250. 0. X X X true true X X false true X false X X true X false false Riverside Tappahannock Hospital 3 false false true X X X X X X X X X 13 true false false true X See Part V, Sec. C X true 13 true www.riversideonline.com/community_benefit/ false false true X 250. 0. X X X true true X X false true X false X X true X false false Riverside Rehabilitation Institute 4 false false true X X X X X X X X X 13 true true false true X See Part V, Sec. C X true 13 true www.riversideonline.com/community_benefit/ false false true X 250. 0. X X X true true X X false true X false X X false X X false false Riverside Doctors Hosp Williamsburg 6 false false true X X X X X X X X X 13 true true false true X See Part V, Sec. C X true 13 true www.riversideonline.com/community_benefit/ false false true X 250. 0. X X X true true X X false true X false X X true X false false Riverside Behavioral Health Center 5 false false true X X X X X X X X X 13 true true false true X See Part V, Sec. C true 13 true WWW.RIVERSIDEONLINE.COM/COMMUNITY_BENEFIT/ false false true X 250. 0. X X X true true X X false true X false X X false X X false false Riverside Regional Medical Center Line 5: In the 2013 CHNA process, five Riverside Health System hospitals worked together to conduct a CHNA for the Peninsula and Williamsburg area. Part of this process included soliciting input from a wide variety of community stakeholders through a survey. Through the consulting group Community Health Solutions, the survey was sent to 158 individuals across the area, of which 83 responded. After the initial surveys were distributed, Riverside reached out through emails, letters and personal phone calls to encourage individuals to take the survey and help provide feedback and guidance in this process. Surveys were sent to individuals who represented the broad community (such as local government, school and business leaders), seniors (such as the Peninsula Agency on Aging), minority populations (such as faith community leaders), uninsured populations (such as local free clinics), people with intellectual disabilities (such as The Arc of the Virginia Peninsula), people with behavioral health and substance abuse challenges (such as the area Community Services Boards), low income populations (safety net organizations including food banks and area social services departments) and individuals with expertise in public health (including the two area health departments as well as the first responders in the various localities). A full list of the organizations of the 83 respondents to the initial survey can be found on page five of the CHNA. In addition to the initial survey work, a smaller group was assembled to review the CHNA and survey results. This group prioritized the needs to be addressed and provided guidance to Riverside on how to best create an implementation plan that would be meaningful to the community. This smaller group met multiple times and included individuals from local governments, sheriffs, public health and free clinics, the Community Services Board, local non-profit groups and members of the local business community. The administrators of the five Riverside hospitals in the region also participated in this group. Line 6a: Riverside Regional Medical Center worked with Riverside Rehabilitation Institute, Riverside Behavioral Health Center, Riverside Doctors Hospital Williamsburg and Hampton Roads Specialty Hospital on the 2013 CHNA process. Line 7a: www.riversideonline.com/community_benefit/ Line 11: Through the CHNA process, many areas were identified as concerns in the community, including high blood pressure, adult obesity, cancer, heart disease and stroke, diabetes, mental health and substance abuse. However, the group determined that trying to build public health responses to all of these disease states at once was unrealistic. Through the community action planning process, the team worked through the key issues and identified one area to address directly as well as several underlying / foundational needs that could impact multiple issues. There were four main categories of needs identified through the CHNA process: 1) services for the elderly; 2) healthy lifestyle, nutrition and wellness; 3) awareness and navigation of resources; and 4) behavioral health. By addressing the foundational issues, Riverside can impact multiple diseases / problems that were noted as concerns in the community. Overall, there are three main ways Riverside has been addressing these areas: 1) addressing them through services Riverside offers; 2) working with other community partners to address these issues jointly; and 3) providing financial and in-kind donations to support organizations that are addressing these problems. Examples include: Riverside expanding its services focused on the aging population; expanding wellness services; Riverside partnering with Newport News City Schools to provide a health care clinic within the Achievable Dream School; and Riversides support of community events such as the Out of the Darkness Walk in support of suicide prevention. Line 13h: Scheduled for or have received services at a Riverside Acute or Riverside Medical Group facility. Provide valid Social Security number. Have "low credit" (defined as having less than $1000 of available line of credit). Line 22d: Patients eligible under the Financial Assistance Policy were provided 100% discount and therefore the maximum amount charged to patients once they were determined to be eligible under FAP was $0.00 Riverside Walter Reed Hospital Line 5: In the 2013 CHNA process, Riverside Walter Reed Hospital conducted a CHNA for the Middle Peninsula area. Part of this process included soliciting input from a wide variety of community stakeholders through a survey. Through the consulting group Community Health Solutions, the survey was sent to 87 individuals across the area, of which 43 responded. After the initial surveys were distributed, Riverside reached out through emails, letters and personal phone calls to encourage individuals to take the survey and help provide feedback and guidance in this process. Surveys were sent to individuals who represented the broad community (such as local government, school and business leaders), seniors (such as Bay Aging), minority populations (such as faith community leaders), uninsured populations (such as local free clinics), people with intellectual disabilities or behavioral health and substance abuse challenges (such as the area Community Services Board), low income populations (safety net organizations including area shelters and area social services departments), and individuals with expertise in public health (including the Three Rivers Health District of the Virginia Department of Health as well as the first responders in the various localities). A full list of the organizations of the 43 respondents to the initial survey can be found on page four of the CHNA. In addition to the initial survey work, a smaller group was assembled to review the CHNA and survey results. This group prioritized the needs to be addressed and provided guidance to Riverside on how to best create an implementation plan that would be meaningful to the community. This smaller group met multiple times and included individuals from Three Rivers Health District, the Alzheimers Association, Bay Aging / Bay Transit, Gloucester County Public Schools, Gloucester County Resource Council, Middlesex County Social Services, Middle Peninsula Northern Neck Community Services Board, Gloucester County Law Enforcement and Riverside Walter Reed Hospital. Line 7a: www.riversideonline.com/community_benefit/ Line 11: Through the CHNA process, many areas were identified as concerns in the community, including diabetes, mental health conditions, adult obesity, dental care /oral health, Alzheimers disease, substance abuse, heart disease and stroke. However, the team determined that trying to develop public health responses to all of these disease states at once was unrealistic. Through the community action planning process, the team worked through the key issues and identified one area to address directly as well as several underlying / foundational needs that could impact multiple issues. There were four main categories of needs identified through the CHNA process: 1) awareness and navigation of resources; 2) resource collaboration; 3) Alzheimers and dementia; and 4) health literacy. Overall, there are three main ways Riverside has been addressing these areas: 1) addressing them through services Riverside offers; 2) working with other community partners to address these issues jointly; and 3) providing financial and in-kind donations to support organizations that are addressing these problems. Examples include: establishing the Middle Peninsula Resource Council to improve awareness of resources; coordinating tele-education through Bay Rivers Telehealth Consortium and the Three Rivers Health District; and working with Three Rivers and Riverside Tappahannock Hospital on a health literacy assessment tool. Line 13h: Scheduled for or have received services at a Riverside Acute or Riverside Medical Group facility. Provide valid Social Security number. Have "low credit" (defined as having less than $1000 of available line of credit). Line 22d: Patients eligible under the Financial Assistance Policy were provided 100% discount and therefore the maximum amount charged to patients once they were determined to be eligible under FAP was $0.00 Riverside Tappahannock Hospital Line 5: In the 2013 CHNA process, Riverside Tappahannock Hospital conducted a CHNA for the Northern Neck area. Part of this process included soliciting input from a wide variety of community stakeholders through a survey. Through the consulting group Community Health Solutions, the survey was sent to 88 individuals across the area, of which 43 responded. After the initial surveys were distributed, Riverside reached out through emails, letters and personal phone calls to encourage individuals to take the survey and help provide feedback and guidance in this process. Surveys were sent to individuals who represented the broad community (such as local government, school and business leaders), seniors (such as The Orchard retirement community), minority populations (such as faith community leaders), uninsured populations (such as Tappahannock Regional Free Clinic), people with intellectual disabilities or behavioral health and substance abuse challenges (such as the area Middle Peninsula Northern Neck Community Services Board), low income populations (area social services departments), and individuals with expertise in public health (including the Three Rivers Health District of the Virginia Department of Health as well as the first responders in the various localities). A full list of the organizations of the 43 respondents to the initial survey can be found on page four of the CHNA. In addition to the initial survey work, a smaller group was assembled to review the CHNA and survey results. This group prioritized the needs to be addressed and provided guidance to Riverside on how to best create an implementation plan that would be meaningful to the community. This smaller group met multiple times and included individuals from Three Rivers Health District, Middle Peninsula Northern Neck Community Services Board, EMS representatives, law enforcement representatives, hospice and home health, county administrators, Tappahannock Regional Free Clinic, local chambers of commerce, YMCA and River Fitness, Bay Aging, Essex Churches Together, Rappahannock Community College, The Haven (Domestic Violence shelter) and Riverside Tappahannock Hospital. Line 7a: www.riversideonline.com/community_benefit/ Line 11: Through the CHNA process, many areas were identified as concerns in the community, including adult obesity, diabetes, alcohol use, substance abuse, cancer, childhood obesity, heart disease and stroke. However, the team determined that trying to develop public health responses to all of these disease states at once was unrealistic. Through the community action planning process, the team worked through the key issues and identified several underlying / foundational needs that could impact multiple issues. There were four main categories of needs identified through the CHNA process: 1) awareness of health services; 2) awareness of social and mental health services; 3) transportation services; 4) health literacy; and 5) healthy lifestyle, nutrition and wellness. Overall, there are three main ways Riverside has been addressing these areas: 1) addressing them through services Riverside offers; 2) working with other community partners to address these issues jointly; and 3) providing financial and in-kind donations to organizations that are addressing these problems. Examples include: Riverside beginning work on a master directory of services; Riverside partnering with Bay Transit to address transportation issues as well as to pursue grant funding for expanded bus routes; and Riversides support of the Tappahannock Free Clinic in their expansion of a healthy lifestyle program. Line 13h: Scheduled for or have received services at a Riverside Acute or Riverside Medical Group facility. Provide valid Social Security number. Have "low credit" (defined as having less than $1000 of available line of credit). Line 22d: Patients eligible under the Financial Assistance Policy were provided 100% discount and therefore the maximum amount charged to patients once they were determined to be eligible under FAP was $0.00 Riverside Rehabilitation Institute Line 5: In the 2013 CHNA process, five Riverside Health System hospitals worked together to conduct a CHNA for the Peninsula and Williamsburg area. Part of this process included soliciting input from a wide variety of community stakeholders through a survey. Through the consulting group Community Health Solutions, the survey was sent to 158 individuals across the area, of which 83 responded. After the initial surveys were distributed, Riverside reached out through emails, letters and personal phone calls to encourage individuals to take the survey and help provide feedback and guidance in this process. Surveys were sent to individuals who represented the broad community (such as local government, school and business leaders), seniors (such as the Peninsula Agency on Aging), minority populations (such as faith community leaders), uninsured populations (such as local free clinics), people with intellectual disabilities (such as The Arc of the Virginia Peninsula), people with behavioral health and substance abuse challenges (such as the area Community Services Boards), low income populations (safety net organizations including food banks and area social services departments), and individuals with expertise in public health (including the two area health departments as well as the first responders in the various localities). A full list of the organizations of the 83 respondents to the initial survey can be found on page five of the CHNA. In addition to the initial survey work, a smaller group was assembled to review the CHNA and survey results. This group prioritized the needs to be addressed and provided guidance to Riverside on how to best create an implementation plan that would be meaningful to the community. This smaller group met multiple times and included individuals from local governments, sheriffs, public health and free clinics, the Community Services Board, local nonprofit groups and members of the local business community. The administrators of the five Riverside hospitals in the region also participated in this group. Line 6a: Riverside Rehabilitation Institute worked with Riverside Behavioral Health Center, Riverside Regional Medical Center, Riverside Rehabilitation Institute, Riverside Doctors Hospital Williamsburg and Hampton Roads Specialty Hospital on the 2013 CHNA process. Line 7a: www.riversideonline.com/community_benefit/ Line 11: Through the CHNA process, many areas were identified as concerns in the community, including high blood pressure, adult obesity, cancer, heart disease and stroke, diabetes, mental health and substance abuse. However, the group determined that trying to build public health responses to all of these disease states at once was unrealistic. Through the community action planning process, the team worked through the key issues and identified one area to address directly as well as several underlying / foundational needs that could impact multiple issues. There were four main categories of needs identified through the CHNA process: 1) services for the elderly; 2) healthy lifestyle, nutrition and wellness; 3) awareness and navigation of resources; and 4) behavioral health. By addressing the foundational issues, Riverside can impact multiple diseases / problems that were noted as concerns in the community. Overall, there are three main ways Riverside has been addressing these areas: 1) addressing them through services Riverside offers; 2) working with other community partners to address these issues jointly; and 3) providing financial and in-kind donations to support organizations that are addressing these problems. Examples include: Riverside expanding its services focused on the aging population; expanding wellness services; Riverside partnering with Newport News City Schools to provide a health care clinic within the Achievable Dream School; and Riversides support of community events such as the Out of the Darkness Walk in support of suicide prevention. Line 13h: Scheduled for or have received services at a Riverside Acute or Riverside Medical Group facility. Provide valid Social Security number. Have "low credit" (defined as having less than $1000 of available line of credit). Line 22d: Patients eligible under the Financial Assistance Policy were provided 100% discount and therefore the maximum amount charged to patients once they were determined to be eligible under FAP was $0.00 Riverside Doctors Hosp Williamsburg Line 5: In the 2013 CHNA process, five Riverside Health System hospitals worked together to conduct a CHNA for the Peninsula and Williamsburg area. Part of this process included soliciting input from a wide variety of community stakeholders through a survey. Through the consulting group Community Health Solutions, the survey was sent to 158 individuals across the area, of which 83 responded. After the initial surveys were distributed, Riverside reached out through emails, letters and personal phone calls to encourage individuals to take the survey and help provide feedback and guidance in this process. Surveys were sent to individuals who represented the broad community (such as local government, school and business leaders), seniors (such as the Peninsula Agency on Aging), minority populations (such as faith community leaders), uninsured populations (such as local free clinics), people with intellectual disabilities (such as The Arc of the Virginia Peninsula), people with behavioral health and substance abuse challenges (such as the area Community Services Boards), low income populations (safety net organizations including food banks and area social services departments) and individuals with expertise in public health (including the two area health departments as well as the first responders in the various localities). A full list of the organizations of the 83 respondents to the initial survey can be found on page five of the CHNA. In addition to the initial survey work, a smaller group was assembled to review the CHNA and survey results. This group prioritized the needs to be addressed and provided guidance to Riverside on how to best create an implementation plan that would be meaningful to the community. This smaller group met multiple times and included individuals from local governments, sheriffs, public health and free clinics, the Community Services Board, local non-profit groups and members of the local business community. The administrators of the five Riverside hospitals in the region also participated in this group. Line 6a: Riverside Doctors Hospital Williamsburg worked with Riverside Regional Medical Center, Riverside Rehabilitation Institute, Riverside Behavioral Health Center and Hampton Roads Specialty Hospital on the 2013 CHNA process. Line 7a: www.riversideonline.com/community_benefit/ Line 11: Through the CHNA process, many areas were identified as concerns in the community, including high blood pressure, adult obesity, cancer, heart disease and stroke, diabetes, mental health and substance abuse. However, the group determined that trying to build public health responses to all of these disease states at once was unrealistic. Through the community action planning process, the team worked through the key issues and identified one area to address directly as well as several underlying / foundational needs that could impact multiple issues. There were four main categories of needs identified through the CHNA process: 1) services for the elderly; 2) healthy lifestyle, nutrition and wellness; 3) awareness and navigation of resources; and 4) behavioral health. By addressing the foundational issues, Riverside can impact multiple diseases / problems that were noted as concerns in the community. Overall, there are three main ways Riverside has been addressing these areas: 1) addressing them through services Riverside offers; 2) working with other community partners to address these issues jointly; and 3) providing financial and in-kind donations to support organizations that are addressing these problems. Examples include: Riverside expanding its services focused on the aging population; expanding wellness services; Riverside partnering with Newport News City Schools to provide a health care clinic within the Achievable Dream School; and Riversides support of community events such as the Out of the Darkness Walk in support of suicide prevention. Line 13h: Scheduled for or have received services at a Riverside Acute or Riverside Medical Group facility. Provide valid Social Security number. Have "low credit" (defined as having less than $1000 of available line of credit). Line 22d: Patients eligible under the Financial Assistance Policy were provided 100% discount and therefore the maximum amount charged to patients once they were determined to be eligible under FAP was $0.00 Riverside Behavioral Health Center Line 5: In the 2013 CHNA process, five Riverside Health System hospitals worked together to conduct a CHNA for the Peninsula and Williamsburg area. Part of this process included soliciting input from a wide variety of community stakeholders through a survey. Through the consulting group Community Health Solutions, the survey was sent to 158 individuals across the area, of which 83 responded. After the initial surveys were distributed, Riverside reached out through emails, letters and personal phone calls to encourage individuals to take the survey and help provide feedback and guidance in this process. Surveys were sent to individuals who represented the broad community (such as local government, school and business leaders), seniors (such as the Peninsula Agency on Aging), minority populations (such as faith community leaders), uninsured populations (such as local free clinics), people with intellectual disabilities (such as The Arc of the Virginia Peninsula), people with behavioral health and substance abuse challenges (such as the area Community Services Boards), low income populations (safety net organizations including food banks and area social services departments), and individuals with expertise in public health (including the two area health departments as well as the first responders in the various localities). A full list of the organizations of the 83 respondents to the initial survey can be found on page five of the CHNA. In addition to the initial survey work, a smaller group was assembled to review the CHNA and survey results. This group prioritized the needs to be addressed and provided guidance to Riverside on how to best create an implementation plan that would be meaningful to the community. This smaller group met multiple times and included individuals from local governments, sheriffs, public health and free clinics, the Community Services Board, local non profit groups and members of the local business community. The administrators of the five Riverside hospitals in the region also participated in this group. Line 6a: Riverside Behavioral Health Center worked with Riverside Regional Medical Center, Riverside Rehabilitation Institute, Riverside Doctors Hospital Williamsburg and Hampton Roads Specialty Hospital on the 2013 CHNA process. Line 7a: www.riversideonline.com/community_benefit/ Line 11: Through the CHNA process, many areas were identified as concerns in the community, including high blood pressure, adult obesity, cancer, heart disease and stroke, diabetes, mental health and substance abuse. However, the group determined that trying to build public health responses to all of these disease states at once was unrealistic. Through the community action planning process, the team worked through the key issues and identified one area to address directly as well as several underlying / foundational needs that could impact multiple issues. There were four main categories of needs identified through the CHNA process: 1) services for the elderly; 2) healthy lifestyle, nutrition and wellness; 3) awareness and navigation of resources; and 4) behavioral health. By addressing the foundational issues, Riverside can impact multiple diseases / problems that were noted as concerns in the community. Overall, there are three main ways Riverside has been addressing these areas: 1) addressing them through services Riverside offers; 2) working with other community partners to address these issues jointly; and 3) providing financial and in-kind donations to support organizations that are addressing these problems. Examples include: Riverside expanding its services focused on the aging population; expanding wellness services; Riverside partnering with Newport News City Schools to provide a health care clinic within the Achievable Dream School; and Riversides support of community events such as the Out of the Darkness Walk in support of suicide prevention. Line 13h: Scheduled for or have received services at a Riverside Acute or Riverside Medical Group facility. Provide valid Social Security number. Have "low credit" (defined as having less than $1000 of available line of credit). Line 22d: Patients eligible under the financial assistance policy were provided 100% discount and therefore the maximum amount charged to patients once they were determined to be eliglble under FAP was $0.00. 43 Brentwood Medical Education 10510 Jefferson Avenue Newport News VA 23601 Physician Clinic PCI-Newport News 12100 Warwick Blvd Newport News VA 23601 Infusion Therapy Center Riverside Cancer Institute Ctr-Va Beach 1200 First Colonial Rd 204A Virginia Beach VA 23455 Infusion Therapy Center Riverside Cancer Institute Ctr-Chesapeak 110 Wimbledon Square Ste E1 Chesapeake VA 23320 Infusion Therapy Center Riverside Cancer Institute Ctr-Suffolk 5835 Harbor View Blvd Ste C1 Suffolk VA 23435 Infusion Therapy Center Riverside Diagnostic & Breast Imaging Ct 895 City Center Blvd Ste 104 Newport News VA 23606 Diagnostic Center Riverside Home Care 856 J Clyde Morris Blvd Newport News VA 23601 Home Health Agency PACE-Hampton 4107 West Mercury Blvd Hampton VA 23666 Elderly Care Services PACE-Manchester 701 Gordon Avenue Richmond VA 23224 Elderly Care Services Shore Cancer Center 10085 William F Bernart Circle Nassawasox VA 23413 Cancer Center PACE-Mactavish 1300 Mactavish Avenue Richmond VA 23230 Elderly Care Services Patriots Colony 6000 Patriots Colony Williamsburg VA 23188 Retirement Center Riverside Cancer Institute Ctr-Gloucest 7544 Medical Center Gloucester VA 23061 Infusion Therapy Center Riverside Radiation Oncology-Wmbg 3901 Treyburn Drive Williamsburg VA 23085 Radiation Oncology Center Hampton Surgery Center 850 Enterprise Parkway Ste 100 Hampton VA 23666 Surgery Center Riverside Diagnostic Ctr-Hampton 850 Enterprise Parkway Ste 1500 Hampton VA 23666 Diagnostic Center Riverside Radiaton Oncology-Npt News 12100 Warwick Blvd Newport News VA 23601 Radiation Oncology Center Riverside Convalescent-Warwick Forest 1000 Old Denbigh Blvd Newport News VA 23602 Nursing Home/Convalescent Svcs Riverside Convalescent-Hampton 414 Algonquin Road Hampton VA 23661 Nursing Home/Convalescent Svcs Riverside Convalescent-Mathews Route 611 PO Box 370 Mathews VA 23109 Nursing Home/Convalescent Svcs Riverside Convalescent-Saluda 672 Gloucester Road Saluda VA 23149 Nursing Home/Convalescent Svcs Riverside Convalescent-Smithfield 200 Lumar Road Smithfield VA 23430 Nursing Home/Convalescent Svcs Riverside Convalescent-West Point 2960 Chelsa Road West Point VA 23181 Nursing Home/Convalescent Svcs Sanders Retirement Center 7385 Walker Avenue Gloucester VA 23061 Retirement Services Riverside Convalescent-Orchard 20 Delfae Drive Warsaw VA 22572 Nursing Home/Convalescent Svcs Riverside Cancer Institute Ctr-Wmbg 120 Kings Way Williamsburg VA 23185 Infusion Therapy Center Riverside Diagnostic Center-Williamsburg 120 Kings Way Ste 1200 Williamsburg VA 23185 Diagnostic Center Riverside Radiation Oncology-Gloucester 7544 Medical Drive Ste A Gloucester VA 23061 Radiation Oncology Center PACE-Newport News 439 C Oriana Road Newport News VA 23608 Elderly Care Services Riverside Convalescent-Regional 1000 Old Denbigh Blvd Newport News VA 23602 Nursing Home/Convalescent Svcs Riverside Diagnostic Center Smithfield 202 Gumwood Drive Smithfield VA 23430 Diagnostic Center Riverside Diagnostic Center Mt Clement 300 Mount Clement Park Ste A2 Tappahannock VA 22560 Diagnostic Center Riverside Neurology Ctr 12200 Warwick Blvd Ste 110 Newport News VA 23608 Neurology Center Peninisula GastroRiverside Endoscopy Ct 101 Phillip Roth Street Ste B Newport News VA 23606 Gastroenterology/Endoscopy Ct Riverside Pain & Interventional Center 12420 Warwick Blvd Ste C Newport News VA 23606 Pain & Interventional Center Riverside Physical Therapy-Hampton 850 Enterprise Parkway Ste 2100 Hampton VA 23666 Physical Therapy Riverside Physical Therapy-Denbigh 12650 Jefferson Ave Ste 100 Newport News VA 23602 Physical Therapy Riverside Pulmonary and Sleep Center 12200 Warwick Blvd Ste 210 Newport News VA 23601 Pulmonary and Sleep Center Riverside Diabetes Services 12200 Warwick Blvd Ste 590A Newport News VA 23601 Diabetes Services Riverside Physical Therapy-Mt Clement 300 Mt Clement Park Ste D Tappahannock VA 22560 Physical Therapy Riverside Physical Therapy-Hayes 2656 George Washington Mem Hwy Ste Hayes VA 23072 Physical Therapy Riverside Hayes Diagnostic Imaging Ctr 2246 George Washington Mem Hwy Hayes VA 23072 Diagnostic Imaging Center Riverside Rehab Outpatient Therapy-Wlbg 120 Monticello Ave Ste 200 Williamsburg VA 23185 Outpatient Therapy Part VI Line 1: Part I Line 3c: Free care uses 250% of the FPG. Our policies do not include "discounted" care. Line 1: Part I Line 7, column F: Bad debt expense removed from total expense in line 7, column F is $100,189,634. Line 1: Part I Line 7A: The cost to charge ratio calculated on worksheet 2 was used for the charity expense calculation. Line 1: Part I Line 7B: Medicaid cost and net revenue are directly from the Medicaid cost report. Line 1: Part I Line 7E: Community health improvement is actual cost accumulated by the individuals participating in the activities. Line 1: Part I Line 7I: Cash and in-kind contributions are the actual dollar value of cash or items given. Line 1: Part III Line 2: Bad debt is the amount remaining on a patient's account after cash payments, third party payer contractual adjustments and hospital discounts have been taken. Before the amount is written off to bad debt the account is sent to a collection agency which returns the account when they have exhausted all possible effort. Upon return the account balance is written off to bad debt. Line 1: Part III Line 3: Patients eligible under the financial assistance policy were provided 100% discount and therefore were not included in bad debt expense. Line 1: Part III Line 4: Bad debt is the amount remaining on a patient's account after cash payments, third party payer contractual adjustments and hospital discounts have been taken. Before the amount is written off to bad debt the account is sent to a collection agency which returns the account when they have exhausted all possible effort. Upon return the account balance is written off to bad debt. Bad debt is referenced in Note 3 Net Patient Service Revenues and Note 4 Community Benefit Expense. Note 3 discusses the allowance for uncollectible accounts as follows: "Patient accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of accounts receivable, the System analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party coverage, the System analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for bad debts, if necessary. For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and co-payment balances due for which third-party coverage exists for part of the bill), the System records a provision for bad debts in the period of service on the basis of its past experience. The difference between standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible amounts." Note 4 states "Distinguishing uncollected patient revenue between charity and bad debt requires full consideration of both the financial and non-financial circumstances of the patient, which are not always available to the organization. Therefore, both traditional charity care and bad debt are included as a component of benefits for the indigent." The bad debt expense on the audited system financial statements is bad debt charges written off. This amount is considered a community expense. No expense is listed for line 3. We do not take any patients to bad debt if we know they qualify for one of our financial assistance programs. Even if a charity status is not known but a financial assistance application is pending we do not send the patient's account to bad debt. The policy states "If a patient has completed a hospital's application for financial assistance that account should not be advanced for collection pending determination of eligibility." Line 1: Part III Line 8: The organization uses CMS cost reporting guidelines and methodology to determine allowable Medicare costs. The shortfall from Medicare should be recognized as a community benefit, since the patients are provided services at a loss for the facility. The Health System is assuring that these essential emergency and acute care services are provided for the population's health. Line 1: Part III Line 9b: Patients eligible under the written Financial Assistance Policy were provided 100% discount and were therefore excluded from debt collection processes. Line 2: Riverside has embraced the Community Health Needs Assessment process as the way to best assess the health care needs of the communities it serves. To supplement this data, Riverside also utilizes resources such as the Virginia Atlas of Community Health, demographic data, as well as observing utilization and diagnoses trends across the Riverside service areas and nationally. Finally, Riverside works closely with other community leaders to identify and respond to local needs. Having community-based, volunteer boards also allows for continuous feedback from individuals living and working in the service area. Line 3: Patients are notified of the FAP while in the hospital, notice is included on the patient statement, and patients are educated directly by customer service agents when they inquire about their bill. They are also contacted for assistance in screening for eligibility for federal, state and local government programs. Line 4: The service area for Riverside Healthcare Association, dba Riverside Health System, covers a wide geographic area, from the Potomac River to south of the James River in southeastern Virginia. The broader Virginia Peninsula area encompassing James City County, York County, New Kent County, Isle of Wight County and the cities of Williamsburg, Newport News, Poquoson and Hampton, has a 2015 census projected population of approximately 540,000 persons. Riverside Regional Medical Center in Newport News is the only trauma center (Level II) located in this area. The Virginia Peninsula is bordered on the east by the Chesapeake Bay and Hampton Roads, on the south by the James River and the north by the York River. Access to health care facilities not located on the Peninsula is restricted by tunnels and bridges, with three connections to various points across the James, and one bridge north across the York. Numerous waterways, inlets and marshland are prominent in the landscape and restrict traffic in certain areas, requiring a system of bridges or circuitous routes for local travel. Interstate 64 runs the length of the Peninsula, providing access some 75 miles from Riverside Regional Medical Center to downtown Richmond and 40 miles to downtown Norfolk (via Hampton Roads Bridge Tunnel). Some 150,000 cars travel along this interstate corridor daily per the 2012 VDOT study. Riverside owns and operates several diagnostic centers throughout its service area. The hospital facilities operate outpatient programs in addition to those in freestanding ambulatory centers. Reasons behind this outpatient reach include: the lack of interconnected public transportation; the traffic congestion on interstates and urban roadways; and the significant elderly population in the service area. Many of the senior citizens, particularly in outlying areas, rely on friends and family members to transport them to appointments. Surplus funds are used to promote and improve access to services in the areas close to where residents live. This Peninsula area is generally considered to have a high quality of life in accordance with standard socioeconomic variables, and a comparatively low cost of living. With the relative exception of the City of Williamsburg, drugs, crime and poverty negatively impact the more densely populated areas of the communities. In terms of demographics and occupations, the Riverside service area is primarily what has traditionally been defined as a blue-collar community. Between the large military presence and the supporting defense industry, almost 50 percent of the economy is connected to defense. The largest private employer is Huntington Ingalls Newport News Shipbuilding with more than 20,000 local workers. The communitys population of people over age 65 is growing quickly, and that aging population points to even stronger hospital utilization in the coming years. The age group of 65 and older comprises 14 percent of the population. The per capita income is just under $30,000, so Riversides charity mission is strong and ongoing with a concerted effort directed to children at risk. Within the market, all of the localities with the exception of the city of Poquoson qualify for full or partial designation as Medically Underserved Service Areas. There is strong competition within 60 miles of Riverside Regional Medical Center. Within seven miles on each si true American Cancer Society 2730 Ellsmere Ave Norfolk VA 23513 131788491 501(c)(3) 18500 Sponsor-Ellis, Mark March of Dimes PO BOX 932852 Atlanta GA 23320 131846366 501(c)(3) 13500 Sponsor2015-Penin Marc American Heart Association 4217 Park Place CT Glen Allen VA 23060 135613797 501(c)(3) 33667 2015-GR01 Senior Advocate LLC PO Box 1046 Williamsburg VA 23187 202276843 13550 Sponsorship VA Center for Inclusive Communities 5511 Staples Mill Road Richmond VA 23228 203188273 501(c)(3) 6500 Sponsorship 2015022615 Office of Human Affairs 2410 Wickham Avenue Suite 202 Newport News VA 23607 237014485 501(c)(3) 30610 Sponsorship Banquet Beyond Boobs Inc PO BOX 443 Toano VA 23168 260606190 501(c)(3) 22500 Sponsorship 051515 WISC 5700 Warhill Trail Williamsburg VA 23188 264134755 501(c)(3) 10000 Sponsorship 2015-WISC Flat-Out Events LLC 11843 Canon Blvd Newport News VA 23606 271675755 20000 One City Marathon Sponsorship Community Free Clinic of Newport News 727 25th Street Suite B Newport News VA 23607 273510814 501(c)(3) 208333 Installment Project Care of VA 416 J Clyde Morris Blvd Newport News VA 23601 273518508 501(c)(3) 47385 Project Care Support 14 Peninsula Agency On Aging 739 Thimble Shoals Blvd Newport News VA 23606 510151069 501(c)(3) 7500 Sponsorship2015-Rides HRSH - Riverside Health System 608 Denbigh Blvd Ste 1006 Newport News VA 23608 521245746 501(c)(3) 141750 Sponsorship ALS Association 7507 Standish Place Rockville MD 20855 521749047 501(c)(3) 7500 Sponsor - Walk to Defeat First Tee YMCA 41 Old Oyster Point Road Newport News VA 23602 540524905 501(c)(3) 9000 Sponsorship 2015 The Mariners Museum 100 Museum Drive Suite C Newport News VA 23606 540541801 501(c)(3) 10000 Sponsorship 2015-2016 Christopher Newport University 1 University Place Newport News VA 23606 540701501 501(c)(3) 15000 Sponsor - Torggler Conce College of William & Mary PO Box 399 Williamsburg VA 23187 540734117 501(c)(3) 9000 2015 Sponsorship Christopher Newport University 1 University Place Newport News VA 23606 541156248 501(c)(3) 132500 Athletics Sponsorship 2015 An Achievable Dream Foundation Inc 10858 Warwick Blvd Newport News VA 23601 541621932 501(c)(3) 30000 Sponsorship Old Towne Medical and Dental 5249 Olde Towne Road Ste A Williamsburg VA 23188 541663905 501(c)(3) 30000 Sponsorship 2014 Dream Catchers PO Box 1261 Williamsburg VA 23187 541692709 501(c)(3) 7500 Sponsorship 051615 Virginia Nurses Foundation 6912 Three Chopt Rd Richmond VA 23226 541788059 501(c)(3) 7600 2015 SPSHIP/Nurses Gala Peninsula Community Foundation of Virginia Inc 11742 Jefferson Ave Ste H Newport News VA 23606 542057957 501(c)(3) 50000 Sponsorship - IMAX College of William & Mary PO Box 8795 Ste 350 Williamsburg VA 23187 546001718 501(c)(3) 34000 Sponsor 2015-2nd Payment City of Newport News 2400 Washington Ave Newport News VA 23607 546022059 501(c)(3) 15000 One City Marathon Sponsorship Virginia Living Museum Inc 524 J Clyde Morris Blvd Newport News VA 23601 546055922 501(c)(3) 18000 2014 OPP Pledge-Final Tidewater Arts Outreach 809 Brandon Ave Norfolk VA 23517 680583526 501(c)(3) 6440 Sponsorship 2015-Sea Le 26 2 Grant Explanation A fund distribution form is completed and signed by an authorized administrator of the benefiting facility. Requests are approved according to the specifics of the fund's governing charter. If a fund request doesn't comply the money is not distributed. X X X X X false true false false false false false false false BARRY GROSS EXEC VP/CMO RHS 513075 0 103502 0 117676 0 31684 0 9258 0 775195 0 0 0 BLAIR MARSTELLER BOARD MEMBER 222497 0 0 0 9480 0 21610 0 17293 0 270880 0 0 0 CARRIE MOSS BOARD MEMBER 222372 0 269812 0 66876 0 30298 0 518 0 589876 0 0 0 CHARLES FRAZIER VP, CLINICAL INNOVATION 354731 0 60181 0 104602 0 29775 0 24515 0 573804 0 0 0 CHARLES GRAHAM VP REVENUE CYCLE 332276 0 25592 0 100156 0 18373 0 20679 0 497076 0 0 0 CHRISTOPHER STOLLE VP MEDICAL AFFAIRS 340892 0 56352 0 63921 0 24998 0 1652 0 487815 0 0 0 DAVID GORE BOARD MEMBER 333756 0 204945 0 2738 0 24998 0 11638 0 578075 0 0 0 DAVID JONES BOARD MEMBER 123988 0 1540 0 141376 0 24998 0 23124 0 315026 0 0 0 DAVID MURON PRESIDENT, MEDICAL STAFF 637401 0 120707 0 16399 0 4727 0 26792 0 806026 0 0 0 DEBORAH ATKINSON EXEC DIRECTOR 132298 0 3014 0 3969 0 16653 0 1057 0 156991 0 0 0 DEBRA BOYER BOARD MEMBER 202768 0 57902 0 15525 0 30298 0 15332 0 321825 0 0 0 DEBRA CAMPBELL ADMINISTRATOR 119260 0 9488 0 13668 0 16063 0 7463 0 165942 0 0 0 MARY DELPRINCE DIRECTOR SYSTEM 163451 0 22901 0 3530 0 18401 0 10559 0 218842 0 0 0 DENNIS LOFTUS SR VP, CHIEF INFORMATION OFFIC 288085 0 44449 0 72843 0 30298 0 17665 0 453340 0 0 0 TRACEY DOWLING DIRECTOR SYSTEM 149688 0 23400 0 10056 0 16864 0 14559 0 214567 0 0 0 ELISABETH WILLIAMS VP, MARKETING, STRATEGY & DEVE 204153 0 33705 0 47531 0 9275 0 22544 0 317208 0 0 0 ELIZABETH MARTIN VP QUALITY 277567 0 47160 0 57729 0 28924 0 20571 0 431951 0 0 0 EMMELINE GASINK BOARD MEMBER 175558 0 11250 0 80238 0 20945 0 442 0 288433 0 0 0 ERIC STONE ASSOCIATE ADMINISTRATOR/VP CLI 274536 0 39655 0 48901 0 10945 0 531 0 374568 0 0 0 FAYE GARGIULO VP RESEARCH/DISCOVERY & PHY DE 241094 0 40511 0 51384 0 30298 0 7958 0 371245 0 0 0 JAMES FOSS DIRECTOR SYSTEM 181169 0 30825 0 24758 0 21584 0 12757 0 271093 0 0 0 GARY KAVIT BOARD MEMBER 326765 0 23424 0 150302 0 24998 0 20644 0 546133 0 0 0 GEORGE KANNARKAT BOARD MEMBER 685344 0 137325 0 10476 0 24340 0 24736 0 882221 0 0 0 JENNIFER GREENWELL CFO 183146 0 25267 0 12987 0 27349 0 16725 0 265474 0 0 0 APRIL GUMINSKY DIRECTOR PRIMARY CARE PROGRAM 197346 0 30092 0 5822 0 22605 0 23984 0 279849 0 0 0 WINFRED GUTHRIE DIRECTOR SYSTEM 142989 0 21220 0 10722 0 16646 0 4672 0 196249 0 0 0 GWENDOLYN HARTZOG VP PATIENT CARE SVS, CNO 147487 0 38141 0 291364 0 20238 0 16111 0 513341 0 0 0 EDWARD HECKLER EXECUTIVE DIRECTOR 153422 0 14139 0 20349 0 17215 0 17591 0 222716 0 0 0 ROBERT HORNSBY DIRECTOR SYSTEM 144359 0 24623 0 8735 0 21034 0 12481 0 211232 0 0 0 JAMES DUDLEY SERVICE LINE CHIEF 236709 0 0 0 99055 0 24423 0 31767 0 391954 0 0 0 JAMES LESNICK VP/MEDICAL DIRECTOR RMG 465406 0 85071 0 104774 0 23673 0 14480 0 693404 0 0 0 JAMES MCCORRY SERVICE LINE CHIEF, RDHW 267856 0 0 0 138276 0 24998 0 560 0 431690 0 0 0 JAMES MULLINS BOARD MEMBER 288798 0 0 0 3173 0 31684 0 7652 0 331307 0 0 0 JASON HOUSER VP, LEGAL AFFAIRS 308922 0 49250 0 56612 0 24998 0 20793 0 460575 0 0 0 JEFFREY HASKINS BOARD MEMBER 210108 0 384 0 2168 0 9692 0 7409 0 229761 0 0 0 JEFFREY HENKE BOARD MEMBER 329911 0 41564 0 97379 0 30298 0 19508 0 518660 0 0 0 JOHN PETERMAN VP/ADMINISTRATOR 209308 0 32897 0 60186 0 26607 0 7367 0 336365 0 0 0 JOHN GRETES BOARD MEMBER 243616 0 53338 0 17349 0 24998 0 14245 0 353546 0 0 0 JOSEPH CONVERSE BOARD MEMBER 437375 0 87523 0 27284 0 24998 0 19129 0 596309 0 0 0 KARL GEDDES BOARD MEMBER 222095 0 35266 0 26629 0 24998 0 25106 0 334094 0 0 0 KEITH PERCIC VP FINANCE 250661 0 34113 0 58878 0 31684 0 20559 0 395895 0 0 0 JASON KILGORE DIRECTOR SYSTEM 137978 0 36015 0 8576 0 18161 0 21527 0 222257 0 0 0 KYLE ALLEN VP CLINICAL INTEGRATION&MED DI 421030 0 47505 0 69153 0 22283 0 27874 0 587845 0 0 0 BARBARA LABONTE DIRECTOR SYSTEM 165735 0 41480 0 2990 0 24030 0 450 0 234685 0 0 0 MARSHALL CROSS CHAIRMAN OF RRMC OPERS COUNCIL 442150 0 93819 0 29484 0 24998 0 18887 0 609338 0 0 0 TODD MARTIN DIRECTOR 171721 0 26793 0 5704 0 18310 0 6477 0 229005 0 0 0 MEGAN KLECKNER VP/ADMINISTRATOR 228204 0 48829 0 45909 0 24061 0 14410 0 361413 0 0 0 KATHEY MENEFEE EXECUTIVE DIRECTOR 152561 0 10178 0 11911 0 15157 0 18390 0 208197 0 0 0 MICHAEL DOUCETTE VP RRMC OPERATIONS 411680 0 61979 0 106221 0 30298 0 20142 0 630320 0 0 0 BRADEN MILLER CFO 209911 0 31272 0 14736 0 24997 0 32379 0 313295 0 0 0 PATRICIA RUSSO VP CARE MANAGEMENT 226212 0 38234 0 45243 0 23488 0 14650 0 347827 0 0 0 RANDY FERRANCE PRESIDENT, RTH MEDICAL STAFF 208545 0 41011 0 74977 0 12873 0 26962 0 364368 0 0 0 RENEE ROUNTREE VP, PATIENT EXPERIENCE OFFICER 100840 0 32490 0 334778 0 13988 0 4461 0 486557 0 0 0 RICHARD DUNN BOARD MEMBER 183180 0 25315 0 4491 0 6743 0 29502 0 249231 0 0 0 ROBERT BRYANT VP/COO LHARS 282260 0 32231 0 80436 0 30298 0 23209 0 448434 0 0 0 ROBERT DAVIS BOARD MEMBER 227305 0 14297 0 5789 0 8878 0 19481 0 275750 0 0 0 ROBERT HARDING CHAIRMAN 222609 0 35266 0 74195 0 31684 0 19716 0 383470 0 0 0 SALLY HARTMAN SR VP, HUMAN RESOURCES 346883 0 53340 0 60136 0 30298 0 16725 0 507382 0 0 0 SALLY RYAN VP PHYSICIAN SERVICES 228513 0 33337 0 48463 0 9507 0 22293 0 342113 0 0 0 LISA SALSBERRY DIRECTOR 212571 0 0 0 55122 0 24297 0 24409 0 316399 0 0 0 REBECCA SCHULKOWSKI DIRECTOR SYSTEM 158732 0 28532 0 4298 0 4047 0 26941 0 222550 0 0 0 SANDRA SNAPP DIRECTOR SERVICE LINE 179276 0 23320 0 5598 0 23482 0 584 0 232260 0 0 0 STEPHEN MCCARY VP/ADMINISTRATOR RDHW 214010 0 38826 0 60808 0 24446 0 11412 0 349502 0 0 0 TERRIS KENNEDY BOARD MEMBER 35137 0 46416 0 5224 0 6074 0 108 0 92959 0 0 0 VERNEETA WILLIAMS BOARD MEMBER 212615 0 0 0 604 0 20657 0 18052 0 251928 0 0 0 WADE BROUGHMAN EXEC VP,COO & SECRETARY 567747 0 114173 0 134849 0 23673 0 19608 0 860050 0 0 0 WALTER AUSTIN SR VP, CFO & TREASURER 417842 0 64009 0 70913 0 9275 0 13903 0 575942 0 0 0 WILLIAM DOWNEY PRESIDENT,CEO RHS 850507 0 232125 0 183173 0 30298 0 14302 0 1310405 0 0 0 WILLIAM MCALLISTER PRESIDENT, MEDICAL STAFF 1006173 0 386458 0 44483 0 24432 0 27533 0 1489079 0 0 0 ROSS YOUNGER ASSOCIATE CMIO 249875 0 32695 0 13719 0 24075 0 28185 0 348549 0 0 0 DEAN KOSTOV PHYSICIAN 630726 0 921101 0 476 0 24998 0 20744 0 1598045 0 0 0 GARY TANNER PHYSICIAN 789173 0 561145 0 1802 0 600 0 3819 0 1356539 0 0 0 MASHOUR YOUSEF PHYSICIAN 730026 0 560892 0 1022 0 24998 0 32127 0 1349065 0 0 0 ROBERT CULLOM PHYSICIAN 510752 0 768432 0 1022 0 600 0 24428 0 1305234 0 0 0 TYLER WIND PHYSICIAN 798233 0 196713 0 51492 0 11925 0 29883 0 1088246 0 0 0 Schedule J, Part I, Line 3 The compensation committee of the parent corporation, Riverside Healthcare Association, Inc. reviews and approves the compensation for top management using independent consultants and surveys. Schedule J, Part 1, Line 4 BARRY GROSS $75,660 CHARLES FRAZIER $42,309 CHARLES GRAHAM $39,962 CHRISTOPHER STOLLE $39,966 DENNIS LOFTUS $31,249 ELIZABETH WILLIAMS $24,061 ELIZABETH MARTIN $33,150 ERIC STONE $28,124 FAYE GARGIULO $28,125 GWENDOLYN HARTZOG $27,050 JAMES LESNICK $55,000 JASON HOUSER $34,625 JOHN PETERMAN $23,124 KEITH PERCIC $29,913 KYLE ALLEN $49,744 MEGAN KLECKNER $26,075 MICHAEL DOUCETTE $43,957 PATRICIA RUSSO $26,876 RENEE ROUNTREE $22,838 ROBERT BRYANT $33,750 SALLY HARTMAN $37,500 SALLY RYAN $26,250 LISA SALSBERRY $20,000 STEPHEN MCCARY $23,213 WADE BROUGHMAN $83,460 WALTER AUSTIN $45,000 WILLIAM DOWNEY $157,500 TOTAL $1,108,481 Riverside has established this SERP to provide retirement benefits to certain executive employees to supplement the retirement benefits to be received from Riverside and Social Security. Although the employee is fully vested in these funds, he/she will not have the right to withdraw these funds from the plan until the later of the employee reaching age 62 or separation from service with Riverside. A Economic Development Authority City NN 521290859 2011-12-20 24570000 2011A ISSUE REFUNDING 1997 SERIES false false false A 5085000 0 24570000 0 0 0 170000 0 0 0 24400000 0 2012 true false true true A 0 A false true true false true false 0 false 0 false true A true Bond Information The 2011 A, B & the 2012 Bond Series are issued as Health System Revenue Bonds under the parent Riverside Health System. Therefore, Riverside Health System (the Parent) is listed as the issuer on the 8038 form filed with the IRS. Patriot's Colony (A subsidiary of Riverside Health System) is one of the borrowers along with Riverside Health System, and it holds the liability for the 2011 A Bond Series that was issued on 12/20/2011 for $24,570,000. The debt is therefore included on the schedule K on this Group Form 990 that includes Patriot's Colony. WADE BROUGHMAN SEE PART V 137224 SEE PART V false MEAGN KLECKNER SEE PART V 487409 SEE PART V false WADE BROUGHMAN Schedule L, Part IV Wade Broughman's family members are employed by Riverside Hospital, Inc. MEGAN KLECKNER Schedule L, Part IV Megan Kleckner's family member has a business relationship with Riverside Hospital, Inc. SCHEDULE O Part V, Line 3A Riverside Hospital, Inc. EIN 52-1245746, a subordinate company, had unrelated business income greater than $1,000 and 990-T was filed. Part VI, Section A, Line 2 Bill Downey, Alan Witt, Gordon Gentry and Conway Shields have a business relationship. Jason Houser and William Brauer have a business relationship. Gordon Gentry, Alan Witt and Bill Downey have a business relationship. Part VI, Section A, Line 6 The Organization is a not for profit corporation with members. The members have the right to participate in the Organization's governance, including electing members of the governing body and to approve significant decisions of the governing body. Part VI, Section A, Line 7a Members of the governing body are subject to approval by the Member. Part VI, Section A, Line 7b Significant items such as merger, amendment of charter documents, and appointment of Board members requires the approval of the member corporation. Part VI, Section B, Line 11B On behalf of the Organization's governing body, the Riverside Healthcare Association, Inc. Board of Directors Salary and Pension Committee reviews key data from the Form 990. The entire Form 990 was reviewed by an independent accounting firm before filing. Part VI, Section B, line 12c All Board Members, Officers, Directors and Key Employees complete an annual Conflict of Interest questionnaire. A report of potential Conflicts of Interest is reviewed by the Compliance Officer. Further concern, as reflected in the Conflict of Interest, Financial Disclosure, and Compliance Certification Questionnaire is reviewed by the Riverside Health System President to determine if additional follow-up is necessary. If a conflict presents, Board Members are required by the By-Laws, to disclose the conflict to the full Board and recuse themselves from voting on a case by case basis. Part VI, Section B, Line 15 A&B The Riverside Healthcare Association, Inc. Board of Directors Salary and Pension Committee determines the compensation of the President and Senior Executives. The Committee relies on market comparative information provided by a reputable independent third party expert to establish the reasonableness of compensation levels. Part VI, Section C, Line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the general public upon request. Part VI, Section C, Line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the general public upon request. Part XI Line 9: Pension Adjustment (16,641,296) Other Change in Fund 5,371,257 FORM 990 PART IX LINE 24 - OTHER EXPENSES DESCRIPTION:MEDICAL SUPPLIES TOTAL EXPENSES:XXX-XX-XXXX PROGRAM SERVICES:XXX-XX-XXXX MANAGEMENT AND GENERAL:5263597 Virginia Surgical Management LLC 608 Denbigh Blvd Ste 800 Newport News VA 23608 542057012 Management VA 406 2458965 RivHosp Peninsula Cancer Institute LLC 608 Denbigh Blvd Ste 800 Newport News VA 23608 201872200 PT Services VA 12066592 61750625 RivPhysSv PENINSULA RADIOSURGERY ASSOCIATES LLC 608 Denbigh Blvd Ste 800 NEWPORT NEWS VA 23608 454854018 PT Services VA 1425485 6445934 RivHosp Shore Health Services Inc 608 Denbigh Blvd Ste 800 Newport News VA 23608 540560500 Hospital VA 501(c)(3) 3 RivHCAssc true Shore Life Care inc 608 Denbigh Blvd Ste 800 Newport News VA 23608 541876370 Nursing Care VA 501(c)(3) 9 ShoreHSvc true Charlottesville Area Retirement Svc Inc 608 Denbigh Blvd Ste 800 Newport News VA 23608 454854018 Pt Services VA 501(c)(3) 9 RivRetSvc true Newport News General & Nonsectarian 608 Denbigh Blvd Ste 800 Newport News VA 23608 540505934 Holding Corp VA 501(c)(2) N/A RivHCAssc true Riverside Healthcare Assocation Inc 608 Denbigh Blvd Ste 800 Newport News VA 23608 521241835 Parent Comp. VA 501(c)(3) 9 N/A false Tilden and Va Davis Suport Found Inc 608 Denbigh Blvd Ste 800 Newport News VA 23608 541527703 Foundation VA 501(c)(3) 11A RivRetSvc true Parker and Mary West Hosp Fund 608 Denbigh Blvd Ste 800 Newport News VA 23608 540797108 Foundation VA 501(C)(3) 11c RivHosp true AtHomePtr 608 Denbigh Blvd Ste 800 Newport News VA 23608 472999121 Management VA RivRetSvc EXCLUDED 112756 0 false true 0.80000 Michumi PLLC 608 Denbigh Blvd Ste 800 Newport News VA 23608 200318732 Pt Services VA RivPhysSv EXCLUDED -780406 0 false true 1.00000 Peninsula Hospital Services 608 Denbigh Blvd Suite 800 Newport News VA 23608 540991295 Laundry VA RivHCAssc COOP 3758621 3737874 0.60670 true RHS Medinsur LTD Craig Appin House 8 Wesley Street Hamilton BD 521241835 Insurance BD RivHCAssc C Corp 3340613 44442724 1.00000 true Riverside Medical Equipment 608 Denbigh Blvd Ste 800 Newport News VA 23608 541325596 Billing VA RivHCAssc C Corp 0 0 1.00000 true false false false false false false false false true true true true true false false false false false Newport News General & Nonsectarian Hosp Inc j 15603586 MARKET VALUE Newport News General & Nonsectarian Hosp Inc L 677439 MARKET VALUE