VCU HEALTH CHILDRENS SERVICES AT BROOK ROAD: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- VCU HEALTH CHILDRENS SERVICES AT BROOK ROAD (EIN 54-0506309)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-04
- IRS object ID
- 201641259349301284
- Schema version
- 2014v6.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-04T14:19:56-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560747981 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 EAST CARY STREET SUITE 1000 | AddressLine1Txt |
| City | RICHMOND | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23219 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540506309 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRIPPLED CHILDREN'S HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CRIP | BusinessNameControlTxt |
| Phone | 8042285874 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2924 BROOK ROAD | AddressLine1Txt |
| City | RICHMOND | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 232201298 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LESLIE G WYATT | PersonNm |
| Person Title | SENIOR VP & EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 8042285874 | PhoneNum |
| Signature | 2016-05-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHRISTOPHER T BENNETT CPA | PreparerPersonNm |
| PTIN | P01232201 | PTIN |
| Phone | 8042827636 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDREN'S HOSPITAL OF RICHMOND OF THE VCU HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LESLIE G WYATT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2924 BROOK ROAD | AddressLine1Txt |
| City | RICHMOND | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 232201298 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $30,051,596 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHRICHMOND.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1920 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | CRIPPLED CHILDREN'S HOSPITAL IS A RESOURCE AND PROVIDER OF SPECIALIZED MEDICAL AND THERAPEUTIC SERVICES CUSTOMIZED TO MEET THE SPECIFIC NEEDS OF CHILDREN AND THEIR FAMILIES. OVER 9,000 CHILDREN WERE SERVED THIS PAST YEAR. WE CONTINUE TO FOCUS ON EXPANDING OUR CAPACITY TO SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 436 | TotalEmployeeCnt |
| Total Volunteers | 194 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,693,751 | PYContributionsGrantsAmt |
| CY Contributions Grants | $634,113 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $29,657,990 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $29,293,812 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,634 | PYInvestmentIncomeAmt |
| CY Investment Income | $7,305 | CYInvestmentIncomeAmt |
| PY Other Revenue | $96,371 | PYOtherRevenueAmt |
| CY Other Revenue | $103,778 | CYOtherRevenueAmt |
| PY Total Revenue | $33,452,746 | PYTotalRevenueAmt |
| CY Total Revenue | $30,039,008 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $24,400,901 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $26,321,438 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,971,657 | PYOtherExpensesAmt |
| CY Other Expenses | $8,357,780 | CYOtherExpensesAmt |
| PY Total Expenses | $32,372,558 | PYTotalExpensesAmt |
| CY Total Expenses | $34,679,218 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,080,188 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,640,210 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $19,578,464 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,266,850 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,479,575 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,769,890 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,098,889 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,496,960 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CRIPPLED CHILDREN'S HOSPITAL IS A RESOURCE AND PROVIDER OF SPECIALIZED MEDICAL AND THERAPEUTIC SERVICES CUSTOMIZED TO MEET THE SPECIFIC NEEDS OF CHILDREN AND THEIR FAMILIES. OVER 9,000 CHILDREN WERE SERVED THIS PAST YEAR. WE CONTINUE TO FOCUS ON EXPANDING OUR CAPACITY TO SERVE MORE CHILDREN. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,568,250 | ExpenseAmt |
| Revenue | $11,459,869 | RevenueAmt |
| Desc | THE TRANSITIONAL CARE UNIT IS THE HOSPITAL'S ONLY INPATIENT UNIT. IT HAS 47 BEDS AND PROVIDES LONG TERM CARE FOR CHILDREN UP TO THE AGE OF 21 WHO REQUIRE SPECIALIZED, AROUND THE CLOCK, NURSING CARE. THE UNIT HAD AN AVERAGE DAILY CENSUS OF 38.4 IN FISCAL YEAR 2015, A SLIGHT DECREASE FROM 38.6 IN FISCAL YEAR 2014. THE UNIT IS CERTIFIED BY THE VIRGINIA DEPARTMENT OF MEDICAL ASSISTANCE SERVICES AND 100% OF THE REVENUE IN THIS PROGRAM COMES FROM VIRGINIA MEDICAID. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,315,685 | ExpenseAmt |
| Revenue | $11,425,935 | RevenueAmt |
| Desc | THE HOSPITAL IS THE PREMIER PROVIDER OF OUTPATIENT PEDIATRIC PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY SERVICES IN CENTRAL VIRGINIA. OUTPATIENT THERAPY VISITS TOTALED 84,868 IN FISCAL YEAR 2015, WHICH IS AN INCREASE OF 8,368 VISITS (11%) FROM THE PRIOR YEAR. THERAPY SERVICES ARE PROVIDED AT THE MAIN HOSPITAL IN THE CITY OF RICHMOND AND AT FIVE COMMUNITY THERAPY CENTERS LOCATED IN GLEN ALLEN, BON AIR, FREDERICKSBURG, PETERSBURG, AND STAFFORD. APPROXIMATELY 50% OF THE THERAPY VISITS ARE FUNDED BY VIRGINIA MEDICAID AND MEDICAID MANAGED CARE ORGANIZATIONS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,836,991 | ExpenseAmt |
| Revenue | $3,227,293 | RevenueAmt |
| Desc | DENTAL PROGRAM SERVICES ARE PROVIDED FOR THE TYPICAL WELL-CHILD AND FOR CHILDREN WITH SPECIAL NEEDS. IN FISCAL YEAR 2015, THE DENTAL PROGRAM COMPLETED 634 SURGERIES AND 5,974 CLINIC VISITS. THE MAJORITY OF THE DENTAL PROGRAM PATIENTS ARE FUNDED BY VIRGINIA MEDICAID AND MEDICAID MANAGED CARE ORGANIZATIONS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,617,573 | ExpenseAmt |
| Revenue | $3,189,063 | RevenueAmt |
| Desc | PHYSICIAN SPECIALTY SERVICES - PEDIATRIC PHYSICIAN SPECIALIST, NURSE PRACTITIONERS AND THERAPIST PROVIDE EVALUATION, DIAGNOSIS AND TREATMENT OF A WIDE VARIETY OF MEDICAL CONDITIONS IN OUR OUTPATIENT CENTER. CLINICS INCLUDE: PHYSICAL MEDICINE AND REHABILITATION; CEREBRAL PALSY; MUSCULAR DYSTROPHY; SPASTICITY AND SPINA BIFIDA. CHILDREN'S FEEDING PROGRAM - THE CHILDREN'S FEEDING PROGRAM IS DESIGNED TO HELP CHILDREN WHO HAVE A MEDICAL CONDITION THAT HAS AFFECTED THEIR FEEDING AND GROWTH. THE CHILD IS INITIALLY SEEN IN THE FEEDING CLINIC BY A TEAM OF SPECIALISTS WHO EVALUATE THE CHILD'S NEEDS AND MAKE RECOMMENDATIONS FOR TREATMENT AND/OR PROVIDES TIPS FOR THE FAMILY. TREATMENT PROGRAMS, EITHER OUTPATIENT OR DAY PATIENT, FOCUS ON ESTABLISHING APPROPRIATE FEEDING AND NUTRITIONAL HABITS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $3,617,573 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $3,189,063 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $27,338,499 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 40 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 436 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES A DEYARMIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8042285874 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2924 BROOK ROAD | AddressLine1Txt |
| City | RICHMOND | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 232201298 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| THOMAS S CAIN | |||||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| PONJOLA CONEY MD | |||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $58,568 | $7,526 | |||
| LINDA E PEARSON | |||||||||
| VICE CHAIR AND TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $420,836 | $57,228 | |||
| JOHN F DUVAL | |||||||||
| DIRECTOR - EX-OFFICIO | 1.00 | Yes (X) | $0 | $805,381 | $94,122 | ||||
| JEROME F STRAUSS III MD | |||||||||
| DIRECTOR - EX-OFFICIO | 1.00 | Yes (X) | $0 | $480,647 | $10,654 | ||||
| BRUCE K RUBIN MD | |||||||||
| DIRECTOR - EX-OFFICIO | 1.00 | Yes (X) | $0 | $404,060 | $37,191 | ||||
| ANN E HONEYCUTT | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| HENRY L VALENTINE III | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN D WARD MD | |||||||||
| DIRECTOR - EX-OFFICIO | 1.00 | Yes (X) | $0 | $515,933 | $36,919 | ||||
| LESLIE G WYATT | |||||||||
| EXECUTIVE DIRECTOR | 45.00 | Yes (X) | $0 | $283,486 | $46,223 | ||||
| SHARON W DARBY | |||||||||
| VP OF CLINICAL OPERATIONS | 45.00 | $200,389 | $0 | $34,313 | Yes (X) | ||||
| JOANNA CASTALDI | |||||||||
| MANAGER OF PSYCHOLOGY SERVICES | 45.00 | $107,419 | $0 | $29,110 | Yes (X) | ||||
| PATRICIA P ANDERSON | |||||||||
| DIRECTOR OF INPATIENT SERVICES | 45.00 | $116,534 | $0 | $21,729 | Yes (X) | ||||
| JAMES A DEYARMIN | |||||||||
| DIRECTOR OF FINANCE | 45.00 | $138,776 | $0 | $23,738 | Yes (X) | ||||
| SALLIE C TIDMAN | |||||||||
| DIRECTOR OF THERAPY SERVICES | 45.00 | $112,373 | $0 | $30,753 | Yes (X) | ||||
| MARK D NICOL | |||||||||
| DIRECTOR OF FACILITIES MANAGEMENT | 45.00 | $108,282 | $0 | $32,340 | Yes (X) | ||||
| SHELDON M RETCHIN MD | |||||||||
| FORMER DIRECTOR - EX-OFFICIO | 1.00 | $0 | $473,750 | $10,167 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $783,773 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,442,661 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $472,013 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 21 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MCV ASSOCIATED PHYSICIANS DBA MCV PHYS | |||||
| PO BOX 79203 | BALTIMORE | MD | 212790203 | CONTRACT PHYSICIANS | $813,956 |
| VCU DENTISTRY | |||||
| 521 NORTH 11TH STREET | RICHMOND | VA | 23298 | CONTRACT DENTISTS | $508,277 |
| ARKANSAS COUNTY ANESTHESIA | |||||
| 48180 KIPPER DRIVE | MOSELEY | VA | 23120 | CONTRACT PHYSICIANS | $293,750 |
| FIRST CHOICE NURSES INC | |||||
| 5310 MARKEL ROAD SUITE 105A | RICHMOND | VA | 23230 | CONTRACT NURSES | $203,785 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $634,113 | AllOtherContributionsAmt |
| Total Contributions | $634,113 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICES | 623000 | $29,265,508 | $29,265,508 |
| INFANT SERVICES | 621610 | $18,000 | $18,000 |
| PHYSICAL THERAPY CONTRACT SERVICE | 623000 | $10,304 | $10,304 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $29,293,812 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,805 | TotalRevenueColumnAmt |
| Exclusion | $4,805 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $600 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $600 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $600 | TotalRevenueColumnAmt |
| Exclusion | $600 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,500 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,500 | TotalRevenueColumnAmt |
| Exclusion | $2,500 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $18,515 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $12,588 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,927 | TotalRevenueColumnAmt |
| Exclusion | $5,927 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MISC REVENUE | 900099 | $73,054 | $73,054 |
| MED RECORDS FEE | 623000 | $11,678 | $11,678 |
| RESEARCH CONTRACT | 541700 | $6,044 | $6,044 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,475 | TotalRevenueColumnAmt |
| Exclusion | $6,475 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $97,251 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,039,008 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $29,293,812 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $111,083 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $238,417 | TotalAmt |
| Program Services | $178,813 | ProgramServicesAmt |
| Management And General | $59,604 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,604,945 | TotalAmt |
| Program Services | $15,659,367 | ProgramServicesAmt |
| Management And General | $2,945,578 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,191,309 | TotalAmt |
| Program Services | $930,973 | ProgramServicesAmt |
| Management And General | $260,336 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,944,142 | TotalAmt |
| Program Services | $4,048,338 | ProgramServicesAmt |
| Management And General | $895,804 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,342,625 | TotalAmt |
| Program Services | $1,122,728 | ProgramServicesAmt |
| Management And General | $219,897 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,302 | TotalAmt |
| Management And General | $311,302 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,103 | TotalAmt |
| Management And General | $8,103 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,100 | TotalAmt |
| Management And General | $29,100 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,185,940 | TotalAmt |
| Program Services | $1,691,061 | ProgramServicesAmt |
| Management And General | $494,879 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,369 | TotalAmt |
| Program Services | $2,363 | ProgramServicesAmt |
| Management And General | $6 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,280,261 | TotalAmt |
| Program Services | $284,412 | ProgramServicesAmt |
| Management And General | $995,849 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,498 | TotalAmt |
| Program Services | $29,669 | ProgramServicesAmt |
| Management And General | $7,829 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,012,108 | TotalAmt |
| Program Services | $506,018 | ProgramServicesAmt |
| Management And General | $506,090 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,052 | TotalAmt |
| Program Services | $41,305 | ProgramServicesAmt |
| Management And General | $12,747 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,147 | TotalAmt |
| Program Services | $56,549 | ProgramServicesAmt |
| Management And General | $22,598 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $968,396 | TotalAmt |
| Program Services | $726,297 | ProgramServicesAmt |
| Management And General | $242,099 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,170 | TotalAmt |
| Program Services | $121,677 | ProgramServicesAmt |
| Management And General | $50,493 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| RESIDENT CARE | $2,168,952 | $1,929,664 | $239,288 |
| DUES & LICENSES | $29,869 | $5,936 | $23,933 |
| MISCELLANEOUS | $18,513 | $3,329 | $15,184 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,679,218 | TotalAmt |
| Program Services | $27,338,499 | ProgramServicesAmt |
| Management And General | $7,340,719 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $832,738 | BOYAmt |
| EOY | $814,016 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,055 | BOYAmt |
| EOY | $3,773 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,878,518 | BOYAmt |
| EOY | $3,422,751 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $166,459 | BOYAmt |
| EOY | $163,487 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,371 | BOYAmt |
| EOY | $92,373 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,428,701 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $31,017,797 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,085,942 | BOYAmt |
| EOY | $8,410,904 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,467,381 | BOYAmt |
| EOY | $6,359,546 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,578,464 | BOYAmt |
| EOY | $19,266,850 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,041,058 | BOYAmt |
| EOY | $3,424,372 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,438,517 | BOYAmt |
| EOY | $11,345,518 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,479,575 | BOYAmt |
| EOY | $14,769,890 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,496,563 | BOYAmt |
| EOY | $809,052 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,179,722 | BOYAmt |
| EOY | $1,235,304 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,422,604 | BOYAmt |
| EOY | $2,452,604 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,098,889 | BOYAmt |
| EOY | $4,496,960 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,578,464 | BOYAmt |
| EOY | $19,266,850 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,640,210 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$961,719 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,602,326 | BeginningYearBalanceAmt |
| Contributions | $120,007 | ContributionsAmt |
| Investment Earnings Or Losses | $99,688 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $134,113 | OtherExpendituresAmt |
| End Year Balance | $3,687,908 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,339,987 | BeginningYearBalanceAmt |
| Contributions | $47,440 | ContributionsAmt |
| Investment Earnings Or Losses | $475,729 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $260,830 | OtherExpendituresAmt |
| End Year Balance | $3,602,326 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,870,417 | BeginningYearBalanceAmt |
| Contributions | $205,967 | ContributionsAmt |
| Investment Earnings Or Losses | $353,072 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $89,469 | OtherExpendituresAmt |
| End Year Balance | $3,339,987 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,996,275 | BeginningYearBalanceAmt |
| Contributions | $563,458 | ContributionsAmt |
| Investment Earnings Or Losses | -$102,298 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $587,018 | OtherExpendituresAmt |
| End Year Balance | $2,870,417 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,609,947 | BeginningYearBalanceAmt |
| Contributions | $541,132 | ContributionsAmt |
| Investment Earnings Or Losses | $605,099 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $759,903 | OtherExpendituresAmt |
| End Year Balance | $2,996,275 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.66500 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.33500 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $54,914 | OtherCostOrOtherBasisAmt |
| Book Value | $54,914 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,713,784 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,461,290 | DepreciationAmt |
| Book Value | $6,252,494 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $583,826 | OtherCostOrOtherBasisAmt |
| Depreciation | $317,495 | DepreciationAmt |
| Book Value | $266,331 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,678,509 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,841,636 | DepreciationAmt |
| Book Value | $1,836,873 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $397,668 | OtherCostOrOtherBasisAmt |
| Depreciation | $397,376 | DepreciationAmt |
| Book Value | $292 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,410,904 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER CURRENT ASSETS | $87,581 |
| EQUITY INTEREST IN FOUNDATION NET ASSETS | $3,687,908 |
| DEPOSITS | $24,836 |
| SETTLEMENTS DUE FROM THIRD PARTY PAYORS | $2,559,221 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,359,546 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| PENSION LIABILITY | $7,275,665 |
| DUE TO AFFILIATES | $3,632,085 |
| OTHER LIABILITIES | $100,522 |
| PATIENT CREDIT BALANCES | $333,335 |
| PATIENT ACCOUNT REFUNDS | $889 |
| UNCLAIMED CHECKS | $3,022 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,345,518 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE HOSPITAL HAS RECORDED ITS BENEFICIAL INTEREST IN CERTAIN TEMPORARILY AND PERMANENTLY RESTRICTED NET ASSETS OF THE FOUNDATION THAT ARE TO BENEFIT THE HOSPITAL. TEMPORARILY RESTRICTED NET ASSETS IN THE FOUNDATION OF $1,235,304 AND $1,179,722 AT JUNE 30, 2015 AND 2014, RESPECTIVELY, ARE AVAILABLE FOR THE PURCHASE OF CAPITAL ASSETS AND TO SUPPORT THE OPERATIONS OF THE HOSPITAL. PERMANENTLY RESTRICTED NET ASSETS IN THE FOUNDATION OF $2,452,604 AND $2,422,604 AT JUNE 30, 2015 AND 2014, RESPECTIVELY, ARE INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT PROGRAMS AT THE HOSPITAL. THE HOSPITAL RECEIVED FROM THE FOUNDATION $134,113 AND $260,830 IN 2015 AND 2014, RESPECTIVELY, TO SUPPORT OPERATIONS OF THE HOSPITAL AND FOR THE PURCHASE OF CAPITAL ASSETS. |
| PART X, LINE 2: | CHILDREN'S HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF THE AUTHORITY: THE AUTHORITY RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. AT JUNE 30, 2015 AND 2014, THE AUHTORITY HAS NO INCOME TAX POSITIONS THAT ARE NOT CONSIDERED GREATER THAN 50% LIKELY OF BEING REALIZED. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 35 | PersonsServedCnt |
| Total Community Benefit Expns | $4,873 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,873 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 3966 | PersonsServedCnt |
| Total Community Benefit Expns | $22,556,879 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,614,225 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,942,654 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11370 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 4001 | PersonsServedCnt |
| Total Community Benefit Expns | $22,561,752 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,614,225 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,947,527 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11380 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 58 | ActivitiesOrProgramsCnt |
| Persons Served | 6475 | PersonsServedCnt |
| Total Community Benefit Expns | $77,548 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $77,548 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 19 | ActivitiesOrProgramsCnt |
| Persons Served | 386 | PersonsServedCnt |
| Total Community Benefit Expns | $46,924 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $46,924 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 216 | PersonsServedCnt |
| Total Community Benefit Expns | $443,300 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,768 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $418,532 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01210 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 78 | ActivitiesOrProgramsCnt |
| Persons Served | 7077 | PersonsServedCnt |
| Total Community Benefit Expns | $567,772 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,768 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $543,004 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01570 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 80 | ActivitiesOrProgramsCnt |
| Persons Served | 11078 | PersonsServedCnt |
| Total Community Benefit Expns | $23,129,524 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,638,993 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,490,531 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12950 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $160,810 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $34,843 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $34,843 | CostOfCareReimbursedByMedcrAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRIPPLED CHILDREN'S HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2924 BROOK ROAD | AddressLine1Txt |
| City | RICHMOND | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23220 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CHRICHMOND.ORG | WebsiteAddressTxt |
| State License | H1842 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Childrens Hospital | Yes (X) | ChildrensHospitalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Other | PEDIATRIC LONG TERM CARE | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRIPPLED CHILDREN'S HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.CHRICHMOND.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.CHRICHMOND.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.CHRICHMOND.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.CHRICHMOND.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.CHRICHMOND.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | 0 | NondisEmergencyCarePolicyInd |
| No Emergency Care | Yes (X) | NoEmergencyCareInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CRIPPLED CHILDREN'S HOSPITAL | PART V, SECTION B, LINE 5: THE HOSPITAL USED A WRITTEN SURVEY TO OBTAIN INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. THE SURVEY RESPONDENTS REPRESENTED SOME OF THE FOLLOWING ORGANIZATIONS: VIRGINIA DEPARTMENT OF HEALTH, VIRGINIA DEPARTMENT OF EDUCATION, RICHMOND CITY HEALTH DISTRICT, CARE CONNECTION FOR CHILDREN, MARCH OF DIMES FOUNDATION, AND GREATER RICHMOND FIT4KIDS. |
| CRIPPLED CHILDREN'S HOSPITAL | PART V, SECTION B, LINE 11: THE HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA BY TAKING THE FOLLOWING ACTIONS:1. ADOPTION OF AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE MAJORITY OF THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA2. EXECUTION OF THE IMPLEMENTATION STRATEGY3. INCLUSION OF A COMMUNITY BENEFIT SECTION IN OPERATIONAL PLANS4. ADOPTION OF A BUDGET FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA5. PRIORITIZATION OF SERVICES THAT THE HOSPITAL WILL UNDERTAKE TO MEET HEALTH NEEDS IN ITS COMMUNITYTHE FOLLOWING HEALTH NEEDS IDENTIFIED IN THE CHNA HAVE NOT BEEN ADDRESSED BY THE HOSPITAL BUT THE CHNA WAS SHARED WITH THE MCV CAMPUS OF CHILDREN'S HOSPITAL OF RICHMOND AT VCU AND IT'S SATELLITE LOCATIONS TO HELP ADDRESS THE NEEDS:1. ASTHMA2. BEHAVIORAL HEALTH CONDITIONS3. HEALTH PROMOTION AND PREVENTION4. HIGH RISK PREGNANCIES AND BIRTH OUTCOMESTHE HOSPITAL IS NOT A FULL SERVICE HOSPITAL BUT IS A SPECIALTY HOSPITAL WITH A REHABILITATIVE FOCUS. |
| CRIPPLED CHILDREN'S HOSPITAL | PART V, SECTION B, LINE 22D: THE HOSPITAL OFFERS A SELF PAY DISCOUNT TO UNINSURED PATIENTS IN ADDITION TO THOSE WHO QUALIFY FOR FINANCIAL ASSISTANCE. AS A CHILDREN'S HOSPITAL WITH LOW MEDICARE UTILIZATION, THE HOSPITAL USED THE MEDICAID PAYMENT RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. THE PROSPECTIVE METHOD WAS USED. |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| CRIPPLED CHILDREN'S HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: | WWW.CHRICHMOND.ORG |
| CRIPPLED CHILDREN'S HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: | WWW.CHRICHMOND.ORG |
| CRIPPLED CHILDREN'S HOSPITAL PART V, SECTION B, LINE 16C WEBSITE: | WWW.CHRICHMOND.ORG |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | THE HOSPITAL REPORTS COMMUNITY BENEFIT DATA TO THE VA HOSPITAL AND HEALTHCARE ASSOCIATION (VHHA). |
| PART I, LINE 7: | COMMUNITY BENEFIT COST FOR EACH CATEGORY IS DETERMINED BY USING EITHER A COST TO CHARGE RATIO OR A COST ACCOUNTING METHODOLOGY. THE SCHEDULE H WORKSHEETS ARE USED TO COMPUTE THE CORRESPONDING LINE. |
| PART I, LINE 7G: | THE COST OF THE INFANT SERVICE PROGRAM THAT MET THE DEFINITION OF A SUBSIDIZED HEALTHCARE SERVICE IS INCLUDED IN SUBSIDIZED HEALTHCARE SERVICES. DIRECT COST FOR THE INFANT SERVICE PROGRAM WAS $330,878. |
| PART III, LINE 2: | CHARGED AMOUNTS NOT EXPECTED TO BE PAID ARE RESERVED AND EXPENSED TO BAD DEBT. A COST TO CHARGE RATIO IS APPLIED TO DETERMINE THE COST OF THE BAD DEBT. |
| PART III, LINE 3: | NO ATTEMPT HAS BEEN MADE TO DETERMINE THE AMOUNT IN BAD DEBT THAT COULD HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| PART III, LINE 4: | SEE PAGE 26 OF THE AUDITED FINANCIAL STATEMENTS FOR THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COST IS FROM THE LOW UTILIZATION MEDICARE COST REPORT. |
| PART III, LINE 9B: | A FINANCIAL COUNSELOR ASSISTS PATIENTS IN UNDERSTANDING THE AVAILABILITY OF COMMUNITY OR GOVERNMENTAL ASSISTANCE PROGRAMS, AS WELL AS, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. NEW PATIENTS RECEIVE NOTIFICATION THROUGH THE PATIENT BOOKLET. THE HOSPITAL PROVIDES A BILLING STATEMENT TO THE FAP INDIVIDUAL THAT SHOWS THE AMOUNTS GENERALLY BILLED FOR THE CARE AND HOW THE HOSPITAL DETERMINED THE AMOUNT THE INDIVIDUAL OWES. THE HOSPITAL WILL ALSO REFUND ANY EXCESS PAYMENTS MADE AND TAKE MEASURES TO REVERSE ANY EXTRAORDINARY COLLECTION ACTION TAKEN. |
| PART VI, LINE 3: | SEE PART V, LINE 16 ANSWERS. |
| PART VI, LINE 4: | THE HOSPITAL SERVICE AREA CONSISTS OF MORE THAN FIFTY ZIP CODES ADJACENT TO ITS SIX LOCATIONS. MOST OF THE ZIP CODES ARE IN THE RICHMOND METROPOLITAN AREA AND EXTEND SOUTH TO PETERSBURG AND NORTH TO STAFFORD. AS A CHILDREN'S HOSPITAL, THE SERVICE POPULATION IS AGED 0-21 YEARS AND AS OF 2011, THE SERVICE AREA INCLUDED MORE THAN 400,000 PERSONS AGED 0-21. |
| PART VI, LINE 5: | THE HOSPITAL IS ULTIMATELY CONTROLLED BY IT'S CORPORATE MEMBER, VCU HEALTH SYSTEM AUTHORITY. THE MAJORITY OF THAT GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF.THE HOSPITAL EXTENDS MEDICAL STAFF PRIVEILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALITIES.THE HOSPITAL USES SURPLUS FUNDS TO FURTHER ITS EXEMPT PURPOSE. MEDICAL EDUCATION AND RESEARCH TAKES PLACE ON THE MCV CAMPUS, WHICH IS AN ACADEMIC MEDICAL CENTER. |
| PART VI, LINE 6: | THE HOSPITAL IS AN AFFILIATE OF THE VCU HEALTH SYSTEM AUTHORITY.THE HOSPITAL PROVIDES PEDIATRIC SPECIALTY CARE TO BOTH INPATIENTS AND OUTPATIENTS.VCU HEALTH SYSTEM AUTHORITY ALSO HAS THE FOLLOWING ADDITIONAL AFFILIATES:THE MEDICAL COLLEGE OF VIRGINIA HOSPITALS IS AN APPROXIMATELY 800-BED TEACHING HOSPITAL THAT PROVIDES INPATIENT AND OUTPATIENT SERVICES PRIMARILY TO PATIENTS IN THE COMMONWEALTH OF VIRGINIA.MCV ASSOCIATED PHYSICIANS FUNCTIONS AS THE GROUP PRACTICE PLAN FOR THOSE PHYSICIANS AND HEALTH CARE PROFESSIONALS WHO HAVE FACULTY APPOINTMENTS IN THE VCU SCHOOL OF MEDICINE.UNIVERSITY HEALTH SERVICES SUPPORTS THE EDUCATIONAL, SCIENTIFIC, AND CHARITABLE PURPOSE AND ACTIVITIES OF VCU AND, IN PARTICULAR, THE ACTIVITIES OF THE SCHOOL OF MEDICINE AND THE MEDICAL COLLEGE OF VIRGINIA HOSPITALS.VA PREMIER IS A MEDICAID HEALTH MAINTENANCE ORGANIZATION WHOSE PRIMARY PURPOSE IS TO PROVIDE QUALITY HEALTH CARE WITHIN A MANAGED CARE FRAMEWORK. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LINDA E PEARSON | ||||||||||||||
| VICE CHAIR AND TREASURER | $0 | $369,328 | $0 | $43,868 | $0 | $7,640 | $0 | $43,699 | $0 | $13,529 | $0 | $478,064 | $0 | $0 |
| JOHN F DUVAL | ||||||||||||||
| DIRECTOR - EX-OFFICIO | $0 | $637,174 | $0 | $0 | $0 | $168,207 | $0 | $77,457 | $0 | $16,665 | $0 | $899,503 | $0 | $0 |
| JEROME F STRAUSS III MD | ||||||||||||||
| DIRECTOR - EX-OFFICIO | $0 | $374,105 | $0 | $60,031 | $0 | $46,511 | $0 | $8,144 | $0 | $2,510 | $0 | $491,301 | $0 | $0 |
| BRUCE K RUBIN MD | ||||||||||||||
| DIRECTOR - EX-OFFICIO | $0 | $308,261 | $0 | $91,756 | $0 | $4,043 | $0 | $35,191 | $0 | $2,000 | $0 | $441,251 | $0 | $0 |
| JOHN D WARD MD | ||||||||||||||
| DIRECTOR - EX-OFFICIO | $0 | $401,032 | $0 | $65,227 | $0 | $49,674 | $0 | $34,369 | $0 | $2,550 | $0 | $552,852 | $0 | $0 |
| LESLIE G WYATT | ||||||||||||||
| EXECUTIVE DIRECTOR | $0 | $255,387 | $0 | $21,396 | $0 | $6,703 | $0 | $31,932 | $0 | $14,291 | $0 | $329,709 | $0 | $0 |
| SHARON W DARBY | ||||||||||||||
| VP OF CLINICAL OPERATIONS | $190,190 | $0 | $0 | $0 | $10,199 | $0 | $20,960 | $0 | $13,353 | $0 | $234,702 | $0 | $0 | $0 |
| JAMES A DEYARMIN | ||||||||||||||
| DIRECTOR OF FINANCE | $135,427 | $0 | $0 | $0 | $3,349 | $0 | $15,193 | $0 | $8,545 | $0 | $162,514 | $0 | $0 | $0 |
| SHELDON M RETCHIN MD | ||||||||||||||
| FORMER DIRECTOR - EX-OFFICIO | $0 | $469,264 | $0 | $0 | $0 | $4,486 | $0 | $7,473 | $0 | $2,694 | $0 | $483,917 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | COMPENSATION OF THE EXECUTIVE DIRECTOR IS DETERMINED BY THE LEADERSHIP OF VCUHS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | ALSO LINES 7A AND 7B - THE SOLE MEMBER OF THE CORPORATION IS VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY (VCUHS), A STATUTORY AUTHORITY CREATED UNDER THE CODE OF VIRGINIA. VCUHS HAS THE EXCLUSIVE RIGHT AND POWER TO ELECT, APPOINT, OR REMOVE THE MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS AS PROVIDED IN THE BYLAWS. THE BOARD OF DIRECTORS OF VCUHS SHALL ACT ON VCUHS'S BEHALF IN EXERCISING VCUHS'S RESERVED POWERS OVER THE CORPORATION. CERTAIN COMMITTEES OF THE BOARD OF DIRECTORS OF VCUHS SHALL OVERSEE THE ACTIVITIES OF THE CORPORATION. LISTED BELOW ARE VCUHS'S RESERVED POWERS: (A) APPROVAL OF AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; (B) APPROVAL OF THE CORPORATION'S CAPITAL AND OPERATING BUDGETS; (C) ELECTION AND REMOVAL OF AN ELECTED DIRECTOR (AS HEREINAFTER DEFINED); (D) APPROVAL OF THE INCURRENCE OF DEBT OR THE ISSUANCE OF GUARANTEES BY THE CORPORATION IN EXCESS OF $500,000 FOR A SINGLE EXPENDITURE; (E) APPROVAL OF ANY NON-BUDGETED CAPITAL EXPENDITURE IN EXCESS OF $500,000 FOR A SINGLE CAPITAL EXPENDITURE OR $1 MILLION FOR ALL SUCH CAPITAL EXPENDITURES ON AN AGGREGATE BASIS IN ANY TWELVE (12) MONTH PERIOD; (F) ANY PROPOSED EXPENDITURE IN EXCESS OF $500,000 FROM FUNDED DEPRECIATION MAINTAINED BY OR ON BEHALF OF THE CORPORATION FOR THE RENOVATION AND REPLACEMENT OF THE CORPORATION'S CAPITAL ASSETS; (G) AUTHORIZATION OF ANY ACTION THAT COULD CAUSE THE CORPORATION TO OPERATE IN A MANNER INCONSISTENT WITH THE COMMUNITY BENEFIT STANDARD ARTICULATED BY THE INTERNAL REVENUE SERVICE, OR OTHERWISE CAUSE THE CORPORATION TO ACT IN POTENTIAL DEROGATION OF ITS FEDERAL, STATE, OR LOCAL TAX-EXEMPTION AND/OR CHARITABLE PURPOSE; (H) SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (I) MERGER, CONSOLIDATION, DISSOLUTION, OR DIVISION OF THE CORPORATION; (J) ASSIGNMENT OF PROPERTY OR OTHER ASSETS OF THE CORPORATION IN TRUST FOR CREDITORS OR ON THE ASSIGNEE'S PROMISE TO PAY THE DEBTS OF THE CORPORATION; (K) DECLARATION OF BANKRUPTCY BY THE CORPORATION; (L) AUTHORIZATION OF ANY ACTION THAT COULD HAVE A MATERIAL ADVERSE IMPACT ON ANY LICENSURE, ACCREDITATION, OR CERTIFICATION HELD OR DESIRED TO BE HELD BY THE CORPORATION, INCLUDING, WITHOUT LIMITATION, STATE LICENSURE, MEDICARE OR MEDICAID CERTIFICATION, THE JOINT COMMISSION OR OTHER FACILITY ACCREDITATION, MEDICAL RESIDENCY PROGRAM ACCREDITATION, OR CLINICAL DESIGNATION OR CERTIFICATION; (M) ANY SIGNIFICANT PROPOSED AFFILIATIONS WITH OTHER HEALTH CARE PROVIDERS OR ACADEMIC INSTITUTIONS, INCLUDING, WITHOUT LIMITATION, ACQUISITION, MERGER, JOINT OPERATION, MANAGEMENT, STAFFING, CLINICAL COORDINATION, OR "CO-BRANDING; (N) ANY ACTION INVOLVING USE OF THE CORPORATION'S LOGO, SERVICE MARK, TRADE OR OTHER DRESS, OTHER THAN FOR THE DIRECT BENEFIT OF THE CORPORATION OR THE DEPARTMENT OF PEDIATRICS OF THE MEMBER; AND (O) HIRING OR TERMINATION OF THE CORPORATION'S CHIEF EXECUTIVE OFFICER (IRRESPECTIVE OF TITLE). |
| FORM 990, PART VI, SECTION A, LINE 7A | SEE RESPONSE TO FORM 990, PART VI, SECTION A, LINE 6 |
| FORM 990, PART VI, SECTION A, LINE 7B | SEE RESPONSE TO FORM 990, PART VI, SECTION A, LINE 6 |
| FORM 990, PART VI, SECTION B, LINE 11 | A PDF COPY OF THE 990 IS SENT TO ALL THE BOARD MEMBERS FOR REVIEW. THIS BOARD REVIEW PROCESS TAKES PLACE PRIOR TO FILING AND A PERIOD OF TIME IS ALLOTED FOR REIVEW COMMENTS BY THE BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL OFFICERS, TRUSTEES AND KEY EMPLOYEES SHALL DISCLOSE A POTENTIAL CONFLICT TO THE CHAIRMAN OF THE BOARD OR COMPLIANCE OFFICER FOR INVESTIGATION AND RESOLUTION. UPON APPOINTMENT TO THE BOARD OR EMPLOYMENT AND ANNUALLY THEREAFTER, OFFICERS, TRUSTEES AND KEY EMPLOYEES SHALL COMPLETE AN AFFIRMATION STATEMENT AND DISCLOSURE FORM FOR REVIEW BY THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15 | AN OUTSIDE CONSULTANT IS USED TO COMPLETE A REVIEW AND ESTABLISH RANGES TO BE USED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THESE RANGES MEET THE 4958 SAFE HARBOR REQUIREMENTS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE PUBLIC VIEWING DOCUMENT IS AVAILABLE FOR INSPECTION AT THE MAIN HOSPITAL LOCATION UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN PLAN ASSETS AND BENEFIT OBLIGATION OF PENSION PLAN -1,047,301. CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS 85,582. |
| FORM 990, PART XII, LINE 2C: | THE BOARD HAS NOT CHANGED THE OVERSIGHT OF ITS PROCESS FOR THE ORGANIZATION'S AUDIT OR SELECTION OF THE INDEPENDENT ACCOUNTANT. |
| FORM 990, PART IX, LINE 25D | FUNDRAISING EXPENSES: THE HOSPITAL DOES NOT PERFORM FUNDRAISING FUNCTIONS. THE CHILDREN'S HOSPITAL FOUNDATION RAISES FUNDS FOR CHILDREN'S SERVICES IN THE RICHMOND AREA AND DONATES TO THE HOSPITAL EACH YEAR. |
| WEBSITE EXPLANATION | CHILDREN'S HOSPITAL OF RICHMOND AT VCU (WEBSITE WWW.CHRICHMOND.ORG) IS A SHARED WEBSITE FOR THE PEDIATRIC SERVICES WITHIN VCUHS AND THE SERVICES AT CCH. THE CCH SERVICES AND DOCUMENTS ARE REFERENCED ON THE WEBSITE AS THE BROOK ROAD CAMPUS. THE CHNA AND IMPLEMENTATION PLAN COMPLETED IN 2013 ARE LOCATED UNDER THE BROOK ROAD CAMPUS LINK AT THE BOTTOM OF THE PAGE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY (VCUHS) | |||||||||||
| PO BOX 980152 | RICHMOND | VA | 23298 | 541848065 | PARENT - ACADEMIC MEDICAL CTR - MCV HOSPITALS | VA | 501(C)(1) | N/A | 0 | ||
| MCV ASSOCIATED PHYSICIANS DBA MCV PHYSICIANS | |||||||||||
| PO BOX 980620 | RICHMOND | VA | 232980510 | 541581185 | GROUP PRACTICE OF PROFESSIONALS SUPPORTING MEDICAL TEACHING | VA | 501(C)(3) | Yes (1) | LINE 11A, I | VCUHS | |
| UNIVERSITY HEALTH SERVICES INC (UHS) | |||||||||||
| PO BOX 980152 | RICHMOND | VA | 23298 | 541790550 | SUPPORT EDUCATIONAL & SCIENTIFIC ACTIVITIES OF VCU. | VA | 501(C)(3) | Yes (1) | LINE 11A, I | VCUHS | |
| UHS MANAGED CARE INC | |||||||||||
| PO BOX 980152 | RICHMOND | VA | 23298 | 541790554 | PROVIDE HEALTHCARE | VA | 501(C)(3) | Yes (1) | LINE 9 | UHS | |
| COMMUNITY MEMORIAL HOSPITAL | |||||||||||
| 125 BUENA VISTA CIRCLE | SOUTH HILL | VA | 23970 | 540221711 | HOSPITAL | VA | 501(C)(3) | Yes (1) | LINE 3 | VCUHS | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCV ASSOCIATED PHYSICIANS DBA MCV PHYSICIANS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $813,956 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |
Comments