2015-11-09T13:32:01-06:00 2014-12-31 221478099 COHNREZNICK LLP 7501 WISCONSIN AVE SUITE 400E BETHESDA MD 20814 990 2014-01-01 540525802 LOUDOUN HOSPITAL CENTER DBA INOVA LOUDOUN HOSPITAL LOUD 7038586000 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 RICHARD MAGENHEIMER CFO 7038586000 2015-10-29 FRED HUTCHISON P00640420 7037446700 2014 2016-04-25 22:37:26Z J KNOX SINGLETON 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 278631593 0 X INOVA.ORG X 1930 VA INOVA LOUDOUN HOSPITAL (ILH) PROVIDES PERSONALIZED, HIGH QUALITY ACUTE CARE HOSPITAL SERVICES AND APPROPRIATE HOSPITAL BASED SERVICES TO MEET THE COMMUNITY HEALTH CARE NEEDS FOR THE RESIDENTS OF LOUDOUN COUNTY AND NEIGHBORING COMMUNITIES 19 14 1361 470 0 0 221995 438514 254772565 271363448 11094255 3049406 3785300 3058898 269874115 277910266 0 0 0 0 92205494 89214185 0 0 0 140636412 142724986 232841906 231939171 37032209 45971095 495060309 547905726 24084343 28977730 470975966 518927996 X ` INOVA LOUDOUN HOSPITAL'S MISSION IS TO PROVIDE ACUTE CARE AND OTHER APPROPRIATE HOSPITAL SERVICES DEDICATED TO PROVIDING QUALITY CARE AND IMPROVING THE HEALTH OF THE DIVERSE COMMUNITIES IT SERVES. 0 0 201323200 275543409 INOVA LOUDOUN HOSPITAL (ILH) IS PART OF THE INOVA HEALTH SYSTEM WHOSE MISSION IS TO SERVE THE NORTHERN VIRGINIA COMMUNITY AS A NOT-FOR-PROFIT ORGANIZATION THROUGH THE PROVISION OF HIGH QUALITY AND ACCESSIBLE HEALTHCARE SERVICES. ILH WAS SPECIFICALLY CHARTERED FOR THE PURPOSE OF SERVING THE HEALTH CARE NEEDS OF THE GREATER LOUDOUN COUNTY, VIRGINIA COMMUNITY BY ESTABLISHING, MAINTAINING AND OPERATING HOSPITAL FACILITIES, PROGRAMS AND OTHER SHARED SERVICE ARRANGEMENTS; FACILITATING HEALTH-RELATED EDUCATION ACTIVITIES; AND ENGAGING IN ACTIVITIES DESIGNED TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY.INOVA LOUDOUN HOSPITAL IS A 183-LICENSED BED GENERAL ACUTE CARE HOSPITAL, WHICH FIRST OPENED ITS DOORS IN 1912. ILH PROVIDES A FULL-SERVICE 24-HOUR EMERGENCY DEPARTMENT; 23 INTENSIVE CARE BEDS; A SPECTRUM OF DIAGNOSTIC SERVICES, INCLUDING FULL-BODY CT SCANNING, MRI, AND A CARDIAC CATHETERIZATION LABORATORY; A VARIETY OF INPATIENT MEDICAL, SURGICAL, AND ORTHOPEDIC SERVICES, AND COMPREHENSIVE OUTPATIENT SERVICES INCLUDING OUTPATIENT SURGERY, PHYSICAL MEDICINE & REHABILITATION SERVICES AND RADIATION THERAPY. IN ADDITION, OBSTETRICAL AND PEDIATRIC SERVICES ARE PROVIDED BY ILH'S LADIES' BOARD BIRTHING INN, A PEDIATRIC EMERGENCY DEPARTMENT AND AN INPATIENT PEDIATRIC UNIT. IN 2014 THE HOSPITAL HAD 17,561 ADMISSIONS AND OBSERVATION CASES AND 43,552 PATIENT DAYS EXCLUDING NEWBORNS. EMERGENCY ROOM VISITS TOTALED 68,180; AND THERE WERE 74,959 OUTPATIENT VISITS DURING THE YEAR. THE HOSPITAL OPENED A 14-BED DEDICATED OBSERVATION UNIT IN 2014 ALLOWING FOR MORE SPECIALIZED CARE TO MEET THE UNIQUE NEEDS OF THOSE PATIENTS NOT REQUIRING AN INPATIENT ADMISSION.SPECIFIC ACUTE CARE PROGRAMSWOMEN'S HEALTH: ILH OFFERS A FULL RANGE OF OBSTETRICAL SERVICES INCLUDING DELIVERY SERVICES, HIGH RISK PRENATAL SERVICES, INPATIENT AND OUTPATIENT OBSTETRICS/GYNECOLOGIC SURGERY AND NURSERY CARE. ILH DELIVERED 2,555 BABIES IN 2014. ILH ALSO OFFERS LEVEL II NEONATAL ICU SPECIALTY SERVICES. IN ADDITION, ILH PROVIDES OBSTETRIC SERVICES TO LOW-INCOME PATIENTS THROUGH ITS OBSTETRICS/GYNECOLOGY CLINIC WHICH HAD 4,751 VISITS IN 2014. LATE 2014, ILH OPENED THE FIRST HOSPITAL-BASED NATURAL BIRTHING CENTER IN THE AREA, PROVIDING AN ALTERNATIVE FOR THOSE MOMS WHO DESIRE A HOME DELIVERY.PEDIATRIC CARE: ILH OPERATES A DEDICATED PEDIATRIC EMERGENCY ROOM THAT PROVIDED SERVICES FOR 17,681 VISITS IN 2014. IN ADDITION ILH OPERATES A 14-BED PEDIATRIC UNIT THAT PROVIDES FOR INPATIENT HOSPITALIZATIONS. ILH ADMITTED 462 CHILDREN TO THE UNIT AND HAD 643 OUTPATIENT OBSERVATION CASES DURING 2014.CARDIOVASCULAR CARE: THE INOVA LOUDOUN HOSPITAL HEART AND VASCULAR INSTITUTE OPENED IN 2005. IT PROVIDES CARDIAC CATHETERIZATION AND ELECTROPHYSIOLOGY SERVICES, A 64-SLICE CT SCANNER AND OTHER DIAGNOSTIC TESTING. IN 2014, 3,463 PATIENTS WERE SERVED BY THE CARDIOVASCULAR PROGRAM AT ILH.STROKE CARE: INOVA LOUDOUN HOSPITAL HAS BEEN CERTIFIED BY THE JOINT COMMISSION SINCE 2009 AS A PRIMARY STROKE CENTER. THE CERTIFICATION ALSO COVERS THE INOVA EMERGENCY CARE CENTER IN LEESBURG WHICH IS THE FIRST FREE-STANDING EMERGENCY DEPARTMENT IN THE STATE TO BE DESIGNATED AS A PRIMARY STROKE CENTER.CANCER CARE: ILH FEATURES A FULL SERVICE CANCER CENTER INCLUDING MEDICAL AND SURGICAL ONCOLOGY, RADIATION THERAPY SERVICES AND AN OUTPATIENT INFUSION CLINIC. ILH PROVIDED CANCER CARE TO 5,745 PATIENTS IN 2014.CHARITY CARE ALL INOVA FACILITIES, INCLUDING THE ILH FACILITIES, PROVIDE CHARITY CARE IN ACCORDANCE WITH INOVA POLICIES WHICH ENSURE ACCESS TO MEDICALLY NECESSARY CARE FOR ALL INDIVIDUALS. CHARITY CARE IS DEFINED AS FREE OR DISCOUNTED HEALTHCARE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD TO PAY. THESE POLICIES INCLUDE THE FOLLOWING KEY PROVISIONS:1 EMERGENCY CARE SHALL BE PROVIDED TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY.2 NON-EMERGENCY MEDICALLY NECESSARY CARE, EXCEPT FOR CERTAIN SPECIALTY OR REFERRAL PROGRAMS, SHALL BE PROVIDED BY ALL HOSPITALS AND ACCESS FACILITIES TO MEDICALLY INDIGENT PATIENTS. "MEDICALLY NECESSARY CARE" REFERS TO INPATIENT AND OUTPATIENT SERVICES DEFINED AS MEDICALLY NECESSARY BY THE FEDERAL MEDICARE PROGRAM. "MEDICALLY INDIGENT" IS DEFINED AS THOSE PATIENTS WHOSE INCOME FALLS AT OR BELOW 300% OF THE FEDERAL POVERTY LEVEL (FPL). IN GENERAL, FREE MEDICALLY NECESSARY CARE IS PROVIDED FOR PATIENTS WITH INCOMES FALLING AT OR BELOW 200% OF THE FPL; AND DISCOUNTED CARE IS PROVIDED FOR SERVICES RENDERED TO PATIENTS WITH INCOMES FALLING BETWEEN 200% AND 300% OF THE FPL.INOVA HEALTH SYSTEM UTILIZES A MULTIFACETED APPROACH TO EDUCATE AND INFORM PATIENTS AND THE PUBLIC ABOUT INOVA'S CHARITY CARE POLICY. UPON ADMISSION TO ANY INOVA HOSPITAL OR ANY VISIT TO OUTPATIENT FACILITIES OR CLINICS INCLUDING EMERGENCY DEPARTMENTS, INOVA HAS INFORMATION POSTED REGARDING PATIENT RIGHTS AND RESPONSIBILITIES. IN ADDITION, INOVA PROVIDES INFORMATION ABOUT THE CHARITY CARE PROGRAM AND REFERRALS TO MEET WITH INOVA FINANCIAL COUNSELORS WHO ASSIST PATIENTS IN COMPLETING INOVA'S CHARITY CARE APPLICATION. THIS FINANCIAL INFORMATION IS REVIEWED BY THE INOVA PATIENT ACCOUNTS DEPARTMENT WITH THE PATIENT CONTACTED IF ADDITIONAL INFORMATION IS REQUIRED IN ORDER TO MAKE A DETERMINATION. THE PATIENT IS SUBSEQUENTLY PROVIDED A LETTER, NOTIFYING THEM AS TO THE LEVEL OF CHARITY CARE FOR WHICH THEY ARE QUALIFIED (WHETHER IT BE 100% COVERAGE OR A SLIDING SCALE PAYMENT BASED UPON THEIR INCOME LEVEL BETWEEN 200-300% OF THE FEDERAL POVERTY LEVEL).IN 2014 ILH'S UNREIMBURSED COST OF CHARITY CARE, INCLUDING FREE AND DISCOUNTED SERVICES, WAS $7.3 MILLION.MEDICAID ESTABLISHED UNDER TITLE XIX OF THE SOCIAL SECURITY ACT, THIS PROGRAM PROVIDES ASSISTANCE FOR THE MEDICALLY INDIGENT, INCLUDING THOSE WHO CANNOT PAY FOR CARE DESPITE BEING ABLE TO AFFORD OTHER LIVING EXPENSES. ALSO INCLUDED UNDER THIS PROGRAM ARE THE BLIND, DISABLED, PREGNANT WOMEN, VERY LOW INCOME PARENTS, CHILDREN AND THE ELDERLY. THE REIMBURSEMENT THAT ILH FACILITIES RECEIVE FROM THE MEDICAID PROGRAM ROUTINELY FALLS BELOW THE ACTUAL COST OF SERVICES PROVIDED. DURING 2014, ILH PROVIDED CARE TO MEDICAID PATIENTS AT AN UNREIMBURSED COST OF APPROXIMATELY $4.4 MILLION. PARTICIPATION IN GOVERNMENTAL PROGRAMS FOR THOSE WITHOUT THE ABILITY TO PAY VARIOUS GOVERNMENT PROGRAMS PROVIDE FOR THE INDIGENT, INCLUDING MEDICAID RECIPIENTS. THESE PROGRAMS PROVIDE A PERCENTAGE OF REIMBURSEMENT FOR QUALIFYING PATIENTS; HOWEVER, PAYMENT IS TYPICALLY BELOW THE COST OF THOSE SERVICES. IN ADDITION TO FEDERAL AND STATE PROGRAMS, THE INOVA SUBSIDIARIES, INCLUDING ILH, WORK WITH VARIOUS COUNTY GOVERNMENTS AND AGENCIES IN PROVIDING CERTAIN FREE SERVICES TO THOSE RESIDENTS THE COUNTY IDENTIFIES AS MOST IN NEED. EACH YEAR, ILH DESIGNATES FUNDS FOR THE DEVELOPMENT AND CONTINUATION OF IDENTIFIED, ACCESSIBLE DIRECT CARE PROGRAMS AND RELATED SERVICES THAT BENEFIT THOSE MOST IN NEED IN THE COMMUNITY. MANY OF THESE PROGRAMS AND SERVICES ARE NOT BILLED TO THE PATIENT OR ARE PROVIDED FOR FEES BELOW THE ACTUAL COST OF PROVIDING THE SERVICE. IN ADDITION TO PROVIDING THE DIRECT CARE SUBSIDIZED SERVICE, INOVA ALSO PROVIDES DISEASE-PREVENTION PROGRAMS, HEALTH AND EXERCISE CLASSES, HEALTH EDUCATION AND HEALTH SCREENINGS AND OTHER PROGRAMS WITHIN THE COMMUNITY IN SUPPORT OF THE ILH MISSION.INOVA LOUDOUN OB CLINIC: THE INOVA LOUDOUN HOSPITAL-BASED OB CLINIC PROVIDES COMPREHENSIVE OBSTETRIC AND GYNECOLOGIC SERVICES FOR UNINSURED AND LOW-INCOME WOMEN (UP TO 115% OF THE FEDERAL POVERTY LEVEL) IN LOUDOUN COUNTY. COMPREHENSIVE OBSTETRICAL SERVICES INCLUDE GESTATIONAL DIABETES MANAGEMENT, CASE MANAGEMENT, NON-STRESS TESTING AND NUTRITIONAL COUNSELING. IN 2014, THE ILH OB CLINIC HAD 4,751 VISITS RESULTING IN 414 DELIVERIES AT INOVA LOUDOUN HOSPITAL AT AN UNREIMBURSED COST OF APPROXIMATELY $1.6 MILLION.LOUDOUN FAMILY AND PATIENT EDUCATION PROGRAM: LOUDOUN FAMILY AND PATIENT EDUCATION PROGRAM SERVES THE COMMUNITY THROUGH HEALTH EDUCATION, PREVENTION, WELLNESS PROGRAMS AND CARE MANAGEMENT. IN 2014, THE PROGRAM PROVIDED EDUCATIONAL PROGRAMS FOR 6,615 PARTICIPANTS. LOUDOUN MOBILE HEALTH PROGRAM: LOUDOUN MOBILE HEALTH IS STAFFED BY NURSES AND OTHER SUPPORT STAFF WHO PROVIDE COMMUNITY HEALTH FAIRS AND HEALTH SCREENING SERVICES. IN 2014, INOVA LOUDOUN MOBILE HEALTH PROVIDED SERVICES TO 12,586 PARTICIPANTS. THE UNREIMBURSED COST OF THIS PROGRAM WAS $319,452.INOVA LOUDOUN CENTER FOR WELLNESS AND METABOLIC HEALTH: THE CENTER PROVIDES OUTPATIENT DIABETES SELF-MANAGEMENT EDUCATION, CARE AND SUPPORT TO PERSONS WITH DIABETES. THE INOVA CENTER FOR WELLNESS AND METABOLIC HEALTH HAS THREE LOCATIONS IN THE NORTHERN VIRGINIA AREA AND EXPANDED SERVICES THIS YEAR TO INCLUDE MEDICAL NUTRITION THERAPY FOR OBESITY AND OTHER CHRONIC DISEASES. IN 2014, THE INOVA CENTER FOR WELLNESS AND METABOLIC HEALTH - LOUDOUN LOCATION PROVIDED 1,317 PATIENT VISITS. CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS: ILH DONATES SPACE, PROVIDES CASH AND IN-KIND SUPPORT SUCH AS HOUSEKEEPING AND DONATED STAFF TIME TO A NUMBER OF COMMUNITY GROUPS AND LOUDOUN COUNTY SERVICES. ILH DONATES SPACE TO THE LOUDOUN FREE CLINIC WHICH IS AN INDEPENDENT 501(C)(3) COMMUNITY HEALTH CENTER PROVIDING PRIMARY HEALTHCARE SERVICES FOR THE UNINSURED AND LOW INCOME RESIDENTS OF LOUDOUN COUNTY; LOUDOUN CARES, AN INDEPENDENT 501(C)(3) ORGANIZATION THAT PROVIDES COORDINATION FOR SOCIAL SERVICES FOR THE RESIDENTS OF LOUDOUN COUNTY; AND THE LOUDOUN CHILD ADVOCACY CENTER. IN 2014, ILH DONATED A TOTAL OF $343,508 FOR THESE GROUPS COVERING BOTH CASH AND IN-KIND TRANSACTIONS. 201323200 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 X 0 0 1 1361 1 0 0 0 0 0 0 X 19 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X LOUDOUN HOSPITAL CENTER 7032085940 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 PATRICK RHODES CHAIRMAN 2.00 5.00 X X 0 0 0 CHRISTINE BRENNAN VICE CHAIRMAN 3.00 2.00 X X 0 0 0 ELIZABETH CASEY HALLEY SECRETARY 3.00 2.00 X X 0 0 0 MILES DAVIS TRUSTEE 3.00 2.00 X 0 0 0 ROBERT LAFSKY MD TRUSTEE 1.00 4.00 X 0 0 0 KAREN DRENKARD PHD TRUSTEE 3.00 2.00 X 0 0 0 VIRGINIA HACKENBERG MD TRUSTEE 2.00 2.00 X 0 0 0 TANYA MATTHEWS TRUSTEE 3.00 2.00 X 0 0 0 BECKY OTTINGER TRUSTEE 3.00 2.00 X 0 0 0 DENIS MCFARLANE TRUSTEE 3.00 2.00 X 0 0 0 MARK STAUDER TRUSTEE 1.50 48.50 X 0 1670590 727275 EDWARD PUCCIO MD TRUSTEE 2.00 3.00 X 0 0 0 MICHAEL WHEELER TRUSTEE 3.00 2.00 X 0 0 0 DAPHNE THOMAS MD TRUSTEE 3.00 2.00 X 0 0 0 PATRICK WALTERS CEO, ILH, ASST SECRETARY 40.00 10.00 X X 531326 0 71288 LORING FLINT EVP CHIEF MEDICAL OFFICER 4.00 46.00 X X 0 715922 195578 J KNOX SINGLETON PRESIDENT 2.50 47.50 X 0 5249251 751544 JOHN GAUL SVP GENERAL COUNSEL 3.00 47.00 X 0 483882 144925 RICHARD MAGENHEIMER TREASURER 2.00 48.00 X 0 913507 764256 WILLIAM BANE AVP ASSOC ADMIN CFO 20.00 20.00 X 247621 0 46069 ELIZABETH DUGAN AVP, CNO 40.00 X 215506 0 75256 CHRISTOPHER CHIANTELLA CHIEF MEDICAL OFFICE, ILH 40.00 X 275592 0 94590 MARISSA JAMARIK SIR DIR NURSING SRVCS 40.00 X 173491 0 28441 DANIEL YIARGA SONOGRAPHER SPECIALTY 40.00 X 149622 0 50842 OMAR CASTANEDA CARDIO INVASIVE SPECIALIST 40.00 X 156526 0 55161 REBECCA VALDESUSO SR DIR PERIOP SVCS 40.00 X 148230 0 33373 CHRISTOPHER WEBSTER CARDIO INVASIVE SPECIALIST 40.00 X 150270 0 42930 JAMES KIM FORMER SECRETARY 3.00 47.00 X 0 277217 61067 SUSAN CARROLL FORMER VP ICI AND ITMI 0.00 40.00 X 0 286543 51311 2048184 9596912 3193906 99 1 1 0 LOUDOUN MEDICAL LLC II 9600 BLACKWELL ROADSUITE 200 ROCKVILLE MD 20850 MEDICAL SERVICES 2012778 DELPHI HEALTHCARE PARTNERS INC 170 SOUTHPORT DRIVE MORRISVILLE NC 27560 MANAGEMENT SERVICES 1771049 MEDICAL TRANSPORTATION SERVICE 360 HERNDON PKWY SUITE 700 HERNDON VA 20170 TRANSPORT SERVICES 849822 RSGPC 14801 MURDOCK STREET CHANTILLY VA 20151 ARCHITECT SERVICES 818525 ASSOCIATES IN MED PHYSICS AMP 10210 GREENBELT ROAD SUITE 110 LANHAM MD 20706 MEDICAL SERVICES 473485 26 438514 438514 NET PATIENT SERVICE REVENUE 900099 263842935 263842935 INOVA AMBULATORY SURGICAL CENTER 621400 7139916 7139916 TDI LLC 900099 380597 380597 271363448 1928343 1928343 1842390 721327 1121063 1121063 1121063 OTHER 900099 3032651 3032651 FOOD SERVICES 900099 26247 26247 3058898 277910266 275543409 0 1928343 2048184 2048184 70238581 60696728 9541853 4801109 4167363 633746 6864324 5958233 906091 5261987 4567405 694582 28704476 24915485 3788991 360037 312512 47525 19040947 16527542 2513405 11308 9815 1493 66331 57575 8756 302056 262185 39871 4704419 4083436 620983 107902 93659 14243 112426 97586 14840 3409308 2959279 450029 13221507 11476268 1745239 651877 565829 86048 SUPPLIES 32464660 28179325 4285335 OUTSOURCED SERVICES 17319468 15033298 2286170 BAD DEBT EXPENSE 17060977 14808928 2252049 PHYSICIAN FEES 3407744 2957922 449822 1779543 1544643 234900 231939171 201323200 30615971 0 8566837 9768197 23879639 24807806 837823 1528323 2448141 2801878 1442576 3363307 320532859 161008624 163678458 159524235 83685747 56328006 24466465 28351907 186054623 261432067 495060309 547905726 13291435 17047727 339396 342524 10453512 11587479 24084343 28977730 X 449517198 497192599 53580 48819 21405188 21686578 470975966 518927996 495060309 547905726 X 45971095 1018577 1898747 -936389 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 23268 23268 0 PART II-B, LINE 1: THERE WERE NO SIGNIFICANT LOBBYING ACTIVITIES DURING 2014. AMOUNTS UNDER OTHER ACTIVITIES PER PART II-B REPRESENT A PORTION OF MEMBERSHIP DUES RELATED TO LOBBYING. 49605504 49605504 108477704 61305378 47172326 53428670 15545395 37883275 91191172 69519636 21671536 17829809 14638215 3191594 159524235 28351907 C 28351907 INVESTMENTS AND RECEIVABLES FROM AFFILIATES 255861961 OTHER LONG TERM ASSETS 464394 CONTRUCTION IN PROGRESS 5105712 261432067 DUE TO THIRD PARTY PAYORS 7388105 DEFERRED COSTS 4199374 11587479 X PART X, LINE 2: FROM INOVA HEALTH SYSTEM CONSOLIDATED STATEMENTS INCLUDING LOUDOUN HOSPITAL CENTER: THE FOUNDATION, IHCS, AND LHC, ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN DETERMINED TO BE EXEMPT FROM FEDERAL INCOME TAX UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. IHI AND ITS SUBSIDIARIES ARE TAXABLE ORGANIZATIONS. DEFERRED INCOME TAXES ARE PROVIDED FOR ALL SIGNIFICANT TIMING DIFFERENCES BETWEEN REVENUES AND EXPENSES REPORTED FOR FINANCIAL STATEMENT AND FOR TAX PURPOSES. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS. 1 1 1 X 1 X 1 1 0 1 1 7292785 7292785 0.03390 15368675 10965220 4403455 0.02050 22661460 10965220 11696240 0.05440 429670 109235 320435 0.00150 1583320 1583320 0.00740 343508 343508 0.00160 2356498 109235 2247263 0.01050 25017958 11074455 13943503 0.06490 1 6969409 0 41472516 62173708 -20701192 X 1 1 1 INOVA LOUDOUN AMBULATORY SURGERY CENTER LLC SURGICAL SERVICES 0.67880 0.00000 0.32120 1 1 INOVA LOUDOUN HOSPITAL 44045 RIVERSIDE PARKWAY LEESBURG VA 20176 VA H1868 X X X INOVA LOUDOUN HOSPITAL 1 0 0 1 X X X X X X X X X 13 1 1 0 1 X WWW.INOVA.ORG 1 13 1 WWW.INOVA.ORG 0 0 1 X 200.000000000000 300.000000000000 X X X X X X 1 1 X X X X 1 X X X X X X X X X 1 X 0 X X X X 1 X 0 0 INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 5: THE HOSPITAL INTERVIEWED 21 KEY INFORMANTS, INCLUDING EXTERNAL STAKEHOLDERS (THOSE WHO REPRESENTED THE BROAD INTERESTS IN THE COMMUNITY) AND INTERNAL INOVA STAFF. THE INTERVIEWS WERE GUIDED BY A STRUCTURED INTERVIEW GUIDE, AND INTERVIEWEES WERE ENCOURAGED TO IDENTIFY AND DISCUSS A WIDE RANGE OF CURRENT AND EMERGING ISSUES AFFECTING COMMUNITY HEALTH. THE HOSPITAL ALSO SOUGHT INPUT FROM THE PUBLIC REGARDING THE HEALTH OF THE COMMUNITY THROUGH AN ONLINE SURVEY PUBLICIZED THROUGH MAILERS AND FLYERS. A DETAILED LISTING OF THE COMMUNITY STAKEHOLDERS WHO PROVIDED COMMUNITY INPUT ARE INCLUDED IN THE APPENDIX OF THE CHNA. INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 6A: INOVA FAIRFAX HOSPITALINOVA MT. VERNON HOSPITALINOVA FAIR OAKS HOSPITALINOVA ALEXANDRIA HOSPITAL INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 11: IN THE CHNA REPORT CONDUCTED IN 2013, INOVA LOUDOUN HOSPITAL IDENTIFIED THE FOLLOWING SIGNIFICANT COMMUNITY HEALTH NEEDS: ACCESS TO HEALTH AND HUMAN SERVICES, CHRONIC DISEASE, DENTAL HEALTH, HEALTH BEHAVIORS, MATERNAL AND CHILD HEALTH, MENTAL HEALTH, MORBIDITY, THE PHYSICAL ENVIRONMENT AND SOCIAL AND ECONOMIC FACTORS.AS DESCRIBED IN THE IMPLEMENTATION STRATEGY ADOPTED BY THE BOARD, INOVA LOUDOUN HOSPITAL INDICATED THAT IT WOULD ADDRESS MANY BUT NOT ALL OF THE IDENTIFIED NEEDS. THE HOSPITAL INDICATED IT WOULD NOT ADDRESS CERTAIN ELEMENTS THAT ARE BEYOND THE SCOPE OF THE MEDICAL CAMPUS OR ARE OUTSIDE OF THE HOSPITAL'S EXPERTISE INCLUDING LACK OF TRANSPORTATION, POOR AIR QUALITY AND BASIC NEEDS INSECURITY. THE HOSPITAL ALSO INDICATED THAT IT WOULD NOT ADDRESS OTHER ELEMENTS THAT ARE ALSO IMPORTANT BUT ARE BEING ADDRESSED BY OTHERS, INCLUDING DISPARITIES IN CHRONIC LIVER DISEASE, HIGH RATES OF TUBERCULOSIS AND HIGH RATES OF LYME DISEASE.SINCE THE 2013 CHNA WAS CONDUCTED, INOVA LOUDOUN HOSPITAL HAS ADDRESSED ALL OF THE SIGNIFICANT NEEDS AS DESCRIBED IN THIS IMPLEMENTATION STRATEGY. THESE NEEDS WERE ADDRESSED BY INITIATIVES INCLUDING THE FOLLOWING: PROVIDING IN-KIND AND FINANCIAL SUPPORT FOR COMMUNITY ORGANIZATIONS SEEKING TO IMPROVE COMMUNITY HEALTH AND MEET SOCIAL SERVICES NEEDS, PARTICIPATING ACTIVELY IN COMMUNITY COALITIONS AND ON BOARDS, OPERATING THE INOVA TRANSITIONAL CARE MANAGEMENT PROGRAM AND DISCHARGE CLINICS FOR LOW-INCOME PATIENTS WITHOUT A MEDICAL HOME, OPERATING INOVACARES CLINICS FOR MEDICAID AND UNINSURED PATIENTS, THE INOVA PACE PROGRAM, INCREASING VISITS FOR UNINSURED PATIENTS TO INOVA-AFFILIATED SPECIALISTS, EXPANDING HEALTH PROMOTION AND EDUCATION PROGRAMS PARTICULARLY TO REDUCE THE PREVALENCE OF DIET AND EXERCISE-RELATED HEALTH PROBLEMS, INCREASING INVESTMENT IN INOVA'S SNAP DOUBLE DOLLARS PROGRAM WHICH ENHANCES ACCESS TO HEALTHY FOOD, AND INCREASING SERVICES PROVIDED BY THE INOVA JUNIPER PROGRAM WHICH IS NORTHERN VIRGINIA'S LARGEST PROVIDER OF SERVICES FOR HIV/AIDS PATIENTS.SOME CHANGES WERE MADE TO SPECIFIC PROGRAMS IN 2014 TO ENHANCE PROGRAM IMPACTS. FOR EXAMPLE, CONGREGATIONAL HEALTH PARTNERSHIP CONCLUDED IN 2014 AND IN ITS PLACE INOVA IS WORKING WITH THE WESLEY THEOLOGICAL SEMINARY'S HEAL THE SICK PROGRAM. THIS COLLABORATION BETWEEN THE HOSPITAL SYSTEM, FAITH COMMUNITY AND SURROUNDING NEIGHBORHOODS WILL IMPROVE HEALTH IN A MORE SUSTAINABLE FASHION. ADDITIONALLY, INOVA PLANNED TO EXPLORE A NEW LOCATION IN THE MERRIFIELD AREA FOR A LOCAL FQHC. BECAUSE VIRGINIA DID NOT EXPAND MEDICAID, THIS NEW CLINIC WAS NOT BUILT. INSTEAD, INOVA HAS HELPED TO SUPPORT A NEW LOCATION FOR FAIRFAX COUNTY'S COMMUNITY HEALTH CARE NETWORK IN THIS AREA, AND IS CO-LOCATING MENTAL HEALTH SERVICES UTILIZED BY THE SAME PATIENT POPULATION. WHILE NOT IDENTIFIED FOR EXPANSION OF SERVICES IN THE 2013 CHNA, INOVA CONTINUES TO SERVE THE COMMUNITY THROUGH MANY ONGOING PROGRAMS, INCLUDING THE PROVISION OF CULTURALLY COMPETENT AND LINGUISTICALLY APPROPRIATE SERVICES; PREVENTION, EDUCATION AND SUPPORT THROUGH THE INOVA LOUDOUN CANCER CENTER; ALCOHOL AND SUBSTANCE ABUSE TREATMENT AT THE INOVA COMPREHENSIVE ADDICTION TREATMENT SERVICES; MEDICAID MANAGED CARE PLANS THROUGH INTOTAL HEALTH; AND COMPREHENSIVE MENTAL HEALTH SERVICES FOR CHILDREN AND YOUNG ADULTS AT THE KELLAR CENTER. INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 13H: CALCULATE FAMILY SIZE INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 15E: FINANCIAL AID BROCHURES EXPLAINING THE CHARITY POLICY ARE AVAILABLE THROUGH OUT THE HOSPITALS. ER ROOMS AND WAITING ROOMS HAVE CHARITY NOTIFICATION NOTICES POSTED IN THEIR AREAS AND ON INOVA'S WEBSITE. INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 16I: FINANCIAL AID BROCHURES EXPLAINING THE CHARITY POLICY ARE AVAILABLE THROUGH OUT THE HOSPITALS. ER ROOMS AND WAITING ROOMS HAVE CHARITY NOTIFICATION NOTICES POSTED IN THEIR AREAS AND ON INOVA'S WEBSITE. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: INOVA.ORG INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: INOVA.ORG INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 16C WEBSITE: INOVA.ORG 2 CORNWALL - ER 224 CORNWALL STREET NW LEESBURG VA 20176 EMERGENCY ROOM INOVA LOUDOUN AMBULATORY SURGICAL CENTER 44045 RIVERSIDE PARKWAY LEESBURG VA 20176 OUTPATIENT SURGERY PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS INCLUDED IN THE CONSOLIDATED INOVA HEALTH SYSTEM REPORT TO THE COMMUNITY ON INOVA.ORG WEBSITE. PART I, LINE 7: COST TO CHARGE RATIO METHOD IS USED BASED ON TABLE 2 IN THE INSTRUCTIONS. TOTAL OPERATING EXPENSE IS DIVIDED BY TOTAL GROSS REVENUE TO ARRIVE AT THE COST TO CHARGE RATIO. PART I, LINE 7G: COST OF PHYSICIAN CLINIC IS $1,583,320. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 17,060,977. PART II, COMMUNITY BUILDING ACTIVITIES: INOVA'S OFFICE OF SUSTAINABILITY PROVIDED COMMUNITY BUILDING SUPPORT FOCUSED ON ENVIRONMENTAL IMPROVEMENTS. ENVIRONMENTAL MISSION STATEMENT: INOVA HEALTH SYSTEM IS COMMITTED TO ESTABLISHING AN ENVIRONMENTAL PROGRAM THAT IS SAFER AND HEALTHIER FOR OUR PATIENTS, EMPLOYEES, AND THE COMMUNITY.COMMUNITY BUILDING ENVIRONMENTAL IMPROVEMENTS WASTE MANAGEMENTINOVA HAS BEEN FOCUSED ON WASTE REDUCTION STRATEGIES INCLUDING RECYCLING AND SEGREGATION SINCE 2008. THROUGHOUT THE HOSPITALS THERE IS A SINGLE STREAM RECYCLING PROCESS AND THERE ARE FOCUSED EFFORTS ON REDUCING REGULATED MEDICAL WASTE. IN 2014, INOVA LAUNCHED A MEDICAL DONATION PROGRAM AND WAS ABLE TO PROVIDE 8,000 LBS OF MATERIAL FOR MEDICAL DONATION. DURING THIS SAME PERIOD INOVA RECYCLED OVER 2.6 MILLION POUNDS OF WASTE AND REDUCED CLOSE TO 500,000 LBS (YEAR OVER YEAR) OF REGULATED MEDICAL WASTE THROUGH SEGREGATION EFFORTS. ELECTRONIC WASTE RECYCLING: EACH YEAR, INOVA RECYCLES OVER 100,000 POUNDS OF ELECTRONICS VIA CERTIFIED ELECTRONICS RECYCLERS, RESPONSIBLY DISPOSING OF COMPONENTS CONTAINING TOXINS AND OTHER HARMFUL CHEMICALSSPECIALIZED AREAS RECYCLING (ORS, KITCHENS): INOVA HAS IMPLEMENTED SPECIALIZED RECYCLING PROGRAMS TO CAPTURE SPECIFIC MATERIALS IN AREAS SUCH AS OPERATING ROOMS AND CONSTRUCTION SITES.ENERGYDURING 2014 INOVA WAS VERY FOCUSED ON ENERGY REDUCTION BY DEVELOPING A STRATEGIC ENERGY MANAGEMENT PLAN. INOVA HAS ALSO DEVELOPED A 5 YEAR ENERGY REDUCTION PLAN WITH TARGETS ON GREEN HOUSE GAS REDUCTIONS. INOVA MOUNT VERNON WENT THROUGH A PROCESS OF SUB-METERING THE ENTIRE CAMPUS AS A PILOT PROJECT WHICH WILL BE ROLLED OUT ACROSS THE ENTIRE SYSTEM IN 2015.THROUGHOUT 2014, INOVA REPLACED 5 CHILLERS AT INOVA FAIRFAX AND INOVA MOUNT VERNON HOSPITALS TO INCREASE EFFICIENCY AND REDUCE ENERGY USE. THROUGHOUT THE SYSTEM, MANY AIR HANDLING UNITS WERE REPLACED, AS WELL AS BURNERS AND CONTROLS FOR BOILERS AND VARIABLE FREQUENCY DRIVES THAT WERE REPLACED ON COOLING TOWERS. A LIGHTING AUDIT WAS DONE ACROSS ALL HOSPITALS WITH A GOAL OF LIGHTING REPLACEMENT PROJECTS IN 2015. WORK WAS DONE TO RETRO-COMMISSION INOVA'S BUILDING MANAGEMENT SYSTEMS (BMS). A FINE TUNED BMS WILL ALLOW STAFF TO BETTER REGULATE ENERGY USE. ALL OF THESE EFFORTS TO INCREASE EFFICIENCY AND RESILIENCE REDUCE INOVA'S GREENHOUSE GASES, CARBON FOOTPRINT AND IMPACT ON COMMUNITY HEALTH.WATERINTEGRATED GREEN TECHNOLOGIES: MOTION SENSOR FAUCETS, LOW-FLOW RESTROOM FIXTURESINCORPORATED NATIVE PLANTS AND LOW-IMPACT IRRIGATION SYSTEMS FOR LANDSCAPINGBUILDINGSCONTINUED LEED CONSTRUCTION ON INOVA WOMEN AND CHILDREN'S BUILDING (IFMC)DEVELOPED INTERIOR DESIGN STANDARDS INCLUDING THE USE OF THE HEALTHIER HOSPITALS INITIATIVE GUIDELINE WITH A FOCUS ON HEALTHIER INTERIORSTRANSPORTATIONPARTNERED WITH FAIRFAX COUNTY DEPARTMENT OF TRANSPORTATION TO PROMOTE ALTERNATIVE COMMUTE OPTIONS FOR INOVA EMPLOYEES; PROGRAMS SUCH AS EMPLOYEE COMMUTER SHUTTLE, RESERVED PARKING FOR CARPOOLS/VANPOOLS/HYBRIDS, BIKE RACKS, AND A PRE-TAX COMMUTER BENEFITS PROGRAM HELP INOVA REDUCE AIR POLLUTION AND TRAFFIC CONGESTION IN LOCAL COMMUNITIESFOODPROVIDED A PILOT COMMUNITY SUPPORTED AGRICULTURE (CSA) PROGRAM TO INOVA FAIRFAX HOSPITAL AND INOVA SYSTEM OFFICE EMPLOYEES, PROVIDING DIRECT SUPPORT TO A LOCAL FARMER AND BRINGING FRESH, HEALTHY, SEASONAL FOODS TO OUR EMPLOYEESPROMOTED SUSTAINABLE FOODS, HEALTHY LIVES COOKBOOK AND FREE LOCAL INGREDIENTS GUIDE TO EDUCATE COMMUNITY AROUND ISSUES OF HEALTH, WELLNESS, AND FOOD; ALL PROCEEDS FROM THE COOKBOOK GO DIRECTLY TO INOVA'S DOUBLE DOLLARS SNAP ENHANCEMENT PROGRAM, WHICH MATCHES THE FIRST $10 OF SNAP BENEFITS SPENT AT SELECT LOCAL FARMERS' MARKETSSPONSOR OF THE NORTHERN VIRGINIA CHAPTER OF BUY FRESH, BUY LOCAL, A NATIONALLY RECOGNIZED PROGRAM THAT IS DEDICATED TO REINTRODUCING AMERICANS TO THEIR FOOD - THE SEEDS IT GROWS FROM, THE FARMERS WHO PRODUCE IT, AND THE ROUTES THAT CARRY IT FROM THE FIELDS TO THEIR TABLES. COMMUNITYDISTRIBUTED OVER 500 NATIVE TREE SEEDLINGS TO BE PLANTED WITHIN THE LOCAL COMMUNITY IN 2014 IN SUPPORT OF EARTH DAYMENTORED PEER ORGANIZATIONS LOCALLY AND NATIONALLY ON SUSTAINABILITY EFFORTS, HELPING THEM CREATE SAFER ENVIRONMENTS FOR THEIR OWN PATIENTS, EMPLOYEES, AND COMMUNITIES PART III, LINE 4: BAD DEBT FOOTNOTE FROM INOVA HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTSPATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, IHS ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, IHS ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), IHS RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.ALL OPERATING ENTITIES OF IHS TREAT EMERGENCY PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. NON-EMERGENCY MEDICALLY NECESSARY CARE IS PROVIDED VIRTUALLY WITHOUT RESTRICTION AT ALL IHS TAX-EXEMPT OPERATING ENTITIES. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BASED UPON ESTABLISHED IHS POLICIES THAT CONSIDER PATIENT INCOME LEVELS AND AVAILABLE ASSETS. SINCE IHS DOES NOT PURSUE COLLECTION OF AMOUNTS THAT QUALIFY AS CHARITY CARE, THEY ARE DEDUCTED FROM GROSS REVENUE. THE PROVISION FOR BAD DEBTS INCLUDES UNPAID ACCOUNTS OF PATIENTS WHO FAIL TO PROVIDE REQUIRED INCOME AND ASSET DOCUMENTATION TO IHS. GUIDELINES USED BY IHS IN DETERMINING CHARITY CARE MAY DIFFER FROM GUIDELINES USED BY CERTAIN STATE OR FEDERAL AGENCIES.COSTING METHODOLOGYACTUAL BAD DEBT EXPENSE IS MULTIPLIED BY THE COST TO CHARGE RATIO USED IN COMPUTING CHARITY CARE EXPENSE IN PART I.THE ARE NO ESTIMATED AMOUNTS FOR BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY. PART III, LINE 8: THE ORGANIZATION DOES NOT TREAT ANY MEDICARE SHORTFALL AS COMMUNITY BENEFIT. THE AMOUNTS ARE TAKEN DIRECTLY FROM THE MEDICARE COST REPORTS AS FILED USING A COST TO CHARGE RATIO METHOD. PART III, LINE 9B: INOVA HEALTH SYSTEM STRIVES TO COMPLY WITH THE GUIDELINES ESTABLISHED BY THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE INTERNATIONAL CODE OF ETHICS AND PROFESSIONAL RESPONSIBILITY (ACA) WHICH REQUIRE MEMBERS TO ENGAGE IN HONORABLE, ETHICAL AND PROFESSIONAL CONDUCT OF CHARACTER NOT LIKELY TO DECEIVE, DEFRAUD OR HARM THE PUBLIC.THE POLICY OF INOVA HEALTH SYSTEM IS TO TAKE LEGAL ACTION, ONLY IF THERE IS EVIDENCE THAT THE PATIENT OR RESPONSIBLE PARTY HAS INCOME AND/OR ASSETS IN EXCESS OF THE LEVELS SUGGESTED IN THE FINANCIAL ASSISTANCE POLICY; THE PATIENT HAS FAILED TO PROVIDE THE INFORMATION NEEDED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE; OR THE PATIENT IS NO LONGER MEETING HIS OBLIGATIONS UNDER AN AGREED-UPON PAYMENT PLAN AND HAS NOT INFORMED THE COLLECTIONS OFFICE OF A CHANGE IN FINANCIAL CONDITION.STAFFS WHO WORK CLOSELY WITH PATIENTS, INCLUDING THOSE INVOLVED IN BILLING AND COLLECTION, ARE EDUCATED ABOUT HOSPITAL BILLING, FINANCIAL ASSISTANCE AND COLLECTION POLICIES AND PRACTICES.AGENCIES ACTING ON BEHALF OF INOVA HEALTH SYSTEM MAY NOT GARNISH WAGES OR FREEZE BANK ACCOUNTS AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS.AGENCIES MAY FILE LIENS ONLY AGAINST ESTATES.THE FORECLOSURE OR FORCED SALE OF A PATIENT'S PRIMARY RESIDENCE TO PAY AN OUTSTANDING HOSPITAL BILL IS PROHIBITED.IT IS NOT THE POLICY OF INOVA HEALTH SYSTEM TO FILE LIENS RELATED TO MEDICARE, MEDICAID, MEDICREDIT FFA OR CHARITY ACCOUNTS. PART VI, LINE 2: INOVA HEALTH SYSTEM (IHS) COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO IDENTIFY PRIORITY HEALTH STATUS AND ACCESS ISSUES FOR PARTICULAR GEOGRAPHIC AREAS AND POPULATIONS BY FOCUSING ON THE FOLLOWING QUESTIONS: WHO IN THE COMMUNITY IS MOST VULNERABLE IN TERMS OF HEALTH STATUS OR ACCESS TO CARE?WHAT ARE THE UNIQUE HEALTH STATUS AND/OR ACCESS NEEDS FOR THESE POPULATIONS?WHERE DO THESE PEOPLE LIVE IN THE COMMUNITY? WHY ARE THESE PROBLEMS PRESENT?INOVA'S CHNA CONSIDERS MULTIPLE DATA SOURCES, INCLUDING SECONDARY DATA (REGARDING DEMOGRAPHICS, HEALTH STATUS INDICATORS, AND MEASURES OF HEALTH CARE ACCESS), ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS IN RECENT YEARS, AND PRIMARY DATA DERIVED FROM A COMMUNITY SURVEY AND FROM INTERVIEWS WITH PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH EXPERTISE IN PUBLIC HEALTH.THE FOLLOWING TOPICS AND DATA ARE ASSESSED IN INOVA'S CHNA REPORT:DEMOGRAPHICS, E.G., NUMBERS AND LOCATIONS OF VULNERABLE PEOPLE;ECONOMIC ISSUES, E.G., POVERTY AND UNEMPLOYMENT RATES, AND IMPACTS OF STATE OR LOCAL BUDGET CHANGES;COMMUNITY ISSUES, E.G., HOMELESSNESS, HOUSING, ENVIRONMENTAL CONCERNS, CRIME, AND AVAILABILITY OF SOCIAL SERVICES;HEALTH STATUS INDICATORS, E.G. MORBIDITY RATES FOR VARIOUS DISEASES AND CONDITIONS, AND MORTALITY RATES FOR LEADING CAUSES OF DEATH;HEALTH ACCESS INDICATORS, E.G., UNINSURANCE RATES, DISCHARGES FOR AMBULATORY CARE SENSITIVE CONDITIONS (ACSC), AND USE OF EMERGENCY DEPARTMENTS FOR NON-EMERGENT CARE;HEALTH DISPARITIES INDICATORS; ANDAVAILABILITY OF HEALTHCARE FACILITIES AND RESOURCES. THE ASSESSMENT IDENTIFIES A PRIORITIZED LIST OF COMMUNITY HEALTH NEEDS.AS A RESULT OF THIS WORK AND PREVIOUS WORK INOVA'S PROGRAMS EXPANDED TO ADDRESS THE IDENTIFIED COMMUNITY HEALTH PRIORITIES. THESE GOALS WERE RE-EVALUATED AND UPDATED TO ALIGN WITH THE HEALTHY PEOPLE 2020 GOALS AND OUTCOMES. INOVA HAS MOVED FORWARD WITH DEVELOPING COORDINATED EFFORTS WITHIN THE HEALTH SYSTEM TO CARRY OUT THE DESIGNED IMPLEMENTATION PLANS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE COMMUNITY AFFAIRS EXECUTIVES ASSIGNED TO EACH HOSPITAL ARE COORDINATING PLANS WITH HOSPITAL LEADERS TO ASSURE EFFECTIVE PLAN IMPLEMENTATION IN EACH OF THE RESPECTIVE COMMUNITIES. COMMUNITY AFFAIRS EXECUTIVES ARE CENTRALIZED TO THE SYSTEM VICE PRESIDENT OF COMMUNITY AFFAIRS AND THEREBY ASSURES SYSTEM COORDINATED EFFORTS ARE CENTRALIZED AND REFLECTIVE OF INOVA HEALTH SYSTEM'S WORK ACROSS NORTHERN VIRGINIA.COMMUNITY HEALTH NEEDS ASSESSMENTS ARE CURRENTLY IN PROGRESS ACROSS NORTHERN VIRGINIA SPONSORED BY THE VARIOUS HEALTH DEPARTMENTS USING THE FRAMEWORK OF THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS. INOVA HEALTH SYSTEM IS A PARTICIPATING MEMBER OF EACH MAPP PROCESS TEAM IN EACH JURISDICTION ACROSS NORTHERN VIRGINIA. INOVA SERVED ON THE MAPP TEAM'S YEAR-LONG TASK FORCE FOR ARLINGTON COUNTY, FOR WHICH THE FINAL REPORT WAS COMPLETED IN 2008. IN 2008 INOVA ALSO PARTICIPATED IN THE FIRST OF FOUR ASSESSMENTS BEING CONDUCTED BY FAIRFAX COUNTY, HAVING INOVA LEADERS IN PIVOTAL LEADERSHIP ROLES IN THIS PROCESS. THIS IS AN ONGOING COMMUNITY-DRIVEN PLANNING PROCESS THAT IS DESIGNED TO PROVIDE INFORMATION FOR IMPROVING THE COMMUNITY'S DELIVERY OF THE 10 ESSENTIAL PUBLIC HEALTH SERVICES. FAIRFAX COUNTY HAS THREE OTHER ASSESSMENTS TO COMPLETE THE MAPP PROCESS. THIS PROCESS BRINGS TOGETHER A DIVERSE GROUP OF KEY COMMUNITY STAKEHOLDERS INCLUDING LOCAL GOVERNMENT, HUMAN SERVICE ORGANIZATIONS, SCHOOLS AND UNIVERSITIES, HEALTHCARE CONSUMERS, ADVOCACY GROUPS, HOSPITALS, FAITH INSTITUTIONS, YOUTH DEVELOPMENT ORGANIZATIONS, ECONOMIC AND PHILANTHROPIC GROUPS, ETC. TO IDENTIFY STRENGTHS AND WEAKNESSES IN THE TEN ESSENTIAL AREAS TO PROVIDE A FOUNDATION FOR COMMUNITY HEALTH PLANNING. INOVA IS PARTICIPATING IN THE CONTINUING LOCAL PUBLIC HEALTH NEEDS ASSESSMENT IN THE CITY OF ALEXANDRIA AS WELL. THE INFORMATION FROM ALL THE MAPP HEALTH NEEDS ASSESSMENTS FROM ALL JURISDICTIONS SERVED BY INOVA HEALTH SYSTEM WILL PROVIDE THE NEW BASELINE FOR THE ONGOING THREE-YEAR COMMUNITY NEEDS ASSESSMENTS AND WERE INCORPORATED INTO THE COMMUNITY NEEDS ASSESSMENT IMPLEMENTATION PLANS THAT WERE FINALIZED IN 2013. IN ADDITION TO PARTICIPATING IN THE MAPP PROCESS AND THE CHNA, INOVA IS CONTINUALLY GARNERING FEEDBACK ON THEIR EXISTING PROGRAMS FROM PROGRAM PARTICIPANTS THROUGH MONTHLY AND QUARTERLY SATISFACTION SURVEYS AND FOCUS GROUPS, PARTICIPATING IN REGIONAL AND LOCAL HEALTH RELATED GROUPS SUCH AS THE NORTHERN VIRGINIA ACCESS TO HEALTH CARE CONSORTIUM, MEETING WITH VARIOUS CULTURAL AND ETHNIC GROUPS IN THE COMMUNITY AND USING INTERNAL UTILIZATION AND OUTCOMES DATA, REVIEW OF BEST PRACTICES AND REGIONAL AND NATIONAL BENCHMARK DATA AND OTHER EXTERNAL SOURCES SUCH AS THE METROPOLITAN WASHINGTON COUNCIL OF GOVERNMENTS (COG) DEMOGRAPHIC DATA TO DEVELOP STRATEGIC GOALS FOR HEALTH IMPROVEMENT ACTIVITIES. COLLECTIVELY, ALL THIS INFORMATION IS UTILIZED IN ASSESSING COMMUNITY HEALTH NEEDS TO GUIDE STRATEGIC PLANNING EFFORTS. PART VI, LINE 3: INOVA HEALTH SYSTEM UTILIZES A MULTIFACETED APPROACH TO EDUCATE AND INFORM PATIENTS AND THE PUBLIC ABOUT INOVA'S CHARITY CARE POLICY. UPON ADMISSION TO ANY INOVA HOSPITAL OR ANY VISIT TO OUTPATIENT FACILITIES OR CLINICS INCLUDING EMERGENCY DEPARTMENTS, INOVA HAS INFORMATION POSTED REGARDING PATIENT RIGHTS AND RESPONSIBILITIES. IN ADDITION, INOVA PROVIDES INFORMATION ABOUT THE CHARITY CARE PROGRAM AND REFERRALS TO MEET WITH INOVA FINANCIAL COUNSELORS WHO ASSIST PATIENTS IN COMPLETING INOVA'S CHARITY CARE APPLICATION. THIS FINANCIAL INFORMATION IS REVIEWED BY THE INOVA PATIENT ACCOUNTS DEPARTMENT WITH THE PATIENT CONTACTED IF ADDITIONAL INFORMATION IS REQUIRED IN ORDER TO MAKE A DETERMINATION. THE PATIENT IS SUBSEQUENTLY PROVIDED A LETTER, NOTIFYING THEM AS TO THE LEVEL OF CHARITY CARE FOR WHICH THEY ARE QUALIFIED (WHETHER IT BE 100% COVERAGE OR A SLIDING SCALE PAYMENT BASED UPON THEIR INCOME LEVEL BETWEEN 200-300% OF THE FEDERAL POVERTY LEVEL). INOVA ALSO HAS MEDICAID ELIGIBILITY WORKERS ON-SITE IN ALL HOSPITALS, IN THE INOVACARES CLINIC FOR WOMEN AND CHILDREN (CLINIC FOR LOW INCOME FAMILIES) AND IN THE COMMUNITY AS PART OF THE PARTNERSHIP FOR HEALTHIER KIDS ACCESS TO CARE PROGRAM. INOVA PARTNERS WITH SCHOOLS ACROSS THE JURISDICTION TO PROVIDE INFORMATION ABOUT STATE FUNDED HEALTH PROGRAMS FOR CHILDREN AND CONTACT INFORMATION TO MEET WITH AN ELIGIBILITY WORKER RESPONSIBLE FOR ENROLLING FAMILIES IN STATE MEDICAID PROGRAMS. THESE ELIGIBILITY WORKERS ALSO GO OUT INTO THE COMMUNITY ATTENDING COMMUNITY EVENTS SUCH AS HEALTH FAIRS, FAITH-BASED COMMUNITY ACTIVITIES AND OTHER FAMILY CENTERED COMMUNITY EVENTS TO PROACTIVELY MEET WITH FAMILIES TO ENCOURAGE ENROLLMENT IN PROGRAMS FOR WHICH THEY ARE ELIGIBLE. INOVA HAS A SECTION OF THE PUBLIC WEBSITE DEDICATED TO INFORMATION ABOUT BILLING AND FINANCIAL COORDINATORS AND FINANCIAL ASSISTANCE RESOURCES. ON THE SITE A BROCHURE CALLED "FINANCIAL HELP FOR HEALTHCARE SERVICES" CAN BE DOWNLOADED AND IS AVAILABLE IN 6 LANGUAGES TO ADDRESS THE NEEDS OF THE CULTURALLY DIVERSE COMMUNITY INOVA SERVES. PART VI, LINE 4: INOVA LOUDOUN HOSPITAL (ILH) IS A NOT-FOR-PROFIT CORPORATION AND A SUBSIDIARY OF THE PARENT ORGANIZATION, INOVA HEALTH SYSTEM FOUNDATION (INOVA). INOVA PROVIDES HEALTHCARE AND RELATED SERVICES THROUGHOUT NORTHERN VIRGINIA AND THE GREATER METROPOLITAN WASHINGTON, D.C. AREA, INCLUDING CERTAIN CONTIGUOUS COUNTIES OF VIRGINIA AND MARYLAND. NORTHERN VIRGINIA IS ONE OF THE FASTEST GROWING URBAN COMMUNITIES IN THE UNITED STATES. WITH APPROXIMATELY 1,314 SQUARE MILES, THE REGION IS THE MOST DENSELY POPULATED IN THE COMMONWEALTH OF VIRGINIA. NORTHERN VIRGINIA IS COMPRISED OF SEVERAL DISTINCT COMMUNITIES, INCLUDING THE CITIES OF ALEXANDRIA, FAIRFAX, FALLS CHURCH, MANASSAS AND MANASSAS PARK, AND THE COUNTIES OF ARLINGTON, FAIRFAX, LOUDOUN AND PRINCE WILLIAM. THE EASTERN SECTIONS ARE URBANIZED WITH ATTENDANT HEALTH PROBLEMS OF OVERCROWDING AND INCREASING DEMAND FOR HEALTH SERVICES AND PUBLIC PROGRAMS. INOVA LOUDOUN HOSPITAL'S PRIMARY SERVICE AREA COVERS ALL OF LOUDOUN COUNTY.LOUDOUN COUNTY'S POPULATION IS FORECASTED TO GROW 21% OVER THE NEXT DECADE, ADDING AN ESTIMATED AVERAGE OF 8,500 PERSONS A YEAR. POPULATION WILL BE SPURRED BY THE LONG-TERM STRENGTH OF THE REGION'S ECONOMY, HIGH RATES OF IN-MIGRATION AND INTERNATIONAL IMMIGRATION. THE REGION'S POPULATION THAT IS 65 YEARS OF AGE AND OLDER IS EXPECTED TO GROW BY 75% OVER THE NEXT 10 YEARS, WHILE THE NUMBER OF CHILDREN WILL INCREASE BY ABOUT 12% IN THE SAME TIME PERIOD. NORTHERN VIRGINIA'S RACIAL AND ETHNIC DIVERSITY IS MORE PRONOUNCED THAN IN THE REST OF THE STATE. WITH INCREASING DIVERSITY, ECONOMICALLY DISADVANTAGED POPULATIONS AND MULTIPLE LANGUAGES, THE NEED FOR ACCESS TO CULTURALLY APPROPRIATE, FLEXIBLE HEALTH CARE CONTINUES TO GROW. THE NORTHERN VIRGINIA GEOGRAPHIC REGION IS 45% MINORITY, UP FROM 23% IN 1990, WHILE THE NATION AS A WHOLE REFLECTS A 37% MINORITY POPULATION (U.S. CENSUS BUREAU, 2013). THE U.S. CENSUS BUREAU ESTIMATES THAT LOUDOUN COUNTY HAD A POPULATION OF 363,050 PEOPLE IN 2014. THIS IS THE FASTEST GROWING JURISDICTION IN NORTHERN VIRGINIA. IN 2014 LOUDOUN COUNTY'S ASIANS, HISPANICS, AND AFRICAN AMERICANS REPRESENTED 16.5%, 13.1%, AND 7.7% OF LOUDOUN'S POPULATION, RESPECTIVELY (U.S. CENSUS BUREAU, 2015).ACCORDING TO THE US CENSUS BUREAU SMALL AREA HEALTH INSURANCE ESTIMATES (SAHIE) IN 2013 APPROXIMATELY 9.1% OF THE TOTAL POPULATION UNDER THE AGE OF 65 IN LOUDOUN COUNTY LACKED HEALTHCARE INSURANCE. OF THE PEOPLE LIVING IN LOUDOUN COUNTY WHOSE FAMILY INCOMES ARE AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL, SAHIE ESTIMATES THAT 37.7% WERE UNINSURED IN 2013.AREA RESIDENTS MOST LIKELY TO BE UNINSURED ARE THOSE WHOSE FAMILY INCOMES ARE AT OR BELOW 200% OF THE POVERTY LEVEL, YOUNG ADULTS (AGE 18-44), PEOPLE OF RACIAL BACKGROUNDS OTHER THAN WHITE, UNEMPLOYED INDIVIDUALS, PART-TIME WORKERS, AND PEOPLE WHO WORK AT COMPANIES WITH FEWER THAN 50 EMPLOYEES. SERVING THIS POPULATION POSES SIGNIFICANT CULTURAL AND LINGUISTIC CHALLENGES, AND THESE UNINSURED CITIZENS ARE WIDELY DISTRIBUTED IN TERMS OF AGE, GEOGRAPHIC REGION, AND HEALTH STATUS. PART VI, LINE 5: INOVA HEALTH SYSTEM'S INVESTMENT IN THE COMMUNITIES ACROSS NORTHERN VIRGINIA IS EVIDENT GIVEN THE PROGRAMS PROVIDING ACCESS TO CARE FOR LOW INCOME, UNINSURED, UNDERINSURED AND VULNERABLE POPULATIONS; PROMOTING HEALTH & WELLNESS AND INCREASING HEALTH LITERACY; PROVIDING THE SUPPORT AND INFRASTRUCTURE FOR DISASTER PREPAREDNESS; AND PROVIDING PROGRAMS TO SUPPORT DEVELOPMENT OF OUR FUTURE HEALTHCARE WORKFORCE TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITIES SERVED. ALL INOVA HEALTHCARE FACILITIES HAVE OPEN MEDICAL STAFFS TO PROVIDE THE MAXIMUM ACCESS TO QUALIFIED PHYSICIANS. A COMMUNITY BOARD OF TRUSTEES PROVIDES FISCAL AND QUALITY OVERSIGHT FOR INOVA HEALTH CARE SERVICES' FACILITIES TO ENSURE THE VISION AND MISSION OF THE ORGANIZATION IS ACHIEVED.ACCESS TO CARE PROGRAMSINOVA'S POPULATION HEALTH DIVISION IS ORGANIZED TO ADDRESS THE HEALTHCARE NEEDS OF THE COMMUNITY. IN ADDITION TO THE PROGRAMS ALREADY DESCRIBED IN THE CORE FORM PROGRAM, ACCOMPLISHMENTS THAT INCREASE ACCESS TO HEALTHCARE SERVICES FOR THE COMMUNITIES SERVED BY INOVA HEALTH SYSTEM INCLUDE THE FOLLOWING PROGRAMS WHICH PROVIDE INFRASTRUCTURE SUPPORT AND SERVICES FOCUSED ON VULNERABLE POPULATIONS:THE STREAMLINED ELIGIBILITY PROGRAM (SES), LAUNCHED BY THE SUCCESSFUL IMPLEMENTATION OF THE FEDERALLY-FUNDED 2001 CAP AND 2004 HCAP GRANTS, CONTINUES TO BE FUNDED BY INOVA. SES PROVIDES LOCAL SAFETY-NET HEALTH CARE PROVIDERS ACCESS TO COORDINATED HEALTH CARE NETWORKS TO SERVE THE UNINSURED AND UNDERINSURED RESIDENTS OF NORTHERN VIRGINIA. A SHARED DATABASE IS USED TO DETERMINE A PATIENT'S ELIGIBILITY FOR SERVICES WHICH PROVIDES ONE CENTRAL INTAKE THEREBY STREAMLINING AND EXPEDITING THE PROCESS. INOVA SUPPORTS THE INFRASTRUCTURE AND EXPANSION OF THE PROGRAM WHICH CURRENTLY CONSISTS OF 12 PUBLIC/PRIVATE PARTNERS SERVING FAIRFAX COUNTY, CITY OF ALEXANDRIA, LOUDOUN COUNTY, ARLINGTON COUNTY, AND PRINCE WILLIAM COUNTY. THE SYSTEM CURRENTLY HOUSES OVER 285,000 ELIGIBILITY RECORDS OF UNINSURED AND MEDICAID PATIENTS. INOVA'S PARTNERSHIP FOR HEALTHIER KIDS (PHK) ACCESS TO CARE PROGRAM PROVIDES FAMILIES WITH COMPREHENSIVE APPLICATION AND ENROLLMENT ASSISTANCE TO CONNECT THEM WITH AN APPROPRIATE AND AFFORDABLE SOURCE OF HEALTH CARE SERVICES. IN 2014, PHK ASSISTED OVER 4,034 CHILDREN WITH ACCESS TO A SOURCE OF COMPREHENSIVE HEALTH CARE SERVICES SUCH AS MEDICAID, FAMIS OR LOCAL SAFETY NET PROVIDERS. TRANSITIONAL CARE MANAGEMENT INOVA TRANSITIONAL CARE MANAGEMENT PROGRAM (TCM), IMPLEMENTED JULY 2011 FOCUSES ON UNMANAGED MEDICARE/ MEDICAID AND UNINSURED PATIENTS DIAGNOSED WITH HEART FAILURE (CHF), CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), PNEUMONIA AND DIABETES. THESE DISEASES ACCOUNT FOR A HIGH PROPORTION OF POTENTIALLY PREVENTABLE READMISSIONS. FOR 30 DAYS AFTER DISCHARGE FROM THE HOSPITAL OR EMERGENCY ROOM, TCM CASE MANAGERS AND HEALTH COACHES MONITOR PATIENTS PRIMARILY BY TELEPHONE. THEY EDUCATE PATIENTS ABOUT THEIR ILLNESSES, ENSURE THEY HAVE A FOLLOW-UP APPOINTMENT WITH THEIR PRIMARY CARE PHYSICIAN (PCP), AND CONFIRM THEY HAVE FILLED ANY PRESCRIPTIONS AND ARE TAKING THE CORRECT MEDICATIONS. FOR THOSE PATIENTS THAT DO NOT HAVE A PCP, INOVA HAS DEVELOPED DISCHARGE AND TRANSITIONAL CLINICS IN THREE LOCATIONS IN WHICH PATIENTS ARE PROVIDED A FOLLOW-UP APPOINTMENT WITH A NURSE PRACTITIONER OR PHYSICIAN WHO WILL FOLLOW THE PATIENT UNTIL THE PATIENT IS READY TO TRANSITION TO A PERMANENT MEDICAL HOME. INOVA HOME HEALTH SERVICES ALSO PARTNERS WITH TCM IN PROVIDING HOME VISITS TO PATIENTS IDENTIFIED BY THE CASE MANAGERS AS NEEDING A HOME VISIT. IN 2014, 5,036 PATIENTS WERE ADMITTED TO THE TCM PROGRAM.INOVA KELLAR CENTERINOVA KELLAR CENTER IS A COMMUNITY BASED BEHAVIORAL HEALTH CENTER AND SPECIAL EDUCATION SCHOOL FOUNDED BY INOVA IN 1991 WITH A GIFT FROM FAIRFAX COUNTY RESIDENTS, ART AND BETTY KELLAR, TO ADDRESS A GAP IN MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR CHILDREN AND ADOLESCENTS. CURRENTLY IKC OFFERS A FULL CONTINUUM OF MENTAL HEALTH SERVICES FROM OUTPATIENT THERAPIES AND MEDICATION MANAGEMENT TO AFTER SCHOOL INTENSIVE OUTPATIENT PROGRAMS AND A FULL DAY PARTIAL HOSPITALIZATION PROGRAM. THE KELLAR SCHOOL, A PRIVATE SPECIAL EDUCATION DAY SCHOOL FOR STUDENTS WITH EMOTIONAL, SOCIAL AND BEHAVIORAL NEEDS PROVIDES ACADEMIC INSTRUCTION WITHIN A THERAPEUTIC ENVIRONMENT. THE CENTER PROVIDED 77,705 HOURS OF PROGRAMMING, TREATMENT AND EDUCATION TO CHILDREN, ADOLESCENTS, AND FAMILIES IN 2014. HEALTH PROMOTION AND PREVENTATIVE CARE PROGRAMSNORTHERN VIRGINIA HEALTHY KIDS' COALITION: TIPPING THE SCALES FOR BETTER HEALTH. INOVA HEALTH SYSTEM IN PARTNERSHIP WITH NORTHERN VIRGINIA SCHOOLS, HEALTH DEPARTMENTS, AND GOVERNMENT ENTITIES HAVE JOINED TOGETHER IN A MULTI-YEAR EFFORT TO ADDRESS THE CHILDHOOD OBESITY EPIDEMIC BY WORKING TO REVERSE THIS TREND. INOVA HEALTH SYSTEM SPONSORS THIS COMMUNITY-BASED COALITION. INOVA PARTNERING ACTIVELY TOWARDS HEALTH (IPATH). THE IPATH MISSION IS TO PROVIDE OPPORTUNITIES FOR STUDENTS TO ENGAGE IN HEALTH ORIENTED ACTIVITIES WITHIN OUR COMMUNITY, STRENGTHEN HEALTHY LIVING AMONGST ADOLESCENTS, AND EXPOSE STUDENTS TO EXCITING MEDICAL CAREERS. THE PATHWAY TO IMPROVED HEALTH PROGRAM IS A TEN-WEEK PROGRAM DESIGNED TO ENGAGE SELECTED STUDENT LEADERS THAT WILL CHAMPION HEALTH AWARENESS ACTIVITIES IN THEIR SCHOOLS AND COMMUNITIES, EMPOWER STUDENTS TO PARTNER WITH HEALTH PROFESSIONALS TO ASSIST INOVA AND THEIR SCHOOL IN DEVELOPING A NEW HEALTH INITIATIVE, AND SERVE AS A HEALTH AMBASSADOR TO THEIR FAMILIES TO HELP ACHIEVE THE GOAL OF IMPROVING THE HEALTH OF THE COMMUNITY ONE FAMILY AT A TIME. CONGREGATIONAL HEALTH PARTNERSHIP (CHP) HAS RESOURCED AND FACILITATED WELLNESS OF SPIRIT, MIND, AND BODY THROUGH MULTI-FAITH COMMUNITIES IN MULTI ETHNIC GROUPS SINCE 1999. CHP'S VISION IS TO STRENGTHEN THE CONNECTION BETWEEN FAITH COMMUNITIES AND HEALTH WITH THE GOAL OF MAKING SYSTEMIC CHANGES FOR THE IMPROVEMENT OF HEALTH BY FOCUSING ON EDUCATION AND PREVENTION. HEALTH LITERACY AND HEALTH EQUITY PROGRAMSTHE OFFICE OF HEALTH EQUITY (OHE) IDENTIFIES AND ADDRESSES HEALTH DISPARITIES IN NORTHERN VIRGINIA THROUGH INTERNAL AND COMMUNITY INITIATIVES. THE DEPARTMENT IS DEDICATED TO THE ELIMINATION OF DISPARITIES IN THE COMMUNITY THROUGH COMMUNITY PARTNERSHIP, DIVERSITY AND CULTURAL COMPETENCE EDUCATION, AND PROVISION OF LANGUAGE SERVICES. IN SUPPORT OF PATIENT SAFETY AND SATISFACTION, LANGUAGE INTERPRETATION AND TRANSLATION SERVICES ARE PROVIDED AT EVERY INOVA FACILITY, TO FACILITATE COMMUNICATION WITH THE 14 PERCENT OF INOVA'S PATIENT POPULATION WHO ARE LIMITED ENGLISH PROFICIENT (LEP). MEDICAL INTERPRETATION IN OVER 150 LANGUAGES IS PROVIDED BY ON-SITE MEDICAL INTERPRETERS AND TELEPHONIC INTERPRETERS. IN 2014, THE OHE DELIVERED 50,677 HOURS OF INTERPRETER SERVICES AND 13,580 HOURS OF SIGN LANGUAGE INTERPRETATION ACROSS INOVA FACILITIES. OVER 360 VITAL DOCUMENTS WERE TRANSLATED INTO INOVA'S TOP LANGUAGES. PART VI, LINE 6: ORGANIZATION IS PART OF INOVA HEALTH SYSTEM INCLUDED IN DESCRIPTION UNDER LINE 5. X X X X X X 0 1 0 0 0 0 0 0 0 MARK STAUDER TRUSTEE 0 962861 0 658128 0 49601 0 705925 0 21350 0 2397865 0 0 PATRICK WALTERS CEO, ILH, ASST SECRETARY 413414 0 16420 0 101492 0 56100 0 15188 0 602614 0 0 0 LORING FLINT EVP CHIEF MEDICAL OFFICER 0 588245 0 89864 0 37813 0 168985 0 26593 0 911500 0 0 J KNOX SINGLETON PRESIDENT 0 1200835 0 3731324 0 317092 0 732655 0 18889 0 6000795 0 3450316 JOHN GAUL SVP GENERAL COUNSEL 0 424310 0 37796 0 21776 0 123448 0 21477 0 628807 0 0 RICHARD MAGENHEIMER TREASURER 0 667029 0 107932 0 138546 0 746708 0 17548 0 1677763 0 0 WILLIAM BANE AVP ASSOC ADMIN CFO 198642 0 12194 0 36785 0 23281 0 22788 0 293690 0 7961 0 ELIZABETH DUGAN AVP, CNO 194770 0 7544 0 13192 0 49496 0 25760 0 290762 0 0 0 CHRISTOPHER CHIANTELLA CHIEF MEDICAL OFFICE, ILH 251394 0 10103 0 14095 0 79396 0 15194 0 370182 0 0 0 MARISSA JAMARIK SIR DIR NURSING SRVCS 142185 0 10420 0 20886 0 10578 0 17863 0 201932 0 0 0 DANIEL YIARGA SONOGRAPHER SPECIALTY 148873 0 696 0 53 0 25459 0 25383 0 200464 0 0 0 OMAR CASTANEDA CARDIO INVASIVE SPECIALIST 155786 0 678 0 62 0 29652 0 25509 0 211687 0 0 0 REBECCA VALDESUSO SR DIR PERIOP SVCS 143950 0 4129 0 151 0 25678 0 7695 0 181603 0 0 0 CHRISTOPHER WEBSTER CARDIO INVASIVE SPECIALIST 149595 0 628 0 47 0 20208 0 22722 0 193200 0 0 0 JAMES KIM FORMER SECRETARY 0 208360 0 13639 0 55218 0 39487 0 21580 0 338284 0 34277 SUSAN CARROLL FORMER VP ICI AND ITMI 0 243252 0 23220 0 20071 0 47961 0 3350 0 337854 0 60541 PART I, LINE 4B SERP PLAN PAYMENTS J. KNOX SINGLETON $237,137 RICHARD MAGENHEIMER $98,945 WILLIAM BANE $25,948 PATRICK WALTERS $61,891 SUSAN CARROLL $84,979 JAMES KIM $45,021 SUPPLEMENTAL RETIREMENT PLAN (SERP PLAN) IS A NONQUALIFIED RETIREMENT PLAN. EMPLOYEES ELIGIBLE TO PARTICIPATE ARE EXECUTIVE DIRECTORS, ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, CFO, COO, AND CEO. EACH YEAR, A CERTAIN PERCENTAGE OF EACH PARTICIPANT'S BASE SALARY IS CONTRIBUTED TO THE SERP PLAN. THIS AMOUNT RANGES FROM 5% TO 20%, DEPENDING ON POSITION. AFTER THREE YEARS OF CONTINUOUS PARTICIPATION, PARTICIPANTS VEST IN 50% OF THEIR BALANCE AT THAT TIME AND ARE PAID OUT THE VESTED BALANCE AS A TAXABLE EVENT. AFTER A TOTAL OF SIX YEARS PARTICIPATION AND AFTER ATTAINING AGE 45, PARTICIPANTS ARE 100% VESTED AND ARE PAID OUT THEIR REMAINING BALANCE AS A TAXABLE EVENT. VESTING THEN REVERTS TO A THREE-YEAR ROLLING SCHEDULE UNTIL YEAR 12. THEREAFTER, THE ANNUAL CONTRIBUTION IS PAID OUT TO THE PARTICIPANT EACH YEAR AS A TAXABLE EVENT. FAIRFAX ANESTHESIOLOGY MAJOR DONOR 18925 PROFESSIONAL MEDICAL FEES. SERVICES PROVIDED AT ARM'S LENGTH AND CUSTOMARY RATES. 0 ROBERT D LAFSKY MAJOR DONOR 106794 PROFESSIONAL MEDICAL FEES. SERVICES PROVIDED AT ARM'S LENGTH AND CUSTOMARY RATES. 0 VIRGINIA HEART MAJOR DONOR 103899 PROFESSIONAL MEDICAL FEES. SERVICES PROVIDED AT ARM'S LENGTH AND CUSTOMARY RATES. 0 PART V, LINE 1A AND 2A - NUMBER OF EMPLOYEES AND 1099S THE ORGANIZATION FILES ITS FORM 1099S UNDER THE PARENT ENTITY AND DOES NOT REPORT ANY AMOUNTS UNDER ITS OWN EIN. THE ORGANIZATION FALLS UNDER A MASTER PAY AGENT AND DOES NOT FILE ANY PAYROLL RETURNS UNDER ITS OWN EIN, HOWEVER ALL REQUIRED RETURNS HAVE BEEN FILED ON TIME. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED AND PROVIDED TO THE CHIEF ACCOUNTING OFFICER AND EXTERNAL TAX CONSULTANTS FOR INITIAL REVIEW. AFTER THE REVIEW IT IS GIVEN TO THE CFO OF INOVA HEALTH SYSTEM FOR HIS REVIEW AND COMMENT. THE FORM 990 IS PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES FOR THEIR REVIEW. UPON COMPLETION OF THE EXECUTIVE COMMITTEE REVIEW, IT IS PROVIDED TO THE FULL BOARD OF TRUSTEES. IN THIS PROCESS, THE FORM 990 HAS BEEN PROVIDED TO THE GOVERNING BOARD APPROXIMATELY TWO WEEKS PRIOR TO THE FILING OF THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C YES, ANNUALLY THE ORGANIZATION DISTRIBUTES THE CONFLICT OF INTEREST POLICY TO ALL DIRECTORS, OFFICERS, TRUSTEES, AND KEY EMPLOYEES. THE ORGANIZATION REQUIRES THAT EACH DIRECTOR, OFFICER, TRUSTEE, AND KEY EMPLOYEE ACKNOWLEDGE THAT THEY HAVE READ, UNDERSTOOD, AND WILL ABIDE BY THE POLICY. EACH DIRECTOR, OFFICER, TRUSTEE, AND KEY EMPLOYEE IS REQUIRED TO COMPLETE AND SUBMIT AN ANNUAL CONFLICT OF INTEREST DISCLOSURE. THESE DISCLOSURES ARE BROAD AND REQUIRE THAT THE INDIVIDUAL LIST ANY BUSINESS RELATIONSHIPS OR PERSONAL RELATIONSHIPS WITH OTHER DIRECTORS, OFFICERS, TRUSTEES, AND KEY EMPLOYEES, AS WELL AS ANY RELATIONSHIPS WITH COMPETITORS, OR CURRENT OR POTENTIAL VENDORS OR CONTRACTORS. DISCLOSURE STATEMENTS ARE REVIEWED BY SENIOR MANAGEMENT AND ANY POTENTIAL CONFLICTS ARE DISCUSSED WITH GOVERNING BODY CHAIRMAN TO ENSURE THAT ANY MEMBER WHO MAY HAVE A CONFLICT DISCLOSES THEIR POTENTIAL CONFLICT, AND IS DISMISSED FROM RELATED DISCUSSIONS AND RECUSED FROM PARTICIPATION IN APPLICABLE DECISIONS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF ALL SENIOR MANAGEMENT POSITIONS IS EVALUATED ANNUALLY IN LIGHT OF EACH MANAGER'S JOB CONTENT, SCOPE AND COMPLEXITY. COMPENSATION LEVELS FOR VICE PRESIDENTS AND ABOVE ARE REVIEWED BY AN INDEPENDENT EXTERNAL CONSULTANT TO ENSURE THAT REMUNERATION IS CONSISTENT WITH THE ORGANIZATION'S COMPENSATION PHILOSOPHY AND OBJECTIVES AND COMPETITIVE WITH OTHER LARGE COMPLEX HEALTH SYSTEMS. THE INDEPENDENT COMPENSATION CONSULTANT MAINTAINS NATIONAL BENCHMARK COMPENSATION DATABASES AND SURVEYS AND ALSO REVIEWS FORMS 990 OF COMPARABLE HEALTHCARE SYSTEMS TO DETERMINE MARKET LEVELS OF COMPENSATION. IN ADDITION, THE INOVA HEALTH SYSTEM'S CEO'S COMPENSATION IS REVIEWED AND APPROVED ANNUALLY BY AN INDEPENDENT GOVERNING BOARD. THE JOB REQUIREMENTS AND COMPLEXITY OF ALL OTHER MANAGEMENT POSITIONS ARE EVALUATED ANNUALLY USING NATIONALLY RECOGNIZED THIRD PARTY SALARY SURVEYS TO ASSURE THAT THE COMPENSATION FOR SUCH POSITIONS IS CONSISTENT WITH EXTERNAL MARKET COMPENSATION COMPARISONS. SALARY RANGES ARE DEVELOPED FOR EACH MANAGEMENT POSITION CLASSIFICATION TO ENSURE THAT THE COMPENSATION LEVELS FOR THESE POSITIONS ARE CONSISTENT WITH THE ORGANIZATION'S COMPENSATION PHILOSOPHY AND OBJECTIVES AND WITH COMPETITIVE MARKET COMPARISONS. COMPENSATION FOR EMPLOYED PHYSICIANS IS REVIEWED AND APPROVED BY THE INOVA HEALTH SYSTEM PHYSICIAN COMPENSATION COMMITTEE. THE COMMITTEE IS COMPRISED OF EXECUTIVE MANAGEMENT OF THE INOVA HEALTH SYSTEM. THE FAIR MARKET VALUE (FMV) COMPENSATION IS BASED ON FOUR NATIONALLY RECOGNIZED INDUSTRY PHYSICIAN COMPENSATION BENCHMARK SURVEYS (MGMA, AMGA, SULLIVAN & COTTER, HAY GROUP). THE COMMITTEE ALSO UTILIZES INDEPENDENT CONSULTANTS TO PROVIDE FMV OPINIONS FOR POSITIONS THAT ARE NOT READILY AVAILABLE IN THE FOUR PUBLISHED BENCHMARK SURVEYS. THE CONSULTANTS' OPINIONS AND COMPENSATION SURVEY DATA ARE PRESENTED TO THE PHYSICIAN COMPENSATION COMMITTEE FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 1023, AND FORM 990 ARE AVAILABLE AT THE ADDRESS LISTED ON PAGE 1 OF THE FORM 990 UPON REQUEST DURING REGULAR BUSINESS HOURS. FORM 990, PART VI, SECTION C, LINE 19 INOVA HEALTH SYSTEM MAKES CERTAIN INFORMATION PUBLICLY AVAILABLE. INOVA'S CONSOLIDATED FINANCIAL STATEMENTS ARE POSTED ON THE ELECTRONIC MUNICIPAL MARKET ACCESS'S (EMMA) WEBSITE ON A QUARTERLY BASIS. INOVA'S FORM 990S ARE DISCLOSED ON THE GUIDESTAR WEBSITE. INOVA'S GOVERNING DOCUMENTS ARE NOT CURRENTLY PUBLICLY AVAILABLE. WHILE THE CONFLICT OF INTEREST POLICY IS NOT SPECIFICALLY PUBLICLY DISCLOSED, INOVA'S CODE OF CONDUCT IS ON THE PUBLIC WEBSITE. SECTION III OF THE CODE OF CONDUCT DESCRIBES WHAT CAN CONSTITUTE A CONFLICT AND REQUIRES THAT POTENTIAL CONFLICTS BE REPORTED TO MANAGEMENT OR THE CHIEF COMPLIANCE OFFICER. THE CODE ALSO REFERS TO THE CONFLICT OF INTEREST POLICY WHICH IS AVAILABLE TO STAFF AND PHYSICIANS ON INOVA'S INTRANET WEBSITE. FORM 990, PART XI, LINE 9: PARTNERSHIP INCOME -7,520,513. TEMP RESTRICTED INCOME/LOSS -4,760. PERM RESTRICTED INCOME/LOSS -152,039. EQUITY IN SUBSIDIARIES 6,740,923. PART XII, LINE 2B AND 2C - AUDITED FINANCIAL STATEMENTS THE COMPANY IS PART OF THE INOVA HEALTH SYSTEM, A NOT-FOR-PROFIT INTEGRATED HEALTH CARE DELIVERY SYSTEM SERVING NORTHERN VIRGINIA AND SURROUNDING AREAS. THE COMPANY'S FINANCIAL STATEMENTS ARE CONSOLIDATED IN THE INOVA HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTS. INOVA HEALTH SYSTEM IS AUDITED ON AN ANNUAL BASIS BY A LARGE "BIG FOUR" INDEPENDENT PUBLIC ACCOUNTING FIRM. IN ADDITION, THEY ARE RESPONSIBLE FOR THE ISSUANCE OF A MANAGEMENT LETTER ENCOMPASSING EACH MEMBER OF THE CONSOLIDATED GROUP. THE FINANCE AND AUDIT COMMITTEE OF THE BOARD OF TRUSTEES OF INOVA HEALTH SYSTEM IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT, INCLUDING THE HIRING OF THE AUDIT FIRM, REVIEW AND APPROVAL OF AUDITED FINANCIAL STATEMENTS AND COMMUNICATION WITH THE EXTERNAL AUDITORS AT LEAST TWICE A YEAR WITHOUT THE PRESENCE OF INTERNAL MANAGEMENT. PART XII, LINE 3A - A-133 AUDIT THE COMPANY IS A SUBSIDIARY OF THE INOVA HEALTH SYSTEM (IHS), A NOT-FOR-PROFIT INTEGRATED HEALTH CARE DELIVERY SYSTEM SERVING NORTHERN VIRGINIA AND SURROUNDING AREAS. IHS RECEIVES VARIOUS FEDERAL GRANTS. THESE GRANTS AND AWARDS ARE AUDITED AS PART OF THE CONSOLIDATED INOVA HEALTH SYSTEM A-133 COMPLIANCE AUDIT. THE INOVA HEALTH SYSTEM'S FEDERAL GRANTS ARE AUDITED ON AN ANNUAL BASIS BY A LARGE "BIG FOUR" INDEPENDENT PUBLIC ACCOUNTING FIRM AND A "REPORT ON COMPLIANCE WITH REQUIREMENTS APPLICABLE TO EACH MAJOR PROGRAM AND ON INTERNAL CONTROLS OVER COMPLIANCE IN ACCORDANCE WITH OMB CIRCULAR A-133" IS ISSUED ON A CONSOLIDATED BASIS. THE FINANCE AND AUDIT COMMITTEE OF THE BOARD OF TRUSTEES OF INOVA HEALTH SYSTEM IS RESPONSIBLE FOR THE OVERSIGHT OF THE A-133 AUDIT, INCLUDING THE HIRING OF THE AUDIT FIRM, REVIEW AND APPROVAL OF AUDITED FINANCIAL STATEMENTS AND COMMUNICATIONS WITH THE EXTERNAL AUDITORS AT LEAST TWICE A YEAR WITHOUT THE PRESENCE OF INTERNAL MANAGEMENT. 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