VCU HEALTH CHILDRENS SERVICES AT BROOK ROAD: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
VCU HEALTH CHILDRENS SERVICES AT BROOK ROAD (EIN 54-0506309)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-03-25
IRS object ID
201400849349300720
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-03-25T11:24:18-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN560747981EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14510 COX ROAD SUITE 200AddressLine1
CityGLEN ALLENCity
StateVAState
ZIP Code230603394ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN540506309EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CRIPPLED CHILDREN'S HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCRIPNameControl
Phone8042285874Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12924 BROOK ROADAddressLine1
CityRICHMONDCity
StateVAState
ZIP Code232201298ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLINDA E PEARSONName
TitleSENIOR VP VCU HEALTH SYSTEMTitle
Phone8042285874Phone
Date Signed2014-03-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDALE P BURGESS CPAName
PTINP01232881PTIN
Phone8042827636Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S HOSPITAL OF RICHMOND OF THE VCU HEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonLINDA E PEARSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12924 BROOK ROADAddressLine1
CityRICHMONDCity
StateVAState
ZIP Code232201298ZIPCode
FieldValueIRS element (for citing)
Gross Receipts35994670GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CHRICHMOND.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1920YearFormation
State Legal DomicileVAStateLegalDomicile
Activity Or Mission DescriptionCRIPPLED 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees422TotalNbrEmployees
Total Nbr Volunteers260TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year587018ContributionsGrantsPriorYear
Contributions Grants Current Year6706388ContributionsGrantsCurrentYear
Program Service Revenue Prior Year25797231ProgramServiceRevenuePriorYear
Program Service Revenue CY29018240ProgramServiceRevenueCY
Investment Income Prior Year13602InvestmentIncomePriorYear
Investment Income Current Year5645InvestmentIncomeCurrentYear
Other Revenue Prior Year77326OtherRevenuePriorYear
Other Revenue Current Year248482OtherRevenueCurrentYear
Total Revenue Prior Year26475177TotalRevenuePriorYear
Total Revenue Current Year35978755TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year21743558SalariesEtcPriorYear
Salaries Etc Current Year23394989SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7620891OtherExpensePriorYear
Other Expenses Current Year7686737OtherExpensesCurrentYear
Total Expenses Prior Year29364449TotalExpensesPriorYear
Total Expenses Current Year31081726TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2889272RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4897029RevenuesLessExpensesCY
Total Assets BOY18736549TotalAssetsBOY
Total Assets EOY17683722TotalAssetsEOY
Total Liabilities BOY13581019TotalLiabilitiesBOY
Total Liabilities EOY9027143TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5155530NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8656579NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionCH 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense9539894Expense
Revenue11962080Revenue
DescriptionTHE 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 40 IN FISCAL YEAR 2013, AN INCREASE OF 3 PATIENTS FROM THE AVERAGE OF 37 IN FISCAL YEAR 2012. 100% OF THE REVENUE IN THIS PROGRAM COMES FROM VIRGINIA MEDICAID.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense8466873Expense
Revenue11235852Revenue
DescriptionTHE HOSPITAL IS THE PREMIER PROVIDER OF OUTPATIENT PEDIATRIC PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY SERVICES IN CENTRAL VIRGINIA. OUTPATIENT THERAPY VISITS TOTALED 75,104 IN FISCAL YEAR 2013 WHICH IS AN INCREASE OF 2,080 VISITS FROM THE PRIOR YEAR. THERAPY SERVICES ARE OFFERED AT THE MAIN HOSPITAL IN THE CITY OF RICHMOND AND AT FOUR COMMUNITY THERAPY CENTERS LOCATED IN GLEN ALLEN, BON AIR, FREDERICKSBURG, AND PETERSBURG.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense2526797Expense
Revenue3634260Revenue
DescriptionDENTAL PROGRAM SERVICES ARE PROVIDED FOR THE TYPICAL WELL-CHILD AND FOR CHILDREN WITH SPECIAL NEEDS. IN FISCAL YEAR 2013, THE DENTAL PROGRAM COMPLETED OVER 600 SURGERIES AND 4,500 CLINIC VISITS. THE MAJORITY OF THE DENTAL PROGRAM PATIENTS ARE FUNDED BY VIRGINIA MEDICAID. IN FISCAL YEAR 2013, THE HOSPITAL CONTINUED WITH THE DENTAL OUTREACH PROGRAM THAT TAKES IMPORTANT DENTAL EDUCATION AND MATERIALS TO AREA ELEMENTARY SCHOOLS.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense3264807Expense
Revenue2195643Revenue
DescriptionPHYSICIAN 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.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp3264807TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev2195643TotalOfOtherProgramServiceRev
Total Program Service Expense23798371TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109634NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees422NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledVAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JAMES A DEYARMINBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8042285874TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12924 BROOK ROADAddressLine1
CityRICHMONDCity
StateVAState
ZIP Code232201298ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
THOMAS S CAIN
CHAIRMAN1.00XX000
PONJOLA CONEY MD
SECRETARY1.00XX0592277777
LINDA E PEARSON
VICE CHAIR AND TREASURER1.00XX039740548969
JOHN F DUVAL
DIRECTOR - EX-OFFICIO1.00X059924284965
SHELDON M RETCHIN MD
DIRECTOR - EX-OFFICIO1.00X039891030758
BRUCE K RUBIN MD
DIRECTOR - EX-OFFICIO1.00X032902558701
ANN E HONEYCUTT
DIRECTOR1.00X000
HENRY L VALENTINE III
DIRECTOR1.00X000
JOHN D WARD MD
DIRECTOR - EX-OFFICIO1.00X045058255750
LESLIE G WYATT
EXECUTIVE DIRECTOR45.00X278731039307
SHARON W DARBY
VP OF CLINICAL OPERATIONS45.00175976028406X
JOANNA CASTALDI
MANAGER OF PHYSIOLOGY45.00101630018635X
SALLIE C TIDMAN
DIRECTOR OF THERAPY SERVICES45.00102685026409X
PATRICIA P ANDERSON
DIRECTOR OF NURSING45.00107152019186X
JAMES A DEYARMIN
CONTROLLER45.00131176019886X
GREGORY FRIEDMAN
DIRECTOR OF INFORMATION TE45.00104789026350X
KAREN A BENNETT
FORMER HIGHEST COMPENSATED EMPLOYEE - VP OF HR45.00143028023424X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1145167TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2234391TotalReportableCompFrmRltdOrgs
Total Other Compensation488523TotalOtherCompensation
Number Individuals GT100 K8NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MCV PHYSICIANS
PO BOX 79203BALTIMOREMD212790203CONTRACT PHYSICIANS1089445
ARKANSAS COUNTRY ANESTHESIA
48180 KIPPER DRIVEMOSELEYVA23120CONTRACT PHYSICIANS320250
SHELTERING ARMS HOSPITAL
8254 ATLEE ROADMECHANICSVILLEVA23116OFFICE SPACE LEASE110615
MEDSITES LLC
1005 SOPHIA STREETFREDERICKSBURGVA22401OFFICE SPACE LEASE104528
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Related Organizations6200919RelatedOrganizations
All Other Contributions505469AllOtherContributions
Total Contributions6706388TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
PATIENT SERVICES6230002899974028999740
INFANT SERVICES6216101800018000
RESEARCH REVENUE541700500$500
FieldValueIRS element (for citing)
Total Program Service Revenue29018240TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5554TotalRevenueColumn
Exclusion$5,554ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real12450Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real12450Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column12450TotalRevenueColumn
Exclusion$12,450ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other1360Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other1269Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other91Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column91TotalRevenueColumn
Related Or Exempt Function Income91RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Sales Of Inventory23387GrossSalesOfInventory
Cost Of Goods Sold14646CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column8741TotalRevenueColumn
Exclusion$8,741ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MISCELLANEOUS900099202605$202,605
MED RECORDS FEE62300012487$12,487
PHYS THERAPY CONTRACT SERVICE6243101000410004

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column2195TotalRevenueColumn
Exclusion$2,195ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue227291TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column35978755TotalRevenueColumn
Related Or Exempt Function Income29027835RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$244,532ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total545151Total
Program Services408863ProgramServices
Management And General136288ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total17120159Total
Program Services13932375ProgramServices
Management And General3187784ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1104834Total
Program Services829055ProgramServices
Management And General275779ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3385282Total
Program Services2705860ProgramServices
Management And General679422ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1239563Total
Program Services1011553ProgramServices
Management And General228010ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total281029Total
Management And General281029ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total2267Total
Management And General2267ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1939940Total
Program Services1526568ProgramServices
Management And General413372ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total2972Total
Program Services2367ProgramServices
Management And General605ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1076918Total
Program Services249087ProgramServices
Management And General827831ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total49169Total
Program Services30967ProgramServices
Management And General18202ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total881191Total
Program Services366675ProgramServices
Management And General514516ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total40591Total
Program Services31836ProgramServices
Management And General8755ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total83812Total
Program Services47915ProgramServices
Management And General35897ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total971427Total
Program Services728570ProgramServices
Management And General242857ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total150011Total
Management And General150011ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
RESIDENT CARE21730941917848255246
DUES & LICENSES29872758022292
MISCELLANEOUS444412523192

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total31081726Total
Program Services23798371ProgramServices
Management And General7283355ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2309118BOY
EOY1421545EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4421BOY
EOY4029EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3061679BOY
EOY2879635EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY169591BOY
EOY167516EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY89817BOY
EOY154124EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis38530486LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec29127128LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY10193929BOY
EOY9403358EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2907994BOY
EOY3653515EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY18736549BOY
EOY17683722EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2549038BOY
EOY2736444EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY11031981BOY
EOY6290699EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY13581019BOY
EOY9027143EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2285113BOY
EOY5316592EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY542895BOY
EOY947383EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2327522BOY
EOY2392604EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5155530BOY
EOY8656579EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY18736549BOY
EOY17683722EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4897029ReconcilationRevenueExpenses
Reconcilation Other Changes-1395981ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited0FSAudited
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2870417BeginningOfYearBalance
Contributions205967Contributions
Investment Earnings Or Losses353072InvestmentEarningsOrLosses
Other Expenditures89469OtherExpenditures
End Of Year Balance3339987EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2996275BeginningOfYearBalance
Contributions563458Contributions
Investment Earnings Or Losses-102298InvestmentEarningsOrLosses
Other Expenditures587018OtherExpenditures
End Of Year Balance2870417EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2609947BeginningOfYearBalance
Contributions541132Contributions
Investment Earnings Or Losses605099InvestmentEarningsOrLosses
Other Expenditures759903OtherExpenditures
End Of Year Balance2996275EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2563739BeginningOfYearBalance
Contributions597294Contributions
Investment Earnings Or Losses41040InvestmentEarningsOrLosses
Other Expenditures592126OtherExpenditures
End Of Year Balance2609947EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3089602BeginningOfYearBalance
Contributions1034025Contributions
Investment Earnings Or Losses82059InvestmentEarningsOrLosses
Other Expenditures1641947OtherExpenditures
End Of Year Balance2563739EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.71600PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.28400TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis54914OtherCostOrOtherBasis
Book Value54914BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis17574281OtherCostOrOtherBasis
Depreciation10592478Depreciation
Book Value6981803BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis477715OtherCostOrOtherBasis
Depreciation208600Depreciation
Book Value269115BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis20025908OtherCostOrOtherBasis
Depreciation17932157Depreciation
Book Value2093751BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis397668OtherCostOrOtherBasis
Depreciation393893Depreciation
Book Value3775BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings9403358TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
OTHER CURRENT ASSETS302132
EQUITY INTEREST IN FOUNDATION NET ASSETS3339987
DEPOSITS11396
FieldValueIRS element (for citing)
Total Book Value Other Assets3653515TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
SETTLEMENTS DUE TO THIRD-PARTY PAYORS$81,068
PENSION LIABILITY$5,985,167
DUE TO AFFILIATES$23,912
OTHER LIABILITES$92,791
PATIENT CREDIT BALANCES$81,534
PATIENT ACCOUNT REFUNDS$23,599
UNCLAIMED CHECKS$2,628
FieldValueIRS element (for citing)
Total Of Amounts6290699TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: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 $947,383 AND $542,895 AT JUNE 30, 2013 AND 2012, 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 $2,392,604 AND $2,327,522 AT JUNE 30, 2013 AND 2012, 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 $89,469 AND $587,018 IN 2013 AND 2012, RESPECTIVELY, TO SUPPORT OPERATIONS OF THE HOSPITAL AND FOR THE PURCHASE OF CAPITAL ASSETS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: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, 2013 AND 2012, THE AUHTORITY HAS NO INCOME TAX POSITIONS THAT ARE NOT CONSIDERED GREATER THAN 50% LIKELY OF BEING REALIZED.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served8PersonsServed
Total Community Benefit Expense6509TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense6509NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served1180PersonsServed
Total Community Benefit Expense14798404TotalCommunityBenefitExpense
Direct Offsetting Revenue13272565DirectOffsettingRevenue
Net Community Benefit Expense1525839NetCommunityBenefitExpense
Percent Of Total Expense0.04910PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served1188PersonsServed
Total Community Benefit Expense14804913TotalCommunityBenefitExpense
Direct Offsetting Revenue13272565DirectOffsettingRevenue
Net Community Benefit Expense1532348NetCommunityBenefitExpense
Percent Of Total Expense0.04930PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs78NumberOfActivitiesOrPrograms
Persons Served28866PersonsServed
Total Community Benefit Expense207636TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense207636NetCommunityBenefitExpense
Percent Of Total Expense0.00670PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs14NumberOfActivitiesOrPrograms
Persons Served2219PersonsServed
Total Community Benefit Expense129965TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense129965NetCommunityBenefitExpense
Percent Of Total Expense0.00420PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served252PersonsServed
Total Community Benefit Expense350733TotalCommunityBenefitExpense
Direct Offsetting Revenue25186DirectOffsettingRevenue
Net Community Benefit Expense325547NetCommunityBenefitExpense
Percent Of Total Expense0.01050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs93NumberOfActivitiesOrPrograms
Persons Served31337PersonsServed
Total Community Benefit Expense688334TotalCommunityBenefitExpense
Direct Offsetting Revenue25186DirectOffsettingRevenue
Net Community Benefit Expense663148NetCommunityBenefitExpense
Percent Of Total Expense0.02140PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs95NumberOfActivitiesOrPrograms
Persons Served32525PersonsServed
Total Community Benefit Expense15493247TotalCommunityBenefitExpense
Direct Offsetting Revenue13297751DirectOffsettingRevenue
Net Community Benefit Expense2195496NetCommunityBenefitExpense
Percent Of Total Expense0.07070PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$23,907BadDebtExpenseAmount
Amount Reimbursed By Medicare35766AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare35766CostOfCareReimbursedByMedicare

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1CRIPPLED CHILDREN'S HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12924 BROOK ROADAddressLine1
CityRICHMONDCity
StateVAState
ZIP Code23220ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Childrens HospitalXChildrensHospital
Teaching HospitalXTeachingHospital
OtherPEDIATRIC LONG TERM CAREOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CRIPPLED CHILDREN'S HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted07NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize ServicesXPrioritizeServices
All Needs Addressed1AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent250.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy0NondiscrimEmergencyCarePolicy
No Emergency CareXNoEmergencyCare
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 6A: THE HOSPITAL AND CHILDREN'S HOSPITAL FOUNDATION REPORTS THROUGH ITS MANY PUBLICATIONS AND WEB SITES THE ACTIVITIES THAT SUPPORT THE COMMUNITY. THE FOUNDATION INCLUDES INFORMATION IN AN ANNUAL REPORT THAT IS DISTRIBUTED THROUGHOUT THE COMMUNITY.
PART I, LINE 7: COST IS USED TO DETERMINE THE AMOUNT OF COMMUNITY BENEFIT FOR EACH CATEGORY. COST IS DETERMINED BY USING EITHER A COST ACCOUNTING METHODOLOGY OR A COST TO CHARGE RATIO.
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 $350,733.
PART III, LINE 4: REVENUE FROM THE MEDICAID PROGRAM ACCOUNTED FOR APPROXIMATELY 70% OF THE HOSPITAL'S NET PATIENT SERVICE REVENUE FOR THE YEAR ENDED JUNE 30, 2013. AMOUNTS NOT EXPECTED TO BE PAID ARE RESERVED AND CHARGED TO BAD DEBT EXPENSE. THE AMOUNT REPORTED AS BAD DEBT EXPENSE IS AT COST AND IS BASED ON A COST TO CHARGE RATIO. NO ATTEMPT HAS BEEN MADE TO DETERMINE THE AMOUNT IN BAD DEBT EXPENSE THAT COULD HAVE BEEN ELIGIBLE FOR CHARITY CARE. THE HOSPITAL WILL REFER TO A CONTRACTED COLLECTION AGENCY ACCOUNTS WHERE THE RESPONSIBLE PARTY HAS NOT ATTEMPTED TO RESOLVE THE BALANCE DUE AND THE RESPONSIBLE PARTY IS NOT ELIGIBLE FOR FINANCIAL ASSISTANCE.
PART III, LINE 8: THE BAD DEBT EXPENSE IS BASED UPON THE COST TO CHARGE RATIO. MEDICARE ALLOWABLE COST IS FROM THE LOW UTILIZATION MEDICARE COST REPORT.
PART III, LINE 9B: A FINANCIAL COUNSELOR ASSISTS PATIENTS IN UNDERSTANDING AVAILABILITY OF COMMUNITY OR GOVERNMENTAL ASSISTANCE PROGRAMS, AS WELL AS THE HOSPITAL'S CHARITY CARE POLICY. PATIENT FAMILIES RECEIVE NOTIFICATION THROUGH THE PATIENT BOOKLET AS A NEW PATIENT.
PART V, SECTION B, LINE 3: 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 20D: THE HOSPITAL OFFERS A SELF-PAY DISCOUNT (APPROXIMATELY 60% OF CHARGES), BASED ON THE MEDICAID RATE, TO UNINUSURED PATIENTS BEYOND THOSE WHO QUALIFY FOR CHARITY CARE. PATIENTS CAN ALSO MAKE MONTHLY PAYMENTS, INTEREST FREE, FOR 18 MONTHS.CRIPPLED CHILDREN'S HOSPITAL
PART VI, LINE 3: SEE PART III, LINE 9B EXPLANATION.
PART VI, LINE 4: SEE PART V EXPLANATION.
PART VI, LINE 5: SEE PART V EXPLANATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
LINDA E PEARSON
VICE CHAIR AND TREASURER033484105038801217604037208597044637400
JOHN F DUVAL
DIRECTOR - EX-OFFICIO058807200011170071281013684068420700
SHELDON M RETCHIN MD
DIRECTOR - EX-OFFICIO0394577000433302722903529042966800
BRUCE K RUBIN MD
DIRECTOR - EX-OFFICIO03013000250000272505660902092038772600
JOHN D WARD MD
DIRECTOR - EX-OFFICIO03756500657340919805272403026050633200
LESLIE G WYATT
EXECUTIVE DIRECTOR242663030064060040275880117190318038000
SHARON W DARBY
VP OF CLINICAL OPERATIONS17263900033370176710107350204382000
JAMES A DEYARMIN
CONTROLLER1285120002664013008068780151062000
KAREN A BENNETT
FORMER HIGHEST COMPENSATED EMPLOYEE1372280005800016565068590166452000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 3ReturnReference
ExplanationCOMPENSATION OF THE EXECUTIVE DIRECTOR IS DETERMINED BY THE LEADERSHIP OF VCUHS.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6ALSO 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.
FORM 990, PART VI, SECTION A, LINE 7ASEE RESPONSE TO PAGE 6, PART VI, LINE 6
FORM 990, PART VI, SECTION A, LINE 7BSEE RESPONSE TO PAGE 6, PART VI, LINE 6
FORM 990, PART VI, SECTION B, LINE 11A PDF COPY OF THE 990 IS SENT TO ALL THE BOARD MEMBERS FOR REVIEW AND A PERIOD OF TIME IS ALLOTTED FOR REIVEW COMMENTS BY THE BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 12CALL 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 15AN OUTSIDE CONSULTANT IS USED TO COMPLETE A REVIEW AND ESTABLISH RANGES TO BE USED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION C, LINE 19THE 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 -1,865,551. CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS 469,570.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHE 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 25DTHE 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.FUNDRAISING EXPENSES
WEBSITE EXPLANATIONON JUNE 30, 2010, CRIPPLED CHILDRENS HOSPITAL (CCH) AFFILIATED WITH THE VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM (VCUHS). CHILDRENS 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 THIS YEAR ARE LOCATED UNDER THE BROOK ROAD CAMPUS LINK AT THE BOTTOM OF THE PAGE.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY (VCUHS)
PO BOX 980152RICHMONDVA23298541848065PARENT - ACADEMIC MEDICAL CTR - MCV HOSPITALSVA501(C)(1)N/A0
MCV ASSOCIATED PHYSICIANS DBA MCV PHYSICIANS
PO BOX 980620RICHMONDVA232980510541581185GROUP PRACTICE OF PROFESSIONALS SUPPORTING MEDICAL TEACHINGVA501(C)(3)0LINE 11A, IVCUHS
UNIVERSITY HEALTH SERVICES INC (UHS)
PO BOX 980152RICHMONDVA23298541790550SUPPORT EDUCATIONAL & SCIENTIFIC ACTIVITIES OF VIRGINIA COMMONWEALTH UNIV.VA501(C)(3)0LINE 11A, IVCUHS
UHS MANAGED CARE INC
PO BOX 980152RICHMONDVA23298541790554PROVIDE HEALTHCAREVA501(C)(3)0LINE 9UHS
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeCTransactionType
Amount Involved6200919AmountInvolved
Method Of Amt DeterminationCASH TRANSFERMethodOfAmtDetermination

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