2012-08-10T15:19:49-05:00 2011-09-30 COHEN RUTHERFORD KNIGHT PC 6903 ROCKLEDGE DRIVE SUITE 500 BETHESDA MD 208171800 990 2010-10-01 540573701 The Fauquier Hospital Incorporated FAUQ 5403165000 500 Hospital Drive Warrenton VA 20186 RODGER BAKER 2012-08-09 3018281008 2010 2016-02-24 21:20:13Z Rodger H Baker 500 Hospital Dr Warrenton VA 20186 141404873 false X www.fauquierhealth.org X 1954 VA OUR MISSION IS TO RESTORE, PROMOTE AND MAINTAIN THE HEALTH OF THE COMMUNITY. 13 13 1157 365 54051 -144786 0 739 121835973 135106090 2283146 6297504 217951 540 124337070 141404873 0 0 0 0 59438034 60091209 0 0 0 59422697 67538676 118860731 127629885 5476339 13774988 204784691 214669766 92882608 94444376 111902083 120225390 OUR MISSION IS TO RESTORE, PROMOTE AND MAINTaiN THE HEALTH OF THE COMMUNITY. false false 99074930 0 135052579 THE COMMUNITY BENEFIT CONTRIBUTION OF FAUQUIER HOSPITAL INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. IN ORDER TO PORTRAY THE FULL BREADTH OF OUR CONTRIBUTION, OUR COMMUNITY BENEFIT INFORMATION IS DESCRIBED BELOW: 1. ORGANIZATIONAL COMMITMENT TO PROVIDING COMMUNITY BENEFIT: THE FAUQUIER HOSPITAL, INC. (FH) IS A 97-BED, NOT-FOR-PROFIT, ACUTE CARE FACILITY ESTABLISHED IN 1954 TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES FOR THE COMMUNITIES IT SERVES. OUR MISSION IS TO RESTORE, PROMOTE AND MAINTAIN THE HEALTH OF OUR COMMUNITY. FH IS THE ONLY HOSPITAL IN OUR PRIMARY SERVICE AREA OF FAUQUIER COUNTY WITH A POPULATION OF 80,417. OUR SERVICE AREA IS GROWING AND AGING, WITH OVERALL PROJECTED GROWTH BETWEEN 2010-2015 OF 8.6% AND WITH THE 45+ POPULATION COMPRISING 45.37% OF THE TOTAL IN 2015. TO ADDRESS THE GROWING AND CHANGING HEALTH CARE NEEDS RESULTING FROM THESE POPULATION CHANGES, FH: ADDED SIX EMPLOYED PHYSICIANS TO THEIR STAFF, AN ENDOCRINOLOGIST, AN OBSTETRICS/GYNECOLOGIST AND THREE FAMILY MEDICINE PHYSICIANS; IMPLEMENTED A HOME HEALTH DISEASE MANAGEMENT TRAINING PROGRAM (TO INCLUDE CONGESTIVE HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND DIABETES) FOR PATIENTS; DEVELOPMENT OF A TRANSITIONS TO HOME PROGRAM THAT ADDRESSES CHRONIC DISEASE MANAGEMENT AND READMISSION RATES FOR PATIENTS; FEASIBILITY STUDIES FOR A NEONATAL INTENSIVE CARE UNIT AND AN AMBULATORY SURGERY CENTER. THROUGH PARTNERSHIPS WITH OTHER HEALTH CARE ORGANIZATIONS WE OPERATE A RETAIL HOME HEALTH SUPPLIES STORE AND A CANCER CENTER. WE ALSO PARTNER WITH LOCAL NON-PROFIT ORGANIZATIONS (E.G. FAUQUIER FREE CLINIC, THE CHAMBER OF COMMERCE, SCHOOLS AND CHURCHES) AND NATIONAL ORGANIZATIONS (E.G. THE AMERICAN CANCER SOCIETY) TO SUPPORT LOCAL EVENTS AND PROVIDE COMMUNITY HEALTH AND WELLNESS PROGRAMS. THESE COMMUNITY BENEFITS ACTIVITIES ARE COORDINATED BY TWO FULL-TIME COMMUNITY OUTREACH STAFF, SUPPORTED BY ADMINISTRATIVE AND CLINICAL DEPARTMENTS, AND OUR AUXILIARY VOLUNTEERS AS NEEDED. WE HAVE A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES FREE CARE FOR RESIDENTS OF FAUQUIER AND RAPPAHANNOCK COUNTIES WHO ARE WITHIN 200% OF THE FEDERAL POVERTY GUIDELINES. THE FINANCIAL ASSISTANCE PROGRAM ALSO PROVIDES FREE CARE TO PATIENTS WHO RESIDE IN OTHER AREAS WHO WITHIN 100% OF THE FEDERAL POVERTY GUIDELINES. ALL UNINSURED PATIENTS, REGARDLESS OF INCOME LEVEL OR COUNTY OF RESIDENCE, RECEIVE A 38% DISCOUNT ON HOSPITAL SERVICES AND THE OPTION FOR AN INTEREST-FREE PAYMENT PLAN FOR BALANCES. EVERY UNINSURED PATIENT IS CONTACTED EITHER DURING THEIR STAY OR THE DAY AFTER AN OUTPATIENT VISIT TO DISCUSS FINANCIAL NEEDS. PATIENTS WHO DO NOT MEET THE REQUIREMENTS FOR STATE FUNDING ARE GIVEN A FINANCIAL AID FORM AND ASSISTANCE WITH COMPLETING THE NECESSARY PAPERWORK. THROUGH THE CONTINUING CARE FUND, THE HOSPITAL OFFERS ASSISTANCE TO INDIVIDUALS WHO HAVE INADEQUATE FINANCIAL MEANS TO COVER THE COSTS OF POST-HOSPITALIZATION HEALTH SERVICES, SUCH AS NURSING CARE; THE COST OF THIS PROGRAM TO FH IN FY11 WAS $85,782. IN FY11, WE PROVIDED $3,929,775 IN FREE MEDICAL CARE, WHICH INCLUDES $208,827 OF CARE PROVIDED TO FREE CLINIC PATIENTS. 2. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION: FH OFFERS ALL PATIENTS IMPARTIAL ACCESS TO TREATMENT OR ACCOMMODATIONS THAT ARE AVAILABLE OR MEDICALLY INDICATED, REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, RELIGION, OR SOURCE OF PAYMENT FOR CARE. OUR 24-HOUR EMERGENCY DEPARTMENT IS OPEN TO EVERYONE IN THE COMMUNITY, REGARDLESS OF ABILITY TO PAY. WE HAVE AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN OUR AREA. THE MAJORITY OF THE MEMBERS OF OUR GOVERNING BODIES FOR BOTH OUR HOSPITAL AND HEALTH SYSTEM ARE INDEPENDENT REPRESENTATIVES OF THE COMMUNITIES WE SERVE. TO HELP TRAIN AND EDUCATE HEALTH CARE PROFESSIONALS, FH WORKS WITH LOCAL COMMUNITY COLLEGES TO PROVIDE TOURS, LECTURES, AND INTERNSHIPS FOR STUDENTS; FH STAFF PROVIDED APPROXIMATELY 17,800 HOURS AT A COST OF APPROXIMATELY $1,008,377. FH PARTICIPATES IN MEDICARE, MEDICAID, ANDCHAMPUS/TRICARE STANDARD. 3. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS: FAUQUIER FREE CLINIC (FFC). FFC PROVIDES PRIMARY HEALTH AND DENTAL CARE TO UNINSURED RESIDENTS OF FAUQUIER AND RAPPAHANNOCK COUNTIES. FH PROVIDED LABORATORY, CARDIOLOGY/NEUROLOGY/PULMONARY SERVICES, AND RADIOLOGY SERVICES AT NO CHARGE TO FCC PATIENTS FOR A TOTAL COST OF $208,827. ATOTAL OF 802 HOURS OF FREE CLINICAL CARE WERE PROVIDED BY COMMUNITY PHYSICIANS AND CLINICAL STAFF. TO HELP FFC EXPAND ITS SERVICES TO MEET THE NEEDS OF A GROWING POPULATION, FH LEASED A BUILDING IN APRIL 2006 TO THE FFC FOR $1 PER YEAR FOR 10 YEARS; THE RENTAL VALUE FY11 WAS $85,284. IN ADDITION, FH CONTRIBUTED $5,000 IN UNRESTRICTED FUNDS. COMMUNITY HEALTH EDUCATION, SCREENINGS AND OUTREACH PROGRAMS FAUQUIER HEALTH PROVIDED HEALTH EDUCATION AT 165 LOCAL EVENTS FOR 97,475 PEOPLE AND SPECIALIZED HEALTH SCREENINGS FOR 1,311 PEOPLE. FH ALSO OFFERS TOURS OF THE HOSPITAL AND SPEAKERS FOR LOCAL SCHOOLS AND COMMUNITY ORGANIZATIONS TO BUILD RELATIONSHIPS WITHIN THE COMMUNITY, PROMOTE COLLABORATION IN MANAGING HEALTH AND WELLNESS, AND EDUCATE THE COMMUNITY ON THE HEALTH SYSTEM. THE TOTAL COMMUNITY BENEFIT OF THESE SERVICES WAS $98,674.96 ONE OF SEVERAL FH PUBLICATIONS IS A COMMUNITY NEWSLETTER, HEALTHY HAPPENINGS, INTENDED TO EDUCATE THE PUBLIC ABOUT HEALTH ISSUES AND HEALTH CARE AND HOSPITAL SERVICES. PUBLISHED QUARTERLY, IT REACHES 94,000 HOMES IN FAUQUIER AND SURROUNDING COUNTIES. THE COST TO FH FOR PUBLICATION AND DISTRIBUTION OF THIS NEWSLETTER IN FY11 WAS $186,746. FH OFFERS ADAM, AN ONLINE ILLUSTRATED HEALTH ENCYCLOPEDIA, ON ITS WEBSITE. THE FY11 ANNUAL COST WAS $23,679. EMERGENCY SERVICES. FH PROVIDES MEDICAL OVERSIGHT, DIRECTION, AND ORDERS TO PARAMEDICS IN THE FIELD AND EN-ROUTE TO THE HOSPITAL. OUR EMERGENCY DEPARTMENT OFFERS 24-HOUR ACCESS TO MEDICAL SERVICES AND HELICOPTER TRANSPORT FOR CRITICALLY ILL OR INJURED INDIVIDUALS, AND ALSO RESTOCKS MEDICAL BOXES AND PROVIDES CLEAN LINENS FOR RESCUE SQUADS AT A COST TO THE HOSPITAL OF APPROXIMATELY $38,822. SUPPORT GROUPS AND COMMUNITY GROUPS. FH SPONSORED, ASSISTED, OR PROVIDED MEETING SPACE FOR FOUR SUPPORT GROUPS THAT MET WEEKLY OR MONTHLY. ADDITIONALLY, FH PROVIDED MEETING SPACE OR CASH DONATIONS FOR SEVERAL NON-PROFIT COMMUNITY GROUPS, (E.G. FAUQUIER FREE CLINIC AND PIEDMONT UNITED WAY). THE TOTAL VALUE OF THE MEETING SPACE IS $51,359. CASH DONATIONS TOTALED $25,939. FH EMPLOYEES PROVIDED REPRESENTATION ON COMMUNITY BOARDS AND COALITIONS AT AN EXPENSE OF $31,812. PHYSICIAN REFERRAL. THE HOSPITAL ASSISTED 3,000 PEOPLE WITH THE PHYSICIAN REFERRAL PROGRAM, WHICH HELPS THE COMMUNITY WITH QUESTIONS ON PHYSICIANS, APPOINTMENTS, CLASSES AND PROGRAMS REGISTRATION, AND HEALTH RESOURCES AVAILABLE THROUGH THE HOSPITAL OR IN THE COMMUNITY. IT COST FH $28,069 TO PROVIDE THIS SERVICE IN FY11. 4. LINKS TO ADDITIONAL COMMUNITY BENEFIT INFORMATION * FAUQUIER HOSPITAL WEBSITE - WWW.FAUQUIERHEALTH.ORG * FAUQUIER ASSISTANCE INFORMATIONN - http://www.fauquierhealth.org/patients.financial-assistance-policy QUANTIFIABLE COMMUNITY BENEFIT CHARITY CARE $3,928,484 GOVERNMENT SPONSORED HEALTH CARE $1,396,909 COMMUNITY BENEFIT PROGRAM $5,234,308 TOTAL QUANTIFIABLE COMM BENEFIT $10,559,701 99074930 true false false false false false false false true true false false true true false false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true false false false false true 103 0 true 1157 true true true false false false false false false false false false X 13 13 false false false false false false false true true false false true true true true true true true true false VA X DARRYL WHITE 5403165000 500 HOSPITAL DR Warrenton VA 20186 X RODGER BAKER 29.0 X X 458264 0 67084 MARSHALL DOELLER 3.0 X X 0 0 0 REV JENNINGS HOBSON 3.0 X 0 0 0 JOHN MCCARTHY 3.0 X 0 0 0 MIRIAM PORTER 3.0 X 0 0 0 ELISE WILKINS 3.0 X X 0 0 0 MARK VAN DE WATER 3.0 X 0 0 0 SUSAN RUBIN 3.0 X 0 0 0 WILBUR HEFLIN 3.0 X X 0 0 0 CAREN EASTHAM 3.0 X 0 0 0 MARY LEIGH MCDANIEL 3.0 X 0 0 0 ADAM WINICK MD 3.0 X 0 0 0 JOSHUA JAKUM MD 3.0 X 0 0 0 ROBIN GULICK 3.0 X 0 0 0 JEFFREY ABRAMS 3.0 X 0 0 0 LIONEL PHILLIPS 30.0 X 267139 0 28054 LINDA SHARKEY 40.0 X 203200 0 18387 KATHERINE REEVES 30.0 X 166956 0 5590 GREGORY BENGSTON 30.0 X 172596 0 20468 MARY SMITH 30.0 X 181816 0 12471 TRACY TURMAN 40.0 X 142877 0 16181 DARRYL WHITE 21.0 X 149844 0 12039 DONNA STATON 30.0 X 148019 0 23144 MARGARET ROWE 40.0 X 141857 0 11344 2032568 0 214762 41 false true false FAIR OAKS ANESTHESIA ASSOCIATES 3998 FAIR RIDGE DR STE 320 FAIRFAX VA 22033 HEALTH CARE 474000 PATHFINDER DIAGNOSTICS PLLC 17175 SPRINGS RD JEFFERSONTON VA 22724 HEALTH CARE 369854 HANCOCK DANIEL JOHNSON NAGLE PC PO BOX 72050 RICHMOND VA 232552050 LEGAL 318883 PULMONARY AND CRITICAL CARE SPEC OF 3650 JOSEPH SIEWICK DR 307 FAIRFAX VA 220331719 HEALTH CARE 291509 COHEN RUTHERFORD KNIGHT PC 6903 ROCKLEDGE DR 500 BETHESDA MD 20817 ACCOUNTING 157387 7 739 739 NET PATIENT REV 132419898 132419898 OTHER OPERATING 1506471 1506471 THERAPY SERVICES 1002743 1002743 OTHER MISC 123467 123467 LAB 621500 53511 53511 135106090 4655928 4655928 0 0 1641576 1641576 1641576 1641576 0 0 0 CATERING 722320 540 540 540 141404873 135052579 54051 6297504 0 0 0 0 1326498 0 1326498 0 0 47071491 36431221 10640270 0 1759199 1324224 434975 0 6443086 4849984 1593102 0 3490935 2627775 863160 0 12337 0 12337 0 761125 0 761125 0 69878 0 69878 0 0 0 0 0 0 0 110187 0 110187 0 734 0 734 0 411616 0 411616 0 1370284 400820 969464 0 2618227 0 2618227 0 0 0 0 0 2321131 2091119 230012 0 412672 120981 291691 0 0 0 0 0 0 0 0 0 3990508 3990508 0 0 0 9706091 7021940 2684151 607374 607374 0 BAD DEBT 11070591 11070591 0 0 BLOOD BANK 745802 745802 0 0 COLLECTION 1181452 74 1181378 0 CONTRACT 3946456 1827393 2119063 0 SUPPLIES AND DRUGS 19956688 19692503 264185 0 8245523 6272621 1972902 0 127629885 99074930 28554955 0 19815466 20738827 14220719 15540680 2142548 2695962 401893 774750 169885272 102247418 73544169 67637854 61498620 85047256 17713617 7869026 15447659 14365411 204784691 214669766 11672405 13684462 76250102 74998443 4960101 5761471 92882608 94444376 X 103851487 112536409 8050596 7688981 111902083 120225390 204784691 214669766 X 13774988 -5451681 X false true true X false X 8050596 739 -99088 250195 13071 7688981 7627551 699 648318 213797 12175 8050596 7434788 1135 442346 237296 13422 7627551 1.00000 false true true 584539 584539 75251260 29538786 45712474 2317853 1445973 871880 86071579 67273290 18798289 5660041 3989369 1670672 67637854 2002 BOND NET DISCOUNT 335676 2002 ISSUANCE COSTS 1475971 DUE FROM HEALTH DYNAMICS 188588 DUE FROM HEALTH SYSTEM 3466 DEPOSITS 106802 BOND FUNDS 10879987 DUE FROM VSM 17881 DUE FROM FHPS 54016 DUE FROM FHSF 41738 DUE FROM AFFILIATES 732455 2008 ISSUANCE COSTS 115021 CAPTIVE EQUITY 413810 14365411 0 DUE TO THIRD PARTY PAYERS 2115993 ACCRUED INTEREST PAYABLE 1975595 DUE TO AFFILIATES 1345253 CAPITAL LEASE 324630 5761471 Sch D Part XIV The Fauquier Hospital Endowment Fund (the Trust) is an irrevocable trust created by the Chichester DuPont System in 1959. A local bank was designated as the trustee and remits income from the Trust to the Hospital semiannually. The income may be employed by the Hospital to further its work in such manner as the Board of Trustees of the Hospital determines. true true true X false false true true false true true 3822397 3822397 0.03280 9089529 7944891 1144638 0.00980 12911926 7944891 4967035 0.04260 1106310 27159 1079151 0.00930 1018931 1018931 0.00870 6680803 3658464 3022339 0.02590 113889 113889 0.00100 8919933 3685623 5234310 0.04490 21831859 11630514 10201345 0.08750 357 357 171074 171074 0.00150 935 935 172366 172366 0.00150 true 4132424 1274135 27225605 40792495 -13566890 X true false 1 1 The Fauquier Hospital Incorporated

500 Hospital Drive Warrenton VA 20186

X X X The Fauquier Hospital Incorporated 1 Part I, Line 3c ALL UNINSURED PATIENTS, REGARDLESS OF INCOME LEVEL OR COUNTY OF RESIDENCE, RECEIVE A 38% DISCOUNT ON HOSPITAL SERVICES AND THE OPTION FOR AN INTEREST-FREE PAYMENT PLAN FOR BALANCES. IN ADDITION TO THIS REDUCTION, ALL PATIENTS WHO ARE RESIDENTS OF FAUQUIER OR RAPPAHANNOCK COUNTIES AND WHOSE ANNUAL HOUSEHOLD INCOME LEVELS ARE AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES AND HAVE NO OTHER SOURCE OF PAYMENT, ARE ELIGIBLE FOR FREE CARE IF THEY COMPLETE THE APPLICATION PROCESS WHICH INCLUDES THE NEED FOR VERIFICATION OF INCOME. ALL PATIENTS WHO ARE NON RESIDENTS OF FAUQUIER OR RAPPAHANNOCK COUNTIES AND WHOSE ANNUAL HOUSEHOLD INCOME LEVELS ARE AT OR BELOW 100% OF THE FEDERAL POVERTY GUIDELINES AND HAVE NO OTHER SOURCE OF PAYMENT, ARE ALSO ELIGIBLE FOR FREE CARE AFTER COMPLETING THE APPLICATION PROCESS, WHICH ALSO INCLUDES INCOME VERIFICATION. Part I, Line 6a Fauquier Health prepares its own community benefit report. Part I, Line 7 PART I, LINE 7G FAUQUIER HEALTH, AS PART OF ITS MEDICAL STAFF DEVELOPMENT PLAN, IDENTIFIES SPECIFIC PHYSICIAN SPECIALTY SHORTAGES IN THE COMMUNITY AND RECRUITS PHYSICIANS TO THE COMMUNITY TO PROVIDE PATIENT SERVICES IN THOSE AREAS OF IDENTIFIED COMMUNITY NEED. THE PHYSICIANS ARE EMPLOYED BY A WHOLLY OWNED HOSPITAL AFFILIATE, FAUQUIER HEALTH PHYSICIANS SERVICES, LLC. THE COST OF OPERATING THIS PHYSICIAN PRACTICE AND MAKING THESE SPECIALTIES AVAILABLE TO THE COMMUNITY WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY EXCEEDS THE REVENUE COLLECTED. THE NECESSARY SUBSIDY IS PROVIDED BY THE FAUQUIER HOSPITAL. THESE SPECIALTIES INCLUDED INFECTIOUS DISEASE, RHUMATOLOGY, NEUROLOGY, ENDOCRINOLOGY, OBSTETRICS, ONCOLOGY, ENT AND PRIMARY CARE. PART I, LINE 7, COLUMN F THE ORGANIZATION REMOVED THE BAD DEBT EXPENSE PRIOR TO CALCULATING THE PERCENTAGE OF TOTAL EXPENSE. Part II FAUQUIER HEALTH'S COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY IN THE FOLLOWING WAYS: COMMUNITY SUPPORT - FAUQUIER HEALTH HAS CREATED A DISASTER READINESS PLAN TO SUPPORT THE LOCAL COMMUNITY IN THE EVENT OF AN INCIDENT OF SIGNIFICANCE. IT IS ONE OF 14 MEMBERS OF THE NORTHERN VIRGINIA HOSPITAL ALLIANCE WHICH COORDINATES EMERGENCY PREPAREDNESS, RESPONSE AND RECOVERY ACTIVITIES FOR THE MEMBER HOSPITAL AND HEALTHCARE SYSTEMS IN COOPERATION WITH LOCAL, REGIONAL AND STATE RESPONSE PARTNERS. IN ADDITION, FAUQUIER HEALTH STOCKPILES MEDICAL, SURGICAL AND PHARMACEUTICAL SUPPLIES IN THE EVENT OF A COMMUNITY EMERGENCY. ENVIRONMENTAL IMPROVEMENTS - FAUQUIER HEALTH HOSTED A MEDICATION AND SHARPS COLLECTION EVENT ON APRIL 2, 2011, TO COLLECT UNWANTED PRESCRIPTION MEDICATIONS, VITAMINS, AND OVER-THE-COUNTER MEDICATIONS AND USED SHARPS FOR SAFE DISPOSAL. BY HOSTING THE EVENT FAUQUIER HEALTH PROVIDED SAFE DISPOSAL FOR 370 POUNDS OF MEDICATION AND 136 GALLONS OF SHARPS THAT COULD HAVE CONTAMINATED THE COMMUNITY'S GROUND WATER AS WELL AS THE LANDFILL. ECONOMIC DEVELOPMENT - FAUQUIER HEALTH LOANED THE USE OF THE CONFERENCE ROOMS TO THE FAUQUIER COUNTY ECONOMIC DEVELOPMENT OFFICE TO HOST A MEETING FOR COMMUNITY BUSINESSES. THE EVENT HELPS TO PROMOTE BUSINESS IN THE COMMUNITY THUS PROVIDING EMPLOYMENT, SALARIES AND BENEFITS FOR THE RESIDENTS. Part III, Line 4 THE HOSPITAL'S PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF ALLOWANCES FOR THE EXCESS OF CHARGES OVER THE PAYMENTS ON PATIENT ACCOUNTS TO BE RECEIVED FROM THIRD PARTY PAYERS (INCLUDING SELF-PAY PATIENTS), AS WELL AS THOSE AMOUNTS WRITTEN OFF TO CHARITY CARE. CHARITY CARE IS BASED ON A REVIEW OF THE PATIENT'S FINANCIAL CIRCUMSTANCES. IF A PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE, THERE ARE NO EFFORTS UNDERTAKEN TO COLLECT ON THE PATIENT'S ACCOUNT AND ANY COLLECTION EFFORTS COMMENCED PRIOR TO THE CHARITY CARE DETERMINATION ARE CEASED. THOSE PATIENT ACCOUNTS RECEIVABLE THAT HAVE NOT BEEN IDENTIFIED AS UNCOLLECTIBLE ARE REPORTED AS NET PATIENT SERVICE REVENUE. AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS RECORDED ON THOSE PATIENT ACCOUNTS RECEIVABLE, TO THE EXTENT THAT THOSE ACCOUNTS ARE ESTIMATED TO NOT BE COLLECTIBLE IN FUTURE PERIODS. ONCE IT HAS BEEN DETERMINED THAT A PATIENT ACCOUNT RECEIVABLE (OR SOME PORTION THEREOF) CANNOT BE COLLLECTED UPON, THE ORGANIZATION WRITES OFF THE PATIENT ACCOUNT (OR THE UNCOLLECTIBLE PORTION) AS A BAD DEBT. THE ORGANIZATION APPLIED ITS COST-TO-CHARGE RATIO, AS CALCULATED IN SCHEDULE H WORKSHEET 2, TO THE PATIENT CHARGES WRITTEN OFF TO BAD DEBT TO DETERMINE THE COST OF THE ORGANIZATION'S BAD DEBT FOR THE TAX YEAR. THE ORGANIZATON ESTIMATED THE AMOUNT OF ITS BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY BY DETERMINING THE PERCENTAGE OF FINANCIAL ASSISTANCE APPLICATIONS SENT TO PATIENTS THAT WERE NEVER COMPLETED (30%) AND MULTIPLYING THAT BY THE BAD DEBT EXPENSE (AT COST). Part III, Line 8 THE COSTING SOURCE IS THE MEDICARE COST REPORT AND THE METHODOLOGY IS MEDICARE ALLOWABLE COST TO MEDICARE REVENUES RECEIVED. THE ORGANIZATION'S MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. ALTHOUGH PROVIDING THE BEST POSSIBLE CARE TO OUR MEDICARE PATIENTS CREATES A FINANCIAL LOSS, PART OF THE MISSION OF OUR ORGANIZATION IS TO SERVE ELDERLY PATIENTS WITHIN THE COMMUNITY, AND WE BELIEVE PROVIDING SUCH CARE HAS CONTRIBUTED TO THE IMPROVEMENT OF COMMUNITY HEALTH. FURTHERMORE, BY PROVIDING THE BEST POSSIBLE CARE TO OUR MEDICARE PATIENTS, WE RELIEVE THE GOVERNMENT AND SURROUNDING OTHER HOSPITALS OF THE FINANCIAL BURDEN OF TREATING THESE PATIENTS INSURED BY THE MEDICARE PROGRAM. Part III, Line 9b THE ORGANIZATION HAS ADOPTED A WRITTEN DEBT COLLECTION POLICY. HOWEVER, AS CURRENTLY WRITTEN, THE POLICY DOES NOT CONTAIN PROVISIONS SPECIFICALLY WITH RESPECT TO COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. THE ORGANIZATION HAS RECENTLY AMEND ITS WRITTEN DEBT COLLECTION POLICY TO INCLUDE PROVISIONS COVERING THE ORGANIZATION'S COLLECTION PRACTICES FOR FINANCIAL ASSISTANCE PATIENTS. UNDER THE ORGANIZATION'S DEBT COLLECTION POLICY, AS SOON AS A PATIENT'S ELIGIBILITY FOR FREE CARE IS INDENTIFIED THROUGH THE FINANCIAL ASSISTANCE APPLICATION PROCESS, ALL BILLING OR COLLECTION EFFORTS CEASE AT THAT TIME. PATIENTS WHO DO NOT APPLY FOR FINANCIAL ASSISTANCE UNTIL THEIR ACCOUNTS HAVE BEEN TURNED OVER TO A THIRD PARTY FOR COLLECTION ARE NOT CHARGED ANY FEES IF THE PATIENT SUBSEQUENTLY QUALIFIES FOR FREE CARE. Part VI, Line 2, Needs Assessment FAUQUIER HEALTH ASSESSES THE HEALTH NEEDS OF THE COMMUNITY THROUGH COMMUNITY NEEDS ASSESSMENTS EVERY THREE YEARS. A COMMUNITY NEEDS ASSESSMENT IS A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL BEING OF THE COMMUNITY. IT SERVES AS THE BASIS FOR FAUQUIER HEALTH'S HEALTH ACTION PLANNING TO DEVELOP HEALTH POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS AND COLLABORATE WITH OTHER COMMUNITY HEALTHCARE PROVIDERS. A COMMUNITY HEALTH NEEDS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES. FAUQUIER HEALTH'S COMMUNITY NEEDS ASSESSMENT PROVIDES THE OPPORTUNITY TO: GAIN INSIGHTS INTO THE NEEDS AND ASSETS OF THE COMMUNITIES SERVED; IDENTIFY AND ADDRESSTHE NEEDS OF VULNERABLE POPULATIONS WITH THE COMMUNITY; ENHANCE HOSPITAL/COMMUNITY RELATIONSHIPS AND THE OPPORTUNITY FOR COLLABORATIVE COMMUNITY ACTION, INCLUDING INVOLVEMENT WITH COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES AND ADVISORY GROUPS; AND PROVIDE INFORMATION FOR COMMUNITY OUTREACH PLANNING. Part VI, Line 3, Patient education of eligibility for assistance NOTIFICATION OF FAUQUIER HOSPITAL'S CHARITY PROGRAM IS DISSEMINATED BY VARIOUS MEANS, INCLUDING NOTIFICATION OF CONTACT INFORMATION TO DISCUSS THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY ON EACH BILLING STATEMENT, NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT ALL POINTS OF PATIENT ACCESS, AND INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE ON THE ORGANIZATION'S WEBSITE. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY A PATIENT AT ANY POINT IN THE COLLECTION CYCLE. EVERY BILLING STATEMENT RECEIVED BY A PATIENT INCLUDES THE FOLLOWING LANGUAGE: "IN MEETING YOUR FINANCIAL OBLIGATIONS FOR THE CARE PROVIDED AT FAUQUIER HOSPITAL, WE ASK THAT YOU WORK WITH US ON ANY BILLS YOUR ARE HAVING DIFFICULTY PAYING. YOU WILL FIND OUR STAFF UNDERSTANDING AND EAGER TO HELP YOU." THIS MESSAGE IS FOLLOWED BY A LIST OF TELEPHONE NUMBERS THAT THE PATIENT MAY CALL TO REACH THE ORGANIZATION'S FINANCIAL COUNSELING STAFF. UPON REACHING THAT NUMBER, THE PATIENT IS PROMPTED TO SELECTIONS TO HELP THE PATIENT REACH THE STAFF MEMBER THAT IS MOST LIKELY TO BEST BE ABLE TO HELP THEM I.E.: UNINSURED, SPANISH SPEAKING, BILLING QUESTIONS, ETC. IN ADDITION, UNINSURED INPATIENTS AND THOSE WITH MEDICARE AND NO SECONDARY CARRIER ARE CONTACTED (USUALLY A PERSONAL VISIT IN THEIR HOSPITAL ROOM) BY AN EMPLOYEE OF ONE OF OUR PARTNERS, ADVANCED PATIENT AVOCACY (APA). THE APA PERSONNEL SCREEN THESE PATIENTS FOR ELIGIBILITY FOR ASSISTANCE FOR ANY APPLICABLE FEDERAL AND STATE PROGRAMS. IF THESE PATIENTS DO NOT MEET THE CRITERIA FOR THESE PROGRAMS, THEY ARE THEN REFERRED TO THE ORGANIZATION'S SELF PAY FINANCIAL COUNSELOR FOR SCREENING FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM. OUTPATIENTS WHOSE ACCOUNT BALANCE MEETS A THRESHOLD OF $750 ARE ALSO CONTACTED BY APA, BUT THESE CONTACTS ARE EITHER BY TELEPHONE OR LETTER.] UNINSURED PATIENTS THAT VISIT OUR EMERGENCY ROOM ARE GIVEN A PACKET THAT INCLUDES A FINANCIAL ASSISTANCE APPLICATION AND A BUSINESS CARD WITH THE NAME AND CONTACT INFORMATION FOR OUR FINANCIAL COUSELOR. THERE IS ALSO SIGNAGE IN OUR PATIENT ACCESS AREAS THAT REMIND PATIENTS THAT WE DO HAVE FINANCIAL COUNSELORS AVAILABLE IN PERSON AND BY PHONE TO ASSIST THEM. Part VI, Line 4, Community Information THE FAUQUIER HOSPITAL, INC. (FH) IS A 97-BED, NOT-FOR-PROFIT, ACUTE CARE FACILITY ESTABLISHED IN 1954 TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES TO THE RURAL COMMUNITIES IT SERVES. OUR MISSION IS TO RESTORE, PROMOTE AND MAINTAIN THE HEALTH OF OUR COMMUNITY. FAUQUIER HOSPITAL IS THE ONLY HOSPITAL IN OUR PRIMARY SERVICE AREA, WHICH INCLUDES FAUQUIER AND MINOR PORTIONS OF FIVE SURROUNDING COUNTIES. THE PRIMARY SERVICE AREA HAS A POPULATION OF 80,817. THE AVERAGE HOUSEHOLD INCOME IS $97,919. 7.3% OF THE COMMUNITY RESIDENTS HAVE INCOMES BELOW THE FEDERAL POVERTY GUIDELINE. 18.4% OF FAUQUIER HOSPITAL'S PATIENTS ARE MEDICAID RECIPIENTS OR SELF-PAY. THE FOLLOWING DISTRICTS WITHIN FAUQUIER COUNTY ARE CONSIDERED MUA/P BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA): LEE DISTRICT AND MARSHALL DISTRICT. Part VI, Line 5, Promotion of community health THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY BY DOING THE FOLLOWING: * ENSURING THAT THE MAJORITY (86%) OF THE INDIVIDUALS SERVING ON THE FAUQUIER HOSPITAL AND FAUQUIER HEALTH SYSTEM BOARD OF DIRECTORS RESIDE IN THE PRIMARY SERVICE AREA AND ARE NOT EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION, * EXTENDING MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY WHO ARE INTERESTED, * USING SURPLUS FUNDS TO: IMPROVE PATIENT CARE BY UPGRADING THE TOOLS NEEDED TO CARE FOR PATIENTS, UNDERTAKING ADDITIONAL PLANNING TO ENHANCE THE HOSPITAL'S CAPABILITY TO PROVIDE EFFECTIVE CARE TO THE COMMUNITY, AND PROVIDING EMERGENCY AND OTHER MEDICALLY NECESSARY CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION, THE ORGANIZATION PARTNERS WITH LOCAL NON-PROFIT ORGANIZATIONS (E.G. FAUQUIER FREE CLINIC, THE CHAMBER OF COMMERCE, SCHOOLS AND CHURCHES) AND NATIONAL ORGANIZATIONS (E.G. THE AMERICAN CANCER SOCIETY) TO SUPPORT LOCAL EVENTS AND PROVIDE COMMUNITY HEALTH AND WELLNESS PROGRAMS. THESE COMMUNITY BENEFITS ACTIVITIES ARE COORDINATED BY TWO FULL-TIME COMMUNITY OUTREACH STAFF, SUPPORTED BY ADMINISTRATIVE AND CLINICAL DEPARTMENTS, AND OUR AUXILIARY VOLUNTEERS AS NEEDED. TO HELP TRAIN AND EDUCATE HEALTH CARE PROFESSIONALS, THE ORGANIZATION WORKS WITH LOCAL COMMUNITY COLLEGES TO PROVIDE TOURS, LECTURES, AND INTERNSHIPS FOR STUDENTS; THE ORGANIZATION'S STAFF PROVIDED APPROXIMATELY 17,800 HOURS AT A COST OF APPROXIMATELY $1,008,377. ADDITIONALLY, THE ORGANIZATION PROVIDES ASSISTANCE TO THE FAUQUIER FREE CLINIC ("FFC"). FFC PROVIDES PRIMARY HEALTH AND DENTAL CARE TO UNINSURED RESIDENTS OF FAUQUIER AND RAPPAHANNOCK COUNTIES. THE ORGANIZATION PROVIDED LABORATORY, CARDIOLOGY/NEUROLOGY/PULMONARY SERVICES, AND RADIOLOGY SERVICES AT NO CHARGE TO FCC PATIENTS FOR A TOTAL COST OF $208,827. A TOTAL OF 802 HOURS OF FREE CLINICAL CARE WAS PROVIDED BY COMMUNITY PHYSICIANS AND CLINICAL STAFF. TO HELP FFC EXPAND ITS SERVICES TO MEET THE NEEDS OF A GROWING POPULATION, FAUQUIER HEALTH LEASED A BUILDING IN APRIL 2006 TO THE FFC FOR $1 PER YEAR FOR 10 YEARS. THE RENTAL VALUE IN TAX YEAR 2010 WAS $85,284. IN ADDITION, THE ORGANIZATION CONTRIBUTED $5,000 IN UNRESTRICTED FUNDS. THE ORGANIZATION PROVIDED HEALTH EDUCATION AT 165 LOCAL EVENTS FOR 97,475 PEOPLE AND SPECIALIZED HEALTH SCREENINGS FOR 1,311 PEOPLE. THE ORGANIZATION ALSO OFFERS TOURS OF THE HOSPITAL AND SPEAKERS FOR LOCAL SCHOOLS AND COMMUNITY ORGANIZATIONS TO BUILD RELATIONSHIPS WITHIN THE COMMUNITY, PROMOTE COLLABORATION IN MANAGING HEALTH AND WELLNESS, AND EDUCATING THE COMMUNITY WITH RESPECT TO THE HEALTH SYSTEM. THE TOTAL COMMUNITY BENEFIT OF THESE SERVICES WAS $98,675. THE ORGANIZATION PUBLISHES A COMMUNITY NEWSLETTER, HEALTHY HAPPENINGS, INTENDED TO EDUCATE THE PUBLIC ABOUT HEALTH ISSUES AND HEALTH CARE AND HOSPITAL SERVICES. PUBLISHED QUARTERLY, IT REACHES 94,000 HOMES IN FAUQUIER AND SURROUNDING COUNTIES. THE COST TO FH FOR PUBLICATION AND DISTRIBUTION OF THIS NEWSLETTER IN TAX YEAR 2010 WAS $186,746. THE ORGANIZATION ALSO OFFERS ADAM, AN ONLINE ILLUSTRATED HEALTH ENCYCLOPEDIA, ON ITS WEBSITE FOR FREE. THE TAX YEAR 2010 COST WAS $23,679. THE ORGANIZATION PROVIDES MEDICAL OVERSIGHT, DIRECTION, AND ORDERS TO PARAMEDICS IN THE FIELD AND EN-ROUTE TO THE HOSPITAL. OUR EMERGENCY DEPARTMENT OFFERS 24-HOUR ACCESS TO MEDICAL SERVICES AND HELICOPTER TRANSPORT FOR CRITICALLY ILL OR INJURED INDIVIDUALS, AND ALSO RESTOCKS MEDICAL BOXES AND PROVIDES CLEAN LINENS FOR RESCUE SQUADS AT A COST TO THE HOSPITAL OF APPROXIMATELY $38,822. THE ORGANIZATON SPONSORED, ASSISTED, OR PROVIDED MEETING SPACE FOR FOUR SUPPORT GROUPS THAT MET WEEKLY OR MONTHLY. ADDITIONALLY, THE ORGANIZATION PROVIDED MEETING SPACE OR CASH DONATIONS FOR SEVERAL NON-PROFIT COMMUNITY GROUPS (E.G. FAUQUIER FRE CLINIC AND PIEDMONT UNITED WAY). THE TOTAL VALUE OF THE MEETING SPACE IS $51,359. CASH DONATIONS TOTALED $25,939. THE ORGANIZATION ASSISTED 3,000 PEOPLE WITH THE PHYSICIAN REFERRAL PROGRAM, WHICH HELPS THE COMMUNITY WITH QUESTIONS ON PHYSICIANS, APPOINTMENTS, CLASSES AND PROGRAMS REGISTRATION, AND HEALTH RESOURCES AVAILABLE THROUGH THE HOSPITAL OR IN THE COMMUNITY. IT COST THE ORGANIZATION $28,069 TO PROVIDE THIS SERVICE IN FY09. Part VI, Line 6, Affiliated health care system THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. THE ORGANIZATION OPERATES A 97-BED ACUTE CARE HOSPITAL, WHICH PROVIDES GENERAL MEDICAL AND SURGICAL SERVICES AND OPERATES A 24/7 EMERGENCY ROOM. THE HOSPITAL IS THE ONLY HOSPITAL IN THE PRIMARY SERVICE AREA OF FAUQUIER COUNTY. THE FAUQUIER HEALTH SYSTEM ALSO OPERATES A 113 BED NURSING HOME AND 67 RESIDENT ASSISTED LIVING FACILITY THROUGH ITS RELATED ORGANIZATION FAUQUIER HEALTH SENIOR LIVING, INC. ADDITIONALLY, THE SYSTEM OPERATES A NUMBER OF PHYSICIAN PRACTICES. THE SYSTEM IDENTIFIES SPECIFIC PHYSICIAN SPECIALTY SHORTAGES IN THE COMMUNITY AND EMPLOYS PHYSICIANS IN THOSE SPECIALTY AREAS TO PROVIDE SUCH CARE TO THE COMMUNITY. THE COST OF OPERATING THESE PHYSICIAN PRACTICES, THEREBY MAKING THESE SPECIALTIES AVAILABLE TO THE COMMUNITY (INCLUDING TO THOSE PATIENTS THAT DO NOT HAVE THE ABILITY TO PAY), FAR EXCEEDS THE REVENUE COLLECTED FROM PROVIDING THE SERVICES. AMONG THE SPECIALTIES PROVIDED BY THE PHYSICIAN PRATICES ARE INFECTIOUS DISEASE, RHUMATOLOGY, NEUROLOGY, ENDOCRINOLOGY, OBSTETRICS, ONCOLOGY, ENT AND PRIMARY CARE. IN THE 2010 TAX YEAR, THE SYSTEM ADDED SIX EMPLOYED PHYSICIANS TO ITS STAFF: AN ENDOCRINOLOGIST, AND OBSTETRICS/GYNECOLOGIST AND THREE FAMILY MEDICINE PHYSICIANS. ADDITIONALLY, THE SYSTEM IMPLEMENTED A HOME HEALTH DISEASE MANAGEMENT TRAINING PROGRAM (TO INCLUDE CONGESTIVE HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND DIABETES) FOR PATIENTS; DEVELOPED A TRANSITION TO HOME PROGRAM THAT ADDRESSES CHRONIC DISEASE MANAGEMENT AND READMISSION RATES FOR PATIENTS; AND UNDERTOOK FEASIBILITY STUDIES FOR A NEONATAL INTENSIVE CARE UNIT AND AN AMBULATORY SURGERY CENTER. Part VI, Line 7, State filing of community benefit report The Commonwealth of Virginia does not require hospitals to file a community benefit report. X X X X X false true false false false true false false false RODGER BAKER 368051 0 43884 0 46329 0 60540 0 6544 0 525348 0 LIONEL PHILLIPS 216337 0 20220 0 30582 0 20236 0 7818 0 295193 0 LINDA SHARKEY 169303 0 23332 0 10565 0 6860 0 11527 0 221587 0 MARY SMITH 143365 0 15960 0 22491 0 6245 0 6226 0 194287 0 KATHERINE REEVES 142463 0 15902 0 8591 0 5396 0 194 0 172546 0 GREGORY BENGSTON 144294 0 14058 0 14244 0 6205 0 14263 0 193064 0 TRACY TURMAN 121427 0 14127 0 7323 0 1962 0 14219 0 159058 0 DARRYL WHITE 136350 0 13334 0 160 0 5829 0 6210 0 161883 0 DONNA STATON 134276 0 13637 0 106 0 5746 0 17398 0 171163 0 MARGARET ROWE 132450 0 8968 0 439 0 5140 0 6204 0 153201 0 net earnings line 6 Fauquier Hospital has a "Management Performance Incentive Program" (MPIP) under which we award $ to our Director Team for accomplishing a pre-determined, measurable set of tasks related to clinical quality outcomes, patient satisfaction, community outreach and positive operating margins. nonqualified retirement plan line 4b FAUQUIER HOSPITAL MAINTAINED A SECTION 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EMPLOYEES. DURING THE 2010 TAX YEAR. THOSE EMPLOYEES THAT PARTICIPATED IN THE SECTION 457(F) PLAN WERE PERMITTED DEFERRALS INTO THE PLAN (THAT IS, NO CONTRIBUTIONS WERE MADE BY THE CORPORATION). RODGER BAKER $48,297 LIONEL PHILLIPS $10,807 Industrial Development Authority Fauquier County 546001274 312066BXO 2008-02-13 22825000 hospital building improvements false false false 0 0 23002992 1348704 0 0 454104 0 0 21200184 0 0 2009 false false true true false false false false false 0.00000 0.00000 0.00000 true false false false true BB&T CO 5.17 true false false 990 Review Process Part VI, Line 11 The organization prepares the Form 990 with assistance from an outside accounting firm. Once a draft of the Form 990 is completed, it is submitted to management of the organization for review and comments. After incorporating changes from management, materially complete draft Forms 990 are made available to the Board of the organization, as well as presented by the outside accounting firm to the organization's Audit & Finance Committee. Comments or questions received from the Board are incorporated into a final Form 990, which is signed by the Persident/CEO of the Fauquier Health System, Rodger Baker. CONFLICTS MONITORING AND ENFORCEMENT PART VI, LINE 12C Under the Conflict of Interest Policy, all Board members, management, and key employees complete an annual disclosure form regarding business relationships that he or she, or any family member, has with any other company that does business with the organization, as well as any business relationships between and among the Board members, management, and key employees. The annual disclosure statements are reviewed by independent legal counsel, the corporate compliance officer, and the audit and compliance committee, who are ultimately responsible if a conflict exists. Any such conflicts would be reported to the full Board. In addition, any person who is covered by the Conflict of Interest Policy has an ongoing obligation to disclose the existence of any actual or potential conflict to the Board or the Board Committee in which the matter arises. Finally, the organization monitors Board member eligibility for any potential conflicts, in order to avoid such conflicts from occurring in the first place. PROCESS FOR DETERMINING COMPENSATION PART VI, LINE 15 THE ORGANIZATION UTILIZES A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE OFFICER COMPENSATION. DOCUMENT AVAILABILITY PART VI, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. net assets reconciliation part xi, line 5 perm rest invest unrealized loss $ (541,737) equity transfers 560,262 unrealized loss on investments (5,577,379) net assets released for property 14,573 net assets released 92,601 rounding (1) ------------- $(5,451,681) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RODGER BAKER TITLE:PRESIDENT/CEO HOURS:11 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARSHALL DOELLER TITLE:VICE CHAIRMAN/CHAIRMAN HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:REV JENNINGS HOBSON TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN MCCARTHY TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MIRIAM PORTER TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ELISE WILKINS TITLE:SECRETARY/TREASURER HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARK VAN DE WATER TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SUSAN RUBIN TITLE:TRUSTEE HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILBUR HEFLIN TITLE:CHAIRMAN HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CAREN EASTHAM TITLE:TRUSTEE HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARY LEIGH MCDANIEL TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ADAM WINICK MD TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOSHUA JAKUM MD TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROBIN GULICK TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JEFFREY ABRAMS TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:LIONEL PHILLIPS TITLE:VP FINANCE/CFO HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:LINDA SHARKEY TITLE:VP PATIENT CARE/CNE HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KATHERINE REEVES TITLE:VP HUMAN RESOURCES HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GREGORY BENGSTON TITLE:VP BUS DEV & PROF SERVICES HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARY SMITH TITLE:VICE PRESIDENT SENIOR SERVICES HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:TRACY TURMAN TITLE:VP SUPPORT SERVICES HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DARRYL WHITE TITLE:CONTROLLER HOURS:19 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DONNA STATON TITLE:DIRECTOR INFO SYSTEMS/CIO HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARGARET ROWE TITLE:DIRCTOR PHARMACY HOURS: FAUQUIER HEALTH SYSTEM INC 500 HOSPITAL DR WARRENTON VA 20186 541416705 MGMT COORDINA VA 501(c)(3) 509(A)(3) NONE FAUQUIER HEALTH FOUNDATION INC 500 HOSPITAL DR WARRENTON VA 20186 300219424 FUNDRAISING VA 501(c)(3) 509(A)(1) FAUQ HLTH SY FAUQUIER HEALTH SENIOR LIVING INC 500 HOSPITAL DR WARRENTON VA 20186 541416703 SKILLED CARE VA 501(c)(3) 509(A)(2) FAQ HLTH SYS false true true false false false false false true true true true true true false false false false