VCU HEALTH CHILDRENS SERVICES AT BROOK ROAD: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
VCU HEALTH CHILDRENS SERVICES AT BROOK ROAD (EIN 54-0506309)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-14
IRS object ID
201231359349301743
Schema version
2010v3.4
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)
Timestamp2012-05-14T10:19:00-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

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 Date2010-07-01TaxPeriodBeginDate

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 Signed2012-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCHRISTOPHER T BENNETT CPAName
Phone8042827636Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S HOSPITALBusinessNameLine1
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 Receipts27220060GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CHILDRENSHOSP-RICHMOND.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1920YearFormation
State Legal DomicileVAStateLegalDomicile
Activity Or Mission DescriptionSEE SCHEDULE O CRIPPLED CHILDREN'S HOSPITAL IS A RESOURCE AND PROVIDER OF SPECIALIZED MEDICAL AND THERAPEUTIC SERVICES CUSTOMIZED TO MEET THE SPECIFIC NEEDS OF CHILDREN AND THEIR FAMILIES. NEARLY 8,000 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 Employees377TotalNbrEmployees
Total Nbr Volunteers107TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year959016ContributionsGrantsPriorYear
Contributions Grants Current Year759903ContributionsGrantsCurrentYear
Program Service Revenue Prior Year24478110ProgramServiceRevenuePriorYear
Program Service Revenue CY26383453ProgramServiceRevenueCY
Investment Income Prior Year15944InvestmentIncomePriorYear
Investment Income Current Year4010InvestmentIncomeCurrentYear
Other Revenue Prior Year187434OtherRevenuePriorYear
Other Revenue Current Year37996OtherRevenueCurrentYear
Total Revenue Prior Year25640504TotalRevenuePriorYear
Total Revenue Current Year27185362TotalRevenueCurrentYear
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 Year18989548SalariesEtcPriorYear
Salaries Etc Current Year21985911SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7844879OtherExpensePriorYear
Other Expenses Current Year7458753OtherExpensesCurrentYear
Total Expenses Prior Year26834427TotalExpensesPriorYear
Total Expenses Current Year29444664TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1193923RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2259302RevenuesLessExpensesCY
Total Assets BOY20430682TotalAssetsBOY
Total Assets EOY18978176TotalAssetsEOY
Total Liabilities BOY8942630TotalLiabilitiesBOY
Total Liabilities EOY8100730TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY11488052NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY10877446NetAssetsOrFundBalancesEOY
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. NEARLY 8,000 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
Expense8702171Expense
Revenue10453779Revenue
DescriptionIN THE FALL OF 2008 THE HOSPITAL COMPLETED A $5.8 MILLION RENOVATION/EXPANSION OF THE INPATIENT TRANSITIONAL CARE UNIT. THE UNIT NOW HAS 47 BEDS AND PROVIDES LONG TERM CARE FOR CHILDREN UP TO THE AGE OF 21 WHO REQUIRE SPECIALIZED ROUND THE CLOCK NURSING CARE. THE UNIT HAD 39 RESIDENTS AS OF JUNE 30, 2011. THIS IS AN INCREASE FROM THE 23 RESIDENTS JUST TWO YEARS PRIOR. THE HOSPITAL'S TRANSITIONAL CARE UNIT WAS THE RECIPIENT OF THE 2011 VIRGINIA HEALTH CARE ASSOCIATION'S COMMUNITY INVOLVEMENT SPECIAL EVENT AWARD FOR THE HOSPITAL'S EDUCATION PROGRAM'S PERFORMANCE OF THE WIZARD OF OZ.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense8147918Expense
Revenue9874521Revenue
DescriptionTHE HOSPITAL IS THE PREMIER PROVIDER OF OUTPATIENT PEDIATRIC PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY IN CENTRAL VIRGINIA. OUTPATIENT THERAPY VISITS APPROXIMATED 72,000 IN FISCAL YEAR 2011 WHICH IS AN INCREASE OF 11% FROM THE PRIOR YEAR. THERAPY SERVICES ARE OFFERED AT THE MAIN HOSPITAL AND AT FOUR THERAPY CENTERS LOCATED IN GLEN ALLEN, BON AIR, FREDERICKSBURG, AND PETERSBURG. THE COMMUNITY THERAPY CENTERS NOW ACCOUNT FOR 62% OF ALL THERAPY SERVICES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense2478357Expense
Revenue3847077Revenue
DescriptionDENTAL PROGRAM SERVICES ARE PROVIDED FOR THE TYPICAL WELL-CHILD AND FOR CHILDREN WITH SPECIAL NEEDS. THE HOSPITAL'S DENTAL PROGRAM CONTINUED TO GROW IN FISCAL YEAR 2011 WITH 733 OUTPATIENT SURGERIES COMPLETED. THIS REPRESENTS AN INCREASE OF 5% OVER THE PRIOR YEAR. DURING THE SAME TIME, THE DENTAL CLINIC VISITS INCREASED BY 9%. THE DENTAL PROGRAM CONTINUES WITH A DENTAL OUTREACH PROGRAM TO TAKE IMPORTANT DENTAL EDUCATION AND MATERIALS TO AREA ELEMENTARY SCHOOLS. DURING THE 2010-2011 SCHOOL YEAR, THE DENTAL OUTREACH PROGRAM HAS PROVIDED SUPPLIES AND INSTRUCTION TO 9,811 CHILDREN IN 84 SCHOOLS. THE PROGRAM WAS DESIGNED BY THE HOSPITAL AND THE VIRGINIA DEPARTMENT OF HEALTH-DENTAL DIVISION TO MEET THE STANDARDS OF LEARNING (SOL) HEALTH REQUIREMENT.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense3453632Expense
Revenue2205309Revenue
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 Exp3453632TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev2205309TotalOfOtherProgramServiceRev
Total Program Service Expense22782078TotalProgramServiceExpense
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 Stmt1IndependentAuditFinancialStmt
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
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109642NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees377NumberOfEmployees
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 Line1JIM DEYARMINBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8042285874TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12924 BROOK ROADAddressLine1
CityRICHMONDCity
StateVAState
ZIP Code232201298ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
THOMAS S CAIN
CHAIRMAN1.00XX000
PONJOLA CONEY MD
SECRETARY1.00XX0571730
LINDA E PEARSON
VICE CHAIR AND TREASURER1.00XX032856523374
JOHN F DUVAL
DIRECTOR - EX-OFFICIO1.00X060334027234
SHELDON M RETCHIN MD
DIRECTOR - EX-OFFICIO1.00X02598418239
BRUCE K RUBIN MD
DIRECTOR - EX-OFFICIO1.00X031408022000
ANN E HONEYCUTT
DIRECTOR1.00X000
HENRY L VALENTINE III
DIRECTOR1.00X000
JOHN D WARD MD
DIRECTOR - EX-OFFICIO1.00X04027050
LESLIE G WYATT
EXECUTIVE DIRECTOR45.00X356533030840
SAMUEL G WEIDMAN
EVP/CFO45.00X352823028087
SHARON W DARBY
VP OF CLINICAL OPERATIONS45.00167500012844X
KAREN A BENNETT
VP OF HUMAN RESOURCES45.00170752015818X
SATISH K MAHAJAN MD
PHYSICIAN45.00165773018090X
ELIZABETH B BORTELL DDS
DENTIST45.00174015032287X
JIM A DEYARMIN
CONTROLLER45.00106139011743X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1493535TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1965704TotalReportableCompFrmRltdOrgs
Total Other Compensation230556TotalOtherCompensation
Number Individuals GT100 K7NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MCV PHYSICIANS
PO BOX 79203BALTIMOREMD212790203CONTRACT PHYSICIANS429083
ARKANSAS COUNTRY ANESTHESIA
48180 KIPPER DRIVEMOSELEYVA23120ANESTHESIA SERVICES297500
TROUTMAN SANDERS LLP
PO BOX 933652ATLANTAGA311933652LEGAL SERVICES283035
HOLLY C LEWIS
2008 STEEPLECHASE PKWYGOOCHLANDVA23063CONTRACT DENTIST127685
MEDSITES LLC
PO BOX 127SPOTSYLVANIAVA22553CONSTRUCTION SERVICE106561
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
All Other Contributions759903AllOtherContributions
Total Contributions759903TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
PATIENT SERVICES6230002635480926354809
INFANT SERVICES6216101700417004
RESEARCH REVENUE54170010845$10,845
DENTAL PROFESSIONAL OT623000795795
FieldValueIRS element (for citing)
Total Program Service Revenue26383453TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column8877TotalRevenueColumn
Exclusion$8,877ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real12600Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real12600Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column12600TotalRevenueColumn
Exclusion$12,600ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other8800Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other13667Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-4867Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-4867TotalRevenueColumn
Exclusion-$4,867ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory24693GrossSalesOfInventory
Cost Of Goods Sold21031CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column3662TotalRevenueColumn
Exclusion$3,662ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
MED RECORDS FEE62300080788078
MISCELLANEOUS9000997967$7,967
MISCELLANEOUS6243102758$2,758

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column2931TotalRevenueColumn
Exclusion$2,931ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue21734TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column27185362TotalRevenueColumn
Related Or Exempt Function Income26380686RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$44,773ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1027893Total
Program Services770920ProgramServices
Management And General256973ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total16257635Total
Program Services13424415ProgramServices
Management And General2833220ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1283486Total
Program Services1021860ProgramServices
Management And General261626ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2173457Total
Program Services1841647ProgramServices
Management And General331810ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1243440Total
Program Services1036730ProgramServices
Management And General206710ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total267648Total
Management And General267648ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total16227Total
Management And General16227ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total61980Total
Management And General61980ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1857565Total
Program Services1469640ProgramServices
Management And General387925ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total158951Total
Program Services2101ProgramServices
Management And General156850ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2575272Total
Program Services1901368ProgramServices
Management And General673904ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total226710Total
Program Services33050ProgramServices
Management And General193660ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total836306Total
Program Services363771ProgramServices
Management And General472535ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total44810Total
Program Services31925ProgramServices
Management And General12885ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total93176Total
Program Services70509ProgramServices
Management And General22667ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1072317Total
Program Services804238ProgramServices
Management And General268079ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total200515Total
Management And General200515ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
DUES & LICENSES37452912328329
MISCELLANEOUS98247819043

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total29444664Total
Program Services22782078ProgramServices
Management And General6662586ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1260804BOY
EOY1756318EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1005507BOY
EOY2927EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2842904BOY
EOY3080504EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY159790BOY
EOY167051EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY266897BOY
EOY97272EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis38051768LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec27220188LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY11648485BOY
EOY10831580EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3246295BOY
EOY3042524EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY20430682BOY
EOY18978176EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2770128BOY
EOY2667281EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6172502BOY
EOY5433449EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8942630BOY
EOY8100730EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY8878105BOY
EOY7881171EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY557925BOY
EOY944253EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2052022BOY
EOY2052022EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11488052BOY
EOY10877446EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY20430682BOY
EOY18978176EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-2259302ReconcilationRevenueExpenses
Reconcilation Other Changes1648696ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
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 Balance2609947BeginningOfYearBalance
Contributions541132Contributions
Investment Earnings Or Losses605099InvestmentEarningsOrLosses
Other Expenditures759903OtherExpenditures
End Of Year Balance2996275EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

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

Current Year Minus2 Years CurrentYearMinus2Years

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 Balance0.68000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.32000TermEndowmentEOYBalance
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
Depreciation9708077Depreciation
Book Value7866204BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis477715OtherCostOrOtherBasis
Depreciation130236Depreciation
Book Value347479BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis19547190OtherCostOrOtherBasis
Depreciation16992630Depreciation
Book Value2554560BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis397668OtherCostOrOtherBasis
Depreciation389245Depreciation
Book Value8423BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings10831580TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
OTHER CURRENT ASSETS28006
EQUITY INTEREST IN FOUNDATION NET ASSETS2996275
DUE FROM AFFILIATES6847
DEPOSITS11396
FieldValueIRS element (for citing)
Total Book Value Other Assets3042524TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
SETTLEMENTS DUE TO THIRD-PARTY PAYORS$1,654,814
PENSION LIABILITY$2,169,811
DUE TO AFFILIATES$1,311,752
OTHER LIABILITES$82,175
PATIENT CREDIT BALANCES$188,163
PATIENT ACCOUNT REFUNDS$22,559
UNCLAIMED CHECKS$4,175
FieldValueIRS element (for citing)
Total Of Amounts5433449TotalOfAmounts
Total Revenue27185362TotalRevenue
Total Expenses29444664TotalExpenses
Excess Or Deficit For Year-2259302ExcessOrDeficitForYear
Other$1,648,696OtherAmount
Total Adjustments1648696TotalAdjustments
Excess Or Deficit Per FS-610606ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt28859960TotRevenueEtcAuditedFinclStmt
Other Revenues2408603OtherRevenues
Revenue Not Rptd F9902408603RevenueNotRptdF990
Revenue Subtotal26451357RevenueSubtotal
Other Revenues Not Included734005OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt734005RevenueNotRptdOnFinStmt
Total Revenue Per Form99027185362TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt29470566TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal29470566ExpensesSubtotal
Other Expenses Not Included-25902OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-25902ExpensesNotRptdOnFinStmt
Total Expenses Per Form99029444664TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 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 $944,253 AND $557,925 AT JUNE 30, 2011 AND 2010, 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 $2,052,022 AT BOTH JUNE 30, 2011 AND 2010, 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 $759,903 AND $959,017 IN 2011 AND 2010, RESPECTIVELY, TO SUPPORT OPERATIONS OF THE HOSPITAL AND FOR THE PURCHASE OF CAPITAL ASSETS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND THE TAX STATUTES OF THE COMMONWEALTH OF VIRGINIA; ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE HOSPITAL HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2011. FISCAL YEARS ENDING ON OR AFTER JUNE 30, 2008 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE IN PLAN ASSETS AND BENEFIT OBLIGATION OF PENSION PLAN 1,262,368. CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS 386,328.
PART XII, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN PLAN ASSETS AND BENEFIT OBLIGATIONS OF PENSION PLAN 1,262,372. CHANGE IN EQUITY INTEREST OF FOUNDATION 1,146,231.
PART XII, LINE 4B - OTHER ADJUSTMENTS:LOSS ON SALE OF ASSET -4,867. SUNSHINE GIFT EXPENSES -21,031. GIFTS TRANSFERRED FROM CHF 759,903.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:LOSS ON SALE OF ASSET -4,867. SUNSHINE GIFTSHOP EXPENSES -21,035.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
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)
Total Community Benefit Expense10986TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense10986NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense13627063TotalCommunityBenefitExpense
Direct Offsetting Revenue12463776DirectOffsettingRevenue
Net Community Benefit Expense1163287NetCommunityBenefitExpense
Percent Of Total Expense0.03950PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense13638049TotalCommunityBenefitExpense
Direct Offsetting Revenue12463776DirectOffsettingRevenue
Net Community Benefit Expense1174273NetCommunityBenefitExpense
Percent Of Total Expense0.03990PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs141NumberOfActivitiesOrPrograms
Persons Served39180PersonsServed
Total Community Benefit Expense144557TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense144557NetCommunityBenefitExpense
Percent Of Total Expense0.00490PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs14NumberOfActivitiesOrPrograms
Persons Served2294PersonsServed
Total Community Benefit Expense147112TotalCommunityBenefitExpense
Net Community Benefit Expense147112NetCommunityBenefitExpense
Percent Of Total Expense0.00500PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served4098PersonsServed
Total Community Benefit Expense1744486TotalCommunityBenefitExpense
Direct Offsetting Revenue275192DirectOffsettingRevenue
Net Community Benefit Expense1469294NetCommunityBenefitExpense
Percent Of Total Expense0.04990PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs157NumberOfActivitiesOrPrograms
Persons Served45572PersonsServed
Total Community Benefit Expense2036155TotalCommunityBenefitExpense
Direct Offsetting Revenue275192DirectOffsettingRevenue
Net Community Benefit Expense1760963NetCommunityBenefitExpense
Percent Of Total Expense0.05980PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs157NumberOfActivitiesOrPrograms
Persons Served45572PersonsServed
Total Community Benefit Expense15674204TotalCommunityBenefitExpense
Direct Offsetting Revenue12738968DirectOffsettingRevenue
Net Community Benefit Expense2935236NetCommunityBenefitExpense
Percent Of Total Expense0.09970PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$83,866BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare38367AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare38367CostOfCareReimbursedByMedicare

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 Conducted0CHNAConducted
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy0NondiscrimEmergencyCarePolicy
No Emergency CareXNoEmergencyCare
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (10 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 CERTAIN PHYSICIAN CLINICS THAT MET THE DEFINITION OF A SUBSIDIZED HEALTHCARE SERVICE IS INCLUDED IN SUBSIDIZED HEALTHCARE SERVICES. DIRECT COST FOR THE SPECIALTY PHYSICIAN CLINICS WAS $1,070,426.
PART III, LINE 4: REVENUE FROM THE MEDICAID PROGRAM ACCOUNTED FOR APPROXIMATELY 69% OF THE HOSPITAL'S NET PATIENT SERVICE REVENUE FOR THE YEAR ENDED JUNE 30, 2011. 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. THE HOSPITAL DOES NOT ENTER INTO PAYMENT PLANS WHERE THE RESPONSIBLE PARTY IS ATTEMPTING TO RESOLVE OUTSTANDING BALANCES.
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 19D: FREE CARE IS PROVIDED TO ELIGIBLE PARTICIPANTS AT 100% OF FPG. BETWEEN 100% AND 200% OF FPG, PATIENTS ARE RESPONSIBLE FOR EITHER 10% OR 20% OF THEIR PATIENT BILL. PATIENTS CAN QUALITY FOR A 70% DISCOUNT WHEN THEY MEET CERTAIN REQUIREMENTS TO BE DEEMED MEDICALLY INDIGENT. THE HOSPITAL ALSO OFFERS A SELF-PAY RATE (APPROXIMATELY 40% OF CHARGES, SIMILAR TO WHAT MEDICAID PAYS) TO UNINSURED 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 6: SEE PART V EXPLANATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
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 (11 entries)

Base 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
0328565000000023374035193900
JOHN F DUVAL
0603340000000027234063057400
SHELDON M RETCHIN MD
025984100000008239026808000
BRUCE K RUBIN MD
0314080000000022000033608000
JOHN D WARD MD
040270500000000040270500
LESLIE G WYATT
302354042179012000015763015077038737301550300
SAMUEL G WEIDMAN
29974604347709600014150013937038091001387480
SHARON W DARBY
1592330826700091760366801803440940530
KAREN A BENNETT
16068101007100085200729801865700749510
SATISH K MAHAJAN MD
1657730000088750921501838630947700
ELIZABETH B BORTELL DDS
17401500000981002247702063020947560

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
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 ALLOTED FOR REIVEW COMMENTS BY THE BOARD MEMBERS.
ALL OFFICERS, TRUSTEES AND KEY EMPLOYEES SHALL DISCLOSE A POTENTIAL CONFLICT TO THE CHAIRMAN OF THE BOARD OR COMPLIANCE OFFICER FOR INVESTIGATION AND RESOLUTION. UPON APPOINTMENT TO THE BOARD OR EMPLOYMENT AND ANNUALLY THEREAFTER, OFFICERS, TRUSTEES AND KEY EMPLOYEES SHALL COMPLETE AN AFFIRMATION STATEMENT AND DISCLOSURE FORM FOR REVIEW BY THE BOARD.FORM 990, PART VI, SECTION B, LINE 12C
AN OUTSIDE CONSULTANT IS USED TO COMPLETE A REVIEW AND ESTABLISH RANGES TO BE USED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE REVIEW INCLUDES ALL SENIOR MANAGEMENT POSITIONS (CEO, EVP/CFO, VP OF CLINICAL OPERATIONS/CNO, VP OF HR AND COMPLIANCE OFFICER).FORM 990, PART VI, SECTION B, LINE 15
THE PUBLIC VIEWING DOCUMENT IS AVAILABLE FOR INSPECTION AT THE MAIN HOSPITAL LOCATION UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
TOTAL REPORTABLE COMPENSATION INCLUDES ONE TIME COMPENSATION PAYOUTS RECEIVED UNDER THE VCU AUTHORITY MERGER AGREEMENTS.FORM 990, PART VII, LINE 1B, COL (D)
CHANGES IN NET ASSETS OR FUND BALANCES:CHANGE IN PLAN ASSETS AND BENEFIT OBLIGATION OF PENSION PLAN 1,262,368. CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS 386,328. TOTAL TO FORM 990, PART XI, LINE 5: 1,648,696.FORM 990, PART XI, LINE 5:
THE BOARD HAS NOT CHANGED THE OVERSIGHT OF ITS PROCESS FOR THE ORGANIZATION'S AUDIT OR SELECTION OF THE INDEPENDENT ACCOUNTANT.FORM 990, PART XII, LINE 2C

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 & NSCIENTIFIC ACTIVITIES OF VIRGINIA COMMONWEALTH UNIVERVA501(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 Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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

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