2011-08-15T12:37:43-05:00 2010-09-30 COHEN RUTHERFORD KNIGHT PC 6903 ROCKLEDGE DRIVE SUITE 500 BETHESDA MD 208171800 990 2009-10-01 521366700 CULPEPER REGIONAL HEALTH SYSTEM CULP 5408298803 501 SUNSET LANE CULPEPER VA 227010592 H LEE KIRK JR 5408298803 2011-08-11 3018281008 2009 2016-02-24 21:20:13Z H LEE KIRK JR 501 SUNSET LANE CULPEPER VA 22701 3290794 false X www.CulpeperHospital.com X 1985 VA THE ORGANIZATION'S MISSION IS TO SUPPORT THE MISSION OF CULPEPER REGIONAL HOSPITAL. 12 11 0 0 0 0 2194171 338406 99805 1577366 1724033 318622 647287 708853 4665296 2943247 3000 11424 0 0 1158680 1323057 0 0 26835 1618738 1763765 2780418 3098246 1884878 -154999 25342641 24994875 365403 505646 24977238 24489229 THE ORGANIZATION'S MISSION IS TO SUPPORT THE MISSION OF CULPEPER REGIONAL HOSPITAL. false false 1875213 11424 2256909 POWELL WELLNESS CENTER, LLC, A WHOLLY-OWNED SUBSIDIARY AND DISREGARDED ENTITY, BEGAN OPERATIONS IN AUGUST 2007 AND OPERATES A WELLNESS CENTER CONSISTENT WITH, AND IN SUPPORT OF, THE MISSION OF CULPEPER MEMORIAL HOSPITAL. CRHS Foundation was organized & is operated for the pupose of soliciting, receiving, & administering gifts, grants & contributions for the benefit of Culpeper Memorial Hospital, DBA Culpeper Regional Hospital. CRHS manages real estate properties for the purpose of promoting the vision & mission of Culpeper Memorial Hospital, DBA Culpeper Regional Hospital. 1875213 true true false false false false false false false true false true false false false false false false true false false false true true false false false false false false false false false false false false true true true false false true 13 0 0 false false false false false true true false false false false 12 11 false false false false false false false true true false false true true true true true true true true false VA X H LEE KIRK JR 5408298803 501 SUNSET LANE CULPEPER VA 227010592 X CONSTANCE KINCHELOE 4.0 X 0 0 0 KARL BEIER MD 4.0 X 0 0 0 MICHAEL ARMM 5.0 X X 0 0 0 WILLIAM CANNON JR 4.0 X X 0 0 0 SALLY CANAVAN 4.0 X 0 0 0 TOM REYNOLDS MD 4.0 X X 0 0 0 CHARLES CRIST 2.0 X 0 0 0 DAVID JONES 2.0 X 0 0 0 H LEE KIRK JR 40.0 X X 0 403040 19822 C WAYNE HAWKINS 2.0 X X 0 0 0 H B SEDWICK 2.0 X 0 0 0 BREVARD WALLACE MD 2.0 X 0 0 0 SAMUEL MORGAN 40.0 X 0 196257 4662 JOHN G MAXWELL 40.0 X 0 178537 12721 0 777834 37205 0 false true false 0 15727 24943 15700 12500 269536 338406 PWC MEMBERSHIP DUES 1495971 1495971 PWC ASSESSMENT FEES 81395 81395 1577366 139306 139306 0 0 838117 345128 492989 492989 492989 179316 179316 179316 179316 11407 24943 2419 8988 0 0 PWC CAFE 20322 20322 PWC MISC INCOME 13918 13918 PWC KID'S CORNER 6158 6158 166478 166478 206876 2943247 2277231 318622 0 11424 11424 0 0 0 0 1109640 560026 549614 0 0 213417 141130 72287 0 0 2496 2496 24180 24180 0 0 22386 22386 0 102632 54532 47402 698 153738 120960 28533 4245 0 0 42593 29093 13500 0 0 18492 18492 0 0 410435 406992 3443 30981 28418 2563 UTILITIES 205350 204846 504 MINOR EQUIPMENT 7713 7713 REPAIRS AND MAINTENANCE 49886 49886 TRAINING 264 39 225 DUES AND SUBCRIPTIONS 8243 8243 684376 260154 402330 21892 3098246 1875213 1196198 26835 2166404 2197262 807921 633997 22270 16177 491781 243676 17749 8561 9822 16994 18609353 3499407 15172537 15109946 5408883 5821096 1241090 945822 4184 1344 25342641 24994875 184448 356485 13548 13914 167407 135247 365403 505646 X 23202942 23045685 1615526 1279359 158770 164185 24977238 24489229 25342641 24994875 X false true true X false X X X X false false false CULPEPER MEMORIAL HOSPITAL DBA CULPEPER REGIONAL HOSPITAL 540622371 03 true true true 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1825530 1825530 13073339 2441622 10631717 3099587 1041772 2057815 610897 16013 594884 15109946 0 DUE TO CMH 106708 ANNUITY PAYABLE LONG TERM 28539 135247 GOLF CLASSIC 36350 24943 11407 1731 688 0 36350 24943 11407 1731 688 2419 8988 true SCHOLARSHIPS 9 10906 nursing student uniforms 5 518 MONITORING THE USE OF GRANT FUNDS SCHEDULE I, PART I All requests for using donated funds must be approved prior to any purchases being processed. Monies expended for items that are not pre-approved for use (as outlined below) are subject to non-reimbursement by the Foundation. All requests shall be submitted on the Use of Donated Funds form (rev. 07/09) and must show approval by the appropriate Department Director, the VP/Sr.VP they report to (as identified in each fund by (), along with the CRH Foundation Executive Director. Requests of $5,000 or greater require an additional approval by the hospital CEO. A new fund may be created, with a minimum donation of $10,000, as per the Gift Acceptance Policies of the CRHF Board (rev. 08/07). false false false false false false false false false SAMUEL MORGAN 0 170613 0 25644 0 0 0 2869 0 1793 0 200919 H LEE KIRK JR 0 287344 0 100696 0 15000 0 6194 0 13628 0 422862 JOHN G MAXWELL 0 143340 0 35197 0 0 0 0 0 12721 0 191258 top managment compensation CRHS relies upon CMH, DBA Culpeper Regional Hospital, which uses an independent compensation consultant, written employment contract, compensation survey or study, and approval by board or compensation committee establish the compensation of the CEO. MONITORING CONFLICTS OF INTEREST PART VI, SECTION B, 12C In addition to the annual disclosure, each meeting of the Board begin with a voluntary verbal self-disclosure of any conflicts with any items on the agenda. As additional issues arise during the course of a meeting, a similar self-disclosure is expected to be made. Challenges by participants are encouraged if self-disclosures are not forth-coming. During the course of doing business, if conflicts are suspected by anyone, they are encouraged to notify the Chief Executive Officer of their suspicions. The CEO will investigate, employing legal counsel as necessary, and will resolve as appropriate. Ultimately it is the responsibility of the Chief Executive Officer and the Chairman of the Board to enforce the policy. REVIEWING THE 990 PART VI, LINE 11 The review of the CRHS 990 is performed by the Chief Financial Officer, a subcommittee of the Board of Directors, as appointed, and by the President & Chief Executive Officer, the latter being responsible for signing the 990. MAKING DOCUMENTS AVAILABLE PART VI, LINE 19 THIS ORGANIZATION MAKES THEIR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. POWELL WELLNESS CENTER 1005 GOLF DRIVE CULPEPER VA 22701 204803079 WELLNESS CENT VA 2108850 9977130 CRHS CULPEPER REGIONAL HOSPITAL 501 SUNSET LANE CULPEPER VA 22701 540622371 COMMUNITY HOS VA 501(C)(3) 170B1(A)III CRHS false false false false false false false false true false true false true true true false true false