2023-05-15T14:52:49+00:00 2022-06-30 346565596 ERNST & YOUNG US LLP 1101 NEW YORK AVENUE NW Washington DC 20005 990 2021-07-01 540551711 Community Memorial Hospital COMM 4344473151 1755 N MECKLENBURG AVE PO BOX 90 SOUTH HILL VA 23970 SHELDON BARR PRESIDENT 2023276000 2023-05-15 true SHELDON BARR 999009999 Amber Gazica P01391011 2023276000 2023-05-13 2021 2023-04-26 12:10:37Z SHELDON BARR 1755 N MECKLENBURG AVE PO BOX 90 SOUTH HILL VA 23970 128623380 false X WWW.VCU-CMH.ORG X 1954 VA TO PROVIDE EXCELLENCE IN THE DELIVERY OF HEALTHCARE. 14 10 1079 32 0 0 10843669 5126419 140028755 122569010 633057 754438 227657 173513 151733138 128623380 0 0 0 0 70608577 74339620 0 0 97285897 99298339 167894474 173637959 -16161336 -45014579 262351261 428867466 156216436 370420043 106134825 58447423 TO PROVIDE EXCELLENCE IN THE DELIVERY OF HEALTHCARE. false false 107962893 95032093 COMMUNITY MEMORIAL HOSPITAL (CMH) IS A VITAL COMPONENT OF THE SOUTHSIDE VIRGINIA AREA, PROVIDING QUALITY CARE TO OUR PATIENTS, SERVICING AS A VITAL PART OF THE SAFETY NET AND ENHANCING COMMUNITY HEALTH. OUR MISSION IS TO PROVIDE EXCELLENCE IN THE DELIVERY OF HEALTHCARE. WE ARE LED BY A VOLUNTEER 14 MEMBER BOARD OF DIRECTORS. CMH IS DESIGNATED AS A SOLE COMMUNITY HOSPITAL BY MEDICARE WHICH MEANS THAT WE ARE LOCATED IN A RURAL AREA AND 35 MILES FROM OTHER HOSPITALS. WE ARE ALSO DESIGNATED A DISPROPORTIONATE SHARE HOSPITAL BY MEDICARE WHICH MEANS THAT WE PROVIDE CARE TO A HIGHER LEVEL OF LOW-INCOME INDIVIDUALS. OUR PRIMARY SERVICE AREA OF MECKLENBURG COUNTY RANKS BELOW THE STATE AVERAGE IN PER CAPITA INCOME AND ABOVE THE STATE AVERAGE IN ESTIMATED TOTAL POPULATION IN POVERTY PERCENTAGE. WE OFFER A FULL SPECTRUM OF SERVICES TO THE COMMUNITY INCLUDING IN-PATIENT ACUTE CARE, POST-ACUTE, AND LONG-TERM CARE, OUT-PATIENT SERVICES, HOME HEALTH AND HOSPICE. OUR EMERGENCY DEPARTMENT SEES PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. WE OFFER FINANCIAL ASSISTANCE TO OUR UNINSURED PATIENTS. UNINSURED PATIENTS QUALIFYING WITH INCOME BELOW THE FEDERAL POVERTY LEVEL ARE OFFERED FREE CARE. UNINSURED PATIENTS WITH FAMILY INCOME UP TO 300% OF THE FEDERAL POVERTY LEVEL ARE OFFERED SLIDING SCALE DISCOUNTS. INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM IS POSTED ON OUR WEBSITE, POSTED IN ALL REGISTRATION WAITING AREAS, PROVIDED TO UNINSURED PATIENTS AT REGISTRATION AND INCLUDED AS A NOTE ON ALL STATEMENTS SENT TO UNINSURED PATIENTS. WE EMPLOY A FINANCIAL SPECIALIST WHOSE RESPONSIBILITY IS TO ASSIST UNINSURED PATIENTS WITH OUR FINANCIAL ASSISTANCE PROGRAMS AS WELL AS TO ASSIST THE PATIENTS WITH APPLYING AND QUALIFYING FOR OTHER COVERAGE SUCH AS DISABILITY OR MEDICAID. WITH THE HELP OF SEVERAL GRANTS, CMH HAS BEEN ABLE TO OFFER FREE MAMMOGRAMS AND BREAST EXAMS TO UNDERSERVED WOMEN IN THE AREA. AS THE GRANTS DO NOT COVER TOTAL PROGRAM EXPENSES, CMH MUST SUPPLEMENT THE COSTS TO PROVIDE THESE SERVICES TO THE COMMUNITY. AS A NOT FOR PROFIT ORGANIZATION, ANY SURPLUS FUNDS GO BACK INTO THE OPERATION OF THE HOSPITAL TO MAINTAIN THE FACILITY AND UPDATE EQUIPMENT AND TECHNOLOGY. CMH ALSO BELONGS TO AND SUPPORTS 8 CHAMBERS OF COMMERCE AND PARTICIPATES IN THEIR COMMUNITY EVENTS. OUR INVOLVEMENT HELPS SUPPORT COMMUNITY GROWTH AND WE SHARE MANY HEALTH RELATED EVENT NOTICES AT THESE MEETINGS. WE ALSO SUPPORT MANY OF THEIR SPECIAL EVENTS AND LOCATE WELLNESS AND SCREENING BOOTHS THERE HOSPITALS PLAY A CRITICAL ROLE IN THEIR COMMUNITY. AS MAJOR EMPLOYERS AND PURCHASERS, HOSPITALS ARE ENGINES OF ECONOMIC GROWTH AND STABILITY. A STRONG COMMUNITY HOSPITAL HELPS TO RECRUIT BUSINESS AND INDUSTRY TO THE AREA AND HELPS ATTRACT AND RETAIN COLLEGE GRADUATES AND SKILLED CRAFTSMEN. CMH IS THE LARGEST SINGLE EMPLOYER IN THE AREA PROVIDING JOBS AT A WIDE RANGE OF SKILL LEVELS FROM OVER 12 VIRGINIA AND NORTH CAROLINA LOCALITIES. CMH AND OUR EMPLOYEES PURCHASE GOODS AND SERVICES LOCALLY, CREATING INCOME AND JOBS FOR OTHER BUSINESSES IN THE COMMUNITY.BY PARTICIPATING ON THE TOWN REVITALIZATION COMMITTEE, CMH HAS BEEN ABLE TO PROVIDE SUPPORT TO EFFORTS TO MODERNIZE THE TOWN IN ORDER TO MAKE IT MORE ATTRACTIVE TO NEW BUSINESSES. BY PROVIDING JOBS IN THE REGION, RESIDENTS HAVE A BETTER OPPORTUNITY TO RECEIVE PREVENTATIVE CARE THROUGH THEIR HEALTH INSURANCE PROGRAMS. THE COMMUNITY IS ALSO INVESTED IN COMMUNITY MEMORIAL HOSPITAL. VOLUNTEERS ARE A VITAL PART OF OUR HEALTH CARE TEAM, GOVERNANCE AND FUNDRAISING. THE MEN AND WOMEN OF OUR AUXILIARY VOLUNTEER THOUSANDS OF HOURS EACH YEAR AND PROVIDE A WIDE RANGE OF SERVICES TO STRENGTHEN OUR HOSPITAL AND ENHANCE THE QUALITY OF CARE FOR PATIENTS AND FAMILIES. THE COMMUNITY ALSO SUPPORTS THE OPERATION OF CMH BY SUPPORT OF THE CMH FOUNDATION. THE CMH FOUNDATION IS ALSO LED BY A VOLUNTEER BOARD OF DIRECTORS AND AIMS TO RAISE FUNDS TO ALLOW OUR HOSPITAL TO OFFER THE BEST POSSIBLE CARE AND MAINTAIN STATE-OF-THE-ART FACILITIES AND TECHNOLOGIES TO BETTER SERVE OUR COMMUNITY. 31493134 0 17685723 CMH PHYSICIANS LLC: LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA, WE OPERATE THREE PRIMARY HEALTH PRACTICES THAT BRING NEEDED PRIMARY CARE SERVICES TO THE COMMUNITY. WE HAVE ALSO MADE THE DECISION TO OPERATE PRACTICES IN THE SPECIALTY AREAS OF CARDIOLOGY/PULMONARY SERVICES, EAR, NOSE & THROAT SERVICES, ORTHOPEDICS, PAIN MANAGEMENT, SURGICAL SERVICES, WOMEN'S HEALTH SERVICES, AND UROLOGY SERVICES AS THESE ARE SPECIALTY SERVICES OTHERWISE MIGHT NOT BE AVAILABLE FOR OUR COMMUNITY WITHOUT SIGNIFICANT TRAVEL. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS BUT RECRUITING TO A RURAL AREA COMES WITH MANY CHALLENGES. 8116449 9866579 THE HUNDLEY CENTER IS A 140 BED EXTENDED CARE FACILITY THAT PROVIDES INTERMEDIATE AND SKILLED NURSING CARE. OUR NURSING HOME IS PROUDLY ACCREDITED BY THE JOINT COMMISSION AND IS A MEDICARE AND MEDICAID CERTIFIED PROVIDER. TWENTY-FOUR HOUR NURSING CARE IS PROVIDED UNDER THE SUPERVISION OF PROFESSIONAL NURSES, AS WELL AS PHYSICIANS ON CALL AT ALL TIMES. FACILITY SERVICES INCLUDE NURSING CARE, PERSONAL CARE, SOCIAL WORK SERVICES, PLANNED ACTIVITY PROGRAMS, MAINTENANCE AND HOUSEKEEPING, PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY, DIETARY AND PHARMACY. 147572476 true true false true false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true true true false false true 2 0 true 1079 true false false false false false false false false false false false false X 14 10 false false false false true true true true true false false true true true true true true false false false VA X MIN CUMMINGS 8048270545 PO BOX 980152 RICHMOND VA 23298 CINDY PECHT CHAIR 1.0 0 X X 0 0 0 CLINT CLARY SECRETARY 1.0 0 X X 0 0 0 DON BRIGHT TREASURER 1.0 0 X X 0 0 0 JAY STAFFORD CHAIR 1.0 0 X X 0 0 0 WILLIAM WELLS JR DIRECTOR / VICE CHAIR 1.0 0 X X 0 0 0 CATHERINE PALMER MD DIRECTOR 1.0 46.0 X 0 237701 237701 CECIL SHELL DIRECTOR 1.0 0 X 0 0 0 DAVID CHELMOW MD DIRECTOR (JUL-MAR) 1.0 65.0 X 0 601965 33300 HARINDER DHINDSA MD DIRECTOR 1.0 50.0 X 0 506206 30381 KENDELE UNDERWOOD DIRECTOR 1.0 0 X 0 0 0 MICHAEL ELLIOTT DIRECTOR (JUNE 2022) 1.0 40.0 X 0 0 0 MIKE ROWE DIRECTOR 1.0 0 X 0 0 0 NINA HOBCROFT DIR (MAR-MAY) 1.0 40.0 X 0 485339 33007 RALPH CLARK MD DIRECTOR 1.0 64.0 X 0 272517 22620 THOMAS YACKEL MD DIRECTOR 1.0 64.0 X 0 613690 64468 WILLIAM WILKINSON DIRECTOR 1.0 0 X 0 0 0 W SCOTT BURNETTE PRESIDENT 40.0 0 X 474820 0 43224 BRYAN MOSORA DO PHYSICIAN 40.0 0 X 694947 0 35944 INDU SHIVARAM MD PULMONOLOGIST 40.0 0 X 606146 0 38852 JOHN PEARSON MD UROLOGIST 40.0 0 X 691094 0 37652 NIMESH PATEL MD CARDIOLOGIST 40.0 0 X 555321 0 39777 RAVI EDARA MD PHYSICIAN 40.0 0 X 608272 0 38092 PAUL NEIMEYER FORMER SECRETARY 0.0 X 0 811125 28168 3630601 3528544 683187 98 true true false VCU HEALTH SYSTEM D/B/A MCV BOX 980620 RICHMOND VA 23298 MEDICAL SERVICE 914478 PHARMACY ASSOCIATES 531 PALMER POINT RD BOYDTON VA 23917 MEDICAL PROFESSIONALS 699283 FUNCTIONAL PATHWAYS 120 DOGWOOD LN ORANGE VA 22960 PHYSICAL THERAPY 255528 VIRGINIA HOSPITAL LAUNDRY INC 1601 OLIVER HILL WAY RICHMOND VA 23219 LAUNDRY SERVICES 201742 LIBERTY DIALYSIS SOUTH HILL 300 E FERREL ST SOUTH HILL VA 23970 MEDICAL SERVICE 193236 9 3436419 1690000 5126419 NET PATIENT SRVC REV 622110 122569010 122569010 0 0 0 0 122569010 424365 424365 3240 3240 0 3240 3240 330073 330073 0 330073 330073 GIFT SHOP 453220 74377 74377 REFERENCE LAB 541380 4324 4324 PHARMACY 446110 11061 11061 80511 0 0 80511 170273 128623380 122584395 0 912566 518044 435157 82887 56694896 47623713 9071183 3816051 3205483 610568 9598493 8062734 1535759 3712136 3118194 593942 3503857 3503857 4364 4364 332 332 136117 136117 4162031 4162031 0 0 10861 9123 1738 586374 492554 93820 2106480 1769443 337037 100906 84761 16145 22358 18781 3577 2294737 1927579 367158 8337187 7003237 1333950 1033345 868010 165335 PURCHASED SERVICES 23880071 20059260 3820811 SHARED SERVICES ALLOCATION 22486360 18888542 3597818 MEDICAL SUPPLIES 19341089 19341089 BAD DEBT EXPENSE 6360084 6360084 4931786 4142701 789085 0 173637959 147572476 26065483 0 3405 3005 12597566 8382299 16092882 17543701 0 0 0 0 2412920 2651158 416198 170470 183869405 90452598 101821806 93416807 18340824 18215509 0 0 110665660 288484517 262351261 428867466 30506073 11231795 0 0 61850670 64323757 63859693 294864491 156216436 370420043 X 106134825 58447423 106134825 58447423 262351261 428867466 -45014579 -2718962 46139 0 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true 6766 6766 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING ACTIVITIES THE ORGANIZATION WAS PART OF SEVERAL ASSOCIATIONS THAT ENGAGED IN LOBBYING ON BEHALF OF ITS MEMBERS. THE FOLLOWING IS A LIST OF THE ORGANIZATIONS AND MEMBER DUES USED FOR LOBBYING. AMERICAN HEALTHCARE ASSOCIATION $6,329 VIRGINIA HEALTHCARE ASSOCIATION $437 1613516 1613516 125710610 49859451 75851159 54038637 38927984 15110653 2506642 1665163 841479 93416807 DUE FROM VCUHS 287309450 MEDICAID RECEIVABLE 847706 OTHER ASSETS 160929 Other Accounts Receivable 131745 AWUIL INTERIM LIFE SAFETY FUND CMH LOAN ISSUE COSTS DEPOSITS 34687 288484517 DUE TO AFFILIATES MEDICARE PAYABLE 294864491 294864491 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE FILING ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. true true X true X 133 true X false true true true true 256018 0 256018 0.0015 41406905 32793859 8613046 0.0515 0 0.0 0 0 41662923 32793859 8869064 0.0530 0 0.0 95221 95221 0.0006 0 0.0 0 0.0 4950 4950 0.0000 0 0 100171 0 100171 0.0006 0 0 41763094 32793859 8969235 0.0536 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 6313945 1078102 44813755 82048693 -37234938 X true true 1 1 COMMUNITY MEMORIAL HOSPITAL 1755 N MECKLENBURG AVE SOUTH HILL VA 23970 WWW.VCU-CMH.ORG H 1847 X X X SKILLED NURSING/LONG TERM CARE FACILITY COMMUNITY MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 20 true false false true X https://www.vcuhealth.org/-/media/media/file/cmh_chna-study-report---may-2021.ashx X true 20 true https://www.vcuhealth.org/-/media/media/file/cmh_chna-response-plan-2021.ashx false true X 133.0 300.0 X X X true true X X X true X https://www.vcuhealth.org/-/media/media/file/2023financialassistancepolicy_vcuhealth_final.ashx X https://www.vcuhealth.org/-/media/media/file/221121_financial_application_rev_1_.ashx X https://www.vcuhealth.org/-/media/media/file/221121_financial_application_rev_1_.ashx X X X X X true X false X X X true X false false Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - COMMUNITY MEMORIAL HOSPITAL. COMMUNITY HEALTH NEEDS ASSESSMENT ADDITIONAL FINDINGS THE NEEDS ASSESSMENT ALSO DESCRIBED INSIGHT FROM COMMUNITY STAKEHOLDERS REGARDING IMPORTANT HEALTH CONCERNS, SIGNIFCANT SERVICE GAPS, SPECIALTY SERVICE GAPS, AND IDEAS FOR ADDRESSING THESE CONCERNS AND GAPS. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - COMMUNITY MEMORIAL HOSPITAL. CHNA, INPUT FROM COMMUNITY IN AN EFFORT TO GENERATE COMMUNITY INPUT, A COMMUNITY INSIGHT SURVEY WAS CONDUCTED WITH COMMUNITY RESIDENTS DURING THE SPRING OF 2021. INSIGHTS WERE COLLECTED VIA SURVEYS ADMINISTERED ONLINE. THE PROFILE OF THE RESPONDENTS WAS 86% WHITE, 14% MINORITY AND MOSTLY FEMALE, UPPER MIDDLE AGED (55-74), AND AT THE HIGHER INCOME LEVELS. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - COMMUNITY MEMORIAL HOSPITAL. HEALTHCARE DISPARITY AND HEALTH INEQUITIES * SCREENING, DATA ANALYTICS AND ACTION PLANNING IN PLACE TO IDENTIFY AND ADDRESS HEALTH EQUITY * PARTNERED WITH FEEDMORE FOR THOSE WITH IDENTIFIED FOOD HUNGER NEEDS LAUNCHED FOR INPATIENTS AND EXPANDED TO ALL OUTPATIENT SITES OF CARE AND CLINICS * GRANT FUNDED MOBILE VAN FOR HEALTH SCREENINGS LAUNCHED IN CONJUNCTION WITH VCU SON, SVCC SON AND VCU HEALTH SCIENCES FOR MOBILE HEALTH ON TUESDAY'S IN ALBERTA VA * LAUNCHED FRONT END PROCESS CHANGE TO DECREASE LEFT WITHOUT BEING SEEN IN THE ED TO ENSURE ACCESS TO CARE NEW SERVICE OFFERINGS: * EMPLOYED GI PHYSICIAN WITH CLINIC, OUTPATIENT INFUSION, INPATIENT AND PROCEDURAL OFFERINGS * RHEUMATOLOGY PHYSICIAN WITH CLINIC AND OUTPATIENT INFUSION THERAPY OFFERINGS PARTICIPATION IN CLINICAL TRIALS AND PHYSICIAN RESEARCH PUBLICATIONS ACROSS ORTHOPEDICS, ONCOLOGY, ICU RED HEART, HEART FAILURE AND COVID WORKFORCE DEVELOPMENT * PARTICIPATION IN MEDICAL AND CLINICAL EDUCATION AND TRAINING THROUGH HOSTING 3RD YEAR VCU MEDICAL STUDENTS, HOSTING VCU NURSING STUDENTS FOR SATURDAY CLINICALS, CLINICAL SITE FOR SVCC NURSING STUDENTS (LPN & AND), CLINICAL SITE FOR RAD ONC, IMAGING, PHYSICAL/OCCUPATIONAL/SPEECH THERAPY * TIMELINE AND PLANNING IN PROCESS TO LAUNCH GRADUATE MEDICAL EDUCATION FAMILY MEDICINE RESIDENCY PROGRAM WITH 3 FAMILY PRACTICE RESIDENTS TO EXPAND ACCESS TO CARE AND RETAIN PHYSICIANS IN RURAL SETTING * SUMMER NURSE EXTERN PROGRAM CONTINUES TO BUILD PIPELINE TO ADDRESS NURSING VACANCIES AND BUILD WORKFORCE HEART DISEASE - 20% CMH MOVED EKG INTERPRETATION TO CARDIOLOGISTS/PEDIATRIC CARDIOLOGISTS AND THEY DO FINAL READS FOR ALL CMH SITES. IMPLEMENTATION OF EPIC ELECTRONIC MEDICAL RECORD ACROSS VCU HEALTH SITES TO STANDARDIZE CARE PLATFORMS. ADDED CARDIOLOGY NP IN JANUARY OF 2023. CURRENTLY RECRUITING 2 FULL TIME CARDIOLOGISTS AND 2ND CARDIOLOGY APP TO MEET COMMUNITY NEEDS. MALIGNANT NEOPLASMS - 20% * INCREASED LOW DOSE LUNG CANCER SCREENINGS BY 10% (OVER 460 COMPLETED IN FY2022). * CMH ENROLLED 19 PARTICIPANTS IN CLINICAL TRIALS, REFLECTING A 6% ENROLLMENT PERCENTAGE. * CMH ADVISED 46% OF ACTIVE SMOKERS IN ONCOLOGY CARE ABOUT TOBACCO CESSATION RESOURCES AND 60% OF THEM ACCEPTED HELP AND ARE ACTIVELY TRYING TO QUIT. * PHYSICAL THERAPY EDUCATED NURSES ON PROSTATE, LACK OF AND PELVIC FLOOR MUSCULATURE CHANGES. * IMPLEMENTED COMMUNITY SCREENINGS FOR PROSTATE CANCER DURING NOVEMBER- PROSTATE AWARENESS MONTH. SINCE BEGINNING SCREENING, PROSTATE CANCER IDENTIFICATIONS THROUGH ONCOLOGY PROGRAM HAS GONE FROM 18 PER YEAR TO 48 IN THE LAST YEAR. WILL MAKE THIS AN ANNUAL OFFERING * THROUGH HEALTH & WELLNESS AND A GRANT THROUGH THE SUSAN KOMEN FOUNDATION, WE CONTINUE TO OFFER FREE MAMMOGRAMS TO WOMEN IN NEED GOAL FOR IS TO DECREASE "NO SHOW" APPOINTMENTS FOR PATIENT IN ACTIVE RADIATION TREATMENT BY IDENTIFYING AND UNDERSTANDING BARRIERS IN OUR COMMUNITY AND IMPLEMENTING INTERVENTIONS. CEREBROVASCULAR DISEASE - 6% * TJC PRIMARY STROKE CENTER ACCREDITED * 1 COMMUNITY NEUROLOGIST CHRONIC LOWER RESPIRATORY - 5% * 2 COMMUNITY PULMONOLOGISTS AND 1 PART TIME APP 5 YR. INFANT MORTALITY RATE 193% OF STATE RATE * ALIGNMENT WITH VCU MEDICAL CENTER HIGH RISK OB FOR CARE AND TREATMENT PROTOCOLS * ALIGNMENT WITH VCU MEDICAL CENTER NICU FOR CARE AND TREATMENT PROTOCOLS * OB/GYN RECRUITMENT COMPLETE WITH 1 ADDITIONAL OB JOINING IN AUGUST OF 2023 RATE OF MENTAL HEALTH DISCHARGES FROM LOCAL HOSPITALS IS 39% LOWER THAN STATE RATE; HOWEVER, THE STUDY DOES NOT TAKE INTO ACCOUNT DISCHARGES FROM STATE MENTAL HEALTH FACILITIES OR OUTPATIENT TREATMENT OPTIONS * OPENED OUTPATIENT MENTAL HEALTH CLINIC WITH 1 PSYCHIATRIST AND HAVE ADDED 1 LICENSED SOCIAL WORKER * WORKING IN CONJUNCTION WITH LOCAL COMMUNITY SERVICE BOARD SURROUNDING CRISIS RECEIVING CENTER THAT WILL OPEN IN OCTOBER OF 2023 INJURY & VIOLENCE RELATED DISCHARGES 53% HIGHER THAN STATE AVERAGE * ONGOING COLLABORATION WITH VCUHS AND CMH WORKPLACE VIOLENCE, TO ASSESS AND PLAN FOR WAYS TO REDUCE WORKPLACE VIOLENCE. * VCU POLICE ONSITE SECURITY SCREENING COMPLETED WITH ACTION PLAN DEVELOPMENT IN PROCESS 16 CMH PHYSICIAN SERVICES - FAMILY CARE 1755 N Mecklenburg Ave South Hill VA 23970 HEALTHCARE PRACTICE CMH CARDIOLOGY LLC 1755 N MECKLENBURG AVE LACROSSE VA 23950 HEALTHCARE PRACTICE CMH ORTHOPEDIC SERVICES LLC 1755 N MECKLENBURG AVE LACROSSE VA 23950 HEALTHCARE PRACTICE CMH SURGICAL SERVICES LLC 1755 N MECKLENBURG AVE LACROSSE VA 23950 HEALTHCARE PRACTICE CMH WOMEN'S HEALTH SERVICES LLC 1755 N MECKLENBURG AVE LACROSSE VA 23930 HEALTHCARE PRACTICE CMH UROLOGICAL SERVICES LLC 1755 N MECKLENBURG AVE LACROSSE VA 23950 HEALTHCARE PRACTICE CMH PULMOLOGY LLC 1755 N MECKLENBURG AVE LACROSSE VA 23950 HEALTHCARE PRACTICE CMH PAIN MANAGEMENT SERVICES LLC 1755 N MECKLENBURG AVE LACROSSE VA 23950 HEALTHCARE PRACTICE CMH DERMATOLOGY LLC 1755 N MECKLENBURG AVE LACROSSE VA 23950 HEALTHCARE PRACTICE CMH EAR NOSE THROAT & ALLERGY LLC CMH EAR NOSE THROAT ALLERGY LLC LACROSSE VA 23950 HEALTHCARE PRACTICE CMH DENTAL CLINIC LLC 1755 N MECKLENBURG AVE SOUTH HILL VA 23970 HEALTHCARE PRACTICE CMH BEHAVIORAL HEALTH SERVICES 140 EAST FERRELL STREET SOUTH HILL VA 23970 HEALTHCARE PRACTICE CMH NEUROLOGICAL SERVICES 1755 N MECKLENBURG AVE SOUTH HILL VA 23970 HEALTHCARE PRACTICE CHASE CITY PRIMARY CARE CENTER LLC 200 E 5TH STREET CHASE CITY VA 23924 RHC RHEUMATOLOGY CMHP 755 N Mecklenburg Ave South Hill VA 23970 HEALTHCARE PRACTICE CMH VASCULAR LLC 1755 N MECKLENBURG AVE SOUTH HILL VA 23970 HEALTHCARE PRACTICE Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 6360084 Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount BAD DEBT FOR PURPOSES OF LINE 2 IS PRESENTED AT ESTIMATED COST. THE COST OF THE BAD DEBT CHARGES WAS CALCULATED USING RATIO OF PATIENT CARE COST TO CHARGES. RATIONALE FOR INCLUDING A PORTION OF BAD DEBT AS COMMUNICATED BENEFIT IS AS FOLLOWS: THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS OTHERWISE ELIGIBLE UNDER THE CHARITY CARE POLICY WAS DETERMINED BY REVIEWING UNCOLLECTIBLE ACCOUNTS FOR THIRD PARTY AND UNINSURED PATIENT ACCOUNTS RECEIVABLE BALANCES FOR WHICH THE PATIENT IS RESPONSIBLE. Schedule H, Part III, Line 3 Bad Debt Expense Methodology DESCRIPTION OF BAD EXPENSE FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE HOSPITAL RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES, DISCOUNTED ACCORDING TO POLICY, FOR SERVICES RENDERED. HISTORICAL EXPERIENCE HAS SHOWN A SIGNIFICANT PROPORTION OF THE HOSPITAL'S UNINSURED PATIENTS, IN ADDITION TO A GROWING PROPORTION OF THE HOSPITAL'S INSURED PATIENTS, WILL BE UNABLE OR UNWILLING TO PAY FOR THEIR RESPONSIBLE AMOUNTS FOR THE SERVICES PROVIDED. IN ORDER TO ESTIMATE THE NET REALIZABLE VALUE OF THE REVENUES AND ACCOUNTS RECEIVABLES ASSOCIATED WITH THIRD-PARTY PAYORS AND UNINSURED PATIENTS, MANAGEMENT REGULARLY ANALYZES COLLECTION HISTORY. BASED ON THESE HISTORICAL ANALYSES, THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS AND AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOR THIRD PARTY AND UNINSURED PATIENT ACCOUNTS RECEIVABLE BALANCES FOR WHICH THE PATIENT IS RESPONSIBLE. THE "EMPLOYER" IS ON ALL PATIENT ACCOUNTS THAT WERE WRITTEN OFF TO BAD DEBT EXPENSE. THOSE ACCOUNTS THAT LISTED NO EMPLOYER WERE ASSUMED TO HAVE QUALIFIED UNDER THE CHARITY CARE POLICY BECAUSE OF THE LACK OF INCOME FROM BEING UNEMPLOYED. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE HOSPITAL RECOGNIZES REVENUE NET OF CONTRACTUAL ALLOWANCE PER THE STANDARD CONTRACTED RATE. HISTORICAL EXPERIENCE HAS DEMONSTRATED A PORTION OF REVENUE IS UNCOLLECTABLE. THE HISTORICAL UNCOLLECTABLE RATE IS APPLIED TO OUTSTANDING NET ACCOUNTS RECEIVABLE AND A PROVISION IS RECORDED PERIODICALLY. THE HOSPITAL PROVIDES HEALTHCARE SERVICES TO INFANTS, CHILDREN, AND ADOLESCENTS UP TO THE AGE OF 21 YEARS. HOSPITAL WILL PROVIDE FINANCIAL ASSISTANCE AS ESTABLISHED UNDER THE GUIDELINES. SERVICES ARE PROVIDED REGARDLESS OF RACE, CREED, RELIGION, NATIONAL ORIGIN, SEX, DISABILITY, SOCIOECONOMIC STATUS, PAYOR SOURCE, OR ANY OTHER MANNER PROHIBITED BY LAW. AS A TAX-EXEMPT ENTITY AND AS PART OF ITS COMMITMENT TO SERVE THE COMMUNITY, HOSPITAL PROVIDES FINANCIAL ASSISTANCE IN THE FORM OF CHARITY CARE ("FINANCIAL ASSISTANCE") TO PATIENTS' FAMILIES WHO QUALIFY BY MEETING THE REQUIREMENTS. PATIENT FAMILIES ARE ELIGIBLE IF THEIR YEARLY HOUSEHOLD INCOME, AS DOCUMENTED ON THE FINANCIAL ASSISTANCE APPLICATION IS LESS THAN OR EQUAL TO 200% OF THE POVERTY GUIDELINES UPDATED ANNUALLY IN THE FEDERAL REGISTER BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ("FEDERAL POVERTY GUIDELINES"). FOOTNOTE 2(E) OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS STATES: THE AUTHORITY RECORDS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS DURING THE PERIOD IN WHICH COLLECTION IS CONSIDERED DOUBTFUL. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS APPROXIMATELY $12,284,000 AT JUNE 30, 2022. ACCOUNTS WAS APPROXIMATELY $11,995,000 AT JUNE 30, 2021. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs MEDICARE COSTING METHODOLOGY MEDICARE ALLOWABLE COST WAS CALCULATED USING A COMBINATION OF COST FROM FILED FY 2022 MEDICARE COST REPORT; COST TO CHARGE RATIOS FROM FILED FY 2022 MEDICARE COST REPORT; AND A CALCULATION OF DIRECT COSTS PLUS ALLOCATED OVERHEAD. THE SHORTFALL IS RELATED TO PROVIDING SERVICES TO OUR RURAL COMMUNITY THAT OUR BOARD OF DIRECTORS HAS DETERMINED TO BE NECESSARY FOR THE BENEFIT OF THE COMMUNITY. THESE SERVICES INCLUDE OPERATING PHYSICIAN PRACTICES BECAUSE THE SERVICES WOULD NOT BE AVAILABLE LOCALLY IF NOT PROVIDED BY THE ORGANIZATION. COMMUNITY MEMORIAL HOSPITAL COULD CEASE TO PROVIDE THE SERVICES BUT OUR COMMUNITY WOULD THEN BE REQUIRED TO TRAVEL UP TO AN HOUR TO RECEIVE THE SERVICES IN ANOTHER COMMUNITY. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance APPLICATION OF COLLECTION PRACTICES TO THOSE QUALIFYING FOR FINANCIAL ASSISTANCE COMMUNITY MEMORIAL HOSPITAL'S COLLECTION POLICY STATES THAT ALL UNINSURED PATIENTS WILL BE REFERRED TO OUR FINANCIAL SPECIALIST TO BE SCREENED FOR FINANCIAL ASSISTANCE CONSISTENT WITH OUR INDIGENT AND CHARITY CARE PROGRAMS. INFORMATION IS PROVIDED UPON REGISTRATION TO ALL UNINSURED PATIENTS INFORMING THEM OF OUR FINANCIAL ASSISTANCE PROGRAMS. A NOTE IS ALSO INCLUDED ON STATEMENTS SENT TO UNINSURED PATIENTS REGARDING HOW TO REQUEST INFORMATION ABOUT FINANCIAL ASSISTANCE. THE POLICY FURTHER STATES THAT WE WILL UNDERTAKE REASONABLE EFFORTS TO ENSURE THAT FINANCIAL ASSISTANCE WAS OFFERED BEFORE ANY COLLECTION AGENCY ASSIGNMENT. Schedule H, Part V, Section B, Line 16a FAP website - COMMUNITY MEMORIAL HOSPITAL: Line 16a URL: https://www.vcuhealth.org/-/media/media/file/2023financialassistancepolicy_vcuhealth_final.ashx; Schedule H, Part V, Section B, Line 16b FAP Application website - COMMUNITY MEMORIAL HOSPITAL: Line 16b URL: https://www.vcuhealth.org/-/media/media/file/221121_financial_application_rev_1_.ashx; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - COMMUNITY MEMORIAL HOSPITAL: Line 16c URL: https://www.vcuhealth.org/-/media/media/file/221121_financial_application_rev_1_.ashx; Schedule H, Part VI, Line 2 Needs assessment A COMMUNITY NEEDS ASSESSMENT IS CONDUCTED ONCE EVERY THREE YEARS. WE COORDINATED WITH LOCAL PARTNERS AND AGENCIES TO GATHER DATA TO COMPLETE AN ECONOMIC AND WORKFLOW PROFILE OF THE SERVICE AREA. FEEDBACK FROM THE COMMUNITY SOUGHT BY UTILIZING FOCUS GROUPS, COMMUNITY FORUMS AND BY MEETINGS OTHER HEALTH CARE PROVIDERS. INFORMATION IS ALSO SOUGHT FROM THE MEMBERS OF THE BOARD OF DIRECTORS WHO REPRESENT THE COMMUNITIES WE SERVE. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance COMMUNITY MEMORIAL HOSPITAL TAKES MANY STEPS TO ENSURE THAT ITS COMMUNITY IS MADE AWARE OF THE FINANCIAL ASSISTANCE PROGRAMS AVAILABLE TO IT. OUR POLICY FOR FINANCIAL ASSISTANCE, INCLUDING THE APPLICATION, IS AVAILABLE ON OUR WEBSITE. A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE IS POSTED AT EACH REGISTRATION AREA. OUR PATIENT FINANCIAL BROCHURE, WHICH DESCRIBES OUR REGISTRATION REQUIREMENTS, BILLING PROCESS AND FINANCIAL ASSISTANCE PROGRAMS, IS PROVIDED TO EACH UNINSURED PATIENT AT REGISTRATION AND IS ALSO AVAILABLE IN ALL REGISTRATION AREAS AND WAITING ROOMS. THE HOSPITAL EMPLOYS A FINANCIAL SPECIALIST WHOSE RESPONSIBILITY IS TO ASSIST OUR PATIENTS WITH OUR FINANCIAL ASSISTANCE PROGRAMS AND WITH OTHER TYPES OF HEALTHCARE COVERAGE INCLUDING MEDICAID AND DISABILITY APPLICATIONS. THE BUSINESS CARD FOR THE FINANCIAL SPECIALIST IS PROVIDED TO EACH UNINSURED PATIENT AT REGISTRATION. THE FINANCIAL SPECIALIST ATTEMPTS TO VISIT EACH UNINSURED PATIENT WHO HAS BEEN ADMITTED AS AN INPATIENT TO THE HOSPITAL WHILE THEY ARE STILL A PATIENT TO DISCUSS FINANCIAL ASSISTANCE PROGRAMS. A NOTE IS INCLUDED ON EACH STATEMENT THAT IS SENT TO AN UNINSURED PATIENT NOTIFYING THEM OF THE FINANCIAL PROGRAM AND WHO THEY CAN CONTACT FOR ASSISTANCE. Schedule H, Part VI, Line 4 Community information COMMUNITY MEMORIAL HOSPITAL IS A RURAL, NON-PROFIT HEALTH SYSTEM LOCATED IN SOUTH CENTRAL VIRGINIA. WE SERVE THE RURAL COUNTIES OF MECKLENBURG, BRUNWICK AND LUNENBURG IN VIRGINIA AS WELL AS WARREN COUNTY, NORTH CAROLINA. OUR PRIMARY MARKET AREA IS MECKLENBURG COUNTY. MECKLENBURG COUNTY HAS A POPULATION OF 30,248 THE PER CAPITA INCOME OF $28,959 IS ABOUT TWO-THIRDS OF THE STATE AVERAGE. THE ESTIMATED TOTAL POPULATION IN POVERTY PERCENTAGE IS 15.7% - ABOVE THE STATE AVERAGE OF 10.2%. COMMUNITY MEMORIAL HOSPITAL QUALIFIES AS A SOLE COMMUNITY HOSPITAL FOR MEDICARE REGULATIONS AS THE CLOSEST HOSPITAL IS 35 MILES AWAY. Schedule H, Part VI, Line 5 Promotion of community health COMMUNITY MEMORIAL HOSPITAL (CMH) IS A VITAL COMPONENT OF THE SOUTHSIDE VIRGINIA AREA, PROVIDING QUALITY CARE TO OUR PATIENTS, SERVING AS A VITAL PART OF THE SAFETY NET AND ENHANCING COMMUNITY HEALTH. OUR MISSION IS TO PROVIDE EXCELLENCE IN THE DELIVERY OF HEALTHCARE. WE ARE LED BY A VOLUNTEER 14 MEMBER BOARD OF DIRECTORS WHO REPRESENT ALL OF THE AREAS WE SERVE AS WELL AS VCU HEALTH SYSTEM REPRESENTATIVES. CMH IS DESIGNATED AS VOLUNTEER 14 MEMBER BOARD OF DIRECTORS WHO REPRESENT ALL OF THE AREAS WE SERVE AS WELL AS VCU HEALTH SYSTEM REPRESENTATIVES. CMH IS DESIGNATED AS A SOLE COMMUNITY HOSPITAL BY MEDICARE WHICH MEANS THAT WE ARE LOCATED IN A RURAL AREA AND 35 MILES FROM OTHER HOSPITALS. WE ARE ALSO DESIGNATED A DISPROPORTIONATE SHARE HOSPITAL BY MEDICARE WHICH MEANS THAT WE PROVIDE CARE TO A HIGHER LEVEL OF LOW-INCOME INDIVIDUALS. OUR PRIMARY SERVICE AREA OF MECKLENBURG COUNTY RANKS BELOW THE STATE AVERAGE IN PER CAPITA INCOME AND ABOVE THE STATE AVERAGE IN ESTIMATED TOTAL POPULATION IN POVERTY PERCENT. WE OFFER A FULL SPECTRUM OF SERVICES TO THE COMMUNITY INCLUDING IN-PATIENT ACUTE CARE, POST ACUTE, AND LONG TERM CARE, OUT-PATIENT SERVICES, HOME HEALTH AND HOSPICE. LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA, WE OPERATE PRIMARY HEALTH PRACTICES THAT BRING NEEDED PRIMARY CARE SERVICES TO THE COMMUNITY. WE HAVE ALSO MADE THE DECISION TO OPERATE PRACTICES IN THE SPECIALTY AREAS OF DENTAL, DERMATOLOGY, VASCULAR, CARDIOLOGY/PULMONARY SERVICES, EAR, NOSE & THROAT SERVICES, ORTHOPEDICS, PAIN MANAGEMENT, SURGICAL SERVICES, WOMEN'S HEALTH SERVICES, AND UROLOGY SERVICES AS THESE SPECIALTY SERVICES OTHERWISE MIGHT NOT BE AVAILABLE FOR OUR COMMUNITY WITHOUT SIGNIFICANT TRAVEL. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS BUT RECRUITING TO A RURAL AREA COMES WITH MANY CHALLENGES. OUR EMERGENCY DEPARTMENT HAD ALMOST 22,000 PATIENT VISITS LAST YEAR AND SEES PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. WE OFFER FINANCIAL ASSISTANCE TO OUR UNINSURED PATIENTS. UNINSURED PATIENTS QUALIFYING WITH INCOME BELOW THE FEDERAL POVERTY LEVEL ARE OFFERED FREE CARE. UNINSURED PATIENTS WITH FAMILY INCOME UP TO 300% OF THE FEDERAL POVERTY LEVEL ARE OFFERED SLIDING SCALE DISCOUNTS. INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM IS POSTED ON OUR WEBSITE, POSTED IN ALL REGISTRATION WAITING AREAS, PROVIDED TO UNINSURED PATIENTS AT REGISTRATION AND INCLUDED AS A NOTE ON ALL PROMOTION OF COMMUNITY SENT TO UNINSURED PATIENTS. WE EMPLOY A FINANCIAL SPECIALIST WHOSE RESPONSIBILITY IS TO ASSIST UNINSURED PATIENTS WITH OUR FINANCIAL ASSISTANCE PROGRAMS AS WELL AS TO ASSIST THE PATIENTS WITH APPLYING AND QUALIFYING FOR OTHER COVERAGE SUCH AS DISABILITY OR MEDICAID. WITH THE HELP OF SEVERAL GRANTS, CMH HAS BEEN ABLE TO OFFER FREE MAMMOGRAMS AND BREAST EXAMS TO UNDERSERVED WOMEN IN THE AREA. AS THE GRANTS DO NOT COVER TOTAL PROGRAM EXPENSES, CMH MUST SUPPLEMENT THE COSTS TO PROVIDE THESE SERVICES TO THE COMMUNITY. LAST YEAR, OUR MEDICATION ASSISTANCE PROGRAM, THE PHARMACY CONNECTION, HELPS PATIENTS OBTAIN MEDICATIONS. ANY SURPLUS FUNDS GO BACK INTO THE OPERATION OF THE HOSPITAL TO MAINTAIN THE FACILITY AND UPDATE EQUIPMENT AND TECHNOLOGY. CMH ALSO BELONGS TO AND SUPPORTS 8 CHAMBERS OF COMMERCE AND PARTICIPATES IN THEIR COMMUNITY EVENTS. OUR INVOLVEMENT HELPS SUPPORT COMMUNITY GROWTH AND WE SHARE MANY HEALTH RELATED EVENT NOTICES AT THESE MEETINGS. WE ALSO SUPPORT MANY OF THEIR SPECIAL EVENTS AND LOCATE WELLNESS AND SCREENING BOOTHS THERE. HOSPITALS PLAY A CRITICAL ROLE IN THEIR COMMUNITY. AS MAJOR EMPLOYERS AND PURCHASERS, HOSPITALS ARE ENGINES OF ECONOMIC GROWTH AND STABILITY. A STRONG COMMUNITY HOSPITAL HELPS TO RECRUIT BUSINESS AND INDUSTRY TO THE AREA AND HELPS ATTRACT AND RETAIN COLLEGE GRADUATES AND SKILLED CRAFTSMEN. CMH IS THE LARGEST SINGLE EMPLOYER IN THE AREA PROVIDING JOBS AT A WIDE RANGE OF SKILL LEVELS FOR PEOPLE FROM VIRGINIA AND NORTH CAROLINA LOCALITIES WE CONTRIBUTE TO THE TAX BASE THROUGH WAGES, SALARIES AND BENEFITS. CMH AND OUR EMPLOYEES PURCHASE GOODS AND SERVICES LOCALLY, CREATING INCOME AND JOBS FOR OTHER BUSINESSES IN THE COMMUNITY. BY PARTICIPATING ON THE TOWN REVITALIZATION COMMITTEE, CMH HAS BEEN ABLE TO PROVIDE SUPPORT TO EFFORTS TO MODERNIZE THE TOWN IN ORDER TO MAKE IT MORE ATTRACTIVE TO NEW BUSINESSES. BY PROVIDING JOBS IN THE REGION, RESIDENTS HAVE A BETTER OPPORTUNITY TO RECEIVE PREVENTATIVE CARE THROUGH THEIR HEALTH INSURANCE PROGRAMS. THE COMMUNITY IS ALSO INVESTED IN CMH. VOLUNTEERS ARE A VITAL PART OF OUR HEALTH CARE TEAM, GOVERNANCE AND FUNDRAISING. ACTIVE VOLUNTEERS SERVE IN DIFFERENT CAPACITIES. THE MEN AND WOMEN OF OUR AUXILIARY VOLUNTEER THOUSANDS OF HOURS EACH YEAR AND PROVIDE A WIDE RANGE OF SERVICES TO STRENGTHEN OUR HOSPITAL AND ENHANCE THE QUALITY OF CARE FOR PATIENTS AND FAMILIES. THE COMMUNITY ALSO SUPPORTS THE OPERATION OF CMH BY SUPPORT OF THE CMH FOUNDATION. THE CMH FOUNDATION IS ALSO LED BY A VOLUNTEER BOARD OF DIRECTORS AND AIMS TO RAISE FUNDS TO ALLOW OUR HOSPITAL TO OFFER THE BEST POSSIBLE CARE AND MAINTAIN STATE-OF-THE-ART FACILITIES AND TECHNOLOGIES TO BETTER SERVE OUR COMMUNITY. Schedule H, Part VI, Line 6 Affiliated health care system EFFECTIVE JULY 1, 2014 CMH ENTERED INTO AN AFFILIATION AGREEMENT WITH VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY (VCUHS). IN CONNECTION WITH THE AFFILIATION TRANSACTION WE HAVE DEVELOPED A COMPREHENSIVE STRATEGIC PLAN FOR CMH THAT IDENTIFIES STRATEGIC CAPITAL PROJECTS, INCLUDING THE DEVELOPMENT AND CONSTRUCTION OF A REPLACEMENT ACUTE CARE FACILITY AND RELATED EQUIPMENT WITH SUFFICIENT INFRASTRUCTURE AND LICENSED BED CAPACITY NECESSARY TO SUPPORT CMH'S EXISTING SERVICE LINES AND CLINICAL PROGRAMS INITIATIVES BASED ON A DETAILED ANALYSIS OF FACILITY NEEDS AND CLINICAL PROGRAM EXPANSIONS NEEDED TO BEST SERVE THE COMMUNITY AND ENSURE LONG-TERM SUCCESS OF CMH. CMH IMPLEMENTED THE SAME ELECTRONIC MEDICAL RECORD SYSTEM AS VCUHS SO PATIENT CARE INFORMATION WILL BE AVAILABLE TO PHYSICIANS IN BOTH MARKETS. Schedule H, Part VI, Line 7 State filing of community benefit report VA false false false false false false false false false RALPH CLARK MD DIRECTOR 0 228583 0 43935 0 0 0 22620 0 0 0 295138 0 0 DAVID CHELMOW MD DIRECTOR (JUL-MAR) 0 484077 0 117888 0 0 0 33040 0 260 0 635265 0 0 NINA HOBCROFT DIR (MAR-MAY) 0 417809 0 36558 0 30972 0 32072 0 935 0 518346 0 0 CATHERINE PALMER MD DIRECTOR 0 -243258 0 475403 0 5556 0 237701 0 0 0 475403 0 0 THOMAS YACKEL MD DIRECTOR 0 541139 0 72512 0 40 0 41074 0 23394 0 678159 0 0 HARINDER DHINDSA MD DIRECTOR 0 434601 0 71605 0 0 0 27631 0 2750 0 536587 0 0 PAUL NEIMEYER FORMER SECRETARY 0 316423 0 0 0 494702 0 27628 0 540 0 839293 0 0 W SCOTT BURNETTE PRESIDENT 404626 0 38682 0 31513 0 34800 0 8424 0 518044 0 0 0 RAVI EDARA MD PHYSICIAN 284291 0 313596 0 10385 0 33040 0 5051 0 646364 0 0 0 BRYAN MOSORA DO PHYSICIAN 430132 0 243142 0 21673 0 32188 0 3756 0 730891 0 0 0 NIMESH PATEL MD CARDIOLOGIST 498286 0 41675 0 15360 0 33040 0 6736 0 595098 0 0 0 JOHN PEARSON MD UROLOGIST 476842 0 214251 0 0 0 33040 0 4612 0 728746 0 0 0 INDU SHIVARAM MD PULMONOLOGIST 421513 0 172325 0 12308 0 33040 0 5812 0 644998 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation FOR FISCAL YEAR ENDING JUNE 30, 2022, COMPENSATION (SALARIES AND INCENTIVES) FOR THE CEO, EXECUTIVE DIRECTOR OR THE TOP MANAGEMENT OFFICIAL OF THE FILING ORGANIZATION, IS APPROVED BY THE CEO OF THE HEALTH SYSTEM. THE ORGANIZATION USES A THIRD PARTY COMPENSATION CONSULTING FIRM TO CONDUCT A MARKET STUDY TO DETERMINE MARKET POSITION. THE ORGANIZATION MAY ALSO CONDUCT A 360 DEGREE EVALUATION OF ALL SENIOR LEVEL ADMINISTRATORS. THESE DATA ELEMENTS IN CONJUNCTION WITH A REVIEW OF THE INDIVIDUAL'S PERFORMANCE AND THE ATTAINMENT OF GOALS FOR THE YEAR, ARE THE BASIS FOR COMPENSATION RECOMMENDATIONS. THE COMPENSATION COMMITTEE OF THE VCUHS BOARD OF DIRECTORS DISCUSSES THE MATTER AND PRESENTS RECOMMENDATIONS TO THE CEO OF THE HEALTH SYSTEM. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE MEMBER OF COMMUNITY MEMORIAL HOSPITAL ("HOSPITAL") IS THE VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY, A PUBLIC BODY CORPORATE AND POLITICAL SUBDIVISION OF THE COMMONWEALTH OF VIRGINIA. THE MEMBER SHALL HAVE THE RIGHTS RESERVED TO IT AS SET FORTH IN THE ARTICLES OF INCORPORATION AND THE BYLAWS OF THE HOSPITAL. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE SOLE MEMBER OF COMMUNITY MEMORIAL HOSPITAL ("HOSPITAL") IS THE VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY, A PUBLIC BODY CORPORATE AND POLITICAL SUBDIVISION OF THE COMMONWEALTH OF VIRGINIA. THE MEMBER SHALL HAVE THE RIGHTS RESERVED TO IT AS SET FORTH IN THE ARTICLES OF INCORPORATION AND THE BYLAWS OF THE HOSPITAL. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders GOVERNANCE DECISIONS RESERVED TO MEMBERS THE RESERVED POWERS OF THE SOLE MEMBER, VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY ("VCUHSA"), INCLUDE THE APPROVAL OF THE FOLLOWING MATTERS: (1) ANY AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION, BYLAWS OR OTHER GOVERNING DOCUMENTS OF THE HOSPITAL OR ITS AFFILIATES, INCLUDING ANY CHANGE TO THE NAME OF THE HOSPITAL, ITS AFFILIATES OR ANY FACILITIES OPERATED BY THE HOSPITAL OR ITS AFFILIATES;(2) APPOINTMENT OF ANY DIRECTORS, MANAGERS OR OTHER GOVERNING PERSONS OF THE HOSPITAL OR ITS AFFILIATES; (3) THE ANNUAL OPERATING AND CAPITAL BUDGETS THE HOSPITAL OR ITS AFFILIATES (TO THE EXTENT SEPARATELY APPROVED FROM THE HOSPITAL'S BUDGETS); (4) ANY TRANSACTION, OR SERIES OF TRANSACTIONS IN ANY FISCAL YEAR, INVOLVING CAPITAL EXPENDITURES OR CONTRACTUAL COMMITMENTS BY THE HOSPITAL OR ITS AFFILIATES NOT PREVIOUSLY SPECIFIED IN A BUDGET APPROVED BY THE MEMBER IN AN AMOUNT EXCEEDING $500,000; (5) ANY TRANSACTION, OR ANY SERIES OF TRANSACTIONS IN ANY FISCAL YEAR, INVOLVING THE INCURRENCE OF DEBT OR THE CREATION OF LIENS OR OTHER ENCUMBRANCES ON ASSETS BY THE HOSPITAL OR ITS AFFILIATES, INCLUDING ANY MORTGAGES, CAPITAL LEASES, SECURITY INTERESTS OR GUARANTEES, NOT PREVIOUSLY SPECIFIED IN A BUDGET APPROVED BY THE MEMBER IN AN AMOUNT EXCEEDING $500,000; (6) ANY SALE, DISTRIBUTION OR OTHER DISPOSITION OF CASH, INVESTMENTS OR OTHER ASSETS BY THE HOSPITAL OR ITS AFFILIATES TO ANY THIRD PARTIES, WITH OR WITHOUT CONSIDERATION, IN AN AMOUNT EXCEEDING $500,000; (7) ANY MERGER, CONSOLIDATION, DISSOLUTION OR SALE OR OTHER DISPOSITION OF SUBSTANTIALLY ALL OF THE ASSETS OF THE HOSPITAL OR ANY OF ITS AFFILIATES; (8) CREATION OF ANY SUBSIDIARY OR AFFILIATED ENTITY, OR PARTICIPATION IN ANY JOINT VENTURE, PARTNERSHIP, LIMITED LIABILITY COMPANY OR SIMILAR ARRANGEMENT, BY THE HOSPITAL OR ITS AFFILIATES; (9) ANY CLOSURE OR OTHER SIGNIFICANT CHANGE TO CLINICAL SERVICE LINES PROVIDED BY THE FACILITIES OPERATED BY THE HOSPITAL OR ITS AFFILIATES;(10) APPOINTMENT OR REMOVAL OF THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER OR CHIEF NURSING OFFICER OF THE HOSPITAL; AND (11) ANY MANAGED CARE PAYOR CONTRACTING ON BEHALF OF THE HOSPITAL. Form 990, Part VI, Line 11b Review of form 990 by governing body PROCESS USED TO REVIEW 990 THE FINANCIAL INFORMATION IS PROVIDED BY VCUHS' FINANCE DEPARTMENT TO AN INDEPENDENT ACCOUTNING FIRM . THE FIRM PREPARES THE FORM 990 FOR REVIEW. THE FINANCE DEPARTMENT REVIEWS THE FORM 990 WITH THE APPROPRIATE EXECUTIVE DIRECTOR AND FINANCE LEADER OF THE ORGANIZATION. UPON FINAL REVIEW WITH LEADERSHIP, THE GOVERNING BODY OF THE ORGANIZATION IS PROVIDED WITH A COPY OF THE RETURN PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy PROCESS TO MONITOR TRANSACTIONS FOR COI THE ORGANIZATION REQUIRES ITS BOARD OF DIRECTORS AND OFFICERS TO SIGN A CONFLICT OF INTEREST POLICY ANNUALLY. BOARD MEMBERS ARE RESPONSIBLE FOR DISCLOSING POTENTIAL CONFLICTS AS THEY ARISE. IF A CONFLICT OF INTEREST ARISES, THE BOARD MEMBER IN CONFLICT ABSTAINS FROM VOTING ON THE MATTER. Form 990, Part VI, Line 19 Required documents available to the public AVAILABILITY OF GOVERNING DOCUMENTS & POLICIES COMMUNITY MEMORIAL HOSPITAL'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Misc Rev - Total Revenue: 80511, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 80511; CMH PHYSICIAN SERVICES LLC 1747 N MECKLENBURG AVE PO BOX 90 SOUTH HILL VA 23970 200999466 HEALTH PRACTICE VA 17685723 42767553 CMH INC COMMUNITY MEMORIAL HOSPITAL FOUNDATION - 1755 N MECKLENBERG AVE RICHMOND VA 23970 541831331 FUNDRAISING ORG VA 501(c)(3) Type I CMH true VCU HEALTH SYSTEM AUTHORITY PO BOX 980648 RICHMOND VA 23298 541848065 HOSPITAL VA NA false VCU AMBULATORY SURGERY CENTER LLC 11958 WEST BROAD ST 5TH FLOOR HENRICO VA 23294 863310585 AMBULATORY SERVICES VA 501(c)(3) 3 VCUHSA false VCU HEALTH CHILDREN'S SERVICES AT BROOK ROAD 2924 BROOK ROAD RICHMOND VA 23220 540506309 PEDIATRIC SERVICES VA 501(c)(3) 3 VCUHSA false VIRGINIA COMMONWEALTH UNIVERSITY PO BOX 842512 RICHMOND VA 23284 546001758 EDU INSTITUTE VA NA false UHS PROFESSIONAL EDUCATION PROGRAM - P O BOX 980048 RICHMOND VA 23298 541790553 EDU SEMINARS VA 501(c)(3) Type I UHS false MCV ASSOCIATED PHYSICIANS PO BOX 98062 RICHMOND VA 23298 541581185 HEALTHCARE VA 501(c)(3) Type I VCUHSA false 7TH AND MARSHALL CORPORATION PO BOX 980152 RICHMOND VA 23298 311568886 SUPPORT ACTIVITY VA 501(c)(3) Type I UHS false UNIVERSITY HEALTH SERVICES INC PO BOX 980152 RICHMOND VA 23298 541790550 PROPERTY VA 501(c)(3) Type I VCUHSA false VCU HEALTH TAPPAHANNOCK HOSPITAL 618 HOSPITAL ROAD TAPPAHANNOCK VA 22560 541489410 HOSPITAL VA 501(c)(3) 3 VCUHSA false VIRGINIA CHILDREN'S CARE NETWORK LLC PO BOX 980152 RICHMOND VA 23298 851396091 CLINICAL CARE VA 501(c)(3) Type I VCUHSA false false true true true false false false false false false false true true true true false false false COMMUNITY MEMORIAL HOSPITAL FOUNDATION C 1146665 FMV