2025-08-14T15:12:38-05:00 2024-09-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2023-10-01 814446403 REHAB JV LLC REHA 8048774000 2000 WILKES RIDGE DR RICHMOND VA 23233 JAMES S LITSINGER CHIEF FINANCIAL OFFICER 8048774000 2025-08-14 1 1 KURT BENNION CPA P01469618 4252506100 2025-08-14 2023 2025-03-06 01:10:19Z SHELTERING ARMS INSTITUTE ALAN LOMBARDO 2000 WILKES RIDGE DR RICHMOND VA 23233 87177122 0 X HTTPS://SHELTERINGARMSINSTITUTE.COM X LLC 2016 VA OPERATE A STATE-OF-THE-SCIENCE INPATIENT PHYSICAL REHABILITATION FACILITY AND OUTPATIENT CENTERS. 10 10 867 10 0 0 979251 2062657 80620200 84997465 0 117000 0 0 81599451 87177122 0 0 0 0 53424050 55275693 0 0 0 30433854 31644864 83857904 86920557 -2258453 256565 79285380 81185441 77016843 70879118 2268537 10306323 X SHELTERING ARMS INSTITUTE (SAI) WAS CREATED AS A COLLABORATION BY SHELTERING ARMS HOSPITAL AND VCU HEALTH TO REINVENT REHABILITATION FOR LIFE BEYOND LIMITS.AS A NATIONAL LEADER IN REHABILITATION MEDICINE, SAI DELIVERS PERSONALIZED CARE IN AN ENVIRONMENT THAT SUPPORTS RECOVERY AND RESTORES POSSIBILITY THROUGH THE INTEGRATION OF COLLABORATIVE SCIENCE AND RESEARCH, INTER-PROFESSIONAL EDUCATION, COMMUNITY ENGAGEMENT, AND STEWARDSHIP. ACROSS THE DISCIPLINES, THERE IS A CONSISTENT AND INTENTIONAL ORGANIZATIONAL CULTURE FOCUSED ON PROPELLING PATIENT OUTCOMES AND TRANSFORMING THE COURSE OF REHABILITATION MEDICINE. 0 0 73989054 0 84997465 SHELTERING ARMS INSTITUTE (SAI) BEGAN OPERATIONS IN JUNE 2020. SAI INCLUDES A 114-BED REHABILITATION HOSPITAL AND 8 OUTPATIENT CLINICS IN AND AROUND RICHMOND, VIRGINIA. THE HOSPITAL AND ITS CLINICIANS PROVIDE EXCEPTIONAL CARE IN ONE PLACE FOR INDIVIDUALS WHO HAVE SURVIVED STROKES, SPINAL CORD INJURIES, BRAIN INJURIES, AS WELL AS THOSE IN NEED OF GENERAL REHABILITATION FOR A VARIETY OF ILLNESSES AND INJURIES. AT THE HOSPITAL, PATIENTS HAVE ACCESS TO ADVANCED THERAPEUTIC TECHNOLOGIES IN A 9,251 SQUARE FOOT MAIN GYM, AS WELL AS OTHER SATELLITE GYMS. DURING FISCAL YEAR 2023-2024, THE HOSPITAL SERVED 2,569 PATIENTS FROM AROUND VIRGINIA AND THE MID-ATLANTIC REGION.(CONTINUED ON SCHEDULE O)IN JULY 2022, SAH DONATED ITS SEVEN OUTPATIENT PHYSICAL REHABILITATION CENTERS TO SAI, PROVIDING PATIENTS ACCESS TO A SEAMLESS CONTINUUM OF CARE. SINCE THEN, SAI HAS OPENED AN OUTPATIENT PHYSICAL REHABILITATION CENTER IN THE HOSPITAL, BRINGING THE TOTAL NUMBER OF OUTPATIENT PHYSICAL REHABILITATION CENTERS TO EIGHT. THE OUTPATIENT CENTERS ARE LOCATED THROUGHOUT THE METRO RICHMOND AREA AND SERVE PATIENTS FROM ACROSS CENTRAL VIRGINIA. SERVICES OFFERED AT THESE CENTERS INCLUDE PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY, AS WELL AS ACCESS TO ADVANCED THERAPEUTIC TECHNOLOGIES. DURING FISCAL YEAR 2023- 2024, THE OUTPATIENT CENTERS SERVED 10,557 PATIENTS, WHO RECEIVED A COMBINED TOTAL OF 115,346 OUTPATIENT VISITS.IN 2024, U.S. NEWS & WORLD REPORT RANTED SHELTERING ARMS INSTITUTE AS THE TOP REHABILITATION HOSPITAL IN VIRGINIA AND #19 IN THE COUNTRY. THE RANKINGS ASSIST PATIENTS AND THEIR DOCTORS IN CHOOSING THE RIGHT HOSPITAL FOR THEM.THROUGH EDUCATIONAL AFFILIATIONS, INCLUDING A PHYSICIAN RESIDENCY PROGRAM WITH THE DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION AT VCU HEALTH, SAI IS INFLUENCING THE PRACTICES AND BROADER RANGE IN BACKGROUNDS AMONG THE NEXT GENERATION OF HEALTHCARE PROFESSIONALS IN REHABILITATION MEDICINE. A COLLABORATIVE APPROACH TO RESEARCH, INCLUDING ACTIVE PARTNERSHIPS WITH VCU HEALTH'S CENTER FOR REHABILITATION SCIENCE AND ENGINEERING AND THE CENTRAL VIRGINIA VETERANS HEALTHCARE SYSTEM, CREATES A RESOURCE-RICH ENVIRONMENT THAT CAN SUPPORT PROGRAMS LIKE THE TRAUMATIC BRAIN INJURY (TBI) AND SPINAL CORD INJURY (SCI) MODEL SYSTEMS, WHICH ARE FUNDED BY FEDERAL GRANTS. THE PURSUIT OF BETTER PATIENT OUTCOMES INCLUDES PRODUCING CLINICAL RESEARCH, AS WELL AS TRANSLATING RESEARCH KNOWLEDGE INTO CLINICAL PRACTICE GUIDELINES USED BY OUR CLINICIANS. AS AN EXAMPLE OF KNOWLEDGE TRANSLATION, RESEARCH SHOWS THAT LONG-TERM PATIENT OUTCOMES IMPROVE THROUGH SUPPORTIVE RELATIONSHIPS WITH COMMUNITY PARTNER ORGANIZATIONS. TO FACILITATE THE DEVELOPMENT OF THOSE RELATIONSHIPS, COMMUNITY PARTNER GROUPS ARE REGULARLY ON-SITE AS A RESOURCE FOR PATIENTS AND THEIR FAMILIES. THE RESOURCES INCLUDE PEER MENTORING, ADAPTIVE SPORTS CLINICS, ADAPTIVE TECHNOLOGIES AS WELL AS DONATED MOBILITY EQUIPMENT FOR PATIENTS WHO QUALIFY. THE ORGANIZATION IS ALSO FOCUSED ON IMPROVING PATIENT OUTCOMES THROUGH A VARIETY OF INITIATIVES. THIS INCLUDES CREATING AND MAINTAINING A WORK ENVIRONMENT THAT ATTRACTS AND RETAINS CLINICIANS AND LEADERS FROM DIFFERENT BACKGROUNDS THAT REPRESENT OUR PATIENT BASE. WITH PARTNERS LIKE VIRGINIA COMMONWEALTH UNIVERSITY AND HAMPTON UNIVERSITY, AN HBCU LOCATED IN HAMPTON, VIRGINIA, SAI PARTICIPATES IN WORKFORCE DEVELOPMENT PROGRAMS TO IMPROVE MINORITY REPRESENTATION IN THE RANKS OF REHABILITATION PROFESSIONALS. THE INSTITUTE IS ALSO COMMITTED TO BETTER UNDERSTANDING THE LONG-TERM OUTCOMES FOR ALL REHABILITATION PATIENTS. BY ANALYZING DATA COLLECTED BY RESEARCH PARTNERS, THE INSTITUTE SEEKS TO UNDERSTAND AND REMOVE BARRIERS SO PATIENTS CAN ACHIEVE THE BEST POSSIBLE OUTCOMES. SAI HAS MORE THAN 500 CLINICAL TEAM MEMBERS, WHICH INCLUDES PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS, RECREATION THERAPISTS, SPEECH-LANGUAGE PATHOLOGISTS, AND NURSES, AS WELL AS A TEAM OF PHYSICIANS. THERE IS ALSO A FULL COMPLEMENT OF SUPPORT SERVICES AT THE HOSPITAL, SUCH AS LABORATORY, RADIOLOGY, RESPIRATORY THERAPY, AND PHARMACY. 73989054 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 42 0 1 867 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 VA X JAMES S LITSINGER 8048774000 8226 MEADOWBRIDGE ROAD MECHANICSVILLE VA 23116 X DIANNE V JEWELL CHAIRMAN 1.00 X X 0 0 0 KARAH GUNTHER VICE CHAIRMAN 1.00 X X 0 0 0 KIMBERLY R BAINE DIRECTOR 1.00 X 0 0 0 DAVID CIFU DIRECTOR 1.00 X 0 0 0 TERESA DI MARCO DIRECTOR (AS OF 2/2024) 1.00 X 0 0 0 EDWARD F GERARDO DIRECTOR 1.00 X 0 0 0 ASHBY HACKNEY DIRECTOR (THROUGH 1/2024) 1.00 X 0 0 0 RYAN RAISIG DIRECTOR 1.00 X 0 0 0 MICHAEL ROUSSOS DIRECTOR (THROUGH 8/2024) 1.00 X 0 0 0 MUHAMMAD SAEED DIRECTOR 1.00 X 0 0 0 JAMES SIEGEL DIRECTOR (AS OF 9/2024) 1.00 X 0 0 0 PETER ZEDLER DIRECTOR 1.00 X 0 0 0 HELEN WEAVER SECRETARY (AS OF 6/2024) 1.00 X 0 0 0 ALAN LOMBARDO CEO 40.00 X 478884 0 103613 JAMES S LITSINGER CFO AND TREASURER 40.00 X 401438 0 33410 MATTHEW WILKS CRO 40.00 X 250022 0 31166 MISTY WOODWARD CNO 40.00 X 246059 0 23242 AMANDA WORLEY VP OF HR AND SECRETARY (THRU 6/2024) 40.00 X 227702 0 30980 ALEX GRISHAM CIO 40.00 X 219599 0 31274 PATRICK ZUNIGA AVP REVENUE CYCLE 40.00 X 179740 0 28736 TANZA WESTRY AVP OF OPERATIONS 40.00 X 176208 0 17482 LINDA M TIEMENS VP OF QUALITY AND CARE COORDINATION 40.00 X 220033 0 6963 BRYAN C GILREATH VP OF OUTPATIENT SERVICES 40.00 X 161666 0 27634 2561351 0 334500 77 0 1 0 VCU HEALTH SYSTEM 57 N 11TH STREET RICHMOND VA 23298 ANCILLARY & PHYSICIAN SERVICES 4158593 ABM HEALTH INC 711 MOOREFIELD PARK DR RICHMOND VA 23236 FOOD AND ENVIRONMENTAL SERVICES 2763562 ORACLE AMERICA INC 2300 ORACLE WAY AUSTIN TX 78741 EHR SOFTWARE 2508233 CROTHALL HEALTHCARE INC 1550 LIBERTY RIDGE DR SUITE 100 WAYNE PA 19087 FACILITY MANAGEMENT SERVICES 825267 22 52489 2010168 270358 2062657 NET PATIENT SERVICE RE 621400 84038868 84038868 SHARED SERVICES 541900 542274 542274 MEDICARE COST REPORT R 621400 225672 225672 FOOD SERVICE REVENUE 722514 190651 190651 84997465 117000 117000 87177122 84997465 0 117000 2706551 2706551 43223294 38634728 4588566 1375241 1297711 77530 4697445 4089114 608331 3273162 2782188 490974 84362 54293 30069 165487 106503 58984 371313 238967 132346 544995 462785 82210 1427539 1296561 130978 3878050 3293064 584986 7099018 6028163 1070855 50664 43022 7642 779441 638581 140860 2306521 1911087 395434 343900 292024 51876 PURCHASED SERVICES 6942430 6144736 797694 PATIENT SUPPLIES 6058251 5144391 913860 BAD DEBT 1183485 1183485 0 EQUIPMENT 332029 281944 50085 77379 65707 11672 86920557 73989054 12931503 0 3482060 6747145 11930627 13505805 255996 284320 1154577 1575076 17271706 8540329 9344208 8731377 53117912 50341718 79285380 81185441 7453422 7472112 11300000 5862000 58263421 57545006 77016843 70879118 X 2268537 10306323 2268537 10306323 79285380 81185441 X 256565 7781221 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 579967 357952 222015 15032805 7900951 7131854 1658934 281426 1377508 8731377 RIGHT OF USE ASSET 50201366 INTERCOMPANY 140352 50341718 RIGHT OF USE LIABILITY 50199127 ESTIMATED THIRD PARTY PAYMENTS 7345879 57545006 X 85993637 0 85993637 1183485 1183485 87177122 85737072 0 85737072 1183485 1183485 86920557 PART X, LINE 2: U.S. GAAP REQUIRES SAI'S MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY SAI AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF SAI HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE THAN LIKELY WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. SAI'S MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY SAI AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2024, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR AN ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. SAI IS SUBJECT TO AUDIT BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT 1,183,485. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT 1,183,485. 1 1 X 1 X 1 X 1 1 0 0 2704000 2704000 0.03150 12059374 9592578 2466796 0.02880 14763374 9592578 5170796 0.06030 706083 706083 0.00820 298660 298660 0.00350 1004743 1004743 0.01170 15768117 9592578 6175539 0.07200 1 1183485 0 34303002 33792205 510797 X 1 1 1 1 SHELTERING ARMS INSTITUTE 2000 WILKES RIDGE DRIVE RICHMOND VA 23233 HTTPS://SHELTERINGARMSINSTITUTE.COM H0201 X PHYSICAL REHABILITATION HOSPITAL SHELTERING ARMS INSTITUTE 1 0 0 1 X X X X X X 21 1 0 0 1 X SEE PART V X 1 21 1 SEE PART V 0 1 X 200.000000000000 350.000000000000 X X X X X X 1 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X 1 X 0 X X X X 0 X X 0 0 SHELTERING ARMS INSTITUTE PART V, SECTION B, LINE 5: THERE WERE TWO VERSIONS OF SURVEYS DISTRIBUTED: ONE SPECIFIC TO CONSUMERS AND ONE SPECIFIC TO HEALTH PROFESSIONALS/COMMUNITY LEADERS. THE HOSPITAL FACILITY DISTRIBUTED THE ELECTRONIC SURVEY FOR HEALTH PROFESSIONALS/COMMUNITY LEADERS VIA EMAIL TO INDIVIDUALS WHO WORK FOR LOCAL PUBLIC HEALTH DEPARTMENTS, COMMUNITY FREE CLINICS, DISEASE-SPECIFIC ASSOCIATIONS, AND TEAM MEMBERS OF THE FACILITY. IN TOTAL, 141 HEALTHCARE PROFESSIONALS WERE SURVEYED FROM ORGANIZATIONS INCLUDING: CHESTERFIELD HEALTH DISTRICT, CHICKAHOMINY HEALTH DISTRICT, RICHMOND CITY HEALTH DISTRICT, VIRGINIA DEPARTMENT OF HEALTH, BON SECOURS, BRAIN INJURY ASSOCIATION OF VIRGINIA, CENTRAL VIRGINIA VA HEALTH CARE SYSTEM, COMMONWEALTH PAIN SPECIALISTS, DEPARTMENT FOR AGING & REHABILITATIVE SERVICES, GOOCHLANDCARES, HEALING INTO POSSIBILITY, OASISSENIOR ADVISORS, PRIMARY HEALTH GROUP - HENRICO, SENIOR CONNECTIONS, UVA MEDICAL CENTER, VCU HEALTH, VIRGINIA ASSISTIVE TECHNOLOGY SYSTEM, VIRGINIA DEPARTMENT FOR AGING AND REHABILITATIVE SERVICES, SHELTERING ARMS, AND SHELTERING ARMS INSTITUTE. SHELTERING ARMS INSTITUTE PART V, SECTION B, LINE 11: BY SURVEYING CONSUMERS AND HEALTHCARE PROFESSIONALS, THE HOSPITAL FACILITY IDENTIFIED FOUR TOP COMMUNITY HEALTH NEED PRIORITIES INCLUDING: EXERCISE, RECREATION, AND LEISURE; FOOD, DIET, AND NUTRITION; NAVIGATION, CARE COORDINATION, AND SUPPORT; AND MENTAL HEALTH. BASED ON THESE PRIORITIES, THE HOSPITAL FACILITY ESTABLISHED AN INTERDEPARTMENTAL WORK GROUP THAT ENCOMPASSES A REPRESENTATIVE FROM EACH OF THE FOUR PRIORITY AREAS. MEMBERS OF THE WORK GROUP COLLABORATED TO DEVELOP 30 SPECIFIC IMPLEMENTATION STRATEGIES, WHICH CAN BE FOUND ON PAGES 8-11 OF THE REPORT. THE WORK GROUP MEETS TWICE ANNUALLY TO DISCUSS PROGRESS MADE ON EACH IMPLEMENTATION STRATEGY TO ENSURE ALL STRATEGIES ARE COMPLETE BY THE NEXT CHNA REPORT IN 2025. NEEDS THE HOSPITAL FACILITY IS NOT ADDRESSING IN THIS REPORT INCLUDE PRIMARY MEDICAL CARE, MEDICAL DEVICES, DENTAL CARE, PREVENTATIVE HEALTH, TRANSPORTATION, AND CARE NAVIGATION. THE PRIMARY REASON THE HOSPITAL FACILITY IS NOT ADDRESSING THESE NEEDS IS BECAUSE OTHER ORGANIZATIONS WITHIN THE COMMUNITY ARE ALREADY ADDRESSING THEM. THE REPORT SPECIFICALLY LISTS THE OTHER ORGANIZATIONS WITHIN THE COMMUNITY WHO PROVIDE RESOURCES TO MEET THOSE NEEDS. ADDITIONALLY, THE HOSPITAL FACILITY INCLUDED A COMMUNITY RESOURCES SECTION IN THE APPENDICES WITH CONTACT INFORMATION. A SECONDARY REASON THE HOSPITAL FACILITY IS NOT ADDRESSING THESE NEEDS IS BECAUSE OF THE FACILITY'S CLOSE COLLABORATION AND PARTNERSHIPS WITH OTHER ORGANIZATIONS WHO ADDRESS THE NEEDS. SCHEDULE H, PART V, SECTION B, LINES 7B AND 10A HTTPS://SHELTERINGARMSINSTITUTE.COM/ABOUT-US/BROCHURES-AND-REPORTS/#COMMUNITY%20HEALTH%20NEEDS%20ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINES 16A-C HTTPS://SHELTERINGARMSINSTITUTE.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-FEES 7 1 - BON AIR OUTPATIENT CENTER 206 TWINRIDGE LANE RICHMOND VA 23235 OUTPATIENT REHABILITATION 2 - CHESTER OUTPATIENT CENTER 12220 IRON BRIDGE ROAD SUITE C CHESTER VA 23831 OUTPATIENT REHABILITATION 3 - HANOVER OUTPATIENT CENTER 8226 MEADOWBRIDGE ROAD MECHANICSVILLE VA 23116 OUTPATIENT REHABILITATION 4 - HULL STREET OUTPATIENT CENTER 13530 HULL STREET ROAD MIDLOTHIAN VA 23112 OUTPATIENT REHABILITATION 5 - LABURNUM OUTPATIENT CENTER 4730 S LABURNUM AVENUE RICHMOND VA 23231 OUTPATIENT REHABILITATION 6 - MIDTOWN OUTPATIENT CENTER 2805 W BROAD STREET RICHMOND VA 23230 OUTPATIENT REHABILITATION 7 - REYNOLDS OUTPATIENT CENTER 6627 W BROAD STREET RICHMOND VA 23230 OUTPATIENT REHABILITATION PART I, LINE 3C: ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY REQUIRES THAT THE INDIVIDUAL (A) RECEIVES MEDICALLY NECESSARY CARE, (B) COMPLETES A FINANCIAL ASSISTANCE APPLICATION, INCLUDING REQUIRED SUPPORTING DOCUMENTATION, EXCEPT AS EXPLAINED BELOW RELATED TO PRESUMPTIVE ELIGIBILITY DETERMINATIONS, (C) UTILIZES INSURANCE COVERAGE AS AVAILABLE TO THEM, (D) RESIDES IN THE SERVICE AREA, (E) COOPERATES IN ATTEMPTING TO OBTAIN ASSISTANCE, SUCH AS POSSIBLE PUBLIC BENEFITS OR COVERAGE PROGRAMS, AVAILABLE TO THEM, AND (F) HAS HOUSEHOLD INCOME LESS THAN 350% OF FEDERAL POVERTY LEVELS. SHELTERING ARMS INSTITUTE REALIZES THAT THERE MAY BE INSTANCES WHEN A PATIENT'S QUALIFICATION FOR FINANCIAL ASSISTANCE CAN BE ESTABLISHED WITHOUT COMPLETING THE FINANCIAL ASSISTANCE APPLICATION. PATIENTS ALREADY ENROLLED IN CERTAIN MEANS-TESTED PROGRAMS ARE DEEMED ELIGIBLE FOR FREE CARE ON A PRESUMPTIVE BASIS. THESE PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO, VIRGINIA WOMEN, INFANTS AND CHILDREN (WIC), VIRGINIA SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP), VIRGINIA TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) AND ALL DUAL-ELIGIBLE MEDICARE/MEDICAID PROGRAMS. ADDITIONAL PRESUMPTIVELY ELIGIBLE CATEGORIES WILL INCLUDE, WITH MINIMAL DOCUMENTATION, HOMELESS PATIENTS, DECEASED PATIENTS WITH NO KNOWN ESTATE, ALL PATIENTS RESULTING FROM OTHER AUTOMATED MEANS TEST SCORING CAMPAIGNS AND DATABASES, AND PATIENTS APPROVED FOR CHARITY CARE OR FINANCIAL ASSISTANCE AT OTHER 501(C)(3) ACUTE CARE FACILITIES IN THE RICHMOND, VIRGINIA METROPOLITAN AREA IN THE LAST 30 DAYS. PART I, LINE 7: COLUMN F REFLECTS THE CHARITY AND FINANCIAL ASSISTANCE AT COST AND OTHER COMMUNITY BENEFITS AS A PERCENTAGE OF THE TOTAL FUNCTIONAL EXPENSES IN PART IX, COLUMN A, LINE 25 OF THE FORM 990. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,183,485. PART II, COMMUNITY BUILDING ACTIVITIES: AS PART OF OUR COMMITMENT TO LIFELONG CARE, OUR OUTPATIENT PHYSICAL REHABILITATION CENTERS PROVIDE A SEAMLESS STREAM OF CARE AFTER PATIENTS ARE DISCHARGED FROM OUR HOSPITAL. PART III, LINE 2: THE AMOUNT REPORTED HERE REPRESENTS AMOUNTS DEEMED TO BE UNCOLLECTIBLE THAT WERE WRITTEN OFF DURING THE FISCAL YEAR. PART III, LINE 3: SHELTERING ARMS INSTITUTE DOES NOT HAVE A MEANS OF CALCULATING THE PORTION OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT FAILED TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. PART III, LINE 4: SEE THE "PATIENT ACCOUNTS RECEIVABLES" PARAGRAPH ON PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE ALLOWABLE COSTS FIGURE WAS OBTAINED FROM THE FISCAL YEAR 2023-2024 MEDICARE COST REPORT. PART III, LINE 9B: PATIENTS MAY APPLY RETROACTIVELY FOR FINANCIAL ASSISTANCE FOR SERVICES UP TO 60 DAYS PRIOR. IF THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE AND ALL OTHER PROGRAMS HAVE BEEN EXHAUSTED FOR PAYMENT ASSISTANCE, A PAYMENT PLAN ARRANGEMENT MAY BE MADE. BALANCES DESIGNATED BY THIRD-PARTY PAYERS AS PATIENT RESPONSIBILITY WILL BE ASSIGNED TO THE PATIENT BALANCE SEGMENT IN THE SHELTERING ARMS HOSPITAL BILLING SYSTEM. QUALIFYING PATIENT RESPONSIBLE BALANCES WILL BE BILLED DIRECTLY TO THE PATIENT BY SHELTERING ARMS. IF PAYMENT IS NOT RECEIVED WITHIN 60 DAYS, ANY UNPAID BALANCES WILL BE FORWARDED TO OUR FIRST-OUT VENDOR FOR CONTINUING COLLECTION EFFORTS TO INCLUDE PATIENT PAYMENT PLANS. ANY UNSETTLED BALANCES REMAINING AFTER A TOTAL OF 120 DAYS AFTER THE FIRST ASSIGNMENT OF BALANCES WILL BE SENT TO OUR COLLECTION AGENCY AND REMOVED FROM OUR ACTIVE ACCOUNTS RECEIVABLE AS BAD DEBT. IF THE COLLECTION AGENCY SUCCESSFULLY COLLECTS THE BALANCES, THE PATIENT ACCOUNT WILL BE REACTIVATED IN OUR ACCOUNTS RECEIVABLE SYSTEM AND THE BAD DEBT WILL BE REVERSED AND CODED AS RECOVERY. IF THE COLLECTION AGENCY IS UNSUCCESSFUL WITH COLLECTIONS AND HAS NO PAYMENT ARRANGEMENT OR A BROKEN PAYMENT ARRANGEMENT, THE ACCOUNT CAN BE PULLED BACK FROM THE COLLECTION VENDOR, THE BAD DEBT STATUS WILL REMAIN, AND COLLECTION EFFORTS WILL CEASE. PART VI, LINE 2: A HOSPITAL ORGANIZATION MUST MEET THE REQUIREMENTS OF SECTION 501(R)WITH RESPECT TO A NEW HOSPITAL FACILITY IT OPERATES BY THE LAST DAY OF THE SECOND TAXABLE YEAR BEGINNING AFTER THE DATE THE FACILITY WAS LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED BY ITS STATE AS A HOSPITAL. SINCE THE INSTITUTE'S NEW FACILITY WAS LICENSED IN JUNE OF 2020, A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN ITS TAXABLE YEAR ENDING SEPTEMBER 30, 2022.THERE WERE TWO VERSIONS OF SURVEYS DISTRIBUTED: ONE SPECIFIC TO CONSUMERS AND ONE SPECIFIC TO HEALTH PROFESSIONALS/COMMUNITY LEADERS. THE HOSPITAL FACILITY DISTRIBUTED THE ELECTRONIC SURVEY FOR HEALTH PROFESSIONALS/COMMUNITY LEADERS VIA EMAIL TO INDIVIDUALS WHO WORK FOR LOCAL PUBLIC HEALTH DEPARTMENTS, COMMUNITY FREE CLINICS, DISEASE-SPECIFIC ASSOCIATIONS, AND TEAM MEMBERS OF THE FACILITY. IN TOTAL, 141 HEALTHCARE PROFESSIONALS WERE SURVEYED FROM ORGANIZATIONS INCLUDING: CHESTERFIELD HEALTH DISTRICT, CHICKAHOMINY HEALTH DISTRICT, RICHMOND CITY HEALTH DISTRICT, VIRGINIA DEPARTMENT OF HEALTH, BON SECOURS, BRAIN INJURY ASSOCIATION OF VIRGINIA, CENTRAL VIRGINIA VA HEALTH CARE SYSTEM, COMMONWEALTH PAIN SPECIALISTS, DEPARTMENT FOR AGING & REHABILITATIVE SERVICES, GOOCHLANDCARES, HEALING INTO POSSIBILITY, OASISSENIOR ADVISORS, PRIMARY HEALTH GROUP - HENRICO, SENIOR CONNECTIONS, UVA MEDICAL CENTER, VCU HEALTH, VIRGINIA ASSISTIVE TECHNOLOGY SYSTEM, VIRGINIA DEPARTMENT FOR AGING AND REHABILITATIVE SERVICES, SHELTERING ARMS, AND SHELTERING ARMS INSTITUTE. PART VI, LINE 3: SHELTERING ARMS INSTITUTE WILL WIDELY PUBLICIZE THE SHELTERING ARMS INSTITUTE FINANCIAL ASSISTANCE POLICY. INFORMATION ON FINANCIAL ASSISTANCE WILL BE PROVIDED TO PATIENTS AND THE COMMUNITY SERVED BY SHELTERING ARMS INSTITUTE. THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION, AND A PLAIN LANGUAGE SUMMARY OF THE POLICY WILL BE AVAILABLEON THE SHELTERING ARMS INSTITUTE' WEBSITE. SHELTERING ARMS INSTITUTE WILL PROVIDE HARD COPIES OF THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND A PLAIN LANGUAGE SUMMARY OF THE POLICY TO PATIENT UPON REQUEST, IN PERSON OR BY MAIL, AND FREE OF CHARGE. FINANCIAL ASSISTANCE INFORMATION WILL BE MADE AVAILABLE IN THE PATIENT ADMISSION INFORMATION PACKAGE AND DISCHARGE PROCESS FOR ALL PATIENTS. INFORMATION ON THE POLICY AND INSTRUCTIONS ON HOW TO CONTACT SHELTERING ARMS INSTITUTE FOR ASSISTANCE WILL BE POSTED IN AREAS THAT INCLUDE, BUT ARE NOT LIMITED TO, ADMITTING AND REGISTRATION. PATIENT STATEMENTS WILL INCLUDEINFORMATION ON THE SHELTERING ARMS INSTITUTE FINANCIAL ASSISTANCE POLICY AND ON HOW AN APPLICATION FORM MAY BE OBTAINED. SHELTERING ARMS INSTITUTE WILL PROVIDE PUBLIC NOTICES YEARLY IN LOCAL NEWSPAPERS SERVING THE HOSPITAL'S TARGET POPULATION. PART VI, LINE 4: SHELTERING ARMS INSTITUTE SERVES A REGIONAL AREA INCLUDING BUT NOT LIMITED TO VIRGINIA AND SURROUNDING STATES. PRIMARY COUNTIES IN VIRGINIA SERVED INCLUDE CAROLINE, CHARLES CITY, ESSEX, HANOVER, HENRICO, KING AND QUEEN, KING WILLIAM, LANCASTER, LOUISA, MIDDLESEX, NEW KENT, NORTHUMBERLAND, RICHMOND, AND RICHMOND CITY. PART VI, LINE 7, REPORTS FILED WITH STATES VA X X X 0 0 0 0 0 0 0 1 0 ALAN LOMBARDO CEO 379339 0 98735 0 810 0 83074 0 20539 0 582497 0 0 0 JAMES S LITSINGER CFO AND TREASURER 313250 0 84672 0 3516 0 13925 0 19485 0 434848 0 0 0 MATTHEW WILKS CRO 208386 0 40680 0 956 0 11860 0 19306 0 281188 0 0 0 MISTY WOODWARD CNO 204048 0 41366 0 645 0 3923 0 19319 0 269301 0 0 0 AMANDA WORLEY VP OF HR AND SECRETARY (THRU 6/2024) 188161 0 38978 0 563 0 11747 0 19233 0 258682 0 0 0 ALEX GRISHAM CIO 181617 0 37622 0 360 0 12064 0 19210 0 250873 0 0 0 LINDA M TIEMENS VP OF QUALITY AND CARE COORDINATION 179032 0 36295 0 4706 0 0 0 6963 0 226996 0 0 0 PATRICK ZUNIGA AVP REVENUE CYCLE 158110 0 20894 0 736 0 9590 0 19146 0 208476 0 0 0 TANZA WESTRY AVP OF OPERATIONS 154599 0 20894 0 715 0 5295 0 12187 0 193690 0 0 0 BRYAN C GILREATH VP OF OUTPATIENT SERVICES 142050 0 19198 0 418 0 8548 0 19086 0 189300 0 0 0 PART I, LINE 7 BONUSES ARE AWARDED BASED ON ACHIEVING PRE-ESTABLISHED PERFORMANCE OBJECTIVES FOLLOWING SAI'S COMPENSATION POLICY. X MEDICAL EQUIPMENT AND SIGNAGE 1 270360 FAIR MARKET VALUE 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO MEMBERS, SHELTERING ARMS HOSPITAL AND VIRGINIA COMMONWEALTH UNIVERSITY HOSPITAL SYSTEM AUTHORITY. FORM 990, PART VI, SECTION A, LINE 7A THE TWO MEMBERS EACH APPOINT 5 OF 10 BOARD MANAGERS. EACH MEMBER ALSO HAS THE POWER TO REMOVE ANY BOARD MANAGER WHICH THEY APPOINTED. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 AND APPLICABLE ATTACHMENTS WERE PROVIDED TO THE BOARD OF MANAGERS EITHER IN ELECTRONIC FORMAT OR BY MAIL. AN OPEN COMMENT AND QUESTION PERIOD WAS WELCOMED TO DIRECT ANY QUESTIONS OR COMMENTS BEFORE FILING THE FORM 990 AND ITS RELATED ATTACHMENTS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MANAGERS ARE REQUIRED TO REVIEW AND SIGN A COPY OF THE CONFLICT OF INTEREST POLICY ANNUALLY. ANY CONFLICTS ARE DISCLOSED AT THAT TIME AND THE SIGNED POLICY IS KEPT ON FILE BY THE ORGANIZATION. IN THE EVENT A POTENTIAL CONFLICT ARISES DURING THE YEAR, THE MANAGER WITH SUCH CONFLICT MUST RECUSE HIM/HERSELF FROM ALL DISCUSSIONS AND VOTE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE CEO HAS A WRITTEN EMPLOYMENT CONTRACT APPROVED BY THE BOARD. THE BOARD USED LEGAL COUNSEL TO DRAFT THE AGREEMENT AND GUIDE THEM ON THE COMPENSATION AMOUNT, INCLUDING THE USE OF A COMPENSATION SPECIALIST. CERTAIN OTHER OFFICERS OF SAI ARE EMPLOYED BY SAC. DEPENDING ON THE INDIVIDUAL, EITHER SAC OR SAI UTILIZES THE SERVICES OF AN INDEPENDENT, EXTERNAL COMPENSATION FIRM TO CONDUCT A REVIEW OF ITS EXECUTIVE COMPENSATION PROGRAM TO ENSURE THE EXECUTIVE COMPENSATION LEVELS ARE COMPETITIVE AND REASONABLE. SHELTERING ARMS COMPENSATION WAS MEASURED AGAINST HEALTHCARE ORGANIZATIONS SIMILAR IN SCOPE AND SCALE USING DATA FROM SIX EXTERNAL MARKET SURVEY SOURCES AS THE COMPARATIVE BASIS; BOTH BASE SALARY AND TOTAL CASH COMPENSATION WERE EVALUATED. THE COMPETITIVE ANALYSIS FINDINGS WERE PRESENTED TO THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS WHO EXAMINED AND APPROVED THEM. IN ADDITION, THE COMPENSATION COMMITTEE EVALUATES PERFORMANCE, COMPENSATION SURVEYS, AND CONTRACT TERMS AND CONDITIONS ANNUALLY BEFORE DETERMINING AND RECOMMENDING COMPENSATION. ALL COMPENSATION COMMITTEE DISCUSSIONS ARE DOCUMENTED IN FORMAL MINUTES. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST, SHELTERING ARMS INSTITUTE WILL MAKE AVAILABLE FOR PUBLIC INSPECTION GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, RELATED POLICIES, AND FINANCIAL STATEMENTS. FORM 990, PART VII, SECTION A OFFICERS JAMES LITSINGER'S AND AMANDA WORLEY'S COMPENSATION IS PAID BY SHELTERING ARMS INSTITUTE. THE OFFICERS PROVIDE FINANCE AND HUMAN RESOURCES SUPPORT, RESPECTIVELY, TO SHELTERING ARMS CORPORATION, SHELTERING ARMS HOSPITAL, SHELTERING ARMS HOSPITAL SOUTH, AND SHELTERING ARMS FOUNDATION, ALL UNRELATED TAX-EXEMPT ORGANIZATIONS. THIS SUPPORT IS PROVIDED THROUGH A SHARED SERVICES AGREEMENT BETWEEN THESE ENTITIES AND SHELTERING ARMS INSTITUTE. FORM 990, PART XI, LINE 9: CAPITAL CONTRIBUTIONS 7,781,221. FORM 990, PART XII, LINE 2C: AUDIT REVIEW PROCESS IS UNCHANGED FROM PRIOR YEAR. SHELTERING ARMS PHYSICAL REHABILITATION ASSOCIATES LLC 8226 MEADOWBRIDGE ROAD MECHANICSVILLE VA 23116 260402064 PHYSICAL REHABILITATION VA 387674 495166 REHAB JV LLC