2019-11-08T15:49:53-06:00 2018-12-31 540737372 PBMARES LLP 725 JACKSON STREET SUITE 210 FREDERICKSBURG VA 22401 990 2018-01-01 541240646 MARY WASHINGTON HEALTHCARE MARY 5407412513 2300 FALL HILL AVENUE NO 418 FREDERICKSBURG VA 22401 SEAN T BARDEN EXECUTIVE VICE PRESIDENT 5407412513 2019-11-06 1 JENNIFER N FRENCH P00659678 5403713566 2019-11-06 X 209.10.80.132 2019-11-06 19:52:42 ES P 21868D59D436FDDBEEFA93A6B6F6C050C073B945 E9DFE3CB1E4125439BCCE9C8A6EA67D68024C52E 2018 2020-04-17 16:48:07Z MICHAEL P MCDERMOTT MD 2300 FALL HILL AVENUE NO 418 FREDERICKSBURG VA 22401 170849187 0 X WWW.MARYWASHINGTONHEALTHCARE.COM/ X 1983 VA OUR MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 17 16 720 16 380000 -217094 57484 99318 97535869 104797897 10738012 8523802 0 0 108331365 113421017 261057 264038 0 0 51200667 55510787 0 0 661910 50771882 76870884 102233606 132645709 6097759 -19224692 453511593 434691972 131196235 128815134 322315358 305876838 X OUR MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. THROUGH OUR SUBSIDIARIES WE PROVIDE INPATIENT AND OUTPATIENT HOSPITAL SERVICES AND OTHER MEDICAL SERVICES. 0 0 130659982 264038 104417897 AS THE PARENT CORPORATION OF THE MWHC AFFILIATED GROUP, MWHC PROVIDES STRATEGIC DIRECTION, MANAGEMENT AND CORPORATE SUPPORT SERVICES TO MEMBERS OF THE AFFILIATED GROUP. AS THE PARENT CORPORATION OF THE MWHC AFFILIATED GROUP, MWHC PROVIDES STRATEGIC DIRECTION, MANAGEMENT AND CORPORATE SUPPORT SERVICES TO MEMBERS OF THE AFFILIATED GROUP. 130659982 1 0 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 424 0 1 720 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 17 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X JENNINGS D DAWSON III 5407412513 2300 FALL HILL AVENUE NO 418 FREDERICKSBURG VA 22401 WILLIAM M BOLDON MBA CHAIR 2.00 3.00 X X 0 0 0 RONALD W BRANSCOME MS BOARD TRUSTEE 2.00 2.00 X 0 0 0 BRUCE L DAVIS BA BOARD TRUSTEE 2.00 2.00 X 0 0 0 JANAMITRA DEVAN BOARD TRUSTEE 2.00 2.00 X 0 0 0 MATTHEW D DUMONT MD BOARD TRUSTEE 2.00 2.00 X 0 0 0 REV ALLEN H FISHER JR BA BOARD TRUSTEE 2.00 2.00 X 0 0 0 JEFFREY A FRAZIER MD BOARD TRUSTEE 2.00 2.00 X 0 0 0 DAVID M GARTH MD BOARD TRUSTEE 4.00 2.00 X 0 0 0 MICHAEL P MCDERMOTT MD MBA PRESIDENT AND CEO 40.00 4.00 X X 1285921 0 41692 JOHN C MCKEOWN MA MPA BOARD TRUSTEE 2.00 2.00 X 0 0 0 SUDEEP J MENACHERY MD BOARD TRUSTEE 2.00 2.00 X 0 0 0 FRED M MESSING MBA LFACHE BOARD TRUSTEE 2.00 2.00 X 0 0 0 CLARENCE A ROBINSON BS SECRETARY/TREASURER 2.00 2.00 X X 0 0 0 JOHN F ROWLEY BS JD BOARD TRUSTEE 2.00 2.00 X 0 0 0 ALDA L WHITE BA JD IMMEDIATE PAST CHAIR 2.00 2.00 X X 0 0 0 MARTIN A WILDER JR EDD BOARD TRUSTEE 2.00 2.00 X 0 0 0 LINDA D WORRELL BOARD TRUSTEE 2.00 2.00 X 0 0 0 SEAN T BARDEN BSBA MBA EXEC VP AND CFO 40.00 4.00 X 655837 0 34565 REBECCA BIGONEY MD EXEC VP AND CMO 40.00 2.00 X 699703 0 29123 JUSTIN BOX MBA SVP & CIO 40.00 2.00 X 365836 0 43241 EILEEN DOHMANN RN BSN MBA NEA-BC SVP & CNO 40.00 2.00 X 343796 0 13566 ERIC FLETCHER MBA APR SVP 40.00 2.00 X 347628 0 39685 XAVIER RICHARDSON BA MBA EVP 40.00 2.00 X 334726 0 29216 TRAVIS TURNER BS MBA SVP 40.00 2.00 X 311159 0 35702 KATHRYN WALL BA MA EVP 40.00 2.00 X 420200 0 20780 ELIESE K BERNARD VICE PRESIDENT 2.00 40.00 X 0 379917 4965 LAUREN BLALOCK VICE PRESIDENT 40.00 2.00 X 201618 0 38127 CODY BLANKENSHIP VICE PRESIDENT 40.00 2.00 X 211088 0 30481 KATHLEEN BOURGAULT MS CPAM VICE PRESIDENT 40.00 2.00 X 243132 0 27514 SANDRA BROWN CPA VICE PRESIDENT 40.00 2.00 X 266911 0 29053 ALAN EDWARDS VICE PRESIDENT 40.00 2.00 X 217385 0 38166 TINA ERVIN VICE PRESIDENT 40.00 2.00 X 240162 0 27644 MARIE FREDRICK RT R CRA MJ VICE PRESIDENT 40.00 2.00 X 245590 0 21718 STEPHEN MANDELL MD VICE PRESIDENT 2.00 40.00 X 0 403921 33738 DOUGLAS SCHULTE MD VICE PRESIDENT 40.00 2.00 X 386607 0 10661 CATHLEEN YABLONSKI BS MS VICE PRESIDENT 2.00 40.00 X 0 268444 25031 DAVID YI MD VICE PRESIDENT 40.00 2.00 X 356883 0 10491 JENNIFER FREELAND EPIC PROJECT DIRECTOR 40.00 2.00 X 180238 0 5629 PHILIP A BROWN DIRECTOR OF PLANNING 40.00 2.00 X 165757 0 29338 KARIN S HAYNES APPLICATIONS DIRECTOR 40.00 2.00 X 162628 0 7581 ANDREA D MATTHEWS BUSINESS ANALYST II 40.00 2.00 X 168032 0 14776 RICHARD A LEWIS MEDICAL DIRECTOR 40.00 2.00 X 265848 0 24940 JAMES R DANIEL FORMER SENIOR MEDICAL DIRECTOR 0.00 0.00 X 0 352973 14678 THOMAS G GETTINGER MHA FORMER EVP & COO 0.00 0.00 X 378086 0 0 8454771 1405255 682101 88 1 1 0 ENCORE A QUINTILES COMPANY 4625 FM 2920 104 SPRING TX 77388 CONTRACT PERSONNEL 6037689 ETTAIN GROUP INC 127 W WORTHINGTON AVE STE 100 CHARLOTTE NC 28203 CONTRACT PERSONNEL 3382921 ALLIED UNIVERSAL COMPANY PO BOX 828854 PHILADELPHIA PA 191828854 SECURITY SERVICES 2925527 TEKSYSTEMS 7437 RACE RD HANOVER MD 21076 CONTRACT PERSONNEL 2825672 STOLTENBERG CONSULTING INC 5815 LIBRARY ROAD BETHEL PARK PA 15102 CONTRACT PERSONNEL 2686352 65 99318 99318 MANAGEMENT SERVICES REVENUE 561000 79728778 79348778 380000 MWHA PHYSICIAN PROGRAMS 561000 19000445 19000445 AFFILIATE CAPTIVE INSURANCE 561000 3103395 3103395 OTHER OPERATING INCOME 561000 2304618 2304618 COLLECTION SERVICES 561000 274048 274048 386613 386613 104797897 4947746 4947746 60989242 14984 57428170 0 3561072 14984 3576056 3576056 113421017 104417897 380000 8523802 X 264038 264038 8033690 7913185 80337 40168 38018398 37448122 380184 190092 1617188 1592930 16172 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-20904017 23690189 X X 0 1 X 1 0 X X 2 MARY WASHINGTON HOSPITAL INC 540519577 3 1 0 0 STAFFORD HOSPITAL LLC 134316364 3 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 PART IV, LINE 1 SUPPORTED ORGANIZATION, MARY WASHINGTON HOSPITAL, INC. IS LISTED BY NAME IN THE ORGANIZATION'S GOVERNING DOCUMENTS. SUPPORTED ORGANIZATION, STAFFORD HOSPITAL, LLC, IS CLASSIFIED AS 501(C)(3) AND IS DESIGNATED BY ITS PURPOSE ALIGNED WITH THAT OF MARY WASHINGTON HEALTHCARE TO ESTABLISH, MAINTAIN AND OPERATE, DIRECTLY OR INDIRECTLY, FACILITIES AND SERVICES PROVIDING HEALTH CARE FOR SICK, INJURED, DISABLED OR AGED PERSONS AND PROVIDING FOR THE PRESERVATION OF HEALTH AS THE BOARD OF TRUSTEES MAY DETERMINE FROM TIME TO TIME TO BE APPROPRIATE, INCLUDING, WITHOUT LIMITATION, HOSPITALS, AMBULATORY CARE SERVICES, NURSING CARE FACILITIES AND AGENCIES OR FACILITIES PROVIDING CARE FOR THE PERSONS IN THEIR HOMES . STAFFORD HOSPITAL, LLC IS ORGANIZED EXCLUSIVELY FOR OTHER CHARITABLE, SCIENTIFIC, EDUCATIONAL AND SCIENTIFIC PURPOSES. MORE SPECIFICALLY DEFINED AS FOLLOWS: TO ESTABLISH, OWN, MANAGE, MAINTAIN AND OPERATE ACUTE CARE HOSPITALS AND OTHER HEALTHCARE INSTITUTIONS AND SERVICES; TO PROMOTE HEALTH THROUGH PARTICIPATION IN INTEGRATED PATIENT CARE MANAGEMENT SYSTEMS THAT OFFER ACCESS TO A COMPLETE SPECTRUM OF HEALTH SERVICES, FROM PREVENTION AND TREATMENT TO EMERGENT, ACUTE, CHRONIC AND LONG-TERM CARE; TO CARRY ON MEDICAL AND SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK AND INJURED; TO CARRY ON EDUCATIONAL OR TRAINING ACTIVITIES RELATED TO THE CARE AND PREVENTION OF SICKNESS, INJURY AND DISEASE OR THE PROMOTION OF HEALTH; TO PARTICIPATE, AS CIRCUMSTANCES MAY WARRANT, IN ANY ACTIVITY DESIGNED AND CARRIED OUT TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY; TO ENGAGE IN ANY OTHER LAWFUL ACTIVITY CONSISTENT WITH AND AS LIMITED BY SECTION 501(C)(3) OF THE CODE; AND TO CONDUCT ANY OR ALL LAWFUL AFFAIRS THAT DO NOT CONFLICT WITH THE ABOVE PURPOSES BUT ARE OTHERWISE CONFERRED UPON LIMITED LIABILITY COMPANIES BY THE VIRGINIA LIMITED LIABILITY COMPANY ACT OR ITS SUCCESSOR. 1 1 0 1 0 0 1 15746 1 1 15746 0 PART II-B, LINE 1: PART II-B LOBBYING EXPENDITURES INCLUDE BOTH DIRECT AND INDIRECT EXPENDITURES. MWHC HAS A COST CODE SPECIFICALLY FOR LOBBYING EXPENDITURES. ALL AMOUNTS FROM THAT COST CODE ARE INCLUDED IN THIS SECTION. IN ADDITION, AN ALLOCABLE SHARE OF SALARIES OF THE ORGANIZATION'S ASSOCIATES ENGAGED IN THE ACTIVITY ARE ALSO INCLUDED. 1481228 228045 1253183 3268139 1167932 2100207 112236288 66307157 45929131 42532 18611 23921 49306442 INVEST-VHA, INC. 200000 C INVEST IN SUB-MWH 98185527 C INVEST IN SUB-SHC -18849158 C INVEST IN SUB-MPI 68162797 C INVEST IN SUB-MSI -6562937 C INVEST IN SUB-REX 13151937 C INVEST IN MWHCS 5299362 C INVEST IN MW MEDICAL GROUP 496536 C INVEST IN SUB-MWHP -598900 C 159485164 IBNR 3265459 LOSS RESERVE ON EXCESS PROGRAM 135390 PENSION LIABILITY 54936987 58337836 X PART X, LINE 2: MWHC WAS RECOGNIZED AS A PUBLIC CHARITY GENERALLY EXEMPT FROM FEDERAL INCOME TAXATION UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE PURSUANT TO A DETERMINATION LETTER ISSUED BY THE IRS IN MARCH 1992. MWHC IS ENTITLED TO RELY ON THIS DETERMINATION AS LONG AS THERE ARE NO SUBSTANTIAL CHANGES IN ITS CHARACTER, PURPOSES, OR METHODS OF OPERATION. MANAGEMENT HAS CONCLUDED THAT THERE HAVE BEEN NO SUCH CHANGES AND, THEREFORE, MWHC'S STATUS AS A PUBLIC CHARITY EXEMPT FROM FEDERAL INCOME TAXATION REMAINS IN EFFECT. THE STATE IN WHICH MWHC OPERATES ALSO PROVIDES GENERAL EXEMPTION FROM STATE INCOME TAXATION FOR ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAXATION. HOWEVER, MWHC IS SUBJECT TO BOTH FEDERAL AND STATE INCOME TAXATION AT CORPORATE TAX RATES ON ITS UNRELATED BUSINESS INCOME. EXEMPTION FROM OTHER STATE TAXES, SUCH AS REAL AND PERSONAL PROPERTY TAXES, IS SEPARATELY DETERMINED. CERTAIN ENTITIES UNDER MWHC ARE TAXABLE ENTITIES. MWHC HAD NO UNRECOGNIZED TAX BENEFITS OR LIABILITIES, OR SUCH AMOUNTS WERE IMMATERIAL DURING THE PERIODS PRESENTED. FOR TAX PERIODS WITH RESPECT TO WHICH NO UNRELATED BUSINESS INCOME WAS RECOGNIZED, NO TAX RETURN WAS REQUIRED. TAX PERIODS FOR WHICH NO RETURN IS FILED REMAIN OPEN FOR EXAMINATION INDEFINITELY. GENERALLY, TAX RETURNS FOR THE YEARS ENDED DECEMBER 31, 2015, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. ALL REQUIRED TAX FILINGS HAVE BEEN FILED ON A TIMELY BASIS. 0 FREDERICKSBURG REGIONAL ALLIANCE THE BOWMAN CENTER ROUTE 2 FREDERICKSBURG VA 22404 541961653 501(C)(3) 50000 COMPREHENSIVE HEALTH INVESTMENT PLAN SUPPORT RAPPAHANNOCK UNITED WAY INC 3310 SHANNON PARK DRIVE FREDERICKSBURG VA 22408 546042936 501(C)(3) 39748 ENRICHMENT VA HEALTH CARE FOUNDATION 707 EAST MAINE ST SUITE 1350 RICHMOND VA 23219 541639924 501(C)(3) 25000 GENERAL SUPPORT LLOYD MOSS FREE CLINIC 1301 SAM PERRY BLVD SUITE 100 FREDERICKSBURG VA 22401 541677934 501(C)(3) 15000 GENERAL SUPPORT THE DOCTOR YUM PROJECT 10482 GEORGETOWN DR SPOTSYLVANIA VA 22553 455245719 501(C)(3) 18500 GENERAL SUPPORT MARINE CORPS MARATHON PO BOX 188 3399 RUSSELL ROAD FREDERICKSBURG VA 22134 541468675 501(C)(3) 7500 GENERAL SUPPORT SAFE HARBOR CHILD ADVOCACY CNT 4702 SOUTHPOINT PKWY FREDERICKSBURG VA 22407 261563081 501(C)(3) 7000 GENERAL SUPPORT AMERICAN HEART ASSOCIATION PO BOX 50045 PRESCOTT AZ 863045045 135613797 501(C)(3) 6500 GENERAL SUPPORT RAPPAHANNOCK POPS ORCHESTRA PO BOX 1972 SPOTSYLVANIA VA 22553 912154808 501(C)(3) 6000 GENERAL SUPPORT LOISANN'S HOPE HOUSE 902 LAFAYETTE BLVD FREDERICKSBURG VA 22401 541419314 501(C)(3) 5500 GENEARL SUPPORT AMERICAN HEART ASSOCIATION 4217 PARK PLACE CT GLENN ALLEN VA 23060 540496629 501(C)(3) 5000 GENERAL SUPPORT STAFFORD COUNTY ARMED SERVICES MEMORIAL PO BOX 1777 STAFFORD VA 22555 546001626 501(C)(3) 5000 GENERAL SUPPORT MARCH OF DIMES PO BOX 932852 ATLANTA GA 311932852 131846366 501(C)(3) 5000 GENERAL SUPPORT ALZHEIMER'S ASSOCIATION 2217 PRINCESS ANNE ST STE 106-1F FREDERICKSBURG VA 22401 541226864 501(C)(3) 5000 GENERAL SUPPORT 14 14 X X 1 1 X X X X X X 1 1 0 0 0 0 0 1 0 MICHAEL P MCDERMOTT MD MBA PRESIDENT AND CEO 815940 0 250871 0 219110 0 8250 0 33442 0 1327613 0 0 0 SEAN T BARDEN BSBA MBA EXEC VP AND CFO 438222 0 126484 0 91131 0 8250 0 26315 0 690402 0 0 0 REBECCA BIGONEY MD EXEC VP AND CMO 430990 0 122431 0 146282 0 8250 0 20873 0 728826 0 0 0 JUSTIN BOX MBA SVP & CIO 284799 0 69405 0 11632 0 8250 0 34991 0 409077 0 0 0 EILEEN DOHMANN RN BSN MBA NEA-BC SVP & CNO 262267 0 63608 0 17921 0 8250 0 5316 0 357362 0 0 0 ERIC FLETCHER MBA APR SVP 274276 0 61401 0 11951 0 8250 0 31435 0 387313 0 0 0 XAVIER RICHARDSON BA MBA EVP 231587 0 51659 0 51480 0 7041 0 22175 0 363942 0 0 0 TRAVIS TURNER BS MBA SVP 243034 0 56568 0 11557 0 6970 0 28732 0 346861 0 0 0 KATHRYN WALL BA MA EVP 272262 0 61390 0 86548 0 8250 0 12530 0 440980 0 0 0 ELIESE K BERNARD VICE PRESIDENT 0 311870 0 59798 0 8249 0 0 0 4965 0 384882 0 0 LAUREN BLALOCK VICE PRESIDENT 159926 0 33833 0 7859 0 5340 0 32787 0 239745 0 0 0 CODY BLANKENSHIP VICE PRESIDENT 172168 0 31093 0 7827 0 2591 0 27890 0 241569 0 0 0 KATHLEEN BOURGAULT MS CPAM VICE PRESIDENT 192607 0 40209 0 10316 0 5572 0 21942 0 270646 0 0 0 SANDRA BROWN CPA VICE PRESIDENT 216132 0 42141 0 8638 0 6929 0 22124 0 295964 0 0 0 ALAN EDWARDS VICE PRESIDENT 170421 0 37001 0 9963 0 5699 0 32467 0 255551 0 0 0 TINA ERVIN VICE PRESIDENT 191675 0 40320 0 8167 0 6107 0 21537 0 267806 0 0 0 MARIE FREDRICK RT R CRA MJ VICE PRESIDENT 194223 0 41072 0 10295 0 0 0 21718 0 267308 0 0 0 STEPHEN MANDELL MD VICE PRESIDENT 0 326714 0 64751 0 12456 0 8250 0 25488 0 437659 0 0 DOUGLAS SCHULTE MD VICE PRESIDENT 313144 0 64371 0 9092 0 8250 0 2411 0 397268 0 0 0 CATHLEEN YABLONSKI BS MS VICE PRESIDENT 0 216078 0 44157 0 8209 0 2298 0 22733 0 293475 0 0 DAVID YI MD VICE PRESIDENT 291093 0 57641 0 8149 0 8250 0 2241 0 367374 0 0 0 JENNIFER FREELAND EPIC PROJECT DIRECTOR 132771 0 45393 0 2074 0 3726 0 1903 0 185867 0 0 0 PHILIP A BROWN DIRECTOR OF PLANNING 146754 0 17562 0 1441 0 4666 0 24672 0 195095 0 0 0 KARIN S HAYNES APPLICATIONS DIRECTOR 145053 0 16683 0 892 0 4418 0 3163 0 170209 0 0 0 ANDREA D MATTHEWS BUSINESS ANALYST II 157649 0 10175 0 208 0 0 0 14776 0 182808 0 0 0 RICHARD A LEWIS MEDICAL DIRECTOR 242304 0 19734 0 3810 0 0 0 24940 0 290788 0 0 0 JAMES R DANIEL FORMER SENIOR MEDICAL DIRECTOR 0 109574 0 47837 0 195562 0 3575 0 11103 0 367651 0 0 THOMAS G GETTINGER MHA FORMER EVP & COO 0 0 0 0 378086 0 0 0 0 0 378086 0 0 0 PART I, LINE 1A PART I, LINE 1A - TRUSTEES WHO ARE UNCOMPENSATED VOLUNTEERS TRAVELING FOR BUSINESS RELATED REASONS ON BEHALF OF THE ORGANIZATION ARE REIMBURSED FOR THE COST OF SPOUSAL TRAVEL. REIMBURSEMENTS PAID FOR SPOUSAL TRAVEL ARE REIMBURSED AND REPORTED AS INCOME ON A FORM 1099 IN THE YEAR PAID. EXECUTIVES WHO ARE TRAVELING FOR BUSINESS RELATED REASONS ON BEHALF OF THE ORGANIZATION ARE REIMBURSED FOR THE COST OF SPOUSAL MEALS PROVIDED AND THE AMOUNT IS REPORTED AS INCOME ON THE EXECUTIVE'S W-2. PART I, LINES 4A-B SEAN BARDEN RECEIVED A 457(F) DISTRIBUTION OF $47,990. KATHRYN WALL RECEIVED A 457(F) DISTRIBUTION OF $44,647. MICHAEL MCDERMOTT RECEIVED A 457(F) DISTRIBUTION OF $130,612 XAVIER RICHARDSON RECEIVED A 457(F) DISTRIBUTION OF $14,800. JOYCE HANSCOME RECEIVED SEVERANCE PAY OF $84,568 AND 457(F) DISTRIBUTION OF $38,557 WHICH WAS INCLUDED IN HER 2017 W-2. PART I, LINE 7 PART I, LINE 7 - ALL EXECUTIVES HAVE AS A PART OF THEIR COMPENSATION A VARIABLE COMPONENT SUCH THAT THEY ARE ELIGIBLE TO RECEIVE A PERCENTAGE OF THEIR BASE PAY AS AN INCENTIVE FOR THE ACHIEVEMENT OF INDIVIDUAL AND CORPORATE GOALS AND OBJECTIVES. BRIAN T MCDERMOTT MD BROTHER OF PRESIDENT/CEO OF MWHC 213947 MARY WASHINGTON HEALTH ALLIANCE PHYSICIANS COLLABORATE TO ADDRESS THE QUALITY, EFFICIENCY, COST EFFECTIVENESS AND OVERALL VALUE OF THE HEALTH CARE THEY PROVIDE THROUGH CONSISTENT ADHERENCE TO EVIDENCE-BASED PROTOCOLS, DATA COLLECTION AND ANALYSIS, AND PEER INTERVENTION AND ACCOUNTABILITY FOR PATIENT CARE OUTCOMES. MWH AND SH COLLABORATES WITH THE ALLIANCE PARTICIPATING PROVIDERS TO IMPLEMENT MUTUALLY AGREEABLE QUALITY INITIATIVES AT MWH AND SH AS PART OF THE CLINICAL INTEGRATION PROGRAM THAT WILL SUPPORT THE QUALITY OF CARE PROVIDED TO THE PATIENTS BY IMPROVING THE EFFICIENCY AND EFFICACY OF VARIOUS HOSPITAL AND TRANSITIONS OF CARE FOCUSED PHYSICIAN CARE PROCESSES IN A MANNER THAT IS TRANSPARENT TO PATIENTS, HAS DETAILED QUALITY CONTROLS AND IMPLEMENTS SAFEGUARDS TO ENSURE COMPLIANCE WITH APPLICABLE LAWS AND REGULATIONS REFERRED TO AS (THE "QUE PROGRAM OR THE "QUE"). 0 FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT COMPLETES A DRAFT OF THE INTERNAL REVENUE SERVICE (IRS) FORM 990 INFORMATION RETURN FOR MARY WASHINGTON HEALTHCARE AND ITS SUBSIDIARIES. THIS DRAFT IS SUBMITTED TO THE AUDIT & COMPLIANCE COMMITTEE OF THE ORGANIZATION'S BOARD OF TRUSTEES. THE FORM 990 AND UNDERLYING INFORMATION ARE PRESENTED TO AND REVIEWED BY THIS COMMITTEE. IF THE CONTENTS OF THE 990 RETURN ARE DEEMED ACCURATE AND ACCEPTABLE BY THE COMMITTEE, THIS BODY RECOMMENDS ACCEPTANCE OF THE RETURN BY THE FULL BOARD OF TRUSTEES. THE FORM 990 RETURN IS SUBSEQUENTLY PRESENTED TO AND REVIEWED BY THE ORGANIZATION'S BOARD OF TRUSTEES. IF DEEMED ACCURATE AND ACCEPTABLE THE BOARD ACCEPTS THE RETURN THROUGH A FORMAL MOTION. AS PART OF THIS PROCESS, THE DRAFT RETURN IS POSTED ON THE BOARD'S WEBSITE WHERE IT REMAINS AVAILABLE FOR REVIEW EVEN AFTER FORMAL ACCEPTANCE BY THE BOARD. THE FORM 990 RETURN IS ALSO AVAILABLE TO MEMBERS OF THE BOARD OF TRUSTEES AS WELL AS THE GENERAL PUBLIC ON MARY WASHINGTON HEALTHCARE'S WEBSITE (WWW.MWHC.COM). FORM 990, PART VI, SECTION B, LINE 12C EVERY TRUSTEE AND EXECUTIVE IS REQUIRED TO DISCLOSE ANY AND ALL CONFLICTS. THE DISCLOSURES ARE MADE ANNUALLY AND SUBMITTED TO THE MARY WASHINGTON HEALTHCARE CHIEF AUDIT EXECUTIVE (CAE). THE CAE PRESENTS ALL CONFLICTS TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES. THE CHAIRMAN OF THE AUDIT AND COMPLIANCE COMMITTEE REPORTS ALL CONFLICTS TO THE FULL BOARD. CONFLICTS ARE CONTINUALLY AND ACTIVELY MANAGED. AT EACH MEETING, THE CHAIR ASKS IF ANYONE AT THE MEETING HAS A CONFLICT TO DISCLOSE. INDIVIDUALS WITH CONFLICTS DISCLOSE THEIR CONFLICTS AND THE RELATED TOPIC. THE INDIVIDUAL THEN RECUSES HIM/HERSELF FROM ANY DECISION RELATED TO THAT TOPIC. THE CONFLICT OF INTERESTS POLICY IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 MARY WASHINGTON HEALTHCARE UTILIZES AN EXECUTIVE COMPENSATION COMMITTEE WITH THE PURPOSE AND AUTHORITY TO ESTABLISH PROCESSES TO ENSURE FAIR AND COMPLETE COMPENSATION FOR THE CEO AND EXECUTIVE LEADERSHIP. IN ORDER TO ENSURE COMPENSATION PAID IS SET AT FAIR MARKET VALUE, THE EXECUTIVE COMPENSATION COMMITTEE UTILIZES COMPENSATION SURVEY DATA AND FORM 990 INFORMATION FROM COMPARABLE HEALTH SYSTEMS AND THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT. SUCH INDEPENDENT THIRD PARTY DATA PROVIDES ASSURANCE THAT EXECUTIVE COMPENSATION IS COMMERCIALLY REASONABLE AND AT A FAIR MARKET VALUE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT PERSONNEL: PROGRAM SERVICE EXPENSES 8,699,968. MANAGEMENT AND GENERAL EXPENSES 88,325. FUNDRAISING EXPENSES 44,162. TOTAL EXPENSES 8,832,455. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 10,392,407. MANAGEMENT AND GENERAL EXPENSES 105,507. FUNDRAISING EXPENSES 52,753. TOTAL EXPENSES 10,550,667. BILLING AND COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 1,364,569. MANAGEMENT AND GENERAL EXPENSES 13,853. FUNDRAISING EXPENSES 6,927. TOTAL EXPENSES 1,385,349. ASP SERVICES: PROGRAM SERVICE EXPENSES 2,924,794. MANAGEMENT AND GENERAL EXPENSES 29,693. FUNDRAISING EXPENSES 14,847. TOTAL EXPENSES 2,969,334. MISCELLANEOUS SERVICES: PROGRAM SERVICE EXPENSES 831,684. MANAGEMENT AND GENERAL EXPENSES 8,444. FUNDRAISING EXPENSES 4,222. TOTAL EXPENSES 844,350. STORAGE SERVICES: PROGRAM SERVICE EXPENSES 116,702. MANAGEMENT AND GENERAL EXPENSES 1,185. FUNDRAISING EXPENSES 592. TOTAL EXPENSES 118,479. WASTE DISPOSAL SERVICES: PROGRAM SERVICE EXPENSES 16,155. MANAGEMENT AND GENERAL EXPENSES 164. FUNDRAISING EXPENSES 82. TOTAL EXPENSES 16,401. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 958,773. MANAGEMENT AND GENERAL EXPENSES 9,734. FUNDRAISING EXPENSES 4,867. TOTAL EXPENSES 973,374. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 2,936,915. MANAGEMENT AND GENERAL EXPENSES 29,816. FUNDRAISING EXPENSES 14,908. TOTAL EXPENSES 2,981,639. OTHER SERVICES: PROGRAM SERVICE EXPENSES 7,303,900. MANAGEMENT AND GENERAL EXPENSES 74,151. FUNDRAISING EXPENSES 37,076. TOTAL EXPENSES 7,415,127. FORM 990, PART XI, LINE 9: DECREASE IN MINIMUM PENSION LIABILITY -2,133,356. INCOME (LOSS) OF SUBSIDIARIES 34,566,757. INCOME ATTRIBUTABLE TO NONCONTROLLING INTEREST -8,743,212. FORM 990, PART XII, LINE 2C THE PROCESS OF RESPONSIBILITY OF THE AUDIT AND SELECTION OF AUDITORS HAS NOT CHANGED FROM PRIOR YEAR. FORM 990, PART III, LINE 1 - ORG. MISSION PROVISION OF HEALTH CARE. MARY WASHINGTON HEALTHCARE WAS ORGANIZED TO ACT AS THE PARENT CORPORATION IN THE MARY WASHINGTON HEALTHCARE AFFILIATED GROUP, AND TO ENGAGE IN SUCH ACTIVITIES FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, AND TO CARRY OUT THE PURPOSE OF MARY WASHINGTON HOSPITAL, STAFFORD HOSPITAL AND ITS AFFILIATED ORGANIZATIONS IN THE SYSTEM. SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: MWHC HAS ENGAGED THE SERVICES OF AN INDEPENDENT CONSULTING FIRM TO ASSESS THE OPPORTUNITIES TO ADDRESS THE QUALITY, EFFICIENCY AND EFFECTIVENESS OF THE HEALTH CARE SERVICES DELIVERED AT MWH AND SH BY PROVIDING A FAIR MARKET VALUATION TO DETERMINE THE SAVINGS AWARDED TO PROVIDERS PARTICIPATING IN THE QUE PROGRAM. THE ALLIANCE IN COORDINATION WITH MWH AND SH IDENTIFY THE TARGET QUALITY BENCHMARKS WHICH MUST BE ACHIEVED FOR EACH PERFORMANCE METRICS FOR EACH QUE INITIATIVE FROM A BASELINE ACHIEVEMENT LEVEL EXISTING PRIOR TO THE COMMENCEMENT OF THE QUE PROGRAM. THE ALLIANCE AND MWH AND SH WILL ASSESS THE PERFORMANCE METRICS AND QUE INITIATIVES TO ASSURE INCENTIVE PAYMENTS ARE MADE ONLY TO MAINTAIN AND/OR ENHANCE DESIRED PERFORMANCE ON THE COMMENCEMENT DATE OF EACH INITIATIVE SCHEDULE. FORM 990, SCHEDULE R ABBREVIATIONS: MWHC - MARY WASHINGTON HEALTHCARE MPI - MEDICORP PROPERTIES, INC. MWHC CLINICAL - MARY WASHINGTON HEALTHCARE CLINICAL SERVICES, INC. MEDIDOCTORS H.C. - MEDIDOCTORS HOLDING COMPANY UNRELATED BUSINESS INCOME MWHC AS A PART OF ITS MISSION PROVIDES STRATEGIC PLANNING AND DIRECTION FOR ALL OF ITS AFFILIATES. IRS REGULATIONS TREAT MANAGEMENT FEES RECEIVED FROM TAXABLE SUBSIDIARIES AS UNRELATED BUSINESS INCOME. AS A RESULT, THE REVENUE REPORTED ON LINE 7A IS INCOME FROM TAXABLE SUBSIDIARIES FOR PROVISION OF MANAGEMENT FEES AND LOSS SUSTAINED IS A RESULT FROM ALLOCATIONS OF CORPORATE SERVICES PROVIDED IN EXCESS OF THE REVENUE RECEIVED. 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