2019-11-13T11:39:06-06:00 2018-12-31 346565596 ERNST & YOUNG US LLP 221 E 4TH ST SUITE 2900 CINCINNATI OH 45202 990 2018-01-01 540525802 LOUDOUN HOSPITAL CENTER DBA INOVA LOUDOUN HOSPITAL LOUD 7038586000 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 ALICE POPE CFO 7038586000 2019-11-12 1 JULIE L SPARKS P01268401 5136121400 167.201.241.175 2019-11-12 08:05:22 ES P E21AF0F1BD5C10A123A0C82CC8A47C454803277B E21AF0F1BD5C10A123A0C82CC8A47C454803277B 2018 2020-03-31 21:24:44Z J STEPHEN JONES MD 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 347583609 0 X N/A X 1930 VA ILH PROVIDES PERSONALIZED, HIGH QUALITY ACUTE CARE HOSPITAL SERVICES FOR THE COMMUNITY. 14 12 1749 378 0 0 1260306 390156 338960140 342270984 12520191 2252100 985554 859459 353726191 345772699 0 0 0 0 109458490 115430913 0 0 0 176858276 190404027 286316766 305834940 67409425 39937759 725680032 776576798 33076627 47887392 692603405 728689406 X INOVA LOUDOUN HOSPITAL'S MISSION IS TO PROVIDE ACUTE CARE AND OTHER APPROPRIATE HOSPITAL SERVICES DEDICATED TO PROVIDING QUALITY CARE AND IMPROVING THE HEALTH OF THE DIVERSE COMMUNITIES IT SERVES. 0 0 262406379 343130443 INOVA LOUDOUN HOSPITAL (ILH) IS PART OF THE INOVA HEALTH SYSTEM WHOSE MISSION IS TO SERVE THE NORTHERN VIRGINIA COMMUNITY AS A NOT-FOR-PROFIT ORGANIZATION THROUGH THE PROVISION OF HIGH QUALITY AND ACCESSIBLE HEALTHCARE SERVICES. ILH WAS SPECIFICALLY CHARTERED FOR THE PURPOSE OF SERVING THE HEALTH CARE NEEDS OF LOUDOUN COUNTY, VIRGINIA, BY ESTABLISHING, MAINTAINING AND OPERATING HOSPITAL FACILITIES, PROGRAMS AND OTHER SHARED SERVICE ARRANGEMENTS; FACILITATING HEALTH-RELATED EDUCATION ACTIVITIES; AND ENGAGING IN ACTIVITIES DESIGNED TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY.INOVA LOUDOUN HOSPITAL IS A 167-LICENSED BED GENERAL ACUTE CARE HOSPITAL, WHICH FIRST OPENED ITS DOORS IN 1912. ILH PROVIDES A FULL-SERVICE 24-HOUR EMERGENCY DEPARTMENT; 23 INTENSIVE CARE BEDS; A SPECTRUM OF DIAGNOSTIC SERVICES, INCLUDING FULL-BODY CT SCANNING, MRI, AND A CARDIAC CATHETERIZATION LABORATORY; A VARIETY OF INPATIENT MEDICAL, SURGICAL, AND ORTHOPEDIC SERVICES, AND COMPREHENSIVE OUTPATIENT SERVICES INCLUDING OUTPATIENT SURGERY, PHYSICAL MEDICINE AND REHABILITATION SERVICES AND RADIATION THERAPY. IN ADDITION, OBSTETRICAL AND PEDIATRIC SERVICES ARE PROVIDED BY ILH'S LADIES' BOARD BIRTHING INN, A PEDIATRIC EMERGENCY DEPARTMENT AND AN INPATIENT PEDIATRIC UNIT. IN 2018, THE HOSPITAL HAD 17,713 ADMISSIONS AND OBSERVATION CASES AND 46,739 PATIENT DAYS EXCLUDING NEWBORNS. EMERGENCY ROOM VISITS TOTALED 75,687 (12,910 EMERGENCY VISITS WERE AT THE ASHBURN HEALTHPLEX); AND THERE WERE 85,889 OUTPATIENT VISITS DURING THE YEAR.SPECIFIC ACUTE CARE PROGRAMSWOMEN'S HEALTH: ILH OFFERS A FULL RANGE OF OBSTETRICAL SERVICES INCLUDING DELIVERY SERVICES, HIGH RISK PRENATAL SERVICES, INPATIENT AND OUTPATIENT OBSTETRICS/GYNECOLOGIC SURGERY, A HOSPITAL-BASED NATURAL BIRTHING CENTER AND NURSERY CARE. ILH DELIVERED 2,269 BABIES IN 2018. ILH ALSO OFFERS LEVEL II NEONATAL ICU SPECIALTY SERVICES. IN ADDITION, ILH PROVIDES OBSTETRIC SERVICES TO LOW-INCOME PATIENTS THROUGH ITS OBSTETRICS/GYNECOLOGY CLINIC WHICH HAD 4,901 VISITS IN 2018. PEDIATRIC CARE: ILH OPERATES A DEDICATED PEDIATRIC EMERGENCY ROOM THAT PROVIDED 15,573 VISITS IN 2018. IN ADDITION ILH OPERATES A 14-BED PEDIATRIC UNIT THAT PROVIDES FOR INPATIENT HOSPITALIZATIONS. ILH ADMITTED 338 CHILDREN TO THE UNIT AND HAD 176 OUTPATIENT OBSERVATION CASES DURING 2018.CARDIOVASCULAR CARE: THE INOVA LOUDOUN HOSPITAL HEART AND VASCULAR INSTITUTE (IHVIL) OPENED IN 2005. IT PROVIDES CARDIAC CATHETERIZATION AND ELECTROPHYSIOLOGY SERVICES, A 64-SLICE CT SCANNER AND OTHER DIAGNOSTIC TESTING. THE INOVA HEART & VASCULAR INSTITUTE AT LOUDOUN HOSPITAL HAS GROWN IN THE LAST FEW YEARS TO BETTER SERVE THE GROWING COMMUNITY, ADDING PROCEDURE ROOMS AND CAPACITY. IN 2018, 3,719 PATIENTS WERE SERVED BY THE CARDIOVASCULAR PROGRAM AT ILH.STROKE CARE: INOVA LOUDOUN HOSPITAL HAS BEEN CERTIFIED BY THE JOINT COMMISSION SINCE 2009 AS A PRIMARY STROKE CENTER. THE CERTIFICATION ALSO COVERS THE INOVA EMERGENCY CARE CENTER IN LEESBURG WHICH IS THE FIRST FREE-STANDING EMERGENCY DEPARTMENT IN THE STATE TO BE DESIGNATED AS A PRIMARY STROKE CENTER.CANCER CARE: ILH FEATURES A FULL SERVICE CANCER CENTER INCLUDING MEDICAL AND SURGICAL ONCOLOGY, RADIATION THERAPY SERVICES AND AN OUTPATIENT INFUSION CLINIC. ILH PROVIDED 5,144 RADIATION THERAPY TREATMENTS TO 238 PATIENTS IN 2018.CHARITY CARE ALL INOVA FACILITIES, INCLUDING THE ILH FACILITIES WITH THE EXCEPTION OF THE ASSISTED LIVING FACILITIES, PROVIDE CHARITY CARE IN ACCORDANCE WITH INOVA POLICIES WHICH ENSURES ACCESS TO MEDICALLY NECESSARY CARE FOR ALL INDIVIDUALS. CHARITY CARE IS DEFINED AS FREE OR DISCOUNTED HEALTHCARE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD TO PAY. THESE POLICIES INCLUDE THE FOLLOWING KEY PROVISIONS:1. EMERGENCY CARE SHALL BE PROVIDED TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY.2. NON-EMERGENCY MEDICALLY NECESSARY CARE, EXCEPT FOR CERTAIN SPECIALTY OR REFERRAL PROGRAMS, SHALL BE PROVIDED BY ALL HOSPITALS AND ACCESS FACILITIES TO MEDICALLY INDIGENT PATIENTS. "MEDICALLY NECESSARY" REFERS TO CONDITIONS WHICH, IF NOT PROMPTLY TREATED, WOULD TO AN ADVERSE CHANGE IN THE HEALTH STATUS OF A PATIENT. FREE CARE IS PROVIDED TO UNINSURED INDIVIDUALS WITH FAMILY INCOMES AT OR BELOW 400% OF THE CURRENT FEDERAL POVERTY GUIDELINES (FPG). FREE CARE IS ALSO AVAILABLE TO CERTAIN INSURED INDIVIDUALS WITH FAMILY INCOMES AT OR BELOW 250% OF THE CURRENT FPG WHO HAVE PARTIAL COVERAGE.INOVA HEALTH SYSTEM UTILIZES A MULTIFACETED APPROACH TO EDUCATE AND INFORM PATIENTS AND THE PUBLIC ABOUT INOVA'S CHARITY CARE POLICY. UPON ADMISSION TO ANY INOVA HOSPITAL OR ANY VISIT TO OUTPATIENT FACILITIES OR CLINICS INCLUDING EMERGENCY DEPARTMENTS, INOVA HAS INFORMATION POSTED REGARDING PATIENT RIGHTS AND RESPONSIBILITIES. IN ADDITION, INOVA PROVIDES INFORMATION ABOUT THE CHARITY CARE PROGRAM AND REFERRALS TO MEET WITH INOVA FINANCIAL COUNSELORS WHO ASSIST PATIENTS IN COMPLETING INOVA'S CHARITY CARE APPLICATION. THIS FINANCIAL INFORMATION IS REVIEWED BY THE INOVA PATIENT ACCOUNTS DEPARTMENT WITH THE PATIENT CONTACTED IF ADDITIONAL INFORMATION IS REQUIRED IN ORDER TO MAKE A DETERMINATION. THE PATIENT IS SUBSEQUENTLY PROVIDED A LETTER, NOTIFYING THEM WHETHER OR NOT THEY QUALIFY FOR CHARITY CARE.IN 2018 ILH'S UNREIMBURSED COST OF CHARITY CARE, INCLUDING FREE AND DISCOUNTED SERVICES, WAS $10.4 MILLION.MEDICAID ESTABLISHED UNDER TITLE XIX OF THE SOCIAL SECURITY ACT, THIS PROGRAM PROVIDES ASSISTANCE FOR THE MEDICALLY INDIGENT, INCLUDING THOSE WHO CANNOT PAY FOR CARE DESPITE BEING ABLE TO AFFORD OTHER LIVING EXPENSES. ALSO INCLUDED UNDER THIS PROGRAM ARE THE BLIND, DISABLED, PREGNANT WOMEN, VERY LOW INCOME PARENTS, CHILDREN AND THE ELDERLY. THE REIMBURSEMENT THAT ILH FACILITIES RECEIVE FROM THE MEDICAID PROGRAM ROUTINELY FALLS BELOW THE ACTUAL COST OF SERVICES PROVIDED. DURING 2018, ILH PROVIDED CARE TO MEDICAID PATIENTS AT AN UNREIMBURSED COST OF APPROXIMATELY $10.6 MILLION.PARTICIPATION IN GOVERNMENTAL PROGRAMS FOR THOSE WITHOUT THE ABILITY TO PAY VARIOUS GOVERNMENT PROGRAMS PROVIDE FOR THE INDIGENT, INCLUDING MEDICAID RECIPIENTS. THESE PROGRAMS PROVIDE A PERCENTAGE OF REIMBURSEMENT FOR QUALIFYING PATIENTS; HOWEVER, PAYMENT IS TYPICALLY BELOW THE COST OF THOSE SERVICES. IN ADDITION TO FEDERAL AND STATE PROGRAMS, THE INOVA SUBSIDIARIES, INCLUDING ILH, WORK WITH VARIOUS COUNTY GOVERNMENTS AND AGENCIES IN PROVIDING CERTAIN FREE SERVICES TO THOSE RESIDENTS THE COUNTY IDENTIFIES AS MOST IN NEED.EACH YEAR, ILH DESIGNATES FUNDS FOR THE DEVELOPMENT AND CONTINUATION OF IDENTIFIED, ACCESSIBLE DIRECT CARE PROGRAMS AND RELATED SERVICES THAT BENEFIT THOSE MOST IN NEED IN THE COMMUNITY. MANY OF THESE PROGRAMS AND SERVICES ARE NOT BILLED TO THE PATIENT OR ARE PROVIDED FOR FEES BELOW THE ACTUAL COST OF PROVIDING THE SERVICE. IN ADDITION TO PROVIDING THE DIRECT CARE SUBSIDIZED SERVICE, INOVA ALSO PROVIDES DISEASE-PREVENTION PROGRAMS, HEALTH AND EXERCISE CLASSES, HEALTH EDUCATION AND HEALTH SCREENINGS AND OTHER PROGRAMS WITHIN THE COMMUNITY IN SUPPORT OF THE ILH MISSION.INOVA LOUDOUN OB CLINIC: THE INOVA LOUDOUN HOSPITAL-BASED OB CLINIC PROVIDES COMPREHENSIVE OBSTETRIC SERVICES FOR UNINSURED AND LOW-INCOME WOMEN IN LOUDOUN COUNTY. COMPREHENSIVE OBSTETRICAL SERVICES INCLUDE GESTATIONAL DIABETES MANAGEMENT, CASE MANAGEMENT, NON-STRESS TESTING AND NUTRITIONAL COUNSELING. IN 2018, THE ILH OB CLINIC HAD 4,901 VISITS RESULTING IN 428 DELIVERIES AT INOVA LOUDOUN HOSPITAL AT AN UNREIMBURSED COST FOR THE CLINIC SERVICES OF APPROXIMATELY $1.67 MILLION. LOUDOUN FAMILY AND PATIENT EDUCATION PROGRAM: LOUDOUN FAMILY AND PATIENT EDUCATION PROGRAM SERVES THE COMMUNITY THROUGH HEALTH EDUCATION, PREVENTION, WELLNESS PROGRAMS AND CARE MANAGEMENT. IN 2018, THE PROGRAM PROVIDED EDUCATIONAL PROGRAMS FOR 2,998 PARTICIPANTS. LOUDOUN MOBILE HEALTH PROGRAM: LOUDOUN MOBILE HEALTH IS STAFFED BY NURSES AND OTHER SUPPORT STAFF WHO PROVIDE COMMUNITY HEALTH FAIRS AND HEALTH SCREENING SERVICES. IN 2018, INOVA LOUDOUN MOBILE HEALTH PROVIDED SERVICES TO 10,690 PARTICIPANTS. THE UNREIMBURSED COST OF THIS PROGRAM WAS $202,563.INOVA LOUDOUN CENTER FOR WELLNESS AND METABOLIC HEALTH: THE CENTER PROVIDES OUTPATIENT DIABETES SELF-MANAGEMENT EDUCATION, CARE AND SUPPORT TO PERSONS WITH DIABETES. THE INOVA CENTER FOR WELLNESS AND METABOLIC HEALTH HAS FOUR LOCATIONS IN THE NORTHERN VIRGINIA AREA. IN 2018, THE INOVA CENTER FOR WELLNESS AND METABOLIC HEALTH - LOUDOUN LOCATION PROVIDED 3,523 PATIENT VISITS. 262406379 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 X 287 0 1 1749 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X LOUDOUN HOSPITAL CENTER 7032085940 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH VA 22042 SCOTT HAMBERGER CHAIRMAN 1.00 2.00 X X 0 0 0 CHRISTINE BRENNAN VICE CHAIRMAN 1.00 2.00 X X 0 0 0 DEBORAH ADDO CEO ILH, SECRETARY 15.00 25.00 X X 856877 0 224807 MILES DAVIS TRUSTEE 2.00 1.00 X 0 0 0 PAMELA JEFFRIES TRUSTEE 2.00 1.00 X 0 0 0 VIRGINIA HACKENBERG MD TRUSTEE 2.00 1.00 X 0 0 0 TANYA MATTHEWS TRUSTEE 2.00 1.00 X 0 0 0 JILL MCCABE MD TRUSTEE 1.00 2.00 X 130000 0 0 ALEXIA ORR TRUSTEE 1.00 2.00 X 0 0 0 JUANITA KOILPILLAI TRUSTEE 2.00 1.00 X 0 0 0 MICHAEL WHEELER TRUSTEE 2.00 1.00 X 0 0 0 JOANNE THEURICH TRUSTEE 2.00 1.00 X 0 0 0 DAVID BOSSERMAN TRUSTEE 1.00 2.00 X 0 0 0 JOHN WOOD TRUSTEE 2.00 1.00 X 0 0 0 J KNOX SINGLETON CEO, PRESIDENT, ENDING 4/9/18 2.50 47.50 X 0 4616750 45945 RICHARD MAGENHEIMER CFO, TREASURER 2.00 48.00 X 0 3312496 716003 J STEPHEN JONES CEO, PRESIDENT, BEGINNING 4/9/18 2.50 47.50 X 0 1350889 447629 PATRICK WALTERS INTERIM CHRO 40.00 10.00 X 0 1000750 404746 WILLIAM BANE AVP ASSOC ADMIN CFO 20.00 20.00 X 278575 0 49574 CHRISTOPHER CHIANTELLA CHIEF MEDICAL OFFICER, ILH 40.00 0.00 X 519158 0 73735 DEBBIE WAGNER MGR PHARMACY PIC 40.00 0.00 X 191866 0 47671 CINDY ANDREJASICH SR DIR NURSING SRVCS 40.00 0.00 X 196399 0 33583 MARISSA JAMARIK AVP CHIEF NURSING OFFICER 40.00 0.00 X 312046 0 33165 JOY LUCAS SR DIR NURSING SRVCS 40.00 0.00 X 189700 0 42487 REBECCA VALDESUSO SR DIR PERIOP SVCS 40.00 0.00 X 194280 0 22584 MARK STAUDER TRUSTEE, FORMER 2.00 48.00 X 0 4784635 26675 LORING FLINT EVP CHIEF MEDICAL OFFICER, FORMER 4.00 46.00 X 0 1777748 579485 JOHN GAUL SVP GENERAL COUNSEL, FORMER 3.00 47.00 X 0 980859 253765 2868901 17824127 3001854 117 1 1 0 DPR CONSTRUCTION 11109 SUNSET HILLS ROAD SUITE 200 RESTON VA 20190 CONSTRUCTION SERVICES 67998388 WHITE-TURNER CONTRACTING CO 300 EAST JOPPA ROAD 8TH FLOOR BALTIMORE MD 21286 CONSTRUCTION SERVICES 16382110 CROTHALL SERVICES GROUP 955 CHESTERBROOK BLVD SUITE 300 WAYNE PA 19087 STAFFING 4708520 HRT OF VIRGINIA INC 3310 WEST END AVE SUITE 700 NASHVILLE TN 37203 TRANSPORT SERVICES 2171918 ALLIED UNIVERSAL COMPANY PO BOX 828854 PHILADELPHIA PA 19182 SECURITY 2165699 66 354658 35498 390156 NET PATIENT SERVICE REVENUE 900099 334712346 334712346 INOVA AMBULATORY SURGICAL CENTER 621400 7095190 7095190 TDI LLC 900099 463448 463448 342270984 1809979 1809979 2253031 1810910 0 -1810910 2253031 442121 442121 OTHER 900099 842623 842623 FOOD SERVICES 900099 16836 16836 859459 345772699 343130443 0 2252100 X 1654609 1654609 92975790 79538273 13437517 4075712 3496961 578751 9900003 8494203 1405800 6824799 5855677 969122 37906407 32523697 5382710 156332 134133 22199 30909 30909 60218461 51667440 8551021 47908 41105 6803 4230226 3629534 600692 557530 478361 79169 3855984 3308434 547550 141336 121266 20070 133477 114523 18954 2676911 2296790 380121 16625842 14264972 2360870 897456 770017 127439 MEDICAL SUPPLIES 38704500 33208461 5496039 BAD DEBT EXPENSE 23520281 20180401 3339880 TAXES AND LICENSES 458585 389077 69508 FOOD 236982 203331 33651 4900 4205 695 305834940 262406379 43428561 0 8995563 871128 33855468 31000750 894945 1879560 3923308 4443865 1270708 1564186 534779793 220005207 240507817 314774586 53782281 49810201 46677932 46081158 335772010 326151364 725680032 776576798 22721272 32148854 411298 10355355 15327240 33076627 47887392 X 670217473 707547040 34734 32350 22351198 21110016 692603405 728689406 725680032 776576798 X 39937759 -3971731 119973 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 30909 30909 0 PART II-B, LINE 1: THERE WERE NO SIGNIFICANT LOBBYING ACTIVITIES DURING 2018. AMOUNTS UNDER OTHER ACTIVITIES PER PART II-B REPRESENT A PORTION OF MEMBERSHIP DUES RELATED TO LOBBYING. LOUDOUN HOSPITAL CENTER PAID $130,843 IN MEMBERSHIP DUES FOR 2018. THE PORTION OF MEMBERSHIP DUES THAT WERE USED FOR LOBBING ACTIVITIES WERE ($130,843 TOTAL MEMBERSHIP DUES X 23.62%) = $30,909. 33041883 33041883 282772060 72059641 210712419 76645816 33505094 43140722 122509845 97243609 25266236 19810189 17196863 2613326 314774586 46081158 C 46081158 INVESTMENTS AND RECEIVABLES FROM AFFILIATES 323132545 OTHER LONG TERM ASSETS 653023 LONG TERM RIGHT OF USE 2365796 326151364 DUE TO THIRD PARTY PAYORS 9850956 DEFERRED COSTS 2517991 LEASE LIABILITY 2958293 15327240 X PART X, LINE 2: FROM INOVA HEALTH SYSTEM CONSOLIDATED STATEMENTS INCLUDING LOUDOUN HOSPITAL CENTER: THE FOUNDATION, IHCS, AND LHC ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN DETERMINED TO BE EXEMPT FROM FEDERAL INCOME TAX UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. IHI AND ITS SUBSIDIARIES ARE TAXABLE ORGANIZATIONS. DEFERRED INCOME TAXES ARE PROVIDED FOR ALL SIGNIFICANT TIMING DIFFERENCES BETWEEN REVENUES AND EXPENSES REPORTED FOR FINANCIAL STATEMENT AND FOR TAX PURPOSES. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS. 1 1 1 X 400.000000000000 1 X 1 1 0 1 1 10435890 10435890 0.03700 20594423 9971418 10623005 0.03760 31030313 9971418 21058895 0.07460 328593 90091 238502 0.00080 1666213 1666213 0.00590 464335 464335 0.00160 2459141 90091 2369050 0.00830 33489454 10061509 23427945 0.08290 1 9069420 0 58334217 83497761 -25163544 X 1 1 1 INOVA LOUDOUN AMBULATORY SURGERY CENTER LLC SURGICAL SERVICES 0.60000 0.00000 0.40000 1 1 INOVA LOUDOUN HOSPITAL 44045 RIVERSIDE PARKWAY LEESBURG VA 20176 VA H1868 X X X INOVA LOUDOUN HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 1 0 1 X SEE PART V, SECTION C X 1 16 1 SEE PART V, SECTION C 0 1 X 400.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X WWW.INOVA.ORG/PATIENT-AND-VISITOR-INFORMATION/FINANCIAL-HELP/INDEX.JSP X WWW.INOVA.ORG/PATIENT-AND-VISITOR-INFORMATION/FINANCIAL-HELP/INDEX.JSP X WWW.INOVA.ORG/PATIENT-AND-VISITOR-INFORMATION/FINANCIAL-HELP/INDEX.JSP X X X X X X X 1 X 0 X X X X 1 X 0 0 INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 3J: QUESTION 3EINOVA LOUDOUN HOSPITAL (ILH) COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2016 AND FOUND THAT NUMEROUS HEALTH STATUS AND ACCESS PROBLEMS ARE PRESENT IN THE COMMUNITY. NINE AREAS WERE IDENTIFIED AS THE MOST SIGNIFICANT HEALTH NEEDS FOR THE ILH COMMUNITY: ACCESS TO BASIC MEDICAL CARE, ACCESS TO DENTAL CARE, CARE AND CONDITIONS OF OLDER ADULTS, CULTURAL COMPETENCY IN CARE, LACK OF AFFORDABLE HOUSING, LYME DISEASE, MENTAL HEALTH AND ACCESS TO MENTAL HEALTH SERVICES, OBESITY AND OBESITY-RELATED CONCERNS AND SUBSTANCE ABUSE AND EXCESSIVE ALCOHOL USE. WITHIN THESE AREAS THERE WAS NO PRIORITIZATION OR RANKING.BASED ON THE CHNA RESULTS, ILH DEVELOPED A THREE-YEAR IMPLEMENTATION STRATEGY TO ADDRESS ITS COMMUNITY BENEFIT SERVICE AREA FOR CALENDAR (TAX) YEARS 2017 THROUGH 2019. PRIORITIES WERE BASED ON COMMUNITY NEED AS DETERMINED BY QUANTITATIVE DATA AND COMMUNITY INPUT, AS WELL AS ON HOSPITAL EXPERTISE, RESOURCES, STRENGTHS OF EXISTING PROGRAMMING AND PARTNERSHIPS, AND ALIGNMENT WITH NATIONAL, STATE, AND LOCAL HEALTH GOALS. BASED ON THE CHNA RECOMMENDATIONS, INOVA LOUDOUN HOSPITAL HAS IDENTIFIED AS ITS COMMUNITY BENEFIT PRIORITIES ACCESS TO PRIMARY CARE, ACCESS TO DENTAL CARE AND ADOLESCENT MENTAL HEALTH AND ACCESS TO MENTAL HEALTH SERVICES. THE HOSPITAL'S 3-YEAR IMPLEMENTATION STRATEGY WAS ENDORSED BY THE INOVA LOUDOUN HOSPITAL BOARD. INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 5: THE HOSPITAL INTERVIEWED 30 KEY INFORMANTS, INCLUDING EXTERNAL STAKEHOLDERS (THOSE WHO REPRESENTED THE BROAD INTERESTS IN THE COMMUNITY) AND INTERNAL INOVA STAFF. THE INTERVIEWS WERE GUIDED BY A STRUCTURED INTERVIEW GUIDE, AND INTERVIEWEES WERE ENCOURAGED TO IDENTIFY AND DISCUSS A WIDE RANGE OF CURRENT AND EMERGING ISSUES AFFECTING COMMUNITY HEALTH. INTERVIEWS WERE CONDUCTED FROM AUGUST 2015 THROUGH JANUARY 2016. A DETAILED LISTING OF THE COMMUNITY STAKEHOLDERS WHO PROVIDED COMMUNITY INPUT IS SHOWN BELOW. THE HOSPITAL ALSO SOUGHT INPUT FROM THE PUBLIC REGARDING THE HEALTH OF THE COMMUNITY THROUGH AN ONLINE SURVEY PUBLICIZED THROUGH EMAILS, HOSPITAL INFORMATION AND COMMUNITY PARTNERS. THE SURVEY WAS ALSO AVAILABLE ON PAPER IN THE HOSPITAL AND AT THE LOCAL FQHC.IN THE PROCESS OF CONDUCTING THE 2016 CHNA, INOVA RECEIVED FEEDBACK FROM CONSTITUENTS ON THE 2013 CHNA PROCESS AND PROGRESS MADE SINCE THEN. AT THE START OF THE 2016 CHNA, INOVA CREATED AN ADVISORY COMMITTEE IN ORDER TO STEER DECISION MAKING, PROVIDE FEEDBACK ON SURVEY CREATION, INTERVIEW CANDIDATES AND PROTOCOLS AND THE PROCESS BY WHICH COMMUNITY HEALTH NEEDS WERE DETERMINED TO BE SIGNIFICANT. THE COMMITTEE INCLUDED REPRESENTATIVES FROM LOCAL FQHCS, LOCAL HEALTH DIRECTORS AND A PUBLIC OFFICIAL. MEMBERS OF THE COMMITTEE PROVIDED FEEDBACK ON THE 2013 CHNA, INCLUDING BOTH THE INITIAL ASSESSMENT AS WELL AS IMPLEMENTATION OF STRATEGIES TO IMPROVE HEALTH SINCE THEN. ADDITIONAL FEEDBACK ON INOVA'S COMMUNITY HEALTH IMPROVEMENT PROGRAMS WAS GATHERED DURING KEY INFORMANT INTERVIEWS.COMMUNITY FOUNDATION FOR LOUDOUN AND NORTHERN FAUQUIER COUNTIES - GENERAL POPULATION, FAMILIES AND LOCAL YOUTHGEORGE MASON UNIVERSITY, COLLEGE OF HEALTH AND HUMAN SERVICES - GENERAL POPULATION , STUDENTSGRACE MINISTRIES - FAITH-BASED COMMUNITY, IMMIGRANT POPULATIONHEALTHWORKS FOR NORTHERN VIRGINIA - GENERAL POPULATION, LOW INCOME, UNINSURED/UNDERINSUREDINOVA BOARD OF DIRECTORS - GENERAL POPULATIONINOVA LOUDOUN INTERNAL STAFF - GENERAL POPULATION, PHYSICIANSINOVA OFFICE OF HEALTH EQUITY - MARGINALIZED POPULATIONS , MINORITY POPULATIONSLOUDOUN COUNTY AREA AGENCY ON AGING - GENERAL POPULATION, AGING POPULATIONLOUDOUN COUNTY HEALTH DEPARTMENT - GENERAL POPULATIONLOUDOUN COUNTY OFFICE OF COUNTY ADMINISTRATOR - GENERAL POPULATIONLOUDOUN COUNTY PUBLIC SCHOOLS - GENERAL POPULATION, YOUTH/ADOLESCENTSLOUDOUN HEALTH COUNCIL - GENERAL POPULATION, PHYSICIANS, FAITH-BASED COMMUNITY , NON-PROFIT COMMUNITYNORTHERN VIRGINIA FAMILY SERVICES - ADOLESCENT/YOUTH , LOW INCOME , HOMELESS , MENTALLY ILLNORTHERN VIRGINIA HEALTH FOUNDATION - GENERAL POPULATION, LOW INCOME, UNINSURED/UNDERINSURED INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 6A: INOVA FAIRFAX HOSPITALINOVA MT. VERNON HOSPITALINOVA FAIR OAKS HOSPITALINOVA ALEXANDRIA HOSPITAL INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 11: INOVA LOUDOUN HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2016 TO IDENTIFY THE SIGNIFICANT HEALTH NEEDS IN ITS COMMUNITY, AND TO INFORM DEVELOPMENT OF AN IMPLEMENTATION STRATEGY TO ADDRESS THOSE NEEDS. THIS PROCESS ALSO RESPONDS TO REGULATORY REQUIREMENTS, WHICH MANDATE THAT TAX-EXEMPT HOSPITAL FACILITIES CONDUCT A CHNA EVERY THREE YEARS AND ADOPT AN IMPLEMENTATION STRATEGY THAT ADDRESSES SIGNIFICANT COMMUNITY HEALTH NEEDS.ONE MAIN AIM OF THE IMPLEMENTATION STRATEGY IS TO GUIDE THE HOSPITAL'S COMMUNITY BENEFIT ACTIVITIES FOR THE PERIOD OF 2017 - 2019. COMMUNITY BENEFITS ARE PROGRAMS OR ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. THE CHNA PROCESS ENCOURAGES HOSPITALS TO FOCUS ON IMPROVING THE HEALTH OF THE COMMUNITIES THEY SERVE, AND NOT TO SELECT OUTREACH EFFORTS BASED SOLELY ON INTERNAL GROWTH PRIORITIES. IMPLEMENTATION STRATEGIES SHOULD BE BROAD BASED AND WORK WITH COMMUNITY ENTITIES TO IMPROVE HEALTH OUTSIDE THE WALLS OF THE HOSPITAL, INCREASE PREVENTION EFFORTS AND IMPROVE PUBLIC HEALTH.THE INOVA LOUDOUN HOSPITAL TEAM SELECTED THE FOLLOWING PRIORITY AREAS FOR THE 2017-19 IMPLEMENTATION STRATEGY: INCREASE ACCESS TO PRIMARY CARE, INCREASE ACCESS TO DENTAL CARE, IMPROVE CARE AND ACCESS TO CARE FOR INDIVIDUALS WITH MENTAL HEALTH AND SUBSTANCE ABUSE NEEDS.UPDATE - YEAR TWOUPON BOARD APPROVAL OF THE 2016 CHNA AND IMPLEMENTATION STRATEGY, THE ILH GOVERNMENT AND COMMUNITY RELATIONS DIRECTOR CONVENED A WORKGROUP TO DISCUSS, PLAN AND IMPLEMENT SPECIFIC ACTION ITEMS RELATED TO THE PRIMARY CARE AND MENTAL HEALTH AND SUBSTANCE ABUSE PRIORITIES (WORK ON INCREASING ACCESS TO DENTAL HEALTH IS STILL PENDING). MEMBERS OF THE WORKGROUP INCLUDE REPRESENTATIVES FROM THE HOSPITAL (THE ED, PEDS ED, CASE MANAGEMENT, COMMUNITY HEALTH AND NURSING) AS WELL AS REPRESENTATIVES FROM LOCAL GOVERNMENT AGENCIES, SAFETY NET PROVIDERS AND OTHER RELATED COMMUNITY SERVICES. THE GROUP HAS BEEN MEETING REGULARLY SINCE INCEPTION.THROUGH THE THOUGHT WORK AND COLLABORATION OF THE COMMITTEE, MUCH PROGRESS HAS BEEN MADE, AS DESCRIBED BELOW.1. INOVA BEHAVIORAL HEALTH SERVICES IS COMMITTED TO OFFERING A FULL SPECTRUM OF MENTAL HEALTH AND ADDICTION TREATMENT SERVICES, AND HAS BEEN WORKING TO INCREASE ACCESS THROUGH CREATIVE AND MULTI-MODAL INITIATIVES. ONE NEW INITIATIVE IS THE IMPLEMENTATION OF SBIRT (SCREENING, BRIEF INTERVENTION AND REFERRAL TO TREATMENT). SBIRT IS A SIMPLE SCREENING TOOL THAT HELPS IDENTIFY PEOPLE AT HIGH RISK OF SUBSTANCE ABUSE, AND IS NOW IN PLACE IN ALL HOSPITAL EMERGENCY DEPARTMENTS (ED). RESULTS OF THE SCREENING GUIDE THE LEVEL OF INTERVENTION. PEOPLE AT MILD OR MODERATE RISK RECEIVE A SHORT COUNSELING SESSION. THOSE DIAGNOSED AS ADDICTED ARE REFERRED FOR TREATMENT.2. TO MEET THE CRITICAL COMMUNITY NEED FOR MENTAL HEALTH SERVICES, INOVA OPENED A NEW KELLAR CENTER LOCATION IN STERLING, BRINGING AFFORDABLE, COMPASSIONATE, PROFESSIONAL MENTAL HEALTHCARE SERVICES TO YOUNG PEOPLE AND THEIR FAMILIES IN LOUDOUN COUNTY. INOVA KELLAR CENTER PROVIDES A FULL CONTINUUM OF OUTPATIENT SERVICES AND PROGRAMS, INCLUDING INDIVIDUAL, FAMILY AND GROUP THERAPY, MEDICATION MANAGEMENT, PSYCHIATRIC EVALUATIONS, PSYCHOLOGICAL TESTING AND PARTIAL HOSPITALIZATION.3. ADDITIONALLY, ILH SPONSORED MULTIPLE INFORMATIONAL SESSIONS IN PARTNERSHIP WITH THE COMMUNITY FOUNDATION (THE PHILANTHROPY SUMMIT) AND LCPS (MENTAL HEALTH & WELLNESS CONFERENCE) FOCUSED ON ACCESS TO BEHAVIORAL HEALTH SERVICES AND RESILIENCY TRAINING FOR ADOLESCENTS. ILH ALSO SPONSORED THE SOURCE OF STRENGTH PROGRAM TO ENABLE LCPS TO BRING THE PROGRAM TO THE MIDDLE SCHOOLS.4. INOVA RECOGNIZES THAT HOSPITALS CAN HAVE A LARGE IMPACT ON THE RISING OPIOID EPIDEMIC. IN ANOTHER STEP TO HELP CURB THE OPIOID EPIDEMIC IN THE COMMUNITY, IN 2018 INOVA LOUDOUN HOSPITAL INSTALLED A PUBLIC DROP-OFF BOX FOR SAFE DISPOSAL OF UNUSED DRUGS.5. AS PART OF ITS FOCUS TO PROMOTE COMMUNITY HEALTH AND EDUCATION, INOVA'S DEPARTMENT OF POPULATION/COMMUNITY HEALTH PROVIDES SMALL GRANTS TO NOT-FOR-PROFIT ORGANIZATIONS. ONE OF THESE GRANTS WAS TO THE RYAN BARTEL FOUNDATION, WHERE FUNDS WILL SUPPORT THE EXTENSION OF THE SOURCES OF STRENGTH (SOS) TRAINING - AN EVIDENCE-LED, YOUTH SUICIDE PREVENTION AND WELLNESS PROGRAM. THIS GRANT WILL ALLOW THE RYAN BARTEL FOUNDATION TO TAKE SOS INTO THE WIDER COMMUNITY, BRIDGING THE GAP FOR THE POPULATION WHO IS NOT DIRECTLY TRAINED OR EXPOSED TO SOS CAMPAIGNS THOUGH LOUDOUN COUNTY PUBLIC SCHOOLS, WHO HAS IMPLEMENTED THE PROGRAM IN 20 SCHOOLS.6. TO CONTINUE TO PROMOTE HEALTH AND MEET THE COMMUNITY WHERE THEY ARE, INOVA LOUDOUN HOSPITAL & THE IHVI SCHAUFELD FAMILY HEART CENTER PARTNERED WITH LOUDOUN HUNGER RELIEF TO BRING "HEART HEALTHY" EDUCATION TO THEIR CLIENTS. THERE WERE THREE EVENING SESSIONS, WHICH INCLUDED BIOMETRIC SCREENINGS (BMI, CHOLESTEROL, GLUCOSE, BLOOD PRESSURE), EDUCATIONAL CLASSES AND GIVE-AWAYS. HEALTHWORKS, THE LOCAL FQHC, WAS PRESENT TO REGISTER INDIVIDUALS AS A NEW PATIENT, GIVING THEM A NEW MEDICAL HOME.7. WORKING WITH COMMUNITY PARTNERS TO INCREASE ACCESS AND UTILIZATION OF ORAL HEALTH SERVICES, INOVA HAS SEVERAL STAFF MEMBERS IN VARIOUS ROLES ON THE VIRGINIA ORAL HEALTH COALITION. SUB-GROUPS ARE WORKING ON IMPROVING ACCESS, UNDERSTANDING THE NEEDS OF CHILDREN WITH SPECIAL HEALTHCARE NEEDS AND INCREASING EDUCATION ON THE IMPORTANCE OF ORAL HEALTH.8. ADDITIONALLY, AT THE END OF 2017 INOVA MADE A DONATION TO SUPPORT THE NORTHERN VIRGINIA DENTAL CLINIC, WHICH HAS A SITE IN STERLING, VA, PART OF THE ILH COMMUNITY.HEALTH NEEDS THE HOSPITAL WILL NOT ADDRESSNO HOSPITAL FACILITY CAN ADDRESS ALL HEALTH NEEDS PRESENT IN ITS COMMUNITY. THE HOSPITAL IS COMMITTED TO REMAINING FINANCIALLY HEALTHY SO THAT IT CAN GROW TO ENHANCE CLINICAL SERVICES AND TO CONTINUE PROVIDING A RANGE OF COMMUNITY BENEFITS. THE HOSPITAL'S IMPLEMENTATION STRATEGY FOCUSES ON MEETING THE PRIORITY AND SPECIFIED COMMUNITY HEALTH NEEDS DESCRIBED ABOVE. CERTAIN ISSUES, SUCH AS AFFORDABLE HOUSING ARE BEYOND THE SCOPE OF THE HOSPITAL AND THE HOSPITAL HAS INSUFFICIENT RESOURCES TO MAKE A MEANINGFUL IMPACT. OTHER TOPICS, SUCH AS CULTURAL COMPETENCY, LYME DISEASE, AND OBESITY AND OBESITY-RELATED CONCERNS ARE NOT COVERED AS PRIORITY TARGET AREAS IN THIS PLAN. EVEN SO, THERE ARE MANY ACTIVITIES IN THESE AREAS THROUGHOUT THE INOVA SYSTEM. INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 13H: CALCULATE FAMILY SIZE INOVA LOUDOUN HOSPITAL PART V, SECTION B, LINE 16J: FINANCIAL AID BROCHURES EXPLAINING THE CHARITY POLICY ARE AVAILABLE THROUGHOUT THE HOSPITAL. ER ROOMS AND WAITING ROOMS HAVE CHARITY NOTIFICATION NOTICES POSTED IN THEIR AREAS AND THE BROCHURES ARE ALSO POSTED ON INOVA'S WEBSITE. PART V, SECTION B, LINE 7A AND LINE 10A HTTP://WWW.INOVA.ORG/INOVA-IN-THE-COMMUNITY/INDEX.JSP 2 1 - INOVA LOUDOUN AMBULATORY SURGICAL CENTER 44045 RIVERSIDE PARKWAY LEESBURG VA 20176 OUTPATIENT SURGERY 2 - CORNWALL - ER 224 CORNWALL STREET NW LEESBURG VA 20176 EMERGENCY ROOM PART I, LINE 3C: CATASTROPHIC FINANCIAL ASSISTANCE: CATASTROPHIC FINANCIAL ASSISTANCE IS AVAILABLE FOR PATIENTS WHO DO NOT QUALIFY FOR FREE CARE BASED ON THE CRITERIA ABOVE, WHO, DUE TO THE NATURE AND EXTENT OF SERVICES PROVIDED, HAVE SIGNIFICANT CARE-RELATED FINANCIAL OBLIGATIONS IN RELATION TO HOUSEHOLD INCOME AND OTHER POTENALLY AVAILABLE RESOURCES. IN SUCH CIRCUMSTANCES, THE PATIENT RESPONSIBILITY WILL BE LIMITED TO THE LESSER OF 30% OF FAMILY INCOME OR THE AMOUNTS GENERALLY BILLED. PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS INCLUDED IN THE CONSOLIDATED INOVA HEALTH SYSTEM REPORT TO THE COMMUNITY ON INOVA.ORG WEBSITE. PART I, LINE 7: COST TO CHARGE RATIO METHOD IS USED BASED ON TABLE 2 IN THE INSTRUCTIONS. TOTAL OPERATING EXPENSE IS DIVIDED BY TOTAL GROSS REVENUE TO ARRIVE AT THE COST TO CHARGE RATIO. PART I, LINE 7G: COST OF PHYSICIAN CLINIC IS $1,666,213. 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 $ 23,520,281. PART II, COMMUNITY BUILDING ACTIVITIES: INOVA'S OFFICE OF SUSTAINABILITY PROVIDES COMMUNITY BUILDING SUPPORT FOCUSED ON ENVIRONMENTAL IMPROVEMENTS. ENVIRONMENTAL MISSION STATEMENT:INOVA HEALTH SYSTEM IS COMMITTED TO ESTABLISHING AN ENVIRONMENTAL PROGRAM THAT IS SAFER AND HEALTHIER FOR PATIENTS, EMPLOYEES AND THE COMMUNITY.COMMUNITY BUILDING ENVIRONMENTAL IMPROVEMENTS WASTE MANAGEMENTINOVA HAS BEEN FOCUSED ON WASTE REDUCTION STRATEGIES INCLUDING RECYCLING AND SEGREGATION SINCE 2008. THROUGHOUT THE HOSPITALS THERE IS A SINGLE STREAM RECYCLING PROCESS AND THERE ARE FOCUSED EFFORTS ON REDUCING REGULATED MEDICAL WASTE. IN 2018, INOVA RECYCLED OR DIVERTED APPROXIMATELY THREE MILLION POUNDS OF MATERIAL FROM LOCAL LANDFILLS AND WASTE TO ENERGY FACILITIES.SPECIALIZED AREAS RECYCLING/REUSE: INOVA HAS IMPLEMENTED SPECIALIZED RECYCLING PROGRAMS TO CAPTURE SPECIFIC MATERIALS THROUGHOUT THE HOSPITALS INCLUDING A MEDICAL DONATION PROGRAM THAT SHIPPED 48,000 POUNDS OF UNUSED, UNOPENED MEDICAL SUPPLIES AND DURABLE MEDICAL EQUIPMENT TO PLACES IN NEED BOTH IN LOCAL COMMUNITIES AND ACROSS THE GLOBE.ENERGYDURING 2018, INOVA CONTINUED TO MAKE PROGRESS TOWARDS ITS ENERGY GOAL OF REDUCING ENERGY USE INTENSITY (EUI) 20 PERCENT BY THE YEAR 2020 (BASELINE YEAR 2012). A VARIETY OF PROJECTS INCLUDING EXTERIOR LIGHTING UPGRADES, SPECIFIC INTERIOR LIGHTING PROJECTS, HVAC IMPROVEMENTS AND ENERGY MONITORING, ALL CONTINUED THROUGHOUT 2018. THESE EFFORTS RESULT IN COST SAVINGS AND IMPROVED RESILIENCE FOR THE OVERALL HEALTH OF THE COMMUNITY.WATERINOVA CONTINUES TO MAINTAIN NATIVE PLANTINGS AND LOW-IMPACT IRRIGATION SYSTEMS FOR LANDSCAPING AS WELL AS REDUCE WATER CONSUMPTION IN OUR HOSPITALS THROUGH THE ROUTINE REPLACEMENT OF LESS EFFICIENT PLUMBING FIXTURES. BUILDINGSINOVA IS CURRENTLY WORKING ON A NUMBER OF PROJECTS PURSING LEED CERTIFICATION INCLUDING THE INOVA CENTER FOR PERSONALIZED HEALTH ALONG WITH INOVA FAIRFAX MEDICAL CAMPUS. THERE ARE OTHER PROJECTS UNDERWAY INCLUDING INOVA LOUDOUN HOSPITAL PURSUING A NUMBER OF GREEN ELEMENTS. THE GOAL OF INOVA'S GREEN BUILDING EFFORTS IS TO ENSURE THAT OUR BUILDINGS ARE OPERATED IN THE MOST EFFICIENT MANNER, LEADING TO BOTH OPERATIONAL SAVINGS AS WELL AS IMPROVED PATIENT/EMPLOYEE OUTCOMES. TRANSPORTATIONCONTINUED COLLABORATION WITH FAIRFAX COUNTY DEPARTMENT OF TRANSPORTATION TO PROMOTE ALTERNATIVE COMMUTING OPTIONS FOR INOVA EMPLOYEES RESULTING IN FEWER SINGLE-OCCUPANCY VEHICLE TRIPS. THE INOVA FAIRFAX MEDICAL CAMPUS ACHIEVED THE REQUIRED MODE-SPLIT AGAIN IN 2018, WITH MORE THAN 18% OF EMPLOYEES USING SOME SORT OF ALTERNATIVE MODE OF TRANSPORTATION. INOVA MOUNT VERNON HOSPITAL ALSO HAS A MODE-SPLIT REQUIREMENT AND 21.5% OF EMPLOYEES THERE ARE USING A FORM OF ALTERNATIVE TRANSPORTATION. THIS IS THE RESULT OF EMPLOYEES TAKING PUBLIC TRANSPORTATION, EMPLOYEE COMMUTER SHUTTLES, CARPOOLS AND SOME EVEN BIKING OR WALKING TO WORK. THESE INITIATIVES CONTRIBUTE TO LOWER LEVELS OF AIR POLLUTION AND CONGESTION AS WELL AS IMPROVEMENTS TO OVERALL COMMUNITY HEALTH. FOODCONTINUED TO PROMOTE AND SERVE LOCAL AND SUSTAINABLE FOODS THROUGHOUT INOVA HOSPITALS WITH 26% OF FOOD SPEND CATEGORIZED AS SUSTAINABLE. INOVA HOSPITALS ALSO TRANSITIONED TO A VARIETY OF NO ANTIBIOTIC EVER (NAE) POULTRY PRODUCTS WHICH RESULTED IN 37% NAE FOR ALL MEATS SERVED. THESE INITIATIVES ARE IMPORTANT FOR THE HEALTH OF ALL PATIENTS AND THE COMMUNITY, AND ALSO SUPPORT LOCAL FARMS. SPONSOR OF THE NORTHERN VIRGINIA CHAPTER OF BUY FRESH, BUY LOCAL, A NATIONALLY RECOGNIZED PROGRAM THAT IS DEDICATED TO REINTRODUCING AMERICANS TO THEIR FOOD - THE SEEDS IT GROWS FROM, THE FARMERS WHO PRODUCE IT, AND THE ROUTES THAT CARRY IT FROM THE FIELDS TO THEIR TABLES. COMMUNITYDISTRIBUTED MORE THAN 500 NATIVE TREE SEEDLINGS TO BE PLANTED WITHIN THE LOCAL COMMUNITY IN 2018 IN SUPPORT OF EARTH DAY.MENTORED PEER ORGANIZATIONS LOCALLY AND NATIONALLY AS WELL AS A VARIETY OF CORPORATE CLIENTS ON SUSTAINABLE PRACTICES THROUGH A COMBINATION OF FORMAL SPEAKING ENGAGEMENTS, NEWS ARTICLE PUBLICATIONS AND INFORMAL DISCUSSIONS, HELPING THEM CREATE SAFER ENVIRONMENTS FOR THEIR PATIENTS, EMPLOYEES, AND COMMUNITIES. PART III, LINE 4: BAD DEBT FOOTNOTE FROM INOVA HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTSPATIENT ACCOUNTS RECEIVABLE INCLUDE CHARGES FOR AMOUNTS DUE FROM ALL PATIENTS LESS PRICECONCESSIONS RELATING TO ALLOWANCES FOR THE EXCESS OF ESTABLISHED CHARGES OVER THE PAYMENTS TO BE RECEIVED ON BEHALF OF PATIENTS COVERED BY MEDICARE, MEDICAID AND OTHER INSURERS. THE PROVISION FOR PRICE CONCESSIONS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE PRICE CONCESSIONS BASED UPON HISTORICAL EXPERIENCE OF SELF-PAY ACCOUNTS RECEIVABLE, INCLUDING THOSE BALANCES AFTER INSURANCE PAYMENTS AND NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR PRICE CONCESSIONS. THERE HAVE BEEN NO SIGNIFICANT CHANGES IN THE CURRENT YEAR TO THE UNDERLYING ASSUMPTIONS USED BY IHS TO ESTIMATE THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH IHS POLICIES. ALL OPERATING ENTITIES OF IHS TREAT EMERGENCY PATIENTS AND PROVIDE MEDICALLY NECESSARY TREATMENT TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BASED UPON ESTABLISHED IHS POLICIES THAT CONSIDER PATIENT INCOME LEVELS. SINCE IHS DOES NOT PURSUE COLLECTION OF AMOUNTS THAT QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE DEDUCTED FROM GROSS REVENUE AS A PRICE CONCESSION. PART III, LINE 8: THE ORGANIZATION DOES NOT TREAT ANY MEDICARE SHORTFALL AS COMMUNITY BENEFIT. THE AMOUNTS ARE TAKEN DIRECTLY FROM THE MEDICARE COST REPORTS AS FILED USING A COST TO CHARGE RATIO METHOD. PART III, LINE 9B: PATIENTS WHO HAVE NOT APPLIED FOR FINANCIAL ASSISTANCE UNDER THIS POLICY WILL BE TREATED AS SELF-PAY AND SUBJECT TO INOVA'S NORMAL BILLING AND COLLECTIONS PROCESSES.ALL PATIENT RESPONSIBILITY PORTIONS OF INOVA'S ACCOUNTS WILL PROCESS THROUGH INOVA'S BILLING AND COLLECTION SYSTEMS FOR EFFECTIVE IN-HOUSE COLLECTIONS AND WITHIN FEDERAL GUIDELINES FOR TRANSITIONING TO EXTERNAL COLLECTION AGENCIES AFTER IN-HOUSE EFFORTS HAVE BEEN EXHAUSTED. PATIENT RESPONSIBILITY PORTIONS WILL BE PROCESSED THROUGH PRE-BILLING, STATEMENT, AND FOLLOW-UP IN AUTOMATED AND SYSTEMATIC STEPS. ALL COLLECTIONS ACTIONS WILL BE IN COMPLIANCE WITH THE FAIR DEBT COLLECTION PRACTICES ACT AND ACA INTERNATIONAL'S CODE OF ETHICS AND PROFESSIONAL RESPONSIBILITY.PATIENTS WILL RECEIVE STATEMENTS FOR 120 DAYS. AFTER 120 DAYS, WITH NO CONTACT FROM THE PATIENT AND WITHOUT THE ESTABLISHMENT OF ACCEPTABLE PAYMENT TERMS, ACCOUNTS WILL BE TRANSFERRED TO A PROFESSIONAL COLLECTION AGENCY. IF CONTINUED NON-PAYMENT OCCURS BEYOND A REASONABLE PERIOD OF TIME, LEGAL ACTIONS MAY BE UNDERTAKEN TO COLLECT PAYMENT.IF A PATIENT WISHES TO MAKE PAYMENT ARRANGEMENTS AND DOES NOT HAVE RESOURCES TO PAY THE ACCOUNT IN FULL, PAYMENT PLANS WILL BE OFFERED.NO INOVA ENTITY OR THIRD-PARTY COLLECTIONS AGENT WILL IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS LEGAL ACTIONS OR ADVERSE CREDIT REPORTING AGAINST ANY PATIENT, WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY. THESE REASONABLE EFFORTS INCLUDE:ASSURING THAT NO ECAS ARE IMPOSED FOR AT LEAST 120 DAYS FROM THE DATE OF THE FIRST BILLING STATEMENT.PROVIDING A 30-DAY WRITTEN NOTICE THAT INCLUDES INFORMATION ABOUT INOVA'S FINANCIAL ASSISTANCE POLICY AND ABOUT ANY INTENDED ECAS TO BE IMPOSED IN THE EVENT OF NONPAYMENT.PROVIDING ORAL NOTIFICATION OF ANY INTENDED ECAS TO BE IMPOSED IN THE EVENT OF NONPAYMENT.IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AFTER PAYMENT IS RECEIVED OR AFTER AN ECA HAS BEEN IMPOSED, THE ACCOUNT WILL BE ADJUSTED AND THE COLLECTIONS ACTION WILL BE REVERSED.THE VICE PRESIDENT OF REVENUE CYCLE OPERATIONS OR HIS/HER DESIGNEE IS RESPONSIBLE FOR DETERMINING WHETHER INOVA HAS MADE REASONABLE EFFORTS TO DETERMINE WHETHER AN INDIVIDUAL IS FAP-ELIGIBLE AND WHETHER ONE OR MORE ECAS MAY BE IMPOSED. PART III, LINE 2 AND 3 ACTUAL BAD DEBT EXPENSE IS MULTIPLIED BY THE COST TO CHARGE RATIO USED IN COMPUTING CHARITY CARE EXPENSE IN PART I. THE PROVISION FOR BAD DEBTS IS RECOGNIZED WHEN PROVIDING AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.THE ARE NO ESTIMATED AMOUNTS FOR BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY. PART VI, LINE 2: INOVA HEALTH SYSTEM (IHS) COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2016 TO IDENTIFY PRIORITY HEALTH STATUS AND ACCESS ISSUES FOR PARTICULAR GEOGRAPHIC AREAS AND POPULATIONS BY FOCUSING ON THE FOLLOWING QUESTIONS: WHO IN THE COMMUNITY IS MOST VULNERABLE IN TERMS OF HEALTH STATUS OR ACCESS TO CARE?WHAT ARE THE UNIQUE HEALTH STATUS AND/OR ACCESS NEEDS FOR THESE POPULATIONS?WHERE DO THESE PEOPLE LIVE IN THE COMMUNITY? WHY ARE THESE PROBLEMS PRESENT?INOVA'S CHNA CONSIDERS MULTIPLE DATA SOURCES, INCLUDING SECONDARY DATA (REGARDING DEMOGRAPHICS, HEALTH STATUS INDICATORS, AND MEASURES OF HEALTH CARE ACCESS), ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS IN RECENT YEARS, AND PRIMARY DATA DERIVED FROM A COMMUNITY SURVEY AND FROM INTERVIEWS WITH PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH EXPERTISE IN PUBLIC HEALTH.THE FOLLOWING TOPICS AND DATA ARE ASSESSED IN INOVA'S CHNA REPORT:DEMOGRAPHICS, E.G., NUMBERS AND LOCATIONS OF VULNERABLE PEOPLE;ECONOMIC ISSUES, E.G., POVERTY AND UNEMPLOYMENT RATES, AND IMPACTS OF STATE OR LOCAL BUDGET CHANGES;COMMUNITY ISSUES, E.G., HOMELESSNESS, HOUSING, ENVIRONMENTAL CONCERNS, CRIME, AND AVAILABILITY OF SOCIAL SERVICES;HEALTH STATUS INDICATORS, E.G. MORBIDITY RATES FOR VARIOUS DISEASES AND CONDITIONS, AND MORTALITY RATES FOR LEADING CAUSES OF DEATH;HEALTH ACCESS INDICATORS, E.G., UNINSURANCE RATES, DISCHARGES FOR AMBULATORY CARE SENSITIVE CONDITIONS (ACSC), AND USE OF EMERGENCY DEPARTMENTS FOR NON-EMERGENT CARE;HEALTH DISPARITIES INDICATORS; ANDAVAILABILITY OF HEALTHCARE FACILITIES AND RESOURCES. THE ASSESSMENT IDENTIFIES A LIST OF SIGNIFICANT COMMUNITY HEALTH NEEDS.AS A RESULT OF THIS WORK AND PREVIOUS WORK, EACH INOVA HOSPITAL SELECTED 2-3 PRIORITY AREAS TO FOCUS ON FOR THE NEXT FEW YEARS, AND IS MOVING FORWARD WITH DEVELOPING COORDINATED EFFORTS WITHIN THE HEALTH SYSTEM TO CARRY OUT THE DESIGNED IMPLEMENTATION PLANS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE PROGRAM OUTREACH ADMINISTRATOR IS COORDINATING PLANS WITH HOSPITAL LEADERS TO ASSURE EFFECTIVE PLAN IMPLEMENTATION IN EACH OF THE RESPECTIVE COMMUNITIES. THE PROGRAM OUTREACH ADMINISTRATOR IS CENTRALIZED TO THE SYSTEM UNDER THE VICE PRESIDENT OF POPULATION HEALTH AND THEREBY ASSURES SYSTEM COORDINATED EFFORTS ARE CENTRALIZED AND REFLECTIVE OF INOVA HEALTH SYSTEM'S WORK ACROSS NORTHERN VIRGINIA.THE VARIOUS PUBLIC HEALTH DEPARTMENTS ALSO CONDUCT COMMUNITY HEALTH NEEDS ASSESSMENTS USING THE FRAMEWORK OF THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS. INOVA HEALTH SYSTEM IS A PARTICIPATING MEMBER OF THE MAPP PROCESS IN EACH JURISDICTION ACROSS NORTHERN VIRGINIA.THE MAPP PROCESS LEADS TO AN ONGOING COMMUNITY-DRIVEN PLANNING PROCESS THAT IS DESIGNED TO PROVIDE INFORMATION FOR IMPROVING THE COMMUNITY'S DELIVERY OF THE TEN ESSENTIAL PUBLIC HEALTH SERVICES. THIS PROCESS BRINGS TOGETHER A DIVERSE GROUP OF KEY COMMUNITY STAKEHOLDERS INCLUDING LOCAL GOVERNMENT, HUMAN SERVICE ORGANIZATIONS, SCHOOLS AND UNIVERSITIES, HEALTHCARE CONSUMERS, ADVOCACY GROUPS, HOSPITALS, FAITH INSTITUTIONS, YOUTH DEVELOPMENT ORGANIZATIONS, ECONOMIC AND PHILANTHROPIC GROUPS, ETC. TO IDENTIFY STRENGTHS AND WEAKNESSES IN THE TEN ESSENTIAL AREAS TO PROVIDE A FOUNDATION FOR COMMUNITY HEALTH PLANNING. THE INFORMATION FROM THE MAPP HEALTH NEEDS ASSESSMENTS IN ALL JURISDICTIONS SERVED BY INOVA HEALTH SYSTEM, AS WELL AS THE ONGOING WORK OF THE ACTION TEAMS, WERE INCORPORATED INTO THE COMMUNITY NEEDS ASSESSMENT IMPLEMENTATION PLANS THAT WERE FINALIZED IN 2016. IN ADDITION TO THESE ACTIVITIES, INOVA IS CONTINUALLY GARNERING FEEDBACK ON EXISTING SAFETY NET AND COMMUNITY PROGRAMS FROM PARTICIPANTS THROUGH MONTHLY AND QUARTERLY SATISFACTION SURVEYS AND FOCUS GROUPS, PARTICIPATING IN REGIONAL AND LOCAL HEALTH RELATED GROUPS SUCH AS THE NORTHERN VIRGINIA HEALTH SERVICES COALITION, MEETING WITH VARIOUS CULTURAL AND ETHNIC GROUPS IN THE COMMUNITY AND USING INTERNAL UTILIZATION AND OUTCOMES DATA, REVIEW OF BEST PRACTICES AND REGIONAL AND NATIONAL BENCHMARK DATA AND OTHER EXTERNAL SOURCES SUCH AS THE METROPOLITAN WASHINGTON COUNCIL OF GOVERNMENTS (COG) DEMOGRAPHIC DATA TO DEVELOP STRATEGIC GOALS FOR HEALTH IMPROVEMENT ACTIVITIES. COLLECTIVELY, ALL THIS INFORMATION IS UTILIZED IN ASSESSING COMMUNITY HEALTH NEEDS TO GUIDE STRATEGIC PLANNING EFFORTS. PART VI, LINE 3: INOVA HEALTH SYSTEM UTILIZES A MULTIFACETED APPROACH TO EDUCATE AND INFORM PATIENTS AND THE PUBLIC ABOUT INOVA'S FINANCIAL ASSISTANCE POLICY (FAP) OR CHARITY CARE POLICY. UPON ADMISSION TO ANY INOVA HOSPITAL OR ANY VISIT TO OUTPATIENT FACILITIES OR CLINICS INCLUDING EMERGENCY DEPARTMENTS, INOVA HAS INFORMATION POSTED REGARDING PATIENT RIGHTS AND RESPONSIBILITIES. IN ADDITION, INOVA PROVIDES INFORMATION ABOUT THE CHARITY CARE PROGRAM AND REFERRALS TO MEET WITH INOVA FINANCIAL COUNSELORS WHO ASSIST PATIENTS IN COMPLETING INOVA'S CHARITY CARE APPLICATION. THIS FINANCIAL INFORMATION IS REVIEWED BY THE INOVA PATIENT ACCOUNTS DEPARTMENT WITH THE PATIENT CONTACTED IF ADDITIONAL INFORMATION IS REQUIRED IN ORDER TO MAKE A DETERMINATION. THE PATIENT IS SUBSEQUENTLY PROVIDED A LETTER NOTIFYING THEM AS TO WHETHER OR NOT THEY QUALIFY FOR CHARITY CARE. INOVA ALSO HAS MEDICAID ELIGIBILITY WORKERS ON-SITE IN ALL HOSPITALS, IN THE INOVACARES CLINIC FOR WOMEN AND CHILDREN (CLINIC FOR LOW INCOME FAMILIES) AND IN THE COMMUNITY AS PART OF THE PARTNERSHIP FOR HEALTHIER KIDS ACCESS TO CARE PROGRAM. INOVA PARTNERS WITH SCHOOLS ACROSS THE JURISDICTION TO PROVIDE INFORMATION ABOUT STATE FUNDED HEALTH PROGRAMS FOR CHILDREN AND CONTACT INFORMATION TO MEET WITH AN ELIGIBILITY WORKER RESPONSIBLE FOR ENROLLING FAMILIES IN STATE MEDICAID PROGRAMS. THESE ELIGIBILITY WORKERS ALSO GO OUT INTO THE COMMUNITY ATTENDING COMMUNITY EVENTS SUCH AS HEALTH FAIRS, FAITH-BASED COMMUNITY ACTIVITIES AND OTHER FAMILY CENTERED COMMUNITY EVENTS TO PROACTIVELY MEET WITH FAMILIES TO ENCOURAGE ENROLLMENT IN PROGRAMS FOR WHICH THEY ARE ELIGIBLE. INOVA HAS A SECTION OF THE PUBLIC WEBSITE DEDICATED TO INFORMATION ABOUT BILLING AND FINANCIAL COORDINATORS AND FINANCIAL ASSISTANCE RESOURCES. PART VI, LINE 4: INOVA LOUDOUN HOSPITAL (ILH) IS A NOT-FOR-PROFIT CORPORATION AND A SUBSIDIARY OF THE PARENT ORGANIZATION, INOVA HEALTH SYSTEM FOUNDATION (INOVA). INOVA PROVIDES HEALTHCARE AND RELATED SERVICES THROUGHOUT NORTHERN VIRGINIA AND THE GREATER METROPOLITAN WASHINGTON, D.C. AREA, INCLUDING CERTAIN CONTIGUOUS COUNTIES OF VIRGINIA AND MARYLAND. NORTHERN VIRGINIA IS ONE OF THE FASTEST GROWING URBAN COMMUNITIES IN THE UNITED STATES. WITH APPROXIMATELY 1,304 SQUARE MILES, THE REGION IS THE MOST DENSELY POPULATED IN THE COMMONWEALTH OF VIRGINIA. NORTHERN VIRGINIA IS COMPRISED OF SEVERAL DISTINCT COMMUNITIES, INCLUDING THE CITIES OF ALEXANDRIA, FAIRFAX, FALLS CHURCH, MANASSAS AND MANASSAS PARK, AND THE COUNTIES OF ARLINGTON, FAIRFAX, LOUDOUN AND PRINCE WILLIAM. THE EASTERN SECTIONS ARE URBANIZED WITH ATTENDANT HEALTH PROBLEMS OF OVERCROWDING AND INCREASING DEMAND FOR HEALTH SERVICES AND PUBLIC PROGRAMS. INOVA LOUDOUN HOSPITAL'S PRIMARY SERVICE AREA COVERS ALL OF LOUDOUN COUNTY.LOUDOUN COUNTY IS SERVED BY TWO HOSPITALS (INOVA LOUDOUN AND HCA STONESPRINGS). THERE ARE SIX CENSUS TRACTS IN LOUDOUN COUNTY THAT ARE MEDICALLY UNDERSERVED.LOUDOUN COUNTY'S POPULATION IS FORECASTED TO GROW 15% OVER THE NEXT DECADE, ADDING AN ESTIMATED AVERAGE OF 6,300 PERSONS A YEAR. POPULATION WILL BE SPURRED BY THE LONG-TERM STRENGTH OF THE REGION'S ECONOMY, HIGH RATES OF IN-MIGRATION AND INTERNATIONAL IMMIGRATION. THE REGION'S POPULATION THAT IS 65 YEARS OF AGE AND OLDER IS EXPECTED TO GROW BY 25% OVER THE NEXT 5 YEARS, WHILE THE NUMBER OF CHILDREN WILL INCREASE BY ABOUT 4% IN THE SAME TIME PERIOD. (MWCOG 9.1 AND ESRI)NORTHERN VIRGINIA'S RACIAL AND ETHNIC DIVERSITY IS MORE PRONOUNCED THAN IN THE REST OF THE STATE. WITH INCREASING DIVERSITY, ECONOMICALLY DISADVANTAGED POPULATIONS AND MULTIPLE LANGUAGES, THE NEED FOR ACCESS TO CULTURALLY APPROPRIATE, FLEXIBLE HEALTH CARE CONTINUES TO GROW. THE NORTHERN VIRGINIA GEOGRAPHIC REGION IN 2018 WAS 41% MINORITY, UP FROM 28% IN 1990, WHILE THE NATION AS A WHOLE REFLECTS A 39% MINORITY POPULATION (U.S. CENSUS BUREAU). THE U.S. CENSUS BUREAU ESTIMATES THAT LOUDOUN COUNTY HAD A POPULATION OF 398,080 PEOPLE IN 2018. THIS IS THE FASTEST GROWING JURISDICTION IN NORTHERN VIRGINIA. IN 2018, LOUDOUN COUNTY'S ASIANS, HISPANICS, AND AFRICAN AMERICANS REPRESENTED 19.4%, 13.9% AND 7.9% OF LOUDOUN'S POPULATION, RESPECTIVELY (U.S. CENSUS BUREAU).ACCORDING TO THE U.S. CENSUS BUREAU SMALL AREA HEALTH INSURANCE ESTIMATES (SAHIE) IN 2015 APPROXIMATELY 6.7% OF THE TOTAL POPULATION UNDER THE AGE OF 65 IN LOUDOUN COUNTY LACKED HEALTHCARE INSURANCE. OF THE PEOPLE LIVING IN LOUDOUN COUNTY WHOSE FAMILY INCOMES ARE AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL, SAHIE ESTIMATES THAT 26.7% WERE UNINSURED IN 2015.AREA RESIDENTS MOST LIKELY TO BE UNINSURED ARE THOSE WHOSE FAMILY INCOMES ARE AT OR BELOW 200% OF THE POVERTY LEVEL, YOUNG ADULTS (AGE 18-44), PEOPLE OF RACIAL BACKGROUNDS OTHER THAN WHITE, UNEMPLOYED INDIVIDUALS, PART-TIME WORKERS, AND PEOPLE WHO WORK AT COMPANIES WITH FEWER THAN 50 EMPLOYEES. SERVING THIS POPULATION POSES SIGNIFICANT CULTURAL AND LINGUISTIC CHALLENGES, AND THESE UNINSURED CITIZENS ARE WIDELY DISTRIBUTED IN TERMS OF AGE, GEOGRAPHIC REGION, AND HEALTH STATUS. PART VI, LINE 5: INOVA HEALTH SYSTEM'S INVESTMENT IN THE COMMUNITIES ACROSS NORTHERN VIRGINIA IS EVIDENT THROUGH NUMEROUS TARGETED COMMUNITY PROGRAMS. THESE PROGRAMS PROVIDE ACCESS TO CARE FOR LOW INCOME, UNINSURED, UNDERINSURED AND VULNERABLE POPULATIONS; PROMOTE HEALTH & WELLNESS; INCREASE HEALTH LITERACY; PROVIDE THE SUPPORT AND INFRASTRUCTURE FOR DISASTER PREPAREDNESS; AND PROVIDE PROGRAMS TO SUPPORT DEVELOPMENT OF OUR FUTURE HEALTHCARE WORKFORCE TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITIES SERVED. ALL INOVA HEALTHCARE FACILITIES HAVE OPEN MEDICAL STAFFS TO PROVIDE THE MAXIMUM ACCESS TO QUALIFIED PHYSICIANS. A COMMUNITY BOARD OF TRUSTEES PROVIDES FISCAL AND QUALITY OVERSIGHT FOR INOVA HEALTH CARE SERVICES' FACILITIES TO ENSURE THE VISION AND MISSION OF THE ORGANIZATION IS ACHIEVED.ACCESS TO CARE PROGRAMSINOVA'S POPULATION AND COMMUNITY HEALTH DIVISION IS ORGANIZED TO ADDRESS A WIDE-SPECTRUM OF COMMUNITY HEALTHCARE NEEDS. IN ADDITION TO THE PROGRAMS ALREADY DESCRIBED IN THE CORE FORM PROGRAM, ACTIVITIES THAT PROVIDE INFRASTRUCTURE SUPPORT AND SERVICES FOCUSED ON VULNERABLE POPULATIONS TO INCREASE ACCESS TO HEALTHCARE SERVICES FOR THE COMMUNITIES SERVED BY INOVA HEALTH SYSTEM INCLUDE THE FOLLOWING PROGRAMS:THE STREAMLINED ELIGIBILITY PROGRAM (SES), LAUNCHED BY THE SUCCESSFUL IMPLEMENTATION OF THE FEDERALLY-FUNDED 2001 CAP AND 2004 HCAP GRANTS, CONTINUES TO BE FUNDED BY INOVA AND FAIRFAX COUNTY. SES PROVIDES LOCAL SAFETY-NET HEALTH CARE PROVIDERS ACCESS TO COORDINATED HEALTH CARE NETWORKS TO SERVE THE UNINSURED AND UNDERINSURED RESIDENTS OF NORTHERN VIRGINIA. A SHARED DATABASE IS USED TO DETERMINE A PATIENT'S ELIGIBILITY FOR SERVICES WHICH PROVIDES ONE CENTRAL INTAKE THEREBY STREAMLINING AND EXPEDITING THE PROCESS. INOVA SUPPORTS THE INFRASTRUCTURE AND EXPANSION OF THE PROGRAM WHICH CURRENTLY CONSISTS OF 12 PUBLIC/PRIVATE PARTNERS SERVING FAIRFAX COUNTY, CITY OF ALEXANDRIA, LOUDOUN COUNTY, ARLINGTON COUNTY, AND PRINCE WILLIAM COUNTY. THE SYSTEM CURRENTLY HOUSES OVER 300,000 ELIGIBILITY RECORDS OF UNINSURED AND MEDICAID PATIENTS.INOVA'S PARTNERSHIP FOR HEALTHIER KIDS (PHK) ACCESS TO CARE PROGRAM PROVIDES FAMILIES WITH COMPREHENSIVE APPLICATION AND ENROLLMENT ASSISTANCE TO CONNECT THEM WITH AN APPROPRIATE AND AFFORDABLE SOURCE OF HEALTH CARE SERVICES. IN 2018, PHK ASSISTED OVER 11,313 CHILDREN AND PARENTS WITH ACCESS TO A SOURCE OF COMPREHENSIVE HEALTH CARE SERVICES SUCH AS MEDICAID, FAMIS OR LOCAL SAFETY NET PROVIDERS. PHK BEGAN EXPANSION EFFORTS IN THE END OF 2018 WITH THE ONSET OF MEDICAID EXPANSION IN VIRGINIA.CARE CONNECTION FOR CHILDREN (CCC) IS FUNDED BY THE VIRGINIA DEPARTMENT OF HEALTH. THE GOAL OF CCC IS TO HELP FAMILIES COORDINATE COMMUNITY AND EDUCATIONAL RESOURCES WITH MEDICAL EXPERTISE TO ENSURE THAT CHILDREN WITH SPECIAL HEALTHCARE NEEDS CAN REACH THEIR MAXIMUM POTENTIAL. CCC PARTNERS WITH FAMILIES OF CHILDREN WHO HAVE CHRONIC HEALTHCARE NEEDS TO HELP OPEN DOORS TO NEEDED RESOURCES AND COORDINATE QUALITY FAMILY-CENTERED CARE. CCC IS COMMITTED TO HELPING CHILDREN MAXIMIZE THEIR POTENTIAL IN A CARING, INNOVATIVE AND CULTURALLY SENSITIVE MANNER. IN 2018, CCC SERVED 856 FAMILIES.TRANSITIONAL CARE MANAGEMENT INOVA TRANSITIONAL SERVICES IS A COMPREHENSIVE SERVICE DESIGNED TO SUPPORT MEDICALLY VULNERABLE PATIENTS WITH A RECENT INOVA HOSPITALIZATION TO ENSURE QUALITY TRANSITIONS OF CARE OUTCOMES AND SUPPORT THE AMBULATORY PHYSICIAN COMMUNITY IN MANAGING THIS CHALLENGING POPULATION AFTER DISCHARGE. INOVA TRANSITIONAL SERVICES ENCOMPASSES THREE MAIN PROGRAMS-TRANSITIONAL CARE MANAGEMENT (TCM), THE TRANSITIONAL SERVICES CLINICS AND THE NEW MEDICARE FOCUSED NAVIGATOR (MFN) PROGRAM. TCM IS A 30 DAY POST-ACUTE TELEPHONIC CASE MANAGEMENT PROGRAM DESIGNED TO ENCOURAGE PATIENTS TO FOLLOW UP WITH THEIR PRIMARY CARE PHYSICIAN (PCP) AND TO FOLLOW PCP INSTRUCTIONS ON MEDICATION RECONCILIATION. TCM ALSO ASSISTS PATIENTS BY PROVIDING EDUCATION ON THEIR DISEASE SYMPTOMS AND EMPOWERS THEM TO TAKE AN ACTIVE, PREVENTATIVE ROLE IN THEIR HEALTHCARE AND WELLNESS. TCM PROMOTES EARLY INTERVENTION AND COMMUNICATION WITH PCPS AT THE FIRST SIGNS OF DISEASE SYMPTOMS AND ASSISTS PATIENTS IN NAVIGATING SERVICES AND RESOURCES IN THE COMMUNITY TO SUPPORT THEIR WELLNESS GOALS.THE TRANSITIONAL SERVICES CLINICS ARE HOSPITALIST-RUN POST-ACUTE CLINICS THAT PROVIDE IMMEDIATE ATTENTION TO MEDICALLY COMPLEX PATIENTS WHO REQUIRE INTENSIVE FOLLOW-UP CARE. PATIENTS ARE PROVIDED APPOINTMENTS TO ENSURE THAT ALL HOSPITAL DISCHARGE INSTRUCTIONS, MEDICATION RECONCILIATION AND SYMPTOMS HAVE BEEN STABILIZED AND RESOLVED PRIOR TO TRANSITIONING BACK TO THEIR PCP. IN 2018, TCM MANAGED OVER 4,000 ADMISSIONS AND THE TRANSITIONAL SERVICES CLINICS SERVED OVER 5,500 PATIENTS WITH OVER 8,800 VISIT ENCOUNTERS. THE MEDICARE FOCUSED NAVIGATOR PROGRAM IS DESIGNED TO PROVIDE OVERSIGHT AND NAVIGATION OF THE MEDICARE 65+ FOCUS DIAGNOSIS PATIENTS THROUGHOUT THE CONTINUUM OF CARE DURING THE 30 DAYS POST INPATIENT HOSPITALIZATION. THE GOAL OF THE PROGRAM IS TO ENSURE PROPER ACCESS AND COORDINATION OF ALL DISCHARGE DISPOSITIONS, POST-ACUTE CARE SERVICES AND ASSIST WITH TRANSITIONS THROUGHOUT THE CONTINUUM BY ASSISTING PATIENTS AND COMMUNITY SERVICE PROVIDERS WITH FOLLOW UP APPOINTMENT COORDINATION, APPOINTMENT REMINDER CALLS, RESOURCE CONNECTION, PROBLEM SOLVING AND COMMUNICATION. THE MFN PROGRAM MANAGED ALMOST 6,000 ADMISSIONS IN 2018. INOVA IS COMMITTED TO PROVIDING A QUALITY, POST-HOSPITALIZATION CARE CONTINUUM TO ENSURE THAT THE AMBULATORY PHYSICIAN COMMUNITY IS SUPPORTED IN CARING FOR THIS MEDICALLY COMPLEX AND VULNERABLE POPULATION.INOVA KELLAR CENTERINOVA KELLAR CENTER (IKC) IS A COMMUNITY BASED BEHAVIORAL HEALTH PROGRAM AND SPECIAL EDUCATION SCHOOL FOUNDED BY INOVA IN 1991 WITH A GIFT FROM FAIRFAX COUNTY RESIDENTS, ART AND BETTY KELLAR, TO ADDRESS A GAP IN MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR CHILDREN AND ADOLESCENTS. CURRENTLY IKC OFFERS A FULL CONTINUUM OF MENTAL HEALTH SERVICES FROM OUTPATIENT THERAPIES AND MEDICATION MANAGEMENT TO AFTER SCHOOL INTENSIVE OUTPATIENT PROGRAMS AND A FULL DAY PARTIAL HOSPITALIZATION PROGRAM. THE KELLAR SCHOOL, A PRIVATE SPECIAL EDUCATION DAY SCHOOL FOR STUDENTS WITH EMOTIONAL, SOCIAL AND BEHAVIORAL NEEDS PROVIDES ACADEMIC INSTRUCTION WITHIN A THERAPEUTIC ENVIRONMENT. THE CENTER PROVIDED 84,891 HOURS OF PROGRAMMING, TREATMENT AND EDUCATION TO CHILDREN, ADOLESCENTS, AND FAMILIES IN 2018. INOVA EWING FORENSIC ASSESSMENT AND CONSULTATION TEAMS (FACT)THE INOVA EWING FACT DEPARTMENT IS A COMPREHENSIVE, OUTPATIENT FORENSIC NURSING PROGRAM FOR CHILDREN AND ADULTS. ESTABLISHED IN THE LATE 1990S, THE INOVA EWING FACT DEPARTMENT HAS PROVIDED SPECIALIZED CARE FOR VICTIMS OF SEXUAL ABUSE, DOMESTIC VIOLENCE AND CHILD ABUSE. FACT SERVES ALL OF NORTHERN VIRGINIA INCLUDING FAIRFAX, ARLINGTON, LOUDOUN AND PRINCE WILLIAM COUNTIES, THE CITIES OF ALEXANDRIA AND FALLS CHURCH, PARTS OF FAUQUIER AND STAFFORD COUNTIES, MILITARY INSTALLATIONS AND UNIVERSITIES. FACT ALSO PERFORMS COURTESY EXAMS FOR OUTLYING JURISDICTIONS INCLUDING THE DISTRICT OF COLUMBIA, MARYLAND AND WEST VIRGINIA. THE PROGRAM HAS GROWN SIGNIFICANTLY OVER THE YEARS AND NOW PROVIDES SERVICES IN THE AREAS OF SEXUAL ASSAULT, INTIMATE PARTNER/DOMESTIC VIOLENCE, PHYSICAL CHILD ABUSE, STRANGULATION AND HUMAN SEX TRAFFICKING. IN 2018, THE DEPARTMENT HAD 934 PATIENT ENCOUNTERS, REFLECTING A 6% INCREASE FROM 2017 AND A 47% INCREASE FROM 2015. HEALTH PROMOTION AND PREVENTATIVE CARE PROGRAMSTO PREVENT AND REDUCE THE INCIDENCE OF NUTRITION-RELATED DISEASES, INOVA FOCUSED ON SEVERAL INITIATIVES TO REDUCE FOOD INSECURITY AND INCREASE FOOD LITERACY AMONG COMMUNITY MEMBERS. SPECIFICALLY, INOVA CONTINUED TO MATCH THE PURCHASES MADE BY SNAP CUSTOMERS (FORMERLY FOOD STAMPS) AT FARMERS MARKETS, ALLOWING LOW-INCOME INDIVIDUALS TO PURCHASE MORE FRESH PRODUCE.INOVA ALSO CONTINUED TO GROW THE INOVA HEALTHY PLATE PROGRAM, AN 8-WEEK SCHOOL-BASED NUTRITION PROGRAM PROVIDED TO TITLE I ELEMENTARY SCHOOLS AND COMMUNITY CENTERS. THE INOVA HEALTHY PLATE CLUB AIMS TO IMPROVE STUDENTS' UNDERSTANDING OF NUTRITION AND THE IMPORTANCE OF HEALTHY BEHAVIORS. IN 2018, THE INOVA HEALTHY PLATE CLUB SERVED OVER 270 STUDENTS.LANGUAGE AND DISABILITY SERVICESTHE LANGUAGE AND DISABILITY SERVICES DEPARTMENT IS DEDICATED TO ENSURING EQUAL ACCESS TO INOVA'S SERVICES REGARDLESS OF LANGUAGE PREFERENCE OR THE NEED FOR SPECIAL ACCOMMODATIONS. IN SUPPORT OF PATIENT SAFETY AND SATISFACTION, LANGUAGE INTERPRETATION AND DOCUMENT TRANSLATIONS ARE PROVIDED AT EVERY INOVA FACILITY, TO FACILITATE COMMUNICATION WITH THE 14% OF INOVA'S PATIENT POPULATION WHO ARE LIMITED ENGLISH PROFICIENT (LEP), AND THE 0.2% OF CLIENTS WHO ARE DEAF OR HARD OF HEARING (D/HH). IN 2018, PHONE, VIDEO AND IN-PERSON MEDICAL INTERPRETERS DELIVERED 81,367 HOURS OF INTERPRETATION IN 200 LANGUAGES, AND 14,878 HOURS IN AMERICAN SIGN LANGUAGE. ADDITIONALLY, 506 VITAL DOCUMENTS WERE TRANSLATED INTO INOVA'S TOP LANGUAGES. PART VI, LINE 6: ORGANIZATION IS PART OF INOVA HEALTH SYSTEM INCLUDED IN DESCRIPTION UNDER LINE 5. PART VI, LINE 5 CONTINUATION CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSINOVA DONATES SPACE, PROVIDES CASH AND IN-KIND SUPPORT SUCH AS HOUSEKEEPING AND DONATED STAFF TIME TO A NUMBER OF COMMUNITY GROUPS AND SERVICES. INOVA PROVIDES SUPPORT TO NOVA SCRIPTS, THE CENTER FOR MULTICULTURAL HUMAN SERVICES, SHENANDOAH UNIVERSITY, AND THE NOVA DENTAL CLINIC. INOVA ALSO PROVIDES FINANCIAL SUPPORT TO THE LOUDOUN FREE CLINIC AND HEALTHWORKS FOR NORTHERN VIRGINIA AND NEIGHBORHOOD HEALTH, THE LOCAL FEDERALLY QUALIFIED HEALTH CENTERS. IN 2018, INOVA DONATED OVER $1.6 MILLION FOR THESE GROUPS COVERING BOTH CASH AND IN-KIND TRANSACTIONS.ADDITIONALLY, AS PART OF INOVA'S EFFORTS TO HARNESS THE COLLECTIVE POWER OF COMMUNITY PARTNERS, AGENCIES AND ORGANIZATIONS TO CREATE POSITIVE SOCIAL IMPACT, INOVA PROVIDED $60,000 IN COMMUNITY GRANTS. APPLICANTS WERE REQUIRED TO PRESENT PROGRAMS OR PROJECTS ADDRESSING THE POPULATION HEALTH NEEDS DESCRIBED IN THE INOVA COMMUNITY HEALTH NEEDS ASSESSMENTS. PART VI, LINE 7 ORGANIZATION HAS NO STATE FILINGS. 1 1 0 0 0 0 0 0 0 DEBORAH ADDO CEO ILH, SECRETARY 441344 0 286180 0 129353 0 221493 0 3314 0 1081684 0 69041 0 J KNOX SINGLETON CEO, PRESIDENT, ENDING 4/9/18 0 718511 0 3779513 0 118726 0 42491 0 3454 0 4662695 0 1890422 RICHARD MAGENHEIMER CFO, TREASURER 0 777202 0 979253 0 1556041 0 697070 0 18933 0 4028499 0 513084 J STEPHEN JONES CEO, PRESIDENT, BEGINNING 4/9/18 0 825142 0 300000 0 225747 0 428108 0 19521 0 1798518 0 0 PATRICK WALTERS INTERIM CHRO 0 432669 0 461490 0 106591 0 383237 0 21509 0 1405496 0 219853 WILLIAM BANE AVP ASSOC ADMIN CFO 209046 0 47485 0 22044 0 24374 0 25200 0 328149 0 0 0 CHRISTOPHER CHIANTELLA CHIEF MEDICAL OFFICER, ILH 286550 0 107101 0 125507 0 56375 0 17360 0 592893 0 110946 0 DEBBIE WAGNER MGR PHARMACY PIC 163376 0 28170 0 320 0 25889 0 21782 0 239537 0 0 0 CINDY ANDREJASICH SR DIR NURSING SRVCS 166732 0 28773 0 894 0 32668 0 915 0 229982 0 0 0 MARISSA JAMARIK AVP CHIEF NURSING OFFICER 214146 0 84989 0 12911 0 16259 0 16906 0 345211 0 0 0 JOY LUCAS SR DIR NURSING SRVCS 158548 0 30688 0 464 0 31706 0 10781 0 232187 0 0 0 REBECCA VALDESUSO SR DIR PERIOP SVCS 166390 0 27703 0 187 0 18647 0 3937 0 216864 0 0 0 MARK STAUDER TRUSTEE, FORMER 0 827779 0 2919962 0 1036894 0 13750 0 12925 0 4811310 0 1554300 LORING FLINT EVP CHIEF MEDICAL OFFICER, FORMER 0 654307 0 873051 0 250390 0 555685 0 23800 0 2357233 0 610394 JOHN GAUL SVP GENERAL COUNSEL, FORMER 0 497263 0 360510 0 123086 0 225359 0 28406 0 1234624 0 160023 PART I, LINE 3 THE FOLLOWING METHODS WERE USED BY IMANCO, INC., A RELATED ORGANIZATION, TO ESTABLISH THE COMPENSATION OF ILH'S CEO FOR THE TAX YEAR: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY FORM 990 OF OTHER ORGANIZATIONS APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINES 4A-B SEVERANCE PAYMENTS: J. KNOX SINGLETON $63,000 RICHARD MAGENHEIMER $1,428,789 MARK STAUDER $224,611 SEVERANCE AMOUNTS WERE PAID WITHIN 24 MONTHS AFTER SEPARATION FROM SERVICE. SERP PLAN PAYMENTS: RICHARD MAGENHEIMER $108,398 PATRICK WALTERS $66,016 WILLIAM BANE $10,745 MARK STAUDER $571,942 JOHN GAUL $82,771 LORING FLINT $211,246 CHRISTOPHER CHIANTELLA $110,946 THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP PLAN) IS A NONQUALIFIED RETIREMENT PLAN. EMPLOYEES ELIGIBLE TO PARTICIPATE ARE EXECUTIVE DIRECTORS, ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, CFO, COO, AND CEO. EACH YEAR, A CERTAIN PERCENTAGE OF EACH PARTICIPANT'S BASE SALARY IS CONTRIBUTED TO THE SERP PLAN. THIS AMOUNT RANGES FROM 5% TO 20%, DEPENDING ON POSITION. AFTER THREE YEARS OF CONTINUOUS PARTICIPATION, PARTICIPANTS VEST IN 50% OF THEIR BALANCE AT THAT TIME AND ARE PAID OUT THE VESTED BALANCE AS A TAXABLE EVENT. AFTER A TOTAL OF SIX YEARS PARTICIPATION AND AFTER ATTAINING AGE 45, PARTICIPANTS ARE 100% VESTED AND ARE PAID OUT THEIR REMAINING BALANCE AS A TAXABLE EVENT. VESTING THEN REVERTS TO A THREE-YEAR ROLLING SCHEDULE UNTIL YEAR 12. THEREAFTER, THE ANNUAL CONTRIBUTION IS PAID OUT TO THE PARTICIPANT EACH YEAR AS A TAXABLE EVENT. JILL MCCABE MD TRUSTEE 130000 FEE FOR MEDICAL DIRECTOR SERVICES. SERVICES PROVIDED AT ARM'S LENGTH AND CUSTOMARY RATES. 0 FORM 990, PART III, LINE 4A CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS: ILH DONATES SPACE, PROVIDES CASH AND IN-KIND SUPPORT SUCH AS HOUSEKEEPING AND DONATED STAFF TIME TO A NUMBER OF COMMUNITY GROUPS AND LOUDOUN COUNTY SERVICES. ILH DONATES SPACE TO THE LOUDOUN FREE CLINIC WHICH IS AN INDEPENDENT 501(C)(3) COMMUNITY HEALTH CENTER PROVIDING PRIMARY HEALTHCARE SERVICES FOR THE UNINSURED AND LOW INCOME RESIDENTS OF LOUDOUN COUNTY; LOUDOUN CARES, AN INDEPENDENT 501(C)(3) ORGANIZATION THAT PROVIDES COORDINATION FOR SOCIAL SERVICES FOR THE RESIDENTS OF LOUDOUN COUNTY; AND THE LOUDOUN CHILD ADVOCACY CENTER. INOVA ALSO PROVIDES FINANCIAL SUPPORT TO HEALTHWORKS FOR NORTHERN VIRGINIA, A FEDERALLY QUALIFIED HEALTH CENTER WITH LOCATIONS IN HERNDON AND LEESBURG, VA. IN 2018, ILH DONATED A TOTAL OF $464,335 FOR THESE GROUPS COVERING BOTH CASH AND IN-KIND TRANSACTIONS. PART V, LINE 1A AND 2A THE ORGANIZATION FILES ITS FORM 1099S UNDER THE PARENT ENTITY AND DOES NOT REPORT ANY AMOUNTS UNDER ITS OWN EIN. THE ORGANIZATION FALLS UNDER A MASTER PAY AGENT AND DOES NOT FILE ANY PAYROLL RETURNS UNDER ITS OWN EIN, HOWEVER ALL REQUIRED RETURNS HAVE BEEN FILED ON TIME. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS A SINGLE MEMBER. THE SOLE MEMBER IS INOVA HEALTH SYSTEM FOUNDATION, A CHARITABLE 501(C)(3) TAX-EXEMPT ORGANIZATION WHICH SERVES AS THE PARENT COMPANY OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE ORGANIZATION, INOVA HEALTH SYSTEM FOUNDATION, IS A CHARITABLE 501(C)(3) TAX-EXEMPT ORGANIZATION. THE SOLE MEMBER ELECTS THE MEMBERS OF THE GOVERNING BODY OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER OF THE ORGANIZATION, INOVA HEALTH SYSTEM FOUNDATION, IS A CHARITABLE 501(C)(3) TAX-EXEMPT ORGANIZATION. THE SOLE MEMBER HOLDS RESERVED POWERS WITH RESPECT TO CERTAIN ACTIONS. IN ADDITION TO THE RESERVED POWERS, UNDER THE LAWS OF THE COMMONWEALTH OF VIRGINIA CERTAIN EXTRAORDINARY ACTIONS REQUIRE MEMBER APPROVAL, SUCH AS MERGERS, CONSOLIDATIONS, LIQUIDATIONS AND THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED AND PROVIDED TO THE CHIEF ACCOUNTING OFFICER AND EXTERNAL TAX CONSULTANTS FOR INITIAL REVIEW. AFTER THE REVIEW IT IS GIVEN TO THE CFO OF INOVA HEALTH SYSTEM FOR REVIEW AND COMMENT. THE FORM 990 IS PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES FOR THEIR REVIEW. UPON COMPLETION OF THE EXECUTIVE COMMITTEE REVIEW, IT IS PROVIDED TO THE FULL BOARD OF TRUSTEES. IN THIS PROCESS, THE FORM 990 HAS BEEN PROVIDED TO THE GOVERNING BOARD APPROXIMATELY TWO WEEKS PRIOR TO THE FILING OF THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C YES, ANNUALLY THE ORGANIZATION DISTRIBUTES THE CONFLICT OF INTEREST POLICY TO ALL DIRECTORS, OFFICERS, TRUSTEES, AND KEY EMPLOYEES. THE ORGANIZATION REQUIRES THAT EACH DIRECTOR, OFFICER, TRUSTEE, AND KEY EMPLOYEE ACKNOWLEDGE THAT THEY HAVE READ, UNDERSTOOD, AND WILL ABIDE BY THE POLICY. EACH DIRECTOR, OFFICER, TRUSTEE, AND KEY EMPLOYEE IS REQUIRED TO COMPLETE AND SUBMIT AN ANNUAL CONFLICT OF INTEREST DISCLOSURE. THESE DISCLOSURES ARE BROAD AND REQUIRE THAT THE INDIVIDUAL LIST ANY BUSINESS RELATIONSHIPS OR PERSONAL RELATIONSHIPS WITH OTHER DIRECTORS, OFFICERS, TRUSTEES, AND KEY EMPLOYEES, AS WELL AS ANY RELATIONSHIPS WITH COMPETITORS, OR CURRENT OR POTENTIAL VENDORS OR CONTRACTORS. DISCLOSURE STATEMENTS ARE REVIEWED BY SENIOR MANAGEMENT AND ANY POTENTIAL CONFLICTS ARE DISCUSSED WITH GOVERNING BODY CHAIRMAN TO ENSURE THAT ANY MEMBER WHO MAY HAVE A CONFLICT DISCLOSES THEIR POTENTIAL CONFLICT, AND IS DISMISSED FROM RELATED DISCUSSIONS AND RECUSED FROM PARTICIPATION IN APPLICABLE DECISIONS. FORM 990, PART VI, SECTION B, LINE 15 COMPLETED BY RELATED ENTITY, IMANCO, INC.: THE COMPENSATION OF ALL SENIOR MANAGEMENT POSITIONS IS EVALUATED ANNUALLY IN LIGHT OF EACH MANAGER'S JOB CONTENT, SCOPE AND COMPLEXITY. COMPENSATION LEVELS FOR VICE PRESIDENTS AND ABOVE ARE REVIEWED BY AN INDEPENDENT EXTERNAL CONSULTANT TO ENSURE THAT REMUNERATION IS CONSISTENT WITH THE ORGANIZATION'S COMPENSATION PHILOSOPHY AND OBJECTIVES AND COMPETITIVE WITH OTHER LARGE COMPLEX HEALTH SYSTEMS. THE INDEPENDENT COMPENSATION CONSULTANT MAINTAINS NATIONAL BENCHMARK COMPENSATION DATABASES AND SURVEYS AND ALSO REVIEWS FORMS 990 OF COMPARABLE HEALTHCARE SYSTEMS TO DETERMINE MARKET LEVELS OF COMPENSATION. IN ADDITION, THE INOVA HEALTH SYSTEM'S CEO'S COMPENSATION AND CERTAIN OTHER SENIOR EXECUTIVES IS REVIEWED AND APPROVED ANNUALLY BY AN INDEPENDENT GOVERNING BOARD. THE JOB REQUIREMENTS AND COMPLEXITY OF ALL OTHER MANAGEMENT POSITIONS ARE EVALUATED ANNUALLY USING NATIONALLY RECOGNIZED THIRD PARTY SALARY SURVEYS TO ASSURE THAT THE COMPENSATION FOR SUCH POSITIONS IS CONSISTENT WITH EXTERNAL MARKET COMPENSATION COMPARISONS. SALARY RANGES ARE DEVELOPED FOR EACH MANAGEMENT POSITION CLASSIFICATION TO ENSURE THAT THE COMPENSATION LEVELS FOR THESE POSITIONS ARE CONSISTENT WITH THE ORGANIZATION'S COMPENSATION PHILOSOPHY AND OBJECTIVES AND WITH COMPETITIVE MARKET COMPARISONS. COMPENSATION FOR EMPLOYED PHYSICIANS IS REVIEWED AND APPROVED BY THE IMG EXECUTIVE COMMITTEE. THE COMMITTEE IS COMPRISED OF EXECUTIVE MANAGEMENT OF THE INOVA MEDICAL GROUP. THE FAIR MARKET VALUE (FMV) COMPENSATION IS BASED ON FOUR NATIONALLY RECOGNIZED INDUSTRY PHYSICIAN COMPENSATION BENCHMARK SURVEYS (MGMA, AMGA, SULLIVAN & COTTER, KORN FERRY HAY GROUP). THE COMMITTEE ALSO UTILIZES INDEPENDENT CONSULTANTS TO PROVIDE FMV OPINIONS FOR POSITIONS THAT ARE NOT READILY AVAILABLE IN THE FOUR PUBLISHED BENCHMARK SURVEYS. THE CONSULTANTS' OPINIONS AND COMPENSATION SURVEY DATA ARE PRESENTED TO THE PHYSICIAN COMPENSATION COMMITTEE FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 INOVA HEALTH SYSTEM MAKES CERTAIN INFORMATION PUBLICLY AVAILABLE. INOVA'S CONSOLIDATED FINANCIAL STATEMENTS ARE POSTED ON THE ELECTRONIC MUNICIPAL MARKET ACCESS'S (EMMA) WEBSITE ON A QUARTERLY BASIS. INOVA'S GOVERNING DOCUMENTS ARE NOT CURRENTLY PUBLICLY AVAILABLE. WHILE THE CONFLICT OF INTEREST POLICY IS NOT SPECIFICALLY PUBLICLY DISCLOSED, INOVA'S CODE OF CONDUCT IS ON THE PUBLIC WEBSITE. SECTION III OF THE CODE OF CONDUCT DESCRIBES WHAT CAN CONSTITUTE A CONFLICT AND REQUIRES THAT POTENTIAL CONFLICTS BE REPORTED TO MANAGEMENT OR THE CHIEF COMPLIANCE OFFICER. THE CODE ALSO REFERS TO THE CONFLICT OF INTEREST POLICY WHICH IS AVAILABLE TO STAFF AND PHYSICIANS ON INOVA'S INTRANET WEBSITE. FORM 990, PART IX, LINE 11G INTERNAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 27,681,654. MANAGEMENT AND GENERAL EXPENSES 4,581,346. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,263,000. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 6,318,899. MANAGEMENT AND GENERAL EXPENSES 1,045,785. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,364,684. OUTSOURCED SERVICES: PROGRAM SERVICE EXPENSES 17,666,887. MANAGEMENT AND GENERAL EXPENSES 2,923,890. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,590,777. FORM 990, PART XI, LINE 9: PARTNERSHIP INCOME -7,558,638. TEMP RESTRICTED INCOME/LOSS -2,384. PERM RESTRICTED INCOME/LOSS 392,289. EQUITY IN SUBSIDIARIES 7,199,283. GRANT CAPITAL REIMBURSEMENTS 89,423. PART XII, LINE 2B AND 2C - AUDITED FINANCIAL STATEMENTS THE COMPANY IS PART OF THE INOVA HEALTH SYSTEM, A NOT-FOR-PROFIT INTEGRATED HEALTH CARE DELIVERY SYSTEM SERVING NORTHERN VIRGINIA AND SURROUNDING AREAS. THE COMPANY'S FINANCIAL STATEMENTS ARE CONSOLIDATED IN THE INOVA HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTS. INOVA HEALTH SYSTEM IS AUDITED ON AN ANNUAL BASIS BY A "BIG FOUR" INDEPENDENT PUBLIC ACCOUNTING FIRM. IN ADDITION, THEY ARE RESPONSIBLE FOR THE ISSUANCE OF A MANAGEMENT LETTER ENCOMPASSING EACH MEMBER OF THE CONSOLIDATED GROUP. THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES OF INOVA HEALTH SYSTEM IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT, INCLUDING THE HIRING OF THE AUDIT FIRM, REVIEW AND APPROVAL OF AUDITED FINANCIAL STATEMENTS AND COMMUNICATION WITH THE EXTERNAL AUDITORS AT LEAST TWICE A YEAR WITHOUT THE PRESENCE OF INTERNAL MANAGEMENT. PART XII, LINE 3A - A-133 AUDIT THE COMPANY IS A PART OF THE INOVA HEALTH SYSTEM (IHS), A NOT-FOR-PROFIT INTEGRATED HEALTH CARE DELIVERY SYSTEM SERVING NORTHERN VIRGINIA AND SURROUNDING AREAS. IHS RECEIVES VARIOUS FEDERAL GRANTS. THESE GRANTS AND AWARDS ARE AUDITED AS PART OF THE CONSOLIDATED INOVA HEALTH SYSTEM UNIFORM GUIDANCE COMPLIANCE AUDIT. THE INOVA HEALTH SYSTEM'S FEDERAL GRANTS ARE AUDITED ON AN ANNUAL BASIS BY A "BIG FOUR" INDEPENDENT PUBLIC ACCOUNTING FIRM AND A "REPORT OF INDEPENDENT AUDITORS ON COMPLIANCE FOR EACH MAJOR PROGRAM; REPORT ON INTERNAL CONTROL OVER COMPLIANCE AND REPORT ON SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS REQUIRED BY THE UNIFORM GUIDANCE" IS ISSUED ON A CONSOLIDATED BASIS. THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES OF INOVA HEALTH SYSTEM IS RESPONSIBLE FOR THE OVERSIGHT OF THE UNIFORM GUIDANCE AUDIT, INCLUDING THE HIRING OF THE AUDIT FIRM, REVIEW AND APPROVAL OF AUDITED FINANCIAL STATEMENTS AND COMMUNICATIONS WITH THE EXTERNAL AUDITORS DURING THE YEAR WITHOUT THE PRESENCE OF INTERNAL MANAGEMENT. 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