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Chesapeake Hospital Corporation: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
Chesapeake Hospital Corporation (EIN 23-7424835)
Tax period
2014-04-01 to 2015-03-31
Filed
2016-02-29
IRS object ID
201600609349300625
Schema version
2014v6.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-02-29T11:34:45-06:00ReturnTs
Tax Period End2015-03-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2014-04-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN237424835EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Chesapeake Hospital CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCHESBusinessNameControlTxt
Phone8044358582PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 Harris DriveAddressLine1Txt
CityKilmarnockCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22482ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSteve QuiriconiPersonNm
Person TitleTreasurerPersonTitleTxt
Phone8044358582PhoneNum
Signature2016-02-29SignatureDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Rappahannock General HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerToni ArdabellPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 Harris DriveAddressLine1Txt
CityKilmarnockCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22482ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$35,076,433GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addressrichmond.bonsecours.com/find-a-facility.htmlWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1977FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionNot-for-profit Acute Care HospitalActivityOrMissionDesc
Voting Members Governing Body20VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee418TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$4,464TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,243,998PYContributionsGrantsAmt
CY Contributions Grants$160,921CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$29,718,519CYProgramServiceRevenueAmt
PY Investment Income$1,536PYInvestmentIncomeAmt
CY Investment Income$2,081CYInvestmentIncomeAmt
PY Other Revenue-$15,592PYOtherRevenueAmt
CY Other Revenue$5,052,777CYOtherRevenueAmt
PY Total Revenue$1,229,942PYTotalRevenueAmt
CY Total Revenue$34,934,298CYTotalRevenueAmt
PY Grants And Similar Paid$660,515PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$18,007,247CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$75,000PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$87,461PYOtherExpensesAmt
CY Other Expenses$24,677,669CYOtherExpensesAmt
PY Total Expenses$822,976PYTotalExpensesAmt
CY Total Expenses$42,684,916CYTotalExpensesAmt
PY Revenues Less Expenses$406,966PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$7,750,618CYRevenuesLessExpensesAmt
Total Assets BOY$25,590,188TotalAssetsBOYAmt
Total Assets EOY$27,353,670TotalAssetsEOYAmt
Total Liabilities BOY$9,036,899TotalLiabilitiesBOYAmt
Total Liabilities EOY$17,804,303TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$16,553,289NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$9,549,367NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe organization operates an acute care general hospital. The hospital has a community based board of directors, has an open medical staff, operates an emergency room providing care to all regardless of ability to pay, and provides non-emergency services to any with the ability to pay including Medicare and Medicaid covered individuals. The organization is dedicated to the provision of quality, compassionate care to all patients in the most cost effective manner. This will be accomplished through the most effective use of available resources and will reflect ethical decisions, including the effective management of pain, made jointly by the patients, the family, and health care professionals involved in its care.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$40,381,573ExpenseAmt
Revenue$30,124,271RevenueAmt
DescRappahannock General Hospital is the only provider of inpatient and outpatient acute care services within a five county area. The hospital is licensed to operate 76 beds, including 47 medical/surgical beds, 7 intensive/critical care beds, 12 telemetry care beds and 10 psych beds. The hospital also offers our community major diagnostic and treatment capabilities; clinical and blood bank laboratory services; radiology services including diagnostic x-ray, digital mammography, digital fluoroscopy, bone densitometry, arteriography, angiography with digital subtraction, noninvasive vascular laboratory, ultrasonography, nuclear medicine, MRI, CT scanning, oncology, inpatient and same day surgery; respiratory therapy; physical therapy; lithotripsy; and radiation therapy. Chesapeake Hospital Corporation provided numerous services for the community which included health fairs for different civic groups in the five county areas. The services offered by the hospital range from cholesterol, blood pressure, glucose, literature and cancer information and/or screenings. Community benefits are provided through many reduced price services and free programs offered throughout the year based on activities and services which the hospital believes will serve a bona fide community health need. This includes the cancer treatment and education center support groups and education for patients and their families. The emergency department offers CPR, heart saver courses, and pediatric basis life support. We also sponsor a diabetic education course for people with diabetes and their families. The organization also volunteers staff and facilities for an annual senior conference to address various issues relevant to the senior population, such as Alzheimer, strokes, home care, etc. The organization was involved in 26 programs and served 1,767 individuals. Please see Sch H for additional information.Desc
Total Program Service Expenses$40,381,573TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document14IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee418EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members20GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldVAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJohn HeadleyPersonNm
Phone8044358000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 Harris RoadAddressLine1Txt
CityKilmarnockCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22482ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (42 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
BH Hubbard III
Chairman (Apr-Dec)/BM (Jan-Mar)2.000.00Yes (X)Yes (X)$0$0$0
James Carter Jr
Board Member (Apr-Dec)10.0030.00Yes (X)$0$0$0
David Charlton Dr
Board Member (Apr-Dec)1.000.00Yes (X)$0$0$0
James Chase Jr
Secretary (Apr-Dec)1.000.00Yes (X)Yes (X)$0$0$0
Frederick Cole
Board Member (Apr-Dec)1.000.00Yes (X)$0$0$0
Elizabeth Crowther Dr
Board Member (Apr-Dec)1.000.00Yes (X)$0$0$0
June Daffeh
Board Member (Apr-Dec)40.000.00Yes (X)Yes (X)$229,000$0$0
Edward Harrow Jr
Board Member (Apr-Dec)1.001.00Yes (X)$0$0$0
James Holmes Jr
President/Treasurer (Apr-Dec)/BD (Jan-Mar)23.0017.00Yes (X)$0$233,879$0
Garfield Parker
Board Member (Apr-Dec)1.000.00Yes (X)$0$0$0
C Penick
Vice Chairman (Apr-Dec)1.000.00Yes (X)Yes (X)$0$0$0
Stephen Whiteway
Board Member (Apr-Dec)1.000.00Yes (X)$0$0$0
Jean Bolling
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
John Bowman MD
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
Barry Case
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
Chandrashekar Challa
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
John Daniel III MD
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
Anup Gokli MD
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
Allen Goolsby III
Secretary (Jan-Mar)2.002.00Yes (X)Yes (X)$0$0$0
Mark Gordon
Board Member (Jan-Mar)2.0048.00Yes (X)$0$546,935$49,326
Pamela Hacker
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
Sr Anne Mack CBS
President (Jan-Mar)3.0048.00Yes (X)Yes (X)$0$0$0
Joanne Nattrass
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
Fr Jack Podsiadlo
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
Michael Robinson
Board Member (Jan-Mar)2.0048.00Yes (X)$0$730,851$25,808
Sr Victoria Segura CBS
Board Member (Jan-Mar)2.0048.00Yes (X)$0$0$0
William Shewmake
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
Shannon Sinclair
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
William Stallings MD
Board Member (Jan-Mar)38.002.00Yes (X)Yes (X)$224,680$0$16,206
Nancy Thomas
Chair (Jan-Mar)3.000.00Yes (X)Yes (X)$0$0$0
Michael Williams
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
Thomas Winfree
Board Member (Jan-Mar)2.000.00Yes (X)$0$0$0
John Headley
Treasurer (Apr-Dec)30.0010.00Yes (X)$0$155,680$0
Toni Ardabell
CEO-Richmond(Jan-Mar)1.0049.00Yes (X)$0$734,625$39,627
Peter Bernard
CEO - Virginia (Jan-Mar)1.0049.00Yes (X)$0$1,489,553$197,160
Stephan Quiriconi
Treasurer (Jan-Mar)2.0048.00Yes (X)$0$307,530$13,955
Jim Godwin
VP HR2.0048.00$0$254,827$28,849Yes (X)
Paul Sutherland MD
Physician40.000.00$348,017$0$12,969Yes (X)
Virginia Gale MD
Physician40.000.00$311,189$0$20,160Yes (X)
Stephen Perkins MD
Physician40.000.00$301,320$0$20,160Yes (X)
Saheed Ojo Oniyun MD
Physician40.000.00$196,786$0$16,704Yes (X)
James Bryant MD
Physician40.000.00$212,602$0$12,942Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,823,594TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,453,880TotReportableCompRltdOrgAmt
Total Other Compensation$453,866TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Virginia Anesthesia
760 McQuire PlaceNewport NewsVA23601Physician Services$700,003
Linde Healthcare
PO Box 915241DallasTX75391Physician Services$195,756
Kaufman & Canoles
PO Box 3037NorfolkVA23514Legal Services$188,694
Carter Financial Corp
PO Box 13750IrvingtonVA22480Consulting$150,000
Richard Carpenter MD
PO Box 3391MartinsvilleVA24115Physician Services$144,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Related Organizations$147,909RelatedOrganizationsAmt
Government Grants$7,686GovernmentGrantsAmt
All Other Contributions$5,326AllOtherContributionsAmt
Total Contributions$160,921TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNet Patient Service ReDesc
Business623000BusinessCd
Total Revenue Column$29,718,519TotalRevenueColumnAmt
Related Or Exempt Func Income$29,714,055RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$4,464UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$29,718,519TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,081TotalRevenueColumnAmt
Exclusion$2,081ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$132,465RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$142,135RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$9,670RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$9,670TotalRevenueColumnAmt
Exclusion-$9,670ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Gain from Revaluation,900099$4,392,840$4,392,840
ER & CMG & HH - Physic623000$389,122$389,122
Cafeteria and Vending900099$226,251$226,251

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$54,234TotalRevenueColumnAmt
Related Or Exempt Func Income$21,094RelatedOrExemptFuncIncomeAmt
Exclusion$33,140ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$5,062,447OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,934,298TotalRevenueColumnAmt
Related Or Exempt Func Income$30,124,271RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$4,464UnrelatedBusinessRevenueAmt
Exclusion$4,644,642ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$241,934TotalAmt
Program Services$217,741ProgramServicesAmt
Management And General$24,193ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$15,107,104TotalAmt
Program Services$13,596,394ProgramServicesAmt
Management And General$1,510,710ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$258,011TotalAmt
Program Services$232,210ProgramServicesAmt
Management And General$25,801ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,146,121TotalAmt
Program Services$1,031,509ProgramServicesAmt
Management And General$114,612ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,254,077TotalAmt
Program Services$1,128,669ProgramServicesAmt
Management And General$125,408ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$264,414TotalAmt
Program Services$237,973ProgramServicesAmt
Management And General$26,441ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$15,278TotalAmt
Program Services$13,750ProgramServicesAmt
Management And General$1,528ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,136,747TotalAmt
Program Services$2,136,747ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$10,594TotalAmt
Program Services$9,535ProgramServicesAmt
Management And General$1,059ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$462,871TotalAmt
Program Services$416,584ProgramServicesAmt
Management And General$46,287ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$80,399TotalAmt
Program Services$72,359ProgramServicesAmt
Management And General$8,040ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$394,774TotalAmt
Program Services$355,297ProgramServicesAmt
Management And General$39,477ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$43,008TotalAmt
Program Services$38,707ProgramServicesAmt
Management And General$4,301ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$327,797TotalAmt
Program Services$327,797ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$927,662TotalAmt
Program Services$834,896ProgramServicesAmt
Management And General$92,766ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$697,551TotalAmt
Program Services$627,796ProgramServicesAmt
Management And General$69,755ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Bad Debt Expense$11,978,364$11,978,364
Medical Supplies$5,208,573$5,208,573
Repairs, Maint., Rental$1,132,817$1,019,535$113,282
Corp Mgmt Dues - CHS$682,848$614,563$68,285

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$313,972TotalAmt
Program Services$282,574ProgramServicesAmt
Management And General$31,398ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$42,684,916TotalAmt
Program Services$40,381,573ProgramServicesAmt
Management And General$2,303,343ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,330BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$49,797BOYAmt
EOY$368,522EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,366,945BOYAmt
EOY$2,749,963EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$54,109BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$818,842BOYAmt
EOY$846,805EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$717,195BOYAmt
EOY$460,980EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$15,833,577LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$296,856LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,746,063BOYAmt
EOY$15,536,721EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$163,216EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$49,669BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$46,567BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,739,671BOYAmt
EOY$7,227,463EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$25,590,188BOYAmt
EOY$27,353,670EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,074,695BOYAmt
EOY$3,581,840EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$835,497BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,126,707BOYAmt
EOY$14,222,463EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,036,899BOYAmt
EOY$17,804,303EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$16,422,611BOYAmt
EOY$9,410,605EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$130,678BOYAmt
EOY$138,762EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,553,289BOYAmt
EOY$9,549,367EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,590,188BOYAmt
EOY$27,353,670EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$7,750,618ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$746,696OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,045,796OtherCostOrOtherBasisAmt
Book Value$1,045,796BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,476,656OtherCostOrOtherBasisAmt
Depreciation$98,990DepreciationAmt
Book Value$5,377,666BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$115,110OtherCostOrOtherBasisAmt
Depreciation$9,846DepreciationAmt
Book Value$105,264BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,196,015OtherCostOrOtherBasisAmt
Depreciation$188,020DepreciationAmt
Book Value$9,007,995BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,536,721TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Due from Affiliates$6,072,400
Due from Medicare$840,466
Other Misc Receivables$314,597
FieldValueIRS element (for citing)
Total Book Value Other Assets$7,227,463TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
Due to BSHSI$10,523,719
Due to St. Mary's Hospital$1,500,000
Due to RGH Foundation$983,680
LT Deferred Rent$639,462
Third Party Reserves$482,738
Other Misc Liabilities$92,864
FieldValueIRS element (for citing)
Total Liability$14,222,463TotalLiabilityAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$924,037TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$924,037NetCommunityBenefitExpnsAmt
Total Expense0.03010TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,165,767TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,741,225DirectOffsettingRevenueAmt
Net Community Benefit Expns$424,542NetCommunityBenefitExpnsAmt
Total Expense0.01380TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,597TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,361DirectOffsettingRevenueAmt
Net Community Benefit Expns$236NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,094,401TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,745,586DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,348,815NetCommunityBenefitExpnsAmt
Total Expense0.04390TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs26ActivitiesOrProgramsCnt
Persons Served1767PersonsServedCnt
Total Community Benefit Expns$20,416TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$20,416NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs26ActivitiesOrProgramsCnt
Persons Served1767PersonsServedCnt
Total Community Benefit Expns$20,416TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$20,416NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs26ActivitiesOrProgramsCnt
Persons Served1767PersonsServedCnt
Total Community Benefit Expns$3,114,817TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,745,586DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,369,231NetCommunityBenefitExpnsAmt
Total Expense0.04460TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$11,978,364BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$130,615,621ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$15,581,422CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$115,034,199MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Chespeake Hospital CorporationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 Harris DriveAddressLine1Txt
CityKilmarnockCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22482ZIPCd
FieldValueIRS element (for citing)
Website Addresshttp://richmond.bonsecours.com/find-a-WebsiteAddressTxt
State LicenseH1885StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Chesapeake Hospital CorpBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely Available0CHNAReportWidelyAvailableInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt12ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttp://www.bonsecours.com/about-us-community-health-needs-assessment.htmlStrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care20000.000000000000FPGFamilyIncmLmtFreeCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Lowest Negotiated RatesYes (X)LowestNegotiatedRatesInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Chesapeake Hospital CorpPart V, Section B, Line 5: Community Survey:The marketing and public relations department of Rappahannock General Hospital went to various locations in the community in January and February of 2013 to survey community members regarding the health needs of their community as part of the Community Health Needs Assessment. The survey was completed by 84 residents of Lancaster County, 32 residents of Northumberland County, and 22 residents of Middlesex County.The survey was administered with the method of convenience sampling where survey responses are based on the convenience of getting the surveys completed. The sampling population was people ages 18 and older and represents the demographic profile of the three counties. The survey was divided into four general sections designed to gather a comprehensive picture of community health. The first section focused on factors that improve the quality of life in the community, the second focused on the problems which have the greatest impact on overall community health, the third section focused on the behaviors that have the greatest impact on overall community health, and the fourth section gathered general demographic data on the survey respondents.Additionally, the hospital conducted interviews during February 2013 with five healthcare professionals with special knowledge and expertise in public health who provided valuable input about the health needs in the community. Priority Needs:The survey results gathered by each county were counted and compiled to make a list of the health needs that the community believed were the most important. Based on the number of responses, eleven health needs were identified as being most significant to the community. Secondary statistical data gathered from Virginia Department of Health, County Health Rankings, Health Indicators Warehouse, State Cancer Profiles, and national benchmarks and targets from Healthy People 2020 supported the identification of these eleven health needs. Once a list was compiled, data from all primary and secondary sources was assessed in preparation for prioritization of the needs.
Chesapeake Hospital CorpPart V, Section B, Line 11: The Implementation Plan focuses on six identified needs to include: Cancer, Heart Disease and Stroke, Mental Health, Access to Healthcare, Aging Problems, and Diabetes and Obesity. In an effort to address the high percentage of cancer deaths within the RGH service area, RGH is working to expand its delivery of Oncology Services, increase awareness both internally with employees and externally with community members, and reduce the prevalence of smoking by providing a smoke free campus and smoking cessation programs.Provider recruitment is a focus area for RGH to aid in expanding the access of its Cardiac Care and Stroke Services and reestablishing its cardiac rehabilitation program in an effort to address Heart Disease and Stroke. Increased provider partnerships and the expansion of mental health services will begin to address the need for additional mental health support. Physician recruitment will also provide additional access to healthcare services including dermatology, ENT, family practice, orthopedics, and maternity care.Expansions of the Senior University Event and the Home Health department will help to address the aging problems identified in the CHNA.Diabetes and Obesity will be addressed through increased community awareness through health fairs, screenings, nutrition services, and community program sponsorships. Additional health promotion programs and activities will be implemented to specifically address childhood obesity.RGH will not be addressing the following community health concerns: Teen Pregnancy, Sexually Transmitted Diseases, Alcohol Abuse, Tobacco Use, and Drug Use. The Chesapeake Medical Group discusses STDs and Pregnancy Prevention with all at risk patients. All three schools in the area work closely with the Three Rivers Health District to address all five of these issues identified on a group and individual basis. Alcoholics Anonymous (AA) host 10 meetings weekly in the areas we serve as well as 3 Narcotics Anonymous (NA) meetings locally. The CSB provides assessment and evaluation, information and referrals, motivational enhancement therapy, family and group therapy, and intensive group therapy to those individuals and families dealing with drug and alcohol abuse. RGH became a smoke free campus in April 2011 and offers smoking cessation resources to all employees and patients.

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7:Costing method is the overall cost to charge ratio from the medicare cost reports. Bad debt is excluded in the calculation.
Part I, Ln 7 Col(f):Bad debt expense included in Part IX; line 25 and excluded from the "percent of total expense" calculation is: $11,978,364
Part III, Line 4:Bad debt expense on the general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates.Part III, line 3: The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospital's charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify.
Part III, Line 8:Any shortfall of medicare payments received directly benefits the community citizens.
Part III, Line 9b:All candidates for financial assistance are evaluated for medicaid eligibility and any other available form of financial assistance prior to any collection activity. No collection activity is performed on patients that qualify for financial assistance.
Part VI, Line 2:The assessment process consisted mainly of gathering data at the county level from primary sources within the community and secondary online resources. Each county utilized a survey to obtain direct input from their residents. Interviews were conducted with medical professionals from the community and discussions were held with public health representatives including leaders from the county health department and the free health clinic. The secondary online data included statistics for the county, community, state, and national level. All data was compiled and assessed at an individual county level and also at a community level, pointing to the overall health needs for all three of the counties.
Part VI, Line 3:Any patient that arrives with no insurance is referred to an onsite third party that attempts to qualify them for charity, Medicaid, and any other assistance available. They are also referred to the internet healthcare exchange website. Patients are offered discounted care on an individual basis. RGH works closely with the Northern Neck Free Clinic (NNFC) by providing them mainly with lab and radiology services including MRI's and CT's.
Part VI, Line 4:Rappahannock General Hospital is an independent community based hospital that serves a population of approximately 35,000 people in Eastern Virginia in the Northern Neck and Middle Peninsula Area contiguous to the Chesapeake Bay. RGH's service area is mostly a rural coastal community and includes Lancaster, Northumberland, and Middlesex counties. Approximately 88% of RGH's patient population is residents of Lancaster, Northumberland, and Middlesex counties. For the purposes of the CHNA, RGH defined these three counties as the community. The population is approximately 73% White, 24% African American, 2% Hispanic, 5% Hispanic, and 5% American Indian and Alaskan Native. 16% of the population is under the age of 18, 54% between ages 18-65, and 30% above age 65. When compared to the state and national averages, the most notable difference is that the age group above age 65 is 17% higher than the state average and 16% above the national average. Rappahannock General Hospital service area mean household income is $50,499 which is $12,803 lower than the state average and $2,263 below the national average.
Part VI, Line 5:Chesapeake Hospital Corporation provides numerous services for the community including health fairs for multiple civic groups in the six surrounding counties. The services offered by the hospital range from cholesterol, blood pressure, glucose literature, and cancer information and/or screenings. Community benefits are provided through many reduced price services which the hospital believes serves a Bona Fide community health need. This includes the cancer treatment and education center support groups and education for patients and their families. The emergency department offers CPR, heart saver courses, and pediatric basic life support. We also sponsor a diabetes education course for people with diabetes and their families. The organization also volunteers staff and facilities for free sport physicals for secondary students in the area. The organization supports the loss incurred by its sister company Chesapeake Medical Group (CMG). CMG represents several groups of physicians including family practice, pediatrics, GYN, surgery and others that are not able to survive without the assistance from RGH. CMG has the only pediatric services in the area. CMG provides physician care regardless of the insurance while other physicians in the area no longer accept new Medicaid patients. CMG also provides coverage for those patients with no insurance.
Part VI, Line 6:Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc, a Maryland nonprofit, nonstock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSHSI, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. BSHSI's vision to bring about the holistic health of the communities it serves is implemented through its Strategic Quality Plan which provides focus in five goal areas for the current three year period (2013-2015). One of those goals was to bring our communities to wholeness. To accomplish this, two key strategies are to: - Improve Health Locally and Globally- Build Partnerships for Population Health As a member of the Catholic health ministry and a member of Bon Secours Health System, Inc. (BSHSI), this organization and it's related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSHSI Vision. "Inspired by the healing ministry of Jesus Christ and the charism of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world."
Part VI, Line 7, Reports Filed With StatesVA

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
June Daffeh
Board Member (Apr-Dec)$229,000$0$0$0$0$0$5,850$0$7,084$0$241,934$0$0$0
James Holmes Jr
President/Treasurer (Apr-Dec)/BD (Ja$0$233,879$0$0$0$0$0$7,939$0$21,070$0$262,888$0$0
Mark Gordon
Board Member (Jan-Mar)$0$336,416$0$144,733$0$65,786$0$21,206$0$28,120$0$596,261$0$17,280
Michael Robinson
Board Member (Jan-Mar)$0$464,732$0$154,883$0$111,236$0$15,600$0$10,208$0$756,659$0$0
William Stallings MD
Board Member (Jan-Mar)$224,680$0$0$0$0$0$5,850$0$10,356$0$240,886$0$0$0
John Headley
Treasurer (Apr-Dec)$0$155,680$0$0$0$0$0$3,750$0$14,151$0$173,581$0$0
Toni Ardabell
CEO-Richmond(Jan-Mar)$0$493,876$0$159,372$0$81,377$0$37,127$0$2,500$0$774,252$0$25,794
Peter Bernard
CEO - Virginia (Jan-Mar)$0$789,743$0$326,469$0$373,341$0$166,398$0$30,762$0$1,686,713$0$186,126
Stephan Quiriconi
Treasurer (Jan-Mar)$0$248,452$0$57,920$0$1,158$0$3,672$0$10,283$0$321,485$0$0
Jim Godwin
VP HR$0$206,334$0$47,086$0$1,407$0$6,792$0$22,057$0$283,676$0$0
Paul Sutherland MD
Physician$348,017$0$0$0$0$0$7,800$0$5,169$0$360,986$0$0$0
Virginia Gale MD
Physician$311,189$0$0$0$0$0$7,800$0$12,360$0$331,349$0$0$0
Stephen Perkins MD
Physician$301,320$0$0$0$0$0$7,800$0$12,360$0$321,480$0$0$0
Saheed Ojo Oniyun MD
Physician$196,786$0$0$0$0$0$5,077$0$11,627$0$213,490$0$0$0
James Bryant MD
Physician$212,602$0$0$0$0$0$5,850$0$7,092$0$225,544$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 4bFormAndLineReferenceDesc
ExplanationThe filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and is available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution include: Peter Bernard, 241,741; Toni Ardabell, 37,602; Mark Gordon, 25,011.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Carter Financial CorpBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionBM, James Carter, Jr is the sole owner of this entityRelationshipDescriptionTxt
Transaction$162,500TransactionAmt
TransactionConsultantTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart IV:FormAndLineReferenceDesc
ExplanationPrior to the membership change of the organization, James Carter, Jr was the Executive Director of the Rappahannock General Hospital Foundation. During and after this transition period, Mr. Carter provided consulting services to the filing entity. Mr. Carter is the 100% owner of Carter Financial Corp which provides development, fundraising and other consulting type services.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 4On December 31, 2014, the articles and bylaws were amended and restated in their entirety to reflect that as a result of the Rappahannock transaction, Bon Secours-Richmond Health System has increased its interest in this entity and is now its sole member.
Form 990, Part VI, Section A, line 6Bon Secours Health System, Inc. is the sole member of Bon Secours Richmond LLC. Bon Secours Richmond LLC holds the majority interest in Bon Secours - Richmond Health System, which in turn is the sole member of the filing organization.
Form 990, Part VI, Section A, line 7aThe governing body of the filing organization is appointed by it's member Bon Secours - Richmond Health System and subject to approval by Bon Secours Health System, Inc.
Form 990, Part VI, Section A, line 7bCertain authorities of the filing organization are reserved to its member or to Bon Secours Health System, Inc.
Form 990, Part VI, Section B, line 11The Form 990 for the filing organization will be provided to the Board after filing. Any material changes to the return will be reflected in an amended return, as necessary.
Form 990, Part VI, Section B, line 12cThe organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members).
Form 990, Part VI, Section B, line 15The compensation committee of the board of Bon Secours Health System, Inc. (BSHSI) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of BSHSI. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Form 990, Part VI, Section b, Line 15b - Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources.
Form 990, Part VI, Section C, line 19The filing organization makes all documents available to the general public upon request.
Form 990, Part XI, line 9:Other misc changes in net assets 746,696.
Form 990, Part VII:Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities. The governing bodies of the hospitals of Bon Secours Richmond Health System, including Bon Secours St. Mary's Hospital, Bon Secours St. Francis Medical Center, Bon Secours Memorial Regional Medical Center and Richmond Community Hospital, Chespeake Hospital Corporation, as well as the Chespeake Medical Group, are comprised of the same board members and board officers (Chairman, President, Secretary and Treasurer). These governing bodies are referred to as the Richmond Joint Board. Hours reported for these voluntary board positions represent total hours worked per week, which include responsibilities for all four hospitals). Sr. Anne Marie Mack and Sr. Victoria Segura do not receive payroll distributions as they have taken vows of poverty.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Chesapeake Health Services
101 Harris RoadKilmarnockVA22482541513371ParentVA501(c)(3)Line 11a, IN/A0
Rappahannock General Hospital Foundation
101 Harris RoadKilmarnockVA22482541210450Supporting OrganizationVA501(c)(3)Line 70Bon Secours Richmond Health System
Chesapeake Medical Group
101 Harris RoadKilmarnockVA22482541857174Healthcare ServicesVA501(c)(3)Line 90Bon Secours Richmond Health System
Bon Secours Health System Inc
1505 Marriottsville RoadMarriottsvilleMD21104521301088Parent Org. Management ServicesMD501(c)(3)Line 11c, III-FI0Bon Secours Inc
Bon Secours Richmond Healthcare Foundation
8580 Magellan ParkwayRichmondVA23227541201346Grant Making FoundationVA501(c)(3)Line 70Bon Secours Richmond LLC
Bon Secours Richmond Health System
8580 Magellan ParkwayRichmondVA23227521988421Local System Parent Org.VA501(c)(3)Line 11c, III-FI0Bon Secours Richmond LLC
Bon Secours Memorial Regional Medical Center
8580 Magellan ParkwayRichmondVA23227541744931Health CareVA501(c)(3)Line 30Bon Secours Richmond Health System
Bon Secours Richmond Community Hospital
8580 Magellan ParkwayRichmondVA23227540647482Health CareVA501(c)(3)Line 30Bon Secours Richmond Health System
Bon Secours St Francis Medical Center
8580 Magellan ParkwayRichmondVA23227311716973Health CareVA501(c)(3)Line 30Bon Secours Richmond Health System
St Mary's Hospital of Richmond Inc
8580 Magellan ParkwayRichmondVA23227540793767Health CareVA501(c)(3)Line 30Bon Secours Richmond Health System
Laburnum Properties
8580 Magellan ParkwayRichmondVA23227521260700Title Holding CompanyVA501(c)(2)0Bon Secours Richmond Health System

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
St Mary's MRI LP
8580 Magellan ParkwayRichmondVA23227541568022Imaging ServicesVAN/A
RI LP
8580 Magellan ParkwayRichmondVA23227541708835Imaging ServicesVAN/A
Broad64 Imaging LLC
8580 Magellan ParkwayRichmondVA23227205886018Imaging ServicesVAN/A
Richmond Radiation Oncology Center I LLC
8580 Magellan ParkwayRichmondVA23227208444551Radiation Oncology ServicesVAN/A
Chesterfield Community Healthcare Center MOB I LLC
435 Southlake BlvdRichmondVA23236541745670Rental - Medical Office BuildingVAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Chesterfield Community Healthcare Center Inc
8580 Magellan ParkwayRichmondVA23227541812738Ambulatory Healthcare ServicesVAN/AC0
RHS Management Corporation
8580 Magellan ParkwayRichmondVA23227541313425Independent Living FacilityVAN/AC0
Bon Secours - Virginia HealthSource Inc
8580 Magellan ParkwayRichmondVA23227541417686Ambulatory Healthcare ServicesVAN/AC0
Richmond MRI Inc
8580 Magellan ParkwayRichmondVA23227541568452Imaging ServicesVAN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd