Chesapeake Hospital Corporation: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- Chesapeake Hospital Corporation (EIN 23-7424835)
- Tax period
- 2013-04-01 to 2014-03-31
- Filed
- 2015-02-16
- IRS object ID
- 201500479349301030
- Schema version
- 2013v4.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-02-16T15:20:49-06:00 | ReturnTs |
| Tax Period End | 2014-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 540737372 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PBMARES LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 TOWN CENTER DRIVE SUITE 900 | AddressLine1 |
| City | NEWPORT NEWS | City |
| State | VA | State |
| ZIP Code | 23606 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237424835 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHESAPEAKE HOSPITAL CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHES | BusinessNameControlTxt |
| Phone | 8044358582 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HARRIS DRIVE | AddressLine1 |
| City | KILMARNOCK | City |
| State | VA | State |
| ZIP Code | 22482 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES M HOLMES JR | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8044358582 | PhoneNum |
| Signature | 2015-02-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS R BROOKS | PreparerPersonNm |
| PTIN | P00168242 | PTIN |
| Phone | 7578731587 | PhoneNum |
| Preparation | 2015-02-16 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RAPPAHANOCK GENERAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAMES M HOLMES JR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HARRIS DRIVE | AddressLine1 |
| City | KILMARNOCK | City |
| State | VA | State |
| ZIP Code | 22482 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $32,573,991 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.RAPPAHANNOCKHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1977 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION OPERATES AN ACUTE CARE GENERAL HOSPITAL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 459 | TotalEmployeeCnt |
| Total Volunteers | 121 | TotalVolunteersCnt |
| Total Gross UBI | $8,948 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $393,845 | PYContributionsGrantsAmt |
| CY Contributions Grants | $677,191 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $35,579,851 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $31,730,116 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,126 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,027 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$41,487 | PYOtherRevenueAmt |
| CY Other Revenue | $9,164 | CYOtherRevenueAmt |
| PY Total Revenue | $35,939,335 | PYTotalRevenueAmt |
| CY Total Revenue | $32,421,498 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,372 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,293,504 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $19,481,381 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $3,459 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,942,051 | PYOtherExpensesAmt |
| CY Other Expenses | $17,595,101 | CYOtherExpensesAmt |
| PY Total Expenses | $36,237,927 | PYTotalExpensesAmt |
| CY Total Expenses | $37,076,482 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$298,592 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,654,984 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $28,439,703 | TotalAssetsBOYAmt |
| Total Assets EOY | $25,590,188 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,231,430 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,036,899 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,208,273 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $16,553,289 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION OPERATES AN ACUTE CARE GENERAL HOSPITAL. THE HOSPITAL HAS A COMMUNITY BASED BOARD OF DIRECTORS, HAS A 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 HIS CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $32,007,121 | ExpenseAmt |
| Revenue | $31,730,332 | RevenueAmt |
| Desc | RAPPAHANOCK 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 FLOUROSCOPY, BONE DENSITOMETRY, ARTERIOGRAPHY, ANGIOGRAPHY WITH DIGITAL SUBTRACTION, NONINVASIVE VASCULAR LABORATORY, ULTRASONOGRAPHY, NUCLEAR MEDICINE, MRI, CT SCANNING, INPATIENT AND SAME DAY SURGERY; RESPIRATORY THERAPY; PHYSICAL THERAPY; HOME HEALTH, LITHOTRIPSY; AND RADIATION THERAPY. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $437,348 | ExpenseAmt |
| Desc | 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 POPULATIONS, SUCH AS ALZHEIMERS, STROKES, HOME CARE, ETC. THE ORGANIZATION WAS INVOLVED IN 281 PROGRAMS AND SERVED 1,151 INDIVIDUALS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $32,444,469 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 15 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 459 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN HEADLEY | PersonNm |
| Phone | 8044358000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HARRIS ROAD | AddressLine1 |
| City | KILMARNOCK | City |
| State | VA | State |
| ZIP Code | 22482 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DAVID H CHARLTON | ||||||||
| VOTING BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| EDWARD P HARROW JR | ||||||||
| VOTING BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ELIZABETH CROWTHER | ||||||||
| VOTING BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| FREDRICK COLE | ||||||||
| VOTING BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GARFIELD PARKER | ||||||||
| VOTING BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES CARTER JR | ||||||||
| VOTING BOARD MEMBER | 10.00 | 30.00 | Yes (X) | $0 | $0 | $0 | ||
| JEFF CHASE JR | ||||||||
| VOTING BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JUNE DAFFEH MD | ||||||||
| PRESIDENT OF MEDICAL STAFF | 40.00 | 0.00 | Yes (X) | $217,409 | $0 | $12,282 | ||
| STEPHEN WHITEWAY | ||||||||
| VOTING BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| WAYNE PENICK | ||||||||
| VOTING BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES M HOLMES JR | ||||||||
| PRESIDENT | 23.00 | 17.00 | Yes (X) | $0 | $366,385 | $29,009 | Yes (X) | |
| B H HUBBARD III | ||||||||
| CHAIRMAN OF THE BOARD | 2.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ANN GUMINA | ||||||||
| VP OF NURSING | 35.00 | 5.00 | $0 | $132,706 | $5,242 | Yes (X) | ||
| BERNARD P LOCKSTAMPFOR JR | ||||||||
| TREASURER/VP-PAT. FIN. SER | 30.00 | 10.00 | $0 | $166,462 | $20,302 | Yes (X) | ||
| WILLIAM R STALLINGS MD | ||||||||
| VICE PRESIDENT OF MEDICAL STAFF | 40.00 | 0.00 | $212,002 | $0 | $12,864 | Yes (X) | ||
| J RANDY HESTER SR | ||||||||
| SR VP-OPERATIONS/SECRETARY | 35.00 | 5.00 | $0 | $211,440 | $17,328 | Yes (X) | ||
| JOHN HEADLEY | ||||||||
| CFO | 30.00 | 10.00 | $0 | $133,282 | $17,901 | Yes (X) | ||
| MARVENE RUIT | ||||||||
| CHIEF OPERATING OFFICER CMG | 1.00 | 39.00 | $0 | $115,568 | $18,030 | Yes (X) | ||
| BARBARA PERONA | ||||||||
| ANESTHESIOLOGIST | 40.00 | 0.00 | $330,849 | $0 | $18,522 | Yes (X) | ||
| PAUL SUTHERLAND | ||||||||
| ER PHYSICIAN | 40.00 | 0.00 | $307,767 | $0 | $16,552 | Yes (X) | ||
| VIRGINIA GALE | ||||||||
| ER PHYSICIAN | 40.00 | 0.00 | $250,155 | $0 | $18,485 | Yes (X) | ||
| STEPHEN PERKINS | ||||||||
| ER PHYSICIAN | 40.00 | 0.00 | $242,124 | $0 | $17,949 | Yes (X) | ||
| SAHEED OJO-ONIYUN | ||||||||
| INHOUSE PHYSICIAN | 40.00 | 0.00 | $198,288 | $0 | $17,844 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,758,594 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,125,843 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $222,310 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CHESAPEAKE HEALTH SERVICES | |||||
| PO BOX 1328 | KILMARNOCK | VA | 22482 | MANAGEMENT SERVICES | $1,330,443 |
| DIAMOND HEALTHCARE CORP | |||||
| PO BOX 85050 | RICHMOND | VA | 23285 | PROGRAM MANAGEMENT SERVICE | $636,422 |
| CARTER FINANCIAL CORP | |||||
| PO BOX 137500 | IRVINGTON | VA | 22480 | CONSULTING | $150,000 |
| NAZIR A CHAUDHARY MD | |||||
| PO BOX 13135 | RICHMOND | VA | 23225 | PHYSICIAN SERVICES | $137,650 |
| DR RICHARD CARPENTER | |||||
| PO BOX 3391 | MARTINSVILLE | VA | 241153391 | PROFESSIONAL SERVICES | $134,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $677,191 | AllOtherContributionsAmt |
| Total Contributions | $677,191 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 623000 | $28,594,871 | $28,594,871 |
| PHYSICIAN PRACTICE SERVICE | 623000 | $2,145,479 | $2,145,479 |
| OTHER REVENUE | 623000 | $482,416 | $482,416 |
| RADIOLOGY REVENUE | 623000 | $271,930 | $271,930 |
| CAFETERIA | 900099 | $226,472 | $226,472 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,948 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $8,948 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $31,730,116 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,849 | TotalRevenueColumnAmt |
| Exclusion | $6,849 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $104,203 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $95,039 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,164 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,164 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,164 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $55,632 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $57,454 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$1,822 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,822 | TotalRevenueColumnAmt |
| Exclusion | -$1,822 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,421,498 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $31,730,332 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $8,948 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,027 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $454,557 | TotalAmt |
| Program Services | $409,101 | ProgramServicesAmt |
| Management And General | $45,456 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,595,550 | TotalAmt |
| Program Services | $14,035,982 | ProgramServicesAmt |
| Management And General | $1,559,568 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $254,886 | TotalAmt |
| Program Services | $229,398 | ProgramServicesAmt |
| Management And General | $25,488 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,980,146 | TotalAmt |
| Program Services | $1,782,131 | ProgramServicesAmt |
| Management And General | $198,015 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,196,242 | TotalAmt |
| Program Services | $1,076,618 | ProgramServicesAmt |
| Management And General | $119,624 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $910,468 | TotalAmt |
| Management And General | $910,468 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,743 | TotalAmt |
| Management And General | $100,743 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,897 | TotalAmt |
| Management And General | $83,897 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,347,135 | TotalAmt |
| Program Services | $1,786,215 | ProgramServicesAmt |
| Management And General | $560,920 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,617 | TotalAmt |
| Management And General | $18,617 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,378 | TotalAmt |
| Program Services | $25,289 | ProgramServicesAmt |
| Management And General | $71,089 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,807 | TotalAmt |
| Management And General | $83,807 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $571,266 | TotalAmt |
| Program Services | $571,266 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,791 | TotalAmt |
| Program Services | $110,409 | ProgramServicesAmt |
| Management And General | $7,382 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,300 | TotalAmt |
| Program Services | $144,300 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $881,833 | TotalAmt |
| Program Services | $881,833 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,401 | TotalAmt |
| Program Services | $266,401 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $5,036,386 | $5,036,386 | |
| BAD DEBT EXPENSE | $4,956,746 | $4,956,746 | |
| REPAIRS AND RENTALS | $1,703,392 | $978,587 | $724,805 |
| DUES AND SUBSCRIPTIONS | $162,643 | $55,296 | $107,347 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,298 | TotalAmt |
| Program Services | $98,511 | ProgramServicesAmt |
| Management And General | $11,328 | ManagementAndGeneralAmt |
| Fundraising | $3,459 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,076,482 | TotalAmt |
| Program Services | $32,444,469 | ProgramServicesAmt |
| Management And General | $4,628,554 | ManagementAndGeneralAmt |
| Fundraising | $3,459 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,330 | BOYAmt |
| EOY | $1,330 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,246 | BOYAmt |
| EOY | $49,797 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,520,738 | BOYAmt |
| EOY | $11,366,945 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $54,109 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $957,125 | BOYAmt |
| EOY | $818,842 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,500,212 | BOYAmt |
| EOY | $717,195 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $31,440,005 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $24,693,942 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,355,544 | BOYAmt |
| EOY | $6,746,063 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,669 | BOYAmt |
| EOY | $49,669 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,845 | BOYAmt |
| EOY | $46,567 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,900,994 | BOYAmt |
| EOY | $5,739,671 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,439,703 | BOYAmt |
| EOY | $25,590,188 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,209,202 | BOYAmt |
| EOY | $4,074,695 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $975,215 | BOYAmt |
| EOY | $835,497 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,047,013 | BOYAmt |
| EOY | $4,126,707 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,231,430 | BOYAmt |
| EOY | $9,036,899 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,061,959 | BOYAmt |
| EOY | $16,422,611 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,314 | BOYAmt |
| EOY | $130,678 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,208,273 | BOYAmt |
| EOY | $16,553,289 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,439,703 | BOYAmt |
| EOY | $25,590,188 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,654,984 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $2,000,000 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,045,796 | OtherCostOrOtherBasisAmt |
| Book Value | $1,045,796 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,900,456 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,743,602 | DepreciationAmt |
| Book Value | $3,156,854 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $115,110 | OtherCostOrOtherBasisAmt |
| Depreciation | $99,935 | DepreciationAmt |
| Book Value | $15,175 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,296,310 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,178,496 | DepreciationAmt |
| Book Value | $2,117,814 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,082,333 | OtherCostOrOtherBasisAmt |
| Depreciation | $671,909 | DepreciationAmt |
| Book Value | $410,424 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,746,063 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| EXTERNALLY RESTRICTED ASSETS | $155,132 |
| DUE FROM CMG | $5,357,965 |
| DUE FROM RGHF AND AUXILLARY | -$57 |
| OTHER RECEIVABLES | $226,631 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,739,671 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| NOTE PAYABLE - SIEMENS | $699,577 |
| DUE TO CHS | $3,427,130 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,126,707 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $713,208 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $713,208 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02220 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $511,855 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $511,855 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01590 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,225,063 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,225,063 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03810 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 281 | ActivitiesOrProgramsCnt |
| Persons Served | 1118 | PersonsServedCnt |
| Total Community Benefit Expns | $142,217 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $142,217 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00440 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 43584 | PersonsServedCnt |
| Total Community Benefit Expns | $428,449 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $428,449 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01330 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $175,610 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $175,610 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 297 | ActivitiesOrProgramsCnt |
| Persons Served | 44702 | PersonsServedCnt |
| Total Community Benefit Expns | $746,276 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $746,276 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02320 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 297 | ActivitiesOrProgramsCnt |
| Persons Served | 44702 | PersonsServedCnt |
| Total Community Benefit Expns | $1,971,339 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,971,339 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06130 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 281 | ActivitiesOrProgramsCnt |
| Persons Served | 1118 | PersonsServedCnt |
| Total Community Benefit Expns | $142,217 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $142,217 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00440 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 281 | ActivitiesOrProgramsCnt |
| Persons Served | 1118 | PersonsServedCnt |
| Total Community Benefit Expns | $142,217 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $142,217 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00440 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,636,509 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $17,644,160 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $20,520,740 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,876,580 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 CHESAPEAKE HEALTH SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | MANAGEMENT SERVICES | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 1.00000 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.00000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RAPPAHANOCK GENERAL HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HARRIS ROAD | AddressLine1 |
| City | KILMARNOCK | City |
| State | VA | State |
| ZIP Code | 22482 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.RAPPAHANNOCKHEALTH.COM | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RAPPAHANNOCK GENERAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | 0 | FPGUsedDetermEligDscntCareInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Lien On Residence | Yes (X) | PermitLienOnResidenceInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| RAPPAHANNOCK GENERAL HOSPITAL | PART V, SECTION B, LINE 3: ASSESSMENT PROCESS AND COMMUNITY INPUTTHE 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. 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. A DETAILED DESCRIPTION OF THE ASSESSMENT PROCESS IS PROVIDED TO INDICATE THE APPROACH TAKEN TO ASSESS THE COMMUNITY'S HEALTH.PRIMARY DATASURVEYS CONDUCTED OF COMMUNITY MEMBERSTHE MARKETING AND PUBLIC RELATIONS COORDINATOR FOR RGH, AND A TEAM OF REGISTERED NURSES WENT TO VARIOUS LOCATIONS IN THE COMMUNITY IN JANUARY AND FEBRUARY OF 2013, TO GIVE OUT SURVEYS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. SURVEYS WERE ALSO GIVEN OUT BY NURSES AT FAMILY PRACTICE OFFICES IN THE THREE COUNTIES. IN ADDITION, THE SAME SURVEY RGH CONDUCTED THROUGHOUT THE COUNTIES WAS GIVEN TO THEIR STAFF AND PRACTICE GROUPS, RESULTING IN 86 RESPONSES FROM EMPLOYEES THAT LIVE THROUGHOUT THE THREE COUNTIES. LANCASTER COUNTY'S SURVEY WAS ADMINISTERED AT THE FRONT DESK OF RAPPAHANNOCK GENERAL HOSPITAL, THE CHESAPEAKE MEDICAL GROUP (CMG) OBSTETRICS/GYNECOLOGY OFFICE, THE NORTHERN NECK FAMILY YMCA, THE LANCASTER CHAMBER OF COMMERCE, AND THE WAL-MART IN KILMARNOCK, VIRGINIA IN LANCASTER COUNTY. THE SURVEY WAS COMPLETED BY 84 RESIDENTS OF LANCASTER COUNTY. NORTHUMBERLAND COUNTY'S SURVEY WAS ADMINISTERED AT CMG HEATHSVILLE FAMILY PRACTICE AND CMG REEDVILLE FAMILY PRACTICE, AND WAS COMPLETED BY 32 RESIDENTS OF NORTHUMBERLAND COUNTY. MIDDLESEX COUNTYS SURVEY WAS ADMINISTERED AT CMG HARTFIELD FAMILY PRACTICE AND WAS COMPLETED BY 22 RESIDENTS OF MIDDLESEX COUNTY. THE SURVEY WAS ADMINISTERED WITH THE METHOD OF CONVENIENCE SAMPLING WHERE SURVEY RESPONDENTS 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 AND INCLUDED A RANKING OF THE THREE MOST IMPORTANT FACTORS FOR A HEALTHY COMMUNITY. THE SECOND SECTION FOCUSED ON THE PROBLEMS WHICH HAVE THE GREATEST IMPACT ON OVERALL COMMUNITY HEALTH AND INCLUDED A RANKING OF THE THREE MOST IMPORTANT HEALTH PROBLEMS. THE THIRD SECTION FOCUSED ON THE BEHAVIORS THAT HAVE THE GREATEST IMPACT ON OVERALL COMMUNITY HEALTH AND INCLUDED A RANKING OF THE THREE MOST IMPORTANT RISKY BEHAVIORS. THE FOURTH SECTION GATHERED GENERAL DEMOGRAPHIC DATA ON THE SURVEY RESPONDENTS.INTERVIEWS CONDUCTED WITH HEALTHCARE PROFESSIONALSLAUREN HOGGE, THE HOSPITAL'S EMS LIAISON, CONDUCTED INTERVIEWS DURING FEBRUARY 2013 WITH FIVE HEALTHCARE PROFESSIONALS. INTERVIEWS WERE CONDUCTED OF PERSONS WITH SPECIAL KNOWLEDGE AND EXPERTISE IN PUBLIC HEALTH, WHO PROVIDED VALUABLE INPUT ABOUT THE HEALTH NEEDS IN THE COMMUNITY. THE INTERVIEW QUESTIONS ASKED FOR A DESCRIPTION OF WHAT THEY SAW AS THE THREE MAJOR HEALTH ISSUES IN THEIR COMMUNITY. FOLLOW UP QUESTIONS WERE THEN ASKED ABOUT COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED HEALTH ISSUE, REASONABLENESS OF ACCESS TO THE RESOURCES, PROGRAMS THAT COULD HELP ADDRESS THE NEED, AND HOW THE HEALTHCARE COMMUNITY CAN MAKE AN IMPACT ON THE ISSUE.THE FIVE HEALTHCARE PROFESSIONAL INTERVIEWEES WERE: LAVENIA ALEXANDER RN, EMERGENCY DEPARTMENT RN AND BOARD OF DIRECTORS MEMBER FOR PENINSULAS EMERGENCY MEDICAL SERVICES REGION; PATRICIA NEWSOME, TRI-COUNTY EMERGENCY SERVICES PROVIDER, PARAMEDIC AND EMERGENCY DEPARTMENT PATIENT CARE TECHNICIAN; DR. PAUL SUTHERLAND, RGH EMERGENCY DEPARTMENT MEDICAL DIRECTOR AND LANCASTER COUNTY EMS; DR. JUNE DAFFEH, INTERNAL HOSPITALIST AT RGH AND SPINNING INSTRUCTOR AT YMCA. ALL INTERVIEWS WERE CONDUCTED ONE-ON-ONE BY THE SAME INDIVIDUAL TO PREVENT BIAS.DISCUSSIONS WITH OTHER PUBLIC HEALTH REPRESENTATIVESRGH HELD MEETINGS VIA TELEPHONE CALL TO OBTAIN INPUT FOR THE CHNA FROM COUNTY HEALTH OFFICIALS AND OTHER REPRESENTATIVES AT THE COUNTY HEALTH DEPARTMENT, THE FREE HEALTH CLINIC, AND A COMMUNITY SERVICES BOARD. THE FOLLOWING ARE A LIST OF INDIVIDUALS WHO PROVIDED INPUT.- LINDA LEE, NURSE MANAGER FOR THREE RIVERS HEALTH DISTRICT, THE COUNTY HEALTH DEPARTMENT FOR THE NORTHERN NECK & MIDDLE PENINSULA AREA. LINDA LEE PROVIDED VALUABLE INPUT AS A REPRESENTATIVE OF THE LOCAL HEALTH DEPARTMENT. (LINDA HAS BEEN WITH TRHD FOR 1 YEAR)- JEANNE NELSON, DIRECTOR - NORTHERN NECK FREE HEALTH CLINIC. (JEANNE HAS BEEN WITH NNFHC 20 YEARS) JESSICA CUTLER, MEDICAL ASSISTANT - NORTHERN NECK FREE HEALTH CLINIC. JESSICA CUTLER PROVIDED VALUABLE INPUT AS A REPRESENTATIVE OF THE MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS OF THE RGH COMMUNITY. (JESSICA HAS BEEN WITH NNFHC FOR 1 YEAR)- CHARLES WALSH JR., EXECUTIVE DIRECTOR - MIDDLE PENINSULA NORTHERN NECK COMMUNITY SERVICES BOARD (CHARLES HAS BEEN WITH MPNNCSB FOR 30 YEARS)- JOANNE BROWN, DIRECTOR OF CLINICAL SERVICES AND QUALITY ASSURANCE DIRECTOR - MIDDLE PENINSULA NORTHERN NECK COMMUNITY SERVICES BOARD (JOANNE HAS BEEN WITH MPNNCSB FOR 15 YEARS) SECONDARY DATA:INFORMATION FROM THE SURVEYS AND INTERVIEWS WERE ANALYZED IN CONJUNCTION WITH SECONDARY HEALTH DATA FOR EACH OF THE THREE COUNTIES AND THE COMMUNITY AS A WHOLE. THE SECONDARY STATISTICAL DATA WAS GATHERED AT THE COUNTY, COMMUNITY, STATE, AND NATIONAL LEVEL FROM THE FOLLOWING ONLINE RESOURCES: THE VIRGINIA DEPARTMENT OF HEALTH, DIVISION OF HEALTH STATISTICS, COUNTY HEALTH RANKINGS, HEALTH INDICATORS WAREHOUSE, STATE CANCER PROFILES, AND BENCHMARKS AND TARGETS FROM HEALTHY PEOPLE 2020. EACH SET OF DATA WAS UTILIZED TO IDENTIFY THE COMMUNITY NEEDS AND PRIORITIZE THE HEALTH ISSUES FOR THE RGH COMMUNITY. |
| RAPPAHANNOCK GENERAL HOSPITAL | PART V, SECTION B, LINE 7: RGH WILL NOT BE ADDRESSING THE FOLLOWING COMMUNITY HEALTH CONCERNS: TEEN PREGNANCY, STD, ALCOHOL ABUSE, TOBACCO USE, AND DRUG USEDR. MATTHEW VOGEL, CHESAPEAKE MEDICAL GROUP EMPLOYED OB/GYN, DISCUSSES STDS AND PREGNANCY PREVENTION WITH ALL AT RISK PATIENTS, PARTICULARLY THE GARDASIL VACCINE TO PREVENT HPV. HE HAS PAMPHLETS AND INFORMATION LITERATURE TO DISTRIBUTE AS NEEDED.SCHOOL SOURCES: ALL THREE SCHOOLS WORK CLOSELY WITH THREE RIVERS HEALTH DISTRICT (THE HEALTH DEPARTMENT) TO ADDRESS ALL FIVE ISSUES ON A GROUP, AS WELL AS INDIVIDUAL BASIS. NORTHUMBERLAND SCHOOL NURSE CITED SEVERAL INSTANCES IN WHICH STUDENTS THOUGHT THEY WERE PREGNANT OR REALIZED THEY WERE AND CAME TO HER, AT WHICH POINT SHE CONTACTED THE HEALTH DEPARTMENT AND EITHER ARRANGED FOR STUDENT TO GO THERE OR HAVE SOMEONE FROM HEALTH DEPARTMENT COME TO STUDENT. AT MIDDLESEX HIGH SCHOOL, THE PUBLIC HEALTH NURSE FROM THREE RIVERS REGULARLY PROVIDES EDUCATIONAL RESOURCES AND PRESENTATIONS FOR THE STUDENTS. THIS COULD BE BECAUSE OF THE CLOSER PROXIMITY MHS HAS TO THE HEALTH DEPARTMENT OFFICE, AS COMPARED TO THE OTHER SCHOOLS.THREE RIVERS HEALTH DISTRICT (TRHD) TRHD SERVES THOSE MINOR CLIENTS WITH TEEN PREGNANCY WITH CONFIDENTIALITY IN ACCORDANCE WITH THE MANDATED REPORTING LAWS IN THE STATE OF VIRGINIA. THEY ASSESS, EDUCATE AND PROVIDE INFORMATION FOR THE APPROPRIATE REFERRALS FOR OB CARE AND INITIATE FP FOR THIS POPULATION. COMPASSIONATELY THEY ASSIST THROUGH THE COORDINATION OF NEEDED REFERRALS AND QUALITY OF LIFE CONCERNS. THEY WORK WITH THE CLIENT, FAMILIES, AND OTHER COMMUNITY PARTNERS DEPENDING ON THE NEEDS OF THE CLIENT. NORTHERN NECK FREE HEALTH CLINIC (NNFHC) NNFHC DISCUSSES STDS AND PREGNANCY PREVENTION WITH THEIR PATIENTS, AND PROVIDES EXAMINATIONS AND TREATMENTS AS NEEDED. PAMPHLETS AND INFORMATIVE LITERATURE ARE AVAILABLE FOR DISTRIBUTION.ALCOHOLICS ANONYMOUS (AA), A GROUP WHOSE MEMBERS' PRIMARY PURPOSE IS TO STAY SOBER AND HELP OTHER ALCOHOLICS ACHIEVE SOBRIETY, ONE LOCAL MEETING IS HELD ON THE HOSPITAL'S CAMPUS AND LED BY A HOSPITAL EMPLOYEE. THERE ARE 10 AA MEETINGS WEEKLY IN THE AREAS WE SERVE, AS WELL AS 3 NARCOTICS ANONYMOUS (NA) MEETINGS LOCALLY, WHICH IS A FELLOWSHIP OR SOCIETY OF MEN AND WOMEN FOR WHOM DRUGS HAD BECOME A MAJOR PROBLEM.MIDDLE PENINSULA-NORTHERN NECK COMMUNITY SERVICES BOARD PROVIDES ALCOHOLICS ANONYMOUS MEETINGS AT THEIR WARSAW AND GLOUCESTER COUNSELING CENTER AND CAN LINK INDIVIDUALS TO OTHER MEETINGS THROUGHOUT THE AREA. THE CSB PROVIDES ASSESSMENT AND EVALUATION; INFORMATION AND REFERRAL; MOTIVATIONAL ENHANCEMENT THERAPY; FAMILY AND GROUP THERAPY; INTENSIVE GROUP THERAPY TO THOSE INDIVIDUALS AND FAMILIES DEALING WITH DRUG AND/OR ALCOHOL ISSUES. THE CSB PREVENTION DIVISION PROVIDES LIFE SKILLS TRAINING TO MANY MIDDLE SCHOOL STUDENTS IN THE AREA FOCUSING ON AMONG OTHER ISSUES DRUG AND ALCOHOL USE. RGH BRIDGES OFTEN REFERS PATIENTS WHO HAVE BEEN DISCHARGED TO THIS PROGRAM FOR FOLLOW UP CARE REGARDING SUBSTANCE ABUSE.RGH BECAME A SMOKE FREE CAMPUS AS OF APRIL 2011. RGH STILL OFFERS SMOKING CESSATION RESOURCES TO OUR EMPLOYEES THROUGH OUR HUMAN RESOURCES DEPARTMENT. NARCOTICS ANONYMOUS (NA), WHICH IS A FELLOWSHIP OR SOCIETY OF MEN AND WOMEN FOR WHOM DRUGS HAD BECOME A MAJOR PROBLEM, HAS AT LEAST 3 MEETINGS WEEKLY IN THE AREAS WE SERVE. ADDITIONALLY, THERE ARE 10 ALCOHOLICS ANONYMOUS MEETINGS WEEKLY AND THE GROUPS AND OFTEN USED INTERCHANGEABLY.RGH BRIDGES BEHAVIORAL HEALTH, AS WELL AS OTHER DEPARTMENTS OF THE HOSPITAL, UTILIZE MANY COMMUNITY RESOURCES TO SEEK ASSISTANCE FOR PATIENTS STRUGGLING WITH SUBSTANCE ABUSE, SUCH AS THE LOCAL AA/NA MEETINGS, LOCAL THERAPISTS WHO PROVIDE PRIVATE SUBSTANCE ABUSE COUNSELING, THE WILLIAMSBURG PAVILION CAN ADMIT PATIENTS NEEDING INPATIENT DETOX PROGRAMS, AND THERE'S A LOCAL VOLUNTEER PROGRAM WHO WILL SET UP A BUDDY SYSTEM TYPE RELATIONSHIP FOR SOMEONE NEEDING HELP WITH A RECOVERED SUBSTANCE ABUSER WHO HAS GOTTEN CLEAN AND CAN RELATE. |
| RAPPAHANNOCK GENERAL HOSPITAL | PART V, SECTION B, LINE 10: 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.WE WORK CLOSELY WITH THE NORTHERN NECK FREE CLINIC (NNFC) BY PROVIDING THEM MAINLY WITH LAB AND RADIOLOGY SERVICES INCLUDING MRI'S AND CT'S.THE HOSPITAL HAS A CHARITY POLICY TO PROVIDE CARE FOR PATIENTS WITH NO INSURANCE AND INCOME UNDER 200% OF THE FEDERAL POVERTY GUIDELINES. THE PATIENT'S ASSETS CANNOT EXCEED $50.000. |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | DETERMINATION OF CHARITY WILL BE MADE THROUGH KNOWLEDGE OF THE MEDICAL AND SOCIAL-ECONOMIC SITUATION AND ITS VARIOUS FINANCIAL IMPLICATIONS; AN INTERVIEW WITH PATIENT (RESPONSIBLE PARTY) AND INVESTIGATION OF FINANCIAL RESOURCES. THE DECISION WILL BE BASED ON COOPERATIVE MEDICAL, SOCIAL SERVICE, AND ADMINISTRATIVE JUDGMENT. |
| PART I, LN 7 COL(F): | COSTING METHOD IS OVERALL COST TO CHARGE RATIO FROM MEDICARE COST REPORT. BAD DEBT IS EXCLUDED IN THE CALCULATION. |
| PART III, LINE 2: | COSTING METHOD IS OVERALL COST TO CHARGE RATIO FROM MEDICARE COST REPORT. BAD DEBT IS EXCLUDED IN THE CALCULATION. |
| PART III, LINE 3: | PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT ESTABLISHED BILLING RATES WHEN PATIENT SERVICES ARE RENDERED. PROVISIONS FOR UNCOLLECTIBLE ACCOUNTS AND CONTRACTUAL ADJUSTMENTS ARE RECORDED AS DEDUCTIONS FROM PATIENT ACCOUNTS RECEIVABLE TO REDUCE RECORDED AMOUNTS TO NET REALIZABLE VALUE. CONTRACTUAL ADJUSTMENTS REPRESENT THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND AMOUNTS REIMBURSED (PRINCIPALLY FROM FEDERAL AND STATE GOVERNMENTS UNDER MEDICARE AND MEDICAID AND OTHER COMMERCIAL INSURERS INCLUDING ANTHEM). |
| PART III, LINE 4: | PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT ESTABLISHED BILLING RATES WHEN PATIENT SERVICES ARE RENDERED. PROVISIONS FOR UNCOLLECTIBLE ACCOUNTS AND CONTRACTUAL ADJUSTMENTS ARE RECORDED AS DEDUCTIONS FROM PATIENT ACCOUNTS RECEIVABLE TO REDUCE RECORDED AMOUNTS TO NET REALIZABLE VALUE. CONTRACTUAL ADJUSTMENTS REPRESENT THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND AMOUNTS REIMBURSED (PRINCIPALLY FROM FEDERAL AND STATE GOVERNMENTS UNDER MEDICARE AND MEDICAID AND OTHER COMMERCIAL INSURERS INCLUDING ANTHEM). |
| PART III, LINE 8: | COSTING METHOD IS COST TO CHARGE RATIO FROM MEDICARE REPORT. SHORTFALL OF MEDICARE PAYMENTS RECEIVED DIRECTLY BENEFIT THE COMMUNITY CITIZENS. |
| PART III, LINE 9B: | PATIENTS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE ASKED TO MEET WITH A FINANCIAL COUNSELOR TO DETERMINE FINANCIAL NEED. IF CHARITY GUIDELINES ARE MET, THEN PATIENT ACCOUNTS ARE ADJUSTED ACCORDINGLY. |
| 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. 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. A DETAILED DESCRIPTION OF THE ASSESSMENT PROCESS IS PROVIDED TO INDICATE THE APPROACH TAKEN TO ASSESS THE COMMUNITY'S HEALTH. |
| PART VI, LINE 3: | THE HOPITAL HAS A CHARITY POLICY, FINANCIAL COUNSELING PROGRAM AND BROCHURES PROVIDED TO PATIENTS TO INFORM AND EDUCATE PATIENTS AND THEIR FAMILIES ABOUT ELIGIBILITY FOR ASSISTANCE. |
| PART VI, LINE 4: | RAPPAHANNOCK GENERAL HOSPITAL IS AN INDEPENDENT COMMUNITY BASED HOSPITAL THAT SERVES A POPULATION OF APPROXIMATELY 35,000 (BASED ON 3 COUNTIES OF FOCUS- ACTUAL COMMUNITY SERVED IS OVER 40,000) 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. THE HOSPITAL'S COMMUNITY IS BASED ON THE POPULATION FROM THESE THREE COUNTIES. APPROXIMATELY 88% OF RGH'S PATIENT POPULATION IS RESIDENTS OF LANCASTER, NORTHUMBERLAND, AND MIDDLESEX COUNTIES. FOR PURPOSES OF THE CHNA PROCESS, RGH DEFINED THESE THREE COUNTIES AS THE COMMUNITY. A MAJORITY OF RGH'S PATIENT ORIGIN IS ENCOMPASSED WITHIN THIS GEOGRAPHICAL AREA. USING COUNTY DEFINITION AS THE SERVICE AREA IS CRUCIAL FOR OUR ANALYSIS AS MANY OF OUR SECONDARY DATA SOURCES ARE COUNTY SPECIFIC AND SERVE AS A COMPARISON TOOL TO THE STATE OF VIRGINIA, AND THE UNITED STATES. THE POPULATION SERVED IS DISTRIBUTED EVENLY BETWEEN THE THREE COUNTIES.THE COMMUNITY'S POPULATION IS APPROXIMATELY 73% WHITE, 24% AFRICAN AMERICAN, 2% HISPANIC, .5% ASIAN, AND .5% AMERICAN INDIAN AND ALASKAN NATIVES. THE AGE DISTRIBUTION CONSISTS OF 16% OF THE POPULATION UNDER THE AGE OF 18, 54% BETWEEN THE AGES OF 18-65, AND 30% ABOVE THE AGE OF 65. BOTH ETHNICITY AND AGE STATISTICS ARE SIMILAR WHEN COMPARED TO VIRGINIA'S STATEWIDE PERCENTAGES. THE MOST NOTABLE DIFFERENCE IS THAT THE AGE GROUP ABOVE THE AGE OF 65 IS 17% HIGHER THAN THE STATE AVERAGE AND 16% ABOVE THE NATIONAL AVERAGE. RAPPAHANNOCK GENERAL HOSPITAL'S SERVICE AREA MEAN HOUSEHOLD INCOME IS $50,499 WHICH IS $12,803 LOWER THAN THE STATE AVERAGE AND $2,263 BELOW THE NATIONAL AVERAGE. RGH AND THE SURROUNDING COMMUNITY HAVE BEEN PARTNERS IN HEALTH CARE SINCE THE HOSPITAL OPENED ITS DOORS IN 1977. THERE ARE GEOGRAPHIC REASONS FOR COMBINING THE THREE COUNTIES INTO A SINGLE COMMUNITY. LANCASTER COUNTY IS CENTRALLY LOCATED BETWEEN NORTHUMBERLAND AND MIDDLESEX COUNTY. THE HOSPITAL IS LOCATED IN THE EASTERN CENTRAL SECTION OF LANCASTER COUNTY WHICH DECREASES THE TRAVELING DISTANCE FOR PATIENTS IN NEIGHBORING COUNTIES AND ALLOWS ALL THREE COUNTIES TO BENEFIT FROM RGHS CENTRAL LOCATION. |
| PART VI, LINE 5: | CHESAPEAKE HOSPITAL CORPORATION PROVIDED NUMEROUS SERVICES FOR THE COMMUNITY WHICH INCLUDED HEALTH FAIRS FOR DIFFERENT CIVIC GROUPS IN THE SIX 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 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 FREE SPORTS PHYSICALS FOR SECONDARY STUDENTS IN THE AREA. THE ORGANIZATION SUPPORTS THE LOSS INCURRED BY ITS SISTER COMPANY CHESAPEAKE MEDICAL GROUP (CMG). CMG REPRESSENTS SEVERAL GROUPS OF PHYSICIANS INCLUDING FAMILY PRACTICE, PEDIATRICS, GYN, SURGERY AND OTHERS, THAT WERE 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: | AS A NOT-FOR PROFIT HEALTHCARE ORGANIZATION, IT IS THE PURPOSE AND RESPONSIBILITY TO PROVIDE OUTSTANDING CARE TO EVERYONE WHO NEEDS IT, REGARDLESS OF THEIR ABILITY TO PAY. RGH'S OPERATIONS ARE SIGNIFICANTLY IMPACTED BY CHARITY CARE AND THE MEDICARE/MEDICAID SHORTFALLS. IN ADDITION TO THE ESSENTIAL HEALTH CARE SERVICES PROVIDED THAT RAPPAHANNOCK HEALTH SYSTEM (RHS) PROVIDES TO OUR COMMUNITY, THE HEALTH SYSTEM HAS A SIGNIFICANT ECONOMIC IMPACT ON OUR COMMUNITY. RHS IS THE LARGEST EMPLOYER IN LANCASTER COUNTY PROVIDING JOBS FOR MORE THAN 500 PEOPLE WHO LIVE IN KILMARNOCK AND THE SURROUNDING AREAS. RHS HAS SEVERAL AFFILIATES. ONE IS THE CHESAPEAKE MEDICAL GROUP WHICH PROVIDES QUALITY, COMPASSIONATE, COST EFFECTIVE PRIMARY MEDICAL CARE SERVICES TO THE KILMARNOCK AREA. CHESAPEAKE HEALTH SERVICES MANAGES THE VARIOUS ENTITIES. CHESAPEAKE PHARMACY SERVICES, INC. PROVIDES PHARMACY SERVICES FOR THE AREA WHILE RAPPAHANOCK GENERAL HOSPITAL FOUNDATION ASSISTS IN PROVIDING FUNDRAISING ABILITIES. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | VA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JUNE DAFFEH MD | ||||||||||||||
| PRESIDENT OF MEDICAL STAFF | $217,409 | $0 | $0 | $0 | $0 | $0 | $5,850 | $0 | $6,432 | $0 | $229,691 | $0 | $0 | $0 |
| JAMES M HOLMES JR | ||||||||||||||
| PRESIDENT | $0 | $232,204 | $0 | $0 | $0 | $134,181 | $0 | $7,939 | $0 | $21,070 | $0 | $395,394 | $0 | $0 |
| BERNARD P LOCKSTAMPFOR JR | ||||||||||||||
| TREASURER/VP-PAT. FIN. SER | $0 | $166,462 | $0 | $0 | $0 | $0 | $0 | $4,207 | $0 | $16,095 | $0 | $186,764 | $0 | $0 |
| WILLIAM R STALLINGS MD | ||||||||||||||
| VICE PRESIDENT OF MEDICAL STAFF | $212,002 | $0 | $0 | $0 | $0 | $0 | $5,850 | $0 | $7,014 | $0 | $224,866 | $0 | $0 | $0 |
| J RANDY HESTER SR | ||||||||||||||
| SR VP-OPERATIONS/SECRETARY | $0 | $211,440 | $0 | $0 | $0 | $0 | $0 | $3,755 | $0 | $13,573 | $0 | $228,768 | $0 | $0 |
| JOHN HEADLEY | ||||||||||||||
| CFO | $0 | $133,282 | $0 | $0 | $0 | $0 | $0 | $3,750 | $0 | $14,151 | $0 | $151,183 | $0 | $0 |
| BARBARA PERONA | ||||||||||||||
| ANESTHESIOLOGIST | $330,849 | $0 | $0 | $0 | $0 | $0 | $7,650 | $0 | $10,872 | $0 | $349,371 | $0 | $0 | $0 |
| PAUL SUTHERLAND | ||||||||||||||
| ER PHYSICIAN | $307,767 | $0 | $0 | $0 | $0 | $0 | $6,825 | $0 | $9,727 | $0 | $324,319 | $0 | $0 | $0 |
| VIRGINIA GALE | ||||||||||||||
| ER PHYSICIAN | $250,155 | $0 | $0 | $0 | $0 | $0 | $6,772 | $0 | $11,713 | $0 | $268,640 | $0 | $0 | $0 |
| STEPHEN PERKINS | ||||||||||||||
| ER PHYSICIAN | $242,124 | $0 | $0 | $0 | $0 | $0 | $6,236 | $0 | $11,713 | $0 | $260,073 | $0 | $0 | $0 |
| SAHEED OJO-ONIYUN | ||||||||||||||
| INHOUSE PHYSICIAN | $198,288 | $0 | $0 | $0 | $0 | $0 | $6,772 | $0 | $11,072 | $0 | $216,132 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7 | PORTION OF PHYSICIAN CONTRACTS PAYMENTS ARE VARIABLE BASED ON CASH COLLECTED |
| SCHEDULE J PART II | THE OTHER COMPENSATION LISTED FOR JAMES M. HOLMES, JR. IS FROM A RHS THIRD PARTY STOCK OPTION PLAN FOR EMPLOYEES. THE PLAN BEGAN IN 1998 AND WAS SET UP TO PROVIDE ADDITIONAL RETIREMENT BENEFITS AND WAS ONLY FUNDED FOR A FEW YEARS. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDUSTRIAL DEVELOPMENT AUTHORITY LANCASTER COUNTY VA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 546001382 | BondIssuerEIN |
| Bond Issued | 2007-08-09 | BondIssuedDt |
| Issue Price | $1,332,800 | IssuePriceAmt |
| Purpose | FINANCE ENERGY SAVING EQUIPMENT | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $636,721 | RetiredAmt |
| Total Proceeds | $1,354,820 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $26,000 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $1,276,948 | CapitalExpendituresAmt |
| Other Spent Proceeds | $51,872 | OtherSpentProceedsAmt |
| Substantial Completion | 2008 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE K, PART I AND II | DIFFERENCE BETWEEN THE ISSUE PRICE (PART I, COLUMN E) AND TOTAL PROCEEDS (PART II, LINE 3) IS DUE TO INVESTMENT EARNINGS OF $22,020. |
| SCHEDULE K, PART IV, LINE 2B | MORE THAN 75% OF THE AVAILABLE CONSTRUCTION PROCEEDS WERE SPENT WITHIN 2-YEARS ON QUALIFIED 501(C)(3) BONDS TO FINANCE CONSTRUCTION EXPENDITURES THAT RESULTS IN PROPERTY THAT IS OWNED BY THE 501(C)(3) ORGANIZATION. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| CHESAPEAKE BANK | |||
| JAMES M. HOLMES, JR. IS A DIRECTOR OF CHESAPEAKE BANK | $224,332 | PRINCIPAL AND INTEREST PAYMENTS ON LOAN TO CHESAPEAKE BANK | 0 |
| CARTER FINANCIAL CORP | |||
| OFFICER OF ORGANIZATION AND OFFICER OF MANAGEMENT CO ORGANIZATION | $75,000 | CONTRACT/DEVELOPMENT | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 7G | QUESTIONS 7G DOES NOT APPLY TO THE ORGANIZATION BECAUSE THE ORGANIZATION DID NOT HAVE CONTRIBUTIONS OF QUALIFIED INTELLECTUAL PROPERTY. |
| FORM 990, PART V, LINE 7H | QUESTIONS 7H DOES NOT APPLY TO THE ORGANIZATION BECAUSE THE ORGANIZATION DID NOT HAVE CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES DURING THE YEAR. |
| FORM 990, PART VI, SECTION B, LINE 11 | WHEN THE COMPLETED FORM 990 COMES BACK FROM THE OUTSIDE TAX PREPARERS, IT IS REVIEWED BY THE CHESAPEAKE HEALTH SERVICES (CHS) CFO FOR ACCURACY. ONCE IT IS DETERMINED TO BE THE FINAL DRAFT, THE PACKAGE IS GIVEN TO THE PRESIDENT. THE PRESIDENT WILL SCHEDULE A MEETING OF THE CHS BOARD'S EXECUTIVE COMMITTEE WHICH CONSISTS OF THE CHAIRMAN-CHESAPEAKE HEALTH SERVICES BOARD, CHAIRMAN-CHESAPEAKE HOSPITAL CORPORATION BOARD, FINANCE COMMITTEE CHAIRMAN, AND A MEMBER OF THE CHS BOARD. THE EXECUTIVE COMMITTEE REVIEWS THE RETURN AND RECOMMENDS THAT THE BOARD OF DIRECTORS ACCEPT IT. ONCE THIS MEETING AND APPROVAL OF THE FORM 990 HAVE TAKEN PLACE, THE RETURN IS SIGNED AND E-FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC FOR REVIEW IN ADMINISTRATION DURING REGULAR BUSINESS HOURS, MONDAY THROUGH FRIDAY. ALL BOARD MEMBERS SIGN A CONFLICT OF INTEREST STATEMENT ONCE A YEAR STATING THEY WILL MAKE THE BOARD AWARE IF THERE IS A CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CHS PRESIDENT WILL SCHEDULE A MEETING OF THE BOARD'S EXECUTIVE SALARY COMMITTEE WHICH CONSISTS OF THE CHAIRMAN-CHESAPEAKE HEALTH SERVICES BOARD, CHAIRMAN-CHESAPEAKE HOSPITAL CORPORATION BOARD, FINANCE COMMITTEE CHAIRMAN, AND A MEMBER OF THE CHS BOARD. THE CHS EXECUTIVE COMMITTEE REVIEWS THE CURRENT SALARY AND BENEFITS OF EACH OFFICER AND KEY EMPLOYEE AND RECOMMENDS ADJUSTMENTS AS NECESSARY. THEIR REVIEW CONSISTS OF COMPARING THE SALARY AND BENEFITS TO A PERIODIC SURVEY DONE BY AN OUTSIDE THIRD PARTY OR HOSPITAL RELATED CIRCULATIONS. IF IT HAS BEEN DETERMINED THAT NO INCREASES WILL BE GIVEN IN THE FISCAL YEAR, NO MEETING WILL TAKE PLACE. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST IN THE ADMINISTRATION OFFICE. |
| FORM 990, PART XI, LINE 9: | CLASS B MEMBERSHIP 2,000,000. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CHESAPEAKE HEALTH SERVICES | ||||||||||
| 101 HARRIS ROAD | KILMARNOCK | VA | 22482 | 541513371 | PARENT | VA | 501(C)(3) | 11 | N/A | 0 |
| RAPPAHANOCK GENERAL HOSP FND | ||||||||||
| 101 HARRIS ROAD | KILMARNOCK | VA | 22482 | 541210450 | SUPPORTING ORGANIZATION | VA | 501(C)(3) | 11 | N/A | 0 |
| CHESAPEAKE MEDICAL GROUP | ||||||||||
| 101 HARRIS ROAD | KILMARNOCK | VA | 22482 | 541857174 | HEALTHCARE SERVICES | VA | 501(C)(3) | 11 | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (8 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CHESAPEAKE HEALTH SERVICES | ||
| M | $910,468 | CASH |
| RAPPAHANNOCK GENERAL HOSPITAL FOUNDATION | ||
| C | $660,515 | CASH |
| CHESAPEAKE MEDICAL GROUP | ||
| D | $1,184,098 | CASH |
| CHESAPEAKE HEALTH SERVICES | ||
| E | $3,427,131 | CASH |
| CHESAPEAKE MEDICAL GROUP | ||
| M | $107,428 | CASH |
| CHESAPEAKE MEDICAL GROUP | ||
| P | $64,862 | CASH |
| CHESAPEAKE MEDICAL GROUP | ||
| R | $509,505 | CASH |
| RAPPAHANNOCK GENERAL HOSPITAL FOUNDATION | ||
| Q | $137,005 | CASH |