FHI SERVICES: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- FHI SERVICES (EIN 54-0573701)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-13
- IRS object ID
- 201402259349301340
- Schema version
- 2012v2.3
- 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 F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-13T10:45:14-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 ROCKVILLE PIKE STE 600 | AddressLine1 |
| City | ROCKVILLE | City |
| State | MD | State |
| ZIP Code | 20850 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540573701 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Fauquier Hospital Incorporated | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % DARRYL WHITE | InCareOfName |
| Name Control | FAUQ | NameControl |
| Phone | 5403165000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 Hospital Drive | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | Warrenton | City |
| State | VA | State |
| ZIP Code | 20186 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Christy Connolly | Name |
| Title | PRESIDENT/CEO | Title |
| Phone | 5403162609 | Phone |
| Date Signed | 2014-08-07 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Aaron D Cohen | Name |
| Phone | 2404033700 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Rodger H Baker | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 Hospital Dr | AddressLine1 |
| City | Warrenton | City |
| State | VA | State |
| ZIP Code | 20186 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 128395072 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.fauquierhealth.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1954 | YearFormation |
| State Legal Domicile | VA | StateLegalDomicile |
| Activity Or Mission Description | OUR MISSION IS TO RESTORE, PROMOTE AND MAINTAIN THE HEALTH OF THE COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1122 | TotalNbrEmployees |
| Total Nbr Volunteers | 300 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 270244 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 794388 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 134281386 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 120255314 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5188605 | InvestmentIncomePriorYear |
| Investment Income Current Year | 7212120 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -3827 | OtherRevenuePriorYear |
| Other Revenue Current Year | 120571 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 139736408 | TotalRevenuePriorYear |
| Total Revenue Current Year | 128382393 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 63095 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 129629 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 63777051 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 60159217 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 67611313 | OtherExpensePriorYear |
| Other Expenses Current Year | 59189977 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 131451459 | TotalExpensesPriorYear |
| Total Expenses Current Year | 119478823 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 8284949 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 8903570 | RevenuesLessExpensesCY |
| Total Assets BOY | 234682832 | TotalAssetsBOY |
| Total Assets EOY | 237338864 | TotalAssetsEOY |
| Total Liabilities BOY | 87820773 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 81250261 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 146862059 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 156088603 | NetAssetsOrFundBalancesEOY |
| Mission Description | OUR MISSION IS TO RESTORE, PROMOTE AND MAINTAIN THE HEALTH OF THE COMMUNITY. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 89865389 | Expense |
| Grants | 129629 | Grants |
| Revenue | 120255314 | Revenue |
| Description | THE COMMUNITY BENEFIT CONTRIBUTION OF FAUQUIER HOSPITAL INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. IN ORDER TO PORTRAY THE FULL BREADTH OF OUR CONTRIBUTION, OUR COMMUNITY BENEFIT INFORMATION IS DESCRIBED BELOW: 1. ORGANIZATIONAL COMMITMENT TO PROVIDING COMMUNITY BENEFIT: THE FAUQUIER HOSPITAL, INC. (FH) IS A 97-BED, NOT-FOR-PROFIT, ACUTE CARE FACILITY ESTABLISHED IN 1954 TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES FOR THE COMMUNITIES IT SERVES. OUR MISSION IS TO RESTORE, PROMOTE AND MAINTAIN THE HEALTH OF OUR COMMUNITY. FH IS THE ONLY HOSPITAL IN OUR PRIMARY SERVICE AREA OF FAUQUIER COUNTY WITH A POPULATION OF 76,599. OUR SERVICE AREA IS GROWING AND AGING, WITH OVERALL PROJECTED GROWTH BETWEEN 2013-2018 OF 3.8% AND WITH THE 45+ POPULATION COMPRISING 47% OF THE TOTAL IN 2018. TO ADDRESS THE GROWING AND CHANGING HEALTH CARE NEEDS RESULTING FROM THESE POPULATION CHANGES, FH CONTINUES TO SUPPORT FIFTEEN EMPLOYED PHYSICIANS, AN ENDOCRINOLOGIST, AN OBSTETRICS/GYNECOLOGIST ,FAMILY MEDICINE PHYSICIANS, A RHEUMATOLOGIST, NEUROLOGIST, INFECTIOUS DISEASE, INTERNAL MEDICINE AND GENERAL SURGERY. THROUGH PARTNERSHIPS WITH OTHER HEALTH CARE ORGANIZATIONS WE OPERATE A RETAIL HOME HEALTH SUPPLIES STORE AND A CANCER CENTER. WE ALSO PARTNER WITH LOCAL NON-PROFIT ORGANIZATIONS (E.G. FAUQUIER FREE CLINIC, THE CHAMBER OF COMMERCE, SCHOOLS AND CHURCHES) AND NATIONAL ORGANIZATIONS (E.G. THE AMERICAN CANCER SOCIETY) TO SUPPORT LOCAL EVENTS AND PROVIDE COMMUNITY HEALTH AND WELLNESS PROGRAMS. THESE COMMUNITY BENEFITS ACTIVITIES ARE COORDINATED BY TWO FULL-TIME COMMUNITY OUTREACH STAFF, SUPPORTED BY ADMINISTRATIVE AND CLINICAL DEPARTMENTS, AND OUR AUXILIARY VOLUNTEERS AS NEEDED. WE HAVE A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES FREE CARE FOR RESIDENTS OF FAUQUIER AND RAPPAHANNOCK COUNTIES WHO ARE WITHIN 200% OF THE FEDERAL POVERTY GUIDELINES. THE FINANCIAL ASSISTANCE PROGRAM ALSO PROVIDES FREE CARE TO PATIENTS WHO RESIDE IN OTHER AREAS WHO ARE WITHIN 100% OF THE FEDERAL POVERTY GUIDELINES. ALL UNINSURED PATIENTS, REGARDLESS OF INCOME LEVEL OR COUNTY OF RESIDENCE, RECEIVE A 38% DISCOUNT ON HOSPITAL SERVICES AND THE OPTION FOR AN INTEREST-FREE PAYMENT PLAN FOR BALANCES. EVERY UNINSURED PATIENT IS CONTACTED EITHER DURING THEIR STAY OR THE DAY AFTER AN OUTPATIENT VISIT TO DISCUSS FINANCIAL NEEDS. PATIENTS WHO DO NOT MEET THE REQUIREMENTS FOR STATE FUNDING ARE GIVEN A FINANCIAL AID FORM AND ASSISTANCE WITH COMPLETING THE NECESSARY PAPERWORK. THROUGH THE CONTINUING CARE FUND, THE HOSPITAL OFFERS ASSISTANCE TO INDIVIDUALS WHO HAVE INADEQUATE FINANCIAL MEANS TO COVER THE COSTS OF POST-HOSPITALIZATION HEALTH SERVICES, SUCH AS NURSING CARE; THE COST OF THIS PROGRAM TO FH IN FY13 WAS $96,846.64. IN FY13, WE PROVIDED $6,637,025 IN FREE MEDICAL CARE, WHICH INCLUDES $232,261 OF CARE PROVIDED TO FREE CLINIC PATIENTS. 2. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION: FH OFFERS ALL PATIENTS IMPARTIAL ACCESS TO TREATMENT OR ACCOMMODATIONS THAT ARE AVAILABLE OR MEDICALLY INDICATED, REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, RELIGION, OR SOURCE OF PAYMENT FOR CARE. OUR 24-HOUR EMERGENCY DEPARTMENT IS OPEN TO EVERYONE IN THE COMMUNITY, REGARDLESS OF ABILITY TO PAY. WE HAVE AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN OUR AREA. THE MAJORITY OF THE MEMBERS OF OUR GOVERNING BODIES FOR BOTH OUR HOSPITAL AND HEALTH SYSTEM ARE INDEPENDENT REPRESENTATIVES OF THE COMMUNITIES WE SERVE. TO HELP TRAIN AND EDUCATE HEALTH CARE PROFESSIONALS, FH WORKS WITH LOCAL COMMUNITY COLLEGES TO PROVIDE TOURS, LECTURES, AND INTERNSHIPS FOR STUDENTS; FH STAFF PROVIDED APPROXIMATELY 17,063 HOURS AT A COST OF APPROXIMATELY $506,903. FH PARTICIPATES IN MEDICARE, MEDICAID, ANDCHAMPUS/TRICARE STANDARD. 3. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS: FAUQUIER FREE CLINIC (FFC). FFC PROVIDES PRIMARY HEALTH AND DENTAL CARE TO UNINSURED RESIDENTS OF FAUQUIER AND RAPPAHANNOCK COUNTIES. FH PROVIDED LABORATORY, CARDIOLOGY/NEUROLOGY/PULMONARY SERVICES, AND RADIOLOGY SERVICES AT NO CHARGE TO FCC PATIENTS FOR A TOTAL COST OF $232,261. A TOTAL OF 798 HOURS OF FREE CLINICAL CARE WERE PROVIDED BY COMMUNITY PHYSICIANS AND CLINICAL STAFF. TO HELP FFC EXPAND ITS SERVICES TO MEET THE NEEDS OF A GROWING POPULATION, FH LEASED A BUILDING IN APRIL 2006 TO THE FFC FOR $1 PER YEAR FOR 10 YEARS; THE RENTAL VALUE FY13 WAS $85,284. IN ADDITION, FH CONTRIBUTED $5,000 IN UNRESTRICTED FUNDS. COMMUNITY HEALTH EDUCATION, SCREENINGS AND OUTREACH PROGRAMS FAUQUIER HEALTH PROVIDED HEALTH EDUCATION AND HEALTH SCREENINGS AT 106 LOCAL EVENTS FOR 2,678 PEOPLE. FH ALSO OFFERS TOURS OF THE HOSPITAL AND SPEAKERS FOR LOCAL SCHOOLS AND COMMUNITY ORGANIZATIONS TO BUILD RELATIONSHIPS WITHIN THE COMMUNITY, PROMOTE COLLABORATION IN MANAGING HEALTH AND WELLNESS, AND EDUCATE THE COMMUNITY ON THE HEALTH SYSTEM. THE TOTAL COMMUNITY BENEFIT OF THESE SERVICES WAS $56,613. TWO OF SEVERAL FH PUBLICATIONS ARE A COMMUNITY NEWSLETTER, HEALTHY HAPPENINGS, INTENDED TO EDUCATE THE PUBLIC ABOUT HEALTH ISSUES AND HEALTH CARE AND HOSPITAL SERVICES. PUBLISHED QUARTERLY HEALTHY HAPPENINGS, REACHES 100,000 HOMES IN FAUQUIER AND SURROUNDING COUNTIES. The SENIOR LIVING publication is published twice a year and REACHES 37,000 individuals who are 55 and older. THE COST TO FH FOR PUBLICATION AND DISTRIBUTION OF THese NEWSLETTERs IN FY13 WAS $344,208. EMERGENCY SERVICES. FH PROVIDES MEDICAL OVERSIGHT, DIRECTION, AND ORDERS TO PARAMEDICS IN THE FIELD AND EN-ROUTE TO THE HOSPITAL. OUR EMERGENCY DEPARTMENT OFFERS 24-HOUR ACCESS TO MEDICAL SERVICES AND HELICOPTER TRANSPORT FOR CRITICALLY ILL OR INJURED INDIVIDUALS, AND ALSO RESTOCKS MEDICAL BOXES AND PROVIDES CLEAN LINENS FOR RESCUE SQUADS AT A COST TO THE HOSPITAL OF APPROXIMATELY $54,769. SUPPORT GROUPS AND COMMUNITY GROUPS. FH SPONSORED, ASSISTED, OR PROVIDED MEETING SPACE FOR THREE SUPPORT GROUPS THAT MET WEEKLY OR MONTHLY, at a cost to FH of $860. ADDITIONALLY, FH PROVIDED MEETING SPACE OR CASH DONATIONS FOR SEVERAL NON-PROFIT COMMUNITY GROUPS, (E.G. The American Red Cross, FAUQUIER FREE CLINIC AND American Cancer Society Fauquier Chapter), with a fair market VALUE OF THE MEETING SPACE of $29,963. CASH DONATIONS TOTALED $14,715. FH EMPLOYEES PROVIDED REPRESENTATION ON COMMUNITY BOARDS AND COALITIONS AT AN EXPENSE OF $73,814. PHYSICIAN REFERRAL. THE HOSPITAL ASSISTED 2,417 PEOPLE WITH THE PHYSICIAN REFERRAL PROGRAM, WHICH HELPS THE COMMUNITY WITH QUESTIONS ON PHYSICIANS, APPOINTMENTS, CLASSES AND PROGRAMS REGISTRATION, AND HEALTH RESOURCES AVAILABLE THROUGH THE HOSPITAL OR IN THE COMMUNITY. IT COST FH $31,733 TO PROVIDE THIS SERVICE IN FY13. 4. LINKS TO ADDITIONAL COMMUNITY BENEFIT INFORMATION * FAUQUIER HOSPITAL WEBSITE - WWW.FAUQUIERHEALTH.ORG * FAUQUIER ASSISTANCE INFORMATIONN - http://www.fauquierhealth.org/patients.financial-assistance-policy | Description |
| Total Program Service Expense | 89865389 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | true | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 187 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1122 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | VA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DARRYL WHITE | NamePerson |
| Telephone Number | 5403165000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 HOSPITAL DR | AddressLine1 |
| City | Warrenton | City |
| State | VA | State |
| ZIP Code | 20186 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| RODGER BAKER | |||||||||
| PRESIDENT/CEO | 29.0 | 11.0 | X | X | 1087052 | 0 | 72527 | ||
| MARSHALL DOELLER | |||||||||
| CHAIRMAN | 3.0 | 3.0 | X | X | 0 | 0 | 0 | ||
| REV JENNINGS HOBSON | |||||||||
| VICE CHAIRMAN | 3.0 | 3.0 | X | X | 0 | 0 | 0 | ||
| JOHN MCCARTHY | |||||||||
| TRUSTEE | 3.0 | 3.0 | X | 0 | 0 | 0 | |||
| KEVIN CARTER | |||||||||
| TRUSTEE | 3.0 | 3.0 | X | 0 | 0 | 0 | |||
| MARK VAN DE WATER | |||||||||
| TRUSTEE | 3.0 | 3.0 | X | 0 | 0 | 0 | |||
| SUSAN RUBIN | |||||||||
| TRUSTEE | 3.0 | 6.0 | X | 0 | 0 | 0 | |||
| CAREN EASTHAM | |||||||||
| TRUSTEE | 3.0 | 6.0 | X | 0 | 0 | 0 | |||
| MARY LEIGH MCDANIEL | |||||||||
| TRUSTEE | 3.0 | 3.0 | X | 0 | 0 | 0 | |||
| ADAM WINICK MD | |||||||||
| TRUSTEE | 3.0 | 3.0 | X | 0 | 0 | 0 | |||
| JOSHUA JAKUM MD | |||||||||
| TRUSTEE | 3.0 | 3.0 | X | 0 | 0 | 0 | |||
| ROBIN GULICK | |||||||||
| SECRETARY/TREASURER | 3.0 | 3.0 | X | X | 0 | 0 | 0 | ||
| RAYMOND KNOTT | |||||||||
| TRUSTEE | 3.0 | 3.0 | X | 0 | 0 | 0 | |||
| JANELLE DOWNES | |||||||||
| TRUSTEE | 3.0 | 3.0 | X | 0 | 0 | 0 | |||
| LYNN SAMUEL MD | |||||||||
| MEDICAL STAFF PRESIDENT | 3.0 | 3.0 | X | 0 | 0 | 0 | |||
| LIONEL PHILLIPS | |||||||||
| VP FINANCE/CFO | 30.0 | 10.0 | X | 305716 | 0 | 21251 | |||
| LINDA SHARKEY | |||||||||
| VP PATIENT CARE/CNE | 40.0 | 0.0 | 188183 | 0 | 13526 | X | |||
| KATHERINE REEVES | |||||||||
| VP HUMAN RESOURCES | 30.0 | 10.0 | 160014 | 0 | 658 | X | |||
| GREGORY BENGSTON | |||||||||
| VP BUS DEV & PROF SERVICES | 30.0 | 10.0 | 180031 | 0 | 20024 | X | |||
| MARY SMITH | |||||||||
| VICE PRESIDENT SENIOR SERVICES | 30.0 | 10.0 | 198128 | 0 | 7818 | X | |||
| TRACY TURMAN | |||||||||
| VP SUPPORT SERVICES | 40.0 | 0.0 | 134220 | 0 | 18446 | X | |||
| CHRISTINE CONNOLLY | |||||||||
| president faquier foundation | 0.0 | 40.0 | 178450 | 0 | 21554 | X | |||
| ANHTAI NGUYEN | |||||||||
| chief medical officer | 40.0 | 0.0 | 263838 | 0 | 21638 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2695632 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 197442 | TotalOtherCompensation |
| Number Individuals GT100 K | 58 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| VIRGINIA EMERGENCY MEDICINE ASSOCIA | |||||
| 4094 MAJESTIC LN | FAIRFAX | VA | 22033 | HEALTH CARE | 1472541 |
| TWIN CONTRACTING CORP | |||||
| 12700 SUNRISE VALLEY DRIVE STE 100 | RESTON | VA | 20191 | SERVICES | 1199933 |
| POINT TO POINT INC | |||||
| 23240 CHAGRIN BLVD STE 200 | CLEVELAND | OH | 44122 | MARKETING SERVICES | 855401 |
| API HEALTHCARE CORP | |||||
| 1550 INNOVVATION WAY | HARTFORD | WI | 530278720 | INFORMATION SYSTEMS | 838648 |
| ALLIANCE HEALTHCARE SERVICES | |||||
| PO BOX 96485 | CHICAGO | IL | 606936485 | HEALTH CARE | 769611 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 20 | NumberOfContractorsGT100K |
| Related Organizations | 793869 | RelatedOrganizations |
| All Other Contributions | 519 | AllOtherContributions |
| Total Contributions | 794388 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| NET PATIENT REV | 116597971 | 116597971 |
| OTHER OPERATING | 2686752 | 2686752 |
| THERAPY SERVICES | 941925 | 941925 |
| OTHER MISC | 28666 | 28666 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 120255314 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4671509 | TotalRevenueColumn |
| Exclusion | $4,671,509 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2540611 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2540611 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2540611 | TotalRevenueColumn |
| Exclusion | $2,540,611 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 133250 | GrossSalesOfInventory |
| Cost Of Goods Sold | 12679 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 120571 | TotalRevenueColumn |
| Exclusion | $120,571 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 128382393 | TotalRevenueColumn |
| Related Or Exempt Function Income | 120255314 | RelatedOrExemptFunctionIncome |
| Exclusion | $7,332,691 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 129629 | Total |
| Program Services | 129629 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1781671 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 1781671 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46885518 | Total |
| Program Services | 39201620 | ProgramServices |
| Management And General | 7683898 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1326833 | Total |
| Program Services | 1068770 | ProgramServices |
| Management And General | 258063 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6654376 | Total |
| Program Services | 5360127 | ProgramServices |
| Management And General | 1294249 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3510819 | Total |
| Program Services | 2827979 | ProgramServices |
| Management And General | 682840 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 838509 | Total |
| Management And General | 838509 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 98513 | Total |
| Management And General | 98513 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 208500 | Total |
| Management And General | 208500 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 582425 | Total |
| Management And General | 582425 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1105138 | Total |
| Program Services | 480657 | ProgramServices |
| Management And General | 624481 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3477702 | Total |
| Management And General | 3477702 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2091008 | Total |
| Program Services | 1822478 | ProgramServices |
| Management And General | 268530 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 447504 | Total |
| Program Services | 144548 | ProgramServices |
| Management And General | 302956 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2408963 | Total |
| Program Services | 2408963 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9065302 | Total |
| Program Services | 7001280 | ProgramServices |
| Management And General | 2064022 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 611341 | Total |
| Program Services | 334722 | ProgramServices |
| Management And General | 276619 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BLOOD BANK | 745496 | 745496 | |
| COLLECTION | 880948 | 880948 | |
| CONTRACT SERVICES | 6200146 | 3394707 | 2805439 |
| SUPPLIES AND DRUGS | 20124987 | 19813707 | 311280 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10303495 | Total |
| Program Services | 5130706 | ProgramServices |
| Management And General | 5172789 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 119478823 | Total |
| Program Services | 89865389 | ProgramServices |
| Management And General | 29613434 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13843903 | BOY |
| EOY | 10620274 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14330729 | BOY |
| EOY | 16841817 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2666534 | BOY |
| EOY | 2610494 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1051598 | BOY |
| EOY | 716796 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 184113489 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 120508225 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63687855 | BOY |
| EOY | 63605264 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115518544 | BOY |
| EOY | 128426207 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8803724 | BOY |
| EOY | 9235188 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14779945 | BOY |
| EOY | 5282824 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 234682832 | BOY |
| EOY | 237338864 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8773562 | BOY |
| EOY | 8082980 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 73688750 | BOY |
| EOY | 66529322 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5358461 | BOY |
| EOY | 6637959 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 87820773 | BOY |
| EOY | 81250261 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 138238824 | BOY |
| EOY | 147030557 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8623235 | BOY |
| EOY | 9058046 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 146862059 | BOY |
| EOY | 156088603 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 234682832 | BOY |
| EOY | 237338864 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 8903570 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 6481037 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -6158063 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 8623235 | BeginningOfYearBalance |
| Contributions | 519 | Contributions |
| Investment Earnings Or Losses | 689130 | InvestmentEarningsOrLosses |
| Other Expenditures | 238906 | OtherExpenditures |
| Administrative Expenses | 15932 | AdministrativeExpenses |
| End Of Year Balance | 9058046 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7688981 | BeginningOfYearBalance |
| Contributions | 616 | Contributions |
| Investment Earnings Or Losses | 1188611 | InvestmentEarningsOrLosses |
| Other Expenditures | 240718 | OtherExpenditures |
| Administrative Expenses | 14255 | AdministrativeExpenses |
| End Of Year Balance | 8623235 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 8050596 | BeginningOfYearBalance |
| Contributions | 739 | Contributions |
| Investment Earnings Or Losses | -99088 | InvestmentEarningsOrLosses |
| Other Expenditures | 250195 | OtherExpenditures |
| Administrative Expenses | 13071 | AdministrativeExpenses |
| End Of Year Balance | 7688981 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7627551 | BeginningOfYearBalance |
| Contributions | 699 | Contributions |
| Investment Earnings Or Losses | 648318 | InvestmentEarningsOrLosses |
| Other Expenditures | 213797 | OtherExpenditures |
| Administrative Expenses | 12175 | AdministrativeExpenses |
| End Of Year Balance | 8050596 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7434788 | BeginningOfYearBalance |
| Contributions | 1135 | Contributions |
| Investment Earnings Or Losses | 442346 | InvestmentEarningsOrLosses |
| Other Expenditures | 237296 | OtherExpenditures |
| Administrative Expenses | 13422 | AdministrativeExpenses |
| End Of Year Balance | 7627551 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 584539 | OtherCostOrOtherBasis |
| Book Value | 584539 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 75521727 | OtherCostOrOtherBasis |
| Depreciation | 37062591 | Depreciation |
| Book Value | 38459136 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2353281 | OtherCostOrOtherBasis |
| Depreciation | 2331807 | Depreciation |
| Book Value | 21474 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 97627356 | OtherCostOrOtherBasis |
| Depreciation | 76681092 | Depreciation |
| Book Value | 20946264 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8026586 | OtherCostOrOtherBasis |
| Depreciation | 4432735 | Depreciation |
| Book Value | 3593851 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 63605264 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO THIRD PARTY PAYERS | $2,828,157 |
| ACCRUED INTEREST PAYABLE | $699,838 |
| CAPITAL LEASE | $726,634 |
| PROFESSIONAL LIABILITY | $2,383,330 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 6637959 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Sch D Part XIV | Identifier |
| Explanation | The Fauquier Hospital Endowment Fund (the Trust) is an irrevocable trust created by the Chichester DuPont System in 1959. A local bank was designated as the trustee and remits income from the Trust to the Hospital semiannually. The income may be employed by the Hospital to further its work in such manner as the Board of Trustees of the Hospital determines. | Explanation |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Central America and the Caribbean | Region |
| Type Of Activities Conducted | Investments | TypeOfActivitiesConducted |
| Total Expenditures | 19304115 | TotalExpenditures |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Amount Spent | 19304115 | SubtotalAmountSpent |
| Total Amount Spent | 19304115 | TotalAmountSpent |
| Transfer To Foreign Corp | true | TransferToForeignCorp |
| Interest In Foreign Trust | false | InterestInForeignTrust |
| Own Foreign Corp | false | OwnForeignCorp |
| Passive Foreign Invest Co | false | PassiveForeignInvestCo |
| Foreign Partnership | false | ForeignPartnership |
| Boycott Countries | false | BoycottCountries |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | false | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6110727 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 6110727 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05110 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7826862 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6488655 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1338207 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01120 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13937589 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6488655 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7448934 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06230 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1232988 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 28981 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1204007 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01010 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 565913 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 565913 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00470 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7666698 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4080808 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3585890 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 88529 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 88529 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9554128 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4109789 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5444339 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04550 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 23491717 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10598444 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12893273 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10780 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2135 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2135 | NetCommunityBuildingExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 564 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 564 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2699 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2699 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $2,905,145 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 37467346 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 51378937 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -13911591 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Fauquier Hospital Incorporated | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 Hospital Drive | AddressLine1 |
| City | Warrenton | City |
| State | VA | State |
| ZIP Code | 20186 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Fauquier Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 11 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200. | FPGFreePercent |
| Uses FPG Discounted | false | UsesFPGDiscounted |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part I, Line 3c | ALL PATIENTS WHO ARE RESIDENTS OF FAUQUIER OR RAPPAHANNOCK COUNTIES, WHOSE ANNUAL HOUSEHOLD INCOME LEVELS ARE AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES, ARE ELIGIBLE FOR FREE CARE. THIS PROCESS REQUIRES AN APPLICATION AND VERIFICATION OF ALL SOURCES OF INCOME. In addition, aLL PATIENTS WHO ARE NON RESIDENTS OF FAUQUIER OR RAPPAHANNOCK COUNTIES AND WHOSE ANNUAL HOUSEHOLD INCOME FALLS AT OR BELOW 100% OF THE FEDERAL POVERTY GUIDELINES ARE ALSO ELIGIBLE FOR FREE CARE AFTER COMPLETING THE SAME APPLICATION AND INCOME VERIFICATION PROCESS. BEFORE FINAL COLLECTION ACTION, ACCOUNTS ARE PUT THROUGH CREDIT SCORING SOFTWARE TO HELP IDENTIFY THOSE PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAVE NOT CONTACTED OUR OFFICE UP TO THAT POINT. IF THE SOFTWARE INDICATES THAT THE PATIENT'S INCOME LEVEL MEETS FINANCIAL ASSISTANCE ELIGIBILITY, THE ACCOUNT IS WRITTEN OFF TO CHARITY AND FURTHER COLLECTION ACTIVITY IS NOT PURSUED. Furthermore, all uninsured patients that do not qualify under the hospital's Financial assistance policy are eligible for a 38% discount on hospital Services and have the option of an interest free payment plan for any balances. |
| Part I, Line 6a | Fauquier Health prepares its own community benefit report, which it posts on the hospital and foundation's websites. In addition, a hard copy of the community benefit report is sent out to approximately 10,000 community leaders and donors. |
| Part I, Line 7 | PART I, LINE 7G FAUQUIER HEALTH, AS PART OF ITS MEDICAL STAFF DEVELOPMENT PLAN, IDENTIFIES SPECIFIC PHYSICIAN SPECIALTY SHORTAGES IN THE COMMUNITY AND RECRUITS PHYSICIANS TO THE COMMUNITY TO PROVIDE PATIENT SERVICES IN THOSE AREAS OF IDENTIFIED COMMUNITY NEED. THE PHYSICIANS ARE EMPLOYED BY A WHOLLY OWNED HOSPITAL AFFILIATE, FAUQUIER HEALTH PHYSICIANS SERVICES, LLC. THE COST OF OPERATING THIS PHYSICIAN PRACTICE AND MAKING THESE SPECIALTIES AVAILABLE TO THE COMMUNITY WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY EXCEEDS THE REVENUE COLLECTED. THE NECESSARY SUBSIDY IS PROVIDED BY THE FAUQUIER HOSPITAL. THESE SPECIALTIES INCLUDED INFECTIOUS DISEASE, RHUMATOLOGY, NEUROLOGY, ENDOCRINOLOGY, OBSTETRICS, ONCOLOGY, ENT AND PRIMARY CARE. |
| Part II | FAUQUIER HEALTH'S COMMUNITY BUILDING ACTIVITIES SUPPORT THE HEALTH OF THE COMMUNITY BY OFFERING COMMUNITY SUPPORT; ENVIRONMENTAL IMPROVEMENTS; AND PHYSICAL IMPROVEMENTS AND HOUSING. COMMUNITY SUPPORT - THE DISASTER READINESS SUPPLIES PREPARE OUR COMMUNITY FOR POTENTIAL DISASTERS SUCH AS NATURAL DISASTERS, ELECTRICITY OUTAGES OR DIRTY BOMBS FOR A TIME PERIOD OF 96 HOURS. IN ADDITION, THE HOSPITAL SERVES AS A DEFAULT SAFE HAVEN FOR HOME BOUND INDIVIDUALS WHO ARE ON OXYGEN. SUPPORT OF FIRST NIGHT HELPS SUPPORT HEALTHY AND SAFE ACTIVITIES FOR THE COMMUNITY TO BE INVOLVED IN FOR NEW YEARS EVE. IN ADDITION, CONTRIBUTIONS SUPPORTED EXERCISE ACTIVITIES AND PLAYGROUND EQUIPMENT FOR A LOCAL SCHOOL. ENVIRONMENTAL IMPROVEMENTS - FAUQUIER HEALTH'S ANNUAL MEDICATION AND SHARPS COLLECTION EVENT HELPS TO SAFELY DISPOSE OF 136 GALLONS OF SHARPS AND 330 LBS OF MEDICATIONS. RATHER THAN COMMUNITY MEMBERS FLUSHING MEDICATIONS INTO THE GROUND WATER OR DISPOSING OF SHARPS AT THE LANDFILL, FAUQUIER HEALTH COLLECTS THEM AND WORKS WITH A MEDICAL WASTE MANAGEMENT COMPANY THAT DISPOSES OF THE ITEMS. LASTLY THE PHYSICAL IMPROVEMENTS AND HOUSING ACTIVITIES HELPED ORGANIZE AND RENOVATE THE FACILITIES AT AT LOCAL NON-PROFIT THAT OFFERS SHELTER AND EDUCATION FOR THE HOMELESS; A FOOD PANTRY AND FREE CLOTHING TO INDIVIDUALS IN NEED. |
| Part III, Line 2 | The hospital's calculated ratio of cost to charge was applied to the total bad debt expense for the reporting year to arrive at the cost of the organization's bad debt expense. The ratio of patient care cost to total charges is developed in Schedule H, Worksheet 2 and applied to the total charges for Bad Debt Expense to arrive at the amount in Part III, Section A, Line 2. The cost from Line 2 is then adjusted down to represent the estimated portion of Bad Debt Expense that would qualify for the Hospital's financial assistance policy, i.e. Charity care. The corresponding cost should be included as a community benefit. |
| Part III, Line 4 | Accounts Receivable are reported net of allowances for the excess of charges over the payments on patient accounts to be received from third party payers and estimates of uncollectible amounts. The system's policy is to write-off all patient accounts that have been identified as uncollectable. Any allowance for doubtful accounts is recorded for accounts not yet written off that may become uncollectable in future periods based on managment's assessment of historical and expected net collections for each of its major payers. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. Net patient service revenue is reported at the estimated net realizable amounts from patients, third-party payers, and others for services rendered, and include estimated retroactive revenue adjustments due to future audits, reviews and investigations. Retroactive adjustments are considered in the recognition of revenue on an estimated basis in the period the related services are rendered, and such amounts are adjusted in future periods as adjustments become known or as years are no longer subject to such audits, reviews and investigations. During the 2012 tax year, Fauquier Hospital periodically employed credit scoring software to help identify patients that might be eligible for financial assistance under the Hospital's financial assistance policy, which had not completed a financial assistance application. If the software indicated that the patient's income level met financial assistance eligibility under the Hospital's financial assistance policy, then the account was written off to charity and further collection activity was not pursued. As a result of the periodic use of such credit scoring software throughout the year, it is difficult to estimate the amount of the bad debt expense attributable to patients that might qualify for financial assistance under the Hospital's financial assistance policy. Therefore, the Hospital has reported $0. |
| Part III, Line 8 | The shortfall for Medicare is not currently included/considered in community benefit. However, the shortfall is due to the reimbursement from Medicare falling short of the cost incurred to provide care to the Medicare population served by The Fauquier Hospital. As with the shortfall experienced for the Medicaid population, the Medicare shortfall should be considered a community benefit as well. It is part of the organization's mission to provide the best possible care to elderly patients within our community, and the organization believes providing such care has improved the overall health of the community. By providing such care to Medicare patients, the governme nt's burden for caring for such individuals is lessened. The Medicare cost report was utilized as outlined in the Schedule H, Part III, Section B, Worksheet B, which utilizes the cost to charge ratio developed within the Medicare Cost Report to determine the allowable cost. |
| Part III, Line 9b | Fauquier Hospital's Financial Assistance policy contains the following provision on collection practices for those patients who qualify for financial assistance: Fauquier Hospital management shall develop policies and procedures for internal and external collection practices (including actions the hospital may take in the event of non-payment, including collections action and reporting to credit agencies) that take into account the extent to which the patient qualifies for charity care or discounted care; a patient's good faith efforts to apply for governmental assistance programs or financial assistance from Fauquier Hospital, and a patient's good faith effort to comply with his or her payment agreements with Fauquier Hospital. Fauquier Hospital will not impose extraordinary collections actions such as lawsuits, wage garnishments, arrests, body attachments, liens on residences, or other similar legal actions against any patient without first making reasonable efforts to determine whether that patient is eligible for financial assistance under this financial assistance policy. "Reasonable efforts" include notifications by the hospital of this financial assistance policy upon admission and in written and oral communications with the patient regarding the patient's bill, including invoices and telephone calls before collection action or reporting to credit agencies is initiated. If a patient is found to qualify for financial assistance after collection actions have started, all collection activity is immediately stopped, notifications are sent to the credit bureau if necessary and patients are not charged for collection fees. If a patient is found to qualify for financial assistance after making payments towards their balance, the payments are refunded to the patient. |
| Part V, Line 3 | FAUQUIER HOSPITAL CONSULTED WITH COMMUNITY HEALTH SOLUTIONS OF RICHMOND, VIRGINIA, TO CONDUCT THE HEALTH NEEDS ASSESSMENT. INPUT WAS REQUESTED FROM 60 COMMUNITY STAKEHOLDERS VIA AN ONLINE SURVEY INCLUDING LOCAL EMS, UNITED WAY, PUBLIC AND PRIVATE SCHOOLS. |
| Part V, Line 5c | In addition to sharing the Health Needs Assessment on the Fauquier Health website, it was distributed to the community stakeholders who were invited to take part in the online survey; the Warrenton office of the Rappahannock Rapidan Health Department as well as anyone who requests a copy of the assessment. |
| Part V, Line 7 | The Fauquier Hospital's health needs assessment identified and evaluated the global community health needs of our primary service area of Fauquier and Rappahannock Counties. Of the many community service gaps and health needs identified, Fauquier Health chose the area of greatest need and where the greatest impact could be made. Those topics are transportation, health education, aging services and early detection and screening in addition to leading causes of death, which are: cancer, heart disease, diabetes and Alzheimer's. Childhood obesity, a community health concern is also being addressed. To help address transportation, Fauquier Health supported with a donation, Voltran, a local nonprofit that coordinates volunteers who drive individuals to medical appointments. In addition Fauquier Health partnered with Virginia Regional Transit and Culpeper Hospital to contribute towards a bus route through the rural, southern part of the county to bring people to the hospital. To address health education and leading causes of death, the hospital hosts free, monthly health lectures on various topics identified in the assessment such as cancer, heart disease, Alzheimers, diabetes, congestive heart failure and chronic obstructive pulmonary disease. The annual health fair provides health screenings for b/p, cholesterol, blood glucose, breast and PSA screenings. Fauquier Health addresses diabetes, by providing diabetes education including lectures, support groups, self-management classes, screenings, counseling and cooking demos. Free mammograms are provided to women turning 40 to provide breast cancer screenings. To address aging services, Fauquier Health facilitates support groups for Alzheimer's, dementia, cancer, caregivers and diabetes. In addition, Fauquier partners with the local community service board and Aging Together to host Medicare/Medicaid counseling and a Falls Symposium and Alzheimer's/Dementia workshop. Fauquier Health partnered with three community organizations to address childhood obesity through an 8 week summer camp program that highlighted physical activity and nutrition. The health needs identified that the hospital is not addressing are those that the hospital believes are better handled by other local organizations or government entities. Examples include, low birth weights which are addressed by the local health department and social services. Dental care is not the expertise of the hospital so is addressed by the local health department and the local free clinic. Behavioral health is currently addressed by the local community services board, however the hospital is exploring initiatives to address the need in the community. The hospital supports the local free clinic financially and with donated lab and radiology services to provide care to the uninsured population. The results of the health needs assessment are continually being reviewed and considered by Fauquier Hospital leadership. They are considering options into incorporating the health needs identified into the hospital's strategic plan for the years to come. |
| Part V, Line 14g | In addition to publishing the Financial Assistance Policy on the hospital's website, signage is posted strategically throughout the hospital (including all inpatient, outpatient, ancillary and emergency department registration offices) which indicates that financial assistance is available and provides contact information for financial counselors who can help with the application process. Notifications regarding the policy are available in both English and Spanish, the primary languages spoken by the population served by Fauquier Hospital. Representatives of our Financial Assistance Eligibility partners, Advanced Patient Advocacy, also direct all patients who are screened for state or federal assistance programs but do not qualify to the hospital financial counselors for hospital charity screening. |
| Part VI, Line 2, Needs Assessment | Fauquier Health assesses the health needs of the community by conducting a health needs assessment every three years as well as continually communicating with the community stakeholders who are serving our areas residents. For example, Fauquier Health meets regularly with the Fauquier Free Clinic leadership and provides financial and in-kind assistance to the Clinic which serves the uninsured in Fauquier and Rappahannock Counties. |
| Part VI, Line 3, Patient education of eligibility for assistance | Notification of Fauquier Hospital's financial assistance program is disseminated by various means, including notification of contact information for financial counselors on all of our billing statements and signage in all of our patient registrations areas. The policy itself is available on the hospital website, which also provides contact information for our financial counselors. Requests for financial assistance may be made at any point in the collection cycle. Every billing statement received by a patient includes the following language: "In meeting your financial obligations for the care provided by Fauquier Hospital we ask that you work with us on any bills that you are having difficulty paying. You will find our staff understanding and eager to help you." This message is followed by a list of telephone numbers that the patient may call to reach the organization's financial counseling staff, hours of operation, and an email address. When patients call the financial counseling telephone number, they are prompted to selections to reach the staff member that is most likely able to help them i.e.: uninsured, Spanish speaking, billing questions, etc. In addition, uninsured inpatients and those with Medicare insurance and no secondary carrier are contacted (usually a personal visit in their hospital room) by an employee of one of our partners, Advanced Patient Advocacy (APA). The APA personnel screen these patients for eligibility for available state or federal programs. If these patients do not meet criteria for these programs, they are then referred to a financial counselor for screening for the hospital's financial assistance program. Outpatients whose accounts meet a threshold of $750 in charges are also contacted by APA by either telephone, letter or both. Uninsured patients who visit our Emergency Department are also given a packet of information that includes a financial assistance application and a business card with the name and contact information for one of our financial counselors. Lastly, we do use Credit Scoring software to help identify patients who might qualify for financial assistance but have not contacted our office. Our financial assistance policy states that we may use this kind of software, which uses information from credit bureaus and screens patients against the criteria of our financial assistance policy. |
| Part VI, Line 4, Community Information | The Fauquier Hospital, Inc. (FH) is a 97-bed, not-for-profit, acute care facility established in 1954 to provide comprehensive health care services to the rural communities it serves. Our mission is to restore, promote and maintain the health of our community. Fauquier Hospital is the only hospital in our primary service area, which includes Fauquier and minor portions of five surrounding counties. The primary service area has a population of 76,599. The average household income is $108,480. 8.1% of the community residents have incomes below the federal poverty guideline. 19.3% of Fauquier Hospital's patients are Medicaid recipients or self-pay. The following districts within Fauquier County are considered MUA/P by the Health Resources and Services Administration (HRSA): Lee District and Marshall District. |
| Part VI, Line 5, Promotion of community health | Fauquier Health promotes the health of the community by: * Ensuring that the majority (92%) of the individuals serving on the Fauquier Hospital and Fauquier Health System Board of Directors reside in the primary service area and are not employees or contractors of the organization. * Extending medical staff privileges to all qualified physicians in the community who are interested. * Fauquier Health uses surplus funds to improve patient care by upgrading the tools needed to care for our patients and planning for improvements. Fauquier Health continues to support twelve employed physicians, an Endocrinologist, and Obstetrics/Gynecologist, family medicine physicians, a Rheumatologist, Neurologist, Infectious Disease, Internal Medicine and General Surgery. * THROUGH PARTNERSHIPS WITH OTHER HEALTH CARE ORGANIZATIONS WE OPERATE A RETAIL HOME HEALTH SUPPLIES STORE AND A CANCER CENTER. WE ALSO PARTNER WITH LOCAL NON-PROFIT ORGANIZATIONS (E.G. FAUQUIER FREE CLINIC, THE CHAMBER OF COMMERCE, SCHOOLS AND CHURCHES) AND NATIONAL ORGANIZATIONS (E.G. THE AMERICAN CANCER SOCIETY) TO SUPPORT LOCAL EVENTS AND PROVIDE COMMUNITY HEALTH AND WELLNESS PROGRAMS. THESE COMMUNITY BENEFITS ACTIVITIES ARE COORDINATED BY TWO FULL-TIME COMMUNITY OUTREACH STAFF, SUPPORTED BY ADMINISTRATIVE AND CLINICAL DEPARTMENTS, AND OUR AUXILIARY VOLUNTEERS AS NEEDED. * TO HELP TRAIN AND EDUCATE HEALTH CARE PROFESSIONALS, FH WORKS WITH LOCAL COMMUNITY COLLEGES TO PROVIDE TOURS, LECTURES, AND INTERNSHIPS FOR STUDENTS; FH STAFF PROVIDED APPROXIMATELY 17,063 HOURS AT A COST OF APPROXIMATELY $506,903. * ADDITIONALLY, THE ORGANIZATION PROVIDES ASSISTANCE TO THE FAUQUIER FREE CLINIC (FFC). FFC PROVIDES PRIMARY HEALTH AND DENTAL CARE TO UNINSURED RESIDENTS OF FAUQUIER AND RAPPAHANNOCK COUNTIES. FH PROVIDED LABORATORY, CARDIOLOGY/NEUROLOGY/PULMONARY SERVICES, AND RADIOLOGY SERVICES AT NO CHARGE TO FCC PATIENTS FOR A TOTAL COST OF $232,261. A TOTAL OF 798 HOURS OF FREE CLINICAL CARE WERE PROVIDED BY COMMUNITY PHYSICIANS AND CLINICAL STAFF. TO HELP FFC EXPAND ITS SERVICES TO MEET THE NEEDS OF A GROWING POPULATION, FH LEASED A BUILDING IN APRIL 2006 TO THE FFC FOR $1 PER YEAR FOR 10 YEARS; THE RENTAL VALUE FY13 WAS $85,284. IN ADDITION, FH CONTRIBUTED $5,000 IN UNRESTRICTED FUNDS. * FAUQUIER HEALTH PROVIDED HEALTH EDUCATION AND HEALTH SCREENINGS AT 106 LOCAL EVENTS FOR 2,678 PEOPLE. FH ALSO OFFERS TOURS OF THE HOSPITAL AND SPEAKERS FOR LOCAL SCHOOLS AND COMMUNITY ORGANIZATIONS TO BUILD RELATIONSHIPS WITHIN THE COMMUNITY, PROMOTE COLLABORATION IN MANAGING HEALTH AND WELLNESS, AND EDUCATE THE COMMUNITY ON THE HEALTH SYSTEM. THE TOTAL COMMUNITY BENEFIT OF THESE SERVICES WAS $56,613. * TWO OF SEVERAL FH PUBLICATIONS ARE A COMMUNITY NEWSLETTER, HEALTHY HAPPENINGS AND SENIOR LIVING, INTENDED TO EDUCATE THE PUBLIC ABOUT HEALTH ISSUES AND HEALTH CARE AND HOSPITAL SERVICES. PUBLISHED QUARTERLY HEALTHY HAPPENINGS, REACHES 100,000 HOMES IN FAUQUIER AND SURROUNDING COUNTIES. The SENIOR LIVING publication is published twice a year and REACHES 37,000 individuals who are age 55 and older. THE COST TO FH FOR publication and distribution of these newletters in FY13 WAS $344,208. * FH PROVIDES MEDICAL OVERSIGHT, DIRECTION, AND ORDERS TO PARAMEDICS IN THE FIELD AND EN-ROUTE TO THE HOSPITAL. OUR EMERGENCY DEPARTMENT OFFERS 24-HOUR ACCESS TO MEDICAL SERVICES AND HELICOPTER TRANSPORT FOR CRITICALLY ILL OR INJURED INDIVIDUALS, AND ALSO RESTOCKS MEDICAL BOXES AND PROVIDES CLEAN LINENS FOR RESCUE SQUADS AT A COST TO THE HOSPITAL OF APPROXIMATELY $54,769. * FH SPONSORED, ASSISTED, OR PROVIDED MEETING SPACE FOR THREE SUPPORT GROUPS THAT MET WEEKLY OR MONTHLY, at a cost to FH of $860. ADDITIONALLY, FH PROVIDED MEETING SPACE OR CASH DONATIONS FOR SEVERAL NON-PROFIT COMMUNITY GROUPS, (E.G. the American Red Cross, FAUQUIER FREE CLINIC AND American Cancer Society Fauquier Chapter). THE fair market VALUE OF THE MEETING SPACE IS $29,963. CASH DONATIONS TOTALED $14,715. FH EMPLOYEES PROVIDED REPRESENTATION ON COMMUNITY BOARDS AND COALITIONS AT AN EXPENSE OF $73,814. * THE HOSPITAL ASSISTED 2,417 PEOPLE through THE PHYSICIAN REFERRAL PROGRAM, WHICH HELPS THE COMMUNITY WITH QUESTIONS ON PHYSICIANS, APPOINTMENTS, CLASSES AND PROGRAMS REGISTRATION, AND HEALTH RESOURCES AVAILABLE THROUGH THE HOSPITAL OR IN THE COMMUNITY. IT COST FH $31,733 TO PROVIDE THIS SERVICE IN FY13. |
| Part VI, Line 6, Affiliated health care system | THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. THE ORGANIZATION OPERATES A 97-BED ACUTE CARE HOSPITAL, WHICH PROVIDES GENERAL MEDICAL AND SURGICAL SERVICES AND OPERATES A 24/7 EMERGENCY ROOM. THE HOSPITAL IS THE ONLY HOSPITAL IN THE PRIMARY SERVICE AREA OF FAUQUIER COUNTY. THE FAUQUIER HEALTH SYSTEM ALSO OPERATES A 113 BED NURSING HOME AND 67 RESIDENT ASSISTED LIVING FACILITY THROUGH ITS RELATED ORGANIZATION FAUQUIER HEALTH SENIOR LIVING, INC. ADDITIONALLY, THE SYSTEM OPERATES A NUMBER OF PHYSICIAN PRACTICES. THE SYSTEM IDENTIFIES SPECIFIC PHYSICIAN SPECIALTY SHORTAGES IN THE COMMUNITY AND EMPLOYS PHYSICIANS IN THOSE SPECIALTY AREAS TO PROVIDE SUCH CARE TO THE COMMUNITY. THE COST OF OPERATING THESE PHYSICIAN PRACTICES, THEREBY MAKING THESE SPECIALTIES AVAILABLE TO THE COMMUNITY (INCLUDING TO THOSE PATIENTS THAT DO NOT HAVE THE ABILITY TO PAY), FAR EXCEEDS THE REVENUE COLLECTED FROM PROVIDING THE SERVICES. AMONG THE SPECIALTIES PROVIDED BY THE PHYSICIAN PRATICES ARE INFECTIOUS DISEASE, RHUMATOLOGY, NEUROLOGY, ENDOCRINOLOGY, OBSTETRICS, ONCOLOGY, ENT AND PRIMARY CARE. IN THE 2010 TAX YEAR, THE SYSTEM ADDED SIX EMPLOYED PHYSICIANS TO ITS STAFF: AN ENDOCRINOLOGIST, AND OBSTETRICS/GYNECOLOGIST AND THREE FAMILY MEDICINE PHYSICIANS. ADDITIONALLY, THE SYSTEM IMPLEMENTED A HOME HEALTH DISEASE MANAGEMENT TRAINING PROGRAM (TO INCLUDE CONGESTIVE HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND DIABETES) FOR PATIENTS; DEVELOPED A TRANSITION TO HOME PROGRAM THAT ADDRESSES CHRONIC DISEASE MANAGEMENT AND READMISSION RATES FOR PATIENTS; AND UNDERTOOK FEASIBILITY STUDIES FOR A NEONATAL INTENSIVE CARE UNIT AND AN AMBULATORY SURGERY CENTER. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Fauquier Hospital Auxiliary | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 Hospital Drive | AddressLine1 |
| City | Warrenton | City |
| State | VA | State |
| ZIP Code | 20186 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Cash Grant | 129629 | AmountOfCashGrant |
| Purpose Of Grant | to support auxiliary with profits from gift shop | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART I, LINE 2 | Identifier |
| Explanation | THE HOSPITAL PROVIDED A GRANT TO FAUQUIER HOSPITAL AUXILIARY. THE FAUQUIER HOSPITAL AUXILIARY IS A VOLUNTEER ORGANIZATION CLOSELY CONNECTED TO THE FAUQUIER HOSPITAL, WHICH OPERATES A GIFT SHOP, THRIFT SHOP AND ENGAGES IN FUNDRAISING ACTIVITIES ON BEHALF OF THE FAUQUIER HOSPITAL AND ITS TAX-EXEMPT AFFILIATES. THE FAUQUIER HOSPITAL AUXILIARY ALSO PROVIDES SCHOLARSHIPS TO LOCAL HIGH SCHOOL STUDENTS WITH IN THE FAUQUIER HOSPITAL COMMUNITY PERSUING DEGREES IN THE MEDICAL FIELD. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | true | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RODGER BAKER | ||||||||||||||
| PRESIDENT/CEO | 450363 | 0 | 70000 | 0 | 566689 | 0 | 60439 | 0 | 12088 | 0 | 1159579 | 0 | 0 | 0 |
| LIONEL PHILLIPS | ||||||||||||||
| VP FINANCE/CFO | 232978 | 0 | 54739 | 0 | 17999 | 0 | 12078 | 0 | 9173 | 0 | 326967 | 0 | 0 | 0 |
| LINDA SHARKEY | ||||||||||||||
| VP PATIENT CARE/CNE | 178310 | 0 | 0 | 0 | 9873 | 0 | 0 | 0 | 13526 | 0 | 201709 | 0 | 0 | 0 |
| MARY SMITH | ||||||||||||||
| VICE PRESIDENT SENIOR SERVICES | 182105 | 0 | 0 | 0 | 16023 | 0 | 0 | 0 | 7818 | 0 | 205946 | 0 | 0 | 0 |
| KATHERINE REEVES | ||||||||||||||
| VP HUMAN RESOURCES | 151705 | 0 | 0 | 0 | 8309 | 0 | 0 | 0 | 658 | 0 | 160672 | 0 | 0 | 0 |
| GREGORY BENGSTON | ||||||||||||||
| VP BUS DEV & PROF SERVICES | 170785 | 0 | 0 | 0 | 9246 | 0 | 0 | 0 | 20024 | 0 | 200055 | 0 | 0 | 0 |
| TRACY TURMAN | ||||||||||||||
| VP SUPPORT SERVICES | 126979 | 0 | 0 | 0 | 7241 | 0 | 0 | 0 | 18446 | 0 | 152666 | 0 | 0 | 0 |
| CHRISTINE CONNOLLY | ||||||||||||||
| president faquier foundation | 166371 | 0 | 0 | 0 | 12079 | 0 | 0 | 0 | 21554 | 0 | 200004 | 0 | 0 | 0 |
| ANHTAI NGUYEN | ||||||||||||||
| chief medical officer | 250822 | 0 | 0 | 0 | 13016 | 0 | 0 | 0 | 21638 | 0 | 285476 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| net earnings | line 6 | Fauquier Hospital has a "Management Performance Incentive Program" (MPIP) under which we award $ to our Director Team for accomplishing a pre-determined, measurable set of tasks related to clinical quality outcomes, patient satisfaction, community outreach and positive operating margins. |
| nonqualified retirement plan | line 4b | FAUQUIER HOSPITAL MAINTAINED A SECTION 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EMPLOYEES. DURING THE 2011 TAX YEAR. THOSE EMPLOYEES THAT PARTICIPATED IN THE SECTION 457(F) PLAN WERE PERMITTED DEFERRALS INTO THE PLAN (THAT IS, NO CONTRIBUTIONS WERE MADE BY THE CORPORATION). RODGER BAKER $60,439 LIONEL PHILLIPS $12,078 During the 2012 tax year, the CEO/President of the organization received a distribution of $539,240.76 from a Section 457(f) Plan. The distribution from the Section 457(f) Plan stemmed entirely from employee contributions made, annually, to the Plan since its inception in 2006. The Section 457(f) Plan was approved by the Board of Directors and was considered by the Compensation Committee and Board of Directors when determining the reasonable compensation of the CEO/President. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|
| INDUSTRIAL DEVELOPMENT AUTHORITY FAUQUIER COUNTY | ||||||||
| A | 546001274 | 312066BXO | 2008-02-13 | 22687593 | HOSPITAL BUILDING IMPROVEMENTS | false | false | false |
| INDUSTRIAL DEVELOPMENT AUTHORITY FAUQUIER CTY VA | ||||||||
| B | 546001274 | 2012-11-07 | 44758638 | 2012 refunding 2002 bonds | false | false | false | |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Bond ReferenceBondReferenceCd | Amount RetiredAmountRetired | Amount Bond DefeasedAmountBondDefeased | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Capitalized InterestCapitalizedInterest | Refunding EscrowRefundingEscrow | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Working Capital ExpendituresWorkingCapitalExpenditures | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Amount UnspentAmountUnspent | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 22865730 | 12348704 | 0 | 0 | 316697 | 0 | 0 | 21200329 | 0 | 0 | 2009 | false | false | true | true |
| B | 0 | 0 | 50597888 | 0 | 0 | 0 | 313298 | 0 | 0 | 0 | 50284590 | 0 | 2005 | false | true | true | true |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Remedial Action TakenRemedialActionTaken | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs | Prcntge Bond Financed PropPrcntgeBondFinancedProp |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | 0.00000 | 0.00000 | 0.00000 | false | false | false | false | |
| B | false | false | false | false | 0.00000 | 0.00000 | 0.00000 | false | false | false | false | 0.00000 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Business Name Line1NameOfGICProvider/BusinessNameLine1 | Term Of GICTermOfGIC | Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0 | ||||||||||||
| A | false | false | false | true | false | false | true | BB&T | 5.1 | true | false | false |
| 0 | ||||||||||||
| B | false | true | false | false | false | false | false | 0 | false | false | ||
Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)
| Bond ReferenceBondReferenceCd | Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction |
|---|---|
| A | false |
| B | false |
Form990 Schedule K Part VI Form990ScheduleKPartVI (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part II | 0 | THE TOTAL PROCEEDS OF THE ISSUE EXCEED THE ISSUE PRICE BECAUSE THE TOTAL PROCEEDS REFLECT INVESTMENT EARNINGS ON THE SALES PROCEEDS. |
| Part II, Line 3 | 0 | Total proceeds of the issue are greater than the issue price because proceeds from the debt service reserve fund ($5,834,024) and principal and interest fund ($366,729) from the 2002 tax-exempt bond issue were allocated to the 2012 tax-exempt bonds. |
| Part IV, LIne 7 | 0 | Although written procedures have not been adopted, the organization engages a professional third party to regularly perform arbitrage rebate computations on its tax-exempt bonds in accordance with IRS regulations under Section 148. No rebatable arbitrage has been computed for any of the outstanding tax-exempt bonds of the organization. |
| Part IV, Line 2c, Column A | 0 | The 2008 bond rebate computation was performed on 2/27/13. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 990 Review Process | Part VI, Line 11 | The organization prepares the Form 990 with assistance from an outside accounting firm. Once a draft of the Form 990 is completed, it is submitted to management of the organization for review and comments. After incorporating changes from management, materially complete draft Forms 990 are made available to the Board of the organization, as well as presented by the outside accounting firm to the organization's Audit & Finance Committee. Comments or questions received from the Board are incorporated into a final Form 990, which is signed by the Persident/CEO of the Fauquier Health System, Rodger Baker. |
| CONFLICTS MONITORING AND ENFORCEMENT | PART VI, LINE 12C | Under the Conflict of Interest Policy, all Board members, management, and key employees complete an annual disclosure form regarding business relationships that he or she, or any family member, has with any other company that does business with the organization, as well as any business relationships between and among the Board members, management, and key employees. The annual disclosure statements are reviewed by independent legal counsel, the corporate compliance officer, and the audit and compliance committee, who are ultimately responsible if a conflict exists. Any such conflicts would be reported to the full Board. In addition, any person who is covered by the Conflict of Interest Policy has an ongoing obligation to disclose the existence of any actual or potential conflict to the Board or the Board Committee in which the matter arises. Finally, the organization monitors Board member eligibility for any potential conflicts, in order to avoid such conflicts from occurring in the first place. |
| PROCESS FOR DETERMINING COMPENSATION | PART VI, LINE 15 | THE ORGANIZATION UTILIZES A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE OFFICER COMPENSATION. |
| DOCUMENT AVAILABILITY | PART VI, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| net assets reconciliation | part xi, line 5 | NET EQUITY TRANSFERS TO RELATED ORGS $(6,158,063) |
| corporate member | Part VI, Section A, Line 6 | Fauquier Health System Inc, is the sole member of the organization. |
| electing members of the board | Part VI, Section A, Line 7 | 1. General Powers. The business and affairs of the Corporation shall be managed by the Board of Directors, which shall have all voting power except the power to vote on electing, appointing or removing Directors and on implementing amendments to the Articles of Incorporation affecting the voting rights of members, which power is vested in the sole member of the Corporation. 2. Number and Qualification of Directors. The Board of Directors shall consist of no more than ten (10). The number of Directors may be changed by amendment of these By-laws but shall not be less than three. 3. Election of Directors. The President of The Fauquier Hospital, Incorporated (Hospital) shall serve ex officio as a voting director of the corporation and the President of Fauquier Health Senior Living, Inc. (Senior Living) and the Medical Director of Fauquier Health Rehabilitation and Nursing Center shall serve ex officio as non-voting directors of the corporation. All other directors shall be elected by Fauquier Health System, Inc. with one member from that Board also serving as a director of the corporation. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| FAUQUIER HEALTH SYSTEM INC | ||||||||||
| 500 HOSPITAL DR | WARRENTON | VA | 20186 | 541416705 | MGMT COORDINA | VA | 501(C)(3) | 11 TYPE III | NONE | false |
| FAUQUIER HEALTH FOUNDATION INC | ||||||||||
| 500 HOSPITAL DR | WARRENTON | VA | 20186 | 300219424 | FUNDRAISING | VA | 501(C)(3) | 7 | FAUQ HLTH SY | true |
| FAUQUIER HEALTH SENIOR LIVING INC | ||||||||||
| 500 HOSPITAL DR | WARRENTON | VA | 20186 | 541416703 | SKILLED CARE | VA | 501(C)(3) | 9 | FAQ HLTH SYS | true |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAUQUIER HEALTH FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 793869 | AmountInvolved |
| Method Of Amt Determination | COST | MethodOfAmtDetermination |