2014-10-30T09:23:17-05:00 2013-12-31 540737372 PBMARES LLP 725 JACKSON STREET SUITE 210 FREDERICKSBURG VA 22401 990 2013-01-01 201106426 MARY WASHINGTON HEALTHCARE GROUP RETURN MARY 5407412513 2300 FALL HILL AVENUE NO 418 FREDERICKSBURG VA 22401 SEAN T BARDEN EXECUTIVE VICE PRESIDENT 5407412513 2014-10-23 1 KEITH L WAMPLER P00436324 5403713566 2014-10-23 X 2013 2015-11-30 17:44:51Z SEAN T BARDEN 2300 FALL HILL AVENUE NO 418 FREDERICKSBURG VA 22401 592231195 1 1 4243 X WWW.MARYWASHINGTONHEALTHCARE.COM X 1983 VA OUR MISSION IS TO IMPROVE THE HEALTH OF PEOPLE IN THE COMMUNITIES WE SERVE. THROUGH OUR SUBSIDIARIES WE PROVIDE INPATIENT AND OUTPATIENT HOSPITAL SERVICES AND OTHER MEDICAL SERVICES. 52 43 3947 0 2328196 -1325133 2411552 4974765 537035684 568469103 2855304 6538697 13215573 12111756 555518113 592094321 2402339 4048808 0 0 249763997 231459510 0 44755 164713 325039772 368327985 577206108 603881058 -21687995 -11786737 491115201 464708560 305149607 297345687 185965594 167362873 OUR MISSION IS TO IMPROVE THE HEALTH OF PEOPLE IN THE COMMUNITIES WE SERVE. THROUGH OUR SUBSIDIARIES WE PROVIDE INPATIENT AND OUTPATIENT HOSPITAL SERVICES AND OTHER MEDICAL SERVICES. 0 0 587642042 4048808 564364885 PROVISION OF INPATIENT AND OUTPATIENT GENERAL ACUTE CARE HOSPITAL, PSYCHIATRIC HOSPITAL SERVICES, HOME HEALTH AND HOSPICE SERVICES, IMAGING AND AMBULATORY SURGERY SERVICES AND PHYSICIAN SERVICES. PRIMARY SERVICE AREAS ARE FAIRFAX, STAFFORD, SPOTSYLVANIA, CAROLINE, KING GEORGE, AND WESTMORELAND COUNTIES IN VIRGINIA AND SECONDARY SERVICE AREAS INCLUDE MANASSAS, FAUQUIER, CULPEPER, ORANGE, LOUISA, HANOVER, ESSEX AND RICHMOND COUNTIES IN VIRGINIA. WE SERVED 118,721 PATIENTS IN OUR EMERGENCY ROOMS, 17,800 SURGICAL CASES AND 26,731 PATIENT DISCHARGES. 587642042 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 1 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 1 X 453 0 3947 1 0 0 0 0 0 0 0 0 0 0 X 52 43 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X WILLIAM YASCKO 5407412513 2300 FALL HILL AVENUE NO 418 FREDERICKSBURG VA 22401 FRED M RANKIN III PRESIDENT 4.00 40.00 X X 0 674956 28919 SEAN T BARDEN EXECUTIVE VP 4.00 40.00 X X 0 382802 34037 WALTER J KIWALL EXECUTIVE VP 4.00 40.00 X X 0 398289 26770 XAVIER R RICHARDSON EXECUTIVE VP 2.00 40.00 X X 0 480354 23465 J THOMAS RYAN MD EXECUTIVE VP 2.00 40.00 X X 0 252812 13297 RAVI MATHUR VICE PRESIDENT 2.00 40.00 X X 0 191316 22548 CHERYL SPRINGHORN EXECUTIVE DIRECTOR 2.00 40.00 X 0 143037 11106 KENNETH N JOSOVITZ MD PRESIDENT-STAFFORD HOSPITA 3.00 2.00 X 24667 0 0 DAVID M GARTH MD PRESIDENT-MARY WASHINGTON 4.00 2.00 X 26000 0 0 ROBERT E HOUCK TRUSTEE 2.00 40.00 X 0 85753 2655 JOHN F FICK III CHAIRMAN-MPI 2.00 8.00 X X 0 0 0 ALDA L WHITE VICE CHAIR-MPI 2.00 2.00 X X 0 0 0 DONALD H NEWLIN SECRETARY/TREAS-MPI 2.00 5.00 X X 0 0 0 WILLIAM BOLDON TRUSTEE 2.00 3.00 X 0 0 0 JAN C ERKERT TRUSTEE 2.00 2.00 X 0 0 0 KURT R LARSON MD TRUSTEE 2.00 2.00 X 0 0 0 RAYMOND C MCAFOOSE TRUSTEE 2.00 3.00 X 0 0 0 MICHAEL P MCDERMOTT MD TRUSTEE 2.00 2.00 X 0 0 0 JOHN C MCKEOWN MD TRUSTEE 2.00 2.00 X 0 0 0 FRED M MESSING TRUSTEE 2.00 2.00 X 0 0 0 CLARENCE A ROBINSON TRUSTEE 2.00 2.00 X 0 0 0 RAYMOND L SLAUGHTER TRUSTEE 2.00 2.00 X 0 0 0 JONATHAN D WALLACE TRUSTEE 2.00 2.00 X 0 0 0 MARY KATHERINE GREENLAW CHAIRMAN-MWH FOUNDATION 4.00 0.00 X X 0 0 0 EDWARD V ALLISON JR VICE CHAIR-MWH FOUNDATION 2.00 0.00 X X 0 0 0 WILLIAM B YOUNG SEC/TREAS MWH FOUNDATION 2.00 0.00 X X 0 0 0 MARK A BUTTERWORTH TRUSTEE 2.00 0.00 X 0 0 0 R LEIGH FRACKELTON JR TRUSTEE 2.00 0.00 X 0 0 0 JEFFREY A FRAZIER TRUSTEE 2.00 0.00 X 0 0 0 ROCHELLE GREY TRUSTEE 2.00 0.00 X 0 0 0 CHRISTOPHER T HUESGEN MD TRUSTEE 2.00 0.00 X 0 0 0 PATRICIA LYNCH TRUSTEE 2.00 0.00 X 0 0 0 EDWARD O MINNIEAR TRUSTEE 2.00 0.00 X 0 0 0 JUDITH G SMITH TRUSTEE 2.00 0.00 X 0 0 0 DOUGLAS G STEWART TRUSTEE 2.00 0.00 X 0 0 0 JOSEPH R WILSON TRUSTEE 2.00 0.00 X 0 0 0 W MALONE SCHOOLER CHAIRMAN-SH FOUNDATION 2.00 0.00 X X 0 0 0 JO D KNIGHT VICE CHAIRMAN-SH FOUNDATIO 2.00 0.00 X X 0 0 0 ELAINE F FARMER SEC/TREAS SH FOUNDATION 2.00 0.00 X X 0 0 0 KEVIN BREEN TRUSTEE 2.00 0.00 X 0 0 0 CLAY HUBER TRUSTEE 2.00 0.00 X 0 0 0 DOUGLAS R JOHNSON MD TRUSTEE 2.00 0.00 X 0 0 0 WILLIAM R JOHNSON TRUSTEE 2.00 0.00 X 0 0 0 GLEN E KINARD TRUSTEE 2.00 0.00 X 0 0 0 H CLARK LEMING TRUSTEE 2.00 0.00 X 0 0 0 TERENCE A MANNION TRUSTEE 2.00 0.00 X 0 0 0 CHARLES W MCDANIEL TRUSTEE 2.00 0.00 X 0 0 0 RAYMOND C MCAFOOSE TRUSTEE 2.00 0.00 X 0 0 0 JACK ROWLEY TRUSTEE 2.00 0.00 X 0 0 0 KATHRYN S WALL EXECUTIVE VP 2.00 40.00 X 0 262203 17670 MARIANNA BEDWAY SENIOR VP 2.00 40.00 X 235731 0 31482 ERIC FLETCHER SENIOR VP 2.00 40.00 X 0 219177 11671 WINIFRED J HAIKEY SENIOR VP 2.00 40.00 X 0 217353 21873 JOYCE HANSCOME SENIOR VP 2.00 40.00 X 0 238527 24420 RANDALL PATRICK STEWART SENIOR VP-(FORMER) 0.00 0.00 X 0 0 0 JAMES K VAN RENAN SENIOR VP 40.00 2.00 X 310583 0 30111 CATHLEEN A YABLONSKI SENIOR VP 40.00 2.00 X 207481 0 27793 AMY ADOME MD VICE PRESIDENT 2.00 40.00 X 0 46727 3151 REBECCA BIGONEY MD EXECUTIVE VP 40.00 2.00 X 324817 0 24244 KATHLEEN BOURGAULT VICE PRESIDENT 2.00 40.00 X 0 202922 22971 EILEEN L DOHMANN RN VICE PRESIDENT 40.00 2.00 X 0 211890 9898 MARIE FREDRICK VICE PRESIDENT 2.00 40.00 X 0 198381 25179 JAMES SWISHER VICE PRESIDENT 2.00 40.00 X 0 171761 13310 GLEN J POFFENBARGER MD NEUROSURGEON 40.00 0.00 X 1138490 0 40260 JT SHERWOOD MD THORACIC SURGEON 40.00 0.00 X 790441 0 40560 CHRISTOS HATJIS MD PERINATOLOGISTS 40.00 0.00 X 637334 0 31267 MAURICE EGGLESTON JR MD PERINATOLOGISTS 40.00 0.00 X 560087 0 37506 THERESA A CONOLOGUE MD DERMATOLOGIST 40.00 0.00 X 718194 0 31210 LAWRENCE ROBERTS MD TRUSTEE (FORMER) 40.00 0.00 X 516864 0 33445 5490689 4378260 640818 3886 1 1 0 MORRISON MANAGEMENT 5801 PEACHTREE DUNWOODY ROAD ATLANTA GA 30342 FOOD SERVICES 4701206 CHILDREN'S NATIONAL HOSPITAL 111 MICHIGAN AVE NW SUITE 3W-100 WASHINGTON DC 20010 PHYSICIAN SERVICES 2807370 WHITING-TURNER CONTRACTING PO BOX 17596 BALTIMORE MD 21297 CONSTRUCTION SERVICES 2227583 W C SPRATT INC PO BOX 824 FREDERICKSBURG VA 224040824 CONSTRUCTION SERVICES 1997533 CROTHALL SERVICES GROUP 955 CHESTERBROOK BLVD STE 300 WAYNE PA 19087 LAUNDRY SERVICES 1652597 62 429362 513686 446530 3585187 32946 4974765 NET PATIENT SERVICES REVENUE 623000 552714578 552714578 MANAGEMENT SERVICES 623000 6445829 6445829 OTHER OPERATING REVENUE 623000 5894693 5894693 LAB FEES 621500 2328196 2328196 OTHER SERVICES 623000 547222 547222 538585 538585 568469103 1274370 1274370 13555615 226807 0 0 13555615 226807 13782422 13782422 5264327 0 5264327 5264327 5264327 242230 429362 136874 105356 105356 INCOME FROM PSHIP/LLC 900099 -1776022 -1776022 -1776022 592094321 564364885 2328196 20426475 X 3981058 3981058 67750 67750 1742551 1695502 46700 349 189658174 184537403 5082839 37932 5139020 5000266 137726 1028 20418143 19866853 547206 4084 14501622 14110079 388643 2900 65090266 63332829 1744419 13018 63009 61307 1689 13 70900 68986 1900 14 44755 44755 112448 109412 3014 22 74952298 72928586 2008721 14991 99555 96867 2668 20 3373869 3282774 90420 675 1969869 1916683 52792 394 30040875 29229772 805095 6008 1476232 1436374 39563 295 412646 401504 11059 83 920108 895265 24659 184 30397538 29576804 814654 6080 4333978 4216960 116151 867 OTHER MEDICAL & HOSPITA 92378080 89883871 2475733 18476 BAD DEBT EXPENSE 53091503 51658033 1422852 10618 MEDICAL AND HOSPITAL SU 3469830 3376145 92991 694 REPAIRS AND MAINTENANCE 3449101 3355975 92436 690 2625880 2554984 70373 523 603881058 587642042 16074303 164713 1228402 974287 1154684 1146333 18513794 17548710 92132649 79331131 4094742 2352885 8678498 9200898 2470759 2834615 694227383 410131918 298871143 284095465 46814526 51217305 15294513 14255183 1861491 1751748 491115201 464708560 33505968 33648086 495 267954672 260051743 3688967 3645363 305149607 297345687 X 167487901 149816967 17219483 16287696 1258210 1258210 185965594 167362873 491115201 464708560 X -11786737 363752 -7179736 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 31457238 139061 3041697 1878976 32759020 29168493 111350 3125019 39250 908374 31457238 31364122 343694 -1155863 63750 1319711 29168492 29030361 455287 3036877 17000 1141403 31364122 25187112 814062 4318842 15000 1275156 29029860 0.71470 0.24690 0.03840 0 0 24284779 24284779 255712751 78773768 176938983 23043803 6547837 16495966 339305480 314233540 25071940 51880570 10576773 41303797 284095465 CAPITAL LEASE OBLIGATIONS 3040 ACCRUED LOSS-PROFESSIONAL LIABILITY 3642323 3645363 X PART V, LINE 4: THE INTEREST EARNED FROM THE ENDOWMENT FUNDS IS USED TO FUND SCHOLARSHIPS AND GRANTS IN FUTHERANCE OF OUR MISSION. PART X, LINE 2: MWHC WAS RECOGNIZED AS A PUBLIC CHARITY GENERALLY EXEMPT FROM FEDERAL INCOME TAXATION UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE PURSUANT TO A DETERMINATION LETTER ISSUED BY THE IRS IN MARCH 1992. MWHC IS ENTITLED TO RELY ON THIS DETERMINATION AS LONG AS THERE ARE NO SUBSTANTIAL CHANGES IN ITS CHARACTER, PURPOSES, OR METHODS OF OPERATION. MANAGEMENT HAS CONCLUDED THAT THERE HAVE BEEN NO SUCH CHANGES, AND THEREFORE MWHC'S STATUS AS A PUBLIC CHARITY EXEMPT FORM FEDERAL INCOME TAXATION REMAINS IN EFFECT. THE STATE IN WHICH MWHC OPERATES ALSO PROVIDES GENERAL EXEMPTION FROM STATE INCOME TAXATION FOR ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAXATION. HOWEVER, MWHC IS SUBJECT TO BOTH FEDERAL AND STATE INCOME TAXATION AT CORPORATE TAX RATES ON ITS UNRELATED BUSINESS INCOME. EXEMPTION FROM OTHER STATE TAXES, SUCH AS REAL AND PERSONAL PROPERTY TAXES, IS SEPARATELY DETERMINED. CERTAIN ENTITIES UNDER MWHC ARE TAXABLE ENTITIES. MWHC HAD NO UNRECOGNIZED TAX BENEFIT OR LIABILITIES OR SUCH AMOUNTS WERE IMMATERIAL DURING THE PERIODS PRESENTED. FOR TAX PERIODS WITH RESPECT TO WHICH NO UNRELATED BUSINESS INCOME WAS RECOGNIZED, NO TAX RETURN WAS REQUIRED. TAX PERIODS FOR WHICH NO RETURN IS FILED REMAIN OPEN FOR EXAMINATION INDEFINITELY. ALL REQUIRED TAX FILINGS HAVE BEEN FILED ON A TIMELY BASIS. X 0 HENDERSON MALLORY PARTNERS 2838 MONTEBELLO ROAD NO 19 AUSTIN TX 78746 FUNDRAISING FOR CANCER CENTER 0 400720 360908 39812 400720 360908 39812 SHF GOLF TOURNAMENT 288620 166580 122040 24134 12117 1140 3978 MWHF GOLF TOURNAMENT 118141 96000 22141 9075 10143 891 518 7 264831 166782 98049 35650 1860 14875 22493 671592 429362 242230 68859 24120 16906 26989 136874 105356 1 1 X 1 X 1 X 1 1 1 0 1 1 26925293 26925293 0.04460 49296728 33822307 15474421 0.02560 76222021 33822307 42399714 0.07020 826337 826337 0.00140 1185258 77182 1108076 0.00180 59526073 40586085 18939988 0.03140 472914 111850 361064 0.00060 889745 1774292 -884547 0.00000 62900327 42549409 20350918 0.03520 139122348 76371716 62750632 0.10540 15673 15673 0.00000 1602 1602 0.00000 516 516 0.00000 310 310 0.00000 1630421 1630421 0.00270 185553 185553 0.00030 1834075 1834075 0.00300 1 17395304 5392544 137571027 172929659 -35358632 X 1 1 1 MEDICAL IMAGING OF FREDERICKSBURG OUTPATIENT IMAGING 0.51000 0.49000 2 FREDERICKSBURG AMBULATORY SURGERY CENTER AMBULATORY SERGICAL SERVICES 0.53370 0.46630 4 BUNKER HILL PARTNERS MEDICAL OFFICE BUILDING 0.20000 0.20000 5 COWAN INVESTMENT PARTNERS MEDICAL OFFICE BUILDING 0.12500 0.37500 6 MEDICAL PLAZA AT COSNER CORNER MEDICAL OFFICE BUILDING 0.39500 0.47400 2 1 MARY WASHINGTON HOSPITAL INC 1101 SAM PERRY BLVD FREDERICKSBURG VA 22401 X X X 437 BED ACUTE CARE HOSPITAL LEVEL 2 TRAUMA 2 STAFFORD HOSPITAL LLC 101 HOSPITAL CENTER BLVD STAFFORD VA 22554 X X X 100 BED HOSPITAL MARY WASHINGTON HOSPITAL INC 1 1 X X X X X X X X 11 1 1 1 X WWW.MARYWASHINGTONHEALTHCARE.COM/MARY-WAS X X X X X 1 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X X X X 1 0 X X X X 1 X 0 0 STAFFORD HOSPITAL LLC 2 1 X X X X X X X X 11 1 1 1 X WWW.MARYWASHINGTONHEALTHCARE.COM/STAFFORD X X X X X 1 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X X X X 0 0 X X X X 1 X 0 0 MARY WASHINGTON HOSPITAL, INC. PART V, SECTION B, LINE 3: IN MAY 2011, MARY WASHINGTON HEALTHCARE (INCLUDING MARY WASHINGTON HOSPITAL AND STAFFORD HOSPITAL) AND THE RAPPAHANNOCK AREA HEALTH DISTRICT LAUNCHED THE HEALTHY COMMUNITIES PARTNERSHIP (HCP). OTHER FOUNDING MEMBERS ARE RAPPAHANNOCK UNITED WAY, KAISER PERMANENTE OF THE MID ATLANTIC STATES, AND THE RAPPAHANNOCK AREA COMMUNITY SERVICES BOARD. THESE INITIAL SPONSORS AGREED THAT SUCCESS WAS DEPENDENT ON GATHERING A DIVERSE GROUP OF INDIVIDUALS TO COLLECTIVELY PROVIDE BROAD PERSPECTIVE ON THE REGION'S HEALTH CARE NEEDS. THIS REGIONAL HOSPITALS, HEALTH DEPARTMENT AND INSURERS, PRIVATE BUSINESSES, COMMUNITY-BASED ORGANIZATIONS, AND HEALTH CARE AND MENTAL HEALTHON THE HCP'S COMMITTEES. AS A DIRECT RESULT OF THIS INITIAL MEETING, THE HCP ADVISORY COMMITTEE NOW HAS 40 ACTIVE VOLUNTEERS REPRESENTING INITIAL MEETING WAS TO COMMUNICATE THIS NEW INITIATIVE WITH COMMUNITY STAKEHOLDERS AND GAUGE BOTH THE LEVEL AND AVAILABILITY TO SERVE GROUP LAUNCHED AN INITIAL KICK-OFF MEETING JUNE 8, 2011, WITH A LARGE GROUP OF COMMUNITY STAKEHOLDERS IN ATTENDANCE. THE PURPOSE OF THIS INITIAL MEETING WAS TO COMMUNICATE THIS NEW INITIATIVE WITH COMMUNITY STAKEHOLDERS AND GAUGE BOTH THE LEVEL AND AVAILABILITY TO SERVE ON THE HCP'S COMMITTEES. AS A DIRECT RESULT OF THIS INITIAL MEETING, THE HCP ADVISORY COMMITTEE NOW HAS 40 ACTIVE VOLUNTEERS REPRESENTING REGIONAL HOSPITALS, HEALTH DEPARTMENT AND INSURERS, PRIVATE BUSINESSES, COMMUNITY-BASED ORGANIZATIONS, AND HEALTH CARE AND MENTAL HEALTH PROVIDERS. STAFFORD HOSPITAL, LLC PART V, SECTION B, LINE 3: IN MAY 2011, MARY WASHINGTON HEALTHCARE (INCLUDING MARY WASHINGTON HOSPITAL AND STAFFORD HOSPITAL) AND THE RAPPAHANNOCK AREA HEALTH DISTRICT LAUNCHED THE HEALTHY COMMUNITIES PARTNERSHIP (HCP). OTHER FOUNDING MEMBERS ARE RAPPAHANNOCK UNITED WAY, KAISER PERMANENTE OF THE MID ATLANTIC STATES, AND THE RAPPAHANNOCK AREA COMMUNITY SERVICES BOARD. THESE INITIAL SPONSORS AGREED THAT SUCCESS WAS DEPENDENT ON GATHERING A DIVERSE GROUP OF INDIVIDUALS TO COLLECTIVELY PROVIDE BROAD PERSPECTIVE ON THE REGION'S HEALTH CARE NEEDS. THIS REGIONAL HOSPITALS, HEALTH DEPARTMENT AND INSURERS, PRIVATE BUSINESSES, COMMUNITY-BASED ORGANIZATIONS, AND HEALTH CARE AND MENTAL HEALTHON THE HCP'S COMMITTEES. AS A DIRECT RESULT OF THIS INITIAL MEETING, THE HCP ADVISORY COMMITTEE NOW HAS 40 ACTIVE VOLUNTEERS REPRESENTING INITIAL MEETING WAS TO COMMUNICATE THIS NEW INITIATIVE WITH COMMUNITY STAKEHOLDERS AND GAUGE BOTH THE LEVEL AND AVAILABILITY TO SERVE GROUP LAUNCHED AN INITIAL KICK-OFF MEETING JUNE 8, 2011, WITH A LARGE GROUP OF COMMUNITY STAKEHOLDERS IN ATTENDANCE. THE PURPOSE OF THIS INITIAL MEETING WAS TO COMMUNICATE THIS NEW INITIATIVE WITH COMMUNITY STAKEHOLDERS AND GAUGE BOTH THE LEVEL AND AVAILABILITY TO SERVE ON THE HCP'S COMMITTEES. AS A DIRECT RESULT OF THIS INITIAL MEETING, THE HCP ADVISORY COMMITTEE NOW HAS 40 ACTIVE VOLUNTEERS REPRESENTING REGIONAL HOSPITALS, HEALTH DEPARTMENT AND INSURERS, PRIVATE BUSINESSES, COMMUNITY-BASED ORGANIZATIONS, AND HEALTH CARE AND MENTAL HEALTH PROVIDERS. MARY WASHINGTON HOSPITAL, INC. PART V, SECTION B, LINE 4: STAFFORD HOSPITAL AND SPOTSYLVANIA REGIONAL MEDICAL CENTER STAFFORD HOSPITAL, LLC PART V, SECTION B, LINE 4: MARY WASHINGTON HOSPITAL AND SPOTSYLVANIA REGIONAL MEDICAL CENTER MARY WASHINGTON HOSPITAL, INC. PART V, SECTION B, LINE 5D: PRESENTED AT NUMEROUS COMMUNITY MEETINGS, SUCH AS THE ROTARY MEETINGS, CHAMBER OF COMMERCE, AND THE MARY WASHINGTON HEALTHCARE CITIZEN ADVISORY COMMITTEE MEETINGS. STAFFORD HOSPITAL, LLC PART V, SECTION B, LINE 5D: PRESENTED AT NUMEROUS COMMUNITY MEETINGS, SUCH AS THE ROTARY MEETINGS, CHAMBER OF COMMERCE, AND THE MARY WASHINGTON HEALTHCARE CITIZEN ADVISORY COMMITTEE MEETINGS. 2 FREDERICKSBURG AMBULATORY SURGERY CENTER 1201 SAM PERRY BLVD SUITE 101 FREDERICKSBURG VA 224014490 AMBULATORY SURGERY CENTER MEDICAL IMAGING OF FREDERICKSBURG 1201 SAM PERRY BLVD SUITE 102 ASC BUILD FREDERICKSBURG VA 224014490 IMAGING SERVICES PART I, LN 7 COL(F): BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER PATIENT FINANCIAL ASSISTANCE POLICY (PFAP)IN DECEMBER 2011, MWHC UTILIZED THE SERVICES OF SEARCHAMERICA TO IDENTIFY PFAP ELIGIBLE PATIENTS WHOSE ACCOUNTS HAD FALLEN INTO BAD DEBT. IN EARLY 2012, SEARCHAMERICA PROVIDED A LIST UTILIZING VARIOUS MARKET RESEARCH TO APPROXIMATE THE FEDERAL POVERTY LEVEL OF EACH ACCOUNT HOLDER. WITH THIS INFORMATION WE WERE ABLE TO DETERMINE ACCOUNTS THAT MAY HAVE BEEN ELIGIBLE FOR FREE CARE OR DISCOUNTED CARE UNDER OUR FINANCIAL ASSISTANCE POLICY. UTILIZING THE STATISTICAL ANALYSIS THAT SEARCHAMERICA PROVIDED WE HAVE EXTRAPOLATED THE DATA AND ARE ABLE TO ESTIMATE THAT ABOUT 84% OF OUR BAD DEBT IS LIKELY ATTRIBUTABLE TO PFAP ELIGIBLE PATIENTS. PART II, COMMUNITY BUILDING ACTIVITIES: IN FURTHERANCE OF ITS MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY IT SERVES THE ORGANIZATION PROMOTES WORKFORCE DEVELOPMENT FOR THE RECRUITMENT OF PHYSICIANS AND OTHER HEALTH PROFESSIONALS IN AREAS IDENTIFIED AS SHORTAGE AREAS THROUGH ITS COMMUNITY NEEDS ASSESSMENTS AND MEDICAL STAFF DEVELOPMENT PLANS. RECRUITMENT OF PHYSICIANS TO PRACTICE IN MWHC'S SERVICE AREA IMPROVES ACCESS TO CARE RESULTING IN GREATER AVAILABILITY OF PHYSICIAN SPECIALISTS, LESS TRAVEL TO OBTAIN CARE, AND SHORTER WAIT TIMES FOR APPOINTMENTS. ADDITIONALLY MWHC, PROVIDES FACILITIES FREE OF CHARGE TO RAPPAHANNOCK EMERGENCY MEDICAL SERVICES WHICH IS VALUED AT APPROXIMATELY $100,000. PART III, LINE 4: THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S JUDGMENTAL ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ITS REVIEW OF ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING, TAKING INTO CONSIDERATION RECENT WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, PAYOR AGREEMENT RATE CHANGES AND OTHER FACTORS. THE RESULTS OF THESE ASSESSMENTS ARE USED TO MAKE MODIFICATIONS TO THE PROVISION FOR BAD DEBTS AND TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE.FOR SELF-PAY PATIENTS, THE PROVISION IS BASED ON AN ANALYSIS OF PAST EXPERIENCE RELATED TO COLLECTION RATE OF SELF-PAY BALANCES. MWHC FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH EXTERNAL COLLECTION AGENCIES. AT DECEMBER 31, 2013 AND 2012, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS REPRESENTED APPROXIMATELY 92% OF THE PATIENTS DUE ACCOUNTS RECEIVABLE BALANCE. THE PATIENTS DUE ACCOUNTS RECEIVABLE BALANCE REPRESENTS THE ESTIMATED UNINSURED PORTION OF ACCOUNTS RECEIVABLE. PART III, LINE 8: AS A NOT-FOR-PROFIT HOSPITAL IT IS OUR MISSION TO IMPROVE THE HEALTH STATUS OF ALL PEOPLE WITHIN OUR COMMUNITY AND TO PROVIDE HEALTHCARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE STATUS. MWHC ACCEPTS MEDICARE AND MEDICAID AND IT IS A WELL ESTABLISHED FACT THAT NOT-FOR-PROFIT FACILITIES DO NO RECOUP THE COST OF CARING FOR THOSE PATIENTS UTILIZING THESE PROGRAMS. UNDER IRS GUIDELINES MEDICARE AND MEDICAID BENEFICIARIES ARE CONSIDERED TO BE MEMBERS OF A CHARITABLE CLASS, THEREFORE BY ASSISTING THESE PATIENTS AND ACCEPTING THE SHORTFALLS IN REPAYMENT, THE ORGANIZATION IS IN FACT RELIEVING GOVERNMENT BURDEN AND PROVIDING A SIGNIFICANT COMMUNITY BENEFIT TO OUR SERVICE AREA. PART III, LINE 9B: PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY POINT IN THE COLLECTION CYCLE AND MODIFICATIONS OF ABILITY TO PAY MAY BE ADJUSTED SHOULD FINANCIAL OR INSURANCE STATUS CHANGE SINCE THE FIRST DAY OF CARE. MWHC DOES NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE THEY HAVE MADE REASONABLE EFFORTS TO DETERMINE WHETHER THE INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS CONSTITUTE NOTIFICATION BY MWHC OF ITS FINANCIAL ASSISTANCE POLICY BY WRITTEN AND/OR ORAL COMMUNICATIONS TO ALL UNINSURED/UNDERINSURED PATIENTS AS WELL AS CONSIDERATION OF ELIGIBILITY BASED UPON THE PRESUMPTIVE ELIGIBILITY GUIDELINES DESCRIBED IN THE FINANCIAL ASSISTANCE POLICY. PART VI, LINE 2: MARY WASHINGTON HEALTHCARE AND ITS AFFILIATES (MARY WASHINGTON HOSPTIAL, MARY WASHINGTON HOSPITAL FOUNDATION, STAFFORD HOSPITAL, LLC, STAFFORD HOSPITAL FOUNDATION, MEDICORP PROPERTIES, INC., MEDICORP HEALTH SERVICES, AND MARY WASHINGTON HEALTHCARE CLINICAL SERVICES, INC.) HAS AS ITS MISSION TO IMPROVE THE HEALTH OF MEMBERS OF THE COMMUNITIES IT SERVES: FREDERICKSBURG, VA AND THE SURROUNDING SIX (6) COUNTIES. THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THESE COMMUNITIES IN NUMEROUS WAYS INCLUDING: 1) SOLICITING INPUT FROM MWHC'S CITIZEN ADVISORY COUNCIL THAT ENCOMPASS INDIVIDUAL MEMBERS AND SUBCOMMITTEES REPRESENTING EACH OF THE COUNTIES IN MWHC'S SERVICE AREA, AND 2) PERFORMING PERIODIC COMMUNITY NEEDS ASSESSMENTS FOR EACH COUNTY IN COLLABORATION WITH GOVERNMENT AGENCIES AND OTHER COMMUNITY ORGANIZATIONS. PART VI, LINE 3: MARY WASHINGTON HEALTHCARE AFFILIATES PROVIDE INFORMATION TO PATIENTS ABOUT ITS FINANCIAL ASSISTANCE PROGRAMS THROUGH SIGNAGE AT INTAKE AREAS, FLYERS AT ADMISSIONS, NOTICES ON BILLS AND COLLECTION STATEMENTS. FINANCIAL COUNSELORS ARE ALSO AVAILABLE TO ASSIST PATIENTS IN OBTAINING FINANCIAL ASSISTANCE. PART VI, LINE 4: MARY WASHINGTON HEALTHCARE PROVIDES EXCEPTIONAL MEDICAL SERVICES TO THE CITY OF FREDERICKSBURG AND THE SURROUNDING "COMMUNITY" THAT CONSIST OF THE PRIMARY SERVICE AREA COUNTIES OF STAFFORD, KING GEORGE, SPOTSYLVANIA, WESTMORELAND, ORANGE, PRINCE WILLIAM, AND SECONDARY SERVICE AREA COUNTIES OF MANASSAS, FAUQUIER, CULPEPER, LOUISA, ESSEX, AND RICHMOND. ESTABLISHED IN 1899, MARY WASHINGTON HOSPITAL (MWH), A 437 BED ACUTE CARE FACILITY, OFFERS COMPREHENSIVE HEALTHCARE AND MULTIPLE CENTERS OF EXCELLENCE INCLUDING CARDIOLOGY AND CARDIOVASCULAR SURGERY, PSYCHIATRY, AND WOMEN AND INFANT HEALTH. STAFFORD HOSPITAL, LLC, A 100 BED ACUTE CARE FACILITY, ALSO OFFERS COMPREHENSIVE HEALTHCARE SERVICES. BOTH MWH AND SH ARE ACCREDITED BY THE JOINT COMMISSION AND LICENSED BY THE COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH AND THE DEPARTMENT OF MENTAL HEALTH, MENTAL RETARDATION AND SUBSTANCE ABUSE SERVICES. MWH ALSO PROVIDES ADVANCE RADIATION THERAPY THROUGH THE CANCER CENTER OF VIRGINIA AND HOME HEALTH SERVICES THROUGH MARY WASHINGTON HOME HEALTH.AS OF THE MOST RECENT CENSUS WITHIN THE RESPECTIVE COUNTIES THE MAJORITY OF THE GEOGRAPHIC SERVICE AREAS IN WHICH BOTH HOSPITALS SERVE ARE MADE UP OF ABOUT 4,164.5 SQUARE MILES OF SUBURBAN AND RURAL LAND. COMMUNITY RESIDENTS IN THE PRIMARY SERVICE AREAS EARN A MEDIAN INCOME PER HOUSEHOLD OF $57,088/YEAR, WITH A COLLECTIVE AVERAGE OF 7.2% OF THE ENTIRE PRIMARY SERVICE AREA LIVING BELOW THE FEDERAL POVERTY GUIDELINES. THE PRIMARY SERVICE AREA HAS AN ESTIMATED POPULATION OF 657,718 INDIVIDUALS AND 187,202 HOUSEHOLDS. PART VI, LINE 5: MARY WASHINGTON HOSPITAL, INC. AND STAFFORD HOSPITAL, LLC EACH OPERATE AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY; HAVE OPEN MEDICAL STAFFS WITH PRIVILEGES TO ALL QUALIFIED PHYSICIANS WHO APPLY, HAVE A GOVERNING BODY WITH A MAJORITY OF INDEPENDENT TRUSTEES, AND PARTICIPATE IN MEDICAID, MEDICARE AND OTHER GOVERNMENT SPONSORED HEALTH CARE PROGRAMS. MARY WASHINGTON HEALTHCARE CLINICAL SERVICES, INC. THROUGH ITS SUBSIDIARIES, PROVIDES ANCILLARY HEALTH SERVICES INCLUDING PHYSICIAN PRACTICES, OUTPATIENT AND AMBULATORY SURGERY, AND HOME HEALTH/HOSPICE SERVICES.THE ORGANIZATION UTILIZES SURPLUS FUNDS TO EXPAND SERVICES PROVIDED TO THE COMMUNITY (IN RESPONSE TO THE COMMUNITY NEEDS ASSESSMENTS), UPGRADE FACILITIES AND EQUIPMENT TO ENHANCE CLINICAL CARE AND PHYSICIAN CONNECTIVITY TO PATIENT ELECTRONIC HEALTH RECORDS, AND HEALTH EDUCATION PROGRAMS. PART VI, LINE 6: MARY WASHINGTON HEALTHCARE AFFILIATES INCLUDE TWO (2) HOSPITALS, OTHER CLINICAL SERVICES THAT INCLUDE AN AMBULATORY SURGERY CENTER, HOSPICE/HOME HEALTH, INDEPENDENT DIAGNOSTIC TESTING FACILITIES, AND PHYSICIAN PRACTICES; TWO (2) FOUNDATIONS AND A PROPERTY DIVISION. ALL ACTIVITIES OF THIS GROUP ARE COORDINATED AND OVERSEEN BY THE PARENT'S (MARY WASHINGTON HEALTHCARE) BOARD OF TRUSTEES. THE AFFILIATED GROUP'S ACTIVITIES ARE CLOSELY PLANNED/INTEGRATED THROUGH INTERLOCKING BOARDS TO ENSURE THE MOST EFFECTIVE DELIVERY OF CARE. EACH MEMBER OF THE AFFILIATED GROUP FOCUSES EFFORTS IN ITS PARTICULAR AREA OF RESPONSIBILITY AND IS ACCOUNTABLE TO THE PARENT'S BOARD FOR ACHIEVING ITS MISSION AND GOALS FOR THE PROVISION OF HEALTH CARE. THE DIVISION OF SERVICES ABOVE ALLOWS PATIENTS TO ACCESS CARE IN THE MOST APPROPRIATE SETTING. THE GOVERNANCE OVERSIGHT PROVIDED BY THE PARENT GUARANTEES OPTIMAL COORDINATION OF THE VARIOUS SEGMENTS OF CARE AND ENSURES HIGH QUALITY SERVICE AS ECONOMICALLY AS POSSIBLE. PART VI, LINE 7, REPORTS FILED WITH STATES VA 0 CENTRAL VIRGINIA HEALTH SERVICES 1506 PALMYRA AVE FREDERICKSBURG VA 22405 540887287 501(C)(3) 5000 COMMUNITY HEALTH INTERNSHIPS: BUILDING THE FUTURE EMPLOYMENT RESOURCES INC PO BOX 801 FREDERICKSBURG VA 22401 541566468 501(C)(3) 5000 SUMMER INTERNSHIP PROGRAM RAPPAHANOCK AREA YMCA 212 BUTLER ROAD FALMOUTH VA 22405 540965826 501(C)(3) 5000 THERAPEUTIC BRIDGE PROGRAM MENTAL HEALTH AMERICA OF FREDERICKSBURG 2217 PRINCESS ANNE ST SUITE 104-1 LADYSMITH VA 22501 540678704 501(C)(3) 5000 MENTAL HEALTH FIRST AID CATHOLIC CHARITIES OF THE DIOCESE OF ARLINGTON 1101 STAFFORD AVE FREDERICKSBURG VA 22401 540515706 5000 FAMILY SERVICES FREDERICKSBURG CAROLINE CHRISTIAN HEALTH CENTER PO BOX 216 LADYSMITH VA 22501 208446785 501(C)(3) 22000 MISSION 2540 CENTRAL VIRGINIA HEALTH SERVICES 1506 PALMYRA AVE FREDERICKSBURG VA 23227 540887287 501(C)(3) 60000 CHCRR PRIMARY CARE THE DISABILITY RESOURCE CENTER OF THE RAPPAHANNOCK AREA INC 409 PROGRESS ST FREDERICKSBURG VA 22401 541687677 501(C)(3) 12500 EQUIPMENT CONNECTION FREDERICKSBURG CHRISTIAN HEALTH CENTER 1129 HEATHERSTONE DR FREDERICKSBURG VA 22407 542061482 501(C)(3) 130000 INDIGENT PROGRAM FREDERICKSBURG REGIONAL TRANSIT 1400 JEFFERSON DAVIS HIGHWAY KILMARNOCK VA 22401 546001293 55000 TRANSPORTATION ASSISTANCE FOR INDIGENT PATIENTS HOSPICE SUPPORT CARE INC 1701 FALL HILL AVE STE 109 FREDERICKSBURG VA 22401 521203673 501(C)(3) 35000 HOSPICE SUPPORT CARE MICAH ECUMENICAL MINISTRIES INC PO BOX 3277 RICHMOND VA 22402 204044884 501(C)(3) 130000 RESIDENTIAL RECOVERY PROGRAM RAPPAHANNOCK AREA HEALTH DISTRICT 608 JACKSON ST FREDERICKSBURG VA 22401 546001775 70000 COMPLICATED OBSTETRICAL AND HIGH RISK MATERNITY CARE PROGRAM RX DRUG ACCESS PARTNERSHIP 2924 EMERYWOOD PARKWAY 300 COLONIAL BEACH VA 23294 571186937 501(C)(3) 20000 501(C)(3) RXP FREDERICKSBURG COUNSELING SERVICES INC 305 HANSON AVE 140 FREDERICKSBURG VA 22401 540844464 501(C)(3) 26000 COUNSELING SERVICES FREDERICKSBURG DEPARTMENT OF SOCIAL SERVICES 608 JACKSON ST SUITE 100 COLONIAL BEACH VA 22401 546001293 29670 COMMUNITY BASED ELIGIBILITY WORKER GEORGE WASHINGTON REGIONAL COMMISSION 406 PRINCESS ANNE ST FREDERICKSBURG VA 22401 540715969 20000 LOCAL FOOD ACCESS, DISEASE PREVENTION, HEALTHY NUTRITION GUADALUPE FREE CLINIC OF COLONIAL BEACH INC PO BOX 275 COLONIAL BEACH VA 22443 510635977 501(C)(3) 55000 FREE CLINIC HAZEL HILL APT CORPORATION 223 BUTLER RD FALMOUTH VA 22405 540859802 501(C)(3) 12000 HAZEL HILL HEALTHCARE PROJECT NORTHERN NECK ALLIANCE INC PO BOX 40 COLONIAL BEACH VA 22443 541678053 501(C)(3) 9000 NORTHERN NECK HEAD START RAPPAHANNOCK AREA HEALTH DISTRICT 608 JACKSON ST FREDERICKSBURG VA 22401 546001775 43950 EVERY WOMAN'S LIFE PROGRAM, PORTABLE ULTRASOUND MACHINE UNIVERSITY OF MARY WASHINGTON 1301 COLLEGE AVE FREDERICKSBURG VA 22401 546001757 25000 BACHELOR OF SCIENCE IN NURSING COMPLETION ACTION IN COMMUNITY THROUGH SERVICE OF PRINCE WILLIAM (ACTS) PO BOX 74 DUMFRIES VA 22026 540897679 501(C)(3) 20000 ACTS HELPLINE ASSISTANCE AND OUTREACH PROJECT STAFFORD SCHOOLS HEAD STARTVPIEARLY HEAD START 610 GAYLE ST FREDERICKSBURG VA 22405 546001628 36875 CHILDREN'S INSURANCE OUTREACH AND ELIGIBILITY PROJECT RAPPAHANNOCK AREA AGENCY ON AGING 171 WARRENTON RD FREDERICKSBURG VA 22405 541027651 501(C)(3) 23000 CARE OPTIONS MAKE FOR PREFERRED SOLUTIONS STAFFORD COUNTY DEPARTMENT OF SOCIAL SERVICES PO BOX 7 FREDERICKSBURG VA 22405 546001626 21750 STAFFORD'S HEALTH INSURANCE ENROLLMENT (SHINE) PROGRAM STAFFORD JUNCTION INC 400 CHATHAM SQUARE OFFICE PARK FREDERICKSBURG VA 22405 203036072 501(C)(3) 23000 HEALTHY LIVING PAYS FREDERICKSBURG AREA REGIONAL HEALTH COUNCIL AKA-LLOYD F MOSS FREE CLINIC 1301 SAM PERRY BLVD FREDERICKSBURG VA 22401 541677934 501(C)(3) 820000 FREE HEALTH CLINIC ANNE GRAZIANI BROADDUS NURSING SCHOLARSHIP 1 1500 APRIL JETT WILLS MEMORIAL NURSING SCHOLARSHIP 1 1000 BARBARA KANE NURSING SCHOLARSHIP 1 750 CAITLIN MORRIS NURSING ONCOLOGY SCHOLARSHIP DONATED BY THE D.E.B FOUNDATION 1 1000 CHARLES M. "PETE" HEARN FELLOWSHIP 1 1500 CORA GRAVES ALLISON NURSING SCHOLARSHIP 1 1000 ELEANOR HEYCOCK PETTIT NURSING SCHOLARSHIP 1 3000 ELIZABETH BRUNELLE RYAN AND CATHERINE RYAN LEGATH SCHOLARSHIP 1 1500 FREDERICKSBURG EMERGENCY MEDICAL ALLIANCE SCHOLARSHIP 3 2250 HAROLD AND FRANCES SCHILZ NURSING SCHOLARSHIP 1 1500 HEWETSON NURSING SCHOLARSHIP 1 2500 IDA RICHARDSON JENKINS MEMORIAL SCHOLARSHIP 1 1000 JANICE HUNT SCHOLARSHIP 2 8000 JEAN C. WILLIAMS MEMORIAL NURSING SCHOLARSHIP 1 750 JEANE BULLOCK NURSING SCHOLARSHIP 1 3000 JENNIE MAE BENSON NURSING SCHOLARSHIP 1 1500 JOHN PAINTER SCHOLARSHIP 1 2000 LAURA LEIGH LUMPKIN MEMORIAL SCHOLARSHIP 1 1500 LIBBY PEARSON ENDOWED NURSING SCHOLARSHIP 1 1000 LINDA WITMER NURSING SCHOLARSHIP 1 2000 MARIE LACY ROLLINS SCHOLARSHIP 1 2000 MARY FRANCES WILLIS & JAMES G. WILLIS MEMORIAL SCHOLARSHIP 2 5000 MARY WASHINGTON HOSPITAL AUXILIARY SCHOLARSHIP 2 2000 REBECCA BENNETT NURSING SCHOLARSHIP 1 1500 SAL KIWALL MEMORIAL SCHOLARSHIP FOR CLINICAL EDUCATION 1 2000 STAFFORD HOSPITAL AUXILIARY SCHOLARSHIP 2 2000 SUE HALL NURSING SCHOLARSHIP 2 6000 THE VICKIE GRAVES PITTMAN GERMANNA NURSING SCHOLARSHIP 1 1000 WILLIAM AND VIOLA ADRIAN NURSING SCHOLARSHIP 2 4000 WILLIAM F. JACOBS, JR. SCHOLARSHIP IN HEALTHCARE ADMINISTRATION 2 4000 X 1 1 X X X X X X 0 1 0 0 0 0 0 1 0 FRED M RANKIN III PRESIDENT 0 584506 0 0 0 90450 0 7650 0 21269 0 703875 0 0 SEAN T BARDEN EXECUTIVE VP 0 346447 0 0 0 36355 0 7650 0 26387 0 416839 0 0 WALTER J KIWALL EXECUTIVE VP 0 349932 0 0 0 48357 0 7650 0 19120 0 425059 0 0 XAVIER R RICHARDSON EXECUTIVE VP 0 210454 0 10000 0 259900 0 6557 0 16908 0 503819 0 226594 J THOMAS RYAN MD EXECUTIVE VP 0 200618 0 0 0 52194 0 5345 0 7952 0 266109 0 0 RAVI MATHUR VICE PRESIDENT 0 174196 0 0 0 17120 0 5377 0 17171 0 213864 0 0 CHERYL SPRINGHORN EXECUTIVE DIRECTOR 0 142843 0 0 0 194 0 3577 0 7529 0 154143 0 0 KATHRYN S WALL EXECUTIVE VP 0 228929 0 0 0 33274 0 7303 0 10367 0 279873 0 0 MARIANNA BEDWAY SENIOR VP 216584 0 0 0 19147 0 6917 0 24565 0 267213 0 0 0 ERIC FLETCHER SENIOR VP 0 200773 0 0 0 18404 0 2164 0 9507 0 230848 0 0 WINIFRED J HAIKEY SENIOR VP 0 181740 0 0 0 35613 0 5814 0 16059 0 239226 0 0 JOYCE HANSCOME SENIOR VP 0 209062 0 10000 0 19465 0 6725 0 17695 0 262947 0 0 JAMES K VAN RENAN SENIOR VP 280793 0 0 0 29790 0 7650 0 22461 0 340694 0 0 0 CATHLEEN A YABLONSKI SENIOR VP 189426 0 0 0 18055 0 2043 0 25750 0 235274 0 0 0 REBECCA BIGONEY MD EXECUTIVE VP 302163 0 0 0 22654 0 7650 0 16594 0 349061 0 0 0 KATHLEEN BOURGAULT VICE PRESIDENT 0 173182 0 15000 0 14740 0 5494 0 17477 0 225893 0 0 EILEEN L DOHMANN RN VICE PRESIDENT 0 196333 0 0 0 15557 0 6083 0 3815 0 221788 0 0 MARIE FREDRICK VICE PRESIDENT 0 181137 0 0 0 17244 0 5982 0 19197 0 223560 0 0 JAMES SWISHER VICE PRESIDENT 0 158712 0 0 0 13049 0 4942 0 8368 0 185071 0 0 GLEN J POFFENBARGER MD NEUROSURGEON 1034186 0 101682 0 2622 0 7650 0 32610 0 1178750 0 0 0 JT SHERWOOD MD THORACIC SURGEON 749886 0 39497 0 1058 0 7650 0 32910 0 831001 0 0 0 CHRISTOS HATJIS MD PERINATOLOGISTS 613664 0 21690 0 1980 0 7650 0 23617 0 668601 0 0 0 MAURICE EGGLESTON JR MD PERINATOLOGISTS 530429 0 0 0 29658 0 7650 0 29856 0 597593 0 0 0 THERESA A CONOLOGUE MD DERMATOLOGIST 581394 0 136500 0 300 0 6435 0 24775 0 749404 0 0 0 LAWRENCE ROBERTS MD TRUSTEE (FORMER) 370910 0 40000 0 105954 0 7650 0 25795 0 550309 0 0 0 PART I, LINE 1A PART I, LINE 1A - TRUSTEES WHO ARE UNCOMPENSATED VOLUNTEERS TRAVELING FOR BUSINESS RELATED REASONS ON BEHALF OF THE ORGANIZATION ARE REIMBURSED FOR THE COST OF SPOUSAL TRAVEL. REIMBURSEMENTS PAID FOR SPOUSAL TRAVEL ARE REIMBURSED AND REPORTED AS INCOME ON A FORM 1099 IN THE YEAR PAID. EXECUTIVES WHO ARE TRAVELING FOR BUSINESS RELATED REASONS ON BEHALF OF THE ORGANIZATION ARE REIMBURSED FOR THE COST OF SPOUSAL MEALS PROVIDED AND THE AMOUNT IS REPORTED AS INCOME ON THE EXECUTIVE'S W-2. PART I, LINE 7 PART I, LINE 7 - ALL EXECUTIVES HAVE AS A PART OF THEIR COMPENSATION A VARIABLE COMPONENT SUCH THAT THEY ARE ELIGIBLE TO RECEIVE A PERCENTAGE OF THEIR BASE PAY AS AN INCENTIVE FOR THE ACHIEVEMENT OF INDIVIDUAL AND CORPORATE GOALS AND OBJECTIVES. THERE WAS NO INCENTIVE COMPENSATION PAID IN 2013. SCHEDULE J - PART I TRUSTEES WHO ARE UNCOMPENSATED VOLUNTEERS TRAVELING FOR BUSINESS RELATED REASONS ON BEHALF OF THE ORGANIZATION ARE REIMBURSED FOR THE COST OF SPOUSAL TRAVEL. REIMBURSEMENTS PAID FOR SPOUSAL TRAVEL ARE REIMBURSED AND REPORTED AS INCOME ON A FORM 1099 IN THE YEAR PAID. EXECUTIVES WHO ARE TRAVELING FOR BUSINESS RELATED REASONS ON BEHALF OF THE ORGANIZATION ARE REIMBURSED FOR THE COST OF SPOUSAL MEALS PROVIDED AND THE AMOUNT IS REPORTED AS INCOME ON THE EXECUTIVE'S W-2 SCHEDULE J, PART II, COLUMN B DISCLOSURE: PRIMARILY REPRESENTS 457(F) DISTRIBUTIONS. A ECONOMIC DEVELOPMENT AUTHORITY 541244413 852431AQ8 2006-12-01 125000000 BUILD STAFFORD HOSPITAL FACILITY 0 0 0 B LYNCHBURG IDA-VHA POOLED FINANCING 2007-12-28 14000000 ACQUISITION OF MWH EQUIPMENT 0 0 0 C CITY OF FREDERICKSBURG ECONOMIC DEV AUTH 521303430 355849AS9 2007-05-10 81860000 REFUNDING OF 1996 MWH BONDS 0 0 0 D CITY OF FREDERICKSBURG ECONOMIC DEV AUTH 521303430 2011-07-12 30000000 BUILD AND EQUIP CANCER CENTER 0 0 0 A 132581641 959500 131622141 2008 0 0 1 1 B 14000000 126000 13874000 2007 0 0 1 1 C 86868312 583010 86285302 2007 1 0 1 1 D 30210000 210000 30000000 2011 0 0 1 1 A 0 0 1 1 0 1 0 1 B 0 0 1 1 0 0.00390 0.00390 1 0 1 D 0 0 1 1 1 1 1 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 D 1 A ECONOMIC DEVELOPMENT AUTHORITY 521303430 355850AC2 2013-11-01 30405000 REFUNDING OF SERIES 2011 BOND 0 0 0 A 30405000 576747 29828253 2013 1 0 1 1 A 0 0 1 1 1 1 1 0 1 A 0 1 0 0 1 0 0 0 1 A 1 STAFFORD MEDICAL OFFICE MANAGEMENT CONTRACT 1555573 RENTAL, MEDICAL OFFICE 0 HEALTH TECH RESOURCES 5% TRUSTEE OWNERSHIP 724244 RENTAL 0 PERMA TREAT PEST CONTROL INC BOARD MEMBER OWNS CO. 57589 PEST CONTROL SERVICES 0 X 12332 FMV X GIFT CARDS AN 55 20114 FMV X ADVERTISING B 1 500 FMV 0 1 0 PART I, LINE 32B: THE GROUP HAS A POLICY REQUIRING REVIEW AND BOARD APPROVAL OF ALL NON-STANDARD CONTRIBUTIONS. FORM 990, PART V, Q 7G AND 7H QUESTIONS 7G AND 7H DO NOT APPLY TO THE ORGANIZATION BECAUSE THE ORGANIZATION DID NOT HAVE CONTRIBUTIONS OF QUALIFIED INTELLECTUAL PROPERTY OR CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES DURING THE YEAR. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE MARY WASHINGTON HEALTHCARE GROUP ALL HAVE ONE SOLE MEMBER, ITS PARENT MARY WASHINGTON HEALTHCARE (MWHC). FORM 990, PART VI, SECTION A, LINE 7A MARY WASHINTON HEALTHCARE (MWHC) HAS THE POWER TO APPOINT BOARD OF TRUSTEES FOR THE GROUP. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS OF THE MARY WASHINGTON HEALTHCARE GROUP ALL HAVE ONE SOLE MEMBER, ITS PARENT MARY WASHINGTON HEALTHCARE (MWHC). MWHC HAS RESERVED CERTAIN POWERS TO ITSELF WITHIN EACH OF ITS SUBSIDIARIES' ORGANIZING DOCUMENTS. THESE RESTRICTIONS INCLUDE AMENDING THE GOVERNING DOCUMENTS, BUDGETING, EXPENDITURES OVER CERTAIN THRESHOLDS. FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT COMPLETES A DRAFT OF THE FORM 990 FOR THE MARY WASHINGTON HEALTHCARE GROUP. AT THAT TIME THE RETURN IS SUBMITTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD FOR REVIEW AND ACCEPTANCE. THE FORM 990 IS ALSO MADE AVAILABLE TO THE BOARD OF TRUSTEES THROUGH THE BOARD WEBSITE FOR FURTHER REVIEW. FORM 990, PART VI, SECTION B, LINE 12C EVERY TRUSTEE, AND EXECUTIVE MEMBER OF MANAGEMENT IS REQUIRED TO DISCLOSE ANY AND ALL POSSIBLE CONFLICTS OF INTERESTS. THE DISCLOSURES ARE MADE ANNUALLY AND SUBMITTED TO THE MWHC CHIEF AUDIT EXECUTIVE (CAE). THE CAE THEN PRESENTS ALL CONFLICTS TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES. THE CHAIRMAN OF THE AUDIT AND COMPLIANCE COMMITTEE REPORTS ALL CONFLICTS TO THE FULL BOARD. CONFLICTS ARE CONTINUALLY AND ACTIVELY MANAGED. AT EACH MEETING, THE CHARI ASKS IF ANYONE AT THE MEETING HAS A CONFLICT TO DISCLOSE. INDIVIDUALS WITH CONFLICTS DISCLOSE THEIR CONFLICTS AND THE RELATED TOPIC. THE INDIVIDUAL THEN RECUSES HIM/HERSELF FROM ANY DECISION RELATED TO THAT TOPIC. THE CONFLICT OF INTERESTS POLICY IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 MARY WASHINGTON HEALTHCARE UTILIZES AN EXECUTIVE COMPENSATION COMMITTEE WITH THE PURPOSE AND AUTHORITY TO ESTABLISH PROCESSES TO ENSURE FAIR AND COMMERCIALLY REASONABLE COMPENSATION FOR THE CEO AND EXECUTIVE LEADERSHIP. IN ORDER TO ENSURE COMPENSATION PAID IS SET AT FAIR MARKET VALUE, THE EXECUTIVE COMPENSATION COMMITTEE UTILIZES COMPENSATION SURVEY DATA, FORM 990 INFORMATION FROM COMPARABLE HEALTH SYSTEMS, AND THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT. SUCH INDEPENDENT THIRD PARTY DATA POINT PROVIDES ASSURANCE THAT EXECUTIVE COMPENSATION IS COMMERCIALLY REASONABLE AND AT A FAIR MARKET VALUE. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIALS STATEMENTS ARE POSTED ON THE MARY WASHINGTON HEALTHCARE WEBSITE FOR PUBLIC VIEW. FORM 990, PART IX, LINE 11G CONTRACT PERSONNEL: PROGRAM SERVICE EXPENSES 6,020,918. MANAGEMENT AND GENERAL EXPENSES 165,838. FUNDRAISING EXPENSES 1,238. TOTAL EXPENSES 6,187,994. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 43,892,039. MANAGEMENT AND GENERAL EXPENSES 1,208,948. FUNDRAISING EXPENSES 9,022. TOTAL EXPENSES 45,110,009. BILLING AND COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 2,148,854. MANAGEMENT AND GENERAL EXPENSES 59,187. FUNDRAISING EXPENSES 442. TOTAL EXPENSES 2,208,483. ASP SERVICES: PROGRAM SERVICE EXPENSES 164,067. MANAGEMENT AND GENERAL EXPENSES 4,519. FUNDRAISING EXPENSES 34. TOTAL EXPENSES 168,620. MISCELLANEOUS SERVICES: PROGRAM SERVICE EXPENSES 5,046,940. MANAGEMENT AND GENERAL EXPENSES 139,011. FUNDRAISING EXPENSES 1,037. TOTAL EXPENSES 5,186,988. STORAGE: PROGRAM SERVICE EXPENSES 123,183. MANAGEMENT AND GENERAL EXPENSES 3,393. FUNDRAISING EXPENSES 25. TOTAL EXPENSES 126,601. WASTE DISPOSAL: PROGRAM SERVICE EXPENSES 977,863. MANAGEMENT AND GENERAL EXPENSES 26,934. FUNDRAISING EXPENSES 201. TOTAL EXPENSES 1,004,998. MANAGEMENT CONTRACTS: PROGRAM SERVICE EXPENSES 14,554,722. MANAGEMENT AND GENERAL EXPENSES 400,891. FUNDRAISING EXPENSES 2,992. TOTAL EXPENSES 14,958,605. FORM 990, PART XI, LINE 9: RELIEF FROM AFFILIATE LOANS -14,209,786. LOSS ON UNCOLLECTED PLEDGES -1,046,020. LOSS FROM RELATED AFFILIATES 8,076,070. FORM 990, PART XII, LINE 2C THE GROUP RETURN IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MWHC. CONSISTENT WITH PRIOR YEARS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AUDITORS RESTS WITH THE AUDIT & COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES. FORM 990, PART V, Q2A NO ENTITY WITHIN THE GROUP FILES W-2S WITH THE IRS. ALL PAYROLL IS PAID THROUGH AN AGENCY AGREEMENT WITH MARY WASHINGTON HEALTCARE, THE PARENT ORGANIZATION. MARY WASHINGTON HEALTHCARE FILES ALL W-2S. 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