Chesapeake Hospital Corporation: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- Chesapeake Hospital Corporation (EIN 23-7424835)
- Tax period
- 2009-04-01 to 2010-03-31
- Filed
- 2011-02-10
- IRS object ID
- 201110419349300331
- Schema version
- 2009v1.7
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-02-10T12:01:08-06:00 | Timestamp |
| Tax Period End Date | 2010-03-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WITT MARES PLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 TOWN CENTER DRIVE SUITE 900 | AddressLine1 |
| City | NEWPORT NEWS | City |
| State | VA | State |
| ZIP Code | 236064287 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-04-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237424835 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Chesapeake Hospital Corporation | BusinessNameLine1 |
| Business Name Line2 | DBA Rappahannock General Hospital | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHES | NameControl |
| Phone | 8044358582 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1449 | AddressLine1 |
| City | Kilmarnock | City |
| State | VA | State |
| ZIP Code | 22482 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | James M Holmes Jr | Name |
| Title | President | Title |
| Phone | 8044358582 | Phone |
| Date Signed | 2011-02-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | THOMAS R BROOKS | Name |
| Phone | 7578731587 | Phone |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | rappahanock general hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | James M Holmes Jr | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1449 | AddressLine1 |
| City | Kilmarnock | City |
| State | VA | State |
| ZIP Code | 22482 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 36317989 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.rgh-hospital.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1977 | YearFormation |
| State Legal Domicile | VA | StateLegalDomicile |
| Activity Or Mission Description | The organization operates an acute care general hospital. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 428 | TotalNbrEmployees |
| Total Nbr Volunteers | 115 | TotalNbrVolunteers |
| Total Gross UBI | 3648 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 702423 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 521551 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 32746167 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 35664123 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 58726 | InvestmentIncomePriorYear |
| Investment Income Current Year | 25326 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 234559 | OtherRevenuePriorYear |
| Other Revenue Current Year | -35697 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 33741875 | TotalRevenuePriorYear |
| Total Revenue Current Year | 36175303 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 18249769 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 18090632 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 74832 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 16598671 | OtherExpensePriorYear |
| Other Expenses Current Year | 17607577 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 34848440 | TotalExpensesPriorYear |
| Total Expenses Current Year | 35698209 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1106565 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 477094 | RevenuesLessExpensesCY |
| Total Assets BOY | 25138829 | TotalAssetsBOY |
| Total Assets EOY | 26378535 | TotalAssetsEOY |
| Total Liabilities BOY | 9140207 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9878939 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 15998622 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 16499596 | NetAssetsOrFundBalancesEOY |
| Mission Description | The organization operates an acute care general hospital. the hospital has a community based board of directors, has a open medical staff, operates an emergency room providing care to all regardless of ability to pay, and provides non-emergency services to any with the ability to pay including medicare and medicaid covered individuals. the organization is dedicated to the provision of quality, compassionate care to all patients in the most cost effective manner. this will be accomplished through the most effective use of available resources and will reflect ethical decisions, including the effective management of pain, made jointly by the patients, the family, and health care professionals involved in his care. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 31033356 | Expense |
| Revenue | 35656385 | Revenue |
| Description | rappahanock general hospital is the only provider of inpatient and outpatient acute care services within a five county area. the hospital is licensed to operate 76 beds, including 48 medical/surgical beds, 7 intensive/critical care beds, 12 telemetry care beds and 10 psych beds. the hospital also offers our community major diagnostic and treatment capabilities; clinical and blood bank laboratory services; radiology services including diagnostic x-ray, digital mammography, digital flouroscopy, bone densitometry, arteriography, angiography with digital subtraction, noninvasive vascular laboratory, ultrasonography, nuclear medicine, mri, ct scanning, inpatient and same day surgery; respiratory therapy; physical therapy; home health, lithotripsy; and radiation therapy. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 375009 | Expense |
| Description | chesapeake hospital corporation provided numerous services for the community which included, health fairs for different civic groups in the five county areas. the services offered by the hospital range from cholesterol, blood pressure, glucose, literature and cancer information and/or screenings. community benefits are provided through many reduced price services and free programs offered throughout the year based on activities and services which the hospital believes will serve a bona fide community health need. this includes the cancer treatment and education center support groups and education for patients and their families. the emergency department offers cpr, heart saver courses, and pediatric basis life support. we also sponsor a diabetic education course for people with diabetes and their families. the organization also volunteers staff and facilities for free sports physicals for secondary students in the area. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 31408365 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 31 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 428 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | 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 | Bernie Lockstampfor Jr | NamePerson |
| Telephone Number | 8044358000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 harris road | AddressLine1 |
| City | kilmarnock | City |
| State | VA | State |
| ZIP Code | 22482 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| James M Holmes Jr | |||||||
| president | 40.00 | X | X | 0 | 280037 | 16577 | |
| Matthew Vogel MD | |||||||
| head of medical staff | 40.00 | X | 1550 | 179982 | 11344 | ||
| J Randy Hester | |||||||
| sr vp-operations/secreta | 40.00 | X | X | 600 | 215629 | 14995 | |
| Bernard P Lockstampfor J | |||||||
| vp finance-treasurer | 40.00 | X | X | 750 | 169128 | 13788 | |
| James Carter Jr | |||||||
| voting board member | 1.00 | X | 0 | 0 | 1400 | ||
| Jeff Chase Jr | |||||||
| voting board member | 1.00 | X | 1150 | 0 | 0 | ||
| David H Charlton | |||||||
| voting board member | 1.00 | X | 0 | 0 | 600 | ||
| Fredrick Cole | |||||||
| voting board member | 1.00 | X | 800 | 0 | 0 | ||
| Elizabeth Crowther | |||||||
| voting board member | 1.00 | X | 1200 | 0 | 0 | ||
| Edward P Harrow Jr | |||||||
| voting board member | 1.00 | X | 0 | 0 | 700 | ||
| B H Hubbard III | |||||||
| chairman of the board | 1.00 | X | 0 | 0 | 1600 | ||
| Garfield Parker | |||||||
| voting board member | 1.00 | X | 600 | 0 | 0 | ||
| Wayne Penick | |||||||
| voting board member | 1.00 | X | 0 | 0 | 1300 | ||
| Stephen Whiteway | |||||||
| voting board member | 1.00 | X | 0 | 0 | 0 | ||
| Emerson L Gravatt | |||||||
| vp human resource | 40.00 | X | 800 | 137970 | 11389 | ||
| Ann Gumina | |||||||
| vp nursing | 40.00 | X | 1050 | 125854 | 4872 | ||
| John Headley | |||||||
| controller | 40.00 | X | 1150 | 100221 | 11538 | ||
| Kevin McGrath MD | |||||||
| Physician | 40.00 | X | 0 | 0 | 0 | ||
| Alice Blackstone | |||||||
| Voting board member | 1.00 | X | 0 | 0 | 0 | ||
| John Deschamps | |||||||
| voting board member | 40.00 | X | 0 | 0 | 0 | ||
| Richard Steelman | |||||||
| Voting Board Member | 1.00 | X | 0 | 0 | 0 | ||
| John B Dorsey | |||||||
| voting board member | 1.00 | X | 0 | 0 | 0 | ||
| Paul Sutherland MD | |||||||
| Physician | 40.00 | 305216 | 0 | 16795 | X | ||
| Virginia Gale | |||||||
| Physician | 40.00 | 226299 | 0 | 15435 | X | ||
| Stephen Perkins | |||||||
| Physician | 40.00 | 254402 | 0 | 16459 | X | ||
| James Bryant | |||||||
| Physician | 40.00 | 196429 | 0 | 11065 | X | ||
| Barbara Perona | |||||||
| Anesthesiologist | 40.00 | 370002 | 0 | 10579 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1361998 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1208821 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 160436 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| chesapeake health services | |||||
| po box 1328 | kilmarnock | VA | 22482 | management services | 1142560 |
| diamond healthcare corp | |||||
| po box 85050 | richmond | VA | 23285 | program management service | 903448 |
| chas lunsford | |||||
| po box 2571 | roanoke | VA | 24010 | general insurance | 551450 |
| Dr Richard Carpenter | |||||
| PO Box 3391 | Martinsville | VA | 241153391 | health insurance | 120000 |
| jackson & coker | |||||
| po box 277638 | atlanta | GA | 30384 | placement services | 117876 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Related Organizations | 521551 | RelatedOrganizations |
| Total Contributions | 521551 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net Patient Revenue | 623000 | 30192879 | 30192879 |
| Physician Practice Ser | 623000 | 5098277 | 5098277 |
| Cafeteria | 900099 | 214940 | 214940 |
| collection fees | 900099 | 82204 | 82204 |
| Other Revenue | 623000 | 68085 | 68085 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7738 | TotalRevenueColumn |
| Unrelated Business Revenue | 7738 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 35664123 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14326 | TotalRevenueColumn |
| Exclusion | $14,326 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 106989 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 142686 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -35697 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -35697 | TotalRevenueColumn |
| Unrelated Business Revenue | -4090 | UnrelatedBusinessRevenue |
| Exclusion | -$31,607 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 11000 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 11000 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11000 | TotalRevenueColumn |
| Exclusion | $11,000 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 36175303 | TotalRevenueColumn |
| Related Or Exempt Function Income | 35656385 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 3648 | UnrelatedBusinessRevenue |
| Exclusion | -$6,281 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11633 | Total |
| Management And General | 11633 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15090493 | Total |
| Program Services | 13528126 | ProgramServices |
| Management And General | 1562367 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 229318 | Total |
| Program Services | 229318 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1682077 | Total |
| Program Services | 1682077 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1077111 | Total |
| Program Services | 1077111 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1060720 | Total |
| Management And General | 1060720 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69417 | Total |
| Management And General | 69417 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110000 | Total |
| Management And General | 110000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3196931 | Total |
| Program Services | 2713547 | ProgramServices |
| Management And General | 483384 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27989 | Total |
| Management And General | 27989 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34171 | Total |
| Program Services | 34171 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 664011 | Total |
| Program Services | 664011 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 127629 | Total |
| Program Services | 100911 | ProgramServices |
| Management And General | 26718 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 223992 | Total |
| Program Services | 223992 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1201188 | Total |
| Program Services | 1201188 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 401047 | Total |
| Program Services | 401047 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Supplies | 6306639 | 6216117 | 90522 |
| Bad Debts | 2464842 | 2464842 | |
| Repairs & Rentals | 1379840 | 717701 | 662139 |
| Dues & Subscriptions | 173192 | 70976 | 102216 |
| Recruitment | 66885 | 66885 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 99084 | Total |
| Program Services | 16345 | ProgramServices |
| Management And General | 7907 | ManagementAndGeneral |
| Fundraising | 74832 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35698209 | Total |
| Program Services | 31408365 | ProgramServices |
| Management And General | 4215012 | ManagementAndGeneral |
| Fundraising | 74832 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 259258 | BOY |
| EOY | 399150 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9604714 | BOY |
| EOY | 10333818 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1016494 | BOY |
| EOY | 953599 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 372636 | BOY |
| EOY | 565034 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 30780037 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 21483187 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9120156 | BOY |
| EOY | 9296850 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49669 | BOY |
| EOY | 49669 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4715902 | BOY |
| EOY | 4780415 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25138829 | BOY |
| EOY | 26378535 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3262172 | BOY |
| EOY | 3777948 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 342796 | BOY |
| EOY | 1430534 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5535239 | BOY |
| EOY | 4670457 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9140207 | BOY |
| EOY | 9878939 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15923212 | BOY |
| EOY | 16400306 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75410 | BOY |
| EOY | 99290 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15998622 | BOY |
| EOY | 16499596 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25138829 | BOY |
| EOY | 26378535 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $7,392 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 7392 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | 24% of vhha and aha dues paid by the hospital are attributable to lobbying. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1045796 | OtherCostOrOtherBasis |
| Book Value | 1045796 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10649099 | OtherCostOrOtherBasis |
| Depreciation | 6412588 | Depreciation |
| Book Value | 4236511 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 115110 | OtherCostOrOtherBasis |
| Depreciation | 97440 | Depreciation |
| Book Value | 17670 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 18136493 | OtherCostOrOtherBasis |
| Depreciation | 14425563 | Depreciation |
| Book Value | 3710930 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 833539 | OtherCostOrOtherBasis |
| Depreciation | 547596 | Depreciation |
| Book Value | 285943 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 9296850 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (7 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| assets whose use is limited | 127147 |
| due from cps | 1641 |
| due from cmg | 4032291 |
| due from rghf and auxillary | 371269 |
| Deferred financing costs | 85579 |
| Due from CHS | 145140 |
| Other Receivables | 17348 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 4780415 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Note payable-siemens | $1,108,007 |
| due to chs | $3,562,450 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4670457 | TotalOfAmounts |
| Total Revenue | 36175303 | TotalRevenue |
| Total Expenses | 35698209 | TotalExpenses |
| Excess Or Deficit For Year | 477094 | ExcessOrDeficitForYear |
| Other | $23,880 | OtherAmount |
| Total Adjustments | 23880 | TotalAdjustments |
| Excess Or Deficit Per FS | 500974 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 36317989 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 142686 | OtherRevenues |
| Revenue Not Rptd F990 | 142686 | RevenueNotRptdF990 |
| Revenue Subtotal | 36175303 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 36175303 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 35840895 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 142686 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 142686 | ExpensesNotRptdF990 |
| Expenses Subtotal | 35698209 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 35698209 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part X: | Description of Uncertain Tax Positions Under FIN 48: | Schedule D Line 2. RHS, the Hospital, CMG and the Foundation are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and are exempt from Federal income taxes on related income pursuant to Section 501(a) of the Code. CPS is a wholly-owned, taxable subsidiary of RHS. RHS is subject to income taxes on profits, if any, from CPS. Effective 2009, FASB Accounting Standards Codification 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. RHS's management has evaluated the impact of the standard to its financial statements, but does not anticipate a material effect. RHS is not aware of any material uncertain tax positions and has not accrued the effect of any uncertain tax positions as of March 31, 2010. |
| Part XI, Line 8 - Other Adjustments: | Donations temporarily restricted net assets: 38847. Direct Payments temporarily restricted net assets: -15541. Interest income temporarily restricted net assets : 574. | |
| Part XII, Line 2d - Other Adjustments: | rental expenses: 142686. | |
| Part XIII, Line 2d - Other Adjustments: | rental expenses: 142686. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 532403 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 532403 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01490 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 107166 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 107166 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00300 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 639569 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 639569 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01790 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 375009 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 375009 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01050 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 375009 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 375009 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01050 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1014578 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1014578 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02840 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 838 | PersonsServed |
| Total Community Building Expense | 375009 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 375009 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.01050 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 838 | PersonsServed |
| Total Community Building Expense | 375009 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 375009 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.01050 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,367,987 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 16058649 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 17554252 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1495603 | 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 | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Chesapeake Health Services | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | Management services | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.00000 | OrganizationProfitOrOwnership |
| Officers Etc Profit Or Ownership | 0.00000 | OfficersEtcProfitOrOwnership |
| Physicans Profit Or Ownership | 0.00000 | PhysicansProfitOrOwnership |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | rappahanock general hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 harris road | AddressLine1 |
| City | kilmarnock | City |
| State | VA | State |
| ZIP Code | 22482 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: Determination of charity will be made through knowledge of the medical and social-economic situation and its various financial implications; an interview with patient (responsible party) and investigation of financial resources. The decision will be based on cooperative medical, social service, and administrative judgment. | IncomeBasedCriteria |
| Costing Method Used | Part I, Line 7: Costing method is overall cost to charge ratio from Medicare Cost Report. No bad debt is included in the calculation. | CostingMethodUsed |
| Bad Debt Footnote | Part III, Line 4: Patient Accounts Receivable are recorded at established billing rates when patient services are rendered. Provisions for uncollectible accounts and contractual adjustments are recorded as deductions from patient accounts receivable to reduce recorded amounts to net realizable value. Contractual adjustments represent the difference between established billing rates and amounts reimbursed (principally from federal and state governments under Medicare and Medicaid and other commercial insurers including Anthem). | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: Costing method is cost to charge ratio from Medicare Report. Shortfall of medicare payments received directly benefit the community citizens. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: Patients who qualify for charity care or financial assistance are asked to meet with a financial counselor to determine financial need. If charity guidelines are met, then patient accounts are adjusted accordingly. | DebtCollectionPolicy |
| Number Of Facility Type Expln | Part V: This organization has no other facilities other than the one listed on part V. | NumberOfFacilityTypeExpln |
| General Explanation | Schedule H, Part I, Line 6a:The organization files a community benefit report in Virginia. | GeneralExplanation |
| Needs Assessment | Part VI, Line 2: The organization looks at the area's population, age, income and financial needs of the area. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: The hospital has a charity policy, financial counseling program and brochures provided to patients to inform and educate patients and their families about eligibility for assistance. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: The organization serves the Middle Peninsula-Northern Neck Counties of Virginia. These counties include:County Population Sq. Miles 65 Plus Per capita incomeLancaster 11,567 231 28.5% $24,663Northumberland 12,259 286 26.2% $22,917Richmond Co. 8,809 216 17.7% $16,675Westmoreland 16,718 253 19.0% $19,473Mathews 9,207 252 21.6% $23,610Middlesex 10,731 130 25.7% $22,708 | CommunityInformation |
| Community Building Activities | Part VI, Line 5: The organization supports the loss incurred by its sister company Chesapeake Medical Group (CMG). CMG represents several groups of physicians including Family Practice, Pediatrics, GYN, surgery and others, that were not able to survive without the assistance from RGH. CMG has the only pediatric services in the area. CMG provides physician care regardless of the insurance while other physicians in the area no longer accept new Medicaid patients. CMG also provides coverage for those patients with no insurance. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: Chesapeake hospital corporation provided numerous services for the community which included, health fairs for different civic groups in the five county areas. the services offered by the hospital range from cholesterol, blood pressure, glucose, literature and cancer information and/or screenings. community benefits are provided through many reduced price services and free programs offered throughout the year based on activities and services which the hospital believes will serve a bona fide community health need. this includes the cancer treatment and education center support groups and education for patients and their families. the emergency department offers cpr, heart saver courses, and pediatric basis life support. we also sponsor a diabetic education course for people with diabetes and their families. the organization also volunteers staff and facilities for free sports physicals for secondary students in the area. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: As a not-for-profit healthcare organization, it is the purpose and responsibility to provide outstanding care to everyone who needs it, regardless of their ability to pay. RGH's operations are significantly impacted by charity care and the Medicare/Medicaid shortfalls. In addition to the essential health care services provided that Rappahannock Health System (RHS)provides to our community, the Heath System has a significant economic impact on our community. RHS is the largest employer in Lancaster county, providing jobs for more than 500 people who live in Kilmarnock and the surrounding areas. RHS has several affiliates. One is the Chesapeake Medical Group which provides quality, compassionate, cost effective primary medical care services to the Kilmarnock area. Chesapeake Health Services manages the various entities. Chesapeake Pharmacy Services, Inc. provides pharmacy services for the area while Rappahannock General Hospital Foundation assists in providing fundraising abilities. | AffiliatedHealthCareSystem |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| James M Holmes Jr | |||||||||||||
| 0 | 279071 | 0 | 0 | 0 | 966 | 0 | 4937 | 0 | 11040 | 0 | 296014 | 0 | 0 |
| Matthew Vogel MD | |||||||||||||
| 1550 | 179982 | 0 | 0 | 0 | 0 | 0 | 5399 | 0 | 5945 | 1550 | 191326 | 0 | 0 |
| J Randy Hester | |||||||||||||
| 600 | 213823 | 0 | 0 | 0 | 1806 | 0 | 4577 | 0 | 10018 | 600 | 230224 | 0 | 0 |
| Bernard P Lockstampfor Jr | |||||||||||||
| 750 | 168162 | 0 | 0 | 0 | 966 | 0 | 4044 | 0 | 9744 | 750 | 182916 | 0 | 0 |
| Emerson L Gravatt | |||||||||||||
| 800 | 135198 | 0 | 0 | 0 | 2772 | 0 | 3141 | 0 | 8248 | 800 | 149359 | 0 | 0 |
| Paul Sutherland MD | |||||||||||||
| 305216 | 0 | 0 | 0 | 0 | 0 | 6367 | 0 | 10428 | 0 | 322011 | 0 | 0 | 0 |
| Virginia Gale | |||||||||||||
| 226299 | 0 | 0 | 0 | 0 | 0 | 5471 | 0 | 9964 | 0 | 241734 | 0 | 0 | 0 |
| Stephen Perkins | |||||||||||||
| 254402 | 0 | 0 | 0 | 0 | 0 | 6253 | 0 | 10206 | 0 | 270861 | 0 | 0 | 0 |
| James Bryant | |||||||||||||
| 196429 | 0 | 0 | 0 | 0 | 0 | 5123 | 0 | 5942 | 0 | 207494 | 0 | 0 | 0 |
| Barbara Perona | |||||||||||||
| 370002 | 0 | 0 | 0 | 0 | 0 | 6865 | 0 | 3714 | 0 | 380581 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part III | ReturnReference |
| Explanation | portion of physician contracts payments are variable based on cash collect | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|
| northern neck state bank | ||
| See Schedule O | bank accts | 0 |
| chesapeake bank | ||
| See Schedule O | loans | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part V, line 7g | The organization did not receive any contributions of qualified intellectual property. | |
| Form 990, Part VI, Section A, line 2 | See schedule L detail for business relationships. | |
| Form 990, Part VI, Section B, line 11 | When the completed form 990 comes back from the outside tax preparers, it is reviewed by the chesapeake health services (chs) vice president-finance or chs controller for accuracy. once it is determined to be the final draft, the package is given to the president. The president will schedule a meeting of the chs board's executive committee which consists of the chairman-chesapeake health services board, chairman-chesapeake hospital corporation board, finance committee chairman, and a member of the chs board. the executive committee reviews the return in detail and recommends that the board of directors accept it. at the next schedules rgh board meeting (or a called meeting if necessary to mail the return on time). the form 990 is discussed with copies being available for any other b0ard member to review. once this meeting and approval of the form 990 have taken place, the return is signed and e filed. | |
| Form 990, Part VI, Section B, line 12c | all documents are available to the public for review in administration during regular business hours, monday through friday. all board members sign a conflict of interest statement once a year stating they will make the board aware if there is a conflict of interest. | |
| Form 990, Part VI, Section B, line 15 | the chesapeake health services (chs) executive salary committee of the board of directors meets at least annually to review the compensation of the ceo, officers and other key employees. these are shared positions with chesapeake health services, rappahannock general hospital, rappahannock general hospital foundation and chesapeake medical group. the chs president will schedule a meeting of the board's executive salary committee which consists of the chairman-chesapeake health services board, chairman-chesapeake hospital corporation board, finance committee chairman, and a member of the chs board. the chs executive committee reviews the current salary and benefits of each officer and key employee and recommends adjustments as necessary. their review consists of comparing the salary and benefits to a periodic survey done by an outside third party or hospital related circulations. if it has been determined that no increases will be given in the fiscal year, no meeting will take place. | |
| Form 990, Part VI, Section C, line 19 | All governing documents, conflict of interest policy, and financial statements are made available upon request in the Administration office. | |
| Form 990, Part XI, Line 2c | The organization does have a committee who assumes the responsibility for oversight of the audit and the process remains unchanged during the year. | |
| Form 990 Schedule L | c wayne penick is a chesapeake hospital corporation board member and board vice chairman and is employed by northern neck state bank which chesapeake hospital corporation does business with. James m holmes jr is an officer of chesapeake hospital corporation and is board member of chesapeake bank. | Business Relationships |
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 | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| chesapeake health services | |||||||||
| 101 harris road | kilmarnock | VA | 22482 | 541513371 | parent | VA | 501(c)(3) | 11 | N/A |
| rappahanock general hosp fnd | |||||||||
| 101 harris road | kilmarnock | VA | 22482 | 541210450 | supporting organization | VA | 501(c)(3) | 11 | N/A |
| chesapeake medical group | |||||||||
| 101 harris road | kilmarnock | VA | 22482 | 541857174 | healthcare services | VA | 501(c)(3) | 11 | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | chesapeake pharmacy services | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 harris road | AddressLine1 |
| City | kilmarnock | City |
| State | VA | State |
| ZIP Code | 22482 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541822516 | EIN |
| Primary Activity | pharmacy | PrimaryActivity |
| Legal Domicile State | VA | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (14 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| chesapeake health services | |
| L | 995317 |
| chesapeake medical group | |
| P | 388393 |
| chesapeake pharmacy services inc | |
| P | 24008 |
| rappahannock general hospital foundation | |
| B | 411872 |
| Chesapeake Health Services | |
| R | 141000 |
| chesapeake medical group | |
| D | 4032291 |
| chesapeake pharmacy services inc | |
| D | 1641 |
| Chesapeake Health Services | |
| E | 145140 |
| rappahannock general hospital foundation | |
| D | 316869 |
| Chesapeake Health Services | |
| E | 3562450 |
| chesapeake medical group | |
| I | 45600 |
| chesapeake pharmacy services inc | |
| I | 9600 |
| chesapeake medical group | |
| K | 29336 |
| chesapeake medical group | |
| L | 221999 |