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FHI SERVICES: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
FHI SERVICES (EIN 54-0573701)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-15
IRS object ID
201112279349301921
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-08-15T09:49:30-04:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1COHEN RUTHERFORD KNIGHT PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line16903 ROCKLEDGE DRIVE SUITE 500AddressLine1
CityBETHESDACity
StateMDState
ZIP Code208171800ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN540573701EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1The Fauquier Hospital IncorporatedBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFAUQNameControl
Phone5403165000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 Hospital DriveAddressLine1
CityWarrentonCity
StateVAState
ZIP Code20186ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRodger H BakerName
TitlePresident/CEOTitle
Phone5403165000Phone
Date Signed2011-08-11DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone3018281008Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRodger H BakerNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1500 Hospital DrAddressLine1
CityWarrentonCity
StateVAState
ZIP Code20186ZIPCode
FieldValueIRS element (for citing)
Gross Receipts124337070GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.fauquierhealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1954YearFormation
State Legal DomicileVAStateLegalDomicile
Activity Or Mission DescriptionOUR MISSION IS TO RESTORE, PROMOTE AND MAINTAIN THE HEALTH OF THE COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees1163TotalNbrEmployees
Total Nbr Volunteers350TotalNbrVolunteers
Total Gross UBI57226TotalGrossUBI
Net Unrelated Business Txbl Income-129221NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year125198331ProgramServiceRevenuePriorYear
Program Service Revenue CY121835973ProgramServiceRevenueCY
Investment Income Prior Year7098892InvestmentIncomePriorYear
Investment Income Current Year2283146InvestmentIncomeCurrentYear
Other Revenue Prior Year291258OtherRevenuePriorYear
Other Revenue Current Year217951OtherRevenueCurrentYear
Total Revenue Prior Year132588481TotalRevenuePriorYear
Total Revenue Current Year124337070TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year75000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year62764336SalariesEtcPriorYear
Salaries Etc Current Year59438034SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year59482380OtherExpensePriorYear
Other Expenses Current Year59422697OtherExpensesCurrentYear
Total Expenses Prior Year122321716TotalExpensesPriorYear
Total Expenses Current Year118860731TotalExpensesCurrentYear
Revenues Less Expenses Prior Year10266765RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5476339RevenuesLessExpensesCY
Total Assets BOY199938751TotalAssetsBOY
Total Assets EOY204784691TotalAssetsEOY
Total Liabilities BOY94232017TotalLiabilitiesBOY
Total Liabilities EOY92882608TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY105706734NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY111902083NetAssetsOrFundBalancesEOY
Mission DescriptionOUR MISSION IS TO RESTORE, PROMOTE AND MAINTIAN THE HEALTH OF THE COMMUNITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense109007118Expense
Revenue121782901Revenue
DescriptionSection 1. The community benefit contribution of Fauquier Hospital includes programs and activities that improve access to health care and improve health in our communities. In order to portray the full breadth of our contribution, our community benefit information is described below: 1. Organizational Commitment to Providing Community Benefit: The Fauquier Hospital, Inc. (FH) is a 97-bed, not-for-profit, acute care facility established in 1954 to provide comprehensive health care services for the communities it serves. Our mission is to restore, promote and maintain the health of our community. FH is the only hospital in our primary service area of Fauquier County, inclusive of 29,777 households. Our service area is growing and aging, with overall projected growth between 2011-2016 of 8.6% and with the 45+ population comprising 45.37% of the total in 2016. To address the growing and changing health care needs resulting from these population changes, FH:renovated the Infusion Center providing improved technology and facilities for the patients with the addition of 8 bays for a total of 18; Renovated and built out shell space to add 11 medical/surgical beds; Fauquier Health added three employed physicians to the staff, a Hematologist/Oncologist, a Rheumatologist and a Otolaryngologist, in response to the community need as a demonstrated in the medical staff development plan.; Opened a Wound Healing Center to offer specialized technology for wound healing care. Through partnerships with other health care organizations we operate a retail home health supplies store and a cancer center. We also partner with local non-profit organizations (e.g. The Chamber of Commerce, schools and churches) and national organizations (e.g. the American Cancer Society) to support local events and provide community health and wellness programs. These community benefits activities are coordinated by two full-time community outreach staff, supported by administrative and clinical departments, and our auxiliary volunteers as needed. We have a financial assistance program that provides free care for residents of Fauquier and Rappahannock counties who are within 200% of the federal poverty guidelines. All uninsured patients, regardless of income level or county of residence, receive a 25% discount on hospital services and an additional 10% discount for payment within 30 days or an interest-free payment plan for balances. Every uninsured patient is contacted either during their stay or the day after an outpatient visit to discuss financial needs. Patients who do not meet the requirements for state funding are given a financial aid form and assistance with completing the necessary paperwork. Through the Continuing Care Fund, the hospital offers assistance to individuals who have inadequate financial means to cover the costs of post-hospitalization health services, such as nursing care; the cost of this program to FH in FY10 was $149,077. In FY10, we provided $4,202,304 in free medical care, which includes $281,228 of care provided to free clinic patients. 2. Organizational Description for Tax Exemption: FH offers all patients impartial access to treatment or accommodations that are available or medically indicated, regardless of race, creed, sex, national origin, religion, or source of payment for care. Our 24-hour Emergency Department is open to everyone in the community, regardless of ability to pay. We have an open medical staff with privileges available to all qualified physicians in our area. The majority of the members of our governing bodies for both our hospital and health system are independent representatives of the communities we serve. To help train and educate health care professionals, FH works with local community colleges to provide tours, lectures, and internships for students; FH staff provided approximately 17,500 hours at a cost of approximately $1,029,184 on these. FH participates in Medicare, Medicaid, and CHAMPUS/TRICARE Standard. 3. Description of Community Benefit Programs: Fauquier Free Clinic (FFC). FFC provides primary health and dental care to uninsured residents of Fauquier and Rappahannock counties. FH provided laboratory, cardiology/neurology/pulmonary services, and radiology services at no charge to FCC patients for a total of $281,228. Our physicians and clinical staff also provided more than 641 hours of free clinical care. To help FFC expand its services to meet the needs of a growing population, FH leased a building in April 2006 to the FFC for $1 per year for 10 years; the rental value FY10 was $85,284. In addition, FH contributed $5,000 in unrestricted funds. Community Health Education, Screenings and Outreach Programs FH staff connected with community members 108,264 times and participated in 67 local events. FH provided 1,912 free specialized screenings (blood pressure, body mass index, prostate, cholesterol and mammograms). FH also offers tours of the hospital and speakers for local schools and community organizations to build relationships within the community, promote collaboration in managing health and wellness, and educate the community on the health system. The total community benefit of these services was $130,220. Health education through advertising, media, and publications. One of several FH publications is a community newsletter, Healthy Happenings, intended to educate the public about health issues and health care and hospital services. Published quarterly, it reaches 94,000 homes in Fauquier and surrounding counties. The cost to FH for publication and distribution of this newsletter in FY10 was $190,375. FH offers ADAM, an online illustrated health encyclopedia, on its website. The FY10 annual cost was $17,052. Emergency Services. FH provides medical oversight, direction, and orders to paramedics in the field and en-route to the hospital. Our Emergency Department offers 24-hour access to medical services and helicopter transport for critically ill or injured individuals, and also restocks medical boxes and provides clean linens for rescue squads at a cost to the hospital of approximately $55,070. Support Groups and Community Groups. FH sponsored, assisted, or provided meeting space for four support groups that met weekly or monthly. Additionally, FH provided meeting space or cash donations for several non-profit community groups, (e.g. the American Red Cross and Fauquier County Department of Social Services). The total value of the meeting space is $51,022. Cash donations totaled $16,062. FH employees provided representation on community boards and coalitions at an expense of $65,711. Physician Referral. The hospital assisted 5,197 people through the Physician Referral program, which helps the community with questions on physicians, appointments, classes and programs registration, and health resources available through the hospital or in the community. It cost FH $35,235 to provide this service in FY10. 4. Links to Additional Community Benefit Information * Fauquier Hospital Website - www.fauquierhospital.org * Fauquier Assistance Informationn - www.fauquierhospital.org/body.cfm?id=230 Quantifiable Community Benefit Charity Care $4,202,304 Government Sponsored Health Care $2,159,485 Community Benefit Program $4,598,012 Total Quanifiable comm benefit $10,959,801Description
Total Program Service Expense109007118TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096103NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1163NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledVAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDARRYL WHITENamePerson
Telephone Number5403165000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1500 HOSPITAL DRAddressLine1
CityWarrentonCity
StateVAState
ZIP Code20186ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
RODGER BAKER
PRESIDENT/CEO40.0XX498342098754
MARSHALL DOELLER
VICE CHAIRMAN/CHAIRMAN4.0XX000
REV JENNINGS HOBSON
TRUSTEE3.0X000
JOHN MCCARTHY
TRUSTEE4.0X000
MIRIAM PORTER
TRUSTEE2.0X000
ELISE WILKINS
SECRETARY/TREASURER8.0XX000
NASSER SITTA MD
TRUSTEE2.0X000
MARK VAN DE WATER
TRUSTEE1.0X000
ANNE HALL
TRUSTEE3.0X000
SUSAN RUBIN
TRUSTEE4.0X000
HUNTON TIFFANY
TRUSTEE3.0X000
WILBUR HEFLIN
CHAIRMAN4.0XX000
CAREN EASTHAM
TRUSTEE4.0X000
MARY LEIGH MCDANIEL
TRUSTEE1.0X000
ADAM WINICK MD
TRUSTEE3.0X000
JOSHUA JAKUM MD
TRUSTEE2.0X000
ROBIN GULICK
TRUSTEE1.0X000
JEFFREY ABRAMS
TRUSTEE1.0X000
LIONEL PHILLIPS
VP FINANCE/CFO40.0X281571043365
KATHERINE REEVES
VICE PRESIDENT40.0X1593450194
LINDA SHARKEY
VP/CHIEF NURSING OFFICER40.0195203021068X
GREGORY BENGSTON
VICE PRESIDENT40.0180126025525X
MARY SMITH
VICE PRESIDENT SENIOR SERVICES40.0185491015699X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1500078TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation204605TotalOtherCompensation
Number Individuals GT100 K48NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
FAIR OAKS ANESTHESIA ASSOCIATES
3998 FAIR RIDGE DR STE 320FAIRFAXVA22033anesthesia services474000
PATHFINDER DIAGNOSTICS PLLC
500 HOSPITAL DRWARRENTONVA20186pathology363110
VIRGINIA EMERGENCY MEDICINE
4094 MAJESTIC LANE 298FAIRFAXVA220332104hospitalist service1190956
NATIONAL HEALING CORP
4850 T-REX AVENUE SUITE 300BOCA RATONFL33431wound care424620
MAYO COLLABORATIVE SERVICES INC
3050 SUPERIOR DRIVE NWROCHESTERMN559051770laboratory testing419043
FieldValueIRS element (for citing)
Number Of Contractors GT100 K27NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeBusiness CodeBusinessCodeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT REV119363024119363024
OTHER OPERATING15425061542506
THERAPY SERVICES859903859903
OTHER MISC1746817468
LAB5307262150053072
FieldValueIRS element (for citing)
Total Program Service Revenue121835973TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2376472TotalRevenueColumn
Exclusion$2,376,472ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities-93326Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-93326Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-93326TotalRevenueColumn
Exclusion-$93,326ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
CATERING72232041544154
ENDOWMENT FUND INCOME213797$213,797
FieldValueIRS element (for citing)
Total Other Revenue217951TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column124337070TotalRevenueColumn
Related Or Exempt Function Income121782901RelatedOrExemptFunctionIncome
Unrelated Business Revenue57226UnrelatedBusinessRevenue
Exclusion$2,496,943ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1196354Total
Program Services0ProgramServices
Management And General1196354ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total46377583Total
Program Services41389325ProgramServices
Management And General4988258ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1557378Total
Program Services1354919ProgramServices
Management And General202459ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6688082Total
Program Services5818631ProgramServices
Management And General869451ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3618637Total
Program Services3148214ProgramServices
Management And General470423ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total394964Total
Management And General394964ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total75118Total
Management And General75118ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total64134Total
Management And General64134ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total378870Total
Management And General378870ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1147855Total
Program Services1147855ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2332690Total
Program Services2216056ProgramServices
Management And General116634ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total221535Total
Program Services221535ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total4054879Total
Program Services4054879ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total9577326Total
Program Services9577326ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total503086Total
Program Services462839ProgramServices
Management And General40247ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT96939769693976
BANK FEES170657170657
BLOOD BANK605977605977
COLLECTION831753831753
CONTRACT11482521148252

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total28221625Total
Program Services28167334ProgramServices
Management And General54291ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total118860731Total
Program Services109007118ProgramServices
Management And General9853613ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY16726738BOY
EOY19815466EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15243759BOY
EOY14220719EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1873066BOY
EOY2142548EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY725875BOY
EOY401893EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis166179949LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec92635780LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY79508365BOY
EOY73544169EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY55862601BOY
EOY61498620EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY15656312BOY
EOY17713617EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY14342035BOY
EOY15447659EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY199938751BOY
EOY204784691EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY12761141BOY
EOY11672405EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY77450124BOY
EOY76250102EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4020752BOY
EOY4960101EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY94232017BOY
EOY92882608EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY98079183BOY
EOY103851487EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7627551BOY
EOY8050596EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY105706734BOY
EOY111902083EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY199938751BOY
EOY204784691EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance7627551BeginningOfYearBalance
Contributions699Contributions
Investment Earnings Or Losses648318InvestmentEarningsOrLosses
Other Expenditures213797OtherExpenditures
Administrative Expenses12175AdministrativeExpenses
End Of Year Balance8050596EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance7434788BeginningOfYearBalance
Contributions1135Contributions
Investment Earnings Or Losses442346InvestmentEarningsOrLosses
Other Expenditures237296OtherExpenditures
Administrative Expenses13422AdministrativeExpenses
End Of Year Balance7627551EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis584539OtherCostOrOtherBasis
Book Value584539BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis74906396OtherCostOrOtherBasis
Depreciation25381931Depreciation
Book Value49524465BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2314479OtherCostOrOtherBasis
Depreciation1185064Depreciation
Book Value1129415BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis82760760OtherCostOrOtherBasis
Depreciation62324852Depreciation
Book Value20435908BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5613775OtherCostOrOtherBasis
Depreciation3743933Depreciation
Book Value1869842BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings73544169TotalOfBookValueLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
MONEY MARKET FUNDS3998F
CORP AND US GOVT OBLIGATIONS9659023F
TFB INVESTMENTS0F
DUPONT ENDOWMENT FUNDS8050596F
FieldValueIRS element (for citing)
Total Of Book Value Securities17713617TotalOfBookValueSecurities

Other Assets OtherAssets (12 entries)

DescriptionDescriptionBook ValueBookValue
2002 BOND NET DISCOUNT354694
2002 ISSUANCE COSTS1557132
DUE FROM HEALTH DYNAMICS194994
DUE FROM HEALTH SYSTEM6057
DEPOSITS14921
BOND FUNDS11026736
DUE FROM SLC756340
DUE FROM FHPS88378
DUE FROM FHSF67719
DUE FROM AFFILIATES812548
2008 ISSUANCE COSTS119431
CAPTIVE EQUITY448709
FieldValueIRS element (for citing)
Total Book Value Other Assets15447659TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
DUE TO THIRD PARTY PAYERS$1,335,335
ACCRUED INTEREST PAYABLE$2,003,638
DUE TO AFFILIATES$1,124,098
CAPITAL LEASE$497,030
FieldValueIRS element (for citing)
Total Of Amounts4960101TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSch D Part XIVIdentifier
ExplanationThe Fauquier Hospital Endowment Fund (the Trust) is an irrevocable trust created by the Chichester DuPont System in 1959. A local bank was designated as the trustee and remits income from the Trust to the Hospital semiannually. The income may be employed by the Hospital to further its work in such manner as the Board of Trustees of the Hospital determines.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigentfalseFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4202304TotalCommunityBenefitExpense
Net Community Benefit Expense4202304NetCommunityBenefitExpense
Percent Of Total Expense0.03850PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense8180753TotalCommunityBenefitExpense
Direct Offsetting Revenue6021268DirectOffsettingRevenue
Net Community Benefit Expense2159485NetCommunityBenefitExpense
Percent Of Total Expense0.01980PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense12383057TotalCommunityBenefitExpense
Direct Offsetting Revenue6021268DirectOffsettingRevenue
Net Community Benefit Expense6361789NetCommunityBenefitExpense
Percent Of Total Expense0.05830PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1299708TotalCommunityBenefitExpense
Direct Offsetting Revenue27434DirectOffsettingRevenue
Net Community Benefit Expense1272274NetCommunityBenefitExpense
Percent Of Total Expense0.01170PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense1029184TotalCommunityBenefitExpense
Net Community Benefit Expense1029184NetCommunityBenefitExpense
Percent Of Total Expense0.00950PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense4149655TotalCommunityBenefitExpense
Direct Offsetting Revenue1984191DirectOffsettingRevenue
Net Community Benefit Expense2165464NetCommunityBenefitExpense
Percent Of Total Expense0.01990PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense131090TotalCommunityBenefitExpense
Net Community Benefit Expense131090NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense6609637TotalCommunityBenefitExpense
Direct Offsetting Revenue2011625DirectOffsettingRevenue
Net Community Benefit Expense4598012NetCommunityBenefitExpense
Percent Of Total Expense0.04230PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense18992694TotalCommunityBenefitExpense
Direct Offsetting Revenue8032893DirectOffsettingRevenue
Net Community Benefit Expense10959801NetCommunityBenefitExpense
Percent Of Total Expense0.10060PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense4420TotalCommunityBuildingExpense
Net Community Building Expense4420NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Total Community Building Expense186386TotalCommunityBuildingExpense
Net Community Building Expense186386NetCommunityBuildingExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served43PersonsServed
Total Community Building Expense2356TotalCommunityBuildingExpense
Net Community Building Expense2356NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served43PersonsServed
Total Community Building Expense193162TotalCommunityBuildingExpense
Net Community Building Expense193162NetCommunityBuildingExpense
Percent Of Total Expense0.00190PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$9,693,976BadDebtExpenseAmount
Amount Attributable To140348AmountAttributableTo
Amount Reimbursed By Medicare24664653AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare37580669CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-12916016MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (8 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipOfficers Etc Profit Or OwnershipOfficersEtcProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
CANCER CENTER AT
CANCER TREATMENT PRIMARILY0.500000.000000.00000
LAKE MANASSAS LLC
RADIATION THERAPY
-------
FAUQUIER HEALTH HOME
DURABLE MEDICAL EQUIPMENT0.500000.000000.00000
MEDICAL STORE LLC
AND RETAIL STORE
-------
WARRENTON
50,000 SQ FT MEDICAL OFFICE0.200000.000000.80000
PROFESSIONAL CENTER
BUILDING

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1The Fauquier Hospital IncorporatedBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1500 Hospital DriveAddressLine1
CityWarrentonCity
StateVAState
ZIP Code20186ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaFauquier Hospital applies a 25% discount to all uninsured patients, regardless of income, at time of final billing. This discount can be increased to 35% if the total balance is paid within 30 days from the discharge/service date. In addition to this reduction, all patients who are residents of Fauquier or Rappahannock Counties and whose annual household income levels are at or below 200% of the Federal Poverty Guidelines and have no other source of payment, are eligible for free care if they complete the application process which includes the need for verification of income. All patients who are non residents of Fauquier or Rappahannock Counties and whose annual household income levels are at or below 100% of the Federal Poverty Guidelines and have no other source of payment, are also eligible for free care after completing the application process, which also includes income verification.IncomeBasedCriteria
Annual Community Benefit ExplnFauquier Health prepares its own community benefit report.AnnualCommunityBenefitExpln
Subsidized Health Services ExplnFauquier Health, as part of its medical staff development plan, identifies specific physician specialty shortages and recruits those physicians to the community. The physicians are employed by a wholly owned Hospital affiliate, Fauquier Health Physician Services, LLC. The cost of operating this service and making these specialties available to the community without regard to the patient's ability to pay exceeds the revenue collected. The necessary subsidy is provided by the Fauquier Hospital. These specialties include infectious disease, rhumatology,neurology,endocrinology,obstretrics, oncology, ENT and primary care.SubsidizedHealthServicesExpln
Percent Of Total Expense ExplnThe organization removed the bad debt expense prior to calculating the percent of total expense.PercentOfTotalExpenseExpln
Bad Debt FootnoteAccounts receivable are reported net of allowances for the excess of charges over the payments on patient accounts to be received from third party payers and estimates of uncollectible amounts. The System's policy is to write-off all patient accounts that have been identified as uncollectible. An allowance for doubtful accounts is recorded for accounts not yet written off, which may become uncollectible in future periods. The policy of the Hospital is to provide needed medical care without regard to the patient's ability to pay for such services. Charity care is defined as care for which collection is not attempted (e.g. indigent care) and operating costs for services rendered for Medicaid patients that are in excess of reimbursement. Charity care is based on a review of the patient's financial circumstances upon admission or the service date. Because collection of the amounts determined to qualify as charity care is not pursued, such amounts are not reported as a component of net patient service revenues. The cost and expenses incurred in providing these services are included in operating expenses.BadDebtFootnote
Shortfall As Community BenefitThe shortfall for Medicare is not currently included/considered in Community Benefit. However, the shortfall is due to the reimbursement from Medicare falling short of the cost incurred to provide care to the Medicare population served by the Fauquier Hospital. As with the shortfall experienced for the Medicaid population, the Medicare shortfall should be considered a community benefit as well. The Medicare Cost Report was utilized as outlined in the Schedule H, Part III, Section B, Worksheet B, which utilizes the cost to charge ratio developed within the Medicare Cost Report to determine the allowable cost.ShortfallAsCommunityBenefit
Debt Collection PolicyThough the hospital does have a written debt collection policy, it does not contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. Notification of Fauquier Hospital's charity program is disseminated by various means, including notification of contact information on our billing statements, notices at all points of patient access, and our website. A request for financial assistance may be done at any point in the collection cycle. As soon as a patient's eligibility for free care is identified through the application process, all billing or collection efforts cease at that time. Patients who do not apply for financial assistance until their accounts have been turned over to collection agencies or attorneys for collection, are not charged for legal or collections fees if it is deemed that they meet all criteria for free care.DebtCollectionPolicy
General ExplanationFauquier Hospital's total annual expense of $118,860,882 includes a bad debt write-off expense of $9,693,976. This amount is made up of both actual patient account write-offs of $9,097,633 and an additional $596,343 to account for an increase in our estimated the bad debt write off reserve for patient accounts carried on the Hospital's Balance Sheet as Accounts Receivable as of September 30, 2010 estimated to be uncollectible but not yet recognized as a bad debt account write-off/ expense. The hospital must generate $ 9,693,976 of net revenue to cover the cost of bad debts.GeneralExplanation
General ExplanationThe Commonwealth of Virginia does not require hospitals to file a community benefit report.GeneralExplanation
Needs AssessmentFauquier Health assesses the health needs of the community through community needs assessments every three years. A community needs assessment is a point-in-time effort to measure the health and well being of the community. It serves as the basis for Fauquier Health's health action planning to develop health policy, allocate resources, improve or expand existing services, implement new programs and collaborate with other community healthcare providers. A community health needs assessment also serves as a benchmark for future assessment of relative progress toward established community health objectives. Fauquier Health's community needs assessment provides the opportunity to: gain insights into the needs and assets of the communities served; identify and address the needs of vulnerable populations with the community; enhance hospital/community relationships and the opportunity for collaborative community action, including involvement with coalitions, partnerships, boards, committees and advisory groups; and provide information for community outreach planning.NeedsAssessment
Patient Education AssistanceFauquier Hospital's Billing Philosophy is displayed on the reverse side of every billing statement that patients receive. It explains that we do provide a "considerable" amount of charity care to those less fortunate and also contains the following statement: "in meeting your financial obligations for the care provided at Fauquier Hospital, we ask that you work with us on any bills you are having difficulty paying. You will find our staff understanding and eager to help you." This message is followed by the telephone numbers that connect patients to our Financial Counseling staff. Upon reaching that number, they are prompted to selections for the staff member that is most likely to best be able to help them i.e.: uninsured, Spanish speaking, billing questions, etc. Our uninsured inpatients and those with Medicare and no secondary carrier are contacted (usually a personal visit in their hospital room) by an employee of one of our corporate partners, Advanced Patient Advocacy (APA). The APA personnel screen these patients for eligibility for assistance for any applicable federal and state programs. If these patients do not meet the criteria for these programs, they are then referred to our self pay financial counselor for screening for our internal charity programs. Outpatients whose account balance meets a threshold of $750 are also contacted by APA, but these contacts are either by telephone or letter. Uninsured patients that visit our emergency room are given a packet that includes a financial assistance application and a business card with the name and contact information for our financial counselor. There is also signage in our Patient Access areas that reminds patients that we do have financial counselors available in person and by phone to assist them.PatientEducationAssistance
Community InformationThe Fauquier Hospital, Inc. (FH) is a 97-bed, not-for-profit, acute care facility established in 1954 to provide comprehensive health care services to the rural communities it serves. Our mission is to restore, promote and maintain the health of our community. Fauquier Hospital is the only hospital in our primary service area, which includes Fauquier and Rappahannock Counties. The primary service area has a population of 78,870. The median household income is $79,285. 6.1% of the community residents have incomes below the federal poverty guideline. 19.9% of Fauquier Hospital's patients are Medicaid recipients or self-pay. The following districts within Fauquier County are considered MUA/P by the Health Resources and Services Administration (HRSA): Lee District and Marshall District.CommunityInformation
Community Building ActivitiesFauquier Health's community building activities promote the health of the community in the following ways: Environmental Improvements - Fauquier Health hosted a Medication and Sharps Collection event on April 24, 2010, to collect unwanted prescription medications, vitamins, and over-the-counter medications and used sharps for safe disposal. By hosting the event Fauquier Health provide safe disposal for 40 gallons of medication and 107 pounds of sharps that could have contaminated the community's ground water as well as the landfill. Physical Improvements and Housing - Fauquier Health contributed to the physical improvement of a transitional housing facility in Vint Hill, Virginia by providing a group of volunteers who worked for the day painting the inside of a town home. The newly painted town home will provide housing for a family that qualifies for the Fauquier Family Shelter Services housing program. Community Support - Fauquier Health has created a disaster readiness plan to support the local community in the event of an incident of significance. It is one of 14 members of the Northern Virginia Hospital Alliance which coordinates emergency preparedness, response and recovery activities for the member hospital and healthcare systems in cooperation with local, regional and state response partners. In addition, Fauquier Health stockpiles medical, surgical and pharmaceutical supplies in the event of a community emergency.CommunityBuildingActivities
Other InformationFauquier Health promotes the health of the community by: * Ensuring that the majority (93%) of the individuals serving on the Fauquier Hospital and Fauquier Health System Board of Directors are not employees or contractors of the organization and are selected for diverse experience and perspective. This is accomplished through a bi-annual governance assessment to determine gaps and needs for certain skills or attributes. * Extending medical staff privileges to all qualified physicians in the community who are interested. * Fauquier Health uses surplus funds to improve patient care by renovating and upgrading facilities and upgrading the tools needed to care for our patients. In FY2010, Fauquier Health renovated the Infusion Center providing improved technology and facilities for the patients with the addition of 8 bays for a total of 18; Implemented Physician Order Entry in the Emergency Department and for Inpatients. Physician Order Entry allows physicians to enter orders electronically and the information (such as allergies or drug interactions) is immediately available to clinical staff. POE improves the timeliness of service for the patients and clinicians that results in improved patient safety and care.; Renovated and built out shell space to add 11 medical/surgical beds; Fauquier Health added three employed physicians to their staff, a Hematologist/Oncologist, a Rheumatologist and an Otolaryngologist, in response to the community need as demonstrated in the medical staff development plan.; Opened a Wound Healing Center to offer specialized technology for wound healing care. The center's hyperbaric oxygen chambers can be used to treat patients suffering from diabetic ulcers or infections as well as uncommon ailments such as gangrene.OtherInformation
Affiliated Health Care SystemFauquier Health is not part of an affiliated health care system.AffiliatedHealthCareSystem

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RODGER BAKER
3715480788380479560703250284290597096000
LIONEL PHILLIPS
2135670212930467110274300159350324936000
LINDA SHARKEY
1662680187920101430108160102520216271000
MARY SMITH
147509017532020450010229054700201190000
KATHERINE REEVES
127478027313045540001940159539000
GREGORY BENGSTON
147770017458014898099200156050205651000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Identifiernet earningsIdentifier
Return Referenceline 6ReturnReference
ExplanationFauquier Hospital has a "Management Performance Incentive Program" (MPIP) under which we award $ to our Director Team for accomplishing a pre-determined, measurable set of tasks related to clinical quality outcomes, patient satisfaction, community outreach and positive operating margins.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1INDUSTRIAL DEVELOPMENT AUTHORITY FAUQUIER COUNTYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN546001274IssuerEIN
CUSIP Number312066BXOCUSIPNumber
Date Issued2008-02-13DateIssued
Issue Price22825000IssuePrice
Description Of Purposehospital building improvementsDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds22825000TotalProceeds
Amount In Reserve Fund1348704AmountInReserveFund
Issuance Costs From Proceeds454104IssuanceCostsFromProceeds
Capital Expenditures21022192CapitalExpenditures
Year Of Subst Completion2009YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertytrueOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedfalseBondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICtrueGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line1BB&T COBusinessNameLine1
FieldValueIRS element (for citing)
Term Of GIC5.17TermOfGIC
Regulatory Safe Harbor SatisfiedtrueRegulatorySafeHarborSatisfied
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatetrueExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
990 Review ProcessPart VI, Line 11Both the management of the organization and the Audit and Compliance committee of the Board of Directors will review/comment on the accuracy of the 990 form prior to filing. Rodger Baker, President/CEO of the Health System will be signing the return.
CONFLICTS MONITORING AND ENFORCEMENTPART VI, LINE 12CThe annual disclosure of conflicts statement is completed by all board members and management. They are reviewed by independent legal counsel, the corporate compliance officer, and the audit and compliance committee, who are ultimately responsible if a conflict exists. Such conflicts would be reported to the full board. Board member eligibility is carefully screened for any potential conflicts in order to avoid such conflicts from occurring.
PROCESS FOR DETERMINING COMPENSATIONPART VI, LINE 15THE ORGANIZATION UTILIZES A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE OFFICER COMPENSATION.
DOCUMENT AVAILABILITYPART VI, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
FAUQUIER HEALTH SYSTEM INC
500 HOSPITAL DRWARRENTONVA20186541416705MGMT COORDINAVA501(C)(3)509(A)(3)NONE
FAUQUIER HEALTH FOUNDATION INC
500 HOSPITAL DRWARRENTONVA20186300219424FUNDRAISINGVA501(C)(3)509(A)(1)FAUQ HLTH SY
FAUQUIER HEALTH SENIOR LIVING INC
500 HOSPITAL DRWARRENTONVA20186541416703SKILLED CAREVA501(C)(3)509(A)(2)FAQ HLTH SYS

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1FAUQUIER HEALTH PHYSICIAN SERVICES LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1500 HOSPITAL DRAddressLine1
CityWARRENTONCity
StateVAState
ZIP Code20186ZIPCode
FieldValueIRS element (for citing)
EIN262121044EIN
Primary ActivityMEDICAL SERVIPrimaryActivity
Legal Domicile StateVALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1FAQ HEALTH SYSBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeINVESTMENTPredominantIncomeType
Share Of Total Income-2165464ShareOfTotalIncome
Share Of EOY Assets1539769ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnerfalseGeneralOrManagingPartner
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1FAUQUIER HEALTH PHYSICIAN SERVICES LLCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeITransactionType
Amount Involved1500AmountInvolved