2011-02-10T11:51:20-06:00 2010-03-31 WITT MARES PLC 701 TOWN CENTER DRIVE SUITE 900 NEWPORT NEWS VA 236064287 990 2009-04-01 541857174 Chesapeake Medical Group Inc CHES 8044358582 PO Box 1328 Kilmarnock VA 22482 James M Holmes Jr 8044358582 2011-02-10 1 THOMAS R BROOKS 7578731587 X 2009 2016-02-24 21:20:13Z James M Holmes Jr PO Box 1328 Kilmarnock VA 22482 5506481 0 X n/a X 1994 VA PROVIDE QUALITY, COMPASSIONATE, COST EFFECTIVE PRIMARY MEDICAL CARE SERVICES TO THE COMMUNITY AS A WHOLE IN A DEFINED GEOGRAPHIC AREA OF THE NORTHERN NECK AND MIDDLE PENINSULA OF VIRGINIA. 7 3 89 5 0 0 0 5013778 5492407 1384 514 -13 -801 5015149 5492120 0 0 3811677 4245763 0 0 1545347 1638689 5357024 5884452 -341875 -392332 1480556 1366380 6331586 6609742 -4851030 -5243362 The mission of Chesapeake Medical Group, Inc., (CMG) is to provide quality, compassionate, cost effective primary medical care services to the community as a whole in a defined geographic area of the Northern Neckand Middle Peninsula of Virginia. The company will pursue its mission through the development and management of one group medical practice operating at multiple locations which are reasonably equipped and efficiently staffed by competent clinical and administrative individuals. The Corporation is committed to providing medical services without regard to the patients' race, color, creed, national origin, religion or disability and will provide primary medical care to any individual with an acute injury or illness without regard to their ability to pay. 0 0 4999182 5492407 During the fiscal year, CMG employed 13 physicians and 5 nurse practitioners who provided either family practice, pediatric, GYN or Surgical medical care at 7 offices located in four counties. CMG providers saw a total of 76,785 patients during the fiscal year. Of the total services rendered, 60% was billed to Medicare/Medicaid; 20% to Anthem; 13% to other commercial payors; and 7% was billed directly to patients. 144485 During the year, CMG physicians and nurse practitioners provided numerous services for the community which included:a. Providing admission services and coverage to five area nursing homes.b. Providing free health care to indigent patients through participation with the Northern Neck Free Health Clinic.c. Providing free community education through speaking and teaching engagements on numerous topics. d. Participation in free sports physicals for secondary school students of Lancaster, Middlesex, Northumberland, Richmond, Westmoreland and Essex Counties.e. Participation in free health screening events in Northumberland counties.The health screenings included free blood glucose testing; cholesterol testing; and blood pressure testing. Additionally, preventative health care information was provided at each screening event.f. Providing free medical services for children in the annual Cub Scout Day Camp held in Lancaster County.g. Our policy remains to provide care to any patient (other than routine care)regardless of their ability to pay. 5143667 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 6 0 89 1 0 0 0 0 0 0 0 0 0 0 7 3 0 1 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X John Headley 8044358000 101 Harris Road Kilmarnock VA 22482 James M Holmes Jr 6.00 X X 0 280037 15977 Bonnie B Abbott 40.00 X X 81897 0 5251 James E Bryant MD 1.00 X 0 196429 11065 David R Antonio MD 1.00 X 0 0 0 Stephen K Whiteway 1.00 X 0 0 0 Marian L Walker 1.00 X 0 0 0 Norman R Tingle Jr MD 40.00 X X 359272 0 11896 Buchanan Dugan MD 40.00 X 224994 0 5678 Matthew Vogel MD 40.00 X 179982 0 11344 John Daniel MD 40.00 X 163934 0 10842 Mathew Jaeger MD 40.00 X 156888 0 9097 Brigitte Wolf-Small MD 40.00 X 153107 0 11528 1320074 476466 92678 6 0 1 0 chesapeake health services 101 harris road kilmarnock VA 22480 management fee 113592 1 Patient Service Revenu 621110 5270365 5270365 Service Contract Reven 621110 222042 222042 5492407 514 514 13560 14361 -801 -801 -801 5492120 5492407 0 -287 472652 378122 94530 3169488 2812577 356911 54091 54091 314722 314722 234810 234810 113592 113592 140 140 340347 228705 111642 8031 5834 2197 105914 79141 26773 205870 184270 21600 12254 3895 8359 47279 47279 55783 55783 206749 206749 Bad Debt Expense 239450 239450 Medical supplies and ph 216040 216040 Dues and subscriptions 39533 37693 1840 Repairs, maintenance an 39137 39137 Other taxes and license 4889 4889 3681 480 3201 5884452 5143667 740785 0 135680 138148 479921 394046 70388 74276 21205 28650 1433691 705723 803750 727968 3612 3292 1480556 1366380 252593 332281 646896 627165 5432097 5650296 6331586 6609742 X -4851030 -5243362 -4851030 -5243362 1480556 1366380 X 0 1 1 X 0 X X X 0 0 0 Chesapeake Hospital Corp 237424835 3 1 1 0 1 0 34000 34000 836191 237649 598542 106716 99942 6774 456784 368132 88652 727968 Due to Rappahannock Gen Hosp 4032291 Due to Chesapeake Health Svcs 1618005 5650296 5492120 5884452 -392332 0 -392332 5506481 14361 14361 5492120 0 5492120 5898814 14362 14362 5884452 0 5884452 Part X: Description of Uncertain Tax Positions Under FIN 48: Schedule D 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 XII, Line 2d - Other Adjustments: Rental expense: 14361. Part XIII, Line 2d - Other Adjustments: Rental expenses: 14361. Rounding: 1. X X X X X 0 0 0 0 0 0 0 0 0 James M Holmes Jr 0 279071 0 0 0 966 0 4937 0 11040 0 296014 0 0 James E Bryant MD 0 196429 0 0 0 0 0 5123 0 5942 0 207494 0 0 Norman R Tingle Jr MD 359272 0 0 0 0 0 3600 0 8296 0 371168 0 0 0 Buchanan Dugan MD 224994 0 0 0 0 0 2856 0 2822 0 230672 0 0 0 Matthew Vogel MD 179982 0 0 0 0 0 5399 0 5945 0 191326 0 0 0 John Daniel MD 163934 0 0 0 0 0 3000 0 7842 0 174776 0 0 0 Mathew Jaeger MD 156888 0 0 0 0 0 2850 0 6247 0 165985 0 0 0 Brigitte Wolf-Small MD 153107 0 0 0 0 0 3000 0 8528 0 164635 0 0 0 Supplemental Information Part III Supplemental Compensation information Chesapeake Bank James M Holmes Jr is an officer of CMG & a Board member of Chesapeake Bank 47279 Interest paid on outstanding loans 0 Form 990, Part V, line 7g The organization did not receive any contributions of qualified intellectual property. Form 990, Part VI, Section A, line 3 DAILY MANAGEMENT DUTIES ARE HANDLED BY CHESAPEAKE HEALTH SERVICES. Form 990, Part VI, Section A, line 6 THE ORGANIZATION HAS STOCKHOLDERS. 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 scheduled 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 board 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 & 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 documents are available upon request by appointment in Administrations, Monday through Friday, during regular business hours. 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. Chesapeake Hospital Corporation po box 1449 kilmarnock VA 22482 237424835 hospital VA 501(c)(3) 3 N/A Chesapeake Health Services inc po box 1449 kilmarnock VA 22482 541513371 management services VA 501(c)(3) 11 N/A Rappahannock General Hospital Foundation po box 1449 kilmarnock VA 22482 541210450 fundraising VA 501(c)(3) 11 N/A 0 0 0 1 1 0 0 0 0 1 1 1 0 0 1 0 0 0 chesapeake hospital corporation J 45600 Chesapeake Hospital Corporation L 29336 Chesapeake Hospital Corporation K 221999 Chesapeake Health Services L 113592 Chesapeake Hospital Corporation O 388393 Chesapeake Hospital Corporation E 4032291 Chesapeake Health Services D 1618005 Chesapeake Health Services J 97056