2023-05-12T18:50:43-05:00 2022-06-30 366055558 GRANT THORNTON LLP 1301 INTERNATIONAL PARKWAY SUITE 300 FORT LAUDERDALE FL 33323 990 2022-01-01 541307595 UVA COMMUNITY HEALTH FOUNDATION PWHF 5712841163 8700 SUDLEY ROAD MANASSAS VA 20110 CHARLES CODER CFO 5712841163 2023-05-12 1 CHARLES CODER XXX-XX-XXXX 0 STEPHANIE LARSEN P01981731 9547689900 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z X KEVIN CALLANAN 8700 SUDLEY ROAD MANASSAS VA 20110 68323 0 X HTTPS://GIVING.UVAHEALTH.COM/UVA-COMMUNITY-HEALTH X 1984 VA SEE SCHEDULE O 14 8 0 29 0 0 28088 9706 0 0 79959 0 0 58617 108047 68323 136807 12284 0 0 0 0 0 0 46 402888 4010 539695 16294 -431648 52029 6833519 6870364 59918 0 6773601 6870364 X SEE SCHEDULE O 0 0 14582 12284 0 UVA COMMUNITY HEALTH FOUNDATION FOCUSES ITS EFFORTS TO RAISE COMMUNITY SUPPORT AND FUNDING THROUGH CHARITABLE GIVING FOR MUCH NEEDED PROGRAMS, IMPROVED FACILITIES, AND STATE OF THE ART TECHNOLOGY FOR UVA COMMUNITY HEALTH INC., UVA PRINCE WILLIAM MEDICAL CENTER, UVA CULPEPER MEDICAL CENTER, AND UVA HEALTH CANCER CENTER. 14582 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 14 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 VA X CHARLES CODER 5712841163 8700 SUDLEY ROAD MANASSAS VA 20110 X IVAN HARANGOZO MD SECRETARY 0.20 0.00 X X 0 0 0 GARY JONES TREASURER 0.20 0.00 X X 0 0 0 MICHAEL PYBUS CHAIR 0.20 0.00 X X 0 0 0 HEATHER ARAM TRUSTEE 0.20 45.20 X 0 0 0 MOLLY GROVE TRUSTEE 0.20 0.00 X 0 0 0 VIKRAM KHOT MD TRUSTEE 0.20 0.60 X 0 0 0 RUTH SIMIONE TRUSTEE 0.20 0.00 X 0 0 0 ELIZABETH WARD TRUSTEE 0.20 0.00 X 0 0 0 STEPHEN WARD TRUSTEE 0.20 0.00 X 0 0 0 DOUGLAS MARKERT MD TRUSTEE 0.20 50.00 X 0 0 0 STEVE DANZIGER TRUSTEE 0.20 1.00 X 0 0 0 DONNA STATON PRES & COO CMH/TRUSTEE 0.20 50.00 X 0 0 0 AMY KARR TRUSTEE 0.20 0.00 X 0 0 0 KEVIN CALLANAN EXECUTIVE DIRECTOR 45.00 0.00 X 0 0 0 ERIK SHANNON INT. CEO 0.20 50.80 X 0 0 0 0 0 0 0 0 0 0 0 9706 9706 CONTRACT REVENUE 900099 58617 58617 58617 68323 0 0 58617 12284 12284 1620 1620 1134 1088 46 1256 678 578 16294 14582 1666 46 6833519 6813336 79847 79847 0 0 0 57028 6833519 6870364 11250 0 48668 0 59918 0 X 5403272 5455302 1370329 1415062 6773601 6870364 6833519 6870364 52029 44734 0 X X 0 0 0 X 321152 210362 185090 28088 9706 754398 321152 210362 185090 28088 9706 754398 110724 643674 54670 62044 47422 13808 0 177944 58617 58617 990959 0.64950 0.73020 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: CONTRACT REVENUE - 2022 AMOUNT: $ 58,617. SCHEDULE A, PART II THE BOARD OF THE ORGANIZATION APPROVED A FISCAL YEAR CHANGE TO 6/30, WHICH REQUIRED THE ORGANIZATION TO FILE A SHORT-PERIOD RETURN. THE AMOUNTS LISTED FOR 2022 REPRESENT THE SHORT-PERIOD FROM 1/1/2022 - 6/30/2022. 1370329 54637 0 8284 1620 1415062 1358245 35591 35663 25129 34041 1370329 1273289 94888 25839 25906 9865 1358245 1088604 223898 51925 4700 86438 1273289 1004069 268811 -25026 7164 152086 1088604 1.00000 0 0 76232 76232 0 3615 3615 0 0 PART V, LINE 4: PART V, LINE 4: INTENDED USES FOR ENDOWMENT FUNDS THE ENDOWMENT FUNDS ARE HELD FOR AFFILIATE HOSPITAL SERVICE COSTS RELATED TO VARIOUS CENTERS AT THE ACUTE CARE FACILITIES AND SUPPORT FOR THE SURROUNDING COMMUNITY. THE VARIOUS ENDOWMENT FUNDS SUPPORT BEHAVIORAL MEDICAL PROGRAMS, MEDICAL STAFF DEVELOPMENT, NURSING EDUCATION, ASSISTANCE TO EMPLOYEES, AND OTHER PROGRAMS THAT BENEFIT UVA COMMUNITY HEALTH FACILITIES. 1 EMPLOYEE ASSISTANCE 9 12284 PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS THE FOUNDATION IS AN INTEGRAL PART OF UVA COMMUNITY HEALTH, INC. ("UVA COMMUNITY HEALTH"), A NOT-FOR-PROFIT INTEGRATED SYSTEM OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. UVA COMMUNITY HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. UVA COMMUNITY HEALTH HAS ESTABLISHED A SYSTEM-WIDE CORPORATE POLICY WITH STANDARDIZED GUIDELINES THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE FILING ORGANIZATION MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS ARE MAINTAINED VIA THE GENERAL LEDGER. FUNDS ARE GENERALLY NOT TRACKED AFTER BEING GRANTED, AS THE ORIGINAL ELIGIBILITY AND SELECTION CRITERIA HAVE ALREADY BEEN MET. FORM 990, HEADER: CHANGE IN ACCOUNTING PERIOD FOR THE PERIOD 1/1/2022 - 6/30/2022. HURRICANE IAN DISASTER RELIEF DR-4673-FL. WEBSITE: HTTPS://GIVING.UVAHEALTH.COM/UVA-COMMUNITY-HEALTH-FOUNDATION FORM 990, PART I, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES UVA COMMUNITY HEALTH FOUNDATION ("THE FOUNDATION"), FOUNDED IN 1984, WAS FORMED TO ACCEPT GIFTS, SEEK GRANTS AND INVEST FUNDS TO SUPPORT PRINCE WILLIAM HOSPITAL DOING BUSINESS AS NOVANT HEALTH UVA HEALTH SYSTEM PRINCE WILLIAM MEDICAL CENTER AS WELL AS THEIR STRATEGIC PARTNERS PROVIDING HEALTHCARE IN THE COMMUNITY. WITH THE JULY 1, 2021 PURCHASE OF NOVANT HEALTH UVA HEALTH SYSTEM BY THE RECTOR AND VISITORS OF THE UNIVERSITY OF VIRGINIA ON BEHALF OF ITS MEDICAL CENTER AND THE TRANSITION OF THE COMMUNITY HEALTH SYSTEM TO UVA COMMUNITY HEALTH, INC., THE FOUNDATION'S MISSION IS NOW TO SUPPORT UVA COMMUNITY HEALTH, INC. AND IMPROVE THE HEALTH OF OUR COMMUNITIES, ONE PERSON AT A TIME. THE FOUNDATION IS AN INTEGRAL PART OF UVA COMMUNITY HEALTH, INC. ("UVA COMMUNITY HEALTH"), A NOT-FOR-PROFIT INTEGRATED SYSTEM OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. UVA COMMUNITY HEALTH CONSISTS OF MORE THAN 1,100 PHYSICIANS AND 2,500 EMPLOYEES WHO MAKE HEALTHCARE REMARKABLE AT MORE THAN 25 LOCATIONS, INCLUDING THREE MEDICAL CENTERS AND DOZENS OF OUTPATIENT FACILITIES AND PHYSICIAN CLINICS. HEADQUARTERED IN WARRENTON, VA., UVA COMMUNITY HEALTH IS COMMITTED TO IMPROVING HEALTH AND INSPIRING HOPE FOR VIRGINIANS AND BEYOND, SERVING MORE THAN 125,000 PATIENTS ANNUALLY. IN 2021, UVA PRINCE WILLIAM MEDICAL CENTER WAS RECOGNIZED AS A LEADER IN HEALTHCARE EQUITY BY THE HUMAN RIGHTS CAMPAIGN HEALTHCARE EQUALITY INDEX. IN 2021, THE UVA COMMUNITY HEALTH SYSTEM REPORTED $482 MILLION IN REVENUES. GENERAL INFORMATION COMMUNITY OUTREACH, ETC. THE FOUNDATION SUPPORTS PEOPLE, PROGRAMS AND SERVICES WITHIN UVA COMMUNITY HEALTH, INC., PROVIDING EXPANDED TREATMENT AND PREVENTION OPTIONS. THE FOUNDATION ALSO PROVIDES MISSION-ALIGNED GRANTS TO COMMUNITY PARTNERS THAT HELP SUPPLEMENT HEALTHCARE AND PREVENTION PROGRAMS FOR UNDERSERVED PATIENTS. THE FOUNDATION'S DIVERSE BOARD OF COMMUNITY LEADERS IN MANASSAS AND NORTHERN VIRGINIA PROVIDES STEWARDSHIP AND OVERSIGHT OF THE ORGANIZATION'S OPERATIONS AND ACTIVITIES. THE FOUNDATION ALSO CONTINUED IT'S FUNDING OF THE FUND FOR FOLKS (STAFF EMERGENCY FUND) WHICH PROVIDES LIMITED FINANCIAL ASSISTANCE FOR TEAM MEMBERS THROUGHOUT THE UVA COMMUNITY HEALTH SYSTEM WHO ARE IN SHORT TERM CRISIS SITUATIONS. THE FUNDS ARE TO BE USED AS A LAST RESORT FOR BASIC NEEDS WHEN ALL OTHER RESOURCES FAIL. FORM 990, PART III, LINE 1: MISSION, VISION AND VALUES OUR MISSION TRANSFORMING HEALTH AND INSPIRING HOPE FOR ALL VIRGINIANS AND BEYOND. OUR VISION TO BE THE NATION'S LEADING PUBLIC ACADEMIC HEALTH SYSTEM AND A BEST PLACE TO WORK WHILE TRANSFORMING PATIENT CARE, RESEARCH, EDUCATION, AND ENGAGEMENT WITH THE DIVERSE COMMUNITIES WE SERVE. OUR VALUES: ASPIRE AT UVA HEALTH, WE PUT THE PATIENT AT THE CENTER OF EVERYTHING WE DO. WE ASPIRE TO CREATE A CULTURE OF EXCELLENCE, ENGAGEMENT, AND TRUST THROUGH OUR VALUES. - ACCOUNTABILITY: ACKNOWLEDGING AND ASSUMING RESPONSIBILITY FOR WHERE WE HAVE SUCCEEDED AND FAILED IN TERMS OF OUR ACTIONS, DECISIONS, POLICIES, AND RESULTS. - STEWARDSHIP: MANAGING OUR RESOURCES AND COMMITMENT TO CONTINUAL IMPROVEMENT AND LEARNING RESPONSIBLY AND CAREFULLY WHILE ACKNOWLEDGING SHORTCOMINGS OR PROBLEMS IN OUR QUEST. - PROFESSIONALISM: APPROACHING ALL THAT WE DO IN A COLLABORATIVE WAY AND DELIVERING EXCELLENT CARE THROUGH THE LENS OF HELPFULNESS, POSITIVITY, KINDNESS, AND COMPETENCY. - INTEGRITY: BEING HONEST, OPEN, AND FAIR THROUGH OUR BEHAVIORS, ATTITUDE, AND TREATMENT OF OTHERS. - RESPECT: VALUING EVERYONE THROUGH OUR COMPASSIONATE AND CARING WAYS. - EQUITY: FOSTERING AN ENVIRONMENT OF BELONGING THAT PROMOTES JUSTICE, EQUITY, DIVERSITY, INCLUSION, AND UNITY THROUGHOUT THE ORGANIZATION AND WITHIN THE COMMUNITIES WE SERVE. FORM 990, PART VI, SECTION A, LINE 2 FORM 990, PART VI, SECTION A, LINE 2: FAMILY OR BUSINESS RELATIONSHIPS ELIZABETH WARD AND STEPHEN WARD - FAMILY RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 FORM 990, PART VI, SECTION A, LINE 6: CLASSES OF MEMBERS OR STOCKHOLDERS THE SOLE MEMBER, UVA PRINCE WILLIAM HEALTH SYSTEM HAS CERTAIN RIGHTS AND POWERS WITH REGARD TO THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF MEMBERS AND THEIR RIGHTS AS THE SOLE MEMBER OF THE ORGANIZATION, UVA PRINCE WILLIAM HEALTH SYSTEM HAS THE POWER TO APPOINT ALL MEMBERS OF THE GOVERNING BODY OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B FORM 990, PART VI, SECTION A, LINE 7B: DECISIONS SUBJECT TO APPROVAL OF MEMBERS AS THE SOLE MEMBER, UVA PRINCE WILLIAM HEALTH SYSTEM HAS THE POWER TO APPROVE CERTAIN TRANSACTIONS, ACTIONS AND CHANGES TO THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990, PART VI, SECTION B, LINE 11: ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE BOARD HAS DELEGATED REVIEW OF THE FORM 990 TO UVA COMMUNITY HEALTH'S BOARD OF TRUSTEES' AUDIT AND COMPLIANCE COMMITTEE ("THE COMMITTEE"), WHICH OVERSEES TAX MATTERS FOR ENTITIES IN THE UVA COMMUNITY HEALTH SYSTEM. THE COMMITTEE IS THE REVIEW BODY FOR ALL OF THE FORM 990S FILED FOR ORGANIZATIONS WITHIN THE UVA COMMUNITY HEALTH SYSTEM. THE COMMITTEE MEETS BEFORE THE FORM 990S ARE FILED WITH THE IRS AND AFTER ALL BOARD MEMBERS HAVE BEEN PROVIDED A PAPER OR ELECTRONIC COPY OF THE FORM 990 AND A SUMMARY OF ITS CONTENTS. THE VICE PRESIDENT OF TAX AND LEGAL COUNSEL FOR UVA COMMUNITY HEALTH ATTEND THE MEETING TO ANSWER ANY QUESTIONS AND ADDRESS ANY SIGNIFICANT DISCLOSURES WITHIN THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C FORM 990, PART VI, SECTION B, LINE 12C: MONITORING AND ENFORCEMENT OF COI THE ORGANIZATION'S TRUSTEE CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES, PRINCIPAL OFFICERS OR MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS. ALL TRUSTEES ARE SENT AN ANNUAL DISCLOSURE QUESTIONNAIRE. THE BEGINNING OF EACH MEETING OF THE BOARD BEGINS WITH VOLUNTARY VERBAL SELF-DISCLOSURE OF ANY CONFLICTS WITH ANY ITEMS ON THE AGENDA. AS ADDITIONAL ISSUES ARISE DURING THE COURSE OF THE MEETING, A SIMILAR SELF-DISCLOSURE IS EXPECTED. CHALLENGES BY PARTICIPANTS ARE ENCOURAGED IF SELF-DISCLOSURES ARE NOT FORTH-COMING. DURING THE COURSE OF DOING BUSINESS, IF CONFLICTS ARE SUSPECTED BY ANYONE, THEY ARE ENCOURAGED TO NOTIFY THE CEO OF THEIR SUSPICIONS. THE CEO WILL INVESTIGATE, EMPLOYING LEGAL COUNSEL AS NECESSARY, AND WILL RESOLVE AS APPROPRIATE. ULTIMATELY IT IS THE RESPONSIBILITY OF THE CEO AND THE CHAIRMAN OF THE BOARD TO ENFORCE THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 FORM 990, PART VI, SECTION B, LINE 15A/15B: THE FILING ORGANIZATION IS AN INTEGRAL PART OF UVA COMMUNITY HEALTH INC. ("THE SYSTEM"). UVA COMMUNITY HEALTH INC.'S BOARD PROVIDES A COMPENSATION REVIEW AND APPROVAL PROCESS TO CERTAIN SYSTEM ENTITIES. THE PROCESS IS CONDUCTED BY AN INDEPENDENT AND DISINTERESTED THIRD PARTY. THE INDEPENDENT COMPENSATION CONSULTANT USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS TO ENSURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE FOR THAT EXECUTIVE'S POSITION. THE UVA COMMUNITY HEALTH BOARD APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE. FORM 990, PART VI, SECTION C, LINE 19 FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS DISCLOSURE THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN ALL ORGANIZATIONS IN THE UVA COMMUNITY HEALTH SYSTEM ARE AVAILABLE UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE EXTENT REQUIRED BY LAW. FORM 990, PART VII: COMPENSATION INFORMATION THE ORGANIZATION IS NOT REPORTING ANY COMPENSATION INFORMATION ON FORM 990, PART VII IN COMPLIANCE WITH THE IRS INSTRUCTIONS FOR SHORT-PERIOD FILERS. FORM 990, PART XII: THE ORGANIZATION IS FILING THIS FORM 990 FOR THE SHORT-PERIOD JANUARY 1 THROUGH JUNE 30, 2022. THE ORGANIZATION DID NOT ISSUE AUDITED FINANCIAL STATEMENTS FOR THIS SHORT PERIOD, BUT THE ORGANIZATION WILL HAVE AUDITED FINANCIAL STATEMENTS FOR THE PERIOD JULY 1, 2021 - JUNE 30, 2022. SUCH FINANCIAL STATEMENTS ARE NOT AVAILABLE AT THE TIME OF FILING OF THIS RETURN. UVA PRINCE WILLIAM MEDICAL CENTER 8700 SUDLEY RD STE 411 MANASSAS VA 20110 540696355 HEALTHCARE VA 501(C)(3) LINE 3 UVA PRINCE WILLIAM HEALTH SYSTEM 0 UVA CULPEPER MEDICAL CENTER 8700 SUDLEY RD STE 411 MANASSAS VA 20110 540622371 HEALTHCARE VA 501(C)(3) LINE 3 UVA COMMUNITY HEALTH INC 0 UVA CATON MERCHANT HOUSE ASSISTED LIVING 8700 SUDLEY RD STE 411 MANASSAS VA 20110 541291284 HEALTHCARE VA 501(C)(3) LINE 10 UVA PRINCE WILLIAM HEALTH SYSTEM 0 UVA PRINCE WILLIAM HEALTH SYSTEM 8700 SUDLEY RD STE 411 MANASSAS VA 20110 541278944 HEALTHCARE VA 501(C)(3) LINE 12C, III-FI UVA COMMUNITY HEALTH INC 0 UVA COMMUNITY HEALTH INC 8700 SUDLEY RD STE 411 MANASSAS VA 20110 810868533 HEALTHCARE VA 501(C)(3) LINE 12A, I UVA MEDICAL CENTER 0 UNIVERSITY OF VIRGINIA MEDICAL CENTER 8700 SUDLEY RD STE 411 MANASSAS VA 20110 546001796 HEALTHCARE VA GOVERNMENTAL N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 1