2023-05-12T18:50:51-05:00 2022-06-30 366055558 GRANT THORNTON LLP 1301 INTERNATIONAL PARKWAY SUITE 300 FORT LAUDERDALE FL 33323 990 2022-01-01 541291284 UVA CATON MERCHANT HOUSE ASSISTED LIVING UVAC 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 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X UVA HEALTH CATON MERCHANT HOUSE AMANDA DICKINSON 8700 SUDLEY ROAD MANASSAS VA 20110 1583473 0 X HTTPS://UVAHEALTH.COM/LOCATIONS/ X 1984 VA SEE SCHEDULE O 16 10 0 10 0 0 0 0 3104925 1583473 3185 0 0 0 3108110 1583473 0 0 0 0 2381712 1176511 0 0 0 2105867 1011500 4487579 2188011 -1379469 -604538 2377265 2848013 750971 1826257 1626294 1021756 X SEE SCHEDULE O 0 0 1864843 1583473 TO PROMOTE HEALTHCARE WITHIN THE COMMUNITY SERVED BY PROVIDING A LONG TERM CARE FACILITY. THE FACILITY MAINTAINS AN OPEN DOOR POLICY AND STRIVES TO SERVE THE INDIVIDUALS IN THE COMMUNITY. DURING THE SHORT PERIOD JANUARY 1, 2022 - JUNE 30, 2022, UVA CATON MERCHANT HOUSE ASSISTED LIVING HAD 125 LICENSED BEDS, 78 APARTMENTS, 9,337 RESIDENT DAYS WITH AN AVERAGE DAILY CENSUS OF 52. 1864843 1 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 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 X 16 10 0 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 MANASAS VA 20110 X STEVE DANZIGER CHAIR 0.20 1.00 X X 0 0 0 STEPHEN NELSON TRUSTEE 0.20 0.20 X 0 0 0 MATTHEW GUILFOYLE TRUSTEE 0.20 0.40 X 0 0 0 VIKRAM KHOT MD TRUSTEE 0.20 0.60 X 0 0 0 JACQUELINE KRICK TRUSTEE 0.20 0.40 X 0 0 0 ROSS SWITKES MD TRUSTEE 0.20 0.40 X 0 0 0 MARY FRANCES SOUTHERLAND TRUSTEE 0.20 0.80 X 0 0 0 KIRSTEN GREEN MD TRUSTEE 0.20 0.60 X 0 0 0 CHARLES BARRELL TRUSTEE 0.20 0.80 X 0 0 0 LISA ANN PEACOCK TRUSTEE 0.20 0.60 X 0 0 0 RICHARD HARRINGTON TRUSTEE 0.20 0.60 X 0 0 0 MICHELLE METZGAR TRUSTEE 0.20 0.60 X 0 0 0 CHRIS HEATON MD TRUSTEE 0.20 45.60 X 0 0 0 PAM KINCHELOE RN JD TRUSTEE 0.20 0.60 X 0 0 0 BEN WAMPLER MD TRUSTEE 0.20 0.60 X 0 0 0 SHIV KHANDELWAL MD TRUSTEE 0.20 0.60 X 0 0 0 AMANDA DICKINSON CATON ADMIN / EXEC DIRECTOR / SEC 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 NET PATIENT REVENUE 623110 1578033 1578033 RESIDENT SERVICES 900099 5440 5440 1583473 1583473 1583473 0 0 X 926155 805755 120400 6268 5401 867 180543 157072 23471 63545 55284 8261 454464 442405 12059 40599 29307 11292 8398 8398 100923 92849 8074 13 11 2 187533 174682 12851 CORPORATE SUPPORT 117897 117897 REPAIRS AND MAINTENANCE 62070 57247 4823 MEDICAL SUPPLIES 21489 21444 45 OTHER SUPPLIES 8470 7821 649 9644 7167 2477 2188011 1864843 323168 0 370311 978835 91523 109334 11782 10221 11387626 9638003 1903649 1749623 2377265 2848013 269690 417773 481281 1408484 750971 1826257 X 1626294 1021756 1626294 1021756 2377265 2848013 -604538 0 X X 0 0 0 X 30467 23432 2185 0 0 56084 4150563 4148213 3492995 3104925 1583473 16480169 4181030 4171645 3495180 3104925 1583473 16536253 0 858152 862972 747713 669705 342924 3481466 858152 862972 747713 669705 342924 3481466 13054787 4181030 4171645 3495180 3104925 1583473 16536253 0.78950 0.79070 0.00000 0.00060 X SCHEDULE A, PART III 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. 7833209 6675944 1157265 3085103 2596708 488395 469314 365351 103963 1749623 RESIDENT DEPOSITS 146080 DUE TO AFFILIATES 1262404 1408484 FORM 990, HEADER: CHANGE IN ACCOUNTING PERIOD FOR THE PERIOD 1/1/2022 - 6/30/2022. HURRICANE IAN DISASTER RELIEF DR-4673-FL. FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES UVA CATON MERCHANT HOUSE ASSISTED LIVING ("CATON") IS PART OF UVA PRINCE WILLIAM HEALTH SYSTEM, WHICH IS PART OF UVA COMMUNITY HEALTH, INC. ("UVA COMMUNITY HEALTH"). UVA COMMUNITY HEALTH, ALONG WITH THE UNIVERSITY OF VIRGINIA MEDICAL CENTER, COMPRISE UVA HEALTH. CATON IS THE ONLY ASSISTED LIVING FACILITY OWNED BY UVA COMMUNITY HEALTH OR UVA HEALTH. CATON RECEIVES STRATEGIC PLANNING, ADMINISTRATIVE, AND OTHER SUPPORT FROM UVA COMMUNITY HEALTH. GENERAL INFORMATION UVA CATON MERCHANT HOUSE, LOCATED IN MANASSAS, VA., IS A 78-APARTMENT UNIT, ADULT ASSISTED LIVING FACILITY WITH 125 LICENSED BEDS. HOLDING A 3-YEAR LICENSURE BY THE COMMONWEALTH OF VIRGINIA, CATON ROUTINELY EXCEEDS LICENSURE STANDARDS. CATON RESIDENTS HAVE ACCESS TO A VARIETY OF AMENITIES, INCLUDING TRANSPORTATION TO AND FROM LOCAL POINTS OF INTEREST, NUTRITIOUS MEALS THREE TIMES DAILY, HOUSEKEEPING, ONSITE LINEN AND LAUNDRY SERVICE AND EDUCATIONAL AND SOCIAL ACTIVITIES. PROGRAMS HAVE ALSO BEEN ESTABLISHED TO PROVIDE RESIDENTS WITH THE OPPORTUNITY TO TAKE PART IN CARING FOR PLANTS AND GARDENS, CARING FOR BIRDS LIVING AT THE FACILITY AND ESTABLISHING TRADITIONAL VISITS WITH CHILDREN. CATON ALSO OFFERS A "RESPITE" PROGRAM FOR THOSE WHO NEED TO STAY A SHORT TIME, FIVE TO THIRTY DAYS. THIS RESPITE PROGRAM GIVES A CAREGIVER A CHANCE TO TAKE A BREAK, OR ALLOWS SOMEONE TO RECUPERATE AFTER A REHAB OR HOSPITAL STAY BEFORE THEY RETURN HOME. IN ADDITION TO OUR QUALITY OF SERVICES AND COMPREHENSIVE CATEGORIES OF SERVICES, WE'RE VERY PROUD OF OUR PATIENT FINANCIAL ASSISTANCE PROGRAM. WE WORK WITH CUSTOMERS TO HELP QUALIFY THEM FOR PUBLIC ASSISTANCE, ESTABLISH A REASONABLE PAYMENT PLAN, OR DISCOUNT THEIR BILL. IN 2021, RESIDENTS OF OUR FACILITY REMAINED FREE OF COVID-19 THANKS TO UNIVERSAL MASKING, HANDWASHING, AND PHYSICAL DISTANCING. DURING THE PEAK NUMBER OF CASES IN THE COMMUNITY DURING THE SURGE, THE FACILITY PAUSED ACTIVITIES AND CONGREGATE DINING TO LIMIT EXPOSURE TO THE RESIDENTS. WHEN DINING RESUMED RESIDENTS WERE PHYSICALLY DISTANCED IN THE DINING ROOM. NEW TECHNOLOGY & SERVICES IN 2021, CATON CONTINUED TO USE A SENIOR-LIVING SPECIFIC ELECTRONIC MEDICAL RECORD AND ELECTRONIC MEDICATION ADMINISTRATION RECORD, POINTCLICKCARE. MODULES THAT ARE USED IN POINTCLICKCARE INCLUDE CUSTOMER RELATIONSHIP MANAGEMENT, EVENT CALENDAR, AND ADDED IN 2021 ELECTRONIC BILLING. THIS CHANGE IN THE BILLING PROCESSES HAS MADE THE INVOICES AND ASSOCIATED CHARGES FOR CARE MORE TRANSPARENT FOR THE RESIDENTS AND FAMILIES. THE FACILITY CONTINUED TO USE "TOUCHTOWN," AN IN-HOUSE TV CHANNEL. ANNOUNCEMENTS, ACTIVITIES AND MEALS ARE DISPLAYED ON THE IN-HOUSE TV CHANNEL AND DIGITAL SIGNS THROUGHOUT THE FIRST FLOOR TO KEEP RESIDENTS INFORMED OF WHAT IS HAPPENING IN THEIR HOME. ACCREDITATION UVA CATON MERCHANT HOUSE IS LICENSED WITH THE VIRGINIA DEPARTMENT OF SOCIAL SERVICES, AS ITS ACTIVITIES, SERVICES, MANAGEMENT AND OVERALL PERFORMANCE ROUTINELY EXCEED THE STATE'S STANDARDS FOR ASSISTED LIVING LICENSURE. 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 6 FORM 990, PART VI, SECTION A, LINE 6: CLASSES OF MEMBERS OR STOCKHOLDERS THE CORPORATION IS A NONPROFIT CORPORATION WITH MEMBERS (OR A MEMBER). THE SOLE MEMBER, UVA PRINCE WILLIAM HEALTH SYSTEM HAS CERTAIN RIGHTS AND POWERS WITH REGARD TO THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A FORM 990, PART VI, SECTION A, LINE 7A: AS THE SOLE MEMBER OF THE ORGANIZATION, UVA PRINCE WILLIAM HEALTH SYSTEM HAS THE POWER TO APPOINT ALL MEMBERS OF THE GOVERNING BODY OF UVA CATON MERCHANT HOUSE ASSISTED LIVING. FORM 990, PART VI, SECTION A, LINE 7B FORM 990, PART VI, SECTION A, LINE 7B: 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 GOVERNING DOCUMENTS DISCLOSURE THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINING 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 IX, LINE 11G FOOD SERVICE: PROGRAM SERVICE EXPENSES 428,836. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 428,836. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 454. MANAGEMENT AND GENERAL EXPENSES 576. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,030. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 13,115. MANAGEMENT AND GENERAL EXPENSES 11,483. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,598. 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. 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