2023-05-12T19:02:05-05:00 2022-06-30 366055558 GRANT THORNTON LLP 1301 INTERNATIONAL PARKWAY SUITE 300 FORT LAUDERDALE FL 33323 990 2022-01-01 540622371 UVA CULPEPER MEDICAL CENTER INC UVAC 5712841163 501 SUNSET LANE CULPEPER 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 UVA CULPEPER MEDICAL CENTER ERIK SHANNON 501 SUNSET LANE CULPEPER VA 20110 74286130 0 X WWW.UVAHEALTH.COM X 1956 VA SEE SCHEDULE O 16 10 0 35 0 0 4136967 3718660 132216411 70124290 19504 4127 1453108 439053 137825990 74286130 594457 5720 0 0 53262371 26642891 0 0 0 71792935 42580053 125649763 69228664 12176227 5057466 142018668 143258753 24827195 21009814 117191473 122248939 X THE MISSION OF UVA CULPEPER MEDICAL CENTER IS TO HELP PEOPLE ACHIEVE AND MAINTAIN OPTIMAL HEALTH BY PROVIDING THE BEST POSSIBLE HEALTH CARE SERVICES. WE WILL ALWAYS MAKE THE NEEDS OF OUR PATIENTS OUR TOP PRIORITY. 0 0 56748514 5720 70278028 UVA CULPEPER MEDICAL CENTER, INC., DOING BUSINESS AS UVA CULPEPER MEDICAL CENTER ("UVACMC") PROVIDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTHCARE AND IMPROVE HEALTH IN OUR COMMUNITY. UVACMC IS A 70-BED NON-PROFIT, ACUTE CARE HOSPITAL LOCATED IN CULPEPER, VA WITH COMPREHENSIVE SERVICES PROVIDING A 24 HOUR, PHYSICIAN STAFFED EMERGENCY DEPARTMENT, FAMILY BIRTH CENTER, SURGICAL SERVICES, INTENSIVE CARE UNIT AND MORE. UVACMC PROVIDES MEDICAL AND OTHER HEALTHCARE SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. OUR MISSION IS TO HELP PEOPLE ACHIEVE AND MAINTAIN OPTIMAL HEALTH BY PROVIDING THE BEST POSSIBLE HEALTHCARE SERVICES. WE ALWAYS MAKE THE NEEDS OF OUR PATIENTS OUR TOP PRIORITY. (SEE SCHEDULE O FOR CONTINUATION.)WE ALSO PARTNER WITH LOCAL NON-PROFIT ORGANIZATIONS (THE CHAMBER OF COMMERCE AND LOCAL SCHOOLS), TO SUPPORT LOCAL EVENTS AND PROVIDE HEALTH AND WELLNESS PROGRAMS. ALL UNINSURED PATIENTS, REGARDLESS OF INCOME LEVEL OR COUNTY OF RESIDENCE, RECEIVE A 20% DISCOUNT ON HOSPITAL SERVICES AND AN ADDITIONAL 15% DISCOUNT FOR PAYMENT WITHIN 30 DAYS. UVACMC WORKS WITH LOCAL COMMUNITY COLLEGES TO PROVIDE TOURS, LECTURES, AND INTERNSHIPS FOR STUDENTS. UVACMC PUBLISHES TWO MAJOR COMMUNITY NEWSLETTERS. "SIMPLY HEALTH AND "AGING WELL" ARE PUBLISHED 3 TIMES A YEAR; THEY REACH 50,000 HOMES IN CULPEPER AND SURROUNDING COUNTIES. DURING THE FIRST 6 MONTHS OF 2022, THERE WERE 6,241 PATIENT DAYS, WITH AN AVERAGE LENGTH OF STAY OF 4 DAYS, AND AN AVERAGE DAILY CENSUS OF 34. THERE WERE 1,578 DISCHARGES, 1,416 INPATIENT AND OUTPATIENT SURGERIES, 53,494 OUTPATIENT ENCOUNTERS AND 17,663 EMERGENCY DEPARTMENT VISITS. 56748514 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 1 1 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 0 0 X 16 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 VA X CHARLES CODER 5712841163 8700 SUDLEY ROAD MANASSAS VA 20110 X DONNA STATON SYSTEM COO & PRESIDENT 50.00 0.20 X 0 0 0 STEVE DANZIGER CHAIR 0.20 1.00 X X 0 0 0 CHARLES BARRELL TRUSTEE 0.20 0.80 X X 0 0 0 RICHARD HARRINGTON TRUSTEE 0.20 0.60 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 LISA ANN PEACOCK TRUSTEE 0.20 0.60 X 0 0 0 MICHELLE METZGAR TRUSTEE 0.20 0.60 X 0 0 0 CHRIS HEATON MD TRUSTEE / PHYS UVA COMM GRP 0.20 45.60 X 0 0 0 JACKIE KRICK TRUSTEE 0.20 0.40 X 0 0 0 VIKRAM KHOT MD TRUSTEE 0.20 0.60 X 0 0 0 MATT GUILFOYLE TRUSTEE 0.20 0.40 X 0 0 0 STEPHEN NELSON TRUSTEE 0.20 0.40 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 ROSS SWITKES MD TRUSTEE 0.20 0.40 X 0 0 0 ERIK SHANNON INT. CEO 0.20 50.80 X 0 0 0 0 0 0 0 0 0 0 0 3712940 5720 3718660 NET PATIENT REVENUE 622110 70124290 70124290 70124290 4127 4127 EQUITY IN SUB 900099 285315 285315 MISCELLANEOUS REVENUE 900099 153738 153738 439053 74286130 70278028 0 289442 X 5720 5720 275609 179146 96463 21484905 13965189 7519716 869542 565202 304340 2383462 1549250 834212 1629373 1059093 570280 6528 6528 13695505 11162403 2533102 16310 16310 872748 681379 191369 663705 663705 923057 886136 36921 1225 797 428 28913 18794 10119 3175964 3054411 121553 91467 8255 83212 PHARMACEUTICALS 9111693 9111693 MEDICAL SUPPLIES 7265856 7265856 BAD DEBT 4145455 4145455 REPAIRS AND MAINTENANCE 1464567 1445827 18740 1117060 963893 153167 69228664 56748514 12480150 0 33759906 18525009 19996516 31388520 348354 285769 2963206 2926889 1397250 1252290 79236589 24617645 54438786 54618944 3751664 3827967 23633260 23493519 1729726 6939846 142018668 143258753 19721033 19164774 5106162 1845040 24827195 21009814 X 117003701 122046493 187772 202446 117191473 122248939 142018668 143258753 5057466 0 X X 0 0 0 X 6192309 6192309 27560389 12906658 14653731 114363 114363 0 40709582 8921166 31788416 4659946 2675458 1984488 54618944 OPERATING LEASE 1332223 CH - DUE TO CWF LT COMMITMENT 500000 OTHER LIABILITIES 12817 1845040 1 1 1 X 1 X 0 1 1 0 1 1 2160290 2160290 0.03330 11423217 11423217 13583507 11423217 2160290 0.03330 1272965 0 1272965 0.01960 563505 0 563505 0.00870 1836470 1836470 0.02830 15419977 11423217 3996760 0.06160 1 4145455 0 28568865 31109323 -2540458 X 1 1 1 CULPEPER SURGERY CENTER LLC OUTPATIENT SURGERY CENTER 0.62670 0.00000 0.37330 1 1 UVACMC DBA UVA CULPEPER MEDICAL CENTER 501 SUNSET LANE CULPEPER VA 22701 SEE SUPPLEMENTAL INFORMATION H1848 X X X UVA CULPEPER MEDICAL CENTER 0 0 1 X X X X X X X X X 20 1 0 0 1 X SEE SECTION C X 1 20 1 SEE SECTION C 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION A: UVA CULPEPER MEDICAL CENTER:LINE 1:HTTPS://UVAHEALTH.COM/LOCATIONS/CULPEPER-MEDICAL-CENTER-5597271UVA CULPEPER MEDICAL CENTER:PART V, SECTION B, LINE 3E:SEVERAL SOCIAL, BEHAVIORAL, AND CLINICAL HEALTH NEEDS WERE IDENTIFIED THROUGH A COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY. ONCE THE HEALTH NEEDS WERE IDENTIFIED, SURVEYS AND COMMUNITY MEETINGS WERE CONDUCTED TO ASK COMMUNITY MEMBERS AND STAKEHOLDERS TO RANK THE TOP HEALTH ISSUES ACCORDING TO YEARS OF POTENTIAL LIFE LOST AND MAGNITUDE OF THESE ISSUES. THE SCORES ARE CALCULATED TO RANK THE FOCUS AREAS AND PRIORITIZE THE IDENTIFIED HEALTH NEEDS. UVA CULPEPER MEDICAL CENTER PART V, SECTION B, LINE 5: WHILE CONDUCTING THE CHNA, THE HOSPITAL FACILITY SOLICITED INPUT FROM, AND CONSULTED WITH, A VARIETY OF COMMUNITY REPRESENTATIVES INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES OF CITY AND COUNTY GOVERNMENT INCLUDING HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, AND OTHER SOCIAL SERVICE AGENCIES. INPUT WAS GATHERED THROUGH A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY AND DATA FROM THE VIRGINIA DEPARTMENT OF HEALTH. THE SCOPE OF EXPERTISE WAS BROAD AND INCLUDED SUCH AREAS AS PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES. WHERE POSSIBLE, WE HAVE LEVERAGED THE RESOURCES OF THE ORGANIZATION TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES. UVA CULPEPER MEDICAL CENTER PART V, SECTION B, LINE 7D: UVA CULPEPER MEDICAL CENTERPART V, SECTION B, LINE 7BHTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX#2019-2021-211UVA CULPEPER MEDICAL CENTERPART V, SECTION B, LINE 10AHTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX#2019-2021-211 UVA CULPEPER MEDICAL CENTER PART V, SECTION B, LINE 11: THE HOSPITAL FACILITY IS A PART OF UVA COMMUNITY HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. THE FACILITY'S CHNA IDENTIFIED MULTIPLE NEEDS FOR THE COMMUNITY SERVED. THE NEEDS IDENTIFIED WERE REVIEWED AND PRIORITIZED BY HOSPITAL LEADERSHIP AND BOARD OF TRUSTEE MEMBERS; AS WELL AS, THE UVA MEDICAL CENTER AND UNIVERSITY OF VIRGINIA PHYSICIANS GROUP. NEEDS WERE EVALUATED BASED ON THE FACILITY'S SCOPE OF SERVICE, EXPERTISE, AVAILABILITY OF RESOURCES, AND THE FACILITY'S ABILITY TO IMPACT OVERALL POPULATION HEALTH. THE HOSPITAL FACILITY HAS ADOPTED AND EXECUTED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE PRIORITIZED COMMUNITY HEALTH NEEDS FROM THE CHNA. THE IMPLEMENTATION STRATEGY OUTLINES THE PLAN THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET THOSE HEALTH NEEDS IN ITS COMMUNITY. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. IT WAS DETERMINED THAT THERE ARE OTHER RESOURCES IN THE COMMUNITY THAT CAN MORE APPROPRIATELY ADDRESS THESE NEEDS BASED ON SCOPE OF SERVICES AND SKILL SET. FOR MORE DETAILED INFORMATION, REFER TO THE PUBLICLY AVAILABLE IMPLEMENTATION PLAN AVAILABLE ON THE WEBSITE; REFER TO THE URL GIVEN PREVIOUSLY FOR THE POSTING OF THE PLAN. UVA CULPEPER MEDICAL CENTER PART V, SECTION B, LINE 13H: UVA CULPEPER MEDICAL CENTER:PART V, LINE 16A, FAP WEBSITE:HTTPS://UVAHEALTH.COM/SERVICES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-INFORMATIONPART V, LINE 16B, FAP APPLICATION:HTTPS://UVAHEALTH.COM/SERVICES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-INFORMATIONPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY:HTTPS://UVAHEALTH.COM/SITES/DEFAULT/FILES/2023-02/UVAHEALTH-NOVA-BILLING-POLICIES-2023.PDF 2 1 - CULPEPER SURGERY CENTER LLC 501 SUNSET LANE CULPEPER VA 22701 AMBULATORY SURGERY CENTER 2 - UVA OUTPATIENT IMAGING CULPEPER LLC 501 SUNSET LANE CULPEPER VA 22701 IMAGING CENTER PART I, LINE 3C: OTHER CRITERIA BESIDES INCOME AND FPG USED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE INCLUDE WHETHER THE PATIENT HAS ANY OF THE FOLLOWING ASSETS: CHECKING OR SAVINGS ACCOUNTS, STOCKS, BONDS, IRAS, 401KS, CDS, LIFE INSURANCE (CASH TO LOAN VALUE), REAL PROPERTY, OR PERSONAL PROPERTY SUCH AS VEHICLES, CAMPERS, OR MOBILE HOMES. PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS PREPARED BY A RELATED ORGANIZATION. NOVANT HEALTH, INC. IS A MEMBER ORGANIZATION OF THE NOVANT HEALTH UVA HEALTH SYSTEM. IT PRODUCES A COMMUNITY BENEFIT REPORT, REFERRED TO AS A COMMUNITY IMPACT REPORT, REPRESENTING THE HEALTH SYSTEM AS A WHOLE INCLUDING THE FILING ORGANIZATION. THE REPORT CAN BE FOUND AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX. PLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE AMOUNTS REPORTED IN LINE 7 WAS A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. PART I, LN 7 COL(F): THE AMOUNT OF BAD DEBT REMOVED FROM TOTAL EXPENSES (DENOMINATOR) WAS $4,145,455. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES ADDRESS THE UNDERLYING CAUSES OF HEALTH PROBLEMS AND IMPACTS THE HEALTH OF OUR COMMUNITY THROUGH PARTNERSHIPS WITH LOCAL AGENCIES DEDICATED TO IMPROVING THE LIVES OF ALL INDIVIDUALS. OUTREACH INCLUDES PROVIDING SUPPORT TO ORGANIZATIONS SUCH AS CHAMBERS OF COMMERCE AND OTHER LOCAL COMMUNITY ORGANIZATIONS, AND PROVIDING EDUCATION SCHOLARSHIPS AND TRAINING FOR COMMUNITY WORKFORCES. PART III, LINE 2: IMPLICIT PRICE CONCESSIONS (ANALOGOUS TO BAD DEBT EXPENSE) ARE DETERMINED BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS, AND ECONOMIC CONDITIONS, THE AGE OF THE ACCOUNTS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PART III, LINE 4: THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS (ANALOGOUS TO BAD DEBT EXPENSE) ON LINE 2 IS CALCULATED USING THE SAME METHODOLOGY AS CHARITY CARE AND OTHER COMMUNITY BENEFITS USING AN ENTITY SPECIFIC COST TO CHARGE RATIO (CCR). FOOTNOTE 2 (ACCOUNTS RECEIVABLE) ON PAGE 8 OF THE AUDITED FINANCIAL STATEMENTS DESCRIBES PRICE CONCESSIONS. PART III, LINE 8: THE METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6 IS DETERMINED BY FOLLOWING THE MEDICARE PRINCIPLES OF ALLOWABLE COSTS. COST FOR THE OVERHEAD DEPARTMENTS ARE STEPPED DOWN TO THE REMAINING COST CENTERS BASED ON STATISTICS FOR EACH OVERHEAD COST CENTER. ONCE THE STEP-DOWN PROCESS IS COMPLETE, A COST TO CHARGE RATIO ("CCR") IS DEVELOPED FOR EACH COST CENTER. THE CCR IS THEN APPLIED TO THE MEDICARE REVENUE BY COST CENTER AND TOTALED. IT SHOULD BE NOTED THAT THE MEDICARE COST REPORTS DO NOT ADDRESS ANY MANAGED CARE MEDICARE REVENUES, COSTS, OR RELATED SHORTFALL. THE TOTAL REVENUES REPORTED AS RECEIVED FROM MEDICARE IN LINE 5 OF SECTION B ARE ONLY REPRESENTATIVE OF MEDICARE FEE FOR SERVICE PAYMENTS RECEIVED. THE ALLOWABLE COSTS ON LINE 6 ARE SIGNIFICANTLY LOWER THAN THE ACTUAL EXPENDITURES. AS SUCH, THE SHORTFALL IS UNDERESTIMATED. EVERY HOSPITAL TREATS MEDICARE PATIENTS. SOME HOSPITALS ARE LOCATED IN HIGH MEDICARE POPULATION AREAS; OTHERS PROVIDE SERVICES DISPROPORTIONATELY USED BY MEDICARE PATIENTS. MEDICARE RATES AND NUMBERS OF MEDICARE PATIENTS ARE NOT NEGOTIATED. AS REIMBURSEMENT RATES DECLINE RELATIVE TO COSTS OF CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THIS SERVICE THESE PATIENTS WOULD BECOME AN OBLIGATION ON THE GOVERNMENT. ANY UNREIMBURSED COSTS OF THIS CARE ARE A COMMUNITY BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT. PART III, LINE 9B: THE FILING ORGANIZATION HAS A POLICY THAT OUTLINES PROCEDURES THE HOSPITAL MAY TAKE FOR NONPAYMENT INCLUDING INTERNAL AND EXTERNAL COLLECTION PRACTICES AND REPORTING TO CREDIT AGENCIES. THE POLICY STATES THAT REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE MUST BE MADE BEFORE THE ORGANIZATION, OR ANY EXTERNAL ORGANIZATION, ENGAGE IN AN EXTRAORDINARY COLLECTION ACTION.FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, THE ORGANIZATION MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS. PART VI, LINE 2: AT THE TIME THE CHNA WAS PERFORMED, THE ORGANIZATION WAS PART OF NOVANT HEALTH UVA HEALTH SYSTEM, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS OF JULY 1, 2021, UVA MEDICAL CENTER TOOK FULL OWNERSHIP OF NHUVAHS, AT WHICH TIME THE SYSTEM TRANSITIONED ITS NAME TO UVA COMMUNITY HEALTH, INC. AND BEGAN THE PROCESS TO REBRAND ALL FACILITIES AND ENTITIES UNDER THE "UVA HEALTH" BRAND. UVA COMMUNITY HEALTH, INC. HAS A COMMUNITY BENEFIT DEPARTMENT ("CB DEPARTMENT") COMPRISED OF COMMUNITY BENEFIT PROFESSIONALS AND AN ASSOCIATED ADVISORY WORKING GROUP ("THE COMMUNITY BENEFIT GROUP") THAT INCLUDES REPRESENTATIVES FROM INTERNAL AUDIT, LEGAL, AND TAX. THE CB DEPARTMENT IS RESPONSIBLE FOR COORDINATING THE PREPARATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) REPORTED IN PART V, SECTION B, FOR EACH HOSPITAL WITHIN UVA COMMUNITY HEALTH, INC. AS WELL AS FOR THE FILING ORGANIZATION. EACH HOSPITAL AND THE COMMUNITY BENEFIT GROUP WORK TOGETHER TO IDENTIFY ORGANIZATIONS AND RESOURCES WITHIN ITS COMMUNITY THAT CONTRIBUTE TO THE PROCESS. THESE ORGANIZATIONS AND RESOURCES INCLUDE PUBLIC HEALTH DEPARTMENTS, LOCAL COMMUNITY COALITIONS REPRESENTING THE MEDICALLY UNDERSERVED, UNITED WAY, LOCAL UNIVERSITIES, ETC. COMMUNITY HEALTH ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS IN THE COMMUNITY ARE USED IN COMBINATION WITH INTERNAL HOSPITAL DATA AND INFORMATION COLLECTED FROM LOCAL AGENCIES TO PREPARE THE HOSPITAL'S CHNA. IN ADDITION TO ADDRESSING NEEDS IDENTIFIED THROUGH THE CHNA, EACH HOSPITAL MAY RESPOND TO REQUESTS FOR SPECIFIC COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS FROM PUBLIC AGENCIES OR COMMUNITY GROUPS. PART VI, LINE 3: UVA CULPEPER MEDICAL CENTER HAS SEVERAL WAYS THAT IT INFORMS AND EDUCATES PATIENTS WHO MAY BE IN NEED AND ARE ELIGIBLE FOR ASSISTANCE. WHEN STAFF (CASHIER, FINANCIAL COUNSELOR, AND REGISTERS) ARE SPEAKING WITH A PATIENT THAT STATES THEY ARE NOT ABLE TO PAY, THE PATIENT IS ENCOURAGED TO APPLY FOR FINANCIAL ASSISTANCE. BROCHURES DESCRIBING THE FINANCIAL ASSISTANCE POLICY ARE PLACED IN OUR BILLING STATEMENTS, AS WELL AS THE APPLICABLE POVERTY GUIDELINES FOR QUALIFYING FOR FINANCIAL ASSISTANCE. IN ADDITION, FINANCIAL ASSISTANCE APPLICATIONS, AS WELL AS FAQS WITH RESPECT TO THE FINANCIAL ASSISTANCE POLICY, ARE HANDED OUT TO PATIENTS UPON REGISTRATION. THE HOSPITAL'S WEBSITE POSTS THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND GUIDELINES FOR APPLYING. PART VI, LINE 4: UVA CULPEPER MEDICAL CENTER, INC. DBA UVA CULPEPER MEDICAL CENTERTHE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA. THE PRIMARY SERVICE AREA FOR UVA CULPEPER MEDICAL CENTER IS DEFINED BY THE ZIP CODES THAT REPRESENT 75% TO 85% OF THE HOSPITAL'S IN-PATIENT POPULATION. THESE ZIP CODES ALL FALL WITHIN CULPEPER COUNTY, VIRGINIA. BASED ON 2020 ESTIMATES, CULPEPER COUNTY HAD AN ESTIMATED 53,428 RESIDENTS. SPREAD ACROSS THE FOOTHILLS OF THE BLUE RIDGE MOUNTAINS' FIELDS OF THE NORTH CENTRAL PIEDMONT REGION, CULPEPER COUNTY, VIRGINIA POSSESSES A RURAL CHARACTER DISPLAYING THE NATURAL SPLENDOR OF RUSTIC VIRGINIA. CULPEPER COUNTY HAD SLIGHT POPULATION GROWTH OF ROUGHLY 12.7% SINCE THE 2010 US CENSUS. CHILDREN AND ADOLESCENTS (AGE 0-18) MAKE UP CLOSE TO ONE-QUARTER (24%) OF THE POPULATION IN CULPEPER COUNTY AND SENIORS (AGE 65 AND OVER) MAKE UP 16% OF THE POPULATION, WHICH IS EQUAL TO THE SENIOR POPULATION ESTIMATE FOR THE STATE OF VIRGINIA. NONWHITE MINORITIES CURRENTLY MAKE UP OVER ONE-THIRD (39%) OF THE RACIAL DEMOGRAPHIC IN CULPEPER COUNTY. THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS: WHITE NON-HISPANIC 74%; BLACK/AFRICAN-AMERICAN 14%; HISPANIC OR LATINO 12%; OTHER 11%. DATA TAKEN FROM THE 2019 US CENSUS BUREAU INCLUDES INDIVIDUALS THAT IDENTIFIED WITH MULTIPLE RACES; THEREFORE, THE PERCENTAGES EXCEED 100%. ACCORDING TO THE US CENSUS BUREAU DATA, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $67,696. THE POVERTY RATE FOR CULPEPER COUNTY IS 9.9.THIS IS THE ONLY ACUTE CARE FACILITY IN THE COMMUNITY. STATISTICAL INFORMATION WAS GATHERED FROM VARIOUS STATE AND FEDERAL SOURCES BUT PRIMARILY THE US CENSUS BUREAU. SPECIFIC REFERENCES AND OTHER SUPPORTING INFORMATION CAN BE FOUND IN THE ORGANIZATION'S MOST RECENT COMMUNITY BENEFIT IMPLEMENTATION PLAN AT: HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX#2019-2021-211 PART VI, LINE 5: THE ORGANIZATION FURTHERS ITS EXEMPT PURPOSES BY DOING THE FOLLOWING:1. ADOPTING A FINANCIAL ASSISTANCE POLICY;2. REMAINING CERTIFIED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO PROVIDE SERVICES TO ALL BENEFICIARIES OF MEDICARE, MEDICAID, AND OTHER GOVERNMENT PAYMENT PROGRAMS, AND PROVIDING SERVICES IN A NONDISCRIMINATORY MANNER TO SUCH BENEFICIARIES;3. OPERATING A FULL-TIME EMERGENCY ROOM WHICH IS OPEN TO AND ACCEPTS ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY;4. MAINTAINING AN OPEN MEDICAL STAFF, SUBJECT TO EXCLUSIVE CONTRACTS FOR HOSPITAL-BASED SERVICES SUCH AS ANESTHESIOLOGY, RADIOLOGY, PATHOLOGY, HOSPITALIST, AND EMERGENCY DEPARTMENT SERVICES, TO THE EXTENT AN EXCLUSIVE CONTRACT FOR THOSE SERVICES IS REQUIRED TO OBTAIN PROPER STAFFING COVERAGE OR TO PERMIT A MORE EFFICIENT DELIVERY OF THOSE SERVICES WITHIN THE HOSPITAL FACILITY;5. MAINTAINING A GOVERNING BOARD CONSISTING PRIMARILY OF A BROAD CROSS-SECTION OF LEADERS IN THE COMMUNITY;6. ADOPTING AND APPLYING A CONFLICT OF INTEREST POLICY, WHICH APPLIES TO THE GOVERNING BOARD AND ORGANIZATION OFFICERS;7. PROVIDING HEALTH EDUCATION LECTURES AND WORKSHOPS;8. PARTICIPATING IN HEALTH FAIRS, AND PROVIDING EDUCATION ON SPECIFIC DISEASES OR CONDITIONS, AND HEALTH PROMOTION AND WELLNESS PROGRAMS TO THE COMMUNITIES IT SERVES;9. PROVIDING SUPPORT GROUPS AND SELF HELP PROGRAMS TO THE COMMUNITIES IT SERVES;10. PROVIDING COMMUNITY-BASED CLINICAL SERVICES, INCLUDING WITHOUT LIMITATION, HEALTH SCREENINGS AND CLINICS FOR UNINSURED OR UNDERINSURED PERSONS TO THE COMMUNITIES IT SERVES;11. PROVIDING HEALTHCARE SUPPORT SERVICES, INCLUDING WITHOUT LIMITATION, INFORMATION AND REFERRAL TO COMMUNITY SERVICES, CASE MANAGEMENT OF UNDERINSURED AND UNINSURED PERSONS, TELEPHONE INFORMATION SERVICES AND ASSISTANCE TO ENROLL IN PUBLIC PROGRAMS, SUCH AS MEDICAID TO THE COMMUNITIES IT SERVES;12. PROVIDING CASH AND IN-KIND CONTRIBUTIONS TO NONPROFIT COMMUNITY HEALTHCARE ORGANIZATIONS IN THE COMMUNITIES IT SERVES; AND13. GENERALLY PROMOTING THE HEALTH, WELLNESS, AND WELFARE OF THE COMMUNITIES IT SERVES BY PROVIDING QUALITY HEALTHCARE SERVICES AT REASONABLE COST.FOR SPECIFIC EXAMPLES OF THIS ORGANIZATION'S COMMUNITY BENEFIT ACTIVITIES, WHICH FURTHER THE ORGANIZATION'S EXEMPT PURPOSES (AND THOSE OF ALL HOSPITALS AND HEALTHCARE FACILITIES IN THE SAME HEALTHCARE SYSTEM), PLEASE SEE THE UVA HEALTH COMMUNITY BENEFIT REPORT, LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX#2019-2021-211PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. PART VI, LINE 6: THE ORGANIZATION IS AN INTEGRAL PART OF UVA COMMUNITY HEALTH AND THE RECTORS AND VISITORS OF THE UNIVERSITY OF VIRGINIA, BOTH NOT-FOR-PROFIT INTEGRATED GROUPS OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. EACH HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITY IT SERVES, AS REPORTED INDIVIDUALLY ON EACH HOSPITAL'S FORM 990, SCHEDULE H. THE SYSTEM'S COMMUNITY BENEFIT AS A WHOLE IS DOCUMENTED IN A SYSTEM-WIDE COMMUNITY BENEFIT REPORT, LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. THERE ARE SIGNIFICANT COMMUNITY BENEFIT ACTIVITIES WITHIN NOVANT HEALTH WHICH MAY NOT BE REPORTABLE ON A SCHEDULE H BECAUSE THEY ARE NOT CONDUCTED BY AN ENTITY WHICH OWNS OR OPERATES A HOSPITAL.IN ADDITION TO HOSPITALS, UVA COMMUNITY HEALTH INC. INCLUDES A PHYSICIAN ORGANIZATION WITH PRACTICES IN VIRGINIA AND A HOSPITAL FOUNDATION WHICH SUPPORTS AND ENHANCES THE ACTIVITIES IN THOSE HOSPITALS' COMMUNITIES. FURTHER, UVA COMMUNITY HEALTH INC. INCLUDES AMBULATORY SURGERY CENTERS, IMAGING CENTERS, REHABILITATION CENTERS, AND OTHER OUTPATIENT FACILITIES; ALL DEDICATED TO PROMOTING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES. PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT UVA CULPEPER MEDICAL CENTER FILES A COMMUNITY BENEFIT REPORT WITH THE VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION IN ACCORDANCE WITH THEIR REPORTING GUIDELINES FOR PURPOSES OF ADVOCACY AND THE STATE'S REPORTING REQUIREMENTS. 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 CULPEPER MEDICAL CENTER UVA CULPEPER MEDICAL CENTER, INC. DOING BUSINESS AS UVA CULPEPER MEDICAL CENTER IS AN INTEGRAL PART OF UVA COMMUNITY HEALTH, INC. ("UVACH"). UVACH IS A NOT-FOR-PROFIT INTEGRATED SYSTEM OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS, AND OTHER HEALTHCARE SERVICES PROVIDERS (COLLECTIVELY KNOWN AS "UVA COMMUNITY HEALTH"). IN 2016, NOVANT HEALTH, INC. AND THE UNIVERSITY OF VIRGINIA MEDICAL CENTER ("UVA MEDICAL CENTER") FORMED A JOINT OPERATING COMPANY CALLED NOVANT HEALTH UVA HEALTH SYSTEM ("NHUVAHS"), WHICH INCLUDED CULPEPER MEDICAL CENTER, HAYMARKET MEDICAL CENTER, PRINCE WILLIAM MEDICAL CENTER, LAKE MANASSAS CANCER CENTER, CATON MERCHANT HOUSE, AND A NETWORK OF PHYSICIAN CLINICS STAFFED BY AN EMPLOYED MEDICAL GROUP. AS OF JULY 1, 2021, UVA MEDICAL CENTER TOOK FULL OWNERSHIP OF NHUVAHS, AT WHICH TIME THE SYSTEM TRANSITIONED ITS NAME TO UVA COMMUNITY HEALTH, INC. AND BEGAN THE PROCESS TO REBRAND ALL FACILITIES AND ENTITIES UNDER THE "UVA HEALTH" BRAND. THIS INCLUDES THE RENAMED UVA CULPEPER MEDICAL CENTER IN OCTOBER OF 2021. GENERAL INFORMATION UVA CULPEPER MEDICAL CENTER IS LOCATED IN CULPEPER, VA. THE HOSPITAL IS FOCUSED ON PROVIDING COMMUNITY SUPPORT, CONSISTENT QUALITY, EXCELLENT CARE AND A REMARKABLE WORK ENVIRONMENT FOR OUR TEAM MEMBERS. WE ARE COMMITTED TO MEETING THE HEALTH CARE NEEDS OF RESIDENTS OF CULPEPER, ORANGE, MADISON AND SURROUNDING COUNTIES IN VIRGINIA, ONE PERSON AT A TIME. IN ADDITION TO OUR QUALITY OF SERVICES AND COMPREHENSIVE CATEGORIES OF SERVICES, WE'RE VERY PROUD OF OUR PATIENT FINANCIAL SERVICES PROGRAM. WE WORK WITH CUSTOMERS TO HELP QUALIFY THEM FOR PUBLIC ASSISTANCE, ESTABLISH A REASONABLE PAYMENT PLAN, DISCOUNT THEIR BILL OR PROVIDE THEM WITH FREE CHARITY CARE. ACCREDITATION UVA CULPEPER MEDICAL CENTER IS FULLY ACCREDITED BY THE JOINT COMMISSION, AN INDEPENDENT ORGANIZATION THAT EVALUATES A HEALTHCARE ORGANIZATION'S PERFORMANCE IN AREAS THAT MOST AFFECT PATIENT HEALTH AND SAFETY. UVA CULPEPER MEDICAL CENTER BREAST CENTER IS ACCREDITED BY THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS BY THE AMERICAN COLLEGE OF SURGEONS. ACCREDITATION IS GRANTED TO CENTERS THAT HAVE VOLUNTARILY COMMITTED TO PROVIDE THE HIGHEST QUALITY OF CARE TO PATIENTS WITH BREAST DISEASES AND THAT UNDERGO A RIGOROUS EVALUATION AND REVIEW OF ITS PERFORMANCE AND COMPLIANCE WITH THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS. UVA CULPEPER MEDICAL CENTER IS ACCREDITED BY THE INTERSOCIETAL COMMISSION FOR THE ACCREDITATION OF VASCULAR LABORATORIES, ENSURING QUALITY PATIENT CARE FOR VASCULAR TESTING. 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, UVACH 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: ELECTION OF MEMBERS AND THEIR RIGHTS AS THE SOLE MEMBER OF THE ORGANIZATION, UVACH HAS THE POWER TO APPOINT ALL MEMBERS OF THE GOVERNING BODY OF UVA CULPEPER MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE MEMBER, UVACH 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 IX, LINE 11G OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 3,487,386. MANAGEMENT AND GENERAL EXPENSES 641,133. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,128,519. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 40,326. MANAGEMENT AND GENERAL EXPENSES 1,680. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,006. COLLECTION SERVICE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 65,094. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65,094. PROFESSIONAL PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 4,245,102. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,245,102. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 3,389,523. MANAGEMENT AND GENERAL EXPENSES 1,825,129. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,214,652. CREDENTIALING FEES: PROGRAM SERVICE EXPENSES 66. MANAGEMENT AND GENERAL EXPENSES 66. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 132. 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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