2024-05-15T12:17:35-05:00 2023-06-30 366055558 GRANT THORNTON LLP 1000 WILSON BOULEVARD SUITE 1500 ARLINGTON VA 22209 990 2022-07-01 541291284 UVA CATON MERCHANT HOUSE ASSISTED LIVING UVAC 5712841163 8700 SUDLEY ROAD MANASSAS VA 20110 CHARLES CODER CFO 5712841163 2024-05-15 1 CHARLES CODER XXX-XX-XXXX 1 MARY TORRETTA P00847851 7038477500 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z UVA HEALTH CATON MERCHANT HOUSE L ERIK SHANNON 8700 SUDLEY ROAD MANASSAS VA 20110 3065652 0 X N/A X 1984 VA SEE SCHEDULE O 14 10 46 16 0 0 0 0 1583473 3059857 0 5795 0 0 1583473 3065652 0 0 0 0 1176511 2266366 0 0 0 1011500 1880631 2188011 4146997 -604538 -1081345 2848013 2971994 1826257 3031583 1021756 -59589 X SEE SCHEDULE O 0 0 3810925 3059857 UVA CATON MERCHANT HOUSE ASSISTED LIVING ("CATON") IS A LONG-TERM CARE FACILITY LOCATED IN MANASSAS, VA. CATON MAINTAINS AN OPEN-DOOR POLICY PROVIDING INDIVIDUALS IN THE COMMUNITY WITH AN LOCAL AFFORDABLE OPTION FOR LONG TERM CARE. DURING FISCAL YEAR 2023, CATON HAD 125 LICENSED BEDS, 78 APARTMENTS, 17,522 RESIDENT DAYS AND AN AVERAGE DAILY CENSUS OF 46. 3810925 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 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 1 0 0 0 1 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 X 14 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X CHARLES CODER 5712841163 8700 SUDLEY ROAD MANASSAS VA 20110 KIRSTEN GREEN MD TRUSTEE 0.20 45.00 X 0 894206 67646 MARY FRANCES SOUTHERLAND INTERIM SEC, TRUSTEE 0.20 50.00 X X 0 449489 37407 CHRIS HEATON MD TRUSTEE 0.40 45.00 X 0 413954 53339 VIKRAM KHOT MD TRUSTEE 0.20 45.00 X 0 10456 0 STEVE DANZIGER CHAIR 0.20 1.00 X X 0 0 0 STEPHEN NELSON TREASURER 0.20 0.20 X X 0 0 0 MATTHEW GUILFOYLE TRUSTEE 0.20 0.40 X 0 0 0 JACQUELINE KRICK TRUSTEE 0.20 0.40 X 0 0 0 CHARLES BARRELL VICE CHAIR 0.20 0.80 X X 0 0 0 LISA ANN PEACOCK TRUSTEE 0.20 0.60 X 0 0 0 RICHARD HARRINGTON SECRETARY 0.20 0.60 X X 0 0 0 MICHELLE METZGAR TRUSTEE 0.20 0.60 X 0 0 0 PAM KINCHELOE RN JD TRUSTEE 0.20 0.60 X 0 0 0 VIPUL PARIKH MD TRUSTEE 0.20 0.60 X 0 0 0 ERIK SHANNON CH SYSTEM CEO / PRESIDENT 0.40 50.00 X 0 923136 2212 AMANDA DICKINSON EXECUTIVE DIRECTOR 45.00 0.00 X 185313 0 11703 CHARLES CODER CH SYSTEM CFO & TREASURER 0.40 50.00 X 0 617644 45856 BRENDA MCKENDRY MANAGER NURSING - ASSISTED LIVING 45.00 0.00 X 117158 0 17455 302471 3308885 235618 2 0 1 0 0 NET PATIENT REVENUE 623110 3052777 3052777 RESIDENT SERVICES 900099 7080 7080 3059857 5795 5795 3065652 3059857 0 5795 X 221756 221756 1609705 1609705 79499 68369 11130 222706 191527 31179 132700 114122 18578 1051850 1040345 11505 75551 70262 5289 48552 48552 101905 101905 768 768 343018 319007 24011 REPAIRS AND MAINTENANCE 178089 165625 12464 MEDICAL SUPPLIES 34370 34370 BAD DEBT 21590 21590 PHARMACEUTICALS 3646 3646 21292 21132 160 4146997 3810925 336072 0 978835 151236 0 1314007 109334 100148 10221 0 11404321 9997718 1749623 1406603 2848013 2971994 417773 357062 1408484 2674521 1826257 3031583 X 0 0 0 0 1021756 -59589 1021756 -59589 2848013 2971994 -1081345 0 X X 0 1 X 0 0 X 23432 2185 0 0 0 25617 4148213 3492995 3104925 1583473 3059857 15389463 4171645 3495180 3104925 1583473 3059857 15415080 0 862972 747713 669705 342924 666089 3289403 862972 747713 669705 342924 666089 3289403 12125677 5795 5795 5795 5795 4171645 3495180 3104925 1583473 3065652 15420875 0.78630 0.78950 0.00040 0.00000 X 7833209 6857186 976023 3101798 2675564 426234 469314 464968 4346 1406603 DUE TO AFFILIATES 2674521 2674521 0 1 0 0 0 0 0 1 0 KIRSTEN GREEN MD TRUSTEE 0 755505 0 78140 0 60561 0 48918 0 18728 0 961852 0 0 ERIK SHANNON CH SYSTEM CEO / PRESIDENT 0 83542 0 145000 0 694594 0 0 0 2212 0 925348 0 0 CHARLES CODER CH SYSTEM CFO & TREASURER 0 349433 0 254781 0 13430 0 17564 0 28292 0 663500 0 0 MARY FRANCES SOUTHERLAND INTERIM SEC, TRUSTEE 0 357425 0 64000 0 28064 0 20451 0 16956 0 486896 0 0 CHRIS HEATON MD TRUSTEE 0 291419 0 17500 0 105035 0 15492 0 37847 0 467293 0 0 AMANDA DICKINSON EXECUTIVE DIRECTOR 161172 0 24141 0 0 0 9664 0 2039 0 197016 0 0 0 PART I, LINE 3 UVA COMMUNITY HEALTH, INC. IS THE PARENT ENTITY OF A NOT-FOR-PROFIT INTEGRATED SYSTEM OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS, AND OTHER HEALTHCARE SERVICES PROVIDERS (COLLECTIVELY KNOWN AS "UVA COMMUNITY HEALTH"). UVACH, IN COMBINATION WITH ITS SOLE MEMBER, THE UNIVERSITY OF VIRGINIA MEDICAL CENTER ("THE MEDICAL CENTER"), COMPRISE UVA HEALTH. THE FILING ORGANIZATION IS AN INTEGRAL PART OF UVA COMMUNITY HEALTH AND UVA HEALTH. THE COMPENSATION OF THE UVA COMMUNITY HEALTH CEO IS ESTABLISHED USING A HOLISTIC SET OF COMPENSABLE FACTORS AND VARIABLE PAY OPTIONS INTENDED TO ASSIST WITH THE RECRUITMENT AND RETENTION OF EXCEPTIONAL OR MISSION-CRITICAL EMPLOYEES AND APPROVED BY THE CHIEF EXECUTIVE OFFICER OF UVA HEALTH ON BEHALF OF THE MEDICAL CENTER AND THE RECTOR AND VISITORS OF THE UNIVERSITY OF VIRGINIA. PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") PAYMENTS MADE IN 2022 ARE THE FINAL PAYMENTS ATTRIBUTABLE TO PARTICIPATION IN THE PLAN OFFERED BY NOVANT HEALTH, INC. PRIOR TO THE UVA MEDICAL CENTER BECOMING THE SOLE MEMBER OF UVA COMMUNITY HEALTH, INC. ("UVACHI") AND THE INTEGRATION OF UVACHI AND ITS SUBSIDIARIES INTO UVA HEALTH. THE PLAN WAS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES AND TO OFFER COMPETITIVE TOTAL COMPENSATION. ELIGIBLE EXECUTIVES WERE NOMINATED BY THE CEO AND APPROVED BY THE NOVANT HEALTH COMPENSATION AND LEADERSHIP COMMITTEE ("THE COMMITTEE") FOR PARTICIPATION. ANNUAL CONTRIBUTIONS TO THE PLAN WERE BASED ON A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AS OF JANUARY 1ST OF THE PREVIOUS PLAN YEAR AND WERE REPORTED IN COLUMN (C) OF SCHEDULE J. PRIOR TO MAKING THE CONTRIBUTIONS, THE COMMITTEE REVIEWED AND APPROVED AMOUNTS AS TO REASONABLENESS, WHEN COMBINED WITH ALL OTHER ANNUAL COMPENSATION. A 3 YEAR CLASS-YEAR VESTING PERIOD WOULD APPLY UP TO AGE 62, WHEN ALL MONEY WOULD BE VESTED AND PAID OUT TO THE PARTICIPANT. FOR THE FINAL PAYMENTS LISTED, VESTING OCCURRED ON JANUARY 1, 2022. - CHRIS HEATON, MD: $10,793 ERIK SHANNON SERVED AS AN INDEPENDENT CONTRACTOR FROM JANUARY THROUGH NOVEMBER BEFORE BEING HIRED AS A FULL TIME EMPLOYEE, THIS PAYMENT IS REFLECTED IN SCHEDULE J, PART II, COLUMN (BIII). PART I, LINE 7 DEPENDING ON INDIVIDUAL PERFORMANCE, SOME EMPLOYEES MAY BE ELIGIBLE FOR PERFORMANCE BONUSES IN ADDITION TO THEIR REGULAR COMPENSATION. THE AWARDING OF ANY COMPENSATION BONUS CONSIDERS THE INDIVIDUAL'S GOALS AND THE GOALS OF THE ORGANIZATION AS A WHOLE. ANY POTENTIAL BONUS IS CONSIDERED WHEN EVALUATING AN EMPLOYEE'S TOTAL COMPENSATION FOR REASONABLENESS. 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. 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: RESPONSIBILITY AND CAREFULLY MANAGING OUR RESOURCES AND COMMITMENT TO CONTINUAL IMPROVEMENT AND LEARNING 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. 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 REVIEW OF THE 990 IS PERFORMED BY THE CHIEF FINANCIAL OFFICER. ALL BOARD MEMBERS HAVE RECEIVED A COPY OF THE FORM 990 BEFORE IT IS FILED WITH THE IRS. 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. ANNUALLY, ALL TRUSTEES ARE SENT A COPY OF THE CONFLICT OF INTEREST POLICY AND RECEIVE INSTRUCTION ON HOW TO DISCLOSE A CONFLICT OF INTEREST. AT THAT TIME, THEY MUST COMPLETE AN ATTESTATION STATEMENT AFFIRMING THEIR ADHERANCE TO THE POLICY. A SUPPLEMENTAL QUESTIONNAIRE IS SENT OUT ANNUALLY THAT INFORMS CERTAIN OF THE FORM 990 DISCLOSURES. IF THE TRUSTEE DISCLOSES A CONFLICT OF INTEREST, THEY MUST RECUSE THEMSELVES FROM DISCUSSIONS AND DELIBERATIONS RELATED TO THE CONFLICTED TRANSACTION. 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, INCLUDING THE FILING ORGANIZATION, ARE AVAILABLE UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE EXTENT REQUIRED BY LAW. FORM 990, PART IX, LINE 11G FOOD SERVICES: PROGRAM SERVICE EXPENSES 549,353. MANAGEMENT AND GENERAL EXPENSES 6,075. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 555,428. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 323,273. MANAGEMENT AND GENERAL EXPENSES 3,575. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 326,848. OTHER SERVICES: PROGRAM SERVICE EXPENSES 156,340. MANAGEMENT AND GENERAL EXPENSES 1,729. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 158,069. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 11,379. MANAGEMENT AND GENERAL EXPENSES 126. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,505. FORM 990, PART XII, LINE 1: THE UNIVERSITY OF VIRGINIA MEDICAL CENTER ("THE MEDICAL CENTER") BECAME THE SOLE MEMBER OF UVA COMMUNITY HEALTH, INC. ("UVACHI") EFFECTIVE JULY 1, 2021. AS A RESULT, UVACHI, AND ITS SUBSIDIARIES, INCLUDING THIS FILING ORGANIZATION, BECAME A FULLY OWNED BLENDED COMPONENT UNIT OF THE MEDICAL CENTER, A COMPONENT UNIT OF THE UNIVERSITY OF VIRGINIA HEALTH SYSTEM. THE MEDICAL CENTER IS A DIVISION OF THE UNIVERSITY OF VIRGINIA, A GOVERNMENTAL ENTITY. HISTORICALLY, THE ORGANIZATION'S FORM 990 PRESENTATION REFLECTED THE STANDARDS FOR GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AS PRESCRIBED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB). AFTER JULY 2021, AS A COMPONENT UNIT OF A GOVERNMENTAL ENTITY, THE STANDARDS FOR GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) ARE PRESCRIBED BY THE GOVERNMENTAL ACCOUNTING STANDARDS BOARD (GASB) FOR PROVIDERS OF HEALTHCARE SERVICES AND THE FORM 990 REFLECTS THAT CHANGE. 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