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 810868533 UVA COMMUNITY HEALTH INC 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 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z L ERIK SHANNON 8700 SUDLEY ROAD MANASSAS VA 20110 3746239 0 X N/A X 2016 VA SEE SCHEDULE O 7 2 0 2 0 0 0 0 9272604 3699511 0 46728 0 0 9272604 3746239 0 0 0 0 789768 1543619 0 0 0 35127543 43501973 35917311 45045592 -26644707 -41299353 312588 15431550 195122981 308486100 -194810393 -293054550 X SEE SCHEDULE O 0 0 45045592 3699511 UVA COMMUNITY HEALTH INC. SUPPORTS UVA HEALTH SYSTEM'S VIRGINIA OPERATIONS, WHICH INCLUDE UVA CULPEPER MEDICAL CENTER, UVA PRINCE WILLIAM MEDICAL CENTER INCLUDING UVA HAYMARKET MEDICAL CENTER, UVA CATON MERCHANT HOUSE ASSISTED LIVING, AND UVA PRINCE WILLIAM HEALTH SYSTEM, WHOSE OPERATIONS INCLUDE UVA CANCER CENTER GAINESVILLE, UVA OUTPATIENT IMAGING CENTERVILLE, AND THE UVA COMMUNITY HEALTH PHYSICIAN CLINICS. 45045592 1 0 0 0 0 0 0 0 0 0 0 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 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 2 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 RD MANASSAS VA 20110 KENNETH CRAIG KENT MD CHAIR (UVA EMPLOYEE) 0.20 50.00 X X 0 1318071 248075 CHRISTOPHER R HEATON TRUSTEE (PWHS EMPLOYEE) 0.40 45.00 X 0 413954 53339 DOUGLAS M LISCHKE TRUSTEE (UVA EMPLOYEE) 0.20 50.00 X 0 633453 116510 MARY FRANCES SOUTHERLAND INTERIM SEC. (UVA EMPLOYEE) 0.20 50.00 X X 0 449489 37407 JASON C LINEEN TRUSTEE (UVA EMPLOYEE) 0.20 50.00 X 0 575108 64085 STEVEN M DANZIGER VICE CHAIR 0.20 1.00 X X 0 0 0 CHARLES BARRELL TRUSTEE 0.20 0.80 X 0 0 0 CHARLES CODER CH SYSTEM CFO & TREASURER 50.00 0.00 X 0 617644 45856 ERIK SHANNON CH SYSTEM CEO / PRESIDENT 50.00 0.40 X 0 923136 2212 DONNA STATON CH SYSTEM COO 25.00 25.40 X 0 510722 47394 DOUGLAS MARKERT VP, CHIEF CLINICAL OFFICER 50.00 0.20 X 0 607809 42444 ZAN ZAIDI VP, CHIEF MEDICAL OFFICER 50.00 0.00 X 0 576491 47438 MICHELLE STRIDER VP CHIEF QUALITY OFFICER / CNO 50.00 0.00 X 0 290725 37657 SARA WHITE SR DIRECTOR OF FINANCE 25.00 25.00 X 0 269170 35256 KIMBERLY B CONQUEST SR DIRECTOR OF MKTG & COMM 50.00 0.00 X 0 237928 14662 0 7423700 792335 0 0 1 0 0 INTERCOMPANY ALLOC. 551114 2890835 2890835 VALUE BASED PERF. REV. 541611 808676 808676 3699511 46728 46728 3746239 3699511 0 46728 X 1192064 1192064 38291 38291 242489 242489 70775 70775 1102781 1102781 519750 519750 39627064 39627064 128363 128363 62039 62039 2407 2407 7304 7304 465 465 2010240 2010240 41560 41560 45045592 45045592 0 0 0 15431550 182032 0 0 0 81588 0 48968 0 312588 15431550 5867355 0 165240000 165240000 24015626 143246100 195122981 308486100 X 0 0 0 0 -194810393 -293054550 -194810393 -293054550 312588 15431550 X -41299353 -56944804 0 X X 0 1 X 0 0 X X 4 UVA CULPEPER MEDICAL CENTER 540622371 3 1 13156051 0 UVA PRINCE WILLIAM MEDICAL CENTER 540696355 3 1 26160460 0 UVA CATON MERCHANT HOUSE ASSISTED LIVING 541291284 10 1 248812 0 THE RECTOR AND VISITORS OF THE UNIVERSITY OF VIRGINIA 546001796 6 1 0 0 4 39565323 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 PART I, LINE 12G: UVA COMMUNITY HEALTH, INC. IS CONTROLLED BY, AND IN TURN SUPPORTS, UVA MEDICAL CENTER AND ITS OTHER SUPPORTED ORGANIZATIONS IN THEIR MISSION TO PROVIDE COMPREHENSIVE MEDICAL CARE TO VIRGINIANS. PART IV, SECTION A, LINE 2: THE ORGANIZATION ALSO SUPPORTS UVA MEDICAL CENTER, A GOVERNMENTAL ENTITY. PART IV, SECTION B, LINE 2: THE RECTOR AND VISITORS OF THE UNIVERSITY OF VIRGINIA ON BEHALF OF ITS MEDICAL CENTER ("UVAMC"), A GOVERNMENTAL ENTITY, IS THE SOLE MEMBER OF THE FILING ORGANIZATION AND HAS THE RIGHT TO APPOINT THE MEMBERS OF ITS BOARD. UVAMC HAS RESERVED POWERS ASSOCIATED WITH THE VARIOUS UVACHI SUBSIDIARIES, ALSO SUPPORTED ORGANIZATIONS OF THE FILING ORGANIZATION. THEREFORE, THEY ARE EFFECTIVELY OPERATING, SUPERVISING, AND CONTROLLING THE FILING ORGANIZATION'S ACTIVITIES THROUGH THE UVAMC SUPPORT SERVICES PROVIDED TO THE FILING ORGANIZATION. 0 DUE TO AFFILIATES 121803555 DUE TO THIRD PARTIES 21442545 143246100 0 1 0 0 0 0 0 0 0 KENNETH CRAIG KENT MD CHAIR (UVA EMPLOYEE) 0 1061932 0 210000 0 46139 0 223474 0 24601 0 1566146 0 0 ERIK SHANNON CH SYSTEM CEO / PRESIDENT 0 83542 0 145000 0 694594 0 0 0 2212 0 925348 0 0 DOUGLAS M LISCHKE TRUSTEE (UVA EMPLOYEE) 0 501506 0 91667 0 40280 0 76637 0 39873 0 749963 0 0 CHARLES CODER CH SYSTEM CFO & TREASURER 0 349433 0 254781 0 13430 0 17564 0 28292 0 663500 0 0 DOUGLAS MARKERT VP, CHIEF CLINICAL OFFICER 0 373353 0 188886 0 45570 0 18300 0 24144 0 650253 0 0 JASON C LINEEN TRUSTEE (UVA EMPLOYEE) 0 481354 0 93000 0 754 0 24850 0 39235 0 639193 0 0 ZAN ZAIDI VP, CHIEF MEDICAL OFFICER 0 368376 0 193844 0 14271 0 18300 0 29138 0 623929 0 0 DONNA STATON CH SYSTEM COO 0 302605 0 169742 0 38375 0 15381 0 32013 0 558116 0 0 MARY FRANCES SOUTHERLAND INTERIM SEC. (UVA EMPLOYEE) 0 357425 0 64000 0 28064 0 20451 0 16956 0 486896 0 0 CHRISTOPHER R HEATON TRUSTEE (PWHS EMPLOYEE) 0 291419 0 17500 0 105035 0 15492 0 37847 0 467293 0 0 MICHELLE STRIDER VP CHIEF QUALITY OFFICER / CNO 0 202627 0 69241 0 18857 0 12634 0 25023 0 328382 0 0 SARA WHITE SR DIRECTOR OF FINANCE 0 188059 0 66375 0 14736 0 11251 0 24005 0 304426 0 0 KIMBERLY B CONQUEST SR DIRECTOR OF MKTG & COMM 0 207207 0 30721 0 0 0 12221 0 2441 0 252590 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. - CHRISTOPHER R. HEATON: $10,793 - DOUGLAS MARKERT: $40,570 - ZAN ZAIDI: $11,771 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 B(III). PART I, LINE 7: NONFIXED PAYMENT 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, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: UVA COMMUNITY HEALTH, INC. ("UVA COMMUNITY HEALTH") 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"). THE UNIVERSITY OF VIRGINIA MEDICAL CENTER, THE SOLE MEMBER OF UVACH, IS CONSISTENTLY RECOGNIZED AS A TOP HOSPITAL IN VIRGINIA BY U.S. NEWS & WORLD REPORT. UVACH, IN COMBINATION WITH ITS SOLE MEMBER, THE UNIVERSITY OF VIRGINIA MEDICAL CENTER, COMPRISE UVA HEALTH. GENERAL INFORMATION UVA HEALTH AND UVA COMMUNITY HEALTH ARE HEALTHCARE LEADERS IN VIRGINIA, DELIVERING A HIGH-QUALITY NETWORK OF MEDICAL CARE FOR RESIDENTS OF OUR LOCAL COMMUNITIES. OUR UNMATCHED PATIENT EXPERIENCE CENTERS UPON CLINICAL SAFETY AND EXCELLENCE AT EACH OF OUR THREE MEDICAL CENTERS UVA HEALTH CULPEPER MEDICAL CENTER, UVA HEALTH HAYMARKET MEDICAL CENTER AND UVA HEALTH PRINCE WILLIAM MEDICAL CENTER. OUR COMPREHENSIVE CARE IS SUPPORTED BY THE SERVICES PROVIDED BY OUR MEDICAL GROUP AND OTHER AMBULATORY SERVICE LINES. WE BRING TOGETHER LEADING-EDGE TECHNOLOGY AND COMFORTING CARE, ENSURING RESIDENTS OF NORTHERN VIRGINIA AND CULPEPER CAN CONTINUE TO RECEIVE EXCELLENT CARE CLOSE TO HOME. IT ALSO MEANS INCREASED ACCESS TO UVA HEALTH PHYSICIANS (LOCALLY AND IN CHARLOTTESVILLE), A WORLD-CLASS MEDICAL CENTER AND EXCEPTIONAL MEDICAL RESEARCH WHEN NEEDED. IN ADDITION TO OUR QUALITY 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, DISCOUNT THEIR BILL OR PROVIDE THEM WITH FREE CHARITY CARE. COMMUNITY ENGAGEMENT COMMUNITY ENGAGEMENT IS A CRITICAL COMPONENT TO THE MISSION OF UVA COMMUNITY HEALTH. UVA COMMUNITY HEALTH THROUGH ITS MEDICAL CENTERS AND OTHER HEALTHCARE PROVIDERS ESTABLISHES AND PROVIDES PROGRAMS THAT SERVE PATIENTS, NEIGHBORS, AND SOME OF OUR COMMUNITIES' MOST VULNERABLE CITIZENS. - WE PROVIDE CHARITY MEDICAL CARE FOR THE UNINSURED, SERVICES TO INDIVIDUALS WITH MEDICAID COVERAGE AT LESS THAN COST AS WELL AS MEDICAL SERVICES THAT LOSE MONEY BUT ARE IMPORTANT FOR THE COMMUNITY - WE PROVIDE COMMUNITY HEALTH EDUCATION, SUPPORT GROUPS, OUTREACH SERVICES, COMMUNITY EVENTS, AND SCREENINGS. - WE PARTICIPATE IN ACADEMIC HEALTH PROGRAMS AND PARTNERSHIPS WITH A DIVERSE GROUP OF ORGANIZATIONS TO PROVIDE OTHER COMMUNITY INITIATIVES. - WE OFFER GRANTS TO SUPPORT NONPROFIT ORGANIZATIONS FOCUSED ON IMPROVING AREAS SUCH AS ACCESS TO MENTAL/BEHAVIORAL HEALTH RESOURCES, PREVENTION OF CHRONIC DISEASE, AND HEALTHCARE WORKFORCE PIPELINE. THE FOLLOWING EXAMPLES ARE A SAMPLE OF THE ACTIVITIES AND INITIATIVES UNDERTAKEN: - MEN'S HEALTH LET'S TALK PROSTATE HEALTH IN CULPEPER. - REHAB CLINIC SCREENING AND EDUCATION ON BALANCE AT MADISON DAY. - EDUCATION PROVIDED AT OUTREACH EVENTS WITH A FOCUS ON ETHNIC COMMUNITIES THAT HAVE HIGHER RISK FACTORS FOR CHRONIC DISEASE SUCH AS BLACK, AFRICAN AMERICAN, AND HISPANIC/LATINO. - EDUCATION ON PREVENTION OF CHRONIC DISEASE AT REMINGTON HEALTH FAIR. - SUPPORT STUDENT STEM+H HEALTH CAREER PROGRAMS THROUGH A PARTNERSHIP WITH CULPEPER COUNTY PUBLIC. - VIRTUAL EVENT ON SUBSTANCE ABUSE AWARENESS & PREVENTION WITH MANASSAS CITY POLICE DEPARTMENT. - LADIES NIGHT OUT EVENT FOR BREAST CANCER AWARENESS. - DRUG TAKE BACK DAY EVENTS HELD IN PARTNERSHIP WITH LOCAL POLICE DEPARTMENTS AND DEA. - PARTNERING WITH LOCAL PARTNERS FOR PAMPER ME PINK TO PROVIDE BREAST CANCER AWARENESS AND RAISE MONEY FOR FREE MAMMOGRAMS FOR THE UNDERSERVED. - PROMOTING MENTAL HEALTH AND HEALTHY HABITS FOR CHILDREN AT CHILDREN'S DAY IN THE PARK HOSTED BY HEALTHY CULPEPER. - PROVIDED FUNDING TO SUPPORT MADISON FREE CLINIC IN THE EXPANSION OF HEALTHCARE ACCESS. - LIVING THE DREAM FOUNDATION GRANT TO SUPPORT MENTAL HEALTH GATEKEEPER TRAINING AND SCHOLARSHIPS. - AGING TOGETHER SUPPORT TO PROVIDE A DEMENTIA TOOLBOX TRAINING FOR CAREGIVERS. - GRANT FUNDING FOR INTEGRATION OF THOSE WITH DEVELOPMENTAL DISABILITIES THROUGH CULPEPER COUNTY PARKS AND RECREATION. - BLOOD PRESSURE SCREENINGS, BODY MASS INDEX SCREENINGS AND HEART HEALTH EDUCATION AT MULTIPLE COMMUNITY EVENTS. - HANDS ONLY CPR EDUCATION IN CLASSES AT THE MANASSAS LATINO FESTIVAL IN SPANISH. - HEART HEALTH EDUCATION AND SCREENING AT EAST END MOBILE HOME PARK COMMUNITY WITH SPANISH LANGUAGE TRANSLATION SERVICES. - EDUCATION ON PREVENTATIVE CARE TO COMBAT CHRONIC DISEASE AT FESTIVALS, FARMERS MARKETS AND VARIOUS OUTREACH EVENTS WITH A FOCUS ON ETHNIC COMMUNITIES THAT HAVE HIGHER RISK. FACTORS FOR CHRONIC DISEASE SUCH AS BLACK, AFRICAN AMERICAN, AND HISPANIC/LATINO - FUTURE KINGS DIABETES RESEARCH FOCUSED ON WELLNESS AND PREVENTION FOR THE BLACK AND AFRICAN AMERICAN COMMUNITY. - CFH INC. & CROSSROADS CONNECTION FOR FOOD INSECURITY. - LIFE LONG LEARNING INSTITUTE PRESENTATIONS FOR SENIORS ON THE AGING HEART AND ACID REFLUX. - SUPPORTED HIRE GROUND ON A PROGRAM FOCUSED ON MOTIVATING 11-12TH GRADERS AT RISK OF DROPPING OUT OF SCHOOL TO STAY ENROLLED UNTIL GRADUATION FROM HIGH SCHOOL. - SUPPORT PWCS DISCOVERY ENRICHMENT SUMMER PROGRAM IN MATHEMATICS AND - STEM+H HEALTH CAREER PROGRAMS. UVA COMMUNITY HEALTH PARTNERED WITH THE FOLLOWING ORGANIZATIONS IN 2023 TO SUPPORT PROGRAMS THAT SERVE OUR PATIENTS AND COMMUNITY: - THE MENTAL HEALTH ASSOCIATION OF FAUQUIER COUNTY - HERO'S BRIDGE - CULPEPER FOOD CLOSET - THE ARC OF NORTH CENTRAL VIRGINIA INC. - HOSPICE OF PIEDMONT - PEOPLE INCORPORATED OF VIRGINIA - LIVING THE DREAM FOUNDATION - CASA - AGING TOGETHER CORPORATION - NAMI - THERAPEUTIC RIDING FOR ADOLESCENTS WITH MENTAL HEALTH DIFFERENCES - YOUTH FOR TOMORROW - MANASSAS CITY PUBLIC SCHOOLS EDUCATION FOUNDATION - PRINCE WILLIAM COUNTY PUBLIC SCHOOL FOUNDATION (SPARK) - THE ARTFACTORY WELLNESS IN THE ARTS PROGRAM - BRAIN INJURY SERVICES - SERVING OUR WILLING WARRIORS ADDITIONALLY, WE CREATED EDUCATION ABOUT STROKE PREVENTION IN ENGLISH AND SPANISH THAT WAS DISTRIBUTED THROUGH OUR COMMUNITIES. BOTH PRINCE WILLIAM MEDICAL CENTER AND HAYMARKET MEDICAL CENTER CONTINUE TO PROVIDE FINANCIAL AND HUMAN RESOURCES TO CARE FOR PATIENTS AT THE MOTHER OF MERCY FREE CLINICS, AND THE GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER. NEW TECHNOLOGY & SERVICES IN 2023, UVA COMMUNITY HEALTH FACILITIES CONTINUED THEIR FOCUS ON DELIVERING A REMARKABLE PATIENT EXPERIENCE WHILE MAKING HEALTHCARE MORE CONVENIENT AND EASIER TO ACCESS FOR THE COMMUNITY. ON JUNE 1, 2023, UVA HEALTH CULPEPER MEDICAL CENTER COMPLETED ITS MIGRATION TO UVA HEALTH'S ELECTRONIC MEDICAL RECORDING SYSTEM. THE NEW EPIC INTEGRATION WAS THE LAST STEP IN CONNECTING ALL UVA HEALTH FACILITIES UNDER ONE ELECTRONIC MEDICAL RECORD SYSTEM. EPIC ALLOWS EFFECTIVE COORDINATION OF PATIENT CARE INCLUDING; INPATIENT, OUTPATIENT, ANCILLARY, ACCESS, AND BILLING AND CODING. AWARDS & ACCREDITATION ALL UVA COMMUNITY HEALTH MEDICAL CENTERS ARE 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. 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 THE CORPORATION IS A NONPROFIT CORPORATION WITH MEMBERS (OR A MEMBER). THE RECTOR AND VISITORS OF THE UNIVERSITY OF VIRGINIA ON BEHALF OF ITS MEDICAL CENTER, THE SOLE MEMBER, HAS CERTAIN RIGHTS AND POWERS WITH REGARD TO THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A FROM 990, PART VI, SECTION A, LINE 7A: THE RECTOR AND VISITORS OF THE UNIVERSITY OF VIRGINIA ON BEHALF OF ITS MEDICAL CENTER HAS CERTAIN RIGHTS AND POWERS WITH REGARD TO THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B FORM 990, PART VI, SECTION A, LINE 7B: THE RECTOR AND VISITORS OF THE UNIVERSITY OF VIRGINIA ON BEHALF OF ITS MEDICAL CENTER, THE SOLE MEMBER, 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: 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: 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 ADHERENCE 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 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 TSA ADMIN PAYMENTS: PROGRAM SERVICE EXPENSES 20,690,879. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,690,879. CONSULTING FEES: PROGRAM SERVICE EXPENSES 15,213,267. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,213,267. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 2,712,276. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,712,276. HEALTH PRO SERVICES: PROGRAM SERVICE EXPENSES 1,010,592. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,010,592. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 50. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50. FORM 990, PART XI, LINE 8: PRIOR PERIOD ADJUSTMENT AS A RESULT OF THE FINANCIAL INTEGRATION INTO NEW SOFTWARE AND THE ALLOCATION OF PURCHASE PRICE BY THE NEW PARENT (UVA HEALTH), PRIOR YEAR BALANCES WERE AFFECTED. THE ORGANIZATION HAS REPORTED ALL CURRENT YEAR ACTIVITIES ON THIS FORM 990. FORM 990, PART XII: FINANCIAL STATEMENTS AND REPORTING 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, COLLECTIVELY KNOWN AS COMMUNITY HEALTH, 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. UVA COMMUNITY HEALTH ACCOUNTABLE CARE ORGANIZATION LLC 8700 SUDLEY RD STE 411 MANASSAS VA 20110 810868533 HEALTHCARE VA 855404 2538584 UVA COMMUNITY HEALTH INC UVA CULPEPER MEDICAL CENTER 501 SUNSET LANE CULPEPER VA 22701 540622371 HEALTHCARE VA 501(C)(3) LINE 3 UVA COMMUNITY HEALTH INC 1 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 1 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 COMMUNITY HEALTH FOUNDATION 8700 SUDLEY RD STE 411 MANASSAS VA 20110 541307595 HEALTHCARE VA 501(C)(3) LINE 7 UVA PRINCE WILLIAM HEALTH SYSTEM 0 UNIVERSITY OF VIRGINIA MEDICAL CENTER 1201 LEE STREET CHARLOTTESVILLE VA 22902 546001796 HEALTHCARE VA GOVERNMENTAL LINE 6 N/A 0 UNIVERSITY OF VIRGINIA PHYSICIANS GROUP 4105 LEWIS AND CLARKE DRIVE CHARLOTTESVILLE VA 22911 541124769 HEALTHCARE VA 501(C)(3) LINE 10 UVA MEDICAL CENTER 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 1 1 1 1 1