Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
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| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
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| PART III, LINE 4A | The Inova Center for Rehabilitation, located on the Inova Mount Vernon campus is accredited by the Commission on Accreditation and Rehabilitation Facilities (CARF) and provides comprehensive inpatient and outpatient medical rehabilitation services to patients with severe head injuries, spinal cord injuries, strokes, multiple sclerosis, and other orthopedic and neurological disabilities. These services are staffed by an interdisciplinary team representing psychiatry, psychology, vocational counseling, physical therapy, occupational therapy, and nursing with treatment tailored to meet the specific needs of each patient. ACCESS of Fairfax, and ACCESS of Reston are 24-hour, free standing emergency centers located in Fairfax City, and Reston, Virginia, respectively. During 2014, ACCESS of Fairfax provided 16,395 emergency room visits and ACCESS of Reston reported 10,674 emergency room visits. IHCS has recently invested significant capital in all three hospital facilities. IHCS has an $850 million facility development program at the Inova Fairfax Hospital campus which was initiated in 2010 and will continue over the next three years. This program will expand existing services, renovate the existing patient tower and provide for a new and separate women's hospital facility. The Inova Mount Vernon Hospital will be investing in a $44 million expansion to create private rooms and upgrade facilities. Long Term Care Services Assisted Living Facilities IHCS's assisted living facilities provide care and services for adults who need assistance with activities of daily living and 24 hour oversight. They provide accommodations with 402 units. Each community has specialized memory care units and programs. A nursing staff is on-site 24 hours a day. IHCS maintains four assisted living facilities in Fairfax, Reston, Fair Oaks, and Mt. Vernon, Virginia. In addition, IHCS owns a 60% interest in an assisted living joint venture in McLean, Virginia. IHCS operates five assisted living facilities across Fairfax County with total assisted living days in 2014 of 156,985. InovaCares for Seniors (PACE) InovaCares for Seniors , a Program of All-inclusive Care for the Elderly (PACE) is the first program of its kind in Northern Virginia. PACE is an evidenced-based model of care that delivers high quality, cost effective care that includes medical, dental, vision and social activities. The program is built on the foundation that seniors with complex health care needs should be able to live in the comfort of their home environment for as long as possible. In 2014, PACE had an enrollment of 78 participants and had $2.3 million in unreimbursed expenses. Physical Therapy Services Inova Physical Therapy Centers IHCS promotes and conducts specific research and educational activities related to the care of the sick and injured. In 2014, outpatient visits totaled 94,535 with services offered at ten outpatient centers located throughout Northern Virginia. Areas of specialty include: Physical Therapy (PT), Occupational Therapy (OT), and Speech Language Therapy (SLT). Urgent Care Centers Inova Urgent Care Centers IHCS mission includes serving the community as a not-for-profit organization through the provision of urgent medical care. In 2014, outpatient visits totaled 93,671 with services being provided seven days a week with no appointment necessary at four locations, and Monday through Friday at our seven other locations. The centers provide services for medical conditions that require prompt attention but do not pose an immediate or serious threat to life. Treatment is provided for such ailments as sore throats, ear infections or minor cuts and bruises. Services offered also include treatment for work-related injuries and worker's compensation cases, physical exams including camp, sport, school, pre-employment, immigration medical examinations and travel medicine. Laboratory tests, X-rays, audiometry & vision screening, alcohol & drug testing and flu shots are provided on-site. The centers are staffed by board-certified/board-eligible physicians licensed in Virginia. A physician, nurse, and radiology technologist are on duty at each center during hours of operation. Employee Assistance Programs Inova Employee Assistance (EAP) is part of IHCS providing counseling, work life services and resources to help improve the overall health and well being of the employees of Inova Health System and the employer communities served by Inova and its affiliates. EAP was organized to promote health through referral to a wide range of behavioral health, financial, legal and other supportive services. In 2014 EAP supported 14,240 Inova employees and approximately 161,931 client company employees with the following services: Confidential Counseling: Short-term counseling services can help find solutions to problems ranging from family or workplace frustrations to alcohol or drug abuse. Financial & Legal Services: Employees and their household members can speak with a financial & legal professional at no charge regarding such issues as retirement planning, debt consolidation, funding a child's college education, mortgage loan options and a variety of other financial concerns. Work Life Referral Services: Work Life consultants help assess needs, pinpoint appropriate resources, and suggest guidelines for evaluating those resources. Consultants can locate resources in a variety of areas, including childcare, adoption, eldercare and convenience services. Behavioral Services IHCS's Behavioral Services are committed to providing intensive, personalized care to help people cope with, and overcome, addictions and emotional problems that prevent them from fully functioning in the community. Comprehensive Addiction Treatment Services (CATS) offers help to adults suffering from alcoholism or other chemical dependencies. CATS provide both inpatient and outpatient treatment services which include: intervention, medically supervised detoxification, rehabilitation and follow-up. In 2014, CATS had 4,507 patient days in its inpatient program and 14,740 patient sessions in its outpatient program. The Kellar Center is a comprehensive, behavioral health treatment center and special education school for children, adolescents and their families. The Kellar Center provides a full continuum of outpatient services for psychiatric disorders, substance use disorders, and behavioral and emotional issues. Services include assessment, psychological testing, educational testing, psychiatric evaluation, medication management, individual, family and group therapy and Intensive In-Home services. For adolescents who require intense mental health interventions, the Center provides an afterschool Intensive Outpatient Program for mental health and co-occurring disorders and a full day Partial Hospitalization Program for adolescents who are in crisis and unable to attend school. The treatment services and programs are provided to children and families regardless of an ability to pay. The Kellar School of Inova Kellar Center provides special education services to children and adolescents who have not been successful in the public school setting and may be at risk for being removed from the community and placed in more restrictive settings. During 2014, the Kellar Center provided 77,705 hours of programming, treatment and education to children, adolescents and families in the community. The total unreimbursed cost for 2014 was approximately $1.6 million dollars. Charity Care All Inova facilities, including the IHCS facilities with the exception of the assisted living facilities, provide charity care in accordance with Inova policies which ensures access to medically necessary care for all individuals. Charity care is defined as free or discounted healthcare services provided to persons who cannot afford to pay. These policies include the following key provisions: 1 Emergency care shall be provided to all persons regardless of their ability to pay. 2. on-emergency medically necessary care, except for certain specialty or referral programs, shall be provided by all hospitals and access facilities to medically indigent patients. "Medically necessary care" refers to inpatient and outpatient services defined as medically necessary by the federal Medicare program. "Medically indigent" is defined as those patients whose income falls at or below 300% of the Federal Poverty Level (FPL). In general, free medically necessary care is provided for patients with incomes falling at or below 200% of the FPL; and discounted care is provided for services rendered to patients with incomes falling between 200% and 300% of the FPL. |
| PART III, LINE 4A | Inova Health System utilizes a multifaceted approach to educate and inform patients and the public about Inova's charity care policy. Upon admission to any Inova hospital or any visit to outpatient facilities or clinics including emergency departments, Inova has information posted regarding patient rights and responsibilities. In addition, Inova provides information about the charity care program and referrals to meet with Inova financial counselors who assist patients in completing Inova's charity care application. This financial information is reviewed by the Inova Patient Accounts Department with the patient contacted if additional information is required in order to make a determination. The patient is subsequently provided a letter, notifying them as to the level of charity care for which they are qualified (whether it be 100% coverage or a sliding scale payment based upon their income level between 200-300% of the Federal Poverty Level). In 2014 IHCS's unreimbursed cost of charity care, including free and discounted services, was $88.5 million. Medicaid Established under Title XIX of the Social Security Act, this program provides assistance for the medically indigent, including those who cannot pay for care despite being able to afford other living expenses. Also included under this program are the blind, disabled, pregnant women, very low income parents, children and the elderly. The reimbursement that IHCS facilities receive from the Medicaid program routinely falls below the actual cost of services provided. During 2014, IHCS provided care to Medicaid patients at an unreimbursed cost of $57.9 million. Participation in Governmental Programs for Those Without the Ability to Pay Various government programs provide for the indigent, including Medicaid recipients. These programs provide a percentage of reimbursement for qualifying patients; however, payment is typically below the cost of those services. In addition to federal and state programs, the Inova subsidiaries, including IHCS, work with various County governments and agencies in providing certain free services to those residents the County identifies as most in need. |
| PART III, LINE 4D | HealthSource HealthSource serves the community as the premier provider of health education and prevention services. Participants engage in prevention activities, receive quality health education, participate in wellness programs and benefit from care management. As a part of the vision, Healthsource targets the community served by holding programs throughout the region in environments that are familiar to and convenient for the clients. Seminars, classes, health fairs, screenings and immunizations are offered at Inova Health System hospitals, community locations and worksites throughout northern Virginia and the Greater Metropolitan Washington Area. During 2014, HealthSource served 273,680 participants at 4,405 events. Program highlights include: Influenza Vaccination The Inova HealthSource Fight the Flu Program provided 46,134 flu shots at 828 immunization clinics for Inova at community and employer sites as well as for Inova employees and physicians. The Fight the Flu Program provided over 11,397 flu shots for Fairfax County Public Schools at 202 clinics and 2,599 shots at 22 clinics for Fairfax County Government employees. Additional clinics were held at 258 worksites vaccinating 15,197 employees. With Inova foundation funds, free flu shots were provided for 180 low income children and parents at a community fair, as well as, children and teachers at Higher Horizons Head Start Program. The Workplace and Community Programs The Workplace and Community Program served 47,921 participants at 577 events that included biometric screenings, seminars, booths and fit testing. The Care Management Programs provided health coaching in weight management, tobacco cessation, back pain management, fitness, pregnancy and breastfeeding. Team Up - HealthSource offers a healthy, fun, team-oriented challenge program for employers. Team Up programs are multi-week competitions that focus on healthy eating, weight loss or activity, with over 7,270 participants completing one of the competitions in 2014. HealthSource provides the Program Manager for The Prince William County Wellness Program. This program delivers a full range of wellness services and programs for county employees. Programs include new employee-only wellness website, Know Your Numbers, Walking Trail, Better Eating series, Health Fairs and health/prevention awareness campaigns. The Health Education Program HealthSource provided 747 life support classes for 9,632 students at worksites and in the community. Over 2,700 students received advanced life support training Over 35,993 community members were served through 1,322 Childbirth Preparation classes. Community members enjoyed about 213 fitness classes at locations throughout the community. Almost all of the classes were multi-session, usually 8-10 weeks. Over 12,744 people took part in fitness classes during 2014. |
| PART V, LINE 2A, NUMBER OF EMPLOYEES | The organization falls under a master pay agent and does not file any payroll returns under its own EIN, however all required returns have been filed on time. |
| Form 990, Part VI, Section B, line 11 | The Form 990 is prepared and provided to the Chief Accounting Officer and external tax consultants for initial review. After the review it is given to the CFO of Inova Health System for his review and comment. The Form 990 is presented to the Executive Committee of the Board of Trustees for their review. Upon completion of the Executive Committee review, it is provided to the full Board of Trustees. In this process, the Form 990 has been provided to the Governing Board approximately two weeks prior to the filing of the return. |
| Form 990, Part VI, Section B, line 12c | Yes, annually the organization distributes the conflict of interest policy to all directors, officers, trustees, and key employees. The organization requires that each director, officer, trustee, and key employee acknowledge that they have read, understood, and will abide by the policy. Each director, officer, trustee, and key employee is required to complete and submit an annual conflict of interest disclosure. These disclosures are broad and require that the individual list any business relationships or personal relationships with other directors, officers, trustees, and key employees, as well as any relationships with competitors, or current or potential vendors or contractors. Disclosure statements are reviewed by senior management and any potential conflicts are discussed with governing body chairman to ensure that any member who may have a conflict discloses their potential conflict, and is dismissed from related discussions and recused from participation in applicable decisions. |
| Form 990, Part VI, Section B, line 15 | The compensation of all senior management positions is evaluated annually in light of each manager's job content, scope and complexity. Compensation levels for Vice Presidents and above are reviewed by an independent external consultant to ensure that remuneration is consistent with the organization's compensation philosophy and objectives and competitive with other large complex health systems. The independent compensation consultant maintains national benchmark compensation databases and surveys and also reviews Forms 990 of comparable healthcare systems to determine market levels of compensation. In addition, the Inova Health System's CEO's compensation is reviewed and approved annually by an independent governing Board. The job requirements and complexity of all other management positions are evaluated annually using nationally recognized third party salary surveys to assure that the compensation for such positions is consistent with external market compensation comparisons. Salary ranges are developed for each management position classification to ensure that the compensation levels for these positions are consistent with the organization's compensation philosophy and objectives and with competitive market comparisons. Compensation for employed physicians is reviewed and approved by the Inova Health System Physician Compensation Committee. The committee is comprised of executive management of the Inova Health System. The Fair Market Value (FMV) compensation is based on four nationally recognized industry physician compensation benchmark surveys (MGMA, AMGA, Sullivan & Cotter, Hay Group). The committee also utilizes independent consultants to provide FMV opinions for positions that are not readily available in the four published benchmark surveys. The consultants' opinions and compensation survey data are presented to the Physician Compensation Committee for review and approval. |
| Form 990, Part VI, Section C, line 18 | The Form 1023, 990T and Form 990 are available at the address listed on page 1 of the Form 990 upon request during regular business hours. |
| Form 990, Part VI, Section C, line 19 | Inova Health System makes certain information publicly available. Inova's consolidated financial statements are posted on the Electronic Municipal Market Access's (EMMA) website on a quarterly basis. Inova's Form 990s are disclosed on the Guidestar website. Inova's governing documents are not currently publicly available. While the conflict of interest policy is not specifically publicly disclosed, Inova's Code of Conduct is on the public website. Section III of the Code of Conduct describes what can constitute a conflict and requires that potential conflicts be reported to management or the Chief Compliance Officer. The Code also refers to the conflict of interest policy which is available to staff and physicians on Inova's intranet website. |
| Form 990, Part XI, line 9: | PARTNERSHIP INCOME -14,532,019. CHANGE IN INVESTMENTS BALANCE -20,451,868. EQUITY IN SUBS 13,396,757. DONATED FUNDS 4,415,831. CAPITAL REIMBURSEMENT 2,176,724. PENSION GAIN -14,027,074. |
| PART XII, LINE 2B AND 2C, AUDITED FINANCIAL STATMENTS | The company is part of the Inova Health System, a not-for-profit integrated health care delivery system serving Northern Virginia and surrounding areas. The company's financial statements are consolidated in the Inova Health System consolidated financial statements. Inova Health System is audited on an annual basis by a large "Big Four" independent public accounting firm. In addition, they are responsible for the issuance of a management letter encompassing each member of the consolidated group. The Finance and Audit Committee of the Board of Trustees of Inova Health System is responsible for the oversight of the audit, including the hiring of the audit firm, review and approval of audited financial statements and communication with the external auditors at least twice a year without the presence of internal management. |
| PART XII, LINE 3A, A-133 AUDITT | The company is a subsidiary of the Inova Health System (IHS), a not-for-profit integrated health care delivery system serving Northern Virginia and surrounding areas. IHS receives various federal grants. These grants and awards are audited as part of the consolidated Inova Health System A-133 compliance audit. The Inova Health System's federal grants are audited on an annual basis by a large "Big Four" independent public accounting firm and a "Report on Compliance with Requirements Applicable to Each Major Program and on Internal Controls over Compliance in Accordance with OMB Circular A-133" is issued on a consolidated basis. The Finance and Audit Committee of the Board of Trustees of Inova Health System is responsible for the oversight of the A-133 audit, including the hiring of the audit firm, review and approval of audited financial statements and communications with the external auditors at least twice a year without the presence of internal management. |
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