TY 2021 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) J STEPHEN JONES...................................................................... PRESIDENT/CEO	35.00 ................. 15.00	X	X			5,264,165	98,219
(2) JOHN GAUL...................................................................... SECRETARY	35.00 ................. 15.00	X	X			1,663,113	68,424
(3) ALICE POPE...................................................................... TREASURER-CFO	35.00 ................. 15.00	X	X			1,531,149	265,031
(4) STEPHEN MOTEW...................................................................... CHIEF CLINICAL ENTERPRISE	40.00 ................. 0.00		X			1,689,871	262,172
(5) JOHN MOYNIHAN...................................................................... PRESIDENT SURGICAL SERVICES	40.00 ................. 0.00			X		1,227,151	81,401
(6) ANUJ NARANG...................................................................... PRESIDENT IFMC	40.00 ................. 0.00			X		1,340,399	266,929
(7) ZOBAIR YOUNOSSI...................................................................... PRESIDENT INOVA MEDICINE	40.00 ................. 0.00			X		1,063,327	220,793
(8) HARVEY MCDUFFIE...................................................................... SVP PRESIDENT INOVA REALTY	40.00 ................. 0.00			X		997,702	66,896
(9) SUSAN CARROLL...................................................................... PRESIDENT IFOH SVP CLIN ENT	40.00 ................. 0.00			X		1,045,139	79,718
(10) TERRI FEELY...................................................................... CHIEF PEOPLE OFFICER IHS	40.00 ................. 10.00			X		1,448,535	99,854
(11) TONI ARDEBELL...................................................................... CHIEF CLINICAL ENTERPRISE	40.00 ................. 0.00			X		1,618,373	80,029
(12) DAVID QUIRKE...................................................................... EVP CIO	40.00 ................. 0.00			X		1,180,145	285,122
(13) JAMES ECKLUND...................................................................... PRESIDENT NEUROSCIENCES	40.00 ................. 0.00				X	1,791,959	308,393
(14) JOHN HAMILTON...................................................................... PHYSICIAN	40.00 ................. 0.00				X	1,866,190	87,651
(15) ANDREW FANOUS...................................................................... PHYSICIAN	40.00 ................. 0.00				X	1,669,808	57,432
(16) CHRISTOPHER O'CONNOR...................................................................... PRESIDENT IHVI	40.00 ................. 0.00				X	1,441,106	51,440
(17) HASHEMI HOMAYOUN...................................................................... PHYSICIAN	40.00 ................. 0.00				X	1,387,264	67,128

(A) Name and business address	(B) Description of services	(C) Compensation
RANDSTAD HEALTHCARE PO BOX 742689 ATLANTA,GA30374	STAFFING	101,737,587
CROTHALL SERVICES GROUP 955 CHESTERBROOK BLVD SUITE 300 WAYNE,PA19087	STAFFING	52,415,018
CLARK CONSTRUCTION LLC 7500 OLD GEORGETOWN RD SUITE 785 BETHESDA,MD20814	CONSTRUCTION	44,312,511
HITT CONTRACTING INC 2900 FAIRVIEW PARK DRIVE FALLS CHURCH,VA22042	CONSTRUCTION	24,818,397
ALLIED UNIVERSAL COMPANY PO BOX 931703 ATLANTA,GA31193	SECURITY	19,227,461
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 720

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

INOVA HEALTH CARE SERVICES

Employer identification number

54-0620889

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2021

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2021

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2021

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
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 0.015 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 0.035	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2021

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Name of the organization

INOVA HEALTH CARE SERVICES

Employer identification number

54-0620889

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization INOVA HEALTH CARE SERVICES

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization INOVA HEALTH CARE SERVICES		Employer identification number 54-0620889

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization INOVA HEALTH CARE SERVICES			Employer identification number 54-0620889
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

INOVA HEALTH CARE SERVICES

Employer identification number

54-0620889

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2021

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(a) Filing organization's totals	(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................	230,785
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................	230,785
d	Other exempt purpose expenditures ...............................................................................	3,629,044,830
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................	3,629,275,615
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.	1,000,000
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................	250,000
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................	0
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................	0
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................		Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount	1,000,000	1,000,000	1,000,000	1,000,000	4,000,000

b	Lobbying ceiling amount (150% of line 2a, column(e))					6,000,000

c	Total lobbying expenditures	368,341	423,405	454,768	230,785	1,477,299

d	Grassroots nontaxable amount	250,000	250,000	250,000	250,000	1,000,000

e	Grassroots ceiling amount (150% of line 2d, column (e))					1,500,000

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2021

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

INOVA HEALTH CARE SERVICES

Employer identification number

54-0620889

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	257,818,091		257,818,091
b	Buildings ....	3,347,182,599	1,732,836,884	1,614,345,715
c	Leasehold improvements
d	Equipment ....	1,856,794,742	1,496,331,042	360,463,700
e	Other .....	192,394,969		192,394,969
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				2,425,022,475

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)OTHER ASSETS				54,755,920
(2)DUE FROM SUBSIDIARIES AND AFFILIATES				2,432,739,773
(3)LONG TERM RIGHT OF USE				122,134,188
(4)EQUITY INVESTMENTS				102,090,400
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				2,711,720,281

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	235,450,324
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Part X, Line 2:

From Inova Health System Foundation consolidated financial statements including Inova Health Care Services: The Foundation and IHCS are not-for-profit corporations and have been determined to be exempt from Federal income tax under the provisions of section 501(c)(3) of the Internal Revenue Code. Therefore, these entities will not incur any liability for federal income tax, except for possible unrelated business income. IHI and its subsidiaries are taxable organizations. Deferred income taxes are provided for all significant timing differences between revenues and expenses reported for financial statement and for tax purposes. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the consolidated financial statements.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

INOVA HEALTH CARE SERVICES

Employer identification number

54-0620889

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 40000.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	97,871,667		97,871,667	2.350 %
b	Medicaid (from Worksheet 3, column a) . . . . .	465,193,672	285,567,510	179,626,162	4.320 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	563,065,339	285,567,510	277,497,829	6.670 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	12,815,600	504,891	12,310,709	0.300 %
f	Health professions education (from Worksheet 5) . . .	20,207,512	1,458,845	18,748,667	0.450 %
g	Subsidized health services (from Worksheet 6) . . . .	25,148,212	4,942,090	20,206,122	0.490 %
h	Research (from Worksheet 7) .	37,978,656	20,167,172	17,811,484	0.430 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	3,513,733		3,513,733	0.080 %
j	Total. Other Benefits . .	99,663,713	27,072,998	72,590,715	1.750 %
k	Total. Add lines 7d and 7j .	662,729,052	312,640,508	350,088,544	8.420 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

24,367,588

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

596,309,493

Enter Medicare allowable costs of care relating to payments on line 5.....

795,244,508

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-198,935,015

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 Franconia-Springfield Surgery Center LLC	Surgical Services	56.090 %	43.910 %
22 Northern Virginia Surgery Center LLC	Surgical Services	58.300 %	41.700 %
33 Inova Ambulatory Surgery Center at Lorton LLC	Surgical Services	65.080 %	34.920 %
44 McLean Ambulatory Surgery LLC	Surgical Services	55.500 %	44.500 %
55 Inova Loudoun Ambulatory Surgery Center LLC	Surgical Services	55.350 %	44.650 %
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2021

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?10Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)								Facility reporting group
1	INOVA FAIRFAX HOSPITAL 3300 GALLOWS ROAD FALLS CHURCH,VA22046 INOVA.ORG VA H1921	X	X	X	X	X	X	A
2	INOVA ALEXANDRIA HOSPITAL 4320 SEMINARY ROAD ALEXANDRIA,VA22304 INOVA.ORG VA H1859	X	X				X	A
3	INOVA LOUDOUN HOSPITAL 44035 RIVERSIDE PARKWAY LEESBURG,VA20176 INOVA.ORG VA H1868	X	X				X	A
4	INOVA FAIR OAKS HOSPITAL 3600 JOSPEH SIEWICK DRIVE FAIRFAX,VA22033 INOVA.ORG VA H1922	X	X				X	A
5	INOVA MOUNT VERNON HOSPITAL 2501 PARKER LANE ALEXANDRIA,VA22306 INOVA.ORG VA H1923	X	X				X	A
6	INOVA LOUDOUN AMBULATORY SURGERY CENTER LLC 44035 RIVERSIDE PARKWAY 200 LEESBURG,VA20176 INOVA.ORG OH728	X	X					A
7	NORTHERN VIRGINIA SURGERY CENTER LLC 3620 JOSEPH SIEWICK DRIVE 202 FAIRFAX,VA22033 INOVA.ORG OH716	X	X					A
8	FRANCONIA-SPRINGFIELD SURGERY CENTER LLC 6355 WALKER LANE 200 ALEXANDRIA,VA22310 INOVA.ORG OH655	X	X					A
9	MCLEAN AMBULATORY SURGERY CENTER LLC 7601 LEWINSVILLE ROAD 440 MCLEAN,VA22102 INOVA.ORG OH728	X	X					A
10	INOVA AMBULATORY SURGERY CENTER AT LORTON LLC 9321 SANGER STREET 200 LORTON,VA22079 INOVA.ORG OH725	X	X					A

Schedule H (Form 990) 2021

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): See line 10a for CHNA website

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): www.inova.org/inova-in-the-community/index.jsp

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 400.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

https://www.inova.org/patient-and-visitor-information/financial-assistance

The FAP application form was widely available on a website (list url):

https://www.inova.org/patient-and-visitor-information/financial-assistance

A plain language summary of the FAP was widely available on a website (list url):
https://www.inova.org/patient-and-visitor-information/financial-assistance

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2021

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Part V, Section A:	The surgery centers listed as hospital facilities 6-10 in Part V, Section A are part of the hospital facilities' CHNAs already conducted and have followed the hospital facilities' financial assistance policy. The surgery centers are reported specifically in the hospital facilities' CHNAs and are listed as hospital facilities in Part V, Section A.
Part V, Section B	Facility Reporting Group A
Facility Reporting Group A consists of:	- Facility 1: INOVA FAIRFAX HOSPITAL, - Facility 2: INOVA ALEXANDRIA HOSPITAL, - Facility 3: INOVA LOUDOUN HOSPITAL, - Facility 4: INOVA FAIR OAKS HOSPITAL, - Facility 5: INOVA MOUNT VERNON HOSPITAL, - Facility 6: INOVA LOUDOUN AMBULATORY SURGERY CENTER LLC, - Facility 7: NORTHERN VIRGINIA SURGERY CENTER LLC, - Facility 8: FRANCONIA-SPRINGFIELD SURGERY CENTER LLC, - Facility 9: MCLEAN AMBULATORY SURGERY CENTER LLC, - Facility 10: INOVA AMBULATORY SURGERY CENTER AT LORTON LLC
Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 3j:	Question 3eInova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Eight areas were identified as the most significant health needs for the IFH community: Chronic Conditions; Economic Stability; Healthcare Access; Injuries and Violence; Mental Health; Neighborhood and Built Environment; Obesity, Nutrition, and Physical Activity; and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, IFH-IMASC has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in 2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system wide approaches to improving CHNA-identified health needs and the Fairfax Regional Action Committee consisting of Inova team members and community partners identifies local needs and opportunities.
Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 5:	For Inova Fairfax Hospital :The IFH-IMASC CHNA adopts knowledge gained during the Fairfax County Health Department's CHA, as well as additional community input. As a part of the collaborative process leading this CHNA, the Fairfax County Health Director and Strategic Planner provided valuable insight and knowledge, and input was received from diverse sources including the local health departments, Inova staff, representatives of key community groups and individual community members.The Fairfax CHA examined a variety of other community assessments to extrapolate significant health needs and themes. The main tool utilized in this process was an analysis of these community assessments produced by key groups and partners in the community. Some assessments examined a broad range of health-related indicators, and others studied a specific program area or health-related issue. Diverse sectors of the community were broadly represented, and together these assessments provide a comprehensive profile of the Fairfax community. The 12 assessments included in the Fairfax County CHA were the following: Community Health DashboardFairfax County Youth SurveyFairfax County Human Services Needs AssessmentInova Community Health Needs AssessmentKaiser Permanente Community Health Needs Assessment,Community Assessment for Public Health Emergency ResponseFairfax Food Council Community Food AssessmentCulturally and Linguistically Appropriate Services SurveyEquitable Growth Profile of Fairfax CountyA Study in Contrasts: Why Life Expectancy Varies in Northern VirginiaFairfax County Park Authority Needs Assessment, The State of the Health Care Workforce in Northern Virginia. For more information on the Fairfax County CHA, visit www.fairfaxcounty.gov/livehealthy.Additionally, Inova staff gathered feedback from the Partnership for a Healthier Fairfax Steering Committee and the Fairfax County Multicultural Advisory Council through targeted focus group questions.Inova and the health departments gathered community input through a public survey promoted to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese [Mandarin], English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics, as well as health department facilities.
Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 6a:	Inova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) Inova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center at Lorton (IASCL) Inova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC)
Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 11:	BackgroundA Community Health Needs Assessment (CHNA) was conducted in 2019 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2020-2022. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Chronic Conditions, Healthcare Access, and Behavioral Health were chosen as the priority areas for the 2020-2022 Implementation Strategy.Update - Year TwoImplementation StructureMembers of the Community Health Division, Inova leadership, Fairfax Health Department, and community partners have been working diligently on the priority areas set forth in the 2019 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in mid-2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the Fairfax Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Steering Committee meets monthly to identify needs and opportunities throughout the system. The Action Committee also meets monthly and brings together representatives from multiple Inova departments, faith-based organizations, mental health stakeholders, Neighborhood Health FQHC, Area Health Education Center, and county teams including the Community Services Board, Neighborhood and Community Services, Public Schools, and the Health Department.Inova in the CommunityAction Committee conversations in Fairfax and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Fairfax, this included participating in events such as County-led Health Resource Fairs in Annandale and the Lee District, LatinX AIDS Awareness Day and HIV testing at Northern Virginia Community College (NVCC), World AIDS Day Awareness testing at NVCC, Community Health Fair at Groveton Baptist Church, and the launch of Dream Big at West Potomac Academy of Fairfax County Public Schools. Creating a Diverse WorkforceDream Big, Inova's health equity-based workforce development initiative, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives minority youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos and share their work-life experiences. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, Inova Community Health and Inova Talent Acquisition joined forces to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. Social Determinants of Health ScreeningIn 2021, Inova established a Clinical Effectiveness sprint to implement Social Determinants of Health screenings across the system. The screening tool is made up of validated questions assessing need in a wide array of social determinants. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting "wheel" should be presented, who it should be available to, and what was necessary to begin socializing its use. The tool launched at the end of August following the project and a variety of mechanisms are in place to gather the information, including directly from patients, via the MyChart patient portal. A resource page was created on the Inova intranet to assist in the use of the tool and referrals based on individual responses. The system is in the process of implementing the UniteUs/Unite Virginia platform for active referrals to social services and non-profit partners, and the Inova team is encouraging referral partners to join the platform as well. This will close the loop for those using the screening tool and needing easy access to resources for patients.Community Health FundEvery year Inova provides Community Health Fund grants to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2021, the overall award amount was doubled to $240,000. Awardees included: The Women's Center who will expand access to effective, equitable, and affordable mental health services for more than 60 low-income Fairfax County residents; and NOVA Scripts Central who provides affordable pharmacy services to low-income, uninsured residents across Northern Virginia and will improve access to culturally competent and linguistically appropriate health information. Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. A charter was developed to identify and address food insecurity and access in the area bordering Fairfax County and the City of Alexandria. This effort led to increased interest in the use of Community Health Workers (CHW) to partner with individuals and communities to promote health and address social determinants of health. In 2020, a CHW was hired for the charter region and another was identified for zip codes in eastern Loudoun County. CHW roles are now present in all Inova Cares Clinic for Families sites located in regions with high rates of health disparities.Healthcare Disparities ConferenceIn October, Inova presented the third annual Healthcare Disparities Conference entitled: "A Call for Transformation: Impactful Strategies for Sustainable Change." This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with topics addressing strategies for implementing individual, team, community, and systemic change to address health disparities and improve the health and wellbeing of culturally and ethnically diverse patients. Speakers shared their experiences with advancing health equity and implementing change in their practice settings and communities. Participants learned how to be a community ally by supporting practice and policy changes that promote health equity.The partnership that coordinated this CME-accredited event includes Inova, George Mason University, Virginia Area Health Education Center, and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA).
Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 13h:	Calculate family size
Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 16j:	Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website.
Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 3j:	Question 3eInova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC) completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Ten areas were identified as the most significant health needs for the IAH/IFFSC community: Chronic Conditions; Economic Stability; Healthcare Access; Injuries and Violence; Mental Health; Neighborhood and Built Environment; Obesity, Nutrition, and Physical Activity; Oral Health; Sexual and Reproductive Health; and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, IAH-IFFSC has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in 2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system wide approaches to improving CHNA-identified health needs and the Alexandria Regional Action Committee consisting of Inova team members and community partners identifies local needs and opportunities
Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 5:	For IAH:Throughout the CHNA/CHA, the Alexandria Health Department (AHD) and Inova worked with community partners and developed public meetings, pop-up events and targeted outreach plans to engage residents who are not always represented. Following are the core strategies AHD used to capture a wide variety of community perspectives and priorities. Inova was an active participant in these activities but relied on AHD core strength in community engagement to lead the process. Throughout the assessment, input was received from diverse sources including the local health department, Inova staff, representatives of key community groups and individual community members. The Community Health Assessment Steering Committee - comprised of community members - guided Alexandria's CHA focus, process and decision-making each step of the way. Through monthly meetings, this group advised AHD staff on outreach strategies, public meeting structure and how to prioritize data using equity as a primary lens. Organization represented include:Alexandria Bicycle and Pedestrian Advisory CommitteeAlexandria City Public SchoolsAlexandria Commission for WomenAlexandria Commission on AgingAlexandria Commission on HIV/AIDSAlexandria Health DepartmentAlexandria Redevelopment and Housing AuthorityAlexandria School Health Advisory BoardCasa ChirilaguaEconomic Opportunities CommissionFriends of Alexandria Mental Health CenterFriends of Guest House Inova Health SystemMedical Reserve CorpsMotley FoolNeighborhood Health (FQHC)Northern Virginia Health FoundationPartnership for a Healthier AlexandriaTheater ChurchPublic MeetingsAHD hosted three community meetings to ensure transparency and engage community members in the CHA process. Meeting locations were selected deliberately for geographic diversity, proximity to public transit, and easy accessibility for those with limited mobility. AHD provided meals and interpreter services in Spanish, Arabic, and Amharic at all meetings. These public meetings were advertised through City of Alexandria media channels, local newspapers, Medical Reserve Corps volunteer flyer distribution, tabling at community events, and email outreach to various partners and other local government agencies.Kickoff and Creating a Vision for Health: April 26, 2018, First Baptist ChurchIntro to Data Collection: July 26, 2018, Durant Recreation CenterGathering Evidence and Examining Results: November 3, 2018, George Washington Middle SchoolBuilding a Healthier Alexandria Together: Community Health Assessment Report Release: June 26, 2019, Beth El Hebrew CongregationPhotoVoicePhotoVoice is a method to crowdsource information using pictures. AHD introduced the concept during the July 26, 2018 public meeting and asked attendees to submit photos that capture either what people are proud of in Alexandria or what could be improved. Participants could submit up to five photos with captions through email or text message. PhotoVoice participants submitted more than 70 pictures and captions. A subset of this group met on August 9, 2018 to discuss the images and sort them into categories. The resulting categories are: equitable access to green space, accessibility in our food system, community cohesion, children and youth, environment and mobility. A full gallery of the images are on Instagram @AlexHealthMatters.Public Health Pop-UpsDuring the Community Themes and Strengths Assessment (CTSA) public survey, AHD staff organized 26 public health pop-ups to collect surveys and promote the November 3, 2018 community meeting. These pop-up locations were selected to meet residents where they are and encourage survey participation from community members who may not be fully engaged in civic processes because of time, awareness, literacy, or language barriers. A combination of AHD employees and Medical Reserve Corps volunteers staffed all of the pop-ups, which were mostly held on evenings and weekends. Of the nearly 1,800 completed CTSA surveys, almost half were collected during public health pop-ups.In addition to the pop-ups, Inova and AHD staff worked with a number of local organizations to administer and collect surveys on their premises on an ongoing basis, such as the Department of Community and Human Services, the Alexandria Redevelopment and Housing Authority, Tenants and Workers United, and Casa Chirilagua. Finally, all AHD locations - 4480 King Street clinics and WIC, Teen Wellness Center at TC Williams, and the Casey Center - administered the survey to clients. Additionally, Inova promoted the online survey on its website and through community partners including safety net providers, social service agencies and others.
Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 6a:	Inova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center at Lorton (IASCL) Inova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC)
Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 11:	BackgroundA Community Health Needs Assessment (CHNA) was conducted in 2019 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2020-2022. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Chronic Conditions, Healthcare Access, and Behavioral Health were chosen as the priority areas for the 2020-2022 Implementation Strategy.Update - Year TwoImplementation StructureMembers of the Community Health Division, IAH leadership, and community partners have been working diligently on the priority areas set forth in the 2019 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in mid-2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the Alexandria Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Steering Committee meets monthly to identify needs and opportunities throughout the system. The Action Committee also meets monthly and brings together representatives from multiple Inova departments, faith based organizations, mental health stakeholders, community businesses and organizations, the Concerned Citizen Network of Alexandria (CCNA), Tenants and Workers United, American Foundation for Suicide Prevention, Medical Reserve Corp - Alexandria, Volunteers of Alexandria, Animal Welfare League of Alexandria, Four Mile Run, Neighborhood Health FQHC, and city teams including Community and Human Services, Parks and Recreation, Public Schools, and Race and Social Equity, Alexandria elected officials, Northern Virginia Community College, and community members that reside in the Alexandria Neighborhoods. Inova in the CommunityAction Committee conversations in Alexandria and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Alexandria, this included the Coat and Vaccine with CCNA at St. Joseph's Catholic Church in Old Town, Back to School Health Fair, two Pets and People Community Event's with the Animal Welfare League of Alexandria in Arlandria, and the Spring 2Motion Movement Challenge for the City of Alexandria. Creating a Diverse WorkforceDream Big, Inova's health equity-based workforce development initiative, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives minority youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos and share their work-life experiences. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, Inova Community Health and Inova Talent Acquisition joined forces to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. Social Determinants of Health ScreeningIn 2021, Inova established a Clinical Effectiveness sprint to implement Social Determinants of Health screenings across the system. The screening tool is made up of validated questions assessing need in a wide array of social determinants. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting "wheel" should be presented, who it should be available to, and what was necessary to begin socializing its use. The tool launched at the end of August following the project and a variety of mechanisms are in place to gather the information, including directly from patients, via the MyChart patient portal. A resource page was created on the Inova intranet to assist in the use of the tool and referrals based on individual responses. The system is in the process of implementing the UniteUs/Unite Virginia platform for active referrals to social services and non-profit partners, and the Inova team is encouraging referral partners to join the platform as well. This will close the loop for those using the screening tool and needing easy access to resources for patients.Community Health FundEvery year Inova provides Community Health Fund grants to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2021, the overall award amount was doubled to $240,000. Awardees included: Boys & Girls Clubs of Greater Washington - Funds were used to expand the Triple Play and Healthy Habits programs, which encourage good nutrition, physical activity, healthy relationships, and active learning.Capital Youth Empowerment Program - Funds were used to boost the Fathers in Tech project, which teaches workforce skills to Arlington, Fairfax, and Alexandria fathers living in Black, Indigenous and People of Color (BIPOC) communities.Carpenter's Shelter Inc - Funds were used to improve access to medical and mental health care among homeless adults and children in Alexandria and help them transition to sustainable homes. La Cocina VA - Funds were used to expand the Healthy Food Assistance program to fight hunger and obesity among immigrants, children, homeless people, veterans, the unemployed, and the underemployed in Arlington.Nueva Vida, Inc- Funds were used to create culturally sensitive cancer and mental health support for the medically under-resourced Latino/a population in Alexandria City and Fairfax County.SCAN of Northern Virginia - Funds were used to increase access to child abuse prevention resources, assessments and medical care for families in Alexandria.The Campagna Center - Funds were used to subsidize the New Neighbors program, which provides students with access to high-quality English language instruction to improve their employment and future opportunities to thrive in the community.The Child and Family Network Centers - Funds were used to provide pre-kindergarten physicals, vaccinations and medical screenings to more than 100 four-year-olds in underserved West End and Alexandria communities.
Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 13h:	Calculate family size
Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 16j:	Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website.
Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 3j:	Question 3eInova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC) completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Nine areas were identified as the most significant health needs for the ILH/ILASC community: Chronic Conditions, Economic Stability, Healthcare Access, Infectious Disease and Immunization, Injuries and Violence, Mental Health, Neighborhood and Built Environment, Oral Health, and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, ILH-ILASC has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in 2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system wide approaches to improving CHNA-identified health needs and the Loudoun Regional Action Committee consisting of Inova team members and community partners identifies local needs and opportunities.
Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 5:	For ILH:While a regional approach guided the CHNA/CHA, each jurisdiction used its own process for community outreach and engagement. As much as possible, the process centered on existing resources, partnerships, and local needs and values. This method ensures that any new initiatives accurately reflect community priorities. Inova and the Loudoun County Health Department planned and produced the Loudoun assessment together. Each member of the team contributed to the assessment in different ways, utilizing individual strengths. As a part of the collaborative process leading this assessment, the Loudoun County Health Director and the Loudoun Health Council provided valuable insight and knowledge, and input was received from diverse sources including the local health department, hospital staff, representatives of key community groups and individual community members.This 2019 Community Health Needs Assessment (CHNA)/Community Health Assessment (CHA) process gathered community input through two main methods - Forces of Change discussions and the community survey.Forces of Change discussions bring together individuals working in and with the community, who represent a broad diversity of stakeholders. Participants included individuals with special knowledge of or expertise in public health; local public health departments; agencies with current data or information about the health and social needs of the community; representatives of social service organizations; business leaders, and leaders, representatives, and members of medically underserved, low income, and minority populations. Inova and Loudoun County Health Department representatives conducted Forces of Change sessions with the Loudoun Health Council, Loudoun Human Services Network, and the Loudoun County Chamber of Commerce.Inova, the Health Department and the Loudoun Health Council promoted the community survey to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese (Mandarin), English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics, as well as health department facilities. Surveys were also distributed to families through the Loudoun County Public School system.
Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 6a:	Inova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) Inova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center at Lorton (IASCL)
Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 11:	BackgroundA Community Health Needs Assessment (CHNA) was conducted in 2019 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2020-2022. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Chronic Conditions, Healthcare Access, and Behavioral Health were chosen as the priority areas for the 2020-2022 Implementation Strategy.Update - Year TwoImplementation StructureMembers of the Community Health Division, Inova leadership, Fairfax Health Department, and community partners have been working diligently on the priority areas set forth in the 2019 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in mid-2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the Fair Oaks Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Steering Committee meets monthly to identify needs and opportunities throughout the system. The Action Committee also meets monthly and brings together representatives from multiple Inova departments, faith-based organizations, Healthworks FQHC, Northern Virginia Family Services, Cornerstones, Western Fairfax Christian Ministries, and county teams including the Health Department, Neighborhood and Community Services, Community Services Board, and Public Schools.Inova in the CommunityAction Committee conversations in the Fair Oaks region and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Fair Oaks, this included participating in events with Western Fairfax Christian Ministries, Cornerstones, and Opportunity Neighborhood.Creating a Diverse WorkforceDream Big, Inova's health equity-based workforce development initiative, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives minority youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos and share their work-life experiences. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, Inova Community Health and Inova Talent Acquisition joined forces to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. Social Determinants of Health ScreeningIn 2021, Inova established a Clinical Effectiveness sprint to implement Social Determinants of Health screenings across the system. The screening tool is made up of validated questions assessing need in a wide array of social determinants. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting "wheel" should be presented, who it should be available to, and what was necessary to begin socializing its use. The tool launched at the end of August following the project and a variety of mechanisms are in place to gather the information, including directly from patients, via the MyChart patient portal. A resource page was created on the Inova intranet to assist in the use of the tool and referrals based on individual responses. The system is in the process of implementing the UniteUs/Unite Virginia platform for active referrals to social services and non-profit partners, and the Inova team is encouraging referral partners to join the platform as well. This will close the loop for those using the screening tool and needing easy access to resources for patients.Community Health FundEvery year Inova provides Community Health Fund grants to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2021, the overall award amount was doubled to $240,000. Awardees included: YMCA of Metropolitan Washington's location in Reston to support both its health promotion programs and its Food and Health Hub program that provides home-delivered local produce to food insecure residents and those with chronic health conditions living. Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. A charter was developed to identify and address food insecurity and access in the area bordering Fairfax County and the City of Alexandria. This effort led to increased interest in the use of Community Health Workers (CHW) to partner with individuals and communities to promote health and address social determinants of health. In 2020, a CHW was hired for the charter region and another was identified for zip codes in eastern Loudoun County. CHW roles are now present in all Inova Cares Clinic for Families sites located in regions with high rates of health disparities.Healthcare Disparities ConferenceIn October, Inova presented the third annual Healthcare Disparities Conference entitled: "A Call for Transformation: Impactful Strategies for Sustainable Change". This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with topics addressing strategies for implementing individual, team, community, and systemic change to address health disparities and improve the health and wellbeing of culturally and ethnically diverse patients. Speakers shared their experiences with advancing health equity and implementing change in their practice settings and communities. Participants learned how to be a community ally by supporting practice and policy changes that promote health equity.The partnership that coordinated this CME-accredited event includes Inova, George Mason University, Virginia Area Health Education Center, and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA).
Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 13h:	Calculate family size
Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 16j:	Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website.
Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 3j:	Question 3eInova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Seven areas were identified as the most significant health needs for the IFOH/INVSC community: Chronic Conditions, Economic Stability, Healthcare Access, Injuries and Violence, Mental Health, Neighborhood and Built Environment, and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, IFOH-INVSC has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in 2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system wide approaches to improving CHNA-identified health needs and the Fair Oaks Regional Action Committee consisting of Inova team members and community partners identifies local needs and opportunities.
Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 5:	For IFOH:The IFOH-INVSC CHNA adopts knowledge gained during the Fairfax County Health Department's CHA, as well as additional community input. As a part of the collaborative process leading this CHNA, the Fairfax County Health Director and Strategic Planner provided valuable insight and knowledge, and input was received from diverse sources including the local health departments, Inova staff, representatives of key community groups and individual community members.The Fairfax CHA examined a variety of other community assessments to extrapolate significant health needs and themes. The main tool utilized in this process was an analysis of these community assessments produced by key groups and partners in the community. Some assessments examined a broad range of health-related indicators, and others studied a specific program area or health-related issue. Diverse sectors of the community were broadly represented, and together these assessments provide a comprehensive profile of the Fairfax community. The 12 assessments included in the Fairfax County CHA were the following: Community Health DashboardFairfax County Youth SurveyFairfax County Human Services Needs AssessmentInova Community Health Needs AssessmentKaiser Permanente Community Health Needs Assessment,Community Assessment for Public Health Emergency ResponseFairfax Food Council Community Food AssessmenCulturally and Linguistically Appropriate Services SurveyEquitable Growth Profile of Fairfax CountyA Study in Contrasts: Why Life Expectancy Varies in Northern VirginiaFairfax County Park Authority Needs Assessment, The State of the Health Care Workforce in Northern Virginia. For more information on the Fairfax County CHA, visit www.fairfaxcounty.gov/livehealthy.Additionally, Inova staff gathered feedback from the Partnership for a Healthier Fairfax Steering Committee and the Fairfax County Multicultural Advisory Council through targeted focus group questions.Inova and the health departments gathered community input through a public survey promoted to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese [Mandarin], English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics, as well as health department facilities.
Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 6a:	Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) Inova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center at Lorton (IASCL) Inova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC)
Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 11:	BackgroundA Community Health Needs Assessment (CHNA) was conducted in 2019 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2020-2022. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Chronic Conditions, Healthcare Access, and Behavioral Health were chosen as the priority areas for the 2020-2022 Implementation Strategy.Update - Year TwoMembers of the Community Health Division, Inova leadership, Fairfax Health Department, and community partners have been working diligently on the priority areas set forth in the 2019 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in mid-2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the Mt. Vernon Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Steering Committee meets monthly to identify needs and opportunities throughout the system. The Action Committee also meets monthly and brings together representatives from multiple Inova departments, faith-based organizations, primary and secondary education institutions, community businesses and organizations, mental health stakeholders, United Community, Neighborhood Health FQHC, and county teams including the Community Services Board, Public Schools, the Health Department, Equity, and Neighborhood and Community Services, and community members who reside in the Mt. Vernon neighborhoods. Inova in the CommunityAction Committee conversations in Mt. Vernon and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Mt. Vernon, this included participating in events such as a Juneteenth celebration at Creekside, Multicultural Community Day at Sequoyah, Multicultural Community Day at Audubon, Woodlawn Apartments Community Day, the Trunk and Treat Halloween Resource Fair at the Sacramento Neighborhood Center, and a month of culturally competent holiday season events in December for the Audubon Community. Creating a Diverse WorkforceDream Big, Inova's health equity-based workforce development initiative, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives minority youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos and share their work-life experiences. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, Inova Community Health and Inova Talent Acquisition joined forces to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. Social Determinants of Health ScreeningIn 2021, Inova established a Clinical Effectiveness sprint to implement Social Determinants of Health screenings across the system. The screening tool is made up of validated questions assessing need in a wide array of social determinants. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting "wheel" should be presented, who it should be available to, and what was necessary to begin socializing its use. The tool launched at the end of August following the project and a variety of mechanisms are in place to gather the information, including directly from patients, via the MyChart patient portal. A resource page was created on the Inova intranet to assist in the use of the tool and referrals based on individual responses. The system is in the process of implementing the UniteUs/Unite Virginia platform for active referrals to social services and non-profit partners, and the Inova team is encouraging referral partners to join the platform as well. This will close the loop for those using the screening tool and needing easy access to resources for patients.Community Health FundEvery year Inova provides Community Health Fund grants to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2021, the overall award amount was doubled to $240,000. Awardees included: United Community who help families find fresh foods and health services and coordinate a Health Work Group to improve community health outcomes and develop a sustainable system for healthy food access, and Our Minds Matter who support peer and programmatic suicide prevention programs and mental health resources in Annandale, Falls Church, Justice, Mount Vernon and West Potomac High Schools in Fairfax County.Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. A charter was developed to identify and address food insecurity and access in the area bordering Fairfax County and the City of Alexandria. This effort led to increased interest in the use of Community Health Workers (CHW) to partner with individuals and communities to promote health and address social determinants of health. In 2020, a CHW was hired for the charter region and another was identified for zip codes in eastern Loudoun County. CHW roles are now present in all Inova Cares Clinic for Families sites located in regions with high rates of health disparities.Healthcare Disparities ConferenceIn October, Inova presented the third annual Healthcare Disparities Conference entitled: "A Call for Transformation: Impactful Strategies for Sustainable Change". This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with topics addressing strategies for implementing individual, team, community, and systemic change to address health disparities and improve the health and wellbeing of culturally and ethnically diverse patients. Speakers shared their experiences with advancing health equity and implementing change in their practice settings and communities. Participants learned how to be a community ally by supporting practice and policy changes that promote health equity.The partnership that coordinated this CME-accredited event includes Inova, George Mason University, Virginia Area Health Education Center, and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA).
Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 13h:	Calculate family size
Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 16j:	Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website.
Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 3j:	Question 3eInova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center (IASCL) at Lorton completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Eight areas were identified as the most significant health needs for the IMVH/IASCL community: Chronic Conditions; Economic Stability; Healthcare Access; Injuries and Violence; Maternal, Infant, and Child Health; Mental Health; Neighborhood and Built Environment; and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, IMVH-IASCL has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in 2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system wide approaches to improving CHNA-identified health needs and the Mt. Vernon Regional Action Committee consisting of Inova team members and community partners identifies local needs and opportunities.
Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 5:	For IMVH:The IMVH-IASCL CHNA adopts knowledge gained during the Fairfax County Health Department's CHA, as well as additional community input. As a part of the collaborative process leading this CHNA, the Fairfax County Health Director and Strategic Planner provided valuable insight and knowledge, and input was received from diverse sources including the local health departments, hospital staff, representatives of key community groups and individual community members.The Fairfax CHA examined a variety of other community assessments to extrapolate significant health needs and themes. The main tool utilized in this process was an analysis of these community assessments produced by key groups and partners in the community. Some assessments examined a broad range of health-related indicators, and others studied a specific program area or health-related issue. Diverse sectors of the community were broadly represented, and together these assessments provide a comprehensive profile of the Fairfax community. The 12 assessments included in the Fairfax County CHA were the following: Community Health DashboardFairfax County Youth SurveyFairfax County Human Services Needs AssessmentInova Community Health Needs AssessmentKaiser Permanente Community Health Needs Assessment,Community Assessment for Public Health Emergency ResponseFairfax Food Council Community Food AssessmentCulturally and Linguistically Appropriate Services SurveyEquitable Growth Profile of Fairfax CountyA Study in Contrasts: Why Life Expectancy Varies in Northern VirginiaFairfax County Park Authority Needs Assessment, The State of the Health Care Workforce in Northern Virginia. For more information on the Fairfax County CHA, visit www.fairfaxcounty.gov/livehealthy.Additionally, Inova staff gathered feedback from the Partnership for a Healthier Fairfax Steering Committee and the Fairfax County Multicultural Advisory Council through targeted focus group questions.Inova and the health departments gathered community input through a public survey promoted to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese [Mandarin], English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics, as well as health department facilities.
Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 6a:	Inova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) Inova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC)
Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 11:	BackgroundA Community Health Needs Assessment (CHNA) was conducted in 2019 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2020-2022. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Chronic Conditions, Healthcare Access, and Behavioral Health were chosen as the priority areas for the 2020-2022 Implementation Strategy.Update - Year TwoImplementation StructureMembers of the Community Health Division, Inova leadership, Loudoun Health Department, and community partners have been working diligently on the priority areas set forth in the 2019 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in mid-2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the Loudoun Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Steering Committee meets monthly to identify needs and opportunities throughout the system. The Action Committee also meets monthly and brings together representatives from multiple Inova departments, faith-based organizations, Healthworks FQHC, Loudoun Free Clinic, Loudoun Hunger Relief, Northern Virginia Family Services, Area Health Education Center, and county teams including the Health Department; Human Services; Mental Health, Substance Abuse, and Developmental Services; and Public Schools.Inova in the CommunityAction Committee conversations in Loudoun and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Loudoun, this included participating in events such as SterlingFest and being present at Loudoun Hunger Relief food distribution events.Creating a Diverse WorkforceDream Big, Inova's health equity-based workforce development initiative, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives minority youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos and share their work-life experiences. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, Inova Community Health and Inova Talent Acquisition joined forces to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. Social Determinants of Health ScreeningIn 2021, Inova established a Clinical Effectiveness sprint to implement Social Determinants of Health screenings across the system. The screening tool is made up of validated questions assessing need in a wide array of social determinants. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting "wheel" should be presented, who it should be available to, and what was necessary to begin socializing its use. The tool launched at the end of August following the project and a variety of mechanisms are in place to gather the information, including directly from patients, via the MyChart patient portal. A resource page was created on the Inova intranet to assist in the use of the tool and referrals based on individual responses. The system is in the process of implementing the UniteUs/Unite Virginia platform for active referrals to social services and non-profit partners, and the Inova team is encouraging referral partners to join the platform as well. This will close the loop for those using the screening tool and needing easy access to resources for patients.Community Health FundEvery year Inova provides Community Health Fund grants to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2021, the overall award amount was doubled to $240,000. Awardees included: Loudoun Literacy Council who will help more than 700 adults and children participate in reading and English as a Second Language programs including Health Education and Literacy, Intervention Instruction, Story Walks, Head Start, and Starting Toward Excellence in Preschool.Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. A charter was developed to identify and address food insecurity and access in the area bordering Fairfax County and the City of Alexandria. This effort led to increased interest in the use of Community Health Workers (CHW) to partner with individuals and communities to promote health and address social determinants of health. In 2020, a CHW was hired for the charter region and another was identified for zip codes in eastern Loudoun County. CHW roles are now present in all Inova Cares Clinic for Families sites located in regions with high rates of health disparities.Healthcare Disparities ConferenceIn October, Inova presented the third annual Healthcare Disparities Conference entitled: "A Call for Transformation: Impactful Strategies for Sustainable Change". This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with topics addressing strategies for implementing individual, team, community, and systemic change to address health disparities and improve the health and wellbeing of culturally and ethnically diverse patients. Speakers shared their experiences with advancing health equity and implementing change in their practice settings and communities. Participants learned how to be a community ally by supporting practice and policy changes that promote health equity.The partnership that coordinated this CME-accredited event includes Inova, George Mason University, Virginia Area Health Education Center, and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA).
Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 13h:	Calculate family size
Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 16j:	Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website.
PART V, SECTION B, LINE 11 INOVA FAIRFAX HOSPITAL	COVID-19 Vaccination Efforts in the CommunityAs the COVID-19 pandemic persisted, Inova collaborated with multiple community partners to get "shots in arms" across the region.Inova's first large-scale vaccine distribution center, which opened at the Inova Center for Personalized Health in late 2020, was soon vaccinating up to 4,000 Inova team members per day. In early 2021, Inova served as the primary source of vaccines for public and private school teachers and employees, and vaccinated community members aged 65+ by appointment. To accommodate increasing demand, the site moved to the Inova Stonebridge COVID-19 Vaccination Center in the City of Alexandria and began accepting walk-in appointments from the general public in mid-March. The site also offered drive-through vaccinations to improve access. Members of Volunteer Fairfax, the Fairfax County Community Emergency Response Team, and the Virginia National Guard helped with patient movement and flow. The Fairfax County Medical Reserve Corps provided 10 volunteers each day in addition to the 100 Inova team members needed daily to administer vaccines. By the end of 2021 more than 450,000 vaccines had been administered.For those who couldn't leave their homes to get a vaccine, the Inova Medical House Calls was one of the first groups to operationalize in-home vaccines in early 2021. Between January and March, the team administered 1,260 doses to 655 homebound older adults and family caregivers without wasting a single dose. Later, the program partnered with the Fairfax County Health Department to continue in-home vaccinations and boosters. Among those who received the vaccine were homebound ElderLink patients over the age of 65. ElderLink is a partnership between Inova and the Fairfax County Area Agency on Aging that promotes the well-being of older adults and caregivers. Despite widespread availability as the year progressed, some community members did not have access or were reluctant to get the vaccine. To reach them, Inova Cares Clinic for Families (ICCF) teamed up with local health departments in Fairfax, Loudoun and Prince Williams counties, which linked ICCF with pastors from local African American churches to rally their congregations. Faith leaders became incredibly important in building trusted relationships between healthcare systems and communities they serve to improve access to care for all. The churches helped to coordinate transportation to ICCF locations, and ICCF set aside clinic days and times during non-work hours to meet the needs of this community.As a result of these joint outreach efforts, more than 4,000 community members were vaccinated at designated ICCF sites. Inova team members administered the shots while church volunteers and health department workers coordinated registration and flow. To educate the community and encourage people to get the COVID-19 vaccine, Inova created and participated in a number of messaging campaigns, including: Get the Vaccine! - Inova produced 45 videos to address vaccine hesitancy and reinforce that the vaccine is safe and effective. Inova physicians from a variety of cultural backgrounds and specialties, including general and internal medicine, surgery, OB-GYN and pediatrics, participated. Providers recorded the message in English and their native languages. Inova also used the videos to engage faith, school and business leaders who found them useful in reaching congregations, families and customers. Vax UP FCPS - In mid-October, Fairfax County Public Schools (FCPS) reached out to request a partnership with Inova's pediatricians to address the questions and concerns of parents considering vaccinating their soon-to-be eligible 5- to 11-year-olds. Within a few weeks, and in time for the official authorization, the joint Inova-FCPS team created videos answering some of the most common questions about the COVID-19 vaccine for kids. These videos were posted to the FCPS page and were made available on the Inova Get the Vaccine! page to maximize their reach in all areas of Northern Virginia.Understanding the COVID-19 Vaccination - In February, Inova team members held a virtual town hall with Black church leaders to discuss the vaccine, address hesitancy and discuss messaging for congregations. This well-informed and collaborative conversation helped shape Inova's outreach efforts to our vulnerable and marginalized populations, while supporting faith leaders in their efforts to keep their communities healthy.Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova Ewing FACT and Inova Cares Clinic for Women opened new clinics in Alexandria to add to their existing presence in Fairfax and Loudoun Counties. Inova Cares Clinic for Families opened a Herndon location to add to its presence in Alexandria, Annandale, Sterling, and Manassas. Inova Medical House Calls continued to grow its service area to include Mt. Vernon. In 2022, Inova's Community Health Division will launch two new programs in the region that address community need - Inova Pride Clinic for LGBTQ+ individuals and Inova Cares for Behavioral Health. Both programs were in development in 2021 and are expected to launch in the first half of 2022.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's Implementation Strategy focuses on meeting the priority and specified community health needs described above. Certain issues are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Even so, there are many activities in these areas throughout the Inova system.
PART V, SECTION B, LINE 11 INOVA ALEXANDRIA HOSPITAL	Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. A charter was developed to identify and address food insecurity and access in the area bordering Fairfax County and the City of Alexandria. This effort led to increased interest in the use of Community Health Workers (CHW) to partner with individuals and communities to promote health and address social determinants of health. In 2020, a CHW was hired for the charter region and another was identified for zip codes in eastern Loudoun County. CHW roles are now present in all Inova Cares Clinic for Families sites located in regions with high rates of health disparities.Healthcare Disparities ConferenceIn October, Inova presented the third annual Healthcare Disparities Conference entitled: "A Call for Transformation: Impactful Strategies for Sustainable Change". This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with topics addressing strategies for implementing individual, team, community, and systemic change to address health disparities and improve the health and wellbeing of culturally and ethnically diverse patients. Speakers shared their experiences with advancing health equity and implementing change in their practice settings and communities. Participants learned how to be a community ally by supporting practice and policy changes that promote health equity.The partnership that coordinated this CME-accredited event includes Inova, George Mason University, Virginia Area Health Education Center, and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA).COVID-19 Vaccination Efforts in the CommunityAs the COVID-19 pandemic persisted, Inova collaborated with multiple community partners to get "shots in arms" across the region.Inova's first large-scale vaccine distribution center, which opened at the Inova Center for Personalized Health in late 2020, was soon vaccinating up to 4,000 Inova team members per day. In early 2021, Inova served as the primary source of vaccines for public and private school teachers and employees, and vaccinated community members aged 65+ by appointment. To accommodate increasing demand, the site moved to the Inova Stonebridge COVID-19 Vaccination Center in the City of Alexandria and began accepting walk-in appointments from the general public in mid-March. The site also offered drive-through vaccinations to improve access. Members of Volunteer Fairfax, the Fairfax County Community Emergency Response Team, and the Virginia National Guard helped with patient movement and flow. The Fairfax County Medical Reserve Corps provided 10 volunteers each day in addition to the 100 Inova team members needed daily to administer vaccines. By the end of 2021 more than 450,000 vaccines had been administered.For those who couldn't leave their homes to get a vaccine, the Inova Medical House Calls was one of the first groups to operationalize in-home vaccines in early 2021. Between January and March, the team administered 1,260 doses to 655 homebound older adults and family caregivers without wasting a single dose. Despite widespread availability as the year progressed, some community members did not have access or were reluctant to get the vaccine. To reach them, Inova Cares Clinic for Families (ICCF) teamed up with local health departments in Fairfax, Loudoun and Prince Williams counties, which linked ICCF with pastors from local African American churches to rally their congregations. Faith leaders became incredibly important in building trusted relationships between healthcare systems and communities they serve to improve access to care for all. The churches helped to coordinate transportation to ICCF locations, and ICCF set aside clinic days and times during non-work hours to meet the needs of this community.As a result of these joint outreach efforts, more than 4,000 community members were vaccinated at designated ICCF sites. Inova team members administered the shots while church volunteers and health department workers coordinated registration and flow. To educate the community and encourage people to get the COVID-19 vaccine, Inova created and participated in a number of messaging campaigns, including: Get the Vaccine! - Inova produced 45 videos to address vaccine hesitancy and reinforce that the vaccine is safe and effective. Inova physicians from a variety of cultural backgrounds and specialties, including general and internal medicine, surgery, OB-GYN and pediatrics, participated. Providers recorded the message in English and their native languages. Inova also used the videos to engage faith, school and business leaders who found them useful in reaching congregations, families and customers. Vax UP FCPS - In mid-October, Fairfax County Public Schools (FCPS) reached out to request a partnership with Inova's pediatricians to address the questions and concerns of parents considering vaccinating their soon-to-be eligible 5- to 11-year-olds. Within a few weeks, and in time for the official authorization, the joint Inova-FCPS team created videos answering some of the most common questions about the COVID-19 vaccine for kids. These videos were posted to the FCPS page and were made available on the Inova Get the Vaccine! page to maximize their reach in all areas of Northern Virginia.Understanding the COVID-19 Vaccination - In February, Inova team members held a town hall with Black church leaders to discuss the vaccine, address hesitancy and discuss messaging for congregations. This well-informed and collaborative conversation helped shape Inova's outreach efforts to our vulnerable and marginalized populations, while supporting faith leaders in their efforts to keep their communities healthy.Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova Ewing FACT and Inova Cares Clinic for Women opened new clinics in Alexandria to add to their existing presence in Fairfax and Loudoun Counties. Inova Cares Clinic for Families opened a Herndon location to add to its presence in Alexandria, Annandale, Sterling, and Manassas. Inova Medical House Calls continued to grow its service area to include Mt. Vernon. In 2022, Inova's Community Health Division will launch two new programs in the region that address community need - Inova Pride Clinic for LGBTQ+ individuals and Inova Cares for Behavioral Health. Both programs were in development in 2021 and are expected to launch in the first half of 2022.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's Implementation Strategy focuses on meeting the priority and specified community health needs described above. Certain issues are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Even so, there are many activities in these areas throughout the Inova system.
PART V, SECTION B, LINE 11 INOVA FAIROAKS HOSPITAL	COVID-19 Vaccination Efforts in the CommunityAs the COVID-19 pandemic persisted, Inova collaborated with multiple community partners to get "shots in arms" across the region.Inova's first large-scale vaccine distribution center, which opened at the Inova Center for Personalized Health in late 2020, was soon vaccinating up to 4,000 Inova team members per day. In early 2021, Inova served as the primary source of vaccines for public and private school teachers and employees, and vaccinated community members aged 65+ by appointment. To accommodate increasing demand, the site moved to the Inova Stonebridge COVID-19 Vaccination Center in the City of Alexandria and began accepting walk-in appointments from the general public in mid-March. The site also offered drive-through vaccinations to improve access. Members of Volunteer Fairfax, the Fairfax County Community Emergency Response Team, and the Virginia National Guard helped with patient movement and flow. The Fairfax County Medical Reserve Corps provided 10 volunteers each day in addition to the 100 Inova team members needed daily to administer vaccines. By the end of 2021 more than 450,000 vaccines had been administered.For those who couldn't leave their homes to get a vaccine, the Inova Medical House Calls was one of the first groups to operationalize in-home vaccines in early 2021. Between January and March, the team administered 1,260 doses to 655 homebound older adults and family caregivers without wasting a single dose. Later, the program partnered with the Fairfax County Health Department to continue in-home vaccinations and boosters. Among those who received the vaccine were homebound ElderLink patients over the age of 65. ElderLink is a partnership between Inova and the Fairfax County Area Agency on Aging that promotes the well-being of older adults and caregivers. Despite widespread availability as the year progressed, some community members did not have access or were reluctant to get the vaccine. To reach them, Inova Cares Clinic for Families (ICCF) teamed up with local health departments in Fairfax, Loudoun and Prince Williams counties, which linked ICCF with pastors from local African American churches to rally their congregations. Faith leaders became incredibly important in building trusted relationships between healthcare systems and communities they serve to improve access to care for all. The churches helped to coordinate transportation to ICCF locations, and ICCF set aside clinic days and times during non-work hours to meet the needs of this community.As a result of these joint outreach efforts, more than 4,000 community members were vaccinated at designated ICCF sites. Inova team members administered the shots while church volunteers and health department workers coordinated registration and flow. To educate the community and encourage people to get the COVID-19 vaccine, Inova created and participated in a number of messaging campaigns, including: Get the Vaccine! - Inova produced 45 videos to address vaccine hesitancy and reinforce that the vaccine is safe and effective. Inova physicians from a variety of cultural backgrounds and specialties, including general and internal medicine, surgery, OB-GYN and pediatrics, participated. Providers recorded the message in English and their native languages. Inova also used the videos to engage faith, school and business leaders who found them useful in reaching congregations, families and customers. Vax UP FCPS - In mid-October, Fairfax County Public Schools (FCPS) reached out to request a partnership with Inova's pediatricians to address the questions and concerns of parents considering vaccinating their soon-to-be eligible 5- to 11-year-olds. Within a few weeks, and in time for the official authorization, the joint Inova-FCPS team created videos answering some of the most common questions about the COVID-19 vaccine for kids. These videos were posted to the FCPS page and were made available on the Inova Get the Vaccine! page to maximize their reach in all areas of Northern Virginia.Understanding the COVID-19 Vaccination - In February, Inova team members held a town hall with Black church leaders to discuss the vaccine, address hesitancy and discuss messaging for congregations. This well-informed and collaborative conversation helped shape Inova's outreach efforts to our vulnerable and marginalized populations, while supporting faith leaders in their efforts to keep their communities healthy.Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova Ewing FACT and Inova Cares Clinic for Women opened new clinics in Alexandria to add to their existing presence in Fairfax and Loudoun Counties. Inova Cares Clinic for Families opened a Herndon location to add to its presence in Alexandria, Annandale, Sterling, and Manassas. Inova Medical House Calls continued to grow its service area to include Mt. Vernon. In 2022, Inova's Community Health Division will launch two new programs in the region that address community need - Inova Pride Clinic for LGBTQ+ individuals and Inova Cares for Behavioral Health. Both programs were in development in 2021 and are expected to launch in the first half of 2022.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's Implementation Strategy focuses on meeting the priority and specified community health needs described above. Certain issues are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Other topics, such as cultural competency, Lyme Disease, and obesity and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system.
PART V, SECTION B, LINE 11 INOVA MT VERNON HOSPITAL	COVID-19 Vaccination Efforts in the CommunityAs the COVID-19 pandemic persisted, Inova collaborated with multiple community partners to get "shots in arms" across the region.Inova's first large-scale vaccine distribution center, which opened at the Inova Center for Personalized Health in late 2020, was soon vaccinating up to 4,000 Inova team members per day. In early 2021, Inova served as the primary source of vaccines for public and private school teachers and employees, and vaccinated community members aged 65+ by appointment. To accommodate increasing demand, the site moved to the Inova Stonebridge COVID-19 Vaccination Center in the City of Alexandria and began accepting walk-in appointments from the general public in mid-March. The site also offered drive-through vaccinations to improve access. Members of Volunteer Fairfax, the Fairfax County Community Emergency Response Team, and the Virginia National Guard helped with patient movement and flow. The Fairfax County Medical Reserve Corps provided 10 volunteers each day in addition to the 100 Inova team members needed daily to administer vaccines. By the end of 2021 more than 450,000 vaccines had been administered.For those who couldn't leave their homes to get a vaccine, the Inova Medical House Calls was one of the first groups to operationalize in-home vaccines in early 2021. Between January and March, the team administered 1,260 doses to 655 homebound older adults and family caregivers without wasting a single dose. Later, the program partnered with the Fairfax County Health Department to continue in-home vaccinations and boosters. Among those who received the vaccine were homebound ElderLink patients over the age of 65. ElderLink is a partnership between Inova and the Fairfax County Area Agency on Aging that promotes the well-being of older adults and caregivers. Despite widespread availability as the year progressed, some community members did not have access or were reluctant to get the vaccine. To reach them, Inova Cares Clinic for Families (ICCF) teamed up with local health departments in Fairfax, Loudoun and Prince Williams counties, which linked ICCF with pastors from local African American churches to rally their congregations. Faith leaders became incredibly important in building trusted relationships between healthcare systems and communities they serve to improve access to care for all. The churches helped to coordinate transportation to ICCF locations, and ICCF set aside clinic days and times during non-work hours to meet the needs of this community.As a result of these joint outreach efforts, more than 4,000 community members were vaccinated at designated ICCF sites. Inova team members administered the shots while church volunteers and health department workers coordinated registration and flow. To educate the community and encourage people to get the COVID-19 vaccine, Inova created and participated in a number of messaging campaigns, including: Get the Vaccine! - Inova produced 45 videos to address vaccine hesitancy and reinforce that the vaccine is safe and effective. Inova physicians from a variety of cultural backgrounds and specialties, including general and internal medicine, surgery, OB-GYN and pediatrics, participated. Providers recorded the message in English and their native languages. Inova also used the videos to engage faith, school and business leaders who found them useful in reaching congregations, families and customers. Vax UP FCPS - In mid-October, Fairfax County Public Schools (FCPS) reached out to request a partnership with Inova's pediatricians to address the questions and concerns of parents considering vaccinating their soon-to-be eligible 5- to 11-year-olds. Within a few weeks, and in time for the official authorization, the joint Inova-FCPS team created videos answering some of the most common questions about the COVID-19 vaccine for kids. These videos were posted to the FCPS page and were made available on the Inova Get the Vaccine! page to maximize their reach in all areas of Northern Virginia.Understanding the COVID-19 Vaccination - In February, Inova team members held a town hall with Black church leaders to discuss the vaccine, address hesitancy and discuss messaging for congregations. This well-informed and collaborative conversation helped shape Inova's outreach efforts to our vulnerable and marginalized populations, while supporting faith leaders in their efforts to keep their communities healthy.Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova Ewing FACT and Inova Cares Clinic for Women opened new clinics in Alexandria to add to their existing presence in Fairfax and Loudoun Counties. Inova Cares Clinic for Families opened a Herndon location to add to its presence in Alexandria, Annandale, Sterling, and Manassas. Inova Medical House Calls continued to grow its service area to include Mt. Vernon. In 2022, Inova's Community Health Division will launch two new programs in the region that address community need - Inova Pride Clinic for LGBTQ+ individuals and Inova Cares for Behavioral Health. Both programs were in development in 2021 and are expected to launch in the first half of 2022.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's Implementation Strategy focuses on meeting the priority and specified community health needs described above. Certain issues are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Other topics, such as cultural competency, obesity, and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system.
PART V, SECTION B, LINE 11 INOVA LOUDOUN HOSPITAL	COVID-19 Vaccination Efforts in the CommunityAs the COVID-19 pandemic persisted, Inova collaborated with multiple community partners to get "shots in arms" across the region.Inova's first large-scale vaccine distribution center, which opened at the Inova Center for Personalized Health in late 2020, was soon vaccinating up to 4,000 Inova team members per day. In early 2021, Inova served as the primary source of vaccines for public and private school teachers and employees, and vaccinated community members aged 65+ by appointment. To accommodate increasing demand, the site moved to the Inova Stonebridge COVID-19 Vaccination Center in the City of Alexandria and began accepting walk-in appointments from the general public in mid-March. The site also offered drive-through vaccinations to improve access. Members of Volunteer Fairfax, the Fairfax County Community Emergency Response Team, and the Virginia National Guard helped with patient movement and flow. The Fairfax County Medical Reserve Corps provided 10 volunteers each day in addition to the 100 Inova team members needed daily to administer vaccines. By the end of 2021 more than 450,000 vaccines had been administered.For those who couldn't leave their homes to get a vaccine, the Inova Medical House Calls was one of the first groups to operationalize in-home vaccines in early 2021. Between January and March, the team administered 1,260 doses to 655 homebound older adults and family caregivers without wasting a single dose. Despite widespread availability as the year progressed, some community members did not have access or were reluctant to get the vaccine. To reach them, Inova Cares Clinic for Families (ICCF) teamed up with local health departments in Fairfax, Loudoun and Prince Williams counties, which linked ICCF with pastors from local African American churches to rally their congregations. Faith leaders became incredibly important in building trusted relationships between healthcare systems and communities they serve to improve access to care for all. The churches helped to coordinate transportation to ICCF locations, and ICCF set aside clinic days and times during non-work hours to meet the needs of this community.In addition, ICCF's Community Health Workers and the Loudoun County Health Department focused on reaching Latino communities. Connections were made at local churches and businesses, as well as community events including food distribution days hosted by Loudoun Hunger Relief. As a result of these joint outreach efforts, more than 4,000 community members were vaccinated at designated ICCF sites. Inova team members administered the shots while church volunteers and health department workers coordinated registration and flow. To educate the community and encourage people to get the COVID-19 vaccine, Inova created and participated in a number of messaging campaigns, including: Get the Vaccine! - Inova produced 45 videos to address vaccine hesitancy and reinforce that the vaccine is safe and effective. Inova physicians from a variety of cultural backgrounds and specialties, including general and internal medicine, surgery, OB-GYN and pediatrics, participated. Providers recorded the message in English and their native languages. Inova also used the videos to engage faith, school and business leaders who found them useful in reaching congregations, families and customers. Vax UP FCPS - In mid-October, Fairfax County Public Schools (FCPS) reached out to request a partnership with Inova's pediatricians to address the questions and concerns of parents considering vaccinating their soon-to-be eligible 5- to 11-year-olds. Within a few weeks, and in time for the official authorization, the joint Inova-FCPS team created videos answering some of the most common questions about the COVID-19 vaccine for kids. These videos were posted to the FCPS page and were made available on the Inova Get the Vaccine! page to maximize their reach in all areas of Northern Virginia.Understanding the COVID-19 Vaccination - In February, Inova team members held a virtual town hall with Black church leaders to discuss the vaccine, address hesitancy and discuss messaging for congregations. This well-informed and collaborative conversation helped shape Inova's outreach efforts to our vulnerable and marginalized populations, while supporting faith leaders in their efforts to keep their communities healthy.Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova Ewing FACT and Inova Cares Clinic for Women opened new clinics in Alexandria to add to their existing presence in Fairfax and Loudoun Counties. Inova Cares Clinic for Families opened a Herndon location to add to its presence in Alexandria, Annandale, Sterling, and Manassas. Inova Medical House Calls continued to grow its service area to include Mt. Vernon. In 2022, Inova's Community Health Division will launch two new programs in the region that address community need - Inova Pride Clinic for LGBTQ+ individuals and Inova Cares for Behavioral Health. Both programs were in development in 2021 and are expected to launch in the first half of 2022.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's Implementation Strategy focuses on meeting the priority and specified community health needs described above. Certain issues are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Other topics, such as cultural competency, Lyme Disease, and obesity and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system.

Schedule H (Form 990) 2021

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?44
Name and address		Type of Facility (describe)
1	1 - FAIRFAX RADIOLOGY CENTERS 2722 MERRILEE DRIVE SUITE 230 FAIRFAX,VA22031	IMAGING CENTER
2	2 - CORNWALL ER 244 CORNWALL STREET NW LEESBURG,VA20176	EMERGENCY ROOM
3	3 - RADIOLOGY IMAGING ASSOCIATES LLC 19455 DEERFIELD AVENUE SUITE 102 LANSDOWNE,VA20176	IMAGING CENTER
4	4 - EMERGENCY CARE CENTER OF FAIRFAX 4315 CHAIN BRIDGE ROAD FAIRFAX,VA22030	EMERGENCY ROOM
5	5 - INOVA RESTON MRI CENTER LLC 2722 MERRILLE DRIVE SUITE 230 FAIRFAX,VA22031	MRI CENTER
6	6 - ASSISTED LIVING AT FAIR OAKS 3750 JOSEPH SIEWICK DRIVE FAIRFAX,VA22033	ASSISTED LIVING
7	7 - EMERGENCY CARE CENTER OF RESTON 11901 BARON CAMERON AVENUE RESTON,VA20190	EMERGENCY ROOM
8	8 - ASSISTED LIVING AT MCLEAN 8315 TURNING LEAF MCLEAN,VA22102	ASSISTED LIVING
9	9 - KELLAR CENTER 11204 WAPLES MILL ROAD FAIRFAX,VA22030	BEHAVIORAL SERVICES
10	10 - ASSISTED LIVING AT RESTON TOWN CENTER 1778 FOUNTAIN DRIVE RESTON,VA20190	ASSISTED LIVING
11	11 - ASSISTED LIVING AT MT VERNON 8033 HOLLAND ROAD ALEXANDRIA,VA22306	ASSISTED LIVING
12	12 - INSTITUTE OF RESEARCH AND EDUCATION 3300 GALLOWS ROAD FALLS CHURCH,VA22042	RESEARCH FACILITY
13	13 - ASSISTED LIVING AT GEORGE MASON 4300 CHAIN BRIDGE ROAD FAIRFAX,VA22030	ASSISTED LIVING
14	14 - POTOMAC RADIATION ONCOLOGY 2296 OPITZ BLVD WOODBRIDGE,VA22191	RADIATION ONCOLOGY
15	15 - INOVA URGENT CARE CTR - W SPRINGFIELD 6230 ROLLING ROAD SUITE J SPRINGFIELD,VA22152	URGENT CARE
16	16 - INOVA URGENT CARE CTR - TYSONS CORNER 8357-E LEESBURG PIKE VIENNA,VA22182	URGENT CARE
17	17 - INOVA URGENT CARE CENTER - VIENNA 180 MAPLE AVENUE WEST VIENNA,VA22180	URGENT CARE
18	18 - ASHBURN OCCUPATIONAL HEALTH 21785 FILLAGREE CT SUITE 103 ASHBURN,VA20147	OCCUPATIONAL HEALTH
19	19 - INOVA URGENT CARE CTR - DULLES SOUTH 24801 PINEBROOK ROAD SUITE 110 CHANTILLY,VA20152	URGENT CARE
20	20 - INOVA PHYSICAL THERAPY CTR - ASHBURN 20905 PROFESSIONAL PLAZA SUITE 110 ASHBURN,VA20147	REHABILITATION
21	21 - INOVA URGENT CARE CTR - CENTREVILLE 6201 CENTREVILLE ROAD SUITE 200 CENTREVILLE,VA20121	URGENT CARE
22	22 - INOVA PHYSICAL THERAPY - SPRINGFIELD 8348 TRAFORD LANE SUITE 100 SPRINGFIELD,VA22152	REHABILITATION
23	23 - INOVA URGENT CARE CTR - S ARLINGTON 3263 COLUMBIA PIKE ARLINGTON,VA22204	URGENT CARE
24	24 - INOVA PHYSICAL THERAPY CTR - VIENNA 8320 OLD COURTHOUSE ROAD SUITE 410 VIENNA,VA22182	REHABILITATION
25	25 - INOVA URGENT CARE CENTER - RESTON 1488 NORTH POINT VILLAGE CENTER RESTON,VA20194	URGENT CARE
26	26 - PRINCE WILLIAM OCCUPATIONAL HEALTH 8480 KAO CIRCLE MANASSAS,VA20110	OCCUPATIONAL HEALTH
27	27 - INOVA PHYSICAL THERAPY CTR - BALLSTON 1005 NORTH GLEBE ROAD SUITE 400 ARLINGTON,VA22201	REHABILITATION
28	28 - IAH OCCUPATIONAL HEALTH 4700 KING ST SUITE 201 ALEXANDRIA,VA22302	OCCUPATIONAL HEALTH
29	29 - INOVA PHYSICAL THERAPY - CENTREVILLE 6201 CENTREVILLE ROAD SUITE 500 CENTREVILLE,VA20121	REHABILITATION
30	30 - INOVA PHYSICAL THERAPY CTR- SPORTPLEX 6355 WALKER LANE SUITE 404 ALEXANDRIA,VA22310	REHABILITATION
31	31 - INOVA URGENT CARE CTR - N ARLINGTON 4600-C LEE HIGHWAY ARLINGTON,VA22207	URGENT CARE
32	32 - INOVA PHYSICAL THERAPY CTR-ALEXANDRIA 4700 KING ST SUITE 200 ALEXANDRIA,VA22302	REHABILITATION
33	33 - INOVA PHYSICAL THERAPY CTR - DULLES 24801 PINEBROOK ROAD SUITE 200 CHANTILLY,VA20152	REHABILITATION
34	34 - INOVA PHYSICAL THERAPY CTR- MT VERNON 8101 HINSON FARM ROAD SUITE 401 ALEXANDRIA,VA22306	REHABILITATION
35	35 - INOVA PHYSICAL THERAPY CTR - FAIROAKS 3620 JOSEPH SIEWICK DRIVE SUITE 101 FAIRFAX,VA22033	REHABILITATION
36	36 - INOVA PHYSICAL THERAPY - WOODBRIDGE 14605 POTOMAC BRANCH DRIVE SUITE 200 WOODBRIDGE,VA22191	REHABILITATION
37	37 - CATS 3300 GALLOWS ROAD FALLS CHURCH,VA22042	BEHAVIORAL SERVICES
38	38 - INOVA URGENT CARE CTR - PURCELLVILLE 7601 LEWINSVILLE ROAD SUITE 440 PURCELLVILLE,VA20132	URGENT CARE
39	39 - INOVA PHYSICAL THERAPY CTR - FAIRFAX 8501 ARLINGTON BLVD SUITE 200 FAIRFAX,VA22031	REHABILITATION
40	40 - INOVA URGENT CARE CTR - DUNN LORING 2671 AVENIR PLACE SUITE A VIENNA,VA22180	URGENT CARE
41	41 - INOVA PHYSICAL THERAPY - VA SQUARE 3833 NORTH FAIRFAX DRIVE SUITE 300 ARLINGTON,VA22203	REHABILITATION
42	42 - INOVA URGENT CARE CENTER - MANASSAS 8051 SUDLEY ROAD MANASSAS,VA22109	URGENT CARE
43	43 - INOVA URGENT CARE CTR - WOODBRIDGE 14605 POTOMAC BRANCH DRIVE SUITE 200 WOODBRIDGE,VA22191	URGENT CARE
44	44 - INOVA PHYSICAL THERAPY - DUNN LORING 2740 PROSPERITY AVENUE SUITE 200 FAIRFAX,VA22033	REHABILITATION

Schedule H (Form 990) 2021

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Part I, Line 3c:	Catastrophic Financial Assistance: Catastrophic Financial Assistance is available for patients who do not qualify for free care based on the criteria above, who, due to the nature and extent of services provided, have significant care-related financial obligations in relation to household income and other potentially available resources. In such circumstances, the patient responsibility will be limited to the lesser of 15% of Family Income or the Amounts Generally Billed.
Part I, Line 6a:	The Community Benefit Report is included in the consolidated Inova Health System report to the community on INOVA.org website.
Part I, Line 7:	Cost to charge ratio method is used based on table 2 in the instructions. Total operating expense is divided by Total Gross Revenue to arrive at the cost to charge ratio.
Part I, Line 7g:	Cost of Physician Clinic is $7,404,120.
Part I, Line 7, Column (f):	The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 54,795,565.
Part II, Community Building Activities:	Inova's Office of Sustainability provides community building support focused on environmental improvements that in turn, benefit community health. Environmental Mission Statement:Inova Health System is committed to establishing an environmental program that is safer and healthier for patients, employees and the community.Community Building Environmental Improvements Waste ManagementInova has been focused on waste reduction strategies including recycling and segregation since 2008. Throughout the hospitals there is a single stream recycling process along with focused efforts on reducing regulated medical waste. In 2021, Inova recycled or diverted more than 3.2 million pounds of material from local landfills and waste to energy facilities.Specialized areas recycling/reuse: Inova has implemented specialized recycling programs to capture specific materials throughout the hospitals such as electronics, batteries, reusable equipment and more. Inova continued the food waste composting program at Inova Fair Oaks Hospital, diverting approximately 600 pounds of food waste each week. EnergyDuring 2021, Inova continued to make progress towards its energy goal of reducing energy use intensity (EUI) by 20 percent. A variety of projects including exterior lighting upgrades, specific interior lighting projects, HVAC improvements and energy monitoring, were implemented. These efforts result in cost savings and improved resilience for the overall health of the community.WaterInova continues to maintain native plantings and low-impact irrigation systems for landscaping as well as reduce water consumption in our hospitals through the routine replacement of less efficient plumbing fixtures. BuildingsInova is currently working on a number of projects pursuing LEED certification including the Inova Center for Personalized Health along with Inova Fairfax Hospital. Inova has also embarked on integrating LEED into the design of the new hospitals at Landmark and Springfield, along with the Healthplex at Oakville. The goal of Inova's green building efforts is to ensure that our buildings are operated in the most efficient manner, leading to both operational savings as well as improved outcomes. TransportationInova continues its collaboration with Fairfax County Department of Transportation to promote alternative commuting options for team members resulting in fewer single-occupancy vehicle trips. The Inova Fairfax Hospital achieved their required mode-split in 2021, with 23% of team members using some sort of alternative mode of transportation. Inova Mount Vernon Hospital also met their mode-split requirement with more than 15% of team members using some form of alternative transportation. The telehealth program also continued in 2021, with approximately 22,000 telehealth visits each month. This equates to approximately 1,000 daily patient trips avoided across all Inova facilities. This benefits not only the environment but patients, team members, and the community by reducing the number of cars on the road. FoodInova continues to promote and serve local and sustainable foods throughout Inova hospitals with 15% of food spend categorized as sustainable. Inova hospitals continued to focus on purchasing meat without routine use of antibiotics. In 2021, 35% of poultry served were certified as antibiotic free. These initiatives are important for the health of all patients and the community, and also support local farms. Inova sponsors the Northern Virginia Chapter of Buy Fresh, Buy Local, a nationally recognized program that is dedicated to reintroducing Americans to their food - the seeds it grows from, the farmers who produce it, and the routes that carry it from the fields to their tables. In 2021, Inova continued the Community Supported Agriculture (CSA) Program to help team members access local and sustainable foods. Team members purchased more than 1,692 orders, contributing to their personal health as well as the health of the planet. CommunityInova engages with peer organizations locally and nationally on sustainable practices through a combination of virtual speaking engagements, news article publications and informal discussion.
Part III, Line 4:	BAD DEBT FOOTNOTE FROM INOVA HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTSPatient accounts receivable include charges for amounts due from all patients less price concessions relating to allowances for the excess of established charges over the payments to be received on behalf of patients covered by Medicare, Medicaid and other insurers. The estimated implicit price concessions is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the price concessions based upon historical experience of self-pay accounts receivable, including those balances after insurance payments and not covered by insurance. The results of this review are then used to make any modifications to the estimated implicit price concessions. There have been no significant changes in the current year to the underlying assumptions used by IHS to estimate the amount expected to be received. Patient accounts receivable are written off after collection efforts have been followed in accordance with IHS policies.
Part III, Line 8:	The organization does not treat any Medicare shortfall as community benefit. The amounts are taken directly from the Medicare Cost Reports as filed using a cost to charge ratio method.
Part III, Line 9b:	Patients who have not applied for Financial Assistance under this policy are subject to Inova's normal billing and collections processes.All patient responsibility portions of Inova's accounts will process through Inova's billing and collection systems for effective collections within federal guidelines. Patient responsibility portions will be processed through pre-billing, statement, and follow-up in automated and systematic steps. All collections actions will be in compliance with the Fair Debt Collection Practices Act and ACA International's Code of Ethics and Professional Responsibility.Patients will receive statements for 120 days. After 120 days, with no contact from the patient and without the establishment of acceptable payment terms, accounts will be transferred to a professional collection agency. If continued non-payment occurs beyond a reasonable period of time, Inova may take additional actions on the account.If a patient wishes to make payment arrangements and does not have resources to pay the account in full, the patient should make Inova aware of their situation and Inova will offer payment plans.No Inova entity or third-party collections agent will impose extraordinary collections actions ("ECAs") such as legal actions or adverse credit reporting against any patient, without first making reasonable efforts to determine whether that patient is eligible for Financial Assistance under this policy. These reasonable efforts include:Assuring that no ECAs are imposed for at least 120 days from the date of the first billing statement.Providing a 30-day written notice that includes information about Inova's Financial Assistance Policy and about any intended ECAs to be imposed in the event of nonpayment.Providing oral notification of any intended ECAs to be imposed in the event of nonpayment.If a patient is determined to be eligible for Financial Assistance after payment is received or after an ECA has been imposed, the account will be adjusted and the collections action will be reversed.The Vice President of Revenue Cycle Operations or his/her designee is responsible for determining whether Inova has made reasonable efforts to determine whether an individual is FAP-eligible and whether one or more ECAs may be imposed.
PART III, Line 2 and 3:	Actual bad debt expense is multiplied by the cost to charge ratio used in computing charity care expense in Part I. The provision for bad debts is recognized when providing an allowance for uncollectible accounts.There are no estimated amounts for bad debt expense attributable to patients under the organization's charity care policy.
Part VI, Line 2:	Inova Health System (IHS) completed a Community Health Needs Assessment (CHNA) in 2019 to identify priority health status and access issues for particular geographic areas and populations by focusing on the following questions: What are the biggest health challenges? Who is most affected? Where are the unmet needs for services? What are the health inequities?Inova's CHNAs consider multiple data sources, including secondary data (regarding demographics, health status indicators, and measures of health care access), assessments prepared by other organizations in recent years, and primary data derived from surveys, interviews, and focus groups of persons who represent the broad interests of the community, including those with expertise in public health.The following topics and data are assessed in Inova's CHNA report:Demographics, e.g., numbers and locations of vulnerable people;Economic issues, e.g., poverty and unemployment rates, and impacts of state or local budget changes;Community issues, e.g., homelessness, housing, environmental concerns, crime, and availability of social services;Health status indicators, e.g. morbidity rates for various diseases and conditions, and mortality rates for leading causes of death;Health access indicators, e.g., uninsured rates, discharges for ambulatory care sensitive conditions (ACSC), and use of emergency departments for non-emergent care;Health disparities indicators; andAvailability of healthcare facilities and resources. The assessment identifies a list of significant community health needs.As a result of this work and previous work, three priority areas will be the focus for the next three years. While the approach to addressing these areas may differ from one community to another, the system-wide selection of priority areas will add value to efforts in each region. The two Directors of Community Health Programs are coordinating plans with Inova and community leaders to ensure plans are implemented effectively and in partnership with existing frameworks and resources in each of the respective communities. The two Directors of Community Health Programs are centralized to the system under the Vice President of Community/Population Health and thereby assures system coordinated efforts are centralized and reflective of Inova Health System's work across Northern Virginia.The various Public Health Departments also conduct community health assessments using the framework of the Mobilizing for Action through Planning and Partnerships (MAPP) process. Due to the timing of these processes, the information from the MAPP health needs assessments in the jurisdictions served by Inova Health System were incorporated differently into the community health needs assessment process and Implementation Strategies in 2019. Fairfax and Arlington Health Departments conducted their own MAPP process and collaborated with Inova, Alexandria conducted its process jointly with Inova but reported separately, and the Loudoun MAPP process was conducted jointly with Inova. The MAPP process leads to an ongoing community-driven planning process that is designed to provide information for improving the community's delivery of the ten essential public health services. This process brings together a diverse group of key community stakeholders including local government, human service organizations, schools and universities, healthcare consumers, advocacy groups, hospitals, faith institutions, youth development organizations, economic and philanthropic groups, etc. to identify strengths and weaknesses in the ten essential areas to provide a foundation for community health planning. In addition to these activities, Inova is continually garnering feedback on existing safety net and community programs from participants through satisfaction surveys, focus groups, participating in regional and local health related groups such as the Northern Virginia Health Services Coalition, and meeting with various cultural and ethnic groups in the community. Internal utilization and outcomes data, review of best practices, regional and national benchmark data, and other external sources such as the Metropolitan Washington Council of Governments (COG) demographic data are used to develop strategic goals for health improvement activities. Collectively, all this information is utilized in assessing community health needs to guide strategic planning efforts.
Part VI, Line 3:	Inova Health System utilizes a multifaceted approach to educate and inform patients and the public about Inova's Financial Assistance Policy (FAP) or sometimes referred to as the Charity Care Policy. Information regarding this policy is kept up to date and widely publicized on the Inova website and through signage. 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 whether or not they qualify for charity care.Inova also has Medicaid eligibility workers on-site in all hospitals, in the Inova Cares Clinics (clinic for low income families) and in the community as part of the Partnership for Healthier Communities Access to Care program. Inova partners with schools across the jurisdiction to provide information about state funded health programs for children and contact information to meet with an eligibility worker responsible for enrolling families in state Medicaid programs. These eligibility workers also go out into the community attending community events such as health fairs, faith-based community activities and other family centered community events to proactively meet with families to encourage enrollment in programs for which they are eligible. Inova has a section of the public website dedicated to information about financial assistance resources.
Part VI, Line 4:	Inova Health Care Services (IHCS) is a not-for-profit corporation and a subsidiary of the parent organization, Inova Health System Foundation (Inova). Inova provides healthcare and related services throughout Northern Virginia and the greater metropolitan Washington, D.C. area, including certain contiguous counties of Virginia and Maryland. Northern Virginia is one of the fastest growing urban communities in the United States. With approximately 1,304 square miles, the region is the most densely populated in the Commonwealth of Virginia. Northern Virginia is comprised of several distinct communities, including the cities of Alexandria, Fairfax, Falls Church, Manassas and Manassas Park, and the counties of Arlington, Fairfax, Loudoun, and Prince William. The eastern sections are urbanized with attendant health problems of overcrowding and increasing demand for health services and public programs. The western regions include rapidly growing communities and rural settings.The region's population served by IHCS is expected to grow steadily through 2035, adding approximately 71,000 people per year, according to the Metropolitan Washington Council of Governments ("MWCOG"). Population will be spurred by the long-term strength of the region's economy, high rates of in-migration and international immigration. The region's population that is 65 years of age and older is expected to grow 20% over the next 5 years, while the number of children will increase by about 4% during the same time period. (MWCOG and ESRI)Northern Virginia's racial and ethnic diversity is more pronounced than in the rest of the state. With increasing diversity, economically disadvantaged populations and multiple languages, the need for access to culturally appropriate, flexible health care continues to grow. The Northern Virginia geographic region in 2019 was 49% minority, while the nation reflects about 40% minority population in 2019 (American Community Survey (ACS) U.S. Census Bureau). Fairfax County, with more than one million residents, is the largest jurisdiction in Northern Virginia and has the largest minority population. In Fairfax County in 2020, Asians, Hispanics, and African Americans represented 47.4%, of the county's population, respectively (Fairfax County Economic, Demographic and Statistical Research, 2020 Decennial Census survey data). According to the US Census Bureau Small Area Health Insurance Estimates (SAHIE) in 2019 approximately 9.1% of the total population under the age of 65 (about 89,030 people) in Fairfax County lacked healthcare insurance. Of the people living in Fairfax County whose family incomes are at or below 200% of the federal poverty level, SAHIE estimates that 27% (about 36,208 people) were uninsured in 2019.Area residents most likely to be uninsured are those whose family incomes are at or below 200% of the poverty level, young adults (age 18-44), people of racial backgrounds other than White, unemployed individuals, part-time workers, and people who work at companies with fewer than 50 employees. Serving this population poses significant cultural and linguistic challenges, and these uninsured citizens are widely distributed in terms of age, geographic region, and health status.
Part VI, Line 5:	Inova Health System's investment in the communities across Northern Virginia is evident through numerous targeted community programs. These programs provide access to care for low income, uninsured, underinsured and vulnerable populations; promote health and wellness; increase health literacy; provide the support and infrastructure for disaster preparedness; and provide programs to support development of our future healthcare workforce to meet the healthcare needs of the communities served. All Inova healthcare facilities have open medical staffs to provide the maximum access to qualified physicians. A Community Board of Trustees provides fiscal and quality oversight for Inova Health Care Services' facilities to ensure the vision and mission of the organization is achieved.Access to Care ProgramsInova's Population and Community Health Division is organized to address a wide-spectrum of community healthcare needs. In addition to the programs already described in the core form program, activities that provide infrastructure support and services focused on vulnerable populations to increase access to healthcare services for the communities served by Inova Health System include the following programs:Inova established a Safety Net Specialty Care Provider Network in partnership with Fairfax County. The physician leader engaged numerous Inova specialty care practices to accept referrals at Medicare rates from community primary care settings such as federally qualified health centers and free clinics. In order to ensure access to specialties not available at Inova, a specialty network including community providers was then established with the same referral arrangement. With funding support from the county, Inova facilitates payment to community specialists that are not part of Inova's charity care for patients otherwise unable to pay for those services. The program was designed utilizing an Inova coordinator who assists the referring clinic, the patient, and the specialty provider with scheduling and navigating the completion of required documentation. The specialties patients are able to access through this program include: Gastroenterology, ENT, Dermatology, Nephrology, Colorectal Surgery, Allergy, Infectious Disease and Pulmonary. There were 326 patients who benefitted from the Safety Net Specialty Fund in 2021.Inova's Partnership for Healthier Communities (PHC) provides children and families with comprehensive application and enrollment assistance to connect them with an appropriate and affordable source of health care services. In 2021, the program assisted over 20,568 children and adults with access to a source of comprehensive health care services such as Medicaid, FAMIS or local safety net providers (3,822 in Medicaid/FAMIS). PHC expanded efforts in 2019 with the onset of Medicaid expansion in Virginia (including a name change from Partnership for Healthier Kids to reflect the updated mission and outreach activities).Care Connection for Children (CCC) is part of the Virginia Department of Health statewide network serving children and youth with special healthcare needs. Professional care coordinators partner with families to coordinate care and find the best healthcare and community resources in Northern Virginia. CCC is committed to helping children maximize their potential in a caring, innovative and culturally sensitive manner. Services are always free and provided regardless of income, health insurance or legal status. In 2021, CCC served 729 families.Inova Cares Clinic for Community BridgingInova Cares Clinic for Community Bridging (ICCCB) was developed to bridge gaps in care that patients experience as they transfer across care delivery settings between illness and recovery. The service focuses on transitional medical care and community collaboration in order to improve health outcomes of patients at the highest risk who lack access to needed resources. ICCCB has locations in Alexandria, Fairfax and Leesburg. The services offered support patients being discharged from an Inova hospital or Inova emergency room who either do not have a medical home or cannot get an appointment with their Primary Care Provider (PCP) within 72 hours following a hospital admission. Patients are typically followed by a hospitalist or nurse practitioner for one to three visits, while the patient and the care team work together to establish a permanent medical home in the community for the patient or transition the patient back to their PCP. Care includes medication reconciliation, medical management and anti-coagulation management if needed as well as referrals to assist with social determinants of health. ICCCB seeks to provide services that will enhance the lives of patients so that they may better manage their healthcare and live longer, more productive lives. In 2021, ICCCB served over 4,000 patients with over 8,000 visit encounters. Over 1,000 visits were in support of patients recovering from COVID-19. Inova Kellar Center Inova Kellar Center (IKC) is a community based behavioral health program and special education school founded by Inova in 1991 with a gift from Fairfax County residents, Art and Betty Kellar, to address a gap in mental health and substance abuse services for children and adolescents. Currently IKC offers a full continuum of mental health services from outpatient therapies and medication management to after school Intensive Outpatient Programs and a full day Partial Hospitalization Program. The Kellar School, a private special education day school for students with emotional, social, and behavioral needs provides academic instruction within a therapeutic environment. The Center provided 85,098 hours of both in-person and tele-psych programming, treatment, and education to children, adolescents, and families in 2021. Inova Ewing Forensic Assessment and Consultation Teams (FACT)The Inova Ewing FACT Department (FACT) is a comprehensive, outpatient forensic nursing program for children and adults. Established in the late 1990s, the Inova Ewing FACT Department has provided specialized care for victims of sexual abuse, domestic violence, human trafficking, and child abuse. FACT serves all of Northern Virginia including Fairfax, Arlington, Loudoun, and Prince William counties, the cities of Alexandria and Falls Church, parts of Fauquier and Stafford counties, military installations, universities and the FBI. The department also performs courtesy exams for outlying jurisdictions including the District of Columbia, Maryland, and West Virginia and beyond. The program has grown significantly over the years and now provides services in the areas of sexual assault, intimate partner/domestic violence, physical child abuse, strangulation, and human sex trafficking. In 2021, the department had 897 patient encounters with a 37% increase in follow-up visits. This is a very meaningful message about enhanced victim support following the initial visit. The department also expanded by opening a new clinic in Alexandria in 2021 allowing for more patient capacity and ease of access. Currently we have clinics available to patients in Falls Church, Leesburg, Vienna, and Alexandria. Health Promotion and Preventative Care ProgramsTo support patients experiencing food insecurity, the Inova Cares Clinic for Women and Children created an emergency food pantry. The pantry serves patients in emergency situations, meaning they have little or no food at home. In 2021, the pantry served more than 60 patients, reaching nearly 300 individuals including household members.Inova also continued to grow the Inova Healthy Plate Club, which helps children and their families learn about the importance of healthy eating. In 2021, the Inova Healthy Plate Club continued its virtual program and returned to the classroom. Nearly 500 students participated in the virtual program in 2021, with more than 180 virtual classes taught. Approximately 40 students participated in the in-person classes, which started again in fall 2021. Lastly, the Inova Healthy Plate Club provided education to more than 700 individuals at community events. During the holidays, Inova Team Members came together to donate more than 7,000 pounds of food to patients in-need. The food went to patients at the Inova Cares Clinic for Women & Children; the Inova Cares Clinic for Families; Care Connections for Children; Inova Ewing FACT Department; and the Inova Fairfax Lung Transplant & Cystic Fibrosis Center.
Part VI, Line 6:	Organization is part of Inova Health System included in description under Line 5.
PART VI, Line 7:	Organization has no state filings.
PART VI, LINE 5 Continued:	Language and Disability ServicesThe Language and Disability Services Department is dedicated to ensuring equal access to Inova's services regardless of language preference or the need for special accommodations. In support of patient safety and satisfaction, language interpretation and document translations are provided at every Inova facility to facilitate communication with the 17% of Inova's patient population who are Limited English Proficient (LEP) and the 0.2% of clients who are Deaf or Hard of Hearing (D/HH). In 2021, medical interpreters delivered 169,923 hours of interpretation in 350 languages, and 17,881 hours in American Sign Language. Additionally, vital documents totaling 1,103,332 English words were translated into Inova's top languages.Cash and In-Kind Contributions to Community GroupsInova donates space, cash, and in-kind support such as utilities, landscaping/grounds keeping, housekeeping, and donated staff time to a number of community groups and services. Inova supports NOVA Scripts, the Center for Multicultural Human Services, and the Northern Virginia Dental Clinic. Inova also provides financial support to The Loudoun Free Clinic, HealthWorks for Northern Virginia, and Neighborhood Health, the local Federally Qualified Health Centers. In 2021, Inova donated over $3.1 million for these groups covering both cash and in-kind transactions.Additionally, as part of Inova's efforts to harness the collective power of community partners, agencies, and organizations to create positive social impact, Inova provided $240,000 in community grants. Applicants were required to present programs or projects addressing the population health needs described in the Inova Community Health Needs Assessments. The following programs were funded in 2021.Boys & Girls Clubs of Greater Washington - $20,000.00. Funds were used to expand the Triple Play and Healthy Habits programs, which encourage good nutrition, physical activity, healthy relationships, and active learning.Capital Youth Empowerment Program - $20,000.00. Funds were used to boost the Fathers in Tech project, which teaches workforce skills to Arlington, Fairfax, and Alexandria fathers living in Black, Indigenous and People of Color (BIPOC) communities.Carpenter's Shelter Inc - $20,000.00. Funds were used to improve access to medical and mental health care among homeless adults and children in Alexandria, and help them transition to sustainable homes. La Cocina VA - $18,431.00. Funds were used to expand the Healthy Food Assistance program to fight hunger and obesity among immigrants, children, homeless people, veterans, the unemployed, and the underemployed in Arlington.Loudoun Literacy Council - $10,000.00. Funds were used to help more than 700 adults and children participate in reading and English as a Second Language programs including Health Education and Literacy, Intervention Instruction, Story Walks, Head Start, and Starting Toward Excellence in Preschool.NOVA Scripts Central - $15,000.00. Funds were used to provide affordable pharmacy services to low-income, uninsured residents across Northern Virginia, and improve access to culturally competent and linguistically appropriate health information. Nueva Vida, Inc- $11,569.00. Funds were used to create culturally sensitive cancer and mental health support for the medically under-resourced Latino/a population in Alexandria City and Fairfax County.Our Minds Matter - $20,000.00. Funds were used to support peer and programmatic suicide prevention programs and mental health resources in Annandale, Falls Church, Justice, Mount Vernon and West Potomac High Schools in Fairfax County.SCAN of Northern Virginia - $20,000.00. Funds were used to increase access to child abuse prevention resources, assessments and medical care for families in Alexandria.The Campagna Center - $20,000.00. Funds were used to subsidize the New Neighbors program, which provides students with access to high-quality English language instruction to improve their employment and future opportunities to thrive in the community.The Child and Family Network Centers - $15,000.00. Funds were used to provide pre-kindergarten physicals, vaccinations and medical screenings to more than 100 four-year-olds in underserved West End and Alexandria communities.The Women's Center - $20,000.00. Funds were used to expand access to effective, equitable, and affordable mental health services for more than 60 low-income Fairfax County residents. United Community - $20,000.00. Funds were used to help families find fresh foods and health services, and coordinate a Health Work Group to improve community health outcomes and develop a sustainable system for healthy food access. YMCA of Metropolitan Washington - $10,000.00. Funds were used to support both its health promotion programs and its Food and Health Hub program that provides home-delivered local produce to food insecure residents and those with chronic health conditions living in Reston.

Schedule H (Form 990) 2021

Additional Data

Software ID:
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- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

INOVA HEALTH CARE SERVICES

Employer identification number

54-0620889

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2021

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1J STEPHEN JONES PRESIDENT/CEO	(i) (ii)	1,862,790 ------------- 0	2,249,566 ------------- 0	1,151,809 ------------- 0	66,500 ------------- 0	31,719 ------------- 0	5,362,384 ------------- 0	659,770 ------------- 0
2JAMES ECKLUND PRESIDENT NEUROSCIENCES	(i) (ii)	1,172,489 ------------- 0	607,986 ------------- 0	11,484 ------------- 0	281,950 ------------- 0	26,443 ------------- 0	2,100,352 ------------- 0	0 ------------- 0
3JOHN HAMILTON PHYSICIAN	(i) (ii)	1,241,751 ------------- 0	622,117 ------------- 0	2,322 ------------- 0	60,616 ------------- 0	27,035 ------------- 0	1,953,841 ------------- 0	0 ------------- 0
4STEPHEN MOTEW CHIEF CLINICAL ENTERPRISE	(i) (ii)	1,046,354 ------------- 0	636,035 ------------- 0	7,482 ------------- 0	250,790 ------------- 0	11,382 ------------- 0	1,952,043 ------------- 0	0 ------------- 0
5ALICE POPE TREASURER-CFO	(i) (ii)	911,919 ------------- 0	585,808 ------------- 0	33,422 ------------- 0	227,708 ------------- 0	37,323 ------------- 0	1,796,180 ------------- 0	0 ------------- 0
6JOHN GAUL SECRETARY	(i) (ii)	704,684 ------------- 0	455,272 ------------- 0	503,157 ------------- 0	38,844 ------------- 0	29,580 ------------- 0	1,731,537 ------------- 0	394,250 ------------- 0
7ANDREW FANOUS PHYSICIAN	(i) (ii)	858,560 ------------- 0	810,763 ------------- 0	485 ------------- 0	49,531 ------------- 0	7,901 ------------- 0	1,727,240 ------------- 0	0 ------------- 0
8TONI ARDEBELL CHIEF CLINICAL ENTERPRISE	(i) (ii)	894,523 ------------- 0	569,070 ------------- 0	154,780 ------------- 0	61,735 ------------- 0	18,294 ------------- 0	1,698,402 ------------- 0	0 ------------- 0
9ANUJ NARANG PRESIDENT IFMC	(i) (ii)	881,141 ------------- 0	455,256 ------------- 0	4,002 ------------- 0	226,378 ------------- 0	40,551 ------------- 0	1,607,328 ------------- 0	0 ------------- 0
10TERRI FEELY CHIEF PEOPLE OFFICER IHS	(i) (ii)	702,204 ------------- 0	455,272 ------------- 0	291,059 ------------- 0	63,304 ------------- 0	36,550 ------------- 0	1,548,389 ------------- 0	160,674 ------------- 0
11CHRISTOPHER O'CONNOR PRESIDENT IHVI	(i) (ii)	965,438 ------------- 0	369,453 ------------- 0	106,215 ------------- 0	40,500 ------------- 0	10,940 ------------- 0	1,492,546 ------------- 0	0 ------------- 0
12DAVID QUIRKE EVP CIO	(i) (ii)	623,615 ------------- 0	401,693 ------------- 0	154,837 ------------- 0	161,580 ------------- 0	123,542 ------------- 0	1,465,267 ------------- 0	0 ------------- 0
13HASHEMI HOMAYOUN PHYSICIAN	(i) (ii)	929,942 ------------- 0	453,758 ------------- 0	3,564 ------------- 0	48,100 ------------- 0	19,028 ------------- 0	1,454,392 ------------- 0	0 ------------- 0
14JOHN MOYNIHAN PRESIDENT SURGICAL SERVICES	(i) (ii)	735,155 ------------- 0	369,148 ------------- 0	122,848 ------------- 0	60,061 ------------- 0	21,340 ------------- 0	1,308,552 ------------- 0	101,489 ------------- 0
15ZOBAIR YOUNOSSI PRESIDENT INOVA MEDICINE	(i) (ii)	693,823 ------------- 0	358,020 ------------- 0	11,484 ------------- 0	194,490 ------------- 0	26,303 ------------- 0	1,284,120 ------------- 0	0 ------------- 0
16SUSAN CARROLL PRESIDENT IFOH SVP CLIN ENT	(i) (ii)	606,515 ------------- 0	343,422 ------------- 0	95,202 ------------- 0	49,618 ------------- 0	30,100 ------------- 0	1,124,857 ------------- 0	0 ------------- 0
17HARVEY MCDUFFIE SVP PRESIDENT INOVA REALTY	(i) (ii)	588,197 ------------- 0	304,395 ------------- 0	105,110 ------------- 0	41,705 ------------- 0	25,191 ------------- 0	1,064,598 ------------- 0	0 ------------- 0
18DEBORAH ADDO FORMER PRESIDENT ILH	(i) (ii)	271,010 ------------- 0	249,785 ------------- 0	5,774 ------------- 0	52,335 ------------- 0	3,386 ------------- 0	582,290 ------------- 0	0 ------------- 0
19CHRISTOPHER CHIANTELLA FORMER CHIEF MEDICAL OFFICER ILH	(i) (ii)	330,642 ------------- 0	128,194 ------------- 0	47,445 ------------- 0	55,361 ------------- 0	20,055 ------------- 0	581,697 ------------- 0	0 ------------- 0
20WILLIAM BANE FORMER VP FINANCE	(i) (ii)	258,243 ------------- 0	110,858 ------------- 0	37,136 ------------- 0	30,077 ------------- 0	26,295 ------------- 0	462,609 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Part I, Line 1a	Gross-up payment made to the following for moving reimbursment taxable as compensation: Alice Pope David Quirke
Part I, Line 3	The following methods were used by Inova Health System Foundation, a related organization, to establish the compensation of IHCS's CEO for the tax year: Compensation committee Independent compensation consultant Written employment contract Compensation survey or study Form 990 of other organizations Approval by the board or compensation committee
Part I, Line 4b	Part I, Line 4b: SERP Plan Payments: Toni Ardabell $131,324 William Bane $26,651 Susan Carroll $92,592 Christopher Chiantella $32,870 Terri Feely $282,219 Harvey McDuffie $87,806 John Moynihan $108,750 J. Stephen Jones $1,089,749 Christopher O'Connor $94,732 John Gaul $499,155 The Supplemental Executive Retirement Plan (SERP Plan) is a nonqualified retirement plan. Employees eligible to participate are at level of Assistant Vice President and above. Each year, a certain percentage of each participant's base salary is contributed to the SERP Plan. This amount ranges from 5% to 20%, depending on position. Participant accounts vest every three years from the date of eligibility. At age 62 and later, participants are 100% vested at the time of each annual award. Any vested balance is paid to participants as a taxable event.

Schedule J (Form 990) 2021

Additional Data

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Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
INOVA HEALTH CARE SERVICES

Employer identification number
54-0620889

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823FM5	05-12-2005	124,000,000	See Part VI		X		X		X
B	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823JJ8	03-08-2010	190,000,000	See Part VI		X		X		X
C	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823KE7	08-23-2012	382,960,937	See Part VI		X		X		X
D	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823KS6	12-20-2012	80,991,559	See Part VI		X		X		X
	Industrial Development Authority of Fairfax County Virginia	91-1920228		12-04-2013	79,530,000	See Part VI		X		X		X
	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823KX5	12-17-2014	209,030,800	See Part VI		X		X		X
	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823LM8	05-11-2016	178,341,611	See Part VI		X		X		X
	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823LR7	05-11-2016	99,685,000	See Part VI		X		X		X
	industrial Development Authority of Fairfax County Virginia	91-1920228	303823MX3	07-31-2018	484,976,577	See Part VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	14,270,000		95,000,000		34,670,000		1,960,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	130,441,544		356,022,667		385,117,977		80,991,559
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............	3,604,217
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	367,125
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	126,470,203		166,022,667		385,117,977
11 Other spent proceeds .............	79,530,000		190,000,000		181,714,070		80,991,559
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2016		2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X	X			X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	1.100 %		0.900 %		0.600 %		0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	1.100 %		1.200 %		2.300 %		1.200 %
6 Total of lines 4 and 5 .............	1.100 %		2.100 %		0.600 %		2.000 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X			X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X			X		X		X
b Name of provider ..........	Morgan Stanley Capital Services
c Term of hedge .........	3000.0000000000 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........	X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 05/12/2010 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 09/10/2017 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 10/12/2017 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 02/18/2018 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 12/17/2019 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 05/11/2021 Issuer Name: industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 07/14/2019
PART I, COLUMN E, ISSUE PRICE	Part I, column E, 2005A bonds 2005A, B, D, E bond issue price per form 8038 476,700,000 2005B, D, E bonds refinanced by subsequent issues (352,700,000) Remaining 2005A issue price 124,000,000
PART I, COLUMN F, DESCRIPTION OF PURPOSE	Bond A 1) Renovate and expand certain portions of Inova Alexandria Hospital (IAH), Inova Fairfax Hospital (IFH), Inova Fair Oaks Hospital (IFOH); 2) Acquire certain capital equipment for use in or in connection with IAH, IFH, IFOH, and Inova Mount Vernon Hospital (IMVH) and renovate any space necessary or incidental to the installation of such equipment; 3) Pay issuance costs for Series 2005 A and B; 4) Refund prior bonds issued by the Industrial Development Authority of Loudoun County, Virginia Hospital Revenue Bonds, Series 1995 issued 10/26/1995 and 2002A issued 6/27/2002, and pay issuance costs of Series 2005D; 5) Refund prior bonds Series 2001A, B, C, and D issued 12/11/2001 Bond B 1) Refund prior bonds - 2009B issued 4/16/2009; 2) Pay issuance costs of series 2010A bonds Bond C 1) Construct, renovate and expand certain portions of IFH, IMVH and IFOH Bond D 1) Advance refund a portion of 2009A bonds issued 4/16/2009 Bond E 1) Refund prior bonds - 1988A-D issued 8/4/1988; 2000 issued 3/23/2000; 2005A and 2005C issued 5/12/2005 Bond F 1) Construct, renovate and expand certain portions of IFH, IMVH and IFOH Bond G 1) Refund prior bonds - portion of 2009A issued 4/16/09 (advance) and portion of 2012C issued 8/23/12 (current) Bond H 1) Refund prior bonds - portion of 2012C issued 8/23/12 Bond I 1) Refunded prior bonds-2000 issued 03/23/2000; 2005C issued 05/12/2005;2017 issued 12/27/2017 2)Expansion of Inova Loudoun Hospital and a variety of projects at IFMC
PART II, LINE 3, PROCEEDS	Part II, line 3. 2005A bonds Issue price 124,000,000 Earnings 6,441,544 Total proceeds 130,441,544 Part II, line 3. 2010A bonds Issue price 190,000,000 Earnings 1,511,888 Transferred proceeds 164,510,779 Total proceeds 356,022,667 Part II, line 3. 2012AB bonds Issue price 382,960,937 Earnings 2,157,040 Total proceeds 385,117,977 Part II, line 3. 2014A bonds Issue price 209,030,800 Earnings 687,091 Total proceeds 209,717,891 Part II, line 3. 2016A bonds issue price 178,341,611 escrow earnings 3,372,459 total proceeds 181,714,070 Part II, line 3. 2018AB bonds issue price 484,976,577 escrow earnings 3,432,529 total proceeds 488,409,106
PART IV, LINE 2C, DATE OF REBATE COMPUTATION	Part 4, line 2C. 2005A Rebate Computation for the bond issued 5/12/2010 was performed: 05/12/2010 Part 4, line 2C. 2010A Rebate Computation for the bond issued 9/10/2012 was performed: 09/10/2017 Part 4, line 2C. 2012AB Rebate Computation for the bond issued 10/12/2017 was performed: 10/12/2017 Part 4, line 2C. 2012D Rebate Computation for the bond issued 12/20/2012 was performed: 2/18/2017 Part 4, line 2C. 2014A Rebate Computation for the bond issued 12/17/2014 was performed: 12/17/2019 Part 4, line 2C. 2018AB Rebate Computation for the bond issued 07/31/2018 was performed: 07/14/2019 Part 4, line 2C. 2016AB Rebate Computation for the bond issued 05/11/2016 was performed: 05/11/2021

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
INOVA HEALTH CARE SERVICES

Employer identification number
54-0620889

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823FM5	05-12-2005	124,000,000	See Part VI		X		X		X
B	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823JJ8	03-08-2010	190,000,000	See Part VI		X		X		X
C	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823KE7	08-23-2012	382,960,937	See Part VI		X		X		X
D	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823KS6	12-20-2012	80,991,559	See Part VI		X		X		X
	Industrial Development Authority of Fairfax County Virginia	91-1920228		12-04-2013	79,530,000	See Part VI		X		X		X
	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823KX5	12-17-2014	209,030,800	See Part VI		X		X		X
	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823LM8	05-11-2016	178,341,611	See Part VI		X		X		X
	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823LR7	05-11-2016	99,685,000	See Part VI		X		X		X
	industrial Development Authority of Fairfax County Virginia	91-1920228	303823MX3	07-31-2018	484,976,577	See Part VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	14,270,000		95,000,000		34,670,000		1,960,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	130,441,544		356,022,667		385,117,977		80,991,559
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............	3,604,217
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	367,125
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	126,470,203		166,022,667		385,117,977
11 Other spent proceeds .............	79,530,000		190,000,000		181,714,070		80,991,559
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2016		2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X	X			X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	1.100 %		0.900 %		0.600 %		0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	1.100 %		1.200 %		2.300 %		1.200 %
6 Total of lines 4 and 5 .............	1.100 %		2.100 %		0.600 %		2.000 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X			X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X			X		X		X
b Name of provider ..........	Morgan Stanley Capital Services
c Term of hedge .........	3000.0000000000 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........	X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 05/12/2010 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 09/10/2017 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 10/12/2017 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 02/18/2018 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 12/17/2019 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 05/11/2021 Issuer Name: industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 07/14/2019
PART I, COLUMN E, ISSUE PRICE	Part I, column E, 2005A bonds 2005A, B, D, E bond issue price per form 8038 476,700,000 2005B, D, E bonds refinanced by subsequent issues (352,700,000) Remaining 2005A issue price 124,000,000
PART I, COLUMN F, DESCRIPTION OF PURPOSE	Bond A 1) Renovate and expand certain portions of Inova Alexandria Hospital (IAH), Inova Fairfax Hospital (IFH), Inova Fair Oaks Hospital (IFOH); 2) Acquire certain capital equipment for use in or in connection with IAH, IFH, IFOH, and Inova Mount Vernon Hospital (IMVH) and renovate any space necessary or incidental to the installation of such equipment; 3) Pay issuance costs for Series 2005 A and B; 4) Refund prior bonds issued by the Industrial Development Authority of Loudoun County, Virginia Hospital Revenue Bonds, Series 1995 issued 10/26/1995 and 2002A issued 6/27/2002, and pay issuance costs of Series 2005D; 5) Refund prior bonds Series 2001A, B, C, and D issued 12/11/2001 Bond B 1) Refund prior bonds - 2009B issued 4/16/2009; 2) Pay issuance costs of series 2010A bonds Bond C 1) Construct, renovate and expand certain portions of IFH, IMVH and IFOH Bond D 1) Advance refund a portion of 2009A bonds issued 4/16/2009 Bond E 1) Refund prior bonds - 1988A-D issued 8/4/1988; 2000 issued 3/23/2000; 2005A and 2005C issued 5/12/2005 Bond F 1) Construct, renovate and expand certain portions of IFH, IMVH and IFOH Bond G 1) Refund prior bonds - portion of 2009A issued 4/16/09 (advance) and portion of 2012C issued 8/23/12 (current) Bond H 1) Refund prior bonds - portion of 2012C issued 8/23/12 Bond I 1) Refunded prior bonds-2000 issued 03/23/2000; 2005C issued 05/12/2005;2017 issued 12/27/2017 2)Expansion of Inova Loudoun Hospital and a variety of projects at IFMC
PART II, LINE 3, PROCEEDS	Part II, line 3. 2005A bonds Issue price 124,000,000 Earnings 6,441,544 Total proceeds 130,441,544 Part II, line 3. 2010A bonds Issue price 190,000,000 Earnings 1,511,888 Transferred proceeds 164,510,779 Total proceeds 356,022,667 Part II, line 3. 2012AB bonds Issue price 382,960,937 Earnings 2,157,040 Total proceeds 385,117,977 Part II, line 3. 2014A bonds Issue price 209,030,800 Earnings 687,091 Total proceeds 209,717,891 Part II, line 3. 2016A bonds issue price 178,341,611 escrow earnings 3,372,459 total proceeds 181,714,070 Part II, line 3. 2018AB bonds issue price 484,976,577 escrow earnings 3,432,529 total proceeds 488,409,106
PART IV, LINE 2C, DATE OF REBATE COMPUTATION	Part 4, line 2C. 2005A Rebate Computation for the bond issued 5/12/2010 was performed: 05/12/2010 Part 4, line 2C. 2010A Rebate Computation for the bond issued 9/10/2012 was performed: 09/10/2017 Part 4, line 2C. 2012AB Rebate Computation for the bond issued 10/12/2017 was performed: 10/12/2017 Part 4, line 2C. 2012D Rebate Computation for the bond issued 12/20/2012 was performed: 2/18/2017 Part 4, line 2C. 2014A Rebate Computation for the bond issued 12/17/2014 was performed: 12/17/2019 Part 4, line 2C. 2018AB Rebate Computation for the bond issued 07/31/2018 was performed: 07/14/2019 Part 4, line 2C. 2016AB Rebate Computation for the bond issued 05/11/2016 was performed: 05/11/2021

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
INOVA HEALTH CARE SERVICES

Employer identification number
54-0620889

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823FM5	05-12-2005	124,000,000	See Part VI		X		X		X
B	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823JJ8	03-08-2010	190,000,000	See Part VI		X		X		X
C	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823KE7	08-23-2012	382,960,937	See Part VI		X		X		X
D	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823KS6	12-20-2012	80,991,559	See Part VI		X		X		X
	Industrial Development Authority of Fairfax County Virginia	91-1920228		12-04-2013	79,530,000	See Part VI		X		X		X
	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823KX5	12-17-2014	209,030,800	See Part VI		X		X		X
	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823LM8	05-11-2016	178,341,611	See Part VI		X		X		X
	Industrial Development Authority of Fairfax County Virginia	91-1920228	303823LR7	05-11-2016	99,685,000	See Part VI		X		X		X
	industrial Development Authority of Fairfax County Virginia	91-1920228	303823MX3	07-31-2018	484,976,577	See Part VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	14,270,000		95,000,000		34,670,000		1,960,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	130,441,544		356,022,667		385,117,977		80,991,559
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............	3,604,217
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	367,125
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	126,470,203		166,022,667		385,117,977
11 Other spent proceeds .............	79,530,000		190,000,000		181,714,070		80,991,559
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2016		2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X	X			X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	1.100 %		0.900 %		0.600 %		0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	1.100 %		1.200 %		2.300 %		1.200 %
6 Total of lines 4 and 5 .............	1.100 %		2.100 %		0.600 %		2.000 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X			X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X			X		X		X
b Name of provider ..........	Morgan Stanley Capital Services
c Term of hedge .........	3000.0000000000 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........	X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 05/12/2010 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 09/10/2017 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 10/12/2017 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 02/18/2018 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 12/17/2019 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 05/11/2021 Issuer Name: industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 07/14/2019
PART I, COLUMN E, ISSUE PRICE	Part I, column E, 2005A bonds 2005A, B, D, E bond issue price per form 8038 476,700,000 2005B, D, E bonds refinanced by subsequent issues (352,700,000) Remaining 2005A issue price 124,000,000
PART I, COLUMN F, DESCRIPTION OF PURPOSE	Bond A 1) Renovate and expand certain portions of Inova Alexandria Hospital (IAH), Inova Fairfax Hospital (IFH), Inova Fair Oaks Hospital (IFOH); 2) Acquire certain capital equipment for use in or in connection with IAH, IFH, IFOH, and Inova Mount Vernon Hospital (IMVH) and renovate any space necessary or incidental to the installation of such equipment; 3) Pay issuance costs for Series 2005 A and B; 4) Refund prior bonds issued by the Industrial Development Authority of Loudoun County, Virginia Hospital Revenue Bonds, Series 1995 issued 10/26/1995 and 2002A issued 6/27/2002, and pay issuance costs of Series 2005D; 5) Refund prior bonds Series 2001A, B, C, and D issued 12/11/2001 Bond B 1) Refund prior bonds - 2009B issued 4/16/2009; 2) Pay issuance costs of series 2010A bonds Bond C 1) Construct, renovate and expand certain portions of IFH, IMVH and IFOH Bond D 1) Advance refund a portion of 2009A bonds issued 4/16/2009 Bond E 1) Refund prior bonds - 1988A-D issued 8/4/1988; 2000 issued 3/23/2000; 2005A and 2005C issued 5/12/2005 Bond F 1) Construct, renovate and expand certain portions of IFH, IMVH and IFOH Bond G 1) Refund prior bonds - portion of 2009A issued 4/16/09 (advance) and portion of 2012C issued 8/23/12 (current) Bond H 1) Refund prior bonds - portion of 2012C issued 8/23/12 Bond I 1) Refunded prior bonds-2000 issued 03/23/2000; 2005C issued 05/12/2005;2017 issued 12/27/2017 2)Expansion of Inova Loudoun Hospital and a variety of projects at IFMC
PART II, LINE 3, PROCEEDS	Part II, line 3. 2005A bonds Issue price 124,000,000 Earnings 6,441,544 Total proceeds 130,441,544 Part II, line 3. 2010A bonds Issue price 190,000,000 Earnings 1,511,888 Transferred proceeds 164,510,779 Total proceeds 356,022,667 Part II, line 3. 2012AB bonds Issue price 382,960,937 Earnings 2,157,040 Total proceeds 385,117,977 Part II, line 3. 2014A bonds Issue price 209,030,800 Earnings 687,091 Total proceeds 209,717,891 Part II, line 3. 2016A bonds issue price 178,341,611 escrow earnings 3,372,459 total proceeds 181,714,070 Part II, line 3. 2018AB bonds issue price 484,976,577 escrow earnings 3,432,529 total proceeds 488,409,106
PART IV, LINE 2C, DATE OF REBATE COMPUTATION	Part 4, line 2C. 2005A Rebate Computation for the bond issued 5/12/2010 was performed: 05/12/2010 Part 4, line 2C. 2010A Rebate Computation for the bond issued 9/10/2012 was performed: 09/10/2017 Part 4, line 2C. 2012AB Rebate Computation for the bond issued 10/12/2017 was performed: 10/12/2017 Part 4, line 2C. 2012D Rebate Computation for the bond issued 12/20/2012 was performed: 2/18/2017 Part 4, line 2C. 2014A Rebate Computation for the bond issued 12/17/2014 was performed: 12/17/2019 Part 4, line 2C. 2018AB Rebate Computation for the bond issued 07/31/2018 was performed: 07/14/2019 Part 4, line 2C. 2016AB Rebate Computation for the bond issued 05/11/2016 was performed: 05/11/2021

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

INOVA HEALTH CARE SERVICES

Employer identification number

54-0620889

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990) 2021

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Matthew Moynihan	Key Employee	161,645	Son of John Moynihan who is employed under Inova Health Care Services. Services provided at arm's length and customary rates.		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

INOVA HEALTH CARE SERVICES

Employer identification number

54-0620889

Return Reference	Explanation
Box C, Doing Business As	Inova Health Care Services (IHCS) Fictitious names: Access of Alexandria Access of Fairfax Access of Reston/Herndon American Medical Collection Bureau Fair Oaks Hospital Fairfax Hospital Inova Behavioral Health Services Inova Blood Donor Services Inova Breast Care Center-Alexandria Inova Breast Care Center-Woodbridge Inova Employee Assistance, Inc. Inova Fair Oaks Hospital Inova Fairfax Hospital Inova Fairfax Hospital Auxiliary Inova Health System Inova HealthPlex Inova HealthSource Inova Mount Vernon Hospital Inova Pathology Associates Inova Pathology Institute Inova Surgery Center Medibill Military to Medicine Mount Vernon Hospital Radiology Imaging Associates, LLC The Fairfax Hospital The Mount Vernon Hospital Treasure Trove Universal Financial Services Virginia Heart Hospital
PART III, LINE 4A	The Inova Heart and Vascular Institute - Schaufeld Family Heart Center at Inova Loudon Hospital opened in 2005. It provides cardiac catheterization and electrophysiology services, a 64-slice CT scanner and other diagnostic testing. The Inova Heart & Vascular Institute at Loudoun Hospital has grown in the last few years to better serve the growing community, adding procedure rooms and capacity. In 2021, 10,244 patients were served by the cardiovascular program at ILH. The Inova Heart & Vascular Institute had over 219,477 patient visits in 2021 at its 5 hospitals, 41 ambulatory offices, and 26 non-invasive cardiovascular imaging and diagnostic service locations. Women's Health: Inova Women's Health Services is the largest program in the Mid-Atlantic region, providing services for over 17,000 births each year. Obstetric services provided include: delivery, high risk prenatal care, inpatient and outpatient obstetrics/gynecologic surgery, and regular and specialty nursery care. Inova Fairfax Hospital was ranked 6th in the nation by U.S. News & World Report for Gynecology. IFH, IFOH, and ILH provide obstetric services to low-income patients through the Inova Cares Clinic for Women with 32,374 visits in 2021. Inova Alexandria Hospital works with the Casey Clinic, now run by a healthcare community partner Neighborhood Health, a Federally Qualified Health Center (FQHC) receiving funding from the State of Virginia, the City of Alexandria and the Alexandria Health Department, providing obstetric services to low-income patients. In addition, obstetrical and pediatric services are provided by ILH's hospital-based Natural Birth Center and nursery care. ILH also offers Level III Neonatal ICU specialty services. Pediatrics: Inova L.J. Murphy Children's Hospital is Northern Virginia's only children's hospital, a regional tertiary and quaternary referral center with 226 licensed acute care beds, providing the highest level of care. Inova L.J. Murphy Children's Hospital is home to the only Pediatric Intensive Care Unit and Pediatric Trauma Center in the region, as well as the region's only Level IV Neonatal ICU. In 2021, Inova Children's Hospital treated nearly 47,000 children in its Pediatric Emergency Department, more than 10,000 children in inpatient units, and performed more than 4,000 surgeries. Inova Children's Hospital provides a complete range of expert, subspecialized children's services in more than 40 subspecialties, including pediatric cardiac surgery, pediatric cancer care, pediatric orthopedics and sports medicine, pediatric spine surgery, pediatric neurology and neurosurgery. As of December 31, 2021, there are 108 Level IV NICU bassinets. Inova Children's provides a primary care medical home for children of low-income families that are uninsured or have Medicaid through the Inova Cares Clinic for Children and Inova Cares Clinic for Families. In 2021, the Inova Care Clinic for Children provided 23,305 visits at an unreimbursed cost of $1,157,002. Inova Loudon Hospital operates a dedicated pediatric emergency room that provided 13,731 visits in 2021. In addition, ILH operates a 14-bed pediatric unit that provides for inpatient hospitalizations. Cancer Care: Inova Schar Cancer Institute (Inova Schar) is a state-of-the-art cancer care destination, offering medical and surgical oncology, radiation therapy services, and outpatient infusion clinics, in the DC-Metropolitan area designed to meet the needs evolving in the region. The Inova Schar team - Comprised of 1,000+ doctors, researchers, nurses, cancer specialists, and emotional support experts. The team delivers the nation's highest standard of compassionate, expert, multi-disciplinary and holistic cancer care customized to the needs of each patient. Inova Schar's coordinated model puts the patient at the center, allowing them to see their entire care team in one visit, at one location, improving communication and minimizing travel time. Nationally renowned specialists, surgeons, genetic counselors and leading researchers are backed by the latest in drug discovery, clinical trials, research and advanced treatments. Inova Schar Cancer Institute, a Department of Inova Fairfax Hospital, operates full-service, accredited cancer centers at four of the five Inova's hospitals - Inova Fairfax Hospital, Inova Alexandria Hospital, Inova Fair Oaks Hospital, and Inova Loudoun Hospital. Inova Fairfax Hospital is designated by the American College of Surgeons Commission on Cancer as a Teaching Hospital Cancer Program and Inova Alexandria Hospital has a Community Hospital Comprehensive Cancer Program designation. Other System Hospitals meet the American College of Surgeons Community Hospital Cancer Program standards. In 2021, Inova Schar Cancer Institute had 177,610 patient visits, providing charity care to 11,897 patients. The System maintains many programs dedicated to different types of cancer, cancer care and cancer risk assessment, including the Inova Breast Care Program (certified at all 5 hospitals), the Cancer Genetic Counseling Program (hereditary conditions), the Inova Melanoma and Skin Cancer Program, the Inova Head and Neck Cancer Program, the Inova Gastrointestinal Multidisciplinary Clinic, the Inova Genitourinary Cancer Program, the Inova Brain Tumor program, the Inova Thoracic Oncology program, the Inova Molecular Tumor Board, and Life with Cancer (support and education for cancer patients). Stroke Care: Inova Loudoun Hospital has been certified by the Joint Commission since 2009 as a Primary Stroke Center. Inova Loudoun Hospital was re-certified in June 2019 as a Joint Commission Certified Advanced Primary Stroke Center. Additionally, the Inova Emergency Room - Leesburg and Inova Emergency Room - Ashburn were certified as Acute Stroke Ready Hospitals (ASRH). Certification as an Advanced Primary Stroke Center and an Acute Stroke Ready Hospital is held by only a small percentage of hospitals nationwide. The Ashburn and Leesburg facilities are the 2nd and 3rd in the state of Virginia to achieve the ASRH designation. The Emergency and Trauma Center at Inova Fairfax Hospital, Northern Virginia's only Level I trauma center, is a state-of-the-art facility. Emergency medical specialists with expertise in trauma care, treat every type of illness, injury, or life-threatening trauma. Inova Center for Rehabilitation, located on the Inova Mount Vernon Hospital campus, is certified by The Joint Commission for Stroke Rehabilitation, and provides comprehensive inpatient and outpatient medical rehabilitation services to patients with traumatic and acquired brain injuries, spinal cord injuries, strokes, multiple sclerosis, and other orthopedic and neurological disabilities. These services are staffed by an interdisciplinary team representing physiatry, neuropsychology, physical therapy, occupational therapy, rehabilitation nursing, therapeutic recreation and case management 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. 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 with 360 units for accommodation. 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 owns and Sunrise operates all four assisted living facilities across Fairfax County with total assisted living days in 2021 of 108,336. Physical Therapy Services Inova Physical Therapy Centers IHCS promotes and conducts specific research and educational activities related to rehabilitative care. In 2021, outpatient visits totaled 189,975 with services offered at seventeen outpatient centers located throughout Northern Virginia. Areas of specialty include: Physical Therapy (PT) and Occupational Therapy (OT). 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 2021, outpatient visits totaled 171,725 with services being provided seven days a week with no appointment necessary at ten locations. Inova ended the year with seven locations, with two having closed in June 2021.
PART III, LINE 4A	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, and sports physicals. Laboratory tests, X-rays, and flu shots are provided on-site. The Centers are staffed by board-certified/board-eligible physicians and Nurse Practioner (providers) licensed in Virginia. A provider, 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 wellbeing 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 2021, EAP supported 20,781 Inova employees and approximately 196,867 total employees/household members 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 and 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, mental health diagnosis, addictions and emotional problems that prevent them from fully functioning in the community and realizing their full potential. Inova Comprehensive Addiction Treatment Services (CATS) Program is a leader in providing the highest quality addiction treatment services in Northern Virginia and surrounding areas. A series of structured programs offers effective, compassionate treatment for individuals dealing with all forms of substance abuse disorders, including addiction to alcohol, prescription drugs, heroin, cocaine and other drugs. Services are available to adults ages 18 and older. The range of services includes: Inpatient Medical Detoxification, Partial Hospitalization Program, Intensive Outpatient Program, Outpatient Groups, Medication Assisted Therapy and Substance Use Assessments. In 2021, the CATS Partial Hospitalization/Intensive Outpatient Program provided 10,272 encounters. Inova Kellar Center is a comprehensive, behavioral health treatment center and special education school for children, adolescents and their families. With locations in Fairfax and Loudoun counties, Inova 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 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 due to an emotional disability, learning disability, autism or other health impairment. The Center provided 85,098 hours of in-person and tele-psych programming and treatment in addition to 35,958 hours of special education to children, adolescents, and families in 2021. The total unreimbursed cost for 2021 was approximately $1,555,038. 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. Non-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" refers to conditions which, if not promptly treated, would lead to an adverse change in the health status of a patient. Free care is provided to uninsured or underinsured individuals with Family Incomes at or below 400% of the current Federal Poverty Guidelines (FPG). 3. In 2021, the Financial Assistance Policy (FAP) expanded eligibility for free care by reducing the minimum Virginia residency period from 90 days to 30 days. Inova Health System utilizes a multifaceted approach to educate and inform patients and the public about Inova's Financial Assistance Policy (FAP) or sometimes referred to as the Charity Care Policy. Information regarding this policy is widely publicized and is kept up to date on the Inova website and through signage. 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 financial assistance 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 whether or not they qualify for charity care. In 2021, IHCS's unreimbursed cost of charity care, including free and discounted services, was $97.9 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. While Virginia Medicaid coverage was expanded in 2019 to increase the number of eligible individuals, the reimbursement that IHCS facilities receive from the Medicaid program routinely falls below the actual cost of services provided. During 2021, IHCS provided care to Medicaid patients at an unreimbursed cost of $179.6 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	Inova Medical House Calls Program The Medical House Calls program is designed to help patients successfully "age in place" while reducing readmissions and overall cost. An interdisciplinary team provides comprehensive primary care in patient homes and assisted living facilities. Patients are generally 65 years of age or older and have difficulty leaving home for medical appointments. Commonly, patients need the most help with multiple chronic illnesses, changes in functional ability, polypharmacy and frailty/debility. These primary care services are "high-touch" with intensive patient management and care coordination with an emphasis on advance care planning. The program staff leverages strong relationships with inpatient teams, hospice agencies, skilled nursing staff, physical therapy staff, occupational therapy staff, mental health counselors and county services for high-quality patient outcomes. In 2021, the program served 952 patients and completed 6,652 physician/nurse practitioner house calls in 51 zip codes across Northern Virginia. Approximately 10,292 nursing/social work encounters were also provided to support the patient population. ElderLink ElderLink is a non-profit partnership between Inova and the Fairfax Area Agency on Aging. ElderLink provides case management, care coordination, health and wellness programming, and caregiver support to older adults and their caregivers. ElderLink provided service to approximately 605 older adults and their caregivers in 2021. Inova Cares Clinic for Families Inova Cares Clinic for Families (ICCF) provides comprehensive primary care services to patients who reflect the culturally diverse community we serve. The clinics serve as medical homes for patients of all ages who qualify for Medicaid, FAMIS, Inova's Financial Assistance Program and/or are uninsured. ICCF provides services to uninsured and under-insured members of the Alexandria, Annandale, Manassas, and Sterling communities. In 2021 we received approval and began implementation efforts to add two new locations: one in Fairfax (opened 3/21/22) and another in Herndon (opening 5/2/22). Early in 2021 and as the COVID-19 vaccine became available, ICCF collaborated with local health departments in Fairfax, Loudoun and Prince William counties and with Alexandria City, along with local pastors, in conducting a COVID-19 vaccination campaign that resulted in vaccinating about 4,000 community members who at the time would have had difficulty finding vaccines or were hesitant to receive it. In 2021, Inova Cares Clinic for Families served 7,405 unique patients with 27,732 total visits. Loudoun Family and Patient Education Program Loudoun Family and Patient Education Program serves the community through health education, prevention, wellness programs, and care management. Loudoun Mobile Health Program Loudoun Mobile Health is staffed by nurses and other support staff who provide community health fairs and health screening services. In 2021, Due to COVID and impacts to staffing, the Inova Loudoun Mobile Health did not provide community services. Cash and In-Kind Contributions to Community Groups ILH donates space, provides cash and in-kind support such as housekeeping and donated staff time to a number of community groups and Loudoun County services. ILH donates space and financial support to the Loudoun Free Clinic which is an independent 501(c)(3) providing primary healthcare services for the uninsured and low-income residents of Loudoun County. ILH donates space to Loudoun Cares, an independent 501(c)(3) organization that provides coordination for social services for the residents of Loudoun County; and the Loudoun Child Advocacy Center. Inova also provides financial support to HealthWorks for Northern Virginia, a Federally Qualified Health Center with locations in Herndon, Reston, and Leesburg, VA. Community Health Education and Promotion As part of Inova's overall health promotion effort, IHCS and its subsidiaries are actively involved in sponsoring programs, activities, and services designed to improve community health and prevent the onset of disease. InovaWell serves the community as the premier provider of health education and wellness services. Knowing that each individual requires different kinds of support and services to meet their personal wellness needs, InovaWell offers a variety of wellness programming. Inova's wellness services include, but are not limited to, personal health coaching and prenatal support, childbirth education, life support re-certification and first aid, health fair screenings, seminars, health challenges, fitness classes and immunizations. In order to reach people where they are most comfortable, InovaWell holds programs in community settings, at employer worksites and other easily accessible locations throughout Northern Virginia and the Greater Metropolitan Washington Area. During 2021, Inova Well served over 610,567 participants. Program highlights are described below. Inova Team Member Well-being InovaWell supports employees and spouses at all health and fitness levels through a comprehensive and supportive wellness program. Employees get tools, support and programs to help improve health or maintain healthy habits. InovaWell provides blood work, biometric screenings, in-person and telephonic wellness coaching, fitness classes and wellness events in Inova's operating units. In 2021, Inova Well was able to provide 3,667 touches within the Inova Health System. It is the goal of the wellness coaches to work with employees to establish realistic wellness goals and to support employees while they work towards optimal health. The wellness coaches held 950 sessions with Inova team members in 2021. The Influenza and Covid Vaccination Program The Inova Well Immunization Program provided 578,195 COVID shots, flu shots, Tdap & Hepatitis B vaccinations and TB screenings at 900 events. Inova Well provides immunizations for Inova employees and physicians, community members and workplaces throughout the metropolitan area. Number of COVID shots: 547,316 Number of flu shots (Quadrivalent, High-Dose & Peds): 30,879 8,295 shots at 197 clinics for Fairfax County Public School employees 3,158 shots at 16 clinics for Loudoun County Public School employees Number of TB plants/readings, Tdap, Hepatitis B vaccinations: 351 The Corporate Wellness and Community Program The Corporate Wellness and Community Program provided over 600 health events that included biometric screenings, seminars, and interactive education stations with a total of 5,796 touches. The Respiratory Fit Testing program served over 11,646 participants. Clients were located throughout the Washington, DC, Metropolitan area and far west into Virginia. The Corporate Wellness Programs continued to provide personalized support and health coaching to encourage healthy behaviors related to weight management, tobacco cessation, back pain management, pregnancy and breastfeeding. InovaWell coaching supported Inova employees, their spouses and 419 community members. Inova Well provides a full time Program Coordinator for The Prince William County Wellness Program, which delivers a full range of wellness services and programs for county employees. Programs include: health and wellness seminars and screenings, weekly meditation, a walking challenge, and a video tutorial around healthy supermarket strategies. In 2021, the Inova Well Program Coordinator provided services to over 5,000 employee lives in Prince William County. The Health Education Program Inova Well provided Life Support education classes for 11,472 students in community and worksite locations. The Inova Well Childbirth Education program served 4,742 community members through educational classes such as breastfeeding, baby care, and childbirth preparation. Additionally, the program offered over 280 free new mom and new parent support groups to 2,711 participants. The Inova WellBaby program, which provides personalized support and education to pregnant and breastfeeding women through email and telephonic outreach, supported around 103 Inova employees and their spouses or partners in 2021. The Healthy Lifestyles Program The Inova Well Fitness program provided over 965 fitness classes to Inova employees and community members in 2022 (a mix of in person and virtual). The program offers classes at locations throughout the community and in a variety of different formats including multi-week series, workshops and drop-in classes. Class types offered include mind body classes (yoga, tai chi), cardio/strength building classes (body toning, Zumba), mommy fitness classes (bootcamp, prenatal yoga) and senior focused classes (strength training for seniors, seniorcize). Over 1,173 individuals took part in these fitness classes, multi-week session based classes and workshops.
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 A, line 1a	With the exception of the duties and responsibilities that are reserved to the Board of Trustees as required by law, the Executive Committee is appointed by the Board to support the Board of Trustees in the performance of its duties and responsibilities that are time-sensitive and must be addressed before the next regularly scheduled meeting of the full Board.
Form 990, Part VI, Section A, line 6	The organization has a single member. The sole member is Inova Health System Foundation, a charitable 501(c)(3) tax-exempt organization which serves as the parent company of the integrated health care delivery system.
Form 990, Part VI, Section A, line 7a	The sole member of the organization, Inova Health System Foundation, is a charitable 501(c)(3) tax-exempt organization. The sole member elects the members of the governing body of the organization.
Form 990, Part VI, Section A, line 7b	The sole member of the organization, Inova Health System Foundation, is a charitable 501(c)(3) tax-exempt organization. The sole member holds reserved powers with respect to certain actions, including approval of borrowings, amendments of Articles of Incorporation and Bylaws. In addition to the reserved powers, under the laws of the Commonwealth of Virginia certain extraordinary actions require member approval, such as mergers, consolidations, liquidations and the sale of substantially all of the assets of the organization.
Form 990, Part VI, Section B, line 11b	The Form 990 is prepared and provided to the Senior Corporate Controller and external tax consultants for initial review. After the review it is given to the CFO of Inova Health System for 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.
Form 990, Part VI, Section B, line 12c	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	Completed by related entity, Inova Health System Foundation: The compensation of all senior management positions is evaluated annually in consideration of each manager's job content, scope and complexity. Compensation levels for executives 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 along with certain other senior executives 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 with competitive market comparisons. Compensation for employed physicians is reviewed and approved by the Provider Contracts Committee. The committee is comprised of executive management of the Clinical Enterprise and Physician Services group. The Fair Market Value (FMV) compensation is based on four nationally recognized industry physician compensation benchmark surveys (MGMA, AMGA, Sullivan & Cotter, Gallagher (formally Integrated)). 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 Provider Contracts Committee for review and approval.
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 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 II 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 and/or Inova's Legal Department. The Code of Conduct contains the conflict of interest principles, is part of Inova's orientation and annual compliance training, and is available to team members and physicians on Inova's intranet website.
Form 990, Part XI, line 9:	PARTNERSHIP INCOME -29,146,611. CHANGE IN UNRESTRICTED NET ASSETS -5,435,876. EQUITY IN SUBS 8,591,228. AMORTIZATION OF INTEREST RATE SWAP 244,323. CAPITAL INFUSION 735,127. AMORTIZATION OF LOSS ON RETIREE HEALTH 525,000. REALIZED LOSS -4,358.
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 "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 AUDIT	The company is part 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 Uniform Guidance compliance audit. The Inova Health System's federal grants are audited on an annual basis by a "Big Four" independent public accounting firm and a "Report of Independent Auditors on Compliance for Each Major Program; Report on Internal Control Over Compliance and Report on Schedule of Expenditures of Federal Awards Required by the Uniform Guidance" 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 Uniform Guidance audit, including the hiring of the audit firm, review and approval of audited financial statements and communications with the external auditors during the year without the presence of internal management.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

INOVA HEALTH CARE SERVICES

Employer identification number

54-0620889

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) INOVA CAP LLC 8110 GATEHOUSE ROAD FALLS CHURCH,VA22042 27-0927074	INSURANCE CAPTIVE	VA	4,466,118	74,113,926	INOVA HEALTH CARE SERVICES
(2) SPRINGFIELD HEALTHPLEX CONDOMINIUM DEVELOPMENT LLC 8110 GATEHOUSE ROAD FALLS CHURCH,VA22042 27-4533736	REAL ESTATE	VA	1,692,801	20,745,541	INOVA HEALTH CARE SERVICES
(3) FC GATEWAY ASSOCIATES LLC 8110 GATEHOUSE ROAD FALLS CHURCH,VA22042 46-1280044	REAL ESTATE	VA	255,097	1,531,695	INOVA HEALTH CARE SERVICES
(4) INOVA METRO CT LLC 8110 GATEHOUSE ROAD FALLS CHURCH,VA22042 47-5049063	INFORMATION SYSTEMS	VA	0	0	INOVA HEALTH CARE SERVICES
(5) CLEAN ADVANCED RENEWABLE ENERGY LLC 8110 GATEHOUSE ROAD FALLS CHURCH,VA22042 81-2395604	ENERGY CONSULTING	VA	0	0	INOVA HEALTH CARE SERVICES
(6) INOVA SHARED SERVICES LLC 8110 GATEHOUSE ROAD FALLS CHURCH,VA22042 81-5346280	IT SERVICES	VA	0	935,242	INOVA HEALTH CARE SERVICES
(7) INOVA PHYSICIAN PARTNERS LLC 8110 GATEHOUSE ROAD FALLS CHURCH,VA22042 27-1219302	PHYSICIAN SERVICES	VA	134,985,857	65,787,564	INOVA HEALTH CARE SERVICES

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)INOVA HEALTH SYSTEM FOUNDATION 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH,VA22042 54-1071867	FUNDRAISING	VA	501(C)(3)	12,II	N/A		No
(2)LOUDOUN NURSING AND REHABILITATION CENTER 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH,VA22042 54-1361310	REHABILITATION SERVICES	VA	501(C)(3)	10	INOVA HEALTH SYSTEM FOUNDATION		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) TECHNICAL DYNAMICS LLC 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH,VA22042 43-2041666	EQUIPMENT REPAIRS	VA	INOVA HEALTH CARE SERVICES	RELATED	4,194,306	8,434,197		No		Yes		99.360 %
(2) INOVA AMBULATORY SURGERY CTR AT LORTON LLC 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH,VA22042 46-1955980	SURGERY CENTER	VA	INOVA HEALTH CARE SERVICES	RELATED	-1,197,939	2,238,385		No		Yes		98.090 %
(3) NORTHERN VIRGINIA SURGERY CENTER 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH,VA22042 20-3502477	SURGERY CENTER	VA	INOVA HEALTH CARE SERVICES	RELATED	3,551,507	6,132,693		No		Yes		58.300 %
(4) FRANCONIA-SPRINGFIELD SURGERY CENTER LLC 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH,VA22042 54-2018390	SURGERY CENTER	VA	INOVA HEALTH CARE SERVICES	RELATED	4,794,035	7,424,053		No		Yes		56.090 %
(5) POTOMAC INOVA HEALTHCARE ALLIANCE LLC 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH,VA22042 54-1802733	RADIATION ONCOLOGY	VA	INOVA HEALTH CARE SERVICES	RELATED	114,012	1,674,974		No		Yes		50.000 %
(6) INOVA RESTON MRI CENTER LLC 2722 MERRILEE DRIVE SUITE 230 FAIRFAX,VA22031 26-4587374	MRI SERVICES	VA	INOVA HEALTH CARE SERVICES	RELATED	3,219,008	3,883,635		No		Yes		65.000 %
(7) SUNRISE INOVA MCLEAN ASSISTED LIVING LLC 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH,VA22042 54-2022822	ASSISTED LIVING	VA	INOVA HEALTH CARE SERVICES	RELATED	1,236,348	7,281,369		No			No	60.000 %
(8) MCLEAN AMBULATORY SURGERY CENTER LLC 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH,VA22042 47-4966649	SURGERY CENTER	VA	INOVA HEALTH CARE SERVICES	RELATED	966,557	5,951,592		No		Yes		55.500 %
(9) INOVA HH HOLDINGS LLC 1050 FORRER BLVD KETTERING,OH45420 82-5217263	HOME CARE	VA	INOVA HEALTH CARE SERVICES	RELATED	1,929,293	5,276,612		No			No	51.000 %
(10) CONTINUUMRX OF NORTH VIRGINIA LLC 2 PERIMETER PARK SOUTH STE 260 BIRMINGHAM,AL35243 81-2936260	PHARMACY SERVICES	VA	INOVA HEALTH CARE SERVICES	RELATED	25,655	1,584,321		No			No	50.000 %
(11) INOVA LOUDOUN AMBULATORY SURGERY CENTER LLC 8110 GATEHOUSE ROAD SUITE 400W FALLS CHURCH,VA22042 20-3523190	SURGERY CENTER	VA	INOVA HEALTH CARE SERVICES	RELATED	7,683,013	12,002,048		No		Yes		55.350 %
(12) FAIRFAX RADIOLOGY CENTERS LLC 2722 MERRILEE DRIVE 230 FAIRFAX,VA22031 35-2672848	RADIOLOGY SERVICES	VA	INOVA HEALTH CARE SERVICES	RELATED	3,444,133	48,954,963		No		Yes		51.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2021

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2021

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: IHCS's mission is to maintain and operate hospitals that provide quality care to the community.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	3
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	0
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	23,619
6	Total number of volunteers (estimate if necessary) .............	6	636
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	5,087,589
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	224,259,814	62,124,887
9	Program service revenue (Part VIII, line 2g) .........	3,487,287,913	4,217,175,865
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	4,715,838	24,561,126
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	118,249,661	129,132,820
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	3,834,513,226	4,432,994,698
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	1,845,909,610	2,257,597,666
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,698,580,918	1,958,595,329
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	3,544,490,528	4,216,192,995
19	Revenue less expenses. Subtract line 18 from line 12.......	290,022,698	216,801,703
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	6,418,021,982	6,535,236,447
21	Total liabilities (Part X, line 26).............	2,715,100,749	2,635,954,602
22	Net assets or fund balances. Subtract line 21 from line 20.....	3,702,921,233	3,899,281,845

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 3,591,268,458 including grants of $ ) (Revenue $ 4,315,108,017 )
	Inova Health Care Services (IHCS) is part of the Inova Health System whose mission is to serve the needs of the community by establishing, maintaining, and operating hospital facilities, programs, and other shared service arrangements; carrying on health-related education activities; promoting and conducting scientific research; and engaging in activities designed to promote the general health of the community. All five of Inova Health System's hospitals have been rated with 5 out of 5 stars in the most recent Centers for Medicare & Medicaid Services (CMS) Five-Star Quality Rating System report. Inova is the only health system in the country comprised of more than three hospitals where all are 5-star rated. A CMS five-star quality rating is based on extensive data that measures patient experience, infection rates, readmissions and mortality.IHCS includes a centralized System Office and the various unincorporated and incorporated subsidiaries. The unincorporated subsidiaries of IHCS include: Inova Fairfax Hospital, Inova Mount Vernon Hospital, Inova Fair Oaks Hospital, Inova Alexandria Hospital, Inova Loudoun Hospital, ACCESS of Reston, ACCESS of Fairfax, Inova Research Center, Assisted Living Facilities, Inova Physical Rehabilitation Services, Inova Urgent Care Centers, Inova Employee Assistance, and Behavioral Health and Addiction Treatment.PROGRAM SERVICESAcute care services are provided on three campuses in Fairfax County, one campus in Loudoun County, and one campus in the City of Alexandria in Virginia. Services provided include emergency and trauma facilities, inpatient and outpatient services, and a variety of ancillary and specialized services. During 2021, IHCS admissions and observations cases totaled 128,353, outpatient visits totaled 645,946, emergency visits totaled 389,308 (25,060 of the total ER visits were at the Springfield Healthplex, 17,211 at the Lorton Healthplex, and 12,912 at the Ashburn Healthplex) and deliveries totaled 19,022. The acute care program services provided by these hospitals are described more fully below.Inova Fairfax Hospital (IFH) includes the Inova Heart and Vascular Institute, Inova Women's Hospital, Inova Fairfax Hospital for Children, and the Inova Schar Cancer Institute. The hospital, located in Central Fairfax County is a 928-licensed bed tertiary care hospital providing comprehensive medical and surgical services which include emergency/trauma, cardiac, transplant, cancer, obstetric, pediatric, neonatal, stroke, and extensive outpatient services. During 2020, as part of the "Pandemic Response Executive Order 52", IFH shifted 20 beds from IFH to ILH. Inova Fairfax Hospital is the home of Northern Virginia's only Level 1 emergency and trauma center and the state-of-the-art Women's and Children's Center. In addition, Inova Fairfax Hospital is a teaching hospital providing clinical training through medical residency, nursing, and paramedical education programs.Inova Mount Vernon Hospital (IMVH) is a 249-licensed bed acute-care hospital serving Southeastern Fairfax County. Inova Mount Vernon Hospital provides a full-service, 24-hour emergency department; broad range of diagnostic, medical, and surgical services; inpatient psychiatric services; the Dorothea R. Fischer Wound Healing Center, and a specialized hyperbaric oxygen therapy program used to treat conditions requiring increased oxygen flow to body tissues (such as grafts and certain types of burns). During 2020, as part of the "Pandemic Response Executive Order 52", the allotment to Inova Mt. Vernon Hospital was 12 beds. These are added to our licensed beds to bring the total from 237 to 249. Inova Mount Vernon Hospital also operates the Lorton Healthplex, a 24-hour free standing emergency facility and the Inova Center for Rehabilitation, a nationally-known accredited program providing inpatient and outpatient rehabilitative services.Inova Fair Oaks Hospital (IFOH) is a top-ranked 174-bed acute care community hospital serving the rapidly growing suburbs of Northern Virginia. Signature service lines include spine, weight loss, joint replacement, and minimally invasive surgery. During 2020, as part of the "Pandemic Response Executive Order 52", IFOH shifted 8 beds from IFOH to ILH. State-of-the-art cancer care and maternity services are also signature offerings. Inova Fair Oaks Hospital is a fully accredited Comprehensive Center for Bariatric Surgery. Inova Alexandria Hospital (IAH) is a 302-licensed bed general acute care hospital, which opened on January 23, 1873. Inova Alexandria Hospital provides a spectrum of diagnostic services, including full-body CT scanning, MRI, and a cardiac catheterization laboratory; a variety of inpatient medical, surgical, and orthopedic services; comprehensive outpatient services, including outpatient surgery, physical medicine, and rehabilitation; and a 24-hour emergency department as well as the Springfield Healthplex, a free standing emergency facility. In addition, specialized obstetric and pediatric services are provided by the hospital's Maternal and Infant Health Center and a children's unit. Inova Loudoun Hospital (ILH) is a 183-licensed bed general acute care hospital, which first opened its doors in 1912. During 2020, as part of the "Pandemic Response Executive Order 52", ILH received 20 beds from IFH and 8 beds from IFOH. These were added to bring the total licensed-beds from 183 to 211. ILH provides a full-service 24-hour emergency department as well as two freestanding emergency rooms; 23 intensive care beds; a spectrum of diagnostic services, including full-body CT scanning, MRI, and a cardiac catheterization laboratory; a variety of inpatient medical, surgical, and orthopedic services, and comprehensive outpatient services including outpatient surgery, physical medicine and rehabilitation services, and radiation therapy. In addition, obstetrical and pediatric services are provided by ILH's Ladies' Board Birthing Inn, a pediatric emergency department and an inpatient pediatric unit. Specific acute care programs include:Cardiovascular Care: Inova Heart and Vascular Institute ("IHVI") offers a variety of services at all five Inova Hospitals and in nearly 60 outpatient locations throughout the northern Virginia region. Inova Fairfax Medical Campus is home to IHVI's dedicated heart hospital, which serves as the hub of the system's cardiac, vascular and pulmonary services. IHVI's clinical capabilities cover the full spectrum of complex cardiovascular and pulmonary care from medical evaluation and diagnostic testing through the most innovative minimally invasive surgical techniques and complex open surgeries, including heart and lung transplantation. IHVI's outstanding performance has been recognized by many measures, including U.S. News & World Report (2021-2022) rankings as "High Performing" in seven cardiac specialties: abdominal aortic aneurysm (AAA) repair, aortic valve surgery, cardiology, heart attack, heart bypass surgery, heart failure and transcatheter aortic valve replacement (TAVR). IHVI has also achieved recognition from the American College of Cardiology as a "Proven Quality Program" for its participation and performance in the National Cardiovascular Data Registry (NCDR) database, 3-star ratings (the highest rating) from the Society of Thoracic Surgeons, and ratings from Healthgrades as one of "America's 100 Best Hospitals for Cardiac Care", "America's 50 Best Hospitals for Cardiac Surgery and "Pulmonary Care Excellence Award". The AHA recognized IHVI as a Mitral Valve Repair Reference Center Award and Extracorporeal Life Support Organization (ELSO) awarded IHVI as a Gold Award of Excellence. IHVI is ranked among the nation's top performing hospitals for patient safety, patient satisfaction and clinical outcomes.IHVI is also a leader in minimally invasive heart valve repair and surgery. Inova Heart and Vascular Institute operates one of the country's busiest structural heart programs (13th in the country), performing minimally invasive transcatheter procedures to treat valvular heart disease and other heart defects. Additionally, IHVI is 14th in the nation in number of Heart Transplants and with excellent outcomes, making Inova one of the top heart transplant programs in the country. The IHVI multidisciplinary cardiogenic shock team is a model of excellence having set a new standard for patient survival rates. The robust Cardiology and Advanced Lung Research Programs provide innovative research to keep IHVI on the leading edge of diagnosis and treatment options for the community.

4b	(Code: ) (Expenses $ 38,007,157 including grants of $ ) (Revenue $ 20,167,172 )
	Inova Research Center - Medical Students The Inova Research Center (IRC), including research and academic activities, is centered at the Inova Fairfax Hospital. In 2021, The Inova campus of the University of Virginia had a total of 36 third year and 36 fourth year medical students who spent their clerkship and fourth year at Inova Fairfax Hospital. In addition, 180 students came to Inova Hospitals for a four-week rotation in 2021.Pharmacy Students and ResidentsAlso located on the Inova campus is the VCU School of Pharmacy which partners with clinicians and practitioners across Inova and Northern Virginia to help educate and train an increasing number of pharmacy students each year. In 2021, 53 third and fourth year pharmacy students completed didactic and experiential learning experiences across Northern Virginia with the Inova Health System. Pharmacy practitioners precepted 196 Introductory Pharmacy Practice Experiences (IPPEs) and Advanced Pharmacy Practice Experiences (APPEs), with all students from the VCU School of Pharmacy. With the advent of the Shenandoah School of Pharmacy at the Inova Center for Personalized Health beginning in 2017, system wide, Inova precepted 44 IPPE's, 84 APPE's by Shenandoah University faculty during 2021.In addition, there are pharmacy post-graduate training opportunities offered at three Inova institutions. Inova Fairfax Hospital offers 4 PGY-1 Pharmacy Practice Residency positons, as well as a PGY-2 Emergency Medicine Pharmacy Residency position and a PGY-2 Critical Care Residency position. Inova Alexandria and Inova Mount Vernon Hospitals each offer 2 PGY-1 Pharmacy Practice Residency positions, as well as one PGY-2 Ambulatory Care residency position for a total of 11 post-graduate training opportunities across Inova Health System. The Claude Moore Health Education CenterThe Claude Moore Health Education Center on the campus of Inova Fairfax Hospital features 11,000 square feet of space dedicated to the educational needs of medical and nursing students as well as residents and fellows. This state-of-the-art Center includes both medical and surgical simulation centers, enabling students to learn through hands-on experience. The Center features two dedicated research floors to support the extensive activities of the Office of Research at Inova where numerous active clinical trials and ongoing outcomes and laboratory research projects are conducted. Many of these clinical and research opportunities are conducted in partnership with universities and other research entities. The unreimbursed cost of these programs in 2021 was $17.8 million. Residents/FellowsInova sponsors accredited residency training programs in: Family Medicine, Pediatrics, General Surgery, Internal Medicine, OB/GYN, Neurosurgery and Podiatry. In addition, Inova also sponsors accredited fellowships in Surgical Critical Care, Pediatric Emergency Medicine, Pediatric Hospitalist Medicine, Cardiology, Hematology/Oncology, Orthopedic Sports Medicine, Family Sports Medicine, Breast Surgery, and Bariatric surgery. Inova supports training programs from affiliates in Emergency Medicine, Psychiatry, Orthopedics, Ophthalmology, Family Practice, Critical Care, Anesthesia, PM&R and a number of other medical and surgical specialties. Inova also supports integrated fellowships with National Capital Consortium in Vascular Surgery, Female Pelvic Medicine and Reconstructive Surgery, and Gynecology/Oncology. In all, Inova trained 734 individual residents/fellows (200 FTEs) from 34 specialties in 2021. As a teaching facility, Inova Fairfax Hospital incurs typical, additional expenses associated with teaching facilities including physician teaching costs and resident salaries, the cost of maintaining higher levels of technology required to support a teaching program and charges resulting from extra tests ordered for instructional purposes. The direct cost of these programs in 2021 was approximately $18.7 million.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	Each year, IHCS designates funds for the development and continuation of identified, accessible direct care programs and services benefiting those most in need in the community. Many of these programs and services are not billed to the patient or are provided at a fee structure below the actual cost of the service. In addition to providing the direct care subsidized service, Inova also provides disease-prevention programs, health and exercise classes, health education and health screenings and other programs within the community in support of the IHCS mission. In 2021, Inova provided over 250,000 people with health education, prevention and wellness programs, health fairs and screenings, and clinically related services resulting in over 130,000 visits for direct health care services at an unreimbursed cost of approximately $36.0 million. These services and programs are described below. Inova Cares Clinic for Women and ChildrenThe Inova Cares Clinic for Women (ICCW) was created in 1960 to serve the uninsured women of Fairfax County, offering a wide range of OB/GYN services for those in need. This program is a service offered to the community in collaboration with the local Health Departments, serving uninsured and low-income patients up to 400% of the Federal Poverty Guidelines (FPG). The clinics work in partnership with the Fairfax and Loudoun County Health Departments, IFH, and ILH to promote early and continuous prenatal care for the culturally diverse population who are its patients. Inova Cares Clinic for Women provides comprehensive outpatient obstetrical services and gynecological care as well as non-stress testing, and LEEP and colposcopy procedures at little to no cost to the patient. The clinic provides specialty gynecological care service as well, including maternal fetal medicine, GYN/Onc, and Uro/GYN. In addition to medical services, the clinic also provides support services including radiology, laboratory, genetic testing, diabetes management, case management, social work, family planning, and nutritional counseling. In 2021, ICCW provided over 32,374 patient encounters for over 4,472 patients, 3,142 newly established. Additionally, ICCW supported over 1,783 deliveries at Inova medical campuses. The Inova Cares Clinic for Children (ICCC) was created in 1993 as a response to the inability of uninsured or Medicaid mothers to secure an affordable medical home for their children. ICCC is recognized as an accredited Patient Centered Medical Home by the National Committee for Quality Assurance, and serves as a medical home for newborns up to 21 years of age. The Inova Cares Clinic for Children provides comprehensive pediatric services that includes well-child care, immunizations, episodic care (sick visits), and school/sports physicals, immunizations, and nutritional counseling. In 2021, the Inova Cares Clinic for Children provided 23,305 clinical services to over 7,517 patients and 2,956 newly established patients.Inova Alexandria Hospital (IAH) OB ClinicIAH donates space on the campus to the Casey Clinic, a community health center currently run by Neighborhood Health, a Federally Qualified Health Center that is funded by the State of Virginia, Alexandria Health Department and the City Of Alexandria to provide primary healthcare services to low-income and uninsured children and adults that are residents of the City of Alexandria. IAH funds the clinic physicians who provide OB patient prenatal examinations and delivery at Inova Alexandria Hospital. Inova Juniper Program, HIV Clinical and Education ServicesInova Juniper Program (IJP) provides outpatient primary medical care, mental health therapy, substance abuse counseling, pharmaceutical assistance, and medical case management services to 1,638 Ryan White funded persons living with HIV disease in the suburban Virginia region. To maximize accessibility for clients, services are provided at the main location in Fairfax, as well as six satellite clinics (Dumfries, Manassas, Mt. Vernon, Falls Church, Leesburg, and Herndon), hospitals, homes, and other community locations throughout the region. Major accomplishments of IJP for 2021 include:Served 1,638 patients living with HIV, providing 40,783 services.Provided 6,714 medical case management services to 833 Ryan White funded clients living with HIV. Provided 349 clients with mental health services and 10 clients with substance abuse outpatient care.Conducted 101 hours of education reaching 615 participants.Conducted 104 HIV tests (primarily at-home tests due to COVID-19) with known seroprevalence of 3.8% across Northern Virginia.Successfully adapted to primarily virtual prevention and education programs to support, motivate and educate healthcare professionals, the public, and people living with HIV. Programs are targeted to incarcerated men and women, men who have sex with men, youth, and the general population. HIV testing, outreach groups, and patient navigation services are also provided.Life with Cancer Life with Cancer, part of the of the Inova Dwight and Martha Schar Cancer Institute, has become Northern Virginia's premier cancer education, wellness, and psychosocial support organization. A variety of integrative therapies, wellness programs, groups and classes are offered to patients (adults and children), survivors, family members (adults and children), friends and staff as well as community organizations. Programs are evidence-based [supported by Society of Integrative Oncology (SIO), The American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN)] and designed to help individuals and the community understand cancer, cancer treatments, survivorship, grief and bereavement and how to maintain physical and psychological health. Life with Cancer's facilities are strategically located throughout the Northern Virginia area with the centerpiece of outpatient care provided at the Life with Cancer Family Center, adjacent to the Inova Fairfax Medical Campus. At the newest location, Inova Schar Cancer Institute (ISCI) - Fairfax, Life with Cancer clinical staff are fully integrated in all 7 clinics to provide the best patient experience possible. Life with Cancer is primarily supported by generous donations from the community, and therefore, all services are available at no charge with minimal exceptions, no matter where the patient's cancer treatment is received. Those exceptions include psychiatry, which is billed to insurance, and oncology massage and acupuncture, for which patients may pay for additional sessions beyond what is offered for free. In 2021, philanthropic funds allowed Life with Cancer to offer 3 free oncology massage sessions and 6 free acupuncture sessions to cancer patients. By the close of 2021, Life with Cancer had provided 23,791 clinical patient encounters, in-person and via telehealth, which included 1,671 educational classes, groups and wellness programs for adults, children and adolescents with 22,921 participants. 15,536 individuals alone participated in exercise/activity programs and Life with Cancer expert dietitians provided 2,549 nutrition counseling appointments to adults and children with cancer as well as caregivers. The Pediatric Program, led by a Pediatric Chief Psychologist, provided the highest quality pediatric care, education, and support for patients and families through more than 3,695 clinical encounters. Life with Cancer psycho-oncologist, who provides whole-person, humanistic, and patient-centered care conducted 1,169 patient consultations.Inova Lions Eye ClinicAdministered by Inova Health System (IHS), the Ophthalmology Clinic provides ophthalmic specialty services to the indigent including treatment of glaucoma, retina, and cataracts. Inova Lions Eye Clinic provides a part-time ophthalmologist, an ophthalmic technician, and a receptionist for the clinic. The remaining physicians volunteer their services. In 2021, Inova Lions Eye Clinic was able to resume normal operations and increased the number of patients served following the significant drop that resulted from the COVID-19 impact in 2020. The number of unique patients served in 2021 increased to 1,345 and total visits increased to 4,786.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses3,629,275,615

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) WILLIAM BANE........................................................................ FORMER VP FINANCE	40.00 .......................10.00	X	406,237	0	56,372
(19) DEBORAH ADDO........................................................................ FORMER PRESIDENT ILH	40.00 .......................10.00	X	526,569	0	55,721
(20) CHRISTOPHER CHIANTELLA........................................................................ FORMER CHIEF MEDICAL OFFICER ILH	40.00 .......................0.00	X	506,281	0	75,416

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	29,664,483	0	2,634,141

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	15,036,751
e	Government grants (contributions)		1e	47,088,136

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		62,124,887

		Business Code
2a	Net Patient Service Revenue	622110	4,188,029,254	4,188,029,254
b	Inova Loudoun Ambulatory Surgery	621400	7,683,013	7,683,013
c	Franconia-Springfield Surgery Ctr	621400	4,794,035	4,794,035
d	Technical Dynamics, LLC	811000	4,194,306	4,194,306
e	Northern Virginia Surgery Center	621400	3,551,507	3,551,507
f	All other program service revenue.		8,923,750	8,923,750
g	Total. Add lines 2a–2f .....		4,217,175,865

3 Investment income (including dividends, interest, and othersimilar amounts) ......			5,660,402		-387,133	6,047,535
4 Income from investment of tax-exempt bond proceeds			8,522			8,522
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents	1,549,096	23,790,230	6a
b	Less: rental expenses	2,276,160	18,231,456	6b
c	Rental income or (loss)	-727,064	5,558,774	6c
d	Net rental income or (loss).......			4,831,710		-727,064	5,558,774
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		18,892,202	7a
b	Less: cost or other basis and sales expenses		0	7b
c	Gain or (loss)		18,892,202	7c
d	Net gain or (loss).........			18,892,202			18,892,202
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	OTHER OPERATING REVENUE		900099	115,999,852	109,798,066	6,201,786
b	COMMUNITY BLOOD SERVICES		900099	8,301,258	8,301,258
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			124,301,110
12	Total revenue. See instructions.....			4,432,994,698	4,335,275,189	5,087,589	30,507,033

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	21,943,660	21,943,660
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	1,871,212,647	1,601,277,513	269,935,134
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	72,052,092	57,840,414	14,211,678
9	Other employee benefits .......	174,732,369	140,424,226	34,308,143
10	Payroll taxes ...........	117,656,898	97,731,699	19,925,199
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	4,459,997	1,733,929	2,726,068
c	Accounting ...........	2,137,034	53,406	2,083,628
d	Lobbying ...........	230,785	230,785
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	312,406,507	310,193,942	2,212,565
12	Advertising and promotion ....	8,860,773	2,251,823	6,608,950
13	Office expenses .......	52,002,969	33,075,662	18,927,307
14	Information technology ......	85,291,402	11,059,275	74,232,127
15	Royalties ..
16	Occupancy ...........	79,518,130	71,195,112	8,323,018
17	Travel ............	6,559,728	5,222,656	1,337,072
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	1,560,708	1,218,550	342,158
20	Interest ...........	46,947,644	46,359,430	588,214
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	286,618,108	222,300,957	64,317,151
23	Insurance ...	19,696,923	19,060,049	636,874
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	460,951,070	458,540,483	2,410,587
b	OTHER PURCHASED SERVICE	293,063,416	231,526,637	61,536,779
c	PHARMACEUTICALS	228,357,884	226,443,806	1,914,078
d	BAD DEBT	54,795,565	54,795,565
e	All other expenses	15,136,686	14,796,036	340,650
25	Total functional expenses. Add lines 1 through 24e	4,216,192,995	3,629,275,615	586,917,380	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			601,742,903	2	547,556,988
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			384,765,436	4	434,247,257
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........			64,158,391	7	68,390,625
8	Inventories for sale or use ............			39,093,759	8	42,056,461
9	Prepaid expenses and deferred charges ......			84,846,782	9	101,633,813
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	5,654,190,401
b	Less: accumulated depreciation	10b	3,229,167,926	2,452,283,709	10c	2,425,022,475
11	Investments—publicly traded securities .			94,231,424	11	141,217,287
12	Investments—other securities. See Part IV, line 11 .....			69,939,570	12	43,167,465
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			19,591,574	14	20,223,795
15	Other assets. See Part IV, line 11 ...........			2,607,368,434	15	2,711,720,281
16	Total assets. Add lines 1 through 15 (must equal line 33)...			6,418,021,982	16	6,535,236,447

17	Accounts payable and accrued expenses .....	432,425,749	17	513,767,479
18	Grants payable ...		18
19	Deferred revenue .........	54,392,598	19	21,868,185
20	Tax-exempt bond liabilities .........	1,867,616,581	20	1,752,997,370
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	107,393,380	23	111,871,244
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	253,272,441	25	235,450,324
26	Total liabilities. Add lines 17 through 25..	2,715,100,749	26	2,635,954,602

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	3,679,004,132	27	3,872,411,586
28	Net assets with donor restrictions ...........	23,917,101	28	26,870,259
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	3,702,921,233	32	3,899,281,845
33	Total liabilities and net assets/fund balances ........	6,418,021,982	33	6,535,236,447