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)
(1) Dean Kostov...................................................................... Physician Specialty	40.0 ................. 0.0			X	2,271,979	72,862
(2) Matthew Reed...................................................................... Physician Specialty	40.0 ................. 0.0			X	2,097,767	30,768
(3) WILLIAM H MCALLISTER MD...................................................................... RMG-BOARD MBR/RMG Physician	40.0 ................. 0.0	X			1,978,160	73,210
(4) WILLIAM BURNS DOWNEY...................................................................... CEO, RHS	40.0 ................. 0.0	X	X		1,495,939	62,904
(5) Anthony Farah...................................................................... Physician Specialty	40.0 ................. 0.0			X	1,432,292	55,732
(6) Romney Andersen...................................................................... Physician Specialty	40.0 ................. 0.0			X	1,351,970	11,050
(7) Robert Cullom...................................................................... Physician Specialty	39.0 ................. 0.0			X	1,272,297	56,423
(8) MICHAEL DACEY MD...................................................................... PRESIDENT/COO, RHS	40.0 ................. 0.0	X	X		975,038	20,487
(9) SCOTT BURGESS...................................................................... RMG-BOARD MBR/RMG Physician	40.0 ................. 0.0	X			804,735	77,096
(10) MICHAEL JOSEPH DOUCETTE...................................................................... RRMC-PRESIDENT, RRMC	40.0 ................. 0.0		X		703,886	80,395
(11) DAVID COHEN...................................................................... RMG-BOARD MEMBER	38.0 ................. 0.0	X	X		696,083	30,323
(12) WALTER WILLIAM AUSTIN JR...................................................................... EVP, CFO & TREASURER	40.0 ................. 0.0		X		695,102	28,051
(13) THOMAS KAYROUZ...................................................................... RMG-PRESIDENT CMO RMG	40.0 ................. 0.0		X		679,385	21,585
(14) CARRIE R MOSS MD...................................................................... RDHW-BOARD MEMBER	40.0 ................. 0.0	X			624,633	43,457
(15) MELVIN D SCHURSKY JR MD...................................................................... RWRH-CMO, RWRH/RMG BOARD MBR	40.0 ................. 0.0	X			591,783	67,011
(16) CHARLES FRAZIER...................................................................... VP MD	40.0 ................. 0.0		X		554,209	84,185
(17) NANCY WICK LITTLEFIELD...................................................................... EVP/CNO, RHS	40.0 ................. 0.0	X	X		604,315	26,892

(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
(18) SALLY HARTMAN........................................................................ SENIOR VP	40.0 .......................0.0		X			570,148	60,681
(19) CHRISTOPHER PATRICK STOLLE MD........................................................................ VP MEDICAL AFFAIRS	40.0 .......................0.0		X			571,390	29,973
(20) ROSS YOUNGER........................................................................ SENIOR VP	40.0 .......................0.0		X			533,489	43,858
(21) JASON O HOUSER........................................................................ GENERAL COUNSEL/SECRETARY, RHS	40.0 .......................0.0		X			500,738	75,385
(22) JOSEPH K KING........................................................................ RRMC-MEDICAL STAFF PRES/BOARD	40.0 .......................0.0	X				480,130	86,092
(23) CATHERINE LINTZENICH MD........................................................................ RMG-BD MBR/PHY RDHW-MDSTAFPRES	40.0 .......................0.0	X				510,186	36,771
(24) CHARLES GRAHAM........................................................................ VP	40.0 .......................0.0		X			497,112	32,768
(25) LISA A CASANOVA MD........................................................................ RMG-BOARD MBR/RMG Physician	40.0 .......................0.0	X				442,797	68,568
(26) JAMES W MCCORRY DO........................................................................ RDHW-CMO/RMG Physician	35.0 .......................0.0	X				439,228	22,570
(27) DWIGHT C HERBERT MD........................................................................ RMG-BOARD MBR/RMG Physician	40.0 .......................0.0	X				404,146	55,162
(28) JEFF T SENSENIG........................................................................ RWRH-MEDICAL STAFF PRESIDENT	38.0 .......................0.0			X		386,102	53,204
(29) Joseph Converse........................................................................ RDHW-FORMER MEDICAL STAFF PRES	0.0 .......................0.0				X	408,677	29,608
(30) MONILLA DENT........................................................................ RRMC-BOARD MEMBER	40.0 .......................0.0	X				398,738	33,082
(31) ESTHER M DESIMINI........................................................................ RWRH-PRESIDENT, RWRH	40.0 .......................0.0		X			398,832	29,200
(32) THERESA SIEVERS........................................................................ SENIOR VP	40.0 .......................0.0		X			392,341	34,383
(33) CYNTHIA WILLIAMS........................................................................ VP	40.0 .......................0.0		X			396,870	26,589
(34) NEHEMIAH THRASH MD........................................................................ RMG-BOARD MBR/RMG Physician	40.0 .......................0.0	X				369,810	53,119
(35) EDWARD G HECKLER........................................................................ VP, LIFELONG HEALTH	40.0 .......................0.0		X			357,576	60,282
(36) TIMOTHY LARKIN II........................................................................ RMG-BOARD MEMBER/RMG PHYSICIAN	40.0 .......................0.0	X				333,643	76,377
(37) ELENA GARRETT MD........................................................................ RMG-BOARD MBR/RMG Physician	33.0 .......................0.0	X				356,427	47,398
(38) John Mincks........................................................................ RDHW-FMR MDSTAFFPRES/RMG PHYS	0.0 .......................0.0				X	335,288	66,062
(39) DAVID F JONES MD........................................................................ RMG-CHAIRMAN/RMG Physician	40.0 .......................0.0	X	X			359,479	41,597
(40) SALLY RYAN........................................................................ VP/COO, RMG	40.0 .......................0.0		X			377,598	20,200
(41) JESSE GOODRICH........................................................................ VP	40.0 .......................0.0		X			332,976	52,686
(42) LISA SALSBERRY........................................................................ Officer Corp Audit & Comp/	40.0 .......................0.0		X			297,153	74,354
(43) ADRIA NICOLE VANHOOZIER........................................................................ RDHW-PRESIDENT, RDHW	40.0 .......................0.0		X			344,770	14,830
(44) JASON KILGORE........................................................................ VP RESULTS MGT AND ANALYTICS	40.0 .......................0.0		X			300,891	58,454
(45) EILEEN VARNSON........................................................................ VP	40.0 .......................0.0		X			314,276	40,356
(46) Braden Miller........................................................................ Associate Vice President Chief	40.0 .......................0.0			X		304,450	36,801
(47) Linwood Nelson........................................................................ Associate Vice President Chief	40.0 .......................0.0			X		242,556	65,123
(48) ROBERT CROSS........................................................................ RMG-BOARD MBR/RMG Physician	30.0 .......................0.0	X				250,548	55,285
(49) Barbara Labonte........................................................................ Associate Vice President	40.0 .......................0.0			X		251,489	53,430
(50) SADIE THURMAN........................................................................ RRMC-VP CNO	40.0 .......................0.0		X			292,125	4,932
(51) Douglas Culbert........................................................................ Associate Vice President Servi	40.0 .......................0.0			X		222,980	66,870
(52) VERNEETA L WILLIAMS MD........................................................................ RHSF-BOARD MBR/RMG Physician	40.0 .......................0.0	X				228,954	60,447
(53) Michael Keesee........................................................................ Associate Vice President Clini	40.0 .......................0.0			X		237,061	47,435
(54) Sandra Snapp........................................................................ Associate Vice President Servi	40.0 .......................0.0			X		247,174	36,828
(55) David Inabinet........................................................................ Associate Vice President Chief	40.0 .......................0.0			X		252,328	30,983
(56) MICHAEL J FRANCIS MD........................................................................ FORMER PRESIDENT, MEDICAL STAF	0.0 .......................0.0				X	259,437	23,150
(57) Mark Rath........................................................................ Support Operations/AVP	40.0 .......................0.0			X		242,680	24,314
(58) Stacey Johnson........................................................................ RBHC-Hospital President/VP	40.0 .......................0.0		X			248,386	18,020
(59) Shelly Johnson........................................................................ RWRH-Support Operations/AVP	40.0 .......................0.0			X		217,122	36,556
(60) REGINALD K MASON........................................................................ FORMER RTH-MEDICAL STAFF PRESI	21.0 .......................0.0				X	212,541	41,088
(61) Timothy Emons........................................................................ Associate Vice President Corpo	40.0 .......................0.0			X		225,446	27,684
(62) Linda Mckee........................................................................ Associate Vice President Servi	40.0 .......................0.0			X		233,565	18,535
(63) Cheryl Ange........................................................................ RMG-Specialty Care Senior Dire	40.0 .......................0.0			X		209,201	31,950
(64) Delvin Peeks........................................................................ Enterprise Resource & Work AVP	40.0 .......................0.0		X			200,519	38,318
(65) Jessica Macalino........................................................................ Associate Vice President Servi	40.0 .......................0.0			X		210,858	17,051
(66) Eric Stone........................................................................ RRMC-FORMER VP CLINICAL O	0.0 .......................0.0				X	217,400	10,139
(67) Kelly Cooper........................................................................ RMG-Primary Care Senior Direct	40.0 .......................0.0			X		189,524	34,754
(68) Lisa Shannon........................................................................ Associate Vice President Risk	40.0 .......................0.0			X		199,378	24,148
(69) Jason Villaflor........................................................................ RWFC-Rehab Services System Dir	40.0 .......................0.0			X		184,720	36,308
(70) Margaret Atkins........................................................................ Associate Vice President Chief	40.0 .......................0.0			X		171,175	28,931
(71) ANDREA STASKIEL........................................................................ FORMER RRS-EXECUTIVE DIRECTOR	36.0 .......................0.0				X	180,872	17,817
(72) Steven Minter........................................................................ RRS-Administrator LLH PCAW/WF/	40.0 .......................0.0			X		177,093	19,340
(73) Lisa Kirby........................................................................ LLH-Executive Director Nursing	40.0 .......................0.0			X		186,224	7,190
(74) KRISTEN WITT........................................................................ RHCF-EXECUTIVE DIRECTOR	40.0 .......................0.0			X		163,268	15,118
(75) MARGARET R LEMLEY PHD........................................................................ PAT-EXECUTIVE DIRECTOR	25.0 .......................0.0			X		169,947	5,146
(76) Elizabeth Martin........................................................................ RMS-FORMER RMS SVP QUALITY	0.0 .......................0.0				X	147,326	13,218
(77) Michelle Wooten........................................................................ RDHW-Chief Nursing Officer	40.0 .......................0.0			X		152,741	5,687
(78) TERESA K THOMPSON NP........................................................................ RMG-BOARD MEMBER/NURSE PRACTIT	32.0 .......................0.0	X				142,198	5,979
(79) APRIL TOWLER........................................................................ RMG-BOARD MEMBER/NURSE PRACTIO	40.0 .......................0.0	X				133,321	13,354
(80) JUDITH MATTHEWS........................................................................ FORMER EXECUTIVE NURSE	21.0 .......................0.0				X	103,529	7,630
(81) SHAWN A FLANAGAN........................................................................ RDHW-BOARD MEMBER/RMG PHYSICIA	5.0 .......................0.0	X				31,562	0
(82) STEPHEN C ADAMS........................................................................ LLH-BOARD MEMBER	1.0 .......................0.0	X				0	0
(83) CELIA L ADOLPHI........................................................................ PAT-BOARD MEMBER	1.0 .......................0.0	X				0	0
(84) JOYCE JARRETT ALEWYNSE........................................................................ CEAGH-BOARD MEMBER	1.0 .......................0.0	X				0	0
(85) VIRGINIA M AMBLER........................................................................ RDHW-BOARD MEMBER	1.0 .......................0.0	X				0	0
(86) WANDA M AUSTIN........................................................................ RRMC-BOARD MEMBER	1.0 .......................0.0	X				0	0
(87) JULIE M BADGER........................................................................ RHCF-BOARD MEMBER	1.0 .......................0.0	X				0	0
(88) PATRICIA P BARRY MD........................................................................ RHCF-BOARD MEMBER	1.0 .......................0.0	X				0	0
(89) JARED L BATES........................................................................ PAT-VICE CHAIRMAN	1.0 .......................0.0	X	X			0	0
(90) DWAYNE B BLAKE........................................................................ RRMC-VICE CHAIRMAN	1.0 .......................0.0	X	X			0	0
(91) BETTY L BLEVINS........................................................................ RWRH-BOARD MEMBER	1.0 .......................0.0	X				0	0
(92) WILLIAM L BRAUER........................................................................ RDHW-CHAIRMAN	1.0 .......................0.0	X	X			0	0
(93) PATRICIA G BROWN........................................................................ RWRH-BOARD MEMBER	1.0 .......................0.0	X				0	0
(94) JAMES C BURNETT CPA........................................................................ RHCF-VICE CHAIRMAN	1.0 .......................0.0	X	X			0	0
(95) THOMAS BYRD........................................................................ RMS-Vice CHAIRMAN	1.0 .......................0.0	X	X			0	0
(96) MICHAEL T CHASE........................................................................ PAT-BOARD MEMBER	1.0 .......................0.0	X				0	0
(97) WALTER R CLEMONS PHD........................................................................ RWRH-BOARD MEMBER	1.0 .......................0.0	X				0	0
(98) ROBERT J COURTER JR........................................................................ RDHW-BOARD MEMBER	1.0 .......................0.0	X				0	0
(99) RICHARD FREDERICK CROWDER MD........................................................................ RWRH-CHAIRMAN	1.0 .......................0.0	X	X			0	0
(100) ROBERT T DAVIS........................................................................ RWRH-BOARD MEMBER	1.0 .......................0.0	X				0	0
(101) FREDRICK N ELOFSON........................................................................ SANN-BOARD MEMBER	1.0 .......................0.0	X				0	0
(102) THERESA EMORY MD........................................................................ RHCF-BOARD MEMBER	1.0 .......................0.0	X				0	0
(103) FAYE P GARGIULO........................................................................ RHSF-BOARD MEMBER	1.0 .......................0.0	X				0	0
(104) GEORGE ROYDEN GOODSON III........................................................................ RRMC-CHAIRMAN	1.0 .......................0.0	X	X			0	0
(105) WILLIAM M GRACE........................................................................ RHSF-BOARD MEMBER	1.0 .......................0.0	X				0	0
(106) BARBARA S HAYWOOD........................................................................ LLH-VICE CHAIRMAN	1.0 .......................0.0	X	X			0	0
(107) WILLIAM P HEATH JR........................................................................ RRMC-BOARD MEMBER	1.0 .......................0.0	X				0	0
(108) SUSANNA B HICKMAN........................................................................ RDHW-BOARD MEMBER	1.0 .......................0.0	X				0	0
(109) MYRON KEITH HODGES........................................................................ RWRH-BOARD MEMBER	1.0 .......................0.0	X				0	0
(110) HALL RENFRO HOWARD MD........................................................................ RDHW-BOARD MEMBER	1.0 .......................0.0	X				0	0
(111) ELIZABETH DAWN HUNT DMD........................................................................ RRMC-BOARD MEMBER	1.0 .......................0.0	X				0	0
(112) SUSAN S JACOBS........................................................................ RRI-BOARD MEMBER	1.0 .......................0.0	X				0	0
(113) HAROLD D JONES........................................................................ RWRH-VICE CHAIRMAN	1.0 .......................0.0	X	X			0	0
(114) EUGENE M JORDAN ESQ........................................................................ RRMC-BOARD MEMBER	1.0 .......................0.0	X				0	0
(115) QUENTIN KIDD PHD........................................................................ RHSF-BOARD MEMBER	1.0 .......................0.0	X				0	0
(116) WILLIAM S MASSEY........................................................................ RWRH-BOARD MEMBER	1.0 .......................0.0	X				0	0
(117) CHARLES G MINTER........................................................................ RRMC-BOARD MEMBER	1.0 .......................0.0	X				0	0
(118) GABRIEL A MORGAN........................................................................ RMS-CHAIRMAN	1.0 .......................0.0	X	X			0	0
(119) JAMES M MULLINS III........................................................................ RRMC-BOARD MEMBER	1.0 .......................0.0	X				0	0
(120) RONALD MURRAY........................................................................ RHSF-BOARD MEMBER	1.0 .......................0.0	X				0	0
(121) DOUGLAS E NAGEL........................................................................ RWRH-BOARD MEMBER	1.0 .......................0.0	X				0	0
(122) RICHARD JOEL PEARCE........................................................................ PAT-BOARD MEMBER	1.0 .......................0.0	X				0	0
(123) ALFRED JOE POOLE III........................................................................ RDHW-BOARD MEMBER	1.0 .......................0.0	X				0	0
(124) CARRINGTON F RANDOLPH........................................................................ RWRH-BOARD MEMBER	1.0 .......................0.0	X				0	0
(125) CONWAY HOWARD SHEILD III........................................................................ RHSF-CHAIRMAN	1.0 .......................0.0	X	X			0	0
(126) DANIEL J SHERLOCK........................................................................ PAT-CHAIRMAN	1.0 .......................0.0	X	X			0	0
(127) STEPHEN SILVASY JR........................................................................ PAT-BOARD MEMBER	1.0 .......................0.0	X				0	0
(128) CONWAY W SMITH III........................................................................ LLH-CHAIRMAN	1.0 .......................0.0	X	X			0	0
(129) CHARLENE E SMITH........................................................................ RDHW-VICE CHAIRMAN	1.0 .......................0.0	X	X			0	0
(130) KIRBY H SMITH........................................................................ RRS-BOARD MEMBER	1.0 .......................0.0	X				0	0
(131) STEVE SPAIN........................................................................ RHSF-BOARD MEMBER	1.0 .......................0.0	X				0	0
(132) ERIC M STONE........................................................................ RDHW-BOARD MEMBER	1.0 .......................0.0	X				0	0
(133) PHILIP G STOWELL........................................................................ PAT-BOARD MEMBER	1.0 .......................0.0	X				0	0
(134) BROOKE TILLER........................................................................ LLH-BOARD MEMBER	1.0 .......................0.0	X				0	0
(135) PAUL TREOLO........................................................................ PAT-BOARD MEMBER	1.0 .......................0.0	X				0	0
(136) CHARVALLA WEST........................................................................ RRMC-BOARD MEMBER	1.0 .......................0.0	X				0	0
(137) JOHN T WHITE III........................................................................ RWRH-BOARD MEMBER	1.0 .......................0.0	X				0	0
(138) JEANNE ZEIDLER........................................................................ RWFC-BOARD MEMBER	1.0 .......................0.0	X				0	0

(A) Name and business address	(B) Description of services	(C) Compensation
CHANGE HEALTHCARE LLC, P O Box 98347 CHICAGO,IL60693	NONEMPLOYEE COMPENS	3,158,294
DPR CONSTRUCTION, 5500 Cox Road Suite M GLEM ALLEN,VA23060	NONEMPLOYEE COMPENS	2,498,089
EAGLE TELEMED HOLDINGS LLC, 280 INTERSTATE NORTH CIRCLE SE STE ATLANTA,GA30339	NONEMPLOYEE COMPENS	1,788,167
QUEST DIAGNOSTICS INC, PO BOX 98347 CHICAGO,IL606938347	NONEMPLOYEE COMPENS	1,720,225
EXCITE IT PARTNERS LLC, P O Box 713424 PHILADELPHIA,PA191713424	NONEMPLOYEE COMPENS	1,504,632
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 48

- 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

Riverside Healthcare Association Inc Group

Employer identification number

90-1000718

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 ...............................3

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

(i) Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 10 above (see instructions))	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN		Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(A) RIVERSIDE HOSPITAL INC	521245746	3	Yes		0	0
(B) RIVERSIDE MIDDLE PENINSULA HOSPITAL INC	521241836	3	Yes		0	0
(C) RIVERSIDE REHABILITATION INSTITUTE	521432269	3	Yes		0	0
Total 3					0	0

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.") ..	3,327,791	3,265,075	1,605,113	3,068,476	5,039,018	16,305,473
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....						0
3	The value of services or facilities furnished by a governmental unit to the organization without charge..						0
4	Total. Add lines 1 through 3	3,327,791	3,265,075	1,605,113	3,068,476	5,039,018	16,305,473
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) ..						1,951,578
6	Public support. Subtract line 5 from line 4.						14,353,895

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..	3,327,791	3,265,075	1,605,113	3,068,476	5,039,018	16,305,473
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	11,996	283,370	93	745,505	1,433,251	2,474,215
9	Net income from unrelated business activities, whether or not the business is regularly carried on..						0
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..	157,475	89,009	1,744,442	30,879	21,820	2,043,625
11	Total support. Add lines 7 through 10						20,823,313

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

1,956,288

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)) .........

68.932 %

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

61.403 %

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.") .	29,493	31,543	0	1,076,060	270,556	1,407,652
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	162,557,613	148,919,430	154,453,978	166,126,071	173,686,565	805,743,657
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....						0
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...						0
5	The value of services or facilities furnished by a governmental unit to the organization without charge						0
6	Total. Add lines 1 through 5	162,587,106	148,950,973	154,453,978	167,202,131	173,957,121	807,151,309
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons						0
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.			88,414,861	91,443,150	98,515,549	278,373,560
c	Add lines 7a and 7b..			88,414,861	91,443,150	98,515,549	278,373,560
8	Public support. (Subtract line 7c from line 6.)						528,777,749

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...	162,587,106	148,950,973	154,453,978	167,202,131	173,957,121	807,151,309
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	-1,095,619	-3,719,539	1,298,816	-24,568	-14,025	-3,554,935
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.						0
c	Add lines 10a and 10b.	-1,095,619	-3,719,539	1,298,816	-24,568	-14,025	-3,554,935
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.						0
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..	18,170,944	30,662,630	692,452	267,521	287,365	50,080,912
13	Total support. (Add lines 9, 10c, 11, and 12.)..	179,662,431	175,894,064	156,445,246	167,445,084	174,230,461	853,677,287

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)) .........

61.941 %

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

63.175 %

Section D. Computation of Investment Income Percentage

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

0.416 %

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

0.424 %

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.

Yes

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.

Yes

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	0
2	Recoveries of prior-year distributions	2	0
3	Other gross income (see instructions)	3	0
4	Add lines 1 through 3	4	0
5	Depreciation and depletion	5	0
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	0
7	Other expenses (see instructions)	7	0
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8	0

	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	0
b	Average monthly cash balances	1b	0
c	Fair market value of other non-exempt-use assets	1c	0
d	Total (add lines 1a, 1b, and 1c)	1d	0
e	Discount claimed for blockage or other factors (explain in detail in Part VI): 0
2	Acquisition indebtedness applicable to non-exempt use assets	2	0
3	Subtract line 2 from line 1d	3	0
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4	0
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5	0
6	Multiply line 5 by 0.035	6	0
7	Recoveries of prior-year distributions	7	0
8	Minimum Asset Amount (add line 7 to line 6)	8	0

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1	0
2	Enter 85% of line 1	2	0
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3	0
4	Enter greater of line 2 or line 3	4	0
5	Income tax imposed in prior year	5	0
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6	0

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	0
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2	0
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3	0
4 Amounts paid to acquire exempt-use assets	4	0
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5	0
6 Other distributions (describe in Part VI). See instructions	6	0
7Total annual distributions. Add lines 1 through 6.	7	0
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8	0
9 Distributable amount for 2021 from Section C, line 6	9	0
10 Line 8 amount divided by Line 9 amount	10	0 %

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			0
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.		0
3 Excess distributions carryover, if any, to 2021:
a From 2016.......0
b From 2017.......0
c From 2018.......0
d From 2019.......0
e From 2020.......0
fTotal of lines 3a through e	0
g Applied to underdistributions of prior years		0
h Applied to 2021 distributable amount			0
i Carryover from 2016 not applied (see instructions)	0
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.	0
4Distributions for 2021 from Section D, line 7:
$ 0
a Applied to underdistributions of prior years		0
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.	0
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.		0
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.			0
7 Excess distributions carryover to 2022. Add lines 3j and 4c.	0
8 Breakdown of line 7:
a Excess from 2017.....0
b Excess from 2018.....0
c Excess from 2019.....0
d Excess from 2020.....0
e Excess from 2021.....0

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, Part 1 Public Charity Status of Subordinates	As a Group filer and due to software limitations, Box 3 has been checked. Boxes 7, 10 and 12 should also be checked for the organizations below. Name of Subordinate EIN Type Center for Excellence in Aging/Geriatric Health 06-1544517 7 Riverside Middle Peninsula Hospital, Inc. 52-1241836 3 Riverside Healthcare Services, Inc. 52-1241839 10 Riverside Management Services, Inc. 52-1241840 10 Riverside Healthcare Foundation, Inc. 52-1241989 12 I Riverside Hospital, Inc. 52-1245746 3 Riverside Convalescent Centers, Inc. 52-1276323 3 The Rehabilitation Institute of Virginia, Inc. 52-1432269 3 Sanders Common, LTD 52-4233030 10 Patrick Henry Hospital, Inc. 54-0601803 3 Francis N. Sanders Nursing Home, Inc. 54-0683174 10 Riverside Wellness and Fitness Centers, Inc. 54-1318861 10 Riverside Retirement Services, Inc. 54-1348674 10 Riverside Physician Services, Inc. 54-1519724 3 Patriots Colony, Inc. 54-1680163 10 Riverside Health System Foundation, Inc. 54-1994013 7 Doctors Hospital of Williamsburg 27-1540267 3 Riverside Advantage, Inc. 87-2223669 12 I
Schedule A, Part I, Lines 12 and 12a	RIVERSIDE HEALTHCARE FOUNDATION AND RIVERSIDE ADVANTAGE ARE SUBORDINATES WITHIN THE GROUP THAT ARE RECOGNIZED BY THE IRS AS A 509(a)(3) TYPE I SUPPORTING ORGANIZATION. ACCORDINGLY, PART IV, SECTIONS A AND B SHOULD BE COMPLETED. Due to software limitations, the following questions should be answered accordingly. Schedule A, Part IV Section A Line 1 is Yes Line 2 is Yes Line 3a is No Line 4a is No Line 5a is No Line 6 is No Line 7 is No Line 8 is No Line 9a-9c are No Line 10a is No Line 11a-11c are No Section B Line 1 is Yes Line 2 is Yes
Schedule A, Part IV, Section A, Line 2	Riverside Healthcare Foundation and Riverside Advantage, which are controlled by Riverside Healthcare Association, Inc., have determined that their hospital supported organizations qualify as public charities under Section 509(a)(1) as entities described in Section 170(b)(1)(A)(iii). They have not received separate IRS determination letters as they are part of the group ruling.
Schedule A, Part IV, Section B, Line 2	Riverside Healthcare Foundation and Riverside Advantage also supported their other supported organizations within the Riverside Health System. That support carried out the purposes of Riverside Healthcare Association, Inc. (RHA) by strengthening the ability of the Foundation's supported organizations to provide quality health care and improve the health of citizens in RHA's community.
Schedule A, Part II, Line 10 Other Income	Description 2017 Intercompany Transactions 14,945 Driving Simulator Revenue 28,623 Other Income 113,908 Total 157,475 Description 2018 Intercompany Transactions 8,760 Driving Simulator Revenue 31,294 Other Income 48,955 Total 89,009 Description 2019 Intercompany Transactions 1,652,550 Driving Simulator Revenue 34,413 Other Income 57,480 Total Total 1,744,442 Description 2020 Other Income 30,879 Total Total 30,879 Description 2021 Other Income 21,820 Total Total 21,820
Schedule A, Part III, Line 12 Other Income	Description 2017 Intercompany Transactions 18,138,871 Wellness Center Fees 32,073 Total 18,170,944 Description 2018 Intercompany Transactions 30,609,472 Wellness Center Fees 53,158 Total 30,662,630 Description 2019 Intercompany Transactions 656,849 Wellness Center Fees 35,603 Total 692,452 Description 2020 Services for Retirement Community Residents 42,034 Other Income 225,487 Total 267,521 Description 2021 Intercompany Transactions 40,722 Services for Retirement Community Residents 65,580 Other Income 181,063 Total 287,365

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

Riverside Healthcare Association Inc Group

Employer identification number

90-1000718

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 Riverside Healthcare Association Inc Group

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 Riverside Healthcare Association Inc Group		Employer identification number 90-1000718

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 Riverside Healthcare Association Inc Group			Employer identification number 90-1000718
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

Riverside Healthcare Association Inc Group

Employer identification number

90-1000718

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.)		(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) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	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) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -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

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

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)? ........

Yes

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? ...................................................................................................................

Yes

168,822

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

168,822

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
Other Advocacy Activities	Salary and Expenses $123,310 Dues $ 45,512 ---------------------------- Total $168,822 Advocates on issues related to certificates of public need and all issues affecting healthcare such as hospitals, patients, physicians, and health insurance.

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

Riverside Healthcare Association Inc Group

Employer identification number

90-1000718

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 ....	1,433,785	1,285,336	1,223,034	1,385,267	1,241,004
b	Contributions ...
c	Net investment earnings, gains, and losses	129,700	176,649	146,702	-26,248	144,263
d	Grants or scholarships ...	25,500	28,200	84,400
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	1,537,985	1,433,785	1,285,336	1,359,019	1,385,267

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

100.000 %

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 .....	12,623,752		12,623,752
b	Buildings ....	440,315,299	211,278,984	229,036,315
c	Leasehold improvements
d	Equipment ....	537,372,796	404,527,037	132,845,759
e	Other .....	29,130,796	16,449,355	12,681,441
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				387,187,267

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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

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	0
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	499,897,476
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

Schedule D Part V Line 4

Endowment funds are used for scholarships

Schedule D - Part X, Line 2

Riverside Healthcare Association Group is included in the consolidated audited financial statements of Riverside Healthcare Association, Inc. and Subsidiaries. The footnote on the consolidated financial statements reads: The System has received a group exemption letter from the Internal Revenue Service (IRS) under the corporation name Riverside Healthcare Association, Inc. recognizing each of its wholly owned subsidiaries, except for Riverside Medical Equipment Company, Inc., Newport News General and Non-Sectarian Hospital Association, Inc., Shore Health Services, Inc., Shore Life Care, Inc., Tilden and Virginia Davis Support Foundation, Inc., and Peninsula Hospital Services, Inc., stating they are exempt from income taxes pursuant to Section 501(c)(3) of the IRC, except for unrelated business income. Newport News General and Non-Sectarian Hospital Association, Inc. has retained its determination letter from the IRS stating it is exempt from income taxes pursuant to IRC Section 501(c)(2). Shore Health Services, Inc., Shore Life Care, Inc., and Tilden and Virginia Davis Support Foundation, Inc. have retained their determination letters stating they are exempt from income taxes pursuant to IRC Section 501(c)(3). No provision for income taxes was required for the years ended December 31, 2021 and 2020. As of December 31, 2021 and 2020, there were no uncertain tax positions.

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

Riverside Healthcare Association Inc Group

Employer identification number

90-1000718

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 %

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) . . .	21,786,476		21,786,476	1.180 %
b	Medicaid (from Worksheet 3, column a) . . . . .	160,648,182	207,815,628		0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	182,434,658	207,815,628	21,786,476	1.180 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	5,342,163		5,342,163	0.290 %
f	Health professions education (from Worksheet 5) . . .	30,103,036	13,974,625	16,128,411	0.870 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .	2,409,826	1,394,219	1,015,607	0.050 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	312,313		312,313	0.020 %
j	Total. Other Benefits . .	38,167,338	15,368,844	22,798,494	1.230 %
k	Total. Add lines 7d and 7j .	220,601,996	223,184,472	44,584,970	2.410 %

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. ......

20,092,181

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).....

290,936,071

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

305,744,712

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

-14,808,641

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 %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
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?5Name, 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)							Other (describe)	Facility reporting group
1	Riverside Regional Medical Center 500 J CLYDE MORRIS BLVD NEWPORT NEWS,VA23601 www.riversideonline.com/rrmc/ H 1887 Riverside Hospital Inc 521245746	X	X	X	X	X	Inpat Psychiatric	A
2	Riverside Walter Reed Hospital 7519 HOSPITAL DRIVE GLOUCESTER,VA23061 www.riversideonline.com/rwrh/ H 1890 Riverside Middle Peninsula H 521241836	X	X			X		A
3	Riverside Doctors Hosp Williamsburg 1500 Commonwealth Avenue Williamsburg,VA23185 www.riversideonline.com/rdhw/ H 1937 Doctors' Hospital of William 271540267	X	X			X		A
4	Riverside Rehabilitation Hospital 250 Josephs Drive Yorktown,VA23693 www.riverside-rehabilitation.com H 1888 Coastal Virginia Rehabilitat 821270202	X					inpat rehabilitation
5	Select Specialty Hospital-Hampton Rds 500 J Clyde Morris Blvd Newport News,VA23601 hamptonroads.selectspecialtyhospitals.co H 1925 LTACH Riverside LLC 743135196	X					Long Term Acute Care

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)

	Riverside Rehabilitation Hospital
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..................................

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 Part V, Section C

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): See Part V, Section C

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)

	Riverside Rehabilitation Hospital
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 200.%
and FPG family income limit for eligibility for discounted care of 400.%

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):

See Part V, Sect. C

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

See Part V, Sect. C

A plain language summary of the FAP was widely available on a website (list url):
See Part V, Sect. C

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

	Riverside Rehabilitation Hospital
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?..................

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)

	Riverside Rehabilitation Hospital
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 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)

	Select Specialty Hospital-Hampton Rds
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?........................

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

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..................................

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 Part V, Section C

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): See Part V, Section C

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

10b

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)

	Select Specialty Hospital-Hampton Rds
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 200.%
and FPG family income limit for eligibility for discounted care of 400.%

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

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):

See Part V, Sect. C

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

See Part V, Sect. C

A plain language summary of the FAP was widely available on a website (list url):
See Part V, Sect. C

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)

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

	Select Specialty Hospital-Hampton Rds
Name of hospital facility or letter of facility reporting group

Yes

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

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

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)

	Select Specialty Hospital-Hampton Rds
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 prospective Medicare or Medicaid method

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 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)

	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?........................

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

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..................................

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 Part V, Section C

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): See Part V, Section C

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

10b

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)

	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 200.%
and FPG family income limit for eligibility for discounted care of 400.%

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

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):

See Part V, Section C

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

See Part V, Section C

A plain language summary of the FAP was widely available on a website (list url):
See Part V, Section C

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)

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

	A
Name of hospital facility or letter of facility reporting group

Yes

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

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

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)

	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 prospective Medicare or Medicaid method

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
Riverside Rehabilitation Hospital	Line 3E: The significant health needs of the community identified in the CNHA are prioritized according to the community needs. Line 5: As described in the CHNA, Riverside conducted a community survey between June 2018 and May 2019 to obtain input for the Community Health Needs Assessment. In partnership with other regional healthcare systems, the Peninsula Community Health Collaborative, non-profit organizations, and the Virginia Department of Health conducted a joint survey utilizing SurveyMonkey. There were two versions of the survey: one for community members which was distributed on each system's website, social media outlets and community meetings; and one for community, medical and public health leaders which was emailed to an identified list of key stakeholders jointly from all of the health systems under the signature of the Medical Director of the Peninsula Health District of the Virginia Department of Health. The specific list of organization affiliations can be found in Appendix A of the CHNA. In addition to the survey, multiple public health sources were consulted in the assembly of the needs assessment. These included CDC's WONDER database, Virginia Department of Health statistics, Virginia Health Information, Urban Institute for the Virginia Health Care Foundation, American Community Survey and the US Health Resources and Service Administration. Line 7A: https://www.riversideonline.com/about/community/community-health-needs-ass essments Line 7D: In addition to the website and the hardcopy available at the facility the report was also mailed to several community leaders. Line 10a: https://www.riversideonline.com/about_riverside/Community/community-health -needs-assessment.cfm LINE 11 BEHAVIORAL/MENTAL HEALTH AND SUBSTANCE ABUSE: AS NATIONAL STATISTICS HAVE SHOWN, BEHAVIORAL HEALTH AND SUBSTANCE ABUSE HAVE BECOME INCREASINGLY IMPORTANT AS THE NUMBER OF INDIVIDUALS SUFFERING WITH THESE ISSUES HAS GROWN THROUGHOUT THE PANDEMIC. RIVERSIDE HAS INCREASED ITS FOCUS ON GROWING THE PROGRAMS AVAILABLE TO SUPPORT INDIVIDUALS FACING BEHAVIORAL HEALTH AND SUBSTANCE ABUSE ISSUES. IN SEPTEMBER 2021, RIVERSIDE CONTINUED TO GROW BY ADDING ITS INTENSIVE OUTPATIENT PROGRAM TO TREAT ADDICTION. WORK WAS ALSO DONE IN 2021 TO PREPARE FOR THE 2022 OPENING OF THE PARTIAL HOSPITALIZATION PROGRAM. FOOD INSECURITIES: FOOD INSECURITY CONTINUED TO BE A SIGNIFICANT PROBLEM IN THE REGION AS THE PANDEMIC ENTERED ITS SECOND YEAR. RIVERSIDE CONTINUED ITS EFFORTS WITH THE HEALTHY FOOD BOX PROGRAM AT RIVERSIDE BRENTWOOD WHERE INDIVIDUALS WITH DIABETES WHO WERE FOOD INSECURE WERE GIVEN ACCESS TO HEALTHY FOOD BOXES AND HEALTH COACHING. THE PROGRAM CONTINUED TO BE A SUCCESS AND HAS SERVED AS A MODEL FOR A SECOND PROGRAM TO BE ROLLED OUT AT THE 25TH STREET CLINIC IN 2022 AS PART OF AN INCREASING FOCUS ON "FOOD AS MEDICINE." ADDITIONALLY, RIVERSIDE CONTINUED TO PARTNER WITH THE LOCAL FOODBANK FOR FOOD DRIVES AS WELL AS INDIVIDUAL PRACTICES HOSTING LOCAL DRIVES TO HELP INDIVIDUAL PATIENTS DIRECTLY. HEALTH INSURANCE COVERAGE/ACCESS TO CARE: 2021 HAD TWO AREAS OF FOCUS FOR THIS ISSUE AT RIVERSIDE. FIRST, RIVERSIDE CONTINUED TO PUSH OUT MESSAGES ABOUT CONTINUING TO RECEIVE PREVENTATIVE HEALTH CARE (SUCH AS ANNUAL PHYSICALS OR ANNUAL WELLNESS VISITS) AS WELL AS SCREENINGS (SUCH AS MAMMOGRAPHY AND COLONOSCOPY) AS SO MANY INDIVIDUALS DELAYED THESE CRITICAL SERVICES DURING 2020. ADDITIONALLY, RIVERSIDE CREATED ITS RIVERSIDE MEDICARE ADVANTAGE COMPLETE PLAN THAT OPENED FOR ENROLLMENT IN OCTOBER 2021. RIVERSIDE FELT THE PROGRAM WAS AN IMPORTANT WAY TO BRING PEOPLE THE ADDITIONAL HEALTH COVERAGE THEY NEEDED FOR LESS OUT OF POCKET COSTS. ADDITIONALLY, THROUGH OUR NETWORK OF CARE WE COULD PROVIDE A BETTER HEALTH CARE EXPERIENCE THOUGH MORE COORDINATION AND FACETIME WITH THE PROVIDERS. NEOPLASMS OF THE LUNG: IN 2021 RIVERSIDE CONTINUED TO PROMOTE THE IMPORTANCE OF LOW DOSE CT LUNG CANCER SCREENING AS AN IMPORTANT TOOL IN DIAGNOSING LUNG CANCER EARLY SO IT IS MORE EASILY TREATED. RIVERSIDE INVESTED IN PATIENT TESTIMONIAL VIDEOS SO INDIVIDUALS WHO HAD CAUGHT AN EARLY-STAGE CANCER WITH THE LOW DOSE CT SCREENING COULD SHARE THEIR STORIES AND HELP INSPIRE OTHERS TO BE SCREENED. ADDITIONALLY, IN NOVEMBER (NATIONAL LUNG CANCER AWARENESS MONTH AND THE DATE OF THE GREAT AMERICAN SMOKEOUT), RIVERSIDE WORKED CLOSELY WITH PROVIDERS FROM MULTIPLE SPECIALTIES TO SHARE EDUCATION ABOUT THE MULTITUDE OF BENEFITS FROM QUITTING SMOKING. MATERNAL AND INFANT CARE: WITH ITS ADVANCED L&D CAPABILITIES AND THE SPECIAL CARE NURSERY, RIVERSIDE CONTINUED TO PROVIDE A SAFE AND HEALTHY START TO OUR NEWEST AND YOUNGEST COMMUNITY MEMBERS IN 2021. IN ADDITION TO THE CLINICAL OFFERINGS, RIVERSIDE CONTINUED ITS FOCUS ON COMMUNITY EDUCATION TO SUPPORT NEW FAMILIES IN THEIR LIVES TOGETHER. SPECIFICALLY, RIVERSIDE HOSTED BREASTFEEDING EDUCATION CLASSES, LACTATION SUPPORT, NEW PARENT CLASSES, INFANT CPR, BIG BROTHER/BIG SISTER AND OTHER EDUCATION TO HELP ENSURE FAMILIES ARE STARTING OFF ON THE RIGHT FOOT. IN 2021 A SPECIAL FOCUS WAS COMMUNITY HEALTH EDUCATION ON HEALTHY SLEEPING FOR PARENTS AND NEW BABIES. COLON CANCER: RIVERSIDE CONTINUED TO FOCUS ON THE IMPORTANCE OF SCREENING AND EARLY DIAGNOSIS FOR COLON CANCER AND PUSHED MESSAGES AROUND DIFFERENT TYPES OF SCREENINGS, INCLUDING COLONOSCOPY, FIT AND STOOL DNA TESTING. THE LATTER HALF OF 2021 WAS FOCUSED ON DEVELOPING COLON CANCER AWARENESS MONTH FOR 2022 WHICH HAD AN ADDITIONAL FOCUS ON REACHING MINORITY PATIENTS. ALSO, IN 2021 RIVERSIDE ADDED AN ADDITIONAL GASTROENTEROLOGIST TO HELP INCREASE CAPACITY IN THIS AREA. AGING SERVICES FOCUSED ON ALZHEIMER'S AND DEMENTIA: LEAD BY OUR CENTER FOR EXCELLENCE IN AGING AND LIFELONG HEALTH, RIVERSIDE CONTINUES TO OFFER LEADERSHIP AT A NATIONAL LEVEL FOR THE IMPORTANCE OF CARING FOR MEMORY CARE PATIENTS AND THEIR CAREGIVERS. WITH PROGRAMS SUCH AS CAREGIVER COMMONS, CARE TO PLAN, CARING FOR YOU LESSONS, MEMORY CAF AND OUR SENIOR CARE NAVIGATORS, RIVERSIDE STANDS READY TO PROVIDE SUPPORT AND ASSISTANCE TO THE DEDICATED INDIVIDUALS CARING FOR THEIR LOVED ONES. RIVERSIDE HAS ALSO FORMED OUTSTANDING CONNECTIONS WITH NATIONAL PROGRAMS SUCH AS THE ROSALYNN CARTER INSTITUTE FOR CAREGIVING AND THE FAMILY CAREGIVER ALLIANCE TO HELP FAMILIES. THESE PROGRAMS ARE IN ADDITION TO OUR SENIOR LIVING OPTIONS FOR INDIVIDUALS WITH ADVANCED MEMORY ISSUES AS WELL AS IN ADDITION TO OUR OUTSTANDING CLINICIANS AT THE RIVERSIDE NEUROLOGICAL AND SPINE INSTITUTE. IN 2021 RIVERSIDE CONTINUED TO RECRUIT TALENTED CLINICIANS TO JOIN THE TEAM AND SERVE OUR COMMUNITY. IN ADDITION TO THE IDENTIFIED NEEDS FROM THE CHNA, THE CARE OF OUR COMMUNITY THROUGH THE COVID-19 PANDEMIC CONTINUED TO BE OUR TOP FOCUS THROUGHOUT 2021. SPECIFICALLY, BETWEEN DECEMBER 16TH, 2020 (OUR FIRST DATE OF VACCINE GIVEN) TO DEC. 16TH, 2021, RIVERSIDE HEALTH SYSTEM WAS ABLE TO VACCINATE OVER 100,000 INDIVIDUALS WITH OVER 225,000 INDIVIDUAL DOSES. OUR COMMUNITY CLINICS, CLINICAL LEADERSHIP AND REFINED SUPPLY CHAIN SYSTEM WAS ABLE TO OBTAIN, STORE AND DISTRIBUTE THE VACCINES TO OUR COMMUNITIES, FOR WHICH RIVERSIDE IS EXTREMELY PROUD. THE COMMUNITY LEADERSHIP WAS SUCH THAT MULTIPLE RIVERSIDE PHARMACISTS WERE HONORED AT A STATE LEVEL FOR THEIR CONTRIBUTIONS DURING THE PANDEMIC. THE ITEMS DETERMINED TO NOT BE THE HIGHEST PRIORITIES INCLUDED FOR THE CHNA ARE NOTED BELOW. ITEMS ON THE LIST MAY BE ALREADY BEING ADDRESSED THROUGH OTHER RIVERSIDE PROGRAMS, SUCH AS HEART DISEASE, SMOKING CESSATION PROGRAMS, CHRONIC PAIN, SMOKING, RESPIRATORY CARE, DOMESTIC VIOLENCE, AND REPRODUCTIVE HEALTH. SOME ISSUES WERE OUTSIDE OF THE AREA OF EXPERTISE OF THE HEALTH SYSTEM, SUCH AS THE FOSTER CARE SYSTEM. ITEMS SUCH AS INFANT MORTALITY ARE IMPORTANT, BUT NOT NECESSARILY AN ITEM THAT COULD BE IMPACTED SIGNIFICANTLY BY THE HEALTH SYSTEM IN A THREE-YEAR PERIOD AND INSTEAD WILL BE ADDRESSED THROUGH OUR CONTINUED PRE- AND POST-NATAL CARE PROGRAMS. OTHER ITEMS NOT RANKED AS TOP HEALTH PROBLEMS THROUGH EITHER THE QUALITATIVE OR QUANTITATIVE DATA ASSESSMENTS INCLUDED: ENVIRONMENTAL HEALTH, DROWNING/WATER SAFETY, AUTISM, HIV/AIDS, DENTAL/ORAL CARE, NEUROLOGICAL PROBLEMS, ARTHRITIS, RENAL DISEASE, ORTHOPEDIC PROBLEMS, SEXUALLY TRANSMITTED INFECTIONS, PHYSICAL DISABILITIES, AND BULLYING. Line 16A: WWW.RIVERSIDE-REHABILITATION.COM/PATIENTS-AND-CAREGIVERS/ADMISSIONS/FINANC IAL-ASSISTANCE/ Line 16B: WWW.RIVERSIDE-REHABILITATION.COM/PATIENTS-AND-CAREGIVERS/ADMISSIONS/FINANC IAL-ASSISTANCE/ Line 16C: WWW.RIVERSIDE-REHABILITATION.COM/PATIENTS-AND-CAREGIVERS/ADMISSIONS/FINANC IAL-ASSISTANCE/ Line 20b. While the hospital facility made reasonable efforts to orally notify all individuals about the FAP and FAP application process, this may not have been uniformly performed for 100% of the patients receiving treatment despite the hospital's best efforts. LINE 20D: PRESUMPTIVE ELIGIBILITY IS NOT USED. DUE TO THE LIMITED NUMBER OF PATIENTS AND APPLICANTS FOR FINANCIAL ASSISTANCE, PERSONNEL WORK WITH PATIENTS TO COMPLETE THE APP
Select Specialty Hospital-Hampton Roads	LINE 3E. THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED IN THE CNHA ARE PRIORITIZED ACCORDING TO THE COMMUNITY NEEDS. LINE 5: AS DESCRIBED IN THE CHNA, RIVERSIDE CONDUCTED A COMMUNITY SURVEY BETWEEN JUNE 2018 TO MAY 2019 TO OBTAIN INPUT FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. IN PARTNERSHIP WITH OTHER REGIONAL HEALTHCARE SYSTEMS, THE PENINSULA COMMUNITY HEALTH COLLABORATIVE, NON-PROFIT ORGANIZATIONS, AND THE VIRGINIA DEPARTMENT OF HEALTH CONDUCTED A JOINT SURVEY UTILIZING SURVEYMONKEY. THERE WERE TWO VERSIONS OF THE SURVEY: ONE FOR COMMUNITY MEMBERS WHICH WAS DISTRIBUTED ON EACH SYSTEM'S WEBSITE, SOCIAL MEDIA OUTLETS AND COMMUNITY MEETINGS; AND ONE FOR COMMUNITY, MEDICAL AND PUBLIC HEALTH LEADERS WHICH WAS EMAILED TO AN IDENTIFIED LIST OF KEY STAKEHOLDERS JOINTLY FROM ALL OF THE HEALTH SYSTEMS UNDER THE SIGNATURE OF THE MEDICAL DIRECTOR OF THE PENINSULA HEALTH DISTRICT OF THE VIRGINIA DEPARTMENT OF HEALTH. THE SPECIFIC LIST OF ORGANIZATION AFFILIATIONS CAN BE FOUND IN APPENDIX A OF THE CHNA. IN ADDITION TO THE SURVEY, MULTIPLE PUBLIC HEALTH SOURCES WERE CONSULTED IN THE ASSEMBLY OF THE NEEDS ASSESSMENT. THESE INCLUDED CDC'S WONDER DATABASE, VIRGINIA DEPARTMENT OF HEALTH STATISTICS, VIRGINIA HEALTH INFORMATION, URBAN INSTITUTE FOR THE VIRGINIA HEALTH CARE FOUNDATION, AMERICAN COMMUNITY SURVEY AND THE US HEALTH RESOURCES AND SERVICE ADMINISTRATION. LINE 7 A: HTTPS://RESOURCES.SELECTMEDICAL.COM/COMMUNICATIONS/SELECT-SPECIALTY-HOSPIT AL-HAMPTON-ROADS/2019-CHNA-SSH-HAMPTON-ROADS.PDF LINE 7D: IN ADDITION TO THE WEBSITE AND THE HARDCOPY AVAILABLE AT THE FACILITY THE REPORT WAS ALSO MAILED TO SEVERAL COMMUNITY LEADERS. LINE 10A: HTTPS://RESOURCES.SELECTMEDICAL.COM/COMMUNICATIONS/SELECT-SPECIALTY-HOSPIT AL-HAMPTON-ROADS/2019-CHNA-SSH-HAMPTON-ROADS.PDF LINE 11 BEHAVIORAL/MENTAL HEALTH AND SUBSTANCE ABUSE: AS NATIONAL STATISTICS HAVE SHOWN, BEHAVIORAL HEALTH AND SUBSTANCE ABUSE HAVE BECOME INCREASINGLY IMPORTANT AS THE NUMBER OF INDIVIDUALS SUFFERING WITH THESE ISSUES HAS GROWN THROUGHOUT THE PANDEMIC. RIVERSIDE HAS INCREASED ITS FOCUS ON GROWING THE PROGRAMS AVAILABLE TO SUPPORT INDIVIDUALS FACING BEHAVIORAL HEALTH AND SUBSTANCE ABUSE ISSUES. IN SEPTEMBER 2021, RIVERSIDE CONTINUED TO GROW BY ADDING ITS INTENSIVE OUTPATIENT PROGRAM TO TREAT ADDICTION. WORK WAS ALSO DONE IN 2021 TO PREPARE FOR THE 2022 OPENING OF THE PARTIAL HOSPITALIZATION PROGRAM. FOOD INSECURITIES: FOOD INSECURITY CONTINUED TO BE A SIGNIFICANT PROBLEM IN THE REGION AS THE PANDEMIC ENTERED ITS SECOND YEAR. RIVERSIDE CONTINUED ITS EFFORTS WITH THE HEALTHY FOOD BOX PROGRAM AT RIVERSIDE BRENTWOOD WHERE INDIVIDUALS WITH DIABETES WHO WERE FOOD INSECURE WERE GIVEN ACCESS TO HEALTHY FOOD BOXES AND HEALTH COACHING. THE PROGRAM CONTINUED TO BE A SUCCESS AND HAS SERVED AS A MODEL FOR A SECOND PROGRAM TO BE ROLLED OUT AT THE 25TH STREET CLINIC IN 2022 AS PART OF AN INCREASING FOCUS ON "FOOD AS MEDICINE." ADDITIONALLY, RIVERSIDE CONTINUED TO PARTNER WITH THE LOCAL FOODBANK FOR FOOD DRIVES AS WELL AS INDIVIDUAL PRACTICES HOSTING LOCAL DRIVES TO HELP INDIVIDUAL PATIENTS DIRECTLY. HEALTH INSURANCE COVERAGE/ACCESS TO CARE: 2021 HAD TWO AREAS OF FOCUS FOR THIS ISSUE AT RIVERSIDE. FIRST, RIVERSIDE CONTINUED TO PUSH OUT MESSAGES ABOUT CONTINUING TO RECEIVE PREVENTATIVE HEALTH CARE (SUCH AS ANNUAL PHYSICALS OR ANNUAL WELLNESS VISITS) AS WELL AS SCREENINGS (SUCH AS MAMMOGRAPHY AND COLONOSCOPY) AS SO MANY INDIVIDUALS DELAYED THESE CRITICAL SERVICES DURING 2020. ADDITIONALLY, RIVERSIDE CREATED ITS RIVERSIDE MEDICARE ADVANTAGE COMPLETE PLAN THAT OPENED FOR ENROLLMENT IN OCTOBER 2021. RIVERSIDE FELT THE PROGRAM WAS AN IMPORTANT WAY TO BRING PEOPLE THE ADDITIONAL HEALTH COVERAGE THEY NEEDED FOR LESS OUT OF POCKET COSTS. ADDITIONALLY, THROUGH OUR NETWORK OF CARE WE COULD PROVIDE A BETTER HEALTH CARE EXPERIENCE THOUGH MORE COORDINATION AND FACETIME WITH THE PROVIDERS. NEOPLASMS OF THE LUNG: IN 2021 RIVERSIDE CONTINUED TO PROMOTE THE IMPORTANCE OF LOW DOSE CT LUNG CANCER SCREENING AS AN IMPORTANT TOOL IN DIAGNOSING LUNG CANCER EARLY SO IT IS MORE EASILY TREATED. RIVERSIDE INVESTED IN PATIENT TESTIMONIAL VIDEOS SO INDIVIDUALS WHO HAD CAUGHT AN EARLY-STAGE CANCER WITH THE LOW DOSE CT SCREENING COULD SHARE THEIR STORIES AND HELP INSPIRE OTHERS TO BE SCREENED. ADDITIONALLY, IN NOVEMBER (NATIONAL LUNG CANCER AWARENESS MONTH AND THE DATE OF THE GREAT AMERICAN SMOKEOUT), RIVERSIDE WORKED CLOSELY WITH PROVIDERS FROM MULTIPLE SPECIALTIES TO SHARE EDUCATION ABOUT THE MULTITUDE OF BENEFITS FROM QUITTING SMOKING. MATERNAL AND INFANT CARE: WITH ITS ADVANCED L&D CAPABILITIES AND THE SPECIAL CARE NURSERY, RIVERSIDE CONTINUED TO PROVIDE A SAFE AND HEALTHY START TO OUR NEWEST AND YOUNGEST COMMUNITY MEMBERS IN 2021. IN ADDITION TO THE CLINICAL OFFERINGS, RIVERSIDE CONTINUED ITS FOCUS ON COMMUNITY EDUCATION TO SUPPORT NEW FAMILIES IN THEIR LIVES TOGETHER. SPECIFICALLY, RIVERSIDE HOSTED BREASTFEEDING EDUCATION CLASSES, LACTATION SUPPORT, NEW PARENT CLASSES, INFANT CPR, BIG BROTHER/BIG SISTER AND OTHER EDUCATION TO HELP ENSURE FAMILIES ARE STARTING OFF ON THE RIGHT FOOT. IN 2021 A SPECIAL FOCUS WAS COMMUNITY HEALTH EDUCATION ON HEALTHY SLEEPING FOR PARENTS AND NEW BABIES. COLON CANCER: RIVERSIDE CONTINUED TO FOCUS ON THE IMPORTANCE OF SCREENING AND EARLY DIAGNOSIS FOR COLON CANCER AND PUSHED MESSAGES AROUND DIFFERENT TYPES OF SCREENINGS, INCLUDING COLONOSCOPY, FIT AND STOOL DNA TESTING. THE LATTER HALF OF 2021 WAS FOCUSED ON DEVELOPING COLON CANCER AWARENESS MONTH FOR 2022 WHICH HAD AN ADDITIONAL FOCUS ON REACHING MINORITY PATIENTS. ALSO, IN 2021 RIVERSIDE ADDED AN ADDITIONAL GASTROENTEROLOGIST TO HELP INCREASE CAPACITY IN THIS AREA. AGING SERVICES FOCUSED ON ALZHEIMER'S AND DEMENTIA: LEAD BY OUR CENTER FOR EXCELLENCE IN AGING AND LIFELONG HEALTH, RIVERSIDE CONTINUES TO OFFER LEADERSHIP AT A NATIONAL LEVEL FOR THE IMPORTANCE OF CARING FOR MEMORY CARE PATIENTS AND THEIR CAREGIVERS. WITH PROGRAMS SUCH AS CAREGIVER COMMONS, CARE TO PLAN, CARING FOR YOU LESSONS, MEMORY CAF AND OUR SENIOR CARE NAVIGATORS, RIVERSIDE STANDS READY TO PROVIDE SUPPORT AND ASSISTANCE TO THE DEDICATED INDIVIDUALS CARING FOR THEIR LOVED ONES. RIVERSIDE HAS ALSO FORMED OUTSTANDING CONNECTIONS WITH NATIONAL PROGRAMS SUCH AS THE ROSALYNN CARTER INSTITUTE FOR CAREGIVING AND THE FAMILY CAREGIVER ALLIANCE TO HELP FAMILIES. THESE PROGRAMS ARE IN ADDITION TO OUR SENIOR LIVING OPTIONS FOR INDIVIDUALS WITH ADVANCED MEMORY ISSUES AS WELL AS IN ADDITION TO OUR OUTSTANDING CLINICIANS AT THE RIVERSIDE NEUROLOGICAL AND SPINE INSTITUTE. IN 2021 RIVERSIDE CONTINUED TO RECRUIT TALENTED CLINICIANS TO JOIN THE TEAM AND SERVE OUR COMMUNITY. IN ADDITION TO THE IDENTIFIED NEEDS FROM THE CHNA, THE CARE OF OUR COMMUNITY THROUGH THE COVID-19 PANDEMIC CONTINUED TO BE OUR TOP FOCUS THROUGHOUT 2021. SPECIFICALLY, BETWEEN DECEMBER 16TH, 2020 (OUR FIRST DATE OF VACCINE GIVEN) TO DEC. 16TH, 2021, RIVERSIDE HEALTH SYSTEM WAS ABLE TO VACCINATE OVER 100,000 INDIVIDUALS WITH OVER 225,000 INDIVIDUAL DOSES. OUR COMMUNITY CLINICS, CLINICAL LEADERSHIP AND REFINED SUPPLY CHAIN SYSTEM WAS ABLE TO OBTAIN, STORE AND DISTRIBUTE THE VACCINES TO OUR COMMUNITIES, FOR WHICH RIVERSIDE IS EXTREMELY PROUD. THE COMMUNITY LEADERSHIP WAS SUCH THAT MULTIPLE RIVERSIDE PHARMACISTS WERE HONORED AT A STATE LEVEL FOR THEIR CONTRIBUTIONS DURING THE PANDEMIC. THE ITEMS DETERMINED TO NOT BE THE HIGHEST PRIORITIES INCLUDED FOR THE CHNA ARE NOTED BELOW. ITEMS ON THE LIST MAY BE ALREADY BEING ADDRESSED THROUGH OTHER RIVERSIDE PROGRAMS, SUCH AS HEART DISEASE, SMOKING CESSATION PROGRAMS, CHRONIC PAIN, SMOKING, RESPIRATORY CARE, DOMESTIC VIOLENCE, AND REPRODUCTIVE HEALTH. SOME ISSUES WERE OUTSIDE OF THE AREA OF EXPERTISE OF THE HEALTH SYSTEM, SUCH AS THE FOSTER CARE SYSTEM. ITEMS SUCH AS INFANT MORTALITY ARE IMPORTANT, BUT NOT NECESSARILY AN ITEM THAT COULD BE IMPACTED SIGNIFICANTLY BY THE HEALTH SYSTEM IN A THREE-YEAR PERIOD AND INSTEAD WILL BE ADDRESSED THROUGH OUR CONTINUED PRE- AND POST-NATAL CARE PROGRAMS. OTHER ITEMS NOT RANKED AS TOP HEALTH PROBLEMS THROUGH EITHER THE QUALITATIVE OR QUANTITATIVE DATA ASSESSMENTS INCLUDED: ENVIRONMENTAL HEALTH, DROWNING/WATER SAFETY, AUTISM, HIV/AIDS, DENTAL/ORAL CARE, NEUROLOGICAL PROBLEMS, ARTHRITIS, RENAL DISEASE, ORTHOPEDIC PROBLEMS, SEXUALLY TRANSMITTED INFECTIONS, PHYSICAL DISABILITIES, AND BULLYING. LINE 16 A: HTTPS://WWW.SELECTSPECIALTYHOSPITALS.COM/LOCATIONS-AND-TOURS/VA/NEWPORT-NE WS/HAMPTON-ROADS/ LINE 16 B: HTTPS://WWW.SELECTSPECIALTYHOSPITALS.COM/LOCATIONS-AND-TOURS/VA/NEWPORT-NE WS/HAMPTON-ROADS/ LINE 16 C: HTTPS://WWW.SELECTSPECIALTYHOSPITALS.COM/LOCATIONS-AND-TOURS/VA/NEWPORT-NE WS/HAMPTON-ROADS/ LINE 20B. WHILE THE HOSPITAL FACILITY MADE REASONABLE EFFORTS TO ORALLY NOTIFY ALL INDIVIDUALS ABOUT THE FAP AND FAP APPLICATION PROCESS, THIS MAY NOT HAVE BEEN UNIFORMLY PERFORMED FOR 100% OF THE PATIENTS RECEIVING TREATMENT DESPITE THE HOSPITAL'S BEST EFFORTS. LINE 20D: PRESUMPTIVE ELIGIBILITY IS NOT USED. DUE TO THE LIMITED NUMBER OF PATIENTS AND APPLICANT
A	Line 3E: The significant health needs of the community identified in the CNHA are prioritized according to the community needs. Line 5: As described in the CHNA, Riverside conducted a community survey between June 2018 and May 2019 to obtain input for the Community Health Needs Assessment. In partnership with other regional healthcare systems, the Peninsula Community Health Collaborative, non-profit organizations, and the Virginia Department of Health conducted a joint survey utilizing SurveyMonkey. There were two versions of the survey: one for community members which was distributed on each system's website, social media outlets and community meetings; and one for community, medical and public health leaders which was emailed to an identified list of key stakeholders jointly from all of the health systems under the signature of the Medical Director of the Peninsula Health District of the Virginia Department of Health. The specific list of organization affiliations can be found in Appendix A of the CHNA. In addition to the survey, multiple public health sources were consulted in the assembly of the needs assessment. These included CDC's WONDER database, Virginia Department of Health statistics, Virginia Health Information, Urban Institute for the Virginia Health Care Foundation, American Community Survey and the US Health Resources and Service Administration. Line 7A: https://www.riversideonline.com/about/community/community-health-needs-ass essments Line 7D: In addition to the website and the hardcopy available at the facility the report was also mailed to several community leaders. Line 10a: https://www.riversideonline.com/about_riverside/Community/community-health -needs-assessment.cfm Line 11: Riverside Regional Medical Center As explained in the CHNA, the significant needs to be addressed include: Behavioral/Mental Health and Substance Abuse: As national statistics have shown, behavioral health and substance abuse have become increasingly important as the number of individuals suffering with these issues has grown throughout the pandemic. Over the past year Riverside Behavioral Health Center has focused on growth and restructure to meet community and patient need. The building began significant renovations to develop private rooms and sensory de-escalation areas. Work will conclude in 2022, creating 4 inpatient acute units where there were previously 3. We added specific Detox beds and in addition, there was an Addiction outpatient suite built and Addiction Intensive Outpatient Services began. Food Insecurities: Food insecurity continued to be a significant problem in the region as the pandemic entered its second year. Riverside continued its efforts with the Healthy Food Box program at Riverside Brentwood where individuals with diabetes who were food insecure were given access to healthy food boxes and health coaching. The program continued to be a success and has served as a model for a second program to be rolled out at the 25th street clinic in 2022 as part of an increasing focus on "food as medicine." Additionally, Riverside continued to partner with the local foodbank for food drives as well as individual practices hosting local drives to help individual patients directly. Health Insurance Coverage/Access to Care: 2021 had two areas of focus for this issue at Riverside. First, Riverside continued to push out messages about continuing to receive preventative health care (such as annual physicals or annual wellness visits) as well as screenings (such as mammography and colonoscopy) as so many individuals delayed these critical services during 2020. Additionally, Riverside created its Riverside Medicare Advantage Complete plan that opened for enrollment in October 2021. Riverside felt the program was an important way to bring people the additional health coverage they needed for less out of pocket costs. Additionally, through our network of care we could provide a better health care experience though more coordination and facetime with the providers. Neoplasms of the Lung: In 2021 Riverside continued to promote the importance of Low Dose CT Lung Cancer Screening as an important tool in diagnosing lung cancer early so it is more easily treated. Riverside invested in patient testimonial videos so individuals who had caught an early-stage cancer with the Low Dose CT screening could share their stories and help inspire others to be screened. Additionally, in November (National Lung Cancer Awareness Month and the date of the Great American Smokeout), Riverside worked closely with providers from multiple specialties to share education about the multitude of benefits from quitting smoking. Maternal and Infant Care: With its advanced L&D capabilities and the Special Care Nursery, Riverside continued to provide a safe and healthy start to our newest and youngest community members in 2021. In addition to the clinical offerings, Riverside continued its focus on community education to support new families in their lives together. Specifically, Riverside hosted breastfeeding education classes, lactation support, new parent classes, infant CPR, Big Brother/Big Sister and other education to help ensure families are starting off on the right foot. In 2021 a special focus was community health education on healthy sleeping for parents and new babies. Colon Cancer: Riverside continued to focus on the importance of screening and early diagnosis for colon cancer and pushed messages around different types of screenings, including colonoscopy, FIT and stool DNA testing. The latter half of 2021 was focused on developing Colon Cancer Awareness Month for 2022 which had an additional focus on reaching minority patients. Also, in 2021 Riverside added an additional gastroenterologist to help increase capacity in this area. Aging Services focused on Alzheimer's and Dementia: Lead by our Center for Excellence in Aging and Lifelong Health, Riverside continues to offer leadership at a national level for the importance of caring for memory care patients and their caregivers. With programs such as Caregiver Commons, Care to Plan, Caring for You Lessons, Memory Caf and our Senior Care Navigators, Riverside stands ready to provide support and assistance to the dedicated individuals caring for their loved ones. Riverside has also formed outstanding connections with National programs such as the Rosalynn Carter Institute for Caregiving and the Family Caregiver Alliance to help families. These programs are in addition to our senior living options for individuals with advanced memory issues as well as in addition to our outstanding clinicians at the Riverside Neurological and Spine Institute. In 2021 Riverside continued to recruit talented clinicians to join the team and serve our community. In addition to the identified needs from the CHNA, the care of our community through the COVID-19 Pandemic continued to be our top focus throughout 2021. Specifically, between December 16th, 2020 (our first date of vaccine given) to Dec. 16th, 2021, Riverside Health System was able to vaccinate over 100,000 individuals with over 225,000 individual doses. Our community clinics, clinical leadership and refined supply chain system was able to obtain, store and distribute the vaccines to our communities, for which Riverside is extremely proud. The community leadership was such that multiple Riverside pharmacists were honored at a state level for their contributions during the pandemic. The items determined to not be the highest priorities included for the CHNA are noted below. Some listed items may be addressed through other Riverside programs, such as heart disease, smoking cessation programs, chronic pain, smoking, respiratory care, domestic violence, and reproductive health. Some issues were outside of the area of expertise of the health system, such as the foster care system. Items such as infant mortality are important, but not necessarily an item that could be impacted significantly by the health system in a three-year period and instead will be addressed through our continued pre- and post-natal care programs. Other items not ranked as top health problems through either the qualitative or quantitative data assessments included: environmental health, drowning/water safety, autism, HIV/AIDS, dental/oral care, neurological problems, arthritis, renal disease, orthopedic problems, sexually transmitted infections, physical disabilities, and bullying. Line 11: Walter Reed Hospital As explained in the CHNA, the significant needs to be addressed include: Aging Services: Lead by our Center for Excellence in Aging and Lifelong Health, Riverside continues to offer leadership at a national level for the important of caring for memory care patients and their caregivers. With programs such as Caregiver Commons, Care to Plan, Caring for You Lessons, Memory Caf and our Senior Care Navigators, Riverside stands ready to provide support and assistance to the dedicated individuals caring fo

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?10
Name and address		Type of Facility (describe)
1	The Gardens at Warwick Forest 1000 Old Denbigh Blvd Newport News,VA23602	Convalescent Services Nursing Home
2	Patriots Colony 6000 Patriots Colony Dr Williamsburg,VA23188	Retirement Center
3	Sanders Retirement Village 7385 Walker Ave Gloucester,VA23061	Retirement Center
4	Riverside Convalescent Saluda 672 Gloucester Road Saluda,VA23149	Convalescent Services Nursing Home
5	Riverside Convalescent Center Mathews 603 Main Street Mathews,VA23109	Convalescent Services Nursing Home
6	Riverside Healthy Living Community Smith 101 John Rolfe Drive Smithfield,VA23430	Convalescent Services Nursing Home
7	Warwick Forest Retirement Community 1004 Old Denbigh Boulevard Newport News,VA23602	Retirement Center
8	Riverside Rehabilitation Center Hampton 414 Algonquin Road Hampton,VA23661	Convalescent Services Nursing Home
9	Riverside Rehabilitation Center Orchard 20 Delfae Drive Warsaw,VA22572	Convalescent Services Nursing Home
10	Riverside Rehabilitation Center West PT 2960 Chelsea Road West Point,VA23181	Convalescent Services Nursing Home

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 VI

Line 3E: The significant health needs of the community identified in the CNHA are prioritized according to the community needs. Line 5: As described in the CHNA, Riverside conducted a community survey between June 2018 and May 2019 to obtain input for the Community Health Needs Assessment. In partnership with other regional healthcare systems, the Peninsula Community Health Collaborative, non-profit organizations, and the Virginia Department of Health conducted a joint survey utilizing SurveyMonkey. There were two versions of the survey: one for community members which was distributed on each system's website, social media outlets and community meetings; and one for community, medical and public health leaders which was emailed to an identified list of key stakeholders jointly from all of the health systems under the signature of the Medical Director of the Peninsula Health District of the Virginia Department of Health. The specific list of organization affiliations can be found in Appendix A of the CHNA. In addition to the survey, multiple public health sources were consulted in the assembly of the needs assessment. These included CDC's WONDER database, Virginia Department of Health statistics, Virginia Health Information, Urban Institute for the Virginia Health Care Foundation, American Community Survey and the US Health Resources and Service Administration. Line 7A: https://www.riversideonline.com/about/community/community-health-needs-ass essments Line 7D: In addition to the website and the hardcopy available at the facility the report was also mailed to several community leaders. Line 10a: https://www.riversideonline.com/about_riverside/Community/community-health -needs-assessment.cfm Line 11: Riverside Regional Medical Center As explained in the CHNA, the significant needs to be addressed include: Behavioral/Mental Health and Substance Abuse: As national statistics have shown, behavioral health and substance abuse have become increasingly important as the number of individuals suffering with these issues has grown throughout the pandemic. Over the past year Riverside Behavioral Health Center has focused on growth and restructure to meet community and patient need. The building began significant renovations to develop private rooms and sensory de-escalation areas. Work will conclude in 2022, creating 4 inpatient acute units where there were previously 3. We added specific Detox beds and in addition, there was an Addiction outpatient suite built and Addiction Intensive Outpatient Services began. Food Insecurities: Food insecurity continued to be a significant problem in the region as the pandemic entered its second year. Riverside continued its efforts with the Healthy Food Box program at Riverside Brentwood where individuals with diabetes who were food insecure were given access to healthy food boxes and health coaching. The program continued to be a success and has served as a model for a second program to be rolled out at the 25th street clinic in 2022 as part of an increasing focus on "food as medicine." Additionally, Riverside continued to partner with the local foodbank for food drives as well as individual practices hosting local drives to help individual patients directly. Health Insurance Coverage/Access to Care: 2021 had two areas of focus for this issue at Riverside. First, Riverside continued to push out messages about continuing to receive preventative health care (such as annual physicals or annual wellness visits) as well as screenings (such as mammography and colonoscopy) as so many individuals delayed these critical services during 2020. Additionally, Riverside created its Riverside Medicare Advantage Complete plan that opened for enrollment in October 2021. Riverside felt the program was an important way to bring people the additional health coverage they needed for less out of pocket costs. Additionally, through our network of care we could provide a better health care experience though more coordination and facetime with the providers. Neoplasms of the Lung: In 2021 Riverside continued to promote the importance of Low Dose CT Lung Cancer Screening as an important tool in diagnosing lung cancer early so it is more easily treated. Riverside invested in patient testimonial videos so individuals who had caught an early-stage cancer with the Low Dose CT screening could share their stories and help inspire others to be screened. Additionally, in November (National Lung Cancer Awareness Month and the date of the Great American Smokeout), Riverside worked closely with providers from multiple specialties to share education about the multitude of benefits from quitting smoking. Maternal and Infant Care: With its advanced L&D capabilities and the Special Care Nursery, Riverside continued to provide a safe and healthy start to our newest and youngest community members in 2021. In addition to the clinical offerings, Riverside continued its focus on community education to support new families in their lives together. Specifically, Riverside hosted breastfeeding education classes, lactation support, new parent classes, infant CPR, Big Brother/Big Sister and other education to help ensure families are starting off on the right foot. In 2021 a special focus was community health education on healthy sleeping for parents and new babies. Colon Cancer: Riverside continued to focus on the importance of screening and early diagnosis for colon cancer and pushed messages around different types of screenings, including colonoscopy, FIT and stool DNA testing. The latter half of 2021 was focused on developing Colon Cancer Awareness Month for 2022 which had an additional focus on reaching minority patients. Also, in 2021 Riverside added an additional gastroenterologist to help increase capacity in this area. Aging Services focused on Alzheimer's and Dementia: Lead by our Center for Excellence in Aging and Lifelong Health, Riverside continues to offer leadership at a national level for the importance of caring for memory care patients and their caregivers. With programs such as Caregiver Commons, Care to Plan, Caring for You Lessons, Memory Caf and our Senior Care Navigators, Riverside stands ready to provide support and assistance to the dedicated individuals caring for their loved ones. Riverside has also formed outstanding connections with National programs such as the Rosalynn Carter Institute for Caregiving and the Family Caregiver Alliance to help families. These programs are in addition to our senior living options for individuals with advanced memory issues as well as in addition to our outstanding clinicians at the Riverside Neurological and Spine Institute. In 2021 Riverside continued to recruit talented clinicians to join the team and serve our community. In addition to the identified needs from the CHNA, the care of our community through the COVID-19 Pandemic continued to be our top focus throughout 2021. Specifically, between December 16th, 2020 (our first date of vaccine given) to Dec. 16th, 2021, Riverside Health System was able to vaccinate over 100,000 individuals with over 225,000 individual doses. Our community clinics, clinical leadership and refined supply chain system was able to obtain, store and distribute the vaccines to our communities, for which Riverside is extremely proud. The community leadership was such that multiple Riverside pharmacists were honored at a state level for their contributions during the pandemic. The items determined to not be the highest priorities included for the CHNA are noted below. Some listed items may be addressed through other Riverside programs, such as heart disease, smoking cessation programs, chronic pain, smoking, respiratory care, domestic violence, and reproductive health. Some issues were outside of the area of expertise of the health system, such as the foster care system. Items such as infant mortality are important, but not necessarily an item that could be impacted significantly by the health system in a three-year period and instead will be addressed through our continued pre- and post-natal care programs. Other items not ranked as top health problems through either the qualitative or quantitative data assessments included: environmental health, drowning/water safety, autism, HIV/AIDS, dental/oral care, neurological problems, arthritis, renal disease, orthopedic problems, sexually transmitted infections, physical disabilities, and bullying. Line 11: Walter Reed Hospital As explained in the CHNA, the significant needs to be addressed include: Aging Services: Lead by our Center for Excellence in Aging and Lifelong Health, Riverside continues to offer leadership at a national level for the important of caring for memory care patients and their caregivers. With programs such as Caregiver Commons, Care to Plan, Caring for You Lessons, Memory Caf and our Senior Care Navigators, Riverside stands ready to provide support and assistance to the dedicated individuals caring fo

Schedule H (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 I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
Riverside Healthcare Association Inc Group

Employer identification number
90-1000718

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) 100 Black Men of the VA Peninsula Chapter PO Box 2400 Newport News,VA23609	24-1621828	501(c)(3)	25,000				2021 Donation
(2) American Cancer Society PO Box 4110 Glen Allen,VA23058	13-1788491	501(c)(3)	22,000				2021 Flagship Sponsorship
(3) American Heart Association Inc 7272 Greenville Avenue Dallas,TX75231	13-5613797	501(c)(3)	25,000				2021 Sponsorship
(4) Christopher Newport Education Foundation 1 Avenue of the Arts CNU North Ste 201 Newport News,VA23606	54-1156248	501(c)(3)	137,500				21-22 Ferguson Ctr Partnership
(5) Community Free Clinic of Newport News 727 25th Street Newport News,VA23607	27-3510814	501(c)(3)	100,000				Free Clinic
(6) Fear 2 Freedom Inc PO Box 6104 Newport News,VA23606	45-2143034	501(c)(3)	10,000				2021 Aftercare Kits
(7) Flat-Out Events LLC 744 City Center Blvd Ste 100 Newport News,VA23606	27-1675755		10,000				Annual Partnership
(8) Greater Williamsburg Chamber & Tourism Alliance 421 North Boundary Street Williamsburg,VA23185	54-0482313	501(c)(3)	15,000				2020-2021 Annual Sponsorship
(9) Hampton Roads Community Action Program 2410 Wickham Avenue Newport News,VA23607	23-7014485	501(c)(3)	26,600				2021-23 Sponsorship
(10) Hampton Univ Career Center 100 E Queen Street Hampton,VA23668	54-2026410	501(c)(3)	75,000				2021 RMG Sponsorship 3rd Pmt
(11) Here For the Girls 1309 Jamestown Rd Ste 204 Williamsburg,VA23185	26-0606190	501(c)(3)	25,000				Beyond Boobs
(12) Lionsbridge Football Club LLC PO Box 1634 Newport News,VA23601	82-3032870		38,587				2021 Spon-Partnership RIV Sports Medicine Team
(13) MCV Foundation 1228 East Broad street Richmond,VA23298	54-6053660	501(c)(3)	25,000				Riverside Leadership Endowment
(14) Peninsula EMS Council Inc 6876 Main Street Gloucester,VA23061	54-1064500	501(c)(3)	15,000				Annual Partnership
(15) Rx Drug Acess Partnership 1500 Forest Ave Richmond,VA23229	57-1186937	501(c)(3)	8,000				2021 Annual Spon/Partnership Support
(16) United Negro College Fund Inc 1805 7th Street NW Washington,DC20001	13-1624241	501(c)(3)	10,000				2021 Masked Ball
(17) Virginia Health Care Foundation 707 East Main Street Ste 1350 Richmond,VA23219	54-1639924	501(c)(3)	25,000				2021 Contribution
(18) Virginia Living Museum Inc 524 J Clyde Morris Blvd Newport News,VA23601	54-6055922	501(c)(3)	8,000				2021 Matching Gifts
(19) Car Donation Foundation 5775 Wayzata Blvd Suite 700 St Louis Park,MN55416	26-3408048	501(c)(3)		9,125	FMV	2 Vehicles	Make-A-Wish

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2021

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) Scholarships	57	25,500
(2) Funeral Expense Assistance	16	15,437
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

Grant Explanation

A fund distribution form is completed and signed by an authorized administrator of the benefiting facility. Requests are approved according to the specifics of the requestor's governing charter. If a request doesn't comply the money is not distributed. Scholarship Eligibility and Requirements: Students must be enrolled or be an applicant to the nursing Program at the Riverside College of Health Careers. Applicants must demonstrate a cumulative GPA of 2.75 in prerequisite courses and enrolled students must have 3.0 in completed coursework. Applicants must also demonstrate financial need.

Funeral Expense Explanation

The funeral assistance program is managed by our facilities administrators. A financial application is completed by the requesting family and approved by authorized administrator.

Schedule I (Form 990) 2021

Additional Data

Software ID:
Software Version:

- 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

Riverside Healthcare Association Inc Group

Employer identification number

90-1000718

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 .....

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? ....

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)
1Romney Andersen Physician Specialty	(i) (ii)	936,000 ------------- 0	332,358 ------------- 0	83,612 ------------- 0	10,280 ------------- 0	770 ------------- 0	1,363,020 ------------- 0	0 ------------- 0
2Cheryl Ange RMG-Specialty Care Senior Dire	(i) (ii)	185,542 ------------- 0	17,544 ------------- 0	6,115 ------------- 0	23,732 ------------- 0	8,218 ------------- 0	241,151 ------------- 0	0 ------------- 0
3Margaret Atkins Associate Vice President Chief	(i) (ii)	142,225 ------------- 0	28,129 ------------- 0	821 ------------- 0	26,369 ------------- 0	2,562 ------------- 0	200,106 ------------- 0	0 ------------- 0
4WALTER WILLIAM AUSTIN JR EVP, CFO & TREASURER	(i) (ii)	523,277 ------------- 0	86,939 ------------- 0	84,886 ------------- 0	12,950 ------------- 0	15,101 ------------- 0	723,153 ------------- 0	0 ------------- 0
5SCOTT BURGESS RMG-BOARD MBR/RMG Physician	(i) (ii)	509,346 ------------- 0	264,129 ------------- 0	31,260 ------------- 0	42,871 ------------- 0	34,225 ------------- 0	881,831 ------------- 0	0 ------------- 0
6LISA A CASANOVA MD RMG-BOARD MBR/RMG Physician	(i) (ii)	307,503 ------------- 0	116,653 ------------- 0	18,641 ------------- 0	48,568 ------------- 0	20,000 ------------- 0	511,365 ------------- 0	0 ------------- 0
7DAVID COHEN RMG-BOARD MEMBER	(i) (ii)	471,817 ------------- 0	96,083 ------------- 0	128,183 ------------- 0	6,109 ------------- 0	24,214 ------------- 0	726,406 ------------- 0	0 ------------- 0
8Joseph Converse RDHW-FORMER MEDICAL STAFF PRES	(i) (ii)	316,779 ------------- 0	91,898 ------------- 0	0 ------------- 0	16,500 ------------- 0	13,108 ------------- 0	438,285 ------------- 0	0 ------------- 0
9Kelly Cooper RMG-Primary Care Senior Direct	(i) (ii)	165,336 ------------- 0	22,986 ------------- 0	1,202 ------------- 0	31,615 ------------- 0	3,139 ------------- 0	224,278 ------------- 0	0 ------------- 0
10ROBERT CROSS RMG-BOARD MBR/RMG Physician	(i) (ii)	203,390 ------------- 0	36,581 ------------- 0	10,577 ------------- 0	26,930 ------------- 0	28,355 ------------- 0	305,833 ------------- 0	0 ------------- 0
11Douglas Culbert Associate Vice President Servi	(i) (ii)	187,540 ------------- 0	26,444 ------------- 0	8,996 ------------- 0	34,484 ------------- 0	32,386 ------------- 0	289,850 ------------- 0	0 ------------- 0
12Robert Cullom Physician Specialty	(i) (ii)	712,654 ------------- 0	554,099 ------------- 0	5,544 ------------- 0	26,000 ------------- 0	30,423 ------------- 0	1,328,720 ------------- 0	0 ------------- 0
13MICHAEL DACEY MD PRESIDENT/COO, RHS	(i) (ii)	713,400 ------------- 0	139,313 ------------- 0	122,325 ------------- 0	12,950 ------------- 0	7,537 ------------- 0	995,525 ------------- 0	0 ------------- 0
14MONILLA DENT RRMC-BOARD MEMBER	(i) (ii)	269,012 ------------- 0	92,184 ------------- 0	37,542 ------------- 0	5,700 ------------- 0	27,382 ------------- 0	431,820 ------------- 0	0 ------------- 0
15ESTHER M DESIMINI RWRH-PRESIDENT, RWRH	(i) (ii)	297,447 ------------- 0	50,935 ------------- 0	50,450 ------------- 0	11,275 ------------- 0	17,925 ------------- 0	428,032 ------------- 0	0 ------------- 0
16MICHAEL JOSEPH DOUCETTE RRMC-PRESIDENT, RRMC	(i) (ii)	510,749 ------------- 0	111,419 ------------- 0	81,718 ------------- 0	57,461 ------------- 0	22,934 ------------- 0	784,281 ------------- 0	0 ------------- 0
17WILLIAM BURNS DOWNEY CEO, RHS	(i) (ii)	1,007,064 ------------- 0	265,669 ------------- 0	223,206 ------------- 0	49,401 ------------- 0	13,503 ------------- 0	1,558,843 ------------- 0	0 ------------- 0
18Timothy Emons Associate Vice President Corpo	(i) (ii)	190,174 ------------- 0	26,444 ------------- 0	8,828 ------------- 0	3,975 ------------- 0	23,709 ------------- 0	253,130 ------------- 0	0 ------------- 0
19Anthony Farah Physician Specialty	(i) (ii)	707,887 ------------- 0	723,565 ------------- 0	840 ------------- 0	13,365 ------------- 0	42,367 ------------- 0	1,488,024 ------------- 0	0 ------------- 0
20CHARLES FRAZIER VP MD	(i) (ii)	409,506 ------------- 0	73,005 ------------- 0	71,698 ------------- 0	50,409 ------------- 0	33,776 ------------- 0	638,394 ------------- 0	0 ------------- 0
21ELENA GARRETT MD RMG-BOARD MBR/RMG Physician	(i) (ii)	229,167 ------------- 0	29,835 ------------- 0	97,425 ------------- 0	46,673 ------------- 0	725 ------------- 0	403,825 ------------- 0	0 ------------- 0
22JESSE GOODRICH VP	(i) (ii)	239,076 ------------- 0	54,210 ------------- 0	39,690 ------------- 0	45,799 ------------- 0	6,887 ------------- 0	385,662 ------------- 0	0 ------------- 0
23CHARLES GRAHAM VP	(i) (ii)	331,178 ------------- 0	81,513 ------------- 0	84,421 ------------- 0	19,179 ------------- 0	13,589 ------------- 0	529,880 ------------- 0	0 ------------- 0
24SALLY HARTMAN SENIOR VP	(i) (ii)	427,466 ------------- 0	71,465 ------------- 0	71,217 ------------- 0	53,145 ------------- 0	7,536 ------------- 0	630,829 ------------- 0	0 ------------- 0
25EDWARD G HECKLER VP, LIFELONG HEALTH	(i) (ii)	251,250 ------------- 0	61,296 ------------- 0	45,030 ------------- 0	40,644 ------------- 0	19,638 ------------- 0	417,858 ------------- 0	0 ------------- 0
26DWIGHT C HERBERT MD RMG-BOARD MBR/RMG Physician	(i) (ii)	213,387 ------------- 0	72,045 ------------- 0	118,714 ------------- 0	40,031 ------------- 0	15,131 ------------- 0	459,308 ------------- 0	0 ------------- 0
27JASON O HOUSER GENERAL COUNSEL/SECRETARY, RHS	(i) (ii)	378,465 ------------- 0	64,155 ------------- 0	58,118 ------------- 0	49,280 ------------- 0	26,105 ------------- 0	576,123 ------------- 0	0 ------------- 0
28David Inabinet Associate Vice President Chief	(i) (ii)	203,749 ------------- 0	39,341 ------------- 0	9,238 ------------- 0	29,863 ------------- 0	1,120 ------------- 0	283,311 ------------- 0	0 ------------- 0
29Stacey Johnson RBHC-Hospital President/VP	(i) (ii)	185,621 ------------- 0	29,322 ------------- 0	33,443 ------------- 0	10,726 ------------- 0	7,294 ------------- 0	266,406 ------------- 0	0 ------------- 0
30Shelly Johnson RWRH-Support Operations/AVP	(i) (ii)	176,797 ------------- 0	31,198 ------------- 0	9,127 ------------- 0	28,774 ------------- 0	7,782 ------------- 0	253,678 ------------- 0	0 ------------- 0
31DAVID F JONES MD RMG-CHAIRMAN/RMG Physician	(i) (ii)	164,986 ------------- 0	51,358 ------------- 0	143,135 ------------- 0	26,544 ------------- 0	15,053 ------------- 0	401,076 ------------- 0	0 ------------- 0
32THOMAS KAYROUZ RMG-PRESIDENT CMO RMG	(i) (ii)	542,228 ------------- 0	45,912 ------------- 0	91,245 ------------- 0	7,250 ------------- 0	14,335 ------------- 0	700,970 ------------- 0	0 ------------- 0
33Michael Keesee Associate Vice President Clini	(i) (ii)	195,588 ------------- 0	32,235 ------------- 0	9,238 ------------- 0	29,299 ------------- 0	18,136 ------------- 0	284,496 ------------- 0	0 ------------- 0
34JASON KILGORE VP RESULTS MGT AND ANALYTICS	(i) (ii)	214,272 ------------- 0	45,309 ------------- 0	41,310 ------------- 0	38,872 ------------- 0	19,582 ------------- 0	359,345 ------------- 0	0 ------------- 0
35JOSEPH K KING RRMC-MEDICAL STAFF PRES/BOARD	(i) (ii)	274,633 ------------- 0	164,815 ------------- 0	40,682 ------------- 0	48,322 ------------- 0	37,770 ------------- 0	566,222 ------------- 0	0 ------------- 0
36Lisa Kirby LLH-Executive Director Nursing	(i) (ii)	147,187 ------------- 0	26,044 ------------- 0	12,993 ------------- 0	3,768 ------------- 0	3,422 ------------- 0	193,414 ------------- 0	0 ------------- 0
37Dean Kostov Physician Specialty	(i) (ii)	1,650,533 ------------- 0	498,186 ------------- 0	123,260 ------------- 0	37,850 ------------- 0	35,012 ------------- 0	2,344,841 ------------- 0	0 ------------- 0
38Barbara Labonte Associate Vice President	(i) (ii)	211,949 ------------- 0	28,898 ------------- 0	10,642 ------------- 0	37,514 ------------- 0	15,916 ------------- 0	304,919 ------------- 0	0 ------------- 0
39TIMOTHY LARKIN II RMG-BOARD MEMBER/RMG PHYSICIAN	(i) (ii)	226,140 ------------- 0	86,147 ------------- 0	21,356 ------------- 0	49,749 ------------- 0	26,628 ------------- 0	410,020 ------------- 0	0 ------------- 0
40MARGARET R LEMLEY PHD PAT-EXECUTIVE DIRECTOR	(i) (ii)	127,543 ------------- 0	29,822 ------------- 0	12,582 ------------- 0	4,220 ------------- 0	926 ------------- 0	175,093 ------------- 0	0 ------------- 0
41CATHERINE LINTZENICH MD RMG-BD MBR/PHY RDHW-MDSTAFPRES	(i) (ii)	411,163 ------------- 0	87,965 ------------- 0	11,058 ------------- 0	12,950 ------------- 0	23,821 ------------- 0	546,957 ------------- 0	0 ------------- 0
42NANCY WICK LITTLEFIELD EVP/CNO, RHS	(i) (ii)	419,821 ------------- 0	102,449 ------------- 0	82,045 ------------- 0	12,950 ------------- 0	13,942 ------------- 0	631,207 ------------- 0	0 ------------- 0
43Jessica Macalino Associate Vice President Servi	(i) (ii)	178,502 ------------- 0	23,585 ------------- 0	8,771 ------------- 0	9,267 ------------- 0	7,784 ------------- 0	227,909 ------------- 0	0 ------------- 0
44Elizabeth Martin RMS-FORMER RMS SVP QUALITY	(i) (ii)	50,939 ------------- 0	57,409 ------------- 0	38,978 ------------- 0	12,007 ------------- 0	1,211 ------------- 0	160,544 ------------- 0	0 ------------- 0
45WILLIAM H MCALLISTER MD RMG-BOARD MBR/RMG Physician	(i) (ii)	1,443,390 ------------- 0	521,158 ------------- 0	13,612 ------------- 0	38,235 ------------- 0	34,975 ------------- 0	2,051,370 ------------- 0	0 ------------- 0
46JAMES W MCCORRY DO RDHW-CMO/RMG Physician	(i) (ii)	218,736 ------------- 0	12,690 ------------- 0	207,802 ------------- 0	21,800 ------------- 0	770 ------------- 0	461,798 ------------- 0	0 ------------- 0
47Linda Mckee Associate Vice President Servi	(i) (ii)	197,275 ------------- 0	26,502 ------------- 0	9,788 ------------- 0	10,446 ------------- 0	8,089 ------------- 0	252,100 ------------- 0	0 ------------- 0
48Braden Miller Associate Vice President Chief	(i) (ii)	249,304 ------------- 0	42,951 ------------- 0	12,195 ------------- 0	33,555 ------------- 0	3,246 ------------- 0	341,251 ------------- 0	0 ------------- 0
49John Mincks RDHW-FMR MDSTAFFPRES/RMG PHYS	(i) (ii)	273,588 ------------- 0	56,275 ------------- 0	5,425 ------------- 0	44,049 ------------- 0	22,013 ------------- 0	401,350 ------------- 0	0 ------------- 0
50Steven Minter RRS-Administrator LLH PCAW/WF/	(i) (ii)	144,941 ------------- 0	22,472 ------------- 0	9,680 ------------- 0	7,849 ------------- 0	11,491 ------------- 0	196,433 ------------- 0	0 ------------- 0
51CARRIE R MOSS MD RDHW-BOARD MEMBER	(i) (ii)	214,136 ------------- 0	310,094 ------------- 0	100,403 ------------- 0	42,969 ------------- 0	488 ------------- 0	668,090 ------------- 0	0 ------------- 0
52Linwood Nelson Associate Vice President Chief	(i) (ii)	205,034 ------------- 0	28,671 ------------- 0	8,851 ------------- 0	38,237 ------------- 0	26,886 ------------- 0	307,679 ------------- 0	0 ------------- 0
53Delvin Peeks Enterprise Resource & Work AVP	(i) (ii)	162,906 ------------- 0	28,269 ------------- 0	9,344 ------------- 0	8,528 ------------- 0	29,790 ------------- 0	238,837 ------------- 0	0 ------------- 0
54Mark Rath Support Operations/AVP	(i) (ii)	191,608 ------------- 0	41,870 ------------- 0	9,202 ------------- 0	22,209 ------------- 0	2,105 ------------- 0	266,994 ------------- 0	0 ------------- 0
55Matthew Reed Physician Specialty	(i) (ii)	187,501 ------------- 0	1,909,814 ------------- 0	452 ------------- 0	0 ------------- 0	30,768 ------------- 0	2,128,535 ------------- 0	0 ------------- 0
56SALLY RYAN VP/COO, RMG	(i) (ii)	283,306 ------------- 0	46,988 ------------- 0	47,304 ------------- 0	12,310 ------------- 0	7,890 ------------- 0	397,798 ------------- 0	0 ------------- 0
57LISA SALSBERRY Officer Corp Audit & Comp/	(i) (ii)	259,329 ------------- 0	494 ------------- 0	37,330 ------------- 0	40,722 ------------- 0	33,632 ------------- 0	371,507 ------------- 0	0 ------------- 0
58MELVIN D SCHURSKY JR MD RWRH-CMO, RWRH/RMG BOARD MBR	(i) (ii)	219,426 ------------- 0	180,445 ------------- 0	191,912 ------------- 0	39,799 ------------- 0	27,212 ------------- 0	658,794 ------------- 0	0 ------------- 0
59JEFF T SENSENIG RWRH-MEDICAL STAFF PRESIDENT	(i) (ii)	330,765 ------------- 0	------------- 0	55,337 ------------- 0	10,050 ------------- 0	43,154 ------------- 0	439,306 ------------- 0	0 ------------- 0
60Lisa Shannon Associate Vice President Risk	(i) (ii)	170,146 ------------- 0	24,531 ------------- 0	4,701 ------------- 0	8,359 ------------- 0	15,789 ------------- 0	223,526 ------------- 0	0 ------------- 0
61THERESA SIEVERS SENIOR VP	(i) (ii)	289,640 ------------- 0	49,070 ------------- 0	53,631 ------------- 0	10,562 ------------- 0	23,821 ------------- 0	426,724 ------------- 0	0 ------------- 0
62Sandra Snapp Associate Vice President Servi	(i) (ii)	208,802 ------------- 0	27,825 ------------- 0	10,547 ------------- 0	36,177 ------------- 0	651 ------------- 0	284,002 ------------- 0	0 ------------- 0
63CHRISTOPHER PATRICK STOLLE MD VP MEDICAL AFFAIRS	(i) (ii)	430,675 ------------- 0	73,196 ------------- 0	67,519 ------------- 0	28,525 ------------- 0	1,448 ------------- 0	601,363 ------------- 0	0 ------------- 0
64Eric Stone RRMC-FORMER VP CLINICAL O	(i) (ii)	170,289 ------------- 0	35,111 ------------- 0	12,000 ------------- 0	9,485 ------------- 0	654 ------------- 0	227,539 ------------- 0	0 ------------- 0
65NEHEMIAH THRASH MD RMG-BOARD MBR/RMG Physician	(i) (ii)	306,526 ------------- 0	48,800 ------------- 0	14,484 ------------- 0	12,950 ------------- 0	40,169 ------------- 0	422,929 ------------- 0	0 ------------- 0
66SADIE THURMAN RRMC-VP CNO	(i) (ii)	206,917 ------------- 0	46,058 ------------- 0	39,150 ------------- 0	4,464 ------------- 0	468 ------------- 0	297,057 ------------- 0	0 ------------- 0
67ADRIA NICOLE VANHOOZIER RDHW-PRESIDENT, RDHW	(i) (ii)	256,001 ------------- 0	46,565 ------------- 0	42,204 ------------- 0	6,102 ------------- 0	8,728 ------------- 0	359,600 ------------- 0	0 ------------- 0
68EILEEN VARNSON VP	(i) (ii)	231,443 ------------- 0	42,989 ------------- 0	39,844 ------------- 0	5,700 ------------- 0	34,656 ------------- 0	354,632 ------------- 0	0 ------------- 0
69Jason Villaflor RWFC-Rehab Services System Dir	(i) (ii)	152,683 ------------- 0	23,021 ------------- 0	9,016 ------------- 0	8,312 ------------- 0	27,996 ------------- 0	221,028 ------------- 0	0 ------------- 0
70VERNEETA L WILLIAMS MD RHSF-BOARD MBR/RMG Physician	(i) (ii)	223,170 ------------- 0	5,000 ------------- 0	784 ------------- 0	37,789 ------------- 0	22,658 ------------- 0	289,401 ------------- 0	0 ------------- 0
71CYNTHIA WILLIAMS VP	(i) (ii)	285,299 ------------- 0	63,015 ------------- 0	48,556 ------------- 0	12,950 ------------- 0	13,639 ------------- 0	423,459 ------------- 0	0 ------------- 0
72KRISTEN WITT RHCF-EXECUTIVE DIRECTOR	(i) (ii)	153,744 ------------- 0	5,689 ------------- 0	3,835 ------------- 0	7,205 ------------- 0	7,913 ------------- 0	178,386 ------------- 0	0 ------------- 0
73Michelle Wooten RDHW-Chief Nursing Officer	(i) (ii)	143,468 ------------- 0	8,641 ------------- 0	632 ------------- 0	5,274 ------------- 0	413 ------------- 0	158,428 ------------- 0	0 ------------- 0
74ROSS YOUNGER SENIOR VP	(i) (ii)	394,509 ------------- 0	72,311 ------------- 0	66,669 ------------- 0	10,100 ------------- 0	33,758 ------------- 0	577,347 ------------- 0	0 ------------- 0
75ANDREA STASKIEL FORMER RRS-EXECUTIVE DIRECTOR	(i) (ii)	136,533 ------------- 0	20,508 ------------- 0	23,831 ------------- 0	7,825 ------------- 0	9,992 ------------- 0	198,689 ------------- 0	0 ------------- 0
76JUDITH MATTHEWS FORMER EXECUTIVE NURSE	(i) (ii)	78,446 ------------- 0	23,727 ------------- 0	1,356 ------------- 0	3,582 ------------- 0	4,048 ------------- 0	111,159 ------------- 0	0 ------------- 0
77MICHAEL J FRANCIS MD FORMER PRESIDENT, MEDICAL STAF	(i) (ii)	242,812 ------------- 0	0 ------------- 0	16,625 ------------- 0	22,860 ------------- 0	290 ------------- 0	282,587 ------------- 0	0 ------------- 0
78REGINALD K MASON FORMER RTH-MEDICAL STAFF PRESI	(i) (ii)	205,910 ------------- 0	5,000 ------------- 0	1,631 ------------- 0	26,917 ------------- 0	14,171 ------------- 0	253,629 ------------- 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

Schedule J, Part I, Line 3

The compensation committee of the parent corporation, Riverside Healthcare Association, Inc. reviews and approves the compensation for top management using independent consultants and surveys.

Schedule J, Part I, Line 4b

ADRIA VANHOOZIER $30,759 CHARLES FRAZIER $54,900 CHARLES GRAHAM $43,358 CHRISTOPHER STOLLE $52,358 CYNTHIA WILLIAMS $34,356 DAVID COHEN $61,989 EDWARD G HECKLER $32,397 EILEEN VARNSON $27,804 ELIZABETH MARTIN $37,038 ESTHER DESIMINI $36,427 JASON KILGORE $26,202 JASON HOUSER $45,891 JESSE GOODRICH $27,621 LISA SALSBERRY $25,464 MICHAEL DACEY $103,638 MICHAEL DOUCETTE $66,420 NANCY LITTLEFIELD $62,598 ROSS YOUNGER $52,403 SADIE THURMAN $24,285 SALLY HARTMAN $56,232 SALLY RYAN $33,902 STACEY JOHNSON $22,602 THERESA SIEVERS $38,610 THOMAS KAYROUZ $72,876 WALTER AUSTIN $68,407 WILLIAM DOWNEY $199,537 --------------------------- TOTAL $1,338,074 Riverside has established this SERP to provide retirement benefits to certain executive employees to supplement the retirement benefits to be received from Riverside and Social Security. Although the employee is fully vested in these funds, he/she will not have the right to withdraw these funds until the later of the employee reaching age 62 or separation from service with Riverside.

Schedule J (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

Riverside Healthcare Association Inc Group

Employer identification number

90-1000718

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) K SNAPP	SEE PART V	78,069	EMPLOYMENT		No

Part V

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

Return Reference	Explanation
Sandra Snapp	Schedule L, Part IV Family member of Sandra Snapp is employed by Riverside Hospital, Inc.

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Riverside Healthcare Association Inc Group

Employer identification number

90-1000718

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	4	139,845	FAIR MARKET VALUE
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Shower trolley and sleep safe bed )	X	2	15,981	FAIR MARKET VALUE
26 Other ( 715 Masks )	X	5	6,990	FAIR MARKET VALUE
27 Other ( 40 Chick-Fil-A For a year cards )	X	1	14,747	FAIR MARKET VALUE
28 Other ( 300 tubs of SaniWipes ($19.98 each) )	X	1	5,994	FAIR MARKET VALUE
Other ( Grand Ballroom evening rental for rehearsal )	X	1	6,000	FAIR MARKET VALUE
Other ( 822 Cases fresh chicken )	X	1	45,284	FAIR MARKET VALUE

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2021)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE M, PART I, COLUMN (B)	THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTORS IN PART I, COLUMN (B).

Schedule M (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

Riverside Healthcare Association Inc Group

Employer identification number

90-1000718

Return Reference	Explanation
Part I, Lines 3 and 4/Part VI Lines 1a and 1b	The number of voting members and independent voting members reported in Part I line 3 and 4/Part VI lines 1a and 1b is higher than the total count of board members reported in Part VII as several of the board members sit on several of the entities included within the Group return but have only been listed once.
Part V, Line 3A	Riverside Hospital, Inc. EIN 52-1245746, a subordinate company, had unrelated business income greater than $1,000 and 990-T was filed
Part VI, Section A, Line 6	The Organization is a group of not for profit corporations with a single member. The member has the right to participate in the Organization's governance, including electing members of the governing body and to approve significant decisions of the governing body.
Part VI, Section A, Line 7a	Members of the governing body are subject to approval by the Member.
Part VI, Section A, Line 7b	Significant items such as merger, amendment of charter documents, and appointment of Board members requires the approval of the member corporation.
Part VI, Section B, Line 11B	On behalf of the Organization's governing body, the Riverside Healthcare Association, Inc. Board of Directors Compensation Committee reviews the Form 990. The entire Form 990 was reviewed by an independent accounting firm before filing and is provided to the Riverside Healthcare Association, Inc. Board of Directors for review.
Part VI, Section B, line 12c	All Board Members, Officers, Directors and Key Employees complete an annual Conflict of Interest questionnaire. A report of potential Conflicts of Interest is reviewed by the Compliance Officer. The Compliance Officer consults with the Riverside Health System CEO regarding identified conflicts of interest as necessary. If a conflict presents, Board Members are required by the By-Laws, to disclose the conflict to the full Board and recuse themselves from voting on a case by case basis.
Part VI, Section B, Line 15 A&B	The Riverside Healthcare Association, Inc. Board of Directors compensation committee reviews and approves the compensation for top management using independent consultants and surveys. The review of the data provided by the independent consultants for 2021 top management salaries was conducted by the compensation committee on December 3, 2020.
Part VI, Section C, Line 19	The Organization makes its governing documents, conflict of interest policy, and financial statements available to the general public upon request.
Part XI Line 9	Pension Adjustment $-81,551,993 Transfer of Fund Balance $ 1,707,081 Rounding $ -27 ------------- Total $-79,844,939

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

Riverside Healthcare Association Inc Group

Employer identification number

90-1000718

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) Virginia Surgical Management LLC 608 Denbigh Blvd Ste 800 Newport News,VA23608 54-2057012	Management	VA	0	2,515,472	RivHosp
(2) Peninsula Cancer Institute LLC 608 Denbigh Blvd Ste 800 Newport News,VA23608 20-1872200	PT Services	VA	10,709,524	-108,432,490	RivPhysSv
(3) PENINSULA RADIOSURGERY ASSOCIATES LLC 608 Denbigh Blvd Ste 800 NEWPORT NEWS,VA23608 03-0596051	PT Services	VA	1,473,877	7,376,438	RivHosp
(4) Michumi LLC 608 Denbigh Blvd Ste 800 Newport News,VA23608 20-0318732	PT Services	VA	15,135,359	-4,804,592	RivPhysSv
(5) Riverside Hospice and Homecare Services 608 Denbigh Blvd Ste 800 Newport News,VA23608 85-3577807	PT SERVICES	VA	4,714,168	3,091,039	PatHenry

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)Shore Health Services Inc 608 Denbigh Blvd Ste 800 Newport News,VA23608 54-0560500	Hospital	VA	501(c)(3)	3	RivHCAssc	Yes
(2)Shore Life Care inc 608 Denbigh Blvd Ste 800 Newport News,VA23608 54-1876370	Nursing Care	VA	501(c)(3)	10	ShoreHSvc	Yes
(3)Newport News General & Nonsectarian 608 Denbigh Blvd Ste 800 Newport News,VA23608 54-0505934	Holding Corp	VA	501(c)(2)	N/A	RivHCAssc	Yes
(4)Riverside Healthcare Assocation Inc 608 Denbigh Blvd Ste 800 Newport News,VA23608 52-1241835	Parent Comp.	VA	501(c)(3)	12 II	N/A		No
(5)Tilden and Va Davis Suport Found Inc 608 Denbigh Blvd Ste 800 Newport News,VA23608 54-1527703	Foundation	VA	501(c)(3)	12I	RivRetSvc	Yes

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) At HomePartner 608 Denbigh Blvd Ste 800 Newport News,VA23608 47-2999121	Management	VA	RivRetSvc	EXCLUDED	37,418	412,086		No		Yes		80.000 %

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
(1) Peninsula Hospital Services 608 Denbigh Blvd Suite 800 Newport News,VA23608 54-0991295	Laundry	VA	RivFound	COOP	4,618,692	4,914,720	100.000 %	Yes
(2) RHS Medinsur LTD Craig Appin House 8 Wesley Street Hamilton BD 52-1241835	Insurance	BD	RivHCAssc	C Corp	0	52,332,033	100.000 %	Yes
(3) Riverside Medical Equipment Company Inc 608 Denbigh Blvd Ste 800 Newport News,VA23608 54-1325596	Billing	VA	RivHCAssc	C Corp	0	0	100.000 %	Yes

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) ............................

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) .......................

Yes

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

Yes

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

Yes

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) ............................

Yes

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) ............................

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
(1) Shore Health Services Inc	J	745,800	MARKET VALUE
(2) Shore Health Services Inc	K	125,808	MARKET VALUE
(3) Shore Health Services Inc	L	13,324,162	MARKET VALUE
(4) Shore Health Services Inc	M	1,415,798	MARKET VALUE
(5) Shore Health Services Inc	O	1,161,665	MARKET VALUE
(6) Newport News General & Nonsectarian Hospital	K	18,790,272	MARKET VALUE
(7) Newport News General & Nonsectarian Hospital	L	783,627	MARKET VALUE
(8) RHS Medinsur Ltd	M	11,064,021	MARKET VALUE
(9) At Home Partners LLC	L	183,229	MARKET VALUE
(10) At Home Partners LLC	M	828,794	MARKET VALUE
(11) At Home Partners LLC	O	51,932	MARKET VALUE
(12) Riverside Healthcare Association Inc	K	31,429,330	MARKET VALUE
(13) Riverside Healthcare Association Inc	L	171,295	MARKET VALUE

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: PROVIDE GENERAL MEDICAL SERVICES TO THE COMMUNITY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	179
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	142
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	11,219
6	Total number of volunteers (estimate if necessary) .............	6	503
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	315,228
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) .........	59,364,863	25,604,361
9	Program service revenue (Part VIII, line 2g) .........	1,262,210,595	1,845,535,203
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,497,665	33,542,116
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	444,066,008	30,293,342
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,769,139,131	1,934,975,022
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	352,480	1,837,085
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)	768,266,474	823,445,129
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 1,534,922
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,006,874,335	1,045,348,012
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,775,493,289	1,870,630,226
19	Revenue less expenses. Subtract line 18 from line 12.......	-6,354,158	64,344,796
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,138,202,405	1,413,824,478
21	Total liabilities (Part X, line 26).............	697,742,942	830,485,533
22	Net assets or fund balances. Subtract line 21 from line 20.....	440,459,463	583,338,945

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,514,107,967 including grants of $ 1,837,084 ) (Revenue $ 1,872,046,034 )
	General hospital, Long-Term Care and physician services provided to the community: 2,624,350 persons were benefited in 2021 with quantifiable community benefits of $79,491,990.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses1,514,107,967

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	22,935,563	0	1,276,527

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	16,840,639

f	All other contributions, gifts, grants, and similar amounts not included above		1f	8,763,722

g	Noncash contributions included in lines 1a - 1f:$		1g	234,841

h Total. Add lines 1a-1f.......		25,604,361

		Business Code
2a	PROGRAM SERVICE REVENUE	622110	1,341,065,647	1,340,750,419	315,228
b	AFFILIATE INCOME C(3)	622110	397,262,580	397,262,580
c	PHARMACY SERVICES	622110	66,561,458	64,917,978		1,643,480
d	RETIREMENT COMMUNITIES	623311	27,180,470	27,180,470
e	WELLNESS AND EDUCATION	611699	6,707,569	6,707,569
f	All other program service revenue.		6,757,479	6,757,479
g	Total. Add lines 2a–2f .....		1,845,535,203

3 Investment income (including dividends, interest, and othersimilar amounts) ......			6,138,742	4,145,675		1,993,067
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		4,284,274	6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	4,284,274	6c
d	Net rental income or (loss).......			4,284,274			4,284,274
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	26,304,996	6,762,035	7a
b	Less: cost or other basis and sales expenses	5,663,657		7b
c	Gain or (loss)	20,641,339	6,762,035	7c
d	Net gain or (loss).........			27,403,374			27,403,374
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	CAFETERIA REVENUE		722514	2,872,452			2,872,452
b	TRANSITION SERVICES		900099	19,533,106	19,533,106
c	RESEARCH REVENUE		541715	771,460			771,460
d	All other revenue ....			2,832,050	2,832,050
e	Total. Add lines 11a–11d ......			26,009,068
12	Total revenue. See instructions.....			1,934,975,022	1,870,087,326	315,228	38,968,107

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,796,148	1,796,148
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	40,937	40,937
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	31,226,474		31,226,474
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	78,069	78,069
7	Other salaries and wages........	653,379,014	583,017,769	69,479,934	881,311
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	33,485,334	29,709,567	3,775,767	0
9	Other employee benefits .......	75,284,051	68,096,809	7,126,330	60,912
10	Payroll taxes ...........	29,992,187	27,002,962	2,942,289	46,936
11	Fees for services (non-employees):
a	Management ......	40,582,989	15,890,414	24,692,575	0
b	Legal .........	948,708	107,851	840,857	0
c	Accounting ...........	6,553,059	1,155,610	5,397,449	0
d	Lobbying ...........	45,512	45,512
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	120,990	0	120,990	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	96,418,664	89,778,686	6,381,595	258,383
12	Advertising and promotion ....	10,006,769	1,967,345	8,039,424	0
13	Office expenses .......	13,485,202	8,683,002	4,630,143	172,057
14	Information technology ......	74,678,881	27,304,946	47,373,935	0
15	Royalties ..	0
16	Occupancy ...........	135,821,909	120,225,004	15,543,766	53,139
17	Travel ............	1,519,954	1,399,541	115,513	4,900
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	60,490	37,531	22,959	0
20	Interest ...........	13,464,280	6,100,203	7,364,077	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	52,990,083	43,798,588	9,172,366	19,129
23	Insurance ...	100,792,696	9,365,201	91,427,495	0
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	264,474,857	264,474,857	0	0
b	BAD DEBT EXPENSES	20,018,253	20,018,253	0	0
c	MEDICAID ASSESSMENT	37,389,685	37,389,685	0	0
d	SERVICES FROM AFFILIATES	166,775,458	147,875,822	18,863,124	36,512
e	All other expenses	9,199,573	8,747,655	450,275	1,643
25	Total functional expenses. Add lines 1 through 24e	1,870,630,226	1,514,107,967	354,987,337	1,534,922
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).	0

1	Cash–non-interest-bearing ........			28,053,998	1	1,339,477
2	Savings and temporary cash investments .........			512,234,594	2	627,149,314
3	Pledges and grants receivable, net ......			0	3	78,134
4	Accounts receivable, net .............			66,201,233	4	215,062,076
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 .......
				0	5	0
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) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			32,520,409	8	32,152,546
9	Prepaid expenses and deferred charges ......			15,027,892	9	19,247,828
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,019,442,643
b	Less: accumulated depreciation	10b	632,255,376	397,166,789	10c	387,187,267
11	Investments—publicly traded securities .			0	11	14,134,005
12	Investments—other securities. See Part IV, line 11 .....			0	12	6,313,848
13	Investments—program-related. See Part IV, line 11 ..			46,514,178	13	68,565,240
14	Intangible assets ...............			40,483,312	14	40,483,311
15	Other assets. See Part IV, line 11 ...........			0	15	2,111,432
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,138,202,405	16	1,413,824,478

17	Accounts payable and accrued expenses .....	385,914,898	17	269,040,873
18	Grants payable ...	0	18	0
19	Deferred revenue .........	7,091,834	19	61,547,184
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
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 .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
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	304,736,210	25	499,897,476
26	Total liabilities. Add lines 17 through 25..	697,742,942	26	830,485,533

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	419,381,063	27	557,333,310
28	Net assets with donor restrictions ...........	21,078,400	28	26,005,635
	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 ...........	440,459,463	32	583,338,945
33	Total liabilities and net assets/fund balances ........	1,138,202,405	33	1,413,824,478