TY 2022 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) CATHERINE PALMER MD DIRECTOR/VICE CHAIR	6.0 ................. 43.0	X	X	260,759	50,551
(2) CLINT CLARY SECRETARY	1.0 ................. 0	X	X	0	0
(3) DON BRIGHT TREASURER	1.0 ................. 0	X	X	0	0
(4) JAY STAFFORD DIRECTOR/CHAIR	1.0 ................. 0	X	X	0	0
(5) BETH COOKE DIRECTOR	1.0 ................. 0	X		0	0
(6) CECIL SHELL DIRECTOR	1.0 ................. 0	X		0	0
(7) DARRELL GRIFFITH DIRECTOR (SEPT-JUNE)	1.0 ................. 60.0	X		482,846	40,291
(8) HARINDER DHINDSA MD DIRECTOR	1.0 ................. 64.0	X		620,368	78,661
(9) Jay Jordan DIRECTOR	1.0 ................. 0	X		0	0
(10) KENDELE UNDERWOOD DIRECTOR	1.0 ................. 0	X		0	0
(11) KRISTA LUZYNSKI DIRECTOR	1.0 ................. 0	X		0	0
(12) MICHAEL ELLIOTT PHARM D DIRECTOR (JULY-FEB)	1.0 ................. 60.0	X		440,405	20,629
(13) MICHAEL ROUSSOS DIRECTOR (MARCH-JUNE)	1.0 ................. 63.0	X		779,088	36,976
(14) MIKE ROWE DIRECTOR	1.0 ................. 0	X		0	0
(15) Quentin Johnson DIRECTOR	1.0 ................. 0	X		0	0
(16) RALPH CLARK MD DIRECTOR	1.0 ................. 66.0	X		660,373	65,522
(17) RONALD THORNHILL PHD DIRECTOR	1.0 ................. 0	X		0	0

(A) Name and business address	(B) Description of services	(C) Compensation
Supplemental Healthcare PO BOX 677896 Dallas,TX75243	Medical Professionals	17,895,114
Morrison Healthcare PO BOX 102289 Atlanta,GA303682289	Cafeteria Services	1,553,743
PHARMACY ASSOCIATES 531 PALMER POINT RD BOYDTON,VA23917	MEDICAL PROFESSIONALS	1,420,958
Medicus Hospitalists LLC 22 ROULSTON ROAD Windham,NH03087	Medical Professionals	1,247,118
AMR MID Atlantic PO BOX 100296 Atlanta,GA303840296	Air and Mobile EMS	944,347
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 26

- 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

2022

Open to Public
Inspection

Name of the organization

Community Memorial Hospital

Employer identification number

54-0551711

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2022 (line 6, column (f) divided by line 11, column (f)) .........

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

16a

33 1/3% support test—2022. 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—2021. 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—2022. 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—2021. 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. 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—2021. 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) 2022

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) 2022

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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

11a

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

11b

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

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

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

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

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

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

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

Schedule A (Form 990) 2022

Page 6

Part V

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

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

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

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

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

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

Schedule A (Form 990) 2022

Page 7

Part V

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

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2022 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2022

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- 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

2022

Name of the organization

Community Memorial Hospital

Employer identification number

54-0551711

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) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization Community Memorial Hospital

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) (2022)

Schedule B (Form 990) (2022)

Page 3

Name of organization Community Memorial Hospital		Employer identification number 54-0551711

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) (2022)

Schedule B (Form 990) (2022)

Page 4


Name of organization Community Memorial Hospital			Employer identification number 54-0551711
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) (2022)

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- 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

Community Memorial Hospital

Employer identification number

54-0551711

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)? ........

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

8,213

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

8,213

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	LOBBYING ACTIVITIES THE ORGANIZATION WAS PART OF SEVERAL ASSOCIATIONS THAT ENGAGED IN LOBBYING ON BEHALF OF ITS MEMBERS. THE FOLLOWING IS A LIST OF THE ORGANIZATIONS AND MEMBER DUES USED FOR LOBBYING. AMERICAN HEALTHCARE ASSOCIATION $7,422 VIRGINIA HEALTHCARE ASSOCIATION $791

Schedule C (Form 990) 2021

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- 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

Community Memorial Hospital

Employer identification number

54-0551711

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

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

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

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

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

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

1a	Land .....	1,613,516		1,613,516
b	Buildings ....	125,710,610	52,117,168	73,593,442
c	Leasehold improvements
d	Equipment ....	48,414,192	41,093,661	7,320,531
e	Other .....	3,230,291	1,743,253	1,487,038
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				84,014,527

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)DUE FROM VCUHS				450,246,259
(2)MEDICAID RECEIVABLE				4,120,450
(3)OTHER ASSETS				148,483
(4)Other Accounts Receivable
(5)AWUIL INTERIM LIFE SAFETY FUND
(6)CMH LOAN ISSUE COSTS
(7)DEPOSITS				34,687
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				454,549,879

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
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	497,933,410
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 X, Line 2 FIN 48 (ASC 740) footnote	THE FILING ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS.

Schedule D (Form 990) 2021

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- 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 20a.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

Community Memorial Hospital

Employer identification number

54-0551711

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"? . . . . . . . . . . . . .

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		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(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) . . .			610,583		610,583	0.34 %
b	Medicaid (from Worksheet 3, column a) . . . . .			51,215,472	43,524,054	7,691,418	4.29 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	51,826,055	43,524,054	8,302,001	4.63 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			2,224		2,224	0 %
f	Health professions education (from Worksheet 5) . . .			123,684		123,684	0.07 %
g	Subsidized health services (from Worksheet 6) . . . .					0	0 %
h	Research (from Worksheet 7) .					0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .					0	0 %
j	Total. Other Benefits . .	0	0	125,908	0	125,908	0.07 %
k	Total. Add lines 7d and 7j .	0	0	51,951,963	43,524,054	8,427,909	4.70 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

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
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	0	0	0	0

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. ......

9,845,107

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. ......

1,568,841

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).....

55,216,163

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

88,355,515

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

-33,139,352

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) 2022

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?1Name, 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)
1	COMMUNITY MEMORIAL HOSPITAL 1755 N MECKLENBURG AVE SOUTH HILL,VA23970 WWW.VCU-CMH.ORG H 1847	X	X	X	SKILLED NURSING/LONG TERM CARE FACILITY

Schedule H (Form 990) 2022

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)

	COMMUNITY MEMORIAL 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 20

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): https://www.vcuhealth.org/-/media/media/file/cmh_chna-study-report---may-2021.ashx

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 20

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

Yes

If "Yes" (list url): https://www.vcuhealth.org/-/media/media/file/cmh_chna-response-plan-2021.ashx

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) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	COMMUNITY MEMORIAL 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 200.0%
and FPG family income limit for eligibility for discounted care of 300.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

https://www.vcuhealth.org/-/media/media/file/2023financialassistancepolicy_vcuhealth_final.ashx

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

https://www.vcuhealth.org/-/media/media/file/221121_financial_application_rev_1_.ashx

A plain language summary of the FAP was widely available on a website (list url):
https://www.vcuhealth.org/-/media/media/file/221121_financial_application_rev_1_.ashx

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) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	COMMUNITY MEMORIAL 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?..................

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) 2022

Page 7

Part VFacility Information (continued)

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

	COMMUNITY MEMORIAL 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) 2022

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
Schedule H, Part V, Section B, Line 3 Facility , 1	Facility , 1 - COMMUNITY MEMORIAL HOSPITAL. COMMUNITY HEALTH NEEDS ASSESSMENT ADDITIONAL FINDINGS THE NEEDS ASSESSMENT ALSO DESCRIBED INSIGHT FROM COMMUNITY STAKEHOLDERS REGARDING IMPORTANT HEALTH CONCERNS, SIGNIFCANT SERVICE GAPS, SPECIALTY SERVICE GAPS, AND IDEAS FOR ADDRESSING THESE CONCERNS AND GAPS.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - COMMUNITY MEMORIAL HOSPITAL. CHNA, INPUT FROM COMMUNITY IN AN EFFORT TO GENERATE COMMUNITY INPUT, A COMMUNITY INSIGHT SURVEY WAS CONDUCTED WITH COMMUNITY RESIDENTS DURING THE SPRING OF 2021. INSIGHTS WERE COLLECTED VIA SURVEYS ADMINISTERED ONLINE. THE PROFILE OF THE RESPONDENTS WAS 86% WHITE, 14% MINORITY AND MOSTLY FEMALE, UPPER MIDDLE AGED (55-74), AND AT THE HIGHER INCOME LEVELS.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - COMMUNITY MEMORIAL HOSPITAL. HEALTHCARE DISPARITY AND HEALTH INEQUITIES * SCREENING, DATA ANALYTICS AND ACTION PLANNING IN PLACE TO IDENTIFY AND ADDRESS HEALTH EQUITY * PARTNERED WITH FEEDMORE FOR THOSE WITH IDENTIFIED FOOD HUNGER NEEDS LAUNCHED FOR INPATIENTS AND EXPANDED TO ALL OUTPATIENT SITES OF CARE AND CLINICS * GRANT FUNDED MOBILE VAN FOR HEALTH SCREENINGS LAUNCHED IN CONJUNCTION WITH VCU SON, SVCC SON AND VCU HEALTH SCIENCES FOR MOBILE HEALTH ON TUESDAY'S IN ALBERTA VA * LAUNCHED FRONT END PROCESS CHANGE TO DECREASE LEFT WITHOUT BEING SEEN IN THE ED TO ENSURE ACCESS TO CARE NEW SERVICE OFFERINGS: * EMPLOYED GI PHYSICIAN WITH CLINIC, OUTPATIENT INFUSION, INPATIENT AND PROCEDURAL OFFERINGS * RHEUMATOLOGY PHYSICIAN WITH CLINIC AND OUTPATIENT INFUSION THERAPY OFFERINGS PARTICIPATION IN CLINICAL TRIALS AND PHYSICIAN RESEARCH PUBLICATIONS ACROSS ORTHOPEDICS, ONCOLOGY, ICU RED HEART, HEART FAILURE AND COVID WORKFORCE DEVELOPMENT * PARTICIPATION IN MEDICAL AND CLINICAL EDUCATION AND TRAINING THROUGH HOSTING 3RD YEAR VCU MEDICAL STUDENTS, HOSTING VCU NURSING STUDENTS FOR SATURDAY CLINICALS, CLINICAL SITE FOR SVCC NURSING STUDENTS (LPN ), CLINICAL SITE FOR RAD ONC, IMAGING, PHYSICAL/OCCUPATIONAL/SPEECH THERAPY * TIMELINE AND PLANNING IN PROCESS TO LAUNCH GRADUATE MEDICAL EDUCATION FAMILY MEDICINE RESIDENCY PROGRAM WITH 3 FAMILY PRACTICE RESIDENTS TO EXPAND ACCESS TO CARE AND RETAIN PHYSICIANS IN RURAL SETTING * SUMMER NURSE EXTERN PROGRAM CONTINUES TO BUILD PIPELINE TO ADDRESS NURSING VACANCIES AND BUILD WORKFORCE HEART DISEASE - 20% CMH MOVED EKG INTERPRETATION TO CARDIOLOGISTS/PEDIATRIC CARDIOLOGISTS AND THEY DO FINAL READS FOR ALL CMH SITES. IMPLEMENTATION OF EPIC ELECTRONIC MEDICAL RECORD ACROSS VCU HEALTH SITES TO STANDARDIZE CARE PLATFORMS. ADDED CARDIOLOGY NP IN JANUARY OF 2023. CURRENTLY RECRUITING 2 FULL TIME CARDIOLOGISTS AND 2ND CARDIOLOGY APP TO MEET COMMUNITY NEEDS. MALIGNANT NEOPLASMS - 20% * INCREASED LOW DOSE LUNG CANCER SCREENINGS BY 10% (OVER 460 COMPLETED IN FY2022). * CMH ENROLLED 19 PARTICIPANTS IN CLINICAL TRIALS, REFLECTING A 6% ENROLLMENT PERCENTAGE. * CMH ADVISED 46% OF ACTIVE SMOKERS IN ONCOLOGY CARE ABOUT TOBACCO CESSATION RESOURCES AND 60% OF THEM ACCEPTED HELP AND ARE ACTIVELY TRYING TO QUIT. * PHYSICAL THERAPY EDUCATED NURSES ON PROSTATE, LACK OF AND PELVIC FLOOR MUSCULATURE CHANGES. * IMPLEMENTED COMMUNITY SCREENINGS FOR PROSTATE CANCER DURING NOVEMBER- PROSTATE AWARENESS MONTH. SINCE BEGINNING SCREENING, PROSTATE CANCER IDENTIFICATIONS THROUGH ONCOLOGY PROGRAM HAS GONE FROM 18 PER YEAR TO 48 IN THE LAST YEAR. WILL MAKE THIS AN ANNUAL OFFERING * THROUGH HEALTH & WELLNESS AND A GRANT THROUGH THE SUSAN KOMEN FOUNDATION, WE CONTINUE TO OFFER FREE MAMMOGRAMS TO WOMEN IN NEED GOAL FOR IS TO DECREASE "NO SHOW" APPOINTMENTS FOR PATIENT IN ACTIVE RADIATION TREATMENT BY IDENTIFYING AND UNDERSTANDING BARRIERS IN OUR COMMUNITY AND IMPLEMENTING INTERVENTIONS. CEREBROVASCULAR DISEASE - 6% * TJC PRIMARY STROKE CENTER ACCREDITED * 1 COMMUNITY NEUROLOGIST CHRONIC LOWER RESPIRATORY - 5% * 2 COMMUNITY PULMONOLOGISTS AND 1 PART TIME APP 5 YR. INFANT MORTALITY RATE 193% OF STATE RATE * ALIGNMENT WITH VCU MEDICAL CENTER HIGH RISK OB FOR CARE AND TREATMENT PROTOCOLS * ALIGNMENT WITH VCU MEDICAL CENTER NICU FOR CARE AND TREATMENT PROTOCOLS * OB/GYN RECRUITMENT COMPLETE WITH 1 ADDITIONAL OB JOINING IN AUGUST OF 2023 RATE OF MENTAL HEALTH DISCHARGES FROM LOCAL HOSPITALS IS 39% LOWER THAN STATE RATE; HOWEVER, THE STUDY DOES NOT TAKE INTO ACCOUNT DISCHARGES FROM STATE MENTAL HEALTH FACILITIES OR OUTPATIENT TREATMENT OPTIONS * OPENED OUTPATIENT MENTAL HEALTH CLINIC WITH 1 PSYCHIATRIST AND HAVE ADDED 1 LICENSED SOCIAL WORKER * WORKING IN CONJUNCTION WITH LOCAL COMMUNITY SERVICE BOARD SURROUNDING CRISIS RECEIVING CENTER THAT WILL OPEN IN OCTOBER OF 2023 INJURY & VIOLENCE RELATED DISCHARGES 53% HIGHER THAN STATE AVERAGE * ONGOING COLLABORATION WITH VCUHS AND CMH WORKPLACE VIOLENCE, TO ASSESS AND PLAN FOR WAYS TO REDUCE WORKPLACE VIOLENCE. * VCU POLICE ONSITE SECURITY SCREENING COMPLETED WITH ACTION PLAN DEVELOPMENT IN PROCESS

Schedule H (Form 990) 2022

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?16
Name and address		Type of Facility (describe)
1	CMH PHYSICIAN SERVICES - FAMILY CARE 1755 N Mecklenburg Ave South Hill,VA23970	HEALTHCARE PRACTICE
2	CMH CARDIOLOGY LLC 1755 N MECKLENBURG AVE LACROSSE,VA23950	HEALTHCARE PRACTICE
3	CMH ORTHOPEDIC SERVICES LLC 1755 N MECKLENBURG AVE LACROSSE,VA23950	HEALTHCARE PRACTICE
4	CMH SURGICAL SERVICES LLC 1755 N MECKLENBURG AVE LACROSSE,VA23950	HEALTHCARE PRACTICE
5	CMH WOMEN'S HEALTH SERVICES LLC 1755 N MECKLENBURG AVE LACROSSE,VA23930	HEALTHCARE PRACTICE
6	CMH UROLOGICAL SERVICES LLC 1755 N MECKLENBURG AVE LACROSSE,VA23950	HEALTHCARE PRACTICE
7	CMH PULMOLOGY LLC 1755 N MECKLENBURG AVE LACROSSE,VA23950	HEALTHCARE PRACTICE
8	CMH PAIN MANAGEMENT SERVICES LLC 1755 N MECKLENBURG AVE LACROSSE,VA23950	HEALTHCARE PRACTICE
9	CMH DERMATOLOGY LLC 1755 N MECKLENBURG AVE LACROSSE,VA23950	HEALTHCARE PRACTICE
10	CMH EAR NOSE THROAT & ALLERGY LLC CMH EAR NOSE THROAT ALLERGY LLC LACROSSE,VA23950	HEALTHCARE PRACTICE
11	CMH DENTAL CLINIC LLC 1755 N MECKLENBURG AVE SOUTH HILL,VA23970	HEALTHCARE PRACTICE
12	CMH BEHAVIORAL HEALTH SERVICES 140 EAST FERRELL STREET SOUTH HILL,VA23970	HEALTHCARE PRACTICE
13	CMH NEUROLOGICAL SERVICES 1755 N MECKLENBURG AVE SOUTH HILL,VA23970	HEALTHCARE PRACTICE
14	CHASE CITY PRIMARY CARE CENTER LLC 200 E 5TH STREET CHASE CITY,VA23924	RHC
15	RHEUMATOLOGY CMHP 755 N Mecklenburg Ave South Hill,VA23970	HEALTHCARE PRACTICE
16	CMH VASCULAR LLC 1755 N MECKLENBURG AVE SOUTH HILL,VA23970	HEALTHCARE PRACTICE

Schedule H (Form 990) 2022

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
Schedule H, Part II, Line 4	FOOTNOTE 2(F) OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS STATES: THE AUTHORITY RECORDS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS DURING THE PERIOD IN WHICH COLLECTION IS CONSIDERED DOUBTFUL. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS APPROXIMATELY 137,960 AND $184,238 AT JUNE 30, 2023 AND 22, RESPECTIVELY.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	9845107
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	7a - Used YTD Provision for Indigent Care on CMH Income Statement and multiplied it by the Patient care Cost to Charges % ratio. See FY23 Financial Assistance spreadsheet. 7b - Medicaid calculations were provided by VCU Reimbursement team using filed cost report data. See CMH Final FY23 Tax Return info spreadsheet.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	BAD DEBT FOR PURPOSES OF LINE 2 IS PRESENTED AT ESTIMATED COST. THE COST OF THE BAD DEBT CHARGES WAS CALCULATED USING RATIO OF PATIENT CARE COST TO CHARGES. RATIONALE FOR INCLUDING A PORTION OF BAD DEBT AS COMMUNICATED BENEFIT IS AS FOLLOWS: THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS OTHERWISE ELIGIBLE UNDER THE CHARITY CARE POLICY WAS DETERMINED BY REVIEWING UNCOLLECTIBLE ACCOUNTS FOR THIRD PARTY AND UNINSURED PATIENT ACCOUNTS RECEIVABLE BALANCES FOR WHICH THE PATIENT IS RESPONSIBLE.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	DESCRIPTION OF BAD EXPENSE FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE HOSPITAL RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES, DISCOUNTED ACCORDING TO POLICY, FOR SERVICES RENDERED. HISTORICAL EXPERIENCE HAS SHOWN A SIGNIFICANT PROPORTION OF THE HOSPITAL'S UNINSURED PATIENTS, IN ADDITION TO A GROWING PROPORTION OF THE HOSPITAL'S INSURED PATIENTS, WILL BE UNABLE OR UNWILLING TO PAY FOR THEIR RESPONSIBLE AMOUNTS FOR THE SERVICES PROVIDED. IN ORDER TO ESTIMATE THE NET REALIZABLE VALUE OF THE REVENUES AND ACCOUNTS RECEIVABLES ASSOCIATED WITH THIRD-PARTY PAYORS AND UNINSURED PATIENTS, MANAGEMENT REGULARLY ANALYZES COLLECTION HISTORY. BASED ON THESE HISTORICAL ANALYSES, THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS AND AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOR THIRD PARTY AND UNINSURED PATIENT ACCOUNTS RECEIVABLE BALANCES FOR WHICH THE PATIENT IS RESPONSIBLE. THE "EMPLOYER" IS ON ALL PATIENT ACCOUNTS THAT WERE WRITTEN OFF TO BAD DEBT EXPENSE. THOSE ACCOUNTS THAT LISTED NO EMPLOYER WERE ASSUMED TO HAVE QUALIFIED UNDER THE CHARITY CARE POLICY BECAUSE OF THE LACK OF INCOME FROM BEING UNEMPLOYED.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	THE HOSPITAL RECOGNIZES REVENUE NET OF CONTRACTUAL ALLOWANCE PER THE STANDARD CONTRACTED RATE. HISTORICAL EXPERIENCE HAS DEMONSTRATED A PORTION OF REVENUE IS UNCOLLECTABLE. THE HISTORICAL UNCOLLECTABLE RATE IS APPLIED TO OUTSTANDING NET ACCOUNTS RECEIVABLE AND A PROVISION IS RECORDED PERIODICALLY. THE HOSPITAL PROVIDES HEALTHCARE SERVICES TO INFANTS, CHILDREN, AND ADOLESCENTS UP TO THE AGE OF 21 YEARS. HOSPITAL WILL PROVIDE FINANCIAL ASSISTANCE AS ESTABLISHED UNDER THE GUIDELINES. SERVICES ARE PROVIDED REGARDLESS OF RACE, CREED, RELIGION, NATIONAL ORIGIN, SEX, DISABILITY, SOCIOECONOMIC STATUS, PAYOR SOURCE, OR ANY OTHER MANNER PROHIBITED BY LAW. AS A TAX-EXEMPT ENTITY AND AS PART OF ITS COMMITMENT TO SERVE THE COMMUNITY, HOSPITAL PROVIDES FINANCIAL ASSISTANCE IN THE FORM OF CHARITY CARE ("FINANCIAL ASSISTANCE") TO PATIENTS' FAMILIES WHO QUALIFY BY MEETING THE REQUIREMENTS. PATIENT FAMILIES ARE ELIGIBLE IF THEIR YEARLY HOUSEHOLD INCOME, AS DOCUMENTED ON THE FINANCIAL ASSISTANCE APPLICATION IS LESS THAN OR EQUAL TO 200% OF THE POVERTY GUIDELINES UPDATED ANNUALLY IN THE FEDERAL REGISTER BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ("FEDERAL POVERTY GUIDELINES"). FOOTNOTE 2(E) OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS STATES: THE AUTHORITY RECORDS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS DURING THE PERIOD IN WHICH COLLECTION IS CONSIDERED DOUBTFUL. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS APPROXIMATELY $12,284,000 AT JUNE 30, 2022. ACCOUNTS WAS APPROXIMATELY $11,995,000 AT JUNE 30, 2021.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	MEDICARE ALLOWABLE COST WAS CALCULATED USING A COMBINATION OF COST FROM FILED FY 2023 MEDICARE COST REPORT; COST TO CHARGE RATIOS FROM FILED FY 2023 MEDICARE COST REPORT; AND A CALCULATION OF DIRECT COSTS PLUS ALLOCATED OVERHEAD. THE SHORTFALL IS RELATED TO PROVIDING SERVICES TO OUR RURAL COMMUNITY THAT OUR BOARD OF DIRECTORS HAS DETERMINED TO BE NECESSARY FOR THE BENEFIT OF THE COMMUNITY. THESE SERVICES INCLUDE OPERATING PHYSICIAN PRACTICES BECAUSE THE SERVICES WOULD NOT BE AVAILABLE LOCALLY IF NOT PROVIDED BY THE ORGANIZATION. COMMUNITY MEMORIAL HOSPITAL COULD CEASE TO PROVIDE THE SERVICES BUT OUR COMMUNITY WOULD THEN BE REQUIRED TO TRAVEL UP TO AN HOUR TO RECEIVE THE SERVICES IN ANOTHER COMMUNITY.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	APPLICATION OF COLLECTION PRACTICES TO THOSE QUALIFYING FOR FINANCIAL ASSISTANCE COMMUNITY MEMORIAL HOSPITAL'S COLLECTION POLICY STATES THAT ALL UNINSURED PATIENTS WILL BE REFERRED TO OUR FINANCIAL SPECIALIST TO BE SCREENED FOR FINANCIAL ASSISTANCE CONSISTENT WITH OUR INDIGENT AND CHARITY CARE PROGRAMS. INFORMATION IS PROVIDED UPON REGISTRATION TO ALL UNINSURED PATIENTS INFORMING THEM OF OUR FINANCIAL ASSISTANCE PROGRAMS. A NOTE IS ALSO INCLUDED ON STATEMENTS SENT TO UNINSURED PATIENTS REGARDING HOW TO REQUEST INFORMATION ABOUT FINANCIAL ASSISTANCE. THE POLICY FURTHER STATES THAT WE WILL UNDERTAKE REASONABLE EFFORTS TO ENSURE THAT FINANCIAL ASSISTANCE WAS OFFERED BEFORE ANY COLLECTION AGENCY ASSIGNMENT.
Schedule H, Part V, Section B, Line 16a FAP website	- COMMUNITY MEMORIAL HOSPITAL: Line 16a URL: https://www.vcuhealth.org/-/media/media/file/2023financialassistancepolicy_vcuhealth_final.ashx;
Schedule H, Part V, Section B, Line 16b FAP Application website	- COMMUNITY MEMORIAL HOSPITAL: Line 16b URL: https://www.vcuhealth.org/-/media/media/file/221121_financial_application_rev_1_.ashx;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- COMMUNITY MEMORIAL HOSPITAL: Line 16c URL: https://www.vcuhealth.org/-/media/media/file/221121_financial_application_rev_1_.ashx;
Schedule H, Part VI, Line 2 Needs assessment	A COMMUNITY NEEDS ASSESSMENT IS CONDUCTED ONCE EVERY THREE YEARS. WE COORDINATED WITH LOCAL PARTNERS AND AGENCIES TO GATHER DATA TO COMPLETE AN ECONOMIC AND WORKFLOW PROFILE OF THE SERVICE AREA. FEEDBACK FROM THE COMMUNITY SOUGHT BY UTILIZING FOCUS GROUPS, COMMUNITY FORUMS AND BY MEETINGS OTHER HEALTH CARE PROVIDERS. INFORMATION IS ALSO SOUGHT FROM THE MEMBERS OF THE BOARD OF DIRECTORS WHO REPRESENT THE COMMUNITIES WE SERVE.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	COMMUNITY MEMORIAL HOSPITAL TAKES MANY STEPS TO ENSURE THAT ITS COMMUNITY IS MADE AWARE OF THE FINANCIAL ASSISTANCE PROGRAMS AVAILABLE TO IT. OUR POLICY FOR FINANCIAL ASSISTANCE, INCLUDING THE APPLICATION, IS AVAILABLE ON OUR WEBSITE. A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE IS POSTED AT EACH REGISTRATION AREA. OUR PATIENT FINANCIAL BROCHURE, WHICH DESCRIBES OUR REGISTRATION REQUIREMENTS, BILLING PROCESS AND FINANCIAL ASSISTANCE PROGRAMS, IS PROVIDED TO EACH UNINSURED PATIENT AT REGISTRATION AND IS ALSO AVAILABLE IN ALL REGISTRATION AREAS AND WAITING ROOMS.
Schedule H, Part VI, Line 4 Community information	COMMUNITY MEMORIAL HOSPITAL IS A RURAL, NON-PROFIT HEALTH SYSTEM LOCATED IN SOUTH CENTRAL VIRGINIA. WE SERVE THE RURAL COUNTIES OF MECKLENBURG, BRUNWICK AND LUNENBURG IN VIRGINIA AS WELL AS WARREN COUNTY, NORTH CAROLINA. OUR PRIMARY MARKET AREA IS MECKLENBURG COUNTY. MECKLENBURG COUNTY HAS A POPULATION OF 30,527 THE PER CAPITA INCOME OF $31,010 IS ABOUT TWO-THIRDS OF THE STATE AVERAGE. THE ESTIMATED TOTAL POPULATION IN POVERTY PERCENTAGE IS 19.4% - ABOVE THE STATE AVERAGE OF 10.6%. COMMUNITY MEMORIAL HOSPITAL QUALIFIES AS A SOLE COMMUNITY HOSPITAL FOR MEDICARE REGULATIONS AS THE CLOSEST HOSPITAL IS 35 MILES AWAY.
Schedule H, Part VI, Line 5 Promotion of community health	COMMUNITY MEMORIAL HOSPITAL (CMH) IS A VITAL COMPONENT OF THE SOUTHSIDE VIRGINIA AREA, PROVIDING QUALITY CARE TO OUR PATIENTS, SERVING AS A VITAL PART OF THE SAFETY NET AND ENHANCING COMMUNITY HEALTH. OUR MISSION IS TO PROVIDE EXCELLENCE IN THE DELIVERY OF HEALTHCARE. WE ARE LED BY A VOLUNTEER 14 MEMBER BOARD OF DIRECTORS WHO REPRESENT ALL OF THE AREAS WE SERVE AS WELL AS VCU HEALTH SYSTEM REPRESENTATIVES. CMH IS DESIGNATED AS VOLUNTEER 14 MEMBER BOARD OF DIRECTORS WHO REPRESENT ALL OF THE AREAS WE SERVE AS WELL AS VCU HEALTH SYSTEM REPRESENTATIVES. CMH IS DESIGNATED AS A SOLE COMMUNITY HOSPITAL BY MEDICARE WHICH MEANS THAT WE ARE LOCATED IN A RURAL AREA AND 35 MILES FROM OTHER HOSPITALS. WE ARE ALSO DESIGNATED A DISPROPORTIONATE SHARE HOSPITAL BY MEDICARE WHICH MEANS THAT WE PROVIDE CARE TO A HIGHER LEVEL OF LOW-INCOME INDIVIDUALS. OUR PRIMARY SERVICE AREA OF MECKLENBURG COUNTY RANKS BELOW THE STATE AVERAGE IN PER CAPITA INCOME AND ABOVE THE STATE AVERAGE IN ESTIMATED TOTAL POPULATION IN POVERTY PERCENT. WE OFFER A FULL SPECTRUM OF SERVICES TO THE COMMUNITY INCLUDING IN-PATIENT ACUTE CARE, POST ACUTE, AND LONG TERM CARE, OUT-PATIENT SERVICES, HOME HEALTH AND HOSPICE. LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA, WE OPERATE PRIMARY HEALTH PRACTICES THAT BRING NEEDED PRIMARY CARE SERVICES TO THE COMMUNITY. WE HAVE ALSO MADE THE DECISION TO OPERATE PRACTICES IN THE SPECIALTY AREAS OF DENTAL, DERMATOLOGY, VASCULAR, CARDIOLOGY/PULMONARY SERVICES, EAR, NOSE & THROAT SERVICES, ORTHOPEDICS, PAIN MANAGEMENT, SURGICAL SERVICES, WOMEN'S HEALTH SERVICES, AND UROLOGY SERVICES AS THESE SPECIALTY SERVICES OTHERWISE MIGHT NOT BE AVAILABLE FOR OUR COMMUNITY WITHOUT SIGNIFICANT TRAVEL. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS BUT RECRUITING TO A RURAL AREA COMES WITH MANY CHALLENGES. OUR EMERGENCY DEPARTMENT HAD ALMOST 22,000 PATIENT VISITS LAST YEAR AND SEES PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. WE OFFER FINANCIAL ASSISTANCE TO OUR UNINSURED PATIENTS. UNINSURED PATIENTS QUALIFYING WITH INCOME BELOW THE FEDERAL POVERTY LEVEL ARE OFFERED FREE CARE. UNINSURED PATIENTS WITH FAMILY INCOME UP TO 300% OF THE FEDERAL POVERTY LEVEL ARE OFFERED SLIDING SCALE DISCOUNTS. INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM IS POSTED ON OUR WEBSITE, POSTED IN ALL REGISTRATION WAITING AREAS, PROVIDED TO UNINSURED PATIENTS AT REGISTRATION AND INCLUDED AS A NOTE ON ALL PROMOTION OF COMMUNITY SENT TO UNINSURED PATIENTS. WE EMPLOY A FINANCIAL SPECIALIST WHOSE RESPONSIBILITY IS TO ASSIST UNINSURED PATIENTS WITH OUR FINANCIAL ASSISTANCE PROGRAMS AS WELL AS TO ASSIST THE PATIENTS WITH APPLYING AND QUALIFYING FOR OTHER COVERAGE SUCH AS DISABILITY OR MEDICAID. WITH THE HELP OF SEVERAL GRANTS, CMH HAS BEEN ABLE TO OFFER FREE MAMMOGRAMS AND BREAST EXAMS TO UNDERSERVED WOMEN IN THE AREA. AS THE GRANTS DO NOT COVER TOTAL PROGRAM EXPENSES, CMH MUST SUPPLEMENT THE COSTS TO PROVIDE THESE SERVICES TO THE COMMUNITY. LAST YEAR, OUR MEDICATION ASSISTANCE PROGRAM, THE PHARMACY CONNECTION, HELPS PATIENTS OBTAIN MEDICATIONS. ANY SURPLUS FUNDS GO BACK INTO THE OPERATION OF THE HOSPITAL TO MAINTAIN THE FACILITY AND UPDATE EQUIPMENT AND TECHNOLOGY. CMH ALSO BELONGS TO AND SUPPORTS 8 CHAMBERS OF COMMERCE AND PARTICIPATES IN THEIR COMMUNITY EVENTS. OUR INVOLVEMENT HELPS SUPPORT COMMUNITY GROWTH AND WE SHARE MANY HEALTH RELATED EVENT NOTICES AT THESE MEETINGS. WE ALSO SUPPORT MANY OF THEIR SPECIAL EVENTS AND LOCATE WELLNESS AND SCREENING BOOTHS THERE. HOSPITALS PLAY A CRITICAL ROLE IN THEIR COMMUNITY. AS MAJOR EMPLOYERS AND PURCHASERS, HOSPITALS ARE ENGINES OF ECONOMIC GROWTH AND STABILITY. A STRONG COMMUNITY HOSPITAL HELPS TO RECRUIT BUSINESS AND INDUSTRY TO THE AREA AND HELPS ATTRACT AND RETAIN COLLEGE GRADUATES AND SKILLED CRAFTSMEN. CMH IS THE LARGEST SINGLE EMPLOYER IN THE AREA PROVIDING JOBS AT A WIDE RANGE OF SKILL LEVELS FOR PEOPLE FROM VIRGINIA AND NORTH CAROLINA LOCALITIES WE CONTRIBUTE TO THE TAX BASE THROUGH WAGES, SALARIES AND BENEFITS. CMH AND OUR EMPLOYEES PURCHASE GOODS AND SERVICES LOCALLY, CREATING INCOME AND JOBS FOR OTHER BUSINESSES IN THE COMMUNITY. BY PARTICIPATING ON THE TOWN REVITALIZATION COMMITTEE, CMH HAS BEEN ABLE TO PROVIDE SUPPORT TO EFFORTS TO MODERNIZE THE TOWN IN ORDER TO MAKE IT MORE ATTRACTIVE TO NEW BUSINESSES. BY PROVIDING JOBS IN THE REGION, RESIDENTS HAVE A BETTER OPPORTUNITY TO RECEIVE PREVENTATIVE CARE THROUGH THEIR HEALTH INSURANCE PROGRAMS. THE COMMUNITY IS ALSO INVESTED IN CMH. VOLUNTEERS ARE A VITAL PART OF OUR HEALTH CARE TEAM, GOVERNANCE AND FUNDRAISING. ACTIVE VOLUNTEERS SERVE IN DIFFERENT CAPACITIES. THE MEN AND WOMEN OF OUR AUXILIARY VOLUNTEER THOUSANDS OF HOURS EACH YEAR AND PROVIDE A WIDE RANGE OF SERVICES TO STRENGTHEN OUR HOSPITAL AND ENHANCE THE QUALITY OF CARE FOR PATIENTS AND FAMILIES. THE COMMUNITY ALSO SUPPORTS THE OPERATION OF CMH BY SUPPORT OF THE CMH FOUNDATION. THE CMH FOUNDATION IS ALSO LED BY A VOLUNTEER BOARD OF DIRECTORS AND AIMS TO RAISE FUNDS TO ALLOW OUR HOSPITAL TO OFFER THE BEST POSSIBLE CARE AND MAINTAIN STATE-OF-THE-ART FACILITIES AND TECHNOLOGIES TO BETTER SERVE OUR COMMUNITY.
Schedule H, Part VI, Line 6 Affiliated health care system	EFFECTIVE JULY 1, 2014 CMH ENTERED INTO AN AFFILIATION AGREEMENT WITH VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY (VCUHS). IN CONNECTION WITH THE AFFILIATION TRANSACTION WE HAVE DEVELOPED A COMPREHENSIVE STRATEGIC PLAN FOR CMH THAT IDENTIFIES STRATEGIC CAPITAL PROJECTS, INCLUDING THE DEVELOPMENT AND CONSTRUCTION OF A REPLACEMENT ACUTE CARE FACILITY AND RELATED EQUIPMENT WITH SUFFICIENT INFRASTRUCTURE AND LICENSED BED CAPACITY NECESSARY TO SUPPORT CMH'S EXISTING SERVICE LINES AND CLINICAL PROGRAMS INITIATIVES BASED ON A DETAILED ANALYSIS OF FACILITY NEEDS AND CLINICAL PROGRAM EXPANSIONS NEEDED TO BEST SERVE THE COMMUNITY AND ENSURE LONG-TERM SUCCESS OF CMH. CMH IMPLEMENTED THE SAME ELECTRONIC MEDICAL RECORD SYSTEM AS VCUHS SO PATIENT CARE INFORMATION WILL BE AVAILABLE TO PHYSICIANS IN BOTH MARKETS.
Schedule H, Part VI, Line 7 State filing of community benefit report	VA

Schedule H (Form 990) 2022

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- 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

2022

Open to Public Inspection

Name of the organization

Community Memorial Hospital

Employer identification number

54-0551711

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? .........

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) 2022

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)
1CATHERINE PALMER MD DIRECTOR/VICE CHAIR	(i) (ii)	0 ------------- 245,469	0 ------------- 15,290	0 ------------- 0	0 ------------- 27,228	0 ------------- 23,323	0 ------------- 311,310	0 ------------- 0
2RALPH CLARK MD DIRECTOR	(i) (ii)	0 ------------- 659,373	0 ------------- 1,000	0 ------------- 0	0 ------------- 48,895	0 ------------- 16,627	0 ------------- 725,895	0 ------------- 0
3HARINDER DHINDSA MD DIRECTOR	(i) (ii)	0 ------------- 537,402	0 ------------- 82,966	0 ------------- 0	0 ------------- 53,542	0 ------------- 25,119	0 ------------- 699,029	0 ------------- 0
4MICHAEL ELLIOTT PHARM D DIRECTOR (JULY-FEB)	(i) (ii)	0 ------------- 402,805	0 ------------- 37,600	0 ------------- 0	0 ------------- 16,777	0 ------------- 3,852	0 ------------- 461,034	0 ------------- 0
5DARRELL GRIFFITH DIRECTOR (SEPT-JUNE)	(i) (ii)	0 ------------- 466,179	0 ------------- 16,667	0 ------------- 0	0 ------------- 36,600	0 ------------- 3,691	0 ------------- 523,137	0 ------------- 0
6MICHAEL ROUSSOS DIRECTOR (MARCH-JUNE)	(i) (ii)	0 ------------- 741,488	0 ------------- 37,600	0 ------------- 0	0 ------------- 36,031	0 ------------- 945	0 ------------- 816,064	0 ------------- 0
7THOMAS YACKEL MD DIRECTOR (JULY-AUG)	(i) (ii)	0 ------------- 887,085	0 ------------- 20,000	0 ------------- 0	0 ------------- 36,081	0 ------------- 4,698	0 ------------- 947,864	0 ------------- 0
8W SCOTT BURNETTE PRESIDENT (JULY-DEC)	(i) (ii)	401,607 ------------- 0	0 ------------- 0	0 ------------- 0	36,600 ------------- 0	6,508 ------------- 0	444,715 ------------- 0	0 ------------- 0
9RAVI EDARA MD Hospitalist Medical Director	(i) (ii)	288,956 ------------- 0	220,368 ------------- 0	0 ------------- 0	34,931 ------------- 0	7,287 ------------- 0	551,542 ------------- 0	0 ------------- 0
10BRYAN MOSORA DO Physician	(i) (ii)	394,231 ------------- 0	171,293 ------------- 0	0 ------------- 0	34,058 ------------- 0	6,087 ------------- 0	605,669 ------------- 0	0 ------------- 0
11NIMESH PATEL MD Physician	(i) (ii)	486,603 ------------- 0	83,675 ------------- 0	0 ------------- 0	34,931 ------------- 0	7,124 ------------- 0	612,333 ------------- 0	0 ------------- 0
12JOHN PEARSON MD Urologist	(i) (ii)	459,627 ------------- 0	171,975 ------------- 0	0 ------------- 0	34,931 ------------- 0	4,520 ------------- 0	671,053 ------------- 0	0 ------------- 0
13INDU SHIVARAM MD Physician	(i) (ii)	416,693 ------------- 0	125,935 ------------- 0	0 ------------- 0	34,931 ------------- 0	326 ------------- 0	577,885 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2022

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 Arrangement used to establish the top management official's compensation

FOR FISCAL YEAR ENDING JUNE 30, 2023, COMPENSATION (SALARIES AND INCENTIVES) FOR THE CEO, EXECUTIVE DIRECTOR OR THE TOP MANAGEMENT OFFICIAL OF THE FILING ORGANIZATION, IS APPROVED BY THE CEO OF THE HEALTH SYSTEM. THE ORGANIZATION USES A THIRD PARTY COMPENSATION CONSULTING FIRM TO CONDUCT A MARKET STUDY TO DETERMINE MARKET POSITION. THE ORGANIZATION MAY ALSO CONDUCT A 360 DEGREE EVALUATION OF ALL SENIOR LEVEL ADMINISTRATORS. THESE DATA ELEMENTS IN CONJUNCTION WITH A REVIEW OF THE INDIVIDUAL'S PERFORMANCE AND THE ATTAINMENT OF GOALS FOR THE YEAR, ARE THE BASIS FOR COMPENSATION RECOMMENDATIONS. THE COMPENSATION COMMITTEE OF THE VCUHS BOARD OF DIRECTORS DISCUSSES THE MATTER AND PRESENTS RECOMMENDATIONS TO THE CEO OF THE HEALTH SYSTEM.

Schedule J (Form 990) 2022

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- 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

Community Memorial Hospital

Employer identification number

54-0551711

Return Reference	Explanation
Form 990, Part VI, Line 6 Classes of members or stockholders	THE SOLE MEMBER OF COMMUNITY MEMORIAL HOSPITAL ("HOSPITAL") IS THE VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY, A PUBLIC BODY CORPORATE AND POLITICAL SUBDIVISION OF THE COMMONWEALTH OF VIRGINIA. THE MEMBER SHALL HAVE THE RIGHTS RESERVED TO IT AS SET FORTH IN THE ARTICLES OF INCORPORATION AND THE BYLAWS OF THE HOSPITAL.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	THE SOLE MEMBER OF COMMUNITY MEMORIAL HOSPITAL ("HOSPITAL") IS THE VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY, A PUBLIC BODY CORPORATE AND POLITICAL SUBDIVISION OF THE COMMONWEALTH OF VIRGINIA. THE MEMBER SHALL HAVE THE RIGHTS RESERVED TO IT AS SET FORTH IN THE ARTICLES OF INCORPORATION AND THE BYLAWS OF THE HOSPITAL.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	GOVERNANCE DECISIONS RESERVED TO MEMBERS THE RESERVED POWERS OF THE SOLE MEMBER, VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY ("VCUHSA"), INCLUDE THE APPROVAL OF THE FOLLOWING MATTERS: (1) ANY AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION, BYLAWS OR OTHER GOVERNING DOCUMENTS OF THE HOSPITAL OR ITS AFFILIATES, INCLUDING ANY CHANGE TO THE NAME OF THE HOSPITAL, ITS AFFILIATES OR ANY FACILITIES OPERATED BY THE HOSPITAL OR ITS AFFILIATES;(2) APPOINTMENT OF ANY DIRECTORS, MANAGERS OR OTHER GOVERNING PERSONS OF THE HOSPITAL OR ITS AFFILIATES; (3) THE ANNUAL OPERATING AND CAPITAL BUDGETS THE HOSPITAL OR ITS AFFILIATES (TO THE EXTENT SEPARATELY APPROVED FROM THE HOSPITAL'S BUDGETS); (4) ANY TRANSACTION, OR SERIES OF TRANSACTIONS IN ANY FISCAL YEAR, INVOLVING CAPITAL EXPENDITURES OR CONTRACTUAL COMMITMENTS BY THE HOSPITAL OR ITS AFFILIATES NOT PREVIOUSLY SPECIFIED IN A BUDGET APPROVED BY THE MEMBER IN AN AMOUNT EXCEEDING $500,000; (5) ANY TRANSACTION, OR ANY SERIES OF TRANSACTIONS IN ANY FISCAL YEAR, INVOLVING THE INCURRENCE OF DEBT OR THE CREATION OF LIENS OR OTHER ENCUMBRANCES ON ASSETS BY THE HOSPITAL OR ITS AFFILIATES, INCLUDING ANY MORTGAGES, CAPITAL LEASES, SECURITY INTERESTS OR GUARANTEES, NOT PREVIOUSLY SPECIFIED IN A BUDGET APPROVED BY THE MEMBER IN AN AMOUNT EXCEEDING $500,000; (6) ANY SALE, DISTRIBUTION OR OTHER DISPOSITION OF CASH, INVESTMENTS OR OTHER ASSETS BY THE HOSPITAL OR ITS AFFILIATES TO ANY THIRD PARTIES, WITH OR WITHOUT CONSIDERATION, IN AN AMOUNT EXCEEDING $500,000; (7) ANY MERGER, CONSOLIDATION, DISSOLUTION OR SALE OR OTHER DISPOSITION OF SUBSTANTIALLY ALL OF THE ASSETS OF THE HOSPITAL OR ANY OF ITS AFFILIATES; (8) CREATION OF ANY SUBSIDIARY OR AFFILIATED ENTITY, OR PARTICIPATION IN ANY JOINT VENTURE, PARTNERSHIP, LIMITED LIABILITY COMPANY OR SIMILAR ARRANGEMENT, BY THE HOSPITAL OR ITS AFFILIATES; (9) ANY CLOSURE OR OTHER SIGNIFICANT CHANGE TO CLINICAL SERVICE LINES PROVIDED BY THE FACILITIES OPERATED BY THE HOSPITAL OR ITS AFFILIATES;(10) APPOINTMENT OR REMOVAL OF THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER OR CHIEF NURSING OFFICER OF THE HOSPITAL; AND (11) ANY MANAGED CARE PAYOR CONTRACTING ON BEHALF OF THE HOSPITAL.
Form 990, Part VI, Line 11b Review of form 990 by governing body	PROCESS USED TO REVIEW 990 THE FINANCIAL INFORMATION IS PROVIDED BY VCUHS' FINANCE DEPARTMENT TO AN INDEPENDENT ACCOUTNING FIRM . THE FIRM PREPARES THE FORM 990 FOR REVIEW. THE FINANCE DEPARTMENT REVIEWS THE FORM 990 WITH THE APPROPRIATE EXECUTIVE DIRECTOR AND FINANCE LEADER OF THE ORGANIZATION. UPON FINAL REVIEW WITH LEADERSHIP, THE GOVERNING BODY OF THE ORGANIZATION IS PROVIDED WITH A COPY OF THE RETURN PRIOR TO FILING WITH THE IRS.
Form 990, Part VI, Line 12c Conflict of interest policy	VCU HEALTH SYSTEM (VCUHS) HAS A CONFLICT OF INTEREST POLICY THAT REQUIRES ANNUAL DISLCOSURE OF ACTUAL OR POTENTIAL CONFLICTS. THIS POLICY APPLIES TO BOARD MEMBERS/MANAGERS, DECISION-MAKING BOARD COMMITTEES AND OFFICERS ACROSS ALL RELATED ENTITIES. THE ANNUAL DISCLOSURE IS COMPLETED BY A LARGER GROUP OF INTERESTED PERSONS, INCLUDING BUT NOT LIMITED TO THOSE REPORTED ON INTERNAL REVENUE SERVICE (IRS) FORM 990. VCUHS IS REQUIRED TO PARTICIPATE IN THE COMMONWEALTH'S STATEMENT OF ECONOMIC INTEREST PROCESS (SOEI). VCUHS' PARTICIPATION IN THIS PROCESS IS MANDATED BY THE ENABLING LEGISLATION FOR VCUHS. PARTICIPATION IS REQUIRED FOR DIRECTORS AND ABOVE. ADDITIONALLY, EMPLOYEES ARE ENCOURAGED TO CONTACT THE COMPLIANCE HELPLINE IF THEY ARE AWARE OF ANY VIOLATIONS OF HEALTH SYSTEM POLICY OR HAVE ANY COMPLIANCE CONCERNS. ALL CONCERNS REPORTED VIA THIS VENUE ARE INVESTIGATED AND APPROPRIATE REMEDIATION IS IMPLEMENTED. WHEN A VOTING BOARD MEMBER HAS A CONFLICT, THE INDIVIDUAL IS PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS RELATED TO THE CONFLICTING TRANSACTION.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	FOR FISCAL YEAR ENDING JUNE 30, 2023, COMPENSATION (SALARIES AND INCENTIVES) FOR THE CEO, EXECUTIVE DIRECTOR OR THE TOP MANAGEMENT OFFICIAL OF THE FILING ORGANIZATION, IS APPROVED BY THE CEO OF THE HEALTH SYSTEM. THE ORGANIZATION USES A THIRD PARTY COMPENSATION CONSULTING FIRM TO CONDUCT A MARKET STUDY TO DETERMINE MARKET POSITION. THE ORGANIZATION MAY ALSO CONDUCT A 360 DEGREE EVALUATION OF ALL SENIOR LEVEL ADMINISTRATORS. THESE DATA ELEMENTS IN CONJUNCTION WITH A REVIEW OF THE INDIVIDUAL'S PERFORMANCE AND THE ATTAINMENT OF GOALS FOR THE YEAR, ARE THE BASIS FOR COMPENSATION RECOMMENDATIONS. THE COMPENSATION COMMITTEE OF THE VCUHS BOARD OF DIRECTORS DISCUSSES THE MATTER AND PRESENTS RECOMMENDATIONS TO THE CEO OF THE HEALTH SYSTEM.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	FOR FISCAL YEAR ENDING JUNE 30, 2023, COMPENSATION (SALARIES AND INCENTIVES) FOR THE CEO, EXECUTIVE DIRECTOR OR THE TOP MANAGEMENT OFFICIAL OF THE FILING ORGANIZATION, IS APPROVED BY THE CEO OF THE HEALTH SYSTEM. THE ORGANIZATION USES A THIRD PARTY COMPENSATION CONSULTING FIRM TO CONDUCT A MARKET STUDY TO DETERMINE MARKET POSITION. THE ORGANIZATION MAY ALSO CONDUCT A 360 DEGREE EVALUATION OF ALL SENIOR LEVEL ADMINISTRATORS. THESE DATA ELEMENTS IN CONJUNCTION WITH A REVIEW OF THE INDIVIDUAL'S PERFORMANCE AND THE ATTAINMENT OF GOALS FOR THE YEAR, ARE THE BASIS FOR COMPENSATION RECOMMENDATIONS. THE COMPENSATION COMMITTEE OF THE VCUHS BOARD OF DIRECTORS DISCUSSES THE MATTER AND PRESENTS RECOMMENDATIONS TO THE CEO OF THE HEALTH SYSTEM.
Form 990, Part VI, Line 19 Required documents available to the public	AVAILABILITY OF GOVERNING DOCUMENTS & POLICIES COMMUNITY MEMORIAL HOSPITAL'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Contracted Revenue - Total Revenue: 10968, Related or Exempt Function Revenue: 10968, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Other Misc Rev - Total Revenue: 39509, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 39509;
FORM 990	In the year ending June 30, 2024, the organization filed Form 8940 - Request for Miscellaneous Determination, requesting an exemption from filing the Form 990. Through it's relationship with VCU Health System Authority, a political subdivision of the State of Virginia, the application was approved. This return for year ending June 30, 2023 will be the final Form 990 filed and open for public disclosure.

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:	22016089
Software Version:	2022v5.0

- 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

Community Memorial Hospital

Employer identification number

54-0551711

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) CMH PHYSICIAN SERVICES LLC 1747 N MECKLENBURG AVE PO BOX 90 SOUTH HILL,VA23970 20-0999466	HEALTH PRACTICE	VA	21,942,792	76,342,748	CMH INC

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)COMMUNITY MEMORIAL HOSPITAL FOUNDATION - 1755 N MECKLENBERG AVE RICHMOND,VA23970 54-1831331	FUNDRAISING ORG	VA	501(c)(3)	Type I	CMH	Yes
(2)VCU HEALTH SYSTEM AUTHORITY PO BOX 980648 RICHMOND,VA23298 54-1848065	HOSPITAL	VA			NA		No
(3)VCU AMBULATORY SURGERY CENTER LLC 11958 WEST BROAD ST 5TH FLOOR HENRICO,VA23294 86-3310585	AMBULATORY SERVICES	VA	501(c)(3)	3	VCUHSA		No
(4)VCU HEALTH CHILDREN'S SERVICES AT BROOK ROAD 2924 BROOK ROAD RICHMOND,VA23220 54-0506309	PEDIATRIC SERVICES	VA	501(c)(3)	3	VCUHSA		No
(5)VIRGINIA COMMONWEALTH UNIVERSITY PO BOX 842512 RICHMOND,VA23284 54-6001758	EDU INSTITUTE	VA			NA		No
(6)UHS PROFESSIONAL EDUCATION PROGRAM - P O BOX 980048 RICHMOND,VA23298 54-1790553	EDU SEMINARS	VA	501(c)(3)	Type I	UHS		No
(7)MCV ASSOCIATED PHYSICIANS PO BOX 98062 RICHMOND,VA23298 54-1581185	HEALTHCARE	VA	501(c)(3)	Type I	VCUHSA		No
(8)7TH AND MARSHALL CORPORATION PO BOX 980152 RICHMOND,VA23298 31-1568886	SUPPORT ACTIVITY	VA	501(c)(3)	Type I	UHS		No
(9)UNIVERSITY HEALTH SERVICES INC PO BOX 980152 RICHMOND,VA23298 54-1790550	PROPERTY	VA	501(c)(3)	Type I	VCUHSA		No
(10)VCU HEALTH TAPPAHANNOCK HOSPITAL 618 HOSPITAL ROAD TAPPAHANNOCK,VA22560 54-1489410	HOSPITAL	VA	501(c)(3)	3	VCUHSA		No
(11)VIRGINIA CHILDREN'S CARE NETWORK LLC PO BOX 980152 RICHMOND,VA23298 85-1396091	CLINICAL CARE	VA	501(c)(3)	Type I	VCUHSA		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(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

Part IV

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

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

Schedule R (Form 990) 2021

Page 3

Part V

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

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

Yes

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

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

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

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

Yes

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

Yes

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

Yes

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

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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:	22016089
Software Version:	2022v5.0

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE EXCELLENCE IN THE DELIVERY OF HEALTHCARE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	1,470
6	Total number of volunteers (estimate if necessary) .............	6	11
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
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) .........	5,126,419	2,213,772
9	Program service revenue (Part VIII, line 2g) .........	122,569,010	144,504,957
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	754,438	1,681,907
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	173,513	568,239
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	128,623,380	148,968,875
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		1,000
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	74,339,620	77,384,380
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	99,298,339	111,720,629
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	173,637,959	189,106,009
19	Revenue less expenses. Subtract line 18 from line 12.......	-45,014,579	-40,137,134
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	428,867,466	582,687,715
21	Total liabilities (Part X, line 26).............	370,420,043	564,364,596
22	Net assets or fund balances. Subtract line 21 from line 20.....	58,447,423	18,323,119

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 120,437,470 including grants of $ ) (Revenue $ 109,808,577 )
	COMMUNITY MEMORIAL HOSPITAL (CMH) IS A VITAL COMPONENT OF THE SOUTHSIDE VIRGINIA AREA, PROVIDING QUALITY CARE TO OUR PATIENTS, SERVICING AS A VITAL PART OF THE SAFETY NET AND ENHANCING COMMUNITY HEALTH. OUR MISSION IS TO PROVIDE EXCELLENCE IN THE DELIVERY OF HEALTHCARE. WE ARE LED BY A VOLUNTEER 14 MEMBER BOARD OF DIRECTORS. CMH IS DESIGNATED AS A SOLE COMMUNITY HOSPITAL BY MEDICARE WHICH MEANS THAT WE ARE LOCATED IN A RURAL AREA AND 35 MILES FROM OTHER HOSPITALS. WE ARE ALSO DESIGNATED A DISPROPORTIONATE SHARE HOSPITAL BY MEDICARE WHICH MEANS THAT WE PROVIDE CARE TO A HIGHER LEVEL OF LOW-INCOME INDIVIDUALS. OUR PRIMARY SERVICE AREA OF MECKLENBURG COUNTY RANKS BELOW THE STATE AVERAGE IN PER CAPITA INCOME AND ABOVE THE STATE AVERAGE IN ESTIMATED TOTAL POPULATION IN POVERTY PERCENTAGE. WE OFFER A FULL SPECTRUM OF SERVICES TO THE COMMUNITY INCLUDING IN-PATIENT ACUTE CARE, POST-ACUTE, AND LONG-TERM CARE, OUT-PATIENT SERVICES, HOME HEALTH AND HOSPICE. OUR EMERGENCY DEPARTMENT SEES PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. WE OFFER FINANCIAL ASSISTANCE TO OUR UNINSURED PATIENTS. UNINSURED PATIENTS QUALIFYING WITH INCOME BELOW THE FEDERAL POVERTY LEVEL ARE OFFERED FREE CARE. UNINSURED PATIENTS WITH FAMILY INCOME UP TO 300% OF THE FEDERAL POVERTY LEVEL ARE OFFERED SLIDING SCALE DISCOUNTS. INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM IS POSTED ON OUR WEBSITE, POSTED IN ALL REGISTRATION WAITING AREAS, PROVIDED TO UNINSURED PATIENTS AT REGISTRATION AND INCLUDED AS A NOTE ON ALL STATEMENTS SENT TO UNINSURED PATIENTS. WE EMPLOY A FINANCIAL SPECIALIST WHOSE RESPONSIBILITY IS TO ASSIST UNINSURED PATIENTS WITH OUR FINANCIAL ASSISTANCE PROGRAMS AS WELL AS TO ASSIST THE PATIENTS WITH APPLYING AND QUALIFYING FOR OTHER COVERAGE SUCH AS DISABILITY OR MEDICAID. WITH THE HELP OF SEVERAL GRANTS, CMH HAS BEEN ABLE TO OFFER FREE MAMMOGRAMS AND BREAST EXAMS TO UNDERSERVED WOMEN IN THE AREA. AS THE GRANTS DO NOT COVER TOTAL PROGRAM EXPENSES, CMH MUST SUPPLEMENT THE COSTS TO PROVIDE THESE SERVICES TO THE COMMUNITY. AS A NOT FOR PROFIT ORGANIZATION, ANY SURPLUS FUNDS GO BACK INTO THE OPERATION OF THE HOSPITAL TO MAINTAIN THE FACILITY AND UPDATE EQUIPMENT AND TECHNOLOGY. CMH ALSO BELONGS TO AND SUPPORTS 8 CHAMBERS OF COMMERCE AND PARTICIPATES IN THEIR COMMUNITY EVENTS. OUR INVOLVEMENT HELPS SUPPORT COMMUNITY GROWTH AND WE SHARE MANY HEALTH RELATED EVENT NOTICES AT THESE MEETINGS. WE ALSO SUPPORT MANY OF THEIR SPECIAL EVENTS AND LOCATE WELLNESS AND SCREENING BOOTHS THERE HOSPITALS PLAY A CRITICAL ROLE IN THEIR COMMUNITY. AS MAJOR EMPLOYERS AND PURCHASERS, HOSPITALS ARE ENGINES OF ECONOMIC GROWTH AND STABILITY. A STRONG COMMUNITY HOSPITAL HELPS TO RECRUIT BUSINESS AND INDUSTRY TO THE AREA AND HELPS ATTRACT AND RETAIN COLLEGE GRADUATES AND SKILLED CRAFTSMEN. CMH IS THE LARGEST SINGLE EMPLOYER IN THE AREA PROVIDING JOBS AT A WIDE RANGE OF SKILL LEVELS FROM OVER 12 VIRGINIA AND NORTH CAROLINA LOCALITIES. CMH AND OUR EMPLOYEES PURCHASE GOODS AND SERVICES LOCALLY, CREATING INCOME AND JOBS FOR OTHER BUSINESSES IN THE COMMUNITY.BY PARTICIPATING ON THE TOWN REVITALIZATION COMMITTEE, CMH HAS BEEN ABLE TO PROVIDE SUPPORT TO EFFORTS TO MODERNIZE THE TOWN IN ORDER TO MAKE IT MORE ATTRACTIVE TO NEW BUSINESSES. BY PROVIDING JOBS IN THE REGION, RESIDENTS HAVE A BETTER OPPORTUNITY TO RECEIVE PREVENTATIVE CARE THROUGH THEIR HEALTH INSURANCE PROGRAMS. THE COMMUNITY IS ALSO INVESTED IN COMMUNITY MEMORIAL HOSPITAL. VOLUNTEERS ARE A VITAL PART OF OUR HEALTH CARE TEAM, GOVERNANCE AND FUNDRAISING. THE MEN AND WOMEN OF OUR AUXILIARY VOLUNTEER THOUSANDS OF HOURS EACH YEAR AND PROVIDE A WIDE RANGE OF SERVICES TO STRENGTHEN OUR HOSPITAL AND ENHANCE THE QUALITY OF CARE FOR PATIENTS AND FAMILIES. THE COMMUNITY ALSO SUPPORTS THE OPERATION OF CMH BY SUPPORT OF THE CMH FOUNDATION. THE CMH FOUNDATION IS ALSO LED BY A VOLUNTEER BOARD OF DIRECTORS AND AIMS TO RAISE FUNDS TO ALLOW OUR HOSPITAL TO OFFER THE BEST POSSIBLE CARE AND MAINTAIN STATE-OF-THE-ART FACILITIES AND TECHNOLOGIES TO BETTER SERVE OUR COMMUNITY.

4b	(Code: ) (Expenses $ 35,757,860 including grants of $ ) (Revenue $ 21,942,792 )
	CMH PHYSICIANS LLC: LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA, WE OPERATE THREE PRIMARY HEALTH PRACTICES THAT BRING NEEDED PRIMARY CARE SERVICES TO THE COMMUNITY. WE HAVE ALSO MADE THE DECISION TO OPERATE PRACTICES IN THE SPECIALTY AREAS OF CARDIOLOGY/PULMONARY SERVICES, EAR, NOSE & THROAT SERVICES, ORTHOPEDICS, PAIN MANAGEMENT, SURGICAL SERVICES, WOMEN'S HEALTH SERVICES, AND UROLOGY SERVICES AS THESE ARE SPECIALTY SERVICES OTHERWISE MIGHT NOT BE AVAILABLE FOR OUR COMMUNITY WITHOUT SIGNIFICANT TRAVEL. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS BUT RECRUITING TO A RURAL AREA COMES WITH MANY CHALLENGES.

4c	(Code: ) (Expenses $ 8,794,189 including grants of $ ) (Revenue $ 12,809,031 )
	THE HUNDLEY CENTER IS A 140 BED EXTENDED CARE FACILITY THAT PROVIDES INTERMEDIATE AND SKILLED NURSING CARE. OUR NURSING HOME IS PROUDLY ACCREDITED BY THE JOINT COMMISSION AND IS A MEDICARE AND MEDICAID CERTIFIED PROVIDER. TWENTY-FOUR HOUR NURSING CARE IS PROVIDED UNDER THE SUPERVISION OF PROFESSIONAL NURSES, AS WELL AS PHYSICIANS ON CALL AT ALL TIMES. FACILITY SERVICES INCLUDE NURSING CARE, PERSONAL CARE, SOCIAL WORK SERVICES, PLANNED ACTIVITY PROGRAMS, MAINTENANCE AND HOUSEKEEPING, PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY, DIETARY AND PHARMACY.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses164,989,519

(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)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) THOMAS YACKEL MD DIRECTOR (JULY-AUG)	1.0 .......................64.0	X			0	907,085	40,779
(19) SHELDON BARR PRESIDENT (DEC-JUNE)	40.0 .......................1.0		X		43,531	0	808
(20) W SCOTT BURNETTE PRESIDENT (JULY-DEC)	40.0 .......................1.0		X		401,607	0	43,108
(21) BRYAN MOSORA DO Physician	40.0 .......................0			X	565,524	0	40,145
(22) INDU SHIVARAM MD Physician	40.0 .......................0			X	542,628	0	35,257
(23) JOHN PEARSON MD Urologist	40.0 .......................0			X	631,602	0	39,451
(24) NIMESH PATEL MD Physician	40.0 .......................0			X	570,278	0	42,055
(25) RAVI EDARA MD Hospitalist Medical Director	40.0 .......................0			X	509,324	0	42,218

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,264,494	4,150,924	576,451

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	2,213,772
e	Government grants (contributions)		1e

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

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

h Total. Add lines 1a-1f.......		2,213,772

		Business Code
2a	NET PATIENT SRVC REV	622110	144,504,957	144,504,957
b
c
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		144,504,957

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,904,753			1,904,753
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		6,240	6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	6,240	6c
d	Net rental income or (loss).......			6,240			6,240
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	50,000		7a
b	Less: cost or other basis and sales expenses	272,846		7b
c	Gain or (loss)	-222,846	0	7c
d	Net gain or (loss).........			-222,846			-222,846
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	Rebates & Incentives		999999	371,353			371,353
b	GIFT SHOP		453220	95,694			95,694
c	PHARMACY		446110	44,475	44,475
d	All other revenue ....			50,477	10,968	0	39,509
e	Total. Add lines 11a–11d ......			561,999
12	Total revenue. See instructions.....			148,968,875	144,560,400	0	2,194,703

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,000	1,000
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	489,054	410,805	78,249
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	59,610,891	50,073,148	9,537,743
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,917,688	3,290,858	626,830
9	Other employee benefits .......	9,419,736	7,912,578	1,507,158
10	Payroll taxes ...........	3,947,011	3,315,489	631,522
11	Fees for services (non-employees):
a	Management ......	116,090		116,090
b	Legal .........	16,557		16,557
c	Accounting ...........	16,000		16,000
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	10,667,117	10,667,117	0	0
12	Advertising and promotion ....
13	Office expenses .......	635,043		635,043
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	2,187,407	1,837,422	349,985
17	Travel ............	111,766	93,883	17,883
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	2,202,787	1,850,341	352,446
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	5,169,730	4,342,573	827,157
23	Insurance ...	1,232,181	1,035,032	197,149
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	SHARED SERVICES ALLOCATION	25,460,523	21,386,839	4,073,684
b	MEDICAL SUPPLIES	21,979,095	21,979,095
c	Purchased Services	22,792,338	19,145,564	3,646,774
d	BAD DEBT EXPENSE	9,845,106	9,845,106
e	All other expenses	9,288,889	7,802,669	1,486,220	0
25	Total functional expenses. Add lines 1 through 24e	189,106,009	164,989,519	24,116,490	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			3,005	1	3,055
2	Savings and temporary cash investments .........			8,382,299	2	7,311,687
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			17,543,701	4	13,970,919
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 ...........				7
8	Inventories for sale or use ............			2,651,158	8	2,501,564
9	Prepaid expenses and deferred charges ......			170,470	9	218,482
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	178,968,609
b	Less: accumulated depreciation	10b	94,954,082	93,416,807	10c	84,014,527
11	Investments—publicly traded securities .			18,215,509	11	20,117,602
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			288,484,517	15	454,549,879
16	Total assets. Add lines 1 through 15 (must equal line 33)...			428,867,466	16	582,687,715

17	Accounts payable and accrued expenses .....	11,231,795	17	5,097,420
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	64,323,757	23	61,333,766
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	294,864,491	25	497,933,410
26	Total liabilities. Add lines 17 through 25..	370,420,043	26	564,364,596

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	58,447,423	27	18,323,119
28	Net assets with donor restrictions ...........		28
	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 ...........	58,447,423	32	18,323,119
33	Total liabilities and net assets/fund balances ........	428,867,466	33	582,687,715