2024-11-08T08:20:35-06:00 2023-12-31 346565596 ERNST & YOUNG US LLP 221 E 4th St Suite 2900 CINCINNATI OH 45202 990 2023-01-01 540620889 INOVA HEALTH CARE SERVICES INOV 5714728123 8095 INNOVATION PARK DRIVE FINANCE FAIRFAX VA 22031 RICK TALENTO Acting CFO 5714728123 2024-11-07 1 0 JULIE L SPARKS P01268401 5136121400 2023 2024-10-15 13:58:12Z See Schedule O J Stephen Jones MD 8095 INNOVATION PARK DRIVE FINANCE FAIRFAX VA 22031 5684015266 0 X INOVA.ORG X 1956 VA IHCS's mission is to maintain and operate hospitals that provide quality care to the community. 3 0 27723 1450 4004642 0 62827423 63321186 4799226260 5264468782 39828982 78470904 166447415 261075485 5068330080 5667336357 0 0 0 0 2650598243 2929059891 0 0 0 2302244263 2477888066 4952842506 5406947957 115487574 260388400 7072230197 7346820217 3096275089 3113147055 3975955108 4233673162 X IHCS was specifically chartered for the purpose of serving the health care needs of the community by establishing, maintaining, and operating hospital facilities, programs, and other shared service arrangements; carrying on health-related education activities; promoting and carrying on health-related scientific research; and engaging in activities designed and carried on to promote the general health of the community. IHCS includes a centralized System Office and the various unincorporated and incorporated subsidiaries which are described below.The unincorporated divisions of IHCS include: Inova Fairfax Hospital, Inova Mount Vernon Hospital, Inova Fair Oaks Hospital, Inova Alexandria Hospital, ACCESS of Reston, ACCESS of Fairfax, Inova Research Center, Assisted Living Facilities, Inova Physical Rehabilitation Services, Inova Urgent Care Centers, Inova Employee Assistance, and Behavioral Health and Addiction Treatment. 0 0 4514850743 5483785751 Inova Health Care Services (IHCS) is part of the Inova Health System whose mission is to serve the needs of the community by establishing, maintaining, and operating hospital facilities, programs, and other shared service arrangements; carrying on health-related education activities; promoting and conducting scientific research; and engaging in activities designed to promote the general health of the community. Three out of five of Inova Health System's hospitals have been rated with 5 out of 5 stars in the most recent Centers for Medicare & Medicaid Services (CMS) Five-Star Quality Rating System report. A CMS five-star quality rating is based on extensive data that measures patient experience, infection rates, readmissions and mortality.IHCS includes a centralized System Office and the various unincorporated and incorporated subsidiaries. The unincorporated subsidiaries of IHCS include: Inova Fairfax Hospital, Inova Mount Vernon Hospital, Inova Fair Oaks Hospital, Inova Alexandria Hospital, Inova Loudoun Hospital, ACCESS of Reston, ACCESS of Fairfax, Inova Research Center, Assisted Living Facilities, Inova Physical Rehabilitation Services, Inova Urgent Care Centers, Inova Employee Assistance, and Behavioral Health and Addiction Treatment.PROGRAM SERVICESAcute care services are provided on three campuses in Fairfax County, one campus in Loudoun County, and one campus in the City of Alexandria in Virginia. Services provided include emergency and trauma facilities, inpatient and outpatient services, and a variety of ancillary and specialized services. During 2023, IHCS admissions and observations cases totaled 115,049, outpatient visits totaled 684,378, emergency visits totaled 382,533 (29,626 of the total ER visits were at the Springfield Healthplex, 22,622 at the Lorton Healthplex, and 16,480 at the Ashburn Healthplex) and deliveries totaled 16,084. The acute care program services provided by these hospitals are described more fully below. Inova Fairfax Hospital (IFH) includes the Inova Schar Heart and Vascular, Inova Women's Hospital, Inova Fairfax Hospital for Children, and the Inova Schar Cancer Institute. The hospital, located in Central Fairfax County is a 928-licensed bed tertiary care hospital providing comprehensive medical and surgical services which include emergency/trauma, cardiac, transplant, cancer, obstetric, pediatric, neonatal, stroke, and extensive outpatient services. During 2020, as part of the "Pandemic Response Executive Order 52", IFH shifted 20 beds from IFH to Inova Loudoun Hospital (ILH). During 2023, IFH had an additional 115 beds in service in response to COVID-19 cases. Inova Fairfax Hospital is the home of Northern Virginia's only Level 1 emergency and trauma center and the state-of-the-art Women's and Children's Center. In addition, Inova Fairfax Hospital is a teaching hospital providing clinical training through medical residency, nursing, and paramedical education programs.Inova Mount Vernon Hospital (IMVH) is a 225 licensed bed acute-care hospital serving Southeastern Fairfax County. Inova Mount Vernon Hospital provides a full-service, 24-hour emergency department; broad range of diagnostic, medical, and surgical services; inpatient psychiatric services; the Dorothea R. Fischer Wound Healing Center, and a specialized hyperbaric oxygen therapy program used to treat conditions requiring increased oxygen flow to body tissues (such as grafts and certain types of burns). Inova Mount Vernon Hospital also operates the Lorton Healthplex, a 24-hour free standing emergency facility and the Inova Center for Rehabilitation, a nationally-known accredited program providing inpatient and outpatient rehabilitative services.Inova Fair Oaks Hospital (IFOH) is a top-ranked 174-bed acute care community hospital serving the rapidly growing suburbs of Northern Virginia. Signature service lines include spine, weight loss, joint replacement, and minimally invasive surgery. During 2020, as part of the "Pandemic Response Executive Order 52", IFOH shifted 8 beds from IFOH to ILH. State-of-the-art cancer care and maternity services are also signature offerings. Inova Fair Oaks Hospital is a fully accredited Comprehensive Center for Bariatric Surgery. Inova Alexandria Hospital (IAH) is a 302-licensed bed general acute care hospital, which opened on January 23, 1873. Inova Alexandria Hospital provides a spectrum of diagnostic services, including full-body CT scanning, MRI, and a cardiac catheterization laboratory; a variety of inpatient medical, surgical, and orthopedic services; comprehensive outpatient services, including outpatient surgery, physical medicine, and rehabilitation; and a 24-hour emergency department as well as the Springfield Healthplex, a free standing emergency facility. In addition, specialized obstetric and pediatric services are provided by the hospital's Maternal and Infant Health Center and a children's unit. Inova Loudoun Hospital (ILH) is a 211-licensed bed general acute care hospital, which first opened its doors in 1912. During 2020, as part of the "Pandemic Response Executive Order 52", ILH received 20 beds from IFH and 8 beds from IFOH. These were added to bring the total licensed-beds from 183 to 211. ILH is a Level 3 trauma center and provides a full-service 24-hour emergency department as well as two freestanding emergency rooms; 23 intensive care beds; a spectrum of diagnostic services, including full-body CT scanning, MRI, and a cardiac catheterization laboratory; a variety of inpatient medical, surgical, and orthopedic services, and comprehensive outpatient services including outpatient surgery, physical medicine and rehabilitation services, and radiation therapy. In addition, obstetrical and pediatric services are provided by ILH's Ladies' Board Birthing Inn, a pediatric emergency department and an inpatient pediatric unit. Specific acute care programs include:Cardiovascular CareInova Schar Heart and Vascular ("ISHV") offers a variety of services at all five Inova hospitals and over 50 outpatient locations throughout the Northern Virginia region. Inova Fairfax Hospital is home to ISHV's dedicated heart hospital, which serves as the hub of the system's cardiac, vascular, and pulmonary services. ISHV's clinical capabilities cover the full spectrum of complex cardiovascular and pulmonary care from medical evaluation and diagnostic testing through the most innovative minimally invasive surgical techniques and complex open surgeries, including heart and lung transplantation. ISHV's outstanding performance has been recognized by many measures, including U.S. News & World Report (2023-2024) rankings as "High Performing" in seven cardiac specialties: abdominal aortic aneurysm (AAA) repair, aortic valve surgery, heart attack, heart bypass surgery, heart failure and transcatheter aortic valve replacement (TAVR). ISHV has also achieved recognition from the American College of Cardiology as a "Proven Quality Program" for its participation and performance in the National Cardiovascular Data Registry (NCDR) database, 3-star ratings (the highest rating) from the Society of Thoracic Surgeons, and ratings from Healthgrades as one of "America's 100 Best Hospitals for Cardiac Care", "America's 50 Best Hospitals for Cardiac Surgery and "Pulmonary Care Excellence Award". The AHA recognized ISHV as a Mitral Valve Repair Reference Center Award and Extracorporeal Life Support Organization (ELSO) awarded ISHV as a Platinum Award of Excellence. ISHV is ranked among the nation's top performing hospitals for patient safety, patient satisfaction, and clinical outcomes.ISHV is also a leader in minimally invasive heart valve repair and surgery. Inova Schar Heart and Vascular operates one of the country's busiest structural heart programs in the country, performing minimally invasive transcatheter procedures to treat valvular heart disease and other heart defects. Additionally, ISHV is amongst the top programs in the nation for total number of Heart Transplants, with excellent outcomes, making Inova one of the top heart transplant programs in the country. The ISHV multidisciplinary cardiogenic shock team is a model of excellence having set a new standard for patient survival rates. The robust Cardiology and Advanced Lung Research Programs provide innovative research to keep ISHV on the leading edge of diagnosis and treatment options for the community.The Inova Heart & Vascular Institute had over 753,287 patient encounters in 2023 at its five hospitals, 50+ ambulatory offices, and 20 non-invasive cardiovascular imaging and diagnostic service locations. 38735438 28641316 Inova Research Center - Medical Students The Inova Research Center (IRC), including research and academic activities, is centered at Inova Fairfax Hospital. In 2023, The Inova Campus of the University of Virginia had a total of 47 third year and 36 fourth year medical students who spent their clerkship and fourth year at Inova Fairfax Hospital. In addition, 273 students came to Inova Hospitals for a four-week rotation in 2023.Pharmacy Students and ResidentsAlso located on the Inova Campus is the VCU School of Pharmacy which partners with clinicians and practitioners across Inova and Northern Virginia to help educate and train numerous pharmacy students each year. In 2023, 53 third and fourth year pharmacy students completed didactic and experiential learning experiences across Northern Virginia with the Inova Health System. Pharmacy practitioners precepted 93 Introductory Pharmacy Practice Experiences (IPPEs) and Advanced Pharmacy Practice Experiences (APPEs) for VCU School of Pharmacy students. Shenandoah School of Pharmacy opened a campus at the Inova Center for Personalized Health (ICPH) in 2017. During 2023, Inova pharmacy practitioners and Shenandoah faculty collectively precepted 10 IPPE's and 62 APPE's.Additionally, Inova has a total of 12 pharmacy post-graduate training opportunities offered across 4 locations. Inova Fairfax Hospital (IFH): 4 PGY-1 Pharmacy Practice Residency 1 PGY-2 Emergency Medicine Pharmacy Practice Residency 0 PGY-2 Critical Care Pharmacy Practice Residency - one-year pause in 2023 Inova Alexandria Hospital (IAH): 2 PGY-1 Pharmacy Practice Residency Inova Mount Vernon Hospital (IMVH): 2 PGY-1 Pharmacy Practice Residency Inova Health System: 1 PGY-2 Ambulatory Care Pharmacy Practice Residency 2 PGY-1 Community Pharmacy Residency 1 PGY-2 Medication-use Safety ResidencyThe Claude Moore Health Education CenterThe Claude Moore Health Education Center on the campus of Inova Fairfax Hospital features 11,000 square feet of space dedicated to the educational needs of medical and nursing students as well as residents and fellows. This state-of-the-art Center includes both medical and surgical simulation centers, enabling students to learn through hands-on experience. The Center features two dedicated research floors to support the extensive activities of the Office of Research at Inova where numerous active clinical trials and ongoing outcomes and laboratory research projects are conducted. Many of these clinical and research opportunities are conducted in partnership with universities and other research entities. The unreimbursed cost of these programs in 2023 was $10.1 million. Residents/FellowsInova sponsors accredited residency training programs in: Family Medicine, Pediatrics, General Surgery, Internal Medicine, OB/GYN, Neurosurgery and Podiatry. In addition, Inova also sponsors accredited fellowships in Surgical Critical Care, Pediatric Emergency Medicine, Pediatric Hospitalist Medicine, Cardiology, Hematology/Oncology, Orthopedic Sports Medicine, Family Sports Medicine, Breast Surgery, Maternal Fetal Medicine and Bariatric surgery. Inova supports training programs from affiliates in Emergency Medicine, Psychiatry, Orthopedics, Ophthalmology, Family Practice, Critical Care, Anesthesia, PM&R and a number of other medical and surgical specialties. Inova also supports integrated fellowships with National Capital Consortium in Vascular Surgery, Female Pelvic Medicine and Reconstructive Surgery, and Gynecology/Oncology. In all, Inova trained 732 individual residents/fellows (271 FTEs) from 34 specialties in 2023. As a teaching facility, Inova Fairfax Hospital incurs typical, additional expenses associated with teaching facilities including physician teaching costs and resident salaries, the cost of maintaining higher levels of technology required to support a teaching program and charges resulting from extra tests ordered for instructional purposes. The direct cost of these programs in 2023 was approximately $21.9 million. Each year, IHCS designates funds for the development and continuation of identified, accessible direct care programs and services benefiting those most in need in the community. Many of these programs and services are not billed to the patient or are provided at a fee structure below the actual cost of the service. In addition to providing the direct care subsidized service, Inova also provides disease-prevention programs, health and exercise classes, health education and health screenings and other programs within the community in support of the IHCS mission. In 2023, Inova provided over 250,000 people with health education, prevention and wellness programs, health fairs and screenings, and clinically related services resulting in over 130,000 visits for direct health care services at an unreimbursed cost of approximately $43.0 million. These services and programs are described below. Inova Cares for Women and ChildrenThe Inova Cares for Women (ICW) was created in 1960. Inova serves the under and uninsured women in Northern Virginia, offering a wide range of OB/GYN services for those in need. This program is a service offered to the community in collaboration with the local Health Departments, serving uninsured and low-income patients up to 400% of the Federal Poverty Guidelines (FPG). The clinics work in partnership with the Alexandria City, Fairfax and Loudoun County Health Departments, IFH, and ILH to promote early and continuous prenatal care for the culturally diverse population who are its patients. Inova Cares for Women provides comprehensive outpatient obstetrical services and gynecological care as well as non-stress testing, and LEEP and colposcopy procedures at little to no cost to the patient. The clinic provides specialty gynecological care services as well, including maternal fetal medicine, GYN/Onc and Uro/GYN. In addition to medical services, the clinic provides support services including radiology, laboratory, genetic testing, diabetes management, case management, behavioral health, family planning, and nutritional counseling. In 2023, ICW provided over 39,941 patient encounters for over 6,123 patients. Additionally, ICW supported over 2,024 deliveries at Inova medical campuses. The Inova Cares for Children (ICC) was created in 1993 as a response to the inability of uninsured or Medicaid mothers to secure an affordable medical home for their children. ICC is recognized as an accredited Patient Centered Medical Home by the National Committee for Quality Assurance, and serves as a medical home for newborns up to 21 years of age. The Inova Cares for Children provides comprehensive pediatric services that includes well-child care, immunizations, episodic care (sick visits), and school/sports physicals, immunizations, and nutritional counseling. There are 7 locations, including a new same day walk in sick clinic that is newly established. In 2023, the Inova Cares for Children provided 28,953 clinical services to over 9,985 patients.Inova Alexandria Hospital (IAH) OB ClinicIAH donates space on the campus to the Casey Clinic, a community health center currently run by Neighborhood Health, a Federally Qualified Health Center that is funded by the State of Virginia, Alexandria Health Department and the City Of Alexandria to provide primary healthcare services to low-income and uninsured children and adults that are residents of the City of Alexandria. IAH funds the clinic physicians who provide OB patient prenatal examinations and delivery at Inova Alexandria Hospital. Inova Juniper Program, HIV Clinical and Education ServicesInova Juniper Program (IJP) provides outpatient primary medical care, mental health therapy, substance abuse counseling, pharmaceutical assistance, and medical and social case management services to 1,737 Ryan White funded persons living with HIV disease in the suburban Virginia region. To maximize accessibility for clients, services are provided at the main location in Fairfax, as well as five satellite clinics (Dumfries, Manassas, newly expanded Mt. Vernon, Leesburg, and Herndon), hospitals, homes, and other community locations throughout the region. Major accomplishments of IJP for 2023 include:Served 1,759 patients living with HIV, providing 14,230 services.Provided 1,498 medical and social case management services to 744 Ryan White funded clients living with HIV. Provided 175 clients with mental health services and substance use outpatient care.Conducted 140 hours of education reaching 788 participants.Conducted 532 HIV tests, with known seroprevalence of 1.9% across Northern Virginia.Provided both in-person and virtual prevention and education programs to support, motivate and educate healthcare professionals, the public, and people living with HIV. Programs are geared to incarcerated men and women, men who have sex with men, youth, and the general population. HIV testing, outreach groups and patient navigation services are also provided.Inova Pride ClinicIn 2022, Inova Pride Clinic opened as the first LGBTQ+ focused primary care medical home in Northern Virginia. For patients 12 years and older, services provided include preventive services, healthcare screenings, chronic care and behavioral health services. In 2023, the Inova Pride Clinic served 836 unique patients, with a total of 3,821 encounters.Inova Cares for Behavioral Health Inova Cares for Behavioral Health provides mental health counseling services for adults. The practice serves patients 18 and older who are approved or eligible for Inova financial assistance program or covered by Virginia Medicaid plans. The purpose of the program is to provide therapeutic support to those experiencing mild to moderate mental health conditions in an effort to reduce unwanted symptoms and improve wellbeing. In 2023, the Inova Cares for Behavioral Health provided mental health services to over 167 patients with over 860 visit encounters. Life with Cancer Life with Cancer, part of the Inova Dwight and Martha Schar Cancer Institute, has become Northern Virginia's premier cancer education, wellness, and psychosocial support organization. A variety of integrative therapies, wellness programs, groups and classes are offered to patients (adults and children), survivors, family members (adults and children), friends and staff as well as community organizations. Programs are evidence-based [supported by Society of Integrative Oncology (SIO), The American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN)] and designed to help individuals and the community understand cancer, cancer treatments, survivorship, grief and bereavement and how to maintain physical and psychological health. Life with Cancer's facilities are strategically located throughout the Northern Virginia area with the centerpiece of outpatient care provided at the Life with Cancer Family Center, adjacent to Inova Fairfax Hospital. At all Inova Schar Cancer Institute (ISCI) locations, Life with Cancer clinical staff are fully integrated into the multidisciplinary care teams through a disease-based model that ensures the best patient experience possible. Life with Cancer is primarily supported by generous donations from the community, and therefore, all services are available at no charge with minimal exceptions, no matter where the patient's cancer treatment is received. Those exceptions include psychiatry, which is billed to insurance, and oncology massage and acupuncture, for which patients may pay for additional sessions beyond what is offered for free. In 2023, philanthropic funds allowed Life with Cancer to offer three free oncology massage sessions and six free acupuncture sessions to Inova cancer patients.By the close of 2023, Life with Cancer had provided 32,017 clinical patient encounters, in-person and via telehealth, which included 2,144 educational classes, groups and wellness programs for adults, children and adolescents with 29,192 participants. 16,308 individuals participated in exercise/activity programs and Life with Cancer dietitians provided 9,644 nutrition counseling appointments to adults and children with cancer as well as caregivers. The Pediatric Program provided the highest quality pediatric care, education, and support for patients and families through more than 2,923 clinical encounters. Life with Cancer psychiatrist, who provides whole-person, humanistic and patient-centered care conducted 1,409 patient consultations. 4553586181 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 X 1561 0 1 27723 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 3 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X Inova Health Care Services 5714728123 8095 Innovation Park Drive Finance Fairfax VA 22031 J STEPHEN JONES MD PRESIDENT/CEO 35.00 15.00 X X 5480396 0 70495 JOHN GAUL SECRETARY 35.00 15.00 X X 1217563 0 256021 ALICE POPE TREASURER-CFO 35.00 15.00 X X 1619969 0 301898 STEPHEN MOTEW CHIEF CLINICAL ENTERPRISE 40.00 0.00 X 1841518 0 344270 JOHN MOYNIHAN PRESIDENT SURGICAL SERVICE 40.00 0.00 X 1317222 0 91777 ANUJ NARANG PRESIDENT IFMC & PEDIATRIC SERVICE 40.00 0.00 X 1379053 0 307996 NILESH VYAS DIVISION CHIEF 40.00 0.00 X 1459225 0 93320 ZOBAIR YOUNOSSI PRESIDENT INOVA MEDICINE 40.00 0.00 X 1258858 0 92480 HARVEY MCDUFFIE SVP PRESIDENT INOVA REALTY 40.00 0.00 X 1082426 0 71974 SUSAN CARROLL PRESIDENT ILH 40.00 10.00 X 965090 0 211214 TERRI FEELY CHIEF PEOPLE OFFICER IHS 40.00 10.00 X 1215529 0 287161 TONI ARDABELL CHIEF CLINICAL ENTERPRISE OPERATIONS 40.00 0.00 X 1776758 0 71876 DAVID QUIRKE EVP CIO 40.00 0.00 X 1379187 0 6847 JAMES ECKLUND PRESIDENT NEUROSCIENCES 40.00 0.00 X 2749469 0 97545 JOHN HAMILTON PHYSICIAN 40.00 0.00 X 2145419 0 102021 CHRISTOPHER O'CONNOR PRESIDENT IHVI 40.00 0.00 X 1758228 0 57302 JAMES ST LOUIS PHYSICIAN 40.00 0.00 X 1799324 0 74171 ROBIN WEST PRESIDENT MUSCULOSKETETAL 40.00 0.00 X 1805775 0 80465 CHRISTOPHER CHIANTELLA FORMER CHIEF MEDICAL OFFICER 40.00 0.00 X 540706 0 89727 32791715 0 2708560 6650 1 1 0 RANDSTAD HEALTHCARE PO BOX 742689 ATLANTA GA 30374 STAFFING 105200644 DNR CONSTRUCTION 11109 SUNSET HILLS RD 200 RESTON VA 20190 CONSTRUCTION 43194424 NORTHSTAR ANESTHESIA OF VIRGINIA 6225 N STATE HWY 161 200 IRVING TX 75038 MEDICAL SERVICES 31809405 HITT CONTRACTING INC 2900 FAIRVIEW PARK DRIVE FALLS CHURCH VA 22042 CONSTRUCTION 31608019 THE BALLINGER COMPANY 833 CHESTNUT ST SUITE 1400 PHILADELPHIA PA 19107 CONSTRUCTION 29872703 646 33219817 30101369 63321186 Net Patient Service Revenue 622110 5220267588 5220267588 Inova Loudoun Ambulatory Surgery 621400 12108527 12108527 FAIRFAX RADIOLOGY CENTERS LLC 621400 7826297 7826297 Franconia-Springfield Surgery Ctr 621400 6085840 6085840 Northern Virginia Surgery Center 621400 5875236 5875236 12305294 12305294 5264468782 71802546 -17918 71820464 242000 242000 24936299 1569112 15841659 837250 9094640 731862 9826502 731862 9094640 6426358 0 6426358 6426358 6426358 OTHER OPERATING REVENUE 900099 241926171 238635473 3290698 COMMUNITY BLOOD SERVICES 900099 9322812 9322812 251248983 5667336357 5512427067 4004642 87583462 21992794 21992794 2443912490 2054394225 389518265 99273102 70772645 28500457 222964509 171121060 51843449 140916996 114318768 26598228 6819931 2450504 4369427 1826130 92762 1733368 226339 226339 428374813 419737764 8637049 32512989 2534642 29978347 53613472 37232396 16381076 95586749 7802748 87784001 95150880 88306260 6844620 13514588 9163165 4351423 3069482 2165183 904299 71921979 403133 71518846 317618518 259694850 57923668 27736586 18845753 8890833 MEDICAL SUPPLIES 501269914 500892329 377585 PHARMACEUTICALS 374162330 371673212 2489118 OTHER PURCHASED SERVICE 345480003 290762286 54717717 BAD DEBT 109003363 109003363 5406947957 4553586181 853361776 0 628668848 678428558 484340467 504806455 110487349 124709670 43424560 47458313 116311649 143163495 6471418708 3580244754 2674415514 2891173954 76092067 75839885 87917991 137357329 17446073 14623352 2833125679 2729259206 7072230197 7346820217 583510025 604779858 19495989 22175872 2090109702 2134520670 108537074 8085812 294622299 343584843 3096275089 3113147055 X 3953130264 4231613707 22824844 2059455 3975955108 4233673162 7072230197 7346820217 X 260388400 5430630 -8100976 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 226339 226339 4553359842 4553586181 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 454768 230785 247417 226339 1159309 250000 250000 250000 250000 1000000 1500000 408104453 408104453 3630780269 1972778177 1658002092 2061994208 1607466577 454527631 370539778 370539778 2891173954 INTEREST RATE SWAP AND OTHER LONG TERM ASSETS 85820133 DUE FROM SUBSIDIARIES AND AFFILIATES 2349097949 LONG TERM RIGHT OF USE 207791249 EQUITY INVESTMENTS 86549875 2729259206 THIRD PARTY SETTLEMENTS 68603580 SELF INSURED LIABILITY 40560318 INTEREST RATE SWAP LIABILITY 838406 LEASE LIABILITY 233582539 343584843 X Part X, Line 2: From Inova Health System Foundation consolidated financial statements including Inova Health Care Services: The Foundation and IHCS are not-for-profit corporations and have been determined to be exempt from federal income tax under the provisions of section 501(c)(3) of the Internal Revenue Code. Therefore, these entities will not incur any liability for federal income tax, except for possible unrelated business income. Inova Holdings Inc. and its subsidiaries are taxable organizations. Deferred income taxes are provided for all significant timing differences between revenues and expenses reported for financial statement and for tax purposes. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the consolidated financial statements. Accounting principles generally accepted in the United States require management to evaluate uncertain tax positions taken by IHS. The financial statement effects of a tax position are recognized when the position is more likely than not, based on the technical merits, to be sustained upon examination by the Internal Revenue Service. Management has concluded that as of December 31, 2023 and 2022, there are no uncertain positions taken or expected to be taken. IHS has recognized no interest or penalties related to uncertain tax positions. IHS is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. Management believes that IHS is no longer subject to income tax examinations for years prior to 2019. 1 1 X 1 X 400.000000000000 1 X 1 1 0 1 1 103138514 103138514 0.01950 511905876 304915931 206989945 0.03910 615044390 304915931 310128459 0.05860 14023856 214424 13809432 0.00260 23429664 1503310 21926354 0.00410 33979114 8058843 25920271 0.00490 38773421 28641316 10132105 0.00190 3477077 3477077 0.00070 113683132 38417893 75265239 0.01420 728727522 343333824 385393698 0.07280 1 42347807 0 657673526 859229370 -201555844 X 1 1 1 Franconia-Springfield Surgery Center LLC Surgical Services 0.60250 0.39750 2 Northern Virginia Surgery Center LLC Surgical Services 0.63650 0.36350 3 Inova Ambulatory Surgery Center at Lorton LLC Surgical Services 0.65080 0.34920 4 McLean Ambulatory Surgery LLC Surgical Services 0.55000 0.45000 5 Inova Loudoun Ambulatory Surgery Center LLC Surgical Services 0.56970 0.43030 10 1 INOVA FAIRFAX HOSPITAL 3300 GALLOWS ROAD FALLS CHURCH VA 22046 INOVA.ORG VA H1921 X X X X X X A 2 INOVA ALEXANDRIA HOSPITAL 4320 SEMINARY ROAD ALEXANDRIA VA 22304 INOVA.ORG VA H1859 X X X A 3 INOVA LOUDOUN HOSPITAL 44035 RIVERSIDE PARKWAY LEESBURG VA 20176 INOVA.ORG VA H1868 X X X A 4 INOVA FAIR OAKS HOSPITAL 3600 JOSEPH SIEWICK DRIVE FAIRFAX VA 22033 INOVA.ORG VA H1922 X X X A 5 INOVA MOUNT VERNON HOSPITAL 2501 PARKER LANE ALEXANDRIA VA 22306 INOVA.ORG VA H1923 X X X A 6 INOVA LOUDOUN AMBULATORY SURGERY CENTER LLC 44035 RIVERSIDE PARKWAY 200 LEESBURG VA 20176 INOVA.ORG OH728 X X A 7 NORTHERN VIRGINIA SURGERY CENTER LLC 3620 JOSEPH SIEWICK DRIVE 202 FAIRFAX VA 22033 INOVA.ORG OH716 X X A 8 FRANCONIA-SPRINGFIELD SURGERY CENTER LLC 6355 WALKER LANE 200 ALEXANDRIA VA 22310 INOVA.ORG OH655 X X A 9 MCLEAN AMBULATORY SURGERY CENTER LLC 7601 LEWINSVILLE ROAD 440 MCLEAN VA 22102 INOVA.ORG OH728 X X A 10 INOVA AMBULATORY SURGERY CENTER AT LORTON LLC 9321 SANGER STREET 200 LORTON VA 22079 INOVA.ORG OH725 X X A Facility Reporting Group - A 0 0 1 X X X X X X X X X 22 1 1 0 1 X See Part VI X 1 22 1 See Part VI 0 1 X 400.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X https://www.inova.org/patient-and-visitor-information/financial-assistance X https://www.inova.org/patient-and-visitor-information/financial-assistance X https://www.inova.org/patient-and-visitor-information/financial-assistance X X X X X X X 1 X 0 X X X X 1 X 0 0 Part V, Section A: The surgery centers listed as hospital facilities 6-10 in Part V, Section A are part of the hospital facilities' CHNAs already conducted and have followed the hospital facilities' financial assistance policy. The surgery centers are reported specifically in the hospital facilities' CHNAs and are listed as hospital facilities in Part V, Section A. Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: INOVA FAIRFAX HOSPITAL, - Facility 2: INOVA ALEXANDRIA HOSPITAL, - Facility 3: INOVA LOUDOUN HOSPITAL, - Facility 4: INOVA FAIR OAKS HOSPITAL, - Facility 5: INOVA MOUNT VERNON HOSPITAL, - Facility 6: INOVA LOUDOUN AMBULATORY SURGERY CENTER LLC, - Facility 7: NORTHERN VIRGINIA SURGERY CENTER LLC, - Facility 8: FRANCONIA-SPRINGFIELD SURGERY CENTER LLC, - Facility 9: MCLEAN AMBULATORY SURGERY CENTER LLC, - Facility 10: INOVA AMBULATORY SURGERY CENTER AT LORTON LLC Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 3j: Question 3eInova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) completed a Community Health Needs Assessment (CHNA) in 2022 and found that numerous health status and access problems are present in the community. Five areas were identified as the most significant health needs for the IFH community: Chronic Conditions; Economic Stability; Healthcare Access; Mental Health; and Neighborhood, Community and Environment. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2022 through 2025. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, IFH-IMASC has identified as its community benefit priorities Healthcare Access, Mental Health and Economic Stability. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board. Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 5: For Inova Fairfax Hospital :While a regional approach guided the CHNA, each jurisdiction used its own process for community outreach and engagement. As much as possible, the process centered on existing resources, partnerships, and local needs and values. This method ensures that any new initiatives accurately reflect community priorities. Inova and the Health Equity Community Action Committee planned and produced the Fairfax assessment together. Each member of the team contributed to the assessment in different ways, utilizing individual strengths. As a part of the collaborative process leading this assessment, input was received from diverse sources including the local health department, hospital staff, representatives of key community groups and individual community members.This 2022 Community Health Needs Assessment (CHNA) process gathered community input through two of the three main assessments - Forces of Change discussions and the Community Themes and Strengths Assessment survey.Forces of Change discussions bring together individuals working in and with the community, who represent a broad diversity of stakeholders. Participants included individuals with special knowledge of or expertise in public health; local public health departments; agencies with current data or information about the health and social needs of the community; representatives of social service organizations; business leaders, and leaders, representatives, and members of medically underserved, low income, and minority populations. Inova representatives conducted Forces of Change sessions with the local Health Departments, the local Federally Qualified Health Centers, elected officials, the County Health Care Advisory Board, the Partnership for Healthier Fairfax, Regional Faith Based Leaders and the local Health Equity Action Committee.Inova and the Health Equity Community Action Committee members promoted the community survey to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese (Mandarin), English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics and were distributed and collected by Community Health Workers. Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 6a: Inova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) Inova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center at Lorton (IASCL) Inova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC) Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 11: A Community Health Needs Assessment (CHNA) was conducted in 2022 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those priorities. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One aim of the Implementation Strategy is to guide Inova's community benefit activities for the period of 2023-2025. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, rather than select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community partners to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Based on the CHNA process, three priority areas were chosen for the 2023-2025 Implementation Strategy: healthcare access, economic stability and behavioral health.Update - Year OneImplementation StructureMembers of the Community Health and Health Equity Division, Inova leadership, the Fairfax County Health Department, and community partners have been working diligently on the priority areas set forth in the 2022 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, including the COVID-19 pandemic, Inova's Implementation Strategy includes the lenses of health equity, antiracism and social drivers of health. A structure was implemented in 2020 whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the local Fairfax Health Equity Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Health Equity Steering Committee meets monthly to create and drive strategy for the system, and the local committees are responsible for bringing together representatives from multiple Inova departments, faith-based organizations, mental health stakeholders, community partners including but not limited to Neighborhood Health (Federally Qualified Health Center/FQHC), George Mason University, Capital City Nurses, Northern Virginia Family Services, Shepherd's Center, Adams Center, Liberty's Promise, Stronger2, Fairfax County local government teams (Health Department, Community Services Board, Neighborhood and Community Services, and Fairfax County Public Schools) and community members who reside in Fairfax neighborhoods.This year, some of the implementation strategy projects that address the top three health issues were aligning the use of community health workers through the Northern Virginia Community Health Access Forum, promoting the use of Unite Us as a hub for resources and active referrals and providing experiential opportunities to youth to diversify and expand the healthcare workforce. Inova in the CommunityLocal action committee conversations in Fairfax and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to continue to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova, guided by our Community Health Workers, works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Fairfax, this included participating in events with the public schools, houses of worship, partner organizations and local colleges. Inova team members provide education, navigation and screening opportunities in a variety of these settings, such as Capital City Nurses' Older Adult Resource Fair, Health Literacy Fairs led by Alpha Kappa Alpha Sorority, the Juneteenth Celebration in Fairfax City, and Summers in Seven Corners.Creating a Diverse WorkforceInova's health equity-based workforce development initiative, Dream B!G, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives under-invited youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos, share their work-life experiences and invite students to visit the healthcare setting. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, the Inova Community Health and Health Equity team partnered with Inova Talent Acquisition to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. In December 2023, 100 Fairfax County Public School students, grades 10-12, attended a Dream B!G event at Inova Fairfax Hospital. They toured and visited with team members in the Advanced Surgical Technology and Education Center, experienced virtual-reality based training in the Inova Center for Advanced Medical Simulation, observed the respiratory system with pig lungs, engaged in neuroscience activities, and practiced physical exams with University of Virginia medical students. Their visit ended with small roundtable discussions with team members from across the hospital.In partnership with the Fairfax County Health Department, Inova provided community-based training and experiential opportunities for Fairfax County Public School students with low-income backgrounds. Community Health Workers (CHWs) from Inova Cares for Families provided training and shadowing experiences for students to supplement computer-based learning modules. Social Drivers of Health ScreeningIn 2021, Inova adopted an SDOH screening tool made up of validated questions assessing need in a wide array of social drivers. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting "wheel" should be presented, who it should be available to, and what was necessary to begin socializing its use. In 2023, Inova continued to socialize the tool in all inpatient and outpatient settings and utilize tracking dashboards to help departments visualize their successes and opportunities in collecting this information. Information available on Inova's intranet helped teams develop approaches to data collection via a variety of mechanisms, including directly from patients and via Inova's online MyChart patient portal. In April, Inova rolled out the Unite Us/Unite Virginia platform for active referrals to social services and non-profit partners. Over 7,000 team members across the Inova system now have the ability to make referrals from the electronic medical record, and several of Inova's community health clinics and programs are set up to accept referrals through the platform. Inova is working closely with community partners to assist in adoption of the platform throughout the non-profit landscape creating a robust referral network. This is a critical collaboration and will close the loop for those using the screening tool by providing easy access to refer patients to multiple community resources that address other components of the social drivers of health. Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 13h: Calculate family size Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 16j: Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website. Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 3j: Question 3eInova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFSSC) completed a Community Health Needs Assessment (CHNA) in 2022 and found that numerous health status and access problems are present in the community. Four areas were identified as the most significant health needs for the IAH/IFSSC community: Economic Stability; Healthcare Access; Mental Health; and Neighborhood, Community and Environment. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2022 through 2025. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, IAH-IFSSC has identified as its community benefit priorities Healthcare Access, Mental Health and Economic Stability. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board. Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 5: For IAH:While a regional approach guided the CHNA, each jurisdiction used its own process for community outreach and engagement. As much as possible, the process centered on existing resources, partnerships, and local needs and values. This method ensures that any new initiatives accurately reflect community priorities. Inova and the Health Equity Community Action Committee planned and produced the Alexandria assessment together. Each member of the team contributed to the assessment in different ways, utilizing individual strengths. As a part of the collaborative process leading this assessment, input was received from diverse sources including the local health department, hospital staff, representatives of key community groups and individual community members.This 2022 Community Health Needs Assessment (CHNA) process gathered community input through two of the three main assessments - Forces of Change discussions and the Community Themes and Strengths Assessment survey.Forces of Change discussions bring together individuals working in and with the community, who represent a broad diversity of stakeholders. Participants included individuals with special knowledge of or expertise in public health; local public health departments; agencies with current data or information about the health and social needs of the community; representatives of social service organizations; business leaders, and leaders, representatives, and members of medically underserved, low income, and minority populations. Inova representatives conducted Forces of Change sessions with the local Health Departments, the local Federally Qualified Health Centers, elected officials, the Partnership for Healthier Alexandria, Regional Faith Based Leaders and the local Health Equity Action Committee.Inova and the Health Equity Community Action Committee members promoted the community survey to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese (Mandarin), English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics and were distributed and collected by Community Health Workers. Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 6a: Inova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center at Lorton (IASCL) Inova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC) Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 11: A Community Health Needs Assessment (CHNA) was conducted in 2022 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those priorities. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One aim of the Implementation Strategy is to guide Inova's community benefit activities for the period of 2023-2025. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, rather than select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community partners to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Based on the CHNA process, three priority areas were chosen for the 2023-2025 Implementation Strategy: healthcare access, economic stability and behavioral health.Update - Year OneImplementation StructureMembers of the Community Health and Health Equity Division, Inova leadership, the Alexandria Health Department, and community partners have been working diligently on the priority areas set forth in the 2022 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, including the COVID-19 pandemic, Inova's Implementation Strategy includes the lenses of health equity, antiracism and social drivers of health. A structure was implemented in 2020 whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the local Alexandria Health Equity Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Health Equity Steering Committee meets monthly to create and drive strategy for the system, and the local committees are responsible for bringing together representatives from multiple Inova departments, faith based organizations, mental health stakeholders, community partners including but not limited to the Concerned Citizen Network of Alexandria (CCNA), Tenants and Workers United, American Foundation for Suicide Prevention, Medical Reserve Corp - Alexandria, Volunteers of Alexandria, Animal Welfare League of Alexandria, Four Mile Run, Neighborhood Health (Federally Qualified Health Center/FQHC), Northern Virginia Community College, George Mason University, the American Psychiatric Association, Capital City Nurses, Blue Cross Blue Shield, Capital Youth Empowerment Program, Housing Alexandria, Move2Learn, Alexandria city local government teams (Health Department, Community and Human Services, Parks and Recreation, Public Schools, Race and Social Equity) and community members that reside in Alexandria neighborhoods. This year, some of the implementation strategy projects that address the top three health issues were aligning the use of community health workers through the Northern Virginia Community Health Access Forum, collaborating to increase community-based workforce development opportunities and support efforts to provide mental health supports through upstream projects like community gardens. Inova in the CommunityLocal action committee conversations in Alexandria and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to continue to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova, guided by our Community Health Workers, works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities and community celebrations. In Alexandria, this included participating in events with the public schools, houses of worship, partner organizations and local colleges. Inova team members provide education, navigation and screening opportunities in a variety of these settings, such as Concerned Citizens Network of Alexandria's Glaucoma Vision Workshops and Coat Drives, Alexandria Police Departments Community Cookouts, and ACPS Resource Fairs.Creating a Diverse WorkforceInova's health equity-based workforce development initiative, Dream B!G, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives under-invited youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos, share their work-life experiences and invite students to visit the healthcare setting. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, the Inova Community Health and Health Equity team partnered with Inova Talent Acquisition to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. Developing a robust and diverse workforce means engaging with all age groups interested in healthcare careers. In May 2023, Inova partnered with the Capital Youth Empowerment Group for a four-week career training program for adults at Charles Houston Recreation Center. More than 10 people received role-specific skill-building, resume support, interview coaching and the opportunity to interview for available positions.In 2023, Inova's Dream B!G Team Members attended speaking opportunities for students in Alexandria City Public School's AVID Programs. They spoke with students in different classrooms, sharing their educational and career stories to over 150 middle schoolers throughout the year. In October 2023, Dream B!G engaged with over 400 children in a Spooky Mad Science Exposition through STEM tabling activities. Social Drivers of Health ScreeningIn 2021, Inova adopted an SDOH screening tool made up of validated questions assessing need in a wide array of social drivers. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting "wheel" should be presented, who it should be available to, and what was necessary to begin socializing its use. In 2023, Inova continued to socialize the tool in all inpatient and outpatient settings and utilize tracking dashboards to help departments visualize their successes and opportunities in collecting this information. Information available on Inova's intranet helped teams develop approaches to data collection via a variety of mechanisms, including directly from patients and via Inova's online MyChart patient portal. In April, Inova rolled out the Unite Us/Unite Virginia platform for active referrals to social services and non-profit partners. Over 7,000 team members across the Inova system now have the ability to make referrals from the electronic medical record, and several of Inova's community health clinics and programs are set up to accept referrals through the platform. Inova is working closely with community partners to assist in adoption of the platform throughout the non-profit landscape creating a robust referral network. This is a critical collaboration and will close the loop for those using the screening tool by providing easy access to refer patients to multiple community resources that address other components of the social drivers of health. Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 13h: Calculate family size Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 16j: Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website. Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 3j: Question 3eInova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC) completed a Community Health Needs Assessment (CHNA) in 2022 and found that numerous health status and access problems are present in the community. Four areas were identified as the most significant health needs for the ILH/ILASC community: Economic Stability, Healthcare Access, Mental Health, and Neighborhood, Community and Environment. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2022 through 2025. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, ILH-ILASC has identified as its community benefit priorities Healthcare Access, Mental Health and Economic Stability. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board. Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 5: For ILH:While a regional approach guided the CHNA, each jurisdiction used its own process for community outreach and engagement. As much as possible, the process centered on existing resources, partnerships, and local needs and values. This method ensures that any new initiatives accurately reflect community priorities. Inova and the Health Equity Community Action Committee planned and produced the Loudoun assessment together. Each member of the team contributed to the assessment in different ways, utilizing individual strengths. As a part of the collaborative process leading this assessment, input was received from diverse sources including the local health department, hospital staff, representatives of key community groups and individual community members.This 2022 Community Health Needs Assessment (CHNA) process gathered community input through two of the three main assessments - Forces of Change discussions and the Community Themes and Strengths Assessment survey.Forces of Change discussions bring together individuals working in and with the community, who represent a broad diversity of stakeholders. Participants included individuals with special knowledge of or expertise in public health; local public health departments; agencies with current data or information about the health and social needs of the community; representatives of social service organizations; business leaders, and leaders, representatives, and members of medically underserved, low income, and minority populations. Inova representatives conducted Forces of Change sessions with the local Health Department; the local Federally Qualified Health Centers; the Board of Supervisors; the Loudoun Human Services Network; Loudoun Mental Health, Substance Abuse, and Disability Services; Loudoun Pediatric Obesity Coalition; a Community Health Worker Collaborative; Regionwide Faith Based leaders and the local Health Equity Action Committee.Inova and the Health Equity Community Action Committee members promoted the community survey to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese (Mandarin), English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics and were distributed and collected by Community Health Workers. Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 6a: Inova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) Inova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center at Lorton (IASCL) Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 11: A Community Health Needs Assessment (CHNA) was conducted in 2022 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those priorities. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One aim of the Implementation Strategy is to guide Inova's community benefit activities for the period of 2023-2025. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, rather than select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community partners to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Based on the CHNA process, three priority areas were chosen for the 2023-2025 Implementation Strategy: healthcare access, economic stability and behavioral health.Update - Year OneImplementation StructureMembers of the Community Health and Health Equity Division, Inova leadership, the Loudoun County Health Department, and community partners have been working diligently on the priority areas set forth in the 2022 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, including the COVID-19 pandemic, Inova's Implementation Strategy includes the lenses of health equity, antiracism and social drivers of health. A structure was implemented in 2020 whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the local Loudoun Health Equity Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Health Equity Steering Committee meets monthly to create and drive strategy for the system, and the local committees are responsible for bringing together representatives from multiple Inova departments, faith-based organizations, community partners including but not limited to Healthworks (Federally Qualified Health Center/FQHC), Loudoun Free Clinic, Loudoun Hunger Relief, Northern Virginia Family Services, Capital City Nurses, Area Health Education Center, Friends of Loudoun Mental Health, National Alliance on Mental Illness, Ryan Bartel Foundation, Loudoun County local government teams (Health Department; Human Services; Mental Health, Substance Abuse and Developmental Services, Public Schools) and community members who reside in Loudoun neighborhoods.This year, some of the implementation strategy projects that address the top three health issues were disseminating a Loudoun medical home resource list to community partners, join marketing at community events and connecting Naloxone training opportunities to communities.Inova in the CommunityLocal action committee conversations in Loudoun and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to continue to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova, guided by our Community Health Workers, works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Loudoun, this included participating in events with the public schools, houses of worship, partner organizations and local colleges. Inova team members provide education, navigation and screening opportunities in a variety of these settings, such as at SterlingFest, Loudoun Human Services Network Family Resource Fair for INMED clients, the annual Latino Festival, and Loudoun Pride Festival.Creating a Diverse WorkforceInova's health equity-based workforce development initiative, Dream B!G, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives under-invited youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos, share their work-life experiences and invite students to visit the healthcare setting. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, the Inova Community Health and Health Equity team partnered with Inova Talent Acquisition to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. In October, over 30 high school students attended a Dream B!G event at Inova Loudoun Hospital. They toured and visited with team members in the cardiac catheterization lab, physical therapy and "Stop the Bleed" program. Their visit wrapped up with small roundtable discussions with team members from across the hospital.In November, 200 students from six middle schools attended the second annual BLOOM! - Building Learning Opportunities and Options in Medical Sciences. The students heard from Inova healthcare professionals about their career journeys and rotated through several hands-on experiences. They explored the Inova Loudoun Hospital Mobile Health Bus, practiced CPR with the Loudoun Fire and Rescue Team, and participated in virtual reality heart surgery with the Future Kings. The SOS program provides high school seniors with educational disabilities the skills and experiences to succeed in the workplace. In Loudoun County, the cohort of SOS students takes a career and technical education course in the first semester of the year to set them up for success. From January through May, students spend three hours each day participating in a paid internship onsite at Inova Loudoun Hospital. The students are mentored by Inova team members in areas such as supply management, supply chain and food services. The program launched its first cohort during the 2022 - 2023 school year, and its second cohort began work in January 2024.Social Drivers of Health ScreeningIn 2021, Inova adopted an SDOH screening tool made up of validated questions assessing need in a wide array of social drivers. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting "wheel" should be presented, who it should be available to, and what was necessary to begin socializing its use. In 2023, Inova continued to socialize the tool in all inpatient and outpatient settings and utilize tracking dashboards to help departments visualize their successes and opportunities in collecting this information. Information available on Inova's intranet helped teams develop approaches to data collection via a variety of mechanisms, including directly from patients and via Inova's online MyChart patient portal. In April, Inova rolled out the Unite Us/Unite Virginia platform for active referrals to social services and non-profit partners. Over 7,000 team members across the Inova system now have the ability to make referrals from the electronic medical record, and several of Inova's community health clinics and programs are set up to accept referrals through the platform. Inova is working closely with community partners to assist in adoption of the platform throughout the non-profit landscape creating a robust referral network. This is a critical collaboration and will close the loop for those using the screening tool by providing easy access to refer patients to multiple community resources that address other components of the social drivers of health. Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 13h: Calculate family size Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 16j: Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website. Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 3j: Question 3eInova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) completed a Community Health Needs Assessment (CHNA) in 2022 and found that numerous health status and access problems are present in the community. Six areas were identified as the most significant health needs for the IFOH/INVSC community: Chronic Conditions, Economic Stability, Healthcare Access, Tobacco and Substance Use, Mental Health, and Neighborhood, Community and Environment. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2022 through 2025. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, IFOH-INVSC has identified as its community benefit priorities Healthcare Access, Mental Health and Economic Stability. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board. Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 5: For IFOH:While a regional approach guided the CHNA, each jurisdiction used its own process for community outreach and engagement. As much as possible, the process centered on existing resources, partnerships, and local needs and values. This method ensures that any new initiatives accurately reflect community priorities. Inova and the Health Equity Community Action Committee planned and produced the Fair Oaks assessment together. Each member of the team contributed to the assessment in different ways, utilizing individual strengths. As a part of the collaborative process leading this assessment, input was received from diverse sources including the local health department, hospital staff, representatives of key community groups and individual community members.This 2022 Community Health Needs Assessment (CHNA) process gathered community input through two of the three main assessments - Forces of Change discussions and the Community Themes and Strengths Assessment survey.Forces of Change discussions bring together individuals working in and with the community, who represent a broad diversity of stakeholders. Participants included individuals with special knowledge of or expertise in public health; local public health departments; agencies with current data or information about the health and social needs of the community; representatives of social service organizations; business leaders, and leaders, representatives, and members of medically underserved, low income, and minority populations. Inova representatives conducted Forces of Change sessions with the local Health Departments, the local Federally Qualified Health Centers, elected officials, the County Health Care Advisory Board, the Partnership for Healthier Fairfax, Regional Faith Based Leaders and the local Health Equity Action Committee.Inova and the Health Equity Community Action Committee members promoted the community survey to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese (Mandarin), English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics and were distributed and collected by Community Health Workers. Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 6a: Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) Inova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center at Lorton (IASCL) Inova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC) Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 11: A Community Health Needs Assessment (CHNA) was conducted in 2022 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those priorities. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One aim of the Implementation Strategy is to guide Inova's community benefit activities for the period of 2023-2025. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, rather than select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community partners to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Based on the CHNA process, three priority areas were chosen for the 2023-2025 Implementation Strategy: healthcare access, economic stability and behavioral health.Update - Year OneImplementation StructureMembers of the Community Health and Health Equity Division, Inova leadership, the Fairfax County Health Department, and community partners have been working diligently on the priority areas set forth in the 2022 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, including the COVID-19 pandemic, Inova's Implementation Strategy includes the lenses of health equity, antiracism and social drivers of health. A structure was implemented in 2020 whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the local Fair Oaks Health Equity Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Health Equity Steering Committee meets monthly to create and drive strategy for the system, and the local committees are responsible for bringing together representatives from multiple Inova departments, faith-based organizations, community partners including but not limited to Healthworks (Federally Qualified Health Center/FQHC), Northern Virginia Family Services, Cornerstones, Western Fairfax Christian Ministries, Capital City Nurses, George Mason University, Reston Community Center, Encore Creativity, National Alliance on Mental Illness, Fairfax County local government teams (Health Department, Neighborhood and Community Services, Community Services Board, and Fairfax County Public Schools) and community members who reside in Fair Oaks neighborhoods.This year, some of the implementation strategy projects that address the top three health issues were promoting the use of Unite Us as a hub for resources and active referrals and connecting community to existing engagement opportunities.Inova in the CommunityLocal action committee conversations in the Fair Oaks region and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to continue to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova, guided by our Community Health Workers, works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Fair Oaks, this included participating in events with the public schools, houses of worship, partner organizations and local colleges. Inova team members provide education, navigation and screening opportunities in a variety of these settings, such as Pi Lambda Lambda's Health Fair in Woodbridge, Capital City Nurses' Older Adult Resource Fair, Manassas Park's Community Day, and Western Fairfax Christian Ministries' Client Resource Fair.Creating a Diverse WorkforceInova's health equity-based workforce development initiative, Dream B!G, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives under-invited youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos, share their work-life experiences and invite students to visit the healthcare setting. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, the Inova Community Health and Health Equity team partnered with Inova Talent Acquisition to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. In December 2023, 100 Fairfax County Public School students, grades 10-12, attended a Dream B!G event at Inova Fairfax Hospital. They toured and visited with team members in the Advanced Surgical Technology and Education Center, experienced virtual-reality based training in the Inova Center for Advanced Medical Simulation, observed the respiratory system with pig lungs, engaged in neuroscience activities, and practiced physical exams with University of Virginia medical students. Their visit ended with small roundtable discussions with team members from across the hospital.In partnership with the Fairfax County Health Department, Inova provided community-based training and experiential opportunities for Fairfax County Public High School students with low-income backgrounds. Community Health Workers (CHWs) from Inova Cares for Families provided training and shadowing experiences for students to supplement computer-based learning modules. Social Drivers of Health ScreeningIn 2021, Inova adopted an SDOH screening tool made up of validated questions assessing need in a wide array of social drivers. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting "wheel" should be presented, who it should be available to, and what was necessary to begin socializing its use. In 2023, Inova continued to socialize the tool in all inpatient and outpatient settings and utilize tracking dashboards to help departments visualize their successes and opportunities in collecting this information. Information available on Inova's intranet helped teams develop approaches to data collection via a variety of mechanisms, including directly from patients and via Inova's online MyChart patient portal. In April, Inova rolled out the Unite Us/Unite Virginia platform for active referrals to social services and non-profit partners. Over 7,000 team members across the Inova system now have the ability to make referrals from the electronic medical record, and several of Inova's community health clinics and programs are set up to accept referrals through the platform. Inova is working closely with community partners to assist in adoption of the platform throughout the non-profit landscape creating a robust referral network. This is a critical collaboration and will close the loop for those using the screening tool by providing easy access to refer patients to multiple community resources that address other components of the social drivers of health. Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 13h: Calculate family size Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 16j: Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website. Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 3j: Question 3eInova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center (IASCL) at Lorton completed a Community Health Needs Assessment (CHNA) in 2022 and found that numerous health status and access problems are present in the community. Seven areas were identified as the most significant health needs for the IMVH/IASCL community: Chronic Conditions; Economic Stability; Healthcare Access; Health Literacy; Mental Health; Neighborhood, Community and Environment; and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2022 through 2025. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, IMVH-IASCL has identified as its community benefit priorities Healthcare Access, Mental Health and Economic Stability. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board. Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 5: For IMVH:While a regional approach guided the CHNA, each jurisdiction used its own process for community outreach and engagement. As much as possible, the process centered on existing resources, partnerships, and local needs and values. This method ensures that any new initiatives accurately reflect community priorities. Inova and the Health Equity Community Action Committee planned and produced the Mount Vernon assessment together. Each member of the team contributed to the assessment in different ways, utilizing individual strengths. As a part of the collaborative process leading this assessment, input was received from diverse sources including the local health department, hospital staff, representatives of key community groups and individual community members.This 2022 Community Health Needs Assessment (CHNA) process gathered community input through two of the three main assessments - Forces of Change discussions and the Community Themes and Strengths Assessment survey.Forces of Change discussions bring together individuals working in and with the community, who represent a broad diversity of stakeholders. Participants included individuals with special knowledge of or expertise in public health; local public health departments; agencies with current data or information about the health and social needs of the community; representatives of social service organizations; business leaders, and leaders, representatives, and members of medically underserved, low income, and minority populations. Inova representatives conducted Forces of Change sessions with the local Health Department, the local Federally Qualified Health Centers, elected officials, the County Health Care Advisory Board, the Partnership for Healthier Fairfax, Regional Faith Based Leaders and the local Health Equity Action Committee.Inova and the Health Equity Community Action Committee members promoted the community survey to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese (Mandarin), English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics and were distributed and collected by Community Health Workers. Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 6a: Inova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) Inova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC) Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 11: A Community Health Needs Assessment (CHNA) was conducted in 2022 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those priorities. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One aim of the Implementation Strategy is to guide Inova's community benefit activities for the period of 2023-2025. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, rather than select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community partners to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Based on the CHNA process, three priority areas were chosen for the 2023-2025 Implementation Strategy: healthcare access, economic stability and behavioral health.Update - Year OneImplementation StructureMembers of the Community Health and Health Equity Division, Inova leadership, the Fairfax County Health Department, and community partners have been working diligently on the priority areas set forth in the 2022 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, including the COVID-19 pandemic, Inova's Implementation Strategy includes the lenses of health equity, antiracism and social drivers of health. A structure was implemented in 2020 whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the local Mount Vernon Health Equity Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Health Equity Steering Committee meets monthly to create and drive strategy for the system, and the local committees are responsible for bringing together representatives from multiple Inova departments, faith-based organizations, primary and secondary education institutions, community businesses and organizations, mental health stakeholders, community partners including but not limited to Mt. Olive Baptist Church, Bethlehem Baptist Church, Gum Springs Community Center, Gum Springs Glen, Hybla Valley Community Center, Lazera Ministries, United Community, Community+, Neighborhood Health (Federally Qualified Health Center/FQHC), George Mason University, Capital City Nurses, Blue Cross Blue Shield, Elevance Health, WISH, Northern Virginia Family Services, Fairfax County local government teams (Neighborhood and Community Services, Public Schools, Health Department) and community members who reside in Mt. Vernon neighborhoods. This year, some of the implementation strategy projects that address the top three health issues were aligning the use and knowledge of community health workers through the Northern Virginia Community Health Access Forum and partnering to provide workforce development opportunities to community members and diversifying the healthcare workforce.Inova in the CommunityLocal action committee conversations in Mt. Vernon and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to continue to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova, guided by our Community Health Workers, works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Mt. Vernon, this included participating in events with the public schools, houses of worship, partner organizations and local colleges. Inova team members provide education, navigation and screening opportunities in a variety of these settings, such as Gum Springs 190th Juneteenth Celebration, Sequoyah Community Barbecues, Bethlehem Baptist Community Day Fair, and Teen Summer Jam with Lazera. Creating a Diverse WorkforceInova's health equity-based workforce development initiative, Dream B!G, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives under-invited youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos, share their work-life experiences and invite students to visit the healthcare setting. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, the Inova Community Health and Health Equity team partnered with Inova Talent Acquisition to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. In December 2023, 100 Fairfax County Public School students, grades 10-12, attended a Dream B!G event at Inova Fairfax Hospital. They toured and visited with team members in the Advanced Surgical Technology and Education Center, experienced virtual-reality based training in the Inova Center for Advanced Medical Simulation, observed the respiratory system with pig lungs, engaged in neuroscience activities, and practiced physical exams with University of Virginia medical students. Their visit ended with small roundtable discussions with team members from across the hospital.Developing a robust and diverse workforce means engaging with all age groups interested in healthcare careers. In November 2023, Inova partnered with the Workforce Innovation Skills Hub (WISH) and Melwood for a four-week career training program for adults at the Hybla Valley Community Center. More than 10 people received role-specific skill-building, resume support, interview coaching and the opportunity to interview for available positions.In partnership with the Fairfax County Health Department, Inova provided community-based training and experiential opportunities for Fairfax County Public High School students with low-income backgrounds. Community Health Workers (CHWs) from Inova Cares for Families provided training and shadowing experiences for students to supplement computer-based learning modules. Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 13h: Calculate family size Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 16j: Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website. PART V, SECTION B, LINE 11 INOVA FAIRFAX HOSPITAL Inova Health Equity Grant OpportunitiesEvery year Inova provides grant and partner funding to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2023, the overall award amount was $1,200,000. Awardees in the Fairfax region included: Act for Alexandria ($50,000) will support families facing economic crisis, provide young people with viable employment opportunities, and amplify community voices and community decision making.Adaptive Fitness Legion ($31,000) will provide people living with physical disabilities access to affordable, safe and effective adaptive workout programs including free gym hours, equipment, trainers and group fitness programs held both in person and online. Cornerstones ($50,000) will connect culturally diverse and socioeconomically challenged community members to healthcare, mental health and dental services with the support of a navigator. The Culmore Clinic ($25,000) will provide monthly dental exams, cleanings, X-rays and fillings for low-income, uninsured and underinsured patients.The Growth and Healing HUB ($50,000) will provide bilingual behavioral health outreach and services to Hispanic/Latino youth and families in the Richmond Highway corridor.The Hamkae Center ($25,000) will offer Health Together Projects, linguistically and culturally appropriate community healthcare outreach events for Asian Americans. Events include referrals to affordable health resources, assistance with citizenship applications and small business counseling. The House ($25,000) will address hunger and food insecurity in children and families in low-income, overcrowded and unsafe neighborhoods through the HANGRY Truck, Mobile Food Market and Street Kitchen.The LAZERA Ministries Community Mental Health Collective ($50,000) will facilitate Thoughtful Thursdays, a program that promotes restorative healing practices; UBUNTU ASA, a program to mitigate young people's exposure to trauma; and Keeping It Real, a monthly meeting for Black women to interact on health, finances, relationships and other topics.Loudoun Cares (rental support) will connect residents in need with local nonprofits and agencies that can assist with a variety of health and human services.Loudoun Child Advocacy Center (rental support) will provide a safe space for child victims of abuse and assault.The Loudoun Education Foundation ($50,000) will support pathways to healthcare careers for diverse students from low-income households and populations underrepresented in STEM career fields through the two-day Building Learning Opportunities and Options in Medical Science (BLOOM) event for middle school students and high school students enrolled in the Health and Medical Sciences Academy.Loudoun Free Clinic ($225,000 and rental support) will provide a preventive healthcare home for low-income, uninsured and underinsured residents of Loudoun County.The Main Street Child Development Center ($30,000) will support early intervention mental health and special education services and counseling for children, regardless of their financial circumstances.Northern Virginia Dental Clinic ($50,000) will provide access to low-income, uninsured and underserved residents throughout Northern Virginia for comprehensive oral health care services, emergency dental care, and oral health education and instruction. Northern Virginia Family Service (rental support) will provide programs, including behavioral health services, that empower individuals and families to improve their quality of life and to promote community cooperation and support in responding to family needs.NOVA ScriptsCentral (rental support) will help underserved communities access quality healthcare and medication.SafeSpot Children's Advocacy Center ($20,000) will provide a safe environment and free support services for child abuse survivors and their families as they navigate the investigation and aftermath of abuse.The Shepherd's Center of Fairfax-Burke ($25,000) will provide free transportation to doctor, dentist and healthcare appointments for seniors.The Stroke Comeback Center ($25,000) will ensure equitable and unrestricted access to programs that help stroke and brain injury survivors with language, cognitive and physical deficiencies.United Community ($20,000) will promote healthy nutrition, physical activity and social-emotional wellbeing for kindergarten and elementary school children in the Creekside Village and Sacramento Community Centers. Virginia Health Care Foundation ($100,000) will increase access to primary healthcare for uninsured Virginians and those in underserved areas.Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. This partnership led to increased interest in the use of Community Health Workers (CHWs) to coordinate with individuals and communities to promote wellness, improve access and address social drivers of health. In 2023, CHWs were embedded in all Inova Cares Clinic for Families sites, located in regions with high rates of health disparities. When Inova opened a new clinic in the Mt. Vernon region in the fall, a CHW was hired as part of the new team. CHWs assist patients to stay connected to care and to address their social needs, while also being present in communities to foster trust and collaboration with the healthcare system.Healthcare Disparities ConferenceIn October, Inova presented its fifth annual Healthcare Disparities Conference titled: "A Call for Connection: Cultural Humility and Allyship." This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with vignettes and storytelling framed around creating brave spaces to address micro- and macroaggressions and addressing healthcare barriers by reframing the patient experience through the lens of SDOH. Keynote speaker Ijeoma Nnodim Opara, MD, FAAP, FAIM, of Wayne State University, shared a rousing call for cultural humility, co-liberation and health justice.The partnership that coordinated this Continuing Medical Education (CME) accredited event includes Inova, George Mason University, the Virginia Area Health Education Center, Carilion Clinic and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA).Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova has expanded services and renamed the OB-GYN clinic at Inova Loudoun Hospital to Inova Cares for Women (ICW). The clinic was established in 2008 as a partnership between Inova Loudoun Hospital and the Loudoun County Health Department to improve birth outcomes and reduce NICU stays among uninsured and low-income women. In 2023, ICW - Lansdowne added gynecologic services for patients, including those referred from the emergency room, and family planning. Colposcopies and well-women services will be available in 2024. Inova Cares for Families (ICF) and the Inova Juniper Program (IJP) opened their Mount Vernon location in October. ICF - Mount Vernon connects families who are uninsured or underinsured with comprehensive primary healthcare services including physicals, nurse case management, wellness education and counseling, psychosocial support, and care coordination. IJP - Mount Vernon provides comprehensive HIV care including primary medical care, mental health, substance use, and case management services. PART V, SECTION B, LINE 11 INOVA ALEXANDRIA HOSPITAL Inova Health Equity Grant OpportunitiesEvery year Inova provides grant and partner funding to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2023, the overall award amount was $1,200,000. Awardees in the Alexandria region included: Act for Alexandria ($50,000) will support families facing economic crisis, provide young people with viable employment opportunities, and amplify community voices and community decision making.The Growth and Healing HUB ($50,000) will provide bilingual behavioral health outreach and services to Hispanic/Latino youth and families in the Richmond Highway corridor.The Hamkae Center ($25,000) will offer Health Together Projects, linguistically and culturally appropriate community healthcare outreach events for Asian Americans. Events include referrals to affordable health resources, assistance with citizenship applications and small business counseling. Housing Alexandria ($25,000) will plant and maintain two community gardens for residents, provide produce to approximately 240 households and provide education on healthy eating.The LAZERA Ministries Community Mental Health Collective ($50,000) will facilitate Thoughtful Thursdays, a program that promotes restorative healing practices; UBUNTU ASA, a program to mitigate young people's exposure to trauma; and Keeping It Real, a monthly meeting for Black women to interact on health, finances, relationships and other topics.Northern Virginia Dental Clinic ($50,000) will provide access to low-income, uninsured and underserved residents throughout Northern Virginia for comprehensive oral health care services, emergency dental care, and oral health education and instruction. Northern Virginia Family Service (rental support) will provide programs, including behavioral health services, that empower individuals and families to improve their quality of life and to promote community cooperation and support in responding to family needs.NOVA ScriptsCentral (rental support) will help underserved communities access quality healthcare and medication.United Community ($20,000) will promote healthy nutrition, physical activity and social-emotional wellbeing for kindergarten and elementary school children in the Creekside Village and Sacramento Community Centers. Virginia Health Care Foundation ($100,000) will increase access to primary healthcare for uninsured Virginians and those in underserved areas.Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. This partnership led to increased interest in the use of Community Health Workers (CHWs) to coordinate with individuals and communities to promote wellness, improve access and address social drivers of health. In 2023, CHWs were embedded in all Inova Cares for Families sites, located in regions with high rates of health disparities. When Inova opened a new clinic in the Mt. Vernon region in the fall, a CHW was hired as part of the new team. CHWs assist patients to stay connected to care and to address their social needs, while also being present in communities to foster trust and collaboration with the healthcare system.Healthcare Disparities ConferenceIn October, Inova presented its fifth annual Healthcare Disparities Conference titled: "A Call for Connection: Cultural Humility and Allyship." This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with vignettes and storytelling framed around creating brave spaces to address micro- and macroaggressions and addressing healthcare barriers by reframing the patient experience through the lens of SDOH. Keynote speaker Ijeoma Nnodim Opara, MD, FAAP, FAIM, of Wayne State University, shared a rousing call for cultural humility, co-liberation and health justice.The partnership that coordinated this Continuing Medical Education (CME) accredited event includes Inova, George Mason University, the Virginia Area Health Education Center, Carilion Clinic and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA).Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova has expanded services and renamed the OB-GYN clinic at Inova Loudoun Hospital to Inova Cares for Women (ICW). The clinic was established in 2008 as a partnership between Inova Loudoun Hospital and the Loudoun County Health Department to improve birth outcomes and reduce NICU stays among uninsured and low-income women. In 2023, ICW - Lansdowne added gynecologic services for patients, including those referred from the emergency room, and family planning. Colposcopies and well-women services will be available in 2024. Inova Cares for Families (ICF) and the Inova Juniper Program (IJP) opened their Mount Vernon location in October. ICF - Mount Vernon connects families who are uninsured or underinsured with comprehensive primary healthcare services including physicals, nurse case management, wellness education and counseling, psychosocial support, and care coordination. IJP - Mount Vernon provides comprehensive HIV care including primary medical care, mental health, substance use, and case management services.Inova also expanded pediatric services in 2023. There is now an Inova Cares for Children (ICC) at the ICF locations in Alexandria, Fairfax, Manassas, Sterling and Herndon. These expanded services include a dedicated pediatrician and a specially trained support team. ICC offers comprehensive pediatric services for children on Medicaid or without insurance. Spaces are designed to encourage connection and foster conversations among parents, caregivers and providers. Inova and Loudoun County Public Schools (LCPS) partnered to implement an onsite mobile health resource and appropriate staffing for uninsured students in need of school physicals and wellness checks. The George Washington University School of Nursing, Inova's nurses, a bus driver and LCPS team members joined the effort, and in June, Inova's mobile health services bus became home to the LCPS Mobile Health Clinic. In 2023, nearly 250 students received clinical services at rotating evening and weekend mobile clinics at all LCPS community schools. In addition, team members from ICF partnered to connect students and caregivers with local medical homes, providing comprehensive care for the entire family. Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. Inova is committed to enhancing its clinical services and providing a range of community benefits to meet the evolving health needs of our community. The CHNA Implementation Strategy focuses on meeting the priority and specified community health needs described above. Inova acknowledges that some community challenges within the social drivers of health fall beyond the scope of the hospital and the hospital's ability to make a meaningful impact. Other topics, such as cultural competency, Lyme Disease, obesity and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system. Further, as outline above, Inova has invested considerable time, effort and resources to strengthen its partnership with other community organizations to help address the diverse, interconnected needs of our shared patient population. PART V, SECTION B, LINE 11 INOVA LOUDOUN HOSPITAL Inova Health Equity Grant OpportunitiesEvery year Inova provides grant and partner funding to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2023, the overall award amount was $1,200,000. Awardees in the Loudoun region included: Loudoun Cares (rental support) will connect residents in need with local nonprofits and agencies that can assist with a variety of health and human services.Loudoun Child Advocacy Center (rental support) will provide a safe space for child victims of abuse and assault.The Loudoun Education Foundation ($50,000) will support pathways to healthcare careers for diverse students from low-income households and populations underrepresented in STEM career fields through the two-day Building Learning Opportunities and Options in Medical Science (BLOOM) event for middle school students and high school students enrolled in the Health and Medical Sciences Academy.Loudoun Free Clinic ($225,000 and rental support) will provide preventive healthcare and a medical home for low-income, uninsured and underinsured residents of Loudoun County.Northern Virginia Dental Clinic ($50,000) will provide access to low-income, uninsured and underserved residents throughout Northern Virginia for comprehensive oral health care services, emergency dental care, and oral health education and instruction. Northern Virginia Family Service (rental support) will provide programs, including behavioral health services, that empower individuals and families to improve their quality of life and to promote community cooperation and support in responding to family needs.NOVA ScriptsCentral (rental support) will help underserved communities access quality healthcare and medication.Shelter House ($50,000) will provide 24/7 emergency shelter through the Loudoun Homeless Service Center for individuals and families experiencing homelessness, a drop-in shelter and hypothermia shelter for adults, and referrals to community resources for clothing, food and healthcare.Virginia Health Care Foundation ($100,000) will increase access to primary healthcare for uninsured Virginians and those in underserved areas.Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. This partnership led to increased interest in the use of Community Health Workers (CHWs) to coordinate with individuals and communities to promote wellness, improve access and address social drivers of health. In 2023, CHWs were embedded in all Inova Cares for Families sites, located in regions with high rates of health disparities. When Inova opened a new clinic in the Mt. Vernon region in the fall, a CHW was hired as part of the new team. CHWs assist patients to stay connected to care and to address their social needs, while also being present in communities to foster trust and collaboration with the healthcare system.Healthcare Disparities ConferenceIn October, Inova presented its fifth annual Healthcare Disparities Conference titled: "A Call for Connection: Cultural Humility and Allyship." This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with vignettes and storytelling framed around creating brave spaces to address micro- and macroaggressions and addressing healthcare barriers by reframing the patient experience through the lens of SDOH. Keynote speaker Ijeoma Nnodim Opara, MD, FAAP, FAIM, of Wayne State University, shared a rousing call for cultural humility, co-liberation and health justice.The partnership that coordinated this Continuing Medical Education (CME) accredited event includes Inova, George Mason University, the Virginia Area Health Education Center, Carilion Clinic and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA).Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova has expanded services and renamed the OB-GYN clinic at Inova Loudoun Hospital to Inova Cares for Women (ICW). The clinic was established in 2008 as a partnership between Inova Loudoun Hospital and the Loudoun County Health Department to improve birth outcomes and reduce NICU stays among uninsured and low-income women. In 2023, ICW - Lansdowne added gynecologic services for patients, including those referred from the emergency room, and family planning. Colposcopies and well-women services will be available in 2024. Inova Cares for Families (ICF) and the Inova Juniper Program (IJP) opened their Mount Vernon location in October. ICF - Mount Vernon connects families who are uninsured or underinsured with comprehensive primary healthcare services including physicals, nurse case management, wellness education and counseling, psychosocial support, and care coordination. IJP - Mount Vernon provides comprehensive HIV care including primary medical care, mental health, substance use, and case management services.Inova also expanded pediatric services in 2023. There is now an Inova Cares for Children (ICC) at the ICF locations in Alexandria, Fairfax, Manassas, Sterling and Herndon. These expanded services include a dedicated pediatrician and a specially trained support team. ICC offers comprehensive pediatric services for children on Medicaid or without insurance. Spaces are designed to encourage connection and foster conversations among parents, caregivers and providers. Inova and Loudoun County Public Schools (LCPS) partnered to implement an onsite mobile health resource and appropriate staffing for uninsured students in need of school physicals and wellness checks. The George Washington University School of Nursing, Inova's nurses, a bus driver and LCPS team members joined the effort, and in June, Inova's mobile health services bus became home to the LCPS Mobile Health Clinic. In 2023, nearly 250 students received clinical services at rotating evening and weekend mobile clinics at all LCPS community schools. In addition, team members from ICF partnered to connect students and caregivers with local medical homes, providing comprehensive care for the entire family. Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. Inova is committed to enhancing its clinical services and providing a range of community benefits to meet the evolving health needs of our community. The CHNA Implementation Strategy focuses on meeting the priority and specified community health needs described above. Inova acknowledges that some community challenges within the social drivers of health fall beyond the scope of the hospital and the hospital's ability to make a meaningful impact. Other topics, such as cultural competency, Lyme Disease, obesity and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system. Further, as outlined above, Inova has invested considerable time, effort and resources to strengthen its partnership with other community organizations to help address the diverse, interconnected needs of our shared patient population. PART V, SECTION B, LINE 11 INOVA FAIR OAKS HOSPITAL Inova Health Equity Grant OpportunitiesEvery year Inova provides grant and partner funding to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2023, the overall award amount was $1,200,000. Awardees in the Fair Oaks region included: Adaptive Fitness Legion ($31,000) will provide people living with physical disabilities access to affordable, safe and effective adaptive workout programs including free gym hours, equipment, trainers and group fitness programs held both in person and online. Cornerstones ($50,000) will connect culturally diverse and socioeconomically challenged community members to healthcare, mental health and dental services with the support of a navigator. The Culmore Clinic ($25,000) will provide monthly dental exams, cleanings, X-rays and fillings for low-income, uninsured and underinsured patients.The Hamkae Center ($25,000) will offer Health Together Projects, linguistically and culturally appropriate community healthcare outreach events for Asian Americans. Events include referrals to affordable health resources, assistance with citizenship applications and small business counseling. The House ($25,000) will address hunger and food insecurity in children and families in low-income, overcrowded and unsafe neighborhoods through the HANGRY Truck, Mobile Food Market and Street Kitchen.Loudoun Cares (rental support) will connect residents in need with local nonprofits and agencies that can assist with a variety of health and human services.Loudoun Child Advocacy Center (rental support) will provide a safe space for child victims of abuse and assault.The Loudoun Education Foundation ($50,000) will support pathways to healthcare careers for diverse students from low-income households and populations underrepresented in STEM career fields through the two-day Building Learning Opportunities and Options in Medical Science (BLOOM) event for middle school students and high school students enrolled in the Health and Medical Sciences Academy.Loudoun Free Clinic ($225,000 and rental support) will provide preventive healthcare and a medical home for low-income, uninsured and underinsured residents of Loudoun County.The Main Street Child Development Center ($30,000) will support early intervention mental health and special education services and counseling for children, regardless of their financial circumstances.Northern Virginia Dental Clinic ($50,000) will provide access to low-income, uninsured and underserved residents throughout Northern Virginia for comprehensive oral health care services, emergency dental care, and oral health education and instruction. Northern Virginia Family Service (rental support) will provide programs, including behavioral health services, that empower individuals and families to improve their quality of life and to promote community cooperation and support in responding to family needs.NOVA ScriptsCentral (rental support) will help underserved communities access quality healthcare and medication.SafeSpot Children's Advocacy Center ($20,000) will provide a safe environment and free support services for child abuse survivors and their families as they navigate the investigation and aftermath of abuse.The Shepherd's Center of Fairfax-Burke ($25,000) will provide free transportation to doctor, dentist and healthcare appointments for seniors.The Stroke Comeback Center ($25,000) will ensure equitable and unrestricted access to programs that help stroke and brain injury survivors with language, cognitive and physical deficiencies.Virginia Health Care Foundation ($100,000) will increase access to primary healthcare for uninsured Virginians and those in underserved areas. PART V, SECTION B, LINE 11 INOVA MT. VERNON HOSPITAL Social Drivers of Health ScreeningIn 2021, Inova adopted an SDOH screening tool made up of validated questions assessing need in a wide array of social drivers. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting "wheel" should be presented, who it should be available to, and what was necessary to begin socializing its use. In 2023, Inova continued to socialize the tool in all inpatient and outpatient settings and utilize tracking dashboards to help departments visualize their successes and opportunities in collecting this information. Information available on Inova's intranet helped teams develop approaches to data collection via a variety of mechanisms, including directly from patients and via Inova's online MyChart patient portal. In April, Inova rolled out the Unite Us/Unite Virginia platform for active referrals to social services and non-profit partners. Over 7,000 team members across the Inova system now have the ability to make referrals from the electronic medical record, and several of Inova's community health clinics and programs are set up to accept referrals through the platform. Inova is working closely with community partners to assist in adoption of the platform throughout the non-profit landscape creating a robust referral network. This is a critical collaboration and will close the loop for those using the screening tool by providing easy access to refer patients to multiple community resources that address other components of the social drivers of health.Inova Health Equity Grant OpportunitiesEvery year Inova provides grant and partner funding to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2023, the overall award amount was $1,200,000. Awardees in the Mount Vernon region included: Act for Alexandria ($50,000) will support families facing economic crisis, provide young people with viable employment opportunities, and amplify community voices and community decision making.The Growth and Healing HUB ($50,000) will provide bilingual behavioral health outreach and services to Hispanic/Latino youth and families in the Richmond Highway corridor.Housing Alexandria ($25,000) will plant and maintain two community gardens for residents, provide produce to approximately 240 households and provide education on healthy eating.The LAZERA Ministries Community Mental Health Collective ($50,000) will facilitate Thoughtful Thursdays, a program that promotes restorative healing practices; UBUNTU ASA, a program to mitigate young people's exposure to trauma; and Keeping It Real, a monthly meeting for Black women to interact on health, finances, relationships and other topics.Northern Virginia Dental Clinic ($50,000) will provide access to low-income, uninsured and underserved residents throughout Northern Virginia for comprehensive oral health care services, emergency dental care, and oral health education and instruction. Northern Virginia Family Service (rental support) will provide programs, including behavioral health services, that empower individuals and families to improve their quality of life and to promote community cooperation and support in responding to family needs.NOVA ScriptsCentral (rental support) will help underserved communities access quality healthcare and medication.SafeSpot Children's Advocacy Center ($20,000) will provide a safe environment and free support services for child abuse survivors and their families as they navigate the investigation and aftermath of abuse.The Shepherd's Center of Fairfax-Burke ($25,000) will provide free transportation to doctor, dentist and healthcare appointments for seniors.United Community ($20,000) will promote healthy nutrition, physical activity and social-emotional wellbeing for kindergarten and elementary school children in the Creekside Village and Sacramento Community Centers. Virginia Health Care Foundation ($100,000) will increase access to primary healthcare for uninsured Virginians and those in underserved areas.Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. This partnership led to increased interest in the use of Community Health Workers (CHWs) to coordinate with individuals and communities to promote wellness, improve access and address social drivers of health. In 2023, CHWs were embedded in all Inova Cares for Families sites, located in regions with high rates of health disparities. When Inova opened a new clinic in the Mt. Vernon region in the fall, a CHW was hired as part of the new team. CHWs assist patients to stay connected to care and to address their social needs, while also being present in communities to foster trust and collaboration with the healthcare system.Healthcare Disparities ConferenceIn October, Inova presented its fifth annual Healthcare Disparities Conference titled: "A Call for Connection: Cultural Humility and Allyship." This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with vignettes and storytelling framed around creating brave spaces to address micro- and macroaggressions and addressing healthcare barriers by reframing the patient experience through the lens of SDOH. Keynote speaker Ijeoma Nnodim Opara, MD, FAAP, FAIM, of Wayne State University, shared a rousing call for cultural humility, co-liberation and health justice.The partnership that coordinated this Continuing Medical Education (CME) accredited event includes Inova, George Mason University, the Virginia Area Health Education Center, Carilion Clinic and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA).Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova has expanded services and renamed the OB-GYN clinic at Inova Loudoun Hospital to Inova Cares for Women (ICW). The clinic was established in 2008 as a partnership between Inova Loudoun Hospital and the Loudoun County Health Department to improve birth outcomes and reduce NICU stays among uninsured and low-income women. In 2023, ICW - Lansdowne added gynecologic services for patients, including those referred from the emergency room, and family planning. Colposcopies and well-women services will be available in 2024. Inova Cares for Families (ICF) and the Inova Juniper Program (IJP) opened their Mount Vernon location in October. ICF - Mount Vernon connects families who are uninsured or underinsured with comprehensive primary healthcare services including physicals, nurse case management, wellness education and counseling, psychosocial support, and care coordination. IJP - Mount Vernon provides comprehensive HIV care including primary medical care, mental health, substance use, and case management services.Inova also expanded pediatric services in 2023. There is now an Inova Cares for Children (ICC) at the ICF locations in Alexandria, Fairfax, Manassas, Sterling and Herndon. These expanded services include a dedicated pediatrician and a specially trained support team. ICC offers comprehensive pediatric services for children on Medicaid or without insurance. Spaces are designed to encourage connection and foster conversations among parents, caregivers and providers. Inova and Loudoun County Public Schools (LCPS) partnered to implement an onsite mobile health resource and appropriate staffing for uninsured students in need of school physicals and wellness checks. The George Washington University School of Nursing, Inova's nurses, a bus driver and LCPS team members joined the effort, and in June, Inova's mobile health services bus became home to the LCPS Mobile Health Clinic. In 2023, nearly 250 students received clinical services at rotating evening and weekend mobile clinics at all LCPS community schools. In addition, team members from ICF partnered to connect students and caregivers with local medical homes, providing comprehensive care for the entire family. PART V, SECTION B, LINE 11 INOVA FAIRFAX HOSPITAL Inova also expanded pediatric services in 2023. There is now an Inova Cares for Children (ICC) at the ICF locations in Alexandria, Fairfax, Manassas, Sterling and Herndon. These expanded services include a dedicated pediatrician and a specially trained support team. ICC offers comprehensive pediatric services for children on Medicaid or without insurance. Spaces are designed to encourage connection and foster conversations among parents, caregivers and providers. Inova and Loudoun County Public Schools (LCPS) partnered to implement an onsite mobile health resource and appropriate staffing for uninsured students in need of school physicals and wellness checks. The George Washington University School of Nursing, Inova's nurses, a bus driver and LCPS team members joined the effort, and in June, Inova's mobile health services bus became home to the LCPS Mobile Health Clinic. In 2023, nearly 250 students received clinical services at rotating evening and weekend mobile clinics at all LCPS community schools. In addition, team members from ICF partnered to connect students and caregivers with local medical homes, providing comprehensive care for the entire family. Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. Inova is committed to enhancing its clinical services and providing a range of community benefits to meet the evolving health needs of our community. The CHNA Implementation Strategy focuses on meeting the priority and specified community health needs described above. Inova acknowledges that some community challenges within the social drivers of health fall beyond the scope of the hospital and the hospital's ability to make a meaningful impact. Other topics, such as cultural competency, Lyme Disease, obesity and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system. Further, as outline above, Inova has invested considerable time, effort and resources to strengthen its partnership with other community organizations to help address the diverse, interconnected needs of our shared patient population. PART V, SECTION B, LINE 11 INOVA FAIR OAKS HOSPITAL Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. This partnership led to increased interest in the use of Community Health Workers (CHWs) to coordinate with individuals and communities to promote wellness, improve access and address social drivers of health. In 2023, CHWs were embedded in all Inova Cares for Families sites, located in regions with high rates of health disparities. When Inova opened a new clinic in the Mt. Vernon region in the fall, a CHW was hired as part of the new team. CHWs assist patients to stay connected to care and to address their social needs, while also being present in communities to foster trust and collaboration with the healthcare system.Healthcare Disparities ConferenceIn October, Inova presented its fifth annual Healthcare Disparities Conference titled: "A Call for Connection: Cultural Humility and Allyship." This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with vignettes and storytelling framed around creating brave spaces to address micro- and macroaggressions and addressing healthcare barriers by reframing the patient experience through the lens of SDOH. Keynote speaker Ijeoma Nnodim Opara, MD, FAAP, FAIM, of Wayne State University, shared a rousing call for cultural humility, co-liberation and health justice.The partnership that coordinated this Continuing Medical Education (CME) accredited event includes Inova, George Mason University, the Virginia Area Health Education Center, Carilion Clinic and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA).Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova has expanded services and renamed the OB-GYN clinic at Inova Loudoun Hospital to Inova Cares for Women (ICW). The clinic was established in 2008 as a partnership between Inova Loudoun Hospital and the Loudoun County Health Department to improve birth outcomes and reduce NICU stays among uninsured and low-income women. In 2023, ICW - Lansdowne added gynecologic services for patients, including those referred from the emergency room, and family planning. Colposcopies and well-women services will be available in 2024. Inova Cares for Families (ICF) and the Inova Juniper Program (IJP) opened their Mount Vernon location in October. ICF - Mount Vernon connects families who are uninsured or underinsured with comprehensive primary healthcare services including physicals, nurse case management, wellness education and counseling, psychosocial support, and care coordination. IJP - Mount Vernon provides comprehensive HIV care including primary medical care, mental health, substance use, and case management services.Inova also expanded pediatric services in 2023. There is now an Inova Cares for Children (ICC) at the ICF locations in Alexandria, Fairfax, Manassas, Sterling and Herndon. These expanded services include a dedicated pediatrician and a specially trained support team. ICC offers comprehensive pediatric services for children on Medicaid or without insurance. Spaces are designed to encourage connection and foster conversations among parents, caregivers and providers. Inova and Loudoun County Public Schools (LCPS) partnered to implement an onsite mobile health resource and appropriate staffing for uninsured students in need of school physicals and wellness checks. The George Washington University School of Nursing, Inova's nurses, a bus driver and LCPS team members joined the effort, and in June, Inova's mobile health services bus became home to the LCPS Mobile Health Clinic. In 2023, nearly 250 students received clinical services at rotating evening and weekend mobile clinics at all LCPS community schools. In addition, team members from ICF partnered to connect students and caregivers with local medical homes, providing comprehensive care for the entire family. Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. Inova is committed to enhancing its clinical services and providing a range of community benefits to meet the evolving health needs of our community. The CHNA Implementation Strategy focuses on meeting the priority and specified community health needs described above. Inova acknowledges that some community challenges within the social drivers of health fall beyond the scope of the hospital and the hospital's ability to make a meaningful impact. Other topics, such as cultural competency, Lyme Disease, obesity and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system. Further, as outline above, Inova has invested considerable time, effort and resources to strengthen its partnership with other community organizations to help address the diverse, interconnected needs of our shared patient population. PART V, SECTION B, LINE 11 INOVA MT. VERNON HOSPITAL Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. Inova is committed to enhancing its clinical services and providing a range of community benefits to meet the evolving health needs of our community. The CHNA Implementation Strategy focuses on meeting the priority and specified community health needs described above. Inova acknowledges that some community challenges within the social drivers of health fall beyond the scope of the hospital and the hospital's ability to make a meaningful impact. Other topics, such as cultural competency, Lyme Disease, obesity and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system. Further, as outline above, Inova has invested considerable time, effort and resources to strengthen its partnership with other community organizations to help address the diverse, interconnected needs of our shared patient population. 45 1 - FAIRFAX RADIOLOGY CENTERS 2722 MERRILEE DRIVE SUITE 230 FAIRFAX VA 22031 IMAGING CENTER 2 - CORNWALL ER 224 CORNWALL STREET NW LEESBURG VA 20176 EMERGENCY ROOM 3 - EMERGENCY CARE CENTER OF FAIRFAX 4315 CHAIN BRIDGE ROAD FAIRFAX VA 22030 EMERGENCY ROOM 4 - EMERGENCY CARE CENTER OF RESTON 11901 BARON CAMERON AVENUE RESTON VA 20190 EMERGENCY ROOM 5 - INOVA RESTON MRI CENTER LLC 2722 MERRILLE DRIVE SUITE 230 FAIRFAX VA 22031 MRI CENTER 6 - INSTITUTE OF RESEARCH AND EDUCATION 3300 GALLOWS ROAD FALLS CHURCH VA 22042 RESEARCH FACILITY 7 - ASSISTED LIVING AT FAIR OAKS 3580 JOSEPH SIEWICK DRIVE 202 FAIRFAX VA 22033 ASSISTED LIVING 8 - ASSISTED LIVING AT MCLEAN 8315 TURNING LEAF MCLEAN VA 22102 ASSISTED LIVING 9 - ASSISTED LIVING AT RESTON TOWN CENTER 1778 FOUNTAIN DRIVE RESTON VA 20190 ASSISTED LIVING 10 - ASSISTED LIVING AT MT VERNON 8033 HOLLAND ROAD ALEXANDRIA VA 22306 ASSISTED LIVING 11 - KELLAR CENTER 11204 WAPLES MILL ROAD FAIRFAX VA 22030 BEHAVIORAL SERVICES 12 - POTOMAC RADIATION ONCOLOGY 2280 OPITZ BLVD 120 WOODBRIDGE VA 22191 RADIATION ONCOLOGY 13 - ASHBURN OCCUPATIONAL HEALTH 21785 FILIGREE CT SUITE 103 ASHBURN VA 20147 OCCUPATIONAL HEALTH 14 - IAH OCCUPATIONAL HEALTH 4700 KING ST SUITE 201 ALEXANDRIA VA 22302 OCCUPATIONAL HEALTH 15 - INOVA PHYSICAL THERAPY CTR - FAIROAKS 3580 JOSEPH SIEWICK DRIVE SUITE 202 FAIRFAX VA 22033 REHABILITATION 16 - INOVA PHYSICAL THERAPY CTR - FFX EAST 8100 INNOVATION PARK DRIVE FAIRFAX VA 22031 REHABILITATION 17 - INOVA PHYSICAL THERAPY CTR - BALLSTON 1005 NORTH GLEBE ROAD SUITE 410 ARLINGTON VA 22201 REHABILITATION 18 - INOVA PHYSICAL THERAPY CTR - VIENNA 8320 OLD COURTHOUSE ROAD SUITE 410 VIENNA VA 22182 REHABILITATION 19 - INOVA PHYSICAL THERAPY CTR - ASHBURN 22505 LANDMARK CT 215 ASHBURN VA 20148 REHABILITATION 20 - INOVA PHYSICAL THERAPY CTR-PROSPERITY 8501 ARLINGTON BLVD SUITE 200 FAIRFAX VA 22031 REHABILITATION 21 - INOVA PHYSICAL THERAPY - CENTREVILLE 6201 CENTREVILLE ROAD SUITE 500 CENTREVILLE VA 20121 REHABILITATION 22 - INOVA PHYSICAL THERAPY CTR- SPORTPLEX 6355 WALKER LANE SUITE 404 ALEXANDRIA VA 22310 REHABILITATION 23 - INOVA PHYSICAL THERAPY - SPRINGFIELD 8348 TRAFORD LANE SUITE 100 SPRINGFIELD VA 22152 REHABILITATION 24 - INOVA PHYSICAL THERAPY CTR - DULLES 24801 PINEBROOK ROAD SUITE 120 CHANTILLY VA 20152 REHABILITATION 25 - INOVA PHYSICAL THERAPY CTR-ALEXANDRIA 4700 KING ST SUITE 200 ALEXANDRIA VA 22302 REHABILITATION 26 - PRINCE WILLIAM OCCUPATIONAL HEALTH 8480 KAO CIRCLE MANASSAS VA 20110 OCCUPATIONAL HEALTH 27 - INOVA PHYSICAL THERAPY - WOODBRIDGE 14605 POTOMAC BRANCH DRIVE SUITE 200 WOODBRIDGE VA 22191 REHABILITATION 28 - INOVA PHYSICAL THERAPY CTR - STERLING 46000 CENTER OAK PLAZA SUITE 250 STERLING VA 20166 REHABILITATION 29 - INOVA PHYSICAL THERAPY CTR- MT VERNON 8101 HINSON FARM ROAD SUITE 401 ALEXANDRIA VA 22306 REHABILITATION 30 - INOVA PHYSICAL THERAPY - CHANTILLY 3914 CENTREVILLE RD SUITE 240 CHANTILLY VA 20151 REHABILITATION 31 - INOVA PHYSICAL THERAPY CTR - FAIRFAX 8100 BRADDOCK ROAD ANNANDALE VA 22003 REHABILITATION 32 - CATS 3300 GALLOWS ROAD FALLS CHURCH VA 22042 BEHAVIORAL SERVICES 33 - INOVA PHYSICAL THERAPY CTR - SPRINGHILL 1239 SPRING HILL ROAD MCLEAN VA 22102 REHABILITATION 34 - RADIOLOGY IMAGING ASSOCIATES LLC 19455 DEERFIELD AVENUE SUITE 102 LANSDOWNE VA 20176 IMAGING CENTER 35 - INOVA URGENT CARE CENTER - VIENNA 180 MAPLE AVENUE WEST VIENNA VA 22180 URGENT CARE 36 - INOVA URGENT CARE CTR - DULLES SOUTH 24801 PINEBROOK ROAD SUITE 110 CHANTILLY VA 20152 URGENT CARE 37 - INOVA URGENT CARE CTR - W SPRINGFIELD 6230 ROLLING ROAD SUITE J SPRINGFIELD VA 22152 URGENT CARE 38 - INOVA URGENT CARE CTR - CENTREVILLE 6201 CENTREVILLE ROAD SUITE 200 CENTREVILLE VA 20121 URGENT CARE 39 - INOVA URGENT CARE CENTER - RESTON 1488 NORTH POINT VILLAGE CENTER RESTON VA 20194 URGENT CARE 40 - INOVA URGENT CARE CTR - N ARLINGTON 4600 LANGSTON BLVD ARLINGTON VA 22207 URGENT CARE 41 - INOVA URGENT CARE CTR - TYSONS CORNER 8357-E LEESBURG PIKE VIENNA VA 22182 URGENT CARE 42 - INOVA URGENT CARE CTR - S ARLINGTON 3263 COLUMBIA PIKE ARLINGTON VA 22204 URGENT CARE 43 - INOVA URGENT CARE CTR - DUNN LORING 2671 AVENIR PLACE SUITE A VIENNA VA 22180 URGENT CARE 44 - INOVA PHYSICAL THERAPY - DUNN LORING 2740 PROSPERITY AVENUE SUITE 200 FAIRFAX VA 22033 REHABILITATION 45 - INOVA PHYSICAL THERAPY - VA SQUARE 3833 NORTH FAIRFAX DRIVE SUITE 300 ARLINGTON VA 22203 REHABILITATION Part I, Line 3c: Catastrophic financial assistance is available for patients with FAP-eligible Incomes over 400% of FPL, who, due to the nature and extent of services provided, have significant care-related financial obligations in relation to FAP-eligible Income and other potentially available resources. In such circumstances, the patient responsibility will be limited to the lesser of the Amounts Generally Billed or 15% of FAP eligible income. Part I, Line 6a: The Community Benefit Report is included in the consolidated Inova Health System report to the community on INOVA.org website. Part I, Line 7: Cost to charge ratio method is used based on table 2 in the instructions. Total operating expense is divided by Total Gross Revenue to arrive at the cost to charge ratio. Part I, Line 7g: Cost of Physician Clinic is $7,343,009. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 109,003,363. Part II, Community Building Activities: Inova's Office of Sustainability provides community building support focused on environmental improvements that in turn, benefit community health. Environmental Mission Statement:Inova Health System is committed to establishing an environmental program that is safer and healthier for patients, team members and the community.Community Building Environmental Improvements Waste ManagementInova has been focused on waste reduction strategies including recycling and segregation since 2008. Throughout the hospitals there is a single stream recycling process along with focused efforts on reducing regulated medical waste. In 2023, Inova recycled approximately 3.3 million pounds of material from local landfills and waste to energy facilities.Specialized areas recycling/reuse: Inova has implemented specialized recycling programs to capture specific materials throughout the hospitals such as electronics, batteries, reusable equipment and more. Inova launched a new system-wide food composting initiative in the fall of 2023, diverting more than 23,000 pounds of waste during the first few months alone. EnergyDuring 2023, Inova continued to make progress on energy reduction. A variety of projects including lighting upgrades, steam trap repairs, commissioning of HVAC controls and chiller plan control upgrades were implemented. These efforts result in cost savings and improved resilience for the overall health of the community. The decarbonization study was also finalized, identifying a number of opportunities that will result in reductions in energy use. Finally, Inova continues to participate in a renewable energy purchase with the utility that provides 100% renewable electricity for Inova Alexandria Hospital. WaterInova continues to maintain native plantings and low-impact irrigation systems for landscaping as well as reduce water consumption in our hospitals through the routine replacement of less efficient plumbing fixtures. BuildingsThe eastern region development continued in 2023, with the first project scheduled to open in the fall of 2024. All buildings currently under design will meet or exceed LEED Silver certification and will be built with flexibility so that Inova can adapt to future energy standards. The eastern region will set the standard for all building projects in the future, resulting in efficiency, long-term cost savings and improved outcomes. TransportationInova continues its collaboration with Fairfax County Department of Transportation to promote alternative commuting options for team members resulting in fewer single-occupancy vehicle trips. Inova administered voluntary commuter surveys in 2023 for both Alexandria and Mount Vernon hospitals as part of an effort to identify new commuting benefits for team members. The results from the surveys are informing leadership on opportunities for 2024 and we also utilized $50 SmartTrip cards for Team Members that signed up for Inova's pre-tax commuting benefit. Inova Fairfax Hospital, Inova Mount Vernon Hospital and Inova Loudoun Hospital were all named Best Workplaces for Commuters for their alternative commuting benefits. The telehealth program also continued in 2023, with more than 250,000 patient home video visits and another 11,893 emergency consultations. This equates to a significant number of avoided daily patient trips across all Inova facilities. This benefits not only the environment but patients, team members, and the community by reducing the number of cars on the road. FoodInova continues to promote and serve local and sustainable foods throughout Inova hospitals with 15% of food spend categorized as sustainable. Inova hospitals saw increases in sustainable food spend categories including eggs, poultry, seafood and more. These initiatives are important for the health of all patients, the community and support local farms. In 2023, Inova continued the Community Supported Agriculture Program to help team members access local and sustainable foods. Team members purchased more than 459 orders, totaling to almost $30,000 in sustainable and healthy food, contributing to their personal health as well as the health of the planet.CommunityInova engages with peer organizations locally and nationally on sustainable practices through a combination of virtual speaking engagements, news article publications and informal discussion. Fairfax ReLeaf continued to provide saplings that were distributed to team members in the spring and fall and Inova continues to organize spring and fall stream clean-ups where team members give back to the region by picking up litter at these events. Part III, Line 4: BAD DEBT FOOTNOTE FROM INOVA HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTSPatient Accounts Receivable: Patient accounts receivable include charges for amounts due from all patients less price concessions relating to allowances for the excess of established charges over the payments to be received on behalf of patients covered by Medicare, Medicaid and other insurers. The estimated implicit price concessions are based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the price concessions based upon historical experience of self-pay accounts receivable, including those balances after insurance payments and not covered by insurance. The results of this review are then used to make any modifications to the estimated implicit price concessions. There have been no significant changes in the current year to the underlying assumptions used by IHS to estimate the amount expected to be received. Patient accounts receivable is written off after collection efforts have been followed in accordance with IHS policies.All operating entities of IHS treat emergency patients and provide medically necessary treatment to patients regardless of their ability to pay. A patient is classified as a charity patient based upon established IHS' policies that consider patient income levels as well as other factors, including credit histories and demographic information. Since IHS does not pursue collection of amounts that qualify as charity care, these amounts are deducted from gross revenue and are not reported as net patient service revenue. Part III, Line 8: The organization does not treat any Medicare shortfall as community benefit. The amounts are taken directly from the Medicare Cost Reports as filed using a cost to charge ratio method. Part III, Line 9b: All Self-Pay (Patient Responsibility) portions of accounts for services provided by Covered Entities and Covered Providers will process through Inova's billing and collection systems for effective in-house collections and within federal guidelines for transitioning to external collection agencies after in-house efforts are exhausted.All billing statements for services provided by Covered Entities and Covered Providers will include a conspicuous written notice regarding financial assistance (including the phone number of the office that can provide information about Inova's Financial Assistance Policy). Billing statements also will include information about online payment options and finance plans available.If patient is being reviewed for potential Medicaid coverage, this will be noted in the patient's account, and it will be placed into the proper workflow for coverage/eligibility verification and billing review/follow up.Patients and responsible parties will receive billing statements over a 120-day Self-Pay billing cycle as follows:Once a final bill is available, all patients or responsible parties with a Self-Pay (Patient Responsibility) balance will receive their first billing statement (Statement-Level 1), indicating payment in full on balance due is expected within 30 days.Patients will receive a second statement (Statement-Level 2) 30 days after the first billing statement is generated. The second statement will indicate any amount that remains past due.Patients will receive a third statement (Statement-Level 3) 30 days after the second billing statement is generated. The third statement will indicate any amount that remains past due.Patients will receive a fourth and final statement (Statement-Level 4) 30 days after the third billing statement is generated. The fourth statement will indicate that it is a final notice for one or more accounts that are delinquent and will state that failure to pay the delinquent account(s) will result in the account being forwarded to a collection agency.All accounts with self-pay balances remaining thirty-one (31) days after the fourth and final statement will be transferred to an initial bad debt placement agency for a period of 547 days for continued collection efforts.After account has aged 547 days from date of placement with primary bad debt agency, account will be returned to Inova for proper disposition.Prohibited Collections ActionsInova prohibits the following Extraordinary Collections Actions:Garnishing wages or freezing bank accounts as a means of collecting unpaid bills.Foreclosure or forced sale of an individual's primary residence to pay an outstanding bill.Filing liens related to self-pay balances after insurance has determined patient responsibility regardless of payer, accounts on a finance plan, FAP-Eligible patients, or Financial Assistance accounts.Inova may take other Extraordinary Collections Actions only if:There is evidence that the individual (or his or her responsible party) has Family Income or assets that make them ineligible for Financial Assistance,After reasonable efforts by Inova, the patient has failed to apply or provide the information needed to determine eligibility for Financial Assistance, orThe individual no longer is meeting obligations under an agreed-upon payment plan and has not informed Inova of a change in financial condition.The patient has gone through all steps within the collection escalation process, and account remains unpaid.Reasonable Efforts Prior to Extraordinary Collections ActionsInova will not initiate any ECAs for at least 120 days from the date the first billing statement has been issued.After 120 days have passed, Inova only will initiate an ECA after undertaking the following efforts.Inova will offer Financial Assistance and will widely publicize the availability of such assistance as described in its Financial Assistance Policy.Inova will accept Applications for Financial Assistance for at least 240 days from the date of the first post-discharge billing statement (the Application Period).At least thirty (30) days prior to initiating any ECAs, Inova will contact the individual to provide oral notice about the Financial Assistance Policy and oral notice regarding any ECAs Inova or an authorized third party intends to initiate. Inova will also make this information available in writing and provide a written copy of the Plain LanguageSummary of the policyInova will notify individuals who submit an incomplete Application for Financial Assistance during the Application Period about how to complete the application (and provide contact information for assistance with the Application) and suspend any ECAs for these individuals until eligibility is determined.Inova will determine whether individuals are eligible for Financial Assistance if completed Applications are submitted during the 240-day Application Period.If a completed application is submitted during the 240-day application period, Inova will:Suspend any ECAs to obtain payment for the care.Process the application within 30 days from receiving necessary income verification and notify the individual in writing of eligibility determination (including the assistance for which the individual is eligible).Provide a billing statement indicating the amount owed and how it was determined, in the event the individual is not eligible for free care.Refund any amounts paid above the amount required by the FAP.Reverse any ECAs (e.g., removing adverse information from the credit report).Inova recognizes that not every patient, or patient's guarantor, is able to complete the financial assistance application or provide the required documentation. In such cases, Inova may deem patients presumptively eligible for Financial Assistance by utilizing a third-party to review a patient's, or the patient's Guarantor's, information to assess eligibility for financial assistance prior to placement to bad debt.The office responsible for determining that Covered Entities and/or Covered Providers have made reasonable efforts to determine whether an individual is FAP-eligible and therefore may engage in ECAs is: Patient Financial Services.In implementing this Policy, all Inova Covered Entities and Covered Providers shall comply with all other federal, state, and local laws, rules, binding agreements, and regulations that apply to activities conducted pursuant to this Policy. PART III, Line 2 and 3: Actual bad debt expense is multiplied by the cost to charge ratio used in computing charity care expense in Part I. The provision for bad debts is recognized when providing an allowance for uncollectible accounts.There are no estimated amounts for bad debt expense attributable to patients under the organization's charity care policy. PART v, SECTION B, LINES 7a AND 10a https://www.inova.org/about-inova/inova-your-community/community-health-needs-assessments Part VI, Line 2: Inova Health System (IHS) completed a Community Health Needs Assessment (CHNA) in 2022 to identify priority health status and access issues for particular geographic areas and populations by focusing on the following questions: What are the biggest health challenges? Who is most affected? Where are the unmet needs for services? What are the health inequities?Inova's CHNAs consider multiple data sources, including secondary data (regarding demographics, health status indicators, and measures of health care access), assessments prepared by other organizations in recent years, and primary data derived from surveys, interviews, and focus groups of persons who represent the broad interests of the community, including those with expertise in public health.The following topics and data are assessed in Inova's CHNA report:Demographics, e.g., numbers and locations of people who are under-resourced or marginalized;Economic issues, e.g., poverty and unemployment rates, and impacts of state or local budget changes;Community issues, e.g., homelessness, housing, environmental concerns, crime, and availability of social services;Health status indicators, e.g. morbidity rates for various diseases and conditions, and mortality rates for leading causes of death;Health access indicators, e.g., uninsured rates, discharges for ambulatory care sensitive conditions (ACSC), and use of emergency departments for non-emergent care;Health disparities indicators; andAvailability of healthcare facilities and resources. The assessment identifies a list of significant community health needs.As a result of this work and previous work, three priority areas will be the focus for the next three years. While the approach to addressing these areas may differ from one community to another, the system-wide selection of priority areas will add value to efforts in each region. The two Directors of Community Health Programs are coordinating plans with Inova and community leaders to ensure plans are implemented effectively and in partnership with existing frameworks and resources in each of the respective communities. The two Directors of Community Health Programs are centralized to the system under the Chief of Health Equity and Community Health and thereby assure system coordinated efforts are centralized and reflective of Inova Health System's work across Northern Virginia.The local Public Health Departments also conduct community health assessments using the framework of the Mobilizing for Action through Planning and Partnerships (MAPP) process. Due to the timing of these processes, the jurisdictions did not conduct these assessments in 2022, but will be able to utilize the CHNA data in their upcoming processes.The MAPP process leads to an ongoing community-driven planning process that is designed to provide information for improving the community's delivery of the ten essential public health services. This process brings together a diverse group of key community stakeholders including local government, human service organizations, schools and universities, healthcare consumers, advocacy groups, hospitals, faith institutions, youth development organizations, economic and philanthropic groups, etc. to identify strengths and weaknesses in the ten essential areas to provide a foundation for community health planning. In addition to these activities, Inova is continually garnering feedback on existing safety net and community programs from participants through satisfaction surveys, focus groups, participating in regional and local health related groups such as the Northern Virginia Health Services Coalition, and meeting with various cultural and ethnic groups in the community. Internal utilization and outcomes data, review of best practices, regional and national benchmark data, and other external sources such as the Metropolitan Washington Council of Governments (COG) demographic data are used to develop strategic goals for health improvement activities. Collectively, all of this information is utilized in assessing community health needs to guide strategic planning efforts. Due to significant changes to the social and health landscapes, including the COVID-19 pandemic, Inova's Implementation Strategy includes the lenses of health equity, antiracism and social drivers of health. A structure was implemented in 2020 whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the Regional Health Equity Community Action Committees, consisting of Inova team members and community partners, identifies local needs and opportunities and develops partnerships to address them. The Health Equity Steering Committee meets monthly to identify needs and opportunities throughout the system. The action committee also meets monthly and brings together representatives from multiple Inova departments, faith-based organizations and community partners. Part VI, Line 3: Inova Health System utilizes a multifaceted approach to educate and inform patients and the public about Inova's Financial Assistance Policy (FAP) or sometimes referred to as the Charity Care Policy. Information regarding this policy is kept up to date and widely publicized on the Inova website and through signage. Upon admission to any Inova hospital or any visit to outpatient facilities or clinics including emergency departments, Inova has information posted regarding patient rights and responsibilities. In addition, Inova provides information about the charity care program and referrals to meet with Inova financial counselors who assist patients in completing Inova's charity care application. This financial information is reviewed by the Inova Patient Accounts Department with the patient contacted if additional information is required in order to make a determination. The patient is subsequently provided a letter, notifying them as to whether or not they qualify for charity care.Inova also has Medicaid eligibility workers on-site in all hospitals, in the Inova Cares Clinics (clinic for low income families) and in the community as part of the Partnership for Healthier Communities Access to Care program. Inova partners with schools across the jurisdiction to provide information about state funded health programs for children and contact information to meet with an eligibility worker responsible for enrolling families in state Medicaid programs. These eligibility workers also go out into the community attending community events such as health fairs, faith-based community activities and other family centered community events to proactively meet with families to encourage enrollment in programs for which they are eligible. Inova has a section of the public website dedicated to information about financial assistance resources. Part VI, Line 4: Inova Health Care Services (IHCS) is a not-for-profit corporation and a subsidiary of the parent organization, Inova Health System Foundation (Inova). Inova provides healthcare and related services throughout Northern Virginia and the greater metropolitan Washington, D.C. area, including certain contiguous counties of Virginia and Maryland. Northern Virginia is one of the fastest growing urban communities in the United States. With approximately 1,304 square miles, the region is the most densely populated in the Commonwealth of Virginia. Northern Virginia is comprised of several distinct communities, including the cities of Alexandria, Fairfax, Falls Church, Manassas and Manassas Park, and the counties of Arlington, Fairfax, Loudoun, and Prince William. The eastern sections are urbanized with attendant health problems of overcrowding and increasing demand for health services and public programs. The western regions include rapidly growing communities and rural settings.The region's population served by IHCS is expected to grow steadily through 2035, adding approximately 71,000 people per year, according to the Metropolitan Washington Council of Governments ("MWCOG"). Population will be spurred by the long-term strength of the region's economy, high rates of in-migration and international immigration. The region's population that is 65 years of age and older is expected to grow 20% over the next 5 years, while the number of children will increase by about 4% during the same time period. (MWCOG and ESRI)Northern Virginia's racial and ethnic diversity is more pronounced than in the rest of the state. With increasing diversity, economically disadvantaged populations and multiple languages, the need for access to culturally appropriate, flexible health care continues to grow. The Northern Virginia geographic region in 2021 was 49% minority, while the nation reflects about 40% minority population in 2021 (American Community Survey (ACS) U.S. Census Bureau). Fairfax County, with more than one million residents, is the largest jurisdiction in Northern Virginia and has the largest minority population. In Fairfax County in 2021, Asians, Hispanics, and African Americans represented 47.4%, of the county's population, respectively (Fairfax County Economic, Demographic and Statistical Research, 2020 Decennial Census survey data). According to the US Census Bureau Small Area Health Insurance Estimates (SAHIE) in 2021 approximately 7.4% of the total population under the age of 65 (about 72,000 people) in Fairfax County lacked healthcare insurance. Of the people living in Fairfax County whose family incomes are at or below 200% of the federal poverty level, SAHIE estimates that 21.7% (about 28,455 people) were uninsured in 2021.Area residents most likely to be uninsured are those whose family incomes are at or below 200% of the poverty level, young adults (age 18-44), people of racial backgrounds other than White, unemployed individuals, part-time workers, and people who work at companies with fewer than 50 employees. Serving this population poses significant cultural and linguistic challenges, and these uninsured citizens are widely distributed in terms of age, geographic region, and health status. Part VI, Line 5: Inova Health System's investment in the communities across Northern Virginia is evident through numerous targeted community programs. These programs provide access to care for low income, uninsured, underinsured and vulnerable populations; promote health and wellness; increase health literacy; provide the support and infrastructure for disaster preparedness; and provide programs to support development of our future healthcare workforce to meet the healthcare needs of the communities served. All Inova healthcare facilities have open medical staffs to provide the maximum access to qualified physicians. A Community Board of Trustees provides fiscal and quality oversight for Inova Health Care Services' facilities to ensure the vision and mission of the organization is achieved.Access to Care ProgramsInova's Community and Health Equity Division is organized to address a wide-spectrum of community healthcare needs. In addition to the programs already described in the core form program, activities that provide infrastructure support and services focused on vulnerable populations to increase access to healthcare services for the communities served by Inova Health System include the following programs:Inova established a Safety Net Specialty Care Provider Network in partnership with Fairfax County. The physician leader engaged numerous Inova specialty care practices to accept referrals at Medicare rates from community primary care settings such as federally qualified health centers and free clinics. In order to ensure access to specialties not available at Inova, a specialty network including community providers was then established with the same referral arrangement. With funding support from the county, Inova facilitates payment to community specialists that are not part of Inova's charity care for patients otherwise unable to pay for those services. The program was designed utilizing an Inova coordinator who assists the referring clinic, the patient, and the specialty provider with scheduling and navigating the completion of required documentation. The specialties patients are able to access through this program include: Gastroenterology, Dermatology, Nephrology, Colorectal Surgery, Allergy, Infectious Disease, Pulmonary and Orthopedics. There were 539 patients who benefited from the Safety Net Specialty Fund in 2023.Inova's Partnership for Healthier Communities (PHC) provides children and families with comprehensive application and enrollment assistance to connect them with an appropriate and affordable source of health care services. In 2023, the program assisted over 34,200 children and adults with access to a source of comprehensive health care services such as Medicaid, FAMIS or local safety net providers (3,953 in Medicaid/FAMIS). For continued care at the Inova Cares for Families (ICF), PHC has Team Members to assist patients in completing their applications for Inova Financial Assistance. In 2023, 4,458 ICF patients were approved for financial assistance with the help of PHC. PHC expanded efforts in 2019 with the onset of Medicaid expansion in Virginia (including a name change from Partnership for Healthier Kids to reflect the updated mission and outreach activities). In August of 2022, PHC expanded their services to include a drop-off location for all community patients, in order to assist them in submitting their financial assistance applications in-person. 4,418 patients were assisted at the community drop-off in 2023. Care Connection for Children (CCC) is part of the Virginia Department of Health statewide network serving children and youth with special healthcare needs. Our caring team of professional case managers partner with families to help coordinate care and gain access to healthcare and community resources. Services are always free and provided regardless of income, health insurance or legal status. In 2023, CCC served 703 families.Inova Cares for Community BridgingInova Cares for Community Bridging (ICCB) was developed to bridge gaps in care that patients experience as they transfer across care delivery settings between illness and recovery. The service focuses on transitional medical care and community collaboration in order to improve health outcomes of patients at the highest risk who lack access to needed resources. ICCB has locations in Alexandria, Fairfax and Leesburg. The services offered support patients being discharged from an Inova hospital or Inova emergency room who either do not have a medical home or cannot get an appointment with their Primary Care Provider (PCP) within 72 hours following a hospital admission. Patients are typically followed by a hospitalist or nurse practitioner for one to three visits, while the patient and the care team work together to establish a permanent medical home in the community for the patient or transition the patient back to their PCP. Care includes medication reconciliation, medical management and anti-coagulation management if needed as well as referrals to assist with social drivers of health. ICCB seeks to provide services that will enhance the lives of patients so that they may better manage their healthcare and live longer, more productive lives. In 2023, ICCB served over 4,000 patients with over 5,500 visit encounters. Inova Kellar Center Inova Kellar Center (IKC) is a community based behavioral health program and special education school founded by Inova in 1991 with a gift from Fairfax County residents, Art and Betty Kellar, to address a gap in mental health and substance abuse services for children and adolescents. Currently IKC offers a full continuum of mental health services from outpatient therapies and medication management to after school Intensive Outpatient Programs and a full day Partial Hospitalization Program. The Kellar School, a private special education day school for students with emotional, social, and behavioral needs provides academic instruction within a therapeutic environment. The Center provided 39,878 hours of in-person and tele-psych programming and treatment in addition to 21,102 hours of special education to children, adolescents, and families in 2023. Inova Ewing Forensic Assessment and Consultation Teams (FACT)The Inova Ewing FACT Department (FACT) is a comprehensive, outpatient forensic nursing program for children and adults. Established in the late 1990s, the Inova Ewing FACT Department has provided specialized care for victims of sexual abuse, domestic violence, human trafficking, and child abuse. FACT serves all of Northern Virginia including Fairfax, Arlington, Loudoun, and Prince William counties, the cities of Alexandria and Falls Church, parts of Fauquier and Stafford counties, military installations, universities and the FBI. The department also performs courtesy exams for outlying jurisdictions including the District of Columbia, Maryland, West Virginia and beyond. In 2023, the department had 867 patient encounters. The program has grown significantly over the years and now provides services in the areas of sexual assault, intimate partner/domestic violence, physical child abuse, strangulation, and human sex trafficking. In late 2023, the department started a program for victims of community violence and are currently hiring for those new roles. The department has clinics available to patients in Falls Church, Leesburg, Vienna, and Alexandria. Health Promotion and Preventative Care ProgramsTo support patients experiencing food insecurity, the Inova Cares Clinics continued to run emergency food pantries throughout most of their locations. The pantries serve patients in emergency situations, meaning they have little or no food at home. In 2023, Inova Cares for Women and Children served more than 140 patients, reaching more than 600 individuals including household members. Across six locations of Inova Cares for Families, the pantries served over 650 patients, reaching over 2,300 individuals including household members. Inova also continued to grow the Inova Healthy Plate Club, which helps children and their families learn about the importance of healthy eating. In 2023, IHPC reached nearly 2,000 students. Two hundred students participated in the virtual program and 47 classes were taught. For the in-person program, over 350 students participated, and 154 classes were taught. IHPC also taught more than 1,200 Kindergarten - 2nd grade students in their classrooms.During the holidays, Inova Team Members came together to donate over 4,800 pounds of food to patients in-need. The food went to patients at Inova Cares for Women & Children; Inova Cares for Families; Care Connection for Children; the Inova Fairfax Lung Transplant & Cystic Fibrosis Center; and more. Part VI, Line 6: Organization is part of Inova Health System included in description under Line 5. PART VI, Line 7: Organization has no state filings. PART VI, LINE 5 Continued: Language and Disability ServicesThe Language and Disability Services Department is dedicated to ensuring equal access to Inova's services regardless of language preference or the need for special accommodations. In support of patient safety and satisfaction, language interpretation and document translations are provided at every Inova facility to facilitate communication with the 16.52% of Inova's patient population who are Limited English Proficient (LEP) and the 0.14% of clients who are Deaf or Hard of Hearing (D/HH). In 2023, staff and contracted medical interpreters delivered 268,300.08 hours of interpretation available in 380 languages, and 20,225.36 hours in American Sign Language. Additionally, vital documents totaling 716,905 words were translated, not only into Inova's top designated languages, but from a multitude of languages to English to facilitate safe and equal access to patient care.Cash and In-Kind Contributions to Community GroupsInova donates space, cash, and in-kind support such as utilities, landscaping/grounds keeping, housekeeping, and donated staff time to a number of community groups and services. Inova provides financial support to NOVA Scripts, the Center for Multicultural Human Services, Loudoun Cares, and Loudoun Child Advocacy Center, The Loudoun Free Clinic and Virginia Healthcare Foundation. In 2023, Inova donated over $3.5 million for these groups covering both cash and in-kind transactions.Additionally, as part of Inova's efforts to harness the collective power of community partners, agencies, and organizations to create positive social impact, as well as addressing social drivers of health, Inova provided $1,200,000 in community opportunity support. Applicants were required to present programs, requests, or projects addressing the community health needs described in the Inova Community Health Needs Assessments. The following programs were funded in 2023.Act for Alexandria - $50,000.00 to support programs that help families facing economic crisis, provide young people with viable employment opportunities, and amplify community voices and community decision making.Adaptive Fitness Legion - $31,000.00 to provide people living with physical disabilities access to affordable, safe and effective adaptive workout programs including free gym hours, equipment, trainers and group fitness programs held both in person and online. Cornerstones, Inc. - $50,000.00 to support a navigator who connects culturally diverse and socioeconomically challenged community members to healthcare, mental health, and dental services. The Culmore Clinic - $25,000.00 received financial support to provide monthly dental exams, cleanings, X-rays and fillings for low-income, uninsured and underinsured patients. The Growth and Healing HUB - $50,000.00 to support a bilingual clinical therapist to provide behavioral health outreach and services to Hispanic/Latino youth and families in the Richmond Highway corridor. The Hamkae Center - $25,000.00 to support the Health Together Projects, which provide linguistically and culturally appropriate community healthcare outreach events to Asian Americans. Events include referrals to affordable health resources, assistance with citizenship applications, and small business counseling. The House, Inc. - $25,000.00. to support programs that address hunger and food insecurity in children and families in low-income, overcrowded, and unsafe neighborhoods through the HANGRY Truck, Mobile Food Market, and Street Kitchen. Housing Alexandria - $25,000.00 to support, soil rehabilitation, plant, and maintain two community gardens for residents, provide produce to approximately 240 households, and provide education on healthy eating. LAZERA Ministries- $50,000.00 to support Thoughtful Thursdays, a program that promotes restorative healing practices; UBUNTU ASA, a program to mitigate young people's exposure to trauma; and Keeping It Real, a monthly meeting for Black women to interact on health, finances, relationships and other topics.Loudoun Cares- connects residents in need with local nonprofits and agencies that can assist with a variety of health and human services.Loudoun Child Advocacy Center- provides a safe space for child victims of abuse and assault.Loudoun Education Foundation - $50,000.00 to support pathways to healthcare careers for a diverse group of students and populations underrepresented in STEM career fields through the two-day BLOOM event for middle school students and high school students enrolled in the Health and Medical Sciences Academy.Loudoun Free Clinic- provides a preventive healthcare home for low-income, uninsured and underinsured residents of Loudoun County.The Main Street Child Development Center - $30,000.00 to support early intervention mental health and special education services and counseling for children, regardless of their financial circumstances. Northern Virginia Dental Clinic - $50,000.00 to provide access to low-income, uninsured, and underserved residents throughout Northern Virginia for comprehensive oral health care services, emergency dental care, and oral health education and instruction. Northern Virginia Family Service- provides programs that empower individuals and families to improve their quality of life and to promote community cooperation and support in responding to family needs.NOVA ScriptsCentral- helps underserved communities access quality healthcare and medication.SafeSpot Children's Advocacy Center - $20,000.00 to provide a safe environment and free support services for child abuse survivors and their families as they navigate the investigation and aftermath of abuse.Shelter House - $50,000.00 to provide 24/7 emergency shelter through the Loudoun Homeless Service Center for individuals and families experiencing homelessness, a drop-in shelter, and hypothermia shelter for adults, and referrals to community resources for clothing, food, and healthcare. The Shepherd's Center of Fairfax-Burke - $25,000.00 to provide free transportation to doctor, dentist and healthcare appointments for seniors. The Stroke Comeback Center - $25,000.00 to ensure equitable and unrestricted access to programs that help stroke and brain injury survivors with language, cognitive, and physical deficiencies.United Community - $20,000.00 to support programs that promote healthy nutrition, physical activity, and social-emotional wellbeing for kindergarten and elementary school children in the Creekside Village and Sacramento Community Centers. Virginia Health Care Foundation- increases access to primary healthcare for uninsured Virginians and Virginians in underserved areas. 1 1 0 0 0 0 0 0 0 J STEPHEN JONES MD PRESIDENT/CEO 2061564 0 2850712 0 568120 0 39000 0 31495 0 5550891 0 0 0 JAMES ECKLUND PRESIDENT NEUROSCIENCES 1251370 0 585975 0 912124 0 69000 0 28545 0 2847014 0 676799 0 JOHN HAMILTON PHYSICIAN 1237934 0 905163 0 2322 0 69000 0 33021 0 2247440 0 0 0 STEPHEN MOTEW CHIEF CLINICAL ENTERPRISE 1157551 0 668368 0 15599 0 317740 0 26530 0 2185788 0 0 0 ALICE POPE TREASURER-CFO 1018623 0 587313 0 14033 0 286609 0 15289 0 1921867 0 0 0 ROBIN WEST PRESIDENT MUSCULOSKETETAL 825209 0 379007 0 601559 0 46500 0 33965 0 1886240 0 0 0 JAMES ST LOUIS PHYSICIAN 1646277 0 150904 0 2143 0 46500 0 27671 0 1873495 0 0 0 TONI ARDABELL CHIEF CLINICAL ENTERPRISE OPERATIONS 996293 0 570857 0 209608 0 69000 0 2876 0 1848634 0 0 0 CHRISTOPHER O'CONNOR PRESIDENT IHVI 1053261 0 484270 0 220697 0 46012 0 11290 0 1815530 0 0 0 ANUJ NARANG PRESIDENT IFMC & PEDIATRIC SERVICE 935993 0 435827 0 7233 0 274390 0 33606 0 1687049 0 0 0 NILESH VYAS DIVISION CHIEF 928540 0 529875 0 810 0 61500 0 31820 0 1552545 0 0 0 TERRI FEELY CHIEF PEOPLE OFFICER IHS 758631 0 443631 0 13267 0 248536 0 38625 0 1502690 0 0 0 JOHN GAUL SECRETARY 761611 0 443631 0 12321 0 221056 0 34965 0 1473584 0 0 0 JOHN MOYNIHAN PRESIDENT SURGICAL SERVICE 785635 0 362738 0 168849 0 69000 0 22777 0 1408999 0 0 0 DAVID QUIRKE EVP CIO 25378 0 299979 0 1053830 0 5660 0 1187 0 1386034 0 0 0 ZOBAIR YOUNOSSI PRESIDENT INOVA MEDICINE 745471 0 344471 0 168916 0 69000 0 23480 0 1351338 0 0 0 SUSAN CARROLL PRESIDENT ILH 656295 0 306021 0 2774 0 179914 0 31300 0 1176304 0 0 0 HARVEY MCDUFFIE SVP PRESIDENT INOVA REALTY 640358 0 297741 0 144327 0 46500 0 25474 0 1154400 0 0 0 CHRISTOPHER CHIANTELLA FORMER CHIEF MEDICAL OFFICER 353003 0 123341 0 64362 0 67676 0 22051 0 630433 0 0 0 Part I, Line 3 The following methods were used by Inova Health System Foundation, a related organization, to establish the compensation of IHCS's CEO for the tax year: Compensation committee Independent compensation consultant Written employment contract Compensation survey or study Form 990 of other organizations Approval by the board or compensation committee Part I, Lines 4a-b Part I, Line 4a: Severance Payments: David Quirke $1,053,275 Severance amounts were paid within 24 months after separation from service. Part I, Line 4b: SERP Plan Payments: Susan Carroll $146,021 Terri Feely $179,536 Stephen Motew $248,739 John Gaul $175,786 Alice Pope $218,574 Anuj Narang $205,390 The Supplemental Executive Retirement Plan (SERP) is a nonqualified retirement plan. Employees eligible to participate are at level of Assistant Vice President and above. Each year, a certain percentage of each participant's base salary is contributed to the SERP ranging from 10% to 25%, depending on the position. Vesting for each contribution will be three years from the award date, and participants are paid out immediately upon vesting. At age 62 and later, participants are 100% vested at the time of each annual award and paid out immediately upon vesting. Any vested balance is paid to participants as a taxable event. A Industrial Development Authority of Fairfax County Virginia 911920228 303823FM5 2005-05-12 124000000 See Part VI 0 0 0 B Industrial Development Authority of Fairfax County Virginia 911920228 303823JJ8 2010-03-08 190000000 See Part VI 0 0 0 C Industrial Development Authority of Fairfax County Virginia 911920228 303823KX5 2014-12-17 209030800 See Part VI 0 0 0 D Industrial Development Authority of Fairfax County Virginia 911920228 303823LM8 2016-05-11 178341611 See Part VI 0 0 0 A 69135000 130441544 3604217 367125 126470203 2007 0 0 1 1 B 95000000 356022667 166022667 190000000 2016 1 0 1 1 C 20000000 209717891 209717891 2017 0 0 1 1 D 23160000 181714070 181714070 1 1 1 1 A 0 1 0 1 1 0.01000 0.01000 0 0 1 B 0 1 0 1 1 0.00800 0.01300 0.02100 0 0 1 C 0 1 0 1 1 0.00500 0.00500 0 0 1 D 0 1 0 1 1 0.01600 0.01700 0.03300 0 0 1 A 0 0 0 1 1 1 Morgan Stanley Capital Services 30.000000000000 0 1 0 0 1 B 0 0 0 1 1 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 05/12/2010 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 09/10/2017 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 12/17/2019 Issuer Name: Industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 05/11/2021 Issuer Name: industrial Development Authority of Fairfax County, Virginia Date the Rebate Computation was Performed: 07/14/2019 PART I, COLUMN E, ISSUE PRICE Part I, column E, 2005A bonds 2005A, B, D, E bond issue price per form 8038 476,700,000 2005B, D, E bonds refinanced by subsequent issues (352,700,000) Remaining 2005A issue price 124,000,000 PART I, COLUMN F, DESCRIPTION OF PURPOSE Bond A 1) Renovate and expand certain portions of Inova Alexandria Hospital (IAH), Inova Fairfax Hospital (IFH), Inova Fair Oaks Hospital (IFOH); 2) Acquire certain capital equipment for use in or in connection with IAH, IFH, IFOH, and Inova Mount Vernon Hospital (IMVH) and renovate any space necessary or incidental to the installation of such equipment; 3) Pay issuance costs for Series 2005 A and B; 4) Refund prior bonds issued by the Industrial Development Authority of Loudoun County, Virginia Hospital Revenue Bonds, Series 1995 issued 10/26/1995 and 2002A issued 6/27/2002, and pay issuance costs of Series 2005D; 5) Refund prior bonds Series 2001A, B, C, and D issued 12/11/2001 Bond B 1) Refund prior bonds - 2009B issued 4/16/2009; 2) Pay issuance costs of series 2010A bonds Bond C 1) Construct, renovate and expand certain portions of IFH, IMVH and IFOH Bond D 1) Refund prior bonds - portion of 2009A issued 4/16/09 (advance) and portion of 2012C issued 8/23/12 (current) Bond E 1) Refund prior bonds - portion of 2012C issued 8/23/12 Bond F 1) Refund prior bonds-2000 issued 03/23/2000; 2005C issued 05/12/2005;2017 issued 12/27/2017 2)Expansion of Inova Loudoun Hospital and a variety of projects at IFMC Bond G 1) Refund prior bonds - 2012AB issued 8/23/2012; 2012D issued 12/20/2012; $20 million of 2014A issued 12/17/2014 Bond H 1) Refund prior bonds - 2005A-1 issued 5/12/2005; 2) a variety of capital projects at IFMC, IFOH and IMVH PART II, LINE 3, PROCEEDS Part II, line 3. 2005A bonds Issue price 124,000,000 Earnings 6,441,544 Total proceeds 130,441,544 Part II, line 3. 2010A bonds Issue price 190,000,000 Earnings 1,511,888 Transferred proceeds 164,510,779 Total proceeds 356,022,667 Part II, line 3. 2014A bonds Issue price 209,030,800 Earnings 687,091 Total proceeds 209,717,891 Part II, line 3. 2016A bonds issue price 178,341,611 escrow earnings 3,372,459 total proceeds 181,714,070 Part II, line 3. 2018AB bonds issue price 484,976,577 escrow earnings 3,432,529 total proceeds 488,409,106 Part II, line 3. 2023 bonds issue price 154,369,150 escrow earnings 1,600,092 total proceeds 155,969,241 PART IV, LINE 2C, DATE OF REBATE COMPUTATION Part 4, line 2C. 2005A Rebate Computation for the bond issued 5/12/2005 was performed: 05/12/2010 Part 4, line 2C. 2010A Rebate Computation for the bond issued 3/8/2010 was performed: 09/10/2022 Part 4, line 2C. 2014A Rebate Computation for the bond issued 12/17/2014 was performed: 12/17/2019 Part 4, line 2C. 2016AB Rebate Computation for the bond issued 05/11/2016 was performed: 05/11/2021 Part 4, line 2C. 2018AB Rebate Computation for the bond issued 07/31/2018 was performed: 07/14/2019 A Industrial Development Authority of Fairfax County Virginia 911920228 303823LR7 2016-05-11 99685000 See Part VI 0 0 0 B industrial Development Authority of Fairfax County Virginia 911920228 303823MX3 2018-07-31 484976577 See Part VI 0 0 0 C Industrial Development Authority of Fairfax County Virginia 911920228 30382VAU0 2022-04-21 399894696 see Part VI 0 0 0 D Industrial Development Authority of Fairfax County Virginia 911920228 30382VAW6 2023-05-15 154369150 See Part VI 0 0 0 A 2875000 99685000 99685000 1 0 1 1 B 89195000 488409106 268358015 220051092 2023 1 0 1 1 C 3960000 399894696 399894696 1 0 1 1 D 155969241 73008041 43565000 39396201 1 0 0 1 A 0 1 0 1 1 0.01200 0.00900 0.02100 0 0 1 B 0 1 0 1 1 0.00300 0.00100 0.00400 0 0 1 C 0 1 0 1 1 0.00500 0.00200 0.00700 0 0 1 D 0 1 0 1 1 0.00400 0.00400 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 0 1 1 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 John Moynihan Key Employee 617958 Family member employed under Inova Health Care Services. Services provided at arm's length and customary rates. 0 Toni Ardabell Key Employee 134509 Family member employed under Inova Health Care Services. Services provided at arm's length and customary rates. 0 0 Box C, Doing Business As Inova Health Care Services (IHCS) Fictitious names: Access of Alexandria Access of Fairfax Access of Reston/Herndon American Medical Collection Bureau Fair Oaks Hospital Fairfax Hospital Inova Behavioral Health Services Inova Blood Donor Services Inova Breast Care Center-Alexandria Inova Breast Care Center-Woodbridge Inova Employee Assistance, Inc. Inova Fair Oaks Hospital Inova Fairfax Hospital Inova Fairfax Hospital Auxiliary Inova Health System Inova HealthPlex Inova HealthSource Inova Mount Vernon Hospital Inova Pathology Associates Inova Pathology Institute Inova Surgery Center Medibill Military to Medicine Mount Vernon Hospital Radiology Imaging Associates, LLC The Fairfax Hospital The Mount Vernon Hospital Treasure Trove Universal Financial Services Virginia Heart Hospital PART III, LINE 4A Women's Health Inova Women's Health Services is the largest program in the Mid-Atlantic region, providing services for 18,737 births in 2023. Obstetric services provided include: delivery, high risk prenatal care, inpatient and outpatient obstetrics/gynecologic surgery, and regular and specialty nursery care. Inova Fairfax Hospital was ranked 6th in the nation by U.S. News & World Report for Gynecology. IFH, IFOH, IAH and ILH provide obstetric services to low-income patients through the Inova Cares for Women with 39,941 in 2023. Inova Alexandria Hospital also works with the Casey Clinic, now run by a healthcare community partner Neighborhood Health, a Federally Qualified Health Center (FQHC) receiving funding from the State of Virginia, the City of Alexandria and the Alexandria Health Department, providing obstetric services to low-income patients. In addition, obstetrical and pediatric services are provided by ILH's hospital-based Natural Birth Center and nursery care. ILH also offers Level III Neonatal ICU specialty services. Pediatrics Inova L.J. Murphy Children's Hospital is Northern Virginia's only children's hospital, a regional tertiary and quaternary referral center with 226 licensed acute care beds, providing the highest level of care. Inova L.J. Murphy Children's Hospital is home to the only Pediatric Intensive Care Unit and Pediatric Trauma Center in the region, as well as the region's only Level IV Neonatal ICU. In 2023, Inova Children's Hospital treated nearly 62,000 visits to children in its Pediatric Emergency Department, more than 10,000 children in inpatient units, and performed more than 5,800 surgeries. Inova Children's Hospital provides a complete range of expert, subspecialized children's services in more than 40 subspecialties, including pediatric cardiac surgery, pediatric cancer care, pediatric orthopedics and sports medicine, pediatric spine surgery, pediatric neurology and neurosurgery. As of December 31, 2023, there are 108 Level IV NICU bassinets. Inova Children's provides a primary care medical home for children of low-income families that are uninsured or have Medicaid through the Inova Cares for Children and Inova Cares for Families. In 2023, the Inova Cares for Children expanded their services to provide care in all 7 locations of the Inova Cares for Families. In 2023, the Inova Cares for Children provided 28,953 visits at an unreimbursed cost of $1.9 million. Inova Loudon Hospital operates a dedicated pediatric emergency room that provided 19,326 visits in 2023. In addition ILH operates a 14-bed pediatric unit that provides for inpatient hospitalizations. Cancer Care Inova Schar Cancer Institute (Inova Schar) is a state-of-the-art cancer care destination, offering medical and surgical oncology, radiation therapy services and outpatient infusion clinics in the DC-Metropolitan area. The comprehensive program is designed to meet the needs evolving in the region. The Inova Schar team is comprised of 1,000+ doctors, researchers, nurses, cancer specialists and emotional support experts. The team delivers the nation's highest standard of compassionate, expert, multi-disciplinary and holistic cancer care customized to the needs of each patient. Inova Schar's coordinated model puts the patient at the center, allowing them to see their entire care team in one visit, at one location, improving communication and minimizing travel time. Nationally renowned specialists, surgeons, genetic counselors and leading researchers are backed by the latest in drug discovery, clinical trials, research and advanced treatments. Inova Schar Cancer Institute, a Department of Inova Fairfax Hospital, operates full-service, accredited cancer centers at four of the five Inova hospitals - Inova Fairfax Hospital, Inova Alexandria Hospital, Inova Fair Oaks Hospital and Inova Loudoun Hospital. Inova Health System is accredited by the American College of Surgeons Commission on Cancer as a Teaching Hospital Cancer Program and has an Integrated Network Cancer Program designation. All radiation oncology departments have also received ASTRO's APEx Accreditation, a designation of excellence in care quality and patient safety. In 2023, Inova Saville Cancer Center expanded community outreach efforts by hiring a Community Health Worker to conduct prevention education and screening for underserved community members. The team launched partnerships with community organizations and conducted outreach to bring 93 mammograms, 190 colon cancer screening kits, 38 pap smears and 88 skin checks to community members. In 2023, Inova Schar Cancer Institute had 240,691 patient visits, providing charity care to 21,476 patients, totaling over $25 Million. The System maintains many programs dedicated to different types of cancer, cancer care and cancer risk assessment, including the Inova Breast Care Program (certified at all 5 hospitals), the Cancer Genetic Counseling Program (hereditary conditions), the Inova Melanoma and Skin Cancer Program, the Inova Head and Neck Cancer Program, the Inova Gastrointestinal Multidisciplinary Clinic, the Inova Genitourinary Cancer Program, the Inova Brain Tumor program, the Inova Thoracic Oncology program, the Inova Molecular Tumor Board, and Life with Cancer (support and education for cancer patients). Stroke Care Inova Loudoun Hospital has been certified by the Joint Commission since 2009 as a Primary Stroke Center. Inova Loudoun Hospital was re-certified in October 2021 as a Joint Commission Certified Advanced Primary Stroke Center. Additionally, the Inova Emergency Room - Leesburg and Inova Emergency Room - Ashburn were certified as Acute Stroke Ready Hospitals (ASRH). Certification as an Advanced Primary Stroke Center and an Acute Stroke Ready Hospital is held by only a small percentage of hospitals nationwide. The Ashburn and Leesburg facilities are the 2nd and 3rd in the state of Virginia to achieve the ASRH designation. The Emergency and Trauma Center at Inova Fairfax Hospital, Northern Virginia's only Level I trauma center, is a state-of-the-art facility and comprehensive stroke center. Emergency medical specialists with specialized expertise in trauma care, pediatrics, neurologic disease, and acute cardiac care treat every type of illness, injury, or life-threatening condition. Inova Center for Rehabilitation, located on the Inova Mount Vernon Hospital campus, is certified by The Joint Commission for Stroke Rehabilitation, and provides comprehensive inpatient and outpatient medical rehabilitation services to patients with traumatic and acquired brain injuries, spinal cord injuries, strokes, multiple sclerosis, and other orthopedic and neurological disabilities. These services are staffed by an interdisciplinary team representing physiatry, neuropsychology, physical therapy, occupational therapy, rehabilitation nursing, therapeutic recreation and case management with treatment tailored to meet the specific needs of each patient. ACCESS of Fairfax, and ACCESS of Reston are 24-hour, free standing emergency centers located in Fairfax City, and Reston, Virginia, respectively. Long Term Care Services and Assisted Living Facilities IHCS's assisted living facilities provide care and services for adults who need assistance with activities of daily living and 24 hour oversight with 360 units for accommodation. Each community has specialized memory care units and programs. A nursing staff is on-site 24 hours a day. IHCS maintains three assisted living facilities in Reston, Fair Oaks, and Mt. Vernon, Virginia. In addition, IHCS owns a 60% interest in an assisted living joint venture in McLean, Virginia. IHCS owns and Sunrise operates all four assisted living facilities across Fairfax County with total assisted living days in 2023 of 107,204. Physical Therapy Services and Inova Physical Therapy Centers IHCS promotes and conducts specific research and educational activities related to rehabilitative care. In 2023, outpatient visits totaled 244,302 with services offered in two locations that are co-located with safety net primary care clinics and at seventeen outpatient centers located throughout Northern Virginia. Areas of specialty include: Physical Therapy (PT) and Occupational Therapy (OT). PART III, LINE 4A Urgent Care Centers and Inova Urgent Care Centers IHCS mission includes serving the community as a not-for-profit organization through the provision of urgent medical care. In 2023, outpatient visits totaled 133,700 with services being provided seven days a week with no appointment necessary at six locations that were open and one that remained closed until the end of 2022. The Centers provide services for medical conditions that require prompt attention but do not pose an immediate or serious threat to life. Treatment is provided for such ailments as sore throats, ear infections or minor cuts and bruises. Services offered also include treatment for work-related injuries and worker's compensation cases. Laboratory tests, X-rays, and flu shots are provided on-site. The Centers are staffed by board-certified/board-eligible physicians and nurse practitioner (providers) licensed in Virginia. A provider, medical assistant and radiology technologist are on duty at the Centers during hours of operation. In the summer of 2022, Inova entered into a partnership with GoHealth Urgent Care. This partnership allows Inova to continue to serve our community and expand our urgent care services throughout the Northern Virginia community. GoHealth provides management services to the centers on a day to day basis and Inova provides expert medical care with our employed providers. This is a new model of care that has been developed by GoHealth. On November 15, 2022 Inova GoHealth Urgent Care centers opened with our new partners with a successful launch. Seven of Inova's existing urgent care locations were acquired and another seven new sites opened in 2023 with more new site openings planned for 2024. Employee Assistance Programs Inova Employee Assistance (EAP) is part of IHCS providing counseling, work life services and resources to help improve the overall health and wellbeing of the team members of Inova Health System and the employer communities served by Inova and its affiliates. EAP was organized to promote health through referral to a wide range of behavioral health, financial, legal and other supportive services. In 2023, EAP supported 24,400 Inova team members with approximately 185,800 total covered employees with the following services: Confidential Counseling: Short-term counseling services can help find solutions to problems ranging from family or workplace frustrations to alcohol and substance use. Financial & Legal Services: Employees and their household members can speak with a financial and legal professional at no charge regarding such issues as retirement planning, debt consolidation, funding a child's college education, mortgage loan options, and a variety of other financial concerns. Work Life Referral Services: Work Life consultants help assess needs, pinpoint appropriate resources, and suggest guidelines for evaluating those resources. Consultants can locate resources in a variety of areas, including childcare, adoption, eldercare, and convenience services. Behavioral Services IHCS's Behavioral Health (BH) Services are committed to providing intensive, personalized care to help people cope with and overcome, mental health diagnosis, addictions and emotional problems that prevent them from fully functioning in the community and realizing their full potential. As the demand for Behavioral Health services continues to rise, Inova has worked to address the need by adding 20 new inpatient BH beds at IMVH, including 6 med psych beds and providing collaborative co-located BH care in Primary Care, Women's, Bariatrics, Neuro, and Transplant Surgery. A systemwide Depression Screening/Care Model was implemented with over 400,000 patients being screened with PHQ 2/9 across Inova ambulatory specialty and primary sites in 2023 with approximately 2% having SI and receiving a warm handoff to BH consultant. A new model was developed to deliver BH care across 11 Emergency Rooms using in-person and telehealth consultation by advanced practice providers (APP's) and BH liaison social workers, allowing medications to be started immediately when indicated and disposition expedited. Inova Comprehensive Addiction Treatment Services (CATS) Program is a leader in providing the highest quality addiction treatment services in Northern Virginia and surrounding areas. A continuum of structured programs offers effective, compassionate treatment for individuals experiencing various forms of addictions including alcohol use, opioid use, and other substance use. Services are available to adults ages 18 and older. The range of services includes Medically Managed Intensive Inpatient, Medically Monitored High-intensity Inpatient service; Partial Hospitalization, Intensive Outpatient, and Outpatient programs; Medication Assisted Therapy and Substance Use Assessments. In 2023, the CATS Partial Hospitalization/Intensive Outpatient Program provided 7,057 encounters. CATS hosted an annual Act On Addiction Summit to community members and facilitated a month long anti-stigma campaign for individuals struggling with substance use disorders. Inova's Medication for Opiate Use Disorders and Alcohol Use Disorders (MOUD/MAUD) was expanded to outpatient programs. Further expansion occurred by placing Peer Recovery Specialists in the Emergency Departments to assist patients who may be presenting with a co-occurring substance use disorder. Inova Kellar Center is a comprehensive, behavioral health treatment center and special education school for children, adolescents, and their families. With locations in Fairfax and Loudoun counties, Inova Kellar Center provides a full continuum of outpatient services for psychiatric disorders, substance use disorders, and behavioral and emotional issues. Services include assessment, psychological testing, educational testing, psychiatric evaluation, medication management, individual, family and group therapy and intensive in-home services. For adolescents who require intense mental health interventions, the Center provides an afterschool Intensive Outpatient Program for mental health and co-occurring disorders and a full day Partial Hospitalization Program for adolescents who are in crisis and unable to attend school. The treatment services and programs are provided to children and families regardless of ability to pay. The Kellar School of Inova Kellar Center provides special education services to children and adolescents who have not been successful in the public-school setting and may be at-risk for being removed from the community and placed in more restrictive settings due to an emotional disability, learning disability, autism or other health impairment. The Center provided 39,878 hours of in-person and tele-psych programming and treatment in addition to 21,102 hours of special education to children, adolescents, and families in 2023. The total unreimbursed cost for 2023 was $3.1 million. Charity Care All Inova facilities, including the IHCS facilities with the exception of the assisted living facilities, provide charity care in accordance with Inova policies which ensures access to medically necessary care for all individuals. Charity care is defined as free or discounted healthcare services provided to persons who cannot afford to pay. These policies include the following key provisions: 1. Emergency care shall be provided to all persons regardless of their ability to pay. 2. Non-emergency medically necessary care, except for certain specialty or referral programs, shall be provided by all hospitals and access facilities to medically indigent patients. "Medically necessary" refers to conditions which, if not promptly treated, would lead to an adverse change in the health status of a patient. Free care is provided to uninsured or underinsured individuals with Family Incomes at or below 400% of the current Federal Poverty Guidelines (FPG). 3. In 2021, the Financial Assistance Policy (FAP) expanded eligible residency by reducing the time of residency from 90 days to 30 days. Form 990, Part III, Line 4a Inova Health System utilizes a multifaceted approach to educate and inform patients and the public about Inova's Financial Assistance Policy (FAP) or sometimes referred to as the Charity Care Policy. Information regarding this policy is widely publicized and is kept up to date on the Inova website and through signage. Upon admission to any Inova hospital or any visit to outpatient facilities or clinics including emergency departments, Inova has information posted regarding patient rights and responsibilities. In addition, Inova provides information about the financial assistance program and referrals to meet with Inova financial counselors who assist patients in completing Inova's financial assistance application. This financial information is reviewed by the Inova Patient Accounts Department with the patient contacted if additional information is required in order to make a determination. The patient is subsequently provided a letter, notifying them as to whether or not they qualify for financial assistance. In 2023, IHCS's unreimbursed cost of charity care, including free and discounted services, was $85.1 million. Medicaid Established under Title XIX of the Social Security Act, this program provides assistance for the medically indigent, including those who cannot pay for care despite being able to afford other living expenses. Also included under this program are the blind, disabled, pregnant women, very low income parents, children, and the elderly. While Virginia Medicaid coverage was expanded in 2022 to increase the number of eligible individuals and include postpartum coverage, the reimbursement that IHCS facilities receive from the Medicaid program routinely falls below the actual cost of services provided. During 2023, IHCS provided care to Medicaid patients at an unreimbursed cost of $150.8 million. Participation in Governmental Programs for Those Without the Ability to Pay Various government programs provide for the indigent, including Medicaid recipients. These programs provide a percentage of reimbursement for qualifying patients; however, payment is typically below the cost of those services. In addition to federal and state programs, the Inova subsidiaries, including IHCS, work with various County governments and agencies in providing certain free services to those residents the County identifies as most in need. PART III, LINE 4D Inova Cares Lions Eye Clinic Administered by Inova Health System (IHS), the Ophthalmology Clinic provides ophthalmic specialty services to the indigent including treatment of glaucoma, retina and cataracts. Inova Cares Lions Eye Clinic provides a part-time ophthalmologist, an ophthalmic technician, and a receptionist for the clinic. The remaining physicians volunteer their services. In 2023, Inova Cares Lions Eye Clinic served 1,376 unique patients with 4,737 visits. Inova Medical House Calls Program The Medical House Calls program is specifically tailored to support elderly patients in their desire to age comfortably at home, aiming to provide primary care to those who have difficulty leaving their homes and promoting their overall health. This initiative is driven by an interdisciplinary team that delivers comprehensive primary care directly to patients in their homes or assisted living facilities. Typically serving patients aged 65 and above who face challenges in attending traditional medical appointments, the program primarily assists individuals managing multiple chronic conditions, coping with changes in functional ability, handling polypharmacy, and dealing with frailty or debility. The primary care services provided through this program involve intensive patient management and meticulous care coordination, with a particular focus on advance care planning. To ensure optimal patient outcomes, the program team establishes robust partnerships with various healthcare entities, including inpatient teams, hospice agencies, skilled nursing facilities, physical therapy, occupational therapy, mental health services, and county support services. In 2023, the program served 1,127 unique patients, with 488 new patients admitted. Additionally, the program completed 8,096 physician/advanced practice provider primary house calls in 51 zip codes across Northern Virginia. Approximately 18,765 nursing and social work case management encounters were provided to support the patient population. ElderLink ElderLink is a non-profit partnership between Inova and the Fairfax Area Agency on Aging. ElderLink provides case management, care coordination, health and wellness programming, and caregiver support to older adults and their caregivers. ElderLink provided service to approximately 550 older adults and their caregivers in 2023. Inova Cares for Families Inova Cares for Families (ICF) provides comprehensive primary care services to patients who reflect the culturally diverse community we serve. The clinics serve as medical homes for patients of all ages, regardless of immigration status, who qualify for Medicaid, FAMIS, Inova's Financial Assistance Program and/or are uninsured. ICF provides services to members of the Alexandria, Annandale, Fairfax, Herndon, Manassas, Mount Vernon and Sterling communities. In 2023, Inova Cares for Families opened a new location in the Mount Vernon community of Virginia. During the summer, free school physicals were held to 268 uninsured children in the Herndon, Manassas and Sterling locations in collaboration with the Loudoun and Prince William Counties school systems and health departments. In 2023, Inova Cares for Families served 15,390 unique patients, a 21 percent increase over 2022, with 33,497 total visits, a 13 percent increase over 2022. Loudoun Family and Patient Education Program Loudoun Family and Patient Education Program serves the community through health education, prevention, wellness programs, and care management. Loudoun Mobile Health Program Loudoun Mobile Health is staffed by nurses and other support staff who provide community health fairs and health screening services. In 2023, the Loudoun Mobile Health Unit was able to screen and educate 2,042 seniors at local community Senior Centers and 845 community members at local health fairs. Through participation in local races, 120 community members received first aid care by the staff. The Loudoun Mobile Health Unit participated in three local parades, where the combined total audience was 30,000 community members. Through a new partnership with Loudoun County Public Schools and the George Washington University School of Nursing, the Loudoun Mobile Health Unit screened 566 individuals through community clinics and school engagements. Cash and In-Kind Contributions to Community Groups ILH donates space, provides cash and in-kind support such as housekeeping and donated staff time to a number of community groups and Loudoun County services. ILH donates space and financial support to the Loudoun Free Clinic which is an independent 501(c)(3) providing primary healthcare services for the uninsured and low-income residents of Loudoun County. ILH donates space to Loudoun Cares, an independent 501(c)(3) organization that provides coordination for social services for the residents of Loudoun County; and the Loudoun Child Advocacy Center. Community Health Education and Promotion As a cornerstone of Inova's holistic health and wellness advocacy, IHCS and its subsidiaries actively spearhead initiatives aimed at enhancing community health and preventing the onset of illnesses. Positioned as a leading purveyor of health education and wellness services, Inova Well is deeply committed to serving the community. Acknowledging the diverse needs of individuals in pursuit of wellness, Inova Well offers a rich array of programming. From personalized health coaching and prenatal assistance to childbirth education, life support recertification, and first aid, our comprehensive services extend to health fair screenings, well-being seminars, fitness classes, and immunizations. Emphasizing accessibility, Inova Well's programs are strategically hosted across community settings, employer worksites, and other convenient locales spanning Northern Virginia and the Greater Metropolitan Washington Area. Inova Team Member Well-being: Inova Well is dedicated to nurturing the health and fitness of team members and their spouses through a comprehensive and nurturing wellness program. Equipping individuals with essential tools, support, and tailored programs, our initiative aims to enhance health and sustain healthy lifestyles. We offer both in-person and virtual wellness coaching sessions, as well as engaging wellness events hosted within Inova's operational units. Throughout 2023, Inova Well facilitated 15,874 meaningful engagements within the health system. The wellness coaches strive to collaboratively set achievable wellness objectives with team members and provide unwavering support as they progress towards optimal health. In 2023 alone, the dedicated board-certified health and wellness coaches conducted 1,105 workshop sessions and organized 291 internal well-being and wellness events exclusively for Inova team members. The Influenza and Covid Vaccination Program alongside Respirator Mask Testing: Under the Inova Well Immunization Program's umbrella, administered a total of 39,375 doses encompassing COVID shots, flu shots, Tdap & Hepatitis B vaccinations, and TB screenings, disseminated across 559 events. The commitment to immunization extends to Inova employees, physicians, community members, and workplaces throughout the metropolitan area. COVID shots: 7,000 doses. Flu shots (Quadrivalent, High-Dose & Peds): 24,095 doses. Including 7,200 shots distributed at 185 clinics for Fairfax County Public School employees and 1,861 shots allocated at 16 clinics for Loudoun County Public School employees. TB screenings, Tdap, Hepatitis B vaccinations: 280 instances. The Respiratory Fit Testing program catered to over 12,473 individuals from both the Inova team and the wider community. The Corporate Wellness and Community Program: Engaging in over 349 health events, the Corporate Wellness and Community Program offers a comprehensive suite of activities, including biometric screenings, seminars, and interactive education stations, totaling 8,013 participations. The Corporate Wellness Programs maintain a steadfast commitment to personalized support and health coaching, targeting behaviors linked to weight management, tobacco cessation, back pain management, pregnancy, and breastfeeding, benefiting 1,452 participants (954 external coaching + 419 external RD = 1,373). Inova Well assigns a dedicated Program Coordinator to The Prince William County Wellness Program, delivering an extensive array of wellness services to county employees. This includes health and wellness seminars, screenings, weekly meditation sessions, a walking challenge, and instructional sessions on healthy supermarket strategies. In 2023 alone, the Program Coordinator reached over 5,000 employee lives in Prince William County. PART III, LINE 4D The Health Education Program: Inova Well delivered essential Life Support education to 15,772 team members and community members, empowering them with crucial life-saving skills. The Inova Well Childbirth Education program provided support to 6,050 community and corporate members, offering comprehensive classes covering topics such as breastfeeding, baby care, and childbirth preparation. The program facilitated over 200 complimentary new mom and new parent support groups, nurturing a supportive community for 1,432 participants. The Inova Well Baby program, specializing in personalized support and education for pregnant and breastfeeding women, extended its reach to approximately 202 Inova team members and their spouses/partners through email and telephonic outreach, ensuring their journey towards parenthood is informed and supported. The Fitness Program: Inova Well's Fitness program delivered a diverse array of over 1,343 fitness classes throughout 2023, catering to both Inova team members and community participants through a blend of in-person and virtual sessions. These classes were hosted across various community locations and offered in multiple formats, including multi-week series, workshops, and drop-in sessions. The program boasts a wide range of class types, including mind-body sessions such as yoga and tai chi, cardio/strength-building exercises like body toning and Zumba, specialized mommy fitness classes such as bootcamp and prenatal yoga, and senior-focused sessions like strength training for seniors and seniorcize. 6,257 individuals actively engaged in these fitness activities, spanning multi-week courses and workshops. The Fitness Program extended beyond traditional exercise by providing over 776 massage therapy appointments to both Inova team members and community members. These appointments ranged from 30 to 90 minutes and offered various massage techniques such as deep tissue, Swedish, Thai, prenatal, postpartum, sports, geriatric, and hot stone massages. Additionally, the Fitness program facilitated over 545 in-person and virtual personal training sessions in 2023, ensuring personalized fitness guidance tailored to individual needs. Witnessing substantial growth, our membership numbers increased from 304 members in January 2023 to 514 by January 2024, with a total membership count of 563 to date. PART V, LINE 2A, NUMBER OF EMPLOYEES The organization falls under a master pay agent and does not file any payroll returns under its own EIN, however all required returns have been filed on time. Form 990, Part VI, Section A, line 1a With the exception of the duties and responsibilities that are reserved to the Board of Trustees as required by law, the Executive Committee is appointed by the Board to support the Board of Trustees in the performance of its duties and responsibilities that are time-sensitive and must be addressed before the next regularly scheduled meeting of the full Board. Form 990, Part VI, Section A, line 6 The organization has a single member. The sole member is Inova Health System Foundation, a charitable 501(c)(3) tax-exempt organization which serves as the parent company of the integrated health care delivery system. Form 990, Part VI, Section A, line 7a The sole member of the organization, Inova Health System Foundation, is a charitable 501(c)(3) tax-exempt organization. The sole member elects the members of the governing body of the organization. Form 990, Part VI, Section A, line 7b The sole member of the organization, Inova Health System Foundation, is a charitable 501(c)(3) tax-exempt organization. The sole member holds reserved powers with respect to certain actions, including approval of borrowings, amendments of Articles of Incorporation and Bylaws. In addition to the reserved powers, under the laws of the Commonwealth of Virginia certain extraordinary actions require member approval, such as mergers, consolidations, liquidations and the sale of substantially all of the assets of the organization. Form 990, Part VI, Section B, line 11b The Form 990 is prepared and provided to the Senior Corporate Controller and external tax consultants for initial review. After the review it is given to the CFO of Inova Health System for review and comment. The Form 990 is presented to the Executive Committee of the Board of Trustees for their review. Upon completion of the Executive Committee review, it is provided to the full Board of Trustees. Form 990, Part VI, Section B, line 12c Annually the organization distributes the conflict of interest policy to all directors, officers, trustees, and key employees. The organization requires that each director, officer, trustee, and key employee acknowledge that they have read, understood, and will abide by the policy. Each director, officer, trustee, and key employee is required to complete and submit an annual conflict of interest disclosure. These disclosures are broad and require that the individual list any business relationships or personal relationships with other directors, officers, trustees, and key employees, as well as any relationships with competitors, or current or potential vendors or contractors. Disclosure statements are reviewed by senior management and any potential conflicts are discussed with governing body chairman to ensure that any member who may have a conflict discloses their potential conflict, and is dismissed from related discussions and recused from participation in applicable decisions. Form 990, Part VI, Section B, line 15 Completed by related entity, Inova Health System Foundation: The compensation of all senior management positions is evaluated annually in consideration of each manager's job content, scope and complexity. Compensation levels for executives are reviewed by an independent external consultant to ensure that remuneration is consistent with the organization's compensation philosophy and objectives and competitive with other large complex health systems. The independent compensation consultant maintains national benchmark compensation databases and surveys and also reviews Forms 990 of comparable healthcare systems to determine market levels of compensation. In addition, the Inova Health System's CEO's compensation is reviewed along with certain other senior executives and approved annually by an independent governing Board, the Executive Compensation & Talent Committee. The job requirements and complexity of all other management positions are evaluated annually using nationally recognized third-party salary surveys to assure that the compensation for such positions is consistent with external market compensation comparisons. Salary ranges are developed for each management position classification to ensure that the compensation levels for these positions are consistent with the organization's compensation philosophy and with competitive market comparisons. Compensation for employed physicians is reviewed and approved by the Provider Contracts Committee. The committee is comprised of executive management of the Clinical Enterprise and Physician Services group. The Fair Market Value (FMV) compensation is based on four nationally recognized industry physician compensation benchmark surveys (MGMA, AMGA, Sullivan & Cotter, Gallagher (formally Integrated)). The committee also utilizes independent consultants to provide FMV opinions for positions that are not readily available in the four published benchmark surveys. The consultants' opinions and compensation survey data are presented to the Provider Contracts Committee for review and approval. Form 990, Part VI, Section C, line 19 Inova Health System makes certain information publicly available. Inova's consolidated financial statements are posted on the Electronic Municipal Market Access's (EMMA) website on a quarterly basis. Inova's governing documents are not currently publicly available. While the conflict of interest policy is not specifically publicly disclosed, Inova's Code of Conduct is on the public website. Section II of the Code of Conduct describes what can constitute a conflict and requires that potential conflicts be reported to management or the Chief Compliance Officer and/or Inova's Legal Department. The Code of Conduct contains the conflict of interest principles, is part of Inova's orientation and annual compliance training, and is available to team members and physicians on Inova's intranet website. Form 990, Part XI, line 9: PARTNERSHIP INCOME -44,201,195. EQUITY IN SUBS 35,300,454. CLOSEOUT ADJUSTMENT 870,110. OTHER -70,345. PART XII, LINE 2B AND 2C, AUDITED FINANCIAL STATMENTS The company is part of the Inova Health System, a not-for-profit integrated health care delivery system serving Northern Virginia and surrounding areas. The company's financial statements are consolidated in the Inova Health System consolidated financial statements. Inova Health System is audited on an annual basis by a "Big Four" independent public accounting firm. In addition, they are responsible for the issuance of a management letter encompassing each member of the consolidated group. The Finance and Audit Committee of the Board of Trustees of Inova Health System is responsible for the oversight of the audit, including the hiring of the audit firm, review and approval of audited financial statements and communication with the external auditors at least twice a year without the presence of internal management. PART XII, LINE 3A, A-133 AUDIT The company is part of the Inova Health System (IHS), a not-for-profit integrated health care delivery system serving Northern Virginia and surrounding areas. IHS receives various federal grants. These grants and awards are audited as part of the consolidated Inova Health System Uniform Guidance compliance audit. The Inova Health System's federal grants are audited on an annual basis by a "Big Four" independent public accounting firm. The Firm issues a "Report of Independent Auditors on Internal Control Over Financial Reporting and on Compliance and Other Matters Based on an Audit of Financial Statements Performed in Accordance with Government Auditing Standards". The Firm also issues a "Report of Independent Auditors on Internal Control Over Financial Reporting and on Compliance and Other Matters Based on an Audit of Financial Statements Performed in Accordance with Government Auditing Standards". The Finance and Audit Committee of the Board of Trustees of Inova Health System is responsible for the oversight of the Uniform Guidance audit, including the hiring of the audit firm, review and approval of audited financial statements and communications with the external auditors without the presence of internal management. INOVA CAP LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 270927074 INSURANCE CAPTIVE VA 6011527 80031284 INOVA HEALTH CARE SERVICES SPRINGFIELD HEALTHPLEX CONDOMINIUM DEVELOPMENT LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 274533736 REAL ESTATE VA 2525613 24756696 INOVA HEALTH CARE SERVICES FC GATEWAY ASSOCIATES LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 461280044 REAL ESTATE VA 239747 2130887 INOVA HEALTH CARE SERVICES INOVA METRO CT LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 475049063 INFORMATION SYSTEMS VA 0 0 INOVA HEALTH CARE SERVICES CLEAN ADVANCED RENEWABLE ENERGY LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 812395604 ENERGY CONSULTING VA 0 0 INOVA HEALTH CARE SERVICES INOVA SHARED SERVICES LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 815346280 IT SERVICES VA 0 732551 INOVA HEALTH CARE SERVICES INOVA PHYSICIAN PARTNERS LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 271219302 PHYSICIAN SERVICES VA 152481370 62512199 INOVA HEALTH CARE SERVICES INOVA PHARMACY PLUS - ISCI LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 833314437 PHARMACY SERVICES VA 130232741 33224359 INOVA HEALTH CARE SERVICES INOVA UCC LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 883046892 URGENT CARE VA 24483167 2778657 INOVA HEALTH CARE SERVICES INOVA OAKVILLE AMBULATORY SURGERY CENTER LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 934412762 SURGERY CENTER VA 0 0 INOVA HEALTH CARE SERVICES INOVA HEALTH SYSTEM FOUNDATION 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 541071867 FUNDRAISING VA 501(C)(3) 12,II N/A 0 LOUDOUN NURSING AND REHABILITATION CENTER 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 541361310 REHABILITATION SERVICES VA 501(C)(3) 10 INOVA HEALTH SYSTEM FOUNDATION 0 TECHNICAL DYNAMICS LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 432041666 EQUIPMENT REPAIRS VA INOVA HEALTH CARE SERVICES RELATED 4732318 10120780 0 1 0.99960 INOVA AMBULATORY SURGERY CTR AT LORTON LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 461955980 SURGERY CENTER VA INOVA HEALTH CARE SERVICES RELATED -2794199 1425320 0 1 0.65080 NORTHERN VIRGINIA SURGERY CENTER 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 203502477 SURGERY CENTER VA INOVA HEALTH CARE SERVICES RELATED 5875236 8675145 0 1 0.63650 FRANCONIA-SPRINGFIELD SURGERY CENTER LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 542018390 SURGERY CENTER VA INOVA HEALTH CARE SERVICES RELATED 6085840 6946326 0 1 0.60250 INOVA RESTON MRI CENTER LLC 8260 WILLOW OAKS CORPORATE DR 750 FAIRFAX VA 22031 264587374 MRI SERVICES VA INOVA HEALTH CARE SERVICES RELATED 5860785 11430933 0 1 0.65000 SUNRISE INOVA MCLEAN ASSISTED LIVING LLC 8260 WILLOW OAKS CORPORATE DR 750 FAIRFAX VA 22031 542022822 ASSISTED LIVING VA INOVA HEALTH CARE SERVICES RELATED 1317616 7451736 0 1317616 0 0.60000 MCLEAN AMBULATORY SURGERY CENTER LLC 8095 INNOVATION PARK DRIVE FAIRFAX VA 22031 474966649 SURGERY CENTER VA INOVA HEALTH CARE SERVICES RELATED 3338301 7976545 0 1 0.55000 INOVA HH HOLDINGS LLC 1050 FORRER BLVD KETTERING OH 45420 825217263 HOME CARE VA INOVA HEALTH CARE SERVICES RELATED -237153 2636480 0 0 0.51000 INOVA LOUDOUN AMBULATORY SURGERY CENTER LLC 8095 INNOVATION PARK DR FAIRFAX VA 22031 203523190 SURGERY CENTER VA INOVA HEALTH CARE SERVICES RELATED 12108527 12620566 0 1 0.56970 FAIRFAX RADIOLOGY CENTERS LLC 8260 WILLOW OAKS CORPORATE DR 750 FAIRFAX VA 22031 352672848 RADIOLOGY SERVICES VA INOVA HEALTH CARE SERVICES RELATED 7826297 46773536 0 1 0.51000 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1