2021-11-14T18:35:56-06:00 2020-12-31 BDO USA LLP 8401 GREENSBORO DRIVE 800 MCLEAN VA 22102 990 2020-01-01 540555201 SOUTHSIDE COMMUNITY HOSPITAL INC % THOMAS L ANGELO SOUT 4343152776 800 OAK STREET FARMVILLE VA 23901 THOMAS L ANGELO CEO 4342004712 2021-11-12 true THOMAS L ANGELO 999009999 Marc Berger P01871563 7038930600 2 2020 2022-09-23 18:48:47Z CENTRA SOUTHSIDE COMMUNITY HOSPITAL THOMAS L ANGELO 800 OAK STREET FARMVILLE VA 23901 95963467 false X HTTP://SCH.CENTRAHEALTH.COM X 1926 VA TO PROVIDE HEALTHCARE SERVICES FOR EIGHT COUNTIES IN CENTRAL VIRGINIA 16 13 624 44 0 23070 7054719 95254440 87967440 164467 89427 1074241 851881 96516218 95963467 26450 0 0 0 34549691 33133203 0 0 0 46326081 46289673 80902222 79422876 15613996 16540591 84765991 131365145 7110826 37003287 77655165 94361858 X WE ARE DEDICATED TO IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE BY PROVIDING HIGH QUALITY HEALTHCARE WITH A PERSONAL TOUCH. false false 69483664 88529250 SOUTHSIDE COMMUNITY HOSPITAL, INC. 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IS INCLUDED IN CENTRA HEALTH, INC'S CONSOLIDATED AUDIT REPORT FOR YEAR ENDING DECEMBER 31, 2020. THE FOLLOWING FOOTNOTE REGARDING LIABILITY FOR UNCERTAIN TAX POSITIONS (FIN48) IS FOUND IN THIS CONSOLIDATED REPORT. CENTRA HEALTH, INC., CCRC, INC., FOUNDATION, SOUTHSIDE, AND BEDFORD ARE EXEMPT FROM INCOME TAX UNDER SECTION 501 (A) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO INCOME TAXES HAVE BEEN PROVIDED FOR THESE ENTITIES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS EXCEPT FOR TAXES RELATED TO CERTAIN UNRELATED BUSINESS INCOME ENGAGED IN BY CENTRA. CENTRA MEDICAL GROUP, LLC, CHIC, CENTRA SPECIALTY HOSPITAL, HEALTHWORKS, CVQCN, AND OUTPATIENT REHAB ARE DISREGARDED FOR FEDERAL INCOME TAX PURPOSES AND, THEREFORE, ARE INCLUDED UNDER CENTRA'S TAX RETURN. CENTRA HAS ADOPTED RELEVANT ACCOUNTING STANDARDS RELATED TO TAXES FOR ITS SUBSIDIARIES, GBC, PCHP HOLDING, INC. AND PCHP. UNDER THE ASSET-AND-LIABILITY METHOD FOR THESE STANDARDS, DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE TEMPORARY DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS AND THE TAX BASIS OF THE SUBSIDIARY'S ASSETS AND LIABILITIES AT INCOME TAX RATES EXPECTED TO BE IN EFFECT WHEN SUCH AMOUNTS ARE REALIZED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN EARNINGS IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. CHIC IS WHOLLY OWNED BY CENTRA HEALTH, INC. ANY LIABILITY FOR TAXES IS PASSED THROUGH TO CENTRA HEALTH, INC. A PROVISION WILL BE MADE WHEN OPERATIONS OF THIS SUBSIDIARY INDICATES A LIABILITY FOR TAXES. CENTRA HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2020. CENTRA BELIEVES THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2017. true true X true X true X true false true true 2018799 2018799 0.02540 17884109 22187972 0 0.00000 19902908 22187972 2018799 0.02540 18630 18630 0.00020 1510 1510 0.00000 20140 20140 0.00020 19923048 22187972 2038939 0.02560 true 9221875 26590567 25364014 1226553 X true true NONE 1 1 SOUTHSIDE COMMUNITY HOSPITAL 800 OAK STREET FARMVILLE VA 23901 WWW.CENTRAHEALTH.COM/SCH X X X SOUTHSIDE COMMUNITY HOSPITAL 1 false false true X X X X X X X X X 18 true false false true X WWW.CENTRAHEALTH.COM/SCH X X true 18 true WWW.CENTRAHEALTH.COM/SCH false true X 200. 400. X X X X true true X X X X true X WWW.CENTRAHEALTH.COM/SCH X WWW.CENTRAHEALTH.COM/SCH X WWW.CENTRAHEALTH.COM/SCH X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5: IN 2017, THE PARTNERSHIP FOR HEALTHY COMMUNITIES WAS FORMED AND IS A PLANNING INITIATIVE LED BY CENTRA, CENTRA FOUNDATION, THE COMMUNITY ACCESS NETWORK AND THE CENTRAL VIRGINIA, PIEDMONT, AND PITTSYLVANIA/DANVILLE HEALTH DISTRICTS IN COLLABORATION WITH THE BEDFORD COMMUNITY HEALTH FOUNDATION, GREATER LYNCHBURG COMMUNITY FOUNDATION, AND UNITED WAY OF CENTRAL VIRGINIA. THE PARTNERS ARE COMMITTED TO REGIONAL ALIGNMENT OF A COLLABORATIVE AND RIGOROUS NEEDS ASSESSMENT PROCESS THAT WILL RESULT IN ACTION-ORIENTED SOLUTIONS TO IMPROVE THE HEALTH OF THE COMMUNITIES THEY SERVE. A COMMUNITY HEALTH ASSESSMENT TEAM COMPOSED OF 30 INDIVIDUALS WITH A BROAD REPRESENTATION OF COMMUNITY LEADERS AND CROSS-SECTOR STAKEHOLDERS ACTED TO OVERSEE, ADVISE AND SUPPORT THE CHNA ACTIVITIES. THE PARTICIPANTS OF THIS CHNA & IMPLEMENTATION PLAN WERE: 2018 Farmville Area Core Team Greater Lynchburg Community Foundation Centra- Pittsylvania Central Virginia Health District Community Access Network Centra Foundation Central Virginia Health District Bedford Community Health Foundation Centra- Bedford Centra- Lynchburg Centra- Farmville Piedmont Health District Christopher Nye Consulting Pittsylvania/Danville Health District Community Access Network United Way of Central Virginia CommunityWorks Data Entry & Analysis Team Liberty University Centra College of Nursing CommunityWorks Virginia Commonwealth University 2018 Farmville Area Community Health Assessment Team Centra Southside Community Hospital STEPS, Inc. Community Action Agency Greater Lynchburg Community Foundation Community Foundation United Way Community Foundation Central Virginia Health District Public Health Piedmont Health Coalition/HEAL Community Coalition Buckingham County DSS Social Services Community Access Network Health center; free clinic Cumberland County Government Farmville Police Department Public Safety Amelia County Government Longwood University Education Central Va Health Services Health center Roma Morris Department of Social Services, Prince Edward County Piedmont Health District Public Health Christopher Nye Consulting Data consultant Heart of Virginia Free Clinic Free Clinic Community Volunteers Farmville Presbyterian Church Faith-based FACES Food Pantry Food Pantry Hampden Sydney College Education Consultant- Economic Development Va Coop Extension Central Virginia Health Services Health center CommunityWorks Project Management Piedmont Senior Resources Area Agency on Aging SCHEDULE H, PART V, SECTION B, LINE 7d: HARD COPIES OF THE CHNA & IMPLEMENTATION PLAN WERE SENT TO ALL CHNA COMMUNITY ADVISORY BOARD MEMBERS. SCHEDULE H, PART V, SECTION B, LINE 11: THE FARMVILLE AREA COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN WAS CONDUCTED IN 2018 AND IDENTIFIED THREE OVERARCHING ACTION PLAN PRIORITIES AIMED AT IMPROVING THE HEALTH OF THE VARIOUS COMMUNITIES SERVED. THESE PRIORITIES INCLUDED TRANSPORTATION; ACCESS TO AFFORDABLE HEALTHCARE AND ACCESS TO AFFORDABLE HOUSING. WITH REGARD TO "TRANSPORTATION", THE CENTRA FOUNDATION, FOR TWO YEARS, HAS COLLABORATED WITH PEIDMONT SENIOR RESOURCES TO PROVIDE VEHICLES TO TRANSPORT THEIR SENIOR CITIZENS. IN JUNE OF 2018, CENTRA STARTED A COMMUNITY PARAMEDIC PROGRAM IN FARMVILLE. IN THIS PROGRAM PARAMEDICS VISIT PATIENTS IN THEIR HOMES AFTER HOSPITAL ADMISSIONS TO PROVIDE CARE AND COORDINATE TRANSPORTATION TO VARIOUS MEDICAL APPOINTMENTS. CENTRA HAS IMPLEMENTED TELEMEDICINE; THE "ACCESS TO AFFORDABLE HEALTHCARE" PRIORITY HAS RESULTED IN CONTINUED EXPANSION OF THE CENTRA SOUTHSIDE COMMUNITY MEDICAL CENTER IN FARMVILLE. CENTRA HAS ADDED SEVERAL MORE PROVIDERS AND SPECIALISTS AND HAS EXTENDED THE HOURS OF OUR MAIN CLINIC TO 8AM-8PM, MONDAY-SATURDAY. CENTRA HAS UTILIZED THE MAMMO-VAN TO INCREASE THE NUMBER OF MAMMOGRAMS TO BE PERFORMED IN THIS AREA. CENTRA CONTINUES TO PROVIDE HEALTHFAIRS AND SCREENINGS IN MANY OF ITS COMMUNITIES, INCLUDING VERY DISCOUNTED SPORTS PHYSICLAS FOR CHILDREN, AND A CARDIAC FAIR AT THE HOSPITAL. THE AUXULIARY CONTINUES THE GUILD FUND, WHICH OFFSETS THE COSTS OF PRESCRIPTIONS FOR THOSE WHO CANNOT AFFORD THEM. WITH REGARD TO AFFORDABLE HOUSING, A COALITION WITH HOSPITAL REPRESENTATION HAS BEEN FORMED. AN APPROXIMATE $3 MILLLION DOLLAR GRANT HAS BEEN SECURED TO PARTNER WITH OTHER BUSINESSES AND SCHOOLS TO DEVELOP A LARGE COMMUNITY THAT HAS MULTIPLE TYPES OF HOUSING. CENTR AHS PARTNERED WITH HABITAT FOR HUMANITY AS WELL. RATIONALE FOR NOT INCLUDING THE REMAINING INDICATORS AS PRIORITIZED BY OUR CHNA COMMUNITY ADVISORY BOARD INCLUDED A SENSE THAT THESE CRITICAL NEEDS WERE HIGHLY COMPLEX IN NATURE AND AFFECTED A WIDE VARIETY OF INFLUENCING FACTORS - MANY WELL BEYOND THE CAPABILITY AND RESOURCES AND AVAILABLE THROUGH CENTRA AND/OR ITS COLLABORATING PARTNERS. FURTHERMORE, OTHER COMMUNITY-BASED INITIATIVES WERE ALREADY TARGETING THESE ISSUES. 3 SOUTHSIDE COMM HOSP HOMECARE SERVICES 711 OAK STREET FARMVILLE VA 23901 HOME HEALTH SERVICES SOUTHSIDE HOSPICE 713 OAK STREET FARMVILLE VA 23901 HOSPICE CARE SOUTHSIDE PACE 1530 SOUTH MAIN STREET FARMVILLE VA 23901 CARE FOR THE ELDERLY PART I, LINE 6A: INFORMATION ON COMMUNITY BENEFIT IS REPORTED ANNUALLY THROUGH A REPORT PREPARED BY CENTRA HEALTH, INC., SOLE MEMBER CORPORATION OF SOUTHSIDE COMMUNITY HOSPITAL, INC. PART I, LINE 7: COST-TO-CHARGE RATIO WAS USED TO CALCULATE THE EXPENSE. PART II: SOUTHSIDE COMMUNITY HOSPITAL, INC. CONTINUOUSLY WORKS ON IMPROVING ITS RELATIONSHIP WITH THE COMMUNITY IT SERVES BY OFFERING MANY SERVICES, SUCH AS, COMMUNITY SUPPORT, COMMUNITY HEALTH IMPROVEMENT, WORKFORCE DEVELOPMENT, ETC. SOUTHSIDE COMMUNITY HOSPITAL, INC. ALSO HOSTS AND/OR PARTICIPATES IN VARIOUS CAREER FAIRS IN ORDER TO REACH OUT TO YOUNG ADULTS WHO MAY BE INTERESTED IN THE HEALTHCARE PROFESSION. COMMUNITY SUPPORT: SOUTHSIDE COMMUNITY HOSPITAL, INC. CONTINUOUSLY WORKS ON IMPROVING ITS RELATIONSHIP WITH THE COMMUNITY IT SERVES BY PARTICIPATING IN NUMEROUS HEALTH FAIRS, CONDUCTING HEALTH EDUCATION SEMINARS, PROVIDING SCHOOL-BASED HEALTH PROGRAMS, ETC. IT SPONSORS AND/OR PARTICIPATES IN NUMEROUS EVENTS THROUGHOUT THE YEAR. WE FEEL AN ESSENTIAL PART OF BEING A GOOD NEIGHBOR WITHIN THE COMMUNITY IS TO PROMOTE HEALTH, SAFETY, AND WELL-BEING ACTIVITIES IN ORDER TO BENEFIT THOSE AROUND THE COMMUNITY. COALITION BUILDING: SOUTHSIDE COMMUNITY HOSPITAL, INC. IS COMMITTED TO REACHING OUT TO THE COMMUNITY IN ORDER TO INFORM THE PUBLIC ABOUT THE NUMEROUS HEALTH FAIRS, HEALTH SEMINARS, AND GENERAL INFORMATIONAL SESSIONS OFFERED BY THE ORGANIZATION THROUGHOUT THE YEAR. WE PARTICIPATE IN LOCAL EVENTS IN ORDER TO REACH AS MANY COMMUNITY MEMBERS AS POSSIBLE IN ORDER TO PROMOTE HEALTH AND WELL-BEING TO AS MANY INDIVIDUALS AS POSSIBLE. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: HELPING THE COMMUNITY IMPROVE THEIR HEALTH IS AN IMPORTANT MISSION OF SOUTHSIDE COMMUNITY HOSPITAL, INC. WE FEEL PASSIONATE ABOUT IMPROVING ACCESS TO CARE, PUBLIC HEALTH, ETC. WE ARE EXCITED TO PARTICIPATE IN NUMEROUS EVENTS SUCH AS THE MORTON COMMUNITY PRAYER BREAKFASTS THROUGHOUT THE YEAR IN ORDER TO STAY CONNECTED TO THE COMMUNITY WE SERVE. BY STAYING CONNECTED WE ARE ABLE TO RECOGNIZE AND ADDRESS NEEDS THROUGHOUT OUR REGION. PART III, SECTION A, LINE 1: ON JANUARY 1, 2012, CENTRA HEALTH, INC. AND SUBSIDIARIES ADOPTED ACCOUNTING STANDARDS UPDATE (ASU) 2011-07 WHICH CHANGED CENTRA'S PRESENTATION OF PROVISION FOR DOUBTFUL ACCOUNTS TO A DEDUCTION FROM NET PATIENT SERVICE REVENUE. THIS HAS BEEN DISCLOSED IN THE FOOTNOTES OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THEREFORE, CENTRA HEALTH, INC. AND ITS SUBSIDIARIES, INCLUDING SOUTHSIDE COMMUNITY HOSPITAL, INC. AND BEDFORD MEMORIAL HOSPITAL, REPORT BAD DEBT IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. PART III, SECTION A, LINES 2 & 3: SEE DESCRIPTION FOR PART III, SECTION A, LINE 4. PART III, SECTION A, LINE 4: THE ORGANIZATION BELIEVES THAT ITS PROCEDURES CONCERNING THE APPLICATION OF ITS FINANCIAL ASSISTANCE POLICY ARE SUFFICIENTLY THOROUGH TO EXCLUDE ALL PATIENTS WHO ARE ELIGIBLE FOR CHARITY CARE FROM BAD DEBT. THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS INCLUDE THE FOLLOWING FOOTNOTE ABOUT BAD DEBT: "GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. CENTRA ALSO PROVIDES SERVICES TO UNINSURED PATIENTS AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT FROM STANDARD CHARGES. CENTRA ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. IMPLICIT PRICE CONCESSIONS RELATE PRIMARILY TO AMOUNTS DUE DIRECTLY FROM PATIENTS. ESTIMATED PRICE CONCESSIONS ARE RECORDED FOR ALL UNINSURED ACCOUNTS, REGARDLESS OF THE AGE OF THOSE ACCOUNTS. ACCOUNTS ARE WRITTEN OFF WHEN ALL REASONABLE INTERNAL AND EXTERNAL COLLECTION EFFORTS HAVE BEEN MADE. THERE HAVE BEEN NO SIGNIFICANT CHANGES IN THE CURRENT YEAR TO THE UNDERLYING ASSUMPTIONS USED BY CENTRA TO ESTIMATE THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SIGNIFICANT CHANGES IN PAYOR MIX, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE COULD AFFECT THE NEATURE, AMOUNT, TIMING, AND UNSERTAINTY OF THESE REVENUES AND CASH FLOWS. ADJUSTMENTS TO PREVIOUS REIMBURSEMENT ESTIMATES ARE REPORTED IN NET PATIENT SERVICE REVENUES IN THE PERIODS THAT SUCH ADJUSTMENTS BECOME KNOWN. FOR THE YEARS ENDED DECEMBER 31, 2020 AND 2019, THE IMPACT OF CHANGES TO PREVIOUS TRANSACTIONS PRICE ESTIMATES WAS CONSIDERED IMMATERIAL TO THE CURRENT PERIOD." (CENTRA HEALTH, INC. AND SUBSIDIARIES, FY 2020 AUDIT REPORT, PAGE 14) "CONSISTENT WITH CENTRA'S MISSION, SERVICES ARE PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, CENTRA HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURANCE BALANCES (FOR EXAMPLE, COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS CENTRA EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS." (CENTRA HEALTH, INC. AND SUBSIDIARIES, FY 2020 AUDIT REPORT, PAGE 15) PATIENTS WHO MEET CENTRA'S CRITERIA FOR CHARITY CARE ARE PROVIDED CARE WITHOUT CHARGE OR AT AMOUNTS SUBSTANTIALLY LESS THAN ESTABLISHED RATES IN ACCORDANCE WITH CENTRA'S FINANCIAL ASSISTANCE POLICY. SINCE CENTRA DOES NOT PURSUE COLLECTION OF THESE AMOUNTS, THEY ARE DETERMINED TO QUALIFY AS CHARITY CARE AND ARE NOT REPORTED AS REVENUE. WHILE CHARITY CARE IS EXCLUDED FROM NET PATIENT SERVICE REVENUE, CENTRA MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THIS INCLUDES THE AMOUNT OF CHARGES FOREGONE AND THE ESTIMATED COSTS INCURRED FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. COSTS INCURRED ARE ESTIMATED BASED ON THE RATIO OF TOTAL OPERATING EXPENSE TO GROSS CHARGES." (CENTRA HEALTH, INC. AND SUBSIDIARIES, FY 2020 AUDIT REPORT, PAGE 15) PART III, SECTION B, LINE 8: THE CALCULATION OF MEDICARE SHORTFALL DOES NOT REFLECT ALL OF THE ORGANIZATION'S REVENUES AND COSTS ASSOCIATED WITH ITS PARTICIPATION IN THE MEDICARE PROGRAM, PER IRS INSTRUCTIONS. MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE MEDICARE COST REPORT USING THE COST TO CHARGE RATIO. THE HOSPITAL DID NOT EXPERIENCE A MEDICARE SHORTFALL IN 2020, THUS NO COMMUNITY BENEFIT WAS RECOGNIZED DUE TO A SHORTFALL. PART III, SECTION C, LINE 9B: SOUTHSIDE COMMUNITY HOSPITAL RECOGNIZES THAT MEDICAL EXPENSES ARE OFTEN UNEXPECTED AND CAUSE FINANCIAL HARDSHIP. ALL ACCOUNTS WITH SELF PAY BALANCES WILL FOLLOW UNIFORM COLLECTION PROTOCOLS. THESE PROTOCOLS ARE ELECTRONICALLY ADMINISTERED THROUGH CENTRA'S HOSPITAL INFORMATION SYSTEM. WHEN AN ACCOUNT REACHES THE END OF THE SYSTEM GENERATED COLLECTION CYCLE AND MEETS SAID CRITERIA, THE ACCOUNT BALANCE WILL BE PROCESSED AS BAD DEBT AND REPORTED TO A COLLECTION AGENCY. CRITERIA FOR BAD DEBT WILL BE APPLIED CONSISTENTLY REGARDLESS OF AGE, RACE, RELIGION OR OTHER PROTECTIVE CLASS. PRIOR TO BAD DEBT PROCESSING, ACCOUNTS ARE ELECTRONICALLY SCREENED FOR PRESUMPTIVE FINANCIAL ASSISTANCE AND WRITTEN DOWN TO ZERO WHEN SCORES ARE WITHIN PRE-ESTABLISHED RANGES. SOUTHSIDE COMMUNITY HOSPITAL APPLIES UNIFORM COLLECTION PROTOCOLS TO ALL UNPAID ELIGIBLE CHARGES REGARDLESS OF RACE, SEX, AGE, DISABILITY, NATIONAL ORIGIN OR RELIGION. PATIENTS KNOWN BY CENTRA TO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT SUBJECT TO COLLECTION PROTOCOLS. IF DURING COLLECTION PROTOCOLS, OR AFTER REFERRAL TO AN OUTSIDE COLLECTION AGENCY, IT IS DISCOVERED PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY, INCLUDING ANY AND ALL EXTRAORDINARY COLLECTION EFFORT, IS IMMEDIATELY STOPPED. FINANCIAL ASSISTANCE FOR ELIGIBLE CHARGES IS AVAILABLE TO ALL CENTRA PATIENTS WHO QUALIFY BASED ON ESTABLISHED AND WIDELY PUBLISHED INCOME AND ASSET CRITERIA. PART VI, LINE 2: THE 2018 FARMVILLE AREA COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INCORPORATED AN EXPANDED COMMUNITY "VOICE" (PRIMARY DATA) AS WELL AS THE COLLECTION OF OVER 65 SOURCES OF PUBLICLY AVAILABLE SECONDARY DATA. IN ADDITION, INFORMATION REGARDING AVAILABLE COMMUNITY RESOURCES WAS GATHERED. PRIMARY DATA INCLUDED FINDINGS FROM A COMMUNITY HEALTH SURVEY; STAKEHOLDERS' FOCUS GROUP AND SURVEY; AND TARGET POPULATION FOCUS GROUPS. DETAILS ON THE SPECIFIC METHODOLOGY AND FINDINGS OF THE PRIMARY AND SECONDARY DATA COMPONENTS ARE INCLUDED IN THE FOLLOWING SECTIONS. THE DATA COLLECTED FOR THE CHNA IS REPORTED USING THE FRAMEWORK FOR COUNTY HEALTH RANKINGS AND ROADMAPS, A COLLABORATION BETWEEN THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE AND THE ROBERT WOOD JOHNSON FOUNDATION. THE WORK IS ROOTED IN A DEEP BELIEF IN HEALTH EQUITY, THE IDEA THAT EVERYONE HAS A FAIR AND JUST OPPORTUNITY TO BE AS HEALTHY AS POSSIBLE, REGARDLESS OF RACE, ETHNICITY, GENDER, INCOME, LOCATION OR ANY OTHER FACTOR. RELEASED ANNUALLY, THE RANKINGS ARE BASED ON A MODEL OF POPULATION HEALTH THAT EMPHASIZES THE MANY FACTORS, THAT IF IMPROVED, CAN HELP MAKE COMMUNITIES HEALTHIER PLACES TO LIVE, LEARN, WORK AND PLAY. THE COUNTY HEALTH RANKINGS MODEL MEASURES HEALTH OUTCOMES AND HEALTH FACTORS FOR EACH COMMUNITY. HEALTH OUTCOMES REPRESENT HOW HEALTHY A COUNTY IS BY DETERMINING: * LENGTH OF LIFE (MORTALITY) --PREMATURE DEATH * QUALITY OF LIFE (MORBIDITY) --HEALTH-RELATED QUALITY OF LIFE (OVERALL HEALTH, PHYSICAL AND MENTAL HEALTH) --BIRTH OUTCOMES HEALTH FACTORS REPRESENT WHAT INFLUENCES THE HEALTH OF A COUNTY AND INCLUDES FOUR TYPES OF FACTORS: * SOCIAL AND ECONOMIC FACTORS (ACCOUNTS FOR 40% OF WHAT INFLUENCES HEALTH) --COMMUNITY SAFETY -- EDUCATION -- EMPLOYMENT -- FAMILY AND SOCIAL SUPPORT -- INCOME * HEALTH BEHAVIORS (ACCOUNTS FOR 30% OF WHAT INFLUENCES HEALTH) --ALCOHOL AND DRUG USE --DIET AND EXERCISE --SEXUAL ACTIVITY --TOBACCO USE --OTHER BEHAVIORS * CLINICAL CARE (ACCOUNTS FOR 20% OF WHAT INFLUENCES HEALTH) --ACCESS TO CARE --QUALITY OF CARE * PHYSICAL ENVIRONMENT (ACCOUNTS FOR 10% OF WHAT INFLUENCES HEALTH) --AIR AND WATER QUALITY --HOUSING AND TRANSIT (HTTP://WWW.COUNTYHEALTHRANKINGS.ORG/) ALL OF THE DATA COLLECTED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS USED TO PRIORITIZE NEEDS FOR THE FARMVILLE SERVICE AREA AND WILL BE USED TO DEVELOPMENT A 3-YEAR IMPLEMENTATION PLAN FOR THE HOSPITAL SYSTEM, COMMUNITY PARTNERS, AND STAKEHOLDERS IN THE FARMVILLE SERVICE AREA. PART VI, LINE 3: SOUTHSIDE COMMUNITY HOSPITAL TAKES A MULTIDISCIPLINARY APPROACH TO INFORMING OUR PATIENTS AND COMMUNITY ABOUT FINANCIAL ASSISTANCE. INFORMATION ABOUT FINANCIAL ASSISTANCE AND CHARITY CAN BE FOUND ON CENTRA'S INTERNET PAGE PROVIDING FULL DISCLOSURE ABOUT QUALIFICATIONS AND THE APPLICATION PROCESS. INDIVIDUALS MAY OBTAIN INFORMATION AND AN APPLICATION FROM ANY REGISTRATION POINT OR CUSTOMER SERVICE UNIT, IN PERSON OR BY PHONE. SIGNS ARE POSTED IN CONSPICUOUS LOCATIONS ALERTING INDIVIDUALS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND WHERE TO OBTAIN ADDITIONAL INFORMATION. BROCHURES ABOUT FINANCIAL ASSISTANCE ARE MADE AVAILABLE IN REGISTRATION AND CUSTOMER SERVICE. WHILE PATIENTS ARE HOSPITALIZED, A FINANCIAL COUNSELOR PROVIDES FINANCIAL ASSISTANCE INFORMATION, SCREENS PATIENTS FOR FEDERAL AND STATE PROGRAMS AND GIVES AN OPPORTUNITY TO ASK QUESTIONS. ADDITIONALLY, ON THE BOTTOM OF THE CURRENT STATEMENTS IS THE FOLLOWING VERBIAGE: "CAN'T PAY YOUR BILL? FINANCIAL ASSISTANCE AND FLEXIBLE PAYMENT OPTIONS ARE AVAILABLE BY CONTACTING CENTRA CUSTOMER SERVICE AT (434) 200-3777." PART VI, LINE 4: SOUTHSIDE COMMUNITY HOSPITAL, INC. IS LOCATED IN FARMVILLE, VIRGINIA, WHICH IS 50 MILES EAST OF LYNCHBURG AND 50 SOUTHWEST OF RICHMOND. AS A SOLE COMMUNITY HOSPITAL, IT IS CENTRALLY LOCATED TO SERVE THE RESIDENTS OF AMELIA, BUCKINGHAM, CHARLOTTE, CUMBERLAND, LUNENBURG, NOTTOWAY, AND PRINCE EDWARD COUNTIES, WHICH MAKES UP ITS PRIMARY SERVICE AREA (PSA). THE HOSPITAL WAS ESTABLISHED TO PROVIDE HEALTHCARE TO THIS MOSTLY RURAL AREA. THE 2020 POPULATION FOR THE HOSPITAL'S PSA WAS APPROXIMATELY 108,193. THE 2020 AVERAGE PERCENT OF THE PSA POPULATION THAT WAS 65 YEARS OF AGE AND OLDER WAS 20.15%. THE MEDIAN HOUSEHOLD INCOME (IN 2019 DOLLARS) IN THE PSA WAS $46,369 AS COMPARED TO THE STATE MEDIAN OF $74,222. __________________________________________________________________________ SCH - 2020 FORM 990, PART VI, LINE #4: COMMUNITY INFORMATION: DESCRIBE THE COMMUNITY THE ORGANIZATION SERVES, TAKING INTO ACCOUNT THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVES: $ 35,995 FARMVILLE $ 40,573 CHARLOTTE $ 44,303 LUNENBURG $ 45,535 NOTTOWAY $ 47,202 PRINCE EDWARD $ 47,469 CUMBERLAND $ 49,025 BUCKINGHAM $ 57,946 AMELIA $ 46,369 MEDIAN HOUSEHOLD INCOME FOR PSA PART VI, LINE 5: SOUTHSIDE COMMUNITY HOSPITAL, INC. PLAYS AN IMPORTANT ROLE IN PROMOTING HEALTH IN THE COMMUNITIES IT SERVES. THE HOSPITAL HOSTS FREE WORKSHOPS AND EDUCATIONAL SEMINARS ON DIABETES, STROKE PREVENTION, AND HEART HEALTH, TO NAME A FEW. SOUTHSIDE COMMUNITY HOSPITAL, INC. ALSO PARTICIPATES IN NUMEROUS HEALTH FAIRS ANNUALLY, PROVIDING FREE SCREENINGS TO THE PUBLIC. THE HOSPITAL HOSTED TWO ADVANCE DIRECTIVE DAYS TO BRING AWARENESS TO THE NEED OF PREPAREDNESS AT END OF LIFE. BREAST-FEEDING, CHILDBIRTH, AND CAR SEAT SAFETY ARE JUST A FEW OF OTHER CLASSES MADE AVAILABLE FOR COMMUNITY MEMBERS. SOUTHSIDE COMMUNITY HOSPITAL, INC. ALSO HOSTS SEVERAL SUPPORT GROUPS INCLUDING CHRONIC PAIN SUPPORT GROUP AND DIABETES SUPPORT GROUP. WE ALSO HAVE A TEEN VOLUNTEER PROGRAM AND A COLLEGE VOLUNTEER PROGRAM FOR STUDENTS AT LONGWOOD UNIVERSITY, HAMPDEN-SYDNEY COLLEGE, AND SOUTHSIDE VIRGINIA COMMUNITY COLLEGE. DURING THE YEAR, THE HOSPITAL ALSO SUPPORTS NUMEROUS HEALTH RELATED SUPPORT GROUPS WITH EDUCATIONAL MATERIALS AND PROFESSIONAL KNOWLEDGE. PART VI, LINE 6: SOUTHSIDE COMMUNITY HOSPITAL, INC.'S AFFILIATION WITH CENTRA HEALTH, INC. BEGAN JANUARY 2006. IT SEEMED ONLY NATURAL THAT SOUTHSIDE COMMUNITY HOSPITAL, INC. WOULD PARTNER WITH CENTRA HEALTH, INC. SINCE THE OTHER CENTRA HOSPITALS ARE LOCATED WITHIN 50 MILES WEST OF SOUTHSIDE COMMUNITY HOSPITAL, INC. CENTRA HEALTH, INC. HAS A NATIONAL REPUTATION FOR CLINICAL EXCELLENCE AND PATIENT SATISFACTION. SOUTHSIDE COMMUNITY HOSPITAL, INC. AND CENTRA OFFICIALS BELIEVE THE COMBINED ORGANIZATIONS WILL BE STRENGTHENED THROUGH AN EXCHANGE OF BEST PRACTICES AND ECONOMIES OF SCALE. SOUTHSIDE PATIENTS HAVE BETTER ACCESS TO A BROADER RANGE OF ADVANCED CLINICAL SERVICES THAT ARE AVAILABLE AT CENTRA HEALTH, INC.'S LYNCHBURG HOSPITALS. THE AFFILIATION IS ONE IN A SERIES OF STEPS IN WHICH SOUTHSIDE COMMUNITY HOSPITAL, INC.'S LEADERS RECOGNIZED THE NEED TO PARTNER WITH AN ORGANIZATION THAT SHARED A MISSION OF EXCELLENT CARE. SOUTHSIDE HAS BEEN ABLE TO MAKE STRUCTURAL IMPROVEMENTS, REPLACE MEDICAL EQUIPMENT WITH NEWER MEDICAL TECHNOLOGY, AND UPDATE COMPUTER SYSTEMS. SOUTHSIDE COMMUNITY HOSPITAL, INC. HAS, ALSO, SUCCESSFULLY RECRUITED BOARD-CERTIFIED SURGEONS AND SPECIALISTS, NEW EMERGENCY PHYSICIANS, AND EXTENDED THEIR HOSPITALIST PROGRAM. SOUTHSIDE COMMUNITY HOSPITAL, INC. HAS BEEN THE HEALTHCARE CENTER OF SOUTHSIDE VIRGINIA SINCE OPENING ITS DOORS NOVEMBER 9, 1927. SINCE THEN, IT HAS OPERATED ON A NON-PROFIT BASIS WITH THE GOAL OF HELPING TO HEAL THE ILL AND INJURED. THE HOSPITAL SERVES THE RESIDENTS OF THE TOWN OF FARMVILLE AND AMELIA, BUCKINGHAM, CHARLOTTE, CUMBERLAND, LUNENBURG, NOTTOWAY, AND PRINCE EDWARD COUNTIES. PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT: VIRGINIA false true false false false false false false false BIKRAM S BAL MD DIRECTOR 850144 0 110629 0 1138 0 11747 0 5926 0 979584 0 0 0 THOMAS ANGELO VP & SCH CEO 236982 0 0 0 9305 0 7287 0 22075 0 275649 0 0 0 CLAUDIA MEINHARD CHIEF NURSING OFFICER 187192 0 1000 0 2495 0 5701 0 10573 0 206961 0 0 0 SUNIL RAJAN MD MEDICAL DOCTOR 729974 0 72990 0 12220 0 11250 0 21249 0 847683 0 0 0 RICHMOND OWUSU MD MEDICAL DOCTOR 436375 0 80000 0 45201 0 4988 0 31724 0 598288 0 0 0 RAKESH JAIN MD MEDICAL DOCTOR 481003 0 33750 0 11833 0 11035 0 31937 0 569558 0 0 0 BABBURI HARITHA MD MEDICAL DOCTOR 385491 0 119192 0 20336 0 12494 0 23507 0 561020 0 0 0 HANY MOUSTAFA MD MEDICAL DOCTOR 428763 0 65875 0 19748 0 10059 0 13337 0 537782 0 0 0 ANDREW MUELLER MD DIRECTOR 0 897481 0 25000 0 22004 0 245233 0 30262 0 1219980 0 0 MICHAEL ELLIOT DIRECTOR 0 463734 0 0 0 72870 0 88566 0 26913 0 652083 0 72260 PART I, LINE 3: UNDER A MANAGEMENT ARRANGEMENT WITH CENTRA HEALTH, INC. (A RELATED PARTY), THE ORGANIZATION'S EXECUTIVE COMPENSATION IS ESTABLISHED IN ACCORDANCE WITH CENTRA HEALTH, INC.'S EXECUTIVE COMPENSATION PRACTICES WHICH INCLUDE THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT(S), AND COMPENSATION STUDY OR SURVEY. PART I, LINE 4B: NO INDIVIDUALS RECEIVED A PAYOUT FROM A NONQUALIFIED RETIREMENT PLAN DURING FY 2020. THE FOLLOWING INDIVIDUALS HAD AMOUNTS DEFERRED INTO A NONQUALIFIED RETIREMENT PLAN DURING FY 2020. NAME TITLE AMOUNT of DEFERRAL MICHAEL ELLIOTT DIRECTOR $72,260 Form 990, Part III, Line 4a: 2020 SOUTHSIDE COMMUNITY HOSPITAL, INC. PROGRAM SERVICE ACCOMPLISHMENT SOUTHSIDE COMMUNITY HOSPITAL, INC. IS A 501(C)(3) HOSPITAL COMMITTED TO OFFERING AFFORDABLE HEALTHCARE TO THE RESIDENTS OF SOUTHSIDE VIRGINIA. WE ARE DEDICATED TO IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE BY PROVIDING HIGH QUALITY HEALTHCARE. (PLEASE SEE THE CONTINUATION ON SCHEDULE O.) COMMUNITY BENEFIT HIGHLIGHTS * DURING FY 2020, $8,647,274 IN CHARGES AT AN ESTIMATED COST OF $2,018,799 WAS CONTRIBUTED AS TRADITIONAL CHARITY CARE TO PATIENTS WHO DID NOT HAVE THE ABILITY TO PAY. ELIGIBILITY FOR CHARITY CARE IS BASED ON POVERTY INCOME LEVELS SET BY THE STATE. * CHARGES OF $9,221,875 AT AN ESTIMATED COST OF $2,152,946, WERE CONTRIBUTED AS BAD DEBT TO PATIENTS WHO DID NOT HAVE THE ABILITY TO PAY. * LOSS FROM MEDICARE BASED ON COST TO CHARGE RATIO TOTALED $0 * LOSS FROM MEDICAID BASED ON COST TO CHARGE RATIO TOTALED $0. * CASH DONATIONS MADE BY SOUTHSIDE COMMUNITY HOSPITAL, INC. TO THE COMMUNITY DURING 2020 TOTALED $1,000. SOUTHSIDE COMMUNITY HOSPITAL, INC. IS EAGER TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY, WHICH CONSISTS OF ITS EIGHT SURROUNDING COUNTIES OF AMELIA, BUCKINGHAM, CHARLOTTE, CUMBERLAND, LUNENBURG, NOTTOWAY, APPOMATTOX, AND PRINCE EDWARD COUNTIES. EMPLOYEES CONTINUALLY OFFER PROFESSIONAL HEALTH EDUCATION PROGRAMS, CLASSES, LECTURES, HEALTH FAIRS, HEALTH SCREENINGS, SUPPORT GROUPS, ETC., THROUGHOUT SOUTHSIDE VIRGINIA. SOUTHSIDE COMMUNITY HOSPITAL, INC. IS DEDICATED TO IMPROVING THE HEALTHCARE OF ITS COMMUNITY. SOME EXAMPLES ARE LISTED BELOW. COMMUNITY EDUCATION AND HEALTH SCREENINGS - ADVANCED DIRECTIVES DAY COLON CANCER AWARENESS DAY COMMUNITY HEALTH FAIRS BREAST CANCER EDUCATION HEALTHY HEART/STROKE EDUCATION BLOOD PRESSURE SCREENINGS FAMILY EDUCATION AND COMMUNITY CLASSES - BREASTFEEDING CLASSES CAR SEAT CLASSES CHILDBIRTH AND FAMILY EDUCATION SUPPORT GROUPS - BREAST FEEDING SUPPORT GROUP SPECIAL PROJECTS/ HEALTH MINISTRY - WOMEN'S MINISTRY HEART HEALTH VOLUNTEER SERVICES SOUTHSIDE COMMUNITY HOSPITAL, INC. IS HONORED TO HAVE MANY VOLUNTEERS FROM THROUGHOUT OUR SERVICE AREA MAKING A DIFFERENCE TO OUR PATIENTS, VISITORS, AND STAFF. IN 2020, 44 VOLUNTEERS DONATED 908 HOURS OF SERVICE TO OUR HOSPITAL. SOME OF OUR VOLUNTEER SERVICES ARE: WOMEN'S AUXILIARY OF SOUTHSIDE COMMUNITY HOSPITAL, INC.: FUNDRAISING FOR HOSPITAL - PROVIDES SCHOLARSHIPS FOR MEDICAL/NURSING STUDENTS. CSCH VOLUNTEERS: FRONT DESK, REGISTRATION, EMERGENCY DEPT., CENTRA MEDICAL GROUP, TRANSPORT, TELE-MED-SURG, OB, SAME DAY SURGERY, ETC. CARDIO-REHAB VOLUNTEERS: ASSISTANTS IN THE GYM FOR CARDIO PATIENTS PACE (PROGRAM FOR ALL INCLUSIVE CARE FOR THE ELDERLY) VOLUNTEERS: ASSISTS WITH ACTIVITIES FOR THE ELDERLY LONGWOOD UNIVERSITY/HAMPDEN-SYDNEY COLLEGE/LOCAL HIGH SCHOOL STUDENT VOLUNTEERS IN 2020, 16 FARMVILLE HOSPICE VOLUNTEERS DONATED 999 HOURS OF SERVICE TO THE HOSPICE PROGRAM. VOLUNTEER SERVICE VISITS TO HOMES AND FACILITIES WAS STOPPED DUE TO THE INCREASE COVID19 RESTRICTIONS FOR VOLUNTEERS. A LARGE PORTION OF THEIR TIME AND TALENT WAS COMMITTED TO GROCERY SHOPPING, MEAL AND MEDICATION DELIVERY. VOLUNTEERS DEVELOPED A NEW PROGRAM OF SENDING CARDS, PHONE CALLS AND SMALL GIFTS TO PATIENTS AND FAMILIES. HOSPICE MEMORIAL SERVICES WAS CANCELED HOWEVER WORKED ON DEVELOPING A NEW VIRTUAL SERVICE. OUR VOLUNTEERS USE THEIR OWN CARS AND HAVE REPORTED DRIVING 130 MILES IN 2020. STORIES OF ASSISTANCE TO THE COMMUNITY Centra Southside Community Hospital serves its community and the surrounding eight counties in many ways. Our nurses and staff are enthusiastic about participating in community events by conducting blood pressure checks, providing free health education materials to the general public, and assisting in health screenings. Although many of these events were cancelled due to the pandemic, we were able to connect through Facebook Live events, and online meetings. We continually donate school supplies to area school supply drives, and we have active members in many civic organizations, such as the Lions Club, the Rotary Club, Chamber of Commerce, Prince Edward United Way, VFW, and the Downtown Farmville Organization. We partnered with the Lions Club this year to build a food pantry at the local High School. A team of employees and volunteers regularly volunteer at FACES, the local food pantry. The hospital leadership continues to conduct meetings with local community leaders and community representatives to better understand the medical needs of our community. The hospital wants to ensure that members of the communities that we serve have the opportunity to voice their current medical care concerns and provide insight on how the hospital can better meet the medical needs of the community in the future. The SCOPE/Meals on Wheels program provides balanced, nutritious meals to the elderly, disabled, or homebound who have no reliable means of obtaining their daily food requirements. Our caring volunteers help alleviate the sense of isolation and worry of clients and observe their physical condition. In cooperation with the community and county agencies, we identify those in need of these services, prepare all meals, and get them ready for distribution by volunteers. During 2020, approximately 13,093 meals were provided by the hospital, at a cost of approximately $40,588. Below is a list of various educational classes and support groups provided by the hospital throughout the year, at no cost to the participants. Volunteers: (only active January and February 2020): Centra Southside Community Hospital is honored to have many volunteers from throughout our service area making a difference to our patients, visitors, and staff. Some of our volunteer services are: * Women's Auxiliary of Southside Community Hospital: Fundraising for hospital - provides scholarships for medical/nursing students. * CSCH Volunteers: Front desk, Registration, Emergency Dept., Centra Medical Group, Transport, Tele- Med-Surg, OB, Same Day Surgery, etc. * Hospice Volunteers: Care for end-of-life patients. * Cardio-Rehab Volunteers: Assistants in the gym for cardio patients. * PACE (Program for All Inclusive Care for the Elderly) Volunteers: Assists with activities for the elderly. * Longwood University/Hampden-Sydney College/Local High School Student Volunteers. In 2020, 40 Centra Southside Community Hospital volunteers donated 908 hours of service. Form 990, Part VI, Section A, Line 2: BOARD MEMBER WILLIAM MCGUIRE AND OFFICER LEROY PFEIFFER, JR. SERVE AS OFFICERS OF THE WOODLAND, INC.'S BOARD OF DIRECTORS. THE WOODLAND. INC IS A FULL-SERVICE RETIREMENT COMMUNITY OFFERING INDEPENDENT LIVING, ASSISTED LIVING AND SKILLED NURSING CARE FACILITIES. FORM 990, PART VI, SECTION A, LINE 6: THROUGH AN AFFILIATION AGREEMENT, SOUTHSIDE COMMUNITY HOSPITAL, INC.'S SOLE CORPORATE MEMBER IS CENTRA HEALTH, INC. FORM 990, PART VI, SECTION A, LINES 7A & 7B: CENTRA HEALTH, INC. IS THE SOLE MEMBER CORPORATION OF SOUTHSIDE COMMUNITY HOSPITAL, INC. AND HAS THE POWER TO ELECT/APPROVE THE BOARD OF DIRECTORS OF SOUTHSIDE COMMUNITY HOSPITAL, INC.'S GOVERNING BODY AND APPROVE DECISIONS MADE BY SOUTHSIDE COMMUNITY HOSPITAL, INC.'S BOARD. FORM 990, PART VI, SECTION A, LINES 8A & 8B: MINUTES ARE TAKEN AT EACH MEETING. FORM 990, PART VI, SECTION B, LINE 11B: THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. SOUTHSIDE COMMUNITY HOSPITAL, INC. WILL PROVIDE ALL VOTING MEMBERS OF THE BOARD OF DIRECTORS WITH A COPY OF THE FORM 990 PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C: ALL SOUTHSIDE COMMUNITY HOSPITAL, INC. OFFICERS, DIRECTORS, AND KEY EMPLOYEES, MUST COMPLETE A CONFLICT-OF-INTEREST QUESTIONNAIRE ON AN ANNUAL BASIS, CERTIFYING THAT NEITHER THEY NOR ANY OF THEIR IMMEDIATE FAMILY MEMBERS HAVE ENGAGED IN ANY ACTIVITIES THAT COULD LEAD TO A POTENTIAL CONFLICT OF INTEREST. ADDITIONALLY, ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES MUST AGREE TO PROMPTLY REPORT ANY POTENTIAL CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR TO THE PRESIDENT OR CHAIRMAN OF SOUTHSIDE COMMUNITY HOSPITAL, INC.'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINES 15A & B: FORM 990, PART VI, LINES 15A & 15B WERE ANSWERED AS "NO", HOWEVER, UNDER A MANAGEMENT AGREEMENT WITH CENTRA HEALTH, INC., A RELATED PARTY, THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER'S COMPENSATION IS ESTABLISHED IN ACCORDANCE WITH CENTRA HEALTH'S EXECUTIVE COMPENSATION PRACTICES WHICH INCLUDE THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT(S), AND COMPENSATION STUDY OR SURVEY. FORM 990, PART VI, SECTION C, LINE 18: PHOTOCOPIES OF THE ORGANIZATION'S FORM 1023 AND RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. ADDITIONALLY, FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19: THE ORGANIZATION PROVIDES PHOTOCOPIES OF ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY UPON REQUEST AT ITS ADMINISTRATIVE OFFICE. FORM 990, PART XI, LINE 9: CONTRIBUTED CAPITAL FROM CENTRA HEALTH $34,778 CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT $4,246 --------- TOTAL TO FORM 990, PART XI, LINE 9 $39,024 ========= FORM 990, PART XII, LINE 2C: COMMITTEE RESPONSIBLE FOR AUDIT PROCESS OVERSIGHT - THE AUDIT PROCESS OF THE ORGANIZATION INCLUDING THE OVERSIGHT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT AUDITOR IS OVERSEEN BY THE AUDIT & COMPLIANCE COMMITTEE OF CENTRA HEALTH, INC., SOLE MEMBER AND RELATED ORGANIZATION. FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:2853223 FORM 990 PART IX LINE 11G DESCRIPTION:CAPITATED MEDICAL CLAIMS TOTAL FEES:3269244 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN REMUNERATION TOTAL FEES:1545012 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL PURCHASED SERVICES TOTAL FEES:7607899 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:1572701 FORM 990 PART IX LINE 11G DESCRIPTION:CLEANING SERVICES TOTAL FEES:37694 FORM 990 PART IX LINE 11G DESCRIPTION:MISCELLANEOUS TOTAL FEES:17148 CENTRA HEALTH INC 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 540715569 HEALTHCARE VA 501(C)(3) 3 NA false CENTRA HEALTH FOUNDATION INC 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 541604094 SUPPORTING OR VA 501(C)(3) 12A NA false CCRC INC 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 541929580 CONTINUE CARE VA 501(C)(3) 12A NA false BEDFORD MEMORIAL HOSPITAL 1613 OAKWOOD STREET BEDFORD VA 24523 540566100 HEALTHCARE VA 501(C)(3) 3 NA false GENERAL BUSINESS CONCERNS INC 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 541299682 REAL ESTATE/PHYS VA NA C Corp PCHP HOLDING INC 2316 ATHERHOLT ROAD LYNCHBURG VA 24501 541749492 HOLDING COMPANY VA NA C Corp PIEDMONT COMMUNITY HEALTH PLAN INC 2316 ATHERHOLT ROAD LYNCHBURG VA 24501 541755768 HEALTH INSURANCE VA NA C Corp false false true true true false false false false true false false false false false true false false false