2019-11-11T12:53:40-06:00 2018-12-31 990 2018-01-01 540648699 HALIFAX REGIONAL HOSPITAL INC HALI 4345173183 6015 POPLAR HALL DRIVE NORFOLK VA 23502 ROBERT A BROERMANN PRESIDENT 4345173183 2019-11-11 163.230.200.172 2019-11-11 13:43:18 ES P D64F4F5DFCDF89C51048D545CDB41D2F0B5DC81C D64F4F5DFCDF89C51048D545CDB41D2F0B5DC81C 2018 2020-03-31 21:24:44Z JASON A STUDLEY 2204 WILBORN AVE SOUTH BOSTON VA 24592 83874577 0 X WWW.SENTARA.COM X 1948 VA TO PROVIDE THE HIGHEST QUALITY CARE BASED ON THE HEALTHCARE NEEDS OF THE PEOPLE WE SERVE. 16 10 585 139 2586347 139920 179098 144982 86908787 83803669 531770 10467 553548 -228389 88173203 83730729 1416550 1851002 0 0 35719295 36822680 0 0 0 54106424 46716155 91242269 85389837 -3069066 -1659108 51362748 50881985 6592822 6195099 44769926 44686886 X THE PURPOSE OF HALIFAX REGIONAL HOSPITAL, INC. IS TO PROVIDE THE HIGHEST QUALITY CARE BASED ON THE HEALTHCARE NEEDS OF THE PEOPLE WE SERVE. FOR MORE INFORMATION, SEE SCHEDULE O. 0 0 68155781 1851002 81218762 SEE SCHEDULE O. 68155781 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 1 0 1 X 53 0 1 585 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 16 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 VA X CORPORATE OFFICERS 7574557020 6015 POPLAR HALL DR NORFOLK VA 23502 ROBERT A BROERMANN DIRECTOR (TERMED 5/18) 1.00 52.00 X 0 1564698 24170 WILLIAM E COLEMAN DIRECTOR 1.00 0.00 X 0 0 0 W JOSEPH FERGUSON MD DIRECTOR 1.00 0.00 X 0 0 0 DABNEY TP GILLIAM JR DIRECTOR 1.00 0.00 X 0 0 0 VALDIVIA T HALL DIRECTOR 1.00 0.00 X 0 0 0 SAID B ISKANDAR MD DIRECTOR (VOTING EX-OFFICIO) 1.00 0.00 X 0 0 0 MICHAEL R LYON DIRECTOR 1.00 0.00 X 0 0 0 J KENNETH MORGAN DIRECTOR 1.00 0.00 X 0 0 0 MEGAN R PERRY DIRECTOR 1.00 45.00 X 0 884177 58779 KATHRYN F ROBERTS DIRECTOR 1.00 0.00 X 0 0 0 TERRANCE J TRUITT MD DIRECTOR 1.00 0.00 X 26200 0 0 DAVID H WHITE JR DIRECTOR 1.00 0.00 X 0 0 0 JENNIFER S SICTOR DIRECTOR (EFFEC 11/18) 1.00 0.00 X 0 328114 37422 HABIB BASSIL MD DIRECTOR/SECRETARY 1.00 0.00 X X 62625 0 0 MICHAEL V GENTRY DIRECTOR/VICE CHAIRMAN (TERMED 2/18) 1.00 52.00 X X 0 1960778 33423 LARRY P SNEED DIRECTOR/TREASURER 1.00 0.00 X X 0 0 0 CAROL C THOMAS DIRECTOR/CHAIR 1.00 6.00 X X 0 0 0 JONATHAN S DAVIS VICE CHAIR (EFFEC 03/18) 1.00 45.00 X X 0 577988 77134 JASON A STUDLEY PRESIDENT (EFFEC 4/18) 40.00 4.00 X 284905 0 35267 CHRIS A LUMSDEN PRESIDENT (RETIRED 3/18) 40.00 6.00 X 212273 0 32177 TORIE B BASHAY DIRECTOR CARDIOVASUCLAR SERVICE - HF 40.00 0.00 X 183539 0 21145 STEWART R NELSON KE/VP AND CFO 8.00 34.00 X 75390 301568 45926 NEIL F SCHACHT MD PHYSICIAN - HD - 2ND POS 40.00 0.00 X 354810 0 39398 PABLO SOUZA MD PHYSICIAN - HF 40.00 0.00 X 344984 0 48011 BETTY T THROCKMORTON RN-CLIN LADDER - LEVEL II - HF 40.00 0.00 X 184485 0 24758 DAVID FITTS MANAGER, PHARMACY 40.00 0.00 X 145946 0 20875 SHERRI F BEE DIRECTOR CARDIOVASUCLAR SERVICE - HF 40.00 0.00 X 138449 0 8986 KENNETH KRAKAUR FORMER OFFICER 0.00 0.00 X 0 578800 0 MING Y LIU MD FORMER TOP 5 0.00 40.00 X 0 430061 61648 GREGORY A SHUFORD MD FORMER TOP 5 0.00 40.00 X 0 412749 57070 HECTOR MARQUEZ MD FORMER TOP 5 0.00 40.00 X 0 420069 57209 2013606 7459002 683398 25 1 1 0 AMN HEALTHCARE INC 12400 HIGH BLUFF DRIVE SAN DIEGO CA 92130 HEALTHCARE STAFFING SOLUTIONS 1694351 PULMONARY ASSOCIATES OF SOUTHSIDE VIRGIN 2210 WILBORN AVENUE SOUTH BOSTON VA 24592 MEDICAL PROFESSIONAL SVCS 1145000 JE BURTON CONSTRUCTION CO INC PO BOX 564 SOUTH BOSTON VA 24592 CONSTRUCTION 976878 MORRISON MANAGEMENT SPECIALISTS INC PO BOX 160266 MOBILE AL 36625 FOOD & FACILITIES MANAGEMENT 791087 LABORATORY CORP OF AMERICA HOLDINGS 531 SOUTH SPRING STREET BURLINGTON NC 27215 MEDICAL PROFESSIONAL SERVICES 732172 17 43899 101083 144982 NET PATIENT SERVICE REVENUE 541900 81218762 81218762 OUTSIDE LAB SERVICES 541900 2584907 2584907 83803669 42478 42478 72276 0 72276 72276 72276 111837 143848 -32011 -32011 -32011 911 0 911 911 CAFE/VENDING 721000 15181 0 15181 MISCELLANEOUS 900099 -316757 1440 -318197 -301576 83730729 81218762 2586347 -219362 1834026 1834026 16976 16976 942707 773114 169593 27374231 22449607 4924624 2199947 1804177 395770 4281341 3511128 770213 2024454 1660255 364199 1213103 994866 218237 30773 25237 5536 7666989 7589241 77748 381212 312632 68580 4188147 3434699 753448 184366 151199 33167 1456445 1194431 262014 339639 278538 61101 14479 11874 2605 4578375 3754725 823650 213080 174747 38333 MEDICAL SUPPLIES 16553891 16553891 SENTARA SERVICE EXPENSE 7912170 0 7912170 PURCHASED SERVICES 918866 753562 165304 UBIT 20908 20908 0 1043712 855948 187764 85389837 68155781 17234056 0 364491 555064 8089734 9566043 393774 173046 2718584 2509509 1165844 1031282 58786159 22264315 38034149 36521844 596172 525197 51362748 50881985 3036239 2358861 34898 10264 3521685 3825974 6592822 6195099 X 44714932 44583776 54994 103110 44769926 44686886 51362748 50881985 X -1659108 1576068 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 54994 70065 16976 4973 103110 50780 134671 114159 16298 54994 40300 61589 50478 631 50780 40300 40300 0.00000 0.00000 1.00000 0 0 2576000 2576000 29376951 4488513 24888438 24370083 16614980 7755103 2463125 1160822 1302303 36521844 DUE TO THIRD-PARTY PROGRAMS 567075 OTHER LONG TERM LIABILITIES 1344695 DUE TO AFFILIATES 3828 GENERAL RESERVE 1910376 3825974 PART V, LINE 4: THE CLARK MEMORIAL FUNDS HELP TO DEFRAY THE COST OF MEDICAL CARE FOR RESIDENTS OF HALIFAX COUNTY WHO QUALIFY FOR THE PATIENT FINANCIAL ASSISTANCE (PFA) PROGRAM OFFERED BY THE HOSPITAL. THE FUNDS ARE USED TO ASSIST IN PAYING MAJOR MEDICAL EXPENSES THAT PERSIST AFTER THE PFA ADJUSTMENT HAS DECREASED THE INITIAL EXPENSE. SURGERIES AND OTHER MAJOR HOSPITALIZATIONS CAN LEAVE INDIVIDUALS WITH THOUSANDS OF DOLLARS IN UNEXPECTED DEBT, AND SOMETIMES WITH DIMINISHED CAPACITY TO EARN MONEY TO PAY THE INCURRED EXPENSES. WHILE THOSE WHO ARE COMPLETELY WITHOUT RESOURCES WILL RECEIVE A 100% DISCOUNT FROM THE HOSPITAL, THOSE WHO HAVE SOME, BUT INSUFFICIENT, RESOURCES WILL GET A LESSER DISCOUNT AND MAY SPEND YEARS TRYING TO CLEAR THE DEBT. THE CLARK FUNDS WILL BE USED TO ASSIST THOSE VERY-LOW-INCOME INDIVIDUALS. 1 1 1 X 1 X 1 1 0 1 1 6630307 6630307 0.07760 7306011 6466222 839789 0.00980 13936318 6466222 7470096 0.08740 130162 130162 0.00150 118130 118130 0.00140 13894360 13894360 0.16270 5290 5290 0.00010 14147942 14147942 0.16570 28084260 6466222 21618038 0.25310 4969 4969 0.00010 8246 8246 0.00010 1491561 1491561 0.01750 1504776 1504776 0.01770 1 0 0 37539747 46569267 -9029520 X 1 1 1 HALIFAX PHO INC MANAGED CARE 0.50000 0.50000 1 1 HALIFAX REGIONAL HOSPITAL INC 2204 WILBORN AVENUE SOUTH BOSTON VA 24592 WWW.SENTARA.COM H1853 X X X HOME HEALTH HOSPICE HALIFAX REGIONAL HOSPITAL INC 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X SEE SECTION C BELOW. X X 1 18 0 1 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X WWW.SENTARA.COM/FINANCIALASSISTANCE X WWW.SENTARA.COM/FINANCIALASSISTANCE X WWW.SENTARA.COM/FINANCIALASSISTANCE X X X X X X X 1 X 0 X X X X X 1 X 0 0 HALIFAX REGIONAL HOSPITAL, INC. PART V, SECTION B, LINE 5: IN CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), SENTARA HALIFAX REGIONAL HOSPITAL (SHRH) TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING REPRESENTATIVES OF THE LOCAL PUBLIC HEALTH DEPARTMENTS AND ORGANIZATIONS SERVING THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS THROUGH: 1) SURVEYING KEY COMMUNITY STAKEHOLDERS BY USE OF AN ONLINE SURVEY TO IDENTIFY SIGNIFICANT HEALTH PROBLEMS AND SERVICE GAPS; 2) REVIEW OF ASSESSMENTS AND OTHER PLANNING DOCUMENTS PREPARED BY COMMUNITY ORGANIZATIONS SUCH AS THE LOCAL HEALTH DEPARTMENT; AND 3) DIRECT COMMUNICATION WITH COMMUNITY STAKEHOLDERS THROUGH INTERVIEWS AND A FOCUS GROUP.1) SHRH IDENTIFIED ITS SENIOR LEADERSHIP TEAM TO SERVE AS THE CHNA STEERING COMMITTEE RESPONSIBLE FOR OVERSEEING THE ASSESSMENT, INCLUDING THE SURVEY. THE SURVEY DISTRIBUTION LIST WAS REVIEWED TO ENSURE BROAD REPRESENTATION, INCLUDING REPRESENTATIVES OF THE LOCAL HEALTH DEPARTMENTS, COMMUNITY SERVICES BOARDS (MENTAL HEALTH AND SUBSTANCE ABUSE), SOCIAL SERVICES DEPARTMENTS, EDUCATIONAL INSTITUTIONS, PROVIDERS (MEDICAL, DENTAL, ETC.), BUSINESSES, VOLUNTARY HEALTH AGENCIES, AREA AGENCIES ON AGING, CIVIC LEAGUES, THE FAITH COMMUNITY AND OTHER HEALTH AND HUMAN SERVICES ORGANIZATIONS AND GROUPS. DURING THE SURVEY PROCESS, THE RESPONSE RATE WAS MONITORED AND FOLLOW UP WAS MADE TO ENSURE GOOD AND BROADLY REPRESENTATIVE PARTICIPATION.2) HEALTH-RELATED ASSESSMENTS AND PLANS DEVELOPED BY OTHER ORGANIZATIONS WERE IDENTIFIED AND REVIEWED. THESE FINDINGS WERE TAKEN INTO ACCOUNT IN THE IDENTIFICATION OF SIGNIFICANT HEALTH ISSUES AND IN THE DEVELOPMENT OF THE HOSPITAL'S IMPLEMENTATION STRATEGIES.3) DIRECT COMMUNICATION WITH COMMUNITY STAKEHOLDERS WAS ALSO AN IMPORTANT PART OF THE PROCESS. MEMBERS OF THE STEERING COMMITTEE PROVIDED INPUT BASED UPON THEIR INVOLVEMENT IN COMMUNITY COALITIONS AND COMMUNITY HEALTH INITIATIVES AND THEIR COMMUNICATIONS WITH INDIVIDUALS IN THE COMMUNITY. IN ADDITION, HOSPITAL STAFF CONDUCTED KEY INFORMANT INTERVIEWS AND A FOCUS GROUP TO RECEIVE BROADER INPUT. HALIFAX REGIONAL HOSPITAL, INC. PART V, SECTION B, LINE 7D: COPIES OF THE ASSESSMENT HAVE BEEN MADE AVAILABLE TO COMMUNITY ORGANIZATIONS.A LINK TO THE HOSPITAL FACILITY'S COMMUNITY HEALTH NEEDS ASSESSMENT IS ALSO ON THE SENTARA HEALTHCARE WEBSITE:HTTP://WWW.SENTARA.COM/ASSETS/PDF/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/SHRH-2018-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF HALIFAX REGIONAL HOSPITAL, INC. PART V, SECTION B, LINE 11: THE SHRH COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED NUMEROUS HEALTH ISSUES. DURING THE CHNA PROCESS, THE HOSPITAL UNDERWENT A PRIORITIZATION PROCESS TO IDENTIFY THE SIGNIFICANT HEALTH NEEDS FOR WHICH IMPLEMENTATION STRATEGIES SHOULD BE DEVELOPED. THE PROCESS CONSIDERED FACTORS SUCH AS SIZE AND SCOPE OF THE HEALTH PROBLEM, THE INTENSITY AND SEVERITY OF THE ISSUE, THE POTENTIAL TO EFFECTIVELY ADDRESS THE PROBLEM AND THE AVAILABILITY OF COMMUNITY RESOURCES, IMPACT ON HEALTH DISPARITIES, THE IMPORTANCE TO THE COMMUNITY, AND SENTARA'S MISSION "TO IMPROVE HEALTH EVERYDAY". FOR THE SIGNIFICANT HEALTH NEEDS, IN ADDITION TO EXECUTION OF THE IMPLEMENTATION STRATEGIES, THE HOSPITAL IS PARTICIPATING IN A VARIETY OF LOCAL INITIATIVES. SOME OF THE AREA NEEDS WHICH ARE NOT SPECIFICALLY ADDRESSED IN THE IMPLEMENTATION STRATEGY WERE IDENTIFIED AS LOWER PRIORITY BECAUSE THEY DID NOT RANK HIGH WITH THE PRIORITIZATION FACTORS. HALIFAX REGIONAL HOSPITAL, INC. PART V, SECTION B, LINE 16J: QUARTERLY ARTICLES WERE PLACED IN LOCAL NEWSPAPERS TO INFORM THE PUBLIC ABOUT THE FINANCIAL ASSISTANCE POLICY. HALIFAX REGIONAL HOSPITAL, INC. PART V, SECTION B, LINE 20E: THE HOSPITAL USES AN OUTSIDE VENDOR THAT SCREENS ALL PATIENTS WITHOUT INSURANCE FOR ELIGIBILITY FOR GOVERNMENT PROGRAMS, AND A FINANCIAL COUNSELOR WHO SCREENS THOSE THAT ARE NOT ELIGIBLE FOR GOVERNMENT PROGRAMS TO DETERMINE WHETHER THEY MEET CRITERIA FOR CHARITY CARE. HALIFAX REGIONAL HOSPITAL, INC.: PART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS PRESENTED IN THE CHNA ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED BY COMMUNITY MEMBERS VIA MULTIPLE METHODS. IN ADDITION TO A KEY STAKEHOLDER SURVEY CONDUCTED ONLINE, FOCUS GROUPS ARE CONDUCTED, WITH ADDITIONAL INTERVIEWS WITH POLICY MAKERS AND REPRESENTATIVES OF INDEPENDENT COMMUNITY ORGANIZATIONS. SENTARA ENSURES THAT RESPONDENTS TO REQUESTS FOR INPUT REPRESENT MANY TYPES OF COMMUNITY ACTORS: POLICY MAKERS, SERVICE PROVIDERS, REPRESENTATIVES OF PUBLIC HEALTH ORGANIZATIONS, REPRESENTATIVES OF UNDERSERVED POPULATIONS, SOCIAL SERVICE PROVIDERS AND GOVERNMENT FUNCTIONS SUCH AS SCHOOLS, AND THE BUSINESS AND LARGER COMMUNITIES. 1 1 - CENTER FOR BEHAVIORAL HEALTH 504 WILBORN AVENUE SOUTH BOSTON VA 24592 REHABILITATION CENTER PART I, LINE 3C: THE ORGANIZATION USES A MULTI-FACETED REVIEW OF AN APPLICANT'S SITUATION TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. AN APPLICANT'S HOUSEHOLD INCOME IS EVALUATED IN LIGHT OF RELEVANT FACTS AND CIRCUMSTANCES, SUCH AS REPORTED INCOME, ASSETS, LIABILITIES, EXPENSES, AND OTHER RESOURCES AVAILABLE TO THE APPLICANT OR THE APPLICANT'S RESPONSIBLE PARTY, WHEN DETERMINING THE LEVEL OF FINANCIAL ASSISTANCE THAT AN APPLICANT QUALIFIES FOR UNDER THE FINANCIAL ASSISTANCE POLICY. PART I, LINE 6A: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT WAS CONTAINED IN A SYSTEM-WIDE REPORT PREPARED BY SENTARA HEALTHCARE, EIN 52-1271901, THE ORGANIZATION'S 501(C)(3) SOLE MEMBER. PART I, LINE 7: EXCEPT FOR SUBSIDIZED HEALTH SERVICES, THE ORGANIZATION USED A COST-TO-CHARGES RATIO FROM WORKSHEET 2 TO DETERMINE THE AMOUNTS REPORTED IN PART I, LINE 7. COST METHOD WAS USED FOR SUBSIDIZED HEALTH SERVICES (7G). PART I, LINE 7G: $ 13,894,360 OF THE AMOUNT REPORTED IN COLUMN (E) WAS ATTRIBUTABLE TO PHYSICIAN CLINICS. PART II, COMMUNITY BUILDING ACTIVITIES: EMPLOYEES DONATE HUNDREDS OF HOURS AND SHARE THEIR TALENTS AND EXPERTISE AS MEMBERS OF VARIOUS CIVIC AND RELIGIOUS ORGANIZATIONS IN THEIR COMMUNITIES, AS WELL AS SERVING ON RESCUE SQUADS AND FIRE DEPARTMENTS. THE HOSPITAL ALLOWS AND ENCOURAGES EMPLOYEES TO PROVIDE SERVICE TO THE COMMUNITY DURING WORKING HOURS ALSO. EMPLOYEES SERVE IN VARIOUS CAPACITIES INCLUDING ON BOARDS AND ADVISORY COMMITTEES OF A NUMBER OF COMMUNITY GROUPS AND STATE ORGANIZATIONS ADVANCING COMMUNITY HEALTH AND WELLNESS AND WORKFORCE DEVELOPMENT INCLUDING THE FOLLOWING: HALIFAX COUNTY CHAMBER OF COMMERCE; CHARLOTTE COUNTY CHAMBER OF COMMERCE; CLARKSVILLE CHAMBER OF COMMERCE; MECKLENBURG COUNTY BUSINESS EDUCATION PARTNERSHIP; HALIFAX ADVOCATES FOR SUBSTANCE ABUSE PREVENTION; SOUTHSIDE HEALTH COALITION, HALIFAX VOCATIONAL EDUCATION FOUNDATION; SOUTHSIDE VIRGINIA COMMUNITY COLLEGE SCHOOL OF NURSING ADVISORY COUNCIL; COMMITTEE FOR THE CENTER FOR NURSING EXCELLENCE; SOUTHERN VIRGINIA HIGHER EDUCATION CENTER; VIRGINIA COMMUNITY COLLEGE SYSTEM; VIRGINIA FOUNDATION FOR COMMUNITY COLLEGES; HALIFAX EDUCATION FOUNDATION; HALIFAX COUNTY PUBLIC SCHOOLS EDUCATION FOUNDATION; VIRGINIA ADVANCED STUDY ON STRATEGIES BOARD; ECONOMIC DEVELOPMENT COMMITTEE; WORKFORCE INVESTMENT BOARD; HALIFAX COUNTY UNITED WAY; TRI-COUNTY COMMUNITY ACTION AGENCY BOARD; HEALTHY FAMILIES TRI-COUNTY ADVISORY COUNCIL; DIXIE YOUTH SOFTBALL BOARD; MENTOR ROLE MODEL PROGRAM AND THE HALIFAX AND MECKLENBURG COUNTY YMCAS.HALIFAX REGIONAL HOSPITAL CONTINUES TO PARTICIPATE IN REGIONAL AND LOCAL EXERCISES TO TEST THE EMERGENCY OPERATIONS PLAN AND TO CONDUCT INTERNAL EXERCISES. THESE INITIATIVES HELP HALIFAX REGIONAL HOSPITAL PREPARE FOR AND COORDINATE CRISIS RESPONSE AND RECOVERY OPERATIONS WITH STATE, LOCAL AND FEDERAL AGENCIES IN THE EVENT OF A BIOTERRORIST EVENT/DISASTER. OUTSIDE THE REALM OF THE GRANT FUNDING, HALIFAX REGIONAL HOSPITAL SUPPLIED THE EMPLOYEE TIME INVOLVED IN TRAINING FOR COMMUNITY EMERGENCY PREPAREDNESS AS WELL AS FOR COMMUNITY DISASTER TRAINING DRILLS. OUR FOCUS CONTINUES TO BE ON PREPARING THE HOSPITAL STAFF AND THE COMMUNITY FOR "ALL HAZARDS." PART III, LINE 2: FOR SCHEDULE H PART III LINE 2 PURPOSES, THE ORGANIZATION REPORTS WHAT WOULD'VE BEEN CONSIDERED BAD DEBT EXPENSE PRIOR TO ITS 2018 ADOPTION OF ASC TOPIC 606. ASC TOPIC 606 NOW CLASSIFIES THIS COMPONENT OF UNCOMPENSATED CARE AS IMPLICIT PRICE CONCESSIONS, WHICH ARE A REDUCTION TO NET OPERATING REVENUE.IMPLICIT PRICE CONCESSIONS REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE ORGANIZATION EXPECTS TO COLLECT BASED ON ITS COLLECTIONS HISTORY WITH THOSE PATIENTS AND CURRENT MARKET CONDITIONS. IT UTILIZES A PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO ACCOUNT FOR PATIENT CONTRACTS WITH SIMILAR CHARACTERISTICS AS A COLLECTIVE GROUP RATHER THAN INDIVIDUALLY.SEE FOOTNOTES 3(R) AND 4 ON PAGES 13-14 OF THE ATTACHED FINANCIAL STATEMENTS FOR ADDITIONAL INFORMATION. PART III, LINE 3: IN COMPUTING LINE 3, THE ORGANIZATION CONSERVATIVELY ESTIMATES THAT 15% OF IMPLICIT PRICE CONCESSIONS (FORMERLY BAD DEBT) ARE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR CHARITY ASSISTANCE IF SUFFICIENT DATA WAS AVAILABLE. THIS ESTIMATE IS BASED ON CREDIT REPORTING DATA PURCHASED FROM EQUIFAX. THIS DATA PROVIDES CREDIT SCORE, INCOME PREDICTION DATA AND NUMEROUS LINES OF CREDIT AND ASSET DATA. FOR UNRESPONSIVE PATIENTS, THE ORGANIZATION USES THE ESTIMATED INCOME, MARITAL STATUS, ASSET INFORMATION AND CREDIT LINE DATA TO DETERMINE WHETHER THE PATIENT WOULD QUALIFY FOR CHARITY BASED ON A PROJECTED INCOME OF 200% OF THE FEDERAL POVERTY GUIDELINES WITH LITTLE TO NO ASSET DATA. THIS INFORMATION IS NOT ALL INCLUSIVE FOR ALL UNRESPONSIVE PATIENTS THAT COULD QUALIFY, AS DEPENDENT INFORMATION IS NOT READILY AVAILABLE. PART III, LINE 4: SEE FOOTNOTES 3(R) AND 4 ON PAGES 13-14 OF THE ATTACHED FINANCIAL STATEMENTS FOR THE FOOTNOTE WHICH DISCUSSES IMPLICIT PRICE CONCESSIONS (FORMERLY BAD DEBT.) PART III, LINE 8: MEDICARE ALLOWABLE COSTS OF CARE AND RELATED REIMBURSEMENT WERE OBTAINED FROM THE 2018 MEDICARE COST REPORT INCLUDING DSH AND BAD DEBT REIMBURSEMENT. THE MEDICARE ALLOWABLE COST AS REPORTED ON THE MEDICARE COST REPORT REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6 IS IN COMPLIANCE WITH FEDERAL MEDICARE REGULATIONS REGARDING THE CALCULATION OF MEDICARE ALLOWABLE COST. PART III, LINE 9B: HALIFAX REGIONAL HOSPITAL HAS AN "ACCOUNT FOLLOW UP" POLICY OUTLINING STATEMENT INTERVALS. THE POLICY APPLIES TO ALL PATIENTS. THE HOSPITAL FACILITY ALSO HAS A "FINANCIAL POLICY" OUTLINING ITS STATEMENT SERIES. IF THE PATIENT QUALIFIES FOR FREE CARE BASED ON 200% OF FEDERAL POVERTY GUIDELINES, THE ENTIRE BALANCE IS WRITTEN OFF TO CHARITY AND NO COLLECTION EFFORTS ARE MADE. A NOTICE IS SENT TO THE PATIENT ADVISING THAT CHARITY QUALIFICATIONS HAVE BEEN MET. IF THE PATIENT QUALIFIES FOR DISCOUNTED CARE, THE APPROPRIATE DISCOUNT IS APPLIED TO THE BALANCE. A NOTICE IS SENT TO THE PATIENT ADVISING THAT CHARITY QUALIFICATIONS HAVE BEEN MET AND THE PATIENT IS REQUESTED TO CONTACT THE HOSPITAL FACILITY TO SET UP THE REMAINING BALANCE ON A PAYMENT PLAN. UNINSURED PATIENTS MAY RECEIVE A 75% DISCOUNT IF THEIR INCOME IS BETWEEN 201-400% OF THE FEDERAL POVERTY GUIDELINES AND A 30% DISCOUNT IF THEIR INCOME IS ABOVE 400% OF FEDERAL POVERTY GUIDELINES. THE HOSPITAL FACILITY DID NOT IMPOSE COLLECTION ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THE PATIENT WAS ELIGIBLE FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF ITS COMMUNITIES THROUGH THESE MEANS:-ANALYSIS OF AREA SOCIODEMOGRAPHIC, HEALTH STATUS, AND OTHER DATA: THE ANALYSIS FOCUSES ON IDENTIFICATION OF HEALTH CARE NEEDS FOR PLANNING AND DEVELOPMENT OF HEALTH SERVICES AND PROGRAMS. THIS ANALYSIS IS UTILIZED IN THE DEVELOPMENT OF ORGANIZATIONAL PLANS.-OBTAINING INPUT FROM KEY STAKEHOLDERS AND THE PUBLIC HEALTH COMMUNITY: IN ADDITION TO THE ANALYSIS OF SOCIODEMOGRAPHIC, HEALTH STATUS, AND OTHER DATA, ADDITIONAL INFORMATION IS OBTAINED AND ANALYZED. THIS INCLUDES INPUT FROM KEY STAKEHOLDERS INCLUDING THE LOCAL PUBLIC HEALTH COMMUNITY.-REVIEW OF HEALTH CARE NEEDS ASSESSMENTS AND DATA DEVELOPED BY COMMUNITY PARTNERS (SUCH AS STATE HEALTH DEPARTMENTS AND LOCAL HEALTH DISTRICTS), REGIONAL AGENCIES (SUCH AS THE PLANNING COUNCIL OR PLANNING DISTRICT COMMISSION), NATIONAL ORGANIZATIONS WHICH REPORT ON A LOCAL BASIS (SUCH AS COUNTY HEALTH RANKINGS), AND INFORMATION REPORTED IN LOCAL MEDIA: THIS INFORMATION IS STUDIED, INCORPORATED INTO THE ORGANIZATION'S PLANS, AND SHARED WITH ORGANIZATIONAL DECISION MAKERS.-PARTICIPATION IN COLLABORATIVE HEALTH PLANNING AND NEEDS ASSESSMENT ACTIVITIES SUCH AS THOSE SPONSORED BY THE LOCAL HEALTH DISTRICTS AND OTHER ORGANIZATIONS. INFORMATION GATHERED THROUGH THESE ACTIVITIES IS INCORPORATED INTO THE ORGANIZATION'S PLANNING.-INFORMATION AND INPUT FROM PATIENTS AND CARE PROVIDERS: PATIENT CHARACTERISTICS AND TRENDS ARE REVIEWED TO ASSIST IN IDENTIFYING NEW COMMUNITY NEEDS. INPUT FROM PATIENTS AND CARE PROVIDERS IS SOUGHT AND CYCLED INTO THE ASSESSMENT PHASE OF PROJECTS. PART VI, LINE 3: WHEN A PATIENT IS REGISTERED AT THE ORGANIZATION'S HOSPITAL FACILITY, S/HE IS OFFERED FINANCIAL ASSISTANCE BROCHURE AND APPLICATION WHICH INCLUDES CONTACT INFORMATION FOR ADDITIONAL INFORMATION. FRAMED COPIES OF THE NOTICE ARE LOCATED IN REGISTRATION AREAS AND KEY PUBLIC AREAS OF THE FACILITY. THE FACILITY'S TELEPHONE SYSTEM OFFERS "ON HOLD" MESSAGING THAT IS UTILIZED TO INFORM INCOMING CALLERS OF FINANCIAL ASSISTANCE INFORMATION EVERY THIRD MONTH. QUARTERLY ARTICLES ARE PLACED IN AREA NEWSPAPERS AS A CUSTOMER SERVICE TOOL TO REMIND PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE INFORMATION, ALONG WITH AN APPLICATION FOR FINANCIAL ASSISTANCE, IS LOCATED ON THE FACILITY'S WEBSITE. A NOTICE REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IS PRINTED ON PATIENT BILLS AND INCLUDES CONTACT INFORMATION FOR ADDITIONAL INFORMATION. ALL INDIVIDUALS RECEIVE A FINANCIAL ASSISTANCE APPLICATION ENCLOSED WITH THE SECOND BILLING STATEMENT WHICH INCLUDES DETAILED INFORMATION.THE ORGANIZATION HAS PARTNERED WITH FIRSTSOURCE TO AID UNINSURED EMERGENCY DEPARTMENT PATIENTS, UNINSURED AND UNDERINSURED INPATIENTS, OUTPATIENT SURGERY, AND OBSERVATION PATIENTS IN APPLYING FOR MEDICAL ASSISTANCE THROUGH GOVERNMENT PROGRAMS. FIRSTSOURCE ASSISTS PATIENTS THROUGHOUT THE ENTIRE APPLICATION PROCESS TO ENSURE ALL DOCUMENTATION IS COMPLETE.FIRSTSOURCE ALSO HELPS PATIENTS COMPLETE FINANCIAL ASSISTANCE APPLICATIONS IF THEY MAY NOT QUALIFY FOR GOVERNMENT ASSISTANCE. PART VI, LINE 4: SENTARA HALIFAX REGIONAL HOSPITAL SERVES RESIDENTS OF HALIFAX, MECKLENBURG, AND CHARLOTTE COUNTIES.THE 2018 POPULATION OF THE AREA IS 79,088 AND THE POPULATION IS PROJECTED TO DECLINE BY 0.9% OVER THE NEXT FIVE YEARS COMPARED TO A PROJECTED U.S. GROWTH RATE OF 3.5%. 24.3% OF THE POPULATION ARE AGE 65+ COMPARED TO THE U.S. AT 15.9%. EDUCATION-WISE, 20.5% HAVE LESS THAN A HIGH SCHOOL DEGREE, COMPARED TO 13.0% FOR THE U.S. INCOME-WISE, THE AVERAGE HOUSEHOLD INCOME IS $53,525 COMPARED TO $86,278 FOR THE U.S. AND 32.8% OF THE HOUSEHOLDS HAVE AN ANNUAL INCOME OF LESS THAN $25,000, COMPARED TO 20.4% FOR THE U.S. THE RACE AND ETHNICITY COMPOSITION IS AS FOLLOWS: 61.1% FOR WHITE NON-HISPANIC, 33.5% FOR BLACK NON-HISPANIC, 2.8% FOR HISPANIC, 0.7% FOR ASIAN AND PACIFIC ISLANDERS NON-HISPANIC, AND 2.0% FOR ALL OTHERS. THIS COMPARES TO THE U.S. COMPOSITION OF 60.4% FOR WHITE NON-HISPANIC, 12.4% FOR BLACK NON-HISPANIC, 18.2% FOR HISPANIC, 5.8% FOR ASIAN AND PACIFIC ISLANDERS NON-HISPANIC, AND 3.2% FOR ALL OTHERS. PART VI, LINE 5: THE ORGANIZATION'S GOVERNING BODY IS A COMMUNITY-BASED BOARD COMPRISED OF A MAJORITY OF MEMBERS WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION OR ITS AFFILIATES, NOR FAMILY MEMBERS THEREOF. GENERALLY, MEDICAL STAFF MEMBERSHIP IS OPEN TO ALL CARE PROVIDERS WHO MEET CREDENTIALING REQUIREMENTS. THE ORGANIZATION'S SURPLUS FUNDS ARE USED FOR IMPROVEMENTS IN PATIENT CARE, PROVISION OF SERVICES TO THE UNINSURED AND UNDERINSURED, MEDICAL EDUCATION, AND COMMUNITY PROGRAMS. PART VI, LINE 6: THE ORGANIZATION IS AFFILIATED WITH THE SENTARA HEALTHCARE SYSTEM ("SENTARA"). SENTARA, A NOT FOR PROFIT HEALTH SYSTEM, OPERATES MORE THAN 300 SITES OF CARE SERVING RESIDENTS ACROSS VIRGINIA AND NORTHEASTERN NORTH CAROLINA. THE SYSTEM IS COMPRISED OF 12 ACUTE CARE HOSPITALS INCLUDING SEVEN IN HAMPTON ROADS, ONE IN NORTHERN VIRGINIA, TWO IN THE BLUE RIDGE REGIONS, ONE IN SOUTH CENTRAL VIRGINIA, AND ONE IN NORTHEASTERN NORTH CAROLINA; ADVANCED IMAGING CENTERS; NURSING AND ASSISTED-LIVING CENTERS; OUT PATIENT CAMPUSES; HOME HEALTH AND HOSPICE CARE; A 3,800-PROVIDER MEDICAL STAFF; AND FOUR MEDICAL GROUPS. ITS AFFILIATION WITH SENTARA ENHANCES THE ORGANIZATION'S ABILITY TO ACHIEVE BEST PRACTICES IN HEALTHCARE DELIVERY; ACQUIRE CUTTING EDGE TECHNOLOGY AND INTEGRATED INFORMATION SYSTEMS; AND PROVIDE A HIGHER LEVEL OF MEDICAL CARE TO VIRGINIA'S SOUTH CENTRAL COMMUNITY. THESE ATTRIBUTES BETTER POSITION THE ORGANIZATION TO ADDRESS HEALTH CARE REFORM AND OTHER PROFOUND CHANGES AFFECTING THE HEALTHCARE ENVIRONMENT. 1 SENTARA HEALTHCARE 6015 POPLAR HALL DRIVE NORFOLK VA 23502 521271901 501(C)(3) 1774901 CORPORATE ALLOCATION TO PARENT COMMUNITY ARTS CENTER FOUNDATION INC 700 BRUCE STREET SOUTH BOSTON VA 24592 541795927 501(C)(3) 15000 DONATION SOUTHERN VIRGINIA BOTANICAL GARDENS & INVIRON EDUCATION CENTER PO BOX 624 HALIFAX VA 24558 371591057 501(C)(3) 8000 DONATION 3 0 ELISE THOMSON CLARK MEMORIAL FUNDS APPLIED TO INDIVIDUAL PATIENT ACCOUNTS 4 1190 EVERY WOMAN'S LIFE FUNDS APPLIED TO INDIVIDUAL PATIENT ACCOUNTS 43 15786 PART I, LINE 2: AS PART OF THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM"), THE ORGANIZATION DONATES FUNDS TO ITS 501(C)(3) PARENT ORGANIZATION, SENTARA HEALTHCARE, IN FURTHERANCE OF THE SYSTEM'S MISSION TO IMPROVE HEALTH EVERYDAY THROUGH THE PROVISION OF HEALTH SERVICES, AND THE PROMOTION OF HEALTH, MEDICAL EDUCATION, AND THE SOCIAL, CULTURAL, EDUCATIONAL, AND ECONOMIC DEVELOPMENT OF THE COMMUNITY. EXPENDITURE OF SUCH FUNDS IS OVERSEEN BY AN INDEPENDENT COMMUNITY BOARD WHICH MANAGES THE BUSINESS AND AFFAIRS OF THE SYSTEM. GRANTS FROM HALIFAX REGIONAL HOSPITAL, INC. ARE ONLY MADE TO AFFILIATES WHOSE FINANCIAL RECORDS ARE MAINTAINED BY THE HOSPITAL. SCHEDULE I, PART III INDIVIDUAL GRANTS ARE FOR THE PROVISION OF HEALTH CARE TO THE UNINSURED. X X 1 1 0 1 0 0 0 0 0 1 0 ROBERT A BROERMANN DIRECTOR (TERMED 5/18) 0 811625 0 544618 0 208455 0 7578 0 16592 0 1588868 0 0 MEGAN R PERRY DIRECTOR 0 481398 0 270365 0 132414 0 39011 0 19768 0 942956 0 61031 JENNIFER S SICTOR DIRECTOR (EFFEC 11/18) 0 241338 0 77576 0 9200 0 8141 0 29281 0 365536 0 0 MICHAEL V GENTRY DIRECTOR/VICE CHAIRMAN (TERMED 2/18) 0 780042 0 492200 0 688536 0 14287 0 19136 0 1994201 0 409007 JONATHAN S DAVIS VICE CHAIR (EFFEC 03/18) 0 411064 0 134952 0 31972 0 50564 0 26570 0 655122 0 0 JASON A STUDLEY PRESIDENT (EFFEC 4/18) 220088 0 0 0 64817 0 14963 0 20304 0 320172 0 0 0 CHRIS A LUMSDEN PRESIDENT (RETIRED 3/18) 99778 0 50771 0 61724 0 25238 0 6939 0 244450 0 0 0 TORIE B BASHAY DIRECTOR CARDIOVASUCLAR SERVICE - HF 160731 0 12501 0 10307 0 14047 0 7098 0 204684 0 0 0 STEWART R NELSON KE/VP AND CFO 57153 228620 8066 32262 10171 40686 5202 20810 3982 15932 84574 338310 0 0 NEIL F SCHACHT MD PHYSICIAN - HD - 2ND POS 352656 0 0 0 2154 0 30151 0 9247 0 394208 0 0 0 PABLO SOUZA MD PHYSICIAN - HF 343274 0 0 0 1710 0 19521 0 28490 0 392995 0 0 0 BETTY T THROCKMORTON RN-CLIN LADDER - LEVEL II - HF 182914 0 0 0 1571 0 -5125 0 29883 0 209243 0 0 0 DAVID FITTS MANAGER, PHARMACY 142073 0 0 0 3873 0 -7230 0 28105 0 166821 0 0 0 KENNETH KRAKAUR FORMER OFFICER 0 0 0 0 0 578800 0 0 0 0 0 578800 0 303404 MING Y LIU MD FORMER TOP 5 0 427519 0 0 0 2542 0 30846 0 30802 0 491709 0 0 GREGORY A SHUFORD MD FORMER TOP 5 0 407847 0 0 0 4902 0 26105 0 30965 0 469819 0 0 HECTOR MARQUEZ MD FORMER TOP 5 0 417519 0 0 0 2550 0 33578 0 23631 0 477278 0 0 PART I, LINE 1A THE ORGANIZATION PAID FOR TAXABLE RELOCATION EXPENSES OF EXECUTIVE RECRUITS AND A TRANSFERRED EXECUTIVE, INCLUDING TEMPORARY HOUSING AND THE ADDITIONAL TAXES ASSOCIATED WITH SUCH BENEFITS, ALL OF WHICH WERE TREATED AS ADDITIONAL COMPENSATION AND REPORTED ON FORM W-2 AS TAXABLE WAGES. PART I, LINE 3 SENTARA HEALTHCARE, THE 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM, ESTABLISHED THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL THROUGH THE USE OF AN INDEPENDENT COMPENSATION CONSULTANT AND A COMPENSATION STUDY. PART I, LINE 4B ROBERT BROERMANN, MICHAEL GENTRY, MEGAN PERRY, CHRIS LUMSDEN, JONATHAN DAVIS, AND JASON STUDLEY PARTICIPATED IN THE SENTARA CAPITAL ACCUMULATION ACCOUNT PLAN. PARTICIPATION IS LIMITED TO A SELECT GROUP OF CORPORATE EXECUTIVES AS APPROVED BY SENTARA HEALTHCARE'S BOARD OF DIRECTOR'S COMPENSATION COMMITTEE. TERMS OF THE PLAN CHANGED EFFECTIVE JANUARY 1, 2009, WHEREBY VESTING OF CONTRIBUTIONS MADE ON OR AFTER THAT DATE NOW OCCURS ON THE EARLIER OF FIVE YEARS FOR EACH YEARS' CONTRIBUTIONS OR AGE 55 WITH 10 YEARS OF SERVICE. UNDER THE OLD TERMS, VESTING OF CONTRIBUTIONS MADE PRIOR TO JANUARY 1, 2009 OCCURS ON THE EARLIEST OF ASSIGNED DISTRIBUTION DATE, DEATH, INVOLUNTARY TERMINATION WITHOUT CAUSE OR COMPLETION OF TWO-YEAR NON-COMPETE AFTER VOLUNTARY TERMINATION (REGARDLESS OF ORIGINAL ASSIGNED DISTRIBUTION DATE). PAST PARTICIPANT INCLUDES KENNETH KRAKAUR. DURING 2018, THE FOLLOWING CORPORATE EXECUTIVES RECEIVED VESTED DISTRIBUTIONS UNDER THE PLAN: ROBERT BROERMANN ($149,185); MICHAEL GENTRY ($667,805); CHRIS LUMSDEN ($6,655); MEGAN PERRY ($89,768) AND KENNETH KRAKAUR ($578,800). THESE AMOUNTS HAVE BEEN REPORTED IN COLUMN (B)(III) OF SCHEDULE J, PART II. PART I, LINE 7 DURING THE CURRENT TAX YEAR, THE ORGANIZATION MADE NON-FIXED PAYMENTS OF COMPENSATION UNDER THE FOLLOWING INCENTIVE PROGRAMS: ANNUAL INCENTIVE PROGRAM - EXECUTIVES AND SENIOR LEADERS ARE ELIGIBLE FOR ANNUAL AWARDS BASED ON SYSTEM AND INDIVIDUAL PERFORMANCE. BOTH SYSTEM AND INDIVIDUAL SCORES ARE DETERMINED AFTER YEAR-END, AT WHICH POINT AWARDS MAY BE PAID AND REPORTED AS COMPENSATION. TARGET AND MAXIMUM OPPORTUNITIES VARY BY LEVEL. KEY CONTRIBUTOR AWARDS - REWARDS EXCEPTIONAL INDIVIDUALS OR TEAMS FOR SIGNIFICANT CONTRIBUTION AND RESULTS AS RECOGNIZED BY BUSINESS UNITS. MANAGER INCENTIVE PLAN - MANAGEMENT EMPLOYEES NOT COVERED UNDER ANOTHER INCENTIVE PLAN ARE ELIGIBLE FOR THE MANAGEMENT INCENTIVE PLAN. AWARDS ARE BASED ON SYSTEM YEAR-END RESULTS AS DETERMINED BY THE BOARD; BUSINESS UNIT RESULTS FOR FINANCIAL, SAFETY, QUALITY AND CUSTOMER SERVICE; AND THE MANAGER'S INDIVIDUAL PERFORMANCE SCORE. SYSTEM, BUSINESS UNIT, AND INDIVIDUAL RESULTS ARE DETERMINED AFTER YEAR-END, AT WHICH POINT AWARDS MAY BE PAID AND REPORTED AS COMPENSATION. HALIFAX HEART CENTER SEE BELOW 1785000 SEE BELOW 0 THOMAS TRUITT MD SEE BELOW 11063 SEE BELOW 0 SCH L, PART IV A) NAME OF PERSON: HALIFAX HEART CENTER(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER SAID ISKANDAR, MD AND BOARD MEMBER/OFFICER HABIB BASSIL, MD ARE GREATER THAN 35% PARTNERS IN HALIFAX HEART CENTER.D) DESCRIPTION OF TRANSACTION: PROFESSIONAL FEES/SUBSIDIES A) NAME OF PERSON: THOMAS TRUITT, MDB) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF DIRECTOR TERRANCE J. TRUITT, MD(D) DESCRIPTION OF TRANSACTION: MEDICAL SERVICES FORM 990, PART III, LINE 1, ORGANIZATION'S MISSION HALIFAX REGIONAL HOSPITAL, INC. IS ORGANIZED TO BUILD, ESTABLISH, MAINTAIN AND OPERATE HOSPITALS AND OTHER HEALTH CARE FACILITIES AND CLINICS; PROVIDE ANCILLARY AND RELATED MEDICAL AND OTHER HEALTHCARE SERVICES; PROVIDE MANAGEMENT, ADVISORY, SERVICE ASSISTANCE AND OTHER SUPPORT TO HEALTH CARE ORGANIZATIONS HAVING THE SAME PURPOSES AS ITS OWN; ENGAGE IN OTHER RELATED, EXCLUSIVELY CHARITABLE, SCIENTIFIC, EDUCATIONAL AND MEDICAL RESEARCH ACTIVITIES AS MAY BE AUTHORIZED FROM TIME TO TIME BY ITS GOVERNING BODY; AND FOR SUCH PURPOSES, SOLICIT AND RECEIVE FUNDS AND OTHER PROPERTY BY GIFT, TRANSFER, DEVISE, OR BEQUEST, AND INVEST, REINVEST, HOLD, MANAGE, ADMINISTER, EXPEND, AND APPLY SUCH FUNDS AND PROPERTY SUBJECT TO APPLICABLE CONDITIONS AND LIMITATIONS. ALL SUCH ACTIVITIES SUPPORT ITS MISSION TO PROVIDE THE HIGHEST QUALITY CARE BASED ON THE HEALTHCARE NEEDS OF THE PEOPLE SERVED. FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS SENTARA HEALTHCARE I. SENTARA HEALTHCARE - YOUR NOT-FOR-PROFIT HEALTHCARE PARTNER SENTARA HEALTHCARE BASED IN NORFOLK, VA, CELEBRATES MORE THAN 130 YEARS IN RELENTLESS PURSUIT OF ITS MISSION TO IMPROVE HEALTH EVERY DAY THROUGH INNOVATION, COMPASSION AND COMMUNITY BENEFIT. SENTARA IS A FULLY INTEGRATED NOT-FOR-PROFIT SYSTEM WITH NEARLY 300 SITES OF CARE OF WHICH THERE ARE 12 HOSPITALS IN VIRGINIA AND NORTH CAROLINA, INCLUDING A LEVEL I TRAUMA CENTER WITH NIGHTINGALE REGIONAL AIR AMBULANCE AND THE NATIONALLY-RANKED SENTARA HEART HOSPITAL. THE SENTARA FAMILY INCLUDES FOUR MEDICAL GROUPS, AMBULATORY CAMPUSES, POST-ACUTE CARE SERVICES, THE PHYSICIAN-LED SENTARA QUALITY CARE NETWORK, THE ACCREDITED SENTARA CANCER NETWORK, THE SENTARA COLLEGE OF HEALTH SCIENCES, OPTIMA HEALTH PLAN MEMBERS IN VIRGINIA AND OHIO, AND A TEAM OF PROFESSIONALS NEARLY 28,000 STRONG. SENTARA PROUDLY INCLUDES ADVANCED IMAGING CENTERS, NURSING AND ASSISTED LIVING CENTERS, PHYSICAL THERAPY AND REHABILITATION SERVICES, HOME HEALTH AND HOSPICE, AND GROUND MEDICAL TRANSPORTATION. SENTARA IS STRATEGICALLY FOCUSED ON CONTINUOUS IMPROVEMENT IN QUALITY, SAFETY, CLINICAL OUTCOMES AND THE PATIENT EXPERIENCE AND PURSUES KEY CLINICAL GOALS THROUGH HIGH PERFORMANCE TEAMS ACROSS THE ENTERPRISE. EFFORTS ARE CENTERED ON PROVIDING THE RIGHT CARE IN THE RIGHT SETTING AT THE RIGHT TIME AND ADDING VALUE TO THE COMMUNITIES WE SERVE. WE STRIVE TO SERVE ALL OF OUR COMMUNITIES THROUGH HEALTH OUTREACH PROGRAMS, EDUCATION, AND FINANCIAL SUPPORT OF OTHER NOT FOR PROFIT ORGANIZATIONS WITH SIMILAR HEALTH MISSIONS. II. COMMITMENT TO THE COMMUNITY A. SENTARA HEALTHCARE AND OPTIMA HEALTH PROVIDED $6.5M IN DONATIONS. DONATIONS WERE DISTRIBUTED TO FOODBANKS, VIRGINIA ASSOCIATION OF FREE AND CHARITABLE CLINICS, COMMUNITY CARE NETWORKS OF VIRGINIA, AND THE VIRGINIA HEALTH CARE FOUNDATION. PART OF THE $6.5M WENT TOWARDS SUPPORTING THE MARKETING BY THE COMMONWEALTH OF VIRGINIA TO MAKE RESIDENTS AWARE OF THE OPPORTUNITY FOR HEALTH INSURANCE THROUGH MEDICAID EXPANSION. ADDITIONALLY, DONATIONS WERE MADE TO 17 HEALTH RELATED PROJECTS ACROSS VIRGINIA AND NORTH CAROLINA. WE PLEDGED $130M TO EASTERN VIRGINIA MEDICAL SCHOOL OVER 5 YEARS. B. SENTARA HAS PROVIDED MUCH IN THE WAY OF COMMUNITY BENEFIT AND CHARITY CARE ON AN ANNUAL BASIS. IN 2018, SENTARA COMMUNITY BENEFIT REACHED NEARLY $390,000,000. SENTARA PROVIDED $354,121.000 IN NET UNCOMPENSATED PATIENT CARE COSTS; $2,086,000 IN NET UNFUNDED COSTS OF TEACHING PROGRAMS; AND $33,768,000 IN INCURRED COSTS FOR COMMUNITY BENEFIT PROGRAMS. C. SENTARA IS PROUD OF THE MISSION-DRIVEN WORK OF THE THREE SENTARA FOUNDATIONS. THESE FOUNDATIONS RAISED MONEY TO SUPPORT THE CLINICAL NEEDS OF THE SYSTEM AND PROVIDED FUNDING THROUGH GRANTS AND DIRECT CONTRIBUTIONS TO COMMUNITY ORGANIZATIONS THAT HAVE SIMILAR INTERESTS IN COMMUNITY HEALTH NEEDS. SENTARA FOUNDATION-HAMPTON ROADS SUPPORTS A WIDE RANGE OF PROGRAMS ACROSS HAMPTON ROADS. IN 2018, THE FOUNDATION RAISED $1.96M AND AWARDED 30 COMMUNITY GRANTS TOTALING $675,000 TO SUPPORT ITS KEY PRIORITY AREAS. THE MARTHA JEFFERSON HOSPITAL FOUNDATION IN CHARLOTTESVILLE, VIRGINIA RAISED NEARLY $3.5M IN NEW GIFTS AND COMMITMENTS AND FOCUSED THEIR EFFORTS ON A HIGH-RISK BREAST PROGRAM, CANCER SURVIVORSHIP PROGRAM, FAMILY AND CAREGIVER SUPPORT PROGRAM AND THE CENTER FOR CLINICAL EDUCATION. THE RMH FOUNDATION RAISED $4.79M IN NEW GIFTS AND COMMITMENTS AND FOCUSED THEIR EFFORTS ON THE SENTARA RMH HAHN CANCER CENTER LINEAR ACCELERATOR. IN 2018, THE RMH FOUNDATION AWARDED 6 COMMUNITY PARTNERSHIP GRANTS FOR A COMBINED $79,897. THIS INCLUDED $20,000 IN SEED FUNDING TO START THE COMMUNITY'S FIRST RAM "REMOTE AREA MEDICAL" CLINIC. SEVERAL YEARS AGO, SENTARA ESTABLISHED THE HOPE (HELPING OVERCOME PERSONAL EMERGENCY) FUND, WHICH IS AN EMERGENCY FINANCIAL RESOURCE FOR SENTARA EMPLOYEES THAT ARE EXPERIENCING CATASTROPHIC HARDSHIP OR LOSS THROUGH NO FAULT OF THEIR OWN. SENTARA EMPLOYEES WHO RECEIVE AID FROM THE HOPE FUND HAVE FACED DEVASTATING CRISES SUCH AS FIRE, DEATH, NATURAL DISASTERS, OR SERIOUS PERSONAL OR FAMILY ILLNESS. IN 2018, THE HOPE FUND AWARDED $165,000 TO SENTARA EMPLOYEES IN CRISES ACROSS THE SYSTEM. D. COMMUNITY HEALTH INITIATIVES SENTARA AND OPTIMA HEALTH HAVE LONG BEEN COMMITTED TO PROVIDING HEALTH AND PREVENTION SERVICES TO THE COMMUNITIES WE SERVE THROUGH MANY CHANNELS INCLUDING THE SENTARA HEALTHCARE COMMUNITY HEALTH AND PREVENTION ORGANIZATION WITHIN SENTARA. BELOW ARE SOME KEY HIGHLIGHTS OF THE EFFORTS IN OUR COMMUNITIES IN 2018: -HEALTH IMPROVEMENT EVENTS WERE OFFERED TO CHURCHES, EMPLOYER GROUPS INCLUDING SENTARA HEALTHCARE AND HAMPTON ROADS SANITATION DISTRICT, COMMUNITY HEALTH CENTERS AND OTHER COMMUNITY LOCATIONS INCLUDING THE POCKET EKG PROGRAM AND THE SENTARA LIVING PROGRAM. -SENTARA CONTINUED TO OFFER PROGRAMS SUCH AS EATING FOR LIFE, WALKABOUT WITH HEALTHY EDGE, HEALTH HABITS, HEALTHY YOU, MEDITATION, TAI CHI AND YOGA. -THE FLU PATROL ADMINISTERED A TOTAL OF 5,365 IMMUNIZATIONS. 4,862 WERE GIVEN TO OPTIMA HEALTH INSURED GROUPS THROUGHOUT VIRGINIA. THE REMAINDER WAS DELIVERED TO CHURCHES AND OTHER COMMUNITY GROUPS. -BIRTHDAY CARD REMINDERS FOR PREVENTIVE HEALTH SCREENINGS WERE DELIVERED TO ADULT MEMBERS OF OPTIMA HEALTH, OHIOHEALTH PLAN MEMBERS AND CHILDREN. SELF-CARE HANDBOOKS ON PLANNING A HEALTHY PREGNANCY WERE DISTRIBUTED TO 5,156 OPTIMA HEALTH PLAN MEMBERS. -THE TOBACCO CESSATION PROGRAMMING WAS UPDATED AND IS OFFERED ON DEMAND ON SENTARA.COM AND OPTIMAHEALTH.COM. OVER 650 PATIENTS FROM SENTARA VIRGINIA BEACH GENERAL HOSPITAL AND SENTARA HEART HOSPITAL WERE CONTACTED AFTER HOSPITAL DISCHARGE FOR TOBACCO CESSATION FOLLOW-UP. AN ELECTRONIC REFERRAL SYSTEM WAS ESTABLISHED WITH QUITNOW VA FOR NON-OPTIMA HEALTH INSURED MEMBERS OF THE COMMUNITY TO RECEIVE PERSONALIZED TOBACCO CESSATION SERVICES. A PARTNERSHIP WITH EVMS AND THEIR HUD SMOKEFREE HOUSING PROJECT WAS ESTABLISHED AND OUR TOBACCO CESSATION MATERIALS WERE DISTRIBUTED. -AS PART OF THE SENTARA BENEFIT ENROLLMENT PROCESS, 18,887 EMPLOYEES COMPLETED A HEALTH RISK ASSESSMENT IN CONJUNCTION WITH THE MISSION: HEALTH PROGRAM. -FINALLY, WEBMD, WHICH SERVES AS OUR HEALTH COACHING AND HEALTH EDUCATION PORTAL PARTNER, HAS NOW 25,691 REGISTERED MEMBERS OF WHICH 16,956 MEMBERS ARE ACTIVELY ENGAGED. SENTARA HOSTS A NUMBER OF COMMUNITY EVENTS RAISING AWARENESS AROUND KEY HEALTH AWARENESS MONTHS. ONE GOOD EXAMPLE IS THE FOCUS ON COLON CANCER PREVENTION: DON'T SIT ON COLON CANCER. THROUGH THE SENTARA CANCER NETWORK, SENTARA HOSTED A 5K AT SENTARA PRINCESS ANNE HOSPITAL IN VIRGINIA BEACH. THROUGH SENTARA HEART, WE PROMOTED THE "28 DAYS OF HEART" IN FEBRUARY, 2018 IN SUPPORT OF HEART HEALTH AWARENESS. ONLINE PROMOTIONS, RADIO ADS, VIDEOS, SCREENINGS AND MORE WERE CONDUCTED TO RAISE AWARENESS OF HEART DISEASE THROUGHOUT THE COMMUNITIES WE SERVE IN VIRGINIA AND NORTH CAROLINA. III. GROWTH IN SENTARA HEALTHCARE SINCE THE BEGINNING, SENTARA HAS REACHED OUT TO OTHER INDUSTRY LEADERS AND JOINED FORCES TO EXTEND QUALITY HEALTHCARE AND SERVICES TO MORE PEOPLE. IN RECENT YEARS, WE HAVE GROWN IN VIRGINIA AND IN OTHER STATES - NORTH CAROLINA AND OHIO - BY SEEKING PARTNERSHIPS WITH SUCCESSFUL HOSPITALS AND HEALTH SYSTEMS THAT SHARE OUR DEDICATION TO EXCELLENCE, VALUE, QUALITY AND CUSTOMER FOCUS. OUR GROWTH IN 2018 INCLUDED THE FOLLOWING: A. AS A RESULT OF THE COMMONWEALTH OF VIRGINIA APPROVING MEDICAID EXPANSION, OPTIMA HEALTH IS ONE OF SIX MANAGED CARE ORGANIZATIONS THAT WILL SERVE THE NEARLY 400,000 ELIGIBLE VIRGINIANS WHO WILL QUALIFY FOR MEDICAID EXPANSION. OPEN ENROLLMENT BEGAN IN NOVEMBER, 2018 WITH THE EFFECTIVE START DATE OF JANUARY 1, 2019. B. THE SENTARA CANCER CENTER CELEBRATED ANOTHER CONSTRUCTION MILESTONE WITH THE TOPPING OUT CEREMONY IN DECEMBER, 2018. THE EXPECTED OPENING DATE FOR THIS COMPREHENSIVE CENTER IS 2020. FORM 990, PART III, LINE 4A C. SENTARA, IN PARTNERSHIP WITH OTHERS, EXPANDED TO 15 VELOCITY URGENT CARE CENTERS ACROSS VIRGINIA. ACROSS SITES, 144,796 PATIENT VISITS WERE SEEN WITH AN AVERAGE DOOR IN TO DOOR OUT TIME OF 45 MINUTES. IV. NEW INITIATIVES A. SENTARA CONTINUES TO DEVELOP OPPORTUNITIES TO ENHANCE OUR BEHAVIORAL HEALTH INITIATIVES AND IMPLEMENT PROGRAMS THAT WILL SUPPORT THE COMMUNITIES WE SERVE. THE CENTER FOR BEHAVIORAL HEALTH LOCATED AT SENTARA VIRGINIA BEACH GENERAL HOSPITAL BEGAN OFFERING STRUCTURED OUTPATIENT PROGRAMS SPECIFICALLY DESIGNED TO MEET THE NEEDS OF ADULTS EXPERIENCING MENTAL HEALTH AND/OR SUBSTANCE ABUSE PROBLEMS. B. SENTARA BUILT THE FOUNDATION FOR OUR NEW AMBULATORY/RETAIL STRATEGY BY UPDATING OUR GROWTH IMPERATIVE AND STRUCTURING THE ORGANIZATION TO CAPTURE OPPORTUNITIES IN THIS AREA. C. IN ITS FOURTH YEAR, CLINICAL PERFORMANCE IMPROVEMENT (CLINICAL PI), AN INITIATIVE TO DRIVE CHANGE AND CREATE RAPID PROCESS IMPROVEMENT IN TARGETED CLINICAL AREAS, RESULTED IN SEEING POSITIVE TRENDS TOWARDS MEETING THE COMPANY'S ULTIMATE GOALS. D. THE VOICE OF THE CUSTOMER MODEL WAS HEAVILY UTILIZED TO UNDERSTAND MORE FROM SENTARA AND OPTIMA CUSTOMERS. THE MODEL IS AN OPERATIONAL DESIGN THAT ENABLES SENTARA TO INTEGRATE THE VOICE OF THE CUSTOMER INTO ALL FACETS OF BUSINESS DECISION-MAKING AND PRODUCT DEVELOPMENT. E. SENTARA BEGAN COMMUNICATING ABOUT THE GOOD WE DO FOR THE COMMUNITIES WE SERVE. WE CREATED AND DISTRIBUTED TWO COMMUNITY BENEFIT REPORTS, COMPLEMENTED WITH FULLY INTEGRATED MARKETING CAMPAIGNS AND, ALSO STEPPED UP OUR PHILANTHROPIC DONATIONS. F. A NUTRITION AS MEDICINE CONFERENCE WAS HELD IN NOVEMBER, 2018. NATIONAL EXPERTS IN PLANT-BASED LIFESTYLES DETAILED THE NUTRITIONAL BENEFITS OF SUCH DIETS IN FRONT OF NEARLY 950 PEOPLE. GUESTS INCLUDED 350 MEDICAL PROFESSIONALS, AND REGISTRANTS TRAVELED FROM 14 STATES AND EVEN CANADA TO LEARN THE POSITIVE EFFECTS NUTRITION CAN HAVE ON CHRONIC ILLNESSES AND QUALITY OF LIFE. G. OLD DOMINION UNIVERSITY IS PARTNERING WITH SENTARA HEALTHCARE ON A THREE-YEAR PROJECT TO DEVELOP A BLOCKCHAIN-EMPOWERED CYBERSECURITY SOLUTION TO MONITOR NETWORK ACTIVITIES OF MOBILE DEVICES AND PROVIDE REAL-TIME ALERTS OF UNAUTHORIZED DEVICES OR COMMUNICATIONS. V. OFFERING NEW PROCEDURES AND TECHNOLOGIES CLINICAL BREAKTHROUGHS AND ADVANCEMENTS: SENTARA INTRODUCED MANY NEW CLINICAL BREAKTHROUGHS AND ADVANCEMENTS THAT BENEFITED THE PATIENT IN MANY AREAS OF CARE, INCLUDING CARDIAC AND REDUCING INFECTIONS. A. PHARMACY ROBOT: I. SENTARA RMH MEDICAL CENTER PHARMACY INSTALLED A NEW STATE-OF-THE-ART PHARMACY ROBOT FOR AUTOMATED DISPENSING OF PATIENT MEDICATIONS. THE HOSPITAL IS THE SECOND IN THE WORLD TO INSTALL THE OMNICELL XR2 AUTOMATED CENTRAL PHARMACY SYSTEM. B. SURGICAL IMAGING: I. SENTARA NORFOLK GENERAL HOSPITAL INTRODUCED THE IMRI. THE GE INTRAOPERATIVE MRI MACHINE IS AN MRI THAT IS DONE MID-SURGERY TO HELP NEUROSURGEONS KNOW IF THEY HAVE REMOVED THE ENTIRE LESION OR TUMOR WITHOUT HAVING TO WAKE THE PATIENT UP. IT PROVIDES REAL-TIME IMAGING DURING SURGICAL PROCEDURES INCLUDING BRAIN TUMORS, GLIOMA AND MOVEMENT DISORDERS/TREMORS LIKE PARKINSON'S DISEASE. II. THE SENTARA HEART TRANSPLANT TEAM IS NOW USING THE SHERPA PAK TM TRANSPORT SYSTEM BY PARAGONIX TECHNOLOGIES TO ENSURE A CONSISTENT TEMPERATURE AT ALL TIMES OF A DONOR HEART TRANSPORT. THE SHERPA PAK TM IS A TEMPERATURE CONTROLLED COOLING SYSTEM THAT ALLOWS THE HEART TO BE STORED AT A CHOSEN TEMPERATURE. VI. EXPANDING EDUCATIONAL OPPORTUNITIES SENTARA IS COMMITTED TO ALWAYS IMPROVING--INCLUDING ENCOURAGING REGISTERED NURSES (RNS) TO CONTINUE PURSUING EDUCATIONAL OPPORTUNITIES. CONTINUOUS LEARNING WILL ADVANCE THE CARE SENTARA NURSES DELIVER TO OUR PATIENTS AND ALLOW THEM TO ADVANCE IN THEIR CAREERS. IN 2018, SENTARA ACHIEVED ITS GOAL OF 80% OF SENTARA NURSES HAVING A BSN BY 2020. IN 2018, SENTARA HAD 64.5% OF ITS NURSING WORKFORCE HOLDING A BSN OR HIGHER DEGREE WITH 16.2% OF LICENSED RNS WITH A CONTRACT TO COMPLETE THEIR BSN. RESEARCH: RESEARCH IS ANOTHER WAY SENTARA IS ALWAYS IMPROVING. HERE ARE A FEW EXAMPLES OF OUR WORK WITHIN THE RESEARCH REALM: A. HEART & VASCULAR: THROUGH THE SENTARA CARDIOVASCULAR RESEARCH INSTITUTE, CARDIOLOGISTS, CARDIOVASCULAR SURGEONS, VASCULAR SURGEONS AND UNIQUELY TRAINED REGISTERED NURSE RESEARCH COORDINATORS MAKE SIGNIFICANT STRIDES IN ADVANCING THE UNDERSTANDING AND TREATMENT OF THE NUMBER ONE KILLER IN AMERICA: CARDIOVASCULAR DISEASE. AS THE PREEMINENT CARDIAC RESEARCH INSTITUTE IN THE MID-ATLANTIC REGION, SENTARA WORKS COLLABORATIVELY WITH LOCAL INSTITUTIONS, GOVERNMENT AGENCIES AND BIOMEDICAL COMPANIES ON NATIONALLY AND INTERNATIONALLY RECOGNIZED CLINICAL RESEARCH TRIALS. WE FOCUS OUR EFFORTS ON DISCOVERING MORE EFFECTIVE CARDIOVASCULAR TREATMENTS AND PROTOCOLS WHILE ELIMINATING THOSE THAT ARE POTENTIALLY HARMFUL OR NOT AS BENEFICIAL. OUR ULTIMATE GOAL IS TO PROVIDE ENHANCED CLINICAL CARE THAT ADVANCES PATIENT OUTCOMES AND IMPROVES THE OVERALL HEALTH OF OUR COMMUNITY. OUR RESEARCH TOUCHES ON EVERY ASPECT OF HEART AND VASCULAR CARE, INCLUDING MEDICAL DEVICES, HEART FAILURE, ELECTROPHYSIOLOGY, CARDIAC SURGERY, VASCULAR SURGERY, CARDIAC INTERVENTIONAL PROCEDURES, STRUCTURAL HEART DISEASE, AND THE MEDICAL MANAGEMENT OF CORONARY ARTERY DISEASE RISK FACTORS SUCH AS DIABETES AND HIGH CHOLESTEROL. COLLECTIVELY, OUR RESEARCH NURSES COORDINATE MORE THAN 90 CLINICAL TRIALS AT ANY GIVEN TIME, SHEPHERDING PARTICIPANTS THROUGH THE ENTIRE TRIAL PROCESS, PROVIDING CARE DURING PERIODS OF NEED, AND TIRELESSLY ADVOCATING FOR THEIR PATIENTS' WELL-BEING. B. CANCER: CLINICIANS AND ACADEMIC RESEARCHERS AT SENTARA CANCER NETWORK PARTNER WITH VIRGINIA ONCOLOGY ASSOCIATES, EASTERN VIRGINIA MEDICAL SCHOOL, GEORGE MASON UNIVERSITY AND OTHER NATIONAL AND LOCAL HEALTHCARE ORGANIZATIONS TO CONDUCT RESEARCH THAT ELEVATES PATIENT CARE. COLLABORATIONS BETWEEN SURGICAL, RADIATION AND MEDICAL ONCOLOGISTS IN OUR SENTARA CANCER NETWORK ARE ESPECIALLY INSTRUMENTAL IN CONNECTING PATIENTS WITH CLINICAL TRIALS. THROUGH COLLABORATION WITH THE NCI NATIONAL CLINICAL TRIALS NETWORK (NCTN), THE ALLIANCE FOR CLINICAL TRIALS IN ONCOLOGY AND NATIONAL RESEARCH GROUP ONCOLOGY, WE DEVELOP AND CONDUCT CLINICAL TRIALS WITH PROMISING NEW CANCER THERAPIES. AS A LEADING CONTRIBUTOR TO NATIONAL RESEARCH, THE SENTARA CANCER NETWORK IS COMMITTED TO PARTICIPATING IN PROMISING CLINICAL TRIALS THAT MAKE NEW FIRST-LINE THERAPIES AVAILABLE TO PATIENTS RIGHT NOW. OUR PHYSICIANS ADDITIONALLY DEVELOP PROTOCOLS TO TEST THEIR OWN IMPORTANT RESEARCH QUESTIONS AND THEORIES, FOCUSING ON THE NEEDS OF OUR PATIENTS, HOSPITALS AND COMMUNITY. OUR TEAM PARTICIPATES IN RESEARCH THAT MAY LEAD TO BETTER OPTIONS FOR PREVENTION, DIAGNOSIS AND TREATMENT IN THE FUTURE. FORM 990, PART III, LINE 4A VII. BUILDING FOR THE FUTURE: A. THE SENTARA BELLEHARBOUR STRATEGIC PLAN WAS COMPLETED AND SENTARA BELLEHARBOUR, LOCATED IN SUFFOLK, OPENED A NEW 20,000 SQ. FT. AMBULATORY SURGERY CENTER WHERE LOWER ACUITY SURGERIES SUCH AS PODIATRY, VASCULAR ACCESS AND HERNIA REPAIR ARE CONDUCTED. B. TO HELP TRAVELERS, SENTARA MARTHA JEFFERSON HOSPITAL, LOCATED IN CHARLOTTESVILLE, OPENED A TRAVELERS' CLINIC. THIS IS A FULL-SERVICE CLINIC PROVIDING PRE-TRAVEL, IN-TRAVEL AND POST-TRAVEL SERVICES. SERVICES WILL BE PROVIDED TO ALL AGE GROUPS. C. SENTARA NORFOLK GENERAL HOSPITAL, OUR LEVEL I TRAUMA CENTER, LOCATED IN NORFOLK IS HOME TO THE NIGHTINGALE REGIONAL AIR AMBULANCE, THE REGION'S PREMIER AIR AMBULANCE. IN 2018, NINE SITES IN EASTERN VIRGINIA AND NORTHEAST NORTH CAROLINA ARE FULLY OPERATIONAL FOR INSTRUMENT FLIGHT RULES (IFR) LANDINGS BY NIGHTINGALE. THE FAA DESIGNATION CREATES DESIGNATED AIR SPACE, ALLOWING FLIGHTS IN CLOUDY, RAINY WEATHER, WHICH HAD TO BE TURNED DOWN UNDER CURRENT VISUAL FLIGHT RULES (VFR) LIMITATIONS. IFR ALLOWS NIGHTINGALE TO MEET GROUND AMBULANCES AT DESIGNATED SAFE SITES IN POOR WEATHER RATHER THAN REMOTE SCENES. D. THE SENTARA SPORTS MEDICINE CENTER OPENED AT THE OUTPATIENT CARE CENTER IN CHARLOTTESVILLE. THE SPECIALISTS PROVIDING CARE AT THE CENTER HAVE EXPERIENCE CARING FOR ATHLETES OF ALL LEVELS, FROM NOVICE TO OLYMPIAN, AND FOR SUCH INJURIES AS SPRAINS AND STRAINS, TORN LIGAMENTS AND TENDONS, JOINT DISLOCATIONS AND FRACTURES. ADVANCED TECHNIQUES SUCH AS INJECTIONS USING PLATELET-RICH PLASMA THERAPY, AS WELL AS OTHER NON-SURGICAL AND SURGICAL PROCEDURES ARE ALSO USED TO AID HEALING. E. SENTARA NORTHERN VIRGINIA MEDICAL CENTER, LOCATED IN WOODBRIDGE, ANNOUNCED THE ADDITION OF NEUROSURGERY AND UNVEILED ITS NEWLY RENOVATED AND EXPANDED SENTARA WOUND HEALING CENTER. F. SENTARA ALBEMARLE MEDICAL CENTER, LOCATED IN ELIZABETH CITY, NORTH CAROLINA, INTRODUCED THE USE OF THE ENDOBRONCHIAL ULTRASOUND (EBUS) BRONCHOSCOPY. THIS WILL ALLOW DOCTORS TO MORE EASILY LOCATE TUMORS, LYMPH NODES, OR OTHER TISSUES OF CONCERN. ADDITIONALLY, SENTARA ALBEMARLE MEDICAL CENTER (SAMC) INTRODUCED THE SENTARA WOUND HEALING CENTER AND THE SAMC CANCER CENTER RECEIVED ACCREDITATION FROM THE COMMISSION ON CANCER. SAMC INTRODUCED THE BREVERA BREAST BIOPSY SYSTEM. THIS BREAST BIOPSY SYSTEM SHORTENS THE IMAGING DELAY BETWEEN BIOPSIES AND IT REDUCES BIOPSY TIMES BY AN AVERAGE OF 10 MINUTES. G. SENTARA VIRGINIA BEACH GENERAL HOSPITAL, LOCATED IN VIRGINIA BEACH, LAUNCHED ITS FRACTURE CENTER WHERE IT PROVIDES HIGH QUALITY, SUBSPECIALTY CARE FROM A SPECIALIZED TEAM OF ORTHOPEDIC SURGEONS. SENTARA VIRGINIA BEACH GENERAL HOSPITAL MARKED ITS COMPLETION OF THE FIRST PHASE OF ITS MODERNIZATION PROJECT WITH THE CONSOLIDATION AND RE-STYLING OF THE HOSPITAL'S THREE SEPARATE INTENSIVE CARE UNITS INTO ONE STATE-OF-THE-ART, 24-BED ICU. H. SENTARA HALIFAX REGIONAL HOSPITAL, LOCATED IN SOUTH BOSTON, OPENED A BEHAVIORAL HEALTH PARTIAL HOSPITALIZATION PROGRAM TO JOIN ITS EXISTING INTENSIVE OUTPATIENT PROGRAM IN ORDER TO FURTHER ENHANCE ITS BEHAVIORAL HEALTH SERVICES FOR THE COMMUNITY. I. SENTARA LEIGH HOSPITAL, LOCATED IN NORFOLK, SENTARA PRINCESS ANNE HOSPITAL, LOCATED IN VIRGINIA BEACH, AND SENTARA VIRGINIA BEACH GENERAL HOSPITAL, LOCATED IN VIRGINIA BEACH, INTRODUCED THEIR SENTARA FOOT AND ANKLE CENTERS. THESE CENTERS HAVE DEVELOPED PATHWAYS FOR PATIENTS TO RECEIVE THE RIGHT CARE FOR THE TYPE OF FOOT OR ANKLE CONCERN INDIVIDUALS MAY HAVE. J. SENTARA PRINCESS ANNE HOSPITAL, LOCATED IN VIRGINIA BEACH, COMPLETED ITS MODERNIZATION PROJECT RESULTING IN THE ADDITION OF TWO NEW FLOORS TO THE HOSPITAL AND THE ADDITION OF 14 INPATIENT HOSPITAL BEDS AND 10 OBSERVATION BEDS; EXPANDED MONITORING FOR CARDIAC PATIENTS; INPATIENT DIALYSIS CENTER TO TREAT PATIENTS WITH KIDNEY FAILURE; AND ALLOWS FOR FUTURE EXPANSION OF SURGICAL SERVICES. K. SENTARA CAREPLEX HOSPITAL, LOCATED IN HAMPTON, EXPERIENCED A STRONG FIRST YEAR OF OFFERING MATERNITY SERVICES. THE BIRTHING CENTER HAS 7 LABOR, DELIVERY, RECOVERY AND POST-PARTUM ROOMS AND PROVIDES A UNIQUELY MODERN, ULTRA-PERSONALIZED EXPERIENCE FOR WOMEN AND FAMILIES IN THE COMMUNITY. L. SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER EARNED AN "A" SAFETY GRADE FROM THE LEAPFROG GROUP FOR THEIR COMMITMENT TO KEEPING PATIENTS SAFE AND MEETING THE HIGHEST SAFETY STANDARDS IN THE U.S. M. SENTARA OBICI HOSPITAL IS NOW THE 8TH HOSPITAL IN SENTARA AWARDED MAGNET STATUS. THE DESIGNATION, GRANTED TO ABOUT 7% OF U.S. HOSPITALS, CULMINATES A MULTI-YEAR JOURNEY TOWARD RECOGNITION FOR EXCELLENCE IN PATIENT CARE, INNOVATION IN NURSING PRACTICE AND A SUPPORTIVE WORK ENVIRONMENT FOR NURSES. N. SENTARA ENTERPRISES PROPRIUM PHARMACY, SENTARA'S HIGH-TOUGH SPECIALTY PHARMACY THAT OPENED IN 2016, ACHIEVED URAC ACCREDITATION. URAC WAS FORMERLY KNOWN AS THE UTILIZATION REVIEW ACCREDITATION COMMISSION. THIS DESIGNATION DEMONSTRATES THAT THE PROPRIUM PHARMACY IS COMMITTED TO QUALITY AND SAFETY AND STRIVES FOR CONTINUOUS IMPROVEMENT OF OUR SERVICES. O. SENTARA LIFE CARE SENTARA LIFE CARE IS COMPRISED OF ASSISTED LIVING CENTERS, NURSING HOMES, MOBILE MEALS AND THE PROGRAM FOR THE ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE). IN 2018, SENTARA LIFE CARE EXPANDED THE PACE (PROGRAM FOR THE ALL-INCLUSIVE CARE FOR THE ELDERLY) SERVICES TO THE WESTERN TIDEWATER AREA TO INCLUDE SURRY, ISLE OF WIGHT AND FRANKLIN CITY. PACE IS A COMPREHENSIVE HEALTH CARE AND SUPPORTIVE SERVICES PROGRAM FOR FRAIL SENIORS WHO WISH TO REMAIN IN THEIR HOMES AND COMMUNITY. THE PROGRAM IS ONE THAT PROVIDES TOTAL CARE FOR PARTICIPANTS, INCLUDING COMPREHENSIVE MEDICAL AND REHABILITATIVE SERVICES, IN-HOME SERVICES AND TRANSPORTATION. THE SENTARA NURSING AND REHABILITATION CENTER WINDERMERE, LOCATED IN VIRGINIA BEACH, OPENED ITS CARDIAC CENTER OF EXCELLENCE, WHICH ALLOWS THEM TO ACCEPT LVAD (LEFT VENTRICULAR ASSIST DEVICE) RESIDENTS NEEDING THERAPY SERVICES. THE SENTARA REHABILITATION AND CARE RESIDENCE, LOCATED IN CHESAPEAKE, OPENED ITS BACK & NECK CENTER OF EXCELLENCE. THE SENTARA NEUROSCIENCES AND ORTHOPEDIC TEAMS HAVE PARTNERED TO DEVELOP A COMPREHENSIVE AND PLANNED COURSE OF TREATMENT FOR PATIENTS UNDERGOING SPINE PROCEDURES. P. SENTARA MEDICAL GROUP (900+ PROVIDERS IN VIRGINIA AND NORTHEASTERN NORTH CAROLINA) SENTARA MEDICAL GROUP LAUNCHED VIDEO VISITS FOR SAME-DAY CARE, ROUTINE CARE, TRANSITION CARE AND MEDICATION REFILLS - ALLOWING FOR SEAMLESS ACCESS TO CARE AND GREATER CONVENIENCE FOR THE CUSTOMER. VIII. QUALITY AND PATIENT SAFETY DISTINCTIONS FORM 990, PART III, LINE 4A A. AWARD-WINNING CARE - AS ALWAYS, SENTARA IS PROUD AND HUMBLED BY THE VARIOUS AWARDS AND RECOGNITIONS THE SYSTEM RECEIVED OVER THE COURSE OF THE YEAR. OUR MISSION IS TO IMPROVE HEALTH EVERY DAY. TO RECEIVE AN AWARD IS SIMPLY AN ADDED ACKNOWLEDGEMENT OF OUR MISSION DRIVEN WORK. HERE ARE A FEW OF THE 2018 AWARDS AND RECOGNITIONS: I. FOR THE 18TH CONSECUTIVE YEAR, THE CARDIOLOGY AND HEART SURGERY PROGRAM AT SENTARA NORFOLK GENERAL HOSPITAL (SENTARA HEART HOSPITAL) WAS LISTED AMONG THE TOP 50 HEART PROGRAMS IN THE U.S. NEWS & WORLD REPORT 'BEST HOSPITALS' RANKING #32 IN 2018. SENTARA NORFOLK GENERAL HOSPITAL ALSO EARNED TWO ADDITIONAL TOP 50 NATIONAL RANKINGS FROM U.S. NEWS & WORLD REPORT: DIABETES AND ENDOCRINOLOGY (RANKED NO. 31), A SPECIALTY AT EASTERN VIRGINIA MEDICAL SCHOOL, AND NEPHROLOGY (RANKED 48). II. SEVEN SENTARA HOSPITALS EARNED HIGHEST GRADE OF "A" FOR DELIVERING SAFE CARE FOR PATIENTS ACCORDING TO THE LEAPFROG HOSPITAL SAFETY SCORE. III. SENTARA NORFOLK GENERAL HOSPITAL EPILEPSY CENTER HAS BEEN ACCREDITED AS A LEVEL III EPILEPSY CENTER THROUGH THE NATIONAL ASSOCIATION OF EPILEPSY CENTERS. IV. SENTARA IS THE ONLY HEALTH SYSTEM ON THE EAST COAST TO BE NATIONALLY RECOGNIZED AMONG THE 15 TOP HEALTH SYSTEMS BY IBM WATSON HEALTH FOR 2018. THE AWARD DEMONSTRATES CONSISTENTLY EXCELLENT PERFORMANCE AND A HIGH RATE OF IMPROVEMENT ACROSS THE ENTIRE ORGANIZATION. V. SENTARA WAS PLEASED TO HAVE BEEN RECOGNIZED AS ONE OF AMERICA'S BEST EMPLOYERS IN 2018 BY FORBES. RANKING IN THE BEST LARGE EMPLOYERS CATEGORY, SENTARA IS NUMBER 177 OF 500 COMPANIES CATEGORIZED INTO 25 INDUSTRIES. SENTARA WAS NAMED ALONGSIDE ONLY 24 OTHER LARGE ORGANIZATIONS IN THE HEALTHCARE AND SOCIAL INDUSTRY GROUP. VI. SENTARA EXCELLED IN STROKE CERTIFICATIONS IN 2018. SENTARA NORFOLK GENERAL HOSPITAL, LOCATED IN NORFOLK, ACHIEVED COMPREHENSIVE STROKE CERTIFICATION AFTER A MULTI-YEAR EFFORT TO DO SO AND SENTARA MARTHA JEFFERSON HOSPITAL, LOCATED IN CHARLOTTESVILLE, RECEIVED A FIRST-EVER PRIMARY STROKE CENTER PLUS CERTIFICATIONS. TWO FREE-STANDING EMERGENCY DEPARTMENTS - SENTARA BELLEHARBOUR AND SENTARA INDEPENDENCE - ACHIEVED AN ACUTE STROKE READY CERTIFICATION. VII. SENTARA HALIFAX REGIONAL HOSPITAL WAS NAMED IN THE TOP 100 RURAL AND COMMUNITY HOSPITALS IN THE UNITED STATES BY IVANTAGE HEALTH ANALYTICS AND THE CHARTIS CENTER FOR RURAL HEALTH. THIS IS THE SECOND CONSECUTIVE YEAR THAT THE HOSPITAL HAS RECEIVED THIS DESIGNATION. VIII. SENTARA LIFE CARE IN VIRGINIA BEACH WAS RECOGNIZED AS A PATHWAYS OF EXCELLENCE CENTER FROM THE AMERICAN NURSES CREDENTIALING CENTER. THIS DESIGNATION RECOGNIZES AN ORGANIZATION'S COMMITMENT TO CREATING A POSITIVE PRACTICE ENVIRONMENT THAT EMPOWERS AND ENGAGES STAFF. THIS IS THE FIRST LONG-TERM CARE FACILITY IN VIRGINIA TO BE DESIGNATED AS A PATHWAYS TO EXCELLENCE CENTER AND ONLY THE FOURTH LONG TERM CENTER NATIONALLY TO HAVE THIS DESIGNATION. IX. OPTIMA HEALTH A. GROWTH OPTIMA HEALTH COMPLETED ITS OPTIMA GROWTH AND STRATEGIC CAPABILITIES PLAN. ADDITIONALLY, OPTIMA HEALTH WAS SELECTED AS ONE OF SIX MANAGED CARE ORGANIZATIONS TO SERVE MEMBERS THROUGH MEDICAID EXPANSION, WHICH WILL ALLOW FOR NEARLY 400,000 VIRGINIANS TO NOW HAVE ACCESS TO QUALITY HEALTH CARE. MEDICAID EXPANSION ENROLLMENT BEGAN NOVEMBER 1, 2018 WITH AN EFFECTIVE DATE STARTING JANUARY 1, 2019. OPTIMA EXPANDED ITS NETWORK TO INCLUDE RIVERSIDE HEALTH SYSTEM FACILITIES AND PROVIDERS, ENABLING FOR BROADER ACCESS TO CARE FOR MEMBERS. CONCLUSION: SENTARA HEALTHCARE IS COMMITTED TO IMPROVING HEALTH EVERY DAY. WE PROVIDE QUALITY CARE THROUGH EXPERT PROVIDERS, USING CUTTING-EDGE TECHNOLOGY, DEPLOYING MEDICAL BREAKTHROUGHS, AND PROVIDING EXCELLENT CUSTOMER SERVICE ALL WITH A CONSTANT FOCUS ON INNOVATION. AND, WE ARE COMMITTED TO SUPPORTING THE COMMUNITIES WE SERVE THROUGH EMPLOYEE VOLUNTEERISM, GRANTS, SPONSORSHIPS, AND SUPPORTING INITIATIVES THAT LIFT OUR COMMUNITIES. WE LOOK FORWARD TO ANOTHER YEAR OF COMMUNITY SUCCESS, GROWTH AND INNOVATION IN 2019. FORM 990, PART V, LINE 1A NUMBER REPORTED IN BOX 3 OF FORM 1096: SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND THE 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM, MAINTAINS AN AGENCY RELATIONSHIP WITH THE ORGANIZATION AND ISSUES ALL 1099S ON ITS BEHALF. THE NUMBER REPORTED IS A BEST ESTIMATE OF THE 1099S ATTRIBUTABLE TO THE ORGANIZATION. THE EXACT NUMBER CANNOT BE DETERMINED; AS SOME OF THE 1099S ISSUED BY THE AGENT ARE ATTRIBUTABLE TO MORE THAN ONE ENTITY, AND THERE IS NO REPORTING MECHANISM TO DETERMINE 1099'S ATTRIBUTABLE SOLELY TO THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 2 DAVID H. WHITE, JR., LARRY P. SNEED, AND CHRIS A. LUMSDEN HAVE A BUSINESS RELATIONSHIP. DRS. HABIB BASSIL AND SAID B. ISKANDAR HAVE A BUSINESS RELATIONSHIP. THE ORGANIZATION'S OFFICERS AND DIRECTORS SERVED TOGETHER ON THE BOARDS OF OTHER ORGANIZATIONS WITHIN THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM"), AS WELL AS JOINT VENTURES IN WHICH THE SYSTEM HAD AN OWNERSHIP INTEREST. SEE SCHEDULE R FOR A LISTING OF SUCH ENTITIES. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE MEMBER WAS SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND SECTION 501(C)(3) TAX EXEMPT ENTITY. FORM 990, PART VI, SECTION A, LINE 7A A BOARD OF DIRECTORS, WHICH SERVED AS THE ORGANIZATIONS GOVERNING BODY, WAS COMPOSED OF TWO CLASSES OF DIRECTORS, A CLASS OF DIRECTORS APPOINTED BY THE ORGANIZATION'S SOLE MEMBER, SENTARA HEALTHCARE, A VIRGINIA NON-STOCK CORPORATION AND THE 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM, AND A CLASS OF DIRECTORS NOMINATED BY HALIFAX REGIONAL HOSPITAL, INC.'S NOMINATING COMMITTEE, AND RATIFIED BY THE BOARD OF DIRECTORS OF SENTARA HEALTHCARE. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION MAY NOT TAKE OR ALLOW ANY OF THE FOLLOWING GOVERNANCE ACTIONS WITHOUT THE CONSENT OF ITS SOLE MEMBER, SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND THE 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEATLH SYSTEM: APPROVAL OR ADOPTION OF ANY PLAN OF MERGER OR CONSOLIDATION, ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE ORGANIZATION, THE VOLUNTARY DISSOLUTION OR LIQUIDATION OF THE ORGANIZATION, REVOCATION OF ANY SUCH VOLUNTARY DISSOLUTION PROCEEDINGS, OR ANY DECISION TO FILE A PETITON REQUESTING OR CONSENTING TO AN ORDER FOR RELIEF UNDER THE FEDERAL BANKRUPTCY LAWS OR SIMILAR STATE LAWS FOR THE ORGANIZATION; ELECTION OF NEW BOARD MEMBERS; ANY ALTERATION, AMENDMENT, RESTATEMENT OR REPEAL OF ANY GOVERNING DOCUMENTS; THE ADOPTION OF ANY NEW GOVERNING DOCUMENTS; OR ANY ACTION TO BE TAKEN AS THE MEMBER UNDER THE GOVERNING DOCUMENTS. THE APPROVAL OF THE SOLE MEMBER IS ALSO REQUIRED FOR CERTAIN OPERATIONAL ACTIONS, AS OUTLINED IN THE ORGANIZATION'S BYLAWS. SUCH ACTIONS INCLUDE, BUT ARE NOT LIMITED TO, APPROVAL OF STRATEGIC OR LONG-RANGE BUSINESS PLANS AND ANNUAL OPERATING AND CAPITAL BUDGETS; CREATION OR ACQUISITION OF SUBSIDIARIES OR INTERESTS IN WHICH THE ORGANIZATION WILL BE A MEMBER; ENTRANCE INTO JOINT VENTURE OR OTHER SIMILAR ARRANGEMENTS; EMPLOYMENT MATTERS CONCERNING THE ORGANIZATION'S PRESIDENT, CHIEF OPERATING OFFICER OR CHIEF FINANCIAL OFFICER; TRANSACTIONS WITH INTERESTED PARTIES; INDEBTEDNESS NOT INCLUDED IN AN OPERATING OR CAPITAL BUDGET APPROVED BY THE MEMBER; THE COMMENCEMENT OR SETTLEMENT OF CERTAIN LITIGATION; AND ENTERING INTO, TERMINATING OR CHANGING ANY THIRD-PARTY PAYOR CONTRACT. SENTARA HEALTHCARE, AS SOLE MEMBER, HAS EXCLUSIVE AUTHORITY TO DIRECT AND MANAGE THE OPERATIONS AND AFFAIRS OF THE ORGANIZATION, AND TO MAKE ALL DECISIONS REGARDING THE BUSINESS OF THE ORGANIZATION, SUBJECT TO BOARD OVERSIGHT TO THE EXTENT AND IN THE MANNER SET FORTH IN THE ORGANIZATION'S BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION WAS PART OF THE SENTARA HEALTH SYSTEM ("THE SYSTEM"), AND AS SUCH, USED THE SYSTEM'S IN-HOUSE TAX DEPARTMENT, HEADED BY A LICENSED CERTIFIED PUBLIC ACCOUNTANT, TO BOTH PREPARE AND REVIEW ITS FORM 990. DURING THE PREPARATION AND REVIEW PROCESS, THE TAX DEPARTMENT WORKED CLOSELY WITH OTHER SYSTEM DEPARTMENTS, SUCH AS LEGAL, COMPENSATION AND BENEFITS, COMPLIANCE, FINANCE, AND MARKETING, TO ENSURE THAT A COMPLETE AND ACCURATE RETURN WAS FILED. THE PARENT OF THE SYSTEM IS SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND SECTION 501(C)(3) TAX EXEMPT ENTITY. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, BOARD-NOMINATED OFFICERS, AND KEY EMPLOYEES ARE REQUESTED TO SUBMIT AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE AND CERTIFY TO THE COMPLETION AND ACCURACY OF THE INFORMATION DISCLOSED. ADDITIONALLY, EACH ORGANIZATION'S GOVERNING BOARD OR APPROPRIATE BODY MONITORS TRANSACTIONS INVOLVING DISCLOSED POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 AS PART OF THE SENTARA HEALTH SYSTEM ("THE SYSTEM"), THE ORGANIZATION FOLLOWED PROCESSES AND PROCEDURES SET FORTH IN ITS GOVERNING DOCUMENTS TO ENSURE COMPLIANCE WITH ITS OBLIGATIONS AS A 501(C)(3) HEALTHCARE ORGANIZATION TO PAY DISQUALIFIED PERSONS REASONABLE COMPENSATION. SUCH PROCESSES AND PROCEDURES ARE INTENDED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERNAL REVENUE CODE SECTION 4958 REGULATIONS. THE COMPENSATION PHILOSOPHY OF THE SYSTEM AS A WHOLE IS TO BASE OVERALL COMPENSATION AND BENEFITS FOR EXECUTIVES ON NOT-FOR-PROFIT MARKET COMPARABLES, ADJUSTED AS APPLIED TO EACH EXECUTIVE, TAKING INTO CONSIDERATION THE INDIVIDUAL SKILLS, EXPERIENCE, TENURE AND PERFORMANCE OF THE EXECUTIVE BEING COMPENSATED AND OVERALL PERFORMANCE OF THE ORGANIZATION. IN LINE WITH THIS PHILOSOPHY, THE SYSTEM PERFORMED SUBSTANTIAL DUE DILIGENCE AS TO MARKET COMPARABLES. THE SYSTEM'S COMPENSATION COMMITTEE, WHICH CONSISTS OF SYSTEM BOARD MEMBERS WITHOUT CONFLICTS OF INTERESTS, ENGAGED AN OUTSIDE CONSULTANT, WHO REPORTS TO THE COMPENSATION COMMITTEE, TO CONDUCT A STUDY ASSESSING THE COMPETITIVENESS OF TOTAL COMPENSATION (INCLUDING CASH COMPENSATION, BENEFITS AND PERQUISITES) OF ITS SENIOR EXECUTIVES PRIOR TO MAKING DECISIONS REGARDING ANNUAL BASE SALARY ADJUSTMENTS, APPROVING INCENTIVE AWARDS, OR CONSIDERING PROGRAMMATIC CHANGES. THE STUDY COMPARED THE COMPENSATION OF THE SYSTEM'S SENIOR EXECUTIVES TO COMPENSATION DATA FROM MULTIPLE PUBLISHED SURVEY SOURCES BASED ON THE SENIOR EXECUTIVE'S FUNCTIONAL RESPONSIBILITY. IN CONDUCTING THE STUDY, THE CONSULTANT TARGETED OTHER NOT-FOR-PROFIT HEALTH SYSTEMS OF SIMILAR SIZE BASED ON NET REVENUE AND COMPLEXITY. FOR HEALTH PLAN POSITIONS, HEALTH PLANS WITH SIMILAR PREMIUMS, OR MEMBERS, WERE TARGETED. THE CONSULTANT ALSO CONDUCTS A REVIEW OF THE ORGANIZATION'S PERFORMANCE RELATIVE TO A GROUP OF NOT-FOR-PROFIT HEALTH SYSTEMS OF COMPARABLE SIZE AND SCOPE OF OPERATIONS EVERY YEAR. THE MOST RECENT STUDY COMPARED SENTARA'S PERFORMANCE TO 32 NOT-FOR-PROFIT HEALTHCARE SYSTEMS BASED ON NET REVENUE GROWTH, OPERATING MARGIN, VARIOUS CLINICAL QUALITY METRICS AND PATIENT SATISFACTION. OVERALL, THE CONSULTANT DETERMINED THAT SENTARA'S PAY WAS ALIGNED WITH ITS RELATIVE PERFORMANCE. THE COMPENSATION STUDY WAS PRESENTED TO THE SYSTEM'S COMPENSATION COMMITTEE, WHICH MADE ITS COMPENSATION DECISIONS BASED ON A)ITS REVIEW AND ANALYSIS OF THE PERFORMANCE OF BOTH THE ORGANIZATION AND ITS SENIOR EXECUTIVES AND, B) A REASONABLENESS OF COMPENSATION ANALYSIS AND OPINION FROM AN EXTERNAL EXPERT IN THE COMPENSATION OF EXECUTIVES IN THE TAX-EXEMPT HEALTH CARE FIELD. THE COMMITTEE'S BASES FOR ITS DECISIONS WERE DOCUMENTED IN COMMITTEE MINUTES TAKEN DURING THE MEETING AND THEN CIRCULATED FOR REVIEW AND APPROVAL. ALL DECISIONS REGARDING COMPENSATION WERE MADE BY THE COMMITTEE, WHICH CONSISTS OF SYSTEM BOARD MEMBERS WITHOUT CONFLICT OF INTERESTS. THE OUTSIDE MARKET STUDY DESCRIBED ABOVE WAS USED TO ESTABLISH COMPENSATION FOR THE ORGANIZATION'S PRESIDENT, WHO IS CONSIDERED THE TOP MANAGEMENT OFFICIAL OF THE ORGANIZATION. RESULTS WERE PRESENTED TO THE PRESIDENT AND CEO OF THE SYSTEM FOR REVIEW AND APPROVAL RATHER THAN THE SYSTEM'S COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE CONSOLIDATED FINANCIAL STATEMENTS FOR SENTARA HEALTHCARE AND SUBSIDIARIES WERE MADE PUBLICLY AVAILABLE THROUGH THE USE OF DAC BOND (DISCLOSURE DISSEMINATION AGENT) AND CAN BE FOUND ON THE INTERNET AT WWW.DACBOND.COM. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC. CORE PART VI LINES 1A AND 1B, BOARD MEMBER INDEPENDENCE: SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND THE 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM, APPOINTS THE ORGANIZATION'S DIRECTORS AS DESCRIBED IN CORE PART VI LINE 7. THE GOVERNING BOARD OF SENTARA HEALTHCARE IS A COMMUNITY-BASED BOARD COMPRISED OF 18 VOTING MEMBERS, 17 OF WHICH ARE CONSIDERED INDEPENDENT, AS DEFINED IN THE FORM 990 INSTRUCTIONS. FORM 990, PART XI, LINE 9: BOOK RECLASS OF INTERCO ACCOUNT BALANCES TO EQUITY 1,576,068. HALIFAX REGIONAL PROFESSIONAL SERVICES LLC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 208386107 PHYSN SUBSIDY VA 0 87188 HALIFAX REGIONAL HOSPITAL INC HALIFAX REGIONAL HEALTH SYSTEM INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541801466 HEALTH CARE VA 501(C)(3) LINE 7 N/A 0 SENTARA HEALTHCARE 6015 POPLAR HALL DRIVE NORFOLK VA 23502 521271901 HEALTH CARE VA 501(C)(3) LINE 7 N/A 0 CLARKSVILLE SENIOR CARE LLC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541957066 SENIOR CARE VA 501(C)(3) LINE 12A, I HALIFAX REGIONAL HOSPITAL 1 HALIFAX REGIONAL DEV FOUNDATION INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541801459 HLTH/WELFARE VA 501(C)(3) LINE 7 HALIFAX REGIONAL HOSPITAL 1 HALIFAX REGIONAL LONG TERM CARE INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 546074529 SENIOR CARE VA 501(C)(3) LINE 12A, I HALIFAX REGIONAL HOSPITAL 1 SENTARA HALIFAX REGIONAL PROPERTIES INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541801463 HLTH/WELFARE VA 501(C)(3) LINE 12A, I HALIFAX REGIONAL HOSPITAL 1 SENTARA PRINCESS ANNE HOSPITAL 6015 POPLAR HALL DRIVE NORFOLK VA 23502 273208969 HEALTH CARE VA 501(C)(3) LINE 3 SENTARA HOSPITALS 1 SENTARA HOSPITALS 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541547408 HEALTH CARE VA 501(C)(3) LINE 3 SENTARA HEALTHCARE 1 SENTARA MEDICAL GROUP 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541217184 HEALTH CARE VA 501(C)(3) LINE 10 SENTARA HEALTHCARE 1 SENTARA ENTERPRISES 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541917649 HEALTH CARE VA 501(C)(3) LINE 10 SENTARA HEALTHCARE 1 SENTARA LIFE CARE CORP 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541217183 HEALTH CARE VA 501(C)(3) LINE 10 SENTARA HEALTHCARE 1 MPB INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541346393 TITLE HOLDING COMPANY VA 501(C)(2) SENTARA ENTERPRISES 1 OPTIMA HEALTH PLAN 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541283337 HMO VA 501(C)(3) LINE 12A, I SENTARA HEALTHCARE 1 POTOMAC HOSPITAL CORP OF PRINCE WILLIAM 6015 POPLAR HALL DRIVE NORFOLK VA 23502 540853898 HEALTH CARE VA 501(C)(3) LINE 3 SENTARA HEALTHCARE 1 SENTARA RMH MEDICAL CENTER 6015 POPLAR HALL DRIVE NORFOLK VA 23502 540506331 HEALTH CARE VA 501(C)(3) LINE 3 SENTARA BLUE RIDGE LLC 1 VALLEY WELLNESS CENTER 6015 POPLAR HALL DRIVE NORFOLK VA 23502 521309257 PREVENTATIVE HEALTH/REHAB VA 501(C)(3) LINE 10 SENTARA RMH MEDICAL CENTER 1 MJH FOUNDATION 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541401357 INVEST/MGT SVCS FOR SUPPORTED ORG VA 501(C)(3) LINE 12A, I MARTHA JEFFERSON HOSPITAL 1 MARTHA JEFFERSON HOSPITAL FOUNDATION 6015 POPLAR HALL DRIVE NORFOLK VA 23502 300041113 FUNDRAISING FOR SUPPORTED ORG VA 501(C)(3) LINE 12A, I MARTHA JEFFERSON HOSPITAL 1 MARTHA JEFFERSON HOSPITAL 6015 POPLAR HALL DRIVE NORFOLK VA 23502 540261840 HEALTH CARE VA 501(C)(3) LINE 3 SENTARA BLUE RIDGE LLC 1 OPTIMA FAMILY CARE OF NC INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 823610648 MEDICAID HMO NC 501(C)(3) LINE 10 OPTIMA HEALTH OF NORTH CAROLINA LLC 1 OPTIMA HEALTH OF NORTH CAROLINA LLC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 823623430 SUPPORTS MCAID HMO NC 501(C)(3) LINE 12A, I SENTARA HEALTHCARE 1 MANAGEMENT SERVICES LLC 814 GREENBRIER CIRCLE CHESAPEAKE VA 23320 541365012 HLTH MGT SV VA N/A OBICI REAL ESTATE HOLDINGS LLC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 261749881 RE RENTAL VA N/A PRINCESS ANNE AMB SURG MGT LLC 1975 GLENN MITCHELL STE 300 VA BEACH VA 23456 204920880 HEALTH CARE VA N/A VA BEACH AMBULATORY SURGERY CENTER 1700 WILL O WISP DRIVE VA BEACH VA 23454 541448218 HEALTH CARE VA N/A CANCER CENTERS OF VA LLC 5900 LAKE WRIGHT DRIVE NORFOLK VA 23502 201338518 HEALTH CARE VA N/A HAMPTON ROADS LITHOTRIPSY LLC 225 CLEARFIELD AVE VIRGINIA BEACH VA 23462 200942600 HEALTH CARE VA N/A RADIOLOGY SERVICES OF HAMPTON ROADS LC 814 GREENBRIER CIRCLE STE L CHESAPEAKE VA 23320 541774472 HEALTH CARE VA N/A SENTARA OBICI AMBULATORY SURGERY LLC 2750 GODWIN BLVD SUFFOLK VA 23434 260144898 HEALTH CARE VA N/A ST LUKES PROPERTIES LLC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 272774684 MOB RENTAL VA N/A POTOMAC INOVA HEALTHCARE ALLIANCE LLC 8110 GATEHOUSE RD STE 400W FALLS CHURCH VA 22042 541802733 HEALTHCARE VA N/A ORTHOPAEDIC HOSPITAL MANAGEMENT LLC 3000 COLISEUM DRIVE HAMPTON VA 23666 274185117 MGT SVCS VA N/A CAREPLEX ORTHOPAEDIC ASC LLC 3000 COLISEUM DRIVE HAMPTON VA 23666 271867311 HEALTH CARE VA N/A PHYSICAL THERAPY ACACLLC 501 ALBEMARLE SQUARE CHARLOTTESVILLE VA 22901 260080717 HEALTH CARE VA N/A MNS SUPPLY CHAIN NETWORK LLC 11525 N COMMUNITY HOUSE RD STE 450 CHARLOTTE NC 28277 454235238 GPO DE N/A LAKE RIDGE AMBULATORY SURGERY CENTER LLC 12825 MINNIEVILLE RD STE 204 WOODBRIDGE VA 22192 455347932 HEALTH CARE VA N/A ALETA HEALTH LLC 2300 OPITZ BLVD WOODBRIDGE VA 22191 465661314 MSO DE N/A OPACC I LLC 18000 W SARAH LANE SUITE 250 BROOKFIELD WI 53045 392021431 RE RENTAL WI N/A MEDSTREAMING LLC 9840 WILLOWS ROAD NE SUITE 200 REDMOND WA 98052 451573625 SOFTWARE DEV WA N/A HIGHLAND CORE FIXED INCOME FUND C/O GTC 12 GILL ST SUITE 2600 WOBURN MA 01801 474618533 POOLED INV FD DE N/A HIGHLAND EQUITY FUND C/O GTC 12 GILL ST SUITE 2600 WOBURN MA 01801 474606269 POOLED INV FD DE N/A HIGHLAND PUBLIC INFLATION HEDGES FD C/O GTC 12 GILL ST SUITE 2600 WOBURN MA 01801 474601867 POOLED INV FD DE N/A SENTARA HOLDINGS INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541555638 HOLDING COMPANY VA N/A C 1 SENTARA HEALTH PLANS INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 522368125 TPA VA N/A C 1 OPTIMA HEALTH GROUP 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541473382 HMO VA N/A C 1 OPTIMA HEALTH INSURANCE COMPANY 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541642752 HEALTH INSURANCE VA N/A C 1 OPTIMA BEHAVIORAL HEALTH SERVICES 6015 POPLAR HALL DRIVE NORFOLK VA 23502 621382666 MENTAL HEALTH SVCS VA N/A C 1 SENTARA VENTURES INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541688615 HOLDING COMPANY VA N/A C 1 SENTARA OBICI PROFESSIONAL CENTER 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541445865 RE RENTAL VA N/A C 1 SENTARA STRATEGIC SOLUTIONS INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541020941 HEALTH CARE VA N/A C 1 SENTARA HEALTH PLANS OF OHIO INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 471509408 TPA OH N/A C 1 SENTARA HEALTH INSURANCE CO OF NC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 471888140 HEALTH INSURANCE NC N/A C 1 SENTARA HEALTH PLANS OF NC INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 465510421 TPA NC N/A C 1 MANAGED CARE SERVICES INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 815421060 ALT HEALTH DELIVERY VA N/A C 1 SENTARA SOUTHSIDE HEALTH SERVICES INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541417772 HEALTH SERVICES VA HALIFAX REGIONAL HOSPITAL INC C 1568710 664333 1.00000 1 DOMINION HEALTH MEDICAL ASSOCIATES LTD 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541060357 PHYS PRACTICE VA HALIFAX REGIONAL PROFESSIONAL SERVICES LLC C 30127020 4730900 1.00000 1 SMG INNOVATIONS INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 203730331 HEALTH CARE VA N/A C 1 POTOMAC VENTURES CORP 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541441420 PHARMACY VA N/A C 1 ROCKINGHAM HEALTH SERVICES INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541721387 CONTRACTING SVCS VA N/A C 1 MARTHA JEFFERSON MEDICAL ENTERPRISES INC 6015 POPLAR HALL DRIVE NORFOLK VA 22911 541841528 MEDICAL BILLING SVCS VA N/A C 1 BAY PRIMEX INSURANCE COMPANY LTD PO BOX 1051 GRAND CAYMAN CJ KY1-1102 980704114 OTHER INSURANCE FUNDS CJ N/A C 1 ALBEMARLE PHYSICIAN SERVICES-SENTARA INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 264592192 PHYS PRACTICE NC N/A C 1 THE PORT WARWICK MEDICAL ARTS BUILDING ASSOCIATION 6015 POPLAR HALL DRIVE NORFOLK VA 23502 562295574 BUILDING ASSOCIATION VA N/A C 1 MEDSTREAMING EGYPT SOFTWARE 15 ANMAR IBN YASSER ST CAIRO EG CONSULTING EG N/A C 1 HIGHLAND DIRECT HEDGED EQUITY FUND LTD 27 HOSPITAL ROAD GEORGE TOWN CJ KY1-9008 INVESTMENT CJ N/A C 1 1 1 1 0 0 0 0 0 0 0 1 1 1 1 0 1 1 1 1 SENTARA HALIFAX REGIONAL PROPERTIES INC A 50348 CORP BOOKS/REC SENTARA HALIFAX REGIONAL PROPERTIES INC L 131524 CORP BOOKS/REC SENTARA HALIFAX REGIONAL PROPERTIES INC B 155351 CORP BOOKS/REC HALIFAX REGIONAL LONG TERM CARE INC C 14859865 CORP BOOKS/REC HALIFAX REGIONAL LONG TERM CARE INC Q 285734 CORP BOOKS/REC HALIFAX REGIONAL LONG TERM CARE INC S 15039978 CORP BOOKS/REC HALIFAX REGIONAL LONG TERM CARE INC L 105621 CORP BOOKS/REC CLARKSVILLE SENIOR CARE LLC C 11988192 CORP BOOKS/REC CLARKSVILLE SENIOR CARE LLC P 80615 CORP BOOKS/REC CLARKSVILLE SENIOR CARE LLC Q 183958 CORP BOOKS/REC CLARKSVILLE SENIOR CARE LLC S 12091535 CORP BOOKS/REC OPTIMA HEALTH PLAN L 3390624 CORP BOOKS/REC SENTARA HEALTH PLAN L 2595487 CORP BOOKS/REC SENTARA HOSPITALS C 5968748 CORP BOOKS/REC SENTARA HOSPITALS N 2461637 CORP BOOKS/REC SENTARA HOSPITALS M 5556565 CORP BOOKS/REC MPB C 54303 CORP BOOKS/REC