2019-11-12T11:14:04-06:00 2018-12-31 990 2018-01-01 541217183 SENTARA LIFE CARE CORPORATION SENT 7574557020 6015 POPLAR HALL DRIVE NORFOLK VA 23502 ROBERT A BROERMANN TREASURER 7574557020 2019-11-12 163.230.200.172 2019-11-12 12:11:22 ES P D64F4F5DFCDF89C51048D545CDB41D2F0B5DC81C D64F4F5DFCDF89C51048D545CDB41D2F0B5DC81C 2018 2020-03-31 21:24:44Z HOWARD P KERN 6015 POPLAR HALL DRIVE NORFOLK VA 23502 78457238 0 X WWW.SENTARA.COM X 1982 VA AS PART OF SENTARA HEALTHCARE'S INTEGRATED HEALTH CARE SYSTEM, WE IMPROVE HEALTH EVERY DAY. 3 0 1131 534 0 28012 11676 3331 87512153 77969407 1090 -109512 63129 78867 87588048 77942093 656169 1227506 0 0 51242465 51274390 0 0 0 41943100 38394119 93841734 90896015 -6253686 -12953922 59293931 58240292 8048358 8374074 51245573 49866218 X SEE SCHEDULE O.AS PART OF SENTARA HEALTHCARE'S INTEGRATED HEALTH CARE SYSTEM, WE IMPROVE HEALTH EVERY DAY THROUGH THE ESTABLISHMENT AND OPERATION OF PROGRAMS AND SERVICES FOR THE PROVISION OF HEALTH CARE AND FOR HEALTH RELATED PURPOSES; THE PROMOTION AND ADVANCEMENT OF THE WELFARE AND SOCIAL, CULTURAL, EDUCATIONAL, AND ECONOMIC DEVELOPMENT OF THE COMMUNITY; AND THE PROMOTION OF HEALTH.SEE THE PROGRAM SERVICE ACCOMPLISHMENTS BELOW FOR FURTHER INFORMATION. 0 0 71701183 1227506 77969407 SEE SCHEDULE O. 71701183 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 X 41 0 1 1131 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 3 0 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X CORPORATE OFFICERS 7574557020 6015 POPLAR HALL DR NORFOLK VA 23502 MICHAEL V GENTRY DIRECTOR 1.00 52.00 X 0 1960778 33423 ROBERT A BROERMANN DIRECTOR/TREASURER 1.00 52.00 X X 0 1564698 24170 HOWARD P KERN DIRECTOR/CHAIRMAN 2.00 53.00 X X 0 3723802 2026220 JEFFREY P KING SECRETARY 1.00 48.00 X 0 722372 94140 TERESA EDWARDS INTERIM PRESIDENT (EFFEC 11/18) 1.00 41.00 X 0 1013011 36718 CAROLE S GUINANE INTERIM PRESIDENT (RESIGNED 6/18) 1.00 40.00 X 0 316495 44874 ANNIE M ALEXANDER REFERRAL SERVICES MANAGER 40.00 0.00 X 133396 0 28478 RHONDA S ROUSE LTC ADMINISTRATOR, SLCC 40.00 0.00 X 130855 0 19077 MERINDA B FORD DIRECTOR PACE PROGRAM 40.00 0.00 X 130714 0 22071 KAREN L WILHELM LTC ADMINISTRATOR, SLCC 40.00 0.00 X 124638 0 14680 LAUREN R NEWMAN TEAM COORDINATOR, AMBULATORY REHAB 40.00 0.00 X 124206 0 16283 643809 9301156 2360134 19 0 1 0 PCA NUSCRIPTRX PHARMACY 5215 LINBAR DRIVE STE 210 NASHVILLE TN 37211 CONTRACT PHARMACY SERVICES 1037705 360 HEALTHCARE STAFFING LLC 5401 WEST KENNEDY BLVD STE 830 TAMPA FL 33609 HEALTHCARE STAFFING SOLUTIONS 593246 MOBILE ONE COURIER INC 1619 DIAMOND SPRINGS RD STE C VIRGINIA BEACH VA 23455 DELIVERY SERVICES 233136 VALLEYCREST LANDSCAPE AND MAINTENANCE PO BOX 404083 ATLANTA GA 30384 LANDSCAPING SERVICES 217766 AMN HEALTHCARE INC 12400 HIGH BLUFF DRIVE SAN DIEGO CA 92130 HEALTHCARE STAFFING SOLUTIONS 171121 9 3331 3331 PATIENT SERVICE REV 900099 77560012 77560012 MEALS ON WHEELS 624210 294455 294455 FACILITY SPACE RENTALS 900099 114940 114940 77969407 12 405621 0 515145 12 -109524 -109512 -109512 OTHER REVENUE 900099 55841 55841 CAFETERIA & VENDING 900099 23026 23026 78867 77942093 77969407 0 -30645 1227506 1227506 41480616 34018253 7462363 741356 607986 133370 6156059 5048584 1107475 2896359 2375304 521055 1868520 1532373 336147 69114 56680 12434 3342436 3147195 195241 1053 864 189 2421527 1985894 435633 177507 145573 31934 2618532 2147458 471074 278628 228503 50125 11050 9062 1988 3681811 3019453 662358 800806 656741 144065 MEDICAL SUPPLIES EXPENS 9182951 9182951 CORP EXPENSE ALLOCATION 7430689 7430689 MEDICAL CLAIM & CAPITAT 5405040 5405040 PURCHASED & CONTRACTED 1578150 1294241 283909 -473695 -388478 -85217 90896015 71701183 19194832 0 449001 345369 13005519 13408129 923243 748056 142446 92136 95294783 52238154 44192741 43056629 577341 577341 3640 12632 59293931 58240292 1434790 979185 30692 26459 244949 228047 6337927 7140383 8048358 8374074 X 51205354 49830569 29753 25183 10466 10466 51245573 49866218 59293931 58240292 X -12953922 -803 11575370 X 0 1 X 1 0 X 5225 28352 8557 11676 3331 57141 93414054 93425218 89211100 87512153 77969407 441531932 41694 29074 49924 63129 78867 262688 93460973 93482644 89269581 87586958 78051605 441851761 0 0 0 441851761 93460973 93482644 89269581 87586958 78051605 441851761 1.00000 1.00000 0.00000 X 0 1 X 40219 3296 7866 35649 33692 10401 3874 40219 28069 8500 2877 33692 26732 27538 26201 28069 18194 420 -8119 26732 0.29360 0.70640 0 0 3650309 3650309 49648618 24726898 24921720 2465741 1107812 1357929 35801029 25278094 10522935 3729086 1125350 2603736 43056629 DUE TO THIRD PARTY PAYORS 1950658 MEDICAL CLAIMS PAYABLE 1562575 GENERAL RESERVE 794747 DUE TO AFFILIATES 1407 OTHER LIABILITIES 2830996 7140383 PART IV, LINE 2B: EXPLANATION OF ESCROW ACCOUNT LIABILITY MEDICAID REGULATIONS REQUIRE NURSING HOME PROVIDERS TO OFFER A DEDICATED BANKING ACCOUNT AVAILABLE TO RESIDENTS FOR THE PURPOSE OF DEPOSITING MONIES, ACCESS TO MINIMAL PETTY CASH, ASSISTANCE OF BILL PAYMENT (NEWSPAPERS, BEAUTICIANS, HEALTH/LIFE INSURANCE PREMIUMS, TELECOMMUNICATION EXPENSES, ETC). ALTHOUGH MEDICAID REGULATIONS REQUIRE THIS, SERVICE IS OFFERED TO ALL RESIDENTS, REGARDLESS OF PAYOR SOURCE. FUNDS ARE STRICTLY THE PROPERTY OF THE RESIDENTS. NO CO-MINGLING WITH (SENTARA) OPERATING FUNDS IS PERMITTED. PART V, LINE 4: AN ENDOWMENT FUND WAS ESTABLISHED AT THE REQUEST OF THE DONOR TO PROVIDE FUNDING FOR THE CONTINUED IMPROVEMENT OF THE CHAPEL AT SENTARA NURSING CENTER - HAMPTON, AS WELL AS TO PROVIDE SOCIAL AND SPIRITUAL PROGRAMS FOR THE SENTARA NURSING CENTER RESIDENTS. FUNDS WERE ALSO CREATED FOR MOBILE MEALS TO COMMUNITY MEMBERS IN NEED; A CLINICAL EDUCATION INITIATIVE PROVIDING SCHOLARSHIPS TO CURRENT NURSE EMPLOYEES FOR OBTAINING A BACHELOR OF SCIENCE IN NURSING; BIOTERRORISM RESPONSE TRAINING; AND RESIDENT ACTIVITIES. 1 SENTARA HEALTHCARE 6015 POPLAR HALL DRIVE NORFOLK VA 23502 521271901 501(C)(3) 1227506 CORPORATE ALLOCATION TO PARENT 1 0 PART I, LINE 2: PROCEDURES FOR MONITORING USE OF GRANTS FUNDS IN U.S. AS PART OF THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM"), THE ORGANIZATION DONATES FUNDS TO ITS SECTION 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. 0 1 0 0 0 0 0 1 0 MICHAEL V GENTRY DIRECTOR 0 780042 0 492200 0 688536 0 14287 0 19136 0 1994201 0 409007 ROBERT A BROERMANN DIRECTOR/TREASURER 0 811625 0 544618 0 208455 0 7578 0 16592 0 1588868 0 0 HOWARD P KERN DIRECTOR/CHAIRMAN 0 1575765 0 1510047 0 637990 0 2002149 0 24071 0 5750022 0 159126 JEFFREY P KING SECRETARY 0 478707 0 158890 0 84775 0 67291 0 26849 0 816512 0 30337 TERESA EDWARDS INTERIM PRESIDENT (EFFEC 11/18) 0 441233 0 236070 0 335708 0 18188 0 18530 0 1049729 0 179910 CAROLE S GUINANE INTERIM PRESIDENT (RESIGNED 6/18) 0 236952 0 76042 0 3501 0 32943 0 11931 0 361369 0 0 ANNIE M ALEXANDER REFERRAL SERVICES MANAGER 77355 0 56004 0 37 0 4200 0 24278 0 161874 0 0 0 MERINDA B FORD DIRECTOR PACE PROGRAM 118966 0 11660 0 88 0 4082 0 17989 0 152785 0 0 0 PART I, LINE 3 SENTARA HEALTHCARE, THE SECTION 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 HOWARD KERN PARTICIPATED IN THE SENTARA SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. PARTICIPATION IN THE PLAN IS LIMITED TO SELECT INDIVIDUALS AS APPROVED BY SENTARA HEALTHCARE'S BOARD OF DIRECTOR'S COMPENSATION COMMITTEE. THE PLAN IS CURRENTLY CLOSED TO ADDITIONAL MEMBERS. VESTING OCCURS UPON THE COMPLETION OF A TWO YEAR NON-COMPETE PERIOD FOLLOWING TERMINATION AFTER EARLY RETIREMENT DATE OR UPON DEATH. EARLY RETIREMENT DATE IS WHEN THE EXECUTIVE OBTAINS AT LEAST AGE 55 AND HAS 10 YEARS OF SERVICE AND BENEFITS ARE FORFEITED IF PARTICIPANT LEAVES PRIOR TO AGE 55 WITH 10 YEARS OF SERVICE. HOWARD KERN, ROBERT BROERMANN, MICHAEL GENTRY, TERESA EDWARDS AND JEFFREY KING 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). DURING 2018, THE FOLLOWING CORPORATE EXECUTIVES RECEIVED VESTED DISTRIBUTIONS UNDER THE PLAN: ROBERT BROERMANN ($149,185); MICHAEL GENTRY ($667,805); HOWARD KERN ($590,013); JEFFREY KING ($46,981); AND TERESA EDWARDS ($302,906). 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: 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. FORM 990, PART III, LINE 4A SENTARA LIFE CARE CORP. PROVIDES LONG TERM HEALTH CARE AND RELATED SERVICES FOR OLDER ADULTS. SERVICES INCLUDE SKILLED AND REHABILITATIVE NURSING CARE, VENTILATOR CARE, A SPECIALTY ALZHEIMER'S UNIT, ADULT DAY HEALTH CARE CENTER, PERSONAL EMERGENCY RESPONSE AND SUPPORT SERVICES, AND MULTIPLE MOBILE MEAL PROGRAMS DELIVERING DAILY TO THE AT-HOME ELDERLY. SENTARA LIFE CARE CORPORATION OPERATES 880 LONG TERM CARE BEDS IN TEN FACILITIES, INCLUDING NURSING CENTERS AND ASSISTED LIVING FACILITIES. PATIENT DAYS FOR THE YEAR ENDED 12/31/18 WERE 243,166, INCLUDING 132,951 MEDICAID PATIENT DAYS. ALL SERVICES ARE PROVIDED TO THE COMMUNITY REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. THE COST OF UNCOMPENSATED CARE PROVIDED BY SENTARA LIFE CARE CORP. TO THE COMMUNITY DURING 2018 WAS OVER $5 MILLION. SEE DESCRIPTION OF PROGRAMS AND ACCOMPLISHMENTS OF THE SENTARA HEALTHCARE SYSTEM FOR 2018. FORM 990, PART III, LINE 4A 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: FORM 1096 SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND THE SECTION 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 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 THE BOARD OF DIRECTORS, WHICH SERVED AS THE ORGANIZATION'S GOVERNING BODY, WAS ELECTED BY ITS SOLE MEMBER, SENTARA HEALTHCARE, A VIRGINIA NON-STOCK CORPORATION AND THE SECTION 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND THE SECTION 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM, IS ENTITLED TO ONE VOTE ON ALL MATTERS AND HAS THE RIGHT TO ELECT AND REMOVE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY; APPROVE ANY ALTERATION, AMENDMENT OR REPEAL OF ITS GOVERNING DOCUMENTS; APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGET AND ALL FORMAL LONG-RANGE PLANS; APPROVE ANY SINGLE CAPITAL EXPENDITURE EXCEEDING $1 MILLION; APPROVE ALL BORROWING OR INDEBTEDNESS WHICH IN ANY ONE TRANSACTION OR RELATED SERIES OF TRANSACTIONS EXCEEDS $500,000; APPROVE 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 OF THE ORGANIZATION, OR REVOCATION OF VOLUNTARY DISSOLUTION PROCEEDINGS; REVIEW THE BOOKS AND RECORDS, CONDUCT AUDITS, AND APPROVE THE SELECTION OF AUDITORS CHOSEN TO CONDUCT AUDITS OF THE ORGANIZATION; AND APPROVE THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OF THE ORGANIZATION, OR THE CREATION OF ANY OTHER CORPORATION OF WHICH THE ORGANIZATION IS TO BE A MEMBER, AND TO APPROVE ANY DISSOLUTION OR OTHER CHANGE IN ANY SUCH LEGAL RELATIONSHIP PREVIOUSLY APPROVED BY SENTARA HEALTHCARE. 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 SECTION 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. THIS PROCESS WAS USED TO ESTABLISH COMPENSATION FOR THE ORGANIZATION'S CHAIRMAN AND TREASURER; WHO ALSO SERVED AS PRESIDENT AND CEO, AND EXECUTIVE VICE PRESIDENT AND CFO OF THE SYSTEM, RESPECTIVELY. THE PROCESS WAS LAST UNDERTAKEN DURING THE CURRENT TAX YEAR FOR THE POSITIONS LISTED. THE OUTSIDE MARKET STUDY DESCRIBED ABOVE WAS ALSO 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. FORM 990, PART VI, LINE 1A & 1B, BOARD MEMBER INDEPENDENCE THE ORGANIZATION'S BOARD OF DIRECTORS IS ELECTED ANNUALLY BY SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND THE SECTION 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM. 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 ACCOUNTS TO EQUITY 11,575,370. 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