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SOUTHSIDE COMMUNITY HOSPITAL INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
SOUTHSIDE COMMUNITY HOSPITAL INC (EIN 54-0555201)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-11
IRS object ID
201633169349302048
Schema version
2015v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-11-11T11:46:32-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11676 International Drive Ste 1200AddressLine1Txt
CityMcLeanCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22102ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN540555201EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SOUTHSIDE COMMUNITY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% THOMAS L ANGELOInCareOfNm
Business Name ControlSOUTBusinessNameControlTxt
Phone4343152776PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 OAK STREETAddressLine1Txt
CityFARMVILLECityNm
State AbbreviationVAStateAbbreviationCd
ZIP23901ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHOMAS L ANGELOPersonNm
Person TitleSCH CEOPersonTitleTxt
Phone4342004712PhoneNum
Signature2016-11-09SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMARGARET A BRADSHAWPreparerPersonNm
PTINP00501222PTIN
Phone7032868000PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1CENTRA SOUTHSIDE COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerTHOMAS L ANGELOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 OAK STREETAddressLine1Txt
CityFARMVILLECityNm
State AbbreviationVAStateAbbreviationCd
ZIP23901ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$79,172,413GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressHTTP://SCH.CENTRAHEALTH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1926FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTHCARE SERVICES FOR EIGHT COUNTIES IN CENTRAL VIRGINIA.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee684TotalEmployeeCnt
Total Volunteers61TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$9,883PYContributionsGrantsAmt
CY Contributions Grants$20,598CYContributionsGrantsAmt
PY Program Service Revenue$69,595,098PYProgramServiceRevenueAmt
CY Program Service Revenue$78,016,445CYProgramServiceRevenueAmt
PY Investment Income$213,715PYInvestmentIncomeAmt
CY Investment Income$134,732CYInvestmentIncomeAmt
PY Other Revenue$1,044,100PYOtherRevenueAmt
CY Other Revenue$868,505CYOtherRevenueAmt
PY Total Revenue$70,862,796PYTotalRevenueAmt
CY Total Revenue$79,040,280CYTotalRevenueAmt
PY Grants And Similar Paid$21,440PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$3,611CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$39,105,367PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$40,950,928CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$29,964,275PYOtherExpensesAmt
CY Other Expenses$33,205,825CYOtherExpensesAmt
PY Total Expenses$69,091,082PYTotalExpensesAmt
CY Total Expenses$74,160,364CYTotalExpensesAmt
PY Revenues Less Expenses$1,771,714PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$4,879,916CYRevenuesLessExpensesAmt
Total Assets BOY$46,599,323TotalAssetsBOYAmt
Total Assets EOY$48,476,620TotalAssetsEOYAmt
Total Liabilities BOY$21,667,869TotalLiabilitiesBOYAmt
Total Liabilities EOY$18,531,522TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$24,931,454NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$29,945,098NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE ARE DEDICATED TO IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE BY PROVIDING HIGH QUALITY HEALTHCARE WITH A PERSONAL TOUCH.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$66,970,330ExpenseAmt
Grant$3,611GrantAmt
Revenue$78,016,445RevenueAmt
DescSOUTHSIDE COMMUNITY HOSPITAL IS A 501(C)(3) HOSPITAL COMMITTED TO OFFERING AFFORDABLE HEALTHCARE TO RESIDENTS OF SOUTHSIDE VIRGINIA. WE ARE DEDICATED TO IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE BY PROVIDING HIGH QUALITY HEALTHCARE. PLEASE SEE THE CONTINUATION ON SCHEDULE O.Desc
Total Program Service Expenses$66,970,330TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document151IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee684EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldVAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTHOMAS L ANGELOPersonNm
Phone4343152776PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1OAK STREETAddressLine1Txt
CityFARMVILLECityNm
State AbbreviationVAStateAbbreviationCd
ZIP23901ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
SHARON L HARRUP
CHAIRMAN2.00.0Yes (X)Yes (X)$0$0$0
FRANCIS WOOD JR
VICE CHAIRMAN2.00.0Yes (X)Yes (X)$0$0$0
LEROY O PFEIFFER JR
SECRETARY/TREASURER2.00.0Yes (X)Yes (X)$0$0$0
LEWIS ADDISON
DIRECTOR (UNTIL 4/2015)2.050.0Yes (X)$0$499,490$22,724
WILLIAM BASS JR
DIRECTOR (AS OF 5/2015)2.050.0Yes (X)Yes (X)$0$313,427$39,589
KWABENA DONKOR MD
MEDICAL STAFF PRESIDENT2.00.0Yes (X)$0$0$0
RHONDA B ALGEIER MD
DIRECTOR2.00.0Yes (X)$0$0$0
REV CALVIN GRAY
DIRECTOR2.00.0Yes (X)$0$0$0
HAROLD M HARRIS JR
DIRECTOR2.00.0Yes (X)$0$0$0
STEPHEN KEITH EDD
DIRECTOR2.00.0Yes (X)$0$0$0
WILLIAM MCGUIRE
DIRECTOR2.00.0Yes (X)$0$0$0
ODESSA PRIDE
DIRECTOR2.00.0Yes (X)$0$0$0
WILLIAM L ROACH
DIRECTOR2.00.0Yes (X)$0$0$0
TIMOTHY R THARPE
DIRECTOR2.00.0Yes (X)$0$0$0
PATRICIA TUCKER
DIRECTOR2.00.0Yes (X)$0$0$0
JULIE DIXON
DIRECTOR2.00.0Yes (X)$0$0$0
KIRSTEN HUBER MD
DIRECTOR50.00.0Yes (X)$248,877$0$17,509
EW TIBBS
DIRECTOR/CENTRA PRESIDENT& CEO2.050.0Yes (X)$0$1,055,428$222,007
TERESITA DIONISIO MD
DIRECTOR (AS OF 7/2015)2.00.0Yes (X)$0$0$0
DR CHARLES TAYLOR
DIRECTOR (UNTIL 6/2015)2.00.0Yes (X)$155,611$0$0
THOMAS ANGELO
SCH CEO (AS OF 5/2015)50.00.0Yes (X)$183,344$0$40,252
CLAUDIA A MEINHARD
SCH CNO50.00.0Yes (X)$185,297$0$20,252
BIKRAM S BAL MD
PHYSICIAN50.00.0$839,174$0$11,272Yes (X)
ROBERT W AH MD
PHYSICIAN50.00.0$479,047$0$40,762Yes (X)
JOHN A KONA MD
PHYSICIAN50.00.0$424,969$0$17,452Yes (X)
JERRY LUCAS MD
PHYSICIAN50.00.0$420,628$0$7,950Yes (X)
JONATHAN R LOGAN MD
PHYSICIAN50.00.0$412,105$0$53,826Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,349,052TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,868,345TotReportableCompRltdOrgAmt
Total Other Compensation$493,595TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K42IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MEDICAL ASSOCIATES OF CENTRAL VIRGI
2215 LANDOVER PLACELYNCHBURGVA24501PHYSICIAN SERVICES$2,588,023
CROTHALL FACILITIES MGMTCROTHALL S
1500 LIBERTY RIDGE DR SUITE 210WAYNEPA19087HOUSEKEEPING SVCS$1,379,899
MOORES ELECTRICAL MECH CONST IN
PO BOX 119ALTAVISTAVA24517ELECTRICAL CONTRACTO$740,874
ROANOKE VALLEY INTERNISTS PC
PO BOX 906FARMVILLEVA23901PHYSICIAN SERVICES$502,113
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX75397PHYSICIAN SVCS$491,406
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K13CntrctRcvdGreaterThan100KCnt
Government Grants$7,686GovernmentGrantsAmt
All Other Contributions$12,912AllOtherContributionsAmt
Total Contributions$20,598TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT REVENUE621400$77,238,468$77,238,468
ANCILLARY SERVICES900099$645,703$645,703
MEANINGFUL USE900099$129,752$129,752
GRANT INCOME900099$2,522$2,522
FieldValueIRS element (for citing)
Total Program Service Revenue$78,016,445TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$57,131TotalRevenueColumnAmt
Exclusion$57,131ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$56,021RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$56,021RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$56,021TotalRevenueColumnAmt
Exclusion$56,021ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$100,180SecuritiesAmt
Other$109,554OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$59,883SecuritiesAmt
Other$72,250OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$40,297SecuritiesAmt
Other$37,304OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$77,601TotalRevenueColumnAmt
Exclusion$77,601ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA621400$249,538$249,538
MISCELLANEOUS REVENUE900099$562,946$562,946
FieldValueIRS element (for citing)
Other Revenue Total$812,484OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$79,040,280TotalRevenueColumnAmt
Related Or Exempt Func Income$78,016,445RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,003,237ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$3,611TotalAmt
Program Services$3,611ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$773,129TotalAmt
Program Services$404,488ProgramServicesAmt
Management And General$368,641ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$10,603TotalAmt
Program Services$10,603ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$33,935,346TotalAmt
Program Services$32,223,565ProgramServicesAmt
Management And General$1,711,781ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,231,850TotalAmt
Program Services$5,814,327ProgramServicesAmt
Management And General$417,523ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,296,362TotalAmt
Management And General$2,296,362ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$63,249TotalAmt
Management And General$63,249ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$39,180TotalAmt
Management And General$39,180ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$12,662,878TotalAmt
Program Services$11,579,483ProgramServicesAmt
Management And General$1,083,395ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$374,882TotalAmt
Management And General$374,882ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,064,724TotalAmt
Program Services$2,419,232ProgramServicesAmt
Management And General$645,492ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$122,177TotalAmt
Management And General$122,177ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,778,342TotalAmt
Program Services$1,778,342ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$423,478TotalAmt
Program Services$377,436ProgramServicesAmt
Management And General$46,042ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$119,392TotalAmt
Program Services$98,082ProgramServicesAmt
Management And General$21,310ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$197,894TotalAmt
Program Services$197,894ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,188,000TotalAmt
Program Services$4,188,000ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$685,643TotalAmt
Program Services$685,643ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLIES$3,992,183$3,992,183
DRUGS$2,932,111$2,932,111
COLLECTIONS EXPENSES$265,330$265,330

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$74,160,364TotalAmt
Program Services$66,970,330ProgramServicesAmt
Management And General$7,190,034ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,662,223BOYAmt
EOY$3,448,961EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$126,550BOYAmt
EOY$113,248EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,266,549BOYAmt
EOY$9,043,277EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,583,549BOYAmt
EOY$1,981,496EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$280,622BOYAmt
EOY$112,011EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$76,874,388LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$51,582,655LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$25,033,372BOYAmt
EOY$25,291,733EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,093,383BOYAmt
EOY$2,078,524EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$49,995BOYAmt
EOY$49,995EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$7,503,080BOYAmt
EOY$6,357,375EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$46,599,323BOYAmt
EOY$48,476,620EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,499,831BOYAmt
EOY$4,990,267EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$130,750BOYAmt
EOY$236,198EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,740,980BOYAmt
EOY$5,898,357EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$194,408BOYAmt
EOY$172,432EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,101,900BOYAmt
EOY$7,234,268EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,667,869BOYAmt
EOY$18,531,522EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$24,802,878BOYAmt
EOY$29,831,522EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$64,427BOYAmt
EOY$49,427EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$64,149BOYAmt
EOY$64,149EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$24,931,454BOYAmt
EOY$29,945,098EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$46,599,323BOYAmt
EOY$48,476,620EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$4,879,916ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$100,180NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$233,908OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$3,528OtherActivitiesAmt
Total Lobbying Expenditures$3,528TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceOTHER LOBBYING ACTIVITIESFormAndLineReferenceDesc
ExplanationPART II-B, LINE 1(I) A PORTION OF THE ORGANIZATIONS HOSPITAL ASSOCIATION DUES FOR THE YEAR 2015 WERE ATTRIBUTABLE TO LOBBYING EXPENSES IN THE AMOUNT OF $3,528.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$64,149BeginningYearBalanceAmt
End Year Balance$64,149EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$64,149BeginningYearBalanceAmt
End Year Balance$64,149EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$64,149BeginningYearBalanceAmt
End Year Balance$64,149EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$64,149BeginningYearBalanceAmt
End Year Balance$64,149EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$64,149BeginningYearBalanceAmt
End Year Balance$64,149EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$163,194OtherCostOrOtherBasisAmt
Book Value$163,194BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$36,077,314OtherCostOrOtherBasisAmt
Depreciation$20,392,629DepreciationAmt
Book Value$15,684,685BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,712,754OtherCostOrOtherBasisAmt
Depreciation$1,937,295DepreciationAmt
Book Value$775,459BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$37,772,712OtherCostOrOtherBasisAmt
Depreciation$29,252,731DepreciationAmt
Book Value$8,519,981BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$148,414OtherCostOrOtherBasisAmt
Book Value$148,414BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$25,291,733TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
DUE FROM RELATED PARTIES$5,952,857
EST. RECEIVABLE - 3RD PARTY$314,650
OTHER ACCOUNTS RECEIVABLE$89,868
FieldValueIRS element (for citing)
Total Book Value Other Assets$6,357,375TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
PAYABLE TO ESTIMATED 3RD PARTY$602,805
INTEREST RATE SWAP$228,798
DUE TO RELATED PARTY$6,402,665
FieldValueIRS element (for citing)
Total Liability$7,234,268TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4THESE FUNDS WERE DONOR RESTRICTED FOR LPN NURSING SCHOLARSHIPS.
PART X, LINE 2FIN 48 FOOTNOTE SOUTHSIDE COMMUNITY HOSPITAL IS INCLUDED IN CENTRA HEALTH, INCS CONSOLIDATED AUDIT REPORT FOR YEAR ENDING DECEMBER 31, 2015. THE FOLLOWING FOOTNOTE REGARDING LIABILITY FOR UNCERTAIN TAX POSITIONS (FIN48) IS FOUND IN THIS CONSOLIDATED REPORT. "CENTRA HEALTH, INC., CENTRA HEALTH FOUNDATION, CCRC, INC., SOUTHSIDE COMMUNITY HOSPITAL, INC., BEDFORD MEMORIAL HOSPITAL, AND LYNCHBURG FAMILY PRACTICE RESIDENCY PROGRAM, INC. ARE EXEMPT FROM INCOME TAX UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO INCOME TAXES HAVE BEEN PROVIDED FOR THESE ENTITIES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS EXCEPT FOR TAXES RELATED TO CERTAIN UNRELATED BUSINESS INCOME ENGAGED IN BY CENTRA. CENTRA MEDICAL GROUP LLC, CENTRA HEALTH INDEMNITY COMPANY LLC, CENTRAL VIRGINIA HOSPITAL FOR RESTORATIVE AND REHABILITATIVE CARE, LLC, CENTRA PANORAMIC, LLC, CENTRAL VIRGINIA QUALITY CARE NETWORK, LLC, AND CENTRA OUTPATIENT REHABILITATION SERVICES, LLC ARE DISREGARDED FOR FEDERAL INCOME TAX PURPOSES AND, THEREFORE, ARE INCLUDED UNDER CENTRAS TAX RETURN. CENTRA HAS ADOPTED RELEVANT ACCOUNTING STANDARDS RELATED TO TAXES FOR ITS SUBSIDIARIES, GENERAL BUSINESS CONCERNS, INC., PCHP HOLDING INC. AND PIEDMONT COMMUNITY HEALTH PLAN, INC. UNDER THE ASSET AND LIABILITY METHOD FOR THESE STANDARDS, DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE TEMPORARY DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS AND THE TAX BASIS OF THE SUBSIDIARYS ASSETS AND LIABILITIES AT INCOME TAX RATES EXPECTED TO BE IN EFFECT WHEN SUCH AMOUNTS ARE REALIZED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN EARNINGS IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. CENTRA HEALTH INDEMNITY COMPANY, LLC IS WHOLLY OWNED BY CENTRA HEALTH, INC. ANY LIABILITY FOR TAXES IS PASSED THROUGH TO CENTRA HEALTH, INC. A PROVISION WILL BE MADE WHEN OPERATIONS OF THIS SUBSIDIARY INDICATES A LIABILITY FOR TAXES. CENTRA HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2015. CENTRA BELIEVES THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2012."

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,163,124TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,163,124NetCommunityBenefitExpnsAmt
Total Expense0.04260TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,128,426TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,882,164DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,246,262NetCommunityBenefitExpnsAmt
Total Expense0.04370TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,291,550TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,882,164DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,409,386NetCommunityBenefitExpnsAmt
Total Expense0.08630TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$118,878TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$118,878NetCommunityBenefitExpnsAmt
Total Expense0.00160TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$29,511TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$29,511NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$148,389TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$148,389NetCommunityBenefitExpnsAmt
Total Expense0.00190TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,439,939TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,882,164DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,557,775NetCommunityBenefitExpnsAmt
Total Expense0.08820TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,438TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,438NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,709TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,709NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,049TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,049NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$25,196TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$25,196NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$9,272,175BadDebtExpenseAmt
Reimbursed By Medicare$26,342,554ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$30,479,012CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,136,458MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line1NONEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SOUTHSIDE COMMUNITY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 OAK STREETAddressLine1Txt
CityFARMVILLECityNm
State AbbreviationVAStateAbbreviationCd
ZIP23901ZIPCd
FieldValueIRS element (for citing)
Website AddressHTTP://SCH.CENTRAHEALTH.COMWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SOUTHSIDE COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTP://SCH.CENTRAHEALTH.COMOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLHTTP://SCH.CENTRAHEALTH.COMStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTP://SCH.CENTRAHEALTH.COMFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTP://SCH.CENTRAHEALTH.COMFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTP://SCH.CENTRAHEALTH.COMFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Average Negotiated RatesYes (X)AverageNegotiatedRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5:CENTRA ORGANIZED THREE COMMUNITY HEALTH NEEDS ASSESSMENT COMMUNITY ADVISORY BOARDS ONE FOR THE CENTRA HEALTH, LYNCHBURG REGION, ONE FOR THE BEDFORD AND ONE FOR THE SOUTHSIDE COMMUNITY HOSPITAL, FARMVILLE REGION. THESE CHNA COMMUNITY ADVISORY BOARDS WERE COMPRISED OF COMMUNITY LEADERS REPRESENTING EDUCATION, BUSINESS, SOCIAL SERVICE AGENCIES, GOVERNMENT, PUBLIC HEALTH AUTHORITIES, COLLEGES (INCLUDING OUR LOCAL SCHOOL OF PUBLIC HEALTH), OTHER HEALTHCARE PROVIDERS, AND NEIGHBORHOOD CITIZEN ORGANIZATIONS IN AN EFFORT TO OBTAIN AS BROAD-BASED COMMUNITY INPUT AS POSSIBLE. PARTICIPANTS INCLUDED ORGANIZATIONS THAT REPRESENT THE NEEDS OF MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. A LIST OF INDIVIDUAL PARTICIPANTS IS LISTED ON THE LAST PAGE OF THE CHNA ASSESSMENT & IMPLEMENTATION PLAN REPORTS.
SCHEDULE H, PART V, SECTION B, LINE 7d:HARD COPIES OF THE CHNA ASSESSMENT & IMPLEMENTATION PLAN WERE SENT TO ALL CHNA COMMUNITY ADVISORY BOARD MEMBERS.
SCHEDULE H, PART V, SECTION B, LINE 11:THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR CENTRA SOUTHSIDE COMMUNITY HOSPITAL IDENTIFIED THREE OVERARCHING ACTION PLAN PRIORITIES AIMED AT IMPROVING THE HEALTH OF THE VARIOUS COMMUNITIES SERVED. THESE PRIORITIES INCLUDED ACCESS TO CARE; HEALTH STATUS IMPROVEMENT; AND HEALTH DISPARITIES. WITH REGARD TO ACCESS TO CARE, CENTRA SOUTHSIDE HAS RECRUITED MANY NEW PRIMARY MEDICAL CARE PROVIDERS TO THEIR PRIMARY CARE CLINICS IN FARMVILLE, LUNENBURG, AND CHARLOTTE PRACTICES. ADDITIONALLY, FUNDING WAS PROVIDED TO THE LOCAL FEDERALLY QUALIFIED HEALTH CENTER TO PROVIDE FREE VACCINATIONS AND FREE PRESCRIPTIONS FOR PEOPLE WHO ARE UNABLE TO AFFORD SUCH SERVICES. LASTLY, THE HOSPITAL ESTABLISHED A SCHOLARSHIP PROGRAM FOR NURSE PRACTITIONERS AND PHYSICIANS ASSISTANTS TO WORK AS PROVIDERS IN THE MEDICALLY UNDERSERVED AREAS OF CENTRA SOUTHSIDES MARKET. ACCESS TO MENTAL HEALTHCARE WAS IMPROVED BY PROVIDING TELEPSYCHIATRY SERVICES TO HOSPITALS EMERGENCY ROOM AND INTEGRATING A NEW PSYCHIATRIST INTO THE FARMVILLE PRIMARY CARE PRACTICE. THE HOSPITAL CONTINUES TO PROVIDE FREE TRANSPORTATION TO THE PEARSON CANCER CENTER. HEALTH STATUS IMPROVEMENT ACTION PLAN PRIORITY INCLUDES A NUMBER OF PROGRAMS AND SERVICES ALL AIMED AT EXPANDING HEALTH EDUCATION AND WELLNESS. THESE PROGRAMS INCLUDE STROKE EDUCATION EVENTS ('STRIKE OUT STROKE'FAST IN A BOX'); FREE LACTATION CLINICS IN FARMVILLE AND CHARLOTTE; SUBSIDIZED MEALS-ON-WHEELS SERVICES; FUNDING TO SUPPORT THE LOCAL SHELTER FOR DOMESTIC VIOLENCE; FUNDING TO SUPPORT AN ANTI-VIOLENCE COMMUNITY CAMPAIGN; AND PROVIDING DIABETIC EDUCATION FOR THE SOUTHSIDE VIRGINIA REGION. LASTLY, PURCHASED BLOOD PRESSURE MONITORING EQUIPMENT, DIGITAL SCALES, AND GLUCOSE METERS TO SUPPORT THE PIEDMONT COMMUNITY IMPACT ORGANIZATION. OTHER INITIATIVES INCLUDE BEING A CORPORATE SPONSOR FOR THE ANNUAL PIEDMONT WALK AND ANNUAL HIGH BRIDGE HALF MARATHON. IN THE ACTION PLAN PRIORITY OF HEALTH DISPARITIES, A NUMBER OF NEW PROGRAMS AND SERVICES WERE INITIATED TO INCREASE ACCESS TO PRENATAL CARE FOR THE AFRICAN AMERICAN COMMUNITY. THESE SERVICES INCLUDE CONTINUATION OF CENTRAS COMMUNITY VOICE PROGRAM INTO THE SOUTHSIDE REGION, WHICH IS A LAY HEALTH EDUCATOR PROGRAM AIMED AT IMPROVING ACCESS TO PRENATAL CARE; EXPANSION OF THE HEALTHY FAMILIES PROGRAM INTO THE SOUTHSIDE REGION WHICH PROVIDES INTENSIVE HOME VISITATIONS WITH NEW AND EXPECTANT FAMILIES WHICH PROVIDES HEALTH EDUCATION SERVICES AND TRANSPORTATION TO APPOINTMENTS; PROVIDED FREE CARSEATS TO ELIGIBLE FAMILIES AT CAR SEAT SAFETY CLASSES; SPONSORSHIP OF FARMVILLES FARMERS MARKET, PROVIDING MATCHING DOLLARS FOR 'SNAP' PURCHASES; PROVIDED FUNDING TO PIEDMONT SENIOR SERVICES IN FARMVILLE AND SOUTHSIDE TO PURCHASE SOFTWARE TO TRACK AT-RISK POPULATIONS; THROUGH HEART OF VIRGINIA FREE CLINIC PROVIDED FUNDING FOR MEDICAL EQUIPMENT, MEDICAL SUPPLIES, SLEEP STUDY SUPPLIES, YMCA MEMBERSHIPS AND GAS CARDS TO THOSE IN NEED. FOUR SIGNIFICANT NEEDS WERE NOT IDENTIFIED FOR FITTING WITHIN THE CHNAS ACTION PLAN PRIORITIES. THESE INCLUDED SOCIAL AND ECONOMIC FACTORS; HIGH SCHOOL GRADUATION RATES; FAMILIES LIVING BELOW POVERTY AND DOMESTIC VIOLENCE. RATIONALE PROVIDED IS THAT THESE CRITICAL NEEDS ARE HIGHLY COMPLEX IN NATURE AND AFFECTED BY A WIDE VARIETY OF INFLUENCING FACTORS MANY WELL BEYOND THE CAPABILITY AND RESOURCES AVAILABLE THROUGH CENTRA SOUTHSIDE HOSPITAL. FURTHERMORE, IT WAS FELT THAT OTHER COMMUNITY BASED INITIATIVES WERE ALREADY ATTEMPTING TO ADDRESS THESE NEEDS (EG: UNITED WAYS COMMUNITY IMPACT FUND).
FieldValueIRS element (for citing)
Facility18FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (18 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
CMG SOUTHSIDE - KEYSVILLE
312 KINGS STREETKEYSVILLEVA23947FAMILY PRACTICE
CMG SOUTHSIDE - FARMVILLE
935 SOUTH MAIN STREETFARMVILLEVA23901FAMILY PRACTICE
CMG SOUTHSIDE - VICTORIA
1418 6TH STREETVICTORIAVA23974FAMILY PRACTICE
CMG SOUTHSIDE - BURKEVILLE
412 NAMOZINE STREETBURKEVILLEVA23922FAMILY PRACTICE
SOUTHSIDE COMMUNITY HOSP HOMECARE SVCS
711 OAK STREETFARMVILLEVA23901HOME HEALTH SERVICES
CMG SOUTHSIDE - CUMBERLAND
1758 ANDERSON HIGHWAYCUMBERLANDVA23942FAMILY PRACTICE
SOUTHSIDE CTR FOR GASTRO LIVER DISEASE
800 OAK STREETFARMVILLEVA23901GASTROLOGY SVCS
CMG SOUTHSIDE ORTHOPEDIC
935 SOUTH MAIN STREETFARMVILLEVA23901ORTHOPEDIC SERVICES
CMG SOUTHSIDE - SURGERY CENTER
800 OAK STREETFARMVILLEVA23901GENERAL SURGERY
CMG SOUTHSIDE - WOMEN'S CENTER
800 OAK STREETFARMVILLEVA23901WOMEN'S HEALTH SVCS
CMG SOUTHSIDE - EMERGENCY SERVICES
800 OAK STREETFARMVILLEVA23901EMERGENCY SERVICES
SOUTHSIDE HOSPICE
713 OAK STREETFARMVILLEVA23901HOSPICE
CMG SOUTHSIDE - NEPHROLOGY CENTER
935 SOUTH MAIN STREETFARMVILLEVA23901NEPHROLOGY SVCS
CMG SOUTHSIDE - NEUROLOGY CENTER
800 OAK STREETFARMVILLEVA23901NEUROLOGY SVCS
SOUTHSIDE PACE
1530 SOUTH MAIN STREETFARMVILLEVA23901CARE FOR ELDERLY
CMG SOUTHSIDE - UROLOGY
800 OAK STREETFARMVILLEVA23901UROLOGY SVCS
CMG SOUTHSIDE - CRNA
800 OAK STREETFARMVILLEVA23901CRNA SVCS
CMG SOUTHSIDE - HOSPTIALISTS
800 OAK STREETFARMVILLEVA23901HOSPITALIST SVCS

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 6A:INFORMATION ON COMMUNITY BENEFIT IS REPORTED ANNUALLY THROUGH A REPORT PREPARED BY CENTRA HEALTH, INC., SOLE MEMBER CORPORATION OF SOUTHSIDE COMMUNITY HOSPITAL.
PART I, LINE 7:COST-TO-CHARGE RATIO WAS USED TO CALCULATE THE EXPENSE.
PART II:SOUTHSIDE COMMUNITY HOSPITAL CONTINUOUSLY WORKS ON IMPROVING ITS RELATIONSHIP WITH THE COMMUNITY IT SERVES BY OFFERING MANY SERVICES, SUCH AS, COMMUNITY SUPPORT, COMMUNITY HEALTH IMPROVEMENT, WORKFORCE DEVELOPMENT, ETC. SOUTHSIDE COMMUNITY HOSPITAL, ALSO, HOSTS AND/OR PARTICIPATES IN VARIOUS CAREER FAIRS IN ORDER TO REACH OUT TO YOUNG ADULTS WHO MAY BE INTERESTED IN THE HEALTHCARE PROFESSION. COMMUNITY SUPPORT: SOUTHSIDE COMMUNITY HOSPITAL CONTINUOUSLY WORKS ON IMPROVING ITS RELATIONSHIP WITH THE COMMUNITY IT SERVES BY PARTICIPATING IN NUMEROUS HEALTH FAIRS, CONDUCTING HEALTH EDUCATION SEMINARS, PROVIDING SCHOOL-BASED HEALTH PROGRAMS, ETC. IT SPONSORS AND/OR PARTICIPATES IN NUMEROUS EVENTS THROUGHOUT THE YEAR, INCLUDING, BUT NOT LIMITED TO: MARCH FOR BABIES WALK, HEALTHY KIDS DAY PROGRAM, MEALS ON WHEELS, ETC. WE FEEL AN ESSENTIAL PART OF BEING A GOOD NEIGHBOR WITHIN THE COMMUNITY IS TO PROMOTE HEALTH, SAFETY, AND WELL-BEING ACTIVITIES IN ORDER TO BENEFIT THOSE AROUND THE COMMUNITY. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: HELPING THE COMMUNITY IMPROVE THEIR HEALTH IS AN IMPORTANT MISSION OF SOUTHSIDE COMMUNITY HOSPITAL. WE FEEL PASSIONATE ABOUT IMPROVING ACCESS TO CARE, PUBLIC HEALTH, ETC. WE ARE EXCITED TO PARTICIPATE IN NUMEROUS EVENTS, SUCH AS THE MORTON COMMUNITY PRAYER BREAKFASTS, THROUGHOUT THE YEAR IN ORDER TO STAY CONNECTED TO THE COMMUNITY WE SERVE. BY STAYING CONNECTED WE ARE ABLE TO RECOGNIZE AND ADDRESS NEEDS THROUGHOUT OUR REGION. WORKFORCE DEVELOPMENT: THROUGHOUT THE YEAR, SOUTHSIDE COMMUNITY HOSPITAL HOSTS AND/OR PARTICIPATES IN VARIOUS CAREER FAIRS AND MEDICAL CAREER CAMP, IN ORDER TO REACH OUT TO YOUNG ADULTS WHO MAY BE INTERESTED IN THE HEALTHCARE PROFESSION.
PART III, SECTION A, LINE 1ON JANUARY 1, 2012, CENTRA HEALTH, INC. AND SUBSIDIARIES ADOPTED ACCOUNTING STANDARDS UPDATE (ASU) 2011-07, WHICH CHANGED CENTRAS PRESENTATION OF PROVISION FOR DOUBTFUL ACCOUNTS TO A DEDUCTION FROM NET PATIENT SERVICE REVENUE. THIS HAS BEEN DISCLOSED IN THE FOOTNOTES OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THEREFORE, CENTRA HEALTH AND ITS SUBSIDIARIES, INCLUDING SOUTHSIDE COMMUNITY HOSPITAL AND BEDFORD MEMORIAL HOSPITAL, REPORT BAD DEBT IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15.
PART III, SECTION A, LINE 2:SEE DESCRIPTION FOR PART III, SECTION A, LINE 4.
PART III, SECTION A, LINE 4:THE ORGANIZATION BELIEVES THAT ITS PROCEDURES CONCERNING THE APPLICATION OF ITS FINANCIAL ASSISTANCE POLICY ARE SUFFICIENTLY THOROUGH TO EXCLUDE ALL PATIENTS WHO ARE ELIGIBLE FOR CHARITY CARE FROM BAD DEBT. THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS INCLUDE THE FOLLOWING FOOTNOTE ABOUT BAD DEBT: "PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR BAD DEBTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, CENTRA ANALYZES HISTORICAL COLLECTIONS AND WRITE-OFFS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR BAD DEBTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, CENTRA ANALYZES CONTRACTUALLY AMOUNTS DUE AND PROVIDES AN ALLOWANCE FOR BAD DEBTS, ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS, PROVISION FOR BAD DEBTS, AND PROVISION FOR CONTRACTUAL ADJUSTMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS OR WITH BALANCES REMAINING AFTER THE THIRD-PARTY COVERAGE HAS ALREADY PAID, CENTRA RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS HISTORICAL COLLECTIONS, WHICH INDICATES THAT SOME PATIENTS ARE UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE DISCOUNTED RATES AND THE AMOUNTS COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR BAD DEBTS." (CENTRA HEALTH, INC. AND SUBSIDIARIES, FY 2015 AUDIT REPORT, PAGE 14)
PART III, SECTION B, LINE 8:THE CALCULATION OF MEDICARE SHORTFALL DOES NOT REFLECT ALL OF THE ORGANIZATIONS REVENUES AND COSTS ASSOCIATED WITH ITS PARTICIPATION IN THE MEDICARE PROGRAM, PER IRS INSTRUCTIONS. MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE MEDICARE COST REPORT USING THE COST TO CHARGE RATIO. THE TOTAL AMOUNT OF MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE SOUTHSIDE COMMUNITY HOSPITALS MISSION IS TO PROMOTE HEALTH IN THE COMMUNITY AND WE DO NOT LIMIT THE CARE AVAILABLE TO ANY OF OUR PATIENTS, INCLUDING THOSE COVERED BY MEDICARE. WE ARE RELIEVING A GOVERNMENT BURDEN BY PROVIDING CARE TO MEDICARE PATIENTS EVEN THOUGH REIMBURSEMENTS WERE LESS THAN THE COST TO PROVIDE SERVICE. TOTAL MEDICARE SHORTFALL FOR 2015 WAS $4,136,458.
PART III, SECTION C, LINE 9B:CENTRA SOUTHSIDE COMMUNITY HOSPITAL RECOGNIZES THAT MEDICAL EXPENSES ARE OFTEN UNEXPECTED AND CAUSE FINANCIAL HARDSHIP. ALL ACCOUNTS WITH SELF PAY BALANCES WILL FOLLOW THE SAME COLLECTION PROTOCOLS. THESE PROTOCOLS ARE ELECTRONICALLY ADMINISTERED THROUGH CENTRA'S HOSPITAL INFORMATION SYSTEM. WHEN AN ACCOUNT REACHES THE END OF THE SYSTEM GENERATED COLLECTION CYCLE AND MEETS SAID CRITERIA, THE ACCOUNT BALANCE WILL BE PROCESSED AS BAD DEBT AND REPORTED TO A COLLECTION AGENCY. CRITERIA FOR BAD DEBT WILL BE APPLIED CONSISTENTLY REGARDLESS OF AGE, RACE, OR RELIGION. CENTRA SOUTHSIDE COMMUNITY HOSPITAL APPLIES UNIFORM COLLECTION PROTOCOLS TO ALL UNPAID ELIGIBLE CHARGES REGARDLESS OF RACE, SEX, AGE, DISABILITY, NATIONAL ORIGIN OR RELIGION. PATIENTS KNOWN BY CENTRA TO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT SUBJECT TO COLLECTION PROTOCOLS. IF DURING COLLECTION PROTOCOLS, OR AFTER REFERRAL TO AN OUTSIDE COLLECTION AGENCY, IT IS DISCOVERED PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY, INCLUDING ANY AND ALL EXTRAORDINARY COLLECTION EFFORT, IS IMMEDIATELY STOPPED. FINANCIAL ASSISTANCE FOR ELIGIBLE CHARGES IS AVAILABLE TO ALL CENTRA PATIENTS WHO QUALIFY BASED ON ESTABLISHED INCOME AND ASSET CRITERIA.
PART VI, LINE 2NEEDS ASSESSMENT: IN LATE 2011, CENTRA CREATED AN ORGANIZATIONAL STRUCTURE AND PROCESS TO ALLOW US TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT AND TO ADOPT AN IMPLEMENTATION STRATEGY. THE ORGANIZATIONAL STRUCTURE INCLUDED CREATING AN INTERNAL STEERING GROUP; CONVENING AN EXTERNAL GROUP OF PARTICIPANTS REPRESENTATIVE OF THE COMMUNITIES SERVED BY CENTRA SOUTHSIDE COMMUNITY HOSPITAL (SOUTHSIDE COMMUNITY HEALTH NEEDS ADVISORY BOARD); AND ESTABLISHING A FORMAL ONGOING RELATIONSHIP WITH PIEDMONT HEALTH COALITION, A COMMUNITY-BASED COALITION DEDICATED TO IMPROVING THE HEALTH OF OUR COMMUNITY WHICH WAS FORMED UNDER THE LEADERSHIP OF THE LOCAL PUBLIC HEALTH AUTHORITY, THE PIEDMONT HEALTH DISTRICT. THE SOUTHSIDE COMMUNITY HEALTH NEEDS ADVISORY BOARD CONSISTS OF APPROXIMATELY 25 MEMBERS FROM DIVERSE DEMOGRAPHIC BACKGROUNDS. THE BOARD WAS DEVELOPED FOR THE PURPOSE OF HAVING REGULAR OPEN DIALOGUE AND BRAINSTORMING SESSIONS CONCERNING COMMUNITY HEALTH NEEDS WITHIN OUR COMMUNITY IN BOTH OUR PRIMARY AND SECONDARY SERVICE AREAS. OUR GOAL IS TO COLLABORATE WITH THESE LEADERS AND PUT PROGRAMS IN PLACE TO ADDRESS THESE NEEDS. SCH.CENTRAHEALTH.COM AND THE LOCAL MEDIA PROVIDE INFORMATION ON UPCOMING COMMUNITY EVENTS. ALSO, EVALUATIONS ARE GIVEN AT COMMUNITY EVENTS. THIS PROVIDES NECESSARY AND VALUABLE FEEDBACK FOR FUTURE EDUCATIONAL EVENTS AND WORKSHOPS.
PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: CENTRA SOUTHSIDE TAKES A MULTIDISCIPLINARY APPROACH TO INFORMING OUR PATIENTS AND COMMUNITY ABOUT FINANCIAL ASSISTANCE. INFORMATION ABOUT FINANCIAL ASSISTANCE AND CHARITY CAN BE FOUND ON CENTRA'S INTERNET PAGE PROVIDING FULL DISCLOSURE ABOUT QUALIFICATIONS AND THE APPLICATION PROCESS. INDIVIDUALS MAY OBTAIN INFORMATION AND AN APPLICATION FROM ANY REGISTRATION POINT OR CUSTOMER SERVICE UNIT, IN PERSON OR BY PHONE. SIGNS ARE POSTED IN CONSPICUOUS LOCATIONS ALERTING INDIVIDUALS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND WHERE TO OBTAIN ADDITIONAL INFORMATION. BROCHURES ABOUT FINANCIAL ASSISTANCE ARE MADE AVAILABLE IN REGISTRATION AND CUSTOMER SERVICE. WHILE PATIENTS ARE HOSPITALIZED, A FINANCIAL COUNSELOR PROVIDES FINANCIAL ASSISTANCE INFORMATION, SCREENS PATIENTS FOR FEDERAL AND STATE PROGRAMS AND GIVES AN OPPORTUNITY TO ASK QUESTIONS. ADDITIONALLY, AN INSERT ABOUT FINANCIAL ASSISTANCE IS MAILED IN EVERY UNINSURED BILL, REFERENCING AVAILABILITY OF FINANCIAL ASSISTANCE WITH CONTACT INFORMATION ON WHERE TO OBTAIN MORE INFORMATION.
PART VI, LINE 4COMMUNITY INFORMATION: CENTRA SOUTHSIDE COMMUNITY HOSPITAL IS LOCATED IN FARMVILLE, VIRGINIA, WHICH IS 50 MILES EAST OF LYNCHBURG AND 50 SOUTHWEST OF RICHMOND. AS A SOLE COMMUNITY HOSPITAL IT IS CENTRALLY LOCATED TO SERVE THE RESIDENTS OF AMELIA, APPOMATTOX, BUCKINGHAM, CHARLOTTE, CUMBERLAND, LUNENBURG, NOTTOWAY, AND PRINCE EDWARD COUNTIES, WHICH MAKES UP ITS PRIMARY SERVICE AREA (PSA). THE HOSPITAL WAS ESTABLISHED TO PROVIDE HEALTHCARE TO THIS MOSTLY RURAL AREA. THE COUNTIES OF BUCKINGHAM, CHARLOTTE, AND LUNENBURG HAVE BEEN DESIGNATED AS MEDICALLY UNDERSERVED AREAS. THE POPULATION FOR THE HOSPITALS PSA IS APPROXIMATELY 53,000. THE PERCENT OF THE PSA POPULATION THAT IS 65 YEARS OF AGE AND OLDER IS 18.0%. THE MEDIAN HOUSEHOLD INCOME IN THE PSA IS $39,207 AS COMPARED TO THE STATE MEDIAN OF $66,155.
PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH: CENTRA SOUTHSIDE COMMUNITY HOSPITAL PLAYS AN IMPORTANT ROLE IN PROMOTING HEALTH IN THE COMMUNITIES IT SERVES. THE HOSPITAL HOSTS FREE WORKSHOPS AND EDUCATIONAL SEMINARS ON DIABETES, STROKE PREVENTION, AND HEART HEALTH, TO NAME A FEW. CSCH ALSO PARTICIPATES IN NUMEROUS HEALTH FAIRS ANNUALLY, PROVIDING FREE SCREENINGS TO THE PUBLIC. IN ADDITION TO THE FREE SCREENINGS AT HEALTH FAIRS, THE HOSPITAL PROVIDES FREE SERVICES, INCLUDING ALL LAB TESTS AND RADIOLOGY EXAMS AT NO CHARGE TO INDIVIDUALS AT THE "HEART OF VIRGINIA FREE CLINIC" LOCATED IN DOWNTOWN FARMVILLE. THE HOSPITALS HEALTH EXPLORERS CAMP, HELD EVERY SUMMER, HOSTS MIDDLE SCHOOL AGE STUDENTS FOR A WEEK TO ALLOW THEM TO EXPLORE OPTIONS IN THE HEALTH CARE FIELD. BREAST-FEEDING, CHILDBIRTH, AND CAR SEAT SAFETY ARE JUST A FEW OF THE CLASSES MADE AVAILABLE FOR COMMUNITY MEMBERS. CSCH ALSO HOSTS SEVERAL SUPPORT GROUPS INCLUDING ALCOHOLICS ANONYMOUS, CHRONIC PAIN SUPPORT GROUP, AND DIABETES SUPPORT GROUP. WE ALSO HAVE A TEEN VOLUNTEER PROGRAM AND A COLLEGE VOLUNTEER PROGRAM FOR STUDENTS AT LONGWOOD UNIVERSITY, HAMPDEN-SYDNEY COLLEGE, AND SOUTHSIDE VIRGINIA COMMUNITY COLLEGE. DURING THE YEAR, THE HOSPITAL ALSO SUPPORTS NUMEROUS HEALTH RELATED SUPPORT GROUPS WITH EDUCATIONAL MATERIALS AND PROFESSIONAL KNOWLEDGE.
PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEM: SOUTHSIDE COMMUNITY HOSPITALS AFFILIATION WITH CENTRA HEALTH BEGAN JANUARY 2006. IT ONLY SEEMED NATURAL THAT SOUTHSIDE COMMUNITY HOSPITAL WOULD PARTNER WITH CENTRA HEALTH, SINCE THE OTHER CENTRA HOSPITALS ARE LOCATED WITHIN 50 MILES WEST OF SOUTHSIDE COMMUNITY HOSPITAL. CENTRA HEALTH HAS A NATIONAL REPUTATION FOR CLINICAL EXCELLENCE AND PATIENT SATISFACTION. SOUTHSIDE COMMUNITY HOSPITAL AND CENTRA OFFICIALS BELIEVE THE COMBINED ORGANIZATIONS WILL BE STRENGTHENED THROUGH AN EXCHANGE OF BEST PRACTICES AND ECONOMIES OF SCALE. SOUTHSIDE PATIENTS HAVE AVAILABLE BETTER ACCESS TO A BROADER RANGE OF ADVANCED CLINICAL SERVICES THAT ARE AVAILABLE AT CENTRA HEALTHS LYNCHBURG HOSPITALS. THE AFFILIATION IS ONE IN A SERIES OF STEPS IN WHICH SOUTHSIDES LEADERS RECOGNIZED THE NEED TO PARTNER WITH AN ORGANIZATION THAT SHARED A MISSION OF EXCELLENT CARE. SOUTHSIDE HAS BEEN ABLE TO MAKE STRUCTURAL IMPROVEMENTS, REPLACE MEDICAL EQUIPMENT WITH NEWER MEDICAL TECHNOLOGY, AND UPDATE COMPUTER SYSTEMS. SOUTHSIDE HAS, ALSO, SUCCESSFULLY RECRUITED BOARD-CERTIFIED SURGEONS AND SPECIALISTS, NEW EMERGENCY PHYSICIANS, AND EXTENDED THEIR HOSPITALIST PROGRAM. SCH HAS BEEN THE HEALTHCARE CENTER OF SOUTHSIDE VIRGINIA SINCE OPENING ITS DOORS NOVEMBER 9, 1927. SINCE THEN, IT HAS OPERATED ON A NON-PROFIT BASIS WITH THE GOAL OF HELPING TO HEAL THE ILL AND INJURED. THE HOSPITAL SERVES THE RESIDENTS OF AMELIA, APPOMATTOX, BUCKINGHAM, CHARLOTTE, CUMBERLAND, LUNENBURG, NOTTOWAY, AND PRINCE EDWARD COUNTIES.
PART VI, LINE 7STATE FILING OF COMMUNITY BENEFIT REPORT VA

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
LEWIS ADDISON
DIRECTOR (UNTIL 4/2015)$0$300,258$0$126,660$0$72,572$0$7,950$0$14,774$0$522,214$0$58,453
WILLIAM BASS JR
DIRECTOR (AS OF 5/2015)$0$248,452$0$37,500$0$27,475$0$7,212$0$32,377$0$353,016$0$25,000
KIRSTEN HUBER MD
DIRECTOR$248,339$0$0$0$538$0$7,511$0$9,998$0$266,386$0$0$0
EW TIBBS
DIRECTOR/CENTRA PRESIDENT& CEO$0$661,548$0$264,493$0$129,387$0$175,752$0$46,255$0$1,277,435$0$50,910
THOMAS ANGELO
SCH CEO (AS OF 5/2015)$161,160$0$10,639$0$11,545$0$4,947$0$35,305$0$223,596$0$0$0
CLAUDIA A MEINHARD
SCH CNO$157,008$0$16,619$0$11,670$0$4,804$0$15,448$0$205,549$0$0$0
BIKRAM S BAL MD
PHYSICIAN$823,396$0$0$0$15,778$0$7,950$0$3,322$0$850,446$0$0$0
ROBERT W AH MD
PHYSICIAN$470,794$0$7,425$0$828$0$7,950$0$32,812$0$519,809$0$0$0
JOHN A KONA MD
PHYSICIAN$421,471$0$0$0$3,498$0$0$0$17,452$0$442,421$0$0$0
JERRY LUCAS MD
PHYSICIAN$419,869$0$0$0$759$0$7,950$0$0$0$428,578$0$0$0
JONATHAN R LOGAN MD
PHYSICIAN$375,428$0$11,257$0$25,420$0$7,950$0$45,876$0$465,931$0$0$0
DR CHARLES TAYLOR
DIRECTOR (UNTIL 6/2015)$155,611$0$0$0$0$0$0$0$0$0$155,611$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3UNDER A MANAGEMENT ARRANGEMENT WITH CENTRA HEALTH, THE ORGANIZATIONS EXECUTIVE DIRECTORS COMPENSATION IS ESTABLISHED IN ACCORDANCE WITH CENTRA HEALTHS EXECUTIVE COMPENSATION PRACTICES WHICH INCLUDE THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT(S), AND COMPENSATION STUDY OR SURVEY.
SCHEDULE J, PART I, LINE 4BTHE FOLLOWING INDIVIDUALS RECEIVED A PAYOUT FROM A NONQUALIFIED RETIREMENT PLAN DURING FY 2015. THE AMOUNT WAS INCLUDED IN THEIR W-2 WAGES. NAME TITLE AMOUNT OF PAYOUT LEWIS ADDISON CENTRA SR VP & CFO 58,453 (A RELATED ORGANIZATION) WILLIAM L. BASS, JR. CENTRA VP COMMUNITY HOSP & REG CENTER 25,000 (A RELATED ORGANIZATION) E.W. TIBBS CENTRA PRESIDENT & CEO 50,910 (A RELATED ORGANIZATION) $134,363 ======== THE FOLLOWING INDIVIDUALS HAD AMOUNTS DEFERRED INTO A NONQUALIFIED RETIREMENT PLAN IN FY 2015: NAME TITLE AMOUNT DEFERRED LEWIS ADDISON CENTRA SR VP & CFO - (A RELATED ORGANIZATION) WILLIAM L. BASS, JR. CENTRA VP COMMUNITY HOSP & REG CENTER - (A RELATED ORGANIZATION) E.W. TIBBS CENTRA PRESIDENT & CEO 167,802 (A RELATED ORGANIZATION) $167,802 ========

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1INDUSTRIAL DEVELOP AUTH OF THE TOWN OF FARMVILLEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN546001272BondIssuerEIN
CUSIP999999999CUSIPNum
Bond Issued2011-06-30BondIssuedDt
Issue Price$9,619,940IssuePriceAmt
PurposeREFUND BONDS ISSUED IN 1997 & 1998PurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$3,721,583RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$9,619,940TotalProceedsAmt
In Reserve Fund$0InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$0RefundingEscrowAmt
Issuance Costs From Proceeds$0IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$0WorkingCapitalExpendituresAmt
Capital Expenditures$0CapitalExpendituresAmt
Other Spent Proceeds$9,619,940OtherSpentProceedsAmt
Unspent$0UnspentAmt
Substantial Completion2000SubstantialCompletionYr
Current RefundingYes (true)CurrentRefundingInd
Advance RefundingfalseAdvanceRefundingInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (true)MgmtContractBondFincdPropInd
Engage Bond Counsel ContractsYes (true)EngageBondCounselContractsInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Private Bus Use By Others0PrivateBusUseByOthersPct
Bond Iss Meet Prvt Sec Pymt TestfalseBondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Remedial Action TakenfalseRemedialActionTakenInd
Procs Nonqualified Bond RemdtdYes (true)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetYes (true)RebateNotDueYetInd
Exception To RebateYes (true)ExceptionToRebateInd
Variable Rate IssueYes (true)VariableRateIssueInd
Hedge Identified In Bks And RecYes (true)HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line1BRANCH BANK & TRUSTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Term Of Hedge11.5TermOfHedgePct
Superintegrated HedgefalseSuperintegratedHedgeInd
Hedge TerminatedfalseHedgeTerminatedInd
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (true)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (true)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE K, PART I, BOND ISSUES(A) ISSUER NAME: INDUSTRIAL DEVELOPMENT AUTHORITY OF THE TOWN OF FARMVILLE, VIRGINIA (F) DESCRIPTION OF PURPOSE: REFUND BONDS ISSUED ON 12/31/1997 AND 10/28/1998
SCHEDULE K, PART IV, LINE 2AThe bond was issued in 2011 and therefore the first computation was performed on August 31, 2016.
Schedule K, Part IVTHE ORGANIZATION ADOPTED A FORMAL WRITTEN POLICY IN 2012 RELATING TO ITS PRACTICES AND PROCEDURES T OBE UTILIZED IN ENSURING THAT ANY POTENTIAL BOND VIOLATIONS ARE IDENTIFIED AND CORRECTED IN A TIMELY MANNER.
Schedule K, Part IV, Line 7POST ISSUANCE COMPLIANCE THE ORGANIZATION ADOPTED A FORMAL WRITTEN POLICY IN 2012 RELATING TO ITS PRACTICES AND PROCEDURES TO ENSURE BOND COMPLIANCE.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonMRS SHARON L TAYLORPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionSEE PART VRelationshipDescriptionTxt
Transaction$10,603TransactionAmt
TransactionSEE PART VTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART IVFormAndLineReferenceDesc
Explanation(A) NAME OF PERSON: MRS. SHARON L. TAYLOR (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF DR. CHARLES TAYLOR, BOARD MEMBER OF SOUTHSIDE COMMUNITY HOSPITAL (RESIGNED FROM BOARD JUNE 2015) (C) AMOUNT OF TRANSACTION: $10,603 (D) DESCRIPTION OF TRANSACTION: PAYMENT FOR CONTRACTED SERVICES RENDERED TO SOUTHSIDE COMMUNITY HOSPITAL (E) SHARING OF ORGANIZATION REVENUE?: NOExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (20 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART III, LINE 4A: COMMUNITY BENEFIT HIGHLIGHTS - " DURING FY 2015, $8,549,984 IN CHARGES AT AN ESTIMATED COST OF $3,163,124 WAS CONTRIBUTED AS TRADITIONAL CHARITY CARE TO PATIENTS WHO DID NOT HAVE THE ABILITY TO PAY. ELIGIBILITY FOR CHARITY CARE IS BASED ON POVERTY INCOME LEVELS SET BY THE STATE. " CHARGES OF $9,272,175 AT AN ESTIMATED COST OF $3,430,303 WERE CONTRIBUTED AS BAD DEBT TO PATIENTS WHO DID NOT HAVE THE ABILITY TO PAY. " LOSS FROM MEDICARE BASED ON COST TO CHARGE RATIO TOTALED $4,136,458. " LOSS FROM MEDICAID BASED ON COST TO CHARGE RATIO TOTALED $3,285,797 " CASH DONATIONS MADE BY SOUTHSIDE COMMUNITY HOSPITAL TO THE COMMUNITY DURING 2015 TOTALED $3,611. SOUTHSIDE COMMUNITY HOSPITAL IS EAGER TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY, WHICH CONSISTS OF ITS EIGHT SURROUNDING COUNTIES OF AMELIA, BUCKINGHAM, CHARLOTTE COUNTY, CUMBERLAND, LUNENBURG, NOTTOWAY, APPOMATTOX, AND PRINCE EDWARD COUNTIES. EMPLOYEES CONTINUALLY OFFER PROFESSIONAL HEALTH EDUCATION PROGRAMS, CLASSES, LECTURES, HEALTH FAIRS, HEALTH SCREENINGS, SUPPORT GROUPS, ETC., THROUGHOUT SOUTHSIDE VIRGINIA. SOUTHSIDE COMMUNITY HOSPITAL IS DEDICATED TO IMPROVING THE HEALTHCARE OF ITS COMMUNITY. SOME EXAMPLES ARE LISTED BELOW. COMMUNITY EDUCATION AND HEALTH SCREENINGS - ADVANCED DIRECTIVES DAY AMELIA COMMUNITY CAREER FAIR BURKEVILLE HEALTH DAY BUCKINGHAM COUNTY DAY LONGWOOD UNIVERSITY HEALTH FAIR LONGWOOD UNIVERSITY - ROCK THE BLOCK (BP SCREENINGS) FIRST FRIDAYS HEALTH FAIR (5) COMMUNITY HEART HEALTH FAIR SOUTHSIDE ELECTRIC COOPERATIVE COMMUNITY HEALTH FAIR SHRINERS HEALTH SCREENING FOR CHILDREN BLOOD DRIVES (7) FAMILY EDUCATION AND COMMUNITY CLASSES - BREASTFEEDING CLASSES CAR SEAT CLASSES CHILDBIRTH AND FAMILY EDUCATION BIRTHING CENTER TOURS NURSING CAREER DAY MEDICAL CAREER CAMP FOR MIDDLE SCHOOLERS SUPPORT GROUPS ALCOHOLICS ANONYMOUS CHRONIC PAIN/FIBROMYALGIA SUPPORT GROUP DIABETIC EDUCATION AND SUPPORT GROUP SPECIAL PROJECTS/ HEALTH MINISTRY ANNUAL PINK RIBBON TEA PARTY (BREAST CANCER AWARENESS) MARCH FOR BABIES MEDICAL CAREER CAMP FOR MIDDLE SCHOOLERS NURSING CAREER DAY SOUTHSIDE VIRGINIA COMMUNITY COLLEGE CAREER FAIR VOLUNTEER SERVICES WOMENS AUXILIARY OF SOUTHSIDE COMMUNITY HOSPITAL: FUNDRAISING FOR HOSPITAL - PROVIDES SCHOLARSHIPS FOR NURSING STUDENTS ($3,000 IN SCHOLARSHIPS WERE GIVEN IN 2015). CSCH VOLUNTEERS: FRONT DESK, REGISTRATION, AND TRANSPORT, TELE-MED-SURG, OB, SAME DAY SURGERY, ETC. HOSPICE VOLUNTEERS: CARE FOR END-OF-LIFE PATIENTS CARDIO-REHAB VOLUNTEERS: ASSISTANTS IN THE GYM FOR CARDIO PATIENTS PACE (PROGRAM FOR ALL INCLUSIVE CARE FOR THE ELDERLY) VOLUNTEERS: ASSISTS WITH ACTIVITIES FOR THE ELDERLY LONGWOOD UNIVERSITY/HAMPDEN-SYDNEY COLLEGE VOLUNTEERS: STUDENTS NEEDING SERVICE HOURS FOR INTERNSHIPS AND PROJECTS Summer Youth Volunteer Program Stories of Assistance to the Community Centra Southside Community Hospital serves its community and the surrounding eight counties in many ways. Our nurses and staff are enthusiastic about participating in community events by conducting blood pressure checks, providing free health education materials to the general public, and assisting in health screenings. Nurses from our Pediatric Unit teach breast feeding classes, child car seat classes and give free car seats to participants. Centra Southside Community Hospital employees are encouraged to share their professional health knowledge to the community by speaking to local organizations. We continually donate school supplies to area school supply drives and we have active members in many civic organizations, such as the Lions Club, the Rotary Club, Jaycees, Chamber of Commerce, and the Downtown Farmville Organization. During 2015, the hospital held many health fairs throughout the community offering cholesterol, glucose, BMI, and blood pressure screenings. In conjunction with the Shriners, we conducted annual free health screening at the hospital for all children with orthopedic or burn issues. Centra Southside Community Hospital had a number of teams walk in fundraising walks such as the Jingle Bell Run for Cancer, the March for Babies, and the Cumberland 5K Run for Scholarships. Centra Southside Community Hospital is the primary participating sponsor in the free monthly community "Moton Museum Prayer Breakfast" event, located in downtown Farmville. The hospital provides the breakfast, and sends employees from different departments each month to assist in serving the breakfast and participate in the prayer time. The hospital is eager to connect with and to help serve our community in this way. The hospital leadership continues to conduct meetings with local community leaders and community representatives to better understand the medical needs of our community. The hospital wants to ensure that members of the communities that we serve have the opportunity to voice their current medical care concerns and provide insight on how the hospital can better meet the medical needs of the community in the future. Centra Southside Community Hospital participates in the "Heart of Virginia Free Clinic", by providing all lab tests and radiology exams for free. In 2015, 625 tests and exams were provided to the community at no charge. This donated service resulted in a community benefit exceeding $58,475. Many of our staff volunteer at the clinic. We also provide food for the clinical workers at the clinic as a small token of appreciation for those individuals who volunteer their professional services to benefit those individuals who cannot afford medical care. The hospital is eager to help educate our community on the importance of preventive care. The SCOPE/Meals on Wheels program provides balanced, nutritious meals to the elderly, disabled, or homebound who have no reliable means of obtaining their daily food requirements. Our caring volunteers help alleviate the sense of isolation and worry of clients and observe their physical condition. In cooperation with the community and county agencies, we identify those in need of these services, prepare all meals, and get them ready for distribution by volunteers. During 2015, approximately 11,927 meals were provided by the hospital, at a cost of approximately $47,065.
FORM 990, PART VI, SECTION A, LINE 2:DIRECTORS E.W. TIBBS AND LEWIS ADDISON SERVE AS BOARD MEMBER OF CENTRAL VIRGINIA IMAGING, A 50% JOINT VENTURE OF CENTRA HEALTH, INC. BOARD MEMBER WILLIAM MCGUIRE AND OFFICER LEROY PFEIFFER, JR. SERVE AS BOARD MEMBERS OF THE WOODLANDS, INC., A NURSING HOME. FORM 990, PART VI, SECTION A, LINE 4: SOUTHSIDE COMMUNITY HOSPITAL HAD THE BELOW LISTED CHANGE TO SECTION 5.6 OF SOUTHSIDE COMMUNITY HOSPITALS AMENDED AND RESTATED BYLAWS; THIS CHANGE WAS APPROVED AT THE SEPTEMBER 2015 BOARD OF DIRECTORS MEETING. "IN ADDITION, IF THE CHIEF EXECUTIVE OFFICER IS ABSENT OR UNAVAILABLE, THE DUTIES OF THE CHIEF EXECUTIVE OFFICER MAY BE PERFORMED BY THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE MEMBER AND/OR THE VICE PRESIDENT, COMMUNITY HOSPITALS AND REGIONAL MEDICAL CENTERS, OF THE MEMBER."
FORM 990, PART VI, SECTION A, LINE 6:THROUGH AN AFFILIATION AGREEMENT, SOUTHSIDE HOSPITAL'S SOLE CORPORATE MEMBER IS CENTRA HEALTH, INC.
FORM 990, PART VI, SECTION A, LINE 7A & B:CENTRA HEALTH, INC. IS THE SOLE MEMBER CORPORATION OF SOUTHSIDE COMMUNITY HOSPITAL (SCH) AND HAS THE POWER TO ELECT/APPROVE THE BOARD OF DIRECTORS OF SCH'S GOVERNING BODY AND APPROVE DECISIONS MADE BY SCH'S BOARD.
FORM 990, PART VI, SECTION A, LINE 8A & B:MINUTES ARE TAKEN AT EACH MEETING.
FORM 990, PART VI, SECTION B, LINE 11B:THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. CENTRA SOUTHSIDE WILL PROVIDE ALL VOTING MEMBERS OF THE BOARD OF DIRECTORS WITH A COPY OF THE FORM 990 PRIOR TO ITS FILING.
FORM 990, PART VI, SECTION B, LINE 12C:ALL CENTRA SOUTHSIDE OFFICERS, DIRECTORS, AND KEY EMPLOYEES, MUST COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ON AN ANNUAL BASIS, CERTIFYING THAT NEITHER THEY NOR ANY OF THEIR IMMEDIATE FAMILY MEMBERS HAVE ENGAGED IN ANY ACTIVITIES THAT COULD LEAD TO A POTENTIAL CONFLICT OF INTEREST. ADDITIONALLY, ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES MUST AGREE TO PROMPTLY REPORT ANY POTENTIAL CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR TO THE PRESIDENT OR CHAIRMAN OF CENTRA SOUTHSIDE'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15A & B:FORM 990, PART VI 15A & 15B WERE ANSWERED AS "NO", HOWEVER, UNDER A MANAGEMENT AGREEMENT WITH CENTRA HEALTH, INC., A RELATED PARTY, THE ORGANIZATIONS CHIEF EXECUTIVE OFFICERS COMPENSATION IS ESTABLISHED IN ACCORDANCE WITH CENTRA HEALTHS EXECUTIVE COMPENSATION PRACTICES WHICH INCLUDE THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT(S), AND COMPENSATION STUDY OR SURVEY.
FORM 990, PART VI, SECTION C, LINE 18:PHOTOCOPIES OF THE ORGANIZATION'S FORM 1023 AND RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE.ADDITIONALLY, FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG .
FORM 990, PART VI, SECTION C, LINE 19:THE ORGANIZATION PROVIDES PHOTOCOPIES OF ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY UPON REQUEST AT ITS ADMINISTRATIVE OFFICE.
FORM 990, PART XI, LINE 9:CONTRIBUTED CAPITAL FROM CENTRA HEALTH $186,194 CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT $47,714 --------- TOTAL TO FORM 990, PART XI, LINE 9 $233,908
FORM 990, PART XII, LINE 2C:COMMITTEE RESPONSIBLE FOR AUDIT PROCESS OVERSIGHT THE AUDIT PROCESS OF THE ORGANIZATION INCLUDING THE OVERSIGHT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT AUDITOR IS OVERSEEN BY THE AUDIT & COMPLIANCE COMMITTEE OF CENTRA HEALTH, INC., SOLE MEMBER AND RELATED ORGANIZATION.
FORM 990 PART IX LINE 11GDESCRIPTION:PHYSICIAN REMUNERATION TOTAL FEES:5947024
FORM 990 PART IX LINE 11GDESCRIPTION:MEDICAL PURCHASED SERVICES TOTAL FEES:152738
FORM 990 PART IX LINE 11GDESCRIPTION:CAPITATED MEDICAL CLAIMS TOTAL FEES:2257312
FORM 990 PART IX LINE 11GDESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:1804739
FORM 990 PART IX LINE 11GDESCRIPTION:CONTRACT LABOR TOTAL FEES:1923012
FORM 990 PART IX LINE 11GDESCRIPTION:RECRUITMENT TOTAL FEES:540
FORM 990 PART IX LINE 11GDESCRIPTION:BILLING FEES TOTAL FEES:544487
FORM 990 PART IX LINE 11GDESCRIPTION:CLEANING SERVICES TOTAL FEES:33026

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1CENTRA MEDICAL GROUP SOUTHSIDE LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 OAK STREETAddressLine1Txt
CityFARMVILLECityNm
State AbbreviationVAStateAbbreviationCd
ZIP23901ZIPCd
FieldValueIRS element (for citing)
EIN260771274EIN
Primary ActivitiesPHYS. OFFICESPrimaryActivitiesTxt
Legal Domicile StateVALegalDomicileStateCd
Total Income$12,540,309TotalIncomeAmt
End Of Year Assets$3,338,759EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SCHBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CENTRA HEALTH INC
1920 ATHERHOLT ROADLYNCHBURGVA24501540715569HEALTHCAREVA501(C)(3)3NAfalse
CENTRA HEALTH FOUNDATION INC
1920 ATHERHOLT ROADLYNCHBURGVA24501541604094SUPPORTING ORVA501(C)(3)11A-1NAfalse
CCRC INC
1920 ATHERHOLT ROADLYNCHBURGVA24501541929580CONTINUE CAREVA501(C)(3)11A-1NAfalse
BEDFORD MEMORIAL HOSPITAL
1613 OAKWOOD STREETBEDFORDVA24523540566100HEALTHCAREVA501(C)(3)3NAfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
GENERAL BUSINESS CONCERNS INC
1920 ATHERHOLT ROADLYNCHBURGVA24501541299682REAL ESTATE/PHYSVANAC Corpfalse
PCHP HOLDING INC
2316 ATHERHOLT ROADLYNCHBURGVA24501541749492HOLDING COMPANYVANAC Corpfalse
PIEDMONT COMMUNITY HEALTH PLAN INC
2316 ATHERHOLT ROADLYNCHBURGVA24501541755768HEALTH INSURANCEVANAC Corpfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd