2014-11-10T15:15:10-06:00 2013-12-31 990 2013-01-01 540853898 POTOMAC HOSPITAL CORPORATION OF PRINCE WILLIAM POTO 7574557020 6015 POPLAR HALL DRIVE NORFOLK VA 23502 MICHAEL R KING CFO 7574557020 2014-11-10 2013 2015-11-30 17:44:51Z SENTARA NORTHERN VA MED CENTER STEPHEN D PORTER 6015 POPLAR HALL DRIVE NORFOLK VA 23502 235763070 0 X WWW.SENTARA.COM X 1968 VA AS PART OF SENTARA HEALTHCARE'S INTEGRATED HEALTH CARE SYSTEM, WE IMPROVE HEALTH EVERY DAY. 8 4 1441 301 0 0 3468094 2758543 216622151 231426203 -649526 3033 -4072257 710215 215368462 234897994 396498 1148440 0 0 82952744 92257402 0 0 0 111697602 119852512 195046844 213258354 20321618 21639640 209460066 216803786 19120917 20684307 190339149 196119479 X AS PART OF SENTARA HEALTHCARE'S INTEGRATED HEALTH CARE SYSTEM, WE IMPROVE HEALTH EVERY DAY THROUGH THE OPERATION OF A HOSPITAL AND OTHER HEALTH CARE FACILITIES IN PRINCE WILLIAM, SOUTHERN FAIRFAX, AND NORTHERN STAFFORD COUNTIES, FOR THE CARE OF ALL PERSONS REGARDLESS OF RACE, COLOR OR CREED, WHO ARE SUFFERING FROM ANY ILLNESS, INJURY OR DISABILITY WHICH MAY REQUIRE HOSPITAL AND OTHER HEALTH CARE. 0 0 179404824 1148440 231426203 SENTARA NORTHERN VIRGINIA MEDICAL CENTER ("SNVMC") PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES THROUGH THE OPERATION OF A 183-BED TERTIARY AND ACUTE CARE HOSPITAL THAT SERVES THE INCREASINGLY DIVERSE COMMUNITY IN PRINCE WILLIAM, SOUTHERN FAIRFAX, AND NORTHERN STAFFORD COUNTIES. THE HOSPITAL PROVIDED 93,290 ADJUSTED PATIENT DAYS OF CARE DURING 2013 AND OFFERS A WIDE RANGE OF MEDICAL SPECIALTIES, A HIGHLY QUALIFIED MEDICAL AND CLINICAL STAFF, AND STATE-OF-THE-ART TECHNOLOGY REQUIRED TO UPHOLD ITS MISSION. SNVMC ALSO OPERATES TWO OFF-SITE OUTPATIENT CAMPUSES THAT OFFER 24-HOUR EMERGENCY CARE, DOCTORS' OFFICES, AND QUALITY DIAGNOSTIC TESTING INCLUDING ADVANCED IMAGING AND LAB SERVICES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 179404824 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 107 0 1 1441 1 0 0 0 0 0 0 0 0 0 0 X 8 4 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 0 0 1 0 VA X CORPORATE OFFICERS 7574557020 6015 POPLAR HALL DRIVE NORFOLK VA 23502 HOWARD P KERN DIRECTOR/VICE CHAIR 1.00 51.20 X X 0 1865703 660096 DAVID L BERND DIRECTOR 1.00 53.20 X 0 3601597 215569 CARLOS CASTRO DIRECTOR 1.00 0.00 X 0 0 0 SAM HILL ED D DIRECTOR 1.00 0.00 X 0 0 0 MARY BETH MICHOS DIRECTOR 1.00 0.00 X 0 0 0 MEGAN R PERRY DIRECTOR/PRESIDENT (THRU 12/13) 2.00 40.00 X X 0 756316 64012 CAROL S SHAPIRO MD DIRECTOR 1.00 0.00 X 0 120280 28934 R MICHAEL SORENSEN DIRECTOR/CHAIRMAN 2.00 1.00 X X 0 0 0 ROBERT A BROERMANN TREASURER 1.00 51.00 X 0 1256843 161559 KELA CASEY ASST SECRETARY 1.00 0.00 X 85191 0 11789 JEFFREY KING SECRETARY 1.00 46.00 X 0 598006 77049 NATHAN VANGENDEREN CFO/ASST TREASURER 40.00 0.00 X 0 355199 30175 VALERIE E KEANE VP, OPERATIONS 40.00 0.00 X 200151 0 -36592 DORKA M PICARD VP, INTEGRATED & FACILITY SERVICES 40.00 0.00 X 178165 0 -6492 MARLENE M BOLSTER VP, OPERATIONS 40.00 0.00 X 152543 0 5232 DAVID SCHWARTZ VP, MEDICAL AFFAIRS VPMA 40.00 0.00 X 460487 0 29136 LINDA G DODGE MID-LEVEL PRACTITIONER 40.00 0.00 X 215369 0 44259 ROBIN ADAMS DIR, MARKET DEVELOPMENT 40.00 0.00 X 184188 0 21035 XING P YUAN RNFA/ROBOTICS COORD 40.00 0.00 X 170596 0 -23740 ADEDAYO AKINBI DIR, PHARMACY 40.00 0.00 X 165669 0 19213 WENDY M ATKINSON FORMER KE (SENIOR DIRECTOR) 40.00 0.00 X 149604 0 -16707 1961963 8553944 1284527 106 1 1 0 SODEXO INC & AFFILIATES PO BOX 536922 ATLANTA GA 30353 FOOD & FACILITY MGMT 4023894 VA HOSPITAL PRACTITIONERS LLC 484 TEMPLE HILL ROAD STE 102 NEW WINDSOR NY 12553 PHYSICIAN GROUP 1425000 DELPHI HEALTHCARE PARTNERS INC 170 SOUTHPORT DR MORRISVILLE NC 27560 PHYSICIAN GROUP 1324387 MASTERPLAN INC 9582 TOPANGA CANYON RD CHATSWORTH CA 91311 MEDICAL SYS. SUPPORT 1193457 PYRAMID HEALTHCARE SOLUTIONS INC PO BOX 17389 CLEARWATER FL 33762 HC CONSULTANTS 1178019 32 1360 10660 2197896 548627 2758543 PATIENT SERVICE REV 900099 230697975 230697975 OTHER PROGRAM SVC REV 900099 770012 770012 EQUITY IN EARN OF AFFIL 900099 -41784 -41784 231426203 3033 3033 1371094 748109 622985 622985 622985 54792 10660 24843 29949 29949 145245 92124 53121 53121 CAFETERIA/CAFE SALES 722210 4160 4160 4160 234897994 231426203 0 713248 1143540 1143540 4900 4900 589987 471990 117997 76107372 60885898 15221474 4785624 3828499 957125 5122063 4097650 1024413 5652356 4521885 1130471 6249914 4999931 1249983 283706 226965 56741 13299763 12908020 391743 969392 775514 193878 8993717 7194974 1798743 795043 636034 159009 4398786 3519029 879757 196980 157584 39396 83327 66662 16665 1780268 1780268 14178191 11342553 2835638 810931 648745 162186 MEDICAL SUPPLIES 31627421 31627421 BAD DEBT 26629862 26629862 SENTARA SERVICE EXPENSE 7134086 7134086 PURCHASED SERVICES 897647 718118 179529 1523478 1218782 304696 213258354 179404824 33853530 0 15124307 17927323 25040660 27787418 337711 382489 744540 934181 3496658 4201391 591429 686917 310305395 155793653 155011972 154511742 2597709 9112789 7774616 209460066 216803786 4498756 6842773 215562 161671 14406599 13679863 19120917 20684307 X 187955018 194026259 1716934 1426023 667197 667197 190339149 196119479 209460066 216803786 X 21639640 -15859310 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2384131 685717 500 976127 2093221 3679757 554601 1000 1849227 2384131 4254093 1262740 1000 1836076 3679757 1200358 3982404 87528 12500 1003697 4254093 1178473 5000 17385 500 1200358 0.31870 0.68130 0 0 8951773 2437851 11389624 159735522 56887402 102848120 123648500 88848239 34800261 15531749 10058012 5473737 154511742 DUE TO AFFILIATES 592971 OTHER LIABILITIES 13086892 13679863 PART V, LINE 4: THE ENDOWMENT FUND IS FOR THE PRIMARY PURPOSE OF PROVIDING SCHOLARSHIPS TO HIGH SCHOOL SENIORS PLANNING TO ENTER HEALTH CARE RELATED FIELDS OF STUDY. TEMPORARILY RESTRICTED CONTRIBUTIONS ARE TO SPECIFIC PURPOSE FUNDS OR PLANT EXPANSION FUNDS. SPECIFIC PURPOSE FUNDS INCLUDE GENERAL BENEFIT FUNDS SUCH AS MOBILE CLINIC OPERATIONS, MOBILE MAMMOVAN, EMS/EKG TRANSMISSION. OTHER SPECIFIC PURPOSE FUNDS ARE FOR CANCER/ONCOLOGY, AND CARDIAC. PLANT EXPANSION FUNDS INCLUDE FUNDS FOR GENERAL BUILDING. SCH D, PART V, COLUMN D, LINE 1B POTOMAC HOSPITAL CORPORATION BECAME AFFILIATED WITH SENTARA HEALTHCARE ON 12/01/09. ADDITIONAL FUNDS OF $3,843,863 WERE RECLASSIFIED AS ENDOWMENT FUNDS AFTER THE AFFILIATION AND HAVE BEEN SHOWN AS CONTRIBUTIONS ON PART V COLUMN (D) LINE 1B. GOLF TOURNAMENT 53309 10660 42649 19674 PECAN SALES 6381 6381 4869 1 5762 5762 300 65452 10660 54792 24843 24843 29949 1 1 1 X 1 X 600.000000000000 1 1 1 0 1 1 17819539 17819539 0.09450 27379634 23358696 4020938 0.02130 45199173 23358696 21840477 0.11580 515801 515801 0.00270 515801 515801 0.00270 45714974 23358696 22356278 0.11850 1816 1816 0.00000 440 440 0.00000 21454 21454 0.00010 23710 23710 0.00010 1 26629862 7988959 43302685 54637694 -11335009 X 1 1 1 LAKE RIDGE AMBULATORY SURGERY CNTR LLC OUTPATIENT SURGERY CENTER 0.42000 0.36380 2 1 SENTARA NORTHERN VIRGINIA MEDICAL CENTER 2300 OPITZ BOULEVARD WOODBRIDGE VA 22191 H 1881 X X X 2 LAKE RIDGE AMBULATORY SURGERY CNTR LLC 12825 MINNIEVILLE RD SUITE 204 WOODBRIDGE VA 22192 OH 720 X AMBULATORY SURGERY CENTER POTOMAC HOSPITAL 1 1 X X X X X X X X X 13 1 0 1 X X X X X X X X X X X 0 0 1 1 200.000000000000 1 600.000000000000 1 X X X X X 1 1 X X 1 0 X X X X 1 X 0 0 LAKE RIDGE AMBULATORY CENTER 2 0 1 1 200.000000000000 1 600.000000000000 1 X X X X 1 1 X 1 X 1 X X 0 X X X 0 0 POTOMAC HOSPITAL PART V, SECTION B, LINE 3: IN CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS), SENTARA NORTHERN VIRGINIA MEDICAL CENTER (SNVMC) TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH THROUGH: 1) SURVEYING KEY COMMUNITY STAKEHOLDERS BY USE OF AN ONLINE SURVEY TO IDENTIFY SIGNIFICANT HEALTH PROBLEMS AND SERVICE GAPS; 2) REVIEW OF ASSESSMENTS AND OTHER PLANNING DOCUMENTS PREPARED BY COMMUNITY ORGANIZATIONS SUCH AS THE LOCAL HEALTH DEPARTMENT; AND 3) DIRECT COMMUNICATION WITH COMMUNITY STAKEHOLDERS.1) SNVMC CONVENED A CHNA STEERING COMMITTEE RESPONSIBLE FOR OVERSEEING THE ASSESSMENT, INCLUDING THE SURVEY. THE STEERING COMMITTEE INCLUDED REPRESENTATIVES OF THE PRINCE WILLIAM HEALTH DISTRICT, THE PRINCE WILLIAM AREA FREE CLINIC, THE GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER, AND SEVERAL OTHER HEALTH-RELATED ORGANIZATIONS. THE COMMITTEE WAS RESPONSIBLE FOR IDENTIFYING KEY STAKEHOLDERS TO RECEIVE THE SURVEY. THE SURVEY LIST WAS REVIEWED TO ENSURE BROAD REPRESENTATION, INCLUDING REPRESENTATIVES OF THE LOCAL HEALTH DEPARTMENTS, FREE CLINICS, FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS, COMMUNITY SERVICES BOARDS (MENTAL HEALTH AND SUBSTANCE ABUSE), SOCIAL SERVICES DEPARTMENTS, EDUCATIONAL INSTITUTIONS, PROVIDERS (MEDICAL, DENTAL, ETC.), BUSINESSES, VOLUNTARY HEALTH AGENCIES, AREA AGENCIES ON AGING, CIVIC LEAGUES, THE FAITH COMMUNITY AND OTHER HEALTH AND HUMAN SERVICES ORGANIZATIONS AND GROUPS. DURING THE SURVEY PROCESS, THE RESPONSE RATE WAS MONITORED AND FOLLOW UP WAS MADE TO ENSURE GOOD AND BROADLY REPRESENTATIVE PARTICIPATION.2) THE STEERING COMMITTEE ALSO REVIEWED HEALTH-RELATED ASSESSMENTS AND PLANS DEVELOPED BY OTHER ORGANIZATIONS. EXAMPLES ARE THE GREATER PRINCE WILLIAM COMMUNITY NEEDS ASSESSMENT AND ASSESSMENTS CONDUCTED BY AND FOR THE POTOMAC HEALTH FOUNDATION. THE FINDINGS OF THESE REPORTS WERE TAKEN INTO ACCOUNT IN THE IDENTIFICATION OF SIGNIFICANT HEALTH ISSUES AND IN THE DEVELOPMENT OF THE HOSPITAL'S IMPLEMENTATION STRATEGIES.3) DIRECT COMMUNICATION WITH COMMUNITY STAKEHOLDERS WAS ALSO AN IMPORTANT PART OF THE PROCESS. THIS OCCURRED WITH MEMBERS OF THE STEERING COMMITTEE AND OTHERS. STEERING COMMITTEE MEMBERS WERE INVALUABLE IN CONTRIBUTING TO THE UNDERSTANDING OF THE ASSESSMENT AND THE SHAPING OF THE IMPLEMENTATION STRATEGIES. POTOMAC HOSPITAL PART V, SECTION B, LINE 5D: A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE AT THE HOSPITAL FACILITY. IN ADDITION, COPIES OF THE ASSESSMENT HAVE BEEN PROVIDED TO OTHER ORGANIZATIONS.THE DIRECT URL ADDRESS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT IS:HTTP://WWW.SENTARA.COM/NORTHERN-VIRGINIA/LOCATIONS/SENTARA-NORTHERN-VIRGINIA-MEDICAL-CENTER/DOCUMENTS/SENTARA%20NORTHERN%20VIRGINIA%20COMPLETE%20CHNA%202013%20FINAL.PDF POTOMAC HOSPITAL PART V, SECTION B, LINE 7: THE SNVMC COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED NUMEROUS HEALTH ISSUES. DURING THE CHNA PROCESS, THE HOSPITAL UNDERWENT A PRIORITIZATION PROCESS TO IDENTIFY THE SIGNIFICANT HEALTH NEEDS FOR WHICH IMPLEMENTATION STRATEGIES SHOULD BE ADDRESSED. THE PROCESS CONSIDERED FACTORS SUCH AS SIZE AND SCOPE OF THE HEALTH PROBLEM, THE INTENSITY AND SEVERITY OF THE ISSUE, THE POTENTIAL TO EFFECTIVELY ADDRESS THE PROBLEM AND THE AVAILABILITY OF COMMUNITY RESOURCES, AND SENTARA'S MISSION "TO IMPROVE HEALTH EVERYDAY". IN OTHER WORDS, SOME OF THE AREA NEEDS WHICH ARE NOT SPECIFICALLY ADDRESSED IN THE IMPLEMENTATION STRATEGY WERE IDENTIFIED AS LOWER PRIORITY BECAUSE THEY DID NOT RANK HIGH WITH THE PRIORITIZATION FACTORS. POTOMAC HOSPITAL PART V, SECTION B, LINE 14G: BROCHURES DESCRIBING THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM WERE AVAILABLE IN THE EMERGENCY ROOM AND PATIENT REGISTRATION AREAS AND INCLUDED A CHARITY CARE APPLICATION AND CONTACT INFORMATION FOR RECEIVING ASSISTANCE. PATIENTS WHO PRESENTED AS SELF-INSURED WERE AUTOMATICALLY PROVIDED WITH THIS INFORMATION UPON REGISTRATION. POSTERS ADVERTISING THE FACILITY'S FINANCIAL ASSISTANCE POLICY WERE CONSPICUOUSLY DISPLAYED IN THE EMERGENCY ROOM AND PATIENT REGISTRATION AREAS. ALL LETTERS FOR PAYMENT INCLUDED A NOTIFICATION REGARDING THE FACILITY'S FINANCIAL ASSISTANCE POLICY ALONG WITH CONTACT INFORMATION FOR APPLYING FOR ASSISTANCE. A SUMMARY OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAMS WAS AVAILABLE ON THE PATIENT BILLING SECTION OF THE WEBSITE. LAKE RIDGE AMBULATORY CENTER PART V, SECTION B, LINE 18E: AS ONLY PRE-ARRANGED PROCEDURES ARE PERFORMED AT THE FACILITY, UNINSURED INDIVIDUALS DESIRING TREATMENT HAD TO FIRST SPEAK WITH FACILITY PERSONNEL BEFORE BEING SCHEDULED FOR SURGERY, IN ORDER TO DISCUSS PAYMENT ARRANGEMENTS. FAP-ELIGIBILITY WAS DISCUSSED AT THIS TIME. INSURED INDIVIDUALS WITH BALANCES DUE WERE MADE AWARE OF THE FINANCIAL ASSISTANCE POLICY WHEN UNABLE TO PAY THEIR BILLS. LAKE RIDGE AMBULATORY CENTER PART V, SECTION B, LINE 19D: THE FACILITY IS AN AMBULATORY SURGERY CENTER AND DOES NOT TREAT INDIVIDUALS REQUIRING EMERGENCY MEDICAL CARE. ONLY PRE-PLANNED PROCEDURES ARE PERFORMED AT THE FACILITY. SEE PART VI NARRATIVE ON THE ORGANIZATION'S AMBULATORY SURGERY CENTER FOR FURTHER INFORMATION. 4 SENTARA LAKE RIDGE 12825 MINNIEVILLE ROAD LAKE RIDGE VA 22192 ADVANCED IMAGING CENTER, LAB, AND FREESTANDING ED ADVANCED IMAGING CENTER-SPRINGFIELD 6128 BRANDON AVE STE 205 SPRINGFIELD VA 22150 ADVANCED IMAGING CENTER SENTARA MT VERNON IMAGING CTR 8101 HINSON FARM ROAD ALEXANDRIA VA 22306 ADVANCED IMAGING CENTER SENTARA LORTON STATION IMAGING CTR 8986 LORTON STATION BLVD LORTON VA 22079 ADVANCED IMAGING CENTER PART I, LINE 6A: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT WAS CONTAINED IN A SYSTEM-WIDE REPORT PREPARED BY SENTARA HEALTHCARE, EIN 52-1271901, THE ORGANIZATION'S 501(C)(3) SOLE MEMBER. PART I, LINE 7: A COST-TO-CHARGE RATIO, CALCULATED USING WORKSHEET 2, WAS USED TO CALCULATE COSTS REPORTED IN THE TABLE. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 26,629,862. PART II, COMMUNITY BUILDING ACTIVITIES: COALITION BUILDING THE ORGANIZATION PARTICIPATED IN VARIOUS COALITIONS ON COMMUNITY ISSUES.COMMUNITY HEALTH IMPROVEMENT ADVOCACY THE ORGANIZATION PARTICIPATED IN VARIOUS COMMUNITY COALITIONS ON ASTHMA AND ON BETTER HEALTH FOR THE COMMUNITY.WORKFORCE DEVELOPMENT - THE ORGANIZATION COLLABORATED WITH OTHER COMMUNITY ORGANIZATIONS TO FUND RADIOLOGY PROGRAM GROWTH IN THE COMMUNITY. PART III, LINE 4: SEE PAGE 17 OF THE ATTACHED FINANCIAL STATEMENTS FOR THE FOOTNOTE WHICH DISCUSSES BAD DEBT. PART III, LINE 8: WORKSHEET A IN THE INSTRUCTIONS WAS USED TO COMPUTE THE AMOUNT REPORTED ON LINE 6. PART III, LINE 9B: UNDER THE ORGANIZATION'S WRITTEN DEBT COLLECTION POLICY, A HOSPITAL FACILITY MUST TAKE REASONABLE EFFORTS TO DETERMINE A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE PRIOR TO ENGAGING IN COLLECTION EFFORTS AGAINST A PATIENT. SUCH EFFORTS INCLUDE NOTIFYING PATIENTS OF THE FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND PRIOR TO DISCHARGE; PROVIDING ASSISTANCE IN THE APPLICATION PROCESS; ADVERTISING THE AVAILABILITY OF FINANCIAL ASSISTANCE ON PATIENT STATEMENTS; FOLLOWING UP WITH PATIENTS WHO HAVE SUBMITTED INCOMPLETE APPLICATIONS TO TRY AND OBTAIN THE MISSING INFORMATION; AND INFORMING APPLICANTS REGARDING THEIR ELIGIBILITY DETERMINATION. PRIOR TO TURNING THE ACCOUNTS OF UNRESPONSIVE PATIENTS OVER TO COLLECTIONS, THE HOSPITAL FACILITY ALSO ATTEMPTS TO QUALIFY AND WRITE OFF BALANCES UNDER THE FINANCIAL ASSISTANCE POLICY BASED ON CREDIT REPORTING DATA THAT ASSISTS IN DETERMINING INCOME AND CREDIT WORTHINESS. WHEN THE CREDIT DATA SUGGESTS THAT A PATIENT'S INCOME IS AT OR BELOW THE 200% FEDERAL POVERTY GUIDELINES, THE ACCOUNT BALANCE IS WRITTEN-OFF TO PRESUMPTIVE CHARITY; AND ALL COLLECTIONS EFFORTS CEASE. IF THE CREDIT REPORTING DATA IS UNCLEAR ON AN UNRESPONSIVE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE, THE PATIENT'S ACCOUNT MAY BE MOVED TO BAD DEBT AND FURTHER COLLECTIONS ACTIONS TAKEN. IF AT ANY TIME DURING THE BAD DEBT COLLECTIONS PROCESS THE HOSPITAL FACILITY RECEIVES INFORMATION THAT THE PATIENT IS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY, THE COLLECTION EFFORTS CEASE; AND THE ACCOUNT IS WRITTEN OFF TO CHARITY. PART III, LINE 2 BAD DEBT EXPENSE IS REPORTED AT ESTABLISHED RATES IN ACCORDANCE WITH THE ORGANIZATION'S BOOKS AND RECORDS, NET OF ANY DISCOUNTS OR COLLECTIONS ON ACCOUNTS THAT WERE PREVIOUSLY WRITTEN-OFF. SEE ALSO THE FOOTNOTE ON PAGE 17 OF THE ATTACHED FINANCIAL STATEMENTS WHICH DISCUSSES BAD DEBT. PART III, LINE 3 IN COMPUTING LINE 3, THE ORGANIZATION CONSERVATIVELY ESTIMATES THAT 30% OF BAD DEBT IS ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR CHARITY ASSISTANCE IF SUFFICIENT DATA WAS AVAILABLE. THIS ESTIMATE IS BASED ON CREDIT REPORTING DATA PURCHASED FROM EQUIFAX. THIS DATA PROVIDES CREDIT SCORE, INCOME PREDICTION DATA AND NUMEROUS LINES OF CREDIT AND ASSET DATA. FOR UNRESPONSIVE PATIENTS, THE ORGANIZATION USES THE ESTIMATED INCOME, MARITAL STATUS, ASSET INFORMATION AND CREDIT LINE DATA TO DETERMINE WHETHER THE PATIENT WOULD QUALIFY FOR CHARITY BASED ON A PROJECTED INCOME OF 200% OF THE FEDERAL POVERTY GUIDELINES WITH LITTLE TO NO ASSET DATA. THIS INFORMATION IS NOT ALL INCLUSIVE FOR ALL UNRESPONSIVE PATIENTS THAT COULD QUALIFY, AS DEPENDENT INFORMATION IS NOT READILY AVAILABLE. PART VI, LINE 2: THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF ITS COMMUNITIES THROUGH THESE MEANS:-ANALYSIS OF AREA SOCIODEMOGRAPHIC, HEALTH STATUS, AND OTHER DATA: THE ANALYSIS FOCUSES ON IDENTIFICATION OF HEALTH CARE NEEDS FOR PLANNING AND DEVELOPMENT OF HEALTH SERVICES AND PROGRAMS. THIS ANALYSIS IS UTILIZED FOR EDUCATION OF BOARD MEMBERS AND HOSPITAL LEADERSHIP AND IS INCORPORATED INTO THE ORGANIZATION'S STRATEGIC PLANS.-OBTAINING INPUT FROM KEY STAKEHOLDERS AND THE PUBLIC HEALTH COMMUNITY: IN ADDITION TO THE ANALYSIS OF SOCIODEMOGRAPHIC, HEALTH STATUS, AND OTHER DATA, ADDITIONAL INFORMATION IS OBTAINED AND ANALYZED. THIS INCLUDES INPUT FROM KEY STAKEHOLDERS INCLUDING THE LOCAL PUBLIC HEALTH COMMUNITY.-REVIEW OF HEALTH CARE NEEDS ASSESSMENTS AND DATA DEVELOPED BY COMMUNITY PARTNERS (SUCH AS STATE HEALTH DEPARTMENTS AND LOCAL HEALTH DISTRICTS), REGIONAL AGENCIES (SUCH AS THE PLANNING COUNCIL OR PLANNING DISTRICT COMMISSION), NATIONAL ORGANIZATIONS WHICH REPORT ON A LOCAL BASIS (SUCH AS COUNTY HEALTH RANKINGS), AND INFORMATION REPORTED IN LOCAL MEDIA: THIS INFORMATION IS STUDIED AND INCORPORATED INTO THE ORGANIZATION'S PLANS.-PARTICIPATION IN COLLABORATIVE HEALTH PLANNING AND NEEDS ASSESSMENT ACTIVITIES SUCH AS THOSE SPONSORED BY LOCAL HEALTH DISTRICTS (MAPP - MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) AND OTHER ORGANIZATIONS SUCH AS UNITED WAY AND ACCESS PARTNERSHIP: INFORMATION GATHERED THROUGH THESE ACTIVITIES IS INCORPORATED INTO THE ORGANIZATION'S PLANNING.-INFORMATION AND INPUT FROM PATIENTS AND CARE PROVIDERS: PATIENT CHARACTERISTICS AND TRENDS ARE REVIEWED TO ASSIST IN IDENTIFYING NEW COMMUNITY NEEDS. INPUT FROM PATIENTS AND CARE PROVIDERS IS SOUGHT AND CYCLED INTO THE ASSESSMENT PHASE OF PROJECTS. PART VI, LINE 3: FINANCIAL ASSISTANCE BROCHURES AND OTHER INFORMATION ARE POSTED AT EACH POINT OF SERVICE. A TOLL-FREE NUMBER IS GIVEN TO PATIENTS TO REACH CUSTOMER SERVICE REPRESENTATIVES DURING THE BUSINESS DAY FOR QUESTIONS OR CONCERNS. FINANCIAL ASSISTANCE PROGRAMS ARE ALSO PUBLISHED ON THE ORGANIZATION'S WEBSITE AND INCLUDED ON THE STATEMENTS PROVIDED TO PATIENTS. THE ORGANIZATION EMPLOYS FINANCIAL COUNSELORS WHO ARE AVAILABLE TO HELP PATIENTS COMPLETE APPLICATIONS FOR MEDICAID OR OTHER GOVERNMENT PAYMENT ASSISTANCE PROGRAMS, OR APPLY FOR CARE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, IF APPLICABLE. THE ORGANIZATION ALSO EMPLOYS AN EXTERNAL FIRM TO ASSIST IN THE ELIGIBILITY PROCESS. PART VI, LINE 4: THE ORGANIZATION'S SERVICE AREA INCLUDES THE FOLLOWING AREAS OF PRINCE WILLIAM, STAFFORD, AND FAIRFAX COUNTIES IN NORTHERN VIRGINIA: WOODBRIDGE, DUMFRIES, STAFFORD, TRIANGLE, QUANTICO, MANASSAS, AND LORTON. THE 2014 POPULATION OF THE ORGANIZATION'S SERVICE AREA IS 394,914 (SOURCE: NIELSEN) AND IS PROJECTED TO GROW BY 8.0% OVER THE NEXT FIVE YEARS, COMPARED TO A PROJECTED U.S. GROWTH RATE OF 3.5%. CURRENTLY APPROXIMATELY 7.5% OF THE POPULATION IS AGE 65+, COMPARED TO 14.2% FOR THE U.S. THIS AGE GROUP IS GROWING IN SIZE AND IS PROJECTED TO COMPRISE 10.0% OF THE ORGANIZATION'S SERVICE AREA POPULATION IN 2019.IN TERMS OF THE RACIAL COMPOSITION, 54.5% OF THE SERVICE AREA'S POPULATION IS WHITE; THIS COMPARES TO 71.3% NATIONWIDE. 24.1% OF THE AREA'S POPULATION IS BLACK; THE U.S. COMPARISON IS 12.7%. THE ASIANS AND PACIFIC ISLANDERS POPULATION REPRESENTS 7.6% OF THE TOTAL, COMPARED TO 5.2% NATIONWIDE. MULTI-RACE AND OTHER GROUPS ACCOUNT FOR 13.8% WITHIN THE SERVICE AREA AND 10.8% NATIONALLY. IN TERMS OF THE ETHNIC COMPOSITION, THE HISPANIC ETHNIC GROUP ACCOUNTS FOR 19.1% OF THE POPULATION OF THE SERVICE AREA, COMPARED TO 17.6% NATIONWIDE. OF THE ORGANIZATION'S SERVICE AREA ADULTS, 90.2% HAVE AT LEAST A HIGH SCHOOL LEVEL OF EDUCATION, COMPARED TO THE 85.4% NATIONALLY. THE AREA'S UNEMPLOYMENT RATE IS 4.8%, COMPARED TO 6.6% NATIONALLY. ABOUT 3.8% OF THE AREA'S WORKFORCE IS EMPLOYED IN THE ARMED FORCES.THE AVERAGE HOUSEHOLD INCOME IN THE ORGANIZATION'S SERVICE AREA IS $123,056 COMPARED TO THE U.S. HOUSEHOLD AVERAGE OF $71,320. 7.8% OF THE ORGANIZATION'S SERVICE AREA HOUSEHOLDS HAVE AN ANNUAL INCOME OF $25,000 OR LESS, COMPARED TO 24.4% OF U.S. HOUSEHOLDS. THE 2014 FEDERAL POVERTY GUIDELINES FOR A FAMILY OF THREE AT 200% IS $39,580. IT IS ESTIMATED THAT APPROXIMATELY 16% OF THE AREA'S FAMILIES MEET THIS GUIDELINE. IN ALL THREE COUNTIES WITHIN THE ORGANIZATION'S SERVICE AREA, PARTS OF THE MUNICIPALITIES ARE DESIGNATED AS MUA (MEDICALLY UNDERSERVED AREA) OR MUP (MEDICALLY UNDERSERVED POPULATION). TWO CIVILIAN GENERAL ACUTE CARE HOSPITALS ARE LOCATED WITHIN THIS AREA; THIS INCLUDES THE SENTARA FACILITY. THE AREA IS ALSO SERVED BY SEVERAL OTHER HOSPITALS LOCATED IN SURROUNDING COMMUNITIES. PART VI, LINE 5: THE ORGANIZATION'S GOVERNING BODY IS ELECTED ANNUALLY BY THE ORGANIZATION'S SOLE MEMBER, SENTARA HEALTHCARE, A 501(C) TAX-EXEMPT ORGANIZATION, WHOSE COMMUNITY-BASED BOARD IS COMPRISED OF A MAJORITY OF MEMBERS WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF SENTARA HEALTHCARE, NOR FAMILY MEMBERS THEREOF.GENERALLY, MEDICAL STAFF MEMBERSHIP IS OPEN TO ALL CARE PROVIDERS WHO MAY QUALIFY. THE ORGANIZATION'S SURPLUS FUNDS ARE USED FOR IMPROVEMENTS IN PATIENT CARE, PROVISION OF SERVICES TO THE UNINSURED AND UNDERINSURED, MEDICAL EDUCATION, AND COMMUNITY PROGRAMS. PART VI, LINE 6: SENTARA HEALTHCARE, THE ORGANIZATION'S 501(C)(3) SOLE MEMBER, PROVIDES A NUMBER OF PROGRAMS TO PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES, IN ADDITION TO THOSE IDENTIFIED FOR THE ORGANIZATION. SEE FORM 990 PART III SCHEDULE O DISCLOSURE FOR FURTHER INFORMATION ON THE SERVICES AND FACILITIES PROVIDED BY THE SENTARA HEALTHCARE SYSTEM. PART VI GENERAL NARRATIVE REGARDING AMBULATORY SURGERY CENTERS:THE ORGANIZATION IS A MEMBER OF A JOINT VENTURE WHICH OWNS AND OPERATES AN AMBULATORY SURGERY CENTER ("ASC") LOCATED IN VIRGINIA (SEE PART IV FOR OWNERSHIP INFORMATION). AS VIRGINIA REQUIRES ASCS TO GO THROUGH A CERTIFICATE OF PUBLIC NEED PROCESS AND RETAIN A HOSPITAL LICENSE, VIRGINIA ASCS MEET THE DEFINITION OF HOSPITAL FACILITIES FOR FORM 990 REPORTING PURPOSES.THE ORGANIZATION'S ASC IS ORGANIZED AND OPERATED IN ACCORDANCE WITH THE ORGANIZATION'S CHARITABLE PURPOSES AS AN EXTENSION OF ITS OUTPATIENT FACILITIES, IN PARTNERSHIP WITH ITS PHYSICIANS, TO PROVIDE A MORE EFFECTIVE MEANS OF CARING FOR LESS SERIOUS NON-EMERGENCY MEDICAL CONDITIONS THAT DO NOT REQUIRE FULL-FLEDGED HOSPITAL CARE. ONLY PRE-PLANNED PROCEDURES ARE PERFORMED AT THE ASC.ON APRIL 5, 2013, THE IRS ISSUED PROPOSED REGULATIONS WHICH CLARIFIED THE EXTENT TO WHICH IRC SEC 501(R) WOULD APPLY TO HOSPITAL FACILITIES OPERATED THROUGH A PARTNERSHIP JOINT VENTURE. ACCORDINGLY, DURING 2013, THE HOSPITAL ORGANIZATION TOOK NECESSARY STEPS TOWARDS ASC COMPLIANCE WITH IRC SEC 501(R). THE ORGANIZATION INTENDS TO FULLY MEET THE REQUIREMENTS UNDER TREAS. REG. 1.501(R) IN REGARDS TO ITS ASC ONCE FINAL OR TEMPORARY REGULATIONS ARE PUBLISHED. 1 THE SKILLSOURCE GROUP INC 8300 BOONE BLVD STE 450 VIENNA VA 22182 300129320 501(C)(3) 21454 DONATION/SPONSORSHIP LORTON ARTS FOUNDATION INC 9517 WORKHOUSE WAY LORTON VA 22079 753057770 501(C)(3) 14100 DONATION/SPONSORSHIP LORTON COMMUNITY ACTION CENTER PO BOX 154 LORTON VA 22199 510181451 501(C)(3) 9000 DONATION/SPONSORSHIP SENTARA HEALTHCARE 6015 POPLAR HALL DR NORFOLK VA 23502 521271901 501(C)(3) 1069479 OVERHEAD ALLOCATION 4 PART I, LINE 2: AS PART OF THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM"), THE ORGANIZATION DONATES FUNDS TO ITS 501(C)(3) PARENT ORGANIZATION, SENTARA HEALTHCARE, IN FURTHERANCE OF THE SYSTEM'S MISSION TO IMPROVE HEALTH EVERYDAY THROUGH THE PROVISION OF HEALTH SERVICES, AND THE PROMOTION OF HEALTH, MEDICAL EDUCATION, AND THE SOCIAL, CULTURAL, EDUCATIONAL, AND ECONOMIC DEVELOPMENT OF THE COMMUNITY. EXPENDITURE OF SUCH FUNDS IS OVERSEEN BY AN INDEPENDENT COMMUNITY BOARD WHICH MANAGES THE BUSINESS AND AFFAIRS OF THE SYSTEM. THE ORGANIZATION DONATES FUNDS TO OTHER 501(C)(3) ORGANIZATIONS WITH A SIMILAR MISSION OF PROVIDING AND PROMOTING HEALTH, MEDICAL EDUCATION, AND THE SOCIAL, CULTURAL, EDUCATIONAL, AND ECONOMIC DEVELOPMENT OF THE COMMUNITY. SUCH ORGANIZATIONS ALSO HAVE COMMUNITY BOARDS WHICH OVERSEE THE PROPER EXPENDITURES OF SUCH FUNDS. 0 1 0 0 0 0 0 1 0 HOWARD P KERN DIRECTOR/VICE CHAIR 0 888192 0 820913 0 156598 0 638375 0 21721 0 2525799 0 200477 DAVID L BERND DIRECTOR 0 1290579 0 1426213 0 884805 0 188187 0 27382 0 3817166 0 394615 MEGAN R PERRY DIRECTOR/PRESIDENT (THRU 12/13) 0 431464 0 305564 0 19288 0 44492 0 19520 0 820328 0 59389 ROBERT A BROERMANN TREASURER 0 700172 0 548870 0 7801 0 138841 0 22718 0 1418402 0 134095 JEFFREY KING SECRETARY 0 426148 0 169597 0 2261 0 56092 0 20957 0 675055 0 36604 NATHAN VANGENDEREN CFO/ASST TREASURER 0 249765 0 105243 0 191 0 13666 0 16509 0 385374 0 14251 VALERIE E KEANE VP, OPERATIONS 169227 0 20822 0 10102 0 -47727 0 11135 0 163559 0 0 0 DORKA M PICARD VP, INTEGRATED & FACILITY SERVICES 153900 0 18755 0 5510 0 -10311 0 3819 0 171673 0 0 0 MARLENE M BOLSTER VP, OPERATIONS 134778 0 17750 0 15 0 0 0 5232 0 157775 0 0 0 DAVID SCHWARTZ VP, MEDICAL AFFAIRS VPMA 436912 0 0 0 23575 0 7650 0 21486 0 489623 0 13952 0 LINDA G DODGE MID-LEVEL PRACTITIONER 213702 0 250 0 1417 0 36437 0 7822 0 259628 0 0 0 ROBIN ADAMS DIR, MARKET DEVELOPMENT 169583 0 14068 0 537 0 5357 0 15678 0 205223 0 0 0 ADEDAYO AKINBI DIR, PHARMACY 149697 0 14933 0 1039 0 96 0 19117 0 184882 0 0 0 WENDY M ATKINSON FORMER KE (SENIOR DIRECTOR) 134429 0 13708 0 1467 0 -38330 0 21623 0 132897 0 0 0 PART I, LINE 3 SENTARA HEALTHCARE, THE 501(C)(3) SOLE MEMBER OF THE ORGANIZATION, ESTABLISHED THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL THROUGH THE USE OF A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A COMPENSATION STUDY, AND APPROVAL BY SENTARA HEALTHCARE'S COMPENSATION COMMITTEE. 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. DAVID BERND PARTICIPATED IN AN INDIVIDUAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. VESTING OCCURS EACH DECEMBER 31 AND THE PRESENT VALUE OF THE ADDITIONAL ACCRUAL IS DISTRIBUTED IN A TAXABLE LUMP SUM. FOR 2013, MR. BERND RECEIVED A TOTAL LUMP SUM DISTRIBUTION OF $844,040. THIS AMOUNT HAS BEEN REPORTED IN COLUMN(B)(III) OF SCHEDULE J, PART II. DAVID BERND AND HOWARD KERN PARTICIPATED IN THE SENTARA OPTION PLAN FOR EXECUTIVES. THIS PLAN IS UNRELATED TO "EQUITY" OF THE EMPLOYER. PARTICIPATION IS LIMITED TO SELECT INDIVIDUALS AS APPROVED BY SENTARA HEALTHCARE'S BOARD OF DIRECTOR'S COMPENSATION COMMITTEE. VESTING IS DETERMINED BY THE GOVERNING BOARD OF SENTARA HEALTHCARE AND IS SEPARATELY STATED IN EACH PARTICIPANT'S OPTION AGREEMENT. THERE WERE NO OPTIONS GRANTED AFTER 2002. DAVID BERND, HOWARD KERN, ROBERT BROERMANN, MEGAN PERRY, 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 2013, HOWARD KERN RECEIVED A VESTED DISTRIBUTION UNDER THE PLAN OF $134,952. THIS AMOUNT HAS BEEN REPORTED IN COLUMN(B)(III) OF SCHEDULE J, PART II. PART I, LINE 7 DURING 2013, THE ORGANIZATION MADE NON-FIXED PAYMENTS OF COMPENSATION UNDER THE FOLLOWING INCENTIVE PROGRAMS: PERFORMANCE PLUS - ELIGIBLE FULL-TIME AND PART-TIME EMPLOYEES NOT COVERED UNDER ANOTHER INCENTIVE PLAN MAY EARN ADDITIONAL COMPENSATION IF THEIR BUSINESS UNIT MEETS FINANCIAL, SAFETY, QUALITY AND CUSTOMER SERVICE GOALS, AND THE SYSTEM NET OPERATING MARGIN GOAL HAS BEEN MET. INDIVIDUAL PAYOUT IS BASED ON JOB CLASSIFICATION, BUSINESS UNIT GOAL SUCCESS AND PERCENTAGE OF POOL AVAILABLE FOR DISTRIBUTION. GOALS AND THE PERCENTAGE OF POOL AVAILABLE FOR DISTRIBUTION ARE DETERMINED AFTER YEAR-END, AT WHICH POINT AWARDS MAY BE PAID AND REPORTED AS COMPENSATION. 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. BLUE POINT SURGICAL GROUP PHYS RECRUIT-INC GUAR X 206112 133114 0 0 1 HALMI & ASSOCIATES INC PHYS RECRUIT-INC GUAR X 315000 249375 0 0 1 382489 SCHEDULE L, PART II LOANS TO INTERESTED PERSONS:THE ORGANIZATION HAS DETERMINED THAT IT HAS A COMMUNITY OBLIGATION IN FURTHERANCE OF ITS CHARITABLE PURPOSES TO ASSIST IN THE RECRUITMENT OF ADDITIONAL PHYSICIANS TO AND RETENTION OF PHYSICIANS IN ITS SERVICE AREA FOR THE PURPOSE OF IMPROVING THE QUALITY, EXPANDING THE SCOPE, AND ENHANCING THE ACCESSIBILITY OF MEDICAL SERVICES TO RESIDENTS OF ITS SERVICE AREA. THE ORGANIZATION HAS DETERMINED THAT THE MOST FEASIBLE METHOD BY WHICH TO MEET THIS COMMUNITY OBLIGATION IS THROUGH THE SELECTIVE USE OF RECRUITMENT INCENTIVES INCLUDING, BUT NOT LIMITED TO, FINANCIAL ASSISTANCE WITH THE COSTS ASSOCIATED WITH RELOCATION OF A PHYSICIAN TO ITS SERVICE AREA, AND THE COSTS ASSOCIATED WITH A PHYSICIAN'S INITIAL YEARS IN PRACTICE IN ITS SERVICE AREA.TO THAT END, THE ORGANIZATION HAS ENTERED INTO CERTAIN PHYSICIAN INCOME GUARANTY LOANS, WHICH INCLUDES THE PRACTICE OF DR. DENIS J. HALMI, A FORMER EX-OFFICIO NON-VOTING DIRECTOR, WHEREBY THE ORGANIZATION PROVIDES FINANCIAL ASSISTANCE TO THE PRACTICE IN ORDER TO HELP IT IN RECRUITING, ATTRACTING AND RETAINING ADDITIONAL PHYSICIANS PRACTICING IN A SPECIALTY AREA WHERE THERE IS CURRENTLY AN EXISTING AND PROJECTED SHORTAGE OF PHYSICIANS WITHIN THE ORGANIZATION'S COMMUNITY. FUNDS ARE ADVANCED TO THE PRACTICE DURING THE INCOME GUARANTY PERIOD. REPAYMENT IS LATER FORGIVEN BASED ON THE PHYSICIAN'S LENGTH OF STAY IN THE SERVICE AREA, IN RECOGNITION OF THE PHYSICIAN'S CONTRIBUTION TO THE HEALTH CARE OF RESIDENTS IN THE SERVICE AREA. AMOUNTS FORGIVEN, INCLUDING INTEREST ON OUTSTANDING LOAN BALANCES, ARE REPORTED TO THE IRS ON THE APPLICABLE REPORTING FORM. SCHEDULE L, PART IV DIRECTORS/TRUSTEES/OFFICERS/KEY EMPLOYEES OF THE ORGANIZATION MAY ALSO SERVE AS DIRECTORS/TRUSTEES/OFFICERS OF RELATED TAXABLE ENTITIES WITHIN THE SENTARA HEALTHCARE SYSTEM. SEE SCHEDULE R FOR A LISTING OF TRANSATIONS THE ORGANIZATION HAD WITH THESE RELATED ENTITIES. SCHEDULE L, PART II FOR THE CALENDAR YEAR 2013, THE FOLLOWING ARE THE AMOUNTS OF PRINCIPAL AND INTEREST FORGIVEN UNDER THE LOANS:DR. HALMI AND ASSOCIATES, INC. FOR DR. JOHN DOCKENS:PRINCIPAL: $65,625ACCRUED INTEREST: $14,566TOTAL AMOUNT FORGIVEN: $80,191BLUE POINT SURGICAL GROUP FOR DR. RAMAN KUMAR:PRINCIPAL: $51,528ACCRUED INTEREST: $9,071TOTAL AMOUNT FORGIVEN: $60,599 FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS: SENTARA HEALTHCARE I.YOUR NOT-FOR-PROFIT HEALTH PARTNER FOR 125 YEARS, SENTARA HAS BEEN COMMITTED TO HELPING PEOPLE JUST LIKE YOU, PEOPLE WHO WANT THE MOST DEDICATED MEDICAL PROFESSIONALS HELPING THEM THROUGH EVERY STAGE OF LIFE. TO PROVIDE A RANGE OF QUALITY CARE, WE HAVE GROWN SLOWLY THROUGHOUT VIRGINIA AND NORTH CAROLINA. WE HAVE REACHED OUT TO INDUSTRY LEADERS AND JOINED FORCES, AND WE NOW OPERATE MORE THAN 100 SITES OF CARE, INCLUDING 12 ACUTE CARE HOSPITALS - SEVEN IN HAMPTON ROADS, ONE IN NORTHERN VIRGINIA, TWO IN THE BLUE RIDGE REGION OF VIRGINIA, ONE IN SOUTHERN VIRGINIA AND ONE IN NORTH CAROLINA. FOR MORE THAN A DECADE, MODERN HEALTHCARE MAGAZINE HAS RANKED US AS ONE OF THE NATION'S TOP INTEGRATED HEALTHCARE SYSTEMS. OUR NOT-FOR-PROFIT SYSTEM PROUDLY INCLUDES ADVANCED IMAGING CENTERS, NURSING AND ASSISTED-LIVING CENTERS, OUTPATIENT CAMPUSES, PHYSICAL THERAPY AND REHABILITATION SERVICES, HOME HEALTH AND HOSPICE AGENCY, A 3,800-PROVIDER MEDICAL STAFF, AND FOUR MEDICAL GROUPS. IN ADDITION, WE PROVIDE MEDICAL TRANSPORT AMBULANCES AND NIGHTINGALE AIR AMBULANCE, AND EXTEND HEALTH INSURANCE TO 440,000 PEOPLE THROUGH OPTIMA HEALTH, OUR AWARD-WINNING HEALTH PLAN. AMONG OUR MANY STRENGTHS, WE ARE A NATIONAL LEADER IN HEART AND KIDNEY CARE, STROKE CARE, AND INFECTION PREVENTION, AND WE WERE THE FIRST IN THE NATION TO PIONEER AND DEVELOP THE EICU, A REMOTE MONITORING SYSTEM FOR INTENSIVE CARE. OUR DEDICATION TO IMPROVING AND INCREASING MEDICAL OPTIONS FOR OUR PATIENTS IS REINFORCED BY OUR ONGOING PARTICIPATION IN NATIONAL AND INTERNATIONAL RESEARCH. THESE VITAL MEDICAL TRIALS HELP US ADVANCE TOWARD OUR MISSION OF IMPROVING HEALTH EVERY DAY. IN NOVEMBER 2013, WE PROUDLY CELEBRATED 125 YEARS OF DELIVERING COMPASSIONATE AND QUALITY CARE. WHEN WE BEGAN AS THE RETREAT FOR THE SICK IN 1888 IN NORFOLK, VIRGINIA, MEDICAL PROVIDERS DEDICATED THEMSELVES TO CARING FOR NORFOLK'S POOR, FOCUSED ON MEETING THEIR IMMEDIATE HEALTHCARE NEEDS. AS NOTED ABOVE AND DETAILED IN THIS REPORT, WE HAVE GROWN INTO A MULTI-STATE, INTEGRATED HEALTHCARE SYSTEM COMMITTED TO STILL DELIVERING THAT SAME COMPASSIONATE AND QUALITY CARE AND REACHING FAR BEYOND THE PATIENTS WHO COME DIRECTLY TO US. WE STRIVE TO SERVE EVERYONE IN OUR COMMUNITIES THROUGH HEALTH OUTREACH PROGRAMS, EDUCATION AND FINANCIAL SUPPORT OF OTHER NOT-FOR-PROFIT HEALTH ORGANIZATIONS. II.GROWING THE SENTARA FAMILY SINCE THE BEGINNING, SENTARA HAS REACHED OUT TO NEARBY INDUSTRY LEADERS AND JOINED FORCES TO EXTEND HEALTHCARE TO MORE PEOPLE. IN RECENT YEARS, WE HAVE GROWN IN VIRGINIA AND NORTH CAROLINA BY SEEKING PARTNERSHIPS WITH LONG-ESTABLISHED AND SUCCESSFUL HOSPITALS AND HEALTHCARE SYSTEMS WHO SHARE OUR DEDICATION TO EXCELLENCE AND VALUE. SOME OF OUR MOST RECENT ADDITIONS INCLUDE: A. HALIFAX REGIONAL HOSPITAL IN THE FALL OF 2012, HALIFAX REGIONAL HOSPITAL SIGNED A LETTER OF INTENT TO AFFILIATE WITH SENTARA HEALTHCARE. IT IS AN INTEGRATED SYSTEM INCLUDING A 192-BED HOSPITAL, THREE LONG-TERM CARE FACILITIES, A HOME CARE AND HOSPICE FACILITY, AND A BROAD RANGE OF SPECIALTIES AND OUTPATIENT SERVICES ACROSS THE SOUTH BOSTON REGION, ABOUT 165 MILES WEST OF NORFOLK. THE MERGER WAS COMPLETED JULY 1, 2013, WHICH ALSO MARKED HALIFAX'S 60TH ANNIVERSARY SERVING THE SOUTH BOSTON COMMUNITY. THE SYSTEM'S EXTENSIVE EXPERIENCE SERVING RURAL COMMUNITIES MAKES IT PARTICULARLY VALUABLE TO LOCALS AND COMPLEMENTS SENTARA'S COMMITMENT TO PERSONALIZED HEALTHCARE IT IS NOW THE 11TH OF 12 HOSPITALS IN SENTARA'S NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM. B. SENTARA ALBEMARLE HOSPITAL, MEDICAL GROUP AND RELATED FACILITIES SENTARA HEALTHCARE AND ALBEMARLE HEALTH OF NORTHEASTERN NORTH CAROLINA BEGAN A PARTNERSHIP MARCH 1, 2014, AFTER APPROVAL BY THE PASQUOTANK COUNTY BOARD OF COMMISSIONERS AND THE ALBEMARLE HOSPITAL AUTHORITY BOARD OF COMMISSIONERS AND THEIR TWO-YEAR PROCESS OF EVALUATING POTENTIAL PARTNERS. ALL FOUR ENTITIES SHARE THE GOALS OF IMPROVING THE COMMUNITY'S ACCESS TO PRIMARY CARE, MANAGING CHRONIC DISEASE AND IMPROVING SERVICES AND PROGRAMS IN THE REGION. LOCATED IN ELIZABETH CITY, SENTARA ALBEMARLE MEDICAL CENTER IS A 182 LICENSED BED, FULL-SERVICE FACILITY OFFERING A WIDE RANGE OF SERVICES, INCLUDING: INPATIENT AND CRITICAL CARE, A FULL ARRAY OF SURGICAL SERVICES, SOPHISTICATED DIAGNOSTIC IMAGING TECHNOLOGY, COMPREHENSIVE WOMEN'S CARE, CARDIOLOGY, CANCER TREATMENT, REHABILITATION SERVICES AND MORE. SENTARA ALBEMARLE MEDICAL CENTER HAS ASSEMBLED A MEDICAL STAFF OF MORE THAN 100 PHYSICIANS, REPRESENTING NEARLY 30 SPECIALTIES, AND A CARING STAFF OF ALMOST 1,000 EMPLOYEES. IT IS NUMBER 12 OF OUR 12 HOSPITALS. ALBEMARLE PHYSICIAN SERVICES SENTARA BRINGS TOGETHER A DEDICATED TEAM OF PRIMARY CARE AND SPECIALTY PHYSICIANS TO CARE FOR PATIENTS ACROSS NORTHEASTERN NORTH CAROLINA. ALL OF THE FACILITIES ADOPTED THE SENTARA NAME IN MAY 2014. III.CONSTANTLY LOOKING AHEAD TO BEST SERVE OUR COMMUNITIES AND PROVIDE THE MOST PATIENT-FOCUSED, COST-EFFECTIVE HEALTHCARE POSSIBLE, WE SEEK TO EXPAND AND ENHANCE OUR SERVICES IN A VARIETY OF WAYS. WE STRIVE TO BE THE FIRST IN OUR COMMUNITIES TO OFFER NEW, YET PROVEN, MEDICAL PROCEDURES, AND WE REACH OUT TO NEW COMMUNITIES TO OFFER SERVICES WE HAVE PROUDLY AND SUCCESSFULLY OFFERED IN OTHER REGIONS. WE ALSO LEAD AND PARTICIPATE IN RESEARCH EFFORTS TO IDENTIFY AND TEST FUTURE TREATMENTS AND BEST PRACTICES. SOME OF THE WAYS WE HAVE DONE THIS RECENTLY INCLUDE: A.OFFERING NEW PROCEDURES AND TECHNOLOGY SENTARA PHYSICIANS LEAD THE WAY BY OFFERING LIFE-SAVING PROCEDURES PREVIOUSLY NOT AVAILABLE OR NOT READILY AVAILABLE. BY DOING SO, THEY GIVE RESIDENTS THE COMFORT AND COST-SAVINGS OF BEING CLOSE TO HOME WHILE IMPROVING THEIR HEALTH. IN 2013, SENTARA ADDED 3D MAMMOGRAPHY, A BREAKTHROUGH TECHNOLOGY FOR DETECTING EARLY BREAST CANCER, AT EIGHT BREAST IMAGING LOCATIONS FROM WILLIAMSBURG TO VIRGINIA BEACH. THIS ADVANCED TECHNOLOGY CREATES 3D BREAST RECONSTRUCTIONS SO RADIOLOGISTS CAN VIEW BREASTS IN THIN LAYERS AND SEE EARLY CANCERS THAT WOULD NOT BE VISIBLE USING OTHER MAMMOGRAPHY. IN 2012, SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER STARTED A NEW TREATMENT FOR SEVERE ASTHMA CALLED BRONCHIAL THERMOPLASTY. THIS MINIMALLY INVASIVE OUTPATIENT PROCEDURE USES A BRONCHOSCOPE TO DELIVER THERMAL ENERGY TO THE LUNGS OF PATIENTS WITH ASTHMA TO DECREASE THE AMOUNT OF SMOOTH MUSCLE IN THE LUNGS THE MUSCLES THAT CONSTRICT AND RESULT IN ASTHMA SYMPTOMS. THAT SAME YEAR, THE SENTARA CANCER NETWORK'S MOBILE PET/CT BEGAN PERFORMING BODY SCANS TO DISCOVER AND STAGE CANCERS THAT MAY HAVE SPREAD TO THE BONES. THIS IS POSSIBLE DUE TO THE FDA'S APPROVAL OF THE USE OF 18F-SODIUM FLUORIDE AS AN INJECTION. AT ROCKINGHAM MEMORIAL HOSPITAL IN 2012, PATIENTS WITH THE HEART CONDITION ATRIAL FIBRILLATION BENEFITTED FROM A PROCEDURE CALLED CARDIAC CRYOABLATION, APPROVED BY THE FDA IN LATE 2010. CRYOABLATION EMPLOYS A SPECIAL BALLOON THAT'S FILLED WITH A COOLANT TO REDUCE ITS TEMPERATURE TO MINUS 80 DEGREES CELSIUS. THE BALLOON IS APPLIED TO THE HEART TISSUES THAT CAUSE IRREGULAR HEARTBEATS, AND THE COLD TEMPERATURES DESTROY THE TISSUE AND CORRECT THE HEART'S PROBLEM. IT HAS PROVED SUCCESSFUL FOR PATIENTS WHO DID NOT RESPOND FULLY TO OTHER TREATMENTS. WITH A $725,000 GRANT FROM THE POTOMAC HEALTH FOUNDATION, SENTARA NORTHERN VIRGINIA MEDICAL CENTER PURCHASED A NEW DIGITAL MAMMOGRAPHY VAN. WITH THE VAN, THE CENTER REACHES WOMEN WITH LITTLE OR NO INSURANCE, IN HOPES OF DETECTING CANCER EARLIER IN WOMEN IN PRINCE WILLIAM COUNTY, WHERE THERE'S A HIGHER-THAN-AVERAGE DEATH RATE FROM BREAST CANCER. ON SEPTEMBER 17, 2012, SURGEONS AND CARDIOLOGISTS AT SENTARA HEART HOSPITAL WERE THE FIRST IN THE WORLD TO BEGIN PERFORMING SURGERIES IN THE DUAL EPICARDIAL ENDOCARDIAL PERSISTENT (DEEP) ATRIAL FIBRILLATION FEASIBILITY TRIAL. THIS FOOD AND DRUG ADMINISTRATION-APPROVED STUDY IS SPONSORED BY CARDIAC DEVICE MANUFACTURER ATRICURE, INC. AND IS DESIGNED TO EVALUATE THE SAFETY AND EFFICACY OF A COMBINED PROCEDURE WHEREBY THE SURGEON CREATES LINES OF BLOCK ON THE OUTSIDE OF THE HEART WORKING THROUGH TINY CHEST INCISIONS. B. EXPANDING SERVICE AREAS AND PARTNERSHIPS IN 2013, WE LAUNCHED AN EFFORT TO BETTER SERVE THE SENIOR POPULATION IN HAMPTON ROADS THROUGH A MEDICARE ADVANTAGE PRODUCT FROM OPTIMA HEALTH, SENTARA HEALTHCARE'S AWARD-WINNING HEALTH PLAN, ONE SPECIALIZED SENTARA MEDICAL GROUP (SMG) PRACTICE AND A NEW COLLABORATION WITH SMG, EASTERN VIRGINIA MEDICAL SCHOOL, OPTIMA HEALTH, SENTARA HOME CARE AND LIFE CARE AND SENTARA HOSPITALS TO CREATE A SEAMLESS EXPERIENCE FOR PATIENTS ACROSS THE CONTINUUM OF CARE. FORM 990, PART III, LINE 4A IN AUGUST 2012, SENTARA AND MDLIVE ANNOUNCED AN EQUITY PARTNERSHIP TO DELIVER REAL-TIME MEDICAL CONSULTATIONS VIA TELEPHONE AND ONLINE VIDEO THROUGH AN ESTABLISHED NETWORK OF PHYSICIANS. PATIENTS USE THE MDLIVE VIRTUAL CONSULT PLATFORM TO CONSULT DIRECTLY WITH A LICENSED SENTARA OR PARTNER PHYSICIAN WHO CAN DIAGNOSE LOW-ACUITY ILLNESSES, PROVIDE CARE, AND SUBSCRIBE PRESCRIPTIONS. IN 2013, SENTARA EMPLOYEES WITH OPTIMA HEALTH AND CIGNA INSURANCE RECEIVED THE BENEFIT OF SENTARA MDLIVE APPOINTMENTS FOR A $15 CO-PAY. WE SAW OVER 2,000 SENTARA EMPLOYEES/DEPENDENTS COVERED UNDER OPTIMA INSURANCE REGISTER WITH MDLIVE. THAT SAME YEAR, 429 EMPLOYEES AND THEIR FAMILIES MADE AN APPOINTMENT WITH MDLIVE. SENTARA IS WORKING WITH MDLIVE TO PARTNER WITH OTHER HEALTH SYSTEMS TO OFFER THE BENEFITS TO THEIR EMPLOYEES AND IS WORKING TO LEVERAGE THE TECHNOLOGY TO PILOT NEW MODELS TO TRANSFORM CARE AND IMPROVE LIVES. C. EXPANDING EDUCATIONAL SERVICES CONTINUING TO GROW AND DEVELOP AS WE AIM TO MEET THE DEMAND FOR WELL-EDUCATED HEALTHCARE EXPERTS, THE SENTARA SCHOOL OF HEALTH PROFESSIONALS CHANGED ITS NAME IN 2009 TO THE SENTARA COLLEGE OF HEALTH SCIENCES (SCHS). AT THE SAME TIME, IT RECEIVED APPROVAL TO OFFER A BACCALAUREATE DEGREE IN NURSING, A REQUIREMENT MORE HOSPITALS ARE SETTING FOR ITS STAFF. OUR BACHELOR OF SCIENCE IN NURSING PROGRAM BEGAN IN AUGUST 2010 WITH FOUR WAYS TO RECEIVE A DEGREE: TRADITIONAL BSN, LPN TO BSN, RN TO BSN AND EARLY ADMISSION FOR HIGH SCHOOL SENIORS. THE COLLEGE IS PROVIDING A NEW POOL OF HIGHLY COMPETENT NURSES: THE FIRST RN TO BSN CLASS GRADUATED IN MAY 2012 WITH SEVEN GRADUATES. TWENTY-SIX STUDENTS ALSO GRADUATED IN THE NEW, TRADITIONAL BSN PROGRAM, AND ONE STUDENT GRADUATED IN THE NEW LPN TO BSN PROGRAM. ALL STUDENTS PRACTICE THEIR SKILLS IN SENTARA'S SIMULATION LAB A MINIMUM OF EIGHT TIMES, ENABLING THEM TO PERFECT THEIR CRITICAL-THINKING SKILLS IN A SAFE ENVIRONMENT. THE LAB, EQUIPPED WITH SIX, HIGH-FIDELITY PROGRAMMABLE MANNEQUINS WHO CAN CRY, SWEAT, BREATHE RAPIDLY AND DEVELOP SYMPTOMS OF CARDIAC ARREST, IS LOCATED INSIDE SCHS -- A FEATURE NOT FOUND IN MANY NURSING PROGRAMS -- SO THAT IT IS EASILY ACCESSIBLE FOR BOTH STUDENTS AND PROFESSORS, AND CLASSROOM INSTRUCTION OR FEEDBACK CAN OCCUR IMMEDIATELY AFTERWARDS. WE FURTHERED OUR OFFERINGS WITH THE SURGICAL TECHNOLOGY PROGRAM AT THE COLLEGE LAUNCHING THE FIRST ASSOCIATE OF OCCUPATIONAL SCIENCE DEGREE WITH THE JANUARY 2013 CLASS. D. RESEARCHING FOR THE FUTURE IN A PATIENT STUDY CONDUCTED AT SENTARA LEIGH HOSPITAL IN 2012, NURSES WERE EMPOWERED TO GIVE IV FLUIDS AT THE EARLIEST SIGNS THAT A KNEE OR HIP JOINT REPLACEMENT PATIENT'S BLOOD PRESSURE WAS TRENDING DOWNWARD. BEFORE THE STUDY, A 10-STEP PROCESS INCLUDING A PHYSICIAN ORDER WAS REQUIRED. THIS NEW PROTOCOL SPED CARE AND REDUCED THE NUMBER OF PATIENTS WHOSE CONDITIONS WORSENED DUE TO LOW BLOOD PRESSURE BY 30 PERCENT. STUDY FINDINGS WERE SHARED WITH ORTHOPEDIC NURSES FROM AROUND THE UNITED STATES DURING THE 33RD ANNUAL NATIONAL ASSOCIATION OF ORTHOPAEDIC NURSES CONFERENCE IN SAN ANTONIO IN MAY 2013. IN APRIL 2012, SENTARA HEART HOSPITAL JOINED THE HEARTLIGHT TRIAL FOR THE TREATMENT OF SYMPTOMATIC ATRIAL FIBRILLATION. USING A FIBER OPTIC LIGHT, DOCTORS LOOK INSIDE THE BEATING HEART OF PATIENTS, TESTING A NEW DEVICE CALLED THE CARDIOFOCUS HEARTLIGHT ENDOSCOPIC ABLATION SYSTEM. THE SYSTEM INCLUDES A BALLOON, SMALL CAMERA AND LASER LIGHT TO PRECISELY DELIVER LIGHT ENERGY TO MISFIRING AREAS OF THE HEART AND TO HELP RESTORE REGULAR HEART RHYTHM. THE STUDY REACHED A MILESTONE IN FEBRUARY 2013 WHEN IT ENROLLED MORE THAN HALF OF THE TOTAL STUDY PARTICIPANTS. IN A 10-MONTH, 2012 STUDY, SENTARA PHYSICIANS WORKED WITH THE EASTERN VIRGINIA MEDICAL SCHOOL STRELITZ DIABETES CENTER TO DEVELOP ALERTS IN THE SENTARA ECARE HEALTH NETWORK, OUR ELECTRONIC MEDICAL RECORD SYSTEM, WHEN A CHANGE OCCURS IN A DIABETIC PATIENT'S CONDITION. THE ALERTS OFFER GUIDANCE ABOUT THE APPROPRIATE CARE FOR EACH SITUATION. DURING THE STUDY PERIOD, PATIENTS SHOWED SUBSTANTIAL IMPROVEMENT. NEARLY 900 PATIENTS MOVED FROM THE HIGHEST LEVEL OF RISK FOR COMPLICATIONS TO A HEALTHIER RANGE. THE RESULTS WERE PRESENTED MAY 2, 2013 IN PHOENIX AT THE 22ND ANNUAL SCIENTIFIC AND CLINICAL CONGRESS OF THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGIST (AACE). SENTARA PARTNERED WITH CUPRON AND EOS SURFACES IN 2013 TO LAUNCH THE WORLD'S LARGEST CLINICAL TRIAL TO TEST THE EFFECTIVENESS OF COPPER-INFUSED HARD SURFACES AND LINENS IN PREVENTING HOSPITAL-ACQUIRED INFECTIONS. THE STUDY LAUNCHED AT SENTARA NORFOLK GENERAL HOSPITAL'S ICU AND SENTARA LEIGH HOSPITAL'S EAST TOWER IN THE FIRST QUARTER OF 2014 WITH MORE THAN 15,000 HORIZONTAL SQUARE FEET OF PATENT-PENDING CUPRON-ENHANCED EOS SURFACES INSTALLED. ANTI-ODOR TEXTILES MANUFACTURED BY ENCOMPASS ARE USED FOR PATIENT BED LINENS, GOWNS AND OTHER TEXTILES. THE COMPREHENSIVE PROGRAM IS BELIEVED TO BE THE WORLD'S LARGEST HOSPITAL EVALUATION OF ANTIMICROBIAL-PROTECTED MATERIALS, WITH THE GOAL OF COMBATING THE SPREAD OF PATHOGENS KNOWN TO CONTRIBUTE TO HEALTHCARE INFECTIONS. APPROXIMATELY SEVEN MILLION PEOPLE WORLDWIDE SUFFER FROM HOSPITAL-ACQUIRED INFECTIONS EACH YEAR. IV. BUILDING FOR THE FUTURE ALONG WITH REACHING OUT TO NEW COMMUNITIES, SENTARA HEALTHCARE STRIVES TO BUILD ON OUR EXISTING SERVICES AND IN OUR ESTABLISHED AREAS SO THAT WE EXCEED OUR PATIENTS' EXPECTATIONS AND MEET GROWING HEALTHCARE DEMANDS. SOME OF THE CHANGES WE HAVE INVESTED IN RECENTLY WITHIN OUR ESTABLISHED COMMUNITIES INCLUDE: A. LORTON OUTPATIENT FACILITIES NEW OUTPATIENT FACILITIES OPENED IN LORTON/FAIRFAX COUNTY IN JUNE 2013. IT INCLUDES A 24-HOUR EMERGENCY DEPARTMENT AND AN ADVANCED IMAGING CENTER WITH A 64-SLICE CT AT LORTON MARKETPLACE AND ANOTHER IMAGING CENTER AT LORTON STATION, WHICH ADDED 3D MAMMOGRAPHY IN JULY 2013. THESE ARE CONVENIENT HEALTHCARE DESTINATIONS IN A FAST-GROWING MARKETPLACE WHERE THE MAJORITY OF POPULATION GROWTH WILL BE FROM PEOPLE OVER 65. B. BEHAVIORAL HEALTH UNIT A 24-BED INPATIENT BEHAVIORAL HEALTH UNIT OPENED AT SENTARA VIRGINIA BEACH GENERAL HOSPITAL IN JANUARY 2014. THE UNIT INCLUDES 16 BEDS DESIGNATED FOR GERIATRIC PATIENTS AND EIGHT GENERAL ADULT BEDS. THE NUMBER OF PATIENTS SEEKING PSYCHIATRIC SERVICES THROUGH THE EMERGENCY DEPARTMENT AT SENTARA VIRGINIA BEACH GENERAL HAS INCREASED 111 PERCENT SINCE 2006. IN THE PAST, SOME PATIENTS HAVE HAD TO WAIT FOR ADMISSION IN THE EMERGENCY DEPARTMENT, WHERE A STAFF PERSON HAD TO BE COMMITTED TO THE PATIENT FOR HIS OR HER SAFETY. THE NEW BEDS SPEED UP ADMISSION AND IMPROVE CARE. C. MARTHA JEFFERSON NEUROSCIENCE CENTER THE NEUROSCIENCE CENTER BEGAN SERVING PATIENTS IN JANUARY 2013. IT IS EQUIPPED WITH THE LATEST TECHNOLOGY, WITH ELECTROMYOGRAPHY (EMG) AND ELECTROENCEPHALOGRAPHY (EEG) DIAGNOSTIC EQUIPMENT, NEW VESTIBULAR BALANCE REHABILITATION EQUIPMENT, LOW-DOSE CT-IMAGING, AND COMPLETE COMPLEX BRAIN SURGERY SUCH AS STEREOTACTIC RADIOSURGERY (SRS). FOUR NEUROLOGISTS, TWO NEUROSURGEONS AND 13 REHAB THERAPISTS ARE UNDER ONE ROOF TO ENSURE PATIENTS RECEIVE CARE IN ONE LOCATION. THE CENTER HAS ROLLED-OUT MULTI-DISCIPLINARY SUBSPECIALTY CLINICS THAT DELIVER A COORDINATED, PATIENT-CENTERED APPROACH. THE CLINICS INCLUDE THE SEIZURE DISORDER AND EPILEPSY CLINIC, THE NEUROPATHY CLINIC, THE STROKE RECOVERY CLINIC, THE COGNITIVE REHABILITATION CLINIC AND THE VESTIBULAR BALANCE AND FALLS PREVENTION CLINIC. D. SENTARA EASTERN VIRGINIA MEDICAL SCHOOL (EVMS) COMPREHENSIVE PELVIC FLOOR CENTER SENTARA AND EVMS PARTNERED IN FEBRUARY 2013 TO CREATE THE CENTER AND COMBINE THE LATEST IN RESEARCH, STATE-OF-THE-ART TECHNOLOGY AND A MULTIDISCIPLINARY CARE TEAM. THE CENTER BRINGS TOGETHER SPECIALISTS IN UROGYNECOLOGY, GASTROENTEROLOGY, SPECIALIZED RADIOLOGY, UROLOGY, COLORECTAL MEDICINE AND SURGERY, PHYSICAL MEDICINE AND REHABILITATION, NUTRITION AND PHYSICAL THERAPY TO HELP PATIENTS WITH PROBLEMS RELATED TO THE LOWER URINARY TRACT AND THE PELVIC FLOOR. ALMOST HALF OF ALL WOMEN AND ONE IN FIVE MEN WILL EXPERIENCE URINARY INCONTINENCE, AND ROUGHLY 10 PERCENT OF WOMEN WILL UNDERGO SURGERY FOR PELVIC ORGAN PROLAPSE OR URINARY INCONTINENCE. FORM 990, PART III, LINE 4A E. SENTARA LEIGH TOWERS WORK BEGAN IN DECEMBER 2011 ON A MULTI-PHASE, THREE-YEAR PROJECT TO BUILD A NEW SENTARA LEIGH HOSPITAL ON THE SITE OF THE CURRENT ONE. SENTARA OPENED THE NEW EAST TOWER IN NOVEMBER 2013. ALONG WITH OUR PLANNED WEST TOWER, IT REPLACES THREE 1970S-ERA WINGS AT THE NORFOLK, VIRGINIA HOSPITAL. THE TOWERS FEATURE STATE-OF-THE-ART PATIENT ROOMS WITH PRIVATE BATHROOMS, NO-STEP SHOWERS AND OVERNIGHT ACCOMMODATIONS FOR FAMILIES. THE PROJECT ALSO INCLUDES A 48-BED ORTHOPEDIC AND REHABILITATION CENTER ON THE FIRST FLOOR AND EMPLOYS PART OF THE OUTSIDE GARDEN SPACE FOR WALKING EXERCISES ON DIFFERENT GRADES AND SURFACES, MAKING IT A TRUE HEALING GARDEN. THE TOWERS PROJECT WILL CONTINUE AS OUR STAFF MAINTAINS EXCELLENT, UNINTERRUPTED PATIENT CARE DURING THE PHASED CONSTRUCTION. F. SENTARA HOSPICE HOUSE IN MARCH 2013, SENTARA OPENED SENTARA HOSPICE HOUSE, AN 8,311 SQUARE-FOOT FACILITY TO PROVIDE CARE FOR UP TO 12 PEOPLE AND THEIR FAMILIES. PREVIOUSLY, WITH ONLY FIVE LIVE-IN HOSPICES IN VIRGINIA AND NONE IN HAMPTON ROADS, PATIENTS WERE NOT OFTEN ABLE TO CHOOSE THIS CARE. NOW THEY CAN. G. ROCKINGHAM MEMORIAL HOSPITAL (RMH) WOMEN'S CENTER CONSTRUCTION BEGAN ON THE RMH FUNKHOUSER WOMEN'S CENTER IN JUNE 2012 AND WAS COMPLETED JUNE 2013. THE 15,000 SQUARE FOOT CENTER HOUSES WOMEN'S IMAGING, INCLUDING ADVANCED BREAST IMAGING/MAMMOGRAPHY AND BONE DENSITY SCREENING, RMH BREAST CARE, THE IMAGE RECOVERY CENTER AND RMH HEART CHECK FOR MEN AND WOMEN AND A SURGEON'S OFFICE. H. ROCKINGHAM MEMORIAL HOSPITAL (RMH) OUTPATIENT ORTHOPEDICS & ADVANCED IMAGING CENTER RMH GAINED APPROVAL FOR THE NEW CENTER IN JULY 2012. THE NEW FACILITY WILL BE AN ORTHOPEDIC AND SPORTS MEDICINE DESTINATION INCLUDING ADVANCED IMAGING, RMH ORTHOPEDICS AND SPORTS MEDICINE, REHABILITATION THERAPY, A SPORTS PERFORMANCE ARENA AND AN INTERVENTIONAL SUITE FOR PAIN MANAGEMENT AND SPECIAL PROCEDURES. THE CENTER IS SCHEDULED TO BE COMPLETED IN LATE 2015. I. MARTHA JEFFERSON OUTPATIENT CARE CENTER A NEW OUTPATIENT CARE CENTER OPENED IN THE FALL OF 2012, WITH A FREE-STANDING 24-HOUR ED AND IMAGING, LABORATORY SERVICES AND A PRIMARY CARE PRACTICE. THE ED SHORTENS TRAVEL TIME FOR EMS PROVIDERS, AND THE FACILITY AS A WHOLE HELPS CUT TRAVEL TIME FOR PATIENTS IN THE NORTHERN COUNTIES OF VIRGINIA. V. SENTARA QUALITY & PATIENT SAFETY DISTINCTIONS A. MEASURING QUALITY HEALTHCARE SINCE OUR HEALTH SYSTEM'S EARLIEST YEARS, WE HAVE BELIEVED THE COMMUNITY DESERVES HEALTHCARE THAT IS MEASURABLY BETTER. SENTARA'S GOAL IS TO BE ACCREDITED BY RESPECTED NATIONAL ORGANIZATIONS AND TO ACHIEVE TOP 10 PERCENT PERFORMANCE WHEREVER BENCHMARKS EXIST. WE ARE PROUD OF THE WORK WE HAVE DONE SO FAR TOWARD THIS GOAL, AS IT HAS BEEN RECOGNIZED IN MANY WAYS: 1. TOP 100 INTEGRATED HEALTHCARE NETWORK SENTARA HAS CONSISTENTLY RANKED AMONG THE NATION'S TOP INTEGRATED HEALTHCARE NETWORKS AS PUBLISHED IN MODERN HEALTHCARE'S FACT-BASED RANKING. THE ONLY HEALTHCARE SYSTEM IN THE COUNTRY TO BE AMONG THE NATION'S TOP 10 FOR ALL 15 YEARS OF THE SURVEY, SENTARA LANDED AT NUMBER ONE IN 2001, 2010 AND 2011. THE STUDY, PUBLISHED ANNUALLY, HIGHLIGHTS THE TOP 100 INTEGRATED HEALTH CARE NETWORKS ACROSS THE NATION AS SELECTED BY SDI, A HEALTH INFORMATION COMPANY. 2. USING TECHNOLOGY TO IMPROVE CARE SENTARA HEALTHCARE WAS BEEN NAMED ONE OF THE NATION'S MOST WIRED HEALTH SYSTEMS IN THE 2013 AND 2012 MOST WIRED SURVEY AND BENCHMARKING STUDY. HOSPITALS & HEALTH NETWORKS POLLED ABOUT 1,570 HOSPITALS. THE SURVEY ASSESSES HOSPITALS AND HEALTH SYSTEMS' MEANINGFUL USE OF ELECTRONIC MEDIA TECHNOLOGY IN FOUR AREAS INFRASTRUCTURE, BUSINESS AND ADMINISTRATIVE MANAGEMENT, CLINICAL QUALITY AND SAFETY, AND CARE CONTINUUM. 3. AWARD-WINING CARDIAC AND NEPHROLOGY CARE SENTARA HEART HOSPITAL/SENTARA NORFOLK GENERAL HOSPITAL IS A COMPREHENSIVE NETWORK OF PROVIDERS, FACILITIES AND SERVICES WORKING TOGETHER TO ENSURE THE HIGHEST LEVEL OF CARE. SENTARA NORFOLK GENERAL HOSPITAL HAS BEEN RANKED THE NUMBER ONE HOSPITAL IN VIRGINIA AND HAMPTON ROADS BY U.S. NEWS & WORLD REPORT. IN THE 2014-15 U.S. NEWS BEST HOSPITALS RANKINGS, THE HOSPITAL WAS RECOGNIZED WITH TWO NATIONALLY RANKED TOP 50 PROGRAMS. CARDIOLOGY AND HEART SURGERY ARE RANKED 44TH, WHICH MARKS THE PROGRAM'S 14TH CONSECUTIVE YEAR AMONG THE NATION'S ELITE PROGRAMS IN THE U.S. NEWS NATIONAL SURVEY. FOR THE FIRST TIME, EAR, NOSE AND THROAT IS ALSO AMONG THE NATION'S TOP 50 PROGRAMS AT NUMBER 41. THIS NATIONAL RANKING IS DUE, IN PART, TO INNOVATIVE PROCEDURES USED BY SURGEONS AND RADIOLOGISTS WITH EASTERN VIRGINIA MEDICAL SCHOOL MEDICAL GROUP FOR PATIENTS WITH HEAD AND NECK CANCERS AND TRAUMATIC INJURIES. THE TWO SPECIALTIES ARE THE ONLY TOP-50 RANKED HEART AND ENT PROGRAMS IN VIRGINIA. IN ADDITION TO THE NATIONAL RANKINGS, U.S. NEWS INCLUDED RANKINGS FOR STATE AND METRO AREAS. SEVEN SENTARA HOSPITALS WERE FEATURED IN THE RANKINGS, WITH SENTARA NORFOLK GENERAL HOSPITAL LISTED AT NUMBER ONE IN THE REGION AND NUMBER ONE IN THE STATE. MARTHA JEFFERSON HOSPITAL RANKED 11TH IN THE STATE AND SENTARA ROCKINGHAM MEMORIAL HOSPITAL 15TH. SENTARA VIRGINIA BEACH GENERAL HOSPITAL WAS 8TH IN THE STATE AND SECOND IN HAMPTON ROADS; SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER TIED WITH SENTARA LEIGH HOSPITAL FOR 20TH IN THE STATE AND WAS RANKED THIRD IN HAMPTON ROADS. SENTARA LEIGH WAS SIXTH IN HAMPTON ROADS. SENTARA PRINCESS ANNE HOSPITAL RANKED 15TH IN THE STATE AND THIRD IN HAMPTON ROADS. 4. OUTSTANDING CANCER CARE AFTER A THREE-DAY SURVEY IN 2012, THE AMERICAN COLLEGE OF SURGEONS' COMMISSION ON CANCER RE-ACCREDITED THE SENTARA CANCER NETWORK FOR THREE YEARS WITH COMMENDATIONS. THE ACCREDITATION WAS AS AN "INTEGRATED NETWORK" THE ONLY ONE IN VIRGINIA WITH NO DEFICIENCIES. 5. SENTARA SYSTEM STROKE TEAM IN FEBRUARY 2013, THE VIRGINIA HOSPITAL ASSOCIATION SELECTED SENTARA'S STANDARDIZED STROKE PROGRAM AS A LEADING BEST PRACTICE. THE SYSTEM STROKE TEAM AT SENTARA DEVELOPED A STANDARDIZED PROGRAM AND IMPLEMENTED IT AT 10 SENTARA HOSPITALS. THE TEAM EVALUATED THE ENTIRE STROKE PROCESS FROM DIAGNOSIS IN THE FIELD AND TREATMENT IN THE EMERGENCY DEPARTMENT TO PATIENT DISCHARGE. THE RESULTS INCLUDED A REDUCTION IN SYSTEM-WIDE STROKE MORTALITY FROM 11 PERCENT IN 2008 TO FIVE PERCENT IN 2012; A REDUCTION IN AVERAGE LENGTH OF STAY BY TWO DAYS WITH AN ASSOCIATED COST SAVINGS OF $1.1 MILLION; AND INCREASED STROKE CORE METRIC PERFORMANCE FROM 54.9 PERCENT OF GOAL MET IN 2009 TO 92.1 PERCENT OF GOAL MET IN 2012. 6.THE JOINT COMMISSION AND DET NORSKE VERITAS HEALTHCARE, INC. (DNVHC) ACCREDITATION THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS HAS GIVEN SEVERAL OF OUR HOSPITALS ITS GOLD SEAL OF APPROVAL AND DISEASE-SPECIFIC CARE CERTIFICATION. AN INDEPENDENT, NOT-FOR-PROFIT ORGANIZATION, THE JOINT COMMISSION ACCREDITS AND CERTIFIES MORE THAN 20,500 HEALTH CARE ORGANIZATIONS AND PROGRAMS IN THE UNITED STATES. JOINT COMMISSION ACCREDITATION AND CERTIFICATION IS RECOGNIZED NATIONWIDE AS A SYMBOL OF QUALITY THAT REFLECTS AN ORGANIZATION'S COMMITMENT TO MEETING CERTAIN PERFORMANCE STANDARDS. THEIR MISSION IS TO CONTINUOUSLY IMPROVE HEALTHCARE FOR THE PUBLIC BY EVALUATING HEALTHCARE ORGANIZATIONS AND INSPIRING THEM TO EXCEL IN PROVIDING SAFE AND EFFECTIVE CARE OF THE HIGHEST QUALITY AND VALUE. SENTARA NORFOLK GENERAL HOSPITAL EARNED THE JOINT COMMISSION'S VASCULAR CERTIFICATION. SENTARA NORFOLK GENERAL HOSPITAL, SENTARA LEIGH HOSPITAL, SENTARA VIRGINIA BEACH GENERAL HOSPITAL, SENTARA CAREPLEX HOSPITAL, SENTARA OBICI HOSPITAL, AND SENTARA PRINCESS ANNE HOSPITAL ALL EARNED PRIMARY STROKE CERTIFICATION. VOLUNTARY HOSPITALS ASSOCIATION "BLUEPRINTED" THE SENTARA HAMPTON ROADS HOSPITALS' STROKE PROGRAMS AS A "LEADING PRACTICE IN STROKE CARE" WITH A WEBINAR ORIGINATING FROM SENTARA. ROCKINGHAM MEMORIAL HOSPITAL (RMH) WAS CERTIFIED BY THE JOINT COMMISSION AS AN ADVANCED PRIMARY STROKE CENTER. THE SURVEYORS RECOGNIZED RMH'S PATIENT DISCHARGE PHONE CALL PROGRAM AND ITS COLLABORATION WITH LOCAL EMS PROVIDERS AS BEST PRACTICES IN STROKE CARE. DNVHC ACCREDITED MARTHA JEFFERSON HOSPITAL WITH A HOSPITAL CERTIFICATION AND A STROKE PROGRAM CERTIFICATION. DNVHC'S ACCREDITATION PROGRAM INVOLVES ANNUAL HOSPITAL SURVEYS AND ENCOURAGES HOSPITALS TO OPENLY SHARE INFORMATION ACROSS DEPARTMENTS AND TO DISCOVER IMPROVEMENTS IN CLINICAL WORKFLOWS AND SAFETY PROTOCOLS. DNVHC IS AN INTERNATIONAL COMPANY BASED OUTSIDE OF OSLO, NORWAY FOUNDED IN 1864. IN 2012, DNV MERGED WITH GERMAN-BASED GERMANISCHER LLOYD TO FORM THE DNV-GL GROUP. FORM 990, PART III, LINE 4A 7. AWARD FOR SUPPORTING BREASTFEEDING FOUR SENTARA HOSPITALS IN HAMPTON ROADS AND SIX PROGRAM CHAMPIONS RECEIVED BUSINESS INVESTMENT IN BABIES (BIB) AWARDS IN 2012 FROM THE BUSINESS CASE FOR BREASTFEEDING PROGRAM ADMINISTERED THROUGH CINCH, THE COALITION FOR INFANT AND CHILD HEALTH AT EASTERN VIRGINIA MEDICAL SCHOOL. SENTARA WAS AMONG THE EMPLOYERS CITED FOR CREATING A SUPPORTIVE ENVIRONMENT FOR NURSING MOTHERS TO PUMP BREAST MILK DURING THE WORKDAY BY PROVIDING TIME, PRIVATE SPACE, AND WRITTEN POLICIES. HOSPITALS INCLUDED SENTARA NORFOLK GENERAL, SENTARA LEIGH, SENTARA VIRGINIA BEACH GENERAL, AND SENTARA PRINCESS ANNE. 8. FIVE-STAR RANKINGS, SILVER ACHIEVEMENT, AND EXCELLENCE IN ACTION AWARDS FOR NURSING CENTERS IN 2013, FOR THE THIRD YEAR IN A ROW, TWO SENTARA NURSING CENTERS RECEIVED A FIVE STAR OVERALL RANKING IN U.S. NEWS & WORLD REPORT'S ANNUAL BEST NURSING HOMES SURVEY. BEST NURSING HOMES RECOGNIZES TOP-RATED HOMES IN THE UNITED STATES. OF MORE THAN 15,500 HOMES RATED, SENTARA NURSING CENTER WINDMERE, VIRGINIA BEACH AND NURSING CENTER PORTSMOUTH WERE AMONG FEWER THAN ONE IN EIGHT THAT RECEIVED A FIVE-STAR OVERALL RATING IN ALL FOUR QUARTERS. SENTARA NURSING CENTER BARCO, NORTH CAROLINA RECEIVED FIVE STARS IN 2012 AND 2013 AS WELL. SENTARA NURSING CENTER-CURRITUCK RECEIVED A 2012 SILVER-ACHIEVEMENT IN QUALITY AWARD FROM THE AMERICAN HEALTHCARE ASSOCIATION AND NATIONAL CENTER FOR ASSISTED LIVING. THE COMPETITIVE AWARDS FOLLOW CRITERIA IN THE BALDRIGE PERFORMANCE EXCELLENCE PROGRAM AND MARK MEASURABLE PROGRESS IN QUALITY IMPROVEMENTS IN LONG TERM CARE. B. PATIENT SAFETY OUR FOCUS GOES BEYOND THE BASICS OF MAKING HEALTHCARE SAFE FOR OUR PATIENTS. SENTARA HAS BUILT A STRONG "CULTURE OF SAFETY" TO REDUCE MEDICAL ERRORS BY MODELING SUCCESSFUL PROGRAMS FROM THE NUCLEAR POWER AND AVIATION INDUSTRIES. THIS CULTURE OF SAFETY PROMOTES BEHAVIORS THAT RESULT IN SAFE, RELIABLE AND EFFECTIVE CARE. THE FOUNDATION OF THIS CULTURE IS A STRONG ACCOUNTABILITY TO PERFORM REGIMENTED BEHAVIORS THAT REDUCE MEDICAL ERRORS. OUR STAFF USES GUIDELINES KNOWN AS "BEHAVIOR BASED EXPECTATIONS" OR BBE'S TO ENSURE THE HIGHEST STANDARD OF CARE. THE GOAL IS TO MAKE THESE TOOLS AND TECHNIQUES A HABIT. FOR OUR DEDICATION, WE HAVE RECEIVED NUMEROUS AWARDS FOR PATIENT SAFETY AND QUALITY OF CARE STANDARDS. 1. THE LEAPFROG HOSPITAL SURVEY THE LEAPFROG HOSPITAL RECOGNITION PROGRAM (LHRP) HONORS HOSPITALS THAT DEMONSTRATE EXCELLENCE OR IMPROVEMENT IN PATIENT SAFETY, QUALITY, AND RESOURCE UTILIZATION. IN 2012, THE LEAPFROG GROUP DEVELOPED THE HOSPITAL SAFETY SCORE, GRADING MORE THAN 2,600 OF THE NATION'S HOSPITALS ON PATIENT SAFETY. IN VIRGINIA, 58 HOSPITALS WERE NAMED IN THE REPORT, AND SEVEN SENTARA HOSPITALS ACHIEVED THE HIGHEST GRADE OF A FOR DELIVERING SAFE CARE TO PATIENTS. IN 2013, LEAPFROG RECOGNIZED SENTARA NORFOLK GENERAL HOSPITAL WITH AN A RATING. 2. INFECTION PREVENTION PREVENTION OF HEALTH CARE-ASSOCIATED INFECTIONS IS A NATIONAL CONCERN, AND SENTARA CONTINUALLY STRIVES TO REDUCE THESE CASES. ALL OF OUR HOSPITALS HAVE BEEN WORKING DILIGENTLY TO REDUCE THE OCCURRENCE OF VENTILATOR-ASSOCIATED PNEUMONIA (VAP), WHICH CAN DEVELOP IN PATIENTS WHO HAVE BEEN ON MECHANICAL VENTILATION FOR 48 HOURS OR MORE. IN 2013, SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER MARKED NINE CONSECUTIVE YEARS WITH ZERO CASES OF VAP, WHICH NO OTHER HOSPITAL IN THE COUNTRY CAN CLAIM. THE DEPARTMENT OF HEALTH AND HUMAN SERVICES AND THE CRITICAL CARE SOCIETIES COLLABORATIVE HAVE RECOGNIZED WILLIAMSBURG FOR OUTSTANDING ACHIEVEMENT AND LEADERSHIP IN THE ELIMINATION OF VAP. VOLUNTARY HOSPITALS OF AMERICA (VHA), A VOLUNTARY NATIONAL ORGANIZATION FOCUSED ON HEALTH CARE FINANCIAL PERFORMANCE THROUGH CLINICAL EXCELLENCE AND SUPPLY CHAIN MANAGEMENT, "BLUEPRINTED" THE PRACTICES AT SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER AS A MODEL FOR HOSPITALS ACROSS THE COUNTRY. 3. IMPROVING PATIENT SAFETY THROUGH TECHNOLOGY SENTARA HEALTHCARE PROVIDES THE SENTARA ECARE HEALTH NETWORK. THE CLINICAL SYSTEM USES INNOVATIVE TECHNOLOGY TO LINK PATIENT MEDICAL INFORMATION BETWEEN OUR HOSPITALS, PHYSICIAN PRACTICES AND OTHER HEALTH CARE SITES OVER A PROTECTED NETWORK, ENABLING THE SECURE SHARING OF PATIENT INFORMATION, INCREASING PATIENT SAFETY AND REDUCING PREVENTABLE MEDICAL ERRORS. MYCHART, THE COMPONENT OF ECARE THAT ALLOWS PATIENTS TO ACCESS PART OF THEIR MEDICAL RECORDS, WAS PROMOTED TO PATIENTS IN 2011. A PHONE APP WAS CREATED TO PROVIDE EASY ACCESS AS WELL. CURRENTLY, 140,000 PATIENTS ACCESS MYCHART EACH YEAR. 2013 MARKED THE 13TH YEAR THAT WE EMPLOYED OUR EICU REMOTE MONITORING SYSTEM FOR OUR SICKEST HOSPITAL PATIENTS. SENTARA WAS THE FIRST HOSPITAL SYSTEM IN THE COUNTRY TO IMPLEMENT THE EICU SYSTEM, WHICH USES A NETWORK OF CAMERAS, MONITORS, ALERTS, AND TWO-WAY COMMUNICATION LINKS. DOCTORS AND CRITICAL CARE NURSES AT THE EICU COMMAND CENTER MAKE VIRTUAL ROUNDS ON ICU PATIENTS. THIS SENTARA-PIONEERED TECHNOLOGY IS NOW USED TO HELP CARE FOR PATIENTS IN NEARLY 5,000 ICU BEDS NATIONALLY. ANOTHER SAFETY INITIATIVE ADOPTED BY SENTARA IS BEDSIDE MEDICATION VERIFICATION, INCLUDING BAR-CODING TECHNOLOGY. NATIONAL STUDIES HAVE FOUND THAT BEDSIDE VERIFICATION CAN REDUCE HOSPITAL MEDICATION ERRORS BY NEARLY 70 PERCENT. VI. COMMITMENT TO THE COMMUNITY AS A NOT-FOR-PROFIT HEALTHCARE ORGANIZATION, WE CONTINUOUSLY REINVEST IN THE COMMUNITY-BY PURCHASING THE MOST MEDICALLY ADVANCED TECHNOLOGY; BUILDING NEW, STATE-OF-THE-ART HEALTHCARE FACILITIES; TRAINING MEDICAL PROFESSIONALS; AND PROVIDING THE HIGHEST QUALITY HEALTHCARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IT'S NOT JUST OUR MISSION, IT'S OUR COMMITMENT TO THE COMMUNITY. MARTHA JEFFERSON HOSPITAL WAS HONORED BY THE CHARLOTTESVILLE REGIONAL CHAMBER OF COMMERCE WITH THE 2012 HOVEY S. DABNEY AWARD FOR CORPORATE CITIZENSHIP. ORGANIZATIONS RECEIVING THIS AWARD ARE KNOWN FOR ENGAGING IN SOUND, SUCCESSFUL BUSINESS PRACTICE AND BEING GOOD PARTNERS WITH OTHER BUSINESSES, INVESTING DIRECTLY IN THE ECONOMIC AND CULTURAL ADVANCEMENT OF THE COMMUNITY, PURSING A POSITIVE WORK ENVIRONMENT, AND INSPIRING BY EXAMPLE. THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES AWARDED ROCKINGHAM MEMORIAL HOSPITAL (RMH) WITH A $3.1 MILLION, FIVE-YEAR GRANT IN NOVEMBER 2012 TO HELP FAMILIES AT RISK FROM SUBSTANCE ABUSE. AS A FISCAL AGENT, RMH OVERSEES ADMINISTRATION OF THE GRANT, AND CENTRAL SHENANDOAH VALLEY FAMILY PARTNERSHIP HELPS FAMILIES WITH CHILDREN IN DANGER OF BEING REMOVED FROM THEIR HOMES BECAUSE OF SUBSTANCE ABUSE BY A CAREGIVER. SOLIANT HEALTH NAMED MARTHA JEFFERSON HOSPITAL THE TOP VOTE-GETTER IN THE COUNTRY IN ITS ANNUAL "MOST BEAUTIFUL HOSPITAL" SURVEY IN 2012. HERE ARE SOME OF THE OTHER WAYS WE'VE INVESTED IN THE PEOPLE WE SERVE: A. THE SENTARA HEALTH FOUNDATION WE ESTABLISHED THE SENTARA HEALTH FOUNDATION IN 1998 TO IMPROVE HEALTH AND QUALITY OF LIFE THROUGHOUT SOUTHEASTERN VIRGINIA AND NORTH CAROLINA, AND TO DEMONSTRATE OUR NOT-FOR-PROFIT MISSION. THE FOUNDATION HAS TOUCHED THE LIVES OF MANY VIRGINIA RESIDENTS FROM THE EASTERN SHORE TO GREATER HAMPTON ROADS THROUGH GRANTS SUPPORTING COMMUNITY HEALTH PROGRAMS. SPECIFICALLY, IT HAS AWARDED OVER $10 MILLION IN GRANTS, INCLUDING $601,800 IN 2013. PROGRAMS INCLUDE DENTAL CARE, PRENATAL SUPPORT, MEDICATION ASSISTANCE, AND REDUCED-COST PRIMARY CARE. THE FOUNDATION ALSO SPONSORS COMMUNITY EVENTS, SUCH AS THE SUSAN G. KOMEN TIDEWATER RACE FOR THE CURE, THE AMERICAN HEART ASSOCIATION HEART GALA AND HEART WALK AND THE AMERICAN CANCER SOCIETY RELAY FOR LIFE. B. IN SUPPORT OF THE COMMUNITY LED BY A VOLUNTEER COMMUNITY BOARD OF DIRECTORS, SENTARA PROUDLY PROVIDES CARE TO ALL, AND REINVESTS IN THE COMMUNITY IN NUMEROUS WAYS: 1. CONTRIBUTIONS EACH YEAR, WE PROVIDE MILLIONS OF DOLLARS IN BENEFITS TO THE COMMUNITY. IN 2013, SENTARA REINVESTED $299,989,000 INTO OUR COMMUNITIES. SENTARA EARMARKED $20,454,000 FOR HEALTH CARE TEACHING PROGRAMS TO ENSURE A QUALIFIED POOL OF PHYSICIANS AND NURSES. WE ALSO SPENT $5,355,000 TO SUPPORT LOCAL COMMUNITY PROGRAMS THAT PROVIDED HEALTH EVENTS AND HEALTH SCREENINGS TO INDIVIDUALS. WE FUNDED $274,180,000 IN UNCOMPENSATED PATIENT CARE FOR PEOPLE WHO WERE UNINSURED OR UNDERINSURED. 2. MEDICALLY UNDERSERVED SENTARA MEDICAL GROUP'S PHYSICIANS AND MEDICAL STAFF VOLUNTEER THOUSANDS OF HOURS TO EASTERN VIRGINIA MEDICAL SCHOOL (EVMS), FREE CLINICS, COMMUNITY EDUCATION, AND CIVIC AND CHARITABLE PROGRAMS. WE SUPPORT AND OPERATE UNCOMPENSATED CARE CLINICS THROUGHOUT THE REGION, INCLUDING THE SENTARA AMBULATORY CARE CENTER (ACC). THE ACC IS A COLLABORATIVE EFFORT WITH EVMS AND IS LOCATED NEAR SENTARA NORFOLK GENERAL HOSPITAL. IT FEATURES AN APPOINTMENT SIDE, WHICH FUNCTIONS LIKE A DOCTOR'S OFFICE, AND A SAME-DAY "WALK-IN" SERVICE SIDE FOR MORE PRESSING AND IMMEDIATE HEALTH CONCERNS. FORM 990, PART III, LINE 4A IN NOVEMBER 2012, SENTARA PARTNERED WITH THE FREE FOUNDATION TO OPEN A VIRGINIA BEACH FACILITY. THE NON-PROFIT COLLECTS, REFURBISHES, STERILIZES, AND DISTRIBUTES USED DURABLE MEDICAL EQUIPMENT TO THOSE WHO CANNOT AFFORD IT. THE SENTARA HEALTH FOUNDATION SUPPORTED THE FREE SET-UP AND DONATED SPACE. C. IN SUPPORT OF COMMUNITY HEALTH INITIATIVES 1. SENTARA COMMUNITY HEALTH AND PREVENTION AS PART OF SENTARA'S COMMITMENT TO PREVENTIVE HEALTH MEASURES, WE SPONSOR AND HOST SPECIAL COMMUNITY INITIATIVES THAT ARE DESIGNED TO EDUCATE THE COMMUNITY ABOUT HEALTH. OUR CAMPAIGNS HAVE INCLUDED: -NATIONAL DRUG TAKE BACK DAY -DRIVE-THRU FLU SHOTS -WOMEN'S DAY HEALTH FAIR -WEBINARS FOR WEIGHT LOSS SURGERY -PAINT FACEBOOK PINK TO RAISE AWARENESS FOR BREAST HEALTH -TEXT OUTREACH TO PREGNANT WOMEN -EATING FOR LIFE, AN AWARD-WINNING NUTRITION AND HEALTHY EATING PROGRAM -KNOW YOUR NUMBERS, A CARDIOVASCULAR RISK REDUCTION AND HEALTH IMPROVEMENT PROGRAM -WALK-ABOUT WITH HEALTHY EDGE, A WALKING PROGRAM THAT ENCOURAGES WALKING FOR CARDIOVASCULAR HEALTH -GET OFF YOUR BUTT: STAY SMOKELESS FOR LIFE, A SMOKING CESSATION PROGRAM -HEALTHY HEART PROGRAM, A CARDIOVASCULAR DISEASE REDUCTION PROGRAM -SENTARA LIVING, A COMPREHENSIVE WELLNESS PROGRAM FOR SENIORS -SENTARA'S MOBILE MAMMOGRAPHY UNIT VISITS NUMEROUS WORK SITES EVERY YEAR TO ENCOURAGE WELLNESS. -CAMP LIGHTHOUSE, A GRIEF CAMP FOR KIDS AGES 5-16 WHO HAVE EXPERIENCED THE DEATH OF A LOVED ONE -DON'T SIT ON COLON CANCER HEALTHY EATING AND SCREENING CAMPAIGN AND 5K -PROSTATE CANCER EDUCATION AND FREE SCREENINGS -MOBILE ER TENTS AT VIRGINIA BEACH ROCK 'N' ROLL HALF MARATHON -A NEW BLOG FOR WOMEN OF CHILDBEARING AGE WITH INFORMATION AND SUPPORT FOR MOTHERS AND MOTHERS-TO-BE -COURAGE F.U.N, A PROJECT TO COMBAT CHILDHOOD OBESITY THROUGH SOCCER TRAINING AND WEIGHT MANAGEMENT EDUCATION -LUNG CANCER SCREENING EDUCATION FOR SMOKERS 55 AND OLDER WHO HAVE SMOKED A PACK A DAY FOR OVER 30 YEARS 2. TOBACCO-FREE ENVIRONMENTS HOSPITALS SEE THE EFFECTS OF TOBACCO EVERY DAY IN HEART DISEASE, RESPIRATORY AILMENTS, AND CANCERS. IN RESPONSE, SENTARA HAS IMPLEMENTED OUR TOBACCO-FREE ENVIRONMENT (TFE) CAMPAIGN. NO ONE IS ALLOWED TO SMOKE, CHEW OR DIP ANYWHERE ON CAMPUS, NOT EVEN IN CARS. THE GOAL IS NOT JUST TO AVOID THE AESTHETIC AND HEALTH ISSUES OF SECOND-HAND SMOKE, BUT TO PUT SENTARA'S MISSION INTO PRACTICE BY HELPING STAFF, PATIENTS, AND VISITORS QUIT THIS HABIT. AS OF 2011, ALL OF OUR FACILITIES ADOPTED THE TOBACCO FREE ENVIRONMENT INITIATIVES. WE HAVE EARNED THE AMERICAN CANCER SOCIETY "EXCELLENCE IN THE WORKPLACE TOBACCO CONTROL" AWARD FOR OUR EFFORTS. VII. OPTIMA HEALTH PLAN A. IMPROVING HEALTH OPERATING WITH THE SAME MISSION IN MIND -- TO IMPROVE HEALTH EVERY DAY --IS OUR HEALTH PLAN, OPTIMA HEALTH. WITH MORE THAN 25 YEARS OF HEALTH INSURANCE EXPERIENCE, OPTIMA HEALTH PROVIDES HEALTH PLAN COVERAGE TO MORE THAN 440,000 MEMBERS THROUGHOUT THE STATE. OUR QUALITY PROVIDER NETWORK FEATURES MORE THAN 15,000 PROVIDERS INCLUDING SPECIALISTS, PRIMARY CARE PHYSICIANS, AND HOSPITALS. B. SUPPORTING THE COMMUNITY OPTIMA HEALTH PROVIDES MORE THAN INSURANCE FOR OUR COMMUNITIES; WE REACH OUT THROUGH HEALTH SCREENINGS, EVENTS, EDUCATION MATERIALS, AND IMMUNIZATIONS. OUR HIGHLIGHTS IN 2013 INCLUDED: -HEALTH IMPROVEMENT EVENT PARTICIPATION NUMBERS INCREASED FROM THE PREVIOUS YEAR (IN 2012 THERE WERE 43,263 PARTICIPANTS COMPARED TO 43,351 PARTICIPANTS IN 2013.) THESE EVENTS WERE OFFERED TO CHURCHES, EMPLOYER GROUPS INCLUDING COMMUNITY HEALTH CENTERS AND OTHER COMMUNITY LOCATIONS. -EATING FOR LIFE, WALKABOUT WITH HEALTHY EDGE, HEALTHY HEART, MEDITATION, TAI CHI AND YOGA, OUR CARDIOVASCULAR DISEASE RISK REDUCTION PROGRAMS, COLLECTIVELY INCREASED IN DISTRIBUTION BY 9 PERCENT OVER 2012. -FLU PATROL ADMINISTERED A TOTAL OF 10,583 IMMUNIZATIONS. 8,573 WERE GIVEN TO OPTIMA HEALTH INSURED EMPLOYERS IN VIRGINIA. THIS NUMBER SURPASSED OUR GOAL OF 8,000. -PREVENTIVE BIRTHDAY CARD REMINDERS FOR PREVENTIVE HEALTH SCREENINGS DELIVERED MESSAGES TO 255,945 ADULT HEALTH PLAN MEMBERS. PREVENTIVE BIRTHDAY CARD REMINDERS FOR CHILDREN DELIVERED ANNUAL PHYSICAL EXAM MESSAGES TO 149,026 HEALTH PLAN MEMBERS. SELF-CARE MANUALS WERE DISTRIBUTED TO HEALTH PLAN MEMBERS AND COMMUNITY ORGANIZATIONS. 1,775 WENT OUT IN 2013. -OUR TOBACCO CESSATION PROGRAM HAD 11,404 INTERVENTIONS IN 2013. WE SENT OUT 46,261 CAMPUS-WIDE ELECTRONIC INTERVENTIONS TO PROMOTE THE GREAT AMERICAN SMOKEOUT AND DISTRIBUTED 5,719 QUIT KITS. OUR CERTIFIED TOBACCO TREATMENT SPECIALISTS FACILITATED 17 TOBACCO CESSATION AWARENESS GROUP PROGRAMS FOR 56 PARTICIPANTS AND PROVIDED 38 TOBACCO AWARENESS PRESENTATIONS FOR COMMUNITY AND EMPLOYER GROUPS. WE CONTACTED OVER 320 INPATIENTS FOUR WEEKS AFTER THEIR HOSPITAL DISCHARGE FOR TOBACCO CESSATION FOLLOW-UP. -DURING THE MONTH OF NOVEMBER, 17,029 EMPLOYEES COMPLETED A HEALTH RISK ASSESSMENT IN CONJUNCTION WITH THE HEALTHY EDGE/MISSION: HEALTH PROGRAM. OF THOSE, 9,690 EMPLOYEES ATTENDED 132 ON-SITE HEALTH SCREENINGS WITHIN SIX MONTHS. IN 2013, WE IDENTIFIED 5,746 EMPLOYEES WITH TWO OR MORE HEALTH RISKS AND 5,423 AGREED TO ENGAGE WITH A HEALTH COACH. 3,238 EMPLOYEES AGREED TO CONTINUE ENGAGING WITH THEIR HEALTH COACH. 1,554 EMPLOYEES FROM 2013 WILL NO LONGER NEED TO ENGAGE WITH A HEALTH COACH. OUR EMPLOYEE MAMMOGRAPHY PROGRAM OFFERED ALL FEMALE SENTARA EMPLOYEES AGE 40 AND OVER THE OPPORTUNITY FOR A MAMMOGRAM. 678 EMPLOYEES SUBMITTED MAMMOGRAPHY, COLORECTAL CANCER SCREENING AND PROSTATE CANCER SCREENING PROGRAM COUPONS IN 2013. -12,205 CITY OF VIRGINIA BEACH AND VIRGINIA BEACH PUBLIC SCHOOL EMPLOYEES ENROLLED IN THE WELLNESS FOR LIFE PROGRAM. OF THOSE, 7,199 EMPLOYEES ATTENDED 59 ON-SITE HEALTH SCREENINGS WITHIN NINE MONTHS. 4,996 EMPLOYEES WERE IDENTIFIED WITH TWO OR MORE HEALTH RISKS. OVERALL, 80 PERCENT OF ELIGIBLE EMPLOYEES PARTICIPATED. -HAMPTON ROADS SANITATION DISTRICT AWARDED A THREE-YEAR HEALTH IMPROVEMENT SERVICES CONTRACT TO OPTIMA HEALTH & PREVENTIVE SERVICES. THIS UNIQUE CONTRACT IS BETWEEN OPTIMA HEALTH AND A GROUP THAT IS INSURED WITH ANOTHER CARRIER FOR OUR OUTSTANDING WELLNESS SERVICES. OUR HEALTH PROGRAMMING IMPACTED 812 EMPLOYEES IN 2013. -POCKET EKG SCREENED 341 PARTICIPANTS IN 2013. WE IDENTIFIED 320 (94 PERCENT) OF THOSE PARTICIPANTS WITH CARDIOVASCULAR HEALTH RISKS. -WE SUPPORTED COMMUNITY PARTNERS INCLUDING VIRGINIA DEPARTMENT OF HEALTH, VIRGINIA DIABETES COUNCIL, PENINSULA AGENCY ON AGING, COMMUNITY HEALTH CENTERS, AND VARIOUS CHURCHES WITH CARDIOVASCULAR HEALTH RISK REDUCTION RESOURCES, CANCER RISK REDUCTION PROGRAMS AND CLINICAL EXPERTISE FOR PROGRAM DEVELOPMENT. C. ACCREDITATION AND AWARDS THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) HAS RECOGNIZED OUR QUEST FOR EXCELLENCE BY AWARDING OUR COMMERCIAL HMO AND MEDICAID HMO PRODUCTS WITH AN "EXCELLENT" ACCREDITATION STATUS. WE HAVE MAINTAINED THIS RATING SINCE 1998, A CLAIM NO OTHER HEALTH PLAN IN THE REGION CAN MAKE. OPTIMA HEALTH RECEIVED AN A+ RATING FROM THESTREET.COM (WEISS RATINGS, INC.) FOR FINANCIAL SOUNDNESS, RECOGNIZING OUR ABILITY TO WITHSTAND SEVERE ECONOMIC ADVERSITY AND SHOWING EXCEPTIONAL FINANCIAL STRENGTH. THESTREET.COM IS THE NATION'S LEADING INDEPENDENT PROVIDER OF RATINGS AND ANALYSES OF FINANCIAL SERVICE COMPANIES, MUTUAL FUNDS, AND STOCKS. THE RATING RECOGNIZES OPTIMA HEALTH AS AN OUTSTANDING INSURER OFFERING EXCELLENT FINANCIAL STABILITY FOR ITS CUSTOMERS. FEWER THAN FIVE PERCENT OF THE NATION'S HMOS AND HEALTH INSURERS MEET THESTREET.COM RATING'S CRITERIA FOR EXCEPTIONAL FINANCIAL STRENGTH. VIII. CONCLUSION THROUGH ALL THAT WE DO AT SENTARA HEALTHCARE AND OPTIMA HEALTH, WE STRIVE TO IMPROVE HEALTH EVERY DAY, WHETHER IT IS BY USING THE MOST ADVANCED MEDICAL EQUIPMENT POSSIBLE, CARING FOR A NEW PATIENT WHO MIGHT NOT OTHERWISE BE HELPED, OR RESEARCHING NEW WAYS TO PREVENT OR CURE CHALLENGING HEALTH CONDITIONS. WHILE OUR OFFICIAL PATIENT COUNT COULD BE FIGURED HOSPITAL BY HOSPITAL AND PHYSICIAN'S OFFICE BY PHYSICIAN'S OFFICE, WE BELIEVE WE MAY HELP OVER THREE MILLION PEOPLE WHETHER ENROLLED "PATIENTS" OR COMMUNITY MEMBERS - ACROSS VIRGINIA AND NORTH CAROLINA, THANKS TO ALL OF OUR VITAL HEALTH SERVICES AND PROGRAMS OFFERED EACH YEAR. FORM 990, PART VI, SECTION A, LINE 2 DAVID BERND AND HOWARD KERN HAVE A BUSINESS RELATIONSHIP THROUGH COMMON OWNERSHIP OF AN ENTITY UNRELATED TO THE ORGANIZATION. 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 HAD ONE CLASS OF MEMBER, THE SOLE MEMBER BEING SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. 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 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER, SENTARA HEALTHCARE, A 501(C)(3) ORGANIZATION, HAD EXCLUSIVE AUTHORITY TO DIRECT AND MANAGE THE OPERATIONS AND AFFAIRS OF THE ORGANIZATION AND TO MAKE ALL DECISIONS REGARDING THE BUSINESS OF THE ORGANIZATION, SUBJECT TO THE OVERSIGHT OF THE ORGANIZATION'S BOARD OF DIRECTORS. BOARD MEMBERS SERVED IN AN ADVISORY CAPACITY, MAKING RECOMMENDATIONS TO THE MEMBER REGARDING THE ESTABLISHMENT OF HOSPITAL POLICIES, THE MAINTENANCE OF QUALITY PATIENT CARE, AND THE PROVISION OF INSTITUTIONAL PLANNING IN A MANNER RESPONSIVE TO LOCAL COMMUNITY NEEDS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION WAS PART OF THE SENTARA HEALTHCARE 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. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, BOARD-NOMINATED OFFICERS, AND KEY EMPLOYEES SUBMIT AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE AND CERTIFY TO THE COMPLETION AND ACCURACY OF THE INFORMATION DISCLOSED. SENTARA HEALTHCARE SYSTEM'S LEGAL DEPARTMENT MONITORS TRANSACTIONS INVOLVING POTENTIAL CONFLICTS OF INTEREST, TO ENSURE THAT THEY ARE REASONABLE AND AT ARM'S LENGTH. REPORTS ON SUCH TRANSACTIONS ARE MADE TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD AS NECESSARY. FORM 990, PART VI, SECTION B, LINE 15 AS PART OF THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM"), THE ORGANIZATION FOLLOWED PROCESSES AND PROCEDURES SET FORTH IN ITS GOVERNING DOCUMENTS TO ENSURE COMPLIANCE WITH ITS OBLIGATIONS AS A 501(C)(3) HEALTHCARE ORGANIZATION TO PAY DISQUALIFIED PERSONS REASONABLE COMPENSATION. SUCH PROCESSES AND PROCEDURES ARE INTENDED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERNAL REVENUE CODE SECTION 4958 REGULATIONS. THE COMPENSATION PHILOSOPHY OF THE SYSTEM AS A WHOLE IS TO BASE OVERALL COMPENSATION AND BENEFITS FOR EXECUTIVES ON NOT-FOR-PROFIT MARKET COMPARABLES, ADJUSTED AS APPLIED TO EACH EXECUTIVE, TAKING INTO CONSIDERATION THE INDIVIDUAL SKILLS, EXPERIENCE, TENURE AND PERFORMANCE OF THE EXECUTIVE BEING COMPENSATED AND OVERALL PERFORMANCE OF THE ORGANIZATION. IN LINE WITH THIS PHILOSOPHY, THE SYSTEM PERFORMED SUBSTANTIAL DUE DILIGENCE AS TO MARKET COMPARABLES. THE SYSTEM'S COMPENSATION COMMITTEE, WHICH CONSISTS OF SYSTEM BOARD MEMBERS WITHOUT CONFLICTS OF INTERESTS, ENGAGED AN OUTSIDE CONSULTANT, WHO REPORTS TO THE COMPENSATION COMMITTEE, TO CONDUCT A STUDY ASSESSING THE COMPETITIVENESS OF TOTAL COMPENSATION (INCLUDING CASH COMPENSATION, BENEFITS AND PERQUISITES) OF ITS SENIOR EXECUTIVES PRIOR TO MAKING DECISIONS REGARDING ANNUAL BASE SALARY ADJUSTMENTS, APPROVING INCENTIVE AWARDS, OR CONSIDERING PROGRAMMATIC CHANGES. THE STUDY COMPARED THE COMPENSATION OF THE SYSTEM'S SENIOR EXECUTIVES TO COMPENSATION DATA FROM MULTIPLE PUBLISHED SURVEY SOURCES BASED ON THE SENIOR EXECUTIVE'S FUNCTIONAL RESPONSIBILITY. IN CONDUCTING THE STUDY, THE CONSULTANT TARGETED OTHER NOT-FOR-PROFIT HEALTH SYSTEMS OF SIMILAR SIZE BASED ON NET REVENUE AND COMPLEXITY. FOR HEALTH PLAN POSITIONS, HEALTH PLANS WITH SIMILAR PREMIUMS, OR MEMBERS, WERE TARGETED. THE CONSULTANT ALSO CONDUCTS A REVIEW OF THE ORGANIZATION'S PERFORMANCE RELATIVE TO A GROUP OF NOT-FOR-PROFIT HEALTH SYSTEMS OF COMPARABLE SIZE AND SCOPE OF OPERATIONS EVERY YEAR. THE MOST RECENT STUDY COMPARED SENTARA'S PERFORMANCE TO 29 NOT-FOR-PROFIT HEALTHCARE SYSTEMS BASED ON NET REVENUE GROWTH, OPERATING MARGIN, BOND RATING, AND QUALITATIVE PERFORMANCE MEASURES BASED ON RANKINGS FROM SDI'S NATIONAL TOP INTEGRATED HEALTH NETWORKS. 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 VICE CHAIRMAN, PRESIDENT, AND TREASURER; WHO ALSO SERVE AS PRESIDENT AND COO, SENIOR VICE PRESIDENT, AND SENIOR VICE PRESIDENT AND CFO OF THE SYSTEM, RESPECTIVELY. THE PROCESS WAS LAST UNDERTAKEN DURING 2013 FOR ALL POSITIONS LISTED. 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 XI, LINE 9: RECLASS OF INTERCOMPANY BALANCES TO EQUITY -15,859,310. FORM 990, PART V, LINE 1A THE 501(C)(3) SOLE MEMBER OF THE ORGANIZATION, SENTARA HEALTHCARE, 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, LINE 1B BOARD MEMBER INDEPENDENCE: BOARD MEMBERS ARE ELECTED ANNUALLY BY THE ORGANIZATION'S 501(C)(3) SOLE MEMBER, SENTARA HEALTHCARE. THE GOVERNING BOARD OF SENTARA HEALTHCARE IS A COMMUNITY-BASED BOARD COMPRISED OF 16 VOTING MEMBERS, 12 OF WHICH ARE CONSIDERED INDEPENDENT, AS DEFINED IN THE FORM 990 INSTRUCTIONS. FORM 990, PART VI, LINE 14 DOCUMENT RETENTION POLICY: THE ORGANIZATION HAD A WRITTEN POLICY FOR DOCUMENT RETENTION AND DESTRUCTION WHICH WAS APPROVED BY MANAGEMENT. FORM 990, PART VI, LINE 16B JOINT VENTURE POLICY: THE SENTARA HEALTHCARE SYSTEM HAD A WRITTEN POLICY REQUIRING EVALUATION OF ITS PARTICIPATION IN JOINT VENTURE ARRANGEMENTS UNDER APPLICABLE FEDERAL TAX LAW. THIS POLICY WAS APPROVED BY MANAGEMENT. THE ORGANIZATION ALSO TOOK STEPS TO SAFEGUARD THE ORGANIZATION'S EXEMPT STATUS WITH RESPECT TO SUCH ARRANGEMENTS. STATEMENT FILED PURSUANT TO TREASURY REGULATION SEC. 1.6038-2(J)(3): THE TAXPAYER IS A MEMBER OF THE SENTARA HEALTHCARE ("SHC") CONTROLLED GROUP. SHC, EIN 52-1271901, OWNS BAY PRIMEX INSURANCE COMPANY, LTD., A CONTROLLED FOREIGN CORPORATION. SHC FURNISHES ALL INFORMATION REQUIRED OF THE TAXPAYER BY IRC SECTION 6038 AND THE REGULATIONS THEREUNDER WITH RESPECT TO BAY PRIMEX INSURANCE COMPANY, LTD. THEREFORE, PURSUANT TO TREASURY REGULATION SEC. 1.6038-2(J)(2), THE TAXPAYER IS EXCEPTED FROM PROVIDING SUCH INFORMATION. THE REQUIRED INFORMATION IS E-FILED WITH SHC'S FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX. IN ADDITION, ONE MEMBER OF THE SHC CONTROLLED GROUP OWNS A NON-CONTROLLING INTEREST IN VIRGINIA SOLUTIONS SPC, LTD., A CONTROLLED FOREIGN CORPORATION. ALL INFORMATION REQUIRED OF THE TAXPAYER BY IRC SECTION 6038 AND THE REGULATIONS THEREUNDER WITH RESPECT TO VIRGINIA SOLUTIONS SPC, LTD. IS FURNISHED BY HALIFAX REGIONAL HOSPITAL, EIN 54-0648699. THEREFORE, PURSUANT TO TREASURY REGULATION SEC. 1.6038-2(J)(2), THE TAXPAYER IS EXCEPTED FROM PROVIDING SUCH INFORMATION. THE REQUIRED INFORMATION IS E-FILED WITH THE ORGANIZATION'S FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX. CLARKSVILLE SENIOR CARE LLC 2204 WILBORN AVENUE SOUTH BOSTON VA 24592 541957066 SENIOR CARE VA 501(C)(3) 11A TYPE I HALIFAX REGIONAL HOSPITAL 1 HALIFAX REGIONAL DEV FOUNDATION INC 2204 WILBORN AVENUE SOUTH BOSTON VA 24592 541801459 HLTH/WELFARE VA 501(C)(3) 11A TYPE I HALIFAX REGIONAL HOSPITAL 1 HALIFAX REGIONAL HOSPITAL INCORPORATED 2204 WILBORN AVENUE SOUTH BOSTON VA 24592 540648699 HEALTHCARE VA 501(C)(3) LN3_HOSPITALCOOPINSE SENTARA HEALTHCARE 1 HALIFAX REGIONAL LONG TERM CARE INC 103 ROSE HILL DRIVE SOUTH BOSTON VA 24592 546074529 SENIOR CARE VA 501(C)(3) 11A TYPE I HALIFAX REGIONAL HOSPITAL 1 HALIFAX REGIONAL PROPERTIES INC 2204 WILBORN AVENUE SOUTH BOSTON VA 24592 541801463 HLTH/WELFARE VA 501(C)(3) 11A TYPE I HALIFAX REGIONAL HOSPITAL 1 SENTARA HEALTHCARE 6015 POPLAR HALL DRIVE NORFOLK VA 23502 521271901 HEALTH CARE VA 501(C)(3) LN7_NORMALGOVTSUPPOR N/A 0 SENTARA PRINCESS ANNE HOSPITAL 6015 POPLAR HALL DRIVE NORFOLK VA 23502 521277419 HEALTH CARE VA 501(C)(3) LN3_HOSPITALCOOPINSE SENTARA HOSPITALS 1 SENTARA HOSPITALS 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541547408 HEALTH CARE VA 501(C)(3) LN3_HOSPITALCOOPINSE SENTARA HEALTHCARE 1 SENTARA MEDICAL GROUP 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541217184 HEALTH CARE VA 501(C)(3) LN9_MORETHAN30PCTCON SENTARA HEALTHCARE 1 SENTARA ENTERPRISES 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541917649 HEALTH CARE VA 501(C)(3) LN9_MORETHAN30PCTCON SENTARA HEALTHCARE 1 SENTARA LIFE CARE CORP 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541217183 HEALTH CARE VA 501(C)(3) LN9_MORETHAN30PCTCON SENTARA HEALTHCARE 1 MPB INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541346393 TITLE HOLDING COMPANY VA 501(C)(2) SENTARA ENTERPRISES 1 OPTIMA HEALTH PLAN 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541283337 HMO VA 501(C)(3) 11A - I SENTARA HEALTHCARE 1 SENTARA RMH MEDICAL CENTER 2010 HEALTH CAMPUS DRIVE HARRISONBURG VA 22801 540506331 HEALTH CARE VA 501(C)(3) LN3_HOSPITALCOOPINSE SENTARA HEALTHCARE 1 VALLEY WELLNESS CENTER 501 STONE SPRING ROAD HARRISONBURG VA 22801 521309257 PREVENTATIVE HEALTH/REHAB VA 501(C)(3) LN9_MORETHAN30PCTCON ROCKINGHAM MEMORIAL HOSPITAL 1 MJH FOUNDATION 500 MARTHA JEFFERSON DRIVE CHARLOTTESVILLE VA 22911 541401357 INVEST/MGT SVCS FOR MARTHA JEFFERSON HOSPITAL VA 501(C)(3) 11A - I MARTHA JEFFERSON HOSPITAL 1 MARTHA JEFFERSON HOSPITAL FOUNDATION 500 MARTHA JEFFERSON DRIVE CHARLOTTESVILLE VA 22911 300041113 FUNDRAISING VA 501(C)(3) 11A - I MARTHA JEFFERSON HOSPITAL 1 MARTHA JEFFERSON HOSPITAL 500 MARTHA JEFFERSON DRIVE CHARLOTTESVILLE VA 22911 540261840 HEALTH CARE VA 501(C)(3) LN3_HOSPITALCOOPINSE SENTARA HEALTHCARE 1 MANAGEMENT SERVICES LLC 814 GREENBRIER CIRCLE CHESAPEAKE VA 23320 541365012 HLTH MGT SV VA N/A OBICI REAL ESTATE HOLDINGS LLC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 261749881 RE RENTAL VA N/A PRINCESS ANNE AMB SURG MGT LLC 1975 GLENN MITCHELL STE 300 VA BEACH VA 23456 204920880 HEALTH CARE VA N/A VA BEACH AMBULATORY SURGERY CENTER 1700 WILL O WISP DRIVE VA BEACH VA 23454 541448218 HEALTH CARE VA N/A AMER HEALTH EVAL CTR-WMSBG LLC 739 THIMBLE SHOALS STE 105 NEWPORT NEWS VA 23606 263761741 HEALTH CARE VA N/A CANCER CENTERS OF VA LLC 5900 LAKE WRIGHT DRIVE NORFOLK VA 23502 201338518 HEALTH CARE VA N/A HAMPTON ROADS LITHOTRIPSY LLC 225 CLEARFIELD AVE VIRGINIA BEACH VA 23462 200942600 HEALTH CARE VA N/A HEALTHCARE PERFORMANCE IMPROVEMENT LLC 5041 CORPORATE WOODS DR STE 180 VIRGINIA BEACH VA 23462 204024074 CONSULTING VA N/A RADIOLOGY SERVICES OF HAMPTON ROADS LC 814 GREENBRIER CIRCLE STE L CHESAPEAKE VA 23320 541774472 HEALTH CARE VA N/A SENTARA OBICI AMBULATORY SURGERY LLC 2750 GODWIN BLVD SUFFOLK VA 23434 260144898 HEALTH CARE VA N/A ST LUKES PROPERTIES LLC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 272774684 MOB RENTAL VA N/A POTOMAC INOVA HEALTHCARE ALLIANCE LLC 8110 GATEHOUSE RD STE 400W FALLS CHURCH VA 22042 541802733 HEALTHCARE VA PHC RELATED -983815 2896696 0 1 0.50000 CAREPLEX WEST LLC 18000 W SARAH LANE STE 250 BROOKFIELD WI 53045 202738977 RENTAL RE WI N/A PORT WARWICK II LLC 18000 WEST SARAH LANE STE 250 BROOKFIELD WI 53045 202739075 RENTAL RE WI N/A OPACC I LLC 18000 WEST SARAH LANE STE 250 BROOKFIELD WI 53045 392021431 RENTAL RE WI N/A ORTHOPAEDIC HOSPITAL MANAGEMENT LLC 3000 COLISEUM DRIVE HAMPTON VA 23666 274185117 MGT SVCS VA N/A CAREPLEX ORTHOPAEDIC ASC LLC 3000 COLISEUM DRIVE HAMPTON VA 23666 271867311 HEALTH CARE VA N/A PORT WARWICK III LLC 18000 WEST SARAH LANE STE 250 BROOKFIELD WI 53045 611499371 RENTAL RE WI N/A VALIANCE HEALTH LLC 3190 PEOPLES DRIVE HARRISONBURG VA 22801 541866081 HEALTH CARE VA N/A PHYSICAL THERAPY ACACLLC 501 ALBEMARLE SQUARE CHARLOTTESVILLE VA 22901 260080717 HEALTH CARE VA N/A NORTHERN VIRGINIA HOME CARE LLC 601 SOUTH CARLIN SPRINGS RD ARLINGTON VA 22204 453940053 HOME CARE VA N/A MNS SUPPLY CHAIN NETWORK LLC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 454235238 GPO DE N/A LAKE RIDGE AMBULATORY SURGERY CENTER LLC 12825 MINNIEVILLE RD STE 204 WOODBRIDGE VA 22192 455347932 HEALTH CARE VA PHC RELATED -287156 1816035 0 1 0.42030 SOUTHSIDE HEALTH SERVICES INC 2204 WILBORN AVENUE SOUTH BOSTON VA 24592 541417772 HEALTH SERVICES VA N/A C 1 DOMINION HEALTH MEDICAL ASSOCIATES LTD 2204 WILBORN AVENUE SOUTH BOSTON VA 24592 541060357 PHYS PRACTICE VA N/A C 1 SENTARA HOLDINGS INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541555638 HOLDING COMPANY VA N/A C 1 SENTARA HEALTH PLANS INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 522368125 TPA VA N/A C 1 OPTIMA HEALTH GROUP 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541473382 HMO VA N/A C 1 OPTIMA HEALTH INSURANCE COMPANY 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541642752 HEALTH INSURANCE VA N/A C 1 OPTIMA BEHAVIORAL HEALTH SERVICES 6015 POPLAR HALL DRIVE NORFOLK VA 23502 621382666 MENTAL HEALTH SVCS VA N/A C 1 SENTARA VENTURES INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541688615 HOLDING COMPANY VA N/A C 1 SMG INNOVATIONS INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 203730331 HEALTH CARE VA N/A C 1 SENTARA OBICI PROFESSIONAL CENTER 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541445865 RE RENTAL VA N/A C 1 SENTARA STRATEGIC SOLUTIONS INC 6015 POPLAR HALL DRIVE NORFOLK VA 23502 541020941 HEALTH CARE VA N/A C 1 POTOMAC VENTURES CORP 2300 OPITZ BLVD WOODBRIDGE VA 22191 541441420 PHARMACY VA POTOMAC HOSPITAL CORP OF PW C 628932 1625192 1.00000 1 ROCKINGHAM HEALTH SERVICES INC 2010 HEALTH CAMPUS DRIVE HARRISONBURG VA 22801 541721387 CONTRACTING SVCS VA N/A C 1 MARTHA JEFFERSON MEDICAL ENTERPRISES INC 500 MARTHA JEFFERSON DRIVE CHARLOTTESVILLE VA 22911 541841528 MEDICAL BILLING SVCS VA N/A C 1 BAY PRIMEX INSURANCE COMPANY LTD PO BOX 1051 GRAND CAYMAN CJ KY1-1102 980704114 INSURANCE CJ N/A C 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 1 SENTARA HOSPITALS B 43971647 CORP BOOKS/REC SENTARA HOSPITALS M 5282119 CORP BOOKS/REC SENTARA HOSPITALS N 13541541 CORP BOOKS/REC SENTARA HOSPITALS O 591934 CORP BOOKS/REC SENTARA MEDICAL GROUP C 3736657 SENTARA MEDICAL GROUP M 4047457 CORP BOOKS/REC SENTARA ENTERPRISES C 1079792 CORP BOOKS/REC SENTARA ENTERPRISES M 1079524 CORP BOOKS/REC POTOMAC VENTURES CORP A 32903 CORP BOOKS/REC POTOMAC VENTURES CORP O 212061 CORP BOOKS/REC OPTIMA HEALTH PLAN L 283219 CORP BOOKS/REC SENTARA HEALTH PLANS L 535874 CORP BOOKS/REC