HALIFAX REGIONAL LONG-TERM CARE INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- HALIFAX REGIONAL LONG-TERM CARE INC (EIN 54-6074529)
- Tax period
- 2011-09-01 to 2012-08-31
- Filed
- 2013-07-12
- IRS object ID
- 201341939349300804
- Schema version
- 2011v1.5
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-07-12T10:35:11-05:00 | Timestamp |
| Tax Period End Date | 2012-08-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1676 International Drive | AddressLine1 |
| City | McLean | City |
| State | VA | State |
| ZIP Code | 22102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-09-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 546074529 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX REGIONAL LONG TERM CARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % STEWART R NELSON | InCareOfName |
| Name Control | HALI | NameControl |
| Phone | 4345173183 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 103 ROSE HILL DRIVE | AddressLine1 |
| City | SOUTH BOSTON | City |
| State | VA | State |
| ZIP Code | 24592 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEWART NELSON | Name |
| Title | CFO | Title |
| Date Signed | 2013-07-11 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7032868000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CHRIS A LUMSDEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2204 WILBORN AVENUE | AddressLine1 |
| City | SOUTH BOSTON | City |
| State | VA | State |
| ZIP Code | 24592 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12976002 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.THEWOODVIEW.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1967 | YearFormation |
| State Legal Domicile | VA | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF HALIFAX REGIONAL LONG TERM CARE, INC. IS TO PROVIDE THE HIGHEST QUALITY OF CARE TO THE INDIVIDUALS REQUIRING LONG TERM CARE SERVICES, RESULTING IN THE HIGHEST ACHIEVABLE QUALITY OF LIFE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 227 | TotalNbrEmployees |
| Total Nbr Volunteers | 90 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1600 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 752525 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 11310567 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 10783158 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 205438 | InvestmentIncomePriorYear |
| Investment Income Current Year | 166274 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 53962 | OtherRevenuePriorYear |
| Other Revenue Current Year | 53977 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 11571567 | TotalRevenuePriorYear |
| Total Revenue Current Year | 11755934 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1400000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6804234 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7273574 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4281124 | OtherExpensePriorYear |
| Other Expenses Current Year | 4156409 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 12485358 | TotalExpensesPriorYear |
| Total Expenses Current Year | 11429983 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -913791 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 325951 | RevenuesLessExpensesCY |
| Total Assets BOY | 9670971 | TotalAssetsBOY |
| Total Assets EOY | 9694172 | TotalAssetsEOY |
| Total Liabilities BOY | 2742023 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2586112 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6928948 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 7108060 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF HALIFAX REGIONAL LONG TERM CARE, INC. IS TO PROVIDE THE HIGHEST QUALITY OF CARE TO THE INDIVIDUALS REQUIRING LONG TERM CARE SERVICES, RESULTING IN THE HIGHEST ACHIEVABLE QUALITY OF LIFE. FOR MORE INFORMATION, SEE SCHEDULE O. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 9983538 | Expense |
| Revenue | 10783158 | Revenue |
| Description | THE WOODVIEW IS COMPOSED OF A 180-BED DUALLY CERTIFIED (MEDICAID AND MEDICARE) NURSING FACILITY, (THE WOODVIEW), PROVIDING PERSONAL SERVICES, HEALTH CARE SERVICES AND REHABILITATION SERVICES; AND AN 18-BED LICENSED ASSISTED LIVING NEIGHBORHOOD (SEASONS AT THE WOODVIEW), FOR INDIVIDUALS WITH ALZHEIMER'S DISEASE OR A RELATED DEMENTIA. FOR MORE INFORMATION, SEE SCHEUDLE O. | Description |
| Total Program Service Expense | 9983538 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | true | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 39 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 227 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | false | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | STEWART R NELSON | NamePerson |
| Telephone Number | 4345173183 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2204 WILBORN AVENUE | AddressLine1 |
| City | SOUTH BOSTON | City |
| State | VA | State |
| ZIP Code | 24592 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (10 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| DAVID H WHITE JR | ||||||||
| CHAIRMAN | 1.0 | X | X | 0 | 0 | 0 | ||
| J AUBREY HOUGHTON | ||||||||
| TREASURER | 1.0 | X | X | 0 | 0 | 0 | ||
| CAROL C THOMAS | ||||||||
| VICE CHAIRMAN | 1.0 | X | X | 0 | 0 | 0 | ||
| HABIB BASSIL MD | ||||||||
| SECRETARY | 1.0 | X | X | 0 | 59600 | 0 | ||
| JAMES PRIEST DDS | ||||||||
| BOARD MEMBER (BEGINNING 11/11) | 1.0 | X | 0 | 0 | 0 | |||
| JAMES WITKO MD | ||||||||
| BOARD MEMBER (THROUGH 11/11) | 1.0 | X | 0 | 10365 | 0 | |||
| CHRIS A LUMSDEN | ||||||||
| CHIEF EXECUTIVE OFFICER | 4.0 | X | 13756 | 403161 | 39911 | |||
| STEWART R NELSON | ||||||||
| CHIEF FINANCIAL OFFICER | 4.0 | X | 9224 | 264926 | 27595 | |||
| THOMAS S KLUGE | ||||||||
| CHIEF OPERATING OFFICER | 4.0 | 7610 | 222672 | 42802 | X | |||
| CONNIE ZAMORA | ||||||||
| DIRECTOR OF LONG TERM CARE SER | 40.0 | 126887 | 0 | 9917 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 157477 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 960724 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 120225 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| FUNCTIONAL PATHWAYS | |||||
| 317 EBENEZER ROAD SUITE 7 | KNOXVILLE | TN | 37923 | REHABILITATION SVCS | 609371 |
| SODEXHO SERVICES INC | |||||
| 806 TYVOLA ROAD | CHARLOTTE | NC | 28290 | DIETARY MANAGEMENT | 160956 |
| VIRGINIA HOSPITAL LAUNDRY | |||||
| 1601 NORTH 17TH STREET | RICHMOND | VA | 23219 | LAUNDRY SERVICES | 149659 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| Related Organizations | 750000 | RelatedOrganizations |
| All Other Contributions | 2525 | AllOtherContributions |
| Total Contributions | 752525 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 623000 | 10741736 | 10741736 |
| BARBER & BEAUTY SHOP REVENUE | 812900 | 41422 | 41422 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 10783158 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 208332 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $208,332 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1178010 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1220068 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -42058 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -42058 | TotalRevenueColumn |
| Exclusion | -$42,058 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| CAFE & VENDING | 722210 | 52759 | $52,759 |
| MISCELLANEOUS | 900099 | 1218 | $1,218 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 53977 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11755934 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10783158 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $220,251 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39482 | Total |
| Management And General | 39482 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5546861 | Total |
| Program Services | 4935777 | ProgramServices |
| Management And General | 611084 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 255783 | Total |
| Program Services | 225996 | ProgramServices |
| Management And General | 29787 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1029721 | Total |
| Program Services | 917234 | ProgramServices |
| Management And General | 112487 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 401727 | Total |
| Program Services | 354943 | ProgramServices |
| Management And General | 46784 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 77626 | Total |
| Management And General | 77626 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23903 | Total |
| Management And General | 23903 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9171 | Total |
| Management And General | 9171 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1151231 | Total |
| Program Services | 1068682 | ProgramServices |
| Management And General | 82549 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 690919 | Total |
| Program Services | 619332 | ProgramServices |
| Management And General | 71587 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 256209 | Total |
| Program Services | 251448 | ProgramServices |
| Management And General | 4761 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7061 | Total |
| Program Services | 6445 | ProgramServices |
| Management And General | 616 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2357 | Total |
| Program Services | 2357 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 444331 | Total |
| Program Services | 444331 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 143194 | Total |
| Management And General | 143194 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| FOOD STOCK | 577783 | 577783 | ||
| PHARMACEUTICALS | 175625 | 175625 | ||
| BAD DEBT | 189400 | 189400 | ||
| EDUCATION | 22661 | 18978 | 3683 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 384938 | Total |
| Program Services | 195207 | ProgramServices |
| Management And General | 189731 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11429983 | Total |
| Program Services | 9983538 | ProgramServices |
| Management And General | 1446445 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 773308 | BOY |
| EOY | 839789 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 269996 | BOY |
| EOY | 142551 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1063333 | BOY |
| EOY | 970513 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40214 | BOY |
| EOY | 40181 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60384 | BOY |
| EOY | 38049 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 12404077 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 8603515 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3579323 | BOY |
| EOY | 3800562 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3819140 | BOY |
| EOY | 3617005 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65273 | BOY |
| EOY | 245522 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9670971 | BOY |
| EOY | 9694172 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1249255 | BOY |
| EOY | 1219148 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 385000 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50621 | BOY |
| EOY | 109837 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1057147 | BOY |
| EOY | 1257127 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2742023 | BOY |
| EOY | 2586112 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6928948 | BOY |
| EOY | 7108060 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6928948 | BOY |
| EOY | 7108060 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9670971 | BOY |
| EOY | 9694172 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 325951 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -146839 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX REGIONAL HOSPITAL INCORPORATED | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540648699 | EIN |
| Type Of Organization | 03 | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Amount | $11,420,812 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 11420812 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $1,168 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 1168 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER LOBBYING ACTIVITIES | Identifier |
| Return Reference | SCHEDULE C, PART II-B, LINE 1 (I) | ReturnReference |
| Explanation | A PORTION OF DUES PAID TO THE VIRGINIA HEALTH CARE ASSOCIATION IS ATTRIBUTABLE TO LOBBYING EXPENSES. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | true | IncludedOnFS |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 199253 | OtherCostOrOtherBasis |
| Book Value | 199253 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8029174 | OtherCostOrOtherBasis |
| Depreciation | 6023975 | Depreciation |
| Book Value | 2005199 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3413860 | OtherCostOrOtherBasis |
| Depreciation | 2405864 | Depreciation |
| Book Value | 1007996 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 761790 | OtherCostOrOtherBasis |
| Depreciation | 173676 | Depreciation |
| Book Value | 588114 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3800562 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO THIRD PARTY PROGRAMS | $171,649 |
| DUE TO AFFILIATE | $203,802 |
| PATIENT SECURITY DEPOSITS | $142,551 |
| OTHER LONG-TERM LIABILITIES | $134,627 |
| ACCRUED PENSION OBLIGATION | $604,498 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1257127 | TotalOfAmounts |
| Total Revenue | 11755934 | TotalRevenue |
| Total Expenses | 11429983 | TotalExpenses |
| Excess Or Deficit For Year | 325951 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 37483 | NetUnrealizedGLOnInvestments |
| Other | -$184,322 | OtherAmount |
| Total Adjustments | -146839 | TotalAdjustments |
| Excess Or Deficit Per FS | 179112 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 11599924 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 37483 | NetUnrealizedGainsInvestments |
| Other Revenues | -184322 | OtherRevenues |
| Revenue Not Rptd F990 | -146839 | RevenueNotRptdF990 |
| Revenue Subtotal | 11746763 | RevenueSubtotal |
| Investment Expenses Not Included | 9171 | InvestmentExpensesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 9171 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 11755934 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 11420812 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 11420812 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 9171 | InvestmentExpensesNotIncluded2 |
| Expenses Not Rptd On Fin Stmt | 9171 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 11429983 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PATIENT ACCOUNTS | SCHEDULE D, PART IV, LINE 2B | THE ORGANIZATION SERVES AS CUSTODIAN OVER PATIENT ACCOUNTS, AND THESE AMOUNTS HAVE BEEN INCLUDED ON THE AUDITED FINANCIAL STATEMENTS AS A LIABILITY. |
| UNCERTAIN TAX POSITIONS | SCHEDULE D, PART X, LINE 2 | THE COMPANY IS GENERALLY EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AS AMENDED. THE COMPANY DOES NOT BELIEVE ITS FINANCIAL STATEMENTS INCLUDE (OR REFLECT) ANY UNCERTAIN TAX POSITIONS. |
| RECONCILIATION OF CHANGE IN NET ASSETS AND REVENUE | SCHEDULE D, PART XI, LINE 8 AND XII, LINE 2D | OTHER CHANGES IN PENSION LIABILITIES ................ $ (184,322) |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHRIS A LUMSDEN | |||||||||||||
| 13756 | 330306 | 0 | 30000 | 0 | 42855 | 2188 | 29612 | 558 | 7553 | 16502 | 440326 | 0 | 0 |
| STEWART R NELSON | |||||||||||||
| 9224 | 221585 | 0 | 20000 | 0 | 23341 | 1772 | 23988 | 126 | 1709 | 11122 | 290623 | 0 | 0 |
| THOMAS S KLUGE | |||||||||||||
| 7610 | 189331 | 0 | 10000 | 0 | 23341 | 1695 | 22935 | 1250 | 16922 | 10555 | 262529 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXECUTIVE COMPENSATION DETERMINATION | Identifier |
| Return Reference | SCHEDULE J, PART I, LINE 3 | ReturnReference |
| Explanation | THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE METHODS LISTED ON LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (21 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION MISSION | PART III, LINE 1 | THE PURPOSE OF HALIFAX REGIONAL HEALTH SYSTEM IS TO PROVIDE THE HIGHEST QUALITY CARE BASED ON THE HEALTHCARE NEEDS OF THE PEOPLE WE SERVE. HALIFAX REGIONAL LONG TERM CARE, INC. IS ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR CARRY OUT THE PURPOSES OF HALIFAX REGIONAL HOSPITAL, INC. THE FUNCTIONS TO BE PERFORMED ARE TO PROVIDE EXTENDED CARE, OUTPATIENT CARE, HOME CARE, ASSISTED LIVING CARE, SENIOR LIVING COMMUNITY OR HOME FOR THE AGED, AND RELATED MEDICAL SERVICES FOR HALIFAX REGIONAL HOSPITAL, INC. OR ANY OTHER SERVICES REQUESTED BY HALIFAX REGIONAL HOSPITAL, INC. AND TO CARRY OUT OTHER EXCLUSIVELY CHARITABLE, EDUCATIONAL, OR SCIENTIFIC PURPOSES OF HALIFAX REGIONAL HOSPITAL, INC. |
| EXEMPT PURPOSE ACHIEVEMENTS | PART III, LINE 4A | THIS ORGANIZATION, DOING BUSINESS AS THE WOODVIEW AND SEASONS AT THE WOODVIEW IS COMPOSED OF A 180-BED DUALLY CERTIFIED (MEDICAID AND MEDICARE) NURSING FACILITY, (THE WOODVIEW), PROVIDING PERSONAL SERVICES, HEALTH CARE SERVICES AND REHABILITATION SERVICES; AND AN 18-BED LICENSED ASSISTED LIVING NEIGHBORHOOD (SEASONS AT THE WOODVIEW), FOR INDIVIDUALS WITH ALZHEIMER'S DISEASE OR A RELATED DEMENTIA. 61.8 PERCENT OF THE FACILITY'S REVENUES WERE REIMBURSABLE UNDER THE MEDICAID PROGRAM IN FY12 AND 19.6 PERCENT WERE REIMBURSABLE UNDER MEDICARE. THE WOODVIEW UTILIZES EXCESS REVENUE OVER EXPENSES TO UPGRADE FACILITIES, TO PURCHASE NEW EQUIPMENT AND TO UPGRADE CLINICAL AND INFORMATION TECHNOLOGY IN ORDER TO IMPROVE QUALITY AND RESIDENT SAFETY. THE WOODVIEW WORKS IN CONJUNCTION WITH HALIFAX REGIONAL HOSPITAL TO PROVIDE HEALTH INFORMATION TO THE COMMUNITY. WITH THE HIGH PREVALENCE OF ALZHEIMER'S DISEASE (5.4 MILLION AMERICANS) AND WITH A HIGH PERCENT OF NURSING HOME RESIDENTS DIAGNOSED WITH ALZHEIMER'S DISEASE OR RELATED DEMENTIAS, THE WOODVIEW DEVOTES RESOURCES TO ACTIVITIES THAT WILL HELP RAISE AWARENESS OF ALZHEIMER'S DISEASE AND THAT WILL HELP THOSE AFFECTED BY THE DISEASE TO LEARN AND UNDERSTAND MORE ABOUT IT. IN ADDITION, THE WOODVIEW HELPS SUPPORT COMMUNITY ACTIVITIES BY PROVIDING STAFF EXPERTISE AND RESOURCES FOR A NUMBER OF ORGANIZATIONS. COMMUNITY HEALTH IMPROVEMENT SERVICES & EDUCATION *EDUCATIONAL FAMILY NIGHT THE WOODVIEW WELCOMES THE RESIDENTS' FAMILIES AND THE COMMUNITY INTO THE FACILITY FOR PROGRAMS OF INTEREST TO THE GENERAL PUBLIC. PROGRAMS DURING FY12 INCLUDED HOSPICE CARE AND HEALTHY COOKING. *WOODVIEW AND SEASONS AT THE WOODVIEW NEWSLETTERS IN-HOUSE PREPARED NEWSLETTERS FROM THE WOODVIEW AND SEASONS AT THE WOODVIEW ARE DISTRIBUTED TO OVER 520 FAMILIES, BUSINESSES AND INDIVIDUALS EACH MONTH. THE WOODVIEW WHISTLE INCLUDES A SPECIAL FEATURE FOCUSING ON AN EMPLOYEE AND ONE OR MORE RESIDENTS AND FEATURES OTHER ITEMS OF INTEREST RELATED TO ACTIVITIES AT THE WOODVIEW. MAKING THE WOODVIEW WHISTLE ESPECIALLY INTERESTING, ARE DRAWINGS BY RESIDENTS THAT DEPICT LIFE AND TIMES AND/OR ACTIVITIES THEY FONDLY REMEMBER. OFTEN THE ARTIST WILL INCLUDE A HANDWRITTEN EXPLANATION WITH THE ARTWORK. ALSO INCLUDED ARE PHOTOS THAT DEPICT RESIDENTS INVOLVED IN THE LIFE OF THE FACILITY. THE SEASONS AT THE WOODVIEW NEWSLETTER FEATURES EDUCATIONAL INFORMATION RELATED TO ALZHEIMER'S DISEASE AND GENERAL INFORMATION ABOUT THE RESIDENTS AND FACILITY EVENTS. *HEALTHY LIVING EXPO AGAIN THIS YEAR, THE WOODVIEW AND SEASONS AT THE WOODVIEW PARTICIPATED IN HALIFAX REGIONAL HEALTH SYSTEM'S HEALTHY LIVING EXPO, AN ANNUAL COMMUNITY HEALTH FAIR THAT PROVIDES A MYRIAD OF FREE HEALTH SCREENINGS AND HEALTH AND WELLNESS EDUCATIONAL ACTIVITIES AND INFORMATION TO THE PUBLIC. IN ADDITION TO ASSISTING WITH PLANNING FOR THIS EVENT, THE WOODVIEW AND SEASONS AT THE WOODVIEW PROVIDED LONG TERM CARE AND ALZHEIMER'S DISEASE INFORMATION. APPROXIMATELY 500 PEOPLE WERE REACHED THROUGH THIS EVENT. *ALZHEIMER'S SUPPORT GROUP THE WOODVIEW PROVIDES FREE SPACE FOR ALZHEIMER'S SUPPORT GROUP MEETINGS ON THE FOURTH WEDNESDAY OF EACH MONTH. THE MEETINGS ARE CO-FACILITATED BY THE SEASONS AT THE WOODVIEW MANAGER AND A MEMBER OF THE HALIFAX REGIONAL HOSPITAL STAFF. MEETINGS ARE DESIGNED TO PROVIDE EDUCATION AND SUPPORT FOR FAMILY MEMBERS AND CAREGIVERS OF THOSE EXPERIENCING ALZHEIMER'S DISEASE OR OTHER FORMS OF DEMENTIA. *OTHER IN FY12 WOODVIEW STAFF PROVIDED INFORMATION AND PRESENTATIONS ON CAREERS IN HEALTHCARE DURING CAREER DAYS AT LOCAL ELEMENTARY SCHOOLS. WOODVIEW STAFF ALSO WORKED WITH HABITAT FOR HUMANITY'S "PUMPKIN PATCH" FUNDRAISER TO RAISE MONEY FOR HABITAT HOMES. |
| EXEMPT PURPOSE ACHIEVEMENTS | PART III, LINE 4A CONTINUED | FINANCIAL AND IN-KIND CONTRIBUTIONS *ALZHEIMER'S MEMORY WALK IN FY2012 THE WOODVIEW AND SEASONS AT THE WOODVIEW STAFF AND VOLUNTEERS PLANNED, COORDINATED AND HOSTED THE ANNUAL ALZHEIMER'S SUPPORT WALK. A NUMBER OF FUNDRAISING EVENTS HELD THROUGHOUT THE YEAR BY THE WOODVIEW AND SEASONS LEAD UP TO WALK DAY WITH 80 WALKERS PARTICIPATING. FUNDS RAISED IN THESE EVENTS WERE DONATED TO THE SOUTHEASTERN VIRGINIA CHAPTER OF THE ALZHEIMER'S ASSOCIATION. THE MONEY IS USED LOCALLY TO SUPPORT ALZHEIMER'S RELATED PROGRAMS INCLUDING FAMILY ORIENTATIONS, THE 24-HOUR HELPLINE, EDUCATIONAL SEMINARS AND TRAINING SESSIONS FOR BOTH FAMILY AND PROFESSIONAL CAREGIVERS, THE SAFE RETURN PROGRAM, LOCAL SUPPORT GROUPS AND THE SPEAKER'S BUREAU, ALL OF WHICH ASSIST INDIVIDUALS AND FAMILIES AFFECTED BY THE DISEASE. NEARLY $4000 WAS COLLECTED FROM FUND-RAISING EFFORTS THROUGHOUT THE YEAR INCLUDING BAKE SALES, ICE CREAM SUNDAE SALES, YARD SALES, DONATIONS AND THE ALZHEIMER'S WALK ITSELF. IN ADDITION, THE WOODVIEW PROVIDED SPACE AND LUNCH FOR THE AREA ALZHEIMER'S WALK TEAM COMMITTEE CAPTAIN KICK-OFF MEETING. *OTHER IN-KIND CONTRIBUTIONS LONG-TERM CARE RESIDENTS ARE ENCOURAGED TO BECOME INVOLVED IN THE LIFE OF THE FACILITY AS WELL AS THE LIFE OF THE COMMUNITY, ADDING TO THEIR QUALITY OF LIFE ALONG WITH ASSISTING THOSE TO WHOM THEIR EFFORTS ARE CONCENTRATED. WITH LEADERSHIP AND COORDINATION FROM THE STAFF, IN FY12, THE WOODVIEW FAMILY - RESIDENTS, VOLUNTEERS AND STAFF ALIKE - CO-HOSTED A FALL BAZAAR WHICH THIS YEAR INCLUDED VENDORS FROM THE COMMUNITY. FUNDS RAISED WERE DONATED TO THE HALIFAX COUNTY CANCER ASSOCIATION. AGAIN IN FY12 WOODVIEW RESIDENTS PREPARED HAND-MADE DOLLS AND STUFFED ANIMALS FOR THE "TOYS FOR TOTS" PROGRAM AND MADE AND DONATED COOKIES TO THE UNITED MISSIONARY SOUP KITCHEN FOR THANKSGIVING. FACILITY USE THE WOODVIEW AND SEASONS AT THE WOODVIEW PROVIDE FREE SPACE AND AVAILABLE EQUIPMENT FOR CLINICAL TRAINING PROGRAMS. *THE WOODVIEW SERVES AS A CLINICAL SITE FOR: -HALIFAX COUNTY HIGH SCHOOL NURSE AIDE CLASSES CLASS; 20 STUDENTS PER SEMESTER -SOUTHSIDE VIRGINIA COMMUNITY COLLEGE, SVCC; 50 NURSING ASSISTANT STUDENTS PER YEAR -SVCC; 20 LPN AND RN STUDENTS PER YEAR -DANVILLE COMMUNITY COLLEGE NURSE AIDE CLASSES - 50 NURSING ASSISTANT STUDENTS PER YEAR *THE WOODVIEW ALSO SERVES AS A TESTING SITE FOR BELTONE HEARING AIDS. COMMUNITY BUILDING THE WOODVIEW AND SEASONS AT THE WOODVIEW TAKE PRIDE IN BEING A CONTRIBUTING MEMBER OF THE SOUTH BOSTON AND HALIFAX COUNTY COMMUNITY AND AS SUCH, REACH OUT INTO THE COMMUNITY IN A VARIETY OF WAYS: *INTERGENERATIONAL PROGRAMS THE WOODVIEW VISITS THE DAN RIVER WEE SCHOOL ON A REGULAR BASIS TO PROVIDE LEARNING EXPERIENCES FOR BOTH THE YOUNG CHILDREN AND THE RESIDENTS. THE CHILDREN AND RESIDENTS VISIT TOGETHER, WORK ON CRAFTS AND ENJOY VARIOUS HOLIDAY PRESENTATIONS AND PROJECTS. PEOPLE OF ALL AGES FROM APPROXIMATELY 50 COMMUNITY GROUPS-CHURCHES, DANCE GROUPS, BANDS AND VARIOUS CLUBS-SHARE THEIR TALENTS WITH RESIDENTS, STAFF MEMBERS, AND FAMILIES AT BOTH THE WOODVIEW AND SEASONS AT THE WOODVIEW. WOODVIEW RESIDENTS OFTEN JOIN OTHER COMMUNITY GROUPS TO HELP WITH LOCAL EVENTS, TOO. EACH YEAR, THE WOODVIEW PLANS, COORDINATES AND HOSTS COMMUNITY EVENTS ESPECIALLY FOR CHILDREN. APPROXIMATELY SIXTY CHILDREN FROM THE COMMUNITY ENJOYED THE WOODVIEW'S ANNUAL EASTER EGG HUNT THIS YEAR WITH CHILDREN ENJOYING FUN ACTIVITIES AND DELICIOUS REFRESHMENTS PROVIDED BY THE FACILITY. DINNER WITH SANTA WAS A TREAT FOR APPROXIMATELY THIRTY-FIVE LOCAL YOUNGSTERS AND APPROXIMATELY 150 CHILDREN PARTICIPATED IN THE FY12 SAFE TRICK OR TREAT. IN FY12 AMERICAN LEGION POST #8 PROVIDED THE RESIDENTS WITH A VETERANS DAY PROGRAM AND CELEBRATION AND THE WOMAN'S AUXILIARY OF POST #8 PROVIDED GIFTS FOR RESIDENTS AT CHRISTMAS, EASTER, VALENTINE'S DAY AND VETERAN'S DAY. IN FY12 SEASONS AT THE WOODVIEW PARTNERED WITH SEVERAL CHURCH YOUTH GROUPS AND A GROUP OF HOME SCHOOLED CHILDREN TO WORK ON SPECIAL PROJECTS, A VALUABLE EXPERIENCE FOR BOTH THE YOUTH AND THE RESIDENTS. THESE PROGRAMS OFFERED THE YOUTH THE OPPORTUNITY TO LEARN HOW TO RELATE TO INDIVIDUALS WITH COGNITIVE IMPAIRMENT AND TO LEARN COMPASSION FOR THE ELDERLY. SEASONS RESIDENTS WERE ALSO VISITED THROUGHOUT THE YEAR BY STUDENTS OF A LOCAL DANCE COMPANY. IN FY12 THE WOODVIEW PARTNERED WITH HELPING HANDS, A SERVICE ORGANIZATION OF HALIFAX COUNTY HIGH SCHOOL. AS A SCHOOL PROJECT THE STUDENTS ASSISTED RESIDENTS AT WEEKLY BINGO EVENTS. *POETRY PROJECT DURING FY12 VIRGINIA'S POET LAUREATE KELLY CHERRY MET REGULARLY WITH RESIDENTS IN POETRY WORKSHOPS AFTER WHICH ACTIVITY STAFF HELPED RESIDENTS WRITE THEIR OWN POEMS. THIS PROJECT CONTINUES WITH PLANS TO COMPILE A SMALL BOOK OF POEMS. *ADOPT A US SOLDIER PROGRAM IN FY12 SEASONS AT THE WOODVIEW CONTINUED SUPPORT OF A STAFF SERGEANT IN THE AIR FORCE "ADOPTED" IN FY11 THROUGH THE ADOPT A US SOLDIER PROGRAM AND THROUGHOUT THE YEAR SENT CARE PACKAGES TO HIM AND HIS PLATOON IN AFGHANISTAN. THE RESIDENTS, THEIR FAMILIES AND THE SEASONS STAFF WERE INVOLVED IN THE PROJECT. |
| EXEMPT PURPOSE ACHIEVEMENTS | PART III, LINE 4A CONTINUED | *COMMUNITY INVOLVEMENT EMPLOYEES PARTICIPATE IN AND SHARE THEIR TALENTS AND EXPERTISE AS MEMBERS OF VARIOUS CIVIC AND RELIGIOUS ORGANIZATIONS IN THEIR RESPECTIVE COMMUNITIES. THEY PARTICIPATE IN THE CHAMBER OF COMMERCE IN HALIFAX COUNTY; SERVE ON VIRGINIA HEALTH CARE ASSOCIATION COMMITTEES; AND SERVE ON VARIOUS BOARDS AND ADVISORY COMMITTEES SUCH AS THE, LAKE COUNTRY COMMISSION ON AGING, THE SOUTHSIDE VIRGINIA COMMUNITY COLLEGE LPN SCHOOL ADVISORY COUNCIL, HALIFAX VOCATIONAL FOUNDATION ADVISORY COUNCIL, LAKE COUNTRY AREA AGENCY ON AGING AND THE HALIFAX COUNTY COMMUNITY FEDERAL CREDIT UNION. *COMMUNITY INVOLVEMENT RECOGNITION THE WOODVIEW AND SEASONS AT THE WOODVIEW HAVE BEEN RECOGNIZED FOR COMMUNITY INVOLVEMENT BY THE VIRGINIA HEALTH CARE ASSOCIATION (VHCA) FREQUENTLY OVER THE YEARS. THE ANNUAL VHCA AWARDS ARE PRESENTED TO FACILITIES THAT DEMONSTRATE A HIGH DEGREE OF PROFESSIONALISM AND CREATIVITY IN IMPLEMENTING PROGRAMS THAT ENCOURAGE AND SUPPORT STRONG COMMUNITY RELATIONS. IN FY12, THE WOODVIEW WAS AGAIN RECOGNIZED, RECEIVING SECOND PLACE FOR YEAR ROUND COMMUNITY INVOLVEMENT, THIRD PLACE FOR NATIONAL NURSING HOME WEEK AND THIRD PLACE IN THE NEWSLETTER CATEGORY. SEASON'S WAS RECOGNIZED WITH THIRD PLACE IN SPECIAL EVENT (ASSISTED LIVING.) OTHER OTHER PROGRAMS OPENED TO THE PUBLIC INCLUDED A FAMILY PICNIC AND ANTIQUE CAR SHOW, AN AFRICAN AMERICAN HISTORY MONTH CELEBRATION AND RECEPTION, WEAR RED DAY FOR CARDIOVASCULAR AWARENESS, MOTHER'S DAY, VETERAN'S DAY, AND FATHER'S DAY OBSERVANCES AND WEAR PINK DAY FOR PUBLIC AWARENESS OF BREAST CANCER. THE WOODVIEW CONTINUED PROVIDING "STRESS FREE" DAYS AND THE WOODVIEW RESIDENT GLEE CLUB PERFORMED A CHRISTMAS CONCERT FOR ALL. THE DIETARY DEPARTMENT ASSEMBLED SEVERAL GIFT BASKETS TO RAFFLE TO RAISE MONEY FOR STAFF WHO EXPERIENCED PERSONAL HARDSHIPS INCLUDING HOUSE FIRES AND EXTENDED ILLNESS; ONE EXAMPLE OF THE WOODVIEW FAMILY CARING FOR ITS OWN. *HEALTHY DIRECTIONS EMPLOYEE PROGRAMS A VARIETY OF WELLNESS PROGRAMS COORDINATED BY HALIFAX REGIONAL HOSPITAL ARE HELD ON A MONTHLY BASIS TO HELP EMPLOYEES AND THEIR FAMILY MEMBERS WITH WEIGHT LOSS, EXERCISE, AND NUTRITION TO LOWER BMI, CHOLESTEROL, GLUCOSE, BLOOD PRESSURE AND RISKS FOR HEART ATTACK, STROKE AND OTHER COMPLICATIONS OF CARDIOVASCULAR DISEASE. BY LOOKING BETTER AND FEELING BETTER, EMPLOYEES "SHOW" THE COMMUNITY THAT GOOD HEALTH IS ACHIEVABLE AND SET A GOOD EXAMPLE FOR THE HEALTHCARE ROLE THE ORGANIZATION PLAYS IN THE COMMUNITY. *VOLUNTEER SERVICES PROGRAM VOLUNTEERS FROM THE COMMUNITY, INDIVIDUALS AND GROUPS, HAVE DONATED MANY HOURS AT THE WOODVIEW AND SEASONS AT THE WOODVIEW DURING FY12, PROVIDING COMPANIONSHIP, RECREATION AND SPIRITUAL ACTIVITIES FOR RESIDENTS. VOLUNTEERS ALSO INCLUDE CERTIFIED PET THERAPY DOGS. VOLUNTEERS AT THE WOODVIEW AND SEASONS AT THE WOODVIEW, COORDINATE BINGO GAMES, CRAFT ACTIVITIES, BIRTHDAY OBSERVANCES AND HOLIDAY CELEBRATIONS. THEY ALSO ACCOMPANY RESIDENTS ON PICNICS AND FISHING EXCURSIONS AND OUT-OF-RESIDENCE ACTIVITIES, INCLUDING BUS TRIPS TO COUNTY FAIRS AND OTHER COMMUNITY EVENTS/FESTIVALS. THE VOLUNTEERS ASSIST WITH THE ANNUAL EASTER EGG HUNT, DINNER WITH SANTA, THE SAFE TRICK-OR-TREAT AND COOKOUTS FOR RESIDENTS AND FAMILIES. AN ANNUAL VOLUNTEER RECOGNITION LUNCHEON IS HOSTED TO RECOGNIZE AND HONOR VOLUNTEERS FOR THEIR SERVICE. |
| FAMILY AND BUSINESS RELATIONSHIPS | PART VI, LINE 2 | DAVID WHITE AND CHRIS LUMSDEN HAVE A BUSINESS RELATIONSHIP. |
| ORGANIZATION MEMBERS | PART VI, LINES 6, 7A AND 7B | PER THE ORGANIZATION'S BYLAWS, ARTICLE III, THE ORGANIZATION HAS A SOLE MEMBER, HALIFAX REGIONAL HEALTH SYSTEM, INC., A VIRGINIA NON-STOCK, NOT-FOR-PROFIT CORPORATION. ARTICLE IV, SECTION 4.4, NOTES THAT ANY MEMBER OF THE BOARD OF DIRECTORS MAY BE REMOVED BY THE CORPORATION'S SOLE MEMBER AND ARTICLE IV, SECTION 4.5, NOTES THAT BOARD OF DIRECTOR VACANCIES ARE FILLED BY THE CORPORATION'S SOLE MEMBER. PER THE BYLAWS, ARTICLE IX, THE ORGANIZATION'S SOLE MEMBER, HALIFAX REGIONAL HEALTH SYSTEM, INC., HAS THE POWER TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION: (I) THE ADOPTION OR AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS, (II) THE ELECTION OF THE CORPORATION'S BOARD OF DIRECTORS, (III) THE MERGER OF THE CORPORATION INTO ANOTHER ORGANIZATION OR THE ACQUISITION AND DISPOSAL OF ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS, (IV) THE BORROWING OF FUNDS FROM THIRD PARTIES, (V) THE ADOPTION OF BUSINESS PLANS, BUDGETS AND DISTRIBUTION OF FUNDS, (VI) THE APPROVAL OF FINANCIAL STATEMENTS, (VII) THE APPOINTMENT OF THE CORPORATION'S CEO AND EXTERNAL AUDITORS, (VIII) THE RECEIPT AND APPROVAL OF AUDIT REPORTS, (IX) THE APPROVAL OF COMPENSATION PLANS, AND (X) THE CREATION OR ACQUISITION OF ANY SUBSIDIARIES. |
| ORGANIZATION'S FORM 990 REVIEW PROCESS | PART VI, LINE 11B | THE RETURN IS PREPARED BY ORGANIZATION'S INDEPENDENT ACCOUNTING FIRM, BASED ON INFORMATION PROVIDED BY THE ORGANIZATION AND IN CONSULTATION WITH ORGANIZATION STAFF. THE DRAFT PREPARED BY THE ACCOUNTING FIRM IS THEN CAREFULLY REVIEWED BY ORGANIZATION MANAGEMENT AND STAFF. CHANGES ARE MADE AS APPROPRIATE. THE FINAL VERSION IS MADE AVAILABLE TO ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS. |
| CONFLICT OF INTEREST POLICY | PART VI, LINE 12C | ALL MEMBERS OF THE BOARD ARE ALSO MEMBERS OF THE BOARD OF DIRECTORS OF HALIFAX REGIONAL HEALTH SYSTEM. THE CONFLICT OF INTEREST QUESTIONNAIRE IS DISTRIBUTED TO EACH MEMBER OF THE HALIFAX REGIONAL HEALTH SYSTEM BOARD IN JANUARY EVERY YEAR. THE QUESTIONNAIRE MUST BE COMPLETED BY ALL MEMBERS. A REPORT OF THE DISCLOSED POTENTIAL CONFLICTS IS PRESENTED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS TO THE BOARD IN EXECUTIVE SESSION ANNUALLY. IF IT IS DETERMINED BY THE BOARD SECRETARY, BOARD PRESIDENT, AND MEDICAL STAFF PRESIDENT THAT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE CIRCUMSTANCES OF THE CONFLICT OF INTEREST SHALL BE SET FORTH IN DETAIL BY THE AFFECTED PARTY. SUBSEQUENTLY, WHEN A RESOLUTION CANNOT BE FOUND TO THE SATISFACTION OF THE BOARD SECRETARY, BOARD PRESIDENT, AND MEDICAL STAFF PRESIDENT, THE MATTER WILL BE REVIEWED AND ADDRESSED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. A RECOMMENDATION WILL BE MADE TO THE AFFECTED PARTY ON HOW TO REMOVE THE CONFLICT. IF THE CONFLICT CANNOT BE RESOLVED TO THE SATISFACTION OF THE EXECUTIVE COMMITTEE, A RECOMMENDATION WILL BE MADE TO REMOVE THE AFFECTED BOARD MEMBER FROM THE BOARD OF DIRECTORS. IN SUCH CASE WHERE REMOVAL IS RECOMMENDED, PROVISIONS OF 4.6 OF THE CORPORATE BYLAWS WILL BE FOLLOWED. THE RESPONSES TO THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE ARE RETAINED BY THE SECRETARY TO THE BOARD OF DIRECTORS. |
| DOCUMENT RETENTION & DESTRUCTION POLICY | PART VI, LINE 14 | A DOCUMENT RETENTION & DESTRUCTION POLICY HAS BEEN IN PLACE AND FUNCTIONAL SINCE OCTOBER 21,1999. THE BOARD OF DIRECTORS FORMALLY APPROVED THE POLICY IN MAY 2012. |
| OFFICER COMPENSATION REVIEW | PART VI, LINES 15 A/B | HALIFAX REGIONAL HEALTH SYSTEM SEEKS TO PAY REASONABLE COMPENSATION UNDER SECTION 4958 TO ATTRACT AND RETAIN THE APPROPRIATE CALIBER OF EMPLOYEES DEDICATED TO CARRYING OUT THE EXEMPT MISSION. LIKEWISE, HALIFAX REGIONAL LONG TERM CARE, INC. SEEKS TO PAY REASONABLE COMPENSATION UNDER SECTION 4958 TO ATTRACT AND RETAIN THE APPROPRIATE CALIBER OF EMPLOYEES DEDICATED TO CARRYING OUT THE EXEMPT MISSION. ORGANIZATION PERIODICALLY CONDUCTS A REVIEW TO DETERMINE THE GOING FAIR MARKET COMPENSATION RANGES FOR COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. ORGANIZATION SETS COMPENSATION WITHIN THE RANGE OF THE GOING MARKET RATE. NO INDIVIDUAL HAVING A CONFLICT OF INTEREST UNDER THE ORGANIZATIONS' CONFLICT OF INTEREST POLICY IS PERMITTED TO PARTICIPATE IN THE REVIEW OR DECISION. ORGANIZATION MAINTAINS RECORDS REGARDING COMPENSATION. THE CHAIRMAN OF THE BOARD OF DIRECTORS ALSO SERVES AS CHAIRMAN OF THE EXECUTIVE (COMPENSATION) COMMITTEE, COORDINATING WITH THE CHIEF EXECUTIVE OFFICER TO REVIEW ANNUAL PERFORMANCE AND COMPARATIVE MARKET INFORMATION FOR THE POSITION OF CHIEF EXECUTIVE OFFICER (CEO), CHIEF OPERATING OFFICER (COO), AND CHIEF FINANCIAL OFFICER (CFO). A RECOMMENDATION IS PRESENTED TO THE EXECUTIVE COMMITTEE BY THE CHAIRMAN. THE EXECUTIVE COMMITTEE TAKES ACTION ON THE RECOMMENDATION. THE FULL BOARD OF DIRECTORS IS MADE AWARE THAT THE EXECUTIVE COMMITTEE HAS TAKEN ACTION OF COMPENSATION FOR THE CEO, COO, AND CFO WITH DETAILS AVAILABLE FOR THEIR REVIEW UPON REQUEST. |
| DOCUMENT REVIEW POLICY | PART VI, LINE 19 | THE ORGANIZATION CURRENTLY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND CONSOLIDATED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| OTHER CHANGE IN NET ASSETS | PART XI, LINE 5 | OTHER CHANGES IN PENSION LIABILITIES ................ $(184,322) UNREALIZED GAINS ON INVESTMENT ...................... 37,483 --------- $(146,839) |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DAVID H WHITE JR TITLE:CHAIRMAN HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:J AUBREY HOUGHTON TITLE:TREASURER HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:CAROL C THOMAS TITLE:VICE CHAIRMAN HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:HABIB BASSIL MD TITLE:SECRETARY HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JAMES PRIEST DDS TITLE:BOARD MEMBER (BEGINNING 11/11) HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JAMES WITKO MD TITLE:BOARD MEMBER (THROUGH 11/11) HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:CHRIS A LUMSDEN TITLE:CHIEF EXECUTIVE OFFICER HOURS:33 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:STEWART R NELSON TITLE:CHIEF FINANCIAL OFFICER HOURS:33 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:THOMAS S KLUGE TITLE:CHIEF OPERATING OFFICER HOURS:33 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| HALIFAX REGIONAL HOSPITAL INCORPORATED | ||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 540648699 | HEALTHCARE | VA | 501(c)3 | 3 | HRHS | true |
| HALIFAX REGIONAL DEVELOPMENT FOUNDATION | ||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541801459 | HLTH/WELFARE | VA | 501(c)3 | 11A TYPE I | HRHS | true |
| HALIFAX REGIONAL PROPERTIES INC | ||||||||||
| 2204 WOBPRAM AVEMIE | SOUTH BOSTON | VA | 24592 | 541801463 | HLTH/WELFARE | VA | 501(c)3 | 11A TYPE I | HRHS | true |
| HALIFAX REGIONAL HEALTH SYSTEM INC | ||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541801466 | HEALTHCARE | VA | 501(c)3 | 11B TYPE II | NA | false |
| CLARKSVILLE SENIOR CARE LLC | ||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541957066 | SENIOR CARE | VA | 501(c)3 | 11A TYPE I | HRHS | true |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| SOUTHSIDE HEALTH SERVICES INC | ||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541417772 | HEALTH SERVICES | VA | NA | C CORP |
| DOMINION HALTH MEDICAL ASSOCIATES LTD | ||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541060357 | PHYS PRACTICE | VA | NA | C CORP |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| HALIFAX REGIONAL HOSPITAL INCORPORATED | ||
| N | 559926 | COST |
| HALIFAX REGIONAL HOSPITAL INCORPORATED | ||
| O | 1731555 | COST |
| CLARKSVILLE SENIOR CARE LLC | ||
| C | 750000 | COST |