TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) SHARON L HARRUP...................................................................... CHAIRMAN	2.0 ................. 0.0	X	X	0	0	0
(2) FRANCIS WOOD JR...................................................................... VICE CHAIRMAN	2.0 ................. 0.0	X	X	0	0	0
(3) LEROY O PFEIFFER JR...................................................................... SECRETARY/TREASURER	2.0 ................. 0.0	X	X	0	0	0
(4) LEWIS ADDISON...................................................................... DIRECTOR (UNTIL 4/2015)	2.0 ................. 50.0	X		0	499,490	22,724
(5) WILLIAM BASS JR...................................................................... DIRECTOR (AS OF 5/2015)	2.0 ................. 50.0	X	X	0	313,427	39,589
(6) KWABENA DONKOR MD...................................................................... MEDICAL STAFF PRESIDENT	2.0 ................. 0.0	X		0	0	0
(7) RHONDA B ALGEIER MD...................................................................... DIRECTOR	2.0 ................. 0.0	X		0	0	0
(8) REV CALVIN GRAY...................................................................... DIRECTOR	2.0 ................. 0.0	X		0	0	0
(9) HAROLD M HARRIS JR...................................................................... DIRECTOR	2.0 ................. 0.0	X		0	0	0
(10) STEPHEN KEITH EDD...................................................................... DIRECTOR	2.0 ................. 0.0	X		0	0	0
(11) WILLIAM MCGUIRE...................................................................... DIRECTOR	2.0 ................. 0.0	X		0	0	0
(12) ODESSA PRIDE...................................................................... DIRECTOR	2.0 ................. 0.0	X		0	0	0
(13) WILLIAM L ROACH...................................................................... DIRECTOR	2.0 ................. 0.0	X		0	0	0
(14) TIMOTHY R THARPE...................................................................... DIRECTOR	2.0 ................. 0.0	X		0	0	0
(15) PATRICIA TUCKER...................................................................... DIRECTOR	2.0 ................. 0.0	X		0	0	0
(16) JULIE DIXON...................................................................... DIRECTOR	2.0 ................. 0.0	X		0	0	0
(17) KIRSTEN HUBER MD...................................................................... DIRECTOR	50.0 ................. 0.0	X		248,877	0	17,509

(A) Name and business address	(B) Description of services	(C) Compensation
MEDICAL ASSOCIATES OF CENTRAL VIRGI, 2215 LANDOVER PLACE LYNCHBURG,VA24501	PHYSICIAN SERVICES	2,588,023
CROTHALL FACILITIES MGMTCROTHALL S, 1500 LIBERTY RIDGE DR SUITE 210 WAYNE,PA19087	HOUSEKEEPING SVCS	1,379,899
MOORES ELECTRICAL MECH CONST IN, PO BOX 119 ALTAVISTA,VA24517	ELECTRICAL CONTRACTO	740,874
ROANOKE VALLEY INTERNISTS PC, PO BOX 906 FARMVILLE,VA23901	PHYSICIAN SERVICES	502,113
WEATHERBY LOCUMS INC, PO BOX 972633 DALLAS,TX75397	PHYSICIAN SVCS	491,406
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 13

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

SOUTHSIDE COMMUNITY HOSPITAL INC

Employer identification number

54-0555201

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

SOUTHSIDE COMMUNITY HOSPITAL INC

Employer identification number

54-0555201

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................
c	Total lobbying expenditures (add lines 1a and 1b) .......................................................................
d	Other exempt purpose expenditures .........................................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ..............................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

3,528

Total. Add lines 1c through 1i ....................................................................................................

3,528

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
OTHER LOBBYING ACTIVITIES	PART II-B, LINE 1(I) A PORTION OF THE ORGANIZATIONS HOSPITAL ASSOCIATION DUES FOR THE YEAR 2015 WERE ATTRIBUTABLE TO LOBBYING EXPENSES IN THE AMOUNT OF $3,528.

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SOUTHSIDE COMMUNITY HOSPITAL INC

Employer identification number

54-0555201

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	64,149	64,149	64,149	64,149	64,149
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	64,149	64,149	64,149	64,149	64,149

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	163,194		163,194
b	Buildings	36,077,314	20,392,629	15,684,685
c	Leasehold improvements	2,712,754	1,937,295	775,459
d	Equipment ...	37,772,712	29,252,731	8,519,981
e	Other ...	148,414		148,414
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				25,291,733

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) DUE FROM RELATED PARTIES				5,952,857
(2) EST. RECEIVABLE - 3RD PARTY				314,650
(3) OTHER ACCOUNTS RECEIVABLE				89,868
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				6,357,375

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
PAYABLE TO ESTIMATED 3RD PARTY	602,805
INTEREST RATE SWAP	228,798
DUE TO RELATED PARTY	6,402,665
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	7,234,268
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

PART V, LINE 4

THESE FUNDS WERE DONOR RESTRICTED FOR LPN NURSING SCHOLARSHIPS.

PART X, LINE 2

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

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SOUTHSIDE COMMUNITY HOSPITAL INC

Employer identification number

54-0555201

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	3,163,124		3,163,124	4.260 %
b	Medicaid (from Worksheet 3, column a) . . . . .	13,128,426	9,882,164	3,246,262	4.370 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	16,291,550	9,882,164	6,409,386	8.630 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	118,878		118,878	0.160 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	29,511		29,511	0.030 %
j	Total. Other Benefits . .	148,389		148,389	0.190 %
k	Total. Add lines 7d and 7j .	16,439,939	9,882,164	6,557,775	8.820 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	7,438	7,438	0.010 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	9,709	9,709	0.010 %
8	Workforce development	8,049	8,049	0.010 %
9	Other
10	Total	25,196	25,196	0.030 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

9,272,175

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

26,342,554

Enter Medicare allowable costs of care relating to payments on line 5.....

30,479,012

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-4,136,458

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1NONE
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	SOUTHSIDE COMMUNITY HOSPITAL 800 OAK STREET FARMVILLE,VA23901 HTTP://SCH.CENTRAHEALTH.COM	X	X	X

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	SOUTHSIDE COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

In conducting its most recent CHNA, did the hospital facility take 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? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTP://SCH.CENTRAHEALTH.COM

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTP://SCH.CENTRAHEALTH.COM

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	SOUTHSIDE COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.% and FPG family income limit for eligibility for discounted care of 400.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTP://SCH.CENTRAHEALTH.COM

The FAP application form was widely available on a website (list url):

HTTP://SCH.CENTRAHEALTH.COM

A plain language summary of the FAP was widely available on a website (list url):
HTTP://SCH.CENTRAHEALTH.COM

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	SOUTHSIDE COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
SCHEDULE H, PART V, SECTION B, LINE 5:	CENTRA ORGANIZED THREE COMMUNITY HEALTH NEEDS ASSESSMENT COMMUNITY ADVISORY BOARDS ONE FOR THE CENTRA HEALTH, LYNCHBURG REGION, ONE FOR THE BEDFORD AND ONE FOR THE SOUTHSIDE COMMUNITY HOSPITAL, FARMVILLE REGION. THESE CHNA COMMUNITY ADVISORY BOARDS WERE COMPRISED OF COMMUNITY LEADERS REPRESENTING EDUCATION, BUSINESS, SOCIAL SERVICE AGENCIES, GOVERNMENT, PUBLIC HEALTH AUTHORITIES, COLLEGES (INCLUDING OUR LOCAL SCHOOL OF PUBLIC HEALTH), OTHER HEALTHCARE PROVIDERS, AND NEIGHBORHOOD CITIZEN ORGANIZATIONS IN AN EFFORT TO OBTAIN AS BROAD-BASED COMMUNITY INPUT AS POSSIBLE. PARTICIPANTS INCLUDED ORGANIZATIONS THAT REPRESENT THE NEEDS OF MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. A LIST OF INDIVIDUAL PARTICIPANTS IS LISTED ON THE LAST PAGE OF THE CHNA ASSESSMENT & IMPLEMENTATION PLAN REPORTS.
SCHEDULE H, PART V, SECTION B, LINE 7d:	HARD COPIES OF THE CHNA ASSESSMENT & IMPLEMENTATION PLAN WERE SENT TO ALL CHNA COMMUNITY ADVISORY BOARD MEMBERS.
SCHEDULE H, PART V, SECTION B, LINE 11:	THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR CENTRA SOUTHSIDE COMMUNITY HOSPITAL IDENTIFIED THREE OVERARCHING ACTION PLAN PRIORITIES AIMED AT IMPROVING THE HEALTH OF THE VARIOUS COMMUNITIES SERVED. THESE PRIORITIES INCLUDED ACCESS TO CARE; HEALTH STATUS IMPROVEMENT; AND HEALTH DISPARITIES. WITH REGARD TO ACCESS TO CARE, CENTRA SOUTHSIDE HAS RECRUITED MANY NEW PRIMARY MEDICAL CARE PROVIDERS TO THEIR PRIMARY CARE CLINICS IN FARMVILLE, LUNENBURG, AND CHARLOTTE PRACTICES. ADDITIONALLY, FUNDING WAS PROVIDED TO THE LOCAL FEDERALLY QUALIFIED HEALTH CENTER TO PROVIDE FREE VACCINATIONS AND FREE PRESCRIPTIONS FOR PEOPLE WHO ARE UNABLE TO AFFORD SUCH SERVICES. LASTLY, THE HOSPITAL ESTABLISHED A SCHOLARSHIP PROGRAM FOR NURSE PRACTITIONERS AND PHYSICIANS ASSISTANTS TO WORK AS PROVIDERS IN THE MEDICALLY UNDERSERVED AREAS OF CENTRA SOUTHSIDES MARKET. ACCESS TO MENTAL HEALTHCARE WAS IMPROVED BY PROVIDING TELEPSYCHIATRY SERVICES TO HOSPITALS EMERGENCY ROOM AND INTEGRATING A NEW PSYCHIATRIST INTO THE FARMVILLE PRIMARY CARE PRACTICE. THE HOSPITAL CONTINUES TO PROVIDE FREE TRANSPORTATION TO THE PEARSON CANCER CENTER. HEALTH STATUS IMPROVEMENT ACTION PLAN PRIORITY INCLUDES A NUMBER OF PROGRAMS AND SERVICES ALL AIMED AT EXPANDING HEALTH EDUCATION AND WELLNESS. THESE PROGRAMS INCLUDE STROKE EDUCATION EVENTS ('STRIKE OUT STROKE'FAST IN A BOX'); FREE LACTATION CLINICS IN FARMVILLE AND CHARLOTTE; SUBSIDIZED MEALS-ON-WHEELS SERVICES; FUNDING TO SUPPORT THE LOCAL SHELTER FOR DOMESTIC VIOLENCE; FUNDING TO SUPPORT AN ANTI-VIOLENCE COMMUNITY CAMPAIGN; AND PROVIDING DIABETIC EDUCATION FOR THE SOUTHSIDE VIRGINIA REGION. LASTLY, PURCHASED BLOOD PRESSURE MONITORING EQUIPMENT, DIGITAL SCALES, AND GLUCOSE METERS TO SUPPORT THE PIEDMONT COMMUNITY IMPACT ORGANIZATION. OTHER INITIATIVES INCLUDE BEING A CORPORATE SPONSOR FOR THE ANNUAL PIEDMONT WALK AND ANNUAL HIGH BRIDGE HALF MARATHON. IN THE ACTION PLAN PRIORITY OF HEALTH DISPARITIES, A NUMBER OF NEW PROGRAMS AND SERVICES WERE INITIATED TO INCREASE ACCESS TO PRENATAL CARE FOR THE AFRICAN AMERICAN COMMUNITY. THESE SERVICES INCLUDE CONTINUATION OF CENTRAS COMMUNITY VOICE PROGRAM INTO THE SOUTHSIDE REGION, WHICH IS A LAY HEALTH EDUCATOR PROGRAM AIMED AT IMPROVING ACCESS TO PRENATAL CARE; EXPANSION OF THE HEALTHY FAMILIES PROGRAM INTO THE SOUTHSIDE REGION WHICH PROVIDES INTENSIVE HOME VISITATIONS WITH NEW AND EXPECTANT FAMILIES WHICH PROVIDES HEALTH EDUCATION SERVICES AND TRANSPORTATION TO APPOINTMENTS; PROVIDED FREE CARSEATS TO ELIGIBLE FAMILIES AT CAR SEAT SAFETY CLASSES; SPONSORSHIP OF FARMVILLES FARMERS MARKET, PROVIDING MATCHING DOLLARS FOR 'SNAP' PURCHASES; PROVIDED FUNDING TO PIEDMONT SENIOR SERVICES IN FARMVILLE AND SOUTHSIDE TO PURCHASE SOFTWARE TO TRACK AT-RISK POPULATIONS; THROUGH HEART OF VIRGINIA FREE CLINIC PROVIDED FUNDING FOR MEDICAL EQUIPMENT, MEDICAL SUPPLIES, SLEEP STUDY SUPPLIES, YMCA MEMBERSHIPS AND GAS CARDS TO THOSE IN NEED. FOUR SIGNIFICANT NEEDS WERE NOT IDENTIFIED FOR FITTING WITHIN THE CHNAS ACTION PLAN PRIORITIES. THESE INCLUDED SOCIAL AND ECONOMIC FACTORS; HIGH SCHOOL GRADUATION RATES; FAMILIES LIVING BELOW POVERTY AND DOMESTIC VIOLENCE. RATIONALE PROVIDED IS THAT THESE CRITICAL NEEDS ARE HIGHLY COMPLEX IN NATURE AND AFFECTED BY A WIDE VARIETY OF INFLUENCING FACTORS MANY WELL BEYOND THE CAPABILITY AND RESOURCES AVAILABLE THROUGH CENTRA SOUTHSIDE HOSPITAL. FURTHERMORE, IT WAS FELT THAT OTHER COMMUNITY BASED INITIATIVES WERE ALREADY ATTEMPTING TO ADDRESS THESE NEEDS (EG: UNITED WAYS COMMUNITY IMPACT FUND).

Schedule H (Form 990) 2015

Page 8

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?18
Name and address		Type of Facility (describe)
1	CMG SOUTHSIDE - KEYSVILLE 312 KINGS STREET KEYSVILLE,VA23947	FAMILY PRACTICE
2	CMG SOUTHSIDE - FARMVILLE 935 SOUTH MAIN STREET FARMVILLE,VA23901	FAMILY PRACTICE
3	CMG SOUTHSIDE - VICTORIA 1418 6TH STREET VICTORIA,VA23974	FAMILY PRACTICE
4	CMG SOUTHSIDE - BURKEVILLE 412 NAMOZINE STREET BURKEVILLE,VA23922	FAMILY PRACTICE
5	SOUTHSIDE COMMUNITY HOSP HOMECARE SVCS 711 OAK STREET FARMVILLE,VA23901	HOME HEALTH SERVICES
6	CMG SOUTHSIDE - CUMBERLAND 1758 ANDERSON HIGHWAY CUMBERLAND,VA23942	FAMILY PRACTICE
7	SOUTHSIDE CTR FOR GASTRO LIVER DISEASE 800 OAK STREET FARMVILLE,VA23901	GASTROLOGY SVCS
8	CMG SOUTHSIDE ORTHOPEDIC 935 SOUTH MAIN STREET FARMVILLE,VA23901	ORTHOPEDIC SERVICES
9	CMG SOUTHSIDE - SURGERY CENTER 800 OAK STREET FARMVILLE,VA23901	GENERAL SURGERY
10	CMG SOUTHSIDE - WOMEN'S CENTER 800 OAK STREET FARMVILLE,VA23901	WOMEN'S HEALTH SVCS
11	CMG SOUTHSIDE - EMERGENCY SERVICES 800 OAK STREET FARMVILLE,VA23901	EMERGENCY SERVICES
12	SOUTHSIDE HOSPICE 713 OAK STREET FARMVILLE,VA23901	HOSPICE
13	CMG SOUTHSIDE - NEPHROLOGY CENTER 935 SOUTH MAIN STREET FARMVILLE,VA23901	NEPHROLOGY SVCS
14	CMG SOUTHSIDE - NEUROLOGY CENTER 800 OAK STREET FARMVILLE,VA23901	NEUROLOGY SVCS
15	SOUTHSIDE PACE 1530 SOUTH MAIN STREET FARMVILLE,VA23901	CARE FOR ELDERLY
16	CMG SOUTHSIDE - UROLOGY 800 OAK STREET FARMVILLE,VA23901	UROLOGY SVCS
17	CMG SOUTHSIDE - CRNA 800 OAK STREET FARMVILLE,VA23901	CRNA SVCS
18	CMG SOUTHSIDE - HOSPTIALISTS 800 OAK STREET FARMVILLE,VA23901	HOSPITALIST SVCS

Schedule H (Form 990) 2015

Page 9

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

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

Schedule H (Form 990) 2015

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SOUTHSIDE COMMUNITY HOSPITAL INC

Employer identification number

54-0555201

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1LEWIS ADDISONDIRECTOR (UNTIL 4/2015)	(i) (ii)	0 ------------- 300,258	0 ------------- 126,660	0 ------------- 72,572	0 ------------- 7,950	0 ------------- 14,774	0 ------------- 522,214	0 ------------- 58,453
2WILLIAM BASS JRDIRECTOR (AS OF 5/2015)	(i) (ii)	0 ------------- 248,452	0 ------------- 37,500	0 ------------- 27,475	0 ------------- 7,212	0 ------------- 32,377	0 ------------- 353,016	0 ------------- 25,000
3KIRSTEN HUBER MDDIRECTOR	(i) (ii)	248,339 ------------- 0	0 ------------- 0	538 ------------- 0	7,511 ------------- 0	9,998 ------------- 0	266,386 ------------- 0	0 ------------- 0
4EW TIBBSDIRECTOR/CENTRA PRESIDENT& CEO	(i) (ii)	0 ------------- 661,548	0 ------------- 264,493	0 ------------- 129,387	0 ------------- 175,752	0 ------------- 46,255	0 ------------- 1,277,435	0 ------------- 50,910
5THOMAS ANGELOSCH CEO (AS OF 5/2015)	(i) (ii)	161,160 ------------- 0	10,639 ------------- 0	11,545 ------------- 0	4,947 ------------- 0	35,305 ------------- 0	223,596 ------------- 0	0 ------------- 0
6CLAUDIA A MEINHARDSCH CNO	(i) (ii)	157,008 ------------- 0	16,619 ------------- 0	11,670 ------------- 0	4,804 ------------- 0	15,448 ------------- 0	205,549 ------------- 0	0 ------------- 0
7BIKRAM S BAL MDPHYSICIAN	(i) (ii)	823,396 ------------- 0	0 ------------- 0	15,778 ------------- 0	7,950 ------------- 0	3,322 ------------- 0	850,446 ------------- 0	0 ------------- 0
8ROBERT W AH MDPHYSICIAN	(i) (ii)	470,794 ------------- 0	7,425 ------------- 0	828 ------------- 0	7,950 ------------- 0	32,812 ------------- 0	519,809 ------------- 0	0 ------------- 0
9JOHN A KONA MDPHYSICIAN	(i) (ii)	421,471 ------------- 0	0 ------------- 0	3,498 ------------- 0	0 ------------- 0	17,452 ------------- 0	442,421 ------------- 0	0 ------------- 0
10JERRY LUCAS MDPHYSICIAN	(i) (ii)	419,869 ------------- 0	0 ------------- 0	759 ------------- 0	7,950 ------------- 0	0 ------------- 0	428,578 ------------- 0	0 ------------- 0
11JONATHAN R LOGAN MDPHYSICIAN	(i) (ii)	375,428 ------------- 0	11,257 ------------- 0	25,420 ------------- 0	7,950 ------------- 0	45,876 ------------- 0	465,931 ------------- 0	0 ------------- 0
12DR CHARLES TAYLORDIRECTOR (UNTIL 6/2015)	(i) (ii)	155,611 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	155,611 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

SCHEDULE J, PART I, LINE 3

UNDER A MANAGEMENT ARRANGEMENT WITH CENTRA HEALTH, THE ORGANIZATIONS EXECUTIVE DIRECTORS COMPENSATION IS ESTABLISHED IN ACCORDANCE WITH CENTRA HEALTHS EXECUTIVE COMPENSATION PRACTICES WHICH INCLUDE THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT(S), AND COMPENSATION STUDY OR SURVEY.

SCHEDULE J, PART I, LINE 4B

THE FOLLOWING INDIVIDUALS RECEIVED A PAYOUT FROM A NONQUALIFIED RETIREMENT PLAN DURING FY 2015. THE AMOUNT WAS INCLUDED IN THEIR W-2 WAGES. NAME TITLE AMOUNT OF PAYOUT LEWIS ADDISON CENTRA SR VP & CFO 58,453 (A RELATED ORGANIZATION) WILLIAM L. BASS, JR. CENTRA VP COMMUNITY HOSP & REG CENTER 25,000 (A RELATED ORGANIZATION) E.W. TIBBS CENTRA PRESIDENT & CEO 50,910 (A RELATED ORGANIZATION) $134,363 ======== THE FOLLOWING INDIVIDUALS HAD AMOUNTS DEFERRED INTO A NONQUALIFIED RETIREMENT PLAN IN FY 2015: NAME TITLE AMOUNT DEFERRED LEWIS ADDISON CENTRA SR VP & CFO - (A RELATED ORGANIZATION) WILLIAM L. BASS, JR. CENTRA VP COMMUNITY HOSP & REG CENTER - (A RELATED ORGANIZATION) E.W. TIBBS CENTRA PRESIDENT & CEO 167,802 (A RELATED ORGANIZATION) $167,802 ========

Schedule J (Form 990) 2015

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
SOUTHSIDE COMMUNITY HOSPITAL INC

Employer identification number
54-0555201

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	INDUSTRIAL DEVELOP AUTH OF THE TOWN OF FARMVILLE	54-6001272	999999999	06-30-2011	9,619,940	REFUND BONDS ISSUED IN 1997 & 1998		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	3,721,583
2 Amount of bonds legally defeased ..............	0
3 Total proceeds of issue ..................	9,619,940
4 Gross proceeds in reserve funds .............	0
5 Capitalized interest from proceeds .............	0
6 Proceeds in refunding escrows ...............	0
7 Issuance costs from proceeds ...............	0
8 Credit enhancement from proceeds .............	0
9 Working capital expenditures from proceeds .............	0
10 Capital expenditures from proceeds .............	0
11 Other spent proceeds .............	9,619,940
12 Other unspent proceeds .............	0
13 Year of substantial completion .............	2000
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X
15 Were the bonds issued as part of an advance refunding issue? .....		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2015

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X
b Exception to rebate? ........	X
c No rebate due? .........
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X
b Name of provider ..........	BRANCH BANK & TRUST
c Term of hedge .........	1150 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........		X

Schedule K (Form 990) 2015

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........	0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

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

Schedule K (Form 990) 2015

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Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SOUTHSIDE COMMUNITY HOSPITAL INC

Employer identification number

54-0555201

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No










Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) MRS SHARON L TAYLOR	SEE PART V	10,603	SEE PART V		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
PART IV	(A) NAME OF PERSON: MRS. SHARON L. TAYLOR (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF DR. CHARLES TAYLOR, BOARD MEMBER OF SOUTHSIDE COMMUNITY HOSPITAL (RESIGNED FROM BOARD JUNE 2015) (C) AMOUNT OF TRANSACTION: $10,603 (D) DESCRIPTION OF TRANSACTION: PAYMENT FOR CONTRACTED SERVICES RENDERED TO SOUTHSIDE COMMUNITY HOSPITAL (E) SHARING OF ORGANIZATION REVENUE?: NO

Schedule L (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

SOUTHSIDE COMMUNITY HOSPITAL INC

Employer identification number

54-0555201

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

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SOUTHSIDE COMMUNITY HOSPITAL INC

Employer identification number

54-0555201

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) CENTRA MEDICAL GROUP SOUTHSIDE LLC 800 OAK STREET FARMVILLE,VA23901 26-0771274	PHYS. OFFICES	VA	12,540,309	3,338,759	SCH

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)CENTRA HEALTH INC 1920 ATHERHOLT ROAD LYNCHBURG,VA24501 54-0715569	HEALTHCARE	VA	501(C)(3)	3	NA		No
(2)CENTRA HEALTH FOUNDATION INC 1920 ATHERHOLT ROAD LYNCHBURG,VA24501 54-1604094	SUPPORTING OR	VA	501(C)(3)	11A-1	NA		No
(3)CCRC INC 1920 ATHERHOLT ROAD LYNCHBURG,VA24501 54-1929580	CONTINUE CARE	VA	501(C)(3)	11A-1	NA		No
(4)BEDFORD MEMORIAL HOSPITAL 1613 OAKWOOD STREET BEDFORD,VA24523 54-0566100	HEALTHCARE	VA	501(C)(3)	3	NA		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) GENERAL BUSINESS CONCERNS INC 1920 ATHERHOLT ROAD LYNCHBURG,VA24501 54-1299682	REAL ESTATE/PHYS	VA	NA	C Corp				No
(2) PCHP HOLDING INC 2316 ATHERHOLT ROAD LYNCHBURG,VA24501 54-1749492	HOLDING COMPANY	VA	NA	C Corp				No
(3) PIEDMONT COMMUNITY HEALTH PLAN INC 2316 ATHERHOLT ROAD LYNCHBURG,VA24501 54-1755768	HEALTH INSURANCE	VA	NA	C Corp				No

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

Yes

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	9,883	20,598
9	Program service revenue (Part VIII, line 2g) .........	69,595,098	78,016,445
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	213,715	134,732
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,044,100	868,505
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	70,862,796	79,040,280
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	21,440	3,611
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	39,105,367	40,950,928
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	29,964,275	33,205,825
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	69,091,082	74,160,364
19	Revenue less expenses. Subtract line 18 from line 12.......	1,771,714	4,879,916
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	46,599,323	48,476,620
21	Total liabilities (Part X, line 26).............	21,667,869	18,531,522
22	Net assets or fund balances. Subtract line 21 from line 20.....	24,931,454	29,945,098

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 66,970,330 including grants of $ 3,611 ) (Revenue $ 78,016,445 )
	SOUTHSIDE COMMUNITY HOSPITAL IS A 501(C)(3) HOSPITAL COMMITTED TO OFFERING AFFORDABLE HEALTHCARE TO RESIDENTS OF SOUTHSIDE VIRGINIA. WE ARE DEDICATED TO IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE BY PROVIDING HIGH QUALITY HEALTHCARE. PLEASE SEE THE CONTINUATION ON SCHEDULE O.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses66,970,330

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) EW TIBBS........................................................................ DIRECTOR/CENTRA PRESIDENT& CEO	2.0 .......................50.0	X			0	1,055,428	222,007
(19) TERESITA DIONISIO MD........................................................................ DIRECTOR (AS OF 7/2015)	2.0 .......................0.0	X			0	0	0
(20) DR CHARLES TAYLOR........................................................................ DIRECTOR (UNTIL 6/2015)	2.0 .......................0.0	X			155,611	0	0
(21) THOMAS ANGELO........................................................................ SCH CEO (AS OF 5/2015)	50.0 .......................0.0		X		183,344	0	40,252
(22) CLAUDIA A MEINHARD........................................................................ SCH CNO	50.0 .......................0.0		X		185,297	0	20,252
(23) BIKRAM S BAL MD........................................................................ PHYSICIAN	50.0 .......................0.0			X	839,174	0	11,272
(24) ROBERT W AH MD........................................................................ PHYSICIAN	50.0 .......................0.0			X	479,047	0	40,762
(25) JOHN A KONA MD........................................................................ PHYSICIAN	50.0 .......................0.0			X	424,969	0	17,452
(26) JERRY LUCAS MD........................................................................ PHYSICIAN	50.0 .......................0.0			X	420,628	0	7,950
(27) JONATHAN R LOGAN MD........................................................................ PHYSICIAN	50.0 .......................0.0			X	412,105	0	53,826

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,349,052	1,868,345	493,595

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE HEALTHCARE SERVICES FOR EIGHT COUNTIES IN CENTRAL VIRGINIA.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	18
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	684
6	Total number of volunteers (estimate if necessary) .............	6	61
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	7,686

f	All other contributions, gifts, grants, and similar amounts not included above		1f	12,912

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		20,598

			Business Code
2a	NET PATIENT REVENUE	621400	77,238,468	77,238,468
b	ANCILLARY SERVICES	900099	645,703	645,703
c	MEANINGFUL USE	900099	129,752	129,752
d	GRANT INCOME	900099	2,522	2,522
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			78,016,445

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			57,131			57,131
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		56,021
b	Less: rental expenses
c	Rental income or (loss)	0	56,021
d	Net rental income or (loss)......			56,021			56,021
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	109,554	100,180
b	Less: cost or other basis and sales expenses	72,250	59,883
c	Gain or (loss)	37,304	40,297
d	Net gain or (loss).....			77,601			77,601
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	CAFETERIA		621400	249,538			249,538
b	MISCELLANEOUS REVENUE		900099	562,946			562,946
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			812,484
12	Total revenue. See Instructions......			79,040,280	78,016,445	0	1,003,237

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	3,611	3,611
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	773,129	404,488	368,641
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	10,603	10,603
7	Other salaries and wages	33,935,346	32,223,565	1,711,781
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	0
9	Other employee benefits .......	6,231,850	5,814,327	417,523
10	Payroll taxes ...........	0
11	Fees for services (non-employees):
a	Management ......	2,296,362		2,296,362
b	Legal .........	63,249		63,249
c	Accounting ...........	39,180		39,180
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	12,662,878	11,579,483	1,083,395
12	Advertising and promotion ....	374,882		374,882
13	Office expenses .......	3,064,724	2,419,232	645,492
14	Information technology ......	122,177		122,177
15	Royalties ..	0
16	Occupancy ...........	1,778,342	1,778,342
17	Travel ............	423,478	377,436	46,042
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	119,392	98,082	21,310
20	Interest ...........	197,894	197,894
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	4,188,000	4,188,000
23	Insurance ...	685,643	685,643
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	3,992,183	3,992,183
b	DRUGS	2,932,111	2,932,111
c	COLLECTIONS EXPENSES	265,330	265,330
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	74,160,364	66,970,330	7,190,034	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			2,662,223	1	3,448,961
2	Savings and temporary cash investments .........			126,550	2	113,248
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			7,266,549	4	9,043,277
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net ....			0	7	0
8	Inventories for sale or use ........			1,583,549	8	1,981,496
9	Prepaid expenses and deferred charges ......			280,622	9	112,011
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	76,874,388
b	Less: accumulated depreciation	10b	51,582,655	25,033,372	10c	25,291,733
11	Investments—publicly traded securities .			2,093,383	11	2,078,524
12	Investments—other securities. See Part IV, line 11 .....			49,995	12	49,995
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			7,503,080	15	6,357,375
16	Total assets. Add lines 1 through 15 (must equal line 34)...			46,599,323	16	48,476,620

17	Accounts payable and accrued expenses .....	5,499,831	17	4,990,267
18	Grants payable ...	0	18	0
19	Deferred revenue .........	130,750	19	236,198
20	Tax-exempt bond liabilities .........	6,740,980	20	5,898,357
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	194,408	23	172,432
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	9,101,900	25	7,234,268
26	Total liabilities. Add lines 17 through 25..	21,667,869	26	18,531,522

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	24,802,878	27	29,831,522
28	Temporarily restricted net assets ...........	64,427	28	49,427
29	Permanently restricted net assets	64,149	29	64,149
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	24,931,454	33	29,945,098
34	Total liabilities and net assets/fund balances ........	46,599,323	34	48,476,620