TY 2018 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) WILLIAM L ACHENBACH...................................................................... DIRECTOR	1.00 ................. 1.00	X		0
(2) JOHN AGOLA...................................................................... DIRECTOR	1.00 ................. 1.00	X		0
(3) GILBERT BLAND...................................................................... DIRECTOR	1.00 ................. 1.00	X		0
(4) FREDERICK C COBLE...................................................................... DIRECTOR	1.00 ................. 1.00	X		0
(5) ROBERT C FORT...................................................................... DIRECTOR (THRU 11/18)	1.00 ................. 1.00	X		0
(6) J LES HALL...................................................................... DIRECTOR	1.00 ................. 1.00	X		0
(7) ANN E C HOMAN...................................................................... DIRECTOR	1.00 ................. 3.00	X		0
(8) CHARLES F LOVELL JR MD...................................................................... DIRECTOR	1.00 ................. 1.00	X		900
(9) L ALLAN PARROTT JR...................................................................... DIRECTOR/VICE CHAIRMAN (EFFEC 11/18)	2.00 ................. 1.00	X	X	0
(10) JEFFERY O SMITH ED D...................................................................... DIRECTOR	1.00 ................. 1.00	X		0
(11) CAROL C THOMAS...................................................................... DIRECTOR	1.00 ................. 6.00	X		0
(12) MARION WALL...................................................................... DIRECTOR	1.00 ................. 1.00	X		0
(13) PETER BROOKS...................................................................... DIRECTOR	1.00 ................. 3.00	X		0
(14) EDWARD GEORGE MD...................................................................... DIRECTOR	1.00 ................. 1.00	X		0
(15) WHITNEY RG SAUNDERS...................................................................... DIRECTOR	1.00 ................. 1.00	X		0
(16) MICHAEL S SMITH...................................................................... DIRECTOR	1.00 ................. 1.00	X		0
(17) DIAN T CALDERONE...................................................................... DIRECTOR/ CHAIR (EFFEC 11/18) VICE CHAIR 11/18	2.00 ................. 1.00	X	X	0

(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)	(F) Estimated amount of other compensation from the organization and related organizations
(18) HENRY U HARRIS III........................................................................ DIRECTOR/CHAIRMAN (THRU 11/18)	2.00 .......................1.00	X	X				0	0	0
(19) HOWARD P KERN........................................................................ PRES/CEO/EX-EFFICIO DIRECTOR	40.00 .......................15.00	X	X				3,723,802	0	2,026,220
(20) ROBERT A BROERMANN........................................................................ CFO	40.00 .......................13.00		X				1,564,698	0	24,170
(21) MICHAEL V GENTRY........................................................................ COO	40.00 .......................13.00		X				1,960,778	0	33,423
(22) JEFFREY P KING........................................................................ SECRETARY	40.00 .......................9.00		X				722,372	0	94,140
(23) BECKY C SAWYER........................................................................ KE (SVP & CHRO)	40.00 .......................0.00			X			579,250	0	67,262
(24) LESTER R ELJAIEK........................................................................ KE (VP,CORPORATE FINANCE)	40.00 .......................0.00			X			519,895	0	63,577
(25) TERRY M GILLILAND MD........................................................................ KE (SHC SVP & CHIEF PHYSICIAN EXEC)	40.00 .......................1.00			X			703,869	0	-3,575
(26) VICKY G GRAY........................................................................ KE (SVP, SYSTEM DEVELOPMENT)	40.00 .......................1.00			X			856,278	0	31,912
(27) JORDAN R ASHER........................................................................ SHC SVP & CHIEF PHYSICIAN EXECUTIVE	40.00 .......................1.00			X			672,652	0	47,579
(28) MEGAN R PERRY........................................................................ CVP, MERGERS & ACQUISITIONS	40.00 .......................6.00				X		884,177	0	58,779
(29) GRACE R HINES........................................................................ CVP, SYSTEM INTERGRATION	40.00 .......................0.00				X		799,590	0	76,590
(30) DOUGLAS L CHAET........................................................................ VP MANAGED CARE CONTRACTING	40.00 .......................0.00				X		600,971	0	31,665
(31) DOUGLAS M THOMPSON........................................................................ VP, DECISION SUPPORT	40.00 .......................0.00				X		583,503	0	43,171
(32) VIKKI CHARLES........................................................................ VP, CORP FINANCE	40.00 .......................0.00				X		440,262	0	36,624
(33) MARY L BLUNT........................................................................ FORMER OFFICER	0.00 .......................41.00					X	0	1,203,138	-24,520
(34) GENEMARIE W MCGEE........................................................................ FORMER OFFICER	0.00 .......................40.00					X	0	699,484	33,226
(35) SAMUEL J HAWLEY........................................................................ FORMER OFFICER	40.00 .......................6.00					X	187,887	0	18,491
(36) MICHAEL M DUDLEY........................................................................ FORMER OFFICER	0.00 .......................40.00					X	0	6,069,291	66,985
(37) KENNETH KRAKAUR........................................................................ FORMER OFFICER/KE	0.00 .......................0.00					X	578,800	0	0
(38) MICHAEL V TAYLOR........................................................................ FORMER OFFICER/KE	16.00 .......................0.00					X	412,865	0	38,950
(39) BERTRAM S REESE........................................................................ FORMER OFFICER/KE	0.00 .......................0.00					X	0	386,438	0

(A) Name and business address	(B) Description of services	(C) Compensation
PMA COMPANIES PO BOX 824857 PHILADELPHIA,PA19182	COMMERCIAL INSURANCE UNDERWRITER	3,262,166
OPTUMINSIGHT 12125 TECHNOLOGY DR EDEN PRAIRIE,MN55344	MANAGEMENT CONSULTING	2,011,094
HIGHLAND ASSOC INC PO BOX 55469 BIRMINGHAM,AL322555469	INVESTMENT MGMT FEES	1,625,438
KPMG LLC PO BOX 71544 CHICAGO,IL60694	PROFESSIONAL SERVICES	1,603,443
WILLIS TOWERS WATSON US LLC 150 WMAIN ST OFFICE TOWER NORFOLK,VA23510	MANAGEMENT CONSULTING	1,571,212
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 67

- 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.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

SENTARA HEALTHCARE

Employer identification number

52-1271901

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 12, 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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	29,714,011	25,243,485	29,480,354	39,207,864	37,655,127	161,300,841
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	29,714,011	25,243,485	29,480,354	39,207,864	37,655,127	161,300,841
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.						161,300,841

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..	29,714,011	25,243,485	29,480,354	39,207,864	37,655,127	161,300,841
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	57,200,957	43,487,068	17,870,375	24,230,861	23,296,836	166,086,097
9	Net income from unrelated business activities, whether or not the business is regularly carried on..	468,849	88,078	346,544		810,061	1,713,532
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						329,100,470

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

506,820,080

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 2018 (line 6, column (f) divided by line 11, column (f)) .........

49.010 %

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

45.310 %

16a

33 1/3% support test—2018. 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—2017. 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—2018. 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—2017. 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) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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—2017. 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) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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) 2018

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) 2018

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 (explain in Part VI). 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) 2018

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 2018 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-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

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) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

SENTARA HEALTHCARE

Employer identification number

52-1271901

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization SENTARA HEALTHCARE

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization SENTARA HEALTHCARE		Employer identification number 52-1271901

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization SENTARA HEALTHCARE			Employer identification number 52-1271901
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

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

SENTARA HEALTHCARE

Employer identification number

52-1271901

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 (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

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) 2018

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) 2015	(b) 2016	(c) 2017	(d) 2018	(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) 2018

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)? ........

Yes

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

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

Yes

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? .......................

Yes

46,058

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

Yes

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

Yes

291,774

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

337,832

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
PART II-B, LINE 1:	THE ORGANIZATION ENGAGED IN THE DISSEMINATION OF INFORMATION CONCERNING HEALTH CARE LEGISLATION TO EMPLOYEES VIA EMAIL. THE ORGANIZATION IS INVOLVED IN INDIRECT LOBBYING ACTIVITIES THROUGH PAYMENT OF MEMBERSHIP DUES TO VHHA AND AHA. FURTHERMORE, THE ORGANIZATION ENGAGED VECTRE CORPORATION TO MONITOR AND PROVIDE CONSULTATION ON FEDERAL, STATE, AND LOCAL HEALTH CARE LEGISLATION.

Schedule C (Form 990 or 990EZ) 2018

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

SENTARA HEALTHCARE

Employer identification number

52-1271901

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 7/25/06, 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) 2018

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 ....	91,403,333	78,955,874	80,973,164	80,469,527	77,170,379
b	Contributions ...	1,133,007	760,191	899,335	1,288,253	1,048,397
c	Net investment earnings, gains, and losses	-5,709,225	12,288,059	-1,710,443	-224,709	2,784,835
d	Grants or scholarships ...	210,000	150,000	680,000	165,000	450,000
e	Other expenditures for facilities and programs ...	778,959	450,791	526,182	394,907	84,084
f	Administrative expenses ....
g	End of year balance ......	85,838,156	91,403,333	78,955,874	80,973,164	80,469,527

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

Board designated or quasi-endowment SchDMd Bullet

95.500 %

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

4.500 %

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 .....	2,493,820		2,493,820
b	Buildings ....	4,986,374	4,040,690	945,684
c	Leasehold improvements	228,337	228,337	0
d	Equipment ....	16,341,270	13,575,017	2,766,253
e	Other .....	461,822	360,378	101,444
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				6,307,201

Schedule D (Form 990) 2018

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) OAKTREE MEZZANINE FUND II	241,360	F
(B) UBS TRUMBULL PROPERTY INCOME FUND	190,704,984	F
(C) UBS TRUMBULL PROPERTY FUND	90,755,299	F
(D) OAKTREE REAL ESTATE OPPORTUNITIES FUND IV	1,112,029	F
(E) OAKTREE REAL ESTATE OPPORTUNITIES FUND V	1,114,935	F
(F) HEALTH ENTERPRISES PARTNERS I, LP	895,222	F
(G) SANTE HEALTH VENTURES I, LP	2,508,716	F
(H) SANTE HEALTH VENTURES II, LP	4,025,825	F
(I) HEALTH ENTERPRISES PARTNERS II, LP	1,776,904	F
(J) OAKTREE PRIVATE INVESTMENT FUND 2012	20,247,004	F
(K) PIMCO BRAVO II FUND	12,356,813	F
(L) TTCP FUND I, LP	7,381,126	F
(M) PELOTON EQUITY FUND I, LP	4,049,325	F
(N) OAKTREE PRINCIPAL OPPORTUNITIES FD IV, L.P.	79,283	F
(O) OAKTREE PRINCIPAL OPPORTUNITIES FD IV, AIF	83,835	F
(P) HIGHLAND PUBLIC INFLATION HEDGE	232,546,270	F
(Q) HIGHLAND DIRECT HEDGED EQUITY	241,264,340	F
(R) PIMCO CORPORATE OPPORTUNITIES FUND ONSHORE FEEDER, LP	10,593,585	F
(S) PIMCO CORPORATE OPPORTUNITIES FUND II OFFSHORE FEEDER AIV I, LP	1,360,775	F
(T) PRIME STORAGE FUND II IDF, LP	6,621,270	F
(U) GRYPHON PARTNERS V-A, LP	4,826,275	F
(V) HEALTH ENTERPRISE PARTNERS III, LP	414,025	F
(W) LEAVITT EQUITY PARTNERS II, LP	1,133,327	F
(X) PELOTON EQUITY II, LP	23,541	F
(Y) SANTE HEALTH VENTURES III, LP	325,168	F
(Z) TTCP FUND II, LP	-390,777	F
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	836,050,459

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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

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
DUE TO AFFILIATES	5,561,888
OTHER LIABILITIES	79,773,264
RETIREMENT OBLIGATIONS	257,471,132
SELF-INSURANCE RESERVE	10,000,000
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	352,806,284
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) 2018

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:

INTENDED USES OF ENDOWMENT FUND THE BOARD DESIGNATED ENDOWMENT FUND IS SET ASIDE FOR THE SENTARA FOUNDATION'S USE. THE FOUNDATION ASSISTS THE COMMUNITY WITH FILLING THE HEALTH CARE GAPS, DEVELOPING NEW PROGRAMS, AND BUILDING CONSENSUS AROUND CURRENT HEALTH ISSUES. THE TEMPORARILY RESTRICTED ENDOWMENT FUNDS ARE USED PREDOMINANTLY FOR EDUCATION & RESEARCH, HOSPICE HOUSE, HEART FUNDS AND SENTARA'S HOPE FUND, WHICH IS AN EMERGENCY FINANCIAL RESOURCE FOR SENTARA EMPLOYEES THAT ARE EXPERIENCING CATASTROPHIC HARDSHIP OR LOSS THROUGH NO FAULT OF THEIR OWN.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
SENTARA HEALTHCARE

Employer identification number

52-1271901

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in region	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in region
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	UNRELATED TRADE OR BUSINESS
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	INVESTMENTS	243,816,427















3a	Sub-total .....	0	0		243,816,427
b	Total from continuation sheets to Part I ...				0
c	Totals (add lines 3a and 3b)	0	0		243,816,427

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2018

Schedule F (Form 990) 2018

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2018

Schedule F (Form 990) 2018Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2018

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2018

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

ReturnReference	Explanation

Schedule F (Form 990) 2018

Additional Data

Software ID:
Software Version:

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
SENTARA HEALTHCARE

Employer identification number
52-1271901

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) ACTION IN COMMUNITY THROUGH SERVICE OF PRINCE WILLIAM 3900 ACTS LN DUMFRIES,VA22026	54-0897679	501(C)(3)	50,000	GRANT FOR OPERATIONAL SUPPORT OF THE HUNGER PREVENTION CENTER
(2) AMERICAN DIABETES ASSOCIATION 870 GREENBRIER CIRCLE SUITE 404 CHESAPEAKE,VA23320	13-1623888	501(C)(3)	7,500	PREVENT AND CURE DIABETES
(3) AN ACHIEVABLE DREAM 10858 WARWICK BLVD SUITE A NEWPORT NEWS,VA23601	54-1621932	501(C)(3)	50,000	SUPPORT OF THE TWO ACHIEVABLE DREAM SCHOOL LOCATIONS
(4) ANGELS OF MERCY INC 7151 RICHMOND ROAD SUITE 401 WILLIAMSBURG,VA23188	54-1901759	501(C)(3)	15,000	REDESIGN PRIMARY CARE TO MEET NEEDS OF UNINSURED AND UNDERINSURED
(5) ARDX FOUNDATION 1215 N MILITARY HWY NORFOLK,VA23502	38-4020916	501(C)(3)	26,250	ON CAMPUS PROGRAM TO PROMOTE MENTAL AND BEHAVIORAL WELLNESS
(6) BEACH HEALTH CLINIC 3396 HOLLAND RD STE 102 VIRGINIA BEACH,VA23452	54-1366960	501(C)(3)	30,000	DIAGNOSTIC AND PHARMACY SERVICES FOR INDIGENT
(7) BOYS AND GIRLS CLUBS 11825 ROCK LANDING DRIVE CHESAPEAKE BUILDING STE B NEWPORT NEWS,VA23606	54-0538202	501(C)(3)	15,000	INSPIRE AND ENABLE YOUNG PEOPLE
(8) CATHOLIC CHARITIES OF EASTERN VA 5361A VIRGINIA BEACH BLVD VIRGINIA BEACH,VA23462	54-0505879	501(C)(3)	22,000	MENTAL HEALTH SERVICES
(9) CHARLOTTESVILLE FREE CLINIC 1138 ROSE HILL DR 200 CHARLOTTESVILLE,VA22903	54-1610405	501(C)(3)	15,000	SUPPORT OF CHARLOTTESVILLE FREE CLINIC'S PHARMACY PATIENT ASSISTANCE COUNSELOR
(10) CHESAPEAKE CARE INC 2145 S MILITARY HWY CHESAPEAKE,VA23320	54-1642754	501(C)(3)	30,000	HEALTHCARE FOR UNINSURED
(11) CHRISTOPHER NEWPORT UNIVERSITY EDUCATION FOUNDATION 1 AVENUE OF THE ARTS NEWPORT NEWS,VA23606	54-1156248	501(C)(3)	10,000	DEVELOP TARGETED WORKFORCE DEVELOPMENT PILOT PROGRAMS IN THE REGION
(12) CITY SCHOOLYARD GARDEN 1562 DAIRY RD CHARLOTTESVILLE,VA22903	27-5103914	501(C)(3)	25,000	HOST GARDENS AND GARDEN PROGRAMS AT CHARLOTTESVILLE CITY SCHOOLS
(13) EVMS RESEARCH FOUNDATION PO BOX 5 NORFOLK,VA23501	23-7053028	501(C)(3)	10,500,000	ENDOWMENT FOR ACADEMIC QUALITY INITIATIVES
(14) FOOD BANK OF THE ALBEMARLE 109 TIDEWATER WAY ELIZABETH CITY,NC27909	56-1341658	501(C)(3)	20,000	PILOT A FOOD PRESCRIPTION (FOOD RX) PROGRAM T
(15) FOODBANK OF SOUTHEASTERN VIRGINIA INC 800 TIDEWATER DR NORFOLK,VA23504	52-1219783	501(C)(3)	50,000	FUND THE COST OF A REFRIGERATION UNIT NEEDED.
(16) FORKIDS INC PO BOX 6044 NORFOLK,VA23508	54-1477799	501(C)(3)	10,000	HEALTHCARE FOR HOMELESS SHELTER
(17) FOUNDATION FOR REHAB PO BOX 88730 ROANOKE,VA24014	54-1934695	501(C)(3)	7,500	PROVIDE REHABILITATION EQUIPMENT TO AT RISK SENIORS
(18) GLOUCESTER-MATHEWS FREE CLINIC 2276 GEORGE WASHINGTON MEM HWY HAYES,VA23072	54-1875619	501(C)(3)	30,000	HEALTHCARE FOR INDIGENTS
(19) HAMPTON ROADS COMMUNITY ACTION PROGRAM INC PO BOX 37 NEWPORT NEWS,VA23607	23-7014485	501(C)(3)	15,000	EARLY CHILDHOOD DEVELOPMENT FOR DISADVANTAGED CHILDREN
(20) HAMPTON ROADS COMMUNITY HEALTH CENTER 664 LINCOLN ST PORTSMOUTH,VA23704	54-1626757	501(C)(3)	55,000	PROVIDE TELEMEDICINE ACCESS TO LOW-INCOME/UNINSURED INDIVIDUALS
(21) HELP INC PO BOX 190 HAMPTON,VA23669	54-1209213	501(C)(3)	10,000	PROVIDE DENTAL CARE TO UNISURED, LOW INCOME ADULTS
(22) HOSPICE HOUSE & SUPPORT CARE OF WILLIAMSBURG 4445 POWHATAN PARKWAY WILLIAMSBURG,VA23188	52-1289657	501(C)(3)	8,000	SUPPORT FOR INVIDUALS IN THE LAST PHASES OF LIFE
(23) JEFFERSON AREA BOARD FOR AGING 674 HILLSDALE DR 9 CHARLOTTESVILLE,VA22901	54-0990078	501(C)(3)	18,750	SUPPORT JEFFERSON AREA BOARD FOR AGING'S PILOT OF A CARE TRANSITIONS PROGRAM
(24) LACKEY FREE CLINIC 1620 OLD WILLIAMSBURG RD YORKTOWN,VA23690	54-1850915	501(C)(3)	30,000	HEALTHCARE FOR INDIGENTS
(25) LEES FRIENDS 7400 HAMPTON BLVD NORFOLK,VA23505	54-1533488	501(C)(3)	10,000	HELP AND SUPPORT CANCER PATIENTS AND THEIR FAMILIES
(26) MOTHER SETON HOUSE 3333 VIRGINIA BEACH BLVD STE 28 VIRGINIA BEACH,VA23452	54-1250483	501(C)(3)	15,000	HIGH-RISK TEEN MENTAL HEALTHCARE
(27) NEPTUNE FESTIVAL 265 KINGS GRANT ROAD STE 102 VIRGINIA BEACH,VA23452	52-1372330	501(C)(3)	25,000	COMMUNITY ENJOYMENT AND ENRICHMENT
(28) NORTH CAROLINA HOSPITAL FOUNDATION 2400 WESTON PKWY CARY,NC27513	56-0773039	501(C)(3)	75,000	DISASTER ASSISTANCE FOR EMPLOYEES OF NC HOSPITAL AND HEALTH SYSTEMS
(29) OLDE TOWN MEDICAL CTR 5249 OLDE TOWNE RD STE D WILLIAMSBURG,VA23188	54-1663905	501(C)(3)	30,000	PEDIATRIC DENTAL SERVICES
(30) PARK PLACE HEALTH AND DENTAL CLINIC 606 W 29TH ST NORFOLK,VA23508	45-3086608	501(C)(3)	30,000	DENTAL HEALTH NEEDS OF LOW INCOME AND UNINSURED
(31) PENINSULA EMERGENCY MEDICAL SERVICES COUNCIL 6876 MAIN ST GLOUCESTER,VA23061	54-1064500	501(C)(3)	80,000	CREATE A REGIONAL PLAN FOR BEHAVIORAL HEALTH EMERGENCIES; PARAMEDICINE
(32) PIN MINISTRY 557 S BIRDNECK ROAD SUITE 109 VIRGINIA BEACH,VA23451	41-2126841	501(C)(3)	20,000	RESOURCES FOR THE POOR
(33) PRIMEPLUS NORFOLK SENIOR CENTER 7300 NEWPORT AVE SUITE 100 NORFOLK,VA23505	54-1118218	501(C)(3)	6,500	SUPPORT THE NEEDS OF ADULTS AGE 50 AND OVER EVERY DAY
(34) REGION TEN COMMUNITY SERVICES BOARD 800 PRESTON AVE CHARLOTTESVILLE,VA22903	54-1625290	501(C)(3)	25,000	CAPITAL CAMPAIGN SUPPORT OF A RESIDENTIAL TREATMENT CENTER FOR WOMEN
(35) RONALD MCDONALD HOUSE CHARITIES OF NORFOLK 404 COLLEY AVE NORFOLK,VA23507	54-1139497	501(C)(3)	50,000	RENOVATE COMMUNAL SPACE IN RONALD MCDONALD HOUSE.
(36) RX PARTNERSHIP 2924 EMERYWOOD PKWY STE 300 RICHMOND,VA23294	57-1186937	501(C)(3)	13,000	ACCESS TO FREE MEDICATION
(37) SAMARITAN HOUSE INC 2620 SOUTHERN BLVD VIRGINIA BEACH,VA23452	54-1291021	501(C)(3)	10,000	SERVING THE HOMELESS
(38) SOUTHEASTERN VIRGINIA HEALTH SYSTEM 1033 28TH STREET NEWPORT NEWS,VA23607	54-1083954	501(C)(3)	55,000	LAB AND MEDICAL SERVICES FOR INDIGENTS
(39) ST COLUMBA ECUMENICAL MINISTRIES 2414 LAFAYETTE BLVD NORFOLK,VA23509	54-1394797	501(C)(3)	18,000	PRESCRIPTIONS
(40) TIDE SWIMMING 2121 LANDSTOWN RD VIRGINIA BEACH,VA23456	54-1737825	501(C)(3)	25,000	PROMOTE THE CITY OF VIRGINIA BEACH IN PURSUING A "BLUE ZONES COMMUNITY" DESIGNATION
(41) UNION MISSION MINISTRIES P O BOX 3203 NORFOLK,VA23514	54-0506427	501(C)(3)	49,000	HEALTHCARE FOR HOMELESS
(42) UNITED WAY OF THE VA PENINSULA 739 THIMBLE SHOALS BLVD SUITE 400 NEWPORT NEWS,VA23606	54-0535602	501(C)(3)	29,250	SUPPORT FOR TRANSPORTATION OF UNINSURED/UNDERINSURED CHRONICALLY ILL PATIENTS
(43) UP CENTER 222 W 19TH ST NORFOLK,VA23517	54-0674774	501(C)(3)	23,000	MENTORING PROGRAM FOR AT RISK YOUTH
(44) VA BASKETBALL ACADEMY PO BOX 2438 CHARLOTTESVILLE,VA22902	20-8861885	501(C)(3)	7,500	BUILD CHARACTER AND SHAPE LIVES THROUGH BASKETBALL
(45) VA BUSINESS HIGHER EDUCATION COUNCIL 1108 EAST MAIN STREET SUITE 1100 RICHMOND,VA23219	54-1827038	501(C)(3)	20,000	INCREASE STATE SUPPORT OF HIGHER EDUCATION IN VIRGINIA
(46) VA SUPPORTIVE HOUSING P O BOX 8585 RICHMOND,VA23226	54-1444564	501(C)(3)	35,000	CASE MANAGEMENT FOR HOMELESS
(47) VOLUNTEER HAMPTON ROADS 5817 WESLEYAN DR VIRGINIA BEACH,VA23455	54-1072533	501(C)(3)	20,000	ADDRESS CRITICAL NONPROFIT INFRASTRUCTURE NEED
(48) WAY TO GO 5401 BARNS AVE ROANOKE,VA24019	61-1487268	501(C)(3)	60,000	ASSIST SENIORS WITH TRANSPORTATION NEEDS
(49) WESTERN TIDEWATER FREE CLINIC 2019 MEADE PKWY SUFFOLK,VA23434	26-3302837	501(C)(3)	30,000	PROVIDE DENTAL PROGRAM ACCESS

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) CLOTHING	1	400
(2) FOOD	80	10,100
(3) HOME REPAIR/MAINTENANCE	2	3,150
(4) HOUSEHOLD GOODS	2	400
(5) MORTGAGE ASSISTANCE	14	21,875
(6) RENTAL ASSISTANCE	62	92,271
(7) UTILITY ASSISTANCE	63	36,539
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

PART I, LINE 2:

SCHEDULE I, PART I, LINE 2: PROCEDURES FOR MONITORING USE OF GRANTS FUNDS IN U.S. PROCEDURES FOR MONITORING USE OF GRANTS FUNDS IN U.S. THE SENTARA FOUNDATION - HAMPTON ROADS, A DIVISION OF THE ORGANIZATION, IS RESPONSIBLE FOR AWARDING AND MONITORING THE USE OF GRANT AND SPONSORSHIP FUNDS DONATED TO OTHER ORGANIZATIONS IN THE COMMUNITY WHO SHARE THE SAME MISSION AS THE ORGANIZATION: IMPROVING HEALTH EVERYDAY THROUGH THE PROVISION OF HEALTH SERVICES, AND THE PROMOTION OF HEALTH, MEDICAL EDUCATION, AND THE SOCIAL, CULTURAL, EDUCATIONAL, AND ECONOMIC DEVELOPMENT OF THE COMMUNITY. COMMUNITY RECOGNITION GRANTS ARE AWARDED ANNUALLY BY THE FOUNDATION'S GRANT COMMITTEE TO OTHER 501(C)(3) ORGANIZATIONS WITHIN THE COMMUNITY AFTER A RIGOROUS APPLICATION AND REVIEW PROCESS. ONCE AWARDED, THE GRANTS ARE DISTRIBUTED THE FOLLOWING YEAR IN TWO PAYMENTS - AT THE BEGINNING OF THE YEAR, THEN AFTER AN INTERIM REPORT HAS BEEN FILED WITH THE FOUNDATION. THE INTERIM REPORT MUST INCLUDE THE GRANT OBJECTIVES, ANY CHANGES IN STATUS OF THE ORGANIZATION'S 501(C)(3) STATUS, DETAILS OF THE GRANT OUTCOMES TO DATE AND COMPLIANCE WITH SUBMITTED FINANCIAL BUDGET. GRANTEES ARE REQUIRED TO SUBMIT WITH THE REPORT A DETAILED LISTING OF MEASUREMENTS INCLUDING THE NUMBER OF PEOPLE SERVED AND INCOME LEVELS. FURTHER, A PLAN OF PROGRAM SUSTAINABILITY MUST BE COMPLETED TO PROMOTE THE INITIATIVE'S GOALS FOR THE FUTURE. COMMUNITY BENEFIT SPONSORSHIPS ARE AWARDED QUARTERLY BASED ON THE RECOMMENDATION OF THE FOUNDATION'S SPONSORSHIP REVIEW COMMITTEE. APPLICANTS MUST SUBMIT A PROPOSAL IN WRITING DEMONSTRATING HOW FUNDS WILL BE USED TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY. SPONSORSHIPS ARE GENERALLY AWARDED TO OTHER 501(C)(3) ORGANIZATIONS WITH ACTIVE COMMUNITY BOARDS WHO OVERSEE THE EXPENDITURE OF SUCH FUNDS. THE SENTARA FOUNDATION - HAMPTON ROADS ALSO ADMINISTERS THE H.O.P.E. (HELPING OVERCOME PERSONAL EMERGENCY) FUND, A PROGRAM FOR EMPLOYEES OF THE SENTARA HEALTHCARE SYSTEM WHO ARE IN NEED OF EMERGENCY ASSISTANCE. THIS PROGRAM IS FUNDED BY DONATIONS FROM EMPLOYEES AND MANAGED BY THE PLANNING COUNCIL, A HUMAN SERVICES AGENCY USED TO PROCESS ALL H.O.P.E. FUND APPLICATIONS TO MAINTAIN CONFIDENTIALITY. EMPLOYEES WHO EXPERIENCE CATASTROPHIC EVENTS THROUGH NO FAULT OF THEIR OWN SUCH AS FIRE, DEATH IN THE FAMILY, FLOODING, HURRICANE, TORNADO, CURRENT PERSONAL ILLNESS OR SERIOUS PERSONAL FAMILY ILLNESS THAT RESULT IN HARDSHIP MAY APPLY FOR ASSISTANCE. APPLICANTS MUST COMPLETE A 3-PAGE APPLICATION FORM. APPLICANTS SUBMIT THESE FORMS ALONG WITH THEIR LATEST PAY STUBS, COPIES OF THE BILLS BEING SUBMITTED FOR PAYMENT, AND OFFICIAL DOCUMENTATION OF THE CATASTROPHIC EVENT. THE PLANNING COUNCIL THEN INTERVIEWS THE APPLICANT AND DETERMINES IF THE GUIDELINES ARE MET FOR ASSISTANCE. IN THE EVENT OF A NATURAL DISASTER, APPLICANTS MUST FIRST APPLY TO OTHER EMERGENCY ASSISTANCE PROGRAMS, SUCH AS THE AMERICAN RED CROSS, SALVATION ARMY, OR F.E.M.A., BEFORE BECOMING ELIGIBLE FOR ASSISTANCE FROM THE H.O.P.E. FUND. A REVIEW COMMITTEE EVALUATES EACH APPLICATION AND DETERMINES ASSISTANCE LEVELS BASED ON DOCUMENTED, APPROPRIATE NEED. FUNDS MAY ONLY BE USED TO PAY EXISTING BILLS OR EXTRAORDINARY EXPENSES RELATED TO A CATASTROPHIC EVENT. BILLS THAT ARE NOT NECESSARY FOR THE PRESERVATION OF DAILY LIVING, INCLUDING NON-ESSENTIAL UTILITIES (I.E., CABLE TV, ETC.), ARE NOT COVERED. PAYMENTS ARE MADE DIRECTLY TO SERVICE PROVIDERS RATHER THAN TO INDIVIDUAL RECIPIENTS. FUNDS ARE ONLY DISTRIBUTED PROVIDED ADEQUATE EMPLOYEE DONATIONS HAVE BEEN MADE BY EMPLOYEES FOR EMPLOYEES. ASSISTANCE IS PROVIDED AS THE AVAILABILITY OF FUNDS PERMIT; DECISIONS ARE MADE IN THE ORDER IN WHICH COMPLETED APPLICATIONS REQUESTS ARE RECEIVED. ASSISTANCE FOR AN INDIVIDUAL EMPLOYEE IS LIMITED TO ONCE PER 12-MONTH PERIOD AND TYPICALLY DOES NOT EXCEED $2,000. DURING 2018, 98 INDIVIDUAL EMPLOYEES WERE ASSISTED BY THE HOPE FUND.

SCHEDULE I, PART III

GRANT FUNDS ARE DISBURSED IN TWO INSTALLMENTS, ONE UPON SIGNING THE LETTER OF AGREEMENT AND THE FINAL PAYMENT UPON REVIEW OF THE FILED INTERIM REPORT. FURTHER, GRANTEES ARE REQUIRED TO FILE A FINAL REPORT EVALUATING RESULTS AGAINST THE ORIGINAL OBJECTIVES SET WITHIN THE LETTER OF AGREEMENT.

Schedule I (Form 990) 2018

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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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

SENTARA HEALTHCARE

Employer identification number

52-1271901

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 .........

Yes

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? ..

Yes

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 nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

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) 2018

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)
1HOWARD P KERN PRES/CEO/EX-EFFICIO DIRECTOR	(i) (ii)	1,575,765 ------------- 0	1,510,047 ------------- 0	637,990 ------------- 0	2,002,149 ------------- 0	24,071 ------------- 0	5,750,022 ------------- 0	159,126 ------------- 0
2ROBERT A BROERMANN CFO	(i) (ii)	811,625 ------------- 0	544,618 ------------- 0	208,455 ------------- 0	7,578 ------------- 0	16,592 ------------- 0	1,588,868 ------------- 0	0 ------------- 0
3MICHAEL V GENTRY COO	(i) (ii)	780,042 ------------- 0	492,200 ------------- 0	688,536 ------------- 0	14,287 ------------- 0	19,136 ------------- 0	1,994,201 ------------- 0	409,007 ------------- 0
4JEFFREY P KING SECRETARY	(i) (ii)	478,707 ------------- 0	158,890 ------------- 0	84,775 ------------- 0	67,291 ------------- 0	26,849 ------------- 0	816,512 ------------- 0	30,337 ------------- 0
5BECKY C SAWYER KE (SVP & CHRO)	(i) (ii)	380,858 ------------- 0	177,187 ------------- 0	21,205 ------------- 0	48,349 ------------- 0	18,913 ------------- 0	646,512 ------------- 0	0 ------------- 0
6LESTER R ELJAIEK KE (VP,CORPORATE FINANCE)	(i) (ii)	365,686 ------------- 0	119,981 ------------- 0	34,228 ------------- 0	28,460 ------------- 0	35,117 ------------- 0	583,472 ------------- 0	0 ------------- 0
7TERRY M GILLILAND MD KE (SHC SVP & CHIEF PHYSICIAN EXEC)	(i) (ii)	21,541 ------------- 0	542,106 ------------- 0	140,222 ------------- 0	-5,340 ------------- 0	1,765 ------------- 0	700,294 ------------- 0	64,688 ------------- 0
8VICKY G GRAY KE (SVP, SYSTEM DEVELOPMENT)	(i) (ii)	437,439 ------------- 0	280,723 ------------- 0	138,116 ------------- 0	22,262 ------------- 0	9,650 ------------- 0	888,190 ------------- 0	16,096 ------------- 0
9JORDAN R ASHER SHC SVP & CHIEF PHYSICIAN EXECUTIVE	(i) (ii)	343,826 ------------- 0	152,487 ------------- 0	176,339 ------------- 0	41,420 ------------- 0	6,159 ------------- 0	720,231 ------------- 0	0 ------------- 0
10MEGAN R PERRY CVP, MERGERS & ACQUISITIONS	(i) (ii)	481,398 ------------- 0	270,365 ------------- 0	132,414 ------------- 0	39,011 ------------- 0	19,768 ------------- 0	942,956 ------------- 0	61,031 ------------- 0
11GRACE R HINES CVP, SYSTEM INTERGRATION	(i) (ii)	331,754 ------------- 0	193,115 ------------- 0	274,721 ------------- 0	54,650 ------------- 0	21,940 ------------- 0	876,180 ------------- 0	69,424 ------------- 0
12DOUGLAS L CHAET VP MANAGED CARE CONTRACTING	(i) (ii)	424,757 ------------- 0	63,251 ------------- 0	112,963 ------------- 0	2,441 ------------- 0	29,224 ------------- 0	632,636 ------------- 0	0 ------------- 0
13DOUGLAS M THOMPSON VP, DECISION SUPPORT	(i) (ii)	316,735 ------------- 0	178,209 ------------- 0	88,559 ------------- 0	28,029 ------------- 0	15,142 ------------- 0	626,674 ------------- 0	0 ------------- 0
14VIKKI CHARLES VP, CORP FINANCE	(i) (ii)	303,613 ------------- 0	100,049 ------------- 0	36,600 ------------- 0	14,388 ------------- 0	22,236 ------------- 0	476,886 ------------- 0	0 ------------- 0
15MARY L BLUNT FORMER OFFICER	(i) (ii)	0 ------------- 628,828	0 ------------- 407,470	0 ------------- 166,840	0 ------------- -42,264	0 ------------- 17,744	0 ------------- 1,178,618	0 ------------- 0
16GENEMARIE W MCGEE FORMER OFFICER	(i) (ii)	0 ------------- 395,343	0 ------------- 213,988	0 ------------- 90,153	0 ------------- 20,826	0 ------------- 12,400	0 ------------- 732,710	0 ------------- 0
17SAMUEL J HAWLEY FORMER OFFICER	(i) (ii)	163,771 ------------- 0	24,004 ------------- 0	112 ------------- 0	7,495 ------------- 0	10,996 ------------- 0	206,378 ------------- 0	0 ------------- 0
18MICHAEL M DUDLEY FORMER OFFICER	(i) (ii)	0 ------------- 569,448	0 ------------- 398,077	0 ------------- 5,101,766	0 ------------- 52,325	0 ------------- 14,660	0 ------------- 6,136,276	0 ------------- 4,969,756
19KENNETH KRAKAUR FORMER OFFICER/KE	(i) (ii)	0 ------------- 0	0 ------------- 0	578,800 ------------- 0	0 ------------- 0	0 ------------- 0	578,800 ------------- 0	303,404 ------------- 0
20MICHAEL V TAYLOR FORMER OFFICER/KE	(i) (ii)	111,056 ------------- 0	282,814 ------------- 0	18,995 ------------- 0	11,576 ------------- 0	27,374 ------------- 0	451,815 ------------- 0	0 ------------- 0
21BERTRAM S REESE FORMER OFFICER/KE	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 386,438	0 ------------- 0	0 ------------- 0	0 ------------- 386,438	0 ------------- 270,980

Schedule J (Form 990) 2018

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
PART I, LINE 1A	CHARTER TRAVEL WAS USED BY CERTAIN OFFICERS OF THE ORGANIZATION IN CONNECTION WITH BUSINESS PURPOSES ONLY AND WAS NOT TREATED AS TAXABLE COMPENSATION. THE ORGANIZATION PAID FOR TAXABLE RELOCATION EXPENSES OF EXECUTIVE RECRUITS, INCLUDING TEMPORARY HOUSING AND THE ADDITIONAL TAXES ASSOCIATED WITH SUCH BENEFITS, ALL OF WHICH WERE TREATED AS ADDITIONAL COMPENSATION AND REPORTED ON FORM W-2 AS TAXABLE WAGES.
PART I, LINE 4B	HOWARD KERN AND MICHAEL DUDLEY PARTICIPATED IN THE SENTARA SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. PARTICIPATION IN THE PLAN IS LIMITED TO SELECT INDIVIDUALS AS APPROVED BY THE ORGANIZATIONS' BOARD OF DIRECTOR'S COMPENSATION COMMITTEE. THE PLAN IS CURRENTLY CLOSED TO ADDITIONAL MEMBERS. VESTING OCCURS UPON THE COMPLETION OF A TWO YEAR NON-COMPETE PERIOD FOLLOWING TERMINATION AFTER EARLY RETIREMENT DATE OR UPON DEATH. EARLY RETIREMENT DATE IS WHEN THE EXECUTIVE OBTAINS AT LEAST AGE 55 AND HAS 10 YEARS OF SERVICE AND BENEFITS ARE FORFEITED IF PARTICIPANT LEAVES PRIOR TO AGE 55 WITH 10 YEARS OF SERVICE. HOWARD KERN, MICHAEL DUDLEY, MARY BLUNT, ROBERT BROERMANN, MICHAEL GENTRY, VICKY GRAY, GRACE HINES, MEGAN PERRY, JEFFREY KING, GENEMARIE MCGEE, LESTER ELJIAEK, DOUGLAS THOMPSON, JORDAN ASHER AND BECKY SAWYER, PARTICIPATED IN THE SENTARA CAPITAL ACCUMULATION ACCOUNT PLAN. PARTICIPATION IS LIMITED TO A SELECT GROUP OF CORPORATE EXECUTIVES AS APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTOR'S COMPENSATION COMMITTEE. TERMS OF THE PLAN CHANGED EFFECTIVE JANUARY 1, 2009, WHEREBY VESTING OF CONTRIBUTIONS MADE ON OR AFTER THAT DATE NOW OCCURS ON THE EARLIER OF FIVE YEARS FOR EACH YEARS' CONTRIBUTIONS OR AGE 55 WITH 10 YEARS OF SERVICE. UNDER THE OLD TERMS, VESTING OF CONTRIBUTIONS MADE PRIOR TO JANUARY 1, 2009 OCCURS ON THE EARLIEST OF ASSIGNED DISTRIBUTION DATE, DEATH, INVOLUNTARY TERMINATION WITHOUT CAUSE OR COMPLETION OF TWO-YEAR NON-COMPETE AFTER VOLUNTARY TERMINATION (REGARDLESS OF ORIGINAL ASSIGNED DISTRIBUTION DATE). PAST PARTICIPANTS INCLUDE MICHAEL TAYLOR, KENNETH KRAKAUR AND TERRY GILLILAND. DURING 2018, THE FOLLOWING CORPORATE EXECUTIVES RECEIVED VESTED DISTRIBUTIONS UNDER THE PLAN: MARY BLUNT ($116,637); ROBERT BROERMANN ($149,185); MICHAEL DUDLEY ($96,921); MICHAEL GENTRY ($667,805); VICKY GRAY ($107,487); GRACE HINES ($239,635); HOWARD KERN ($590,013); JEFFREY KING ($46,981); GENEMARIE MCGEE ($58,950); MEGAN PERRY ($89,768); DOUGLAS THOMPSON ($47,522); KENNETH KRAKAUR ($578,800); TERRY GILLILAND ($109,005) AND BERTRAM REESE ($386,438). THESE AMOUNTS HAVE BEEN REPORTED IN COLUMN (B)(III) OF SCHEDULE J, PART II. DURING THE CURRENT TAX YEAR, MICHAEL DUDLEY PARTICIPATED IN THE SENTARA NON-QUALIFIED DEFERRED COMPENSATION PLAN. A NEW PLAN YEAR BEGINS EACH JANUARY 1ST. ELIGIBILITY REQUIRES THAT AN EMPLOYEE MUST BE IN THE TOP 5% BY SALARY AND HAVE COMPENSATION GREATER THAN OR EQUAL TO THE HIGHLY COMPENSATED AMOUNT SET BY THE PLAN IN ORDER TO PARTICIPATE. PARTICIPANTS MUST MAKE THEIR ELECTIONS IN THE YEAR PRECEDING THE DEFERRAL YEAR AND SELECT A DISTRIBUTION DATE. NEW ELECTIONS MUST BE MADE EACH YEAR. ALL PARTICIPANTS ARE 100% VESTED IN THEIR ACCOUNT BALANCES AND LUMP SUM IS THE FORM OF PAYMENT AT THE DISTRIBUTION DATE UNLESS A 5 OR 10 YEAR INSTALLMENT PAYMENT WAS SELECTED.
PART I, LINE 7	DURING THE CURRENT TAX YEAR, THE ORGANIZATION MADE NON-FIXED PAYMENTS OF COMPENSATION UNDER THE FOLLOWING INCENTIVE PROGRAMS: ANNUAL INCENTIVE PROGRAM - EXECUTIVES AND SENIOR LEADERS ARE ELIGIBLE FOR ANNUAL AWARDS BASED ON SYSTEM AND INDIVIDUAL PERFORMANCE. BOTH SYSTEM AND INDIVIDUAL SCORES ARE DETERMINED AFTER YEAR-END, AT WHICH POINT AWARDS MAY BE PAID AND REPORTED AS COMPENSATION. TARGET AND MAXIMUM OPPORTUNITIES VARY BY LEVEL. TOP HAT- WITHIN THE ANNUAL INCENTIVE PROGRAM, EXECUTIVES AND SENIOR LEADERS MAY RECEIVE ADDITIONAL INCENTIVE PAY TO REWARD EXCEPTIONAL INDIVIDUAL PERFORMANCE. MANAGER INCENTIVE PLAN - MANAGEMENT EMPLOYEES NOT COVERED UNDER ANOTHER INCENTIVE PLAN ARE ELIGIBLE FOR THE MANAGEMENT INCENTIVE PLAN. AWARDS ARE BASED ON SYSTEM YEAR-END RESULTS AS DETERMINED BY THE BOARD; BUSINESS UNIT RESULTS FOR FINANCIAL, SAFETY, QUALITY AND CUSTOMER SERVICE; AND THE MANAGER'S INDIVIDUAL PERFORMANCE SCORE. SYSTEM, BUSINESS UNIT, AND INDIVIDUAL RESULTS ARE DETERMINED AFTER YEAR-END, AT WHICH POINT AWARDS MAY BE PAID AND REPORTED AS COMPENSATION.

Schedule J (Form 990) 2018

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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 Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
SENTARA HEALTHCARE

Employer identification number
52-1271901

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	EDA THE CITY OF NORFOLK VA	52-1375010	NONEAVAIL	07-16-2003	53,100,000	FINANCING FOR CAPITAL AND FIXED ASSETS		X		X		X
B	EDA THE CITY OF SUFFOLK VA	54-1131047	86481QAA7	06-25-2008	156,615,000	REFUNDED BONDS ISSUED OCTOBER 2006		X		X		X
C	VA SMALL BUSINESS FINANCING AUTHORITY	54-1300845	928105AV7	01-28-2010	296,243,684	REFUND PRIOR BONDS AND FUND NEW PROJECT		X		X		X
D	EDA THE CITY OF NORFOLK VA	52-1375010	65588NBB7	05-16-2012	163,163,080	REF. POTOMAC 2003, MJH 2002, NEW PROJ.		X		X		X
	EDA THE CITY OF NORFOLK VA	52-1375010	65588TAP4	05-05-2016	197,670,000	REF. SERIES 2012A, 2010B, AND 2010C		X		X		X
	EDA OF THE CITY OF HARRISONBURG VA	54-2000436	NONEAVAIL	08-15-2016	183,535,000	CURRENTLY REFUND SERIES 2006 RMH		X		X		X
	EDA OF THE CITY OF HARRISONBURG VA	54-2000436	NONEAVAIL	10-04-2016	27,600,000	CURRENTLY REFUND SERIES 2011ABC RMH		X		X		X
	EDA OF THE CITY OF HARRISONBURG VA	54-2000436	NONEAVAIL	11-01-2016	65,379,312	CURRENTLY REFUND SERIES 2010ABC RMH		X		X		X
	EDA OF THE CITY OF NORFOLK	52-1375010	65588TAT6	05-15-2018	150,000,788	CURRENT REFUND SERIES 2017 BONDS		X		X		X
	EDA OF ALBERMARLE COUNTY VA	52-1297503	012663AM2	05-15-2018	154,550,000	CURRENTLY REFUND SERIES 2013AB BONDS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	24,300,000		10,990,000		74,480,000		15,640,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	53,100,000		156,615,000		296,443,256		163,873,559
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	788				2,715,612
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	19,317,907				230,220,167		75,585,411
11 Other spent proceeds .............	53,100,000		156,615,000		63,507,476		88,288,148
12 Other unspent proceeds .............
13 Year of substantial completion .............	2003		2008		2011		2014
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X	X		X			X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		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		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2018

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		X		X		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		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		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?	X
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 ....
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		X		X		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		X		X		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? .............
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		X		X		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		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X			X		X
c No rebate due? .........	X		X		X		X
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			X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

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		X		X		X
b Name of provider ..........
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		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		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		X		X		X

Part Ⅵ

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

Return Reference	Explanation
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: EDA THE CITY OF NORFOLK, VA DATE THE REBATE COMPUTATION WAS PERFORMED: 12/16/2007
SCHEDULE K, PART VI	ENTITY 1, ISSUE A: SERIES 2003 COMMERCIAL PAPER PROGRAM (SENTARA HEALTHCARE) PART II, 1 - SENTARA ISSUED TAXABLE COMMERCIAL PAPER NOTES IN 2012 TO PARTIALLY REFUND THIS 2003 COMMERCIAL PAPER PROGRAM. PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDES ISSUE PRICE. NO INTEREST WAS EARNED, ALL PROCEEDS SPENT WITHIN 18 MONTHS OF RECEIPT OF PROCEEDS. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART IV, 2C - SENTARA HAD ARBITRAGE COMPLIANCE REPORT COMPLETED FOR THIS ISSUE AS OF 12/16/2007, WHICH REFLECTED NO REBATE DUE TO THE IRS FOR THIS 2003 ISSUANCE. DEBT WAS ISSUED AS REIMBURSEMENT FOR PRIOR EXPENDITURES INCURRED. THEREFORE, THIS ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION. ENTITY 1, ISSUE B: SERIES 2008 ( SENTARA HEALTHCARE SYSTEM) PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDED ISSUE PRICE. NO INTEREST WAS EARNED, ALL PROCEEDS SPENT ON OR AROUND DATE OF CLOSING FOR REFUNDING PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - ISSUE REFUNDED A PRIOR SERIES 2006 ISSUE. THE REFUNDING WAS TREATED AS A CURRENT REFUNDING FOR FEDERAL TAX PURPOSES. ALL PROCEEDS WERE SPENT ON THE DAY OF ISSUE. PART IV, 2B - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA PROVIDED WITH ARBITRAGE COMPLIANCE CERTIFICATE IN SEPTEMBER OF 2008. FIRST INSTALLMENT EVALUATION DATE WOULD BE NO LATER THAN 6/25/2013. ON MAY 1, 2015, SENTARA HEALTHCARE MODIFIED AN EXISTING TOTAL RETURN SWAP ("TRS") FOR THE $156,615,000 SERIES 2008 REVENUE BONDS. THE TRS WAS NOT ORIGINALLY TREATED OR IDENTIFIED AS A QUALIFIED HEDGE FOR TAX PURPOSES AND THEREFORE ANY MODIFICATIONS SHOULD NOT HAVE RESULTED IN A REISSUANCE FOR FEDERAL TAX PURPOSES. HOWEVER, BOND COUNSEL AND THE SWAP PROVIDERS COUNSEL REVIEWED PRIVATE LETTER RULING PLR-147816-13, WHICH OUTLINED A VERY SIMILAR SITUATION. THE PLR CONCLUDED THAT AN AMENDMENT TO THE TRS WOULD NOT RESULT IN AN ABUSIVE ARBITRAGE DEVICE AS DEFINED WITHIN THE U.S. TREASURY REGULATIONS. THE PLR DID NOT CONCLUDE WHETHER OR NOT A REISSUANCE SHOULD APPLY IN SUCH A SITUATION. AS A CONSERVATIVE APPROACH, BOND COUNSEL AND THE SWAP PROVIDERS COUNSEL DECIDED TO FOLLOW THE DIRECTION TAKEN BY THE ISSUER IN THE PLR AND ALSO TREAT THE MODIFICATION OF THE TRS AS A REISSUANCE AND FILED A NEW FEDERAL FORM 8038 WITH THE INTERNAL REVENUE SERVICE, DATED MAY 1, 2015. AGAIN, THE TREATMENT OF THE TRS MODIFICATION AS A REISSUANCE WAS PURELY DONE AS A CONSERVATIVE APPROACH. AS STATED ABOVE, THE SERIES 2008 BONDS QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION. THEREFORE, THIS ISSUE WAS EXEMPT FROM THE ARBITRAGE REBATE CALCULATION. UNDER THE REISSUANCE TREATMENT, NO REBATE AMOUNTS WOULD HAVE BEEN DUE TO THE IRS AS OF THE MAY 1, 2015 REISSUANCE DATE. FURTHERMORE, THE 2008 REISSUED BONDS WOULD ALSO QUALIFY FOR THE SIX-MONTH SPENDING EXCEPTION AND WOULD NOT OWE AN ARBITRAGE REBATE PAYMENT TO THE IRS AS OF MAY 1, 2020 (FIFTH ANNIVERSARY DATE OF THE REISSUANCE). ENTITY 1, ISSUER C: SERIES 2010 (SENTARA HEALTHCARE SYSTEM - VSBFA) PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDES ISSUE PRICE, PLUS INTEREST EARNINGS (MAINLY FROM PROJECT FUND AND ESCROW FUND). PART II, 11 - OTHER SPENT PROCEEDS INCLUDES REFUNDING PROCEEDS AND INTEREST EARNINGS FROM REFUNDING ESCROW FUND. PART II, 14 - ISSUE REFUNDED A PRIOR SERIES 1997A AND 1998 ISSUE. THE REFUNDINGS WERE TREATED AS CURRENT REFUNDINGS FOR FEDERAL TAX PURPOSES. REFUNDING PROCEEDS WERE DEPOSITED INTO AN ESCROW FUND AND INVESTED. THOSE AMOUNTS WERE FULLY EXPENDED ON OR AROUND 3/1/2010 TO REDEEM THE PRIOR BONDS. PART IV, 2B - FIRST INSTALLMENT PERIOD FOR THIS ISSUE ENDED ON1/28/2015. ARBITRAGE COMPLIANCE REPORT COMPLETED THROUGH DECEMBER 31, 2011, WHICH REFLECTED ALL PROCEEDS SPENT AND NO ACCRUING ARBITRAGE LIABILITY FOR SENTARA.
SCHEDULE K, PART VI	ENTITY 1, ISSUER D: SERIES 2012B (SENTARA HEALTHCARE SYSTEM) PART II, 3 - TOTAL PROCEEDS OF THE ISSUE INCLUDES ISSUE PRICE, PLUS INTEREST EARNINGS ASSOCIATED WITH PROJECT FUND AND ESCROW FUNDS. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 11 - OTHER SPENT PROCEEDS INCLUDES REFUNDING PROCEEDS AND INTEREST EARNINGS FROM REFUNDING ESCROW FUNDS. PART II, 12 - UNSPENT PROCEEDS CONSIST OF THE REMAINING PROJECT FUND PROCEEDS. PART II, 15 - SERIES 2012B ADVANCE REFUNDED THE MARTHA JEFFERSON SERIES 2002 BONDS MATURING 10/1/2012 - 10/1/2035 WITH A CALL FOR REDEMPTION DATE OF 10/1/2012. THE SERIES 2012B ALSO ADVANCE REFUNDED THE POTOMAC HOSPITAL SERIES 2003 BONDS MATURING 10/1/2012 - 10/1/2036 WITH A CALL FOR REDEMPTION DATE OF 10/1/2013. PART IV, 2A, SENTARA RECEIVES ANNUAL ARBITRAGE COMPLIANCE REPORTS COMPLETED FOR THIS ISSUE. ALL PROCEEDS OF THE SERIES 2012B BONDS WERE FULLY EXPENDED AS OF 3/19/2014. ARBITRAGE COMPLIANCE CERTIFICATE WAS PROVIDED THROUGH THE 5/1/2017 FIFTH BOND YEAR, WHICH REFLECTED THAT NO ARBITRAGE REBATE LIABILITY WAS DUE TO THE IRS. ENTITY 2, ISSUER A: SERIES 2016A&B (SENTARA HEALTHCARE) PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2016A AND 2016B BONDS. THE SERIES 2016A&B BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016A&B CURRENT REFUNDED THE SERIES 2012A, 2010B, AND 2010C ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE MAY 5, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 2, ISSUER B: SERIES 2016C&D (SENTARA RMH MEDICAL CENTER) PART II, 3 - PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2016C AND 2016D BONDS. THE SERIES 2016C&D BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS.
SCHEDULE K, PART VI	PART II, 14 - SERIES 2016C&D CURRENT REFUNDED THE SERIES 2006 RMH BONDS ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE AUGUST 15, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 2, ISSUER C: SERIES 2016E (SENTARA RMH MEDICAL CENTER) PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016E CURRENT REFUNDED THE SERIES 2011AB&C RMH ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE OCTOBER 4, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 2, ISSUER D: SERIES 2016F (SENTARA RMH MEDICAL CENTER) PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016F CURRENT REFUNDED THE SERIES 2010A, 2010B, AND 2010C RMH BONDS ON THE DATE OF CLOSING. SERIES 2010AB&C BONDS WERE MODIFIED/REISSUED ON 11/28/2011. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE NOVEMBER 1, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 3, ISSUER A: SERIES 2018A&B (SENTARA HEALTHCARE) PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2018A AND 2018B BONDS. THE SERIES 2018A&B BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. THE TOTAL AMOUNT INCLUDED ON LINE 3 INCLUDES THE ISSUE PRICE OF THE SERIES 2018A&B BONDS, PLUS $19M OF TRANSFERRED PROCEEDS, PLUS INTEREST EARNINGS RECEIVED FROM THE TRANSFERRED PROCEEDS (SERIES 2017 PROJECT FUND). PART II, 7 - ONLY A RESIDUAL AMOUNT OF BOND PROCEEDS WERE USED FOR COST OF ISSUANCE EXPENSES. A MAJORITY OF THESE COST OF ISSUANCE EXPENSES WERE PAID WITH EQUITY FROM SENTARA. PART II, 14 - SERIES 2018A&B CURRENT REFUNDED SERIES 2017 BONDS ON THE DATE OF CLOSING. THE SERIES 2018A&B BONDS RECEIVED TRANSFERRED PROCEEDS ON MAY 15, 2018 REDEMPTION DATE. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. HOWEVER, THE SERIES 2018A&B RECEIVED TRANSFERRED PROCEEDS THAT WERE SUBJECT TO ARBITRAGE COMPLIANCE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. ALL TRANSFERRED PROCEEDS WERE FULLY EXPENDED BY NOVEMBER 1, 2018. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE MAY 15, 2023 FIRST INSTALLMENT EVALUATION DATE. ENTITY 3, ISSUER B: SERIES 2018A&B (SENTARA MARTHA JEFFERSON HOSPITAL) PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2018A AND 2018B BONDS. THE SERIES 2018A&B BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2018A&B CURRENT REFUNDED SERIES 2013A&B BONDS ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE DECEMBER 31, 2022 FIRST INSTALLMENT EVALUATION DATE.

Schedule K (Form 990) 2018

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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 Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
SENTARA HEALTHCARE

Employer identification number
52-1271901

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	EDA THE CITY OF NORFOLK VA	52-1375010	NONEAVAIL	07-16-2003	53,100,000	FINANCING FOR CAPITAL AND FIXED ASSETS		X		X		X
B	EDA THE CITY OF SUFFOLK VA	54-1131047	86481QAA7	06-25-2008	156,615,000	REFUNDED BONDS ISSUED OCTOBER 2006		X		X		X
C	VA SMALL BUSINESS FINANCING AUTHORITY	54-1300845	928105AV7	01-28-2010	296,243,684	REFUND PRIOR BONDS AND FUND NEW PROJECT		X		X		X
D	EDA THE CITY OF NORFOLK VA	52-1375010	65588NBB7	05-16-2012	163,163,080	REF. POTOMAC 2003, MJH 2002, NEW PROJ.		X		X		X
	EDA THE CITY OF NORFOLK VA	52-1375010	65588TAP4	05-05-2016	197,670,000	REF. SERIES 2012A, 2010B, AND 2010C		X		X		X
	EDA OF THE CITY OF HARRISONBURG VA	54-2000436	NONEAVAIL	08-15-2016	183,535,000	CURRENTLY REFUND SERIES 2006 RMH		X		X		X
	EDA OF THE CITY OF HARRISONBURG VA	54-2000436	NONEAVAIL	10-04-2016	27,600,000	CURRENTLY REFUND SERIES 2011ABC RMH		X		X		X
	EDA OF THE CITY OF HARRISONBURG VA	54-2000436	NONEAVAIL	11-01-2016	65,379,312	CURRENTLY REFUND SERIES 2010ABC RMH		X		X		X
	EDA OF THE CITY OF NORFOLK	52-1375010	65588TAT6	05-15-2018	150,000,788	CURRENT REFUND SERIES 2017 BONDS		X		X		X
	EDA OF ALBERMARLE COUNTY VA	52-1297503	012663AM2	05-15-2018	154,550,000	CURRENTLY REFUND SERIES 2013AB BONDS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	24,300,000		10,990,000		74,480,000		15,640,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	53,100,000		156,615,000		296,443,256		163,873,559
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	788				2,715,612
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	19,317,907				230,220,167		75,585,411
11 Other spent proceeds .............	53,100,000		156,615,000		63,507,476		88,288,148
12 Other unspent proceeds .............
13 Year of substantial completion .............	2003		2008		2011		2014
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X	X		X			X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		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		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2018

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		X		X		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		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		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?	X
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 ....
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		X		X		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		X		X		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? .............
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		X		X		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		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X			X		X
c No rebate due? .........	X		X		X		X
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			X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

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		X		X		X
b Name of provider ..........
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		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		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		X		X		X

Part Ⅵ

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

Return Reference	Explanation
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: EDA THE CITY OF NORFOLK, VA DATE THE REBATE COMPUTATION WAS PERFORMED: 12/16/2007
SCHEDULE K, PART VI	ENTITY 1, ISSUE A: SERIES 2003 COMMERCIAL PAPER PROGRAM (SENTARA HEALTHCARE) PART II, 1 - SENTARA ISSUED TAXABLE COMMERCIAL PAPER NOTES IN 2012 TO PARTIALLY REFUND THIS 2003 COMMERCIAL PAPER PROGRAM. PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDES ISSUE PRICE. NO INTEREST WAS EARNED, ALL PROCEEDS SPENT WITHIN 18 MONTHS OF RECEIPT OF PROCEEDS. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART IV, 2C - SENTARA HAD ARBITRAGE COMPLIANCE REPORT COMPLETED FOR THIS ISSUE AS OF 12/16/2007, WHICH REFLECTED NO REBATE DUE TO THE IRS FOR THIS 2003 ISSUANCE. DEBT WAS ISSUED AS REIMBURSEMENT FOR PRIOR EXPENDITURES INCURRED. THEREFORE, THIS ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION. ENTITY 1, ISSUE B: SERIES 2008 ( SENTARA HEALTHCARE SYSTEM) PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDED ISSUE PRICE. NO INTEREST WAS EARNED, ALL PROCEEDS SPENT ON OR AROUND DATE OF CLOSING FOR REFUNDING PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - ISSUE REFUNDED A PRIOR SERIES 2006 ISSUE. THE REFUNDING WAS TREATED AS A CURRENT REFUNDING FOR FEDERAL TAX PURPOSES. ALL PROCEEDS WERE SPENT ON THE DAY OF ISSUE. PART IV, 2B - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA PROVIDED WITH ARBITRAGE COMPLIANCE CERTIFICATE IN SEPTEMBER OF 2008. FIRST INSTALLMENT EVALUATION DATE WOULD BE NO LATER THAN 6/25/2013. ON MAY 1, 2015, SENTARA HEALTHCARE MODIFIED AN EXISTING TOTAL RETURN SWAP ("TRS") FOR THE $156,615,000 SERIES 2008 REVENUE BONDS. THE TRS WAS NOT ORIGINALLY TREATED OR IDENTIFIED AS A QUALIFIED HEDGE FOR TAX PURPOSES AND THEREFORE ANY MODIFICATIONS SHOULD NOT HAVE RESULTED IN A REISSUANCE FOR FEDERAL TAX PURPOSES. HOWEVER, BOND COUNSEL AND THE SWAP PROVIDERS COUNSEL REVIEWED PRIVATE LETTER RULING PLR-147816-13, WHICH OUTLINED A VERY SIMILAR SITUATION. THE PLR CONCLUDED THAT AN AMENDMENT TO THE TRS WOULD NOT RESULT IN AN ABUSIVE ARBITRAGE DEVICE AS DEFINED WITHIN THE U.S. TREASURY REGULATIONS. THE PLR DID NOT CONCLUDE WHETHER OR NOT A REISSUANCE SHOULD APPLY IN SUCH A SITUATION. AS A CONSERVATIVE APPROACH, BOND COUNSEL AND THE SWAP PROVIDERS COUNSEL DECIDED TO FOLLOW THE DIRECTION TAKEN BY THE ISSUER IN THE PLR AND ALSO TREAT THE MODIFICATION OF THE TRS AS A REISSUANCE AND FILED A NEW FEDERAL FORM 8038 WITH THE INTERNAL REVENUE SERVICE, DATED MAY 1, 2015. AGAIN, THE TREATMENT OF THE TRS MODIFICATION AS A REISSUANCE WAS PURELY DONE AS A CONSERVATIVE APPROACH. AS STATED ABOVE, THE SERIES 2008 BONDS QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION. THEREFORE, THIS ISSUE WAS EXEMPT FROM THE ARBITRAGE REBATE CALCULATION. UNDER THE REISSUANCE TREATMENT, NO REBATE AMOUNTS WOULD HAVE BEEN DUE TO THE IRS AS OF THE MAY 1, 2015 REISSUANCE DATE. FURTHERMORE, THE 2008 REISSUED BONDS WOULD ALSO QUALIFY FOR THE SIX-MONTH SPENDING EXCEPTION AND WOULD NOT OWE AN ARBITRAGE REBATE PAYMENT TO THE IRS AS OF MAY 1, 2020 (FIFTH ANNIVERSARY DATE OF THE REISSUANCE). ENTITY 1, ISSUER C: SERIES 2010 (SENTARA HEALTHCARE SYSTEM - VSBFA) PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDES ISSUE PRICE, PLUS INTEREST EARNINGS (MAINLY FROM PROJECT FUND AND ESCROW FUND). PART II, 11 - OTHER SPENT PROCEEDS INCLUDES REFUNDING PROCEEDS AND INTEREST EARNINGS FROM REFUNDING ESCROW FUND. PART II, 14 - ISSUE REFUNDED A PRIOR SERIES 1997A AND 1998 ISSUE. THE REFUNDINGS WERE TREATED AS CURRENT REFUNDINGS FOR FEDERAL TAX PURPOSES. REFUNDING PROCEEDS WERE DEPOSITED INTO AN ESCROW FUND AND INVESTED. THOSE AMOUNTS WERE FULLY EXPENDED ON OR AROUND 3/1/2010 TO REDEEM THE PRIOR BONDS. PART IV, 2B - FIRST INSTALLMENT PERIOD FOR THIS ISSUE ENDED ON1/28/2015. ARBITRAGE COMPLIANCE REPORT COMPLETED THROUGH DECEMBER 31, 2011, WHICH REFLECTED ALL PROCEEDS SPENT AND NO ACCRUING ARBITRAGE LIABILITY FOR SENTARA.
SCHEDULE K, PART VI	ENTITY 1, ISSUER D: SERIES 2012B (SENTARA HEALTHCARE SYSTEM) PART II, 3 - TOTAL PROCEEDS OF THE ISSUE INCLUDES ISSUE PRICE, PLUS INTEREST EARNINGS ASSOCIATED WITH PROJECT FUND AND ESCROW FUNDS. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 11 - OTHER SPENT PROCEEDS INCLUDES REFUNDING PROCEEDS AND INTEREST EARNINGS FROM REFUNDING ESCROW FUNDS. PART II, 12 - UNSPENT PROCEEDS CONSIST OF THE REMAINING PROJECT FUND PROCEEDS. PART II, 15 - SERIES 2012B ADVANCE REFUNDED THE MARTHA JEFFERSON SERIES 2002 BONDS MATURING 10/1/2012 - 10/1/2035 WITH A CALL FOR REDEMPTION DATE OF 10/1/2012. THE SERIES 2012B ALSO ADVANCE REFUNDED THE POTOMAC HOSPITAL SERIES 2003 BONDS MATURING 10/1/2012 - 10/1/2036 WITH A CALL FOR REDEMPTION DATE OF 10/1/2013. PART IV, 2A, SENTARA RECEIVES ANNUAL ARBITRAGE COMPLIANCE REPORTS COMPLETED FOR THIS ISSUE. ALL PROCEEDS OF THE SERIES 2012B BONDS WERE FULLY EXPENDED AS OF 3/19/2014. ARBITRAGE COMPLIANCE CERTIFICATE WAS PROVIDED THROUGH THE 5/1/2017 FIFTH BOND YEAR, WHICH REFLECTED THAT NO ARBITRAGE REBATE LIABILITY WAS DUE TO THE IRS. ENTITY 2, ISSUER A: SERIES 2016A&B (SENTARA HEALTHCARE) PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2016A AND 2016B BONDS. THE SERIES 2016A&B BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016A&B CURRENT REFUNDED THE SERIES 2012A, 2010B, AND 2010C ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE MAY 5, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 2, ISSUER B: SERIES 2016C&D (SENTARA RMH MEDICAL CENTER) PART II, 3 - PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2016C AND 2016D BONDS. THE SERIES 2016C&D BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS.
SCHEDULE K, PART VI	PART II, 14 - SERIES 2016C&D CURRENT REFUNDED THE SERIES 2006 RMH BONDS ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE AUGUST 15, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 2, ISSUER C: SERIES 2016E (SENTARA RMH MEDICAL CENTER) PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016E CURRENT REFUNDED THE SERIES 2011AB&C RMH ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE OCTOBER 4, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 2, ISSUER D: SERIES 2016F (SENTARA RMH MEDICAL CENTER) PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016F CURRENT REFUNDED THE SERIES 2010A, 2010B, AND 2010C RMH BONDS ON THE DATE OF CLOSING. SERIES 2010AB&C BONDS WERE MODIFIED/REISSUED ON 11/28/2011. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE NOVEMBER 1, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 3, ISSUER A: SERIES 2018A&B (SENTARA HEALTHCARE) PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2018A AND 2018B BONDS. THE SERIES 2018A&B BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. THE TOTAL AMOUNT INCLUDED ON LINE 3 INCLUDES THE ISSUE PRICE OF THE SERIES 2018A&B BONDS, PLUS $19M OF TRANSFERRED PROCEEDS, PLUS INTEREST EARNINGS RECEIVED FROM THE TRANSFERRED PROCEEDS (SERIES 2017 PROJECT FUND). PART II, 7 - ONLY A RESIDUAL AMOUNT OF BOND PROCEEDS WERE USED FOR COST OF ISSUANCE EXPENSES. A MAJORITY OF THESE COST OF ISSUANCE EXPENSES WERE PAID WITH EQUITY FROM SENTARA. PART II, 14 - SERIES 2018A&B CURRENT REFUNDED SERIES 2017 BONDS ON THE DATE OF CLOSING. THE SERIES 2018A&B BONDS RECEIVED TRANSFERRED PROCEEDS ON MAY 15, 2018 REDEMPTION DATE. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. HOWEVER, THE SERIES 2018A&B RECEIVED TRANSFERRED PROCEEDS THAT WERE SUBJECT TO ARBITRAGE COMPLIANCE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. ALL TRANSFERRED PROCEEDS WERE FULLY EXPENDED BY NOVEMBER 1, 2018. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE MAY 15, 2023 FIRST INSTALLMENT EVALUATION DATE. ENTITY 3, ISSUER B: SERIES 2018A&B (SENTARA MARTHA JEFFERSON HOSPITAL) PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2018A AND 2018B BONDS. THE SERIES 2018A&B BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2018A&B CURRENT REFUNDED SERIES 2013A&B BONDS ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE DECEMBER 31, 2022 FIRST INSTALLMENT EVALUATION DATE.

Schedule K (Form 990) 2018

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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 Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
SENTARA HEALTHCARE

Employer identification number
52-1271901

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	EDA THE CITY OF NORFOLK VA	52-1375010	NONEAVAIL	07-16-2003	53,100,000	FINANCING FOR CAPITAL AND FIXED ASSETS		X		X		X
B	EDA THE CITY OF SUFFOLK VA	54-1131047	86481QAA7	06-25-2008	156,615,000	REFUNDED BONDS ISSUED OCTOBER 2006		X		X		X
C	VA SMALL BUSINESS FINANCING AUTHORITY	54-1300845	928105AV7	01-28-2010	296,243,684	REFUND PRIOR BONDS AND FUND NEW PROJECT		X		X		X
D	EDA THE CITY OF NORFOLK VA	52-1375010	65588NBB7	05-16-2012	163,163,080	REF. POTOMAC 2003, MJH 2002, NEW PROJ.		X		X		X
	EDA THE CITY OF NORFOLK VA	52-1375010	65588TAP4	05-05-2016	197,670,000	REF. SERIES 2012A, 2010B, AND 2010C		X		X		X
	EDA OF THE CITY OF HARRISONBURG VA	54-2000436	NONEAVAIL	08-15-2016	183,535,000	CURRENTLY REFUND SERIES 2006 RMH		X		X		X
	EDA OF THE CITY OF HARRISONBURG VA	54-2000436	NONEAVAIL	10-04-2016	27,600,000	CURRENTLY REFUND SERIES 2011ABC RMH		X		X		X
	EDA OF THE CITY OF HARRISONBURG VA	54-2000436	NONEAVAIL	11-01-2016	65,379,312	CURRENTLY REFUND SERIES 2010ABC RMH		X		X		X
	EDA OF THE CITY OF NORFOLK	52-1375010	65588TAT6	05-15-2018	150,000,788	CURRENT REFUND SERIES 2017 BONDS		X		X		X
	EDA OF ALBERMARLE COUNTY VA	52-1297503	012663AM2	05-15-2018	154,550,000	CURRENTLY REFUND SERIES 2013AB BONDS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	24,300,000		10,990,000		74,480,000		15,640,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	53,100,000		156,615,000		296,443,256		163,873,559
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	788				2,715,612
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	19,317,907				230,220,167		75,585,411
11 Other spent proceeds .............	53,100,000		156,615,000		63,507,476		88,288,148
12 Other unspent proceeds .............
13 Year of substantial completion .............	2003		2008		2011		2014
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X	X		X			X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		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		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2018

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		X		X		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		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		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?	X
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 ....
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		X		X		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		X		X		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? .............
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		X		X		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		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X			X		X
c No rebate due? .........	X		X		X		X
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			X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

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		X		X		X
b Name of provider ..........
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		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		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		X		X		X

Part Ⅵ

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

Return Reference	Explanation
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: EDA THE CITY OF NORFOLK, VA DATE THE REBATE COMPUTATION WAS PERFORMED: 12/16/2007
SCHEDULE K, PART VI	ENTITY 1, ISSUE A: SERIES 2003 COMMERCIAL PAPER PROGRAM (SENTARA HEALTHCARE) PART II, 1 - SENTARA ISSUED TAXABLE COMMERCIAL PAPER NOTES IN 2012 TO PARTIALLY REFUND THIS 2003 COMMERCIAL PAPER PROGRAM. PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDES ISSUE PRICE. NO INTEREST WAS EARNED, ALL PROCEEDS SPENT WITHIN 18 MONTHS OF RECEIPT OF PROCEEDS. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART IV, 2C - SENTARA HAD ARBITRAGE COMPLIANCE REPORT COMPLETED FOR THIS ISSUE AS OF 12/16/2007, WHICH REFLECTED NO REBATE DUE TO THE IRS FOR THIS 2003 ISSUANCE. DEBT WAS ISSUED AS REIMBURSEMENT FOR PRIOR EXPENDITURES INCURRED. THEREFORE, THIS ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION. ENTITY 1, ISSUE B: SERIES 2008 ( SENTARA HEALTHCARE SYSTEM) PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDED ISSUE PRICE. NO INTEREST WAS EARNED, ALL PROCEEDS SPENT ON OR AROUND DATE OF CLOSING FOR REFUNDING PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - ISSUE REFUNDED A PRIOR SERIES 2006 ISSUE. THE REFUNDING WAS TREATED AS A CURRENT REFUNDING FOR FEDERAL TAX PURPOSES. ALL PROCEEDS WERE SPENT ON THE DAY OF ISSUE. PART IV, 2B - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA PROVIDED WITH ARBITRAGE COMPLIANCE CERTIFICATE IN SEPTEMBER OF 2008. FIRST INSTALLMENT EVALUATION DATE WOULD BE NO LATER THAN 6/25/2013. ON MAY 1, 2015, SENTARA HEALTHCARE MODIFIED AN EXISTING TOTAL RETURN SWAP ("TRS") FOR THE $156,615,000 SERIES 2008 REVENUE BONDS. THE TRS WAS NOT ORIGINALLY TREATED OR IDENTIFIED AS A QUALIFIED HEDGE FOR TAX PURPOSES AND THEREFORE ANY MODIFICATIONS SHOULD NOT HAVE RESULTED IN A REISSUANCE FOR FEDERAL TAX PURPOSES. HOWEVER, BOND COUNSEL AND THE SWAP PROVIDERS COUNSEL REVIEWED PRIVATE LETTER RULING PLR-147816-13, WHICH OUTLINED A VERY SIMILAR SITUATION. THE PLR CONCLUDED THAT AN AMENDMENT TO THE TRS WOULD NOT RESULT IN AN ABUSIVE ARBITRAGE DEVICE AS DEFINED WITHIN THE U.S. TREASURY REGULATIONS. THE PLR DID NOT CONCLUDE WHETHER OR NOT A REISSUANCE SHOULD APPLY IN SUCH A SITUATION. AS A CONSERVATIVE APPROACH, BOND COUNSEL AND THE SWAP PROVIDERS COUNSEL DECIDED TO FOLLOW THE DIRECTION TAKEN BY THE ISSUER IN THE PLR AND ALSO TREAT THE MODIFICATION OF THE TRS AS A REISSUANCE AND FILED A NEW FEDERAL FORM 8038 WITH THE INTERNAL REVENUE SERVICE, DATED MAY 1, 2015. AGAIN, THE TREATMENT OF THE TRS MODIFICATION AS A REISSUANCE WAS PURELY DONE AS A CONSERVATIVE APPROACH. AS STATED ABOVE, THE SERIES 2008 BONDS QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION. THEREFORE, THIS ISSUE WAS EXEMPT FROM THE ARBITRAGE REBATE CALCULATION. UNDER THE REISSUANCE TREATMENT, NO REBATE AMOUNTS WOULD HAVE BEEN DUE TO THE IRS AS OF THE MAY 1, 2015 REISSUANCE DATE. FURTHERMORE, THE 2008 REISSUED BONDS WOULD ALSO QUALIFY FOR THE SIX-MONTH SPENDING EXCEPTION AND WOULD NOT OWE AN ARBITRAGE REBATE PAYMENT TO THE IRS AS OF MAY 1, 2020 (FIFTH ANNIVERSARY DATE OF THE REISSUANCE). ENTITY 1, ISSUER C: SERIES 2010 (SENTARA HEALTHCARE SYSTEM - VSBFA) PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDES ISSUE PRICE, PLUS INTEREST EARNINGS (MAINLY FROM PROJECT FUND AND ESCROW FUND). PART II, 11 - OTHER SPENT PROCEEDS INCLUDES REFUNDING PROCEEDS AND INTEREST EARNINGS FROM REFUNDING ESCROW FUND. PART II, 14 - ISSUE REFUNDED A PRIOR SERIES 1997A AND 1998 ISSUE. THE REFUNDINGS WERE TREATED AS CURRENT REFUNDINGS FOR FEDERAL TAX PURPOSES. REFUNDING PROCEEDS WERE DEPOSITED INTO AN ESCROW FUND AND INVESTED. THOSE AMOUNTS WERE FULLY EXPENDED ON OR AROUND 3/1/2010 TO REDEEM THE PRIOR BONDS. PART IV, 2B - FIRST INSTALLMENT PERIOD FOR THIS ISSUE ENDED ON1/28/2015. ARBITRAGE COMPLIANCE REPORT COMPLETED THROUGH DECEMBER 31, 2011, WHICH REFLECTED ALL PROCEEDS SPENT AND NO ACCRUING ARBITRAGE LIABILITY FOR SENTARA.
SCHEDULE K, PART VI	ENTITY 1, ISSUER D: SERIES 2012B (SENTARA HEALTHCARE SYSTEM) PART II, 3 - TOTAL PROCEEDS OF THE ISSUE INCLUDES ISSUE PRICE, PLUS INTEREST EARNINGS ASSOCIATED WITH PROJECT FUND AND ESCROW FUNDS. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 11 - OTHER SPENT PROCEEDS INCLUDES REFUNDING PROCEEDS AND INTEREST EARNINGS FROM REFUNDING ESCROW FUNDS. PART II, 12 - UNSPENT PROCEEDS CONSIST OF THE REMAINING PROJECT FUND PROCEEDS. PART II, 15 - SERIES 2012B ADVANCE REFUNDED THE MARTHA JEFFERSON SERIES 2002 BONDS MATURING 10/1/2012 - 10/1/2035 WITH A CALL FOR REDEMPTION DATE OF 10/1/2012. THE SERIES 2012B ALSO ADVANCE REFUNDED THE POTOMAC HOSPITAL SERIES 2003 BONDS MATURING 10/1/2012 - 10/1/2036 WITH A CALL FOR REDEMPTION DATE OF 10/1/2013. PART IV, 2A, SENTARA RECEIVES ANNUAL ARBITRAGE COMPLIANCE REPORTS COMPLETED FOR THIS ISSUE. ALL PROCEEDS OF THE SERIES 2012B BONDS WERE FULLY EXPENDED AS OF 3/19/2014. ARBITRAGE COMPLIANCE CERTIFICATE WAS PROVIDED THROUGH THE 5/1/2017 FIFTH BOND YEAR, WHICH REFLECTED THAT NO ARBITRAGE REBATE LIABILITY WAS DUE TO THE IRS. ENTITY 2, ISSUER A: SERIES 2016A&B (SENTARA HEALTHCARE) PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2016A AND 2016B BONDS. THE SERIES 2016A&B BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016A&B CURRENT REFUNDED THE SERIES 2012A, 2010B, AND 2010C ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE MAY 5, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 2, ISSUER B: SERIES 2016C&D (SENTARA RMH MEDICAL CENTER) PART II, 3 - PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2016C AND 2016D BONDS. THE SERIES 2016C&D BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS.
SCHEDULE K, PART VI	PART II, 14 - SERIES 2016C&D CURRENT REFUNDED THE SERIES 2006 RMH BONDS ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE AUGUST 15, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 2, ISSUER C: SERIES 2016E (SENTARA RMH MEDICAL CENTER) PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016E CURRENT REFUNDED THE SERIES 2011AB&C RMH ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE OCTOBER 4, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 2, ISSUER D: SERIES 2016F (SENTARA RMH MEDICAL CENTER) PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016F CURRENT REFUNDED THE SERIES 2010A, 2010B, AND 2010C RMH BONDS ON THE DATE OF CLOSING. SERIES 2010AB&C BONDS WERE MODIFIED/REISSUED ON 11/28/2011. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE NOVEMBER 1, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 3, ISSUER A: SERIES 2018A&B (SENTARA HEALTHCARE) PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2018A AND 2018B BONDS. THE SERIES 2018A&B BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. THE TOTAL AMOUNT INCLUDED ON LINE 3 INCLUDES THE ISSUE PRICE OF THE SERIES 2018A&B BONDS, PLUS $19M OF TRANSFERRED PROCEEDS, PLUS INTEREST EARNINGS RECEIVED FROM THE TRANSFERRED PROCEEDS (SERIES 2017 PROJECT FUND). PART II, 7 - ONLY A RESIDUAL AMOUNT OF BOND PROCEEDS WERE USED FOR COST OF ISSUANCE EXPENSES. A MAJORITY OF THESE COST OF ISSUANCE EXPENSES WERE PAID WITH EQUITY FROM SENTARA. PART II, 14 - SERIES 2018A&B CURRENT REFUNDED SERIES 2017 BONDS ON THE DATE OF CLOSING. THE SERIES 2018A&B BONDS RECEIVED TRANSFERRED PROCEEDS ON MAY 15, 2018 REDEMPTION DATE. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. HOWEVER, THE SERIES 2018A&B RECEIVED TRANSFERRED PROCEEDS THAT WERE SUBJECT TO ARBITRAGE COMPLIANCE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. ALL TRANSFERRED PROCEEDS WERE FULLY EXPENDED BY NOVEMBER 1, 2018. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE MAY 15, 2023 FIRST INSTALLMENT EVALUATION DATE. ENTITY 3, ISSUER B: SERIES 2018A&B (SENTARA MARTHA JEFFERSON HOSPITAL) PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2018A AND 2018B BONDS. THE SERIES 2018A&B BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2018A&B CURRENT REFUNDED SERIES 2013A&B BONDS ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE DECEMBER 31, 2022 FIRST INSTALLMENT EVALUATION DATE.

Schedule K (Form 990) 2018

Additional Data

Software ID:
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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

SENTARA HEALTHCARE

Employer identification number

52-1271901

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
(1) MICHAEL DUDLEY	FORMER OFFICER	EMPLOYMENT TAX ADVANCE		X	116,650	118,699		No		No	Yes





Total ............... $						118,699

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) 2018

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	(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

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2018

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

SENTARA HEALTHCARE

Employer identification number

52-1271901

Return Reference	Explanation
FORM 990, PART III, LINE 4A	SENTARA HEALTHCARE I. SENTARA HEALTHCARE - YOUR NOT-FOR-PROFIT HEALTHCARE PARTNER SENTARA HEALTHCARE BASED IN NORFOLK, VA, CELEBRATES MORE THAN 130 YEARS IN RELENTLESS PURSUIT OF ITS MISSION TO IMPROVE HEALTH EVERY DAY THROUGH INNOVATION, COMPASSION AND COMMUNITY BENEFIT. SENTARA IS A FULLY INTEGRATED NOT-FOR-PROFIT SYSTEM WITH NEARLY 300 SITES OF CARE OF WHICH THERE ARE 12 HOSPITALS IN VIRGINIA AND NORTH CAROLINA, INCLUDING A LEVEL I TRAUMA CENTER WITH NIGHTINGALE REGIONAL AIR AMBULANCE AND THE NATIONALLY-RANKED SENTARA HEART HOSPITAL. THE SENTARA FAMILY INCLUDES FOUR MEDICAL GROUPS, AMBULATORY CAMPUSES, POST-ACUTE CARE SERVICES, THE PHYSICIAN-LED SENTARA QUALITY CARE NETWORK, THE ACCREDITED SENTARA CANCER NETWORK, THE SENTARA COLLEGE OF HEALTH SCIENCES, OPTIMA HEALTH PLAN MEMBERS IN VIRGINIA AND OHIO, AND A TEAM OF PROFESSIONALS NEARLY 28,000 STRONG. SENTARA PROUDLY INCLUDES ADVANCED IMAGING CENTERS, NURSING AND ASSISTED LIVING CENTERS, PHYSICAL THERAPY AND REHABILITATION SERVICES, HOME HEALTH AND HOSPICE, AND GROUND MEDICAL TRANSPORTATION. SENTARA IS STRATEGICALLY FOCUSED ON CONTINUOUS IMPROVEMENT IN QUALITY, SAFETY, CLINICAL OUTCOMES AND THE PATIENT EXPERIENCE AND PURSUES KEY CLINICAL GOALS THROUGH HIGH PERFORMANCE TEAMS ACROSS THE ENTERPRISE. EFFORTS ARE CENTERED ON PROVIDING THE RIGHT CARE IN THE RIGHT SETTING AT THE RIGHT TIME AND ADDING VALUE TO THE COMMUNITIES WE SERVE. WE STRIVE TO SERVE ALL OF OUR COMMUNITIES THROUGH HEALTH OUTREACH PROGRAMS, EDUCATION, AND FINANCIAL SUPPORT OF OTHER NOT FOR PROFIT ORGANIZATIONS WITH SIMILAR HEALTH MISSIONS. II. COMMITMENT TO THE COMMUNITY A. SENTARA HEALTHCARE AND OPTIMA HEALTH PROVIDED $6.5M IN DONATIONS. DONATIONS WERE DISTRIBUTED TO FOODBANKS, VIRGINIA ASSOCIATION OF FREE AND CHARITABLE CLINICS, COMMUNITY CARE NETWORKS OF VIRGINIA, AND THE VIRGINIA HEALTH CARE FOUNDATION. PART OF THE $6.5M WENT TOWARDS SUPPORTING THE MARKETING BY THE COMMONWEALTH OF VIRGINIA TO MAKE RESIDENTS AWARE OF THE OPPORTUNITY FOR HEALTH INSURANCE THROUGH MEDICAID EXPANSION. ADDITIONALLY, DONATIONS WERE MADE TO 17 HEALTH RELATED PROJECTS ACROSS VIRGINIA AND NORTH CAROLINA. WE PLEDGED $130M TO EASTERN VIRGINIA MEDICAL SCHOOL OVER 5 YEARS. B. SENTARA HAS PROVIDED MUCH IN THE WAY OF COMMUNITY BENEFIT AND CHARITY CARE ON AN ANNUAL BASIS. IN 2018, SENTARA COMMUNITY BENEFIT REACHED NEARLY $390,000,000. SENTARA PROVIDED $354,121.000 IN NET UNCOMPENSATED PATIENT CARE COSTS; $2,086,000 IN NET UNFUNDED COSTS OF TEACHING PROGRAMS; AND $33,768,000 IN INCURRED COSTS FOR COMMUNITY BENEFIT PROGRAMS. C. SENTARA IS PROUD OF THE MISSION-DRIVEN WORK OF THE THREE SENTARA FOUNDATIONS. THESE FOUNDATIONS RAISED MONEY TO SUPPORT THE CLINICAL NEEDS OF THE SYSTEM AND PROVIDED FUNDING THROUGH GRANTS AND DIRECT CONTRIBUTIONS TO COMMUNITY ORGANIZATIONS THAT HAVE SIMILAR INTERESTS IN COMMUNITY HEALTH NEEDS. SENTARA FOUNDATION-HAMPTON ROADS SUPPORTS A WIDE RANGE OF PROGRAMS ACROSS HAMPTON ROADS. IN 2018, THE FOUNDATION RAISED $1.96M AND AWARDED 30 COMMUNITY GRANTS TOTALING $675,000 TO SUPPORT ITS KEY PRIORITY AREAS. THE MARTHA JEFFERSON HOSPITAL FOUNDATION IN CHARLOTTESVILLE, VIRGINIA RAISED NEARLY $3.5M IN NEW GIFTS AND COMMITMENTS AND FOCUSED THEIR EFFORTS ON A HIGH-RISK BREAST PROGRAM, CANCER SURVIVORSHIP PROGRAM, FAMILY AND CAREGIVER SUPPORT PROGRAM AND THE CENTER FOR CLINICAL EDUCATION. THE RMH FOUNDATION RAISED $4.79M IN NEW GIFTS AND COMMITMENTS AND FOCUSED THEIR EFFORTS ON THE SENTARA RMH HAHN CANCER CENTER LINEAR ACCELERATOR. IN 2018, THE RMH FOUNDATION AWARDED 6 COMMUNITY PARTNERSHIP GRANTS FOR A COMBINED $79,897. THIS INCLUDED $20,000 IN SEED FUNDING TO START THE COMMUNITY'S FIRST RAM "REMOTE AREA MEDICAL" CLINIC. SEVERAL YEARS AGO, SENTARA ESTABLISHED THE HOPE (HELPING OVERCOME PERSONAL EMERGENCY) FUND, WHICH IS AN EMERGENCY FINANCIAL RESOURCE FOR SENTARA EMPLOYEES THAT ARE EXPERIENCING CATASTROPHIC HARDSHIP OR LOSS THROUGH NO FAULT OF THEIR OWN. SENTARA EMPLOYEES WHO RECEIVE AID FROM THE HOPE FUND HAVE FACED DEVASTATING CRISES SUCH AS FIRE, DEATH, NATURAL DISASTERS, OR SERIOUS PERSONAL OR FAMILY ILLNESS. IN 2018, THE HOPE FUND AWARDED $165,000 TO SENTARA EMPLOYEES IN CRISES ACROSS THE SYSTEM. D. COMMUNITY HEALTH INITIATIVES SENTARA AND OPTIMA HEALTH HAVE LONG BEEN COMMITTED TO PROVIDING HEALTH AND PREVENTION SERVICES TO THE COMMUNITIES WE SERVE THROUGH MANY CHANNELS INCLUDING THE SENTARA HEALTHCARE COMMUNITY HEALTH AND PREVENTION ORGANIZATION WITHIN SENTARA. BELOW ARE SOME KEY HIGHLIGHTS OF THE EFFORTS IN OUR COMMUNITIES IN 2018: -HEALTH IMPROVEMENT EVENTS WERE OFFERED TO CHURCHES, EMPLOYER GROUPS INCLUDING SENTARA HEALTHCARE AND HAMPTON ROADS SANITATION DISTRICT, COMMUNITY HEALTH CENTERS AND OTHER COMMUNITY LOCATIONS INCLUDING THE POCKET EKG PROGRAM AND THE SENTARA LIVING PROGRAM. -SENTARA CONTINUED TO OFFER PROGRAMS SUCH AS EATING FOR LIFE, WALKABOUT WITH HEALTHY EDGE, HEALTH HABITS, HEALTHY YOU, MEDITATION, TAI CHI AND YOGA. -THE FLU PATROL ADMINISTERED A TOTAL OF 5,365 IMMUNIZATIONS. 4,862 WERE GIVEN TO OPTIMA HEALTH INSURED GROUPS THROUGHOUT VIRGINIA. THE REMAINDER WAS DELIVERED TO CHURCHES AND OTHER COMMUNITY GROUPS. -BIRTHDAY CARD REMINDERS FOR PREVENTIVE HEALTH SCREENINGS WERE DELIVERED TO ADULT MEMBERS OF OPTIMA HEALTH, OHIOHEALTH PLAN MEMBERS AND CHILDREN. SELF-CARE HANDBOOKS ON PLANNING A HEALTHY PREGNANCY WERE DISTRIBUTED TO 5,156 OPTIMA HEALTH PLAN MEMBERS. -THE TOBACCO CESSATION PROGRAMMING WAS UPDATED AND IS OFFERED ON DEMAND ON SENTARA.COM AND OPTIMAHEALTH.COM. OVER 650 PATIENTS FROM SENTARA VIRGINIA BEACH GENERAL HOSPITAL AND SENTARA HEART HOSPITAL WERE CONTACTED AFTER HOSPITAL DISCHARGE FOR TOBACCO CESSATION FOLLOW-UP. AN ELECTRONIC REFERRAL SYSTEM WAS ESTABLISHED WITH QUITNOW VA FOR NON-OPTIMA HEALTH INSURED MEMBERS OF THE COMMUNITY TO RECEIVE PERSONALIZED TOBACCO CESSATION SERVICES. A PARTNERSHIP WITH EVMS AND THEIR HUD SMOKEFREE HOUSING PROJECT WAS ESTABLISHED AND OUR TOBACCO CESSATION MATERIALS WERE DISTRIBUTED. -AS PART OF THE SENTARA BENEFIT ENROLLMENT PROCESS, 18,887 EMPLOYEES COMPLETED A HEALTH RISK ASSESSMENT IN CONJUNCTION WITH THE MISSION: HEALTH PROGRAM. -FINALLY, WEBMD, WHICH SERVES AS OUR HEALTH COACHING AND HEALTH EDUCATION PORTAL PARTNER, HAS NOW 25,691 REGISTERED MEMBERS OF WHICH 16,956 MEMBERS ARE ACTIVELY ENGAGED. SENTARA HOSTS A NUMBER OF COMMUNITY EVENTS RAISING AWARENESS AROUND KEY HEALTH AWARENESS MONTHS. ONE GOOD EXAMPLE IS THE FOCUS ON COLON CANCER PREVENTION: DON'T SIT ON COLON CANCER. THROUGH THE SENTARA CANCER NETWORK, SENTARA HOSTED A 5K AT SENTARA PRINCESS ANNE HOSPITAL IN VIRGINIA BEACH. THROUGH SENTARA HEART, WE PROMOTED THE "28 DAYS OF HEART" IN FEBRUARY, 2018 IN SUPPORT OF HEART HEALTH AWARENESS. ONLINE PROMOTIONS, RADIO ADS, VIDEOS, SCREENINGS AND MORE WERE CONDUCTED TO RAISE AWARENESS OF HEART DISEASE THROUGHOUT THE COMMUNITIES WE SERVE IN VIRGINIA AND NORTH CAROLINA. III. GROWTH IN SENTARA HEALTHCARE SINCE THE BEGINNING, SENTARA HAS REACHED OUT TO OTHER INDUSTRY LEADERS AND JOINED FORCES TO EXTEND QUALITY HEALTHCARE AND SERVICES TO MORE PEOPLE. IN RECENT YEARS, WE HAVE GROWN IN VIRGINIA AND IN OTHER STATES - NORTH CAROLINA AND OHIO - BY SEEKING PARTNERSHIPS WITH SUCCESSFUL HOSPITALS AND HEALTH SYSTEMS THAT SHARE OUR DEDICATION TO EXCELLENCE, VALUE, QUALITY AND CUSTOMER FOCUS. OUR GROWTH IN 2018 INCLUDED THE FOLLOWING: A. AS A RESULT OF THE COMMONWEALTH OF VIRGINIA APPROVING MEDICAID EXPANSION, OPTIMA HEALTH IS ONE OF SIX MANAGED CARE ORGANIZATIONS THAT WILL SERVE THE NEARLY 400,000 ELIGIBLE VIRGINIANS WHO WILL QUALIFY FOR MEDICAID EXPANSION. OPEN ENROLLMENT BEGAN IN NOVEMBER, 2018 WITH THE EFFECTIVE START DATE OF JANUARY 1, 2019. B. THE SENTARA CANCER CENTER CELEBRATED ANOTHER CONSTRUCTION MILESTONE WITH THE TOPPING OUT CEREMONY IN DECEMBER, 2018. THE EXPECTED OPENING DATE FOR THIS COMPREHENSIVE CENTER IS 2020.
FORM 990, PART III, LINE 4A	C. SENTARA, IN PARTNERSHIP WITH OTHERS, EXPANDED TO 15 VELOCITY URGENT CARE CENTERS ACROSS VIRGINIA. ACROSS SITES, 144,796 PATIENT VISITS WERE SEEN WITH AN AVERAGE DOOR IN TO DOOR OUT TIME OF 45 MINUTES. IV. NEW INITIATIVES A. SENTARA CONTINUES TO DEVELOP OPPORTUNITIES TO ENHANCE OUR BEHAVIORAL HEALTH INITIATIVES AND IMPLEMENT PROGRAMS THAT WILL SUPPORT THE COMMUNITIES WE SERVE. THE CENTER FOR BEHAVIORAL HEALTH LOCATED AT SENTARA VIRGINIA BEACH GENERAL HOSPITAL BEGAN OFFERING STRUCTURED OUTPATIENT PROGRAMS SPECIFICALLY DESIGNED TO MEET THE NEEDS OF ADULTS EXPERIENCING MENTAL HEALTH AND/OR SUBSTANCE ABUSE PROBLEMS. B. SENTARA BUILT THE FOUNDATION FOR OUR NEW AMBULATORY/RETAIL STRATEGY BY UPDATING OUR GROWTH IMPERATIVE AND STRUCTURING THE ORGANIZATION TO CAPTURE OPPORTUNITIES IN THIS AREA. C. IN ITS FOURTH YEAR, CLINICAL PERFORMANCE IMPROVEMENT (CLINICAL PI), AN INITIATIVE TO DRIVE CHANGE AND CREATE RAPID PROCESS IMPROVEMENT IN TARGETED CLINICAL AREAS, RESULTED IN SEEING POSITIVE TRENDS TOWARDS MEETING THE COMPANY'S ULTIMATE GOALS. D. THE VOICE OF THE CUSTOMER MODEL WAS HEAVILY UTILIZED TO UNDERSTAND MORE FROM SENTARA AND OPTIMA CUSTOMERS. THE MODEL IS AN OPERATIONAL DESIGN THAT ENABLES SENTARA TO INTEGRATE THE VOICE OF THE CUSTOMER INTO ALL FACETS OF BUSINESS DECISION-MAKING AND PRODUCT DEVELOPMENT. E. SENTARA BEGAN COMMUNICATING ABOUT THE GOOD WE DO FOR THE COMMUNITIES WE SERVE. WE CREATED AND DISTRIBUTED TWO COMMUNITY BENEFIT REPORTS, COMPLEMENTED WITH FULLY INTEGRATED MARKETING CAMPAIGNS AND, ALSO STEPPED UP OUR PHILANTHROPIC DONATIONS. F. A NUTRITION AS MEDICINE CONFERENCE WAS HELD IN NOVEMBER, 2018. NATIONAL EXPERTS IN PLANT-BASED LIFESTYLES DETAILED THE NUTRITIONAL BENEFITS OF SUCH DIETS IN FRONT OF NEARLY 950 PEOPLE. GUESTS INCLUDED 350 MEDICAL PROFESSIONALS, AND REGISTRANTS TRAVELED FROM 14 STATES AND EVEN CANADA TO LEARN THE POSITIVE EFFECTS NUTRITION CAN HAVE ON CHRONIC ILLNESSES AND QUALITY OF LIFE. G. OLD DOMINION UNIVERSITY IS PARTNERING WITH SENTARA HEALTHCARE ON A THREE-YEAR PROJECT TO DEVELOP A BLOCKCHAIN-EMPOWERED CYBERSECURITY SOLUTION TO MONITOR NETWORK ACTIVITIES OF MOBILE DEVICES AND PROVIDE REAL-TIME ALERTS OF UNAUTHORIZED DEVICES OR COMMUNICATIONS. V. OFFERING NEW PROCEDURES AND TECHNOLOGIES CLINICAL BREAKTHROUGHS AND ADVANCEMENTS: SENTARA INTRODUCED MANY NEW CLINICAL BREAKTHROUGHS AND ADVANCEMENTS THAT BENEFITED THE PATIENT IN MANY AREAS OF CARE, INCLUDING CARDIAC AND REDUCING INFECTIONS. A. PHARMACY ROBOT: I. SENTARA RMH MEDICAL CENTER PHARMACY INSTALLED A NEW STATE-OF-THE-ART PHARMACY ROBOT FOR AUTOMATED DISPENSING OF PATIENT MEDICATIONS. THE HOSPITAL IS THE SECOND IN THE WORLD TO INSTALL THE OMNICELL XR2 AUTOMATED CENTRAL PHARMACY SYSTEM. B. SURGICAL IMAGING: I. SENTARA NORFOLK GENERAL HOSPITAL INTRODUCED THE IMRI. THE GE INTRAOPERATIVE MRI MACHINE IS AN MRI THAT IS DONE MID-SURGERY TO HELP NEUROSURGEONS KNOW IF THEY HAVE REMOVED THE ENTIRE LESION OR TUMOR WITHOUT HAVING TO WAKE THE PATIENT UP. IT PROVIDES REAL-TIME IMAGING DURING SURGICAL PROCEDURES INCLUDING BRAIN TUMORS, GLIOMA AND MOVEMENT DISORDERS/TREMORS LIKE PARKINSON'S DISEASE. II. THE SENTARA HEART TRANSPLANT TEAM IS NOW USING THE SHERPA PAK TM TRANSPORT SYSTEM BY PARAGONIX TECHNOLOGIES TO ENSURE A CONSISTENT TEMPERATURE AT ALL TIMES OF A DONOR HEART TRANSPORT. THE SHERPA PAK TM IS A TEMPERATURE CONTROLLED COOLING SYSTEM THAT ALLOWS THE HEART TO BE STORED AT A CHOSEN TEMPERATURE. VI. EXPANDING EDUCATIONAL OPPORTUNITIES SENTARA IS COMMITTED TO ALWAYS IMPROVING--INCLUDING ENCOURAGING REGISTERED NURSES (RNS) TO CONTINUE PURSUING EDUCATIONAL OPPORTUNITIES. CONTINUOUS LEARNING WILL ADVANCE THE CARE SENTARA NURSES DELIVER TO OUR PATIENTS AND ALLOW THEM TO ADVANCE IN THEIR CAREERS. IN 2018, SENTARA ACHIEVED ITS GOAL OF 80% OF SENTARA NURSES HAVING A BSN BY 2020. IN 2018, SENTARA HAD 64.5% OF ITS NURSING WORKFORCE HOLDING A BSN OR HIGHER DEGREE WITH 16.2% OF LICENSED RNS WITH A CONTRACT TO COMPLETE THEIR BSN. RESEARCH: RESEARCH IS ANOTHER WAY SENTARA IS ALWAYS IMPROVING. HERE ARE A FEW EXAMPLES OF OUR WORK WITHIN THE RESEARCH REALM: A. HEART & VASCULAR: THROUGH THE SENTARA CARDIOVASCULAR RESEARCH INSTITUTE, CARDIOLOGISTS, CARDIOVASCULAR SURGEONS, VASCULAR SURGEONS AND UNIQUELY TRAINED REGISTERED NURSE RESEARCH COORDINATORS MAKE SIGNIFICANT STRIDES IN ADVANCING THE UNDERSTANDING AND TREATMENT OF THE NUMBER ONE KILLER IN AMERICA: CARDIOVASCULAR DISEASE. AS THE PREEMINENT CARDIAC RESEARCH INSTITUTE IN THE MID-ATLANTIC REGION, SENTARA WORKS COLLABORATIVELY WITH LOCAL INSTITUTIONS, GOVERNMENT AGENCIES AND BIOMEDICAL COMPANIES ON NATIONALLY AND INTERNATIONALLY RECOGNIZED CLINICAL RESEARCH TRIALS. WE FOCUS OUR EFFORTS ON DISCOVERING MORE EFFECTIVE CARDIOVASCULAR TREATMENTS AND PROTOCOLS WHILE ELIMINATING THOSE THAT ARE POTENTIALLY HARMFUL OR NOT AS BENEFICIAL. OUR ULTIMATE GOAL IS TO PROVIDE ENHANCED CLINICAL CARE THAT ADVANCES PATIENT OUTCOMES AND IMPROVES THE OVERALL HEALTH OF OUR COMMUNITY. OUR RESEARCH TOUCHES ON EVERY ASPECT OF HEART AND VASCULAR CARE, INCLUDING MEDICAL DEVICES, HEART FAILURE, ELECTROPHYSIOLOGY, CARDIAC SURGERY, VASCULAR SURGERY, CARDIAC INTERVENTIONAL PROCEDURES, STRUCTURAL HEART DISEASE, AND THE MEDICAL MANAGEMENT OF CORONARY ARTERY DISEASE RISK FACTORS SUCH AS DIABETES AND HIGH CHOLESTEROL. COLLECTIVELY, OUR RESEARCH NURSES COORDINATE MORE THAN 90 CLINICAL TRIALS AT ANY GIVEN TIME, SHEPHERDING PARTICIPANTS THROUGH THE ENTIRE TRIAL PROCESS, PROVIDING CARE DURING PERIODS OF NEED, AND TIRELESSLY ADVOCATING FOR THEIR PATIENTS' WELL-BEING. B. CANCER: CLINICIANS AND ACADEMIC RESEARCHERS AT SENTARA CANCER NETWORK PARTNER WITH VIRGINIA ONCOLOGY ASSOCIATES, EASTERN VIRGINIA MEDICAL SCHOOL, GEORGE MASON UNIVERSITY AND OTHER NATIONAL AND LOCAL HEALTHCARE ORGANIZATIONS TO CONDUCT RESEARCH THAT ELEVATES PATIENT CARE. COLLABORATIONS BETWEEN SURGICAL, RADIATION AND MEDICAL ONCOLOGISTS IN OUR SENTARA CANCER NETWORK ARE ESPECIALLY INSTRUMENTAL IN CONNECTING PATIENTS WITH CLINICAL TRIALS. THROUGH COLLABORATION WITH THE NCI NATIONAL CLINICAL TRIALS NETWORK (NCTN), THE ALLIANCE FOR CLINICAL TRIALS IN ONCOLOGY AND NATIONAL RESEARCH GROUP ONCOLOGY, WE DEVELOP AND CONDUCT CLINICAL TRIALS WITH PROMISING NEW CANCER THERAPIES. AS A LEADING CONTRIBUTOR TO NATIONAL RESEARCH, THE SENTARA CANCER NETWORK IS COMMITTED TO PARTICIPATING IN PROMISING CLINICAL TRIALS THAT MAKE NEW FIRST-LINE THERAPIES AVAILABLE TO PATIENTS RIGHT NOW. OUR PHYSICIANS ADDITIONALLY DEVELOP PROTOCOLS TO TEST THEIR OWN IMPORTANT RESEARCH QUESTIONS AND THEORIES, FOCUSING ON THE NEEDS OF OUR PATIENTS, HOSPITALS AND COMMUNITY. OUR TEAM PARTICIPATES IN RESEARCH THAT MAY LEAD TO BETTER OPTIONS FOR PREVENTION, DIAGNOSIS AND TREATMENT IN THE FUTURE.
FORM 990, PART III, LINE 4A	VII. BUILDING FOR THE FUTURE: A. THE SENTARA BELLEHARBOUR STRATEGIC PLAN WAS COMPLETED AND SENTARA BELLEHARBOUR, LOCATED IN SUFFOLK, OPENED A NEW 20,000 SQ. FT. AMBULATORY SURGERY CENTER WHERE LOWER ACUITY SURGERIES SUCH AS PODIATRY, VASCULAR ACCESS AND HERNIA REPAIR ARE CONDUCTED. B. TO HELP TRAVELERS, SENTARA MARTHA JEFFERSON HOSPITAL, LOCATED IN CHARLOTTESVILLE, OPENED A TRAVELERS' CLINIC. THIS IS A FULL-SERVICE CLINIC PROVIDING PRE-TRAVEL, IN-TRAVEL AND POST-TRAVEL SERVICES. SERVICES WILL BE PROVIDED TO ALL AGE GROUPS. C. SENTARA NORFOLK GENERAL HOSPITAL, OUR LEVEL I TRAUMA CENTER, LOCATED IN NORFOLK IS HOME TO THE NIGHTINGALE REGIONAL AIR AMBULANCE, THE REGION'S PREMIER AIR AMBULANCE. IN 2018, NINE SITES IN EASTERN VIRGINIA AND NORTHEAST NORTH CAROLINA ARE FULLY OPERATIONAL FOR INSTRUMENT FLIGHT RULES (IFR) LANDINGS BY NIGHTINGALE. THE FAA DESIGNATION CREATES DESIGNATED AIR SPACE, ALLOWING FLIGHTS IN CLOUDY, RAINY WEATHER, WHICH HAD TO BE TURNED DOWN UNDER CURRENT VISUAL FLIGHT RULES (VFR) LIMITATIONS. IFR ALLOWS NIGHTINGALE TO MEET GROUND AMBULANCES AT DESIGNATED SAFE SITES IN POOR WEATHER RATHER THAN REMOTE SCENES. D. THE SENTARA SPORTS MEDICINE CENTER OPENED AT THE OUTPATIENT CARE CENTER IN CHARLOTTESVILLE. THE SPECIALISTS PROVIDING CARE AT THE CENTER HAVE EXPERIENCE CARING FOR ATHLETES OF ALL LEVELS, FROM NOVICE TO OLYMPIAN, AND FOR SUCH INJURIES AS SPRAINS AND STRAINS, TORN LIGAMENTS AND TENDONS, JOINT DISLOCATIONS AND FRACTURES. ADVANCED TECHNIQUES SUCH AS INJECTIONS USING PLATELET-RICH PLASMA THERAPY, AS WELL AS OTHER NON-SURGICAL AND SURGICAL PROCEDURES ARE ALSO USED TO AID HEALING. E. SENTARA NORTHERN VIRGINIA MEDICAL CENTER, LOCATED IN WOODBRIDGE, ANNOUNCED THE ADDITION OF NEUROSURGERY AND UNVEILED ITS NEWLY RENOVATED AND EXPANDED SENTARA WOUND HEALING CENTER. F. SENTARA ALBEMARLE MEDICAL CENTER, LOCATED IN ELIZABETH CITY, NORTH CAROLINA, INTRODUCED THE USE OF THE ENDOBRONCHIAL ULTRASOUND (EBUS) BRONCHOSCOPY. THIS WILL ALLOW DOCTORS TO MORE EASILY LOCATE TUMORS, LYMPH NODES, OR OTHER TISSUES OF CONCERN. ADDITIONALLY, SENTARA ALBEMARLE MEDICAL CENTER (SAMC) INTRODUCED THE SENTARA WOUND HEALING CENTER AND THE SAMC CANCER CENTER RECEIVED ACCREDITATION FROM THE COMMISSION ON CANCER. SAMC INTRODUCED THE BREVERA BREAST BIOPSY SYSTEM. THIS BREAST BIOPSY SYSTEM SHORTENS THE IMAGING DELAY BETWEEN BIOPSIES AND IT REDUCES BIOPSY TIMES BY AN AVERAGE OF 10 MINUTES. G. SENTARA VIRGINIA BEACH GENERAL HOSPITAL, LOCATED IN VIRGINIA BEACH, LAUNCHED ITS FRACTURE CENTER WHERE IT PROVIDES HIGH QUALITY, SUBSPECIALTY CARE FROM A SPECIALIZED TEAM OF ORTHOPEDIC SURGEONS. SENTARA VIRGINIA BEACH GENERAL HOSPITAL MARKED ITS COMPLETION OF THE FIRST PHASE OF ITS MODERNIZATION PROJECT WITH THE CONSOLIDATION AND RE-STYLING OF THE HOSPITAL'S THREE SEPARATE INTENSIVE CARE UNITS INTO ONE STATE-OF-THE-ART, 24-BED ICU. H. SENTARA HALIFAX REGIONAL HOSPITAL, LOCATED IN SOUTH BOSTON, OPENED A BEHAVIORAL HEALTH PARTIAL HOSPITALIZATION PROGRAM TO JOIN ITS EXISTING INTENSIVE OUTPATIENT PROGRAM IN ORDER TO FURTHER ENHANCE ITS BEHAVIORAL HEALTH SERVICES FOR THE COMMUNITY. I. SENTARA LEIGH HOSPITAL, LOCATED IN NORFOLK, SENTARA PRINCESS ANNE HOSPITAL, LOCATED IN VIRGINIA BEACH, AND SENTARA VIRGINIA BEACH GENERAL HOSPITAL, LOCATED IN VIRGINIA BEACH, INTRODUCED THEIR SENTARA FOOT AND ANKLE CENTERS. THESE CENTERS HAVE DEVELOPED PATHWAYS FOR PATIENTS TO RECEIVE THE RIGHT CARE FOR THE TYPE OF FOOT OR ANKLE CONCERN INDIVIDUALS MAY HAVE. J. SENTARA PRINCESS ANNE HOSPITAL, LOCATED IN VIRGINIA BEACH, COMPLETED ITS MODERNIZATION PROJECT RESULTING IN THE ADDITION OF TWO NEW FLOORS TO THE HOSPITAL AND THE ADDITION OF 14 INPATIENT HOSPITAL BEDS AND 10 OBSERVATION BEDS; EXPANDED MONITORING FOR CARDIAC PATIENTS; INPATIENT DIALYSIS CENTER TO TREAT PATIENTS WITH KIDNEY FAILURE; AND ALLOWS FOR FUTURE EXPANSION OF SURGICAL SERVICES. K. SENTARA CAREPLEX HOSPITAL, LOCATED IN HAMPTON, EXPERIENCED A STRONG FIRST YEAR OF OFFERING MATERNITY SERVICES. THE BIRTHING CENTER HAS 7 LABOR, DELIVERY, RECOVERY AND POST-PARTUM ROOMS AND PROVIDES A UNIQUELY MODERN, ULTRA-PERSONALIZED EXPERIENCE FOR WOMEN AND FAMILIES IN THE COMMUNITY. L. SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER EARNED AN "A" SAFETY GRADE FROM THE LEAPFROG GROUP FOR THEIR COMMITMENT TO KEEPING PATIENTS SAFE AND MEETING THE HIGHEST SAFETY STANDARDS IN THE U.S. M. SENTARA OBICI HOSPITAL IS NOW THE 8TH HOSPITAL IN SENTARA AWARDED MAGNET STATUS. THE DESIGNATION, GRANTED TO ABOUT 7% OF U.S. HOSPITALS, CULMINATES A MULTI-YEAR JOURNEY TOWARD RECOGNITION FOR EXCELLENCE IN PATIENT CARE, INNOVATION IN NURSING PRACTICE AND A SUPPORTIVE WORK ENVIRONMENT FOR NURSES. N. SENTARA ENTERPRISES PROPRIUM PHARMACY, SENTARA'S HIGH-TOUGH SPECIALTY PHARMACY THAT OPENED IN 2016, ACHIEVED URAC ACCREDITATION. URAC WAS FORMERLY KNOWN AS THE UTILIZATION REVIEW ACCREDITATION COMMISSION. THIS DESIGNATION DEMONSTRATES THAT THE PROPRIUM PHARMACY IS COMMITTED TO QUALITY AND SAFETY AND STRIVES FOR CONTINUOUS IMPROVEMENT OF OUR SERVICES. O. SENTARA LIFE CARE SENTARA LIFE CARE IS COMPRISED OF ASSISTED LIVING CENTERS, NURSING HOMES, MOBILE MEALS AND THE PROGRAM FOR THE ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE). IN 2018, SENTARA LIFE CARE EXPANDED THE PACE (PROGRAM FOR THE ALL-INCLUSIVE CARE FOR THE ELDERLY) SERVICES TO THE WESTERN TIDEWATER AREA TO INCLUDE SURRY, ISLE OF WIGHT AND FRANKLIN CITY. PACE IS A COMPREHENSIVE HEALTH CARE AND SUPPORTIVE SERVICES PROGRAM FOR FRAIL SENIORS WHO WISH TO REMAIN IN THEIR HOMES AND COMMUNITY. THE PROGRAM IS ONE THAT PROVIDES TOTAL CARE FOR PARTICIPANTS, INCLUDING COMPREHENSIVE MEDICAL AND REHABILITATIVE SERVICES, IN-HOME SERVICES AND TRANSPORTATION. THE SENTARA NURSING AND REHABILITATION CENTER WINDERMERE, LOCATED IN VIRGINIA BEACH, OPENED ITS CARDIAC CENTER OF EXCELLENCE, WHICH ALLOWS THEM TO ACCEPT LVAD (LEFT VENTRICULAR ASSIST DEVICE) RESIDENTS NEEDING THERAPY SERVICES. THE SENTARA REHABILITATION AND CARE RESIDENCE, LOCATED IN CHESAPEAKE, OPENED ITS BACK & NECK CENTER OF EXCELLENCE. THE SENTARA NEUROSCIENCES AND ORTHOPEDIC TEAMS HAVE PARTNERED TO DEVELOP A COMPREHENSIVE AND PLANNED COURSE OF TREATMENT FOR PATIENTS UNDERGOING SPINE PROCEDURES. P. SENTARA MEDICAL GROUP (900+ PROVIDERS IN VIRGINIA AND NORTHEASTERN NORTH CAROLINA) SENTARA MEDICAL GROUP LAUNCHED VIDEO VISITS FOR SAME-DAY CARE, ROUTINE CARE, TRANSITION CARE AND MEDICATION REFILLS - ALLOWING FOR SEAMLESS ACCESS TO CARE AND GREATER CONVENIENCE FOR THE CUSTOMER. VIII. QUALITY AND PATIENT SAFETY DISTINCTIONS
FORM 990, PART III, LINE 4A	A. AWARD-WINNING CARE - AS ALWAYS, SENTARA IS PROUD AND HUMBLED BY THE VARIOUS AWARDS AND RECOGNITIONS THE SYSTEM RECEIVED OVER THE COURSE OF THE YEAR. OUR MISSION IS TO IMPROVE HEALTH EVERY DAY. TO RECEIVE AN AWARD IS SIMPLY AN ADDED ACKNOWLEDGEMENT OF OUR MISSION DRIVEN WORK. HERE ARE A FEW OF THE 2018 AWARDS AND RECOGNITIONS: I. FOR THE 18TH CONSECUTIVE YEAR, THE CARDIOLOGY AND HEART SURGERY PROGRAM AT SENTARA NORFOLK GENERAL HOSPITAL (SENTARA HEART HOSPITAL) WAS LISTED AMONG THE TOP 50 HEART PROGRAMS IN THE U.S. NEWS & WORLD REPORT 'BEST HOSPITALS' RANKING #32 IN 2018. SENTARA NORFOLK GENERAL HOSPITAL ALSO EARNED TWO ADDITIONAL TOP 50 NATIONAL RANKINGS FROM U.S. NEWS & WORLD REPORT: DIABETES AND ENDOCRINOLOGY (RANKED NO. 31), A SPECIALTY AT EASTERN VIRGINIA MEDICAL SCHOOL, AND NEPHROLOGY (RANKED 48). II. SEVEN SENTARA HOSPITALS EARNED HIGHEST GRADE OF "A" FOR DELIVERING SAFE CARE FOR PATIENTS ACCORDING TO THE LEAPFROG HOSPITAL SAFETY SCORE. III. SENTARA NORFOLK GENERAL HOSPITAL EPILEPSY CENTER HAS BEEN ACCREDITED AS A LEVEL III EPILEPSY CENTER THROUGH THE NATIONAL ASSOCIATION OF EPILEPSY CENTERS. IV. SENTARA IS THE ONLY HEALTH SYSTEM ON THE EAST COAST TO BE NATIONALLY RECOGNIZED AMONG THE 15 TOP HEALTH SYSTEMS BY IBM WATSON HEALTH FOR 2018. THE AWARD DEMONSTRATES CONSISTENTLY EXCELLENT PERFORMANCE AND A HIGH RATE OF IMPROVEMENT ACROSS THE ENTIRE ORGANIZATION. V. SENTARA WAS PLEASED TO HAVE BEEN RECOGNIZED AS ONE OF AMERICA'S BEST EMPLOYERS IN 2018 BY FORBES. RANKING IN THE BEST LARGE EMPLOYERS CATEGORY, SENTARA IS NUMBER 177 OF 500 COMPANIES CATEGORIZED INTO 25 INDUSTRIES. SENTARA WAS NAMED ALONGSIDE ONLY 24 OTHER LARGE ORGANIZATIONS IN THE HEALTHCARE AND SOCIAL INDUSTRY GROUP. VI. SENTARA EXCELLED IN STROKE CERTIFICATIONS IN 2018. SENTARA NORFOLK GENERAL HOSPITAL, LOCATED IN NORFOLK, ACHIEVED COMPREHENSIVE STROKE CERTIFICATION AFTER A MULTI-YEAR EFFORT TO DO SO AND SENTARA MARTHA JEFFERSON HOSPITAL, LOCATED IN CHARLOTTESVILLE, RECEIVED A FIRST-EVER PRIMARY STROKE CENTER PLUS CERTIFICATIONS. TWO FREE-STANDING EMERGENCY DEPARTMENTS - SENTARA BELLEHARBOUR AND SENTARA INDEPENDENCE - ACHIEVED AN ACUTE STROKE READY CERTIFICATION. VII. SENTARA HALIFAX REGIONAL HOSPITAL WAS NAMED IN THE TOP 100 RURAL AND COMMUNITY HOSPITALS IN THE UNITED STATES BY IVANTAGE HEALTH ANALYTICS AND THE CHARTIS CENTER FOR RURAL HEALTH. THIS IS THE SECOND CONSECUTIVE YEAR THAT THE HOSPITAL HAS RECEIVED THIS DESIGNATION. VIII. SENTARA LIFE CARE IN VIRGINIA BEACH WAS RECOGNIZED AS A PATHWAYS OF EXCELLENCE CENTER FROM THE AMERICAN NURSES CREDENTIALING CENTER. THIS DESIGNATION RECOGNIZES AN ORGANIZATION'S COMMITMENT TO CREATING A POSITIVE PRACTICE ENVIRONMENT THAT EMPOWERS AND ENGAGES STAFF. THIS IS THE FIRST LONG-TERM CARE FACILITY IN VIRGINIA TO BE DESIGNATED AS A PATHWAYS TO EXCELLENCE CENTER AND ONLY THE FOURTH LONG TERM CENTER NATIONALLY TO HAVE THIS DESIGNATION. IX. OPTIMA HEALTH A. GROWTH OPTIMA HEALTH COMPLETED ITS OPTIMA GROWTH AND STRATEGIC CAPABILITIES PLAN. ADDITIONALLY, OPTIMA HEALTH WAS SELECTED AS ONE OF SIX MANAGED CARE ORGANIZATIONS TO SERVE MEMBERS THROUGH MEDICAID EXPANSION, WHICH WILL ALLOW FOR NEARLY 400,000 VIRGINIANS TO NOW HAVE ACCESS TO QUALITY HEALTH CARE. MEDICAID EXPANSION ENROLLMENT BEGAN NOVEMBER 1, 2018 WITH AN EFFECTIVE DATE STARTING JANUARY 1, 2019. OPTIMA EXPANDED ITS NETWORK TO INCLUDE RIVERSIDE HEALTH SYSTEM FACILITIES AND PROVIDERS, ENABLING FOR BROADER ACCESS TO CARE FOR MEMBERS. CONCLUSION: SENTARA HEALTHCARE IS COMMITTED TO IMPROVING HEALTH EVERY DAY. WE PROVIDE QUALITY CARE THROUGH EXPERT PROVIDERS, USING CUTTING-EDGE TECHNOLOGY, DEPLOYING MEDICAL BREAKTHROUGHS, AND PROVIDING EXCELLENT CUSTOMER SERVICE ALL WITH A CONSTANT FOCUS ON INNOVATION. AND, WE ARE COMMITTED TO SUPPORTING THE COMMUNITIES WE SERVE THROUGH EMPLOYEE VOLUNTEERISM, GRANTS, SPONSORSHIPS, AND SUPPORTING INITIATIVES THAT LIFT OUR COMMUNITIES. WE LOOK FORWARD TO ANOTHER YEAR OF COMMUNITY SUCCESS, GROWTH AND INNOVATION IN 2019.
FORM 990, PART V, LINE 1A: FORM 1096	AS THE 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM, THE ORGANIZATION MAINTAINS AGENCY RELATIONSHIPS AND ISSUES 1099S ON BEHALF OF OTHER ENTITIES IN THE SYSTEM. THE NUMBER REPORTED IS A BEST ESTIMATE OF THE 1099S ATTRIBUTABLE TO THE ORGANIZATION. THE EXACT NUMBER CANNOT BE DETERMINED; AS SOME OF THE 1099S ISSUED BY THE ORGANIZATION ARE ATTRIBUTABLE TO MORE THAN ONE ENTITY, AND THERE IS NO REPORTING MECHANISM TO DETERMINE 1099'S ATTRIBUTABLE SOLELY TO THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 2	BUSINESS OR FAMILY RELATIONSHIP OF OFFICERS, DIRECTORS: THE ORGANIZATION'S OFFICERS AND DIRECTORS SERVED TOGETHER ON THE BOARDS OF OTHER ORGANIZATIONS WITHIN THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM"), AS WELL AS JOINT VENTURES IN WHICH THE SYSTEM HAD AN OWNERSHIP INTEREST. SEE SCHEDULE R FOR A LISTING OF SUCH ENTITIES.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW PROCESS THE ORGANIZATION USED ITS OWN IN-HOUSE TAX DEPARTMENT, HEADED BY A LICENSED CERTIFIED PUBLIC ACCOUNTANT, TO BOTH PREPARE AND REVIEW ITS FORM 990. DURING THE PREPARATION AND REVIEW PROCESS, THE TAX DEPARTMENT WORKED CLOSELY WITH OTHER DEPARTMENTS, SUCH AS LEGAL, COMPENSATION AND BENEFITS, COMPLIANCE, FINANCE, AND MARKETING, TO ENSURE THAT A COMPLETE AND ACCURATE RETURN WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS: DIRECTORS, BOARD-NOMINATED OFFICERS, AND KEY EMPLOYEES ARE REQUESTED TO SUBMIT AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE AND CERTIFY TO THE COMPLETION AND ACCURACY OF THE INFORMATION DISCLOSED. ADDITIONALLY, EACH ORGANIZATION'S GOVERNING BOARD OR APPROPRIATE BODY MONITORS TRANSACTIONS INVOLVING DISCLOSED POTENTIAL CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15	THE ORGANIZATION FOLLOWED PROCESSES AND PROCEDURES SET FORTH IN ITS GOVERNING DOCUMENTS TO ENSURE COMPLIANCE WITH ITS OBLIGATIONS AS A 501(C)(3) HEALTHCARE ORGANIZATION TO PAY DISQUALIFIED PERSONS REASONABLE COMPENSATION. SUCH PROCESSES AND PROCEDURES ARE INTENDED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERNAL REVENUE CODE SECTION 4958 REGULATIONS. THE COMPENSATION PHILOSOPHY OF THE ORGANIZATION IS TO BASE OVERALL COMPENSATION AND BENEFITS FOR EXECUTIVES ON NOT-FOR-PROFIT MARKET COMPARABLES, ADJUSTED AS APPLIED TO EACH EXECUTIVE, TAKING INTO CONSIDERATION THE INDIVIDUAL SKILLS, EXPERIENCE, TENURE AND PERFORMANCE OF THE EXECUTIVE BEING COMPENSATED AND OVERALL PERFORMANCE OF THE ORGANIZATION. IN LINE WITH THIS PHILOSOPHY, THE ORGANIZATION PERFORMED SUBSTANTIAL DUE DILIGENCE AS TO MARKET COMPARABLES. THE COMPENSATION COMMITTEE, WHICH CONSISTS OF BOARD MEMBERS WITHOUT CONFLICTS OF INTERESTS, ENGAGED AN OUTSIDE CONSULTANT, WHO REPORTS TO THE COMPENSATION COMMITTEE, TO CONDUCT A STUDY ASSESSING THE COMPETITIVENESS OF TOTAL COMPENSATION (INCLUDING CASH COMPENSATION, BENEFITS AND PERQUISITES) OF ITS SENIOR EXECUTIVES PRIOR TO MAKING DECISIONS REGARDING ANNUAL BASE SALARY ADJUSTMENTS, APPROVING INCENTIVE AWARDS, OR CONSIDERING PROGRAMMATIC CHANGES. THE STUDY COMPARED THE COMPENSATION OF THE ORGANIZATION'S SENIOR EXECUTIVES TO COMPENSATION DATA FROM MULTIPLE PUBLISHED SURVEY SOURCES BASED ON THE SENIOR EXECUTIVE'S FUNCTIONAL RESPONSIBILITY. IN CONDUCTING THE STUDY, THE CONSULTANT TARGETED OTHER NOT-FOR-PROFIT HEALTH SYSTEMS OF SIMILAR SIZE BASED ON NET REVENUE AND COMPLEXITY. FOR HEALTH PLAN POSITIONS, HEALTH PLANS WITH SIMILAR PREMIUMS, OR MEMBERS, WERE TARGETED. THE CONSULTANT ALSO CONDUCTS A REVIEW OF THE ORGANIZATION'S PERFORMANCE RELATIVE TO A GROUP OF NOT-FOR-PROFIT HEALTH SYSTEMS OF COMPARABLE SIZE AND SCOPE OF OPERATIONS EVERY YEAR. THE MOST RECENT STUDY COMPARED SENTARA'S PERFORMANCE TO 32 NOT-FOR-PROFIT HEALTHCARE SYSTEMS BASED ON NET REVENUE GROWTH, OPERATING MARGIN, VARIOUS CLINICAL QUALITY METRICS AND PATIENT SATISFACTION. OVERALL, THE CONSULTANT DETERMINED THAT SENTARA'S PAY WAS ALIGNED WITH ITS RELATIVE PERFORMANCE. THE COMPENSATION STUDY WAS PRESENTED TO THE ORGANIZATION'S COMPENSATION COMMITTEE, WHICH MADE ITS COMPENSATION DECISIONS BASED ON A)ITS REVIEW AND ANALYSIS OF THE PERFORMANCE OF BOTH THE ORGANIZATION AND ITS SENIOR EXECUTIVES AND, B) A REASONABLENESS OF COMPENSATION ANALYSIS AND OPINION FROM AN EXTERNAL EXPERT IN THE COMPENSATION OF EXECUTIVES IN THE TAX-EXEMPT HEALTH CARE FIELD. THE COMMITTEE'S BASES FOR ITS DECISIONS WERE DOCUMENTED IN COMMITTEE MINUTES TAKEN DURING THE MEETING AND THEN CIRCULATED FOR REVIEW AND APPROVAL. ALL DECISIONS REGARDING COMPENSATION WERE MADE BY THE COMMITTEE, WHICH CONSISTS OF BOARD MEMBERS WITHOUT CONFLICT OF INTERESTS. THIS PROCESS WAS USED TO ESTABLISH COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND CEO, EXECUTIVE VICE PRESIDENT AND COO, EXECUTIVE VICE PRESIDENT AND CFO, AND OTHER SENIOR AND CORPORATE VICE PRESIDENTS. THE PROCESS WAS LAST UNDERTAKEN DURING THE CURRENT TAX YEAR FOR ALL POSITIONS LISTED.
FORM 990, PART VI, SECTION C, LINE 19	PROVISION OF GOVERNING DOCS, COI POLICY AND FINANCIALS TO PUBLIC: THE CONSOLIDATED FINANCIAL STATEMENTS FOR SENTARA HEALTHCARE AND SUBSIDIARIES WERE MADE PUBLICLY AVAILABLE THROUGH THE USE OF DAC BOND (DISCLOSURE DISSEMINATION AGENT) AND CAN BE FOUND ON THE INTERNET AT WWW.DACBOND.COM. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 9:	EQUITY IN EARNINGS OF AFFILIATE -996,556. CHANGE IN FUNDED STATUS OF PENSION LIABILITY -32,647,621. PARTNERSHIP INCOME BOOK > TAX -1,086,883. SECTION 351 TRANSFER TO SUBSIDIARY (BOOK BASIS) -35,783,015. RECLASS OF INTERCOMPANY ACCTS TO EQUITY 179,208,741. DISTRIBUTION FROM SUBSIDIARY 60,000,000. BOOK DEFERRED GAIN ON ASSETS PURCHASED FROM SUBSIDIARIES -17,566,192.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

SENTARA HEALTHCARE

Employer identification number

52-1271901

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	(f) Direct controlling entity
(1) SENTARA QUALITY CARE NETWORK LLC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 46-1265616	HEALTH CARE	VA	6,515,869	SENTARA HEALTHCARE

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)CLARKSVILLE SENIOR CARE LLC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1957066	SENIOR CARE	VA	501(C)(3)	LINE 12A, I	HALIFAX REGIONAL HOSPITAL	Yes
(2)HALIFAX REGIONAL DEV FOUNDATION INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1801459	HLTH/WELFARE	VA	501(C)(3)	LINE 7	HALIFAX REGIONAL HOSPITAL	Yes
(3)HALIFAX REGIONAL HOSPITAL INCORPORATED 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-0648699	HEALTHCARE	VA	501(C)(3)	LINE 3	SENTARA HEALTHCARE	Yes
(4)HALIFAX REGIONAL LONG TERM CARE INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-6074529	SENIOR CARE	VA	501(C)(3)	LINE 12A, I	HALIFAX REGIONAL HOSPITAL	Yes
(5)SENTARA HALIFAX REGIONAL PROPERTIES INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1801463	HLTH/WELFARE	VA	501(C)(3)	LINE 12A, I	HALIFAX REGIONAL HOSPITAL	Yes
(6)SENTARA PRINCESS ANNE HOSPITAL 6015 POPLAR HALL DRIVE NORFOLK,VA23502 27-3208969	HEALTH CARE	VA	501(C)(3)	LINE 3	SENTARA HOSPITALS	Yes
(7)SENTARA HOSPITALS 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1547408	HEALTH CARE	VA	501(C)(3)	LINE 3	SENTARA HEALTHCARE	Yes
(8)SENTARA MEDICAL GROUP 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1217184	HEALTH CARE	VA	501(C)(3)	LINE 10	SENTARA HEALTHCARE	Yes
(9)SENTARA ENTERPRISES 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1917649	HEALTH CARE	VA	501(C)(3)	LINE 10	SENTARA HEALTHCARE	Yes
(10)SENTARA LIFE CARE CORP 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1217183	HEALTH CARE	VA	501(C)(3)	LINE 10	SENTARA HEALTHCARE	Yes
(11)MPB INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1346393	TITLE HOLDING COMPANY	VA	501(C)(2)		SENTARA ENTERPRISES	Yes
(12)OPTIMA HEALTH PLAN 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1283337	HMO	VA	501(C)(3)	LINE 12A, I	SENTARA HEALTHCARE	Yes
(13)POTOMAC HOSPITAL CORP OF PRINCE WILLIAM 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-0853898	HEALTH CARE	VA	501(C)(3)	LINE 3	SENTARA HEALTHCARE	Yes
(14)SENTARA RMH MEDICAL CENTER 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-0506331	HEALTH CARE	VA	501(C)(3)	LINE 3	SENTARA BLUE RIDGE LLC	Yes
(15)VALLEY WELLNESS CENTER 6015 POPLAR HALL DRIVE NORFOLK,VA23502 52-1309257	PREVENTATIVE HEALTH/REHAB	VA	501(C)(3)	LINE 10	SENTARA RMH MEDICAL CENTER	Yes
(16)MJH FOUNDATION 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1401357	INVEST/MGT SVCS FOR SUPPORTED ORG	VA	501(C)(3)	LINE 12A, I	MARTHA JEFFERSON HOSPITAL	Yes
(17)MARTHA JEFFERSON HOSPITAL FOUNDATION 6015 POPLAR HALL DRIVE NORFOLK,VA23502 30-0041113	FUNDRAISING FOR SUPPORTED ORGFUNDRAISING FOR SUPPORTED ORGFUNDRAISING FO	VA	501(C)(3)	LINE 12A, I	MARTHA JEFFERSON HOSPITAL	Yes
(18)MARTHA JEFFERSON HOSPITAL 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-0261840	HEALTH CARE	VA	501(C)(3)	LINE 3	SENTARA BLUE RIDGE LLC	Yes
(19)OPTIMA FAMILY CARE OF NC INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 82-3610648	MEDICAID HMO	NC	501(C)(3)	LINE 10	OPTIMA HEALTH OF NORTH CAROLINA LLC	Yes
(20)OPTIMA HEALTH OF NORTH CAROLINA LLC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 82-3623430	SUPPORTS MCAID HMO	NC	501(C)(3)	LINE 12A, I	SENTARA HEALTHCARE	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

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	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(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?		(k) Percentage ownership
(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
(1) MANAGEMENT SERVICES LLC 814 GREENBRIER CIRCLE CHESAPEAKE,VA23320 54-1365012	HLTH MGT SV	VA	SVI	UNRELATED	-4,287	538,077		No			No	40.000 %
(2) MANAGEMENT SERVICES LLC 814 GREENBRIER CIRCLE CHESAPEAKE,VA23320 54-1365012	HLTH MGT SV	VA	SH	UNRELATED	-2,143	269,043		No			No	20.000 %
(3) OBICI REAL ESTATE HOLDINGS LLC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 26-1749881	RE RENTAL	VA	SH	RELATED	264,174	3,272,121		No			No	64.370 %
(4) PRINCESS ANNE AMB SURG MGT LLC 1975 GLENN MITCHELL STE 300 VA BEACH,VA23456 20-4920880	HEALTH CARE	VA	SH	RELATED	1,871,149	3,611,730		No			No	51.530 %
(5) VA BEACH AMBULATORY SURGERY CENTER 1700 WILL O WISP DRIVE VA BEACH,VA23454 54-1448218	HEALTH CARE	VA	SH	RELATED	667,290	3,338,653		No			No	50.000 %
(6) CANCER CENTERS OF VA LLC 5900 LAKE WRIGHT DRIVE NORFOLK,VA23502 20-1338518	HEALTH CARE	VA	SH	RELATED	1,039,718	7,711,790		No			No	50.000 %
(7) HAMPTON ROADS LITHOTRIPSY LLC 225 CLEARFIELD AVE VIRGINIA BEACH,VA23462 20-0942600	HEALTH CARE	VA	SVI	UNRELATED	372,351	91,155		No			No	33.330 %
(8) RADIOLOGY SERVICES OF HAMPTON ROADS LC 814 GREENBRIER CIRCLE STE L CHESAPEAKE,VA23320 54-1774472	HEALTH CARE	VA	SE	RELATED	47,779	1,160,656		No			No	25.000 %
(9) RADIOLOGY SERVICES OF HAMPTON ROADS LC 814 GREENBRIER CIRCLE STE L CHESAPEAKE,VA23320 54-1774472	HEALTH CARE	VA	SH	RELATED	47,779	1,160,656		No			No	25.000 %
(10) SENTARA OBICI AMBULATORY SURGERY LLC 2750 GODWIN BLVD SUFFOLK,VA23434 26-0144898	HEALTH CARE	VA	SH	RELATED	270,683	1,556,019		No			No	56.140 %
(11) ST LUKES PROPERTIES LLC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 27-2774684	MOB RENTAL	VA	SE	RELATED	-18,942	4,550,029		No			No	70.000 %
(12) POTOMAC INOVA HEALTHCARE ALLIANCE LLC 8110 GATEHOUSE RD STE 400W FALLS CHURCH,VA22042 54-1802733	HEALTHCARE	VA	PHC	RELATED	106,504	1,056,315		No			No	50.000 %
(13) ORTHOPAEDIC HOSPITAL MANAGEMENT LLC 3000 COLISEUM DRIVE HAMPTON,VA23666 27-4185117	MGT SVCS	VA	SH	RELATED	59,325	6,926		No			No	40.000 %
(14) CAREPLEX ORTHOPAEDIC ASC LLC 3000 COLISEUM DRIVE HAMPTON,VA23666 27-1867311	HEALTH CARE	VA	SH	RELATED	2,767,430	2,846,294		No			No	50.000 %
(15) PHYSICAL THERAPY ACACLLC 501 ALBEMARLE SQUARE CHARLOTTESVILLE,VA22901 26-0080717	HEALTH CARE	VA	MJME	UNRELATED	263,794	885,448		No			No	50.000 %
(16) MNS SUPPLY CHAIN NETWORK LLC 11525 N COMMUNITY HOUSE RD STE 450 CHARLOTTE,NC28277 45-4235238	GPO	DE	SHC	UNRELATED	-17,930	57,186		No	-17,930	Yes		33.330 %
(17) LAKE RIDGE AMBULATORY SURGERY CENTER LLC 12825 MINNIEVILLE RD STE 204 WOODBRIDGE,VA22192 45-5347932	HEALTH CARE	VA	PHC	RELATED	349,984	2,024,263		No			No	60.680 %
(18) ALETA HEALTH LLC 2300 OPITZ BLVD WOODBRIDGE,VA22191 46-5661314	MSO	DE	PVC	UNRELATED	-9,584			No			No	51.000 %
(19) OPACC I LLC 18000 W SARAH LANE SUITE 250 BROOKFIELD,WI53045 39-2021431	RE RENTAL	WI	SVI	UNRELATED	790,181	2,789,908	Yes				No	80.880 %
(20) MEDSTREAMING LLC 9840 WILLOWS ROAD NE SUITE 200 REDMOND,WA98052 45-1573625	SOFTWARE DEV	WA	SVI	UNRELATED	-2,745,995	27,430,042		No			No	62.400 %
(21) HIGHLAND CORE FIXED INCOME FUND C/O GTC 12 GILL ST SUITE 2600 WOBURN,MA01801 47-4618533	POOLED INV FD	DE	SHC	EXCLUDED	10,481,555	877,248,673	Yes				No	86.240 %
(22) HIGHLAND EQUITY FUND C/O GTC 12 GILL ST SUITE 2600 WOBURN,MA01801 47-4606269	POOLED INV FD	DE	SHC	EXCLUDED	79,697,957	1,537,743,454	Yes				No	84.230 %
(23) HIGHLAND PUBLIC INFLATION HEDGES FD C/O GTC 12 GILL ST SUITE 2600 WOBURN,MA01801 47-4601867	POOLED INV FD	DE	SHC	EXCLUDED	16,302,091	309,707,888	Yes				No	68.160 %

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	(h) Percentage ownership	(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) SENTARA HOLDINGS INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1555638	HOLDING COMPANY	VA	SENTARA HEALTHCARE	C	3,538,250	6,776,727	100.000 %	Yes
(2) SENTARA HEALTH PLANS INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 52-2368125	TPA	VA	SENTARA HOLDINGS INC	C	37,577,239	54,733,646	100.000 %	Yes
(3) OPTIMA HEALTH GROUP 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1473382	HMO	VA	SENTARA HEALTH PLANS INC	C	31,208	2,585,379	100.000 %	Yes
(4) OPTIMA HEALTH INSURANCE COMPANY 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1642752	HEALTH INSURANCE	VA	SENTARA HEALTH PLANS INC	C	44,716,088	30,103,677	100.000 %	Yes
(5) OPTIMA BEHAVIORAL HEALTH SERVICES 6015 POPLAR HALL DRIVE NORFOLK,VA23502 62-1382666	MENTAL HEALTH SVCS	VA	SENTARA HEALTH PLANS INC	C	6,299,044	2,385,130	100.000 %	Yes
(6) SENTARA VENTURES INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1688615	HOLDING COMPANY	VA	SENTARA HOLDINGS INC	C	40,328,467	27,075,094	100.000 %	Yes
(7) SENTARA OBICI PROFESSIONAL CENTER 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1445865	RE RENTAL	VA	SENTARA HOLDINGS INC	C			100.000 %	Yes
(8) SENTARA STRATEGIC SOLUTIONS INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1020941	HEALTH CARE	VA	SEN OBICI PROF CTR	C	17,768		100.000 %	Yes
(9) SENTARA HEALTH PLANS OF OHIO INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 47-1509408	TPA	OH	SENTARA HOLDINGS INC	C	2,922,049		100.000 %	Yes
(10) SENTARA HEALTH INSURANCE CO OF NC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 47-1888140	HEALTH INSURANCE	NC	SENTARA HOLDINGS INC	C	29,988	2,553,110	100.000 %	Yes
(11) SENTARA HEALTH PLANS OF NC INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 46-5510421	TPA	NC	SENTARA HOLDINGS INC	C		5,000	100.000 %	Yes
(12) MANAGED CARE SERVICES INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 81-5421060	ALT HEALTH DELIVERY	VA	SENTARA HEALTH PLANS INC	C	21,630,087	4,281,413	100.000 %	Yes
(13) SENTARA SOUTHSIDE HEALTH SERVICES INC 2204 WILBORN AVENUE SOUTH BOSTON,VA24592 54-1417772	HEALTH SERVICES	VA	HALIFAX REGIONAL HOSPITAL INC	C	1,568,710	664,333	100.000 %	Yes
(14) DOMINION HEALTH MEDICAL ASSOCIATES LTD 2204 WILBORN AVENUE SOUTH BOSTON,VA24592 54-1060357	PHYS PRACTICE	VA	HALIFAX REGIONAL PROFESSIONAL SERVICES LLC	C	30,127,020	4,730,900	100.000 %	Yes
(15) SMG INNOVATIONS INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 20-3730331	HEALTH CARE	VA	SENTARA MEDICAL GROUP	C	6,729,900	1,846,578	100.000 %	Yes
(16) POTOMAC VENTURES CORP 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1441420	PHARMACY	VA	POTOMAC HOSPITAL CORP	C	327,414	3,198,354	100.000 %	Yes
(17) ROCKINGHAM HEALTH SERVICES INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 54-1721387	CONTRACTING SVCS	VA	SENTARA RMH MEDICAL CENTER	C			100.000 %	Yes
(18) MARTHA JEFFERSON MEDICAL ENTERPRISES INC 6015 POPLAR HALL DRIVE NORFOLK,VA22911 54-1841528	MEDICAL BILLING SVCS	VA	MARTHA JEFFERSON HOSPITAL	C	263,794	3,947,066	100.000 %	Yes
(19) BAY PRIMEX INSURANCE COMPANY LTD PO BOX 1051 GRAND CAYMAN KY1-1102 CJ 98-0704114	OTHER INSURANCE FUNDS	CJ	SENTARA HEALTHCARE	C	5,409,310	83,465,298	100.000 %	Yes
(20) ALBEMARLE PHYSICIAN SERVICES-SENTARA INC 6015 POPLAR HALL DRIVE NORFOLK,VA23502 26-4592192	PHYS PRACTICE	NC	SENTARA ALBEMARLE REGIONAL MEDICAL CENTER LLC	C	10,319,087	22,973,485	100.000 %	Yes
(21) THE PORT WARWICK MEDICAL ARTS BUILDING ASSOCIATION 6015 POPLAR HALL DRIVE NORFOLK,VA23502 56-2295574	BUILDING ASSOCIATION	VA	MPB INC	C	257,952	99,382	86.100 %	Yes
(22) MEDSTREAMING EGYPT SOFTWARE 15 ANMAR IBN YASSER ST CAIRO EG	CONSULTING	EG	MEDSTREAMING LLC	C	1,921,102	134,470	56.870 %	Yes
(23) HIGHLAND DIRECT HEDGED EQUITY FUND LTD 27 HOSPITAL ROAD GEORGE TOWN KY1-9008 CJ	INVESTMENT	CJ	SENTARA HEALTHCARE	C	-13,259,258	435,965,296	55.350 %	Yes

Schedule R (Form 990) 2018

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 .....................

Yes

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

Yes

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) ............................

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

Yes

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) ......................

Yes

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

Yes

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) ...................

Yes

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

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

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

Yes

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

Yes

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

Yes

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
(1) BAY PRIMEX INSURANCE COMPANY LTD	S	9,858,641	CORP BOOKS/REC
(2) CLARKSVILLE SENIOR CARE	B	10,704,963	CORP BOOKS/REC
(3) CLARKSVILLE SENIOR CARE	L	206,948	CORP BOOKS/REC
(4) DOMINION HEALTH MEDICAL ASSOCIATES	L	395,158	CORP BOOKS/REC
(5) HALIFAX REGIONAL DEVELOPMENT FOUNDATION	B	116,543	CORP BOOKS/REC
(6) HALIFAX REGIONAL HOSPITAL	C	32,904,594	CORP BOOKS/REC
(7) HALIFAX REGIONAL HOSPITAL	L	2,355,605	CORP BOOKS/REC
(8) HALIFAX REGIONAL LONG TERM CARE	B	14,198,320	CORP BOOKS/REC
(9) HALIFAX REGIONAL LONG TERM CARE	L	261,284	CORP BOOKS/REC
(10) HALIFAX REGIONAL PROPERTIES	B	640,648	CORP BOOKS/REC
(11) MARTHA JEFFERSON HOSPITAL	B	237,287,609	CORP BOOKS/REC
(12) MARTHA JEFFERSON HOSPITAL	C	3,020,739	CORP BOOKS/REC
(13) MARTHA JEFFERSON HOSPITAL	L	5,541,636	CORP BOOKS/REC
(14) MPB INC	B	25,356,334	CORP BOOKS/REC
(15) MPB INC	K	1,056,071	CORP BOOKS/REC
(16) MPB INC	L	1,661,255	CORP BOOKS/REC
(17) MPB INC	Q	1,121,055	CORP BOOKS/REC
(18) OBICI ASC	Q	228,733	CORP BOOKS/REC
(19) POTOMAC HOSPITAL CORP OF PRINCE WILLIAM	C	2,459,818	CORP BOOKS/REC
(20) POTOMAC HOSPITAL CORP OF PRINCE WILLIAM	B	92,400,411	CORP BOOKS/REC
(21) POTOMAC HOSPITAL CORP OF PRINCE WILLIAM	L	6,361,897	CORP BOOKS/REC
(22) POTOMAC HOSPITAL CORP OF PRINCE WILLIAM	S	5,889,993	CORP BOOKS/REC
(23) PRINCESS ANNE ASC	Q	468,874	CORP BOOKS/REC
(24) SENTARA ALBEMARLE PHYSICIANS SERVICES	L	370,984	CORP BOOKS/REC
(25) SENTARA ENTERPRISES	B	48,815,693	CORP BOOKS/REC
(26) SENTARA ENTERPRISES	C	1,041,359	CORP BOOKS/REC
(27) SENTARA ENTERPRISES	L	2,236,332	CORP BOOKS/REC
(28) SENTARA ENTERPRISES	R	5,888,624	CORP BOOKS/REC
(29) SENTARA HEALTH PLANS INC	L	12,227,945	CORP BOOKS/REC
(30) SENTARA HEALTH PLANS INC	Q	26,450,377	CORP BOOKS/REC
(31) SENTARA HEALTH PLANS INC	S	3,837,571	CORP BOOKS/REC
(32) SENTARA HOLDINGS INC	H	3,538,250	CORP BOOKS/REC
(33) SENTARA VENTURES INC	H	14,027,942	CORP BOOKS/REC
(34) SENTARA HOSPITALS	C	703,089,399	CORP BOOKS/REC
(35) SENTARA HOSPITALS	L	64,925,445	CORP BOOKS/REC
(36) SENTARA HOSPITALS	N	628,793	CORP BOOKS/REC
(37) SENTARA LIFE CARE CORP	B	6,626,749	CORP BOOKS/REC
(38) SENTARA LIFE CARE CORP	C	1,227,506	CORP BOOKS/REC
(39) SENTARA LIFE CARE CORP	L	1,491,018	CORP BOOKS/REC
(40) SENTARA MEDICAL GROUP	C	13,263,160	CORP BOOKS/REC
(41) SENTARA MEDICAL GROUP	K	65,916	CORP BOOKS/REC
(42) SENTARA MEDICAL GROUP	L	4,651,354	CORP BOOKS/REC
(43) SENTARA PRINCESS ANNE HOSPITAL	A	7,386,859	CORP BOOKS/REC
(44) SENTARA PRINCESS ANNE HOSPITAL	D	150,573,766	CORP BOOKS/REC
(45) SENTARA PRINCESS ANNE HOSPITAL	L	6,737,543	CORP BOOKS/REC
(46) SENTARA PRINCESS ANNE HOSPITAL	Q	187,767,113	CORP BOOKS/REC
(47) SENTARA PRINCESS ANNE HOSPITAL	S	11,866,433	CORP BOOKS/REC
(48) SENTARA PRINCESS ANNE HOSPITAL	R	28,000,000	CORP BOOKS/REC
(49) SENTARA RMH MEDICAL CENTER	B	141,248,138	CORP BOOKS/REC
(50) SENTARA RMH MEDICAL CENTER	C	2,946,377	CORP BOOKS/REC
(51) SENTARA RMH MEDICAL CENTER	L	7,491,912	CORP BOOKS/REC
(52) SMG INNOVATIONS INC	Q	119,479	CORP BOOKS/REC
(53) ST LUKES PROPERTIES LLC	Q	448,004	CORP BOOKS/REC
(54) VALLEY WELLNESS CENTER	B	2,573,983	CORP BOOKS/REC
(55) VALLEY WELLNESS CENTER	L	84,172	CORP BOOKS/REC
(56) OPTIMA HEALTH PLAN	S	60,000,000	CORP BOOKS/REC

Schedule R (Form 990) 2018

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) 2018

Page 5

Part VII

Supplemental Information

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

Return Reference

Explanation

FORM 990, SCHEDULE R

THE ORGANIZATION AND ITS SUBSIDIARIES PARTICIPATE IN CASH MANAGEMENT ARRANGEMENTS WHEREBY ALL CASH OPERATING ACCOUNTS ARE SWEPT INTO OR FUNDED BY A MASTER OVERNIGHT INVESTMENT ACCOUNT ON A DAILY BASIS, IN ORDER TO MAINTAIN A $0 BALANCE IN ALL OPERATING ACCOUNTS AND MAXIMIZE INVESTMENT EARNINGS. THE DAILY TRANSFERS OF CASH, WHICH RESULT FROM THIS CONSOLIDATED CASH ARRANGEMENT, HAVE NOT BEEN REPORTED ON SCHEDULE R PART V.

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: AT SENTARA, WE IMPROVE HEALTH EVERY DAY.
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	17
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	696
6	Total number of volunteers (estimate if necessary) .............	6	22
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	3,704,558
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	1,025,394

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	39,207,864	37,655,127
9	Program service revenue (Part VIII, line 2g) .........	108,478,537	121,718,741
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	33,184,730	54,163,163
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	31,923,609	15,373,517
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	212,794,740	228,910,548
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,480,123	12,102,764
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)	90,857,441	90,655,011
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	14,967	15,000
b	Total fundraising expenses (Part IX, column (D), line 25) 626,741
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	56,023,474	64,405,349
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	149,376,005	167,178,124
19	Revenue less expenses. Subtract line 18 from line 12.......	63,418,735	61,732,424
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	4,115,245,894	4,108,352,962
21	Total liabilities (Part X, line 26).............	2,066,396,507	2,039,803,863
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,048,849,387	2,068,549,099

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 142,204,845 including grants of $ 12,102,764 ) (Revenue $ 129,486,409 )
	SEE 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 expenses142,204,845

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	15,791,649	8,359,251	2,764,669

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	36,522,120
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,133,007

g	Noncash contributions included in lines 1a - 1f:$ 2,799
h Total. Add lines 1a-1f.......		37,655,127

		Business Code
2a	SUPPORT SERVICES	900099	115,426,497	113,834,418	1,592,079
b	SQCN	900099	6,292,244	5,269,400	1,022,844
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		121,718,741

3 Investment income (including dividends, interest, and othersimilar amounts) ......			23,296,836			23,296,836
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		488,217,989
b	Less: cost or other basis and sales expenses		457,351,662
c	Gain or (loss)		30,866,327
d	Net gain or (loss).....			30,866,327			30,866,327
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..
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..
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..
Business Code			Miscellaneous Revenue
11a	INTERCO INTEREST CHARGES		900099	6,769,639	6,769,639
b	INTERCO DEFERRED GAIN RECOGNIZED		900099	3,538,250			3,538,250
c	MANAGEMENT FEES		900099	1,661,255	1,658,503	2,752
d	All other revenue ....			3,404,373	1,954,449	1,086,883	363,041
e	Total. Add lines 11a–11d ......			15,373,517
12	Total revenue. See Instructions......			228,910,548	129,486,409	3,704,558	58,064,454

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	11,938,029	11,938,029
2	Grants and other assistance to domestic individuals. See Part IV, line 22	164,735	164,735
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	13,688,302	11,224,408	2,463,894
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	714,924	586,238	128,686
7	Other salaries and wages	60,676,106	49,457,674	10,856,563	361,869
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	6,579,686	5,360,224	1,176,635	42,827
9	Other employee benefits .......	4,585,354	3,735,517	819,991	29,846
10	Payroll taxes ...........	4,410,639	3,596,949	789,574	24,116
11	Fees for services (non-employees):
a	Management ......	6,763,106	5,545,747	1,217,359
b	Legal .........	1,384,428	1,135,231	249,197
c	Accounting ...........	1,572,652	1,289,575	283,077
d	Lobbying ...........	44,412	36,418	7,994
e	Professional fundraising services. See Part IV, line 17	15,000			15,000
f	Investment management fees ......	5,050,420	4,141,344	909,076
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	13,357,430	12,288,655	1,037,281	31,494
12	Advertising and promotion ....	11,067,882	9,073,469	1,991,737	2,676
13	Office expenses .......	1,814,844	1,450,233	318,344	46,267
14	Information technology ......	2,150,043	1,763,035	387,008
15	Royalties ..
16	Occupancy ...........	1,900,805	1,558,660	342,145
17	Travel ............	555,294	455,341	99,953
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	342,545	280,887	61,658
20	Interest ...........	9,969,466	9,951,752	17,714
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	803,346	658,744	144,602
23	Insurance ...	1,482,446	1,215,606	266,840
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	UNRELATED BUSINESS TAX	237,672	237,672
b	ORGANIZATIONAL DUES	1,493,040	1,224,293	268,747
c	TAXES & LICENSES	1,435,263	1,176,916	258,347
d	MEDICAL SUPPLIES	1,268,078	1,268,078
e	All other expenses	1,712,177	1,389,415	250,116	72,646
25	Total functional expenses. Add lines 1 through 24e	167,178,124	142,204,845	24,346,538	626,741
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 ........				1
2	Savings and temporary cash investments .........			431,546,823	2	527,888,041
3	Pledges and grants receivable, net ......			666,161	3	729,503
4	Accounts receivable, net .............				4
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5	118,699
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 ..............
					6
7	Notes and loans receivable, net ....			135,352,205	7	157,020,114
8	Inventories for sale or use ........				8
9	Prepaid expenses and deferred charges ......			7,225,568	9	7,338,999
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	24,511,623
b	Less: accumulated depreciation	10b	18,204,422	5,932,060	10c	6,307,201
11	Investments—publicly traded securities .			2,486,624,454	11	2,469,901,780
12	Investments—other securities. See Part IV, line 11 .....			933,164,147	12	836,050,459
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			114,734,476	15	102,998,166
16	Total assets. Add lines 1 through 15 (must equal line 34)...			4,115,245,894	16	4,108,352,962

17	Accounts payable and accrued expenses .....	316,919,319	17	314,021,873
18	Grants payable ...	13,608,583	18	8,866,720
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	1,392,437,620	20	1,364,108,986
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
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..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
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	343,430,985	25	352,806,284
26	Total liabilities. Add lines 17 through 25..	2,066,396,507	26	2,039,803,863

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	2,045,206,127	27	2,064,689,455
28	Temporarily restricted net assets ...........	3,643,260	28	3,859,644
29	Permanently restricted net assets		29
	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 ...........	2,048,849,387	33	2,068,549,099
34	Total liabilities and net assets/fund balances ........	4,115,245,894	34	4,108,352,962

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No