Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
A For the 2020 calendar year, or tax year beginning 01-01-2020 , and ending 12-31-2020
BCheck if applicable:
CName of organization
HALIFAX REGIONAL HOSPITAL INC
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
6015 POPLAR HALL DRIVE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NORFOLK, VA23502
D Employer identification number

54-0648699
E Telephone number

G Gross receipts $ 85,943,606
F Name and address of principal officer:
BRIAN K ZWOYER
2204 WILBORN AVE
SOUTH BOSTON,VA24592
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SENTARA.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1948
M State of legal domicile: VA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE THE HIGHEST QUALITY CARE BASED ON THE HEALTHCARE NEEDS OF THE PEOPLE WE SERVE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 15
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 9
5 Total number of individuals employed in calendar year 2020 (Part V, line 2a) ...... 5 396
6 Total number of volunteers (estimate if necessary) ............. 6 59
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,308,842
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 79,580 6,930,510
9 Program service revenue (Part VIII, line 2g) ......... 87,082,274 78,842,750
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 125,499 25,894
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 118,544 119,642
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 87,405,897 85,918,796
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,421,297 708,663
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) 36,291,390 30,607,851
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 52,713,922 56,982,625
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 90,426,609 88,299,139
19 Revenue less expenses. Subtract line 18 from line 12....... -3,020,712 -2,380,343
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 50,187,984 49,612,708
21 Total liabilities (Part X, line 26)............. 8,306,735 22,658,722
22 Net assets or fund balances. Subtract line 21 from line 20..... 41,881,249 26,953,986
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2020)
Form 990 (2020)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: THE PURPOSE OF HALIFAX REGIONAL HOSPITAL, INC. IS TO PROVIDE THE HIGHEST QUALITY CARE BASED ON THE HEALTHCARE NEEDS OF THE PEOPLE WE SERVE. FOR MORE INFORMATION, SEE SCHEDULE O.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 70,268,347 including grants of $ 708,663 ) (Revenue $ 77,533,908 )
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 expensesMediumBullet70,268,347
Form 990 (2020)
Form 990 (2020)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II.........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2020)
Form 990 (2020)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
63
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2020)
Form 990 (2020)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
396
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2020)
Form 990 (2020)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
15
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
9
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
VA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletCORPORATE OFFICERS6015 POPLAR HALL DR   NORFOLK,VA23502 (757) 455-7020
Form 990 (2020)
Form 990 (2020)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) MEGAN R PERRY......................................................................
DIRECTOR
1.00
.................
41.40
X           0 998,610 411,747
(2) JONATHAN S DAVIS......................................................................
DIRECTOR/VICE CHAIR
1.00
.................
46.00
X   X       0 637,378 119,865
(3) JENNIFER S SICTOR......................................................................
DIRECTOR
1.00
.................
40.00
X           0 427,867 147,412
(4) HABIB BASSIL MD......................................................................
DIRECTOR/SECRETARY
1.00
.................
0.00
X   X       58,625 0 0
(5) TERRANCE J TRUITT MD......................................................................
DIRECTOR
1.00
.................
0.00
X           18,995 0 0
(6) WILLIAM E COLEMAN......................................................................
DIRECTOR
1.00
.................
0.00
X           0 0 0
(7) W JOSEPH FERGUSON MD......................................................................
DIRECTOR
1.00
.................
0.00
X           0 0 0
(8) DABNEY TP GILLIAM JR......................................................................
DIRECTOR
1.00
.................
0.00
X           0 0 0
(9) VALDIVIA T HALL......................................................................
DIRECTOR
1.00
.................
0.00
X           0 0 0
(10) SAID B ISKANDAR MD......................................................................
DIRECTOR (VOTING EX-OFFICIO)
1.00
.................
0.00
X           0 0 0
(11) J KENNETH MORGAN......................................................................
DIRECTOR
1.00
.................
0.00
X           0 0 0
(12) KATHRYN F ROBERTS......................................................................
DIRECTOR
1.00
.................
0.00
X           0 0 0
(13) DAVID H WHITE JR......................................................................
DIRECTOR
1.00
.................
0.00
X           0 0 0
(14) LARRY P SNEED......................................................................
DIRECTOR/TREASURER
1.00
.................
0.00
X   X       0 0 0
(15) CAROL C THOMAS......................................................................
DIRECTOR/CHAIR
1.60
.................
4.30
X   X       0 0 0
(16) BRIAN K ZWOYER......................................................................
PRESIDENT
40.00
.................
4.00
    X       267,496 0 44,722
(17) PABLO SOUZA MD......................................................................
PHYSICIAN - HF
40.00
.................
0.00
        X   348,056 0 87,192
Form 990 (2020)
Form 990 (2020)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) DAVID FITTS........................................................................
MANAGER, PHARMACY
40.00
.......................0.00
        X   178,052 0 112,983
(19) BETTY T THROCKMORTON........................................................................
RN UC -CLIN LADDER - LEVEL II
40.00
.......................0.00
        X   163,318 0 112,591
(20) JAMES E CHILDREY........................................................................
MGT, PATIENT CARE SERVICES - HF
40.00
.......................0.00
        X   151,379 0 99,364
(21) ANTHONY J MILAM........................................................................
CLINICAL PHARMACIST- INPATIENT - HF
40.00
.......................0.00
        X   149,864 0 37,371
(22) MICHAEL V GENTRY........................................................................
FORMER OFFICER
0.00
.......................52.00
          X 0 1,771,839 417,079
(23) STEWART R NELSON........................................................................
FORMER OFFICER AND KE
0.00
.......................42.00
          X 2,370 283,524 20,428
(24) JASON A STUDLEY........................................................................
FORMER OFFICER
0.00
.......................0.00
          X 11,252 192,875 6,815
(25) TORIE B BASHAY........................................................................
FORMER KE
0.00
.......................40.00
          X 0 179,028 104,859
(26) SHERRI F BEE........................................................................
FORMER KE
40.00
.......................0.00
          X 146,657 0 72,530
(27) MING Y LIU MD........................................................................
FORMER TOP 5
0.00
.......................40.00
          X 0 412,154 85,760
(28) GREGORY A SHUFORD MD........................................................................
FORMER TOP 5
0.00
.......................40.00
          X 0 245,466 76,321




1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 1,496,064 5,148,741 1,957,039
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet30
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
HEALTH CAROUSEL LLC

3805 EDWARDS ROAD SUITE 700
CINCINNATI,OH45209
HEALTHCARE STAFFING SERVICES 1,377,518
PULMONARY ASSOCIATES OF SOUTHSIDE VIRGIN

2210 WILBORN AVENUE
SOUTH BOSTON,VA24592
MEDICAL PROFESSIONAL SVCS 1,178,500
MORRISON MANAGEMENT SPECIALISTS INC

PO BOX 160266
MOBILE,AL36625
FOOD & FACILITIES MANAGEMENT 649,026
TRIMEDX

5451 LAKEVIEW PARKWAY SOUTH DRIVE
INDIANAPOLIS,IN46268
CLINICAL ASSET MANAGEMENT 543,006
J E BURTON CONSTRUCTION CO INC

220 WEBSTER STREET
SOUTH BOSTON,VA24592
CONSTRUCTION 427,301
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet19
Form 990 (2020)
Form 990 (2020)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e 6,825,712
f All other contributions, gifts, grants, and similar amounts not included above1f 104,798
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 6,930,510
 Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 541900 77,493,331 77,493,331    
b OUTSIDE LAB SERVICES 541900 1,308,842   1,308,842  
c OTHER PROGRAM SERVICE REVENUE 990009 40,577 40,577 0  
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 78,842,750
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 27,284     27,284
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   88,064 6a
b Less: rental expenses   0 6b
c Rental income or (loss)   88,064 6c
d Net rental income or (loss).......MediumBullet 88,064     88,064
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory     7a
b Less: cost or other basis and sales expenses 1,390   7b
c Gain or (loss) -1,390   7c
d Net gain or (loss).........MediumBullet -1,390     -1,390
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a 39,217
b Less: cost of goods sold .. 10b 23,420
c Net income or (loss) from sales of inventory..MediumBullet 15,797     15,797
Business Code Miscellaneous Revenue
11a CAFE/VENDING 721000 15,223     15,223
b MISCELLANEOUS 900099 558     558
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 15,781
12 Total revenue. See instructions.....MediumBullet 85,918,796 77,533,908 1,308,842 145,536
Form 990 (2020)
Form 990 (2020)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 708,663 708,663
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 389,838 328,361 61,477  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 23,144,227 19,494,382 3,649,845  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 2,423,571 2,041,374 382,197  
9 Other employee benefits ....... 2,975,977 2,506,665 469,312  
10 Payroll taxes ........... 1,674,238 1,410,211 264,027  
11 Fees for services (non-employees):        
a Management ...... 792,282 667,339 124,943  
b Legal ......... 115,356 97,164 18,192  
c Accounting ........... 21,440 18,059 3,381  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 12,554,618 12,376,371 178,247  
12 Advertising and promotion .... 28,841 24,293 4,548  
13 Office expenses ....... 3,535,948 2,978,329 557,619  
14 Information technology ...... 192,769 162,369 30,400  
15 Royalties ..        
16 Occupancy ........... 1,753,648 1,477,098 276,550  
17 Travel ............ 86,331 72,717 13,614  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 4,940 4,161 779  
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 4,460,012 3,756,668 703,344  
23 Insurance ... 291,608 245,621 45,987  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 17,651,301 17,651,301    
b SENTARA SERVICE EXPENSE 11,064,108   11,064,108  
c TAXES & LICENSES 3,242,008 3,240,195 1,813  
d UBIT 43,410 43,410    
e All other expenses 1,144,005 963,596 180,409  
25 Total functional expenses. Add lines 1 through 24e 88,299,139 70,268,347 18,030,792 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2020)
Form 990 (2020)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 520,399 1 179,757
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 10,663,922 4 9,992,782
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ........... 216,655 7 158,419
8 Inventories for sale or use ............ 2,324,646 8 2,523,958
9 Prepaid expenses and deferred charges ...... 52,845 9 65,627
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 66,301,301
b Less: accumulated depreciation 10b 30,948,876 36,306,197 10c 35,352,425
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14 1,263,353
15 Other assets. See Part IV, line 11 ........... 103,320 15 76,387
16 Total assets. Add lines 1 through 15 (must equal line 33)... 50,187,984 16 49,612,708
Liabilities 17 Accounts payable and accrued expenses ..... 5,150,152 17 13,120,613
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  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 3,156,583 25 9,538,109
26 Total liabilities. Add lines 17 through 25.. 8,306,735 26 22,658,722
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 41,733,139 27 26,433,000
28 Net assets with donor restrictions ........... 148,110 28 520,986
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 41,881,249 32 26,953,986
33 Total liabilities and net assets/fund balances ........ 50,187,984 33 49,612,708
Form 990 (2020)
Form 990 (2020)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
85,918,796
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
88,299,139
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-2,380,343
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
41,881,249
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-12,546,920
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
26,953,986
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2020)
Form 990 (2020)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number

54-0648699
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
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) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2020

Schedule A (Form 990 or 990-EZ) 2020
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) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (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) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c 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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
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).
8
 
 
9a
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.
9a
 
 
b
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.
9b
 
 
c
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.
9c
 
 
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
 
 
b
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) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in 11a above?
11b
 
 
c
A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, 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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
By reason of the relationship described in line 2 above, 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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
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.
2a
 
 
b
Did the activities described in line 2a, above 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.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
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?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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 0.015 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 0.035 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  
7
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2020 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2020
(iii)
Distributable
Amount for 2020
1 Distributable amount for 2020 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2020:
a From 2015.......  
b From 2016.......  
c From 2017.......  
d From 2018.......  
e From 2019.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2020 distributable amount  
i Carryover from 2015 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2020 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2020 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2020, 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 2020. 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 2021. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2016.....  
b Excess from 2017.....  
c Excess from 2018.....  
d Excess from 2019.....  
e Excess from 2020.....  
Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020
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) 2020


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Name of the organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number

54-0648699
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




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
Special Rules
......... 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) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2
Name of organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number
54-0648699
Part I
Contributors
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
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Page 3
Name of organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number

54-0648699
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) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Page 4
Name of organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number

54-0648699
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2020)
Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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 instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number

54-0648699
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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.
1a
If the organization elected, as permitted under FASB 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.
b
If the organization elected, as permitted under FASB 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 $  
2
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 FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2020

Schedule D (Form 990) 2020
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 .... 148,110 103,110 54,994 50,780 40,300
b Contributions ... 438,540 45,100 70,065 134,671 61,589
c Net investment earnings, gains, and losses          
d Grants or scholarships ...     16,976 114,159 50,478
e Other expenditures for facilities
and programs ...
65,664 100 4,973 16,298 631
f Administrative expenses ....          
g End of year balance ...... 520,986 148,110 103,110 54,994 50,780
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet0 %
c
Term endowment SchDMd Bullet100.000 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .......................
3a(i)
 
No
(ii) Related organizations .......................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 .....   2,576,000 2,576,000
b Buildings ....   29,751,806 4,696,627 25,055,179
c Leasehold improvements        
d Equipment ....   29,021,831 24,661,907 4,359,924
e Other .....   4,951,664 1,590,342 3,361,322
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 35,352,425
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
Page 3
Part VII
Investments - Other 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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments - Program 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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
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  
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 9,538,109
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) 2020

Schedule D (Form 990) 2020
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: THE CLARK MEMORIAL FUNDS HELP TO DEFRAY THE COST OF MEDICAL CARE FOR RESIDENTS OF HALIFAX COUNTY WHO QUALIFY FOR THE PATIENT FINANCIAL ASSISTANCE (PFA) PROGRAM OFFERED BY THE HOSPITAL. THE FUNDS ARE USED TO ASSIST IN PAYING MAJOR MEDICAL EXPENSES THAT PERSIST AFTER THE PFA ADJUSTMENT HAS DECREASED THE INITIAL EXPENSE. SURGERIES AND OTHER MAJOR HOSPITALIZATIONS CAN LEAVE INDIVIDUALS WITH THOUSANDS OF DOLLARS IN UNEXPECTED DEBT, AND SOMETIMES WITH DIMINISHED CAPACITY TO EARN MONEY TO PAY THE INCURRED EXPENSES. WHILE THOSE WHO ARE COMPLETELY WITHOUT RESOURCES WILL RECEIVE A 100% DISCOUNT FROM THE HOSPITAL, THOSE WHO HAVE SOME, BUT INSUFFICIENT, RESOURCES WILL GET A LESSER DISCOUNT AND MAY SPEND YEARS TRYING TO CLEAR THE DEBT. THE CLARK FUNDS WILL BE USED TO ASSIST THOSE VERY-LOW-INCOME INDIVIDUALS.
Schedule D (Form 990) 2020


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number

54-0648699
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    999,917   999,917 1.130 %
b Medicaid (from Worksheet 3, column a) . . . . .     16,595,067 16,140,790 454,277 0.510 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     17,594,984 16,140,790 1,454,194 1.640 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     177,677   177,677 0.200 %
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .     7,601,520   7,601,520 8.610 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     83,328   83,328 0.090 %
j Total. Other Benefits . .     7,862,525   7,862,525 8.900 %
k Total. Add lines 7d and 7j .     25,457,509 16,140,790 9,316,719 10.540 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development     29,058   29,058 0.030 %
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development     1,453   1,453 0 %
9 Other     16,878   16,878 0.020 %
10 Total     47,389   47,389 0.050 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
4,669,804
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
700,471
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
25,862,102
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
34,497,786
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-8,635,684
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
11 HALIFAX PHO INC
 
MANAGED CARE 50.000 %   50.000 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 HALIFAX REGIONAL HOSPITAL INC
2204 WILBORN AVENUE
SOUTH BOSTON,VA24592
WWW.SENTARA.COM
H1853
X X         X   HOME HEALTH HOSPICE  
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
HALIFAX REGIONAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
HALIFAX REGIONAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.SENTARA.COM/FINANCIALASSISTANCE
b
WWW.SENTARA.COM/FINANCIALASSISTANCE
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
HALIFAX REGIONAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
HALIFAX REGIONAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
HALIFAX REGIONAL HOSPITAL, INC. PART V, SECTION B, LINE 5: IN CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), SENTARA HALIFAX REGIONAL HOSPITAL (SHRH) TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING REPRESENTATIVES OF THE LOCAL PUBLIC HEALTH DEPARTMENTS AND ORGANIZATIONS SERVING THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS THROUGH: 1) SURVEYING KEY COMMUNITY STAKEHOLDERS BY USE OF AN ONLINE SURVEY TO IDENTIFY SIGNIFICANT HEALTH PROBLEMS AND SERVICE GAPS; 2) REVIEW OF ASSESSMENTS AND OTHER PLANNING DOCUMENTS PREPARED BY COMMUNITY ORGANIZATIONS SUCH AS THE LOCAL HEALTH DEPARTMENT; AND 3) DIRECT COMMUNICATION WITH COMMUNITY STAKEHOLDERS THROUGH INTERVIEWS AND A FOCUS GROUP.1) SHRH IDENTIFIED ITS SENIOR LEADERSHIP TEAM TO SERVE AS THE CHNA STEERING COMMITTEE RESPONSIBLE FOR OVERSEEING THE ASSESSMENT, INCLUDING THE SURVEY. THE SURVEY DISTRIBUTION LIST WAS REVIEWED TO ENSURE BROAD REPRESENTATION, INCLUDING REPRESENTATIVES OF THE LOCAL HEALTH DEPARTMENTS, COMMUNITY SERVICES BOARDS (MENTAL HEALTH AND SUBSTANCE ABUSE), SOCIAL SERVICES DEPARTMENTS, EDUCATIONAL INSTITUTIONS, PROVIDERS (MEDICAL, DENTAL, ETC.), BUSINESSES, VOLUNTARY HEALTH AGENCIES, AREA AGENCIES ON AGING, CIVIC LEAGUES, THE FAITH COMMUNITY AND OTHER HEALTH AND HUMAN SERVICES ORGANIZATIONS AND GROUPS. DURING THE SURVEY PROCESS, THE RESPONSE RATE WAS MONITORED AND FOLLOW UP WAS MADE TO ENSURE GOOD AND BROADLY REPRESENTATIVE PARTICIPATION.2) HEALTH-RELATED ASSESSMENTS AND PLANS DEVELOPED BY OTHER ORGANIZATIONS WERE IDENTIFIED AND REVIEWED. THESE FINDINGS WERE TAKEN INTO ACCOUNT IN THE IDENTIFICATION OF SIGNIFICANT HEALTH ISSUES AND IN THE DEVELOPMENT OF THE HOSPITAL'S IMPLEMENTATION STRATEGIES.3) DIRECT COMMUNICATION WITH COMMUNITY STAKEHOLDERS WAS ALSO AN IMPORTANT PART OF THE PROCESS. MEMBERS OF THE STEERING COMMITTEE PROVIDED INPUT BASED UPON THEIR INVOLVEMENT IN COMMUNITY COALITIONS AND COMMUNITY HEALTH INITIATIVES AND THEIR COMMUNICATIONS WITH INDIVIDUALS IN THE COMMUNITY. IN ADDITION, HOSPITAL STAFF CONDUCTED KEY INFORMANT INTERVIEWS AND A FOCUS GROUP TO RECEIVE BROADER INPUT.
HALIFAX REGIONAL HOSPITAL, INC. PART V, SECTION B, LINE 7D: COPIES OF THE ASSESSMENT HAVE BEEN MADE AVAILABLE TO COMMUNITY ORGANIZATIONS.A LINK TO THE HOSPITAL FACILITY'S COMMUNITY HEALTH NEEDS ASSESSMENT IS ALSO ON THE SENTARA HEALTHCARE WEBSITE:HTTP://WWW.SENTARA.COM/ASSETS/PDF/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/SHRH-2018-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF
HALIFAX REGIONAL HOSPITAL, INC. PART V, SECTION B, LINE 11: THE SHRH COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED NUMEROUS HEALTH ISSUES. DURING THE CHNA PROCESS, THE HOSPITAL UNDERWENT A PRIORITIZATION PROCESS TO IDENTIFY THE SIGNIFICANT HEALTH NEEDS FOR WHICH IMPLEMENTATION STRATEGIES SHOULD BE DEVELOPED. THE PROCESS CONSIDERED FACTORS SUCH AS SIZE AND SCOPE OF THE HEALTH PROBLEM, THE INTENSITY AND SEVERITY OF THE ISSUE, THE POTENTIAL TO EFFECTIVELY ADDRESS THE PROBLEM AND THE AVAILABILITY OF COMMUNITY RESOURCES, IMPACT ON HEALTH DISPARITIES, THE IMPORTANCE TO THE COMMUNITY, AND SENTARA'S MISSION "TO IMPROVE HEALTH EVERYDAY". FOR THE SIGNIFICANT HEALTH NEEDS, IN ADDITION TO EXECUTION OF THE IMPLEMENTATION STRATEGIES, THE HOSPITAL IS PARTICIPATING IN A VARIETY OF LOCAL INITIATIVES. SOME OF THE AREA NEEDS WHICH ARE NOT SPECIFICALLY ADDRESSED IN THE IMPLEMENTATION STRATEGY WERE IDENTIFIED AS LOWER PRIORITY BECAUSE THEY DID NOT RANK HIGH WITH THE PRIORITIZATION FACTORS.
HALIFAX REGIONAL HOSPITAL, INC. PART V, SECTION B, LINE 16J: QUARTERLY ARTICLES WERE PLACED IN LOCAL NEWSPAPERS TO INFORM THE PUBLIC ABOUT THE FINANCIAL ASSISTANCE POLICY.
HALIFAX REGIONAL HOSPITAL, INC. PART V, SECTION B, LINE 20E: THE HOSPITAL USES OUTSIDE VENDORS THAT SCREEN ALL PATIENTS WITHOUT INSURANCE FOR ELIGIBILITY FOR GOVERNMENT PROGRAMS, AND FINANCIAL COUNSELORS WHO SCREEN THOSE THAT ARE NOT ELIGIBLE FOR GOVERNMENT PROGRAMS TO DETERMINE WHETHER THEY MEET CRITERIA FOR FINANCIAL ASSISTANCE. IN ADDITION, THE PRESUMPTIVE ELIGIBILITY PROCESS ELIMINATES FROM COLLECTION EFFORTS THOSE PATIENTS WHO ARE UNLIKELY TO HAVE THE RESOURCES TO PAY THEIR ACCOUNT BALANCES, EVEN IF THEY ARE INELIGIBLE FOR FINANCIAL ASSISTANCE BY MODEL.
HALIFAX REGIONAL HOSPITAL: PART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS PRESENTED IN THE CHNA ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED BY COMMUNITY MEMBERS VIA MULTIPLE METHODS. IN ADDITION TO A KEY STAKEHOLDER SURVEY CONDUCTED ONLINE, FOCUS GROUPS ARE CONDUCTED, WITH ADDITIONAL INTERVIEWS WITH POLICY MAKERS AND REPRESENTATIVES OF INDEPENDENT COMMUNITY ORGANIZATIONS. SENTARA ENSURES THAT RESPONDENTS TO REQUESTS FOR INPUT REPRESENT MANY TYPES OF COMMUNITY ACTORS: POLICY MAKERS, SERVICE PROVIDERS, REPRESENTATIVES OF PUBLIC HEALTH ORGANIZATIONS, REPRESENTATIVES OF UNDERSERVED POPULATIONS, SOCIAL SERVICE PROVIDERS AND GOVERNMENT FUNCTIONS SUCH AS SCHOOLS, AND THE BUSINESS AND LARGER COMMUNITIES.
HALIFAX REGIONAL HOSPITAL: PART V, SECTION B, LINE 13A: DURING 2020, THE HOSPITAL FACILITY RAISED ITS FREE CARE INCOME LIMIT FOR UNINSURED PATIENTS FROM 200% TO 300% OF FPG.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?2
Name and address Type of Facility (describe)
1 1 - CENTER FOR BEHAVIORAL HEALTH
504 WILBORN AVENUE
SOUTH BOSTON,VA24592
REHABILITATION CENTER
2 2 - SENTARA SOUTHSIDE HEMATOLOGY & ONCOLOGY
2232 WILBORN AVE STE D
SOUTH BOSTON,VA24592
OTHER OUTPATIENT SITE
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 3C: IN ADDITION TO FPG, THE ORGANIZATION ALSO USED INSURANCE STATUS AND AN ASSET TEST AS FACTORS IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE:-UNINSURED PATIENTS WITH A HOUSEHOLD INCOME AT OR BELOW 300% OF FPG AND WITH LESS THAN $50,000 IN AVAILABLE ASSETS WERE ELIGIBLE FOR FREE CARE.-INSURED PATIENTS WITH A HOUSEHOLD INCOME AT OR BELOW 200% OF FPG AND WITH LESS THAN $50,000 IN AVAILABLE ASSETS WERE ELIGIBLE FOR FREE CARE.-UNINSURED PATIENTS WITH A HOUSEHOLD INCOME ABOVE 300%, BUT AT OR BELOW 400%, OF THE FPG AND WITH LESS THAN $50,000 IN AVAILABLE ASSETS WERE ELIGIBLE FOR DISCOUNTED CARE AT 75% OFF OF GROSS CHARGES."AVAILABLE ASSETS" INCLUDE THE PATIENT HOUSEHOLD'S TOTAL AMOUNT OF ASSETS AVAILABLE, INCLUDING ANY LIQUID AND/OR FIXED ASSETS, FOR USE IN PAYING FOR MEDICAL CARE INCLUDING, BUT NOT LIMITED TO: CASH AND CASH EQUIVALENTS, BANK ACCOUNTS, CERTIFICATES OF DEPOSIT, INVESTMENTS, TRUST ACCOUNTS, AUTOMOBILES, RECREATIONAL VEHICLES AND OTHER FORMS OF LEISURE TRANSPORT, AND REAL ESTATE EQUITY IN REAL PROPERTY OTHER THAN THE PRINCIPAL PLACE OF RESIDENCE. SPECIFICALLY EXCLUDED FROM AVAILABLE ASSETS IS THE EQUITY IN AN APPLICANT'S PRINCIPAL PLACE OF RESIDENCE, PRIMARY SOURCE OF TRANSPORTATION, IRS RECOGNIZED RETIREMENT SAVINGS ACCOUNTS, BUSINESS ASSETS, AND 3.99 ACRES OF LAND.
PART I, LINE 6A: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT WAS CONTAINED IN A SYSTEM-WIDE REPORT PREPARED BY SENTARA HEALTHCARE, EIN 52-1271901, THE 501(C)(3) PARENT ORGANIZATION OF THE SENTARA HEALTH SYSTEM.
PART I, LINE 7: EXCEPT FOR SUBSIDIZED HEALTH SERVICES, THE ORGANIZATION USED A COST-TO-CHARGES RATIO FROM WORKSHEET 2 TO DETERMINE THE AMOUNTS REPORTED IN PART I, LINE 7. COST METHOD WAS USED FOR SUBSIDIZED HEALTH SERVICES (7G).
PART I, LINE 7G: $7,601,520 OF THE AMOUNT REPORTED IN COLUMN (E) WAS ATTRIBUTABLE TO PHYSICIAN CLINICS.
PART I, LINE 3, OTHER: DURING 2020, THE ORGANIZATION MODIFIED ITS ELIGIBILITY CRITERIA FOR FREE AND DISCOUNTED CARE TO INCLUDE AN ASSET TEST AND ALSO RAISED ITS FREE CARE INCOME LIMIT FOR UNINSURED PATIENTS FROM 200% TO 300% OF FPG. SEE THE PART I LINE 3C DESCRIPTION FOR FURTHER INFORMATION ON THE ORGANIZATION'S CRITERIA FOR FINANCIAL ASSISTANCE.
PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION IS PART OF THE SENTARA HEALTH SYSTEM AND FUNDS THE SYSTEM'S CORPORATE SOCIAL RESPONSIBILITY DEPARTMENT AND ITS PROGRAM, SENTARA CARES. SENTARA CARES GOES ABOVE AND BEYOND THE DELIVERY OF MEDICAL CARE AND COMPREHENSIVE HEALTH SERVICES TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH--THE CONDITIONS IN WHICH PEOPLE LIVE, WORK, AND LEARN--WHICH ARE PROVEN TO HAVE A SIGNIFICANT AND LASTING IMPACT ON HEALTH OUTCOMES. THROUGH THE PROGRAM, SENTARA COLLABORATES WITH COMMUNITY ORGANIZATIONS TO ADDRESS LONGSTANDING HEALTH DISPARITIES WITH A FOCUS ON AFFORDABLE HOUSING, SKILLED CAREERS AND HIGHER-PAYING JOBS, FOOD SECURITY, BEHAVIORAL HEALTH, AND COMMUNITY ENGAGEMENT. DURING THE CURRENT YEAR, THE PROGRAM INCLUDED PARTNERSHIPS WITH THE LOCAL INITIATIVES SUPPORT CORPORATION (LISC) TO CREATE HOUSING AND ECONOMIC OPPORTUNITIES FOR UNDERSERVED POPULATIONS IN VIRGINIA; TRUIST, THE COMMONWEALTH OF VIRGINIA, AND THE FEDERATION OF VIRGINIA FOOD BANKS TO ADDRESS FOOD INSECURITY THROUGH A NEW STATEWIDE INITIATIVE, "WE CARE" COVID-19 VIRGINIA EMERGENCY FOOD SUPPORT PLAN; AND VA READY AND THE HAMPTON ROADS WORKFORCE COUNCIL (HRWC) TO PROVIDE NO-COST, PATIENT CARE TECHNICIAN TRAINING AT THE SYSTEM'S COLLEGE OF HEALTH SCIENCES.IN ADDITION TO THE ABOVE, THE ORGANIZATION'S EMPLOYEES DONATE HUNDREDS OF HOURS AND SHARE THEIR TALENTS AND EXPERTISE AS MEMBERS OF VARIOUS CIVIC AND RELIGIOUS ORGANIZATIONS IN THEIR COMMUNITIES, AS WELL AS SERVING ON RESCUE SQUADS AND FIRE DEPARTMENTS. THE HOSPITAL ALLOWS AND ENCOURAGES EMPLOYEES TO PROVIDE SERVICE TO THE COMMUNITY DURING WORKING HOURS ALSO. EMPLOYEES SERVE IN VARIOUS CAPACITIES INCLUDING ON BOARDS AND ADVISORY COMMITTEES OF A NUMBER OF COMMUNITY GROUPS AND STATE ORGANIZATIONS ADVANCING COMMUNITY HEALTH AND WELLNESS AND WORKFORCE DEVELOPMENT INCLUDING THE FOLLOWING: HALIFAX COUNTY CHAMBER OF COMMERCE; CHASE CITY CHAMBER OF COMMERCE; CLARKSVILLE CHAMBER OF COMMERCE; MECKLENBURG COUNTY BUSINESS EDUCATION PARTNERSHIP; HALIFAX ADVOCATES FOR SUBSTANCE ABUSE PREVENTION; SOUTHSIDE HEALTH COALITION, HALIFAX VOCATIONAL EDUCATION FOUNDATION; SOUTHSIDE VIRGINIA COMMUNITY COLLEGE SCHOOL OF NURSING ADVISORY COUNCIL; COMMITTEE FOR THE CENTER FOR NURSING EXCELLENCE; SOUTHERN VIRGINIA HIGHER EDUCATION CENTER; VIRGINIA COMMUNITY COLLEGE SYSTEM; VIRGINIA FOUNDATION FOR COMMUNITY COLLEGES; HALIFAX EDUCATION FOUNDATION; HALIFAX COUNTY PUBLIC SCHOOLS EDUCATION FOUNDATION; VIRGINIA ADVANCED STUDY ON STRATEGIES BOARD; ECONOMIC DEVELOPMENT COMMITTEE; WORKFORCE INVESTMENT BOARD; TRI-COUNTY COMMUNITY ACTION AGENCY BOARD; HEALTHY FAMILIES TRI-COUNTY ADVISORY COUNCIL; DIXIE YOUTH SOFTBALL BOARD; MENTOR ROLE MODEL PROGRAM AND THE HALIFAX AND MECKLENBURG COUNTY YMCAS.THE ORGANIZATION CONTINUES TO PARTICIPATE IN REGIONAL AND LOCAL EXERCISES TO TEST THE EMERGENCY OPERATIONS PLAN AND TO CONDUCT INTERNAL EXERCISES. THESE INITIATIVES HELP THE ORGANIZATION PREPARE FOR AND COORDINATE CRISIS RESPONSE AND RECOVERY OPERATIONS WITH STATE, LOCAL AND FEDERAL AGENCIES IN THE EVENT OF A BIOTERRORIST EVENT/DISASTER. OUTSIDE THE REALM OF THE GRANT FUNDING, THE ORGANIZATION SUPPLIED THE EMPLOYEE TIME INVOLVED IN TRAINING FOR COMMUNITY EMERGENCY PREPAREDNESS AS WELL AS FOR COMMUNITY DISASTER TRAINING DRILLS. OUR FOCUS CONTINUES TO BE ON PREPARING THE HOSPITAL STAFF AND THE COMMUNITY FOR "ALL HAZARDS."
PART III, LINE 2: FOR SCHEDULE H PART III LINE 2 PURPOSES, THE ORGANIZATION REPORTS WHAT WOULD'VE BEEN CONSIDERED BAD DEBT EXPENSE PRIOR TO ITS 2018 ADOPTION OF ASC TOPIC 606. ASC TOPIC 606 NOW CLASSIFIES THIS COMPONENT OF UNCOMPENSATED CARE AS IMPLICIT PRICE CONCESSIONS, WHICH ARE A REDUCTION TO NET OPERATING REVENUE.IMPLICIT PRICE CONCESSIONS REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE ORGANIZATION EXPECTS TO COLLECT BASED ON ITS COLLECTIONS HISTORY WITH THOSE PATIENTS AND CURRENT MARKET CONDITIONS. IT UTILIZES A PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO ACCOUNT FOR PATIENT CONTRACTS WITH SIMILAR CHARACTERISTICS AS A COLLECTIVE GROUP RATHER THAN INDIVIDUALLY.SEE FOOTNOTE 4 ON PAGES 18-22 OF THE ATTACHED FINANCIAL STATEMENTS FOR ADDITIONAL INFORMATION.
PART III, LINE 3: IN COMPUTING LINE 3, THE ORGANIZATION CONSERVATIVELY ESTIMATES THAT 15% OF IMPLICIT PRICE CONCESSIONS (FORMERLY BAD DEBT) ARE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR CHARITY ASSISTANCE IF SUFFICIENT DATA WAS AVAILABLE. THIS ESTIMATE IS BASED ON CREDIT REPORTING DATA PURCHASED FROM EQUIFAX. THIS DATA PROVIDES CREDIT SCORE, INCOME PREDICTION DATA AND NUMEROUS LINES OF CREDIT AND ASSET DATA. FOR UNRESPONSIVE PATIENTS, THE ORGANIZATION USES THE ESTIMATED INCOME, MARITAL STATUS, ASSET INFORMATION AND CREDIT LINE DATA TO DETERMINE WHETHER THE PATIENT WOULD QUALIFY FOR CHARITY BASED ON A PROJECTED INCOME OF 200% OF THE FEDERAL POVERTY GUIDELINES FOR INSURED PATIENTS AND 300% OF THE FEDERAL POVERTY GUIDELINES FOR UNINSURED (SELF-PAY) PATIENTS WITH LITTLE TO NO ASSET DATA. THIS INFORMATION IS NOT ALL INCLUSIVE FOR ALL UNRESPONSIVE PATIENTS THAT COULD QUALIFY, AS DEPENDENT INFORMATION IS NOT READILY AVAILABLE.
PART III, LINE 4: SEE FOOTNOTE 4 ON PAGES 18-22 OF THE ATTACHED FINANCIAL STATEMENTS FOR THE FOOTNOTE WHICH DISCUSSES IMPLICIT PRICE CONCESSIONS (FORMERLY BAD DEBT.)
PART III, LINE 8: WORKSHEET A IN THE INSTRUCTIONS WAS USED TO COMPUTE THE AMOUNT REPORTED ON LINE 6.
PART III, LINE 9B: IF AN INSURED PATIENT QUALIFIES FOR FREE CARE BASED ON 200% OF FEDERAL POVERTY GUIDELINES, AND AN UNINSURED (SELF-PAY) PATIENT QUALIFIES FOR FREE CARE BASED ON 300% OF FEDERAL POVERTY GUIDELINES, THE ENTIRE BALANCE IS WRITTEN OFF TO CHARITY AND NO COLLECTION EFFORTS ARE MADE. A NOTICE IS SENT TO THE PATIENT ADVISING THAT CHARITY QUALIFICATIONS HAVE BEEN MET IF THE PATIENT MAKES A FORMAL APPLICATION OF FINANCIAL ASSISTANCE WITH THE HOSPITAL. IF THE PATIENT QUALIFIES FOR DISCOUNTED CARE, THE APPROPRIATE DISCOUNT IS APPLIED TO THE BALANCE. A NOTICE IS SENT TO THE PATIENT ADVISING THAT CHARITY QUALIFICATIONS HAVE BEEN MET AND THE PATIENT IS REQUESTED TO CONTACT THE HOSPITAL FACILITY TO SET UP THE REMAINING BALANCE ON A PAYMENT PLAN. UNINSURED PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE RECEIVE A 75% DISCOUNT IF THEIR INCOME IS BETWEEN 301-400% OF THE FEDERAL POVERTY GUIDELINES. THE HOSPITAL FACILITY DID NOT IMPOSE COLLECTION ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THE PATIENT WAS ELIGIBLE FOR FINANCIAL ASSISTANCE.
PART VI, LINE 2: THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF ITS COMMUNITIES THROUGH THESE MEANS:-ANALYSIS OF AREA SOCIODEMOGRAPHIC, HEALTH STATUS, AND OTHER DATA: THE ANALYSIS FOCUSES ON IDENTIFICATION OF HEALTH CARE NEEDS FOR PLANNING AND DEVELOPMENT OF HEALTH SERVICES AND PROGRAMS. THIS ANALYSIS IS UTILIZED IN THE DEVELOPMENT OF ORGANIZATIONAL PLANS.-OBTAINING INPUT FROM KEY STAKEHOLDERS AND THE PUBLIC HEALTH COMMUNITY: IN ADDITION TO THE ANALYSIS OF SOCIODEMOGRAPHIC, HEALTH STATUS, AND OTHER DATA, ADDITIONAL INFORMATION IS OBTAINED AND ANALYZED. THIS INCLUDES INPUT FROM KEY STAKEHOLDERS INCLUDING THE LOCAL PUBLIC HEALTH COMMUNITY.-REVIEW OF HEALTH CARE NEEDS ASSESSMENTS AND DATA DEVELOPED BY COMMUNITY PARTNERS (SUCH AS STATE HEALTH DEPARTMENTS AND LOCAL HEALTH DISTRICTS), REGIONAL AGENCIES (SUCH AS THE PLANNING COUNCIL OR PLANNING DISTRICT COMMISSION), NATIONAL ORGANIZATIONS WHICH REPORT ON A LOCAL BASIS (SUCH AS COUNTY HEALTH RANKINGS), AND INFORMATION REPORTED IN LOCAL MEDIA: THIS INFORMATION IS STUDIED, INCORPORATED INTO THE ORGANIZATION'S PLANS, AND SHARED WITH ORGANIZATIONAL DECISION MAKERS.-PARTICIPATION IN COLLABORATIVE HEALTH PLANNING AND NEEDS ASSESSMENT ACTIVITIES SUCH AS THOSE SPONSORED BY THE LOCAL HEALTH DISTRICTS AND OTHER ORGANIZATIONS. INFORMATION GATHERED THROUGH THESE ACTIVITIES IS INCORPORATED INTO THE ORGANIZATION'S PLANNING.-INFORMATION AND INPUT FROM PATIENTS AND CARE PROVIDERS: PATIENT CHARACTERISTICS AND TRENDS ARE REVIEWED TO ASSIST IN IDENTIFYING NEW COMMUNITY NEEDS. INPUT FROM PATIENTS AND CARE PROVIDERS IS SOUGHT AND CYCLED INTO THE ASSESSMENT PHASE OF PROJECTS.
PART VI, LINE 3: WHEN A PATIENT IS REGISTERED AT THE ORGANIZATION'S HOSPITAL FACILITY, S/HE IS OFFERED A FINANCIAL ASSISTANCE BROCHURE AND APPLICATION WHICH INCLUDES CONTACT INFORMATION FOR ADDITIONAL INFORMATION. FRAMED COPIES OF THE NOTICE ARE LOCATED IN REGISTRATION AREAS AND KEY PUBLIC AREAS OF THE FACILITY. THE FACILITY'S TELEPHONE SYSTEM OFFERS "ON HOLD" MESSAGING THAT IS UTILIZED TO INFORM INCOMING CALLERS OF FINANCIAL ASSISTANCE INFORMATION EVERY THIRD MONTH. QUARTERLY ARTICLES ARE PLACED IN AREA NEWSPAPERS AS A CUSTOMER SERVICE TOOL TO REMIND PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE INFORMATION, ALONG WITH AN APPLICATION FOR FINANCIAL ASSISTANCE, IS LOCATED ON THE FACILITY'S WEBSITE. A NOTICE REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IS PRINTED ON PATIENT BILLS AND INCLUDES CONTACT INFORMATION FOR ADDITIONAL INFORMATION. ALL INDIVIDUALS RECEIVE A FINANCIAL ASSISTANCE APPLICATION ENCLOSED WITH THE SECOND BILLING STATEMENT WHICH INCLUDES DETAILED INFORMATION.THE ORGANIZATION HAS PARTNERED WITH FIRSTSOURCE TO AID UNINSURED EMERGENCY DEPARTMENT PATIENTS, UNINSURED AND UNDERINSURED INPATIENTS, OUTPATIENT SURGERY, AND OBSERVATION PATIENTS IN APPLYING FOR MEDICAL ASSISTANCE THROUGH GOVERNMENT PROGRAMS. FIRSTSOURCE ASSISTS PATIENTS THROUGHOUT THE ENTIRE APPLICATION PROCESS TO ENSURE ALL DOCUMENTATION IS COMPLETE.FIRSTSOURCE ALSO HELPS PATIENTS COMPLETE FINANCIAL ASSISTANCE APPLICATIONS IF THEY MAY NOT QUALIFY FOR GOVERNMENT ASSISTANCE.
PART VI, LINE 4: SENTARA HALIFAX REGIONAL HOSPITAL SERVES RESIDENTS OF HALIFAX, MECKLENBURG, AND CHARLOTTE COUNTIES.THE 2020 POPULATION OF THE SERVICE AREA IS 77,036, AND IS EXPECTED TO DECLINE OVER THE NEXT FIVE YEARS, DECREASING BY 2.3% WHILE THE OVERALL US POPULATION IS EXPECTED TO GROW BY 2.9%. THE AGE DISTRIBUTION OF THE POPULATION IS COMPARABLE TO THE OVERALL US DISTRIBUTION, WITH A HIGHER PERCENT OF THE POPULATION 65+ (25.2% VS. 16.9%) AND A LOWER PERCENT OF THE POPULATION YOUNGER THAN 20 YEARS (21.5% VS. 24.7%). A HIGHER NUMBER OF RESIDENTS OF THE SERVICE AREA HAVE COMPLETED AT LEAST A HIGH SCHOOL DIPLOMA, 35.8% VS. 26.9% FOR THE US OVERALL, WHILE 11.2% HAVE ACHIEVED AT LEAST A BACHELOR'S DEGREE, VS. 20.4% FOR THE US AS A WHOLE. THE MEDIAN INCOME OF THE RESIDENTS OF THE SERVICE AREA IS $47,451 VS. $73,066 FOR THE US, AND A LOWER PERCENT OF HOUSEHOLDS, 28.4% VS. 18.2%, SUBSIST ON LESS THAN $25,000 PER YEAR. RACIALLY, THE SERVICE AREA IS HOME TO 62.2% WHITES (VS. 69.5% FOR THE US), 34.0% BLACK/AFRICAN AMERICANS (VS. 13.5% US), 0.8% ASIANS (VS. 6.0% US), WITH 1.1% REPORTING ANOTHER RACE VS. 6.6% NATIONALLY. ETHNICALLY, THE SERVICE AREA IS HOME TO 2.6% HISPANICS VS. 18.2% NATIONALLY, AND 97.4% NON-HISPANICS, VS. 81.8% NATIONALLY.
PART VI, LINE 5: THE ORGANIZATION'S GOVERNING BODY IS A COMMUNITY-BASED BOARD COMPRISED OF A MAJORITY OF MEMBERS WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION OR ITS AFFILIATES, NOR FAMILY MEMBERS THEREOF. GENERALLY, MEDICAL STAFF MEMBERSHIP IS OPEN TO ALL CARE PROVIDERS WHO MEET CREDENTIALING REQUIREMENTS. THE ORGANIZATION'S SURPLUS FUNDS ARE USED FOR IMPROVEMENTS IN PATIENT CARE, PROVISION OF SERVICES TO THE UNINSURED AND UNDERINSURED, MEDICAL EDUCATION, AND COMMUNITY PROGRAMS.
PART VI, LINE 6: THE ORGANIZATION IS AFFILIATED WITH THE SENTARA HEALTH SYSTEM ("SENTARA.") NAMED TO IBM WATSON HEALTH'S 2018 "TOP 15 HEALTH SYSTEMS," SENTARA IS AN INTEGRATED, NOT-FOR-PROFIT SYSTEM OF 12 HOSPITALS IN VIRGINIA AND NORTHEASTERN NORTH CAROLINA, INCLUDING A LEVEL I TRAUMA CENTER, THE SENTARA HEART HOSPITAL AND THE SENTARA HEALTHCARE CARDIOVASCULAR RESEARCH INSTITUTE, THE SENTARA BROCK CANCER CENTER AND THE ACCREDITED SENTARA CANCER NETWORK, TWO ORTHOPEDIC HOSPITALS, AND THE SENTARA NEUROSCIENCES INSTITUTE. THE SENTARA FAMILY ALSO INCLUDES FOUR MEDICAL GROUPS, NIGHTINGALE REGIONAL AIR AMBULANCE AND GROUND MEDICAL TRANSPORT, HOME CARE AND HOSPICE, AMBULATORY OUTPATIENT CAMPUSES, ADVANCED IMAGING AND DIAGNOSTIC CENTERS, A CLINICALLY INTEGRATED NETWORK, THE SENTARA COLLEGE OF HEALTH SCIENCES AND THE OPTIMA HEALTH PLAN AND VIRGINIA PREMIER HEALTH PLAN SERVING 858,000 MEMBERS IN VIRGINIA, NORTH CAROLINA AND OHIO. WITH NEARLY 30,000 EMPLOYEES AND RANKED ONE OF FORBES "AMERICA'S BEST EMPLOYERS" IN 2018, SENTARA IS STRATEGICALLY FOCUSED ON CLINICAL QUALITY AND SAFETY, INNOVATION AND CREATING AN EXTRAORDINARY HEALTH CARE EXPERIENCE FOR OUR PATIENTS AND MEMBERS.
Schedule H (Form 990) 2020
Additional Data


Software ID:  
Software Version:  

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
2020
Open to Public
Inspection
Name of the organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number
54-0648699
Part I
General Information on Grants and Assistance
1
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? ........................
2
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 (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) SENTARA HEALTHCARE
6015 POPLAR HALL DRIVE
NORFOLK,VA23502
52-1271901 501(C)(3) 655,363       CORPORATE ALLOCATION TO PARENT
(2) COMMUNITY ARTS CENTER FOUNDATION INC
700 BRUCE STREET
SOUTH BOSTON,VA24592
54-1795927 501(C)(3) 15,000       DONATION
(3) SOUTHERN VIRGINIA BOTANICAL GARDENS & INVIRON EDUCATION CENTER
PO BOX 624
HALIFAX,VA24558
37-1591057 501(C)(3) 8,000       DONATION
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
3
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020

Schedule I (Form 990) 2020
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)
(2)
(3)
(4)
(5)
(6)
(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: AS PART OF THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM"), THE ORGANIZATION DONATES FUNDS TO ITS 501(C)(3) PARENT ORGANIZATION, SENTARA HEALTHCARE, IN FURTHERANCE OF THE SYSTEM'S MISSION TO IMPROVE HEALTH EVERYDAY THROUGH THE PROVISION OF HEALTH SERVICES, AND THE PROMOTION OF HEALTH, MEDICAL EDUCATION, AND THE SOCIAL, CULTURAL, EDUCATIONAL, AND ECONOMIC DEVELOPMENT OF THE COMMUNITY. EXPENDITURE OF SUCH FUNDS IS OVERSEEN BY AN INDEPENDENT COMMUNITY BOARD WHICH MANAGES THE BUSINESS AND AFFAIRS OF THE SYSTEM.
Schedule I (Form 990) 2020



Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number

54-0648699
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
If any of the boxes on 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 .....
1b
Yes
 
2
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 on Line 1a? ....
2
 
No
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
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
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1MICHAEL V GENTRY
FORMER OFFICER
(i)

(ii)
0
-------------
851,459
0
-------------
755,619
0
-------------
164,761
0
-------------
395,379
0
-------------
21,700
0
-------------
2,188,918
0
-------------
0
2MEGAN R PERRY
DIRECTOR
(i)

(ii)
0
-------------
486,725
0
-------------
347,832
0
-------------
164,053
0
-------------
391,002
0
-------------
20,745
0
-------------
1,410,357
0
-------------
64,433
3JONATHAN S DAVIS
DIRECTOR/VICE CHAIR
(i)

(ii)
0
-------------
414,439
0
-------------
145,489
0
-------------
77,450
0
-------------
91,038
0
-------------
28,827
0
-------------
757,243
0
-------------
25,667
4JENNIFER S SICTOR
DIRECTOR
(i)

(ii)
0
-------------
297,620
0
-------------
120,678
0
-------------
9,569
0
-------------
116,086
0
-------------
31,326
0
-------------
575,279
0
-------------
0
5MING Y LIU MD
FORMER TOP 5
(i)

(ii)
0
-------------
389,835
0
-------------
0
0
-------------
22,319
0
-------------
57,966
0
-------------
27,794
0
-------------
497,914
0
-------------
0
6PABLO SOUZA MD
PHYSICIAN - HF
(i)

(ii)
346,346
-------------
0
0
-------------
0
1,710
-------------
0
56,929
-------------
0
30,263
-------------
0
435,248
-------------
0
0
-------------
0
7GREGORY A SHUFORD MD
FORMER TOP 5
(i)

(ii)
0
-------------
210,041
0
-------------
0
0
-------------
35,425
0
-------------
56,025
0
-------------
20,296
0
-------------
321,787
0
-------------
0
8BRIAN K ZWOYER
PRESIDENT
(i)

(ii)
208,140
-------------
0
17,970
-------------
0
41,386
-------------
0
11,922
-------------
0
32,800
-------------
0
312,218
-------------
0
0
-------------
0
9STEWART R NELSON
FORMER OFFICER AND KE
(i)

(ii)
2,355
-------------
162,198
0
-------------
94,427
15
-------------
26,899
72
-------------
7,083
177
-------------
13,096
2,619
-------------
303,703
0
-------------
0
10DAVID FITTS
MANAGER, PHARMACY
(i)

(ii)
148,957
-------------
0
22,583
-------------
0
6,512
-------------
0
82,220
-------------
0
30,763
-------------
0
291,035
-------------
0
0
-------------
0
11TORIE B BASHAY
FORMER KE
(i)

(ii)
0
-------------
144,127
0
-------------
29,608
0
-------------
5,293
0
-------------
97,789
0
-------------
7,070
0
-------------
283,887
0
-------------
0
12BETTY T THROCKMORTON
RN UC -CLIN LADDER - LEVEL II
(i)

(ii)
159,842
-------------
0
750
-------------
0
2,726
-------------
0
79,179
-------------
0
33,412
-------------
0
275,909
-------------
0
0
-------------
0
13JAMES E CHILDREY
MGT, PATIENT CARE SERVICES - HF
(i)

(ii)
134,423
-------------
0
16,420
-------------
0
536
-------------
0
77,919
-------------
0
21,445
-------------
0
250,743
-------------
0
0
-------------
0
14SHERRI F BEE
FORMER KE
(i)

(ii)
128,610
-------------
0
17,080
-------------
0
967
-------------
0
61,994
-------------
0
10,536
-------------
0
219,187
-------------
0
0
-------------
0
15JASON A STUDLEY
FORMER OFFICER
(i)

(ii)
11,208
-------------
8,140
0
-------------
80,351
44
-------------
104,384
349
-------------
0
1,217
-------------
5,249
12,818
-------------
198,124
0
-------------
0
16ANTHONY J MILAM
CLINICAL PHARMACIST- INPATIENT - HF
(i)

(ii)
143,448
-------------
0
2,250
-------------
0
4,166
-------------
0
27,214
-------------
0
10,157
-------------
0
187,235
-------------
0
0
-------------
0
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
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 THE ORGANIZATION PAID FOR TEMPORARY HOUSING OF AN EXECUTIVE RECRUIT, INCLUDING THE ADDITIONAL TAXES ASSOCIATED WITH SUCH BENEFIT, ALL OF WHICH WERE TREATED AS ADDITIONAL COMPENSATION AND REPORTED ON FORM W-2 AS TAXABLE WAGES.
PART I, LINE 3 SENTARA HEALTHCARE, THE 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM, ESTABLISHED THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL THROUGH THE USE OF AN INDEPENDENT COMPENSATION CONSULTANT AND A COMPENSATION STUDY. SENTARA HEALTHCARE RECOGNIZES THAT PROVIDING THE BEST POSSIBLE CARE REQUIRES US TO ATTRACT AND RETAIN THE VERY BEST EMPLOYEES. OUR ORGANIZATION IS COMMITTED TO INVESTING IN OUR PEOPLE BY OFFERING COMPETITIVE COMPENSATION OPPORTUNITIES AND A STRONG WORKPLACE ENVIRONMENT.
PART I, LINES 4A-B JASON A. STUDLEY RECEIVED $70,938 IN COMPENSATION RELATED TO HIS SEPARATION FROM SERVICE. THIS AMOUNT HAS BEEN INCLUDED IN COLUMN (B)(III) OF SCHEDULE J, PART II. MICHAEL GENTRY, MEGAN PERRY, JONATHAN DAVIS, AND BRIAN ZWOYER PARTICIPATED IN THE SENTARA CAPITAL ACCUMULATION ACCOUNT PLAN. THE CAPITAL ACCUMULATION PLAN IS A NONQUALIFIED DEFERRED COMPENSATION PROGRAM. SUCH PLANS ARE COMMONLY OFFERED TO NOT-FOR-PROFIT HEALTH CARE EXECUTIVES TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO SUPPLEMENT LIMITATIONS IN QUALIFIED PLANS. PARTICIPATION IS LIMITED TO A SELECT GROUP OF CORPORATE EXECUTIVES AS APPROVED BY SENTARA HEALTHCARE'S BOARD OF DIRECTOR'S COMPENSATION COMMITTEE. TERMS OF THE PLAN CHANGED EFFECTIVE JANUARY 1, 2009, WHEREBY VESTING OF CONTRIBUTIONS MADE ON OR AFTER THAT DATE NOW OCCURS ON THE EARLIER OF FIVE YEARS FOR EACH YEARS' CONTRIBUTIONS OR AGE 55 WITH 10 YEARS OF SERVICE. UNDER THE OLD TERMS, VESTING OF CONTRIBUTIONS MADE PRIOR TO JANUARY 1, 2009 OCCURS ON THE EARLIEST OF ASSIGNED DISTRIBUTION DATE, DEATH, INVOLUNTARY TERMINATION WITHOUT CAUSE OR COMPLETION OF TWO-YEAR NON-COMPETE AFTER VOLUNTARY TERMINATION (REGARDLESS OF ORIGINAL ASSIGNED DISTRIBUTION DATE). DURING 2020, THE FOLLOWING CORPORATE EXECUTIVES RECEIVED VESTED DISTRIBUTIONS UNDER THE PLAN: MICHAEL GENTRY ($131,794); MEGAN PERRY ($98,994); AND JONATHAN DAVIS ($38,453). THESE AMOUNTS HAVE BEEN REPORTED IN COLUMN (B)(III) OF SCHEDULE J, PART II. DURING THE CURRENT TAX YEAR MING Y LIU 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. KEY CONTRIBUTOR AWARDS - REWARDS EXCEPTIONAL INDIVIDUALS OR TEAMS FOR SIGNIFICANT CONTRIBUTION AND RESULTS AS RECOGNIZED BY BUSINESS UNITS. 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. YEAR-END BONUS PAYMENTS EMPLOYEES WHO ARE NOT COVERED UNDER ANOTHER INCENTIVE PROGRAM ARE ELIGIBLE FOR YEAR-END BONUSES WHICH ARE CONDITIONED UPON SYSTEM YEAR-END RESULTS.
Schedule J (Form 990) 2020

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet 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.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number

54-0648699
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 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 (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
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?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
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) 2020
Schedule L (Form 990 or 990-EZ) 2020
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) HALIFAX HEART CENTER
 
SEE BELOW 1,316,206 SEE BELOW   No
(2) PULMONARY ASSOCIATES
 
SEE BELOW 1,178,500 SEE BELOW   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCH L, PART IV A) NAME OF PERSON: HALIFAX HEART CENTERB) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: 35%-CONTROLLED ENTITY OF BOARD MEMBERS HABIB BASSIL, MD AND SAID ISKANDAR, MDD) DESCRIPTION OF TRANSACTION: PROFESSIONAL FEES/SUBSIDIESA) NAME OF PERSON: PULMONARY ASSOCIATESB) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: 35%-CONTROLLED ENTITY OF BOARD MEMBER TERRANCE J. TRUITT, MDD) DESCRIPTION OF TRANSACTION: PROFESSIONAL FEES/SUBSIDIES
Schedule L (Form 990 or 990-EZ) 2020


Additional Data


Software ID:  
Software Version:  




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
2020
Open to Public
Inspection
Name of the organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number

54-0648699
Return Reference Explanation
FORM 990, PART III, LINE 1, ORGANIZATION'S MISSION HALIFAX REGIONAL HOSPITAL, INC. IS ORGANIZED TO BUILD, ESTABLISH, MAINTAIN AND OPERATE HOSPITALS AND OTHER HEALTH CARE FACILITIES AND CLINICS; PROVIDE ANCILLARY AND RELATED MEDICAL AND OTHER HEALTHCARE SERVICES; PROVIDE MANAGEMENT, ADVISORY, SERVICE ASSISTANCE AND OTHER SUPPORT TO HEALTH CARE ORGANIZATIONS HAVING THE SAME PURPOSES AS ITS OWN; ENGAGE IN OTHER RELATED, EXCLUSIVELY CHARITABLE, SCIENTIFIC, EDUCATIONAL AND MEDICAL RESEARCH ACTIVITIES AS MAY BE AUTHORIZED FROM TIME TO TIME BY ITS GOVERNING BODY; AND FOR SUCH PURPOSES, SOLICIT AND RECEIVE FUNDS AND OTHER PROPERTY BY GIFT, TRANSFER, DEVISE, OR BEQUEST, AND INVEST, REINVEST, HOLD, MANAGE, ADMINISTER, EXPEND, AND APPLY SUCH FUNDS AND PROPERTY SUBJECT TO APPLICABLE CONDITIONS AND LIMITATIONS. ALL SUCH ACTIVITIES SUPPORT ITS MISSION TO PROVIDE THE HIGHEST QUALITY CARE BASED ON THE HEALTHCARE NEEDS OF THE PEOPLE SERVED.
FORM 990, PART III, LINE 4A SENTARA HEALTHCARE I. SENTARA HEALTHCARE - YOUR NOT-FOR-PROFIT HEALTHCARE PARTNER SENTARA HEALTHCARE CELEBRATES MORE THAN 132 YEARS IN PURSUIT OF ITS MISSION "WE IMPROVE HEALTH EVERY DAY." NAMED TO IBM WATSON HEALTH'S 2018 "TOP 15 HEALTH SYSTEMS," SENTARA IS AN INTEGRATED, NOT-FOR-PROFIT SYSTEM OF 12 HOSPITALS IN VIRGINIA AND NORTHEASTERN NORTH CAROLINA, INCLUDING A LEVEL I TRAUMA CENTER, THE SENTARA HEART HOSPITAL AND THE SENTARA HEALTHCARE CARDIOVASCULAR RESEARCH INSTITUTE, THE SENTARA BROCK CANCER CENTER AND THE ACCREDITED SENTARA CANCER NETWORK, TWO ORTHOPEDIC HOSPITALS, AND THE SENTARA NEUROSCIENCES INSTITUTE. THE SENTARA FAMILY ALSO INCLUDES FOUR MEDICAL GROUPS, NIGHTINGALE REGIONAL AIR AMBULANCE AND GROUND MEDICAL TRANSPORT, HOME CARE AND HOSPICE, AMBULATORY OUTPATIENT CAMPUSES, ADVANCED IMAGING AND DIAGNOSTIC CENTERS, A CLINICALLY INTEGRATED NETWORK, THE SENTARA COLLEGE OF HEALTH SCIENCES AND THE OPTIMA HEALTH PLAN AND VIRGINIA PREMIER HEALTH PLAN SERVING 858,000 MEMBERS IN VIRGINIA, NORTH CAROLINA AND OHIO. WITH MORE THAN 28,000 EMPLOYEES AND RANKED ONE OF FORBES "AMERICA'S BEST EMPLOYERS" IN 2018, SENTARA IS STRATEGICALLY FOCUSED ON CLINICAL QUALITY AND SAFETY, INNOVATION AND CREATING AN EXTRAORDINARY HEALTH CARE EXPERIENCE FOR OUR PATIENTS AND MEMBERS. 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 OUR COMMUNITIES THROUGH HEALTH OUTREACH PROGRAMS, EDUCATION, AND FINANCIAL SUPPORT FOR OTHER NOT FOR PROFIT ORGANIZATIONS WITH SIMILAR HEALTH MISSIONS. II. COMMITMENT TO THE COMMUNITY A. SENTARA HAS PROVIDED MUCH IN THE WAY OF COMMUNITY BENEFIT AND CHARITY CARE ON AN ANNUAL BASIS. THE 2020 VALUE OF COMMUNITY BENEFIT TOTALED $256,000,000. SENTARA PROVIDED $180,000,000 IN NET UNCOMPENSATED PATIENT CARE COSTS; $45,000,000 IN NET UNFUNDED COSTS OF TEACHING PROGRAMS; $20,000,000 IN INCURRED COSTS FOR COMMUNITY BENEFIT PROGRAMS; AND $11,000,000 IN PHILANTHROPY. B. SENTARA OFFICIALLY LAUNCHED ITS CORPORATE SOCIAL RESPONSIBILITY (CSR) PROGRAM, SENTARA CARES, TO SUPPORT THE NEEDS OF THE COMMUNITIES WE SERVE IN THE MOST IMPACTFUL WAY. THROUGH CSR WE EITHER GAVE OR PLEDGED NEARLY $6.5M TO THE COMMUNITIES WE SERVE THROUGH SPONSORSHIPS, GRANTS, AND PARTNERSHIPS. THE CSR PROGRAM WILL DELIVER ECONOMIC, SOCIAL, AND ENVIRONMENTAL BENEFITS FOR STAKEHOLDERS ACROSS ALL SENTARA MARKETS AND INCREASE OUR COMMUNITY CONNECTION. IT WILL BUILD ON SENTARA RECOGNIZED LEADERSHIP AND COMMITMENT TO THE COMMUNITIES WE SERVE. C. SENTARA HEALTHCARE AND OPTIMA HEALTH, IN PARTNERSHIP WITH THE LOCAL INITIATIVES SUPPORT CORPORATION (LISC), THE NATION'S LARGEST COMMUNITY DEVELOPMENT ORGANIZATION, CONTINUED ITS WORK TO INVEST $100 MILLION TO ADDRESS SOCIAL DETERMINANTS OF HEALTH IN UNDERSERVED COMMUNITIES ACROSS THE COMMONWEALTH OF VIRGINIA. THIS INVESTMENT, WHICH IS PART OF OUR CORPORATE SOCIAL RESPONSIBILITY PROGRAM, BUILDS UPON SENTARA'S COMMITMENT TO CREATE HEALTHIER COMMUNITIES AND IMPROVE THE QUALITY OF LIFE FOR VIRGINIANS MOST IN NEED. SENTARA WILL CONTRIBUTE $50M TO ADVANCE THESE GOALS IN PARTNERSHIP WITH LISC, WHO HAS COMMITTED TO ASSEMBLING AN ADDITIONAL $50M FROM PUBLIC AND PRIVATE SOURCES TO COMPLEMENT SENTARA'S INVESTMENT. FURTHER RESULTING FROM THE LISC PARTNERSHIP, $1.5M OF OUR PHILANTHROPY FUNDING WENT TOWARD THE DEVELOPMENT OF TWO FINANCIAL OPPORTUNITY CENTERS AND 2 HOUSING PROJECTS PLANNED IN 2021. D. THE SENTARA CHIEF DIVERSITY OFFICER CONTINUED THE FOCUS ON THE IMPORTANT WORK OF DIVERSITY IN OUR WORKFORCE, TO DEEPEN OUR UNDERSTANDING ON CARING FOR OUR DIVERSE PATIENT POPULATION AND TO DEVELOP STRONG RELATIONSHIPS WITH DIVERSE COMMUNITY POPULATIONS. WE FORMED SEVERAL PARTNERSHIPS WITH KEY DIVERSITY-FOCUSED ORGANIZATIONS. WE BEGAN ESTABLISHING DIVERSITY AND INCLUSION COUNCILS AT ALL 12 HOSPITALS. AND, WE DEVELOPED NEW DIVERSITY AND INCLUSION COMPONENTS AND EDUCATION FOR ALL TEAM MEMBERS. THIS WAS ESPECIALLY IMPORTANT GIVEN THE SOCIAL JUSTICE ISSUES AND CIVIL UNREST IN 2020. TO THAT END, WE HOSTED SEVERAL "SAFE SPACES" SESSIONS WITH OUR TEAM MEMBERS FOR THEM TO SHARE, HEAR AND LEARN GIVEN OUR SOCIAL JUSTICE ENVIRONMENT. ADDITIONALLY, THE DIRECTOR OF HEALTH EQUITY CONTINUED THE EXCELLENT WORK IN IDENTIFYING AND REMOVING BARRIERS SO PEOPLE CAN RECEIVE THE CARE THEY NEED. THE TEAM IDENTIFIES HEALTH DISPARITIES AND RESEARCHES POSSIBLE CAUSES. THIS INCLUDES CHRONIC HEALTH ISSUES SUCH AS HYPERTENSION, DIABETES, AND THE HIGH RATES OF CANCER DEATHS IN MINORITY COMMUNITIES. ADDITIONALLY, WE CREATED POLICIES AND GUIDELINES TO ENSURE PROTECTION OF LGBTQ PATIENTS' RIGHTS AND PARTNERED WITH NUMEROUS COMMUNITY GROUPS TO PROVIDE EDUCATION AND EARLY DETECTION FOR COLORECTAL AND BREAST CANCERS. A MAJOR FOCUS IN 2020 FOR THE HEALTH EQUITY DIVISION WAS TO ENABLE ACCESS FOR COVID TESTING IN UNDERSERVED COMMUNITIES AND ENABLE ACCESS TO THE COVID VACCINE FOR THOSE SAME COMMUNITIES. OUTREACH TO OUR FAITH-BASED ORGANIZATIONS AND COMMUNITY PARTNERS WAS UNPRECEDENTED AND STRONGLY POSITIONS OUR COMMUNITIES TO COLLABORATE DURING UNPRECEDENTED TIMES. E. IN RESPONSE TO THE TRAGEDY THAT TOOK PLACE AT THE VIRGINIA BEACH MUNICIPAL CENTER IN MAY 2019, SENTARA COLLABORATED WITH THE CITY OF VIRGINIA BEACH TO OPEN THE VB STRONG CENTER, WHICH CONTINUES TO PROVIDE RESOURCES AND DEDICATED STAFF TO ENSURE THOSE IN THE COMMUNITY WHO NEED OR WANT ASSISTANCE FOLLOWING THE TRAGEDY CAN RECEIVE PERSONALIZED CARE. SERVICES INCLUDE INDIVIDUAL COUNSELING, GROUP THERAPY, ART, YOGA, MEDITATION, MENTAL HEALTH COUNSELING, INTAKE AND CASE COORDINATION, AND OTHER SERVICES AS DIRECTED BY A LICENSED MENTAL HEALTH CLINICIAN. F. 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 SUPPORTING COMMUNITY HEALTH NEEDS.
FORM 990, PART III, LINE 4A G. 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 2020, THE HOPE FUND AWARDED $166,992 TO SENTARA EMPLOYEES IN CRISES ACROSS THE SYSTEM. ADDITIONALLY, SENTARA ESTABLISHED A SPECIAL COVID HOPE FUND TO HELP EMPLOYEES WHO EXPERIENCED EXTRAORDINARY HARDSHIP DURING THE COVID-19 PANDEMIC. THIS SENTARA COVID-19 HOPE FUND AWARDED $545,117 IN 2020. H. AS A RESULT OF COVID-19, FOOD INSECURITY REACHED NEW LEVELS OF UNPRECEDENTED NEED. IN PARTNERSHIP WITH TRUIST, THE COMMONWEALTH OF VIRGINIA, THE FEDERATION OF VIRGINIA FOOD BANKS AND MANY OTHER COMMUNITY-MINDED COMPANIES, SENTARA SPEARHEADED THE "WE CARE" COVID-19 VIRGINIA EMERGENCY FOOD SUPPORT PLAN. THIS INITIATIVE CENTERED ON PROVIDING FIVE-DAY, SHELF-STABLE FOOD SUPPLY BOXES CONTAINING 15 NUTRITIOUS MEALS THAT COULD BE MORE EASILY AND SAFELY ASSEMBLED AND DISTRIBUTED AT THE HEIGHT OF THE PANDEMIC. AS A RESULT, APPROXIMATELY 200,000 20-POUND, FIVE-DAY SUPPLY FOOD BOXES HAVE BEEN DISTRIBUTED THROUGH SENTARA'S "WE CARE" COVID -19 VIRGINIA EMERGENCY FOOD SUPPORT PLAN. SENTARA AND TRUIST EACH CONTRIBUTED $500,000. THE COMMONWEALTH OF VIRGINIA COMMITTED $1.4M FROM CARES ACT FUNDS PLUS OTHER FEDERAL FUNDING CAME THROUGH VIA THE COMMONWEALTH. ALONG WITH OTHER CORPORATE DONATIONS THE TOTAL AMOUNT RAISED FOR THIS EFFORT TOTALED OVER $6.4 MILLION. BECAUSE OF THE GROWING NUMBER OF INDIVIDUALS FACING HOMELESSNESS, SENTARA PARTNERED WITH MANY ORGANIZATIONS TO ADDRESS THIS CRITICAL NEED THAT HAS REACHED NEW HEIGHTS DUE TO THE COVID-19 PANDEMIC. HERE ARE A FEW EXAMPLES: I. HEALTHY HOTEL PROJECT: THANKS TO OUR PARTNERSHIP WITH THE NORFOLK COMMUNITY SERVICES BOARD (NCSB), SENTARA'S MEDICAL GROUP AND HOME CARE DIVISION HAVE BEEN ABLE TO HELP NCSB SAFELY LEVERAGE HOTEL ROOMS CONVERTED INTO A SAFE AND SUPPORTIVE SHELTER PROGRAM. THROUGH THE HEALTHY HOTEL PROJECT, NCSB IS PROVIDING TEMPORARY SHELTER FOR NORFOLK'S MOST VULNERABLE HOMELESS RESIDENTS, WHILE SENTARA PROVIDES PREVENTIVE SCREENING, SUPPORT, AND CHRONIC DISEASE MANAGEMENT SERVICES. II. THE HELP CLINIC: THIS FREE CLINIC IN HAMPTON, VIRGINIA, OPENED A SINGLE SITE SHELTER FOR THE HOMELESS WITH COVID SAFEGUARDS. SENTARA CAREPLEX HOSPITAL CASE MANAGERS WORK WITH THE HELP CLINIC TO ENSURE HOMELESS INDIVIDUALS HAVE ACCESS TO THERMAL SHELTERS, WHERE THEY CAN LINK THE CLIENTS TO MORE PERMANENT HOUSING SOLUTIONS. III. SUITCASE CLINIC: A COLLABORATION AMONG JAMES MADISON UNIVERSITY AND OTHER COMMUNITY PARTNERS, INCLUDING THE RMH FOUNDATION, WORKS TO OVERCOME BARRIERS TO HEALTHCARE IN THE HARRISONBURG, VIRGINIA COMMUNITY. IMPORTANTLY, IT SUPPORTS HEALTH AND WELLNESS AMONG THE REGION'S HOMELESS POPULATION THROUGH MOBILE HEALTH SERVICES. I. 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 2020: HEALTH IMPROVEMENT EVENTS WERE OFFERED TO CHURCHES, EMPLOYER GROUPS, COMMUNITY HEALTH CENTERS AND OTHER COMMUNITY LOCATIONS. SENTARA CONTINUED TO OFFER PROGRAMS SUCH AS EATING FOR LIFE, WALKABOUT WITH HEALTHY EDGE, HEALTH HABITS, HEALTHY YOU, MEDITATION, TAI CHI AND YOGA. SENTARA HOSTS SEVERAL COMMUNITY EVENTS RAISING AWARENESS AROUND KEY HEALTH AWARENESS MONTHS. ONE GOOD EXAMPLE IS THROUGH SENTARA HEART, WE PROMOTED THE "28 DAYS OF HEART" IN FEBRUARY 2020 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. ADDITIONALLY, TWO SENTARA HOSPITALS, SENTARA NORFOLK GENERAL HOSPITAL (NORFOLK) AND SENTARA CAREPLEX HOSPITAL (HAMPTON) ACTIVATED THE VIOLENCE PREVENTION GRANTS THEY RECEIVED FROM THE VIRGINIA HOSPITALS AND HEALTHCARE ASSOCIATION ON JUNE 5, 2020 WEAR ORANGE DAY. THE GRANTS SUPPORT DEVELOPMENT OF COMMUNITY-BASED PROGRAMS TO PREVENT GUN AND INTIMATE PARTNER VIOLENCE BEFORE THEY RESULT IN MORE TRAUMATIC INJURIES. III. GROWTH IN SENTARA HEALTHCARE 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 2020 INCLUDED THE FOLLOWING: A. SENTARA PURCHASED 80% OF VIRGINIA PREMIER, AN INSURANCE COMPANY AFFILIATED WITH VCU HEALTH IN RICHMOND, VIRGINIA. THE TWO PLANS WILL SERVE MORE THAN 858,000 MEMBERS. B. OPTIMA HEALTH CONTINUED AS ONE OF 6 MANAGED CARE ORGANIZATIONS THAT COLLECTIVELY SERVED OVER 490,000 (BY END OF 2020) ELIGIBLE VIRGINIANS WHO QUALIFIED FOR MEDICAID EXPANSION. C. SENTARA OPENED THE NEW SENTARA BROCK CANCER CENTER IN NORFOLK, VIRGINIA, WHICH IS A PATIENT-CENTERED FACILITY THAT IS TRANSFORMING CANCER CARE IN SOUTHEAST VIRGINIA/NORTHEAST NORTH CAROLINA.
FORM 990, PART III, LINE 4A IV. DIGITAL INITIATIVES AND INNOVATION SUCCESS A. SENTARA CONTINUED ITS FOCUS ON ENHANCING THE CONSUMER DIGITAL EXPERIENCE THROUGH THE ONGOING DEVELOPMENT AND ENHANCEMENT OF THE SENTARA "APP AND THE OPTIMA "APP". SENTARA AND OPTIMA EXPERIENCED 118,963 NEW APP DOWNLOADS AND A COMBINED TOTAL OF 148,654 LOG-INS. OUR AIM IS TO CONTINUOUSLY IMPROVE THE VIRTUAL EXPERIENCE, ENABLE VOICE OF THE CUSTOMER TO DRIVE CHANGE TO THE EXPERIENCE, AND ALLOW FOR A MORE FRICTIONLESS EXPERIENCE. B. 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 BOTH IN THE BRICK AND MORTAR WORLD AND IN THE WORLD OF VIRTUAL CARE. C. SENTARA WAS NAMED TO THE CIO 100 LIST OF THE WORLD'S LEADING INNOVATIVE ORGANIZATIONS FOR CLOUD-HOSTING APPLICATION DESIGN, SUPPORT, AND COST OPTIMIZATION. V. OFFERING NEW PROCEDURES AND TECHNOLOGIES A. CLINICAL BREAKTHROUGHS AND ADVANCEMENTS: SENTARA INTRODUCED MANY NEW CLINICAL BREAKTHROUGHS AND ADVANCEMENTS THAT BENEFITED THE PATIENT IN MANY AREAS OF CARE. ONE EXAMPLE IS THE FOLLOWING: I. SEPSIS SNIFFER: SENTARA HOSPITALS CREATED AND IMPLEMENTED THE SEPSIS SNIFFER, AN ARTIFICIAL INTELLIGENCE SYSTEM TO PREDICT WHICH PATIENTS ARE MOST AT RISK FOR SEPSIS. VI. EXPANDING EDUCATIONAL OPPORTUNITIES A. 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 2020, SENTARA REACHED 83.9% OF SENTARA NURSES HAVING EARNED OR ARE UNDER CONTRACT TO EARN A BSN. SENTARA HAD 68.7% OF ITS NURSING WORKFORCE HOLDING A BSN OR HIGHER DEGREE WITH 15.2% OF LICENSED RNS WITH A CONTRACT TO COMPLETE THEIR BSN. B. RESEARCH: RESEARCH IS ANOTHER WAY SENTARA IS ALWAYS IMPROVING. HERE ARE A FEW EXAMPLES OF OUR WORK WITHIN THE RESEARCH REALM: I. HEART AND VASCULAR: THE SENTARA CARDIOVASCULAR RESEARCH INSTITUTE WAS ESTABLISHED IN 2005 TO ADVANCE THE UNDERSTANDING AND TREATMENT OF CARDIOVASCULAR DISEASE, WHICH IS THE NATION'S NUMBER-ONE KILLER. UNIQUELY QUALIFIED REGISTERED NURSE RESEARCH COORDINATORS, CARDIOLOGISTS, HEART, AND VASCULAR SURGEONS COLLABORATE WITH LOCAL INSTITUTIONS, GOVERNMENT AGENCIES AND BIOMEDICAL COMPANIES TO PERFORM CLINICAL RESEARCH TRIALS. ULTIMATELY, THE WORK ENABLES CLINICIANS TO IMPROVE CLINICAL CARE DELIVERY, PATIENT OUTCOMES AND THE OVERALL HEALTH OF OUR COMMUNITY. OUR SERVICES COVER ALL TYPES OF CARDIOVASCULAR RESEARCH SUCH AS MEDICAL DEVICES, HEART FAILURE, ELECTROPHYSIOLOGY, CARDIAC SURGERY, VASCULAR SURGERY, CARDIAC INTERVENTIONAL PROCEDURES, AND MEDICAL MANAGEMENT OF CAD RISK FACTORS SUCH AS DIABETES AND LIPID MANAGEMENT, AMONG OTHERS. RESEARCH NURSES EDUCATE AND FOLLOW RESEARCH PARTICIPANTS THROUGH THE ENTIRE TRIAL PROCESS. THEY COORDINATE ALL ASPECTS OF THE PATIENT EXPERIENCE AND ADVOCATES FOR THEM, HELPING THEM FEEL CARED FOR WHILE AT THEIR MOST VULNERABLE. OUR PROGRAM CURRENTLY HAS RESEARCH NURSES WHO ARE HIGHLY AUTONOMOUS AND SELF-DIRECTED. COLLECTIVELY, THEY COORDINATE MORE THAN 80 CLINICAL TRIALS. MANY OF THE TRIALS WE PARTICIPATE IN ARE NATIONALLY AND INTERNATIONALLY RECOGNIZED. THEY HAVE BEEN DESIGNED TO IDENTIFY NEW, IMPROVED TREATMENT METHODS AND PROTOCOLS, WHILE AT THE SAME TIME ELIMINATE THERAPIES AND APPROACHES TO CLINICAL CARE THAT ARE NOT AS EFFECTIVE OR MAY HAVE BEEN SHOWN TO BE HARMFUL. II. CANCER: THE SENTARA CANCER NETWORK CONTINUES TO EXPAND ITS RESEARCH CAPABILITIES IN CONJUNCTION WITH VIRGINIA ONCOLOGY ASSOCIATES, EASTERN VIRGINIA MEDICAL SCHOOL, GEORGE MASON UNIVERSITY, AND OTHER NATIONAL AND LOCAL HEALTHCARE ORGANIZATIONS TO CHANGE THE FUTURE OF CANCER AND IMPROVE OUR PATIENTS' QUALITY OF LIFE. FOR TODAY'S PATIENTS, PHYSICIANS IN THE SENTARA NETWORK CAN PROVIDE ACCESS TO NUMEROUS CLINICAL TRIALS, BOTH LOCAL AND NATIONAL, THROUGHOUT THE SENTARA SYSTEM, WITH A FOCUS IN HAMPTON ROADS AND BLUE RIDGE REGIONS. PROMISING CLINICAL TRIALS ARE BEING CONDUCTED ALL OVER THE COUNTRY FOR PATIENTS WITH CANCER, AND SOME OF THESE ARE BEING CONDUCTED WITHIN THE SENTARA CANCER NETWORK. SOME PEOPLE THINK THAT CLINICAL RESEARCH IS INTENDED AS A LAST RESORT, BUT MANY OF THESE TRIALS ARE LOOKING AT PROMISING NEW FIRST-LINE TREATMENTS. MANY STUDIES ARE NOT FOCUSED ON INCREASED TREATMENTS, BUT ADJUSTMENTS IN TREATMENTS AND OPTIONS FOR LESS INVASIVE OPTIONS IN ADDITION TO CLINICAL TRIALS THAT ARE ADMINISTERED AS PART OF CANCER TREATMENT FOR PATIENTS NOW. THE SENTARA CANCER NETWORK PARTICIPATES IN RESEARCH THAT COULD LEAD TO MORE AND BETTER OPTIONS FOR PREVENTION, DIAGNOSIS, AND TREATMENT IN THE FUTURE. EXAMPLES OF OTHER RESEARCH INCLUDE FINDING WAYS TO IMPROVE THE QUALITY OF LIFE FOR OUR PATIENTS, COMPARING COMMON CHARACTERISTICS FOR A SPECIFIC TYPE OF CANCER, AND IMPROVING PROCESSES AND TECHNOLOGY. VII. BUILDING FOR TOMORROW AND STRENGTHENING OUR COMMUNITIES A. SENTARA OPENED AN ORTHOPEDIC MEDICAL OFFICE BUILDING IN NORFOLK, VIRGINIA THAT HOUSES A SURGERY CENTER, REHABILITATION, AND IMAGING SERVICES. ADDITIONALLY, SENTARA EXPANDED ITS EMERGENCY DEPARTMENTS AT SENTARA OBICI HOSPITAL AND SENTARA LEIGH HOSPITAL. B. IN THE BLUE RIDGE REGION (HARRISONBURG AND CHARLOTTESVILLE), SENTARA LAUNCHED NEW ANESTHESIA PROGRAMS; ADDED NEW CARDIOLOGISTS AT SENTARA RMH MEDICAL CENTER FOR THE STRUCTURAL HEART PROGRAM; ADDED A NEONATOLOGIST PROGRAM TO ENHANCE LEVEL II NURSERY CARE FOR THE SRMH COMMUNITY; ADDED TWO NEW PRIMARY LOCATIONS IN WAYNESBORO AND CHARLOTTESVILLE; AND EXPANDED THE GASTROINTESTINAL PROGRAM CAPACITY. C. IN THE HALIFAX REGION, SENTARA HALIFAX REGIONAL HOSPITAL AND ITS ASSOCIATED MEDICAL PRACTICES FULLY IMPLEMENTED EPIC, OUR ELECTRONIC MEDICAL RECORD SYSTEM.
FORM 990, PART III, LINE 4A D. IN NORTHERN VIRGINIA, SENTARA OPENED A NEW NEUROLOGY PRACTICE AND A NEW PHYSICAL THERAPY CENTER. VIII. QUALITY, PATIENT SAFETY, AND COMMUNITY DISTINCTIONS AND AWARDS 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 2020 AWARDS AND RECOGNITIONS: I. SENTARA NORFOLK GENERAL HOSPITAL EARNED A TOP 50 NATIONAL RANKING FROM U.S. NEWS & WORLD REPORT: UROLOGY. THIS EXTRAORDINARY RANKING, 23RD IN THE NATION, IS DUE TO THE GREAT PARTNERSHIP AND COLLABORATION WITH UROLOGY OF VIRGINIA AND EASTERN VIRGINIA MEDICAL SCHOOL (EVMS). UROLOGY SERVICES INCLUDE EXPERT TREATMENT METHODS FOR KIDNEY STONES TO COMPLEX BLADDER SURGERY, ROBOTIC SURGERY FOR PROSTATE, KIDNEY AND BLADDER CANCERS, GREEN LIGHT THERAPY FOR ENLARGED PROSTATE, AND THE SENTARA-EVMS COMPREHENSIVE PELVIC FLOOR CENTER. II. SENTARA WAS RANKED #1 IN THE 2020 GENEROUS VIRGINIANS REPORT BY VA BUSINESS IN SUPPORT OF NONPROFIT ORGANIZATIONS, A RANKING BASED OFF DOLLARS DONATED OR PLEDGED. III. SENTARA WAS NAMED ONE OF FORBES 2020 BEST EMPLOYERS FOR WOMEN. SENTARA WAS ONE OF ONLY 22 HEALTH SYSTEMS INCLUDED. IV. ALL 12 SENTARA HOSPITALS EARNED A "LEADER IN LGBTQ HEALTHCARE EQUALITY" IN THE 2020 HEALTHCARE EQUALITY INDEX (HEI), A NATIONAL LGBTQ BENCHMARKING TOOL FROM THE HUMAN RIGHTS CAMPAIGN. IX. OPTIMA HEALTH A. GROWTH OPTIMA HEALTH CONTINUES TO SEE GROWTH IN THE COMMERCIAL EMPLOYER MARKET. OPTIMA HEALTH ALONG WITH VIRGINIA PREMIER SERVES OVER 858,000 MEMBERS IN VIRGINIA, NORTH CAROLINA, AND OHIO. OPTIMA MEDICARE STAR RATING INCREASED TO 3.5 FROM 3.0 AND OPTIMA CONTINUES TO PRESS FORWARD ON ITS QUALITY, AFFORDABILITY, ACCESSIBILITY, HEALTH AND WELLNESS, VIRTUAL CARE, AND CUSTOMER EXPERIENCE. X. COVID-19 A. THE YEAR 2020 WAS ONE OF GREAT UNKNOWNS DUE TO THE COVID-19 PANDEMIC. SENTARA LEADERS AND TEAM MEMBERS ROSE TO NEW HEIGHTS WITH THEIR HARD WORK AND PERSEVERANCE IN TAKING CARE OF EACH OTHER AS WELL AS OUR MEMBERS AND PATIENTS. HERE ARE A FEW HIGHLIGHTS: I. SAFETY FOR OUR PATIENTS AND VISITORS: SENTARA INCORPORATED NATIONAL GUIDELINES FOR CLEANING/SANITIZING PATIENT CARE AREAS, MANDATORY MASKING, AND SOCIAL DISTANCING. SENTARA LAUNCHED A CALL CENTER AND DEVELOPED A WEBSITE TO FACILITATE PATIENT COMMUNICATION AND QUESTIONS. II. PROTECTING OUR TEAM MEMBERS: SENTARA PARTNERED WITH SEVERAL LOCAL COMPANIES TO PROCURE OR CREATE PERSONAL PROTECTION EQUIPMENT (PPE) AND OTHER MATERIALS. WE DEVELOPED EXTENSIVE PROCEDURES TO PROCURE AND SAFELY REPROCESS PPE. SENTARA IMPLEMENTED RIGOROUS SCREENING PROCEDURES AT ALL OUR FACILITIES AND WORK LOCATIONS. III. SUPPORTING OUR TEAM MEMBERS: SENTARA LAUNCHED A PROGRAM, "YOU MATTER" TO HELP TEAM MEMBERS WITH THEIR SOCIAL, EMOTIONAL, AND BEHAVIORAL HEALTH NEEDS DURING THIS DIFFICULT PANDEMIC PERIOD. YOU MATTER HAS AN ABUNDANCE OF RESOURCES FOR STRESS MANAGEMENT, MINDFULNESS, RESILIENCE, MENTAL WELLNESS, AND CARE GIVER STRESS. SENTARA STRESSED THE NEED FOR TEAM MEMBERS TO TAKE CARE OF THEMSELVES AND EACH OTHER. IV. COMMUNITY TESTING: SENTARA WAS THE FIRST IN VIRGINIA TO IMPLEMENT DRIVE-THROUGH TESTING SITES. WE TESTED 8,700+ COMMUNITY MEMBERS IN DRIVE-THRU LOCATIONS AND PROVIDED FREE COVID-19 TESTING TO OVER 14,000+ PEOPLE IN UNDERSERVED COMMUNITIES. V. VIRTUAL CARE: SENTARA ACCELERATED THE USE OF VIRTUAL VISITS. EARLY IN THE PANDEMIC SENTARA TRAINED MORE THAN 900 PROVIDERS TO DELIVER VIRTUAL CARE. VI. SENTARA INCIDENT COMMAND CENTER: AS WITH ALL MAJOR INCIDENTS IMPACTING OUR COMMUNITY, PATIENTS, MEMBERS, AND INDUSTRY, SENTARA CREATED THE COVID-19 STEERING COMMITTEE IN JANUARY 2020 TO MONITOR AND RESPOND TO THE PANDEMIC. A CENTRALIZED DAILY INCIDENT COMMAND CENTER WAS ESTABLISHED IN MARCH WITH LEADERS FROM ALL KEY AREAS OF THE COMPANY REPRESENTED. THIS COMMAND CENTER STRUCTURE ALLOWED SENTARA TO SUCCESSFULLY RESPOND, PIVOT, PLAN, AND COORDINATE ACTIONS IN RESPONSE TO THE UNPRECEDENTED PANDEMIC. ADDITIONALLY, SENTARA LEADERS FREQUENTLY WERE IN COMMUNICATION WITH FEDERAL, STATE, REGIONAL AND LOCAL ELECTED OFFICIALS, AND OTHER KEY STAKEHOLDERS TO COLLECTIVELY LEARN AND ADVISE OTHERS OF NEEDS AND ISSUES. CONCLUSION: SENTARA HEALTHCARE IS COMMITTED TO OUR MISSION-WE IMPROVE 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 OUR CORPORATE SOCIAL RESPONSIBILITY PROGRAM, SERVING DIVERSITY AND EXPLORING HEALTH EQUITIES, VOLUNTEERISM, GRANTS, SPONSORSHIPS, AND SUPPORTING INITIATIVES THAT LIFT OUR COMMUNITIES. WE LOOK FORWARD TO ANOTHER YEAR OF COMMUNITY SUCCESS, GROWTH, AND INNOVATION IN 2021.
FORM 990, PART V, LINE 1A, NUMBER REPORTED IN BOX 3 OF FORM 1096: SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND THE 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM, MAINTAINS AN AGENCY RELATIONSHIP WITH THE ORGANIZATION AND ISSUES ALL 1099S ON ITS BEHALF. THE NUMBER REPORTED IS A BEST ESTIMATE OF THE 1099S ATTRIBUTABLE TO THE ORGANIZATION. THE EXACT NUMBER CANNOT BE DETERMINED; AS SOME OF THE 1099S ISSUED BY THE AGENT ARE ATTRIBUTABLE TO MORE THAN ONE ENTITY, AND THERE IS NO REPORTING MECHANISM TO DETERMINE 1099'S ATTRIBUTABLE SOLELY TO THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 2 DAVID H. WHITE, JR. AND LARRY P. SNEED HAVE A BUSINESS RELATIONSHIP. DRS. HABIB BASSIL AND SAID B. ISKANDAR HAVE A BUSINESS RELATIONSHIP. THE ORGANIZATION'S OFFICERS AND DIRECTORS SERVED TOGETHER ON THE BOARDS OF OTHER ORGANIZATIONS WITHIN THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM"), AS WELL AS JOINT VENTURES IN WHICH THE SYSTEM HAD AN OWNERSHIP INTEREST. SEE SCHEDULE R FOR A LISTING OF SUCH ENTITIES.
FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE MEMBER WAS SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND 501(C)(3) TAX EXEMPT ENTITY.
FORM 990, PART VI, SECTION A, LINE 7A A BOARD OF DIRECTORS, WHICH SERVED AS THE ORGANIZATION'S GOVERNING BODY, WAS COMPOSED OF TWO CLASSES OF DIRECTORS, A CLASS OF DIRECTORS APPOINTED BY THE ORGANIZATION'S SOLE MEMBER, SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND THE 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM, AND A CLASS OF DIRECTORS NOMINATED BY HALIFAX REGIONAL HOSPITAL, INC.'S NOMINATING COMMITTEE, AND RATIFIED BY THE BOARD OF DIRECTORS OF SENTARA HEALTHCARE.
FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION MAY NOT TAKE OR ALLOW ANY OF THE FOLLOWING GOVERNANCE ACTIONS WITHOUT THE CONSENT OF ITS SOLE MEMBER, SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND THE 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEATLH SYSTEM: APPROVAL OR ADOPTION OF ANY PLAN OF MERGER OR CONSOLIDATION, ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE ORGANIZATION, THE VOLUNTARY DISSOLUTION OR LIQUIDATION OF THE ORGANIZATION, REVOCATION OF ANY SUCH VOLUNTARY DISSOLUTION PROCEEDINGS, OR ANY DECISION TO FILE A PETITON REQUESTING OR CONSENTING TO AN ORDER FOR RELIEF UNDER THE FEDERAL BANKRUPTCY LAWS OR SIMILAR STATE LAWS FOR THE ORGANIZATION; ELECTION OF NEW BOARD MEMBERS; ANY ALTERATION, AMENDMENT, RESTATEMENT OR REPEAL OF ANY GOVERNING DOCUMENTS; THE ADOPTION OF ANY NEW GOVERNING DOCUMENTS; OR ANY ACTION TO BE TAKEN AS THE MEMBER UNDER THE GOVERNING DOCUMENTS. THE APPROVAL OF THE SOLE MEMBER IS ALSO REQUIRED FOR CERTAIN OPERATIONAL ACTIONS, AS OUTLINED IN THE ORGANIZATION'S BYLAWS. SUCH ACTIONS INCLUDE, BUT ARE NOT LIMITED TO, APPROVAL OF STRATEGIC OR LONG-RANGE BUSINESS PLANS AND ANNUAL OPERATING AND CAPITAL BUDGETS; CREATION OR ACQUISITION OF SUBSIDIARIES OR INTERESTS IN WHICH THE ORGANIZATION WILL BE A MEMBER; ENTRANCE INTO JOINT VENTURE OR OTHER SIMILAR ARRANGEMENTS; EMPLOYMENT MATTERS CONCERNING THE ORGANIZATION'S PRESIDENT, CHIEF OPERATING OFFICER OR CHIEF FINANCIAL OFFICER; TRANSACTIONS WITH INTERESTED PARTIES; INDEBTEDNESS NOT INCLUDED IN AN OPERATING OR CAPITAL BUDGET APPROVED BY THE MEMBER; THE COMMENCEMENT OR SETTLEMENT OF CERTAIN LITIGATION; AND ENTERING INTO, TERMINATING OR CHANGING ANY THIRD-PARTY PAYOR CONTRACT. SENTARA HEALTHCARE, AS SOLE MEMBER, HAS EXCLUSIVE AUTHORITY TO DIRECT AND MANAGE THE OPERATIONS AND AFFAIRS OF THE ORGANIZATION, AND TO MAKE ALL DECISIONS REGARDING THE BUSINESS OF THE ORGANIZATION, SUBJECT TO BOARD OVERSIGHT TO THE EXTENT AND IN THE MANNER SET FORTH IN THE ORGANIZATION'S BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION WAS PART OF THE SENTARA HEALTH SYSTEM ("THE SYSTEM"), AND AS SUCH, USED THE SYSTEM'S IN-HOUSE TAX DEPARTMENT, HEADED BY A LICENSED CERTIFIED PUBLIC ACCOUNTANT, TO BOTH PREPARE AND REVIEW ITS FORM 990. DURING THE PREPARATION AND REVIEW PROCESS, THE TAX DEPARTMENT WORKED CLOSELY WITH OTHER SYSTEM DEPARTMENTS, SUCH AS LEGAL, COMPENSATION AND BENEFITS, COMPLIANCE, FINANCE, AND MARKETING, TO ENSURE THAT A COMPLETE AND ACCURATE RETURN WAS FILED. THE PARENT OF THE SYSTEM IS SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND 501(C)(3) TAX EXEMPT ENTITY.
FORM 990, PART VI, SECTION B, LINE 12C 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 AS PART OF THE SENTARA HEALTH SYSTEM ("THE SYSTEM"), THE ORGANIZATION FOLLOWED PROCESSES AND PROCEDURES SET FORTH IN ITS GOVERNING DOCUMENTS TO ENSURE COMPLIANCE WITH ITS OBLIGATIONS AS A 501(C)(3) HEALTHCARE ORGANIZATION TO PAY DISQUALIFIED PERSONS' REASONABLE COMPENSATION. SUCH PROCESSES AND PROCEDURES ARE INTENDED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERNAL REVENUE CODE SECTION 4958 REGULATIONS. THE COMPENSATION PHILOSOPHY OF THE SYSTEM AS A WHOLE IS TO BASE OVERALL COMPENSATION AND BENEFITS FOR EXECUTIVES ON NOT-FOR-PROFIT MARKET COMPARABLES, ADJUSTED AS APPLIED TO EACH EXECUTIVE, TAKING INTO CONSIDERATION THE INDIVIDUAL SKILLS, EXPERIENCE, TENURE AND PERFORMANCE OF THE EXECUTIVE BEING COMPENSATED AND OVERALL PERFORMANCE OF THE ORGANIZATION. IN LINE WITH THIS PHILOSOPHY, THE SYSTEM PERFORMED SUBSTANTIAL DUE DILIGENCE AS TO MARKET COMPARABLES. THE SYSTEM'S COMPENSATION COMMITTEE, WHICH CONSISTS OF SYSTEM BOARD MEMBERS WITHOUT CONFLICTS OF INTEREST, ENGAGED AN OUTSIDE CONSULTANT, WHO REPORTS TO THE COMPENSATION COMMITTEE, TO CONDUCT A STUDY ASSESSING THE COMPETITIVENESS OF TOTAL COMPENSATION (INCLUDING CASH COMPENSATION, BENEFITS AND PERQUISITES) OF ITS SENIOR EXECUTIVES PRIOR TO MAKING DECISIONS REGARDING ANNUAL BASE SALARY ADJUSTMENTS, APPROVING INCENTIVE AWARDS, OR CONSIDERING PROGRAMMATIC CHANGES. THE STUDY COMPARED THE COMPENSATION OF THE SYSTEM'S SENIOR EXECUTIVES TO COMPENSATION DATA FROM MULTIPLE PUBLISHED SURVEY SOURCES BASED ON EACH 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 28 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 SYSTEM'S COMPENSATION COMMITTEE, WHICH MADE ITS COMPENSATION DECISIONS BASED ON A) ITS REVIEW AND ANALYSIS OF THE PERFORMANCE OF BOTH THE ORGANIZATION AND ITS SENIOR EXECUTIVES AND, B) A REASONABLENESS OF COMPENSATION ANALYSIS AND OPINION FROM AN EXTERNAL EXPERT IN THE COMPENSATION OF EXECUTIVES IN THE TAX-EXEMPT HEALTH CARE FIELD. THE COMMITTEE'S BASES FOR ITS DECISIONS WERE DOCUMENTED IN COMMITTEE MINUTES TAKEN DURING THE MEETING AND THEN CIRCULATED FOR REVIEW AND APPROVAL. ALL DECISIONS REGARDING COMPENSATION WERE MADE BY THE COMMITTEE, WHICH CONSISTS OF SYSTEM BOARD MEMBERS WITHOUT CONFLICTS OF INTEREST. THE OUTSIDE MARKET STUDY DESCRIBED ABOVE WAS USED TO ESTABLISH COMPENSATION FOR THE ORGANIZATION'S PRESIDENT, WHO IS CONSIDERED THE TOP MANAGEMENT OFFICIAL OF THE ORGANIZATION. RESULTS WERE PRESENTED TO THE PRESIDENT AND CEO OF THE SYSTEM FOR REVIEW AND APPROVAL RATHER THAN THE SYSTEM'S COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19 THE CONSOLIDATED FINANCIAL STATEMENTS FOR SENTARA HEALTHCARE AND SUBSIDIARIES WERE MADE PUBLICLY AVAILABLE THROUGH THE USE OF DAC BOND (DISCLOSURE DISSEMINATION AGENT) AND CAN BE FOUND ON THE INTERNET AT WWW.DACBOND.COM. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC.
CORE PART VI LINES 1A AND 1B, BOARD MEMBER INDEPENDENCE: SENTARA HEALTHCARE, A VIRGINIA NONSTOCK CORPORATION AND THE 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM, APPOINTS THE ORGANIZATION'S DIRECTORS AS DESCRIBED IN CORE PART VI LINE 7. THE GOVERNING BOARD OF SENTARA HEALTHCARE IS A COMMUNITY-BASED BOARD COMPRISED OF 16 VOTING MEMBERS, 15 OF WHICH ARE CONSIDERED INDEPENDENT, AS DEFINED IN THE FORM 990 INSTRUCTIONS.
FORM 990, PART IX, LINE 11G OTHER NON-EMPLOYEE PROFESSIONALS: PROGRAM SERVICE EXPENSES 952,044. MANAGEMENT AND GENERAL EXPENSES 178,247. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,130,291. NON-EMPLOYEE HEALTHCARE PROFESSIONALS: PROGRAM SERVICE EXPENSES 11,424,327. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,424,327.
FORM 990, PART XI, LINE 9: BOOK RECLASS OF INTERCOMPANY ACCOUNT BALANCES TO EQUITY -12,462,435. OTHER CHANGE IN FUND BALANCE 4. CAPITAL CONTRIBUTION TO SUBSIDIARY -84,489.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2020


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number

54-0648699
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) HALIFAX REGIONAL PROFESSIONAL SERVICES LLC
6015 POPLAR HALL DRIVE
NORFOLK,VA23502
20-8386107
PHYSN SUBSIDY VA 0 87,188 HALIFAX REGIONAL HOSPITAL INC
 










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?
Yes No
(1)SENTARA HEALTHCARE
6015 POPLAR HALL DRIVE

NORFOLK,VA23502
52-1271901
HEALTHCARE VA 501(C)(3) LINE 7 N/A
 
No
(2)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
 
(3)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
 
(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
HEALTHCARE VA 501(C)(3) LINE 3 SENTARA HOSPITALS
 
Yes
 
(7)SENTARA HOSPITALS
6015 POPLAR HALL DRIVE

NORFOLK,VA23502
54-1547408
HEALTHCARE VA 501(C)(3) LINE 3 SENTARA HEALTHCARE
 
Yes
 
(8)SENTARA MEDICAL GROUP
6015 POPLAR HALL DRIVE

NORFOLK,VA23502
54-1217184
HEALTHCARE VA 501(C)(3) LINE 10 SENTARA HEALTHCARE
 
Yes
 
(9)SENTARA ENTERPRISES
6015 POPLAR HALL DRIVE

NORFOLK,VA23502
54-1917649
HEALTHCARE VA 501(C)(3) LINE 10 SENTARA HEALTHCARE
 
Yes
 
(10)SENTARA LIFE CARE CORP
6015 POPLAR HALL DRIVE

NORFOLK,VA23502
54-1217183
HEALTHCARE 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
HEALTHCARE VA 501(C)(3) LINE 3 SENTARA HEALTHCARE
 
Yes
 
(14)SENTARA RMH MEDICAL CENTER
6015 POPLAR HALL DRIVE

NORFOLK,VA23502
54-0506331
HEALTHCARE 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 ORG VA 501(C)(3) LINE 12A, I MARTHA JEFFERSON HOSPITAL
 
Yes
 
(18)MARTHA JEFFERSON HOSPITAL
6015 POPLAR HALL DRIVE

NORFOLK,VA23502
54-0261840
HEALTHCARE 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
 
(21)SENTARA MEDICARE ADVANTAGE OF NORTH CAROLINA INC
6015 POPLAR HALL DRIVE

NORFOLK,VA23502
84-2066617
MEDICAID HMO NC 501(C)(4) LINE 12A, I SENTARA HEALTHCARE
 
Yes
 
(22)VIRGINIA PREMIER HEALTH PLAN INC
6015 POPLAR HALL DRIVE

NORFOLK,VA23502
54-1760974
MEDICAID HMO VA 501(C)(3) LINE 10 SENTARA HEALTHCARE
 
Yes
 
(23)SENTARA COMMERCIAL HEALTH PLANS OF NORTH CAROLINA INC
6015 POPLAR HALL DRIVE

NORFOLK,VA23502
85-1043564
SOCIAL WELFARE NC 501(C)(4)   SENTARA HEALTHCARE
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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


Yes No Yes No
(1) MANAGEMENT SERVICES LLC

814 GREENBRIER CIRCLE STE H
CHESAPEAKE,VA23320
54-1365012
HLTH MGT SV VA N/A
        No     No  
(2) OBICI REAL ESTATE HOLDINGS LLC

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
26-1749881
RE RENTAL VA N/A
        No     No  
(3) PRINCESS ANNE AMB SURG MGT LLC

1975 GLENN MITCHELL STE 300
VA BEACH,VA23456
20-4920880
HEALTH CARE VA N/A
        No     No  
(4) VA BEACH AMBULATORY SURGERY CENTER

1700 WILL O WISP DRIVE
VA BEACH,VA23454
54-1448218
HEALTH CARE VA N/A
        No     No  
(5) CANCER CENTERS OF VA LLC

5900 LAKE WRIGHT DRIVE
NORFOLK,VA23502
20-1338518
HEALTH CARE VA N/A
        No     No  
(6) HAMPTON ROADS LITHOTRIPSY LLC

225 CLEARFIELD AVE
VIRGINIA BEACH,VA23462
20-0942600
HEALTH CARE VA N/A
        No     No  
(7) RADIOLOGY SERVICES OF HAMPTON ROADS LC

814 GREENBRIER CIRCLE STE H
CHESAPEAKE,VA23320
54-1774472
HEALTH CARE VA N/A
        No     No  
(8) SENTARA OBICI AMBULATORY SURGERY LLC

2750 GODWIN BLVD
SUFFOLK,VA23434
26-0144898
HEALTH CARE VA N/A
        No     No  
(9) ST LUKES PROPERTIES LLC

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
27-2774684
MOB RENTAL VA N/A
        No     No  
(10) POTOMAC INOVA HEALTHCARE ALLIANCE LLC

8110 GATEHOUSE RD STE 400W
FALLS CHURCH,VA22042
54-1802733
HEALTH CARE VA N/A
        No     No  
(11) CAREPLEX ORTHOPAEDIC ASC LLC

3000 COLISEUM DRIVE
HAMPTON,VA23666
27-1867311
HEALTH CARE VA N/A
        No     No  
(12) PHYSICAL THERAPY ACACLLC

501 ALBEMARLE SQUARE
CHARLOTTESVILLE,VA22901
26-0080717
HEALTH CARE VA N/A
        No     No  
(13) MNS SUPPLY CHAIN NETWORK LLC

11525 N COMMUNITY HOUSE RD STE 450
CHARLOTTE,NC28277
45-4235238
GPO DE N/A
        No     No  
(14) LAKE RIDGE AMBULATORY SURGERY CENTER LLC

12825 MINNIEVILLE RD STE 204
WOODBRIDGE,VA22192
45-5347932
HEALTH CARE VA N/A
        No     No  
(15) HIGHLAND CORE FIXED INCOME FUND

C/O GTC 12 GILL ST SUITE 2600
WOBURN,MA01801
47-4618533
POOLED INV FD DE N/A
        No     No  
(16) HIGHLAND EQUITY FUND

C/O GTC 12 GILL ST SUITE 2600
WOBURN,MA01801
47-4606269
POOLED INV FD DE N/A
        No     No  
(17) HIGHLAND PUBLIC INFLATION HEDGES FD

C/O GTC 12 GILL ST SUITE 2600
WOBURN,MA01801
47-4601867
POOLED INV FD DE N/A
        No     No  
(18) LEIGH ORTHOPEDIC SURGERY CENTER LLC

830 KEMPSVILLE ROAD
NORFOLK,VA23502
83-2402528
HEALTH CARE VA N/A
        No     No  
(19) SURGICAL SUITES OF COASTAL VIRGINIA LLC

400 SENTARA CIRCLE
WILLIAMSBURG,VA23188
83-3205375
HEALTH CARE VA N/A
        No     No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) SENTARA HOLDINGS INC

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
54-1555638
HOLDING COMPANY VA N/A
C       Yes  
(2) SENTARA HEALTH PLANS INC

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
52-2368125
TPA VA N/A
C       Yes  
(3) OPTIMA HEALTH GROUP

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
54-1473382
HMO VA N/A
C       Yes  
(4) OPTIMA HEALTH INSURANCE COMPANY

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
54-1642752
HEALTH INSURANCE VA N/A
C       Yes  
(5) OPTIMA BEHAVIORAL HEALTH SERVICES

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
62-1382666
MENTAL HEALTH SVCS VA N/A
C       Yes  
(6) SENTARA VENTURES INC

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
54-1688615
HOLDING COMPANY VA N/A
C       Yes  
(7) SENTARA HEALTH INSURANCE CO OF NC

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
47-1888140
HEALTH INSURANCE NC N/A
C       Yes  
(8) SENTARA HEALTH PLANS OF NC INC

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
46-5510421
TPA NC N/A
C       Yes  
(9) MANAGED CARE SERVICES INC

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
81-5421060
ALT HEALTH DELIVERY VA N/A
C       Yes  
(10) SENTARA SOUTHSIDE HEALTH SERVICES INC

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
54-1417772
HEALTH SERVICES VA HALIFAX REGIONAL HOSPITAL INC
 
C 42,447 2,204,661 100.000 % Yes  
(11) DOMINION HEALTH MEDICAL ASSOCIATES LTD

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
54-1060357
PHYS PRACTICE VA HALIFAX REGIONAL PROFESSIONAL SERVICES LLC
 
C 26,597,421 14,572,929 100.000 % Yes  
(12) SMG INNOVATIONS INC

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
20-3730331
HEALTH CARE VA N/A
C       Yes  
(13) POTOMAC VENTURES CORP

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
54-1441420
HOLDING COMPANY VA N/A
C       Yes  
(14) ROCKINGHAM HEALTH SERVICES INC

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
54-1721387
CONTRACTING SVCS VA N/A
C       Yes  
(15) MARTHA JEFFERSON MEDICAL ENTERPRISES INC

6015 POPLAR HALL DRIVE
NORFOLK,VA22911
54-1841528
MEDICAL BILLING SVCS VA N/A
C       Yes  
(16) BAY PRIMEX INSURANCE COMPANY LTD

PO BOX 1051
GRAND CAYMAN   KY1-1102
CJ
98-0704114
OTHER INSURANCE FUNDS CJ N/A
C       Yes  
(17) ALBEMARLE PHYSICIAN SERVICES-SENTARA INC

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
26-4592192
PHYS PRACTICE NC N/A
C       Yes  
(18) THE PORT WARWICK MEDICAL ARTS BUILDING ASSOCIATION

6015 POPLAR HALL DRIVE
NORFOLK,VA23502
56-2295574
BUILDING ASSOCIATION VA N/A
C       Yes  
(19) MEDSTREAMING EGYPT SOFTWARE

15 ANMAR IBN YASSER ST
CAIRO    
EG
CONSULTING EG N/A
C       Yes  
(20) HIGHLAND DIRECT HEDGED EQUITY FUND LTD

27 HOSPITAL ROAD
GEORGE TOWN   KY1-9008
CJ
INVESTMENT CJ N/A
C         No
(21) MEDSTREAMING INC

9840 WILLOWS ROAD NE SUITE 200
REDMOND,WA98052
45-1573625
SOFTWARE DEVELOPMENT WA N/A
C       Yes  
(22) PINEBRIDGE SSL SUB-TRUST 2

190 ELGIN AVENUE
GEORGE TOWN   KY1-9005
CJ
98-6079263
INVESTMENT CJ N/A
T         No
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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
No
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 .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
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) CLARKSVILLE SENIOR CARE LLC

C 4,769,198 CORP BOOKS/REC
(2) CLARKSVILLE SENIOR CARE LLC

Q 90,293 CORP BOOKS/REC
(3) CLARKSVILLE SENIOR CARE LLC

S 4,823,432 CORP BOOKS/REC
(4) HALIFAX REGIONAL LONG TERM CARE INC

C 7,805,571 CORP BOOKS/REC
(5) HALIFAX REGIONAL LONG TERM CARE INC

Q 159,572 CORP BOOKS/REC
(6) HALIFAX REGIONAL LONG TERM CARE INC

S 7,980,825 CORP BOOKS/REC
(7) MPB INC

C 511,823 CORP BOOKS/REC
(8) OPTIMA HEALTH INSURANCE COMPANY

L 133,792 CORP BOOKS/REC
(9) OPTIMA HEALTH PLAN

L 2,310,283 CORP BOOKS/REC
(10) SENTARA ENTERPRISES

B 195,412 CORP BOOKS/REC
(11) SENTARA HALIFAX REGIONAL PROPERTIES INC

A 67,881 CORP BOOKS/REC
(12) SENTARA HALIFAX REGIONAL PROPERTIES INC

K 574,448 CORP BOOKS/REC
(13) SENTARA HEALTH PLANS INC

L 3,955,866 CORP BOOKS/REC
(14) SENTARA HOSPITALS

B 11,125,886 CORP BOOKS/REC
(15) SENTARA HOSPITALS

M 8,174,444 CORP BOOKS/REC
(16) SENTARA MEDICAL GROUP

C 5,021,114 CORP BOOKS/REC
(17) SENTARA SOUTHSIDE HEALTH SERVICES INC

B 76,160 CORP BOOKS/REC
(18) VIRGINIA PREMIER HEALTH PLAN

L 509,615 CORP BOOKS/REC
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2020

Additional Data


Software ID:  
Software Version: