2020-08-17T04:34:49-05:00 2019-09-30 560574444 CHERRY BEKAERT LLP 200 SOUTH 10TH ST STE 900 RICHMOND VA 23219 990 2018-10-01 352258075 SHELTERING ARMS HOSPITAL SOUTH INC SHEL 8043424340 8254 ATLEE ROAD MECHANICSVILLE VA 23116 JAMES S LITSINGER CFO/TREASURER 8043424340 2020-08-13 1 AMANDA ADAMS P00748038 8046735700 73.122.178.143 2020-08-13 16:52:52 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 18694F53AD11E15FFCEA276DE93F63B2E746D691 2018 2020-09-23 17:36:50Z MARY A ZWEIFEL 8254 ATLEE ROAD MECHANICSVILLE VA 23116 13351083 0 X WWW.SHELTERINGARMS.COM X 2005 VA TO PROVIDE PHYSICAL REHABILITATION, ENHANCE THE QUALITY OF LIFE TO THOSE PERSONS EXPERIENCING DISABILITIES, AND OFFER FINANCIAL ASSISTANCE. 15 15 0 0 0 0 0 0 12589617 13351083 0 0 0 0 12589617 13351083 6525 11874 0 0 0 0 0 0 0 12898353 12785530 12904878 12797404 -315261 553679 2915529 3166479 248497 344172 2667032 2822307 TO PROVIDE COMPREHENSIVE PHYSICAL REHABILITATION OF THE HIGHEST CALIBER WITH COMPASSION AND RESPECT, TO ENHANCE THE QUALITY OF LIFE TO THOSE PERSONS EXPERIENCING DISABILITIES, AND TO OFFER FINANCIAL ASSISTANCE TO THOSE IN NEED. 0 0 12142838 13351083 PHYSICAL REHABILITATION SERVICES:SHELTERING ARMS HOSPITAL SOUTH OPERATES A 28 BED ACUTE PHYSICAL REHABILITATION INPATIENT HOSPITAL IN MIDLOTHIAN, VIRGINIA. THE PRIMARY SERVICE AREA IS CENTRAL VIRGINIA ALTHOUGH PATIENTS ARE ADMITTED FROM VIRGINIA AND SURROUNDING STATES. DURING FISCAL YEAR 2019, 596 PATIENTS WERE ADMITTED RESULTING IN 8,917 PATIENT DAYS. SHELTERING ARMS HOSPITAL SOUTH PROVIDES OUTPATIENT PHYSICAL REHABILITATION SERVICES AT THE HOSPITAL CAMPUS. DURING FISCAL YEAR 2019, SHELTERING ARMS HOSPITAL SOUTH PROVIDED OUTPATIENT THERAPY SERVICES RESULTING IN 8,716 OUTPATIENT VISITS. 15289 11874 CHARITY CARE AND COMMUNITY SUPPORT:SHELTERING ARMS HOSPITAL SOUTH ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND PROVIDES FINANCIAL ASSISTANCE FOR MEDICAL BILLS TO QUALIFIED PATIENTS LACKING ADEQUATE FINANCIAL RESOURCES. DURING FISCAL YEAR 2019, THE COST OF CHARGES FOREGONE FOR FINANCIAL ASSISTANCE AND CHARITY CARE WAS $539,403. FREE MOBILITY AND THERAPY EQUIPMENT ASSISTANCE AS WELL AS PHARMACY ASSISTANCE WERE ALSO PROVIDED TO THOSE PATIENTS WHO QUALIFIED, FOR USE DURING THEIR RECOVERY AT HOME. THE COST OF PROVIDING THIS ASSISTANCE WAS $11,874. TRANSPORTATION WAS PROVIDED FOR PATIENTS AT A COST TO SHELTERING ARMS HOSPITAL SOUTH OF $3,215. 12158127 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 10 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 0 1 0 0 0 VA X JAMES S LITSINGER CFO 8043424340 8254 ATLEE RD MECHANICSVILLE VA 23116 DIANNE V JEWELL CHAIRMAN 2.00 3.00 X X 0 0 0 ASHBY R HACKNEY VICE CHAIR 2.00 3.00 X X 0 0 0 JOHN D BURNS 2ND VICE CHAIR 2.00 3.00 X X 0 0 0 HOLLY ANTRIM DIRECTOR 2.00 3.00 X 0 0 0 PETER H BOWLES DIRECTOR 1.00 4.00 X 0 0 0 W LEE CHENEY III DIRECTOR 2.00 3.00 X 0 0 0 DAVID E CONSTINE III DIRECTOR 2.00 3.00 X 0 0 0 PATRICIA B CUSHNIE DIRECTOR 2.00 3.00 X 0 0 0 TERESA DIMARCO DIRECTOR 2.00 3.00 X 0 0 0 SANDRA M DOUGLAS DIRECTOR 2.00 3.00 X 0 0 0 LAWRENCE E GIBSON DIRECTOR 2.00 3.00 X 0 0 0 THEODORE W PRICE DIRECTOR 1.00 4.00 X 0 0 0 AMES J RUSSELL DIRECTOR 2.00 3.00 X 0 0 0 LESLIE WYATT DIRECTOR 2.00 3.00 X 0 0 0 DR PETER ZEDLER DIRECTOR 2.00 3.00 X 0 0 0 MARY A ZWEIFEL PRESIDENT & CEO 13.00 27.00 X 0 485317 25378 JAMES S LITSINGER CFO/TREASURER 10.00 30.00 X 0 240357 31024 CHRISTOPHER SORENSON VP OF INFORMATION TECHNOLOGY 10.00 30.00 X 0 172685 27903 ELLEN VANCE CHIEF HR OFFICER 10.00 30.00 X 0 213356 23615 SANDY EYLER CHIEF NURSING OFFICER 10.00 30.00 X 0 212383 19048 AMY J SHOWALTER CHIEF OPERATING OFFICER 10.00 30.00 X 0 252135 24266 HILLARY S HAWKINS MEDICAL DIRECTOR - SAH 20.00 20.00 X 0 425979 21248 TIMOTHY M SILVER MEDICAL DIRECTOR - SAHS 20.00 20.00 X 0 355645 29482 GREGORY LEGHART PHYSICIAN 20.00 20.00 X 0 325136 31147 AARON M JONES PHYSICIAN 20.00 20.00 X 0 288369 28222 ALBERT M JONES PHYSICIAN 20.00 20.00 X 0 256611 31085 0 3227973 292418 0 0 1 0 BON SECOURS ST FRANCES MEDICAL CENTER 8580 MAGELLAN PARKWAY RICHMOND VA 23227 HOSPITAL AND ANCILLARY SERVICES 1147116 HR ST FRANCIS MOB 1 SPE LLC 13710 ST FRANCIS BOULEVARD MIDLOTHIAN VA 23114 HOSPITAL AND ANCILLARY SERVICES 947509 CROTHALL HEALTHCARE INC 1500 LIBERTY RIDGE DRIVE STE 210 WAYNE PA 19087 ENVIRONMENTAL SVCS 143585 3 PATIENT REVENUE 621400 13242354 13242354 108729 108729 13351083 13351083 13351083 0 0 X 11874 11874 1381290 1312225 69065 1565 1487 78 1152772 1095133 57639 7620 7239 381 210398 199878 10520 SHARED SERVICES 4832984 4591335 241649 OVERHEAD ALLOCATION 4789373 4549904 239469 PATIENT/DEPT SUPPLIES 231146 219589 11557 EQUIPMENT/MAINTENANCE 178382 169463 8919 12797404 12158127 639277 0 27319 1928276 2444324 101917 4116268 3421432 885336 694836 2915529 3166479 248497 344172 248497 344172 X 2667032 2822307 2667032 2822307 2915529 3166479 X 553679 -398404 X 0 1 X 1 0 X 16345 16345 0 1774277 1461852 312425 2325646 1943235 382411 694836 X PART X, LINE 2: GAAP REQUIRES THE CORPORATION'S MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE CORPORATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE THAN LIKELY WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE CORPORATION'S MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CORPORATION AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2019, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR AN ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO AUDIT BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 1 1 X 1 X 1 X 1 1 0 1 1 302700 302700 0.02370 783993 783993 0.06130 1086693 1086693 0.08500 11874 11874 0.00090 11874 11874 0.00090 1098567 1098567 0.08590 1 398404 43149 8190583 5952824 2237759 X 1 1 1 1 SHELTERING ARMS HOSPITAL SOUTH INC 13700 ST FRANCIS BLVD SUITE 400 MIDLOTHIAN VA 23114 WWW.SHELTERINGARMS.COM VA DEPT OF HEALTH LICENSE NO. H-1927 X PHYSICAL REHABILITATION HOSPITAL SHELTERING ARMS HOSPITAL SOUTH INC 1 0 0 1 X X X X X X X X X 18 1 1 0 1 X WWW.SHELTERINGARMS.COM X 1 18 1 WWW.SHELTERINGARMS.COM 0 1 X 200.000000000000 250.000000000000 X X X X X 1 1 X X X X 1 X WWW.SHELTERINGARMS.COM X WWW.SHELTERINGARMS.COM X WWW.SHELTERINGARMS.COM X X X X X X 1 X 0 X X X 0 X X 0 0 SHELTERING ARMS HOSPITAL SOUTH, INC. PART V, SECTION B, LINE 5: THE CONTENT OF THE SURVEY WAS BASED ON BROAD COMMUNITY HEALTH DATA. ON A NATIONAL LEVEL, SAH SOUTH LOOKED AT HEALTHY PEOPLE 2020 FOR IMPROVING HEALTH OF ALL AMERICANS AND SPECIFIC OBJECTIVES RELATED TO DISABILITY AND HEALTH. AT THE STATE LEVEL SAH SOUTH LOOKED AT THE VIRGINIA HEALTH PROMOTION FOR PEOPLE WITH DISABILITIES AT VIRGINIA COMMONWEALTH UNIVERSITY WHOSE MISSION IS TO PROMOTE THE HEALTH OF PEOPLE WITH DISABILITIES, PREVENT SECONDARY CONDITIONS, AND ELIMINATE DISPARITY BETWEEN PEOPLE WITH AND WITHOUT DISABILITIES. AT THE LOCAL LEVEL SHELTERING ARMS LOOKED TO THE VIRGINIA DEPARTMENT OF HEALTH-OFFICE OF MINORITY HEALTH AND HEALTH EQUITY TO DETERMINE THE MANY FACTORS DETERMINING HEALTH INCLUDING COMMUNITY WALKABILITY, FOOD ACCESSIBILITY, AFFORDABILITY, INCOME INEQUALITY AND ACCESS TO CARE. THERE WERE TWO SURVEYS CONDUCTED: ONE FOR CLIENTS AND PATIENTS AND THEN ANOTHER FOR AGENCIES AND PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH AND ASSESS THE NEEDS OF THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. SHELTERING ARMS SOUTH CARES FOR PATIENTS IN THE CENTRAL AND EASTERN VIRGINIA REGION COVERING 14 COUNTIES AND THE CITY OF RICHMOND. SHELTERING ARMS HOSPITAL SOUTH, INC. PART V, SECTION B, LINE 6A: SHELTERING ARMS HOSPITAL SHELTERING ARMS HOSPITAL SOUTH, INC. PART V, SECTION B, LINE 11: SHELTERING ARMS SOUTH IS ADDRESSING THE CHNA USING CHIP. THE CHNA IDENTIFIED AND THEN PRIORITIZED THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED IN THE TWO SURVEYS CONDUCTED. THE SURVEY RESULTS WERE GROUPED IN TO FOUR MAJOR AREAS: ACCESS TO HEALTHCARE, ACCESS TO EDUCATION AND SUPPORT, ACCESS RESOURCES, AND ACCESS TO FITNESS AND WELLNESS. SHELTERING ARMS LEADERSHIP REVIEWED THE RESULTS AND PRIORITIZED THEM BASED ON THE NUMBER OF RESPONSES AND GROUPED THE RESPONSES IN TO FOUR TOP COMMUNITY HEALTH NEEDS. THE HEALTH NEED PRIORITIES ARE: HEALTHY LIFESTYLE WHICH INCLUDES NUTRITION, HEALTH, WELLNESS, FITNESS AND MOBILITY; CARE NAVIGATION; CAREGIVER SUPPORT; MEDICAL DEVICES-RAMPS SINCE THE SURVEY DETERMINED THAT THEY ARE DIFFICULT TO OBTAIN AND MAKE A DIFFERENCE IN PATIENTS GOING HOME VERSUS LONG TERM CARE FACILITIES. 1 1 - SHELTERING ARMS HOSPITAL SOUTH NEURO 13700 ST FRANCIS BLVD SUITE 400 MIDLOTHIAN VA 23114 OUTPATIENT THERAPY CENTER PART I, LINE 6A: THE FY 2018-19 COMMUNITY BENEFIT REPORT WAS PUBLISHED IN THE SHELTERING ARMS HOSPITAL ANNUAL REPORT AND IS AVAILABLE ON THE WEBSITE AT WWW.SHELTERINGARMS.COM. PART I, LINE 7: COLUMN F REFLECTS THE CHARITY AND FINANCIAL ASSISTANCE AT COST AND OTHER COMMUNITY BENEFITS AS A PERCENTAGE OF THE TOTAL FUNCTIONAL EXPENSES IN PART IX, COLUMN A, LINE 25 OF THE FORM 990. INFORMATION REGARDING THE CASH GRANTS TO OTHERS CAN BE FOUND IN SCHEDULE I OF THE FORM 990. PART III, LINE 2: BAD DEBT REPRESENTS THE UNCOLLECTIBLE ACTUAL AMOUNTS WRITTEN OFF DURING THE FISCAL YEAR. PART III, LINE 3: BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS ESTIMATED BASED ON A PATIENT'S INABILITY TO PAY AND WHO FAIL TO COMPLETE THE APPLICATION AND/OR SUBMIT THE REQUIRED DOCUMENTS WITHIN THE 60 DAY GRACE PERIOD ALLOWED TO APPLY FOR ASSISTANCE. PART III, LINE 4: SEE PAGE 11 OF THE AUDITED FINANCIAL STATEMENTS - NOTE 1 - NATURE OF ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES "PATIENT ACCOUNTS RECEIVABLE" PART III, LINE 8: THE MEDICARE GAIN WAS OBTAINED DIRECTLY FROM THE FY 2018-2019 MEDICARE COST REPORT. PART III, LINE 9B: PATIENTS MAY APPLY RETROACTIVELY FOR FINANCIAL ASSISTANCE FOR SERVICES UP TO 60 DAYS OLD. IF THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE AND ALL OTHER PROGRAMS HAVE BEEN EXHAUSTED FOR PAYMENT ASSISTANCE, A PAYMENT PLAN ARRANGEMENT MAY BE MADE. BALANCES DESIGNATED BY 3RD PARTY PAYERS AS PATIENT RESPONSIBILITY WILL BE ASSIGNED TO THE PATIENT BALANCE SEGMENT IN THE SAH BILLING SYSTEM. QUALIFYING PATIENT RESPONSIBLE BALANCES WILL BE BILLED DIRECTLY TO THE PATIENT BY SHELTERING ARMS. IF PAYMENT IS NOT RECEIVED WITHIN 60 DAYS ANY UNPAID BALANCES WILL BE FORWARDED TO OUR FIRST OUT VENDOR FOR CONTINUING COLLECTION EFFORTS TO INCLUDE PATIENT PAYMENT PLANS. ANY UNSETTLED BALANCES REMAINING AFTER A TOTAL OF 120 DAYS AFTER THE FIRST ASSIGNMENT OF BALANCES AS PATIENT PAY THE BALANCES WILL BE SENT TO OUR COLLECTION AGENCY AND REMOVED FROM OUR ACTIVE ACCOUNTS RECEIVABLE AS BAD DEBT. IF THE COLLECTION AGENCY SUCCESSFULLY COLLECTS THE BALANCES THE PATIENT ACCOUNT WILL BE REACTIVATED IN OUR AR SYSTEM AND THE BAD DEBT WILL BE REVERSED AND CODED AS RECOVERY. IF THE COLLECTION AGENCY IS UNSUCCESSFUL WITH COLLECTIONS AND HAS NO PAYMENT ARRANGEMENT, OR A BROKEN PAYMENT ARRANGEMENT, THEN THE ACCOUNT CAN BE PULLED BACK FROM THE COLLECTION VENDOR, THE BAD DEBT STATUS WILL REMAIN AND COLLECTION EFFORTS WILL CEASE. PART VI, LINE 2: NEEDS ASSESSMENT: SHELTERING ARMS HOSPITAL ASSESSES THE SERVICE GAPS AND HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE TO IDENTIFY NEEDED PROGRAMS AND EVENTS. THE LATEST CHNA AND CORRESPONDING CHIP CAN BE ACCESSED AT WWW.SHELTERINGARMS.COM. THE 1ST IDENTIFIED SIGNIFICANT HEALTH NEED IS HEALTHY LIFESTYLE. IT ENCOMPASSES NUTRITION, HEALTH, WELLNESS, FITNESS, RECREATION AND MOBILITY. THE CHIP PLAN CALLS FOR FOLLOW-UP PHONE CALLS FROM INPATIENT DIETICIAN TWO WEEKS POST-DISCHARGE FROM THE INPATIENT REHABILITATION HOSPITAL; PARTNERING WITH LOCAL GROUPS ON NUTRITIONAL EDUCATION TWICE A YEAR TO INCLUDE BON SECOURS, RELAY FOODS, AND VCU HEALTH SYSTEM; COMPILING RESOURCE LIST FOR PATIENTS TO ACCESS FOOD SERVICES IN THE COMMUNITY AND DEVELOPING A PROCESS FOR CONNECTING PATIENTS TO THESE SERVICES; ADDING NUTRITION SCREENING QUESTION AT DISCHARGE FROM INPATIENT HOSPITAL; ADDING NUTRITION SCREENING QUESTION FOR OUTPATIENT THERAPY; AND EXPANDING FITNESS/WELLNESS PROGRAMS FOR PERSONS WITH NEUROLOGIC DISORDERS. CURRENTLY WE HAVE ADDED A NEW PARKINSON'S BOXING PROGRAM AND EXPANDED THE NEURO-FIT PROGRAM. IN ADDITION OUR PLAN INCLUDES SHORT SCREENING TOOLS FOR INPATIENT AND OUTPATIENT REGARDING NEED FOR HEALTH, WELLNESS, AND EDUCATION CLASSES. WE ARE ADDING NUTRITION EDUCATION AN SHELTERING ARMS CHANNEL IN INPATIENT, ADDING NUTRITION TRAINING/SPECIALIZATION FOR FITNESS STAFF, A SERIES OF HEALTHY COOKING AND MEAL PLANNING FOR PATIENTS AND CAREGIVERS, A NUTRITION SUPPORT GROUP IN INPATIENT FOR PATIENTS AND CAREGIVERS, AN OUTPATIENT DIETICIAN TO ADDRESS POST-INPATIENT NUTRITION NEEDS AS PART OF A COMPREHENSIVE HEALTH/WELLNESS CARE MODEL AND INPATIENT AND OUTPATIENT THERAPEUTIC RECREATION AS PART OF THE COMPREHENSIVE CARE MODEL. THE SECOND SIGNIFICANT HEALTH NEED IDENTIFIED IS CARE NAVIGATION, WE HAVE MAPPED IN CERNER (OUR EHR) FOR TOUCH POINTS TO BUILD AND FOSTER CARE NAVIGATION. ALSO AS A STANDARD OF CARE AT DISCHARGE, REFER APPROPRIATE AND INTERESTED PATIENTS TO SENIOR CONNECTIONS. WE HAVE IMPROVED INTERNAL AND EXTERNAL EDUCATION OF WHAT SHELTERING ARMS OFFERS FOR CONTINUUM OF CARE THROUGH INTERNAL EDUCATION PROVIDED TO NURSE LIAISONS AND THE COMMUNITY LIAISON TEAMS. WE ARE IMPLEMENTING SCREENSAVER TIPS ON SHELTERING ARMS COMPUTERS TO EDUCATE CLINICIANS ON RESOURCES AVAILABLE FOR PATIENTS/FAMILIES. IN ADDITION WE ARE DEVELOPING A STRATEGY FOR HIGH RISK PATIENTS AND WE PLAN TO ADD A SOCIAL WORKER AS PART OF THE COMPREHENSIVE HEALTH AND WELLNESS CARE MODEL. THE 3RD SIGNIFICANT HEALTH NEED IDENTIFIED IS CAREGIVER SUPPORT. THIS PLAN INCLUDES DEVELOPING EDUCATION MATERIALS AND REFERENCES FOR CAREGIVERS NEEDING SUPPORT AND A SCREENING TOOL FOR ALL SITES THAT ASKS ABOUT THE NEED FOR CAREGIVER SUPPORT. THE 4TH SIGNIFICANT HEALTH CARE NEED IS MEDICAL DEVICES-RAMPS. WE ARE PARTNERING WITH LOCAL ORGANIZATIONS THAT PROVIDE RAMPS TO IDENTIFY HOW WE CAN SUPPORT THEM. WE ARE CURRENTLY IN DISCUSSIONS WITH PROJECT HOMES TO DEVELOP A PROCESS. THE SHELTERING ARMS FOUNDATION CURRENTLY PROVIDES SUPPORT TO PROJECTHOMES AND RAMPS MADE POSSIBLE BY STUDENTS. AS PART OF THIS INITIATIVE WE ARE ACTIVELY LOOKING TO IDENTIFY OTHER RAMP BUILDING RESOURCES IN THE COMMUNITIES SHELTERING ARMS SERVES. PART VI, LINE 3: THE HOSPITAL HAS POSTED POSTERS NOTIFYING INDIVIDUALS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE (IN ENGLISH AND SPANISH) IN THE ADMISSIONS AND PATIENT INTAKE AREAS OF EACH OF ITS INPATIENT AND OUTPATIENT LOCATIONS AS WELL AS IN THE PATIENT ACCOUNTING DEPARTMENT. NEW PATIENT ADMISSIONS RECEIVE A FORM UPON ARRIVAL DISCLOSING THE FINANCIAL AGREEMENT TO PAY WHICH INCLUDES OFFERING MONTHLY PAYMENT ARRANGEMENTS AS WELL AS AN APPLICATION FOR FINANCIAL ASSISTANCE. OUTPATIENT AND PHYSICIAN SERVICES APPOINTMENT VERIFICATION LETTERS FOR NEW PATIENTS ALSO DISCLOSE AVAILABILITY OF FINANCIAL ASSISTANCE. ADDITIONALLY, THE HOSPITAL INCLUDES A NOTICE ABOUT ITS FINANCIAL ASSISTANCE POLICY ON ITS BILLING STATEMENTS. PART VI, LINE 4: BASED ON THE RECENT COMMUNITY HEALTH NEEDS ASSESSMENT THE STUDY REGION IS BASED ON THE SHELTERING ARMS HANOVER CAMPUS SERVICE AREA WHICH INCLUDES URBAN AND RURAL AREAS. THE COUNTIES INCLUDED ARE CAROLINE, CHARLES CITY, ESSEX, HANOVER, HENRICO, KING AND QUEEN, KING WILLIAM, LANCASTER, LOUISA, MIDDLESEX, NEW KENT, NORTHUMBERLAND, RICHMOND AND RICHMOND CITY. AS AN ACUTE INPATIENT REHABILITATION HOSPITAL, THE ORGANIZATION SERVES THE TARGET POPULATION OF PEOPLE WITH PHYSICAL DISABILITIES. SPECIFICALLY, THE HOSPITAL PROVIDES REHABILITATION SERVICES TO PATIENTS WITH THE FOLLOWING DIAGNOSES: STROKE, BRAIN INJURY, SPINAL CORD INJURY, ORTHOPEDIC, NEUROLOGICAL, AND GENERAL REHAB/MEDICAL. PART VI, LINE 5: OUR COMMUNITY SUPPORT INITIATIVES INCLUDE PARTICIPATION IN THE DSCR EMPLOYEE HEALTH FAIR; THE RICHMOND DIABETES WALK; THE RICHMOND HEALTH EXPO; THE VIRGINIA HOME WALK AND ROLL; THE CHESTERFIELD TRIAD SENIOR HEALTH FAIR; THE LOCAL MULTIPLE SCLEROSIS SUPPORT GROUP MEETING; AND THE AREA AMPUTEE SUPPORT GROUP MEETING. IN ADDITION, SA NURSE LIAISONS PROVIDE INFORMATION TO LOCAL ACUTE CARE HOSPITALS WITH REGARD TO APPROPRIATE SERVICES, AND SITES OF SERVICE, FOR SENIORS WHO REQUIRE REHABILITATIVE CARE AND A WIDE PORTFOLIO OF UNIQUE, COMMUNITY-BASED SERVICES INTENDED LARGELY TO MEET THE NEEDS OF INDIVIDUALS WHO ARE TRANSITIONING FROM A MEDICAL TREATMENT REGIMEN TO AN EMPHASIS ON SELF-MANAGEMENT. THE BENEFITS OF PHYSICAL AND RECREATIONAL ACTIVITY PARTICIPATION HIGHLIGHT A NEED FOR INDIVIDUALS WITH PHYSICAL DISABILITIES, THE AGING POPULATION, AND INDIVIDUALS MANAGING CHRONIC CONDITIONS TO ACCESS SERVICES THAT CAN POSITIVELY IMPACT QUALITY OF LIFE AND PHYSICAL ACTIVITY LEVEL. SA IS DEDICATED TO HELPING PEOPLE FIND WITHIN THEMSELVES THE POWER TO OVERCOME SERIOUS SETBACKS FOLLOWING ILLNESS, INJURY, OR ACCIDENT THROUGH INTERNATIONALLY RECOGNIZED PHYSICAL REHABILITATION PROGRAMS. THE SA COMMITMENT DOES NOT END WHEN THERAPY OR PHYSICIAN SERVICES ARE COMPLETE. SA PROVIDES A COMPREHENSIVE PORTFOLIO OF UNIQUE, COMMUNITY-BASED RECREATION AND HEALTH AND WELLNESS SERVICES TO MEET THE NEEDS OF THE COMMUNITY. THESE SERVICES MAKE UP THE PARTNER FOR LIFE (LEISURE, INTERACTION, FITNESS, AND ENJOYMENT) PROGRAM (PFL) EMPOWERING INDIVIDUALS TO EMBRACE A LIFETIME OF RECREATION AND WELLNESS. OUR UNIQUE PROGRAM PROVIDES AN OPPORTUNITY FOR PEOPLE TO RE-ENGAGE IN ACTIVITIES THEY ONCE ENJOYED AND MAINTAIN AN ACTIVE SOCIAL AND PHYSICAL LIFESTYLE DESPITE THEIR LIMITATIONS. THE SERVICES PROVIDED ARE OPEN TO THE PUBLIC AND THE MAJORITY OF THE SERVICES DO NOT REQUIRE A PHYSICIAN REFERRAL. SERVICES OFFERED INCLUDE GROUP RECREATION AND SOCIAL EVENTS, ADAPTIVE GOLF PROGRAM, ADAPTIVE BOWLING LEAGUE, ACCESSIBLE TRAVEL PROGRAM, THERAPEUTIC POOL AND FITNESS CENTER MEMBERSHIPS, PERSONAL TRAINING SERVICES, GROUP EXERCISE CLASSES, EDUCATIONAL SEMINARS, CHRONIC DISEASE AND DIABETES SELF-MANAGEMENT CLASSES, A MATTER OF BALANCE CLASSES, POWEREX, NEUROFIT, AND OUR CLUB REC PROGRAM. CLUB REC IS A NON-MEDICALLY BASED SOCIAL, RECREATION PROGRAM PROVIDING OPPORTUNITIES FOR FITNESS, WELLNESS, RECREATION, SOCIALIZATION, AND COMMUNITY REINTEGRATION FOR MEMBERS UP TO FIVE DAYS PER WEEK. SA CERTIFIED THERAPEUTIC RECREATION SPECIALISTS CREATE A MONTHLY CALENDAR PROGRAM PLANNING ACTIVITIES AND SERVICES THAT ADDRESS THE SEVEN DIMENSIONS OF HEALTH AND WELLNESS. PROGRAMS PLANNED INCLUDE SOCIAL, RECREATIONAL, PHYSICAL, EMOTIONAL AND COGNITIVE ACTIVITIES, AS WELL AS OPPORTUNITIES FOR COMMUNITY REINTEGRATION AND CIVIC ENGAGEMENT. CLUB REC FOCUSES ON ENHANCING QUALITY OF LIFE FOR THOSE RECOVERING FROM INJURY OR ILLNESS. MEMBERS ENROLLED IN CLUB REC HAVE OPPORTUNITIES TO UTILIZE THE ON-SITE FITNESS CENTER, PARTICIPATE IN SPIRITUALITY GROUP, THE COMPUTER LAB, WEEKLY TRIPS TO OUR THERAPEUTIC POOL, AS WELL AS COMMUNITY OUTINGS. IN FY 18-19, CLUB REC HAD 7,179 VISITS TO THE PROGRAM. THIS YEAR CLUB REC PARTNERED WITH THE BON SECOURS CLASS A ROLL PROGRAM WHICH ALLOWED OPPORTUNITIES FOR A REGISTERED DIETICIAN TO ADDRESS NUTRITION SERVICES WITHIN THE PROGRAM. THIS WAS A SUCCESSFUL PARTNERSHIP ALLOWING THE OPPORTUNITY TO EDUCATE OUR PARTICIPANTS ON NUTRITION, TOPICS, PRACTICAL RECIPES, AND HEALTHY EATING ON A BUDGET. PFL SPECIAL EVENT PROGRAMS INCLUDE: ADAPTIVE YOGA, ADAPTIVE GOLF, ADAPTIVE BOWLING LEAGUE, ACCESSIBLE TRAVEL PROGRAMS, FISHING OUTINGS, AND SOCIAL RECREATION PROGRAMS. THESE PROGRAMS PROVIDE OPPORTUNITIES FOR INDIVIDUALS WITH DISABILITIES TO PARTICIPATE IN ORGANIZED RECREATION ACTIVITIES. RECREATIONAL THERAPISTS, VOLUNTEERS, AND ADAPTIVE RECREATION EQUIPMENT ARE PROVIDED AT EACH PROGRAM TO ENSURE SUCCESSFUL PARTICIPATION REGARDLESS OF PHYSICAL LIMITATION. IN FY 18-19, THERE WERE 20 EVENTS TOTALING 306 PARTICIPANTS. AN ACCESSIBLE CRUISE TO BERMUDA WAS HELD THIS YEAR FOR INDIVIDUALS WITH DISABILITIES, AS WELL AS THEIR CAREGIVERS AND FAMILY MEMBERS. ALL ACCESSIBLE TRAVEL PLANS, AIRLINE ACCOMMODATIONS, EQUIPMENT NEEDS, EXCURSION ADAPTATIONS ARE PLANNED AND ORGANIZED BY THE RECREATIONAL THERAPISTS. SA ALSO PARTNERED WITH SPORTABLE OFFERING HAND CYCLING CLINIC TO INTRODUCE OUR PATIENTS AND CLUB REC MEMBERS TO HAND CYCLING. SA ALSO PARTNERED WITH SPORTABLE BY HOSTING THEIR SWIMMING PROGRAM AT OUR BON AIR FACILITY WHICH ALLOWS ACCESS FOR ATHLETES ENROLLED IN THE PROGRAM TO AN ACCESSIBLE AND WARM WATER THERAPEUTIC POOL FOR THIS PROGRAM. CHRONIC DISEASE SELF-MANAGEMENT, DIABETES SELF MANAGEMENT, AND MATTER OF BALANCE CLASSES WERE OFFERED FREE TO THE COMMUNITY THROUGH PARTNERSHIP WITH LOCAL SENIOR AND HEALTH CARE AGENCIES. THE GOAL OF THE PROGRAM IS FOR PARTICIPANTS TO LEARN STRATEGIES TO IMPLEMENT HEALTHY LIFESTYLE CHANGES TO SUCCESSFULLY MANAGE THEIR CHRONIC CONDITION. THESE PROGRAMS ARE OPEN TO SA PATIENTS AS WELL AS THE COMMUNITY. IN ADDITION TO RECREATION EVENTS, PFL SERVICES FOCUS ON THE NECESSITY OF MAINTAINING PHYSICAL ACTIVITY TO CONTINUE AN ACTIVE LIFESTYLE, MAINTAIN PROGRESS ACHIEVED IN SKILLED THERAPY, AS WELL AS PREVENT FUTURE INJURY OR ILLNESS. WE HAVE A WARM WATER THERAPEUTIC POOL AND FITNESS CENTER OFFERING POOL AND FITNESS MEMBERSHIPS, AQUATIC AND LAND GROUP EXERCISE CLASSES, AND PERSONAL TRAINING SERVICES TO THE COMMUNITY. OUR WARM WATER THERAPEUTIC POOL PROVIDES A RAMP FOR WHEELCHAIR ENTRY INTO THE WATER, SUBMERGED PARALLEL BARS, AND LAP LANE SWIMMING FOR THOSE WHO FIND LESS PAIN AND INCREASED RANGE OF MOTION IN A WARM WATER ENVIRONMENT. POOL AND FITNESS MEMBERSHIPS PROVIDE A TRANSITION PLAN FOR PATIENTS BEING DISCHARGED FROM INPATIENT HOSPITAL AND OUTPATIENT THERAPY CLINICS THE OPPORTUNITY TO CONTINUE TO ENGAGE IN PHYSICAL ACTIVITY. FITNESS SPECIALISTS PROVIDE FITNESS MEMBERS WITH PERSONALIZED ATTENTION, AS WELL AS PERSONAL TRAINING SERVICES FOR THOSE WHO ARE INTERESTED IN INDIVIDUALIZED GOAL SETTING AND EXERCISE PROGRAMS DESIGNED TO MEET THEIR NEEDS. SA FITNESS CENTERS HAVE SEEN SIGNIFICANT GROWTH IN SILVER SNEAKER MEMBERS. THIS COMMUNITY PROGRAM PROVIDES FINANCIAL FITNESS MEMBERSHIP SUPPORT FOR THOSE WITH A SILVER SNEAKER WELLNESS OPTION THROUGH THEIR PRIVATE INSURANCE COMPANY. DURING FY 18-19, THERE WERE 29,578 COMMUNITY MEMBERSHIP VISITS TO THE POOLS AND FITNESS CENTERS. SA LED 1,140 GROUP EXERCISE CLASSES AND WELLNESS EDUCATION CLASSES TOTALING 5,152 CLASS PARTICIPANTS. FITNESS SPECIALISTS AT OUR BON AIR, REYNOLDS, AND HANOVER LOCATIONS PROVIDE PERSONAL TRAINING SERVICES TO THOSE TRANSITIONING FROM OUTPATIENT THERAPY SERVICES, WHILE ALSO PROVIDING PERSONAL TRAINING SERVICE TO THE COMMUNITY FOR PREVENTION AND WELLNESS. FITNESS SPECIALISTS CONDUCTED 4,342 PERSONAL TRAINING VISITS. ON OUR HANOVER AND SOUTH HOSPITAL CAMPUS THE FITNESS SPECIALISTS UTILIZE ADVANCED TECHNOLOGIES TO PROVIDE UNIQUE PERSONAL TRAINING SERVICES FOR THE NEUROLOGICALLY IMPAIRED IN OUR NEUROFIT PROGRAM. NEUROFIT FITNESS SPECIALISTS PROVIDED 1,865 TRAINING SESSIONS. THE GOAL IS TO ENSURE LIFELONG PHYSICAL ACTIVITY AFTER A CATASTROPHIC INJURY OR ILLNESS. SPECIALTY PARKINSON DISEASE GROUP EXERCISE CLASSES ARE OFFERED AT OUR BON AIR AND MIDTOWN LOCATIONS. OUR PARKINSON'S WELLNESS RECOVERY BI-WEEKLY GROUP EXERCISE CLASS AT BON AIR HAS SEEN SIGNIFICANT GROWTH IN CLASS PARTICIPANTS. POWER PUNCH, A PARKINSON'S BOXING CLASS, HAS BEEN SUCCESSFUL AT OUR MIDTOWN LOCATION. IN FY 2018-2019, THE PFL DEPARTMENT CONTINUED TO PROVIDE COMMUNITY OUTREACH PRESENTATIONS TO LOCAL AMPUTEE, MULTIPLE SCLEROSIS, AND PARKINSON'S, AND STROKE SUPPORT GROUPS SHARING INFORMATION ON STRATEGIES TO STAY ENGAGED IN PHYSICAL, SOCIAL AND RECREATION ACTIVITIES WHILE MANAGING CHRONIC HEALTH CONDITIONS. HEALTH AND WELLNESS EDUCATION SESSIONS RELATING TO SENIOR SAFETY, NUTRITION, AND HEALTHY EATING ON A BUDGET WERE HELD AT THE BON AIR FACILITY. ADAPTIVE YOGA CLASSES WERE PILOTED IN OUR INPATIENT REHABILITATION HOSPITAL SETTINGS, AS WELL AS GROUP RECREATION AND DIVERSIONAL ACTIVITIES PROVIDED BY RECREATION THERAPISTS WEEKLY AT BOTH INPATIENT HOSPITALS. IT'S NEVER 2 LATE (IN2L) ADAPTIVE TECHNOLOGY IMPLEMENTED IN BOTH INPATIENT HOSPITALS AS WELL AS TWO OUT-PATIENT FACILITIES. THE IN2L IS UTILIZED BY ALL DISCIPLINES AS A THERAPEUTIC TOOL BY CLINICIANS, ASSISTS RECREATIONAL THERAPISTS WITH PROGRAM PLANNING, AND SUPPORTS PATIENT ENGAGEMENT AND PATIENT EXPERIENCE IN THE INPATIENT HOSPITAL SETTING DURING THE PATIENT'S DOWNTIME. AS WE CONTINUE TO FACE THE TRANSITION OF HEALTH CARE IN OUR COMMUNITY THE FOCUS OF HEALTH, WELLNESS, AND PREVENTION CONTINUE TO EMERGE AS A CRITICAL COMPONENT IN LIFE LONG CARE. PFL SERVICES PROVIDE A UNIQUE NICHE FOR INDIVIDUALS WITH PHYSICAL DISABILITIES, AS WELL AS THE COMMUNITY, TO MAINTAIN AN ACTIVE AND HEALTHY LIFESTYLE. IN FY 2018-2019, THE FITNESS, RECREATION, AND WELLNESS PROGRAMS RECORDED 48,369 VISITS IMPACTING QUALITY OF LIFE. PART VI, LINE 7, REPORTS FILED WITH STATES VA 1 PHARMACY, EQUIPMENT SUPPLIED TO DISCHARGED PATIENTS 25 11874 FMV COST OF SUPPLIES GRANTED TO PATIENTS PART I, LINE 2: THE HOSPITAL ONLY MAKES GRANTS OF NONCASH ITEMS NEEDED BY PATIENTS DURING THEIR RECOVERY. NO MONITORING OF THE ITEMS OCCURS AFTER BEING PROVIDED. 0 0 0 0 0 0 0 0 0 MARY A ZWEIFEL PRESIDENT & CEO 0 362557 0 122760 0 0 0 12000 0 13378 0 510695 0 0 JAMES S LITSINGER CFO/TREASURER 0 240357 0 0 0 0 0 12000 0 19024 0 271381 0 0 CHRISTOPHER SORENSON VP OF INFORMATION TECHNOLOGY 0 172685 0 0 0 0 0 9145 0 18758 0 200588 0 0 ELLEN VANCE CHIEF HR OFFICER 0 185493 0 27863 0 0 0 10912 0 12703 0 236971 0 0 SANDY EYLER CHIEF NURSING OFFICER 0 161819 0 50564 0 0 0 6439 0 12609 0 231431 0 0 AMY J SHOWALTER CHIEF OPERATING OFFICER 0 206820 0 45315 0 0 0 5356 0 18910 0 276401 0 0 HILLARY S HAWKINS MEDICAL DIRECTOR - SAH 0 345857 0 80122 0 0 0 0 0 21248 0 447227 0 0 TIMOTHY M SILVER MEDICAL DIRECTOR - SAHS 0 335548 0 20097 0 0 0 10067 0 19415 0 385127 0 0 GREGORY LEGHART PHYSICIAN 0 275136 0 50000 0 0 0 12000 0 19147 0 356283 0 0 AARON M JONES PHYSICIAN 0 225636 0 62733 0 0 0 9250 0 18972 0 316591 0 0 ALBERT M JONES PHYSICIAN 0 251611 0 5000 0 0 0 12000 0 19085 0 287696 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE MEMBER, THE RELATED ORGANIZATION, SHELTERING ARMS CORPORATION, EIN 54-1615598. FORM 990, PART VI, SECTION A, LINE 7A SHELTERING ARMS CORPORATION AS SOLE MEMBER HAS THE POWER TO APPOINT THE BOARD OF SHELTERING ARMS HOSPITAL SOUTH PER THE ORGANIZATION BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 AND APPLICABLE ATTACHMENTS WERE PROVIDED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS OF THE RELATED ORGANIZATION SHELTERING ARMS HOSPITAL AND SHELTERING ARMS HOSPITAL SOUTH WHICH ARE COMPRISED OF THE SAME INDEPENDENT BOARD MEMBERS FOR EACH ORGANIZATION, EITHER IN ELECTRONIC FORMAT OR BY MAIL. AN OPEN COMMENT AND QUESTION PERIOD WAS WELCOMED TO DIRECT ANY QUESTIONS OR COMMENTS BEFORE FILING THE FORM 990 AND ITS RELATED ATTACHMENTS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A COPY OF THE CONFLICT OF INTEREST POLICY ANNUALLY. ANY CONFLICTS ARE DISCLOSED AT THAT TIME, AND THE SIGNED POLICY IS KEPT ON FILE BY THE ORGANIZATION. IN THE EVENT THAT A POTENTIAL CONFLICT ARISES DURING THE YEAR, THE DIRECTOR WITH SUCH A CONFLICT MUST RECUSE HIM/HERSELF FROM ALL DISCUSSIONS AND VOTE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVES LISTED ARE EMPLOYEES OF THE RELATED ORGANIZATION SHELTERING ARMS HOSPITAL, AND THEIR COMPENSATION IS REVIEWED AND APPROVED AT A FORMAL MEETING OF THE INDEPENDENT COMPENSATION COMMITTEE OF SHELTERING ARMS HOSPITAL. THE COMPENSATION COMMITTEE EVALUATES PERFORMANCE, COMPENSATION SURVEYS, AND CONTRACT TERMS AND CONDITIONS ANNUALLY BEFORE DETERMINING AND RECOMMENDING COMPENSATION. ALL COMPENSATION COMMITTEE DISCUSSIONS ARE DOCUMENTED IN FORMAL MINUTES. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST, SHELTERING ARMS HOSPITAL SOUTH WILL MAKE AVAILABLE FOR PUBLIC INSPECTION GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, RELATED POLICIES, AND FINANCIAL STATEMENTS. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 131,017. MANAGEMENT AND GENERAL EXPENSES 6,896. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 137,913. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,181,208. MANAGEMENT AND GENERAL EXPENSES 62,169. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,243,377. FORM 990, PART XI, LINE 9: PROVISION FOR DOUBTFUL ACCOUNTS -398,404. SHELTERING ARMS FOUNDATION 8254 ATLEE ROAD MECHANICSVILLE VA 23116 541615599 SEE SUPPLEMENTAL INFORMATION, PART VII VA 501(C)(3) LINE 12B, II SHELTERING ARMS CORPORATION 0 SHELTERING ARMS HOSPITAL 8254 ATLEE ROAD MECHANICSVILLE VA 23116 540505955 PHYSICAL REHABILITATION VA 501(C)(3) LINE 3 SHELTERING ARMS CORPORATION 0 PALMYRA REHABILITATION CORPORATION 8254 ATLEE ROAD MECHANICSVILLE VA 23116 541615601 PHYSICAL REHABILITATION VA 501(C)(3) LINE 12B, II SHELTERING ARMS CORPORATION 0 SHELTERING ARMS CORPORATION 8254 ATLEE ROAD MECHANICSVILLE VA 23116 541615598 PHYSICAL REHABILITATION VA 501(C)(3) LINE 12B, II N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 SCHEDULE R, PART II, COLUMN (B): SHELTERING ARMS FOUNDATION SUPPORTS SHELTERING ARMS CORPORATION, SHELTERING ARMS HOSPITAL, AND SHELTERING ARMS HOSPITAL SOUTH IN PROVIDING HEALTHCARE TO THE COMMUNITIES SERVED BY THE ORGANIZATION.