2017-11-14T09:29:45-06:00 2016-12-31 990 2016-01-01 521271901 SENTARA HEALTHCARE SENT 7574557020 6015 POPLAR HALL DRIVE NORFOLK VA 23502 ROBERT A BROERMANN SR VP/CFO 7574557020 2017-11-14 163.230.250.197 2017-11-14 10:26:16 ES P 5DE4645C05D0C16B02C5EBC66FC9207F882F5D80 5DE4645C05D0C16B02C5EBC66FC9207F882F5D80 2016 2017-02-10 21:41:12Z HOWARD P KERN 6015 POPLAR HALL DRIVE NORFOLK VA 23502 152267304 0 X WWW.SENTARA.COM X 1982 VA AT SENTARA, WE IMPROVE HEALTH EVERY DAY. 16 15 720 20 3324756 525067 25243485 29480324 79103612 88195579 118065181 23040311 9553744 -8400027 231966022 132316187 22249350 1912154 0 0 81962896 86732087 14865 14682 596234 52518721 52464092 156745832 141123015 75220190 -8806828 3314890142 3468852721 1945116675 1932088423 1369773467 1536764298 X WE IMPROVE HEALTH EVERY DAY THROUGH COORDINATING, PROMOTING AND PLANNING FOR THE PROVISION OF HEALTH SERVICES AND THE PROMOTION OF HEALTH, MEDICAL EDUCATION, AND THE SOCIAL, CULTURAL, EDUCATIONAL, AND ECONOMIC DEVELOPMENT OF THE COMMUNITY. 0 0 112848822 1912154 70235222 SEE SCHEDULE O. 112848822 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 1 0 1 X 184 0 1 720 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 16 15 1 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X CORPORATE OFFICERS 7574557020 6015 POPLAR HALL DR NORFOLK VA 23502 WILLIAM L ACHENBACH DIRECTOR 1.00 2.00 X 0 0 0 JOHN AGOLA DIRECTOR 1.00 1.00 X 0 0 0 GILBERT BLAND DIRECTOR (EFFEC 11/16) 1.00 1.00 X 0 0 0 JOAN P BROCK DIRECTOR (THRU 11/16) 1.00 1.00 X 0 0 0 FREDERICK C COBLE DIRECTOR 1.00 1.00 X 0 0 0 LAWRENCE G CUMMING DIRECTOR (THRU 11/16) 1.00 1.00 X 0 0 0 JACK L EZZELL JR DIRECTOR 1.00 1.00 X 0 0 0 ROBERT C FORT DIRECTOR 1.00 1.00 X 0 0 0 L ALVIN GARRISON JR DIRECTOR (THRU 11/16) 1.00 1.00 X 0 0 0 J LES HALL DIRECTOR 1.00 1.00 X 0 0 0 ANN E C HOMAN DIRECTOR 1.00 4.00 X 0 0 0 CHARLES F LOVELL JR MD DIRECTOR 1.00 1.00 X 0 1200 0 L ALLAN PARROTT JR DIRECTOR 1.00 1.00 X 0 0 0 JEFFERY O SMITH ED D DIRECTOR (EFFEC 11/16) 1.00 1.00 X 0 0 0 CAROL C THOMAS DIRECTOR 1.00 6.00 X 0 0 0 MARION WALL DIRECTOR 1.00 1.00 X 0 0 0 DAVID L BERND DIRECTOR/CEO (THRU 3/16) 40.00 11.00 X X 7825434 0 81327 DIAN T CALDERONE DIRECTOR/VICE CHAIRMAN (EFFEC 11/16) 2.00 1.00 X X 0 0 0 HENRY U HARRIS III DIR/VICE CHAIR/CHAIR (EFFEC 11/16) 2.00 1.00 X X 0 0 0 HOWARD P KERN PRES/CEO (EFFEC 3/16)/EX-EFFICIO DIRECTOR 40.00 11.00 X X 2428937 0 1918643 PETER D PRUDEN III DIRECTOR/VICE CHAIRMAN (THRU 11/16) 2.00 1.00 X X 0 0 0 ROBERT A BROERMANN CFO 40.00 13.00 X 1503780 0 71355 MICHAEL V GENTRY COO 40.00 14.00 X 1044814 0 143725 SAMUEL J HAWLEY ASSIST. SECRETARY 40.00 5.00 X 159506 0 23483 JEFFREY P KING SECRETARY 40.00 9.00 X 664448 0 100828 MICHAEL M DUDLEY KE (SHC SVP & PRESIDENT, SHP) 10.00 41.00 X 980455 0 383631 LESTER R ELJAIEK KE (VP, HOSPITAL FINANCE) 40.00 0.00 X 488082 0 83783 TERRY M GILLILAND MD KE (SVP & CMO) 40.00 6.00 X 1329070 0 156497 VICKY G GRAY KE (SVP, SYSTEM DEVELOPMENT) 40.00 1.00 X 738995 0 76361 MICHAEL V TAYLOR KE (SVP HUMAN RESOURCES) 40.00 0.00 X 945081 0 64872 MEGAN R PERRY CVP, MERGERS & ACQUISITIONS 40.00 2.00 X 1131911 0 175405 STEPHEN D PORTER CVP, NO VA REGN 0.00 40.00 X 200767 523938 88681 GRACE R HINES CVP, SYSTEM INTERGRATION 40.00 0.00 X 582223 0 87764 DOUGLAS M THOMPSON VP, DECISION SUPPORT 40.00 0.00 X 554505 0 73663 VIKKI CHARLES VP, CORP FINANCE 40.00 0.00 X 420517 0 115794 MARY L BLUNT FORMER OFFICER 0.00 41.00 X 0 1070206 137911 DAVID R MAIZEL MD FORMER OFFICER 0.00 0.00 X 130298 0 -2162 GENEMARIE W MCGEE FORMER OFFICER 0.00 40.00 X 0 527608 122498 BERTRAM S REESE FORMER OFFICER 0.00 0.00 X 0 451040 39704 KENNETH M KRAKAUR FORMER OFFICER/KE 0.00 0.00 X 679158 0 22093 GARY R YATES MD FORMER OFFICER 40.00 0.00 X 100526 0 41615 21908507 2573992 4007471 155 1 1 0 PMA COMPANIES PO BOX 824857 PHILADELPHIA PA 19182 COMMERCIAL INSURANCE UNDERWRITER 2615177 MCKINSEY AND COMPANY INC US PO BOX 7247-7255 PHILADELPHIA PA 191707255 SOFTWARE ENGINEERING 1950000 KPMG LLC PO BOX 71544 CHICAGO IL 60694 PROFESSIONAL SERVICES 1537883 TRUVEN HEALTH ANALYTICS INC PO BOX 95334 CHICAGO IL 60694 HEALTHCARE CONSULTANTS 1340856 HIGHLAND ASSOC INC PO BOX 55469 BIRMINGHAM AL 322555469 INVESTMENT MGMT FEES 1318552 63 28579228 901096 53952 29480324 SUPPORT SERVICES 900099 85494188 84268462 1225726 SQCN 900099 2467904 1484827 983077 WORKING DESIGN 900099 233487 233487 0 88195579 15773468 15773468 27098148 119812 19833302 117815 7264846 1997 7266843 7266843 DEEMED DISTR. FROM CFC 524298 8326805 8326805 INTERCO INTEREST CHARGES 900099 6834779 6834779 SUBPART F INCOME 524298 1266610 0 436313 830297 -24828221 -22586333 679640 -2921528 -8400027 132316187 70235222 3324756 29275885 1228411 1228411 683743 683743 21213107 16546223 4666884 92940 72493 20447 51078361 39592873 11167221 318267 6032538 4676929 1319134 36475 4077320 3161080 891587 24653 4237821 3287787 927325 22709 5381367 4197466 1183901 963604 751152 211863 589 1280425 998732 281693 26532 20695 5837 14682 14682 5347754 4171248 1176506 6813645 5803999 1009646 7453485 5803031 1636752 13702 2481196 1896907 535025 49264 3551963 2770531 781432 1250463 975361 275102 792969 618516 174453 272256 212360 59896 10443811 10437219 6592 693952 541283 152669 721646 562884 158762 UNRELATED BUSINESS TAX -63436 -63436 PURCHASED & CONTRACTED 2073758 1532658 432288 108812 ORGANIZATIONAL DUES 1563110 1219226 343884 OTHER 617774 476341 134352 7081 797818 673110 124708 141123015 112848822 27677959 596234 507278591 382558820 1023163 900597 142078291 133165067 6790293 9127300 23386989 17082586 5540461 6304403 1951785436 2034859640 625588824 842168786 74805083 59768108 3314890142 3468852721 202520295 220705021 31586130 16863624 1272889487 1266852068 438120763 427667710 1945116675 1932088423 X 1366147634 1533365104 3625833 3399194 1369773467 1536764298 3314890142 3468852721 X -8806828 130673321 45124338 X 0 1 X 1 0 X 21133614 29774513 29714011 25243485 29480354 135345977 21133614 29774513 29714011 25243485 29480354 135345977 135345977 42959801 40863885 57200957 43487068 17870375 202382086 1182283 619603 468849 88078 346544 2705357 340433420 397217683 0.39760 0.42970 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 0 0 1 31480 1 1 202971 234451 0 PART II-B, LINE 1: THE ORGANIZATION ENGAGED IN THE DISSEMINATION OF INFORMATION CONCERNING HEALTH CARE LEGISLATION TO EMPLOYEES VIA EMAIL. THE ORGANIZATION IS INVOLVED IN INDIRECT LOBBYING ACTIVITIES THROUGH PAYMENT OF MEMBERSHIP DUES TO VHHA AND AHA. FURTHERMORE, THE ORGANIZATION ENGAGED VECTRE CORPORATION TO MONITOR AND PROVIDE CONSULTATION ON FEDERAL, STATE, AND LOCAL HEALTH CARE LEGISLATION. 80973164 899335 -1710443 680000 526182 78955874 80469527 1288253 -224709 165000 394907 80973164 77170379 1048397 2784835 450000 84084 80469527 71429647 783033 5356116 190000 208417 77170379 61588154 612380 9724182 210000 285069 71429647 0.95690 0.04310 0 0 2493820 2493820 4640222 3826815 813407 228337 228337 0 14943353 12623209 2320144 1081257 404225 677032 6304403 OAKTREE MEZZANINE FUND II 675021 F UBS TRUMBULL PROPERTY INCOME FUND 167996388 F UBS TRUMBULL PROPERTY FUND 80030766 F OAKTREE REAL ESTATE OPPORTUNITIES FUND IV 2281416 F OAKTREE REAL ESTATE OPPORTUNITIES FUND V 3713299 F HEALTH ENTERPRISES PARTNERS I, LP 1559870 F SANTE HEALTH VENTURES I, LP 3314753 F SANTE HEALTH VENTURES II, LP 2034417 F POINTER OFFSHORE LTD - HEDGE FUND 13090859 F HEALTH ENTERPRISES PARTNERS II, LP 1952830 F OAKTREE PRIVATE INVESTMENT FUND 2012 22298784 F PIMCO BRAVO II FUND 19483665 F TTCP FUND I LP 4574582 F PELOTON EQUITY FUND I LP 3190127 F OAKTREE PRINCIPAL OPPORTUNITIES FD IV, L.P. 3102941 F PINEBRIDGE GLOBAL DYNAMIC ASSET ALLOCATION FUND LLC 114707975 F HIGHLAND PUBLIC INFLATION HEDGE 191390220 F HIGHLAND DIRECT HEDGED EQUITY 203565106 F PIMCO CORPORATE OPPORTUNITIES FUND 3205767 F 842168786 DUE TO AFFILIATES 17246576 OTHER LT LIABILITIES 111791911 OTHER CURRENT LIABILITIES 37468086 RETIREMENT OBLIGATIONS 251161137 SELF-INSURANCE RESERVE 10000000 427667710 PART V, LINE 4: INTENDED USES OF ENDOWMENT FUND THE BOARD DESIGNATED ENDOWMENT FUND IS SET ASIDE FOR THE SENTARA FOUNDATION'S USE. THE FOUNDATION ASSISTS THE COMMUNITY WITH FILLING THE HEALTH CARE GAPS, DEVELOPING NEW PROGRAMS, AND BUILDING CONSENSUS AROUND CURRENT HEALTH ISSUES. THE TEMPORARILY RESTRICTED ENDOWMENT FUNDS ARE USED PREDOMINANTLY FOR EDUCATION & RESEARCH, HOSPICE HOUSE, HEART FUNDS AND SENTARA'S HOPE FUND, WHICH IS AN EMERGENCY FINANCIAL RESOURCE FOR SENTARA EMPLOYEES THAT ARE EXPERIENCING CATASTROPHIC HARDSHIP OR LOSS THROUGH NO FAULT OF THEIR OWN. CENTRAL AMERICA AND THE CARIBBEAN 0 0 UNRELATED TRADE OR BUSINESS CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 221874011 0 0 0 0 0 0 221874011 0 221874011 1 0 1 1 1 0 PART I, LINE 3 CENTRAL AMERICA AND THE CARIBBEAN, UNRELATED TRADE OR BUSINESS: THE ORGANIZATION OWNS BAY PRIMEX INSURANCE COMPANY, LTD., A CAPTIVE INSURANCE COMPANY WHOSE PRINCIPAL ACTIVITY IS THE REINSURANCE, ON A FACULTATIVE BASIS, OF A MODIFIED CLAIMS-MADE RETROSPECTIVELY RATED PROFESSIONAL AND COMMERCIAL GENERAL LIABILITY INSURANCE POLICY ISSUED BY LEXINGTON INSURANCE COMPANY. COVERAGE INCLUDES THE EMPLOYEES OF THE ORGANIZATION, ITS CONTROLLED SUBSIDIARIES, ITS AFFILIATED JOINT VENTURES, CERTAIN PHYSICIANS ON THE MEDICAL STAFF OF ITS RELATED FACILITIES, AND SOME NON-EMPLOYED PHYSICIANS. PROVISION OF INSURANCE TO NON-EMPLOYED PHYSICIANS IS TREATED AS AN UNRELATED TRADE OR BUSINESS. TO THE EXTENT THERE IS SUBPART F INCOME, IT IS REPORTED AS SUCH ON FORM 990 PART VIII LINE 11. 1 757 ANGELS INC 932 LASKIN ROAD STE 300 VIRGINIA BEACH VA 23451 472382748 501(C)(4) 15000 GROW AND DIVERSIFY THE HAMPTON ROADS ECONOMY ANGELS OF MERCY INC 7151 RICHMOND ROAD SUITE 401 WILLIAMSBURG VA 23188 541901759 501(C)(3) 8000 REDESIGN PRIMARY CARE TO MEET NEEDS OF UNINSURED AND UNDERINSURED BEACH HEALTH CLINIC 3396 HOLLAND RD STE 102 VIRGINIA BEACH VA 23452 541366960 501(C)(3) 25000 DIAGNOSTIC AND PHARMACY SERVICES FOR INDIGENT BETH SHALOM VILLAGE 6401 AUBURN DR VIRGINIA BEACH VA 23464 541862383 501(C)(3) 25000 PROVIDE PROGRAMS AND SRVICES TO BENEFIT ELDERLY AND INFIRM PERSONS BOYS AND GIRLS CLUBS 11825 ROCK LANDING DRIVE CHESAPEAKE BUILDING STE B NEWPORT NEWS VA 23606 540538202 501(C)(3) 15000 INSPIRE AND ENABLE YOUNG PEOPLE CATHOLIC CHARITIES OF EASTERN VA 5361 A VIRGINIA BEACH BLVD VIRGINIA BEACH VA 23462 540505879 501(C)(3) 15000 MENTAL HEALTH SERVICES CHESAPEAKE CARE INC 2145 S MILITARY HWY CHESAPEAKE VA 23320 541642754 501(C)(3) 25000 HEALTHCARE FOR UNINSURED CHILDREN'S HEALTH INVESTMENT PROGRAM 1302 JEFFERSON ST CHESAPEAKE VA 23324 541893166 501(C)(3) 17000 ORAL HEALTH PROGRAM FOR CHILDREN COALITION TO PROTECT AMERICA'S HEALTH CARE PO BOX 30211 BETHESDA MD 20824 522253225 501(C)(4) 35000 SUPPORT PUBLIC EDUCATION REGARDING AMERICA'S HEALTHCARE ALTERNATIVES COMMUNITY FREE CLINIC OF NEWPORT NEWS 727 25TH STREET NEWPORT NEWS VA 23607 273510814 501(C)(3) 25000 NEW CLINIC CONTRIBUTION FORKIDS INC P O BOX 6044 NORFOLK VA 23508 541477799 501(C)(3) 175000 HEALTHCARE FOR HOMELESS SHELTER GLOUCESTER-MATHEWS FREE CLINIC 2276 GEORGE WASHINGTON MEM HWY HAYES VA 23072 541875619 501(C)(3) 25000 HEALTHCARE FOR INDIGENTS HELP INC PO BOX 190 HAMPTON VA 23669 541209213 501(C)(3) 25000 PROVIDE DENTAL CARE TO UNISURED, LOW INCOME ADULTS JDRF 291 INDEPENDENCE BLVD STE 157 VIRGINIA BEACH VA 23462 231907729 501(C)(3) 20000 CURE, PREVENT AND TREAT TYPE I DIABETES AND ITS COMPLICATIONS LACKEY FREE CLINIC 1620 OLD WILLIAMSBURG RD YORKTOWN VA 23690 541850915 501(C)(3) 25000 HEALTHCARE FOR INDIGENTS LEES FRIENDS 7400 HAMPTON BLVD NORFOLK VA 23505 541533488 501(C)(3) 10000 HELP AND SUPPORT CANCER PATIENTS AND THEIR FAMILIES LIGHT RAIL NOW 5101 CLEVELAND ST STE 202 VIRGINIA BEACH VA 23462 271612714 501(C)(4) 10000 SUPPORT LIGHT RAIL AS A TRANSPORTATION ALTERNATIVE MAKE-A-WISH FOUNDATION OF GREATER VIRGINIA 2810 NORTH PARHAM RD STE 302 RICHMOND VA 23294 541429614 501(C)(3) 9500 GRANT WISHES OF CHILDREN WITH LIFE-THREATENING MEDICAL CONDITIONS MARCH OF DIMES PO BOX 932852 ATLANTA GA 31193 131846366 501(C)(3) 10000 IMPROVE HEALTH OF BABIES BY PREVENTING BIRTH DEFECTS, PREMATUR BIRTH AND INFANT MORTALITY MOTHER SETON HOUSE 3333 VIRGINIA BEACH BLVD STE 28 VIRGINIA BEACH VA 23452 541250483 501(C)(3) 20000 HIGH-RISK TEEN MENTAL HEALTHCARE NEPTUNE FESTIVAL 265 KINGS GRANT ROAD STE 102 VIRGINIA BEACH VA 23452 521372330 501(C)(3) 25000 COMMUNITY ENJOYMENT AND ENRICHMENT OLDE TOWN MEDICAL CTR 5249 OLDE TOWNE RD STE D WILLIAMSBURG VA 23188 541663905 501(C)(3) 25000 PEDIATRIC DENTAL SERVICES PARK PLACE HEALTH AND DENTAL CLINIC 606 W 29TH ST NORFOLK VA 23508 453086608 501(C)(3) 25000 DENTAL HEALTH NEEDS OF LOW INCOME AND UNINSURED PIN MINISTRY 557 S BIRDNECK ROAD SUITE 109 VIRGINIA BEACH VA 23451 412126841 501(C)(3) 13000 RESOURCES FOR THE POOR PORTSMOUTH COMMUNITY HEALTH CENTER 664 LINCOLN STREET PORTSMOUTH VA 23704 541626757 501(C)(3) 50000 PROVIDE QUALITY AND AFFORDABLE HEALTH SERVICES IN A SAFE ENVIRONMENT PRIMEPLUS NORFOLK SENIOR CENTER 7300 NEWPORT AVE SUITE 100 NORFOLK VA 23505 541118218 501(C)(3) 6000 SUPPORT THE NEEDS OF ADULTS AGE 50 AND OVER EVERY DAY RX PARTNERSHIP 2924 EMERYWOOD PKWY STE 300 RICHMOND VA 23294 571186937 501(C)(3) 13000 ACCESS TO FREE MEDICATION SAMARITAN HOUSE INC 2620 SOUTHERN BLVD VIRGINIA BEACH VA 23452 541291021 501(C)(3) 10000 SERVING THE HOMELESS SENIOR SERVICES OF SOUTHEASTERN VIRGINIA 6350 CENTER DR BUILDING 5 NO 101 NORFOLK VA 23502 546069786 501(C)(3) 16000 ASSISTS OLDER PERSONS LOCATE AND ACCESS NEEDED SERVICES SHARE OUR STRENGTH INC 1030 15TH ST NW STE 1100 W WASHINGTON DC 20005 521367538 501(C)(3) 150000 END HUNGER AND POVERTY IN US AND ABROAD SOUTHEASTERN VIRGINIA HEALTH SYSTEM 1033 28TH STREET NEWPORT NEWS VA 23607 541083954 501(C)(3) 25000 LAB AND MEDICAL SERVICES FOR INDIGENTS ST COLUMBA ECUMENICAL MINISTRIES 2414 LAFAYETTE BLVD NORFOLK VA 23509 541394797 501(C)(3) 12000 PRESCRIPTIONS THE VIRGINIA SYMPHONY 150 BOUSH STREET SUITE 201 NORFOLK VA 23510 546000598 501(C)(3) 7124 SUPPORT SYMPHONY IN PERFORMANCES TO BENEFIT THE PUBLIC UNION MISSION MINISTRIES P O BOX 3203 NORFOLK VA 23514 540506427 501(C)(3) 40000 HEALTHCARE FOR HOMELESS UNITED WAY GREATER WILLIAMSBURG 312 WALLER MILL ROAD SUITE 100 WILLIAMSBURG VA 23185 540844073 501(C)(3) 9200 SPONSORSHIP UNITED WAY OF SOUTH HAMPTON ROADS 2515 WALMER ROAD PO BOX 41069 NORFOLK VA 23513 540506322 501(C)(3) 23669 SPONSORSHIP UNITED WAY OF THE VA PENINSULA 739 THIMBLE SHOALS BLVD SUITE 400 NEWPORT NEWS VA 23606 540535602 501(C)(3) 10000 SPONSORSHIP UP CENTER 222 W 19TH ST NORFOLK VA 23517 540674774 501(C)(3) 15000 MENTORING PROGRAM FOR AT RISK YOUTH VA DENTAL ASSOCIATION 3460 MARYLAND CT 110 RICHOMD VA 23233 540697647 501(C)(6) 25000 PROMOTE THE PRACTICE OF DENTISTRY VA SUPPORTIVE HOUSING P O BOX 8585 RICHMOND VA 23226 541444564 501(C)(3) 30000 CASE MANAGEMENT FOR HOMELESS VA STEAM ACADEMY INC PO BOX 324 SUFFOLK VA 23439 371636703 501(C)(3) 20000 ENCOURAGE THE STUDY OF SCIENCE, TECHNOLOGY, ENGINEERING AND MATHEMATICS WESTERN TIDEWATER FREE CLINIC 2019 MEADE PKWY SUFFOLK VA 23434 263302837 501(C)(3) 25000 PROVIDE DENTAL PROGRAM ACCESS WILLIAM AND MARY ATHLETIC EDUCATIONAL FOUNDATION P O BOX 399 WILLIAMSBURG VA 23187 546056480 501(C)(3) 13000 FUNDING FOR ATHLETIC SCHOLARSHIPS YMCA CHESAPEAKE 633 S BATTLEFIELD BLVD CHESAPEAKE VA 23322 540445205 501(C)(3) 5500 SUPPORTS PROGRAMS THAT BUILD SPIRIT, MIND AND BODY FOR ALL 40 4 CLOTHING 2 500 FOOD 87 13430 HOME REPAIRS 6 16969 TEMP HOUSING 1 585 HOUSEHOLD GOODS 14 3600 MORTGAGE ASSISTANCE 16 21063 RENTAL ASSISTANCE 77 92159 UTILITY ASSISTANCE 62 35437 SCHOLARSHIPS 100 500000 PART I, LINE 2: SCHEDULE I, PART I, LINE 2: PROCEDURES FOR MONITORING USE OF GRANTS FUNDS IN U.S. PROCEDURES FOR MONITORING USE OF GRANTS FUNDS IN U.S. THE SENTARA FOUNDATION - HAMPTON ROADS, A DIVISION OF THE ORGANIZATION, IS RESPONSIBLE FOR AWARDING AND MONITORING THE USE OF GRANT AND SPONSORSHIP FUNDS DONATED TO OTHER ORGANIZATIONS IN THE COMMUNITY WHO SHARE THE SAME MISSION AS THE ORGANIZATION: IMPROVING HEALTH EVERYDAY THROUGH THE PROVISION OF HEALTH SERVICES, AND THE PROMOTION OF HEALTH, MEDICAL EDUCATION, AND THE SOCIAL, CULTURAL, EDUCATIONAL, AND ECONOMIC DEVELOPMENT OF THE COMMUNITY. COMMUNITY RECOGNITION GRANTS ARE AWARDED ANNUALLY BY THE FOUNDATION'S GRANT COMMITTEE TO OTHER 501(C)(3) ORGANIZATIONS WITHIN THE COMMUNITY AFTER A RIGOROUS APPLICATION AND REVIEW PROCESS. ONCE AWARDED, THE GRANTS ARE DISTRIBUTED THE FOLLOWING YEAR IN TWO PAYMENTS - AT THE BEGINNING OF THE YEAR, THEN AFTER AN INTERIM REPORT HAS BEEN FILED WITH THE FOUNDATION. THE INTERIM REPORT MUST INCLUDE THE GRANT OBJECTIVES, ANY CHANGES IN STATUS OF THE ORGANIZATION'S 501(C)(3) STATUS, DETAILS OF THE GRANT OUTCOMES TO DATE AND COMPLIANCE WITH SUBMITTED FINANCIAL BUDGET. GRANTEES ARE REQUIRED TO SUBMIT WITH THE REPORT A DETAILED LISTING OF MEASUREMENTS INCLUDING THE NUMBER OF PEOPLE SERVED AND INCOME LEVELS. FURTHER, A PLAN OF PROGRAM SUSTAINABILITY MUST BE COMPLETED TO PROMOTE THE INITIATIVE'S GOALS FOR THE FUTURE. COMMUNITY BENEFIT SPONSORSHIPS ARE AWARDED QUARTERLY BASED ON THE RECOMMENDATION OF THE FOUNDATION'S SPONSORSHIP REVIEW COMMITTEE. APPLICANTS MUST SUBMIT A PROPOSAL IN WRITING DEMONSTRATING HOW FUNDS WILL BE USED TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY. SPONSORSHIPS ARE GENERALLY AWARDED TO OTHER 501(C)(3) ORGANIZATIONS WITH ACTIVE COMMUNITY BOARDS WHO OVERSEE THE EXPENDITURE OF SUCH FUNDS. THE SENTARA FOUNDATION - HAMPTON ROADS ALSO ADMINISTERS THE H.O.P.E. (HELPING OVERCOME PERSONAL EMERGENCY) FUND, A PROGRAM FOR EMPLOYEES OF THE SENTARA HEALTHCARE SYSTEM WHO ARE IN NEED OF EMERGENCY ASSISTANCE. THIS PROGRAM IS FUNDED BY DONATIONS FROM EMPLOYEES AND MANAGED BY THE PLANNING COUNCIL, A HUMAN SERVICES AGENCY USED TO PROCESS ALL H.O.P.E. FUND APPLICATIONS TO MAINTAIN CONFIDENTIALITY. EMPLOYEES WHO EXPERIENCE CATASTROPHIC EVENTS THROUGH NO FAULT OF THEIR OWN SUCH AS FIRE, DEATH IN THE FAMILY, FLOODING, HURRICANE, TORNADO, CURRENT PERSONAL ILLNESS OR SERIOUS PERSONAL FAMILY ILLNESS THAT RESULT IN HARDSHIP MAY APPLY FOR ASSISTANCE. APPLICANTS MUST COMPLETE A 3-PAGE APPLICATION FORM. APPLICANTS SUBMIT THESE FORMS ALONG WITH THEIR LATEST PAY STUBS, COPIES OF THE BILLS BEING SUBMITTED FOR PAYMENT, AND OFFICIAL DOCUMENTATION OF THE CATASTROPHIC EVENT. THE PLANNING COUNCIL THEN INTERVIEWS THE APPLICANT AND DETERMINES IF THE GUIDELINES ARE MET FOR ASSISTANCE. IN THE EVENT OF A NATURAL DISASTER, APPLICANTS MUST FIRST APPLY TO OTHER EMERGENCY ASSISTANCE PROGRAMS, SUCH AS THE AMERICAN RED CROSS, SALVATION ARMY, OR F.E.M.A., BEFORE BECOMING ELIGIBLE FOR ASSISTANCE FROM THE H.O.P.E. FUND. A REVIEW COMMITTEE EVALUATES EACH APPLICATION AND DETERMINES ASSISTANCE LEVELS BASED ON DOCUMENTED, APPROPRIATE NEED. FUNDS MAY ONLY BE USED TO PAY EXISTING BILLS OR EXTRAORDINARY EXPENSES RELATED TO A CATASTROPHIC EVENT. BILLS THAT ARE NOT NECESSARY FOR THE PRESERVATION OF DAILY LIVING, INCLUDING NON-ESSENTIAL UTILITIES (I.E., CABLE TV, ETC.), ARE NOT COVERED. PAYMENTS ARE MADE DIRECTLY TO SERVICE PROVIDERS RATHER THAN TO INDIVIDUAL RECIPIENTS. FUNDS ARE ONLY DISTRIBUTED PROVIDED ADEQUATE EMPLOYEE DONATIONS HAVE BEEN MADE BY EMPLOYEES FOR EMPLOYEES. ASSISTANCE IS PROVIDED AS THE AVAILABILITY OF FUNDS PERMIT; DECISIONS ARE MADE IN THE ORDER IN WHICH COMPLETED APPLICATIONS REQUESTS ARE RECEIVED. ASSISTANCE FOR AN INDIVIDUAL EMPLOYEE IS LIMITED TO ONCE PER 12-MONTH PERIOD AND TYPICALLY DOES NOT EXCEED $2,000. DURING 2016, 113 INDIVIDUAL EMPLOYEES WERE ASSISTED BY THE HOPE FUND. THE ORGANIZATION AWARDED 100 SCHOLARSHIPS ANNUALLY FOR REGISTERED NURSES TO PURSUE A BACCAULAREATE DEGREE IN NURSING. AWARDS WERE MADE TO QUALIFIED EMPLOYEES IN TWO ROUNDS PER YEAR BASED UPON MERIT. RECIPIENTS WERE SELECTED FROM QUALIFIED APPLICANTS ACCORDING TO PRESCRIBED GUIDELINES. ALL SCHOLARSHIPS ARE AWARDED ON A NONDISCRIMINATORY BASIS, AND THEIR USE IS MONITORED BY THE ORGANIZATION'S HIRED VENDOR ENSURING COMPLIANCE. X X X X 0 1 0 0 0 0 0 1 0 DAVID L BERND DIRECTOR/CEO (THRU 3/16) 841431 0 1546313 0 5437690 0 57745 0 23582 0 7906761 0 2319488 0 HOWARD P KERN PRES/CEO (EFFEC 3/16)/EX-EFFICIO DIR 1292371 0 892734 0 243832 0 1897938 0 20705 0 4347580 0 0 0 ROBERT A BROERMANN CFO 761691 0 577570 0 164519 0 52625 0 18730 0 1575135 0 0 0 MICHAEL V GENTRY COO 642866 0 328762 0 73186 0 126898 0 16827 0 1188539 0 55185 0 SAMUEL J HAWLEY ASSIST. SECRETARY 136906 0 20284 0 2316 0 13208 0 10275 0 182989 0 0 0 JEFFREY P KING SECRETARY 451951 0 150361 0 62136 0 77120 0 23708 0 765276 0 26371 0 MICHAEL M DUDLEY KE (SHC SVP & PRESIDENT, SHP) 540523 0 362914 0 77018 0 369959 0 13672 0 1364086 0 0 0 LESTER R ELJAIEK KE (VP, HOSPITAL FINANCE) 344688 0 116339 0 27055 0 49081 0 34702 0 571865 0 0 0 TERRY M GILLILAND MD KE (SVP & CMO) 754660 0 508349 0 66061 0 141827 0 14670 0 1485567 0 0 0 VICKY G GRAY KE (SVP, SYSTEM DEVELOPMENT) 332939 0 311987 0 94069 0 62373 0 13988 0 815356 0 7171 0 MICHAEL V TAYLOR KE (SVP HUMAN RESOURCES) 480529 0 365925 0 98627 0 46962 0 17910 0 1009953 0 0 0 MEGAN R PERRY CVP, MERGERS & ACQUISITIONS 454475 0 254845 0 422591 0 160344 0 15061 0 1307316 0 401024 0 STEPHEN D PORTER CVP, NO VA REGN 3981 273509 0 213286 196786 37143 20497 52381 4313 11490 225577 587809 0 37559 GRACE R HINES CVP, SYSTEM INTERGRATION 311684 0 189195 0 81344 0 66415 0 21349 0 669987 0 0 0 DOUGLAS M THOMPSON VP, DECISION SUPPORT 298232 0 172010 0 84263 0 59925 0 13738 0 628168 0 0 0 VIKKI CHARLES VP, CORP FINANCE 286194 0 97011 0 37312 0 95732 0 20062 0 536311 0 0 0 MARY L BLUNT FORMER OFFICER 0 592007 0 332778 0 145421 0 122151 0 15760 0 1208117 0 0 DAVID R MAIZEL MD FORMER OFFICER 0 0 0 0 130298 0 -2680 0 518 0 128136 0 67919 0 GENEMARIE W MCGEE FORMER OFFICER 0 361518 0 108293 0 57797 0 110870 0 11628 0 650106 0 0 BERTRAM S REESE FORMER OFFICER 0 9072 0 322563 0 119405 0 39256 0 448 0 490744 0 33873 KENNETH M KRAKAUR FORMER OFFICER/KE 358511 0 115246 0 205401 0 20687 0 1406 0 701251 0 42065 0 GARY R YATES MD FORMER OFFICER 0 0 86671 0 13855 0 41615 0 0 0 142141 0 8705 0 PART I, LINE 4B HOWARD KERN AND MICHAEL DUDLEY PARTICIPATED IN THE SENTARA SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. PARTICIPATION IN THE PLAN IS LIMITED TO SELECT INDIVIDUALS AS APPROVED BY THE ORGANIZATIONS' BOARD OF DIRECTOR'S COMPENSATION COMMITTEE. THE PLAN IS CURRENTLY CLOSED TO ADDITIONAL MEMBERS. VESTING OCCURS UPON THE COMPLETION OF A TWO YEAR NON-COMPETE PERIOD FOLLOWING TERMINATION AFTER EARLY RETIREMENT DATE OR UPON DEATH. EARLY RETIREMENT DATE IS WHEN THE EXECUTIVE OBTAINS AT LEAST AGE 55 AND HAS 10 YEARS OF SERVICE AND BENEFITS ARE FORFEITED IF PARTICIPANT LEAVES PRIOR TO AGE 55 WITH 10 YEARS OF SERVICE. DAVID BERND PARTICIPATED IN THE SENTARA OPTION PLAN FOR EXECUTIVES. THIS PLAN IS UNRELATED TO "EQUITY" OF THE EMPLOYER. PARTICIPATION IS LIMITED TO SELECT INDIVIDUALS AS APPROVED BY THE ORGANIZATIONS' BOARD OF DIRECTOR'S COMPENSATION COMMITTEE. VESTING IS DETERMINED BY THE GOVERNING BOARD OF THE ORGANIZATION AND IS SEPARATELY STATED IN EACH PARTICIPANT'S OPTION AGREEMENT. THERE WERE NO OPTIONS GRANTED AFTER 2002. DURING 2016, MR. BERND RECEIVED $5,243,877 UPON EXERCISE OF OPTIONS GRANTED UNDER THE PLAN. THIS AMOUNT HAS BEEN REPORTED IN COLUMN(B)(III) OF SCHEDULE J, PART II. DAVID BERND, HOWARD KERN, MICHAEL DUDLEY, MARY BLUNT, ROBERT BROERMANN, MICHAEL GENTRY, VICKY GRAY, KENNETH KRAKAUR, BERTRAM REESE, MICHAEL TAYLOR, DOUGLAS THOMPSON, GARY YATES, M.D., GRACE HINES, DAVID MAIZEL, M.D., MEGAN PERRY, STEPHEN PORTER, JEFFREY KING, TERRY GILLILAND, M.D., GENEMARIE MCGEE AND LESTER ELJAIEK PARTICIPATED IN THE SENTARA CAPITAL ACCUMULATION ACCOUNT PLAN. PARTICIPATION IS LIMITED TO A SELECT GROUP OF CORPORATE EXECUTIVES AS APPROVED BY THE ORGANIZATIONS' 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 2016, THE FOLLOWING CORPORATE EXECUTIVES RECEIVED VESTED DISTRIBUTIONS UNDER THE PLAN: DAVID BERND ($115,509) MARY BLUNT ($88,150); ROBERT BROERMANN ($138,886); MICHAEL DUDLEY ($26,463); MICHAEL GENTRY ($58,192); VICKY GRAY ($62,667); GRACE HINES ($47,777); HOWARD KERN ($202,907); JEFFREY KING ($40,639): KENNETH KRAKAUR ($154,524); DAVID MAIZEL, M.D. ($123,528); GENEMARIE MCGEE ($51,976); MEGAN PERRY ($58,078); STEPHEN PORTER ($63,180); BERTRAM REESE ($61,296); MICHAEL TAYLOR ($70,415); DOUGLAS THOMPSON ($44,794); AND GARY YATES, M.D. ($13,857). THESE AMOUNTS HAVE BEEN REPORTED IN COLUMN (B)(III) OF SCHEDULE J, PART II. PART I, LINE 7 NON-FIXED PAYMENTS NOT LISTED DURING THE CURRENT TAX YEAR, THE ORGANIZATION MADE NON-FIXED PAYMENTS OF COMPENSATION UNDER THE FOLLOWING INCENTIVE PROGRAMS: ANNUAL INCENTIVE PROGRAM - EXECUTIVES AND SENIOR LEADERS ARE ELIGIBLE FOR ANNUAL AWARDS BASED ON SYSTEM AND INDIVIDUAL PERFORMANCE. BOTH SYSTEM AND INDIVIDUAL SCORES ARE DETERMINED AFTER YEAR-END, AT WHICH POINT AWARDS MAY BE PAID AND REPORTED AS COMPENSATION. TARGET AND MAXIMUM OPPORTUNITIES VARY BY LEVEL. TOP HAT- WITHIN THE ANNUAL INCENTIVE PROGRAM, EXECUTIVES AND SENIOR LEADERS MAY RECEIVE ADDITIONAL INCENTIVE PAY TO REWARD EXCEPTIONAL INDIVIDUAL PERFORMANCE. 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. A EDA OF ALBEMARLE COUNTY VA 521297503 2013-06-05 160515000 REFUND MARTHA JEFFERSON SERIES 2008A, 2008B, 2008C, AND 2008D 0 0 0 B EDA THE CITY OF NORFOLK VA 521375010 2003-07-16 53100000 FINANCING FOR CAPITAL AND FIXED ASSETS 0 0 0 C EDA THE CITY OF SUFFOLK VA 541131047 86481QAA7 2008-06-25 156615000 REFUNDED BONDS ISSUED OCTOBER 2006 0 0 0 D VA SMALL BUSINESS FINANCING AUTHORITY 541300845 928105AV7 2010-01-28 296243684 REFUND PRIOR BONDS AND FUND NEW PROJECT 0 0 0 A 4595000 160515000 160515000 2013 1 0 1 1 B 16300000 53100000 53100000 2003 0 0 1 1 C 5215000 156615000 156615000 2008 1 0 1 1 D 60210000 296443256 2715612 230220167 63507476 2011 1 0 1 1 A 0 1 1 1 0 0 0 1 B 0 1 1 1 0 0 0 1 C 0 1 1 1 0 0 0 1 D 0 1 1 1 0 0 0 1 A 0 1 1 0 1 0 0 0 1 B 0 0 1 1 1 0 0 0 1 C 0 0 1 1 0 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: EDA THE CITY OF NORFOLK, VA DATE THE REBATE COMPUTATION WAS PERFORMED: 12/16/2007 SCHEDULE K, PART VI ENTITY 1, ISSUER A: SERIES 2013A & 2013B (MARTHA JEFFERSON HOSPITAL) HOSPITAL FACILITIES & DEBT NOW ACQUIRED AND OWNED BY SENTARA HEALTHCARE. PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDES ISSUE PRICE. NO INTEREST WAS EARNED, ALL PROCEEDS SPENT ON OR AROUND DATE OF CLOSING FOR REFUNDING PURPOSES. PART II 7, - THE COST OF ISSUANCES EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - ISSUE CURRENT REFUNDED THE MARTHA JEFFERSON HOSPITAL SERIES 2008A, SERIES 2008B, SERIES 2008C, AND SERIES 2008D. PART IV, 2B - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. ARBITRAGE COMPLIANCE CERTIFICATE PROVIDED TO SENTARA. FIRST INSTALLMENT WOULD BE NO LATER THAN 6/5/2018. ENTITY 1, ISSUE B: SERIES 2003 COMMERCIAL PAPER PROGRAM (SENTARA HEALTHCARE) PART II, 1 - SENTARA ISSUED TAXABLE COMMERCIAL PAPER NOTES IN 2012 TO PARTIALLY REFUND THIS 2003 COMMERCIAL PAPER PROGRAM. PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDES ISSUE PRICE. NO INTEREST WAS EARNED, ALL PROCEEDS SPENT WITHIN 18 MONTHS OF RECEIPT OF PROCEEDS. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART IV, 2C - SENTARA HAD ARBITRAGE COMPLIANCE REPORT COMPLETED FOR THIS ISSUE AS OF 12/16/2007, WHICH REFLECTED NO REBATE DUE TO THE IRS FOR THIS 2003 ISSUANCE. DEBT WAS ISSUED AS REIMBURSEMENT FOR PRIOR EXPENDITURES INCURRED. THEREFORE, THIS ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION. ENTITY 1, ISSUE C: SERIES 2008 ( SENTARA HEALTHCARE SYSTEM) PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDED ISSUE PRICE. NO INTEREST WAS EARNED, ALL PROCEEDS SPENT ON OR AROUND DATE OF CLOSING FOR REFUNDING PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - ISSUE REFUNDED A PRIOR SERIES 2006 ISSUE. THE REFUNDING WAS TREATED AS A CURRENT REFUNDING FOR FEDERAL TAX PURPOSES. ALL PROCEEDS WERE SPENT ON THE DAY OF ISSUE. PART IV, 2B - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA PROVIDED WITH ARBITRAGE COMPLIANCE CERTIFICATE IN SEPTEMBER OF 2008. FIRST INSTALLMENT EVALUATION DATE WOULD BE NO LATER THAN 6/25/2013. ON MAY 1, 2015, SENTARA HEALTHCARE MODIFIED AN EXISTING TOTAL RETURN SWAP ("TRS") FOR THE $156,615,000 SERIES 2008 REVENUE BONDS. THE TRS WAS NOT ORIGINALLY TREATED OR IDENTIFIED AS A QUALIFIED HEDGE FOR TAX PURPOSES AND THEREFORE ANY MODIFICATIONS SHOULD NOT HAVE RESULTED IN A REISSUANCE FOR FEDERAL TAX PURPOSES. HOWEVER, BOND COUNSEL AND THE SWAP PROVIDERS COUNSEL REVIEWED PRIVATE LETTER RULING PLR-147816-13, WHICH OUTLINED A VERY SIMILAR SITUATION. THE PLR CONCLUDED THAT AN AMENDMENT TO THE TRS WOULD NOT RESULT IN AN ABUSIVE ARBITRAGE DEVICE AS DEFINED WITHIN THE U.S. TREASURY REGULATIONS. THE PLR DID NOT CONCLUDE WHETHER OR NOT A REISSUANCE SHOULD APPLY IN SUCH A SITUATION. AS A CONSERVATIVE APPROACH, BOND COUNSEL AND THE SWAP PROVIDERS COUNSEL DECIDED TO FOLLOW THE DIRECTION TAKEN BY THE ISSUER IN THE PLR AND ALSO TREAT THE MODIFICATION OF THE TRS AS A REISSUANCE AND FILED A NEW FEDERAL FORM 8038 WITH THE INTERNAL REVENUE SERVICE, DATED MAY 1, 2015. AGAIN, THE TREATMENT OF THE TRS MODIFICATION AS A REISSUANCE WAS PURELY DONE AS A CONSERVATIVE APPROACH. AS STATED ABOVE, THE SERIES 2008 BONDS QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION. THEREFORE, THIS ISSUE WAS EXEMPT FROM THE ARBITRAGE REBATE CALCULATION. UNDER THE REISSUANCE TREATMENT, NO REBATE AMOUNTS WOULD HAVE BEEN DUE TO THE IRS AS OF THE MAY 1, 2015 REISSUANCE DATE. FURTHERMORE, THE 2008 REISSUED BONDS WOULD ALSO QUALIFY FOR THE SIX-MONTH SPENDING EXCEPTION AND WOULD NOT OWE AN ARBITRAGE REBATE PAYMENT TO THE IRS AS OF MAY 1, 2020 (FIFTH ANNIVERSARY DATE OF THE REISSUANCE). ENTITY 1, ISSUER D: SERIES 2010 (SENTARA HEALTHCARE SYSTEM - VSBFA) PART II, 3 - AMOUNT OF TOTAL PROCEEDS OF ISSUE INCLUDES ISSUE PRICE, PLUS INTEREST EARNINGS (MAINLY FROM PROJECT FUND AND ESCROW FUND). PART II, 11 - OTHER SPENT PROCEEDS INCLUDES REFUNDING PROCEEDS AND INTEREST EARNINGS FROM REFUNDING ESCROW FUND. PART II, 14 - ISSUE REFUNDED A PRIOR SERIES 1997A AND 1998 ISSUE. THE REFUNDINGS WERE TREATED AS CURRENT REFUNDINGS FOR FEDERAL TAX PURPOSES. REFUNDING PROCEEDS WERE DEPOSITED INTO AN ESCROW FUND AND INVESTED. THOSE AMOUNTS WERE FULLY EXPENDED ON OR AROUND 3/1/2010 TO REDEEM THE PRIOR BONDS. PART IV, 2B - FIRST INSTALLMENT PERIOD FOR THIS ISSUE ENDED ON1/28/2015. ARBITRAGE COMPLIANCE REPORT COMPLETED THROUGH DECEMBER 31, 2011, WHICH REFLECTED ALL PROCEEDS SPENT AND NO ACCRUING ARBITRAGE LIABILITY FOR SENTARA. ENTITY 2, ISSUER A: SERIES 2012B (SENTARA HEALTHCARE SYSTEM) PART II, 3 - TOTAL PROCEEDS OF THE ISSUE INCLUDES ISSUE PRICE, PLUS INTEREST EARNINGS ASSOCIATED WITH PROJECT FUND AND ESCROW FUNDS. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 11 - OTHER SPENT PROCEEDS INCLUDES REFUNDING PROCEEDS AND INTEREST EARNINGS FROM REFUNDING ESCROW FUNDS. PART II, 12 - UNSPENT PROCEEDS CONSIST OF THE REMAINING PROJECT FUND PROCEEDS. PART II, 15 - SERIES 2012B ADVANCE REFUNDED THE MARTHA JEFFERSON SERIES 2002 BONDS MATURING 10/1/2012 - 10/1/2035 WITH A CALL FOR REDEMPTION DATE OF 10/1/2012. THE SERIES 2012B ALSO ADVANCE REFUNDED THE POTOMAC HOSPITAL SERIES 2003 BONDS MATURING 10/1/2012 - 10/1/2036 WITH A CALL FOR REDEMPTION DATE OF 10/1/2013. PART IV, 2A, SENTARA RECEIVES ANNUAL ARBITRAGE COMPLIANCE REPORTS COMPLETED FOR THIS ISSUE. THE FIRST INSTALLMENT PERIOD WILL END NO LATER THAN 05/16/2017. ALL PROCEEDS OF THE SERIES 2012B BONDS WERE FULLY EXPENDED AS OF 3/19/2014. ARBITRAGE COMPLIANCE CERTIFICATE WAS PROVIDED FORECASTING RESULTS THROUGH THE 5/1/2017 FIFTH BOND YEAR, WHICH REFLECTED THAT NO ARBITRAGE REBATE LIABILITY WILL BE DUE TO THE IRS AS OF THE FIRST INSTALLMENT PERIOD. ENTITY 2, ISSUER B: SERIES 2016A&B (SENTARA HEALTHCARE) PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2016A AND 2016B BONDS. THE SERIES 2016A&B BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016A&B CURRENT REFUNDED THE SERIES 2012A, 2010B, AND 2010C ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE MAY 5, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 2, ISSUER C: SERIES 2016C&D (SENTARA RMH MEDICAL CENTER) PART II, 3 - PART II, 3 - COMBINED ISSUE PRICE OF THE SERIES 2016C AND 2016D BONDS. THE SERIES 2016C&D BONDS WERE TREATED AS A SINGLE ISSUE FOR FEDERAL TAX PURPOSES. PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016C&D CURRENT REFUNDED THE SERIES 2006 RMH BONDS ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE AUGUST 15, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 2, ISSUER D: SERIES 2016E (SENTARA RMH MEDICAL CENTER) PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016E CURRENT REFUNDED THE SERIES 2011AB&C RMH ON THE DATE OF CLOSING. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE OCTOBER 4, 2021 FIRST INSTALLMENT EVALUATION DATE. ENTITY 3, ISSUER A: SERIES 2016F (SENTARA RMH MEDICAL CENTER) PART II, 7 - THE COST OF ISSUANCE EXPENSES OF THE ISSUE WERE PAID WITH EQUITY FROM SENTARA AND NOT FROM BOND PROCEEDS. PART II, 14 - SERIES 2016F CURRENT REFUNDED THE SERIES 2010A, 2010B, AND 2010C RMH BONDS ON THE DATE OF CLOSING. SERIES 2010AB&C BONDS WERE MODIFIED/REISSUED ON 11/28/2011. PART IV, 2B&C - ISSUE QUALIFIED FOR THE SIX-MONTH SPENDING EXCEPTION TO REBATE. SENTARA RECEIVED AN ARBITRAGE REBATE COMPLIANCE CERTIFICATE FROM ITS ARBITRAGE CONSULTANT FOR THIS ISSUE. NO REBATE PAYMENT IS EXPECTED TO BE DUE TO THE IRS FOR THIS ISSUE AS OF THE NOVEMBER 1, 2021 FIRST INSTALLMENT EVALUATION DATE. A EDA THE CITY OF NORFOLK VA 237253445 65588NBB7 2012-05-16 163163080 REF. POTOMAC 2003 & MARTHA JEFFERSON 2002 AND FINANCE NEW PROJECTS 0 0 0 B EDA THE CITY OF NORFOLK VA 521375010 65588TAP4 2016-05-05 197670000 REF. SERIES 2012A, 2010B, AND 2010C 0 0 0 C IDA OF THE CITY OF HARRISONBURG VA 542000436 2016-08-15 183535000 CURRENTLY REFUND SERIES 2006 RMH 0 0 0 D EDA OF THE CITY OF HARRISONBURG VA 542000436 2016-10-04 27600000 CURRENTLY REFUND SERIES 2011ABC RMH 0 0 0 A 10865000 163873559 75585411 88288148 2014 0 1 1 1 B 1820000 197670000 197670000 2016 1 0 1 1 C 183535000 183535000 2016 1 0 1 1 D 27600000 27600000 2016 1 0 1 1 A 0 1 1 1 0 0 0 1 B 0 1 1 1 1 1 0 0 1 C 0 1 1 1 0 0 0 1 D 0 1 1 1 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 1 0 1 0 0 0 1 C 0 1 1 0 1 0 0 0 1 D 0 1 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 A EDA OF THE CITY OF HARRISONBURG VA 542000436 2016-11-01 65379312 CURRENTLY REFUND SERIES 2010ABC RMH 0 0 0 A 65379312 65379312 2016 1 0 1 1 A 0 1 1 1 0 0 0 1 A 0 1 1 0 1 0 0 0 1 A 1 ALLISON K GREENE FAMILY MEMBER OF KEN KRAKAUR, FORMER OFFICER/KEY EMPLOYEE 128845 EMPLOYMENT 0 KELLY B LAMPING FAMILY MEMBER OF DAVID BERND, DIRECTOR AND OFFICER 92940 EMPLOYMENT 0 X 10 53952 FAIR MARKET VALUE 0 1 0 FORM 990, PART III, LINE 4A SENTARA HEALTHCARE I. SENTARA HEALTHCARE - YOUR NOT FOR PROFIT HEALTHCARE PARTNER SENTARA HEALTHCARE BASED IN NORFOLK, VA, CELEBRATES MORE THAN 128 YEARS IN RELENTLESS PURSUIT OF ITS MISSION TO IMPROVE HEALTH EVERY DAY THROUGH INNOVATION, COMPASSION AND COMMUNITY BENEFIT. SENTARA IS A FULLY-INTEGRATED NOT-FOR-PROFIT SYSTEM WITH NEARLY 300 SITES OF CARE OF WHICH THERE ARE 12 HOSPITALS IN VIRGINIA AND NORTH CAROLINA, INCLUDING A LEVEL I TRAUMA CENTER WITH NIGHTINGALE REGIONAL AIR AMBULANCE AND THE NATIONALLY-RANKED SENTARA HEART HOSPITAL. THE SENTARA FAMILY INCLUDES FOUR MEDICAL GROUPS, AMBULATORY CAMPUSES, POST-ACUTE CARE SERVICES, THE PHYSICIAN-LED SENTARA QUALITY CARE NETWORK, THE ACCREDITED SENTARA CANCER NETWORK, THE SENTARA COLLEGE OF HEALTH SCIENCES, OPTIMA HEALTH PLAN MEMBERS IN VIRGINIA, ALABAMA AND OHIO, AND A TEAM OF PROFESSIONALS NEARLY 30,000 STRONG. SENTARA PROUDLY INCLUDES ADVANCED IMAGING CENTERS, NURSING AND ASSISTED LIVING CENTERS, PHYSICAL THERAPY AND REHABILITATION SERVICES, HOME HEALTH AND HOSPICE, AND GROUND MEDICAL TRANSPORTATION. SENTARA IS STRATEGICALLY FOCUSED ON CONTINUOUS IMPROVEMENT IN QUALITY, SAFETY, CLINICAL OUTCOMES AND THE PATIENT EXPERIENCE AND PURSUES KEY CLINICAL GOALS THROUGH HIGH-PERFORMANCE TEAMS ACROSS THE ENTERPRISE. EFFORTS ARE CENTERED ON PROVIDING THE RIGHT CARE IN THE RIGHT SETTING AT THE RIGHT TIME AND ADDING VALUE TO THE COMMUNITIES WE SERVE. WE STRIVE TO SERVE ALL OF OUR COMMUNITIES THROUGH HEALTH OUTREACH PROGRAMS, EDUCATION, AND FINANCIAL SUPPORT OF OTHER NOT FOR PROFIT ORGANIZATIONS WITH SIMILAR HEALTH MISSIONS. II. COMMITMENT TO THE COMMUNITY A. SENTARA HAS PROVIDED MUCH IN THE WAY OF COMMUNITY BENEFIT AND CHARITY CARE ON AN ANNUAL BASIS. IN 2016, SENTARA COMMUNITY BENEFIT REACHED $341,145,000. SENTARA PROVIDED $310,123,000 IN NET UNCOMPENSATED PATIENT CARE; $18,923,000 IN MEDICAL EDUCATION; AND $12,099,000 IN COMMUNITY PROGRAMS. B. SENTARA IS PROUD OF THE MISSION-DRIVEN WORK OF THE THREE SENTARA FOUNDATIONS. THESE FOUNDATIONS RAISED MONEY TO SUPPORT THE CLINICAL NEEDS OF THE SYSTEM AND PROVIDED FUNDING THROUGH GRANTS AND DIRECT CONTRIBUTIONS TO COMMUNITY ORGANIZATIONS THAT HAVE SIMILAR INTERESTS IN COMMUNITY HEALTH NEEDS. SENTARA FOUNDATION-HAMPTON ROADS FUNDED 31 COMMUNITY GRANTS IN 2016 TOTALING $580,000. THE RMH FOUNDATION FUNDED 7 COMMUNITY HEALTH GRANTS, AWARDING $87,000. ADDITIONALLY, THEY PROVIDED FUNDING FOR THE NEW HYBRID OPERATING ROOM AND CREATED A NEW FUND TO PROVIDE PREVENTIVE SCREENINGS FOR CANCER PATIENTS IN THE COMMUNITY. THE MARTHA JEFFERSON HOSPITAL FOUNDATION RAISED FUNDS TO SUPPORT WOMEN'S HEALTH IN THE COMMUNITY. ALL THREE FOUNDATIONS RALLIED AROUND SUPPORT FOR NURSING EXCELLENCE AND INNOVATION, FUNDING 168 SCHOLARSHIPS FOR REGISTERED NURSES WHO ARE PURSUING THEIR BACHELORS OF SCIENCE IN NURSING. 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 2016, THE HOPE FUND AWARDED $183,743 TO SENTARA EMPLOYEES IN CRISES ACROSS THE SYSTEM. C. 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 2016: -HEALTH IMPROVEMENT EVENTS WERE OFFERED TO CHURCHES, EMPLOYER GROUPS INCLUDING SENTARA HEALTHCARE AND HAMPTON ROADS SANITATION DISTRICT, COMMUNITY HEALTH CENTERS AND OTHER COMMUNITY LOCATIONS INCLUDING THE POCKET EKG PROGRAM AND THE SENTARA LIVING PROGRAM. -CONTINUED TO OFFER PROGRAMS SUCH AS EATING FOR LIFE, WALKABOUT WITH HEALTHY EDGE, HEALTH HABITS, HEALTHY YOU, MEDITATION, TAICHI AND YOGA. -THE FLU PATROL ADMINISTERED A TOTAL OF 5,802 IMMUNIZATIONS. 5,124 WERE GIVEN TO OPTIMA HEALTH INSURED GROUPS THROUGHOUT VIRGINIA. THE REMAINDER WAS DELIVERED TO CHURCHES AND OTHER COMMUNITY GROUPS. -BIRTHDAY CARD REMINDERS FOR PREVENTIVE HEALTH SCREENINGS WERE DELIVERED TO ADULT MEMBERS OF OPTIMA HEALTH, OHIOHEALTH PLAN MEMBERS AND CHILDREN. SELF-CARE HANDBOOKS ON PLANNING A HEALTHY PREGNANCY WERE DISTRIBUTED TO OPTIMA HEALTH - HEALTH PLAN MEMBERS. -THE TOBACCO CESSATION PROGRAM CREATED SEVERAL NEW LITERATURE PIECES FOR THE GREAT AMERICAN SMOKEOUT. PATIENTS DISCHARGED FROM SENTARA VIRGINIA BEACH GENERAL HOSPITAL AND SENTARA HEART HOSPITAL WERE CONTACTED FOUR WEEKS AFTER THEIR HOSPITAL DISCHARGE FOR TOBACCO CESSATION FOLLOW-UP. -AS PART OF THE SENTARA BENEFIT ENROLLMENT PROCESS, 18,720 EMPLOYEES COMPLETED A HEALTH RISK ASSESSMENT IN CONJUNCTION WITH THE MISSION: HEALTH PROGRAM. -FINALLY, WEBMD, WHICH SERVES AS OUR HEALTH COACHING AND HEALTH EDUCATION PORTAL PARTNER, HAS NOW 21,549 REGISTERED MEMBERS OF WHICH 15,076 MEMBERS ARE ACTIVELY ENGAGED. SENTARA HOSTS A NUMBER OF COMMUNITY EVENTS RAISING AWARENESS AROUND KEY HEALTH AWARENESS MONTHS. ONE GOOD EXAMPLE IS THE FOCUS ON COLON CANCER: DON'T SIT ON COLON CANCER. THROUGH THE SENTARA CANCER NETWORK, WE HOSTED A 5K AT SENTARA PRINCESS ANNE HOSPITAL IN VIRGINIA BEACH. THROUGH SENTARA HEART, WE PROMOTED THE "28 DAYS OF HEART" IN FEBRUARY, 2016 IN SUPPORT OF HEART HEALTH AWARENESS. ONLINE PROMOTIONS, RADIO ADS, FACEBOOK LIVE EDUCATION SESSIONS, SCREENINGS AND MORE WERE CONDUCTED TO RAISE AWARENESS OF HEART DISEASE THROUGHOUT THE COMMUNITIES WE SERVE IN VIRGINIA AND NORTH CAROLINA. III. GROWTH IN SENTARA HEALTHCARE SINCE THE BEGINNING, SENTARA HAS REACHED OUT TO OTHER INDUSTRY LEADERS AND JOINED FORCES TO EXTEND QUALITY HEALTHCARE AND SERVICES TO MORE PEOPLE. IN RECENT YEARS, WE HAVE GROWN IN VIRGINIA AND IN OTHER STATES - NORTH CAROLINA, ALABAMA 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 2016 INCLUDED THE FOLLOWING: A. SENTARA QUALITY CARE NETWORK (SQCN): SQCN IS A CLINICALLY INTEGRATED NETWORK (CIN) SERVING THE COMMUNITIES OF HAMPTON ROADS, CHARLOTTESVILLE AND HARRISONBURG REGIONS IN VIRGINIA. SQCN IS A COLLABORATION AMONG INDEPENDENT/PRIVATE PRACTICE AND EMPLOYED PHYSICIANS AND A HOSPITAL OR HEALTH SYSTEM, TO DEVELOP A CLINICAL INTEGRATION PROGRAM; A CLINICAL INTEGRATION PROGRAM IS AN ACTIVE AND ONGOING PROGRAM OF CLINICAL INITIATIVES TO IMPROVE THE QUALITY AND DELIVERY OF HEALTH CARE SERVICES, LEADING TO GREATER EFFICIENCY IN CARE DELIVERY AND COST SAVINGS. THE SENTARA QUALITY CARE NETWORK INCREASED TO 2,981 PROVIDERS (2,754 IN 2015) AND 67,573 PATIENTS (30,647 IN 2015) ACROSS VIRGINIA. B. SENTARA DEVELOPED THE FIRST EVER SYSTEM-WIDE BEHAVIORAL HEALTH STRATEGIC PLAN. THE PLAN PROVIDES THE STRATEGIC DIRECTION FOR THE COMPANY AS TO HOW TO PROVIDE APPROPRIATE, COMPASSIONATE, AND TIMELY CARE TO A VULNERABLE POPULATION OF PATIENTS AND MEMBERS. SENTARA VIRGINIA BEACH GENERAL HOSPITAL, LOCATED IN VIRGINIA BEACH, VIRGINIA, AND SENTARA OBICI HOSPITAL, LOCATED IN SUFFOLK, VIRGINIA, INCREASED THEIR BEHAVIORAL HEALTH ADMISSIONS BY 10+%. IV. NEW INITIATIVES A. SENTARA JOINED SIXTEEN OTHER HEALTHCARE INSTITUTIONS TO COLLABORATE WITH IBM'S WATSON HEALTH IN A LARGE - SCALE MEDICAL IMAGING EFFORT TO IMPROVE PATIENT DIAGNOSIS AND CARE. IBM WATSON HEALTH IS A TECHNOLOGY PLATFORM THAT USES NATURAL LANGUAGE PROCESSING MACHINE LEARNING TO REVEAL INSIGHTS FROM LARGE AMOUNTS OF UNSTRUCTURED DATA. B. SENTARA KICKED OFF THE IMPLEMENTATION OF TWO EPIC PRODUCTS, "PRELUDE AND "RESOLUTE." PRELUDE IS THE EPIC SYSTEM RELATED TO REGISTRATION AND RESOLUTE IS THE BILLING SYSTEM. THIS IMPLEMENTATION WILL TAKE PLACE SYSTEM-WIDE OVER THE NEXT SEVERAL YEARS. FORM 990, PART III, LINE 4A C. SENTARA EXPANDED OUR TELEHEALTH SERVICES THROUGHOUT THE SYSTEM. SENTARA PRINCESS ANNE HOSPITAL, LOCATED IN VIRGINIA BEACH, VIRGINIA, INSTALLED A "VIRTUAL VISITATION" SERVICE IN ITS NEONATAL INTENSIVE CARE UNIT TO CONNECT REMOTE FAMILY MEMBERS WITH PATIENTS. SENTARA EXPANDED ITS EICU REMOTE MONITORING SYSTEM FOR ICU BEDS AT SENTARA OBICI HOSPITAL, LOCATED IN SUFFOLK, VIRGINIA. A TOTAL OF 119 ICU BEDS IN SEVERAL HOSPITALS HAVE ACCESS TO THE REMOTE MONITORING SYSTEM. TELESTROKE WAS INTRODUCED AT SENTARA ALBEMARLE MEDICAL CENTER, LOCATED IN ELIZABETH CITY, NORTH CAROLINA. SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER, LOCATED IN WILLIAMSBURG, VIRGINIA, EXPANDED INPATIENT TELENEUROLOGY SERVICES. SENTARA EXPANDED ITS TELEPSYCH SERVICES TO SIX EMERGENCY DEPARTMENTS TO REMOTELY ASSESS PSYCHIATRIC PATIENTS. MORE THAN HALF OF THE PSYCHIATRIC EVALUATIONS IN SENTARA EMERGENCY ROOMS ARE PERFORMED BY VIRTUAL TECHNOLOGIES. TELEMAGISTRATE SERVICES WERE EXPANDED TO SENTARA NORFOLK GENERAL HOSPITAL, LOCATED IN NORFOLK, VIRGINIA AND SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER, LOCATED IN WILLIAMSBURG, VIRGINIA ALLOWING MAGISTRATES TO REMOTELY CONNECT WITH PSYCHIATRIC EVALUATORS TO DETERMINE IF EMERGENCY OR TEMPORARY DETENTION ORDERS SHOULD BE ISSUED FOR PATIENTS. D. SENTARA VOLUNTARILY BECAME A PARTICIPANT IN THE CMS BUNDLED PAYMENT FOR CLINICAL IMPROVEMENT PROGRAM (BPCI) AND PARTNERED WITH SQCN TO DEVELOP CRITICALLY IMPORTANT MULTI-DISCIPLINARY AND MULTI-DIVISION 90 DAY PLANS FOR CARE FOR THE EFFECTIVE MANAGEMENT OF PATIENTS FOLLOWING TRANSITION FROM A HOSPITAL WITH SPECIFIC ATTENTION TO CARE IN THE POST - ACUTE AND AMBULATORY VENUES. E. IN ITS SECOND YEAR, CLINICAL PERFORMANCE IMPROVEMENT (CLINICAL PI), AN INITIATIVE TO DRIVE CHANGE AND CREATE RAPID PROCESS IMPROVEMENT IN TARGETED CLINICAL AREAS, RESULTED IN ALL 8 FOCUS AREAS EXCEEDING THEIR GOALS, BUT MORE IMPORTANTLY, MADE AN INCREDIBLE POSITIVE IMPACT ON QUALITY AND OUTCOMES COLLECTIVELY IMPACTING MORE THAN 750,000 PATIENTS AND MEMBERS. V. OFFERING NEW PROCEDURES AND TECHNOLOGIES CLINICAL BREAKTHROUGHS: SENTARA INTRODUCED MANY NEW CLINICAL BREAKTHROUGHS THAT BENEFITED THE PATIENT IN MANY AREAS OF CARE, INCLUDING CARDIAC AND VASCULAR. A. CARDIAC: I. SENTARA CARDIAC SPECIALISTS PLACED HAMPTON ROADS' (SOUTHEASTERN VIRGINIA) FIRST DISSOLVABLE STENT AT SENTARA HEART HOSPITAL. "ABSORB" IS THE FIRST FULLY DISSOLVING DEVICE OF ITS KIND - A DRUG ELUTING CORONARY STENT THAT DISSOLVES, COMPLETELY AND NATURALLY, IN THE BODY OVER TIME. THE DEVICE DISAPPEARS IN APPROXIMATELY THREE YEARS, ONCE IT HAS DONE THE JOB OF KEEPING A CLOGGED ARTERY OPEN AND PROMOTING HEALING OF THE ARTERY. II. SENTARA HEART HOSPITAL IS THE FIRST HOSPITAL IN HAMPTON ROADS (SOUTHEASTERN VIRGINIA) AND THE SECOND IN VIRGINIA TO IMPLANT THE WORLD'S SMALLEST PACEMAKER, MICRA TRANSCATHETER PACING SYSTEM (TPS). THE MICRA DEVICE IS MUCH SMALLER THAN A TRADITIONAL PACEMAKER, COMPARABLE IN SIZE TO A LARGE VITAMIN. THE SMALL SIZE ALLOWS THE DEVICE TO BE DELIVERED THROUGH A CATHETER AND IMPLANTED DIRECTLY INTO THE HEART, WITHOUT THE NEED FOR CARDIAC WIRE LEADS. B. VASCULAR: THE VEIN CENTER OF VIRGINIA, OPERATED BY SENTARA MEDICAL GROUP, BECAME THE FIRST CIVILIAN MEDICAL CENTER IN SOUTHEAST VIRGINIA TO USE THE VENASEAL CLOSURE SYSTEM TO TREAT VARICOSE VEINS - VENOUS REFLUX DISEASE -A CONDITION AFFECTING MORE THAN 30 MILLION AMERICANS. THE VENASEAL SYSTEM IS A NEW, MINIMALLY INVASIVE PROCEDURE PROVEN TO TREAT VENOUS REFLUX DISEASE. THE DISEASE OCCURS WHEN VALVES IN THE VEINS OF THE LOWER LEG NO LONGER FUNCTION PROPERLY. BLOOD REFLUXES (FLOWS BACKWARD), RESULTING IN VARICOSE VEINS AND OTHER SYMPTOMS. VI. EXPANDING EDUCATIONAL OPPORTUNITIES SENTARA IS COMMITTED TO ALWAYS IMPROVING-INCLUDING ENCOURAGING REGISTERED NURSES (RNS) TO CONTINUE PURSUING EDUCATIONAL OPPORTUNITIES. CONTINUOUS LEARNING WILL ADVANCE THE CARE SENTARA NURSES DELIVER TO OUR PATIENTS AND ALLOW THEM TO ADVANCE IN THEIR CAREERS. IN 2016, SENTARA MARKED FURTHER PROGRESS TOWARD ACHIEVING OUR GOAL OF 80% OF SENTARA NURSES HAVING A BSN BY 2020. IN 2016 SENTARA HAD 56.4% OF ITS NURSING WORKFORCE HOLDING A BSN OR HIGHER DEGREE WITH 19.6% OF LICENSED RNS WITH A CONTRACT TO COMPLETE THEIR BSN. SENTARA IS MOVING THE NEEDLE ON THIS MEASURE AND THE SENTARA FOUNDATIONS ARE AN ENORMOUS SUPPORT. ALL SENTARA FOUNDATIONS RALLIED AROUND ADVANCING NURSING EDUCATION BY FUNDING 168 SCHOLARSHIPS IN 2016 FOR RNS WHO ARE PURSUING THEIR BSN. VII. RESEARCH: RESEARCH IS ANOTHER WAY SENTARA IS ALWAYS IMPROVING. HERE ARE A FEW EXAMPLES OF OUR WORK WITHIN THE RESEARCH REALM: A. COPPER: SENTARA CONDUCTED THE WORLD'S LARGEST STUDY ON THE USE OF COPPER INFUSED MATERIALS (SHEETS, BLANKETS, PILLOW CASES, GOWNS, TOWELS, WASHCLOTHS, BEDSIDE TABLES, HANDRAILS AND OTHER SURFACES) IN REDUCING HOSPITAL ACQUIRED INFECTIONS. A 10-MONTH CLINICAL TRIAL AT SENTARA LEIGH HOSPITAL DETERMINED THAT HARD SURFACES AND LINENS INFUSED WITH COPPER OXIDE COMPOUNDS CONTRIBUTED TO A STATISTICALLY SIGNIFICANT REDUCTION IN C-DIFFICILE, MULTI-DRUG RESISTANT ORGANISMS AND HOSPITAL ACQUIRED INFECTIONS. THESE RESULTS OCCURRED IN A HOSPITAL WITH A ROBUST PROTOCOL FOR MANAGING INFECTION RISK CERTIFIED BY THE HEALTH CARE ACCREDITING BODY DNV-GL HEALTHCARE. RESULTS OF THE TRIAL WERE PUBLISHED IN THE PEER-REVIEWED AMERICAN JOURNAL OF INFECTION CONTROL ON SEPTEMBER 28, 2016. THE RESULTS WERE ASTOUNDING AND SENTARA IS NOW PLACING THESE MATERIALS IN ALL 12 HOSPITALS. B. CARDIAC: THROUGH THE SENTARA CARDIOVASCULAR RESEARCH INSTITUTE, CARDIOLOGISTS AND UNIQUELY TRAINED REGISTERED NURSE RESEARCH COORDINATORS MAKE SIGNIFICANT STRIDES IN ADVANCING THE UNDERSTANDING AND TREATMENT OF THE NO. 1 KILLER IN AMERICA: CARDIOVASCULAR DISEASE. AS THE PREEMINENT CARDIAC RESEARCH INSTITUTE IN THE MID-ATLANTIC REGION, SENTARA HEART WORKS COLLABORATIVELY WITH LOCAL INSTITUTIONS, GOVERNMENT AGENCIES AND BIOMEDICAL COMPANIES ON NATIONALLY AND INTERNATIONALLY RECOGNIZED CLINICAL RESEARCH TRIALS. WE FOCUS OUR EFFORTS ON DISCOVERING MORE EFFECTIVE CARDIOVASCULAR TREATMENTS AND PROTOCOLS WHILE ELIMINATING THOSE THAT ARE POTENTIALLY HARMFUL OR NOT AS BENEFICIAL. OUR ULTIMATE GOAL IS TO PROVIDE ENHANCED CLINICAL CARE THAT ADVANCES PATIENT OUTCOMES AND IMPROVES THE OVERALL HEALTH OF OUR COMMUNITY. OUR RESEARCH TOUCHES ON EVERY ASPECT OF HEART CARE, INCLUDING MEDICAL DEVICES, HEART FAILURE, ELECTROPHYSIOLOGY, CARDIAC SURGERY, CARDIAC INTERVENTIONAL PROCEDURES, STRUCTURAL HEART DISEASE, AND THE MEDICAL MANAGEMENT OF CORONARY ARTERY DISEASE RISK FACTORS SUCH AS DIABETES AND HIGH CHOLESTEROL. COLLECTIVELY, OUR RESEARCH NURSES COORDINATE MORE THAN 80 CLINICAL TRIALS AT ANY GIVEN TIME, SHEPHERDING PARTICIPANTS THROUGH THE ENTIRE TRIAL PROCESS, PROVIDING CARE DURING PERIODS OF NEED, AND TIRELESSLY ADVOCATING FOR THEIR PATIENTS' WELL-BEING. C. CANCER: WITHIN THE SENTARA CANCER NETWORK, CLINICIANS AND ACADEMIC RESEARCHERS WORK TOGETHER TO ELEVATE CARE FOR CURRENT AND FUTURE PATIENTS. THIS COLLABORATIVE PHILOSOPHY FOSTERS INNOVATION IN THE NETWORK AND DRIVES ACCESS TO CLINICAL TRIAL OPTIONS FOR OUR PATIENTS. OUR PARTICIPATION IN CLINICAL TRIALS AND RESEARCH ALSO CONTRIBUTES TO CANCER STUDIES VIA TISSUE DONATION, RETROSPECTIVE CHART STUDIES AND CONTROL GROUP PARTICIPATION. THROUGH COLLABORATION WITH THE NCI NATIONAL CLINICAL TRIALS NETWORK (NCTN), THE ALLIANCE FOR CLINICAL TRIALS IN ONCOLOGY AND NRG ONCOLOGY, OUR PHYSICIANS HAVE ACCESS TO THE SCIENCE TO DEVELOP OPTIMAL TREATMENT AND PREVENTION STRATEGIES FOR CANCER, AS WELL AS RESEARCH METHODS TO ALLEVIATE SIDE EFFECTS OF CANCER AND CANCER TREATMENTS. THERE ARE PROMISING CLINICAL TRIALS BEING CONDUCTED ALL OVER THE COUNTRY FOR PATIENTS WITH CANCER, AND BY MAKING THEM ACCESSIBLE LOCALLY, WE DEMONSTRATE THE AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER PRINCIPLE TO DELIVER QUALITY CARE CLOSE TO HOME. OUR CLINICAL TRIALS INCLUDE EFFICACY AND SAFETY TRIALS FOR INVESTIGATIONAL BIOLOGICS; COMBINATION TRIALS FOR ONCOLOGY DRUGS; SURGICAL AND RADIATION THERAPY RESEARCH TRIALS; ADJUVANT AND MAINTENANCE DRUG TRIALS, POSTOPERATIVE ONCOLOGY OPTIONS; AND RETROSPECTIVE CHART REVIEWS. THE SENTARA CANCER NETWORK CURRENTLY MAINTAINS ACADEMIC RESEARCH PARTNERSHIPS WITH EASTERN VIRGINIA MEDICAL SCHOOL AND GEORGE MASON UNIVERSITY. VIII. BUILDING FOR THE FUTURE A. SENTARA NORTHERN VIRGINIA MEDICAL CENTER, LOCATED IN WOODBRIDGE, VIRGINIA, OPENED A DEDICATED ELECTROPHYSIOLOGY LAB IN THE SENTARA HEART AND VASCULAR CENTER. SENTARA MEDICAL GROUP INTRODUCED A NEW PRIMARY CARE LOCATION, SENTARA FAMILY MEDICINE PHYSICIANS, IN DUMFRIES, VIRGINIA AND ACQUIRED AN INDEPENDENT PRIMARY CARE PRACTICE IN LAKE RIDGE RESULTING IN THE OPENING OF SENTARA FAMILY AND INTERNAL MEDICINE PHYSICIANS. FORM 990, PART III, LINE 4A B. SENTARA RMH MEDICAL CENTER (SRMH), LOCATED IN HARRISONBURG, VIRGINIA, IMPLEMENTED SENTARA ECARE AND MYCHART, THE EPIC ELECTRONIC MEDICAL RECORD USED THROUGHOUT SENTARA. SENTARA RMH MEDICAL CENTER OPENED THE SENTARA ROCKINGHAM ORTHOPEDICS CENTER, A NEW BUILDING ON THE HOSPITAL CAMPUS. SRMH COMPLETED THE CONSTRUCTION OF THE NEW HYBRID CARDIAC OPERATING ROOM IN SUPPORT OF THE STRUCTURAL HEART PROGRAM LAUNCH IN 2017. SRMH ALONG WITH CARILION CLINIC BROKE GROUND ON THE FUTURE BRIDGEWATER HEALTH CENTER. THE FACILITY WILL HOUSE SENTARA LAB SERVICES, SENTARA THERAPY SERVICES, AND SENTARA IMAGING SERVICES. CARILION WILL MOVE ITS BRIDGEWATER FAMILY MEDICINE CLINIC TO THIS NEW FACILITY ONCE COMPLETE. ADDITIONALLY, SRMH MEDICAL GROUP OPENED A PRIMARY CARE PRACTICE AT THE SENTARA EAST MARKET STREET HEALTH CENTER. SENTARA RMH MEDICAL GROUP OPENED SENTARA RMH TIMBER WAY HEALTH CENTER AND COMBINED THE OPERATIONS OF PRIMARY CARE CLINICS IN BROADWAY AND TIMBERVILLE IN A NEW STATE OF THE ART FACILITY. C. SENTARA MARTHA JEFFERSON HOSPITAL (SMJH), LOCATED IN CHARLOTTESVILLE, VIRGINIA, IMPLEMENTED SENTARA ECARE AND MYCHART, THE EPIC ELECTRONIC MEDICAL RECORD USED THROUGHOUT SENTARA. SMJH INTRODUCED A NEW HELIPAD IN JULY 2016. THE MEDEVAC SERVICE WILL ALLOW FASTER TRANSPORT TO SMJH FOR CRITICALLY ILL PATIENTS, INCLUDING PATIENTS EXPERIENCING A STROKE OR HEART ATTACK. WITH THE NEW HELIPAD, TRAINED PERSONNEL WILL BE ABLE TO BRING PATIENTS VIA HELICOPTER DIRECTLY TO THE EMERGENCY DEPARTMENT FROM OUTLYING COUNTIES WHERE SERVICES ARE NOT READILY AVAILABLE. ADDITIONALLY, SMJH INTRODUCED NEURO-INTERVENTIONAL RADIOLOGY, WHICH CAN BE USED TO TREAT SEVERE STROKES AND OTHER ACUTE ENDOVASCULAR ISSUES. SMJH LAUNCHED AN ADVANCED ENDOSCOPY PROGRAM THROUGH THE ADDITION OF A HIGHLY SKILLED GASTROENTEROLOGIST, GREATLY EXPANDING THE SERVICES AVAILABLE TO PATIENTS. THE SMJH BARIATRIC CARE CENTER WAS AWARDED FULL ACCREDITATION AS A COMPREHENSIVE BARIATRIC CARE CENTER FROM THE METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM. THROUGH THE SENTARA CANCER NETWORK, SMJH INTRODUCED LOW-DOSE CT LUNG SCREENINGS FOR THE EARLY DETECTION OF LUNG CANCER. FINALLY, SMJH INTRODUCED A NEW WALK-IN SPORTS INJURY CLINIC SPECIALIZING IN SPORTS MEDICINE WITH THE ABILITY TO CARE FOR ATHLETES OF ALL AGES AND ABILITIES. D. HAMPTON ROADS (SOUTHEASTERN VIRGINIA): I. SENTARA HEART AT SENTARA PRINCESS ANNE HOSPITAL, LOCATED IN VIRGINIA BEACH, VIRGINIA, LAUNCHED THE DR. DEAN ORNISH HEART REVERSAL PROGRAM FOR CARDIAC DISEASE PATIENTS. THIS PROGRAM HAS BEEN CLINICALLY SHOWN TO REVERSE THE EFFECTS OF HEART DISEASE. SENTARA PRINCESS ANNE HOSPITAL IS THE FIRST TO OFFER THIS PROGRAM IN VIRGINIA. SENTARA PRINCESS ANNE HOSPITAL RECEIVED CERTIFICATE OF PUBLIC NEED (COPN) APPROVAL FOR 14 ADDITIONAL INPATIENT BEDS BRINGING THE INPATIENT BED COUNT TO 174 FROM THE ORIGINAL 160 BEDS WHEN IT OPENED IN 2011. TEN OBSERVATIONAL BEDS ALSO WILL BE PUT INTO PLACE. SENTARA PRINCESS ANNE HOSPITAL INTRODUCED A NEW SENTARA BACK & NECK CENTER. SENTARA PRINCESS ANNE HOSPITAL WAS AWARDED MAGNET STATUS IN NURSING - THE SIXTH HOSPITAL IN SENTARA TO ACHIEVE THIS DISTINCTION. II. SENTARA VIRGINIA BEACH GENERAL HOSPITAL, LOCATED IN VIRGINIA BEACH, VIRGINIA, OPENED THE SENTARA WOMEN'S HEALTH CENTER, WHICH IS A MULTI-DISCIPLINARY SERVICE FOCUSED ON THE UNIQUE HEALTH NEEDS OF WOMEN OF ALL AGES. THE CENTER IS DEDICATED TO PROVIDING WOMEN WITH SEAMLESS AND CONVENIENT ACCESS TO QUALITY MEDICAL CARE AND A VARIETY OF SPECIALIZED WOMEN'S HEALTHCARE SERVICES. III. SENTARA NORFOLK GENERAL HOSPITAL, LOCATED IN NORFOLK, VIRGINIA, KICKED OFF THE $199M, 5 YEAR EXPANSION AND MODERNIZATION PROJECT TO BRING FACILITIES UP TO MODERN STANDARDS AND ENHANCE THE OFFERINGS OF THIS MID-ATLANTIC MEDICAL DESTINATION CENTER. THE PROJECT WILL ADD THREE FLOORS, EXPAND THE EMERGENCY DEPARTMENT, EXPAND AND MODERNIZE 18 OPERATING ROOMS, REPLACE A 48 BED WARD STYLE SPECIAL CARE NURSERY WITH A STATE OF THE ART UNIT AND CONSOLIDATE THE HOSPITAL'S 54 ICU BEDS ON TWO FLOORS. SENTARA NORFOLK GENERAL HOSPITAL INTRODUCED A NEW SENTARA BACK & NECK CENTER. IV. SENTARA LEIGH HOSPITAL, LOCATED IN NORFOLK, VIRGINIA, COMPLETED ITS MULTI - YEAR CONSTRUCTION PROJECT RESULTING IN THE RENOVATION OF THE SURGERY RELATED DEPARTMENTS, EXPANDING THE EMERGENCY DEPARTMENT TO 34 BEDS FROM 21, AND TWO NEW FIVE-STORY PATIENT TOWERS. V. SENTARA OBICI HOSPITAL, LOCATED IN SUFFOLK, VIRGINIA, RECEIVED CERTIFICATE OF PUBLIC NEED (COPN) APPROVAL FOR STEREOTACTIC RADIOSURGERY, WHICH IS A MINIMALLY INVASIVE FORM OF RADIATION ONCOLOGY THAT USES A THREE-DIMENSIONAL COORDINATES SYSTEM TO LOCATE SMALL TARGETS INSIDE THE BODY. IMPLEMENTATION WILL TAKE PLACE IN QUARTER 2, 2017. VI. SENTARA CAREPLEX HOSPITAL, LOCATED IN HAMPTON, VIRGINIA, RECEIVED CERTIFICATE OF PUBLIC NEED (COPN) APPROVAL TO INTRODUCE OBSTETRIC SERVICES. ORTHOPEDIC HOSPITAL AT SENTARA CAREPLEX, LOCATED IN HAMPTON, VIRGINIA, INTRODUCED THE SENTARA BACK & NECK CENTER. THIS SPECIALIZED PROGRAM BRINGS TOGETHER A TEAM INCLUDING EXPERT SURGEONS WITH CARING AND SPECIALLY TRAINED NURSES, THERAPISTS AND OTHER HEALTH PROFESSIONALS. VII. SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER (SWRMC), LOCATED IN WILLIAMSBURG, VIRGINIA, EXPANDED INPATIENT TELENEUROLOGY SERVICES. ADDITIONALLY, TELEMAGISTRATE SERVICES ARE NOW AVAILABLE AT SWRMC ALLOWING MAGISTRATES TO REMOTELY CONNECT WITH PSYCHIATRIC EVALUATORS TO DETERMINE IF EMERGENCY OR TEMPORARY DETENTION ORDERS SHOULD BE ISSUED FOR PATIENTS. VIII. SENTARA ALBEMARLE MEDICAL CENTER (SAMC), LOCATED IN ELIZABETH CITY, NC, NOW PROVIDES LOW-DOSE CT LUNG SCREENING FOR THE EARLY DETECTION OF LUNG CANCER IN DEFINED POPULATIONS. SAMC BEGAN CONSTRUCTION ON THE $1M ORTHOPEDIC CENTER THAT WILL INCLUDE THE FUTURE SENTARA ORTHOJOINT CENTER, SENTARA SPORTS MEDICINE AND ORTHOPEDIC PHYSICIAN OFFICES. SAMC KICKED OFF ITS EPIC ELECTRONIC MEDICAL RECORD IMPLEMENTATION AND EXPECTS TO LAUNCH SENTARA ECARE AND MYCHART IN OCTOBER, 2017. SAMC LAUNCHED THE "MEDS TO BEDS" PROGRAM, WHICH FULFILLS MEDICATION PRESCRIPTIONS TO PATIENTS BEFORE THEY LEAVE THE HOSPITAL. THIS WILL ENHANCE MEDICATION COMPLIANCE WITH THE AIM OF ASSURING A STRONG RECOVERY AND REDUCING THE OPPORTUNITY FOR READMISSION. IX. SENTARA LAUNCHED THE SENTARA REGIONAL TRANSFER CENTER, WHICH IS A CENTRALIZED RESOURCE DEVELOPED TO FACILITATE TRANSFERS OF APPROPRIATE PATIENTS FOLLOWING THE PRINCIPLE OF RIGHT PLACE, RIGHT TIME, RIGHT LEVEL OF CARE TO PARTICIPATING SENTARA HOSPITALS WITHIN HAMPTON ROADS (SOUTHEASTERN VIRGINIA.) THE CENTER SERVICES 8 SENTARA HOSPITALS AND 3 SENTARA OUTPATIENT EMERGENCY DEPARTMENTS. FORM 990, PART III, LINE 4A E. SOUTH BOSTON/HALIFAX: SENTARA HALIFAX REGIONAL HOSPITAL, LOCATED IN SOUTH BOSTON, VIRGINIA, OPENED THE 10TH SENTARA ORTHOJOINT CENTER IN THE SENTARA SYSTEM. SENTARA CLARKSVILLE FAMILY MEDICINE EXPANDED THEIR PRACTICE TO BETTER SERVE THE RESIDENTS OF MECKLENBURG COUNTY. THIS EXPANSION ALLOWS FOR GROWTH OF THE EXISTING PRIMARY CARE PRACTICE AS WELL AS FOR SPECIALISTS TO COME TO THE PRACTICE AND PROVIDE APPOINTMENTS TO MECKLENBURG COUNTY RESIDENTS IN A MORE CONVENIENT LOCATION. SENTARA HALIFAX PEDIATRICS IS THE FIRST PRACTICE IN SENTARA TO INTRODUCE "BABY BOX", A STARTER KIT FOR NEW BABIES WITH THE AIM OF REDUCING INFANT MORTALITY THROUGH THE PROVISION OF INFANT CARE ITEMS AND WITH EDUCATION OF PROPER SLEEP PRACTICES. F. SENTARA ENTERPRISES: SENTARA HOME CARE SERVICES OF ALLEGHANY, VIRGINIA AND ELIZABETH CITY, NC, WERE EACH NAMED AS A TOP AGENCY OF THE 2016 HOME CARE ELITE. THIS AWARD RECOGNIZES THE TOP-PERFORMING HOME HEALTH AGENCIES IN THE UNITED STATES. SENTARA HOME CARE SERVICES INTRODUCED PITCH (PROMOTING INDEPENDENCE THROUGH CARE AT HOME) TO REDUCE READMISSIONS IN THE HOME HEALTH POPULATION. SENTARA ENTERPRISES SUCCESSFULLY DESIGNED, BUILT AND HIRED STAFF TO OPEN "PROPRIUM PHARMACY", THE SENTARA SPECIALTY PHARMACY. THIS SPECIALTY PHARMACY WILL ENHANCE CARE COORDINATION AND REDUCE COSTS FOR THESE HIGH COST, COMPLEX DRUGS THAT MAY REQUIRE UNIQUE ADMINISTRATION. G.SENTARA LIFE CARE: SENTARA LIFE CARE IS COMPRISED OF ASSISTED LIVING CENTERS, NURSING HOMES, MOBILE MEALS AND THE PROGRAM FOR THE ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE). IN 2016, SENTARA LIFE CARE CELEBRATED THE 20TH ANNIVERSARY OF PACE. PACE IS A COMPREHENSIVE HEALTH CARE AND SUPPORTIVE SERVICES PROGRAM FOR FRAIL SENIORS WHO WISH TO REMAIN IN THEIR HOMES AND COMMUNITY. THE PROGRAM IS ONE THAT PROVIDES TOTAL CARE FOR PARTICIPANTS, INCLUDING COMPREHENSIVE MEDICAL AND REHABILITATIVE SERVICES, IN-HOME SERVICES AND TRANSPORTATION. SENTARA PACE IS OFFERED IN NORFOLK, VIRGINIA BEACH, CHESAPEAKE, SUFFOLK AND PORTSMOUTH. SENTARA LIFE CARE ACHIEVED NICHE (NURSING IMPROVING CARE FOR HEALTHSYSTEM ELDERS) CERTIFICATION. H. SENTARA MEDICAL GROUP (900+ PROVIDERS IN VIRGINIA AND NORTHEASTERN NORTH CAROLINA): I. EASE OF PATIENT ACCESS AND GROWING OUR SERVICES ARE MAJOR AREAS OF FOCUS FOR SENTARA MEDICAL GROUP (SMG). SMG LAUNCHED AN IMPROVED PRIMARY CARE ONLINE SCHEDULING TOOL FOR NEW PATIENTS VIA WWW.SENTARA.COM. THIS ENHANCED ACCESS POINT GIVES CONSUMERS DIRECT LINE OF SITE TO AVAILABLE APPOINTMENT TIMES AND LOCATIONS. IN THE SPIRIT OF TRANSPARENCY AND GIVING THE CUSTOMER WHAT THEY ARE ASKING FOR, SMG NOW POSTS PROVIDER REVIEWS ONLINE VIA WWW.SENTARA.COM. THESE STAR RATINGS ARE THE RESULT OF SURVEYS TAKEN BY PATIENTS SEEN IN THE OFFICE BY A PROVIDER. IX. QUALITY AND PATIENT SAFETY DISTINCTIONS 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 2016 AWARDS AND RECOGNITIONS: I. FOR THE 16TH CONSECUTIVE YEAR, THE CARDIOLOGY AND HEART SURGERY PROGRAM AT SENTARA NORFOLK GENERAL HOSPITAL (SENTARA HEART HOSPITAL) WAS LISTED AMONG THE TOP 50 HEART PROGRAMS IN THE U.S. NEWS & WORLD REPORT 'BEST HOSPITALS' EDITION AND IMPROVED ITS RANKING FROM 41ST IN 2014 TO 31ST IN 2015 TO #24 IN 2016. DIABETES AND ENDOCRINOLOGY AT SENTARA NORFOLK GENERAL HOSPITAL, A SPECIALTY AT EASTERN VIRGINIA MEDICAL SCHOOL, IS RANKED #24. II. SENTARA LEIGH HOSPITAL WAS NAMED BY BECKER'S HOSPITAL REVIEW AS ONE OF ITS "100 HOSPITALS WITH GREAT ORTHOPEDIC PROGRAMS" FOR 2016. THE LIST HIGHLIGHTS NATIONALLY LEADING PROGRAMS IN ORTHOPEDIC CARE AND THE ORGANIZATIONS INCLUDED HAVE RECEIVED RECOGNITION FOR EXCELLENCE FROM VARIOUS PUBLICATIONS, INDUSTRY-LEADING ORGANIZATIONS AND ACCREDITING ORGANIZATIONS. III. SENTARA HALIFAX REGIONAL HOSPITAL (SHRH) IS ONE OF SEVEN HOSPITALS IN VIRGINIA AND MARYLAND TO RECEIVE THE VHQC'S 2015 QUALITY INNOVATION AWARD. VHQC IS A NONPROFIT HEALTH QUALITY CONSULTING COMPANY THAT STUDIES HOSPITAL PERFORMANCE. THE AWARD RECOGNIZES HOSPITALS THAT ARE ACHIEVING REDUCTIONS IN HOSPITAL-ACQUIRED INFECTIONS (HAIS) AND CREATING A CULTURE OF PATIENT SAFETY. ALL HOSPITALS CONSIDERED FOR THIS AWARD WERE ENROLLED IN THE VHQC MARYLAND-VIRGINIA HAI IMPROVEMENT NETWORK AND WERE ELIGIBLE BASED ON THEIR PERFORMANCE IN 2015. IV. SENTARA HEALTHCARE WAS THE FIRST HEALTH CARE SYSTEM IN THE U.S. TO RECEIVE MULTI-SITE CERTIFICATION IN THE ISO 9001 QUALITY MANAGEMENT SYSTEM FROM OUR ACCREDITING BODY, DNV-GL. THE CERTIFICATION VALIDATES SENTARA PROCESSES AND PROMOTES ACCOUNTABILITY. IT REFLECTS OUR FOCUS ON THE PATIENTS AND OUR COMMITMENT TO REDUCE VARIABILITY AND INCREASE CONSISTENCY THROUGH RAPID DEPLOYMENT OF BEST PRACTICES ACROSS THE SYSTEM. V. SENTARA ALBEMARLE MEDICAL CENTER (SAMC) WAS SELECTED AS ONE OF THE 2016 TOP 100 RURAL & COMMUNITY HOSPITALS. THE SELECTION OF HOSPITALS IS BASED ON IVANTAGE'S HOSPITAL STRENGTH INDEX(R) - AN ANALYSIS OF MORE THAN 70 DIFFERENT PERFORMANCE MEASURES INCLUDING QUALITY, OUTCOMES, PATIENT PERSPECTIVE, AFFORDABILITY, POPULATION RISK AND EFFICIENCY. DATA USED IN THE ANALYSIS IS GATHERED FROM PUBLICALLY AVAILABLE SOURCES, WHICH IS USED TO COMPARE THE PERFORMANCE OF HOSPITALS NATIONWIDE. THE RESULTS DEMONSTRATE THE HARD WORK OF THE SAMC PROVIDERS AND STAFF TO DELIVER A CRITICAL SERVICE OF QUALITY HEALTHCARE TO THE COMMUNITIES THEY SERVE. VI. THE RESPECTED PEER-REVIEWED JOURNAL MEDICAL LABORATORY OBSERVER NAMED SENTARA LAB SERVICES 'LAB OF THE YEAR' FOR 2016. THE SENTARA LAB SERVICES (SLS) TEAM OFFERED A COMPELLING NOMINATION COVERING SIX REQUIRED CATEGORIES: CUSTOMER SERVICE, PRODUCTIVITY, TEAMWORK, EDUCATION AND TRAINING, STRATEGIC OUTLOOK AND INSPECTION RESULTS. WHILE MANY LAB TESTS ARE PERFORMED FOR HOSPITAL INPATIENTS, THERE IS ALSO SIGNIFICANT USE OF LABS BY OUTPATIENTS. VII. EIGHT SENTARA HOSPITALS EARNED THE HIGHEST GRADE OF "A" FOR DELIVERING SAFE CARE FOR PATIENTS ACCORDING TO THE LEAPFROG HOSPITAL SAFETY SCORE (2016) INCLUDING: SENTARA CAREPLEX HOSPITAL, SENTARA LEIGH HOSPITAL, SENTARA MARTHA JEFFERSON HOSPITAL, SENTARA NORFOLK GENERAL HOSPITAL, SENTARA OBICI HOSPITAL, SENTARA PRINCESS ANNE HOSPITAL, SENTARA VIRGINIA BEACH GENERAL HOSPITAL, SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER. VIII. THE PRESTIGIOUS TRUVEN HEALTH 100 TOP HOSPITALS ANNUAL AWARDS PROGRAM HAS NAMED SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER AS ONE OF THE HIGHEST-PERFORMING HOSPITALS IN THE NATION. USING INDEPENDENT PUBLIC DATA AND PROPRIETARY ANALYTICS, THE 100 TOP HOSPITALS STUDY RECOGNIZES HOSPITALS THAT HAVE CLEARLY DEMONSTRATED THE VISION TO DEVELOP LONG-TERM EXCELLENCE IN CARE, EFFICIENCY, AND COMMUNITY VALUE. AS A 2016 AWARD WINNER, OUR LEADERSHIP TEAM, MEDICAL STAFF, AND EMPLOYEES - TOGETHER AS A TEAM - HAVE MET NATIONAL BENCHMARKS FOR THE HIGHEST-BALANCED PERFORMANCE IN THE U.S. IX. OPTIMA HEALTH WAS VERY PLEASED TO HAVE RECEIVED AN OVERALL STAR RATING OF 4.5 OUT OF 5 FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) FOR ITS 2017 MEDICARE ADVANTAGE PLAN AND PRESCRIPTION DRUG PLAN KNOW AS OPTIMA MEDICARE. ADDITIONALLY, OPTIMA MEDICARE WAS ALSO LISTED IN THE U.S. NEWS BEST MEDICARE ADVANTAGE PLANS 2017. B. SENTARA PRINCESS ANNE HOSPITAL BECAME THE LATEST HOSPITAL WITHIN THE SENTARA FAMILY TO EARN THE NURSING MAGNET DESIGNATION FROM THE AMERICAN NURSES CREDENTIALING CENTER. MAGNET SPEAKS TO A SUPPORTIVE WORKING ENVIRONMENT FOR NURSES AND SUPERIOR CLINICAL CARE BASED ON STRICT CRITERIA THAT MAGNET HOSPITALS MUST MEET. X. OPTIMA HEALTH PROGRAM AND PRODUCT DEVELOPMENT: THROUGH AN EXTENSIVE COMMONWEALTH OF VIRGINIA RFP PROCESS OPTIMA HEALTH WAS AWARDED PARTICIPATION IN VIRGINIA'S NEW MLTSS (MANAGED LONG TERM SERVICES AND SUPPORT) INITIATIVE, ONE OF SEVEN HEALTH PLANS SELECTED TO SERVE SIX REGIONS THROUGHOUT THE STATE OF VIRGINIA. LAUNCH IS SLATED FOR AUGUST 1, 2017 IN THE TIDEWATER REGION WITH THE REMAINING 5 REGIONS TO FOLLOW. SENTARA ADVANTEDGE, A PROGRAM THAT ESTABLISHED STRATEGIC HEALTH PLAN PARTNERSHIPS OUTSIDE OF VIRGINIA, CONTINUED TO SERVE AS THE THIRD PARTY ADMINISTRATOR (TPA) FOR OHIO HEALTH EMPLOYEES, WITH TOTAL MEMBERSHIP GROWING BY ABOUT 2,000 FROM 2015 TO 2016. OPTIMA MEDICARE INTRODUCED A $0 PREMIUM OPTION AND ADDED BENEFIT ENHANCEMENTS COMPETITIVE WITH OTHERS IN THE MARKET. XI. CONCLUSION: SENTARA HEALTHCARE IS COMMITTED TO IMPROVING HEALTH EVERY DAY. WE DO SO BY PROVIDING QUALITY CARE THROUGH EXPERT PROVIDERS, USING CUTTING-EDGE TECHNOLOGY, DEPLOYING MEDICAL BREAKTHROUGHS, AND PROVIDING EXCELLENT CUSTOMER SERVICE - ALL WITH A CONSTANT FOCUS ON INNOVATION. WE LOOK FORWARD TO ANOTHER YEAR OF GROWTH AND INNOVATION IN 2017. FORM 990, PART V, LINE 1A: FORM 1096 THE ORGANIZATION IS THE 501(C)(3) SOLE MEMBER OR SHAREHOLDER OF SEVERAL OTHER ORGANIZATIONS FOR WHICH IT MAINTAINS AGENCY RELATIONSHIPS AND ISSUES 1099S. THE NUMBER REPORTED IS A BEST ESTIMATE OF THE 1099S ATTRIBUTABLE TO THE ORGANIZATION. THE EXACT NUMBER CANNOT BE DETERMINED; AS SOME OF THE 1099S ISSUED BY THE ORGANIZATION ARE ATTRIBUTABLE TO MORE THAN ONE ENTITY, AND THERE IS NO REPORTING MECHANISM TO DETERMINE 1099S ATTRIBUTABLE SOLELY TO THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS OR FAMILY RELATIONSHIP OF OFFICERS, DIRECTORS: THE ORGANIZATION'S OFFICERS AND DIRECTORS SERVED TOGETHER ON THE BOARDS OF OTHER ORGANIZATIONS WITHIN THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM"), AS WELL AS JOINT VENTURES IN WHICH THE SYSTEM HAD AN OWNERSHIP INTEREST. SEE SCHEDULE R FOR A LISTING OF SUCH ENTITIES. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE SEPTEMBER 26, 2016, THE ORGANIZATION'S BYLAWS WERE AMENDED AS FOLLOWS: A. OFFICERS - REVISED TO PROVIDE THAT THE GOVERNANCE COMMITTEE RECOMMENDS AND THE BOARD APPOINTS THE CEO, BOARD CHAIR, VICE-CHAIR AND SECRETARY, AND TO SPECIFY THAT THE CEO APPOINTS THE COO AND CFO. DELETES REFERENCES TO "PRESIDENT." (ARTICLE III, SECTIONS 1 AND 3, AND ARTICLE IV, SECTIONS 3 AND 5.) REFINES LANGUAGE REGARDING EACH OFFICER'S AUTHORITY TO SIGN OR COUNTERSIGN "INSTRUMENTS" OF THE CORPORATION THAT MAY REQUIRE HIS OR HER SIGNATURE. (ARTICLE III, SECTION 3.) B. QUORUMS - REVISED SO THAT A QUORUM FOR A BOARD MEETING IS ESTABLISHED IF A MAJORITY OF THE DIRECTORS ARE PRESENT, AS MEASURED AT THE TIME OF THE BOARD MEETING. (ARTICLE II, SECTION 4.E. ) C. "MAJORITY OF THE BOARD OF DIRECTORS"- DEFINES "MAJORITY OF THE BOARD OF DIRECTORS" TO MEAN SIMPLY AT LEAST A MAJORITY OF THE DIRECTORS THEN CURRENTLY ON THE BOARD. (ARTICLE II, SECTION 2, AND ARTICLE VIII.) D. REMOVAL OF DIRECTOR - LANGUAGE REGARDING REPLACEMENT OF A DIRECTOR WHO IS REMOVED BEING PERMISSIVE INSTEAD OF MANDATORY. (ARTICLE II, SECTION 4.F.) E. ACTION WITHOUT A MEETING - ADDS EXPRESS AUTHORIZATION FOR BOARD ACTION TO BE TAKEN BY UNANIMOUS WRITTEN CONSENT. (ARTICLE II, SECTION 6.) FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS THE ORGANIZATION USED ITS OWN IN-HOUSE TAX DEPARTMENT, HEADED BY A LICENSED CERTIFIED PUBLIC ACCOUNTANT, TO BOTH PREPARE AND REVIEW ITS FORM 990. DURING THE PREPARATION AND REVIEW PROCESS, THE TAX DEPARTMENT WORKED CLOSELY WITH OTHER DEPARTMENTS, SUCH AS LEGAL, COMPENSATION AND BENEFITS, COMPLIANCE, FINANCE, AND MARKETING, TO ENSURE THAT A COMPLETE AND ACCURATE RETURN WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS: DIRECTORS, BOARD-NOMINATED OFFICERS, AND KEY EMPLOYEES SUBMIT AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE AND CERTIFY TO THE COMPLETION AND ACCURACY OF THE INFORMATION DISCLOSED. THE ORGANIZATION'S GOVERNING BOARD OR APPROPRIATE COMMITTEE MONITORS TRANSACTIONS INVOLVING DISCLOSED POTENTIAL CONFLICTS OF INTEREST, TO ENSURE THAT THEY ARE REASONABLE AND AT ARM'S LENGTH. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION FOLLOWED PROCESSES AND PROCEDURES SET FORTH IN ITS GOVERNING DOCUMENTS TO ENSURE COMPLIANCE WITH ITS OBLIGATIONS AS A 501(C)(3) HEALTHCARE ORGANIZATION TO PAY DISQUALIFIED PERSONS REASONABLE COMPENSATION. SUCH PROCESSES AND PROCEDURES ARE INTENDED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERNAL REVENUE CODE SECTION 4958 REGULATIONS. THE COMPENSATION PHILOSOPHY OF THE ORGANIZATION IS TO BASE OVERALL COMPENSATION AND BENEFITS FOR EXECUTIVES ON NOT-FOR-PROFIT MARKET COMPARABLES, ADJUSTED AS APPLIED TO EACH EXECUTIVE, TAKING INTO CONSIDERATION THE INDIVIDUAL SKILLS, EXPERIENCE, TENURE AND PERFORMANCE OF THE EXECUTIVE BEING COMPENSATED AND OVERALL PERFORMANCE OF THE ORGANIZATION. IN LINE WITH THIS PHILOSOPHY, THE ORGANIZATION PERFORMED SUBSTANTIAL DUE DILIGENCE AS TO MARKET COMPARABLES. THE COMPENSATION COMMITTEE, WHICH CONSISTS OF BOARD MEMBERS WITHOUT CONFLICTS OF INTERESTS, ENGAGED AN OUTSIDE CONSULTANT, WHO REPORTS TO THE COMPENSATION COMMITTEE, TO CONDUCT A STUDY ASSESSING THE COMPETITIVENESS OF TOTAL COMPENSATION (INCLUDING CASH COMPENSATION, BENEFITS AND PERQUISITES) OF ITS SENIOR EXECUTIVES PRIOR TO MAKING DECISIONS REGARDING ANNUAL BASE SALARY ADJUSTMENTS, APPROVING INCENTIVE AWARDS, OR CONSIDERING PROGRAMMATIC CHANGES. THE STUDY COMPARED THE COMPENSATION OF THE ORGANIZATION'S SENIOR EXECUTIVES TO COMPENSATION DATA FROM MULTIPLE PUBLISHED SURVEY SOURCES BASED ON THE SENIOR EXECUTIVE'S FUNCTIONAL RESPONSIBILITY. IN CONDUCTING THE STUDY, THE CONSULTANT TARGETED OTHER NOT-FOR-PROFIT HEALTH SYSTEMS OF SIMILAR SIZE BASED ON NET REVENUE AND COMPLEXITY. FOR HEALTH PLAN POSITIONS, HEALTH PLANS WITH SIMILAR PREMIUMS, OR MEMBERS, WERE TARGETED. THE CONSULTANT ALSO CONDUCTS A REVIEW OF THE ORGANIZATION'S PERFORMANCE RELATIVE TO A GROUP OF NOT-FOR-PROFIT HEALTH SYSTEMS OF COMPARABLE SIZE AND SCOPE OF OPERATIONS EVERY YEAR. THE MOST RECENT STUDY COMPARED SENTARA'S PERFORMANCE TO 31 NOT-FOR-PROFIT HEALTHCARE SYSTEMS BASED ON NET REVENUE GROWTH, OPERATING MARGIN, VARIOUS CLINICAL QUALITY METRICS AND PATIENT SATISFACTION. OVERALL, THE CONSULTANT DETERMINED THAT SENTARA'S PAY WAS ALIGNED WITH ITS RELATIVE PERFORMANCE. THE COMPENSATION STUDY WAS PRESENTED TO THE ORGANIZATION'S COMPENSATION COMMITTEE, WHICH MADE ITS COMPENSATION DECISIONS BASED ON A)ITS REVIEW AND ANALYSIS OF THE PERFORMANCE OF BOTH THE ORGANIZATION AND ITS SENIOR EXECUTIVES AND, B) A REASONABLENESS OF COMPENSATION ANALYSIS AND OPINION FROM AN EXTERNAL EXPERT IN THE COMPENSATION OF EXECUTIVES IN THE TAX-EXEMPT HEALTH CARE FIELD. THE COMMITTEE'S BASES FOR ITS DECISIONS WERE DOCUMENTED IN COMMITTEE MINUTES TAKEN DURING THE MEETING AND THEN CIRCULATED FOR REVIEW AND APPROVAL. ALL DECISIONS REGARDING COMPENSATION WERE MADE BY THE COMMITTEE, WHICH CONSISTS OF BOARD MEMBERS WITHOUT CONFLICT OF INTERESTS. THIS PROCESS WAS USED TO ESTABLISH COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND CEO, SENIOR VICE PRESIDENT AND COO, SENIOR VICE PRESIDENT AND CFO, AND OTHER SENIOR AND CORPORATE VICE PRESIDENTS. THE PROCESS WAS LAST UNDERTAKEN DURING THE CURRENT TAX YEAR FOR ALL POSITIONS LISTED. FORM 990, PART VI, SECTION C, LINE 19 PROVISION OF GOVERNING DOCS, COI POLICY AND FINANCIALS TO PUBLIC: THE CONSOLIDATED FINANCIAL STATEMENTS FOR SENTARA HEALTHCARE AND SUBSIDIARIES WERE MADE PUBLICLY AVAILABLE THROUGH THE USE OF DAC BOND (DISCLOSURE DISSEMINATION AGENT) AND CAN BE FOUND ON THE INTERNET AT WWW.DACBOND.COM. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CAPITAL CONTRIBUTIONS TO SUBSIDIARY -23,850,290. CHANGE IN FUNDED STATUS OF PENSION LIABILITY -32,824,937. PARTNERSHIP INCOME TAX > BOOK -676,929. BOOK RECLASS OF INTERCOMPANY ACCTS TO EQUITY 116,407,512. SUBPART F LOSS NOT ON BOOKS -1,266,610. DEEMED DISTRIBUTION FROM CFC -8,326,805. PENSION LIABILITY FROM AFFILIATE -4,337,603. 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THE DAILY TRANSFERS OF CASH, WHICH RESULT FROM THIS CONSOLIDATED CASH ARRANGEMENT, HAVE NOT BEEN REPORTED ON SCHEDULE R PART V.