2016-04-12T17:11:11-05:00 2014-09-30 560574444 CHERRY BEKAERT LLP 828 MAIN ST STE 1701 LYNCHBURG VA 24504 990 2013-10-01 540505955 SHELTERING ARMS HOSPITAL SHEL 8043424340 8254 ATLEE ROAD MECHANICSVILLE VA 23116 MICHAEL E DACUS TREASURER 8043424340 2016-03-24 1 SAMUEL JOHNSON P00019699 4348476643 2013 2016-08-17 19:52:53Z X MICHAEL E DACUS 8254 ATLEE ROAD MECHANICSVILLE VA 23116 59931510 0 X WWW.SHELTERINGARMS.COM X 1941 VA TO PROVIDE COMPREHENSIVE PHYSICAL REHABILIATION 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. 19 19 757 19 0 -152204 9950677 14413853 41914846 44658615 -1268 29689 595647 224919 52459902 59327076 246763 203092 0 0 23815906 23924932 0 0 331881 31386455 35334477 55449124 59462501 -2989222 -135425 18332170 18741881 3416475 3993097 14915695 14748784 X THE MISSION OF SHELTERING ARMS HOSPITAL IS 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 1 54296652 44431308 INPATIENT PHYSICAL REHABILITATION SERVICES:SHELTERING ARMS HOSPITAL OPERATES A 40 BED ACUTE PHYSICAL REHABILITATION INPATIENT HOSPITAL IN MECHANICSVILLE, VIRGINIA. THE PRIMARY SERVICE AREA IS CENTRAL VIRGINIA ALTHOUGH PATIENTS ARE ADMITTED FROM VIRGINIA AND SURROUNDING STATES. DURING FISCAL YEAR 2014, 894 PATIENTS WERE ADMITTED RESULTING IN 13,087 PATIENT DAYS.OUTPATIENT PHYSICAL REHABILITATION SERVICES:SHELTERING ARMS HOSPITAL PROVIDES OUTPATIENT PHYSICAL REHABILITATION SERVICES AT THE HOSPITAL CAMPUS AND NINE ADDITIONAL LOCATIONS IN THE RICHMOND AREA. THE OUTPATIENT CONTINUUM OF SERVICES INCLUDES ORTHOPEDIC REHABILITATION SERVICES, NEUROLOGICAL REHABILITATION SERVICES, PHYSICIANS' REHABILITATION SERVICES, AND OUTPATIENT REHABILITATION THERAPIES. DURING FISCAL YEAR 2014, SHELTERING ARMS HOSPITAL PROVIDED OUTPATIENT THERAPY SERVICES RESULTING IN 73,710 THERAPY VISITS. FOR FISCAL YEAR 2014, PHYSICIAN AND PSYCHOLOGY SERVICES RESULTED IN 32,324 PATIENT VISITS. 1699096 449455 PARTNER FOR L.I.F.E.: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. SHELTERING ARMS 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 SHELTERING ARMS COMMITMENT DOES NOT END WHEN THERAPY OR PHYSICIAN SERVICES ARE COMPLETE. SHELTERING ARMS 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 L.I.F.E. PROGRAM (LEISURE, INTERACTION, FITNESS, AND ENJOYMENT), EMPOWERING INDIVIDUALS TO EMBRACE A LIFETIME OF RECREATION AND WELLNESS. OUR UNIQUE PROGRAMMING 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 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, AND OUR CLUB REC PROGRAM.CLUB REC IS A NON MEDICALLY BASED SOCIAL, RECREATION PROGRAM PROVIDING OPPORTUNITIES FOR FITNESS, WELLNESS, SOCIALIZATION, AND COMMUNITY REINTEGRATION FOR MEMBERS FIVE DAYS PER WEEK. CERTIFIED THERAPEUTIC RECREATION AND FITNESS SPECIALISTS ORGANIZE DAILY PROGRAMS, COMMUNITY OUTINGS, GROUP AND INDIVIDUAL EXERCISE SESSIONS, SOCIAL PROGRAMS, COGNITIVE ACTIVITIES, ADAPTIVE LEISURE ACTIVITIES, EDUCATIONAL PROGRAMS, AND AN ARRAY OF WEEKLY LEISURE ACTIVITIES. 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, INTERGENERATIONAL PROGRAMS, COMMUNITY SERVICES OPPORTUNITIES, AS WELL AS A COMMUNITY OUTINGS. IN FY 2014 CLUB REC ENJOYED 7,450 VISITS FROM INDIVIDUALS WITH DISABILITIES.PARTNER FOR L.I.F.E. SPECIAL EVENT PROGRAMS (INCLUDING ADAPTIVE GOLF & ADAPTIVE BOWLING LEAGUE) PROVIDE OPPORTUNITIES FOR INDIVIDUALS WITH DISABILITIES TO PARTICIPATE IN ORGANIZED RECREATION ACTIVITIES WITH THE SUPPORT OF RECREATIONAL THERAPISTS, AND NECESSARY ADAPTIVE RECREATION EQUIPMENT, TO ENSURE SUCCESSFUL PARTICIPATION REGARDLESS OF THEIR PHYSICAL LIMITATIONS. EDUCATIONAL SESSIONS ON WELLNESS AND LEARNING TO LIVE LIFE AFTER A DISABILITY ARE ORGANIZED AND OFFERED TO THE COMMUNITY. IN FISCAL YEAR 2014 THERE WERE 35 EVENTS TOTALING 491 PARTICIPANTS.IN ADDITION TO RECREATION EVENTS, PARTNER FOR L.I.F.E. SERVICES BELIEVE IN 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 TWO WARM WATER THERAPEUTIC POOLS AND FITNESS CENTERS OFFERING POOL AND FITNESS MEMBERSHIPS, AQUATIC AND LAND GROUP EXERCISE CLASSES, AND PERSONAL TRAINING SERVICES TO THE COMMUNITY. ONE 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 THE INPATIENT HOSPITAL AND OUTPATIENT THERAPY CLINICS THE OPPORTUNITY TO CONTINUE TO ENGAGE IN PHYSICAL ACTIVITY. FITNESS SPECIALISTS WORK WITH INDIVIDUASL PROVIDING PERSONALIZED ATTENTION TO THE MEMBERS, AS WELL AS PERSONAL TRAINING SERVICES FOR THOSE WHO ARE INTERESTEED IN INDIVIDUALIZED GOAL SETTING AND EXERCISE POGRAMS DESIGNED TO MEET THEIR NEEDS. DURING FISCAL YEAR 2014 THERE WERE 29,940 VISITS TO THE POOLS AND FITNESS CENTERS. SHELTERING ARMS LEAD 1,551 GROUP EXERCISE CLASSES TOTALING 6,706 PARTICPANTS. FITNESS SPECIALISTS CONDUCTED 3,634 NEUROFIT, PERSONAL TRAINING UTILIZING ADVANCED TECHNOLOGIES FOR THE NEUROGLOGICALLY IMPAIRED, AND PERSONAL TRAINING SESSIONS TO THE COMMUNITY. 1535492 203092 CHARITY CARE AND COMMUNITY SUPPORT:SHELTERING ARMS HOSPITAL ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND PROVIDES FINANCIAL ASSISTANCE FOR MEDICAL BILLS TO QUALIFIED PATIENTS LACKING ADEQUATE FINANCIAL RESOURCES. FINANCIAL ASSISTANCE IS ALSO OFFERED FOR THE PARTNERS FOR LIFE PROGRAM. DURING FISCAL YEAR 2014, CHARITY CARE AND/OR FINANCIAL ASSISTANCE RESULTED IN TOTAL DISCOUNTED CHARGES FOREGONE BY SHELTERING ARMS HOSPITAL OF $1,027,604. IN FISCAL YEAR 2014, SHELTERING ARMS ALSO TRANSPORTED PATIENTS PARTICIPATING IN PATIENT THERAPY SERVICES AT AN UNREIMBURSED COST OF $681. SHELTERING ARMS ALSO PROVIDED FREE MOBILITY AND THERAPY EQUIPMENT AND PHARMACY ASSISTANCE TO THOSE PATIENTS WHO QUALIFIED, FOR USE DURING THEIR RECOVERY AT HOME. THE COST OF PROVIDING THIS ASSISTANCE WAS $31,045. IN ADDITION, SHELTERING ARMS HOSPITAL CONTRIBUTED $172,047 TO SUPPORT OTHER COMMUNITY ORGANIZATIONS AND EVENTS. 57531240 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 94 0 1 757 1 1 1 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 VA X MICHAEL E DACUS VP OF FINANCE AND CFO 8043424340 8254 ATLEE RD MECHANICSVILLE VA 23116 X TERESA REYNOLDS DIMARCO DIRECTOR 1.00 3.00 X 0 0 0 HOLLY ANTRIM DIRECTOR 1.00 3.00 X 0 0 0 WILLIAM T CLARKE JR DIRECTOR 1.00 3.00 X 0 0 0 BARBARA H DUNN DIRECTOR 1.00 3.00 X 0 0 0 WILLIAM E HARDY DIRECTOR 1.00 3.00 X 0 0 0 SUSAN J RAWLES DIRECTOR 1.00 3.00 X 0 0 0 JAMES A SLABAUGH SR DIRECTOR 1.00 3.00 X 0 0 0 KATHRYN M BARLEY DIRECTOR 1.00 3.00 X 0 0 0 ANNE H BENNETT DIRECTOR 1.00 3.00 X 0 0 0 PETER BOWLES DIRECTOR 1.00 3.00 X 0 0 0 DAVID CONSTINE DIRECTOR 1.00 3.00 X 0 0 0 W BATES CHAPPELL DIRECTOR 1.00 3.00 X 0 0 0 ABRAHAM SEGRES DIRECTOR 1.00 3.00 X 0 0 0 ASHBY R HACKNEY DIRECTOR 1.00 3.00 X 0 0 0 AMES J RUSSELL DIRECTOR 1.00 3.00 X 0 0 0 THEODORE PRICE DIRECTOR 1.00 3.00 X 0 0 0 PATRICIA B CUSHNIE CHAIRMAN 1.00 3.00 X X 0 0 0 J WAVERLY PULLEY III FIRST VICE CHAIRMAN 1.00 3.00 X X 0 0 0 DIANNE V JEWELL SECOND VICE CHAIRMAN 1.00 3.00 X X 0 0 0 JAMES E SOK PRESIDENT/CEO 8.00 32.00 X 596523 0 132699 JAMES A BRAITH SECRETARY/VP OF BUS. DEVELOPMENT 8.00 32.00 X 261871 0 29765 MICHAEL E DACUS VP OF FINANCE & CFO/TREASURER 8.00 32.00 X 304241 0 18878 ELLEN VANCE VP & CHIEF HUMAN RESOURCES OFFICER 10.00 30.00 X 227525 0 28426 CHRISTOPHER P SORENSON VP OF INFORMATION TECHNOLOGY 10.00 30.00 X 213983 0 15479 SANDY EYLER VP & CHIEF NURSING OFFICER 10.00 30.00 X 157011 0 16332 MARY ZWEIFEL VP OPERATIONS 10.00 30.00 X 262109 0 8934 TIMOTHY M SILVER MEDICAL DIRECTOR 0.00 40.00 X 391094 0 28894 HILLARY S HAWKINS MEDICAL DIRECTOR 40.00 0.00 X 404726 0 19907 GREGORY LEGHART PHYSICIAN 40.00 0.00 X 302255 0 29618 CHARLES MATTHEW GIBELLATO PHYSICIAN 40.00 0.00 X 287257 0 26912 ALBERT M JONES PHYSICIAN 40.00 0.00 X 262402 0 25388 MARIA C LITTAUA PHYSICIAN 40.00 0.00 X 238575 0 30987 JOHN E GIBBS II PHYSICIAN 40.00 0.00 X 237226 0 19657 4146798 0 431876 28 0 1 0 MEMORIAL REGIONAL MEDICAL 8260 ATLEE ROAD MECHANICSVILLE VA 23116 HOSPITAL ANCILLARY & SUPPORT 2212766 TROUTMAN SANDERS LLP 1001 HAXALL POINT RICHMOND VA 23219 LEGAL ADVICE 441269 CROTHALL 1500 LIBERTY RIDGE DRIVE STE 210 WAYNE PA 19087 HOUSEKEEPING 392682 INTERACTIVE DATA SYSTEMS 203 BURNING LAMP LANE FOREST VA 24551 SYSTEM MAINTENANCE & SUPPORT 298426 JDA EHEALTH SYSTEMS INC 1415 U DIEHL ROAD STE 200-N NAPERVILLE FL 60563 ACCOUNTS RECEIVABLE CLAIM PROCESSING 233168 35 13384978 1028875 14413853 PATIENT REVENUE 621400 44013913 44013913 THERAPEUTIC RECREATION 621400 644702 644702 44658615 1823 1823 149110 0 149110 149110 119110 30000 42041 14175 27866 27866 27866 563030 590259 -27229 -27229 MISCELLANEOUS 621400 103038 103038 103038 59327076 44880763 0 32460 172047 172047 31045 31045 3118397 2549953 568444 16546506 16546506 1194598 1134868 59730 864783 864783 2200648 2090616 110032 472440 156827 315613 132759 99569 33190 976706 821226 6344 149136 628078 619660 5942 2476 404276 404276 1017245 875067 142178 2697026 2519311 566 177149 98467 89171 6426 2870 182646 134634 48012 6733049 6733049 1883889 1624433 259456 231717 207381 24086 250 CONTRACTUAL ADJUSTMENTS 16681721 16681721 PURCHASED SERVICES 2754589 2754589 BAD DEBT EXPENSE 320254 320254 MEMBERSHIPS 119615 100254 19361 59462501 57531240 1599380 331881 222219 211372 1203079 984701 3265557 3461075 42857 47179 893060 990456 36258631 23949594 11984301 12309037 100000 100000 502313 498981 118784 139080 18332170 18741881 3416475 3993097 3416475 3993097 X 14763913 14647155 51782 1629 100000 100000 14915695 14748784 18332170 18741881 X -135425 20298 -51784 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 416370 416370 11135716 5691679 5444037 3222548 2158138 1064410 17652671 14385620 3267051 3831326 1714157 2117169 12309037 X PART X, LINE 2: THE CORPORATION HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC") AND IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE IRC. 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, 2014, 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. THE CORPORATION'S MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR TAX YEARS PRIOR TO THE FISCAL YEAR ENDED SEPTEMBER 30, 2011. BAL-DU-BOIS 563030 563030 144058 446201 563030 563030 144058 446201 590259 -27229 1 1 X 1 X 1 X 0 1 1 0 0 1059330 1059330 0.01780 127549 127549 0.00210 1186879 1186879 0.01990 1699096 449455 1249641 0.02100 141825 141825 0.00240 172047 172047 0.00290 2012968 449455 1563513 0.02630 3199847 449455 2750392 0.04620 1 320254 16013 11378979 8906502 2472477 X 1 1 1 1 SHELTERING ARMS HOSPITAL 8254 ATLEE ROAD MECHANICSVILLE VA 23116 X PHYSICAL REHABILITATION HOSPITAL SHELTERING ARMS HOSPITAL 1 1 X X X X X X X X X 12 1 0 1 X X X X X X X X X 0 0 1 1 200.000000000000 1 350.000000000000 1 X X X X X X 1 1 X X X X X 1 X 0 X X X X 0 X X 0 0 SHELTERING ARMS HOSPITAL PART V, SECTION B, LINE 3: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS DEVELOPED AND CONDUCTED IN 2012 IN COLLABORATION WITH COMMUNITY HEALTH SOLUTIONS, A RICHMOND, VIRGINIA BASED HEALTH RESEARCH AND CONSULTING COMPANY. THE TARGET COMMUNITY WAS DEFINED AND THE THREE KEY ELEMENTS WERE FOCUSED ON: 1. IMPORTANT HEALTH CONCERNS IN THE COMMUNITY 2. SIGNIFICANT SERVICE GAPS IN THE COMMUNITY 3. IDEAS AND SUGGESTIONS FOR IMPROVING THE COMMUNITY. THE SURVEY WAS SENT TO 162 COMMUNITY STAKE HOLDERS IDENTIFIED BY SHELTERING ARMS HOSPITAL IN COLLABORATION WITH COMMUNITY HEALTH SOLUTIONS. THE RESPONDENTS INCLUDED TWO PUBLIC HEALTH ENTITIES. MORE THAN 20 HEALTH CONCERNS AND MORE THAN 24 SERVICE GAPS WERE IDENTIFIED IN THE COMMUNITY. RESPONDENTS ALSO HAD THE ABILITY, THROUGH THE WRITE-IN OPTION, IDEAS AND SUGGESTIONS FOR IMPROVING COMMUNITY HEALTH. SHELTERING ARMS HOSPITAL THEN PRIORITIZED THE CONCERNS AND SERVICE GAPS TO THOSE WITH WHICH RESOURCES COULD BE FOCUSED WHICH ARE WITHIN THE SCOPE OF PHYSICAL REHABILITATION AND CAN BE ADDRESSED IN PART THROUGH COMMUNITY COLLABORATION. SHELTERING ARMS HOSPITAL PART V, SECTION B, LINE 7: HEALTH CARE SERVICE GAPS IDENTIFIED BUT NOT ADDRESSED BY DETAILED INITIATIVES ARE OUTSIDE THE SCOPE OF THE SHELTERING ARMS MISSION, PURPOSE, COMPETENCIES AND/OR RESOURCES. HOWEVER SHELTERING ARMS HOSPITAL ADDRESSES THOSE SERVICE GAPS IN THE COMMUNITY HEALTH NEEDS ASSESSMENT IN TERMS OF ITS CURRENT PRACTICE AND HOW SHELTERING ARMS HOSPITAL CAN CONTINUE TO SUPPORT THE COMMUNITY IN THOSE AREAS. 10 SHELTERING ARMS HANOVER REHABILITATION C 8226 MEADOWBRIDGE ROAD MECHANICSVILLE VA 23116 OUTPATIENT THERAPY AND PHYSICIANS CLINIC SHELTERING ARMS SOUTH PHYSICIANS CLINIC 13700 ST FRANCES BLVD MIDLOTHIAN VA 23114 OUTPATIENT THERAPY AND PHYSICIANS CLINIC SHELTERING ARMS BON AIR CENTER 206 TWINRIDGE LANE RICHMOND VA 23235 OUTPATIENT THERAPY AND PHYSICIANS CLINIC SHELTERING ARMS CHESTER CENTER 12220 IRONBRIDGE ROAD CHESTER VA 23831 OUTPATIENT THERAPY AND PHYSICIANS CLINIC SHELTERING ARMS LABURNAM CENTER 4730 S LABURNUM AVENUE RICHMOND VA 23231 OUTPATIENT THERAPY AND PHYSICIANS CLINIC SHELTERING ARMS MAPLE CENTER 1501 MAPLE AVENUE SUITE 100 RICHMOND VA 23226 OUTPATIENT THERAPY AND PHYSICIANS CLINIC SHELTERING ARMS MIDTOWN CLUB REC 2805 WEST BROAD STREET RICHMOND VA 23230 OUTPATIENT DAY PROGRAM AND FITNESS CENTER PT WORKS CENTER 2296 JOHN ROLFE PARKWAY RICHMOND VA 23233 OUTPATIENT THERAPY AND PHYSICIANS CLINIC SHELTERING ARMS HANOVER NEURO CTR 8254 ATLEE ROAD MECHANICSVILLE VA 23116 OUTPATIENT THERAPY AND PHYSICIANS CLINIC SHELTERING ARMS HULL STREET CENTER 13530 HULL STREET ROAD MIDLOTHIAN VA 23114 OUTPATIENT THERAPY AND PHYSICIANS CLINIC PART I, LINE 3C: VICE PRESIDENT FINANCE/CFO WILL REVIEW APPLICATIONS THAT DO NOT MEET THE PROGRAM GUIDELINES BUT FOR WHICH EXTRAORDINARY CIRCUMSTANCES MAY EXIST. ALSO, APPLICATIONS BY PATIENTS/FAMILIES WHO DISAGREE WITH THE PROGRAM DETERMINATION AND WHO REQUEST RECONSIDERATION.PART I, LINE 6A: THE TAX YEAR 2014 COMMUNITY BENEFIT REPORT IS NOT YET COMPLETED. ONE WILL BE FILED ON AUGUST 31, 2015 THROUGH THE VHHA. IN ADDITION, THE 2014 ANNUAL REPORT OF THE SHELTERING ARMS HOSPITAL AND AFFILIATES WILL BE PUBLISHED AND MADE AVAILABLE TO THE PUBLIC IN THE FALL OF 2015 AND WILL CONTAIN COMMUNITY BENEFIT REPORTING. 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. A COMPLETE LIST OF THE CASH GRANTS TO OTHERS CAN BE FOUND ON SCHEDULE I OF THE FORM 990. PART III, LINE 2: THIS IS THE ACTUAL SELF PAY BALANCES WRITTEN OFF THE HOSPITALS ACCOUNTS RECEIVABLE IN FY 2014. PART III, LINE 4: DOUBTFUL ACCOUNTS GENERALLY ARISE BASED UPON A PATIENT'S INABILITY TO PAY THEIR PORTION OF THE AMOUNT BILLED FOR SERVICES. MANAGEMENT'S ESTIMATES ARE BASED UPON AN ANALYSIS OF HISTORICAL COLLECTION TRENDS, CURRENT PAYER MIX, INDUSTRY FACTORS, CURRENT AND ANTICIPATED ECONOMIC CONDITIONS, AND OTHER RISKS INHERENT IN THE ACCOUNTS RECEIVABLE TRIAL BALANCE. PART III, LINE 8: PART III: LINE 8: THE MEDICARE GAIN WAS OBTAINED FROM THE MEDICARE COST REPORT FILED FOR FY 2014. 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 BY SHELTERING ARMS EVERY WEDNESDAY. PATIENT BALANCES WILL BE BILLED FOR 2 CYCLES (60 DAYS) UPON WHICH ANY UNPAID BALANCES WILL BE FORWARDED TO OUR FIRST OUT VENDOR FOR RESOLUTION OF THE REMAINING DEBT BEGINNING ON DAY 61. THE FIRST OUT VENDOR WILL WORK IN AN ATTEMPT TO COLLECT THE OUTSTANDING BALANCE OR ESTABLISH PAYMENT PLAN ARRANGEMENTS WITH THE PATIENT OR THEIR ESTATE. ANY ACCOUNTS WITH: UNSETTLED BALANCES REMAINING, NO PAYMENT ARRANGEMENTS, OR BROKEN PAYMENT ARRANGEMENTS AFTER 60 DAYS (120 DAYS SINCE DESIGNATION AS PATIENT RESPONSIBILITY), WILL BE RETURNED SYSTEMATICALLY FROM THE VENDOR AND SHELTERING ARMS WILL DESIGNATE THE BALANCES AS "OUTSOURCED" TO COLLECTION VENDOR AS COLLECTION BALANCES. THE COLLECTION VENDOR WILL RECEIVE AND PROCESS DESIGNATED ACCOUNTS FOR BALANCES AND WORK ACCOUNTS DESIGNATED AS BAD DEBT FOR AN ADDITIONAL 120 DAYS (240 DAYS SINCE DESIGNATION AS A PATIENT RESPONSIBLE BALANCE) AT WHICH TIME ANY ACCOUNTS WITH UNSETTLED BALANCES REMAINING, NO PAYMENT ARRANGEMENTS, OR BROKEN PAYMENT ARRANGEMENTS WILL BE RETRACTED FROM THE VENDOR AND ASSOCIATED COLLECTION EFFORTS WILL CEASE. PART VI, LINE 2: SHELTERING ARMS HOSPITAL CONTINUES TO ASSESS THE SERVICE GAPS AND HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE THROUGH DIALOG WITH AREA AGENCIES TO IDENTIFY NEEDED PROGRAMS AND EVENTS; EXPANDED OUTREACH SERVICES THROUGH PRESENTATIONS AND EDUCATIONAL SEMINARS; CURRENT PATIENTS AND STAFF ARE ALSO ENCOURAGE TO DISCUSS SERVICES AND EDUCATIONAL TRAINING AND SUPPORT THEY SEE OR HAVE ENCOUNTERED AS A GAP IN AVAILABILITY TO THE POPULATION IN NEED. PART VI, LINE 3: FINANCIAL ASSISTANCE INFORMATION AND APPLICATIONS WILL BE PROVIDED TO PATIENTS/FAMILIES WHO EXPRESS CONCERN ABOUT THEIR ABILITY TO PAY FOR SHELTERING ARMS SERVICES. APPLICATIONS WITH INSTRUCTIONS MAY BE OBTAINED FROM THE PATIENT ACCESS STAFF, CASE MANAGER OR PATIENT FINANCIAL SERVICES REPRESENTATIVE AND ARE AVAILABLE ON THE SHELTERING ARMS WEBSITE AT WWW.SHELTERINGARMS.COM WITH THE COMPLETE POLICY AND APPLICATION. ALL COMPLETED APPLICATIONS MUST BE SUBMITTED TO THE PATIENT INFORMATION DEPARTMENT, AS PER PRINTED INSTRUCTIONS, FOR REVIEW AND VERIFICATION OF INFORMATION. THE UTILIZATION MANAGER MAY BE CONSULTED AS NEEDED. NEW INPATIENT ADMISSIONS RECEIVE A FORM UPON ARRIVAL DISCLOSING THE FINANCIAL AGREEMENT TO PAY WHICH INCLUDES OFFERING MONTHLY PAYMENT ARRANGEMENTS OR APPLICATION FOR FINANCIAL ASSISTANCE. THIS FORM REQUIRES SIGNATURE. OUTPATIENT AND PHYSICIAN SERVICES APPOINTMENT VERIFICATION LETTERS FOR NEW PATIENTS DISCLOSES AVAILABILITY OF FINANCIAL ASSISTANCE IF THE PATIENT WISHES TO APPLY. PART VI, LINE 4: BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT PATIENT POPULATION IS LARGELY COMPRISED OF ADULT RESIDENTS IN CENTRAL AND EASTERN VIRGINIA. THE STUDY POPULATION FOR THIS CHNA IS ADULT RESIDENTS AGE 18+. THE STUDY REGION IS BASED ON THE SA HANOVER SERVICE AREA OF 47 ZIP CODES. MOST OF THESE ZIP CODES FALL WITHIN THE COUNTIES OF CAROLINE, CHARLES CITY, ESSEX, HANOVER, HENRICO, KING WILLIAM, LANCASTER, NEW KENT, NORTHUMBERLAND, AND RICHMOND; AND THE CITY OF RICHMOND. DEMOGRAPHIC PROFILE. AS OF 2012, THE STUDY REGION INCLUDED AN ESTIMATED 459,123 PERSONS AGE 18+. COMPARED TO THE COMMONWEALTH OF VIRGINIA AS A WHOLE, THE STUDY REGION IS MORE DENSELY POPULATED, AND PROPORTIONALLY MORE BLACK/AFRICAN AMERICAN. THE REGION HAS SLIGHTLY LOWER INCOME LEVELS THAN VIRGINIA AS A WHOLE.THE STUDY INCLUDED A MORTALITY PROFILE, ADULT HEALTH RISK PROFILE, MEDICALLY UNDERSERVED PROFILE, PREVENTATIVE HOSPITALIZATION PROFILE, AND BEHAVIORAL HEALTH HOSPITALIZATION DISCHARGE PROFILE. THESE PROFILES WERE INSTRUMENTAL IN DETERMINING THE IMPORTANT HEALTH CONCERNS AND THE SIGNIFICANT SERVICE GAPS USED BY SHELTERING ARMS TO MODIFY A STRATEGY THAT COULD BEST SERVE THE NEEDS OF THE COMMUNITIES. PART VI, LINE 5: SHELTERING HAS DEVELOPED A HOME HEALTH AGENCY, SPECIALIZING IN REHABILITATION SERVICES, TO PROVIDE SERVICES TO A LARGELY SENIOR POPULATION TO SUPPORT AGING IN PLACE IN THE COMMUNITY SETTING; HOSTS AN EDUCATIONAL SERIES AND EVENTS SUCH AS THE CHRONIC DISEASE SELF- MANAGEMENT CLASS, SPONSORED BY SENIOR CONNECTIONS; SEMINARS ON HEALTHY LIVING PROVIDED TO LONG TERM CARE FACILITIES; AND SEMINARS ON FALL PREVENTION, NUTRITION, AND SO ON; HOLDS A SIX-WEEK STROKE EDUCATION SERIES PROVIDED AT THE SHELTERING ARMS HOSPITAL; A LOW-VISION PROGRAM TO PROVIDE SPECIALIZED SCREENING AND TREATMENT SERVICES; REFERRAL RELATIONSHIPS WITH COMMUNITY AGENCIES AND ORGANIZATIONS TO ASSIST PATIENTS AND FAMILIES IN LOCATING NEEDED SERVICES; HOSTS AN ANNUAL POSTER DAY ON ADVANCED DIRECTIVES; SHELTERING ARMS HOSPITAL GRANTS SUPPORT OF ENTITIES SUCH AS CIRCLE CENTER ADULT DAY SERVICES, COMMUNITY BRAIN INJURY SERVICES, CROSS OVER MINISTRY, INC., FOUNDATION FOR REHABILITATION EQUIPMENT AND ENDOWMENT-ROANOKE, IVNA HEALTH SERVICES, JEWISH FAMILY SERVICES, PARALYZED VETERANS OF AMERICA-MID-ATLANTIC CHAPTER, POSITIVE VIBE FOUNDATION, ELDERHOMES CORPORATION, RAMP ACCESS MADE POSSIBLE BY STUDENTS, SPORTABLE RICHMOND ADAPTIVE SPORT & RECREATION, INC., GOOCHLAND FREE CLINIC AND FAMILY SERVICES, SAILING 4 ALL, AND SOUTH RICHMOND ADULT DAY CARE CENTER. IN ADDITION, SHELTERING ARMS 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.SHELTERING ARMS PROVIDES A COMPREHENSIVE PORTFOLIO OF UNIQUE, COMMUNITY-BASED RECREATION AND HEALTH AND WELLNESS SERVICES TO MEET THE NEEDS OF THE COMMUNITY. SHELTERING ARMS PARTNER FOR LIFE PROGRAMS (LEISURE; INTERACTION; FITNESS; AND ENJOYMENT) PROVIDE A VARIETY OF SOCIAL AND WELLNESS OPPORTUNITIES TO EXTEND THE SHELTERING ARMS CONTINUUM WHILE ALSO SERVING INDIVIDUALS FROM THE COMMUNITY- OR THOSE REFERRED BY OTHER HEALTHCARE PROVIDERS - WHO ARE INTERESTED IN PREVENTION, WELLNESS AND SELF-MANAGEMENT ACTIVITIES. THE PARTNERS FOR LIFE PROGRAMS INCLUDE NEUROFIT- A COMPREHENSIVE "AFTER-CARE" EXERCISE PROGRAM- BASED ON A FITNESS MODEL - FOR INDIVIDUALS WHO HAVE NEUROLOGICAL CONDITIONS BUT NO LONGER REQUIRE FORMAL THERAPY. PROGRAM EMPHASES INCLUDE IMPROVED OR MAINTAINED STRENGTH, RANGE OF MOTION, BALANCE AND FUNCTIONAL MOVEMENT - COMPLEMENTING THE PROGRESS MADE IN PHYSICAL THERAPY AND OTHER CLINICAL VENUES. POOL AND FITNESS MEMBERSHIPS- SHELTERING ARMS PROVIDES TWO FITNESS CENTERS AND TWO THERAPEUTIC (WARM WATER) POOLS TO MEMBERS WHO MAY BE FORMER PATIENTS OR MAY SIMPLY RESIDE IN THE COMMUNITY. FITNESS CENTERS FEATURE HIGH QUALITY EQUIPMENT AND THE AVAILABILITY OF CERTIFIED PERSONAL TRAINERS TO PROVIDE INDIVIDUALIZED FITNESS PLANS AND SERVICES. THE FITNESS ENVIRONMENT IS COMFORTABLE AND NON-INTIMIDATING TO SERVE AN AGING AND/OR CHALLENGED COMMUNITY POPULATION. POOLS PROVIDE A NEEDED EXERCISE MODALITY FOR THOSE STRUGGLING WITH PAIN CONDITIONS AND/OR MOBILITY RESTRICTIONS. AQUATIC AND FITNESS CLASSES- IN WATER OR ON LAND, EXERCISE CLASSES INCLUDE STRENGTH & CONDITIONING; SENIORLITE (LIMITED INDIVIDUALS CAN TOLERATE EXERCISE), CORE STRENGTHENING, CARDIO BLAST, YOGA, AND AQUATIC FITNESS. CLUB REC- A DAY RECREATION PROGRAM FOR INDIVIDUALS WITH DISABILITY OR PHYSICAL LIMITATIONS WHO CAN BENEFIT FROM A SUPERVISED SOCIAL AND WELLNESS PROGRAM. THE MODEL IS HOLISTIC, ANCHORED IN SELF-MANAGEMENT CONCEPTS, AND INCLUDES: ORGANIZED PROGRAMS AND MODULES IN HEALTH, EDUCATION AND LEISURE - PROVIDED BY RECREATION THERAPISTS AND FITNESS SPECIALISTS; COPING SKILLS GROUP (LED BY A LICENSED CLINICAL SOCIAL WORKER); USE OFSPECIALIZED RECREATION/ADAPTIVE EQUIPMENT; A COMPUTER LAB; ACCESS TO A FITNESS CENTER AND POOL; SPORTING EVENTS; AND COMMUNITY SERVICE PROJECTS. TO FURTHER SERVE THE NEEDS OF THE - LARGELY - AGING POPULATION OF CLUB REC MEMBERS, SHELTERING ARMS ADDED OUTPATIENT PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH-LANGUAGE PATHOLOGY SERVICES TO THE CLUB REC FACILITY TO CREATE AN EFFICIENT AND HIGHLY COORDINATED EXPERIENCE FOR THOSE INDIVIDUALS WHO REQUIRE FORMAL TREATMENT SERVICES. CHRONIC DISEASE SELF-MANAGEMENT CLASS - A SIX-WEEK PROGRAM DESIGNED TO TEACH CRITICAL PREVENTION AND HEALTH SELF-MANAGEMENT SKILLS. CLASS TOPICS INCLUDE: NUTRITION; EXERCISE; MANAGEMENT OF PAIN AND FATIGUE; EFFECTIVE COMMUNICATION ABOUT HEALTH MATTERS; MANAGING FEAR, ANGER & FRUSTRATION; AND ACTION PLANS FOR LIFESTYLE CHANGES. FITNESS & WELLNESS EDUCATION SERIES - FREE MONTHLY EDUCATION SESSIONS FOCUSED ON HEART HEALTH, FALL PREVENTION, NUTRITION, GENERAL EXERCISE, AND OTHER TOPICS AS REQUESTED BY ATTENDEES. SHAREGIVER PROGRAM - A SIX-WEEK EDUCATIONAL PROGRAM, DESIGNED BY THE AMERICAN HEART & STROKE ASSOCIATION, FOR STROKE SURVIVORS AND THEIR CAREGIVERS. TOPICS INCLUDE: PREVENTING RECURRENCE; EMOTIONAL WELLNESS; SAFETY IN THE HOME; AND ACCESSING COMMUNITY RESOURCES. SPECIAL ADAPTIVE SPORTING AND TRAVEL EVENTS - INCLUDING BOWLING CLINICS; ADAPTIVE GOLF CLINICS AND TOURNAMENTS; FISHING TRIPS; ADAPTIVE SKI TRIPS; AND AN ACCESSIBLE TRAVEL PROGRAM. COLLABORATIVE EVENTS - SHELTERING ARMS PARTNERS WITH LOCAL AGENCIES TO PROVIDE HEALTH AND WELLNESS EDUCATION EVENTS TO THE COMMUNITY. PARTNER AGENCIES AND ORGANIZATIONSINCLUDE: ARTHRITIS FOUNDATION; VCU PARTNERSHIPS FOR PEOPLE WITH DISABILITIES; VIRGINIA ARTHRITIS ACTION COALITION; SENIOR NAVIGATOR; AMERICAN HEART & STROKE ASSOCIATION; NATIONAL MULTIPLE SCLEROSIS SOCIETY; VIRGINIA BRAIN INJURY ASSOCIATION; VIRGINIA DEPARTMENT OF HEALTH; AND VIRGINIA DEPARTMENT ON AGING. 1 THE COMMUNITY FOUNDATION SERVING RICHMOND AND CENTRAL VIRGINIA 7501 BOULDERS VIEW DRIVE SUITE 110 RICHMOND VA 23225 237009135 501(C)(3) 143500 TO SUPPORT FOURTEEN PROGRAMS IDENTIFIED IN THE COMMUNITY SERVING POPULATIONS INTERNATIONAL BRAIN INJURY ASSOCIATION PO BOX 1804 ALEXANDRIA VA 22313 363892309 501(C)(3) 13300 TO SUPPORT PROFESSIONALS STUDYING BRAIN INJURY AND TREATMENT SENIOR NAVIGATOR 7501 BOULDERS VIEW DRIVE SUITE 201 RICHMOND VA 23225 541977334 501(C)(3) 5600 SUPPORT OF ONLINE SEARCH WEBSITE TO ASSIST SENIORS AND CAREGIVERS TO FIND COMMUNITY PROGRAMS AND SERVICES. 3 0 EQUIPMENT AND PHARMACY ASSISTANCE 20 31045 FMV COST OF SUPPLIES GRANTED PART I, LINE 2: THE ORGANIZATION MAINTAINS RECORDS OF ALL GRANTS GIVEN. THE DONATIONS WERE MADE TO COMMUNITY PROGRAMS IDENTIFIED BY THE INDEPENDENT BOARD AND MANAGEMENT AS SERVING THE HOSPITAL'S MISSION AND POPULATIONS IN NEED OF ASSISTANCE. X X X X X 0 1 0 0 0 0 0 0 0 JAMES E SOK PRESIDENT/CEO 403900 0 192623 0 0 0 121639 0 11060 0 729222 0 0 0 JAMES A BRAITH SECRETARY/VP OF BUS. DEVELOPMENT 190303 0 71568 0 0 0 14675 0 15090 0 291636 0 0 0 MICHAEL E DACUS VP OF FINANCE & CFO/TREASURER 223395 0 80846 0 0 0 3483 0 15395 0 323119 0 0 0 ELLEN VANCE VP & CHIEF HUMAN RESOURCES OFFICER 160703 0 66822 0 0 0 13391 0 15035 0 255951 0 0 0 CHRISTOPHER P SORENSON VP OF INFORMATION TECHNOLOGY 142881 0 71102 0 0 0 2216 0 13263 0 229462 0 0 0 SANDY EYLER VP & CHIEF NURSING OFFICER 129327 0 27684 0 0 0 6451 0 9881 0 173343 0 0 0 MARY ZWEIFEL VP OPERATIONS 191379 0 70730 0 0 0 3257 0 5677 0 271043 0 0 0 TIMOTHY M SILVER MEDICAL DIRECTOR 313071 0 78023 0 0 0 13085 0 15809 0 419988 0 0 0 HILLARY S HAWKINS MEDICAL DIRECTOR 286868 0 117858 0 0 0 4243 0 15664 0 424633 0 0 0 GREGORY LEGHART PHYSICIAN 246828 0 55427 0 0 0 14248 0 15370 0 331873 0 0 0 CHARLES MATTHEW GIBELLATO PHYSICIAN 220150 0 67107 0 0 0 11633 0 15279 0 314169 0 0 0 ALBERT M JONES PHYSICIAN 239414 0 22988 0 0 0 10963 0 14425 0 287790 0 0 0 MARIA C LITTAUA PHYSICIAN 206575 0 32000 0 0 0 15753 0 15234 0 269562 0 0 0 JOHN E GIBBS II PHYSICIAN 191796 0 45430 0 0 0 9750 0 9907 0 256883 0 0 0 PART I, LINE 4B THE ORGANIZATION HAS A 457B PLAN FOR JAMES E. SOK. THE AGGREGATE EARNED PORTION OF THE EMPLOYER PAID CONTRIBUTION FOR THE CALENDAR YEAR 2013 WAS $70,174. SCHEDULE J, PART 1, LINE 4: FOR ANY EXECUTIVE OR OTHER EMPLOYEE WHO HAS SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION THE COMPENSATION ARRANGEMENT MUST BE APPROVED BY THE ORGANIZATIONS GOVERNING BODY OR A COMMITTEE OF THE GOVERNING BODY COMPRISED OF INDIVIDUALS WHO DO NOT HAVE A CONFLICT OF INTEREST WITH RESPECT TO THE ARRANGEMENT. THE GOVERNING BODY OR ITS COMMITTEE OBTAINS AND RELIES UPON APPROPRIATE DATA AS TO COMPARABILITY PRIOR TO MAKING ITS DECISION AND THE GOVERNING BODY OR ITS COMMITTEE ADEQUATELY DOCUMENTS THE BASIS FOR ITS DECISION. TROUTMAN SANDERS LLP DAVID CONSTINE, A BOARD MEMBER, IS A PARTNER IN THIS LAW FIRM. 441269 LEGAL THE SERVICES ARE NEGOTIATED AT ARM'S LENGTH AND ARE AT FAI 0 FORM 990, PART III, LINE 3 THE INPATIENT SERVICES PROVIDED TO OTHER LOCAL HOSPITALS HAS BEEN MOVED TO THE RELATED ENTITY, PALMYRA REHABILITATION SERVICES. 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 INC. PER THE ORGANIZATION BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 AND APPLICABLE ATTACHMENTS WERE PROVIDED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS OF SHELTERING ARMS HOSPITAL AND TO ALL OTHER BOARD MEMBERS, 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 A POTENTIAL CONFLICT ARISES DURING THE YEAR, THE DIRECTOR WITH SUCH CONFLICT MUST RECUSE HIM/HERSELF FROM ALL DISCUSSIONS AND VOTE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 SHELTERING ARMS HOSPITAL UTILIZED THE SERVICES OF AN INDEPENDENT, EXTERNAL COMPENSATION FIRM TO CONDUCT A REVIEW OF ITS EXECUTIVE COMPENSATION PROGRAM TO ENSURE THE EXECUTIVE COMPENSATION LEVELS ARE COMPETITIVE AND REASONABLE. SHELTERING ARMS' COMPENSATION WAS MEASURED AGAINST HEALTHCARE ORGANIZATIONS SIMILAR IN SCOPE AND SCALE USING DATA FROM SIX EXTERNAL MARKET SURVEY SOURCES AS THE COMPARATIVE BASIS; BOTH BASE SALARY AND TOTAL CASH COMPENSATION WERE EVALUATED. THE COMPETITIVE ANALYSIS FINDINGS WERE PRESENTED TO THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS WHO EXAMINED AND APPROVED THEM. IN ADDITION, 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 WILL MAKE AVAILABLE FOR PUBLIC INSPECTION GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, WHISTLEBLOWER POLICIES, RELATED POLICIES, AND FINANCIAL STATEMENTS. SCHEDULE J, PART B, COLUMN III THE WAGES AND BONUS COMPENSATION WAS DOUBLE REPORTED IN THE OTHER COMPENSATION COLUMN III. THE AMOUNTS IN COLUMN III HAVE BEEN REMOVED FOR THE TOP FIVE HIGHEST COMPENSATED EMPLOYEES. FORM 990, PART XI, LINE 9: TEMPORAIRILY RESTRICTED ASSETS RELEASED -51,784. PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SHELTERING ARMS PHYSICAL REHABILITATION ASSOCIATES LLC 8254 ATLEE ROAD MECHANICSVILLE VA 23116 260402064 PHYSICAL REHABILITATION VA -3479769 642009 SHELTERING ARMS HOSPITAL SHELTERING ARMS THERAPY CLINICS LLC DBA PT WORKS 8254 ATLEE ROAD MECHANICSVILLE VA 23116 271939022 PHYSICAL REHABILITATION VA -319392 653467 SHELTERING ARMS HOSPITAL SHELTERING ARMS FOUNDATION 8254 ATLEE ROAD MECHANICSVILLE VA 23116 541615599 PHYSICAL REHABILITATION VA 501(C)(3) LINE 11B, II SHELTERING ARMS CORPORATION 0 SHELTERING ARMS HOSPITAL SOUTH 8254 ATLEE ROAD MECHANICSVILLE VA 23116 352258075 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 11A, I SHELTERING ARMS CORPORATION 0 SHELTERING ARMS CORPORATION 8254 ATLEE ROAD MECHANICSVILLE VA 23116 541615598 PHYSICAL REHABILITATION VA 501(C)(3) LINE 3 N/A 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 SHELTERING ARMS HOSPITAL SOUTH C 4872239 AMOUNT TRANSFERRED SHELTERING ARMS FOUNDATION C 7630859 AMOUNT TRANSFERRED PALMYRA REHABILITATION CORPORATION C 881881 AMOUNT TRANSFERRED SHELTERING ARMS HOSPITAL SOUTH B 4312624 AMOUNT TRANSFERRED PALMYRA REHABILITATION CORPORATION B 1783377 AMOUNT TRANSFERRED SHELTERING ARMS FOUNDATION B 637048 AMOUNT TRANSFERRED