HALIFAX REGIONAL DEVELOPMENT FOUNDATION INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- HALIFAX REGIONAL DEVELOPMENT FOUNDATION INC (EIN 54-1801459)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-13
- IRS object ID
- 201503179349301785
- Schema version
- 2014v5.0
- Note
- A later return for the same period supersedes this one.
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-13T08:46:39-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541801459 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX REGIONAL DEVELOPMENT FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HALI | BusinessNameControlTxt |
| Phone | 4345173183 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2204 WILBORN AVENUE | AddressLine1Txt |
| City | SOUTH BOSTON | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24592 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEWART R NELSON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4345173183 | PhoneNum |
| Signature | 2015-11-13 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHRIS A LUMSDEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2204 WILBORN AVENUE | AddressLine1Txt |
| City | SOUTH BOSTON | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24592 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $470,874 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HRHS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | TO PROMOTE COMMUNITY HEALTH AND TO DEVELOP FUNDRAISING AND SUPPORT FOR HALIFAX REGIONAL HOSPITAL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $139,671 | PYContributionsGrantsAmt |
| CY Contributions Grants | $430,398 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $14,359 | PYInvestmentIncomeAmt |
| CY Investment Income | $27,453 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $989 | CYOtherRevenueAmt |
| PY Total Revenue | $154,030 | PYTotalRevenueAmt |
| CY Total Revenue | $458,840 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $275,427 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $589,222 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $464 | PYOtherExpensesAmt |
| CY Other Expenses | $93 | CYOtherExpensesAmt |
| PY Total Expenses | $275,891 | PYTotalExpensesAmt |
| CY Total Expenses | $589,315 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$121,861 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$130,475 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,283,851 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,196,820 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $143,231 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $172,367 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,140,620 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,024,453 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HALIFAX REGIONAL DEVELOPMENT FOUNDATION, INC. IS ORGANIZED TO PROMOTE THE GENERAL HEALTH/WELFARE OF THE COMMUNITY, DEVELOP FUNDRAISING EFFORTS AND IMPROVE COMMUNITY SUPPORT FOR HALIFAX REGIONAL HOSPITAL. FOR MORE INFORMATION, SEE SCHEDULE O. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $112,550 | ExpenseAmt |
| Grant | $112,550 | GrantAmt |
| Desc | HALIFAX REGIONAL COMMUNITY PARTNERSHIP PROGRAMREFER TO SCHEDULE O. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $201,200 | ExpenseAmt |
| Grant | $201,200 | GrantAmt |
| Desc | HALIFAX REGIONAL DENTAL CLINICREFER TO SCHEDULE O. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $175,255 | ExpenseAmt |
| Grant | $175,255 | GrantAmt |
| Desc | HOSPICE FUNDREFER TO SCHEDULE O. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (5 entries)
| ExpenseExpenseAmt | GrantGrantAmt | DescDesc |
|---|---|---|
| $49,726 | $49,726 | MEDICATION ASSISTANCE PROGRAMWITH FUNDING SUPPORT FROM THE VIRGINIA HEALTH CARE FOUNDATION, THE CHASTAIN HOME AND THE HALIFAX REGIONAL DEVELOPMENT FOUNDATION, MEDASSIST OF HALIFAX PROVIDES MEDICATION ASSISTANCE TO LOW INCOME, UNINSURED AND UNDERINSURED RESIDENTS IN HALIFAX AND MECKLENBURG COUNTIES. MEDASSIST OF HALIFAX COLLABORATES WITH OTHER HEALTHCARE PROVIDERS AND AGENCIES IN THE AREA TO IDENTIFY INDIVIDUALS WHO CAN BENEFIT FROM THIS SERVICE. THIS PROGRAM PROVIDES PARTICIPANTS A STABLE PROCESS FOR RECEIVING LIFE SUSTAINING AND/OR PREVENTIVE MEDICATIONS. HALIFAX COUNTY HAS A HIGHER INCIDENCE THAN THE STATE MEDIAN FOR HEALTH CONDITIONS FOR WHICH HOSPITALIZATIONS CAN BE PREVENTED WITH CONSISTENT, AVAILABLE AMBULATORY CARE AND GOOD PATIENT COMPLIANCE WITH TREATMENT/SELF-PROTOCOLS, INCLUDING HYPERTENSION, ASTHMA AND DIABETES. COMPLIANCE WITH PRESCRIBED COURSES OF MEDICATION IMPROVES THE QUALITY OF LIFE FOR PATIENTS, WHILE DECREASING THE NUMBER OF HOSPITAL VISITS OF PATIENTS WHO RETURN DUE TO INABILITY TO COMPLY. EMERGENCY DEPARTMENT VISITS PRECIPITATED BY CONDITIONS WHICH COULD HAVE BEEN MANAGED WITH COMPLIANCE WITH THE PRESCRIBED MEDICATION REGIMEN ARE EXPECTED TO ALSO BE REDUCED. THIS PROGRAM IS ADMINISTERED THROUGH THE HALIFAX REGIONAL DEVELOPMENT FOUNDATION, INC. DURING 2014 1,325 PATIENTS RECEIVED MEDICATIONS VALUED AT $5,496,170. |
| $2,000 | $2,000 | CANCER CARE FUNDTHE CANCER CARE FUND WAS ESTABLISHED TO PROVIDE ASSISTANCE TO UNINSURED AND UNDERINSURED PATIENTS WHO MEET THE MEDICAL CRITERIA FOR SCREENING FOR BREAST CANCER AND/OR COLON CANCER. IN 2014, THE CANCER CARE FUND PROVIDED $2,000 TO 2 INDIVIDUALS FOR SCREENINGS. THE PROGRAM IS ADMINISTERED AND PROMOTED BY HALIFAX REGIONAL HOSPITAL, INC. |
| $26,023 | $26,023 | PROJECT PRIME SCHOLARSHIP ENDOWMENT FUNDPROJECT PRIME (PUBLIC RALLY FOR INDIVIDUAL MEDICAL EDUCATION), BEGUN 30 YEARS AGO WITH CONTRIBUTIONS FROM INDIVIDUALS AND BUSINESSES IN THE AREA, PROVIDES FINANCIAL ASSISTANCE TO THOSE IN THE REGION WHO WANT TO PURSUE A CAREER IN A HEALTHCARE OR A HEALTHCARE-RELATED FIELD. IN 2014 APPROXIMATELY $26,023 IN SCHOLARSHIPS WAS AWARDED TO 65 INDIVIDUALS - 38 STUDENTS PURSUING NURSING EDUCATION AND 27 PEOPLE ENTERING CLINICAL AND/OR BUSINESS EDUCATION PROGRAMS. PROJECT PRIME IS ADMINISTERED AND PROMOTED BY HALIFAX REGIONAL HOSPITAL, INC. |
| $6,000 | $6,000 | DR. JESSE J. BATES SCHOLARSHIP PROGRAMTHIS PROGRAM WAS STARTED IN 2002 IN HONOR OF DR. JESSE J. BATES, ONE OF TWELVE PHYSICIANS ON HALIFAX REGIONAL HOSPITAL'S MEDICAL STAFF WHEN THE HOSPITAL OPENED IN 1953. IN 2014, THE BATES SCHOLARSHIP PROVIDED $6,000 IN SCHOLARSHIP FUNDS TO SIX GRADUATING HIGH SCHOOL SENIORS FROM THE HALIFAX REGIONAL HOSPITAL SERVICE AREA. THE PURPOSE OF THE SCHOLARSHIP IS TO ENCOURAGE HIGH SCHOOL SENIORS TO SEEK EDUCATION TO FILL CRITICAL HEALTHCARE VACANCIES AND ACQUIRE SKILLS FOR USE WITH TECHNOLOGICALLY ADVANCED EQUIPMENT AND TREATMENT THERAPIES. THE SCHOLARSHIP ENDOWMENT FUND RECEIVES DONATIONS FROM THE COMMUNITY AND THE LATE DR. BATES' FAMILY. THIS SCHOLARSHIP IS ADMINISTERED AND PROMOTED BY SENTARA HALIFAX REGIONAL HOSPITAL. |
| $16,561 | $16,468 | OTHER GRANTS LESS THAN $5,000 ARE APPLIED FOR AND AWARDED TO ORGANIZATIONS WITHIN THE COMMUNITY. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $100,310 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $100,217 | TotalOtherProgSrvcGrantAmt |
| Total Program Service Expenses | $589,315 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | 0 | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEWART R NELSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4345173183 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2204 WILBORN AVENUE | AddressLine1Txt |
| City | SOUTH BOSTON | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24592 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ROBERT A BROERMANN | ||||||||
| TREASURER/DIRECTOR | 0.20 | 52.60 | Yes (X) | Yes (X) | $0 | $1,506,536 | $238,926 | |
| CAROL C THOMAS | ||||||||
| CHAIRMAN(EFF. 5/14) | 1.00 | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVID H WHITE JR | ||||||||
| CHAIRMAN(THRU 5/14) | 1.00 | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MICHAEL V GENTRY | ||||||||
| VICE CHAIR(EFF. 5/14) | 0.20 | 43.60 | Yes (X) | Yes (X) | $0 | $945,093 | $137,601 | |
| CHRIS A LUMSDEN | ||||||||
| PRESIDENT/DIRECTOR | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $408,433 | $41,192 | |
| SAID B ISKANDAR | ||||||||
| SECRETARY(EFF. 11/14)/DIRECTOR | 1.00 | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| STEWART R NELSON | ||||||||
| CHIEF FINANCIAL OFFICER | 1.00 | 39.00 | Yes (X) | $0 | $270,234 | $28,139 | ||
| THOMAS S KLUGE | ||||||||
| CHIEF OPERATING OFFICER | 1.00 | 39.00 | $0 | $234,877 | $54,986 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,365,173 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $500,844 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $23,150 | FundraisingAmt |
| Related Organizations | $57,472 | RelatedOrganizationsAmt |
| All Other Contributions | $349,776 | AllOtherContributionsAmt |
| Total Contributions | $430,398 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,453 | TotalRevenueColumnAmt |
| Exclusion | $27,453 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $13,023 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $23,150 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $12,034 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $989 | TotalRevenueColumnAmt |
| Exclusion | $989 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $458,840 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $28,442 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $486,986 | TotalAmt |
| Program Services | $486,986 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,236 | TotalAmt |
| Program Services | $102,236 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FEES | Desc |
| Total | $93 | TotalAmt |
| Program Services | $93 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $589,315 | TotalAmt |
| Program Services | $589,315 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,691 | BOYAmt |
| EOY | $67,540 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $613,653 | BOYAmt |
| EOY | $613,653 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,808 | BOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $429,206 | BOYAmt |
| EOY | $458,611 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,493 | BOYAmt |
| EOY | $57,016 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,283,851 | BOYAmt |
| EOY | $1,196,820 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,346 | BOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,808 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,077 | BOYAmt |
| EOY | $172,367 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,231 | BOYAmt |
| EOY | $172,367 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,140,620 | BOYAmt |
| EOY | $1,024,453 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,140,620 | BOYAmt |
| EOY | $1,024,453 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,283,851 | BOYAmt |
| EOY | $1,196,820 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$130,475 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $14,308 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX REGIONAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540648699 | EIN |
| Organization Type | 3 | OrganizationTypeDesc |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $589,222 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $589,222 | SupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,140,620 | BeginningYearBalanceAmt |
| Contributions | $407,248 | ContributionsAmt |
| Investment Earnings Or Losses | $41,761 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $589,222 | GrantsOrScholarshipsAmt |
| Other Expenditures | -$24,139 | OtherExpendituresAmt |
| Administrative Expenses | $93 | AdministrativeExpensesAmt |
| End Year Balance | $1,024,453 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $902,277 | BeginningYearBalanceAmt |
| Contributions | $511,195 | ContributionsAmt |
| Investment Earnings Or Losses | $3,039 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $275,427 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $464 | AdministrativeExpensesAmt |
| End Year Balance | $1,140,620 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,304,628 | BeginningYearBalanceAmt |
| Contributions | $315,911 | ContributionsAmt |
| Investment Earnings Or Losses | -$15,404 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $702,849 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $9 | AdministrativeExpensesAmt |
| End Year Balance | $902,277 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,225,984 | BeginningYearBalanceAmt |
| Contributions | $614,039 | ContributionsAmt |
| Investment Earnings Or Losses | $30,580 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $565,883 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $92 | AdministrativeExpensesAmt |
| End Year Balance | $1,304,628 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,214,574 | BeginningYearBalanceAmt |
| Contributions | $390,056 | ContributionsAmt |
| Investment Earnings Or Losses | $36,496 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $415,057 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $85 | AdministrativeExpensesAmt |
| End Year Balance | $1,225,984 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $172,367 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $172,367 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | THE HALIFAX REGIONAL COMMUNITY PARTNERSHIP IS A CHARITABLE PROGRAM ESTABLISHED TO PROMOTE ALL AREAS OF HEALTH AND WELLNESS IN THE COMMUNITIES WE SERVE, INCLUDING PHYSICAL, MENTAL, VOCATIONAL, EMOTIONAL, INTELLECTUAL AND SPIRITUAL WELL-BEING. THE CHARITABLE GIVING COMMITTEE CONSISTS OF NO LESS THAN THREE AND NO MORE THAN FIVE MEMBERS, WITH ONE MEMBER SERVING AS CHAIR AND ONE MEMBER SERVING AS THE COORDINATOR. CONTRIBUTIONS CAN ONLY BE GIVEN TO ORGANIZATIONS THAT: (1) TIE DIRECTLY WITH PROMOTING A HEALTHY LIFESTYLE AND AWARENESS OF HEALTH ISSUES, (2) PROMOTE KEY COMMUNITY GOALS AND FILL IMPORTANT UNMET NEEDS AS IDENTIFIED BY ELECTED OFFICIALS AND LEADERS IN THE COMMUNITY, (3) SUPPORT THE HALIFAX REGIONAL HOSPITAL INC. ("HRH") PHILOSOPHY OF BEING AN EXCELLENT CORPORATE CITIZEN, (4) THAT ARE NON-PROFIT ENTITIES, AND (5) THAT INCLUDE HRH SYSTEM EMPLOYEES, ESPECIALLY WHEN THESE EMPLOYEES SERVE IN LEADERSHIP ROLES. ALL REQUESTS MUST BE IN WRITING AS NO VERBAL REQUESTS WILL BE REVIEWED OR FUNDED. THE REQUEST MUST STATE THE INTENDED USE OF THE FUNDS. THE PROCESS FOR REVIEWING REQUESTS IS AS FOLLOWS: (1) ALL REQUESTS FOR CONTRIBUTIONS SHOULD BE DIRECTED TO THE COORDINATOR. (2) THE COORDINATOR WILL CONSOLIDATE THE REQUESTS AND BE READY TO PROVIDE A SUMMARY FOR THE COMMITTEE DURING MEETINGS. (3) THE CHAIR WILL PRESENT RECOMMENDATIONS FOR GIVING. (4) THE COMMITTEE WILL REVIEW THE REQUESTS AND DECIDE ON THE AMOUNT OF FUNDING. (5) THE COORDINATOR WILL ISSUE THE CHECK REQUEST TO THE ACCOUNTING DEPARTMENT AND PROVIDE AN APPROVAL LETTER WITH THE CHECK WHEN IT IS MAILED OUT. THE PROJECT PRIME SCHOLARSHIP FUND IS ADMINISTERED BY HALIFAX REGIONAL HOSPITAL TO PROVIDE FINANCIAL ASSISTANCE TO INDIVIDUALS WHO WISH TO PURSUE A CAREER IN HEALTHCARE OR A HEALTHCARE-RELATED FIELD. THE APPLICANTS MUST SUBMIT GRADES AND RECEIPTS UPON COMPLETION OF EACH SEMESTER TO VERIFY THAT THE GRANTS WERE USED AS INTENDED. THE RECIPIENT IS REQUIRED TO REPAY ANY FUNDS NOT USED OR IF THE RECIPIENT CANNOT PROVIDE RECEIPTS AND GRADES AT AN ACCEPTABLE LEVEL. THE JESSE J. BATES SCHOLARSHIP PROGRAM PROVIDES SCHOLARSHIPS TO GRADUATING HIGH SCHOOL SENIORS TO SEEK EDUCATION TO FILL CRITICAL HEALTHCARE VACANCIES. RECIPIENTS ARE REQUIRED TO PROVIDE DOCUMENTATION OF ACCEPTANCE INTO A PROGRAM AT THE TIME OF APPLICATION. THE FUNDS ARE MADE PAYABLE TO THE EDUCATIONAL INSTITUTIONS. THE THOMAS C. CROWELL, JR., MEMORIAL LIBRARY FUND PROVIDES EDUCATIONAL MATERIALS FOR THE LIBRARY OF HALIFAX REGIONAL HOSPITAL. THE MEDICATION ASSISTANCE PROGRAM (MEDASSIST) PROVIDES ASSISTANCE TO UNINSURED AND UNDERINSURED PATIENTS TO OBTAIN PRESCRIPTION MEDICATIONS AT REDUCED OR NO COST. THE PROGRAM IS ADMINISTERED THROUGH DOMINION HEALTH GROUP AND DOMINION HEALTH MEDICAL ASSOCIATES. APPLICANTS ARE REQUIRED TO SUBMIT FINANCIAL INFORMATION TO SUPPORT THE NEED FOR ASSISTANCE ON A PERIODIC BASIS. FUNDS ARE USED TO COVER THE EXPENSES OF THE PROGRAM. THE HOSPICE FUND WAS ESTABLISHED TO PROVIDE ASSISTANCE TO TERMINALLY ILL PATIENTS WHO ARE UNABLE TO AFFORD GOODS AND SERVICES NECESSARY FOR THE PROVISION OF END-OF-LIFE MEDICAL SERVICES. THE PROGRAM IS ADMINISTERED BY HALIFAX HOME HEALTH AND HOSPICE. THE CANCER CARE FUND WAS ESTABLISHED TO PROVIDE ASSISTANCE TO UNINSURED AND UNDERINSURED PATIENTS WHO MEET THE MEDICAL CRITERIA FOR SCREENING FOR BREAST CANCER AND/OR COLON CANCER. THE PROGRAM IS ADMINISTERED BY HALIFAX REGIONAL HOSPITAL. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GALA | Event1Nm |
| Gross Receipts Event1 | $36,173 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $23,150 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $13,023 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $1,000 | CashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $1,000 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $7,162 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $1,600 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $1,272 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $36,173 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $23,150 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $13,023 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $1,000 | CashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,000 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $7,162 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $1,600 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,272 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $12,034 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $989 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| SOUTHERN VIRGINIA HIGHER EDUCATION CENTER | |||||||
| 820 BRUCE STREET | SOUTH BOSTON | VA | 24592 | 141931584 | 501(C)(3) | $65,445 | SUPPORT OF CENTER FOR NURSING EXCELLENCE |
| THE PRIZERY | |||||||
| 700 BRUCE STREET | SOUTH BOSTON | VA | 24592 | 541795927 | 501(C)(3) | $15,000 | SUPPORT OF THE CACF/PRIZERY SUMMER THEATRE |
| DOMINION HEALTH MEDICAL ASSOCIATES | |||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541060357 | $201,200 | FUNDING FOR HALIFAX REGIONAL DENTAL CLINIC | |
| HALIFAX REGIONAL HOSPITAL | |||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 540648699 | 501(C)(3) | $96,000 | HOSPICE SUPPORT |
| SOUTHSIDE HEALTH SERVICES INC | |||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541417772 | $49,726 | MEDICATION ASSISTANCE PROGRAM | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
| Total Other Org | 2 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| CANCER CARE GRANT | 2 | $2,000 |
| HOSPICE PATIENTS | 244 | $68,213 |
| SCHOLARSHIPS | 71 | $32,023 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ALL REQUESTS MUST BE IN WRITING AS NO VERBAL REQUESTS WILL BE REVIEWED OR FUNDED. THE REQUEST MUST STATE THE INTENDED USE OF THE FUNDS. THE REQUESTS ARE REVIEWED BY THE RESPECTIVE COMMITTEES. ANY UNRELATED ORGANIZATION RECEIVING MORE THAN $5,000 IS REQUIRED TO PROVIDE A FORM W-9 AND AN INTERNAL REVENUE SERVICE DETERMINATION LETTER. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT A BROERMANN | ||||||||||||||
| TREASURER/DIRECTOR | $0 | $750,106 | $0 | $537,843 | $0 | $218,587 | $0 | $221,150 | $0 | $17,776 | $0 | $1,745,462 | $0 | $98,673 |
| MICHAEL V GENTRY | ||||||||||||||
| VICE CHAIR(EFF. 5/14) | $0 | $534,422 | $0 | $307,694 | $0 | $102,977 | $0 | $123,532 | $0 | $14,069 | $0 | $1,082,694 | $0 | $52,785 |
| CHRIS A LUMSDEN | ||||||||||||||
| PRESIDENT/DIRECTOR | $0 | $365,115 | $0 | $0 | $0 | $43,318 | $0 | $28,249 | $0 | $12,943 | $0 | $449,625 | $0 | $0 |
| STEWART R NELSON | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $244,579 | $0 | $2,000 | $0 | $23,655 | $0 | $27,094 | $0 | $1,045 | $0 | $298,373 | $0 | $0 |
| THOMAS S KLUGE | ||||||||||||||
| CHIEF OPERATING OFFICER | $0 | $209,536 | $0 | $2,000 | $0 | $23,341 | $0 | $42,231 | $0 | $12,755 | $0 | $289,863 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE METHODS LISTED ON LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. |
| PART I, LINE 4B | ROBERT BROERMANN AND MICHAEL GENTRY PARTICIPATED IN THE SENTARA CAPITAL ACCUMULATION ACCOUNT PLAN. PARTICIPATION IS LIMITED TO A SELECT GROUP OF CORPORATE EXECUTIVES AS APPROVED BY SENTARA HEALTHCARE'S BOARD OF DIRECTOR'S COMPENSATION COMMITTEE. TERMS OF THE PLAN CHANGED EFFECTIVE JANUARY 1, 2009, WHEREBY VESTING OF CONTRIBUTIONS MADE ON OR AFTER THAT DATE NOW OCCURS ON THE EARLIER OF FIVE YEARS FOR EACH YEARS' CONTRIBUTIONS OR AGE 55 WITH 10 YEARS OF SERVICE. UNDER THE OLD TERMS, VESTING OF CONTRIBUTIONS MADE PRIOR TO JANUARY 1, 2009 OCCURS ON THE EARLIEST OF ASSIGNED DISTRIBUTION DATE, DEATH, INVOLUNTARY TERMINATION WITHOUT CAUSE OR COMPLETION OF TWO-YEAR NON-COMPETE AFTER VOLUNTARY TERMINATION (REGARDLESS OF ORIGINAL ASSIGNED DISTRIBUTION DATE). DURING 2014, ROBERT BROERMANN AND MICHAEL GENTRY RECEIVED DISTRIBUTIONS OF $210,317 AND $88,045, RESPECTIVELY. THESE AMOUNTS HAVE BEEN REPORTED IN COLUMN (B)(III) OF SCHEDULE J, PART II. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 1, ORGANIZATION'S MISSION | HALIFAX REGIONAL DEVELOPMENT FOUNDATION, INC. IS ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF HALIFAX REGIONAL HOSPITAL, INC. THE FUNCTIONS TO BE PERFORMED BY THE CORPORATION ARE TO SOLICIT, RECEIVE, AND ADMINISTER GIFTS, GRANTS, CONTRIBUTIONS AND DONATIONS FOR HALIFAX REGIONAL HOSPITAL, INC. OR PROVIDE SUCH OTHER SERVICES THAT ARE REQUESTED BY HALIFAX REGIONAL HOSPITAL, INC. AND TO CARRY OUT OTHER EXCLUSIVELY CHARITABLE, EDUCATIONAL AND SCIENTIFIC PURPOSES OF HALIFAX REGIONAL HOSPITAL, INC. |
| FORM 990, PART III, LINE 4A, 4B, 4C, PROGRAM SERVICE ACCOMPLISHMENTS | STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS HALIFAX REGIONAL DEVELOPMENT FOUNDATION, INC. (FOUNDATION) IS ORGANIZED TO PROMOTE THE GENERAL HEALTH AND WELFARE OF THE COMMUNITY AND IS RESPONSIBLE FOR THE DEVELOPMENT OF FUNDRAISING EFFORTS AND IMPROVEMENT OF COMMUNITY SUPPORT FOR HALIFAX REGIONAL HOSPITAL, INC.; FOR ADMINISTERING GIFTS, GRANTS AND CONTRIBUTIONS FOR THE HOSPITAL AND FOR PROVIDING OTHER SERVICES THAT ARE EXCLUSIVELY CHARITABLE, EDUCATIONAL OR SCIENTIFIC IN NATURE. THE FOUNDATION IS ALSO RESPONSIBLE FOR MANAGING THE INVESTMENT OF HALIFAX REGIONAL HOSPTIAL, INC'S ENDOWMENT FUNDS AND FOR MANAGEMENT OF THE AFFILIATED GROUPS' EDUCATIONAL ASSISTANCE PROGRAM. HALIFAX REGIONAL COMMUNITY PARTNERSHIP PROGRAM AS A CORNERSTONE ORGANIZATION IN OUR REGION, HALIFAX REGIONAL HOSPITAL TAKES SERIOUSLY ITS RESPONSIBILITY TO BE AN ACTIVE CORPORATE CITIZEN. THE HEALTH SYSTEM CONTRIBUTES TO VARIOUS ORGANIZATIONS THAT SHARE ITS MISSION TO PROMOTE GOOD HEALTH AND WELLNESS AND TO HELP IMPROVE THE QUALITY OF LIFE OF ALL AGES. AS PART OF THE HEALTH SYSTEM'S CONTINUED ACTIVE COMMUNITY INVOLVEMENT, THE HALIFAX REGIONAL COMMUNITY PARTNERSHIP PROGRAM WAS ESTABLISHED IN FY05 TO ENABLE HALIFAX REGIONAL HOSPITAL TO MAXIMIZE ITS RESOURCES TO PROVIDE THE GREATEST BENEFIT TO CITIZENS IN SOUTHSIDE VIRGINIA. GUIDELINES FOR REQUESTS HELP ANSWER IMPORTANT QUESTIONS THAT ENABLE THE PROGRAM TO DISPERSE RESOURCES IN THE MOST EFFECTIVE MANNER. IN 2014 $112,550 WAS DONATED TO SUPPORT COMMUNITY PROGRAMS IN OUR SERVICE AREA. ADDITIONALLY, HUNDREDS OF HEALTH EDUCATION BROCHURES AND GIVEAWAYS WERE PROVIDED TO COMMUNITY ORGANIZATIONS TO HELP SUPPORT THEIR EVENTS AND PROGRAMS HOSPICE FUND HALIFAX REGIONAL HOSPICE IS THE RECIPIENT OF MANY GENEROUS DONATIONS FROM THE COMMUNITY MEMORIALIZING OR HONORING FAMILY AND FRIENDS. HOSPICE ALSO HOSTS AN ANNUAL GALA FUNDRAISING EVENT. FUNDS RAISED THROUGH DONATIONS AND THE GALA ARE USED TO SUPPORT UNFUNDED PATIENT CARE, THE VOLUNTEER AND R.I.S.E BEREAVEMENT PROGRAMS, STAFF, PATIENT AND FAMILY EDUCATION, MARKETING AND EDUCATIONAL MATERIALS, SPECIAL PROJECTS SUCH AS THE C.A.R.E. CHANNEL FOR HOSPITALIZED PATIENTS, AND ITEMS SUCH AS CDS AND DVDS USED IN MUSIC THERAPY. HOSPICE FUNDS ALSO PAY THE SALARIES OF A PART TIME CLERICAL SUPPORT PERSON, PART TIME CHAPLAIN AND A PART-TIME BEREAVEMENT COORDINATOR. HOSPICE DOES NOT DISCRIMINATE ON THE ABILITY TO PAY. IN 2014 HOSPICE RECEIVED CONTRIBUTIONS OF $84,772. DISBURSEMENTS IN 2014 TOTALED $175,255. HALIFAX REGIONAL DENTAL CLINIC HALIFAX REGIONAL DENTAL CLINIC (HRDC), WHICH OPENED IN FEBRUARY 2013, WAS BUILT TO GIVE CHILDREN A FUN, EASY EXPERIENCE AT THE DENTIST, WITH PLENTY TO KEEP THEM BUSY AS THEY HAVE THEIR APPOINTMENT. HRDC WAS BUILT AS A PARTNERSHIP WITH THE GENEROUS SUPPORT OF THE VIRGINIA DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT, THE VIRGINIA TOBACCO COMMISSION, AND OTHER PARTNERING ORGANIZATIONS. CONTINUE OPERATING SUPPORT IS PROVIDED BY THE VIRGINIA HEALTH CARE FOUNDATION, WHICH FUNDS SAFETY NET AND COMMUNITY MEDICAL AND DENTAL SERVICES THROUGHOUT THE COMMONWEALTH. HRDC IS ONE OF ONLY A FEW LOCAL PRACTICES THAT WILL ACCEPT MEDICAID PAYMENT FOR SERVICES. THE CLINIC HOPES TO REACH OUT TO MORE THAN 2,400 KIDS ANNUALLY WHEN IT IS RUNNING AT FULL CAPACITY. DURING 2014, 2,926 PEOPLE VISITED FOR CHECKUPS, FILLINGS, EXTRACTIONS OR OTHER DENTAL WORK. IN FACT, THE CLINIC HAS PROVIDED MORE THAN 10,144 APPOINTMENTS SINCE IT OPENED FOR MORE THAN 3,030 PATIENTS. IN 2014, 55% OF THE PATIENTS SEEN WERE CHILDREN, AND 67% WERE EITHER LOW-TO-MODERATE-INCOME (LMI) PATIENTS OR PATIENTS COVERED BY MEDICAID, INDICATING THAT THEY, TOO, ARE LOW INCOME (2,038 OF THE 2,926 PATIENTS). ADDITIONALLY, 68% OF THE TOTAL PATIENT VISITS CONDUCTED DURING 2014 PROVIDED DENTAL CARE TO LMI OR MEDICAID-COVERED PATIENTS. CURRENTLY, 67% OF THE 3,203 PATIENTS ENROLLED IN THE CLINIC ARE EITHER LMI OR MEDICAID-COVERED. IN 2014, THE CLINIC PROVIDED $201,200 IN CHARITY CARE TO ITS UNINSURED AND LOW-INCOME PATIENTS. |
| FORM 990, PART VI, SECTION A, LINE 2 | DAVID H. WHITE, JR. AND CHRIS A. LUMSDEN HAVE A BUSINESS RELATIONSHIP. THE ORGANIZATION'S OFFICERS AND DIRECTORS SERVED TOGETHER ON THE BOARDS OF OTHER ORGANIZATIONS WITHIN THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM"), AS WELL AS JOINT VENTURES IN WHICH THE SYSTEM HAD AN OWNERSHIP INTEREST. SEE SCHEDULE R FOR A LISTING OF SUCH ENTITIES. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION'S SOLE MEMBER WAS HALIFAX REGIONAL HOSPITAL, INC., A VIRGINIA NONSTOCK CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS, WHICH SERVED AS THE ORGANIZATION'S GOVERNING BODY, WAS ELECTED BY HALIFAX REGIONAL HOSPITAL, INC., THE 501(C)(3) SOLE MEMBER OF THE ORGANIZATION, SUBJECT TO RATIFICATION BY ITS 501(C)(3) SOLE MEMBER, SENTARA HEALTHCARE. |
| FORM 990, PART VI, SECTION A, LINE 7B | SENTARA HEALTHCARE ("SENTARA"), IN ITS CAPACITY AS THE 501(C)(3) SOLE MEMBER OF HALIFAX REGIONAL HOSPITAL, INC. ("HRH"), THE SOLE MEMBER OF THE ORGANIZATION, HAS RESERVED THE EXCLUSIVE RIGHT, POWER AND AUTHORITY TO MAKE DECISIONS FOR AND ON BEHALF OF THE ORGANIZATION WITH RESPECT TO THE APPROVAL OR ADOPTION OF ANY PLAN OF MERGER OR CONSOLIDATION; ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE ORGANIZATION; AND THE VOLUNTARY DISSOLUTION OR LIQUIDATION OF THE ORGANIZATION, REVOCATION OF ANY SUCH VOLUNTARY DISSOLUTION PROCEEDINGS, OR ANY DECISION TO FILE A PETITION REQUESTING OR CONSENTING TO AN ORDER FOR RELIEF UNDER THE FEDERAL BANKRUPTCY LAWS OR SIMILAR STATE LAWS FOR THE ORGANIZATION. ELECTION OF THE ORGANIZATION'S GOVERNING BODY IS ALSO SUBJECT TO RATIFICATION BY SENTARA. FINALLY, SPECIAL APPROVAL BY HRH'S GOVERNING BODY IS REQUIRED FOR CERTAIN OTHER ACTIONS OF THE ORGANIZATION. THESE INCLUDE A CHANGE IN THE ORGANIZATION'S MISSION; THE ESTABLISHMENT OF, AND APPOINTMENT OF MEMBERS TO, ANY COMMITTEES WHICH WILL HAVE ANY OF THE AUTHORITY OF THE HRH GOVERNING BODY; AND ANY ALTERATION, AMENDMENT, RESTATEMENT OR REPEAL OF ANY GOVERNING DOCUMENTS, THE ADOPTION OF ANY NEW GOVERNING DOCUMENTS; OR ANY ACTION TO BE TAKEN AS THE MEMBER UNDER THE GOVERNING DOCUMENTS. FINAL AUTHORITY FOR THE ESTABLISHMENT OF ALL POLICY PERTAINING TO THE ORGANIZATION FOR ITS OPERATION, MAINTENANCE AND DEVELOPMENT, AND FOR THE ATTAINMENT OF ITS OBJECTIVES, IS VESTED IN THE GOVERNING BODY OF HRH, AND SUBJECT TO RATIFICATION AND APPROVAL BY SENTARA. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE RETURN IS PREPARED BY SENTARA CORPORATE TAX DEPARTMENT, BASED ON INFORMATION PROVIDED BY ORGANIZATION AND IN CONSULTATION WITH ORGANIZATION STAFF. THE DRAFT PREPARED BY CORPORATE IS THEN CAREFULLY REVIEWED BY ORGANIZATION MANAGEMENT AND STAFF. CHANGES ARE MADE AS APPROPRIATE. THE FINAL VERSION IS MADE AVAILABLE TO ALL MEMBERS OF THE BOARD PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST QUESTIONNAIRE IS DISTRIBUTED TO EACH BOARD MEMBER IN JANUARY EVERY YEAR. THE QUESTIONNAIRE MUST BE COMPLETED BY ALL MEMBERS. A REPORT OF THE DISCLOSED POTENTIAL CONFLICTS IS PRESENTED BY THE SOLE MEMBER'S BOARD CHAIRMAN TO ITS BOARD IN EXECUTIVE SESSION ANNUALLY. IF IT IS DETERMINED BY THE SOLE MEMBER'S BOARD SECRETARY, BOARD PRESIDENT, AND MEDICAL STAFF PRESIDENT THAT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE CIRCUMSTANCES OF THE CONFLICT OF INTEREST SHALL BE SET FORTH IN DETAIL BY THE AFFECTED PARTY. SUBSEQUENTLY, WHEN A RESOLUTION CANNOT BE FOUND TO THE SATISFACTION OF THE SOLE MEMBER'S BOARD SECRETARY, BOARD PRESIDENT, AND MEDICAL STAFF PRESIDENT, THE MATTER WILL BE REVIEWED AND ADDRESSED BY THE SOLE MEMBER'S EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. A RECOMMENDATION WILL BE MADE TO THE AFFECTED PARTY ON HOW TO REMOVE THE CONFLICT. IF THE CONFLICT CANNOT BE RESOLVED TO THE SATISFACTION OF THE SOLE MEMBER'S EXECUTIVE COMMITTEE, A RECOMMENDATION WILL BE MADE TO REMOVE THE AFFECTED BOARD MEMBER FROM THE BOARD. IN SUCH CASE WHERE REMOVAL IS RECOMMENDED, SUCH REMOVAL PROCEDURES OUTLINED IN THE CORPORATE BYLAWS WILL BE FOLLOWED. THE RESPONSES TO THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE ARE RETAINED BY THE SOLE MEMBER'S BOARD SECRETARY. |
| FORM 990, PART VI, SECTION B, LINE 15 | AS PART OF THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM"), THE ORGANIZATION FOLLOWED PROCESSES AND PROCEDURES SET FORTH IN ITS GOVERNING DOCUMENTS TO ENSURE COMPLIANCE WITH ITS OBLIGATIONS AS A 501(C)(3) HEALTHCARE ORGANIZATION TO PAY DISQUALIFIED PERSONS REASONABLE COMPENSATION. SUCH PROCESSES AND PROCEDURES ARE INTENDED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERNAL REVENUE CODE SECTION 4958 REGULATIONS. THE COMPENSATION PHILOSOPHY OF THE SYSTEM AS A WHOLE IS TO BASE OVERALL COMPENSATION AND BENEFITS FOR EXECUTIVES ON NOT-FOR-PROFIT MARKET COMPARABLES, ADJUSTED AS APPLIED TO EACH EXECUTIVE, TAKING INTO CONSIDERATION THE INDIVIDUAL SKILLS, EXPERIENCE, TENURE AND PERFORMANCE OF THE EXECUTIVE BEING COMPENSATED AND OVERALL PERFORMANCE OF THE ORGANIZATION. IN LINE WITH THIS PHILOSOPHY, THE SYSTEM PERFORMED SUBSTANTIAL DUE DILIGENCE AS TO MARKET COMPARABLES. THE SYSTEM'S COMPENSATION COMMITTEE, WHICH CONSISTS OF SYSTEM BOARD MEMBERS WITHOUT CONFLICTS OF 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 SYSTEM'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 30 NOT-FOR-PROFIT HEALTHCARE SYSTEMS BASED ON NET REVENUE GROWTH, OPERATING MARGIN, BOND RATING, AND QUALITATIVE PERFORMANCE MEASURES BASED ON RANKINGS FROM SDI'S NATIONAL TOP INTEGRATED HEALTH NETWORKS. OVERALL, THE CONSULTANT DETERMINED THAT SENTARA'S PAY WAS ALIGNED WITH ITS RELATIVE PERFORMANCE. THE COMPENSATION STUDY WAS PRESENTED TO THE SYSTEM'S COMPENSATION COMMITTEE, WHICH MADE ITS COMPENSATION DECISIONS BASED ON A)ITS REVIEW AND ANALYSIS OF THE PERFORMANCE OF BOTH THE ORGANIZATION AND ITS SENIOR EXECUTIVES AND, B) A REASONABLENESS OF COMPENSATION ANALYSIS AND OPINION FROM AN EXTERNAL EXPERT IN THE COMPENSATION OF EXECUTIVES IN THE TAX-EXEMPT HEALTH CARE FIELD. THE COMMITTEE'S BASES FOR ITS DECISIONS WERE DOCUMENTED IN COMMITTEE MINUTES TAKEN DURING THE MEETING AND THEN CIRCULATED FOR REVIEW AND APPROVAL. ALL DECISIONS REGARDING COMPENSATION WERE MADE BY THE COMMITTEE, WHICH CONSISTS OF SYSTEM BOARD MEMBERS WITHOUT CONFLICT OF INTERESTS. THIS PROCESS WAS USED TO ESTABLISH COMPENSATION FOR THE ORGANIZATION'S VICE CHAIRMAN AND TREASURER; WHO ALSO SERVE AS CORPORATE VICE PRESIDENT AND SENIOR VICE PRESIDENT/CFO OF THE SYSTEM, RESPECTIVELY. THE PROCESS WAS LAST UNDERTAKEN DURING 2014 FOR THE POSITIONS LISTED. THE OUTSIDE MARKET STUDY DESCRIBED ABOVE WAS ALSO USED TO ESTABLISH COMPENSATION FOR THE ORGANIZATION'S PRESIDENT, WHO IS CONSIDERED THE TOP MANAGEMENT OFFICIAL OF THE ORGANIZATION, AND THE ORGANIZATION'S CFO. RESULTS WERE PRESENTED TO SENIOR EXECUTIVES OF THE SYSTEM FOR REVIEW AND APPROVAL RATHER THAN THE SYSTEM'S COMPENSATION COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CONSOLIDATED FINANCIAL STATEMENTS FOR SENTARA HEALTHCARE AND SUBSIDIARIES WERE MADE PUBLICLY AVAILABLE THROUGH THE USE OF DAC BOND (DISCLOSURE DISSEMINATION AGENT) AND CAN BE FOUND ON THE INTERNET AT WWW.DACBOND.COM. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART VI, LINES 1A AND 1B, BOARD MEMBER INDEPENDENCE | THE ORGANIZATION'S BOARD OF DIRECTORS IS APPOINTED BY HALIFAX REGIONAL HOSPITAL, INC., THE 501(C)(3) SOLE MEMBER OF THE ORGANIZATION. APPOINTMENTS ARE SUBJECT TO RATIFICATION BY SENTARA HEALTHCARE, THE 501(C)(3) SOLE MEMBER OF HALIFAX REGIONAL HOSPITAL, INC. THE GOVERNING BOARD OF SENTARA HEALTHCARE IS A COMMUNITY-BASED BOARD COMPRISED OF 18 VOTING MEMBERS, 16 OF WHICH ARE CONSIDERED INDEPENDENT, AS DEFINED IN THE FORM 990 INSTRUCTIONS. |
| STATEMENT FILED PURSUANT TO TREASURY REGULATION SEC. 1.6038-2(J)(3): | THE TAXPAYER IS A MEMBER OF THE SENTARA HEALTHCARE ("SHC") CONTROLLED GROUP. SHC, EIN 52-1271901, OWNS BAY PRIMEX INSURANCE COMPANY, LTD., A CONTROLLED FOREIGN CORPORATION. SHC FURNISHES ALL INFORMATION REQUIRED OF THE TAXPAYER BY IRC SECTION 6038 AND THE REGULATIONS THEREUNDER WITH RESPECT TO BAY PRIMEX INSURANCE COMPANY, LTD. THEREFORE, PURSUANT TO TREASURY REGULATION SEC. 1.6038-2(J)(2), THE TAXPAYER IS EXCEPTED FROM PROVIDING SUCH INFORMATION. THE REQUIRED INFORMATION IS E-FILED WITH SHC'S FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX. IN ADDITION, ONE MEMBER OF THE SHC CONTROLLED GROUP OWNS A NON-CONTROLLING INTEREST IN VIRGINIA SOLUTIONS SPC, LTD., A CONTROLLED FOREIGN CORPORATION. ALL INFORMATION REQUIRED OF THE TAXPAYER BY IRC SECTION 6038 AND THE REGULATIONS THEREUNDER WITH RESPECT TO VIRGINIA SOLUTIONS SPC, LTD. IS FURNISHED BY HALIFAX REGIONAL HOSPITAL, EIN 54-0648699. THEREFORE, PURSUANT TO TREASURY REGULATION SEC. 1.6038-2(J)(2), THE TAXPAYER IS EXCEPTED FROM PROVIDING SUCH INFORMATION. THE REQUIRED INFORMATION IS E-FILED WITH THE ORGANIZATION'S FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (19 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SENTARA HEALTHCARE | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 521271901 | HEALTH CARE | VA | 501(C)(3) | LN7_NORMALGOVTSUPPOR | N/A | 0 | |
| CLARKSVILLE SENIOR CARE LLC | |||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541957066 | SENIOR CARE | VA | 501(C)(3) | 11A TYPE I | Yes (1) | HALIFAX REGIONAL HOSPITAL | |
| HALIFAX REGIONAL HOSPITAL INCORPORATED | |||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 540648699 | HEALTHCARE | VA | 501(C)(3) | LN3_HOSPITALCOOPINSE | 0 | SENTARA HEALTHCARE | |
| HALIFAX REGIONAL LONG TERM CARE INC | |||||||||||
| 103 ROSE HILL DRIVE | SOUTH BOSTON | VA | 24592 | 546074529 | SENIOR CARE | VA | 501(C)(3) | 11A TYPE I | Yes (1) | HALIFAX REGIONAL HOSPITAL | |
| SENTARA HALIFAX REGIONAL PROPERTIES INC | |||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541801463 | HLTH/WELFARE | VA | 501(C)(3) | 11A TYPE I | Yes (1) | HALIFAX REGIONAL HOSPITAL | |
| TIDEWATER HEALTH CARE INC | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 521277419 | HEALTH CARE | VA | 501(C)(3) | LN3_HOSPITALCOOPINSE | Yes (1) | SENTARA HOSPITALS | |
| SENTARA HOSPITALS | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541547408 | HEALTH CARE | VA | 501(C)(3) | LN3_HOSPITALCOOPINSE | Yes (1) | SENTARA HEALTHCARE | |
| SENTARA MEDICAL GROUP | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541217184 | HEALTH CARE | VA | 501(C)(3) | LN9_MORETHAN30PCTCON | Yes (1) | SENTARA HEALTHCARE | |
| SENTARA ENTERPRISES | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541917649 | HEALTH CARE | VA | 501(C)(3) | LN9_MORETHAN30PCTCON | Yes (1) | SENTARA HEALTHCARE | |
| SENTARA LIFE CARE CORP | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541217183 | HEALTH CARE | VA | 501(C)(3) | LN9_MORETHAN30PCTCON | Yes (1) | SENTARA HEALTHCARE | |
| MPB INC | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541346393 | TITLE HOLDING COMPANY | VA | 501(C)(2) | Yes (1) | SENTARA ENTERPRISES | ||
| OPTIMA HEALTH PLAN | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541283337 | HMO | VA | 501(C)(3) | 11A - I | Yes (1) | SENTARA HEALTHCARE | |
| POTOMAC HOSPITAL CORP OF PRINCE WILLIAM | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 540853898 | HEALTH CARE | VA | 501(C)(3) | LN3_HOSPITALCOOPINSE | Yes (1) | SENTARA HEALTHCARE | |
| SENTARA RMH MEDICAL CENTER | |||||||||||
| 2010 HEALTH CAMPUS DRIVE | HARRISONBURG | VA | 22801 | 540506331 | HEALTH CARE | VA | 501(C)(3) | LN3_HOSPITALCOOPINSE | Yes (1) | SENTARA HEALTHCARE | |
| VALLEY WELLNESS CENTER | |||||||||||
| 501 STONE SPRING ROAD | HARRISONBURG | VA | 22801 | 521309257 | PREVENTATIVE HEALTH/REHAB | VA | 501(C)(3) | LN9_MORETHAN30PCTCON | Yes (1) | SENTARA RMH MEDICAL CENTER | |
| MJH FOUNDATION | |||||||||||
| 500 MARTHA JEFFERSON DRIVE | CHARLOTTESVILLE | VA | 22911 | 541401357 | INVEST/MGT SVCS FOR MARTHA JEFFERSON HOSPITAL | VA | 501(C)(3) | 11A - I | Yes (1) | MARTHA JEFFERSON HOSPITAL | |
| MARTHA JEFFERSON HOSPITAL FOUNDATION | |||||||||||
| 500 MARTHA JEFFERSON DRIVE | CHARLOTTESVILLE | VA | 22911 | 300041113 | FUNDRAISING | VA | 501(C)(3) | 11A - I | Yes (1) | MARTHA JEFFERSON HOSPITAL | |
| MARTHA JEFFERSON HOSPITAL | |||||||||||
| 500 MARTHA JEFFERSON DRIVE | CHARLOTTESVILLE | VA | 22911 | 540261840 | HEALTH CARE | VA | 501(C)(3) | LN3_HOSPITALCOOPINSE | Yes (1) | SENTARA HEALTHCARE | |
| HALIFAX REGIONAL HEALTH SYSTEM | |||||||||||
| 2204 WILBORN AVE | SOUTH BOSTON | VA | 24592 | 541801466 | HEALTH CARE | VA | 501(C)(3) | 11B TYPE II | N/A | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| MANAGEMENT SERVICES LLC | |||||||
| 814 GREENBRIER CIRCLE | CHESAPEAKE | VA | 23320 | 541365012 | HLTH MGT SV | VA | N/A |
| OBICI REAL ESTATE HOLDINGS LLC | |||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 261749881 | RE RENTAL | VA | N/A |
| PRINCESS ANNE AMB SURG MGT LLC | |||||||
| 1975 GLENN MITCHELL STE 300 | VA BEACH | VA | 23456 | 204920880 | HEALTH CARE | VA | N/A |
| VA BEACH AMBULATORY SURGERY CENTER | |||||||
| 1700 WILL O WISP DRIVE | VA BEACH | VA | 23454 | 541448218 | HEALTH CARE | VA | N/A |
| AMER HEALTH EVAL CTR-WMSBG LLC | |||||||
| 739 THIMBLE SHOALS STE 105 | NEWPORT NEWS | VA | 23606 | 263761741 | HEALTH CARE | VA | N/A |
| CANCER CENTERS OF VA LLC | |||||||
| 5900 LAKE WRIGHT DRIVE | NORFOLK | VA | 23502 | 201338518 | HEALTH CARE | VA | N/A |
| HAMPTON ROADS LITHOTRIPSY LLC | |||||||
| 225 CLEARFIELD AVE | VIRGINIA BEACH | VA | 23462 | 200942600 | HEALTH CARE | VA | N/A |
| HEALTHCARE PERFORMANCE IMPROVEMENT LLC | |||||||
| 5041 CORPORATE WOODS DR STE 180 | VIRGINIA BEACH | VA | 23462 | 204024074 | CONSULTING | VA | N/A |
| RADIOLOGY SERVICES OF HAMPTON ROADS LC | |||||||
| 814 GREENBRIER CIRCLE STE L | CHESAPEAKE | VA | 23320 | 541774472 | HEALTH CARE | VA | N/A |
| SENTARA OBICI AMBULATORY SURGERY LLC | |||||||
| 2750 GODWIN BLVD | SUFFOLK | VA | 23434 | 260144898 | HEALTH CARE | VA | N/A |
| ST LUKES PROPERTIES LLC | |||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 272774684 | MOB RENTAL | VA | N/A |
| POTOMAC INOVA HEALTHCARE ALLIANCE LLC | |||||||
| 8110 GATEHOUSE RD STE 400W | FALLS CHURCH | VA | 22042 | 541802733 | HEALTHCARE | VA | N/A |
| ORTHOPAEDIC HOSPITAL MANAGEMENT LLC | |||||||
| 3000 COLISEUM DRIVE | HAMPTON | VA | 23666 | 274185117 | MGT SVCS | VA | N/A |
| CAREPLEX ORTHOPAEDIC ASC LLC | |||||||
| 3000 COLISEUM DRIVE | HAMPTON | VA | 23666 | 271867311 | HEALTH CARE | VA | N/A |
| PHYSICAL THERAPY ACACLLC | |||||||
| 501 ALBEMARLE SQUARE | CHARLOTTESVILLE | VA | 22901 | 260080717 | HEALTH CARE | VA | N/A |
| MNS SUPPLY CHAIN NETWORK LLC | |||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 454235238 | GPO | DE | N/A |
| LAKE RIDGE AMBULATORY SURGERY CENTER LLC | |||||||
| 12825 MINNIEVILLE RD STE 204 | WOODBRIDGE | VA | 22192 | 455347932 | HEALTH CARE | VA | N/A |
| ALETA HEALTH LLC | |||||||
| 2300 OPITZ BLVD | WOODBRIDGE | VA | 22191 | 465661314 | MSO | DE | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (19 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SENTARA SOUTHSIDE HEALTH SERVICES INC | ||||||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541417772 | HEALTH SERVICES | VA | N/A | C | Yes (1) | |||||
| DOMINION HEALTH MEDICAL ASSOCIATES LTD | ||||||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541060357 | PHYS PRACTICE | VA | N/A | C | Yes (1) | |||||
| SENTARA HOLDINGS INC | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541555638 | HOLDING COMPANY | VA | N/A | C | Yes (1) | |||||
| SENTARA HEALTH PLANS INC | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 522368125 | TPA | VA | N/A | C | Yes (1) | |||||
| OPTIMA HEALTH GROUP | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541473382 | HMO | VA | N/A | C | Yes (1) | |||||
| OPTIMA HEALTH INSURANCE COMPANY | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541642752 | HEALTH INSURANCE | VA | N/A | C | Yes (1) | |||||
| OPTIMA BEHAVIORAL HEALTH SERVICES | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 621382666 | MENTAL HEALTH SVCS | VA | N/A | C | Yes (1) | |||||
| SENTARA VENTURES INC | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541688615 | HOLDING COMPANY | VA | N/A | C | Yes (1) | |||||
| SMG INNOVATIONS INC | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 203730331 | HEALTH CARE | VA | N/A | C | Yes (1) | |||||
| SENTARA OBICI PROFESSIONAL CENTER | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541445865 | RE RENTAL | VA | N/A | C | Yes (1) | |||||
| SENTARA STRATEGIC SOLUTIONS INC | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541020941 | HEALTH CARE | VA | N/A | C | Yes (1) | |||||
| POTOMAC VENTURES CORP | ||||||||||||||
| 2300 OPITZ BLVD | WOODBRIDGE | VA | 22191 | 541441420 | PHARMACY | VA | N/A | C | Yes (1) | |||||
| ROCKINGHAM HEALTH SERVICES INC | ||||||||||||||
| 2010 HEALTH CAMPUS DRIVE | HARRISONBURG | VA | 22801 | 541721387 | CONTRACTING SVCS | VA | N/A | C | Yes (1) | |||||
| MARTHA JEFFERSON MEDICAL ENTERPRISES INC | ||||||||||||||
| 500 MARTHA JEFFERSON DRIVE | CHARLOTTESVILLE | VA | 22911 | 541841528 | MEDICAL BILLING SVCS | VA | N/A | C | Yes (1) | |||||
| BAY PRIMEX INSURANCE COMPANY LTD | ||||||||||||||
| 980704114 | INSURANCE | N/A | C | Yes (1) | PO BOX 1051 | GRAND CAYMAN | CJ | KY1-1102 | CJ | |||||
| ALBEMARLE PHYSICIAN SERVICES-SENTARA INC | ||||||||||||||
| 1144 NORTH ROAD STREET | ELIZABETH CITY | NC | 27909 | 264592192 | PHYS PRACTICE | NC | N/A | C | Yes (1) | |||||
| SENTARA HEALTH PLANS OF OHIO INC | ||||||||||||||
| 4417 CORPORATION LANE | VIRGINIA BEACH | VA | 23462 | 471509408 | TPA | OH | N/A | C | Yes (1) | |||||
| SENTARA HEALTH INSURANCE CO OF NC | ||||||||||||||
| 4417 CORPORATION LANE | VIRGINIA BEACH | VA | 23462 | 471888140 | HEALTH INSURANCE | NC | N/A | C | Yes (1) | |||||
| SENTARA HEALTH PLANS OF NC INC | ||||||||||||||
| 4417 CORPORATION LANE | VIRGINIA BEACH | VA | 23462 | 465510421 | TPA | NC | N/A | C | Yes (1) | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOMINION HEALTH MEDICAL ASSOCIATES LTD | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionTypeTxt |
| Involved | $201,200 | InvolvedAmt |
| Method Of Amount Determination | CORP BOOKS/REC | MethodOfAmountDeterminationTxt |
Comments