SENTARA HALIFAX REGIONAL PROPERTIES INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SENTARA HALIFAX REGIONAL PROPERTIES INC (EIN 54-1801463)
- Tax period
- 2012-09-01 to 2013-08-31
- Filed
- 2014-07-15
- IRS object ID
- 201411969349301511
- Schema version
- 2012v2.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-07-15T15:52:54-05:00 | Timestamp |
| Tax Period End Date | 2013-08-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-09-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541801463 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX REGIONAL PROPERTIES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HALI | NameControl |
| Phone | 4345173183 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2204 WILBORN AVENUE | AddressLine1 |
| City | SOUTH BOSTON | City |
| State | VA | State |
| ZIP Code | 24592 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEWART R NELSON | Name |
| Title | CFO | Title |
| Phone | 4345173183 | Phone |
| Date Signed | 2014-07-15 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CHRIS A LUMSDEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2204 WILBORN AVENUE | AddressLine1 |
| City | SOUTH BOSTON | City |
| State | VA | State |
| ZIP Code | 24592 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 2962630 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HRHS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1996 | YearFormation |
| State Legal Domicile | VA | StateLegalDomicile |
| Activity Or Mission Description | TO PROMOTE THE HEALTH/WELFARE OF THE COMMUNITY AND TO SUPPORT HALIFAX REGIONAL HOSPITAL. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 2 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 5 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 635000 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1849425 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 995160 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1113860 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | -655 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1630160 | TotalRevenuePriorYear |
| Total Revenue Current Year | 2962630 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 30447 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 41433 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1285132 | OtherExpensePriorYear |
| Other Expenses Current Year | 1390251 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1315579 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1431684 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 314581 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1530946 | RevenuesLessExpensesCY |
| Total Assets BOY | 7875419 | TotalAssetsBOY |
| Total Assets EOY | 16064779 | TotalAssetsEOY |
| Total Liabilities BOY | 1319274 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 859233 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6556145 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 15205546 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | HALIFAX REGIONAL PROPERTIES, INC. IS ORGANIZED TO PROMOTE THE GENERAL HEALTH AND WELFARE OF THE COMMUNITY AND IS RESPONSIBLE FOR THE SUPPORT OF HALIFAX REGIONAL HOSPITAL, INC. FOR MORE INFORMATION, SEE SCHEDULE O. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 1375583 | Expense |
| Revenue | 1113860 | Revenue |
| Description | CONSTRUCTION, ACQUISITION AND MANAGEMENT OF HALIFAX REGIONAL HOSPITAL, INC.'S REAL ESTATE HOLDINGS SITUATED ON CAMPUS AND IN MEDICALLY UNDERSERVED AREAS OF THE SERVICE AREA. | Description |
| Total Program Service Expense | 1375583 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 19 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 2 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 0 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEWART R NELSON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4345173183 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2204 WILBORN AVENUE | AddressLine1 |
| City | SOUTH BOSTON | City |
| State | VA | State |
| ZIP Code | 24592 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (9 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee |
|---|---|---|---|---|---|---|---|---|
| HABIB BASSIL MD | ||||||||
| SECRETARY (THROUGH 6/30/13) | 1.00 | 5.00 | X | X | 0 | 78750 | 0 | |
| J AUBREY HOUGHTON | ||||||||
| TREASURER (THROUGH 6/30/13) | 1.00 | 5.00 | X | X | 0 | 0 | 0 | |
| CAROL C THOMAS | ||||||||
| VICE CHAIR | 1.00 | 5.00 | X | X | 0 | 0 | 0 | |
| DAVID H WHITE JR | ||||||||
| CHAIRMAN | 1.00 | 5.00 | X | X | 0 | 0 | 0 | |
| JAMES H PRIEST DDS | ||||||||
| DIRECTOR | 1.00 | 5.00 | X | 0 | 0 | 0 | ||
| CHRIS A LUMSDEN | ||||||||
| CEO(THRU 6/30)/PRES/SEC(EFF 7/1/13) | 1.00 | 39.00 | X | X | 9740 | 383915 | 21110 | |
| ROBERT A BROERMANN | ||||||||
| TREASURER (EFF 7/1/13) | 1.00 | 54.00 | X | X | 0 | 0 | 0 | |
| STEWART R NELSON | ||||||||
| CHIEF FINANCIAL OFFICER | 1.00 | 39.00 | X | 6560 | 252843 | 4655 | ||
| THOMAS S KLUGE | ||||||||
| CHIEF OPERATING OFFICER | 1.00 | 39.00 | 5782 | 217988 | 14338 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 22082 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 933496 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 40103 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Related Organizations | 1830000 | RelatedOrganizations |
| Government Grants | 18708 | GovernmentGrants |
| All Other Contributions | 717 | AllOtherContributions |
| Total Contributions | 1849425 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | RENTAL INCOME | Description |
| Business Code | 531390 | BusinessCode |
| Total Revenue Column | 1113860 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1113860 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1113860 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -655 | TotalRevenueColumn |
| Exclusion | -$655 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2962630 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1113860 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$655 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41433 | Total |
| Management And General | 41433 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5740 | Total |
| Management And General | 5740 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8272 | Total |
| Management And General | 8272 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 223706 | Total |
| Program Services | 223706 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55153 | Total |
| Program Services | 55153 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 258157 | Total |
| Program Services | 258157 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 751777 | Total |
| Program Services | 751777 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13581 | Total |
| Program Services | 13581 | ProgramServices |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| TAXES & LICENSES | 70195 | 70195 | |
| MISCELLANEOUS | 3670 | 3014 | 656 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1431684 | Total |
| Program Services | 1375583 | ProgramServices |
| Management And General | 56101 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57978 | BOY |
| EOY | 213913 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 361271 | BOY |
| EOY | 18491 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8972 | BOY |
| EOY | 10051 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 15956365 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 139300 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7420891 | BOY |
| EOY | 15817065 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26307 | BOY |
| EOY | 5259 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7875419 | BOY |
| EOY | 16064779 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 766011 | BOY |
| EOY | 25743 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75404 | BOY |
| EOY | 791441 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 477859 | BOY |
| EOY | 42049 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1319274 | BOY |
| EOY | 859233 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6556145 | BOY |
| EOY | 15205546 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6556145 | BOY |
| EOY | 15205546 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7875419 | BOY |
| EOY | 16064779 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1530946 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 7118455 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX REGIONAL HOSPITAL INCORPORATED | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540648699 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5005000 | OtherCostOrOtherBasis |
| Book Value | 5005000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9124029 | OtherCostOrOtherBasis |
| Depreciation | 118525 | Depreciation |
| Book Value | 9005504 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 65708 | OtherCostOrOtherBasis |
| Depreciation | 873 | Depreciation |
| Book Value | 64835 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1761628 | OtherCostOrOtherBasis |
| Depreciation | 19902 | Depreciation |
| Book Value | 1741726 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 15817065 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO AFFILIATES | $41,013 |
| OTHER LIABILITIES | $1,036 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 42049 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | THE HOSPITAL, THE FOUNDATION, PROPERTIES, THE WOODVIEW, AND MEADOWVIEW TERRACE ARE GENERALLY EXEMPT FROM FEDERAL INCOME TAXES UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE, AS AMENDED. HRPS IS DISREGARDED FOR FEDERAL AND STATE INCOME TAX PURPOSES AS ITS OPERATIONS ARE CONSIDERED PART OF THE HOSPITAL FOR INCOME TAX PURPOSES. DHMA AND SOUTHSIDE ARE FOR-PROFIT, TAXABLE ORGANIZATIONS. THE HOSPITAL DOES NOT BELIEVE ITS CONSOLIDATED FINANCIAL STATEMENTS INCLUDE(OR REFLECT) ANY UNCERTAIN TAX POSITIONS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHRIS A LUMSDEN | ||||||||||||||
| CEO(THRU 6/30)/PRES/SEC(EFF 7/1/13) | 9740 | 311060 | 0 | 30000 | 0 | 42855 | 420 | 2081 | 3122 | 15487 | 13282 | 401483 | 0 | 0 |
| STEWART R NELSON | ||||||||||||||
| CHIEF FINANCIAL OFFICER | 6560 | 209502 | 0 | 20000 | 0 | 23341 | 470 | 2334 | 310 | 1541 | 7340 | 256718 | 0 | 0 |
| THOMAS S KLUGE | ||||||||||||||
| CHIEF OPERATING OFFICER | 5782 | 184647 | 0 | 10000 | 0 | 23341 | -677 | -3360 | 3083 | 15292 | 8188 | 229920 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 3 | ReturnReference |
| Explanation | 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. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOMINION HEALTH MEDICAL ASSOCIATES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | COMMON DIRECTOR | Relationship |
| Amount Of Transaction | 511312 | AmountOfTransaction |
| Description Of Transaction | AT FISCAL YEAR-END, DAVID H. WHITE, JR., BOARD CHAIRMAN, WAS ALSO ON THE BOARD OF DIRECTORS AT DOMINION HEALTH MEDICAL ASSOCIATES, LTD, A TAXABLE AFFILIATE ORGANIZATION WHICH LEASES FACILITIES, EQUIPMENT OR OTHER ASSETS FROM HALIFAX REGIONAL PROPERTIES. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | DIRECTORS/TRUSTEES/OFFICERS/KEY EMPLOYEES OF THE ORGANIZATION MAY ALSO SERVE AS DIRECTORS/TRUSTEES/OFFICERS OF RELATED TAXABLE ENTITIES WITHIN THE SENTARA HEALTHCARE SYSTEM. SEE SCHEDULE R FOR A LISTING OF TRANSACTIONS THE ORGANIZATION HAD WITH THESE RELATED TAXABLE ENTITIES. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (16 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION MISSION | PART III, LINE 1 | HALIFAX REGIONAL PROPERTIES, 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 THIS CORPORATION ARE TO OWN, HOLD, MANAGE, AND TO OTHERWISE DEAL IN AND WITH THE REAL ESTATE AND OTHER PROPERTIES FOR HALIFAX REGIONAL HOSPITAL, INC. OR PROVIDE SUCH OTHER SERVICES AS REQUESTED BY HALIFAX REGIONAL HOSPITAL, INC. AND TO CARRY OUT OTHER EXCLUSIVELY CHARITABLE, EDUCATIONAL, OR SCIENTIFIC PURPOSES OF HALIFAX REGIONAL HOSPITAL, INC. |
| PROGRAM SERVICE ACCOMPLISHMENTS | FORM 990, PART III, LINE 4A | HALIFAX REGIONAL PROPERTIES, INC. (PROPERTIES) IS ORGANIZED TO PROMOTE THE GENERAL HEALTH AND WELFARE OF THE COMMUNITY AND IS RESPONSIBLE FOR CONSTRUCTION, ACQUISITION, AND MANAGEMENT OF HALIFAX REGIONAL HOSPITAL, INC.'S REAL ESTATE HOLDINGS OTHER THAN THE HOSPITAL FACILITY AND THE LONG-TERM CARE FACILITIES. THESE HOLDINGS ARE SITUATED BOTH ON CAMPUS AND IN MEDICALLY-UNDERSERVED AREAS WITHIN THE SERVICE AREA OF HALIFAX REGIONAL HOSPITAL, INC. |
| 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 TAXABLE ORGANIZATIONS WITHIN THE SENTARA HEALTHCARE SYSTEM ("THE SYSTEM"), AS WELL AS JOINT VENTURES IN WHICH THE SYSTEM HAD AN OWNERSHIP INTEREST. SEE SCHEDULE R FOR A LISTING OF SUCH ENTITIES. | |
| FORM 990, PART VI, SECTION A, LINE 4 | EFFECTIVE JULY 1, 2013, HALIFAX REGIONAL HOSPITAL, INC. ("HRH"), A 501(C)(3) AFFILIATE, REPLACED HALIFAX REGIONAL HEALTH SYSTEM, INC.("HRHS") AS SOLE MEMBER OF THE ORGANIZATION. THE MEMBER CHANGE OCCURRED IN ACCORDANCE WITH THE APRIL 23, 2013 AFFILIATION AGREEMENT AMONG HRHS, HRH, AND SENTARA HEALTHCARE ("SENTARA"), A 501(C)(3) ORGANIZATION, WHEREBY SENTARA REPLACED HRHS AS THE SOLE MEMBER OF HRH. AS A RESULT OF THE AFFILIATION, THE ORGANIZING AND GOVERNING DOCUMENTS OF THE ORGANIZATION WERE CHANGED IN THE FOLLOWING MANNER: -HRH REPLACED HRHS AS SOLE MEMBER OF THE ORGANIZATION. -THE NUMBER OF DIRECTORS ON THE BOARD WAS CHANGED FROM FIVE TO NOT LESS THAN THREE. DIRECTORS ARE APPOINTED BY THE SOLE MEMBER, SUBJECT TO RATIFICATION BY SENTARA. -AS SOLE MEMBER OF HRH, SENTARA HAS THE EXCLUSIVE AUTHORITY TO DIRECT AND MANAGE THE OPERATIONS AND AFFAIRS OF THE ORGANIZATION AND TO MAKE ALL DECISIONS REGARDING ITS BUSINESS, SUBJECT TO OVERSIGHT BY THE HRH BOARD AS AND TO THE EXTENT SET FORTH IN THE AFFILIATION AGREEMENT. SENTARA HAS ALSO BEEN GRANTED CERTAIN RESERVED POWERS, AS OUTLINED IN THE AFFILIATION AGREEMENT, WHEREBY HRH WILL NOT PERMIT THE ORGANIZATION TO TAKE OR ALLOW CERTAIN ACTIONS WITHOUT THE PRIOR WRITTEN CONSENT OF SENTARA . SEE PART VI SECTION A LINE 7B FOR FURTHER INFORMATION. -DURING THE COVENANT PERIOD, AS DEFINED IN THE AFFILIATION AGREEMENT, 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 REQUIRE THE APPROVAL OF A MAJORITY OF CLASS A DIRECTORS OF HRH, VOTING AS A SEPARATE CLASS, AND OF SENTARA. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAD ONE CLASS OF MEMBER. EFFECTIVE JULY 1, 2013, THE SOLE MEMBER WAS HALIFAX REGIONAL HOSPITAL, INC., A VIRGINIA NONSTOCK CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION'S SOLE MEMBER PRIOR TO JULY 1, 2013 WAS HALIFAX REGIONAL HEALTH SYSTEM, INC., A VIRGINIA NONSTOCK CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. | |
| FORM 990, PART VI, SECTION A, LINE 7A | EFFECTIVE JULY 1, 2013, HALIFAX REGIONAL HOSPITAL, INC. REPLACED HALIFAX REGIONAL HEALTH SYSTEM, INC. AS SOLE MEMBER OF THE ORGANIZATION AND APPOINTED MEMBERS OF THE BOARD OF DIRECTORS IN ACCORDANCE WITH THE APRIL 23, 2013 AFFILIATION AGREEMENT WITH SENTARA HEALTHCARE. PRIOR TO ITS AFFILIATION WITH SENTARA, BOARD MEMBERS WERE APPOINTED BY HALIFAX REGIONAL HEALTH SYSTEM, INC. | |
| FORM 990, PART VI, SECTION A, LINE 7B | EFFECTIVE JULY 1, 2013, 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. PRIOR TO ITS AFFILIATION WITH SENTARA, HALIFAX REGIONAL HEALTH SYSTEM, INC., HAD THE POWER TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION: (I) THE ADOPTION OR AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS, (II) THE ELECTION OF THE CORPORATION'S BOARD OF DIRECTORS, (III) THE MERGER OF THE CORPORATION INTO ANOTHER ORGANIZATION OR THE ACQUISITION AND DISPOSAL OF ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS, (IV) THE BORROWING OF FUNDS FROM THIRD PARTIES, (V) THE ADOPTION OF BUSINESS PLANS, BUDGETS AND DISTRIBUTION OF FUNDS, (VI) THE APPROVAL OF FINANCIAL STATEMENTS, (VII) THE APPOINTMENT OF THE CORPORATION'S CEO AND EXTERNAL AUDITORS, (VIII) THE RECEIPT AND APPROVAL OF AUDIT REPORTS, (IX) THE APPROVAL OF COMPENSATION PLANS, AND (X) THE CREATION OR ACQUISITION OF ANY SUBSIDIARIES. | |
| 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 OF TRUSTEES 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. | |
| THE ORGANIZATION SEEKS TO PAY REASONABLE COMPENSATION UNDER IRC SECTION 4958 TO ATTRACT AND RETAIN THE APPROPRIATE CALIBER OF EMPLOYEES DEDICATED TO CARRYING OUT ITS TAX-EXEMPT MISSION. THE SOLE MEMBER OF THE ORGANIZATION PERIODICALLY CONDUCTS A REVIEW TO DETERMINE THE GOING FAIR MARKET COMPENSATION RANGES FOR COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE SOLE MEMBER SETS COMPENSATION WITHIN THE RANGE OF THE GOING MARKET RATE. NO INDIVIDUAL HAVING A CONFLICT OF INTEREST IS PERMITTED TO PARTICIPATE IN THE REVIEW OR DECISION. THE SOLE MEMBER MAINTAINS RECORDS REGARDING COMPENSATION. THE SOLE MEMBER'S BOARD CHAIRMAN ALSO SERVES AS THE CHAIRMAN OF ITS EXECUTIVE (COMPENSATION) COMMITTEE, COORDINATING WITH THE CHIEF EXECUTIVE OFFICER/PRESIDENT TO REVIEW ANNUAL PERFORMANCE AND COMPARATIVE MARKET INFORMATION FOR THE POSITION OF CHIEF EXECUTIVE OFFICER (CEO)/PRESIDENT, CHIEF OPERATING OFFICER (COO), AND CHIEF FINANCIAL OFFICER (CFO). A RECOMMENDATION IS PRESENTED TO THE EXECUTIVE COMMITTEE BY ITS CHAIRMAN. THE EXECUTIVE COMMITTEE TAKES ACTION ON THE RECOMMENDATION. THE SOLE MEMBER'S FULL BOARD OF DIRECTORS IS MADE AWARE THAT ITS EXECUTIVE COMMITTEE HAS TAKEN ACTION ON COMPENSATION FOR THE CEO/PRESIDENT, COO, AND CFO WITH DETAILS AVAILABLE FOR THEIR REVIEW UPON REQUEST. THIS PROCESS WAS LAST UNDERTAKEN DURING THE TAX YEAR. | ||
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION CURRENTLY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART VII, SECTION A | THE EFFECTIVE DATE OF THE ORGANIZATION'S AFFILIATION WITH SENTARA HEALTHCARE, ITS NEW 501(C)(3) SOLE MEMBER, WAS JULY 1, 2013. SINCE THE COMPENSATION REQUIRED TO BE REPORTED IN PART VII SECTION A IS FROM THE 2012 CALENDAR YEAR, AND SENTARA HEALTHCARE WAS NOT RELATED TO THE ORGANIZATION AT ANY TIME DURING 2012, NO RELATED COMPENSATION HAS BEEN REPORTED IN PART VII SECTION A FOR BOARD MEMBER AND TREASURER ROBERT BROERMANN, WHO IS AN EMPLOYED OFFICER OF SENTARA HEALTHCARE. | |
| OTHER FEES | FORM 990, PART IX, LINE 11G | NON-EMPLOYEE CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 223,706. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 223,706. |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 9: | ASU 2010-07 FMV ADJUSTMENTS 7,118,455. |
| CHANGE IN AFS OVERSIGHT PROCESS | FORM 990, PART XII, LINE 2C | DURING THE YEAR, THE ORGANIZATION AFFILIATED WITH THE SENTARA HEALTHCARE SYSTEM, WHO ASSUMED RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTED THE INDEPENDENT ACCOUNTANT. |
| STATEMENT FILED PURSUANT TO TREASURY REGULATION SEC. 1.6038-2(J)(3): | HALIFAX REGIONAL HOSPITAL,INC. ("HRH"), THE TAXPAYER'S 501(C)(3) SOLE MEMBER, 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 HRH, 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 HRH'S FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (19 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HALIFAX REGIONAL HOSPITAL INCORPORATED | |||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 540648699 | HEALTHCARE | VA | 501(C)(3) | 3 | SENTARA HEALTHCARE | 1 | |
| HALIFAX REGIONAL DEVELOPMENT FOUNDATION | |||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541801459 | HLTH/WELFARE | VA | 501(C)(3) | 11A TYPE I | HALIFAX REGIONAL HOSPITAL | 1 | |
| HALIFAX REGIONAL LONG TERM CARE INC | |||||||||||
| 103 ROSE HILL DRIVE | SOUTH BOSTON | VA | 24592 | 546074529 | SENIOR CARE | VA | 501(C)(3) | 11A TYPE I | HALIFAX REGIONAL HOSPITAL | 1 | |
| HALIFAX REGIONAL HEALTH SYSTEM INC | |||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541801466 | HEALTHCARE | VA | 501(C)(3) | 11B TYPE II | 0 | N/A | |
| CLARKSVILLE SENIOR CARE LLC | |||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541957066 | SENIOR CARE | VA | 501(C)(3) | 11A TYPE I | HALIFAX REGIONAL HOSPITAL | 1 | |
| SENTARA HEALTHCARE | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 521271901 | HEALTH CARE | VA | 501(C)(3) | LN7_NORMALGOVTSUPPOR | 0 | N/A | |
| SENTARA PRINCESS ANNE HOSPITAL | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 521277419 | HEALTH CARE | VA | 501(C)(3) | LN3_HOSPITALCOOPINSE | SENTARA HOSPITALS | 1 | |
| SENTARA HOSPITALS | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541547408 | HEALTH CARE | VA | 501(C)(3) | LN3_HOSPITALCOOPINSE | SENTARA HEALTHCARE | 1 | |
| SENTARA MEDICAL GROUP | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541217184 | HEALTH CARE | VA | 501(C)(3) | LN9_MORETHAN30PCTCON | SENTARA HEALTHCARE | 1 | |
| SENTARA ENTERPRISES | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541917649 | HEALTH CARE | VA | 501(C)(3) | LN9_MORETHAN30PCTCON | SENTARA HEALTHCARE | 1 | |
| SENTARA LIFE CARE CORP | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541217183 | HEALTH CARE | VA | 501(C)(3) | LN9_MORETHAN30PCTCON | SENTARA HEALTHCARE | 1 | |
| MPB INC | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541346393 | TITLE HOLDING COMPANY | VA | 501(C)(2) | SENTARA ENTERPRISES | 1 | ||
| OPTIMA HEALTH PLAN | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541283337 | HMO | VA | 501(C)(3) | 11A - I | SENTARA HEALTHCARE | 1 | |
| POTOMAC HOSPITAL CORP OF PRINCE WILLIAM | |||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 540853898 | HEALTH CARE | VA | 501(C)(3) | LN3_HOSPITALCOOPINSE | SENTARA HEALTHCARE | 1 | |
| ROCKINGHAM MEMORIAL HOSPITAL | |||||||||||
| 2010 HEALTH CAMPUS DRIVE | HARRISONBURG | VA | 22801 | 540506331 | HEALTH CARE | VA | 501(C)(3) | LN3_HOSPITALCOOPINSE | SENTARA HEALTHCARE | 1 | |
| VALLEY WELLNESS CENTER | |||||||||||
| 501 STONE SPRING ROAD | HARRISONBURG | VA | 22801 | 521309257 | PREVENTATIVE HEALTH/REHAB | VA | 501(C)(3) | LN9_MORETHAN30PCTCON | ROCKINGHAM MEMORIAL HOSPITAL | 1 | |
| MJH FOUNDATION | |||||||||||
| 500 MARTHA JEFFERSON DRIVE | CHARLOTTESVILLE | VA | 22911 | 541401357 | INVEST/MGT SVCS FOR MARTHA JEFFERSON HOSPITAL | VA | 501(C)(3) | 11A - I | MARTHA JEFFERSON HOSPITAL | 1 | |
| MARTHA JEFFERSON HOSPITAL FOUNDATION | |||||||||||
| 500 MARTHA JEFFERSON DRIVE | CHARLOTTESVILLE | VA | 22911 | 300041113 | FUNDRAISING | VA | 501(C)(3) | 11A - I | MARTHA JEFFERSON HOSPITAL | 1 | |
| MARTHA JEFFERSON HOSPITAL | |||||||||||
| 500 MARTHA JEFFERSON DRIVE | CHARLOTTESVILLE | VA | 22911 | 540261840 | HEALTH CARE | VA | 501(C)(3) | LN3_HOSPITALCOOPINSE | SENTARA HEALTHCARE | 1 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (23 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|
| 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 |
| CAREPLEX WEST LLC | |||||||
| 18000 W SARAH LANE STE 250 | BROOKFIELD | WI | 53045 | 202738977 | RENTAL RE | WI | N/A |
| PORT WARWICK II LLC | |||||||
| 18000 WEST SARAH LANE STE 250 | BROOKFIELD | WI | 53045 | 202739075 | RENTAL RE | WI | 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 |
| PORT WARWICK III LLC | |||||||
| 18000 WEST SARAH LANE STE 250 | BROOKFIELD | WI | 53045 | 611499371 | RENTAL RE | WI | N/A |
| MARTHA JEFFERSON OSC LLC | |||||||
| 595 MARTHA JEFFERSON DR | CHARLOTTESVILLE | VA | 22911 | 113656095 | HEALTH CARE | VA | N/A |
| VALIANCE HEALTH LLC | |||||||
| 3190 PEOPLES DRIVE | HARRISONBURG | VA | 22801 | 541866081 | HEALTH CARE | VA | N/A |
| PHYSICAL THERAPY ACACLLC | |||||||
| 501 ALBEMARLE SQUARE | CHARLOTTESVILLE | VA | 22901 | 260080717 | HEALTH CARE | VA | N/A |
| NORTHERN VIRGINIA HOME CARE LLC | |||||||
| 601 SOUTH CARLIN SPRINGS RD | ARLINGTON | VA | 22204 | 453940053 | HOME 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 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (15 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SOUTHSIDE HEALTH SERVICES INC | ||||||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541417772 | HEALTH SERVICES | VA | N/A | C | 1 | |||||
| DOMINION HEALTH MEDICAL ASSOCIATES LTD | ||||||||||||||
| 2204 WILBORN AVENUE | SOUTH BOSTON | VA | 24592 | 541060357 | PHYS PRACTICE | VA | N/A | C | 1 | |||||
| SENTARA HOLDINGS INC | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541555638 | HOLDING COMPANY | VA | N/A | C | 1 | |||||
| SENTARA HEALTH PLANS INC | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 522368125 | TPA | VA | N/A | C | 1 | |||||
| OPTIMA HEALTH GROUP | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541473382 | HMO | VA | N/A | C | 1 | |||||
| OPTIMA HEALTH INSURANCE COMPANY | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541642752 | HEALTH INSURANCE | VA | N/A | C | 1 | |||||
| OPTIMA BEHAVIORAL HEALTH SERVICES | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 621382666 | MENTAL HEALTH SVCS | VA | N/A | C | 1 | |||||
| SENTARA VENTURES INC | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541688615 | HOLDING COMPANY | VA | N/A | C | 1 | |||||
| SMG INNOVATIONS INC | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 203730331 | HEALTH CARE | VA | N/A | C | 1 | |||||
| SENTARA OBICI PROFESSIONAL CENTER | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541445865 | RE RENTAL | VA | N/A | C | 1 | |||||
| SENTARA STRATEGIC SOLUTIONS INC | ||||||||||||||
| 6015 POPLAR HALL DRIVE | NORFOLK | VA | 23502 | 541020941 | HEALTH CARE | VA | N/A | C | 1 | |||||
| POTOMAC VENTURES CORP | ||||||||||||||
| 2300 OPITZ BLVD | WOODBRIDGE | VA | 22191 | 541441420 | PHARMACY | VA | N/A | C | 1 | |||||
| ROCKINGHAM HEALTH SERVICES INC | ||||||||||||||
| 2010 HEALTH CAMPUS DRIVE | HARRISONBURG | VA | 22801 | 541721387 | CONTRACTING SVCS | VA | N/A | C | 1 | |||||
| MARTHA JEFFERSON MEDICAL ENTERPRISES INC | ||||||||||||||
| 500 MARTHA JEFFERSON DRIVE | CHARLOTTESVILLE | VA | 22911 | 541841528 | MEDICAL BILLING SVCS | VA | N/A | C | 1 | |||||
| BAY PRIMEX INSURANCE COMPANY LTD | ||||||||||||||
| 980704114 | INSURANCE | N/A | C | 1 | PO BOX 1051 | GRAND CAYMAN | CJ | KY1-1102 | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| HALIFAX REGIONAL LONG TERM CARE INC | ||
| C | 300000 | CORP BOOKS/REC |
| DOMINION HEALTH MEDICAL ASSOCIATES LTD | ||
| J | 511312 | CORP BOOKS/REC |
| HALIFAX REGIONAL HOSPITAL INC | ||
| J | 123733 | CORP BOOKS/REC |
| HALIFAX REGIONAL HOSPITAL INC | ||
| M | 110958 | CORP BOOKS/REC |
| HALIFAX REGIONAL HOSPITAL INC | ||
| P | 147505 | CORP BOOKS/REC |
| HALIFAX REGIONAL HOSPITAL INC | ||
| C | 1530000 | CORP BOOKS/REC |
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