Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
HALIFAX REGIONAL HOSPITAL INC
 
Employer identification number

54-0648699
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..
2
 
No
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2020
Page 2

Schedule J (Form 990) 2020
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1MICHAEL V GENTRY
FORMER OFFICER
(i)

(ii)
0
-------------
851,459
0
-------------
755,619
0
-------------
164,761
0
-------------
395,379
0
-------------
21,700
0
-------------
2,188,918
0
-------------
0
2MEGAN R PERRY
DIRECTOR
(i)

(ii)
0
-------------
486,725
0
-------------
347,832
0
-------------
164,053
0
-------------
391,002
0
-------------
20,745
0
-------------
1,410,357
0
-------------
64,433
3JONATHAN S DAVIS
DIRECTOR/VICE CHAIR
(i)

(ii)
0
-------------
414,439
0
-------------
145,489
0
-------------
77,450
0
-------------
91,038
0
-------------
28,827
0
-------------
757,243
0
-------------
25,667
4JENNIFER S SICTOR
DIRECTOR
(i)

(ii)
0
-------------
297,620
0
-------------
120,678
0
-------------
9,569
0
-------------
116,086
0
-------------
31,326
0
-------------
575,279
0
-------------
0
5MING Y LIU MD
FORMER TOP 5
(i)

(ii)
0
-------------
389,835
0
-------------
0
0
-------------
22,319
0
-------------
57,966
0
-------------
27,794
0
-------------
497,914
0
-------------
0
6PABLO SOUZA MD
PHYSICIAN - HF
(i)

(ii)
346,346
-------------
0
0
-------------
0
1,710
-------------
0
56,929
-------------
0
30,263
-------------
0
435,248
-------------
0
0
-------------
0
7GREGORY A SHUFORD MD
FORMER TOP 5
(i)

(ii)
0
-------------
210,041
0
-------------
0
0
-------------
35,425
0
-------------
56,025
0
-------------
20,296
0
-------------
321,787
0
-------------
0
8BRIAN K ZWOYER
PRESIDENT
(i)

(ii)
208,140
-------------
0
17,970
-------------
0
41,386
-------------
0
11,922
-------------
0
32,800
-------------
0
312,218
-------------
0
0
-------------
0
9STEWART R NELSON
FORMER OFFICER AND KE
(i)

(ii)
2,355
-------------
162,198
0
-------------
94,427
15
-------------
26,899
72
-------------
7,083
177
-------------
13,096
2,619
-------------
303,703
0
-------------
0
10DAVID FITTS
MANAGER, PHARMACY
(i)

(ii)
148,957
-------------
0
22,583
-------------
0
6,512
-------------
0
82,220
-------------
0
30,763
-------------
0
291,035
-------------
0
0
-------------
0
11TORIE B BASHAY
FORMER KE
(i)

(ii)
0
-------------
144,127
0
-------------
29,608
0
-------------
5,293
0
-------------
97,789
0
-------------
7,070
0
-------------
283,887
0
-------------
0
12BETTY T THROCKMORTON
RN UC -CLIN LADDER - LEVEL II
(i)

(ii)
159,842
-------------
0
750
-------------
0
2,726
-------------
0
79,179
-------------
0
33,412
-------------
0
275,909
-------------
0
0
-------------
0
13JAMES E CHILDREY
MGT, PATIENT CARE SERVICES - HF
(i)

(ii)
134,423
-------------
0
16,420
-------------
0
536
-------------
0
77,919
-------------
0
21,445
-------------
0
250,743
-------------
0
0
-------------
0
14SHERRI F BEE
FORMER KE
(i)

(ii)
128,610
-------------
0
17,080
-------------
0
967
-------------
0
61,994
-------------
0
10,536
-------------
0
219,187
-------------
0
0
-------------
0
15JASON A STUDLEY
FORMER OFFICER
(i)

(ii)
11,208
-------------
8,140
0
-------------
80,351
44
-------------
104,384
349
-------------
0
1,217
-------------
5,249
12,818
-------------
198,124
0
-------------
0
16ANTHONY J MILAM
CLINICAL PHARMACIST- INPATIENT - HF
(i)

(ii)
143,448
-------------
0
2,250
-------------
0
4,166
-------------
0
27,214
-------------
0
10,157
-------------
0
187,235
-------------
0
0
-------------
0
Schedule J (Form 990) 2020
Page 3

Schedule J (Form 990) 2020
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 1A THE ORGANIZATION PAID FOR TEMPORARY HOUSING OF AN EXECUTIVE RECRUIT, INCLUDING THE ADDITIONAL TAXES ASSOCIATED WITH SUCH BENEFIT, ALL OF WHICH WERE TREATED AS ADDITIONAL COMPENSATION AND REPORTED ON FORM W-2 AS TAXABLE WAGES.
PART I, LINE 3 SENTARA HEALTHCARE, THE 501(C)(3) TAX EXEMPT PARENT OF THE SENTARA HEALTH SYSTEM, ESTABLISHED THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL THROUGH THE USE OF AN INDEPENDENT COMPENSATION CONSULTANT AND A COMPENSATION STUDY. SENTARA HEALTHCARE RECOGNIZES THAT PROVIDING THE BEST POSSIBLE CARE REQUIRES US TO ATTRACT AND RETAIN THE VERY BEST EMPLOYEES. OUR ORGANIZATION IS COMMITTED TO INVESTING IN OUR PEOPLE BY OFFERING COMPETITIVE COMPENSATION OPPORTUNITIES AND A STRONG WORKPLACE ENVIRONMENT.
PART I, LINES 4A-B JASON A. STUDLEY RECEIVED $70,938 IN COMPENSATION RELATED TO HIS SEPARATION FROM SERVICE. THIS AMOUNT HAS BEEN INCLUDED IN COLUMN (B)(III) OF SCHEDULE J, PART II. MICHAEL GENTRY, MEGAN PERRY, JONATHAN DAVIS, AND BRIAN ZWOYER PARTICIPATED IN THE SENTARA CAPITAL ACCUMULATION ACCOUNT PLAN. THE CAPITAL ACCUMULATION PLAN IS A NONQUALIFIED DEFERRED COMPENSATION PROGRAM. SUCH PLANS ARE COMMONLY OFFERED TO NOT-FOR-PROFIT HEALTH CARE EXECUTIVES TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO SUPPLEMENT LIMITATIONS IN QUALIFIED PLANS. 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 2020, THE FOLLOWING CORPORATE EXECUTIVES RECEIVED VESTED DISTRIBUTIONS UNDER THE PLAN: MICHAEL GENTRY ($131,794); MEGAN PERRY ($98,994); AND JONATHAN DAVIS ($38,453). THESE AMOUNTS HAVE BEEN REPORTED IN COLUMN (B)(III) OF SCHEDULE J, PART II. DURING THE CURRENT TAX YEAR MING Y LIU PARTICIPATED IN THE SENTARA NON-QUALIFIED DEFERRED COMPENSATION PLAN. A NEW PLAN YEAR BEGINS EACH JANUARY 1ST. ELIGIBILITY REQUIRES THAT AN EMPLOYEE MUST BE IN THE TOP 5% BY SALARY AND HAVE COMPENSATION GREATER THAN OR EQUAL TO THE HIGHLY COMPENSATED AMOUNT SET BY THE PLAN IN ORDER TO PARTICIPATE. PARTICIPANTS MUST MAKE THEIR ELECTIONS IN THE YEAR PRECEDING THE DEFERRAL YEAR AND SELECT A DISTRIBUTION DATE. NEW ELECTIONS MUST BE MADE EACH YEAR. ALL PARTICIPANTS ARE 100% VESTED IN THEIR ACCOUNT BALANCES AND LUMP SUM IS THE FORM OF PAYMENT AT THE DISTRIBUTION DATE UNLESS A 5 OR 10 YEAR INSTALLMENT PAYMENT WAS SELECTED.
PART I, LINE 7 DURING THE CURRENT TAX YEAR, THE ORGANIZATION MADE NON-FIXED PAYMENTS OF COMPENSATION UNDER THE FOLLOWING INCENTIVE PROGRAMS: ANNUAL INCENTIVE PROGRAM - EXECUTIVES AND SENIOR LEADERS ARE ELIGIBLE FOR ANNUAL AWARDS BASED ON SYSTEM AND INDIVIDUAL PERFORMANCE. BOTH SYSTEM AND INDIVIDUAL SCORES ARE DETERMINED AFTER YEAR-END, AT WHICH POINT AWARDS MAY BE PAID AND REPORTED AS COMPENSATION. TARGET AND MAXIMUM OPPORTUNITIES VARY BY LEVEL. KEY CONTRIBUTOR AWARDS - REWARDS EXCEPTIONAL INDIVIDUALS OR TEAMS FOR SIGNIFICANT CONTRIBUTION AND RESULTS AS RECOGNIZED BY BUSINESS UNITS. MANAGER INCENTIVE PLAN - MANAGEMENT EMPLOYEES NOT COVERED UNDER ANOTHER INCENTIVE PLAN ARE ELIGIBLE FOR THE MANAGEMENT INCENTIVE PLAN. AWARDS ARE BASED ON SYSTEM YEAR-END RESULTS AS DETERMINED BY THE BOARD; BUSINESS UNIT RESULTS FOR FINANCIAL, SAFETY, QUALITY AND CUSTOMER SERVICE; AND THE MANAGER'S INDIVIDUAL PERFORMANCE SCORE. SYSTEM, BUSINESS UNIT, AND INDIVIDUAL RESULTS ARE DETERMINED AFTER YEAR-END, AT WHICH POINT AWARDS MAY BE PAID AND REPORTED AS COMPENSATION. YEAR-END BONUS PAYMENTS EMPLOYEES WHO ARE NOT COVERED UNDER ANOTHER INCENTIVE PROGRAM ARE ELIGIBLE FOR YEAR-END BONUSES WHICH ARE CONDITIONED UPON SYSTEM YEAR-END RESULTS.
Schedule J (Form 990) 2020

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