Webster County Memorial Hospital: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- Webster County Memorial Hospital (EIN 55-6005561)
- Tax period
- 2021-07-01 to 2021-12-31
- Filed
- 2022-11-01
- IRS object ID
- 202203059349300430
- Schema version
- 2021v4.2
- 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) |
|---|---|---|
| Return | 2022-11-01T15:33:06-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baker Tilly US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 Washington Street East | AddressLine1Txt |
| City | Charleston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25329 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 556005561 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Webster County Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WEBS | BusinessNameControlTxt |
| Phone | 3048475682 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 324 Miller Mountain Drive | AddressLine1Txt |
| City | Webster Springs | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26288 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | William Dempsey | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3048475682 | PhoneNum |
| Signature | 2022-10-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | William | PersonFirstNm |
| Person Last | Dempsey | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Dolores Rose | PreparerPersonNm |
| PTIN | P01286262 | PTIN |
| Phone | 3043460441 | PhoneNum |
| Preparation | 2022-10-03 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | William Dempsey | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 324 Miller Mountain Drive | AddressLine1Txt |
| City | Webster Springs | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26288 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,023,837 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.wcmhwv.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1951 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | To provide acute short-term care to residents of Webster and surrounding counties of West Virginia. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 211 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $139,587 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,828,118 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,982,743 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,137,420 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,255 | PYInvestmentIncomeAmt |
| CY Investment Income | $771 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,855,794 | PYOtherRevenueAmt |
| CY Other Revenue | $57,528 | CYOtherRevenueAmt |
| PY Total Revenue | $21,981,379 | PYTotalRevenueAmt |
| CY Total Revenue | $10,023,837 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,705,283 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,436,279 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,226,905 | PYOtherExpensesAmt |
| CY Other Expenses | $4,220,542 | CYOtherExpensesAmt |
| PY Total Expenses | $18,932,188 | PYTotalExpensesAmt |
| CY Total Expenses | $10,656,821 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,049,191 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$632,984 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,179,382 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,245,641 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,742,928 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,842,496 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,436,454 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,403,145 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of Webster County Memorial Hospital is to provide excellent, high quality care in a compassionate and cost-effective manner. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,584,050 | ExpenseAmt |
| Revenue | $8,194,948 | RevenueAmt |
| Desc | Critical Access Hospital services provided included 386 inpatient days, 35,707 outpaitent visits, and 7,108 RHC visits. Charges forgone for charity amounted to $5,561. | Desc |
| Total Program Service Expenses | $8,584,050 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 211 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 | 0 | QuidProQuoContributionsInd |
| 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 |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | 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 | Dalila Miller | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3048475682 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 324 Miller Mountain Drive | AddressLine1Txt |
| City | Webster Springs | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26288 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Mary Anne Carpenter | |||||||
| Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Christopher Graham | |||||||
| Vice Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Larry Lynch | |||||||
| Secretary/Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Karen Dotson | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Keith Hamrick | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Jim Phares | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Dalila Miller | |||||||
| Director of Business Opera | 40.00 | Yes (X) | $60,146 | $0 | $1,300 | ||
| William Dempsey | |||||||
| CEO | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| Frankie Pucket MD | |||||||
| ER Director | 40.00 | $682,057 | $0 | $0 | Yes (X) | ||
| Robert Sutherland MD | |||||||
| ER Physician | 40.00 | $354,635 | $0 | $15,000 | Yes (X) | ||
| Johathan Beam MD | |||||||
| Pharmacist | 40.00 | $173,224 | $0 | $19,405 | Yes (X) | ||
| Jeanette Boyce MD | |||||||
| Physician | 40.00 | $175,202 | $0 | $8,643 | Yes (X) | ||
| Janak Patel MD | |||||||
| Chief of Staff | 40.00 | $525,630 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,970,894 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $44,348 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| McKesson Medical Surgical | |||||
| 9954 Mayland Drive | Richmond | VA | 23233 | Medical Supplies | $511,469 |
| HealthlandCPSI | |||||
| PO Box 11407 | Birmingham | AL | 35246 | Electronic Medical Records | $335,247 |
| LabCorp | |||||
| PO Box 12140 | Burlington | NC | 27216 | Lab Services | $286,079 |
| Arnet Carbis Toothman | |||||
| PO Box 45723 | Charleston | WV | 25239 | CPA's | $151,424 |
| Concordance Healthcare | |||||
| PO Box 94631 | Cleveland | OH | 44101 | Medical Supplies | $104,953 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,789,521 | GovernmentGrantsAmt |
| All Other Contributions | $38,597 | AllOtherContributionsAmt |
| Total Contributions | $1,828,118 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 622110 | $4,443,935 | $4,443,935 |
| 340B Pharmacy Revenue | 900099 | $3,693,485 | $3,693,485 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,137,420 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $771 | TotalRevenueColumnAmt |
| Exclusion | $771 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Other Revenue | 900099 | $44,010 | $44,010 |
| Employee Meals | 722514 | $13,518 | $13,518 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $57,528 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,023,837 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,194,948 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $771 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,905 | TotalAmt |
| Program Services | $45,307 | ProgramServicesAmt |
| Management And General | $15,598 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,323,056 | TotalAmt |
| Program Services | $3,959,821 | ProgramServicesAmt |
| Management And General | $1,363,235 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,744 | TotalAmt |
| Program Services | $39,236 | ProgramServicesAmt |
| Management And General | $13,508 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $665,580 | TotalAmt |
| Program Services | $495,125 | ProgramServicesAmt |
| Management And General | $170,455 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333,994 | TotalAmt |
| Program Services | $248,458 | ProgramServicesAmt |
| Management And General | $85,536 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,871 | TotalAmt |
| Management And General | $101,871 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $412,397 | TotalAmt |
| Program Services | $398,029 | ProgramServicesAmt |
| Management And General | $14,368 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,709 | TotalAmt |
| Management And General | $2,709 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239,607 | TotalAmt |
| Program Services | $210,190 | ProgramServicesAmt |
| Management And General | $29,417 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $278,269 | TotalAmt |
| Program Services | $207,004 | ProgramServicesAmt |
| Management And General | $71,265 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,165 | TotalAmt |
| Program Services | $92,366 | ProgramServicesAmt |
| Management And General | $31,799 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,761 | TotalAmt |
| Program Services | $29,578 | ProgramServicesAmt |
| Management And General | $10,183 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,155 | TotalAmt |
| Program Services | $9,786 | ProgramServicesAmt |
| Management And General | $3,369 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $235,415 | TotalAmt |
| Program Services | $175,125 | ProgramServicesAmt |
| Management And General | $60,290 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,006 | TotalAmt |
| Program Services | $134,650 | ProgramServicesAmt |
| Management And General | $46,356 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical supplies | $1,752,537 | $1,752,537 | |
| Bad debt expense | $516,419 | $516,419 | |
| Repairs & maintenance | $164,773 | $122,575 | $42,198 |
| Provider tax | $116,679 | $116,679 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,779 | TotalAmt |
| Program Services | $31,165 | ProgramServicesAmt |
| Management And General | $10,614 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,656,821 | TotalAmt |
| Program Services | $8,584,050 | ProgramServicesAmt |
| Management And General | $2,072,771 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,312,445 | BOYAmt |
| EOY | $5,750,863 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,546 | BOYAmt |
| EOY | $44,515 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,390,687 | BOYAmt |
| EOY | $1,093,249 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $369,838 | BOYAmt |
| EOY | $600,148 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $42,716 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,141,870 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,482,509 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,786,028 | BOYAmt |
| EOY | $1,659,361 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $275,838 | BOYAmt |
| EOY | $54,789 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,179,382 | BOYAmt |
| EOY | $9,245,641 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,495,137 | BOYAmt |
| EOY | $1,437,687 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,200,000 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $954,865 | BOYAmt |
| EOY | $639,717 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,092,926 | BOYAmt |
| EOY | $2,765,092 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,742,928 | BOYAmt |
| EOY | $4,842,496 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,391,908 | BOYAmt |
| EOY | $4,358,630 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,546 | BOYAmt |
| EOY | $44,515 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,436,454 | BOYAmt |
| EOY | $4,403,145 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,179,382 | BOYAmt |
| EOY | $9,245,641 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$632,984 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $599,675 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,800 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,800 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | A portion of dues paid by the Hospital to the American Hospital Association and West Virginia Hospital Association is attributable to lobbying. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $152,765 | OtherCostOrOtherBasisAmt |
| Book Value | $152,765 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,793,535 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,767,904 | DepreciationAmt |
| Book Value | $25,631 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,029,935 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,570,827 | DepreciationAmt |
| Book Value | $1,459,108 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $165,635 | OtherCostOrOtherBasisAmt |
| Depreciation | $143,778 | DepreciationAmt |
| Book Value | $21,857 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,659,361 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Third-party settlements | $1,226,918 |
| Covid 19 Advance | $1,538,174 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,765,092 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $9,507,418 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,507,418 | RevenueSubtotalAmt |
| Other Revenues Not Included | $516,419 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $516,419 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $10,023,837 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,127,247 | TotExpnsEtcAuditedFinclStmtAmt |
| Prior Year Adjustments | -$13,155 | PriorYearAdjustmentsAmt |
| Expenses Not Reported | -$13,155 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,140,402 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $516,419 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $516,419 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,656,821 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | The Hospital is a not-for-profit corporation and is exempt from income taxes under Section 115 of the Internal Revenue Code. Accordingly, no provision for income taxes has been provided. The Hospital follows the guidance for accounting for uncertainty in income taxes recognized in a companys financial statements that prescribes a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold has been met. The Hospitals policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in operating expenses. There were no interest or penalties recognized on the statements of revenue and expenses and changes in net position as a result of this guidance. |
| Part XI, Line 4b - Other Adjustments: | Bad debts netted against income on financial statements 516,419. |
| Part XII, Line 4b - Other Adjustments: | Bad debts netted against income on financial statements 516,419. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 175.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 175.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $121,136 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $121,136 | DirectOffsettingRevenueAmt |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $168,808 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $160,030 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,778 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $289,944 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $281,166 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,778 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,100 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,100 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $291,044 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $281,166 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $516,419 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $1,196,544 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $1,196,544 | CostOfCareReimbursedByMedcrAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Webster County Memorial Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 312 | AddressLine1Txt |
| City | Webster Springs | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26288 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://www.wcmhwv.org/ | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Rural Health Clinic | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Webster County Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| CHNA Conducted | 20 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.wcmhwv.org/downloadable-forms-1 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.wcmhwv.org/downloadable-forms-1 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 175.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 175.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.wcmhwv.org/downloadable-forms-1 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.wcmhwv.org/downloadable-forms-1 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.wcmhwv.org/downloadable-forms-1 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Webster County Memorial Hospital | Part V, Section B, Line 5: The Community Health Needs Assessment (CHNA) questionnaire was taken to multiple public locations for community members to fill out and give their opinion of services needed and their satisfaction with services already provided by the hospital. Officials and employees were interviewed for the CHNA from the following: Webster County Health Department, Board of Education, Family Resource Network, United National Bank, Catholic Charities, and the food pantry. |
| Webster County Memorial Hospital | Part V, Section B, Line 11: Based upon the results of the Community Health Needs Assessment, Webster County Memorial Hospital will develop a three-year Implementation Strategy to address the following significant community health related needs:*Increased education and promotion of community resources*Utilize existing affiliations to promote healthier lifestyle choices*Chronic disease maintenance and prevention (Diabetes, Cardiovascular, Respiratory)*Improve overall health statusThe CHNA, approved on June 30, 2021, has provided valuable insight to the contributing factors of health related issues faced by the residents of Webster County and the surrounding communities. It will assist Webster County Memorial Hospital as well as other community providers to collaborate their efforts to provide the necessary resources for the community. Initiatives were aggregated among two main categories, increased education and promotion of community resources and promotion of healthier lifestyle choices. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - The Cowen Clinic | ||||
| 70 Technology Drive | Cowen | WV | 26206 | Prenatal primary care, pain management, wellness clinic |
| 2 - Webster Physical Therapy | ||||
| 139 Bakers Island | Webster Springs | WV | 26288 | Physical therapy |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | The patient's income is considered and reviewed to determine the amount of discount they receive, if not free care. The patient's assets are also reviewed. They can only have one vehicle and one house. If the patient has more than one vehicle, the total value of the vehicles cannot exceed $2,000. If the value exceeds $2,000, the patient will automatically be reduced to a percentage less than 100%. |
| Part I, Line 7: | The Hospital is a CAH and is paid 100% costs from Medicaid with the exception of the RHC which is PPS. The Medicaid community benefit expense reported on Part I, Line 7b is from the RHC excess cost over reimbursements. |
| Part I, Line 7, Column (f): | The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 516,419. |
| Part II, Community Building Activities: | The Hospital distributes educational material regarding smoking cessation, healthy eating, saying no to drugs, cancer, diabetes & other diseases, how to live a healthier life along with physical activities. The Hospital also assists the community with kids needs for sports. |
| Part III, Line 4: | Patient accounts receivable are carried at the original charge less an estimate made for doubtful or uncollectible accounts. The allowance is based upon a review of the outstanding balances aged by financial class. Management uses collection percentages based upon historical collection experience to determine collectibility. Management also reviews troubled, aged accounts to determine collection potential. Patient accounts receivable are written off when deemed uncollectible. Recoveries of accounts previously written off are recorded as a reduction to bad debt expense when received. Interest is not charged on patient accounts receivable. |
| Part III, Line 8: | The Medicare cost report was used to report Medicare revenue and expenses.CAH's receive cost reimbursement for Medicare services. A settlement process takes place after the Medicare cost report is filed in order to make payments (revenue) equal allowable cost. Thus, there is no "shortfall" of cost versus payments for CAH Medicare services. |
| Part III, Line 9b: | Patient's are informed about the finanical assistance program when they call to ask about their medical bills. The billers offer patient information about the program over the phone or if the patient is seen by the biller in person, they are shown the application and the documents that are needed. |
| Part VI, Line 2: | Director of Clinical Operations & Quality continuously reviews referral logs made by secretaries to see if there are any services we can provide here. Then we find out cost and reimbursement issues and present to CEO. |
| Part VI, Line 3: | If the patient presents to the registration desk and is private pay, the registration clerk informs the patient that we currently have a Financial Assistance program that will help them receive a discount or have the total amount written off and offers them the application. If a patient is private pay and admitted as an observation or inpatient, the social worker reviews the financial assistance program with the patient and offers them the application before discharge. If a patient calls into the billing office to ask about their billing statement and they state they don't think they can pay or want to make a payment contract, the billers will offer the patient information on the program and offer to mail them an application. |
| Part VI, Line 4: | Our geographical service area is rural. The majority (91.2%) of the Hospital's patients reside in Webster County, West Virginia. A portion of the remaining patients reside in Nicholas County (3.1%) and Randolph County (1.5%). The population of Webster County is 8249. The residents of Webster County have a median household income of $33,358 and 23% of the residents live in poverty. There is one hospital serving the community and the next nearest facility is 40 miles away. |
| Part VI, Line 5: | Governing body is comprised of members of all areas of the community and are not employees of the organization. The Hospital extends privileges to all qualified staff working for the facility. The Hospital uses surplus funds to provide new services for patients. The emergency room is available to all patients whether they have the ability to pay or not. The Hospital offers MRI, Cardiac and Pulmonary Rehab and Nuclear medicine, which are not available at any other location in the County. The Hospital offers charitable care and serves as a source of community volunteer activities. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Frankie Pucket MD | ||||||||||||||
| ER Director | $681,545 | $0 | $512 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $682,057 | $0 | $0 | $0 |
| Janak Patel MD | ||||||||||||||
| Chief of Staff | $525,630 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $525,630 | $0 | $0 | $0 |
| Robert Sutherland MD | ||||||||||||||
| ER Physician | $354,635 | $0 | $0 | $0 | $0 | $0 | $15,000 | $0 | $0 | $0 | $369,635 | $0 | $0 | $0 |
| Johathan Beam MD | ||||||||||||||
| Pharmacist | $172,717 | $0 | $507 | $0 | $0 | $0 | $19,405 | $0 | $0 | $0 | $192,629 | $0 | $0 | $0 |
| Jeanette Boyce MD | ||||||||||||||
| Physician | $174,695 | $0 | $507 | $0 | $0 | $0 | $8,643 | $0 | $0 | $0 | $183,845 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Form 990, Part VII, Section A, Line 5 | FormAndLineReferenceDesc |
| Explanation | Webster County Memorial Hospital (Hospital) entered into a management services agreement with Davis Health System (DHS) in January 2017. DHS provides a full-time Chief Executive Officer (CEO) to the Hospital. As of the filing date of the 990, William Dempsey is the CEO. The Hospital reimburses DHS for the CEO's compensation and benefits. The compensation and benefits paid to the CEO for the year ended December 31, 2021 was $162,059. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Christopher Dotson | |||
| Family Member of Karen Dotson, Board Member | $10,837 | Employee compensation | 0 |
| Lisa Clutter | |||
| Family Member of Chris Graham, Board Member | $15,618 | Employee compensation | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | On January 1, 2022, the Hospital's operations were disposed of and transferred to a nonprofit corporation, Davis Health System, Inc. |
| Form 990, Part VI, Section A, line 4 | Webster County Memorial Hospital (Hospital) entered into a Management Services Agreement with Davis Health System (DHS) in January 2017. DHS provides a full-time Chief Executive Officer(CEO) and provides support to the CEO in the performance of his or her duties as appropriate. As of the filing date of the 990, William Dempsey is the CEO. The Hospital reimburses DHS for the CEO's compensation and benefits. |
| Form 990, Part VI, Section B, line 11b | During a regularly scheduled board meeting, each board member receives a copy of the completed Form 990. The board will vote and approve the completed form before filing. If the return is completed and due between regularly scheduled board meetings, an electronic copy of the 990 is emailed to all board members and approved before the return is filed. |
| Form 990, Part VI, Section B, line 12c | Officers and Directors are required to complete an annual conflict of interest questionnaire. This questionnaire is then reviewed by the Board of Trustees, annually, for any interests that could give rise to conflicts. If a conflict should arise, the individual would have to disclose this conflict to the Board of Trustees. The board member would not be permitted to vote on the issue, if applicable. |
| Form 990, Part VI, Section B, line 15 | To determine compensation of the Organization's CEO, the organization compares Forms 990 of other organizations, reviews written employment contracts and performs compensation surveys of similar facilities. A review of compensation is conducted internally by the Board of Trustees. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents, conflict of interest policy and financial statements are made available upon request. |
| Form 990, Part XII, Line 2c: | The Organization's finance committee of the board of directors selects the independent accountant. The process remains unchanged from prior years. |