ST JOSEPHS HOSPITAL OF BUCKHANNON INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- ST JOSEPHS HOSPITAL OF BUCKHANNON INC (EIN 55-0356996)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-15
- IRS object ID
- 202113199349315286
- Schema version
- 2020v4.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-15T08:39:26-00:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550356996 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Joseph's Hospital of Buckhannon Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STJO | BusinessNameControlTxt |
| Phone | 3044732000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Amalia Drive | AddressLine1Txt |
| City | Buckhannon | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26201 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Ivar Gjolberg | PersonNm |
| Person Title | President | PersonTitleTxt |
| Signature | 2021-05-06 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Ivar | PersonFirstNm |
| Person Last | Gjolberg | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Ivar Gjolberg | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Amalia Drive | AddressLine1Txt |
| City | Buckhannon | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $77,384,996 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://wvumedicine.org/st-josephs-hospital/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | We are inspired by the love of Christ to provide our community with quality health care in ways that respect the God-given dignity of each person and the sacredness of human life. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 531 | TotalEmployeeCnt |
| Total Volunteers | 41 | TotalVolunteersCnt |
| Total Gross UBI | -$9,782 | TotalGrossUBIAmt |
| PY Contributions Grants | $17,805 | PYContributionsGrantsAmt |
| CY Contributions Grants | $259,455 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $69,068,115 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $74,512,929 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$63,564 | PYInvestmentIncomeAmt |
| CY Investment Income | $386,072 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,597,744 | PYOtherRevenueAmt |
| CY Other Revenue | $2,172,453 | CYOtherRevenueAmt |
| PY Total Revenue | $71,620,100 | PYTotalRevenueAmt |
| CY Total Revenue | $77,330,909 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $29,654,347 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $30,757,539 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $34,701,514 | PYOtherExpensesAmt |
| CY Other Expenses | $33,649,280 | CYOtherExpensesAmt |
| PY Total Expenses | $64,355,861 | PYTotalExpensesAmt |
| CY Total Expenses | $64,406,819 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,264,239 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $12,924,090 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $46,795,153 | TotalAssetsBOYAmt |
| Total Assets EOY | $62,494,414 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $28,937,056 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $32,292,436 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $17,858,097 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $30,201,978 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | We are inspired by the love of Christ to provide our community with quality health care in ways that respect the God-given dignity of each person and the sacredness of human life. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $21,476,464 | ExpenseAmt |
| Revenue | $28,460,693 | RevenueAmt |
| Desc | The Physicians of St.Josephs provide healthcare to the entire family from infancy to the elderly in their family medicine department. St. Josephs family medicine department provides convenient and comprehensive care that recognizes the uniqueness of every individual who is treated. Family medicine at St. Josephs had 18,110 visits in 2020. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,093,090 | ExpenseAmt |
| Revenue | $15,784,353 | RevenueAmt |
| Desc | St. Josephs emergency department is a level four trauma center and is open seven days per week, 24 hours per day. In addition to the emergency department, St. Josephs has a PromptCare Walk-In Treatment Center that is located adjacent to the emergency department and is open seven days per week. In 2020, St. Josephs emergency department had 12,916 visits. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $7,317,140 | ExpenseAmt |
| Revenue | $9,273,326 | RevenueAmt |
| Desc | St. Josephs Hospital provides a wide scope of general surgery services. There were 6,135 clinic visits and 2,785 OR procedures in 2020. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $16,027,588 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $23,157,465 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $52,914,282 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 100 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 542 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | false | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Russell Plywaczynski | PersonNm |
| Phone | 3044732000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Amalia Drive | AddressLine1Txt |
| City | Buckhannon | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26201 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| Susan Long MD | ||||||||
| Director, Physician | 040.00 | Yes (X) | $786,980 | $0 | $35,385 | |||
| Michael C Tillman | ||||||||
| Director - CEO UHC | 001.00 | Yes (X) | $0 | $698,829 | $44,667 | 040.00 | ||
| Robert Riddick MD | ||||||||
| Physician | 040.00 | $462,904 | $0 | $28,791 | Yes (X) | |||
| Ivar Gjolberg | ||||||||
| Administrator | 040.00 | $348,064 | $0 | $59,750 | Yes (X) | |||
| Matthan Jackson | ||||||||
| Hospitalist | 040.00 | $366,747 | $0 | $25,879 | Yes (X) | |||
| Bartley Brown DO | ||||||||
| Director | 040.00 | Yes (X) | $321,779 | $0 | $32,278 | |||
| David Faber MD | ||||||||
| Physician | 040.00 | $285,268 | $0 | $0 | Yes (X) | |||
| Sara Chua | ||||||||
| Physician | 040.00 | $259,144 | $0 | $19,499 | Yes (X) | |||
| LaWanna Starks MD | ||||||||
| Physician | 040.00 | $263,103 | $0 | $12,414 | Yes (X) | |||
| Rodney Baker | ||||||||
| VP - Phys - Ancillary Services | 040.00 | $147,187 | $0 | $21,985 | Yes (X) | |||
| Annamarie Chidester | ||||||||
| VP Patient Services | 040.00 | $146,910 | $0 | $18,817 | Yes (X) | |||
| Brenda Bauer | ||||||||
| VP of Quality | 040.00 | $132,320 | $0 | $21,756 | Yes (X) | |||
| Anissa Hite-Davis | ||||||||
| VP Human Resources | 040.00 | $120,864 | $0 | $27,851 | Yes (X) | |||
| Lisa Wharton | ||||||||
| VP, Marketing | 040.00 | $111,292 | $0 | $11,575 | Yes (X) | |||
| Sr Francesca Lowis | ||||||||
| Director, Secretary | 040.00 | Yes (X) | $48,584 | $0 | $693 | Yes (X) | ||
| Dennis Xander | ||||||||
| Chairperson | 001.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Sr Mary Grace Barile | ||||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | |||
| John Bohman | ||||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | |||
| Shawn Hanifan | ||||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | |||
| Don Nestor | ||||||||
| Director, Vice Chairperson | 001.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Sam Nolte | ||||||||
| Director, Treasurer | 001.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Katharine Wagner | ||||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,801,146 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $698,829 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $361,340 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 30 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Clinical Colleagues Inc | |||||
| 1121 North Bethlehem Pike | Spring House | PA | 19477 | Anesthesia Services | $898,879 |
| Alliance Healthcare Services Inc | |||||
| 18201 Von Karman Ave Suite 600 | Irvine | CA | 926121176 | Radiology Services | $255,300 |
| Mayo Collaborative Services Inc | |||||
| 200 SW 1st St | Rochester | MN | 559050001 | Laboratory Services | $213,211 |
| Medical Solutions LLC | |||||
| 13609 California St | Omaha | NE | 681545260 | Medical Staffing Services | $154,460 |
| KRC Enterprises LLC | |||||
| 1868 Craigshire Road | Saint Louis | MO | 631464006 | Logistics Services / Specimen Delivery | $125,155 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $72,794 | RelatedOrganizationsAmt |
| Government Grants | $138,791 | GovernmentGrantsAmt |
| All Other Contributions | $47,870 | AllOtherContributionsAmt |
| Total Contributions | $259,455 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 621110 | $68,878,207 | $68,878,207 |
| COVID Relief Funds | 900099 | $5,634,722 | $5,634,722 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $74,512,929 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $109,604 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$9,782 | UnrelatedBusinessRevenueAmt |
| Exclusion | $119,386 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $63,632 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $54,087 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,545 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,545 | TotalRevenueColumnAmt |
| Exclusion | $9,545 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $276,468 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $276,468 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $276,468 | TotalRevenueColumnAmt |
| Exclusion | $276,468 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Pharmacy Income | 446110 | $1,777,702 | $1,777,702 |
| Cafeteria Income | 624200 | $230,916 | $230,916 |
| Rebate Revenue | 900099 | $74,918 | $74,918 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $79,372 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $79,372 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,162,908 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $77,330,909 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $76,675,837 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$9,782 | UnrelatedBusinessRevenueAmt |
| Exclusion | $405,399 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,394,070 | TotalAmt |
| Program Services | $1,342,148 | ProgramServicesAmt |
| Management And General | $1,051,922 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,434,018 | TotalAmt |
| Program Services | $18,882,265 | ProgramServicesAmt |
| Management And General | $2,551,753 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $403,640 | TotalAmt |
| Program Services | $355,586 | ProgramServicesAmt |
| Management And General | $48,054 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,717,863 | TotalAmt |
| Program Services | $4,272,412 | ProgramServicesAmt |
| Management And General | $445,451 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,807,948 | TotalAmt |
| Program Services | $1,592,709 | ProgramServicesAmt |
| Management And General | $215,239 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239,043 | TotalAmt |
| Program Services | $222 | ProgramServicesAmt |
| Management And General | $238,821 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,250 | TotalAmt |
| Management And General | $11,250 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,021 | TotalAmt |
| Program Services | $7,021 | ProgramServicesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees For Services Prof Fundraising | FeesForServicesProfFundraising |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,834,220 | TotalAmt |
| Program Services | $5,382,116 | ProgramServicesAmt |
| Management And General | $452,104 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $305,900 | TotalAmt |
| Program Services | $7,549 | ProgramServicesAmt |
| Management And General | $298,351 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,188,390 | TotalAmt |
| Program Services | $1,593,079 | ProgramServicesAmt |
| Management And General | $595,311 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,885 | TotalAmt |
| Program Services | $1,385 | ProgramServicesAmt |
| Management And General | $4,500 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $657,909 | TotalAmt |
| Program Services | $529,755 | ProgramServicesAmt |
| Management And General | $128,154 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,666 | TotalAmt |
| Program Services | $144,467 | ProgramServicesAmt |
| Management And General | $17,199 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,247 | TotalAmt |
| Program Services | $8,701 | ProgramServicesAmt |
| Management And General | $1,546 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $255,951 | TotalAmt |
| Program Services | $207,094 | ProgramServicesAmt |
| Management And General | $48,857 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,061,005 | TotalAmt |
| Program Services | $3,657,564 | ProgramServicesAmt |
| Management And General | $4,403,441 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,984,380 | TotalAmt |
| Program Services | $1,597,843 | ProgramServicesAmt |
| Management And General | $386,537 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $684,253 | TotalAmt |
| Program Services | $614,346 | ProgramServicesAmt |
| Management And General | $69,907 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $9,644,912 | $9,644,912 | |
| Provision for Doubtful Accounts | $1,937,403 | $1,937,403 | |
| Taxes, Licenses Fees | $1,458,617 | $1,113,434 | $345,183 |
| Recruiting | $68,353 | $68,353 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,875 | TotalAmt |
| Program Services | $22,271 | ProgramServicesAmt |
| Management And General | $110,604 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,406,819 | TotalAmt |
| Program Services | $52,914,282 | ProgramServicesAmt |
| Management And General | $11,492,537 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $554,191 | BOYAmt |
| EOY | -$12,562 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,009,017 | BOYAmt |
| EOY | $20,498,057 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,633,152 | BOYAmt |
| EOY | $5,729,778 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $4,770 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,254,922 | BOYAmt |
| EOY | $1,924,429 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,184,239 | BOYAmt |
| EOY | $613,672 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $25,270,916 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,684,629 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,081,995 | BOYAmt |
| EOY | $17,586,287 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,396,854 | BOYAmt |
| EOY | $5,015,796 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $697,641 | BOYAmt |
| EOY | $147,254 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,983,142 | BOYAmt |
| EOY | $10,986,933 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,795,153 | BOYAmt |
| EOY | $62,494,414 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,033,805 | BOYAmt |
| EOY | $5,756,974 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $4,500,000 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,860,000 | BOYAmt |
| EOY | $7,860,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,791,563 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,251,688 | BOYAmt |
| EOY | $14,175,462 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,937,056 | BOYAmt |
| EOY | $32,292,436 | 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 | $17,858,097 | BOYAmt |
| EOY | $30,201,978 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,858,097 | BOYAmt |
| EOY | $30,201,978 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,795,153 | BOYAmt |
| EOY | $62,494,414 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $12,924,090 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $569,156 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,149,365 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $7,021 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,021 | TotalLobbyingExpendituresAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | II-B 1i | FormAndLineReferenceDesc |
| Explanation | This amount is calculated based on information provided by the West Virginia Hospital Association and the American Hospital Association. The American Hospital Association estimates that 25.56 of the 2020 dues were allocated to lobbying expense. The West Virginia Hospital Association estimates that during 2020, 16.77 of the dues paid should be allocated to lobbying expense. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,397,498 | OtherCostOrOtherBasisAmt |
| Book Value | $1,397,498 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,407,142 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,744,789 | DepreciationAmt |
| Book Value | $9,662,353 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,422,921 | OtherCostOrOtherBasisAmt |
| Depreciation | $209,706 | DepreciationAmt |
| Book Value | $1,213,215 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,380,455 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,730,134 | DepreciationAmt |
| Book Value | $4,650,321 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $662,900 | OtherCostOrOtherBasisAmt |
| Book Value | $662,900 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $17,586,287 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc |
|---|
| Financial derivatives and other financial products |
| Closely-held equity interests |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Unamortized Borrowing Costs | $331,443 |
| Goodwill Other Intangibles | $10,552,144 |
| Deferred Compensation | $103,346 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $10,986,933 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| Federal income taxes | |
| Due to Third Party Payors | $6,586,714 |
| Other Current Liabilities | $42,315 |
| Pension Obligation | $7,236,493 |
| Deferred Compensation | $103,346 |
| Long Term Lease Liability | $206,594 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $14,175,462 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $75,774,160 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $569,156 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$2,117,198 | OtherRevenueAmt |
| Revenue Not Reported | -$1,548,042 | RevenueNotReportedAmt |
| Revenue Subtotal | $77,322,202 | RevenueSubtotalAmt |
| Other Revenues Not Included | $8,707 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $8,707 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $77,330,909 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $62,343,708 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $54,087 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $54,087 | ExpensesNotReportedAmt |
| Expenses Subtotal | $62,289,621 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,117,198 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,117,198 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $64,406,819 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| X 2 | Most of the entities that comprise the System are tax-exempt organizations and not subject to federal or state income taxes in accordance with Section 501c3 of the Internal Revenue Code. On such basis, they will not incur any liability for income taxes, except for possible unrelated business income. AHS and WVUIS are organizations subject to federal and/or state income taxes. The System does not have any material uncertain tax positions as of December 31, 2020 and 2019. |
| XI 2d | This amount shown on line 2d consists of 1,937,403 provision for doubtful accounts and 179,795 defined benefit reported as an offset to revenue on the financial statements but is reported as an expense on the Form 990. |
| XI 4b | The amount shown on line 4b consists of 54,087 expenses associated with the properties for which rental income is received and presented as an offset to revenue on the 990 and 62,794 of contributions from St. Josephs Foundation posted in Net Assets. |
| XII 2d | The amount shown on line 2d consists 54,087 of expenses associated with the properties for which rental income is received and reported in Part VII line 6b. |
| XII 4b | The amount shown on line 4b consists of 1,937,403 provision for doubtful accounts and 179,795 defined benefit reported as an offset to revenue on the financial statements but is reported as an expense on the Form 990. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,527,431 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,527,431 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02450 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,307,057 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,307,057 | DirectOffsettingRevenueAmt |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $219,431 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $219,431 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,053,919 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,526,488 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,527,431 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02450 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,308 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,308 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,994 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,994 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,302 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,302 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,072,221 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,526,488 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,545,733 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02480 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 267 | PersonsServedCnt |
| Total Community Benefit Expns | $16,387 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $16,387 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,266 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $37,266 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 105 | PersonsServedCnt |
| Total Community Benefit Expns | $6,401 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,401 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 372 | PersonsServedCnt |
| Total Community Benefit Expns | $60,054 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $60,054 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $777,092 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $19,944 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $25,239,857 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $25,612,653 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$372,796 | MedicareSurplusOrShortfallAmt |
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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | St Joseph's Hospital of Buckhannon | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Amalia Drive | AddressLine1Txt |
| City | Buckhannon | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | wvumedicine.org/st-josephs-hospital/ | WebsiteAddressTxt |
| State License | 87 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Skilled Nursing Facility, Outpatient | OtherDesc |
| Facility Reporting Group | A | FacilityReportingGroupCd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | A | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https//wvumedicine.org/wp-content/uploads/2020/11/SJH-Community-Health-Needs-Assessment-CHNA-2019-Fi | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https//wvumedicine.org/wp-content/uploads/2020/11/SJH-Community-Health-Implementation-Plan-CHIP-2019 | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 0000000200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https//wvumedicine.org/bill-pay/financial-assistance/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https//wvumedicine.org/wp-content/uploads/2020/03/Financial-Assistance-Application-Form-3-17-2020.pd | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https//wvumedicine.org/bill-pay/financial-assistance/ | 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 |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | 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 (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | Yes (true) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Group St. Josephs Hospital of Buckhannon Line Part V, Section B, Line 5 | The 2019 Community Health Needs Assessment CHNA was prepared by Thomas Bias, Christiaan Abildso, and Emily Sarkees from the West Virginia University School of Public Health - Health Research Center. The CHNA process began with a thorough review of the previous cycles needs assessment report and implementation plan. The CHNA also involved both primary and secondary data. Primary data was collected using a survey of community members perceptions of health issues, a community meeting that focused on reviewing survey data, discussing community resources and assets that impact population health in the area, and working as a group to outline possible implementation strategies for each area of concern. The CHNA can be found here wvumedicine.org/st-josephs-hospital/patients-visitors/community-health-needs-assessment/. |
| Group St. Josephs Hospital of Buckhannon Line Part V, Section B, Line 5 | According to the CHNA, the public input survey included topics with questions about perceptions of overall health of the community, quality of life, access to healthcare and medical needs, risky personal behaviors, and demographic information including age, education and income. The survey was available both online and through hard copies and were to be completed by residents who were 18 years of age or older. Collection points and contact lists included SJH employees, SJH website, SJH board members, Spring Health Fair, Partners in Care Council Meeting, Chamber of Commerce, Create Buckhannon and other community groups, hospital lobby, press release, and Upshur County Economic Development Authority. |
| Group St. Josephs Hospital of Buckhannon Line Part V, Section B, Line 5 | The community meeting was hosted by St. Josephs Hospital leadership and was open to the public to solicit input on community health needs. Organizations represented at the community meeting included 2nd Congressional District Office, HealthRight, JH Consulting Inc., Mountain CAP of WV, ResCare HomeCare, Upshur County EMS, Upshur County Senior Citizens Center and West Virginia Wesleyan College. |
| Group St. Josephs Hospital of Buckhannon Line Part V, Section B, Line 11 | Following the community meeting, the SJH leadership team discussed the totality of information collected through the survey and community events, working to identify priority areas for developing implementation strategies. The WVU SPH reviewed summarized survey data, including overall responses to the three most important health problems or issues. Health problems pertains to mainly clinical items such as health and disease topics however, when creating the survey tool, the hospital leadership saw value in asking about factors affecting health outcomes. For this reason, topics were grouped into three questions clinical health and disease items e.g. air quality, availability of sidewalks, cost of medications, as well as things seen as personal choices or behaviors e.g. vaping, distracted driving, poor eating choices. This allowed the leadership team to cross-reference clinical items with the life factors and personal choices for a deeper understanding of the common themes, and a snapshot perspective of where in life the hospital might be able to implement strategies that will impact many. Survey results for health and disease included 1. Drug addiction/dependence 2. Obesity 3. Diabetes. Survey results for quality of life and environment included 1. Employment access/good jobs 2. Low income 3. Food insecurity. Survey results for personal choice risky behaviors included 1. Drug addiction/dependence 2. Alcohol abuse and 3. Tobacco. |
| Group St. Josephs Hospital of Buckhannon Line Part V, Section B, Line 11 | According to the CHNA, after review of the primary and secondary data, St. Josephs Hospital identified the following prioritized needs 1. Substance Use and Abuse 2. Disease Prevention and Management and 3. Access to Care/Transportation. In regards to substance use and abuse, SJH has programming underway to address this issue and has identified opportunities for community collaboration. To further address the needs of disease prevention and management, new clinical cancer-related efforts are already underway and existing programming is already in place. Finally, SJH understands and is aware of the transportation challenges that some stakeholders face which prohibit these individuals from accessing essential specialty care at medical centers that are further away in the state. While this is something SJH cannot handle on their own at this time, they have found ways to refer patients to the closest sister hospital within the West Virginia University Health System that provides the care needed. |
| Group St. Josephs Hospital of Buckhannon Line Part V, Section B, Line 13b | St. Josephs Hospital offers discounted care only to individuals who qualify for free care. St. Josephs Hospital offers a Prompt - Pay Discount Program - patients who have no third party coverage uninsured or uninsurable may be eligible for a 50 self-pay discount while patients who have a guarantor balance may be eligible for a 20 discount. To be eligible for either prompt pay discount, the patient/guarantor must meet certain requirements. |
| Group St. Josephs Hospital of Buckhannon Line Part V, Section B, Line 24 | All patients are charged an amount equal to gross charges regardless of payment method. Once FAP eligibility is confirmed, charge amounts are moved to Charity Care and no longer charged to the patient. |
Supplemental Information Detail SupplementalInformationDetail (23 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I Line 3c | St. Josephs uses 200 Federal Poverty Guideline FPG to determine free care eligibility. However, St. Joesphs does not offer discounted care to individuals who fail the 200 FPG test. |
| Part I Line 6a | St. Josephs community benefit numbers are reported in total with the other hospitals within West Virginia United Health System. The 2019 amounts can be found at the following web address https//wvumedicine.org/about/community-benefit/. |
| Part I Line 7 | Total community benefit expense for 2020 is 19,072,221 and is 30.53 of total net expenses. To calculate net expense, bad debt of 1,937,403 was deducted from total expenses of 64,406,819 as shown in Part IX line 25 of the core Form 990, for a net expense of 62,469,416. |
| Part I Line 7 | Worksheet 2 from the IRS Schedule H instructions was used to derive the Cost-to-Charge ratio, which was used to calculate Charity Care, Unreimbursed Medicaid and other means-tested government programs at cost. |
| Part II | St. Josephs reported Community Building activities of 60,054 for 2020. Some of the Community Building activities participated in during the year included blood drives, participating in Chamber of Commerce meetings, assisting at a local church, and staff serving on the Board of Directors for local non-profits. |
| Part III Line 2 | Bad Debt Expense at cost was calculated by multiplying bad debt expense of 1,937,403 by our cost-to-charge ratio of 40.11 derived from Worksheet 2 in the IRS Schedule H instructions for a total of 777,092. |
| Part III Line 3 | Estimated bad debt attributable to patients eligible for charity care was calculated by running a report within our patient revenue software of all bad debt account balances greater than 15,000. The total of that report was 49,724 which we then multiplied by our cost to charge ratio of 40.11 for a total of 19,944. |
| Part III Line 3 | The estimated bad debt attributable to patients eligible for charity care of 19,944 should be considered community benefit due to the fact that anyone with outstanding balances of 15,000 or greater usually qualifies as catastrophic if the patient completes the application process. |
| Part III Line 3 | In our charity care policy, we define catastrophic care as any illness or injury that will likely require continuous or frequent treatment for more than one year. Regardless, that bad debt should be considered community benefit as we provide services to those in need regardless of their ability to pay. |
| Part III Line 4 | St. Josephs Hospitals financial statements are prepared on a consolidated basis as a member of the WV United Health System. The footnote for Accounts Receivable is as follows Patient accounts receivable are reported at net realizable value. For accounts receivable associated with services provided to patients who have third-party coverage, the System estimates net realizable value based on the estimated contractual reimbursement percentage, which in turn is based on current contract provisions and historical paid claims by payor. For self-pay accounts, including uninsured and patient responsibility accounts, the net realizable value is determined using historical collection experience, adjusted for estimated conversions of patient responsibility portions, expected recoveries and changes in trends to estimate implicit price concessions. Management continually reviews the estimated net realizable value of accounts receivable by monitoring cash collections, economic conditions and trends, changes in payor mix, changes in federal or state healthcare coverage and other matters. The System grants credit without collateral to its patients, most of whom are local residents and are insured under third-party payor agreements, primarily with Medicare, Medicaid and various commercial insurance companies. The System records accounts receivable net of estimated price concessions and such amounts have historically been within managements expectations. The mix of accounts receivable at December 31, 2020 from patients and third-party payors is as follows Medicare - 29, Medicaid - 17, Blue Cross - 21, Commercial, managed care and other - 28 and Patients - 5, totaling 100. |
| Part III Line 4 | For receivables associated with self-pay patients, which includes both patients without insurance and insured patients with deductible and copayment balances, the System records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the billed rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. |
| Part III Line 8 | The amount reported in Part III Line 6 25,612,653 was calculated using the total Medicare allowable cost from the Medicare cost report. |
| Part III Line 9b | St. Josephs does have a debt collection policy. When a patient has been approved for financial assistance under our charity care policy, they will not be sent to bad debt. Additionally, if a patient is being evaluated for charity, the patient will not be sent to bad debt agency pending charity guarantor status until the pending status has been finalized approved/denied. All other patients with outstanding balances will be processed through billing and collections pursuant to our Financial Policy. |
| Part VI Line 2 | St. Josephs Hospital has contracted with the West Virginia University School of Public Health to perform the community wide needs assessment survey and has translated this information into the Community Health Needs Assessment Report which outlines actions taken. St. Josephs Hospital considers several components in assessing how the organization determines the need of the communities it serves. Through feedback from stakeholders, outside consultants and collaborating with various departments, a needs assessment takes into account several factors including physicians to population ratios, physician availability in the entire service area, and general health risks that are perceived to be the highest priority by the stakeholders and hospital leadership. The community served by St. Josephs Hospital is primarily Upshur County, WV. However, the Hospital serves many patients from portions of Barbour, Lewis, Randolph, Webster, and other counties. |
| Part VI Line 3 | St. Josephs Hospital of Buckhannon will advise patients and their families of financial assistance through the following means direct patient contact, in person or over the phone notice of availability of financial assistance will be posted in each registration area and emergency department and other waiting areas notice of availability of financial assistance will be printed with each patient initial bill availability of financial assistance will be printed on applicable letters and statements notice of availability will be posted on the hospitals website published in additional languages if needed by more than 10 of the population outreach to community most likely to utilize the FAP to include outreach to public agencies and other non-for-profit agencies and availability of financial assistance will be posted annually in local paper. |
| Part VI Line 4 | St. Josephs Hospital is located in Buckhannon, a small rural town in a mountainous region of Upshur County, West Virginia. The Hospital primarily serves Upshur County. In 2020, Upshur County had a population of 23,816, a median household income of 40,322, an employment rate of 49.8, 20.6 of residents living in poverty and 7.4 of residents without healthcare coverage |
| Part VI Line 4 | However, the Hospital also serves patients from Barbour, Lewis, Webster counties and the surrounding area. Barbour County had a 2020 population of 15,465, a median household income of 38,459, an employment rate of 48.6 and 4.9 of residents reported they are without healthcare coverage. Lewis County had a 2020 population of 17,033, a median household income of 39,908, an employment rate of 47.1, and 6.4 of residents reported they are without healthcare coverage. Webster County had a 2020 population of 8,378, a median household income of 34,927, an employment rate of 42.5, and 5.9 of residents reported they are without healthcare coverage. Population and demographic information was obtained from the United States Census Bureau https//data.census.gov/cedsci/. |
| Part VI Line 4 | The following hospitals provide a full range of acute care, ancillary and case management services and many also provide long-term care. The hospitals are located in the immediate service area or the contiguous service area Stonewall Jackson Memorial Hospital, United Hospital Center, Davis Memorial Hospital, Louis A. Johnson VA Medical Center, and Broaddus Hospital. In addition, William J. Sharpe Hospital in Weston, West Virginia provides comprehensive psychiatric services for patients that have been involuntarily committed. |
| Part VI Line 5 | St. Josephs hospital promotes the health of the community by maintaining an open medical staff, using community members on its board of directors, providing support of community health activities blood screenings, health fair, flu shot clinics, etc.. The hospital has also been actively recruiting both primary care providers and specialists to meet the healthcare needs of our service area. |
| Part VI Line 6 | St. Josephs Hospital of Buckhannon, Inc. is a not-for-profit health care facility wholly owned and sponsored by United Hospital Center, Inc. UHC. United Hospital Center is a subsidiary of the West Virginia United Health System. The West Virginia United Health System is comprised of 12 hospitals in 2020 including Camden Clark Medical Center, Berkeley Medical Center, Jefferson Medical Center, Potomac Valley Hospital, Reynolds Memorial Hospital, St. Josephs Hospital, United Hospital Center, West Virginia University Hospitals, Braxton County Memorial Hospital, Summersville Regional Medical Center, Jackson General Hospital, and Wetzel County Hospital. St. Josephs Hospital is committed to the core values of compassion, hospitality, reverence, interdependence, stewardship, and trust. |
| Part VI Line 6 | St. Josephs Hospital of Buckhannon is a part of the WV United Health System WVUHS. WVUHS is a not-for-profit corporation formed to serve as part of an integrated health science and healthcare delivery team. WVUHS serves as the parent corporation to an affiliated group of healthcare providing entities. The strategic plan of the System states intent to build a regional health care delivery system in its service areas, while offering a variety of options for providers who want to participate. The System maintains a demonstrated commitment to assist rural communities in preserving and improving the health care available to the patients it serves. |
| Part VI Line 6 | System management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems service areas. Other hospitals in the System include West Virginia University Hospitals, Inc. in Morgantown, WV, United Hospital Center in Bridgeport, WV, Camden-Clark Memorial Hospital in Parkersburg, WV, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, Potomac Valley Hospital in Keyser, WV, Reynolds Memorial Hospital, in Glen Dale, WV, West Virginia Health Care Cooperative, doing business as, Summersville Regional Medical Center in Summersville, WV, Braxton County Memorial Hospital in Gassaway, WV, Community Health Association, doing business as, Jackson General Hospital in Ripley, WV and Wetzel County Hospital, Inc. in New Martinsville, WV. |
| Part VI Line 6 | In addition to the above mentioned hospitals, the System includes physician practices of United Physicians Care, Inc. and Camden-Clark Physician Corp that operate in conjunction with the System hospitals along with United Summit Center, Inc. a behavioral health center located in Clarksburg, WV. The System also includes, WVUH-East, Inc. and Camden-Clark Health Services, Inc. which operate as management companies for their respective hospitals. University Healthcare Foundation, Inc. in Martinsburg, WV, United Health Foundation, Inc. in Bridgeport, WV, Camden-Clark Foundation, Inc. in Parkersburg, WV, St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Foundation, Inc. in Glen Dale, WV, which perform various fundraising activities for their respective hospitals. In 2020, the System formed WVUHS Home Care, LLC to provide Home Health and Hospice services to our service areas, supporting System hospitals by providing continuous care to our patients. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (true) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Susan Long MD | ||||||||||||
| Director, Physician | $610,259 | $150,846 | $25,875 | $7,524 | $27,861 | $822,365 | ||||||
| David Faber MD | ||||||||||||
| Physician | $285,268 | $285,268 | ||||||||||
| Robert Riddick MD | ||||||||||||
| Physician | $458,840 | $500 | $3,564 | $8,960 | $19,831 | $491,695 | ||||||
| Sara Chua | ||||||||||||
| Physician | $203,158 | $6,789 | $49,197 | $3,498 | $16,001 | $278,643 | ||||||
| Bartley Brown DO | ||||||||||||
| Director | $292,832 | $500 | $28,447 | $5,331 | $26,947 | $354,057 | ||||||
| Michael C Tillman | ||||||||||||
| Director - CEO UHC | $439,106 | $167,456 | $92,267 | $16,878 | $27,789 | $743,496 | ||||||
| Ivar Gjolberg | ||||||||||||
| Administrator | $270,570 | $70,742 | $6,752 | $32,560 | $27,190 | $407,814 | ||||||
| Brenda Bauer | ||||||||||||
| VP of Quality | $118,800 | $12,857 | $663 | $2,864 | $18,892 | $154,076 | ||||||
| Annamarie Chidester | ||||||||||||
| VP Patient Services | $137,166 | $8,957 | $787 | $3,276 | $15,541 | $165,727 | ||||||
| LaWanna Starks MD | ||||||||||||
| Physician | $261,158 | $500 | $1,445 | $2,511 | $9,903 | $275,517 | ||||||
| Matthan Jackson | ||||||||||||
| Hospitalist | $300,672 | $500 | $65,575 | $25,879 | $392,626 | |||||||
| Rodney Baker | ||||||||||||
| VP - Phys - Ancillary Services | $127,923 | $16,216 | $3,048 | $3,084 | $18,901 | $169,172 | ||||||
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I Line 3 | The CEOs compensation is paid by United Hospital Center, Inc. UHC. Compensation for CEOs is determined by the WV United Health System compensation committee. The System engages an independent group to perform an executive compensation review and compensation survey every two years. This information is provided to the committee, which is made up of independent board members who are then responsible for setting the compensation packages offered to each executive, ensuring that the compensation package offered does not exceed fair market value. |
| Part I Line 4b | Ivar Gjolberg deferred compensation through CAA contributions in 2020 in the amount of 26,391 and received 30,732 CAA distributions in 2020. Michael Tillman received CAA distributions of 67,658 from related party, United Hospital Center, Inc. in 2020. These amounts were appropriately reported as compensation on Form W-2 for 2020. |
| Part I Line 6a | Per the WVUHS Incentive Plan incentives are contingent on meeting a net earning target. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4d | Program Service Expenses 16,027,588, Grants and allocations 0, Revenue 23,157,465 The hospital provides impartial access to treatment or accommodation for care that is available or medically indicated regardless of race, creed, sex, national origin or source of payment. In order to enable our patients to lead healthy, productive lives, the hospital strives to supply a comprehensive range of acute inpatient, long-term and outpatient care, outreach clinics, home care and emergency room services including prevention, guidance, diagnosis, treatment, restoration, rehabilitation, and other efforts as may be required, to meet the health care needs of the community as the hospital resources will permit. Although payment for services rendered is essential to the operation and stability of the hospital, it is recognized that not all individuals possess the financial means to purchase essential medical services. Our mission is to serve the community with respect to providing health care services and health care education. In keeping with this commitment, the hospital will serve all members of its community regardless of means or source of payment. |
| Form 990, Part III, Line 4d | Program Service Expenses 0, Grants and allocations 0, Revenue 0 The hospital also operates physician clinics. |
| Form 990, Part VI, Section B, Line 11 | The Form 990 is prepared by the West Virginia United Health System, Inc. Tax Team and then reviewed by the Director of Finance at St. Josephs Hospital of Buckhannon. After gaining approval from the Director of Finance, it is then presented to the board members for a final review. Upon board review, it is signed and submitted to the IRS. |
| Form 990, Part VI, Section B, Line 12c | Upon employment and annually thereafter, each key employee and officer of the organization is required to complete a conflict of interest and disclosure form, providing sufficient information about his/her personal interests and relationships so the organization can 1 determine whether any potential or actual conflicts of interest may exist, and 2 monitor work or service assignments to avoid placing the key employee, officer, or director in a position where there may be an appearance potential or actual of a conflict of interest or a question of objectivity. The completed conflict of interest and disclosure forms for directors are returned to the organization. These members are monitored and not assigned any projects that would create any potential conflict of interest. Any board member with a potential conflict recuses himself or herself from all discussions regarding the conflict. |
| Form 990, Part VI, Section B, Line 15 a b | The compensation of the CEO is determined by the WV United Health System Compensation Committee based upon a salary and benefit survey prepared by an independent company using data of comparable facilities. This information is provided to the compensation committee which is made up of independent board members who are then responsible for setting the compensation packages offered to each executive, ensuring that the compensation package does not exceed fair market value based on the data from the consultant group. The minutes of the compensation committee are contemporaneously documented and retained. A full compensation survey was completed in 2019 for 2020 compensation amounts. The compensation of all officers at the Vice President level and below is determined based upon a salary and benefit survey prepared by an independent company using data of comparable facilities. This data is then interpreted and provided to an independent compensation committee. The independent compensation committee then uses this data to determine a fair and reasonable compensation package. All relevant data as well as minutes from each meeting are retained. |
| Form 990, Part VI, Section C, Line 19 | The organization makes its governming documents, conflict of interest policy, and financial statements available to the public upon request at its office at 1 Amalia Drive, Buckhannon, WV 26201. A nominal fee is charged if copies are requested. |
| Form 990, Part VI, Section A, Line 6 | The organization is a membership not a stock corporation under West Virginia State law. The Organizations sole coporate member is United Hospital Center, Inc., a related not-for-profit organization. |
| Form 990, Part VI, Section A, Line 7a | In accordance with the terms and requirements of its governing documents i.e. bylaws, on an annual basis, the organizations current board members recommend the list of candidates for membership to the governing body for the subsequent term to the St. Josephs Hospital board of directors. The United Hospital Center, Inc., board of directors will approve and elect these candidates to serve as the organizations board of directors. |
| Form 990, Part VI, Section A, Line 7b | United Hospital Center, Inc., as the sole corporate member, also has the right to approve or ratify significant decisions of the organizations governing body including the amendment of bylaws and charters, removal of members of the governing body, and the decision to dissolve the organization. |
| Form 990, Part XI, Line 9 | Line 9 consists of 706,460 pension plan adjustment and 442,905 related organization capitalization. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (23 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| West Virginia United Health System Inc | |||||||||||
| PO Box 8034 | Morgantown | WV | 26506 | 550754713 | Healthcare Access | WV | 501C3 | 12a | N/A | false | |
| West Virginia University Hospitals | |||||||||||
| PO Box 8034 | Morgantown | WV | 26506 | 550643304 | Patient Care | WV | 501C3 | 3 | false | West Virginia United Health System Inc | |
| West Virginia University Hospitals - East Inc | |||||||||||
| 2500 Foundation Way | Martinsburg | WV | 25401 | 202337985 | Healthcare Access | WV | 501C3 | 12a | false | West Virginia University Hospitals Inc | |
| Jefferson Memorial Hospital Inc | |||||||||||
| 300 S Preston St | Ranson | WV | 25438 | 550359755 | Patient Care | WV | 501C3 | 3 | false | West Virginia University Hospitals - East Inc | |
| University Healthcare Foundation | |||||||||||
| 2500 Foundation Way | Martinsburg | WV | 25401 | 311118075 | Hospital Support | WV | 501C3 | 12a | false | West Virginia University Hospitals Inc | |
| United Health Foundation | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550621706 | Hospital Support | WV | 501C3 | 12a | false | United Hospital Center Inc | |
| United Hospital Center Inc | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550525724 | Patient Care | WV | 501C3 | 3 | false | West Virginia United Health System Inc | |
| United Physicians Care Inc | |||||||||||
| 686 South Pike Street | Shinnston | WV | 26431 | 550638563 | Patient Care | WV | 501C3 | 3 | false | United Hospital Center Inc | |
| United Summit Center Inc | |||||||||||
| 6 Hospital Plaza | Clarksburg | WV | 26301 | 550752788 | Behavioral Health | WV | 501C3 | 3 | false | West Virginia University Hospitals Inc | |
| West Virginia Health Care Cooperative Inc | |||||||||||
| 400 Fairview Heights Rd | Summersville | WV | 26651 | 550650441 | Patient Care | WV | 501C3 | 3 | false | West Virginia University Hospitals Inc | |
| Camden-Clark Memorial Hospital | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26101 | 311524546 | Patient Care | WV | 501C3 | 3 | false | Camden-Clark Health Services | |
| Camden-Clark Health Services | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26101 | 550769602 | Healthcare Access | WV | 501C3 | 12a | false | West Virginia United Health System Inc | |
| Camden-Clark Foundation | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26101 | 550667789 | Hospital Support | WV | 501C3 | 7 | false | Camden-Clark Health Services | |
| Camden-Clark Physician Corp | |||||||||||
| 604 Ann Street | Parkersburg | WV | 26101 | 264058719 | Patient Care | WV | 501C3 | 3 | false | Camden-Clark Health Services | |
| Potomac Valley Hospital of W Va Inc | |||||||||||
| 100 Pin Oak Lane | Keyser | WV | 26726 | 550420956 | Patient Care | WV | 501C3 | 3 | false | West Virginia University Hospitals Inc | |
| Reynolds Memorial Hospital | |||||||||||
| 800 Wheeling Ave | Glen Dale | WV | 26038 | 550357045 | Patient Care | WV | 501C3 | 3 | false | West Virginia University Hospitals Inc | |
| Reynolds Memorial Foundation | |||||||||||
| 800 Wheeling Ave | Glen Dale | WV | 26038 | 550710402 | Hospital Support | WV | 501C3 | 12a | false | Reynolds Memorial Hospital Inc | |
| St Joseph's Foundation of Buckhannon Inc | |||||||||||
| 1 Amalia Drive | Buckhannon | WV | 26201 | 550727650 | Hospital Support | WV | 501C3 | 12b | Yes (true) | St Joseph's Hospital of Buckhannon Inc | |
| City Hospital Inc | |||||||||||
| 2500 Foundation Way | Martinsburg | WV | 25401 | 550383321 | Patient Care | WV | 501C3 | 3 | false | West Virginia University Hospitals - East Inc | |
| Braxton County Memorial Hospital | |||||||||||
| 100 Hoylman Drive | Gassaway | WV | 26624 | 550611919 | Patient Care | WV | 501C3 | 3 | false | West Virginia University Hospitals Inc | |
| Community Health Association | |||||||||||
| 122 Pinnell Street | Ripley | WV | 25271 | 550462730 | Patient Care | WV | 501C3 | 3 | false | West Virginia University Hospitals Inc | |
| Wetzel County Hospital Inc | |||||||||||
| 3 East Benjamin Drive | New Martinsville | WV | 26155 | 843480493 | Patient Care | WV | 501C3 | 3 | false | West Virginia University Hospitals Inc | |
| WVUHS Home Care LLC | |||||||||||
| PO Box 8059 | Morgantown | WV | 26506 | 852915642 | Home Health and Hospice | WV | 509a2 | false | West Virginia United Health System Inc | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Allied Health Sourcing Solutions | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 8034 | AddressLine1Txt |
| City | Morgantown | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26506 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 842403526 | EIN |
| Primary Activities | Supply Chain Management | PrimaryActivitiesTxt |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Allied Health Services Inc | |||||||||
| PO Box 782 | Morgantown | WV | 26507 | 550652017 | Medical Lab | WV | WV United Health System | C Corp | false |
| West Virginia United Insurance Services Inc | |||||||||
| 3040 University Avenue Suite 3200 | Morgantown | WV | 26505 | 550756055 | Provider Network | WV | WV United Health System | C Corp | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |