2021-11-12T11:52:53-00:00 2020-12-31 990 2020-01-01 311524546 Camden-Clark Memorial Hospital Corporation CAMD 3044242202 800 Garfield Avenue Parkersburg WV 26101 Kyle Pierson VP Finance 2021-05-07 false Kyle Pierson XXX-XX-XXXX 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Camden Clark Medical Center Steve Altmiller 800 Garfield Avenue Parkersburg WV 26101 341076373 false X https://wvumedicine.org/camden-clark/ X 1997 WV To operate an acute care and emergency hospital facility. 8 8 1979 200 3059088 82000 0 314368070 335034426 210248 342939 5277135 5671225 319937453 341048590 52980 59142 0 101029447 106361812 0 0 206000351 234552295 307082778 340973249 12854675 75341 236758740 285852885 280582276 341146077 -43823536 -55293192 X The mission of Camden-Clark Memorial Hospital is to meet the health care needs of our community for a lifetime. false false 126025235 59142 149902084 Camden Clark Memorial Hospital strives to supply a comprehensive range of inpatient, outpatient, outreach clinics, including prevention, guidance, diagnosis, treatment, restoration, rehabilitation and other efforts as may be required to meet the health care needs of the community and as the hospitals resources will permit. Although reimbursement for services rendered is critical to the operation and stability of the hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. Our mission is to serve the community by providing health care services and health care education. Therefore, in keeping with this commitment to service all members of the community, Camden-Clark Memorial Hospital will provide the following where the individuals need and/or an inability to pay coexist free care and/or subsidized care, and care provided to persons covered by governmental programs at or below cost. 17550964 30649235 Camden Clark Memorial Hospital offers emergency room services as part of the hospitals mission of meeting the healthcare needs of the community for a lifetime. Due to the community that it serves, the majority of patients visiting the ER are either underinsured or uninsured. For the reporting period, there were approximately 41,553 ER visits, of this total, 8,311 were ultimately admitted to the hospital. A significant portion of the hospitals inpatient volume comes directly from the ER. 15179083 22723075 Camden-Clark Memorial Hospital is a leader in cancer care for the mid-ohio valley, providing cancer care to patients in a 45 mile radius from the hospital. In addition to a wide range of treatment options provided, the hospital offers a number of related services to its patients. Through the hospitals collaboration with the American Cancer Society, the development of the organizations cancer resource center, a hair restoration salon, a patient navigator and an oncology social, the hospital has enhanced the education, navigation and social support of its cancer patients and families. The hospitals community and social services provide a holistic healing environment which includes support groups for patients/families. 124564749 130215800 283320031 true false false true false false false false false false true false false false true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true false false false true 294 0 2335 true true true false false false false false false false false false false false X 8 8 false false false false true true true true true false false true true true true true true false false true true X Kyle Pierson 3044242202 800 Garfield Avenue Parkersburg WV 26101 X Steve Altmiller President 038.00 002.00 X 804711 0 29098 Todd Kruger General Legal Counsel 039.00 001.00 X 451972 0 31519 Sean Smith VP, Operations 039.00 001.00 X 306021 0 51752 Christine Daniels VP, Nursing 039.00 001.00 X 299195 0 55372 Kyle Pierson VP, Finance 038.00 002.00 X 296075 0 49306 Cynthia Kern Vice President, Quality 040.00 X 315014 0 5470 MarJean Kennedy Director of Marketing 040.00 X 169218 0 28158 Gene Sexton Pharmacy Manager 040.00 X 152872 0 28574 Christopher Childress Director of Pharmacy 040.00 X 162506 0 18915 Matthew West Pharmacy Specialist 040.00 X 148929 0 29801 Jennifer Stauch Pharmacy Operations Manager 040.00 X 150150 0 28543 Michael Trimble Pharmacist 040.00 X 161497 0 12170 Mary Jo Shahan Former CCMC Interim CFO 2019 040.00 X 0 103655 0 Terry W Capel MD Chairman 001.00 X X 0 0 0 Kathy G Eddy Vice Chairman 001.00 X X 0 0 0 Randall E Snider Board Member, Secretary 001.00 X X 0 0 0 Michael A Morehead MD Board Member 001.00 X 0 0 0 Orton C Armstrong MD Board Member 001.00 X 0 0 0 Joe D Campbell Board Member 001.00 X 0 0 0 Lynford C Lovell Board Member 001.00 X 0 0 0 Sister Joan Kreyenbuhl Board Member 001.00 X 0 0 0 3418160 103655 368678 73 true true false United Anesthesia Inc 3211 Dudley Avenue Parkersburg WV 26101 Anesthesia Services 3965479 Health Carousel LLC 3805 Edwards Road Suite 700 Cincinnati OH 45209 Healthcare Staffing Services 1753098 Pars Neurosurgical Associates Inc 1212 Garfield Avenue Suite 300 Parkersburg WV 26101 Healthcare Staffing Services 1305624 Restorix Health Inc 455 Hamilton Ave Suite 800 White Plains NY 106011829 Wound Care Services 986021 Jackson Nurse Professionals LLC 3452 Lake Lynda Drive Suite 200 Orlando FL 328171481 Travel Nursing Services 980390 32 Patient Service Revenue, Net 621110 314383772 311323978 3059794 Pharmacy Sales - Patients 621110 10738842 10709463 29379 COVID Relief Funding 621990 9081098 9081098 Health and Wellness Center 621990 551682 551682 Ambulance Services 621110 279032 279032 335034426 328659 -30085 358744 1574860 27783 1547077 1547077 1547077 14280 14280 14280 14280 Rebate Revenue 900099 969278 969278 Sales Tax Refund 900099 827491 827491 Cafeteria Income 624200 782438 782438 1544941 1544941 4124148 341048590 333490194 3059088 4499308 X 57183 57183 1959 1959 0 0 2892884 675052 2217832 0 77659619 69904047 7755572 223514 217077 6437 17629952 15584704 2045248 7955843 6970810 985033 0 260731 1392 259339 10294 10294 23875 23875 0 27590640 25548306 2042334 881289 32252 849037 9030358 5574520 3455838 9251 3340 5911 0 4311274 3618423 692851 533590 493073 40517 0 76290 63586 12704 9700496 8141559 1558937 66568958 36770442 29798516 16525150 13892763 2632387 5981085 5592387 388698 Medical Supplies Patient Chargables 65068496 65068496 Provision for Doubtful Accounts 14103538 14103538 Taxes, Licenses Fees 11803634 9825376 1978258 Dues, Education Training Recruiting 1492778 1046754 446024 580568 109117 471451 340973249 283320031 57653218 0 1275475 233392 7275691 47897435 37305451 49235517 84426 5852592 6984437 3812938 5563046 372907272 230689964 148509957 142217308 23217177 26396192 3907726 5144629 5601733 2096503 236758740 285852885 24791341 36776770 37084472 190162202 192597043 26627113 44630344 39001620 30057448 280582276 341146077 X -43823536 -55293192 -43823536 -55293192 236758740 285852885 X 75341 -4861110 -6683887 X false true X true false X false false false false false false false false true 23875 23875 false II-B 1 The organization paid dues to the American Hospital Association AHA as well as the West Virginia Hospital Association WVHA. A portion of these dues, specifically 23,875, was related to lobbying activities of the AHA and WVHA. 2107095 2107095 168049049 79546173 88502876 182826683 145927078 36899605 19924445 5216713 14707732 142217308 Financial derivatives and other financial products Closely-held equity interests Federal income taxes Accrued wages, benefits and payroll taxes Malpractice Liability 1183644 Accrued bond interest Due to third party payors 1982560 Interest rate swaps 15613005 Self insurance liability 7092153 Debt Issuance Costs -1232139 Deferred Compensation 217745 Minimum Pension Liability Adjustment Finance Lease Liability - Long Term Long Term Lease Liability 5200480 30057448 X 322109840 -4861110 -14105423 -18966533 341076373 -27783 -27783 341048590 326895609 27783 27783 326867826 14105423 14105423 340973249 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 includes 14,103,538 provision for bad debts and a scholarship payment of 1,885 that were reported as an offset to revenue on the audited financial statements but are reported as an expense on the Form 990. XI 4b This amount includes expenses associated with rental property of 27,783 that was reported in Part VIII line 6b as an offset to revenue revenue. XII 4b This amount includes provision for bad debts of 14,103,538 and a scholarship payment of 1,885 that were reported as an offset to revenue on the audited financial statements but are reported as an expense on the Form 990. XII 2d This amount includes rental expense of 27,783 that is an offset to revenue on Form 990 but an expense on the audited financial statements. true true X true X false true true true false true true 3141901 3141901 0.00960 78344072 41007706 37336366 0.11420 358634 358634 81844607 41366340 40478267 0.12380 68558 19966 48592 0.00010 2271897 1234710 1037187 0.00320 134383 134383 0.00040 2474838 1254676 1220162 0.00370 84319445 42621016 41698429 0.12750 1 1000 1087 1087 1 1000 1087 1087 true 4538519 232582 122014566 177930835 -55916269 X true true 1 1 Camden-Clark Memorial Hospital 800 Garfield Avenue Parkersburg WV 26101 wvumedicine.org/camden-clark/ 102 X X X X Disproportionate Share Hospital A A 1 false false false true false true X 0000000200.000000000000 X X X X X true true X X X X true X wvumedicine.org/bill-pay/financial-assistance/ X wvumedicine.org/wp-content/uploads/2020/03/Financial-Assistance-Application-Form-3-17-2020.pdf X wvumedicine.org/bill-pay/financial-assistance/ X X X X X X true X false X X X X true X false true Group Camden-Clark Memorial Hospital Line Part V, Section B, Line 5 In 2017, the WV United Health System entered into a contract with the WVU School of Public Health to organize CHNAs for all System hospitals. In July 2017, CCMC leadership began meeting with WVU School of Public Health faculty and staff to begin the process of preparing the next CHNA for CCMC. To prepare the 2017 CHNA, the organization compiled demographics and analysis of health indicators taking into account input from the community, including public health professionals identifying resources and prioritizing community health needs. The CHNA was prepared by Thomas Bias, Christiaan Abildso, and Emily Sarkees. The CHNA can be found here https//wvumedicine.org/wp-content/uploads/2020/11/CCMC-CHNA-Report-August-2018-Revision.pdf and the Implementation Plan can be found here https//wvumedicine.org/wp-content/uploads/2020/11/CCMC-Community-Health-Implementation-Plan.pdf. Group Camden-Clark Memorial Hospital Line Part V, Section B, Line 11 The 2017 CHNA results identified several prevalent community risk factors and strategies for each for reducing risk and improving health outcomes. The top three health concerns of Wood County and other primary service area residents were Drug/Substance Abuse, Cancer, and Obesity/Chronic Disease respectively. In order to address these concerns, the leadership team utilized a prioritization matrix to help aid in the discussion of the degree to which the hospital can realistically affect health outcomes for each factor identified, as well as level of importance relative to the reach of their impact. Regarding the area of drug and substance abuse, the CCMC leadership sees an ability to have high impact for this community risk factor by possibly integrating tobacco cessation with substance abuse/addiction care. The leadership team agreed that cancer was a risk factor that needs to be prioritized. While CCMC already houses a cancer center and provides community benefits through free screenings, this topic will be addressed more going into the implementation phase. Finally, the leadership team has decided to combine obesity and chronic disease in the initial implementation planning stage because they see several ways in which providing a particular community benefit can positively influence both obesity and chronic disease outcomes simultaneously. Group Camden-Clark Memorial Hospital Line Part V, Section B, Line 13b Camden-Clark Medical Center offers discounted care only to individuals who qualify for free care. Camden Clark Medical Center 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 Camden-Clark Memorial Hospital Line Part V, Section B, Line 15e A state Medicaid representative was on site to help determine eligibility and help patients through the eligibility process. Group Camden-Clark Memorial Hospital 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. Group Camden-Clark Memorial Hospital Part V Line 12b - On March 25, 2020, the IRS unveiled The People First Initiative Initiative, which was the IRSs effort to help taxpayers during the COVID-19 Pandemic. IRS Commissioner Chuck Rettig described the Initiative as follows The IRS is pursuing unprecedented actions to ease the burden on people facing tax issues. During this difficult time, we want people working together, focused on their well-being, helping each other and others less fortunate. The Initiative contained some specific measures. For instance, the IRS allowed taxpayers to suspend installment agreements, stopped the issuance of liens and levies, and suspended all face-to-face meetings with field revenue agents. The IRS has made clear that the initiative was and is broader than these types of specific measures. In other words, the purpose of the Initiative was to accommodate and provide leniency to taxpayers, in particular taxpayers who were hit hardest by the pandemic. Group Camden-Clark Memorial Hospital Part V line 12b - Moreover, Treas. Reg. section 1.501r-2b establishes that the excise tax under I.R.C. section 4959 will not be assessed if a taxpayer has reasonable cause for failure to meet the CHNA. The fact that a hospital has established procedures to comply with the CHNA is a factor supporting reasonable cause. Treas. Reg. section 1.501r-2b4. All tax law support that reasonable cause requires only ordinary care and prudence. Group Camden-Clark Memorial Hospital Part V line 12 - In short, the Taxpayer is a hospital that could not reasonably be expected to timely complete its 2020 CHNA because of the pandemic. The assessment of a 50,000 excise tax runs contrary to both reasonable cause and the IRSs own Initiative. Group Camden-Clark Memorial Hospital Part V line 12b - The Taxpayer serves a rural community that continues to be severely impacted by the COVID-10 emergency. The Taxpayer partners with local entities representing the broad interests of a rural community to collect survey data, hold focus group sessions, and gain input from community members. These efforts, which began on August 6, 2020, were adversely impacted due to the ongoing pandemic as healthcare and outreach organizations were required to shift focus to emergency efforts. Events and activities were canceled prohibiting the collection of survey data and community response. To gain input from all representative groups, including families with young children, the Taxpayer changed collection methods and extended the survey period to ensure appropriate needed input. Some planning team members and the director of the largest community partner collecting surveys suffered from COVID-19 infection and quarantine during this period. Additionally, the Taxpayer led community vaccination efforts throughout the region, which required significant resources that would have otherwise been allocated to the CHNA effort. The Taxpayer continues to be further challenged by capacity constraints in its ER, ICU, and COVID units as well as staffing and equipment shortages. All of these challenges, compounded by periodic infrastructure failures, including loss of oxygen pressure due to increased demand, required constant reprioritization of focus for the leadership and staff. Prevention and mitigation efforts continue to strain the organizations resources. Group Camden-Clark Memorial Hospital Part V 12b - In spite of all this, the Taxpayer has completed all aspects of its assessment and prioritization phase. The assessment report will be presented to the Board of Directors for adoption on December 7, 2021, and posted to its website and made widely available to the public on December 8, 2021. The Implementation Plan process will begin immediately following adoption of the assessment and will be completed and approved by May 15, 2022. 3 Patriot Point Diagnostic 2838 Pike Street Parkersburg WV 26101 Radiology/Lab Garfield Diagnositc 2012 Garfield Ave Bdng 2 Ste 1 Parkersburg WV 26101 Radiology/Lab Sleep Lab 19th Street Campus Parkersburg WV 26101 Diagnostic Part I Line 3c Camden-Clark Medical Center CCMC uses 200 Federal Poverty Guideline FPG to determine free care eligibility. However, CCMC does not offer discounted care to individuals who fail the 200 FPG test. Part I Line 6a WVU Medicine prepared a System wide summary report of 2019 Community Benefits which can be found online - http//wvumedicine.org/about/community-benefit/. Part I Line 7 Total community benefit expense for 2020 is 84,319,445 and is 25.80 of total net expenses. To calculate net expense, bad debt of 14,103,538 was deducted from total expenses of 340,973,249 as shown in Part IX line 25 of the core Form 990, for a net expense of 326,869,711. 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 Camden-Clark Medical Center CCMC started a leadership program in 2007. Employees who are selected to participate in this leadership program are required to volunteer in the community or at hospital activities which benefit the broader community as a whole. The activities these individuals participated in during the current year included various health fairs, church community events, Wood County Telethon, National Healthcare Decision Day, Try-Again Homes work project and various local school activities and events. These individuals also worked with and supported various community organizations such as United Way of America, The Salvation Army, Boys and Girls Club of America, and various community boards. Part III Line 2 Bad Debt Expense at cost was calculated by multiplying bad debt expense of 14,103,538 by our cost to charge ratio of 32.18 derived from Worksheet 2 in the IRS Schedule H instructions for a toal of 4,538,519. 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 25,000. The total of that report was 722,754 which we then multipled by our cost to charge ratio of 32.18 for a total of 232,582. Part III Line 3 We feel that, at a minimum, the estimated bad debt attributable to patients eligible for charity care of 232,582 should be considered community benefit due to the fact that a patient with an outstanding balance of 25,000 or greater usually qualifies as catastrophic if the patient completes the application process. 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. Part III Line 4 Camden-Clark Memorial Hospitals financial statements are prepared on a consolidated basis as a member of the WV United Health System. WVUHS consolidated footnote for Patient Accounts Receivable states Patient accounts receivables 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, 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 6 177,930,835 was calculated using the total Medicare allowable cost from the Medicare cost report, less Medicare reimbursement of direct GME. Part III Line 8 CCMCs shortfall, 55,916,269 of Medicare program reimbursement should be considered a community benefit because we are relieving a government burden by providing care in excess of our costs to these patients. Part III Line 9b CCMC 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 a 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 Camden Clark Medical Center considers several components in assessing how the organization determines the need of the communities it serves. The CHNA utilized a robust community based process designed to engage a wide range of community members. CCMC conducted a Community Health Needs Assessment CHNA in 2017 that was adopted by the Board of Directors in 2018. The CHNA can be found here https//wvumedicine.org/wp-content/uploads/2020/11/CCMC-CHNA-Report-August-2018-Revision.pdf. Part VI Line 3 CCMC provides, in writing, all options for possible financial assistance. This information is also available on CCMCs website. CCMC also has representatives that are available to discuss options with inpatients and outpatients on a daily basis. WV State Medicaid workers are onsite to help determine patient eligibility and to assist patients through the eligibility process. Part VI Line 4 CCMCs leadership defined the community served as a 10 county area comprised of Calhoun, Jackson, Pleasants, Ritchie, Roane, Tyler, Wirt, and Wood in WV, as well as Washington and Meigs counties in OH. This geographic area is considerably larger than the last CHNA, and fully captures the service area of CCMC. CCMC also sees a large number of patients from Athens County, OH. CCMC, located in Parkersburg, WV is a part of Wood County. Wood County has a population of 84,296, median household income of 47,944 and an employment rate of 50.7. 14.1 of Wood County residents are living in poverty and 5.4 of residents reported they are without health care coverage. The remaining 9 counties considered to be in CCMCs defined service area had a combined total population of 159,633 and approximately 6.4 of residents reported they are without health care coverage. Population and demographic information was obtained from the United States Census Bureau https//data.census.gov/cedsci/. Part VI Line 5 A majority of the organizations governing body is comprised of persons who reside in the primary service area and who are neither employees nor independent contractors of the hospital, not family members thereof. The organization extends medical staff privileges to all qualified physicians in the community to many of its departments. Part VI Line 5 Any surplus of funds is used primarily to enhance patient care. While no research is done in this facility, a residency program was started in 2009. Part VI Line 6 CCMC 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 services area, 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, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, Potomac Valley Hospital located in Keyser, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, WV, Reynolds Memorial Hospital, in Glen Dale, WV, 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. true The Hope Recovery Manor Inc 1016 Market Street Parkersburg WV 26101 832268028 501c3 7500 Sponsorship Wood County Development Authority 409 1/2 Market Street Parkersburg WV 26102 550575873 501c4 5500 Support Greater Parkersburg Chamber of Commerce 501 Avery St FL 9 Parkersburg WV 26101 550249560 501c6 5000 Support Boys & Girls Club of Parkersburg Inc 1200 Mary Street Parkersburg WV 26101 550476226 501c3 5000 Sponsorship Parkersburg Art Center Inc 725 Market Street Parkersburg WV 26101 550526227 501c3 5000 Sponsorship 3 2 Part I Line 2 Contributions are discretionary and decisions on which organizations Camden-Clark Memorial Hospital supports are made by the President in conjunction with the Director of Marketing. Typically, local organizations are supported throughout the year and the donations are typically not specifically restricted, so there is no follow up process for monitoring the use of the funds. X true true false true false false false true false false false Todd Kruger General Legal Counsel 319434 86750 45788 4810 26709 483491 Cynthia Kern Vice President, Quality 228501 61837 24675 4239 1232 320484 Christopher Childress Director of Pharmacy 161753 500 253 3838 15077 181421 Michael Trimble Pharmacist 139761 500 21236 3363 8807 173667 Matthew West Pharmacy Specialist 134368 500 14061 3340 26461 178730 Jennifer Stauch Pharmacy Operations Manager 144000 500 5650 2737 25806 178693 Sean Smith VP, Operations 241356 59988 4677 25482 26270 357773 Christine Daniels VP, Nursing 231495 62585 5115 28664 26708 354567 Steve Altmiller President 502928 179100 122683 9033 20065 833809 MarJean Kennedy Director of Marketing 158169 10500 549 18539 9619 197376 Gene Sexton Pharmacy Manager 150322 500 2050 2919 25655 181446 Kyle Pierson VP, Finance 229360 61984 4731 28388 20918 345381 Mary Jo Shahan Former CCMC Interim CFO 2019 103655 103655 Part I Line 1a Memberships at the health and wellness center are offered to each member of the senior leadership team. These are covered in the applicable employment contracts and are included in taxable income. Part I Line 3 Compensation for the CEO 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 responsibile for setting the compensation packages offered to each executive, ensuring that the compensation package does not exceed fair market value. Part I Line 4b The following individuals received deferred compensation contributions in 2020 Sean Smith in the amount of 22,375 Kyle Pierson in the amount of 22,880 Douglas Frary in the amount of 8,046 Christine Daniels in the amount of 23,103 and MarJean Kennedy in the amount of 15,375. These amounts were properly recorded in deferred compensation on the Form 990 Schedule J. Part I Line 6a Per the WVUHS Incentive Plan incentives are contingent on meeting a net earning target. Part II Line 14 Mary Jo Shahan was interim CFO in 2019 for Camden-Clark Memorial Hospital Corporation. However, in 2020 she was compensated for consulting work and interim CFO for related party, United Summit Center, Inc.. A West Virginia Hospital Finance Authority 621256910 956622L85 2016-06-15 19440924 2016 A - Refunding of 2007 A Bonds false false false B West Virginia Hospital Finance Authority 621256910 956622P40 2018-07-31 56880000 2018C Series - Refund 2004 BC Bonds false false false C false false false A 1568763 19440924 149889 19291023 12 2016 true true true true B 3230000 56880000 422708 56457292 2018 true false false true A false false true true false false false true B false false true true false false false true A false true false false false false true Cantor Fitzgerald true false true B false true false false true false false false true A true B true Part I Line A 2016 A Bond - The 2016 A Bonds were issued on behalf of the West Virginia United Health System Obligated Group with an issue price of 288,869,596 per Form 8038. The 2016 A Bonds were issued to refund certain outstanding bonds. Per internal allocations based on the balance of the refunded bonds in the general ledger CCMC received 19,440,924 in proceeds to refund the 2007A bond issuance as an advanced refunding. The remaining amounts allocated from this issuance are reported on Form 990 for WVUH and UHC. Part I Schedule K - For purposes of reporting bond issuance allocations on Schedule K to the Internal Revenue Service, West Virginia University Hospitals, Inc. WVUH as parent company to City Hospital, Inc. CHI, The Charles Town General Hospital dba Jefferson Medical Center JMC, University Healthcare Foundation, Inc. UHF, and Potomac Valley Hospital is reporting bond issuances allocated to WVUH and its subsidiaries on a consolidated basis on Schedule K attached to their tax return. United Hospital Center, Inc. UHC EIN 55-0525724 and Camden-Clark Memorial Hospital Corporation CCMH EIN 31-1524546 are reporting bond allocations issued to them on the return filed by such taxpayer. Part I Several bond issuances were issued in multiple series and each series is reported in this tax return separately. For each series identified in Schedule K, Part I, the taxpayer will reconcile the series amount reported in this tax return and the tax return filed by UHC and CCMC to the applicable 8038 filed with the IRS for each bond issuance. Each bond series is reported on the appropriate Form 990, Schedule K, only once in this manner. Part I Line 2 Column B - The CUSIP shown on the Form 8038 956622P65 is for another bond in the 2018 issue - 2018 A D which are reported on the Schedule Ks for WVUH and UHC respectively. Part II Line 12 The amount reported in Line 12 Column A is a result of a balance that remained in the account that is used to fund principal and interest payments on this issuance. We are provided an amount to fund prior to the payment date, once funds that are sold/redeemed to make our payment there is occisaionally a residual amount. That amount is left in the account to apply to future payments. Part IV Line 2c Column A - Rebate calculation for the 2016 Series A issuance is not due until 2021. Column B - Rebate calculation for the 2018 Series C issuance is not due until 2023. Part IV Line 5c Column A - The securities for the 2016 A Bonds were purchased on June 15, 2016 and the last one matured on May 31, 2019. Form 990, Part III, Line 4d Program Service Expenses 9,047,353, Grants and allocations 0, Revenue 17,510,512 Camden-Clark Memorial Hospital offers heart and vascular services for its immediate service area directly through the hospital. In addition, services are provided to underserved counties throughout the area via physicians that are employed by Camden Clark Physician Corporation, a related entity. Form 990, Part III, Line 4d Program Service Expenses 115,517,396, Grants and allocations 0, Revenue 112,705,288 Camden Clark offers a wide range of other medical services that include Nephrology, OBGYN services, Neurosurgery, Orthopedics, Pediatrics, General Surgery, Vascular Surgery and various other services that can be found on our website https//wvumedicine.org/camden-clark/. Form 990, Part IV, Line 20b The organization must attach a copy of its most recent audited financial statements. Attached are the consolidated financial statements of West Virginia United Health System, Inc. WVUHS and controlled entities. WVUHS became the sole member of Camden Clark Health Services, Inc., the parent corporation of Camden-Clark Memorial Hospital on March 1, 2011. The financial position, results of operations, and cash flows of Camden-Clark Memorial Hospital are included in the aforementioned consolidated audited financial statements. Form 990, Part VI, Section A, Line 6 Camden-Clark Health Services, Inc., a non-profit, tax-exempt corporation, is the sole member of the organization. Form 990, Part VI, Section A, Line 7a Camden-Clark Health Services, Inc., the organizations sole member, nominates all board members of the organization. Board members are elected by West Virginia United Health System WVUHS from the CCHS nominations. WVUHS elects all CCHS, CCMC, CCPC, and CCF board members from a slate of Director Nominees submitted to them by CCHS. CCHS will consider the underlying nominations of CCMC, CCPC, and CCF before they submit their nominations. Form 990, Part VI, Section A, Line 7b As the sole member of Camden Clark Health Services, Inc., WVUHS through its affiliation agreement, holds power to approve certain decisions such as annual budget, capital expenditures over 1 million, new debt over 1 million, new programs, and extraordinary filings. Form 990, Part VI, Section B, Line 11 The Form 990 is prepared by the WVUHS Tax Team and is provided for review to the VP of Finance, General Counsel, and Accounting Director. It is also reviewed by the non-profit tax manager of our independent auditing firm. It is then reviewed by the Finance Committee. After being presented to the committee, it is provided to all board members for comments prior to filing with the IRS. Form 990, Part VI, Section B, Line 12c To identify and monitor any conflicts, a signed conflict of interest statement is required from board members of the organization and key individuals that are in a position to make or influence decisions. If an actual or possible conflict of interest is observed or disclosed, the organization invokes the procedures set out in the policy, bylaws for addressing the conflict of interest. For key individuals employees, a specific conflict of interest standard in the organizations code of ethics and business conduct also exists. 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 organizations financial statements are made available on request and are also available on the West Virginia Healthcare Authority website. The organizations governing documents and conflict of interest policy are made available upon request. Form 990, Part XI, Line 9 Changes in Net Assets Transfers to related organizations 3,772,264 and an audit adjustment of 2,911,623 for OVASC goodwill. Form 990, Part IX, Line 11g Other service expenses consist of the following items Consulting Professional fees, Contracted Labor, Contract Labor - Patient Care, Contracted Physician Expense, Resident Expense, and Collection Agency Fees. Consulting and Professional fees of 546,726, 230,624 is considered program service and 316,102 is considered management and general expense. Contracted Labor fees of 9,417,522 of which 7,830,519 is considered program service and 1,587,003 is considered management and general. Contract Labor - Patient Care of 5,854,444 of which all is considered program service. Contracted Physician Expense of 11,546,807 of which 11,497,974 is considered program service and 48,833 management and general expense. Resident Expense of 2,397 of which all is considered program service expense. Lastly, Collection Agency Fees of 222,744 of which 132,349 is considered program service and 90,395 is considered management and general expense. Camden-Clark Health Services Inc 800 Garfield Avenue Parkersburg WV 26101 550769602 Healthcare Access WV 501c3 Line 12A West Virginia United Health System false Camden-Clark Foundation 800 Garfield Avenue Parkersburg WV 26101 550667789 Hospital Support WV 501c3 Line 7 Camden-Clark Health Services false Auxiliary of Camden-Clark Memorial Hospital 800 Garfield Avenue Parkersburg WV 26101 550386283 Patient Care WV 501c3 Line 3 N/A false Camden-Clark Physician Corporation 604 Ann Street Parkersburg WV 26101 264058719 Patient Care WV 501c3 Line 3 Camden-Clark Health Services false West Virginia United Health System PO Box 8034 Morgantown WV 26506 550754713 Healthcare Access WV 501c3 Line 12A N/A false West Virginia University Hospitals Inc PO Box 8034 Morgantown WV 26506 550643304 Patient Care WV 501c3 Line 3 West Virginia United Health System false West Virginia University Hospitals East 2500 Foundation Way Martinsburg WV 25401 202337985 Healthcare Access WV 501c3 Line 12A West Virginia University Hospitals Inc false City Hospital Inc 2500 Foundation Way Martinsburg WV 25401 550383321 Patient Care WV 501c3 Line 3 West Virginia University Hospitals East false Jefferson Memorial Hospital 300 S Preston St Ranson WV 25438 550359755 Patient Care WV 501c3 Line 3 West Virginia University Hospitals East false University Healthcare Foundation 2500 Foundation Way Martinsburg WV 25401 311118075 Hospital Support WV 501c3 Line 12A West Virginia University Hospitals Inc false United Hospital Center Inc 327 Medical Park Drive Bridgeport WV 26330 550525724 Patient Care WV 501c3 Line 3 West Virginia United Health System false United Physicians Care Inc 686 South Pike Street Shinnston WV 26431 550638563 Patient Care WV 501c3 Line 3 United Hospital Center Inc false United Health Foundation 327 Medical Park Drive Bridgeport WV 26330 550621706 Hospital Support WV 501c3 Line 12A United Hospital Center Inc false West Virginia Health Care Cooperative Inc 400 Fairview Heights Rd Summersville WV 26651 550650441 Patient Care WV 501c3 Line 3 West Virginia University Hospitals Inc false United Summit Center 6 Hospital Plaza Clarksburg WV 26301 550752788 Behavioral Health WV 501c3 Line 3 West Virginia University Hospitals Inc false Potomac Valley Hospital Inc 100 Pin Oak Lane Keyser WV 26726 550420956 Patient Care WV 501c3 Line 3 West Virginia University Hospitals Inc false St Joseph's Hospital of Buckhannon Inc 1 Amalia Drive Buckhannon WV 26201 550356996 Patient Care WV 501c3 Line 3 West Virginia United Health System false Reynolds Memorial Hospital Inc 800 Wheeling Ave Glen Dale WV 26038 550357045 Patient Care WV 501c3 Line 3 West Virginia University Hospitals Inc false Reynolds Memorial Foundation 800 Wheeling Ave Glen Dale WV 26038 550710402 Hospital Support WV 501c3 Line 12A Reynolds Memorial Hospital Inc false St Joseph's Foundation of Buckhannon Inc 1 Amalia Drive Buckhannon WV 26201 550727650 Hospital Support WV 501c3 Line 12b St Joseph's Hospital of Buckhannon false Braxton County Memorial Hospital 100 Hoylman Drive Gassaway WV 26624 550611919 Patient Care WV 501c3 3 West Virginia University Hospitals Inc false Community Health Association 122 Pinnell Street Ripley WV 25271 550462730 Patient Care WV 501c3 3 West Virginia University Hospitals Inc false Wetzel County Hospital Inc 3 East Benjamin Drive New Martinsville WV 26155 843480493 Patient Care WV 501c3 3 West Virginia University Hospitals Inc false WVUHS Home Care LLC PO Box 8059 Morgantown WV 26506 852915642 Home Health and Hospice WV 509a2 WV United Health System false Ohio Valley Ambulatory Surgery Center 608 Washington Blvd Belpre OH 45714 208671724 Outpatient Surgical Services OH Camden-Clark Memorial Hospital Inc Related 743106 false true 0.67500 Allied Health Sourcing Solutions PO Box 8034 Morgantown WV 26506 842403526 Supply Chain Management WV AHS LLC false false 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 3040 University Avenue Suite 3200 Morgantown WV 26505 550756055 Provider Network WV WV United Health System C Corp false false true false false false false false false true true true false false true true true true true true