2020-11-15T02:02:06-00:00 2019-12-31 990 2019-01-01 311524546 Camden-Clark Memorial Hospital Corporation CAMD 3044242202 800 Garfield Avenue Parkersburg WV 26101 Kyle Pierson VP Finance 3044242202 2020-11-13 false 157.182.216.2 2020-11-15 18:34:18 ES P 870EFB8F4D4B335661AFD9F3B52637157C2F45F8 961A8E11061A341FA9665A68F3B1FFC5AE12E713 2019 2021-01-29 14:40:06Z Camden Clark Medical Center Steve Altmiller 800 Garfield Avenue Parkersburg WV 26101 319968172 false X https://wvumedicine.org/camden-clark/ X 1997 WV To operate an acute care and emergency hospital facility. 8 8 1933 207 590223 43205 82000 272149611 314368070 1153496 210248 3450095 5277135 276796407 319937453 184739 52980 0 99309457 101029447 0 0 184754412 206000351 284248608 307082778 -7452201 12854675 217386406 236758740 265566322 280582276 -48179916 -43823536 X The mission of Camden-Clark Memorial Hospital is to meet the health care needs of our community for a lifetime. false false 106256715 138625994 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 need 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. 18205681 35792596 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 51,919 ER visits, of this total, 8,633 were ultimately admitted to the hospital. A significant portion of the hospitals inpatient volume comes directly from the ER. 11644447 21975670 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. 109789866 118743770 245896709 true true 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 false true 251 0 2332 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 true true true true X Kyle Pierson 3044242202 800 Garfield Avenue Parkersburg WV 26101 Steve Altmiller President 038.00 002.00 X 660930 0 32019 Todd Kruger General Legal Counsel 040.00 X 383209 0 38114 Douglas Frary Chief Operating Officer 038.00 002.00 X 342836 0 62136 Thomas Heller Vice President, Human Resources 030.00 010.00 X 358183 0 13378 Christine Daniels VP, Nursing 040.00 X 246070 0 55868 Sean Smith VP, Operations 040.00 X 225988 0 50182 Cynthia Kern Vice President, Quality 040.00 X 260392 0 10779 Kyle Pierson VP, Finance 030.00 010.00 X 210141 0 41749 Christopher Childress Director of Pharmacy 040.00 X 151915 0 21381 Gene Sexton Pharmacy Manager 040.00 X 141715 0 30801 Jennifer Stauch Pharmacy Operations Manager 040.00 X 140261 0 30565 Michael Trimble Pharmacist 040.00 X 155153 0 6396 Pamela Mincks Pharmacist 040.00 X 138246 0 14394 Janice Midcap Chief Experience Officer 040.00 X 135584 0 14640 Mary Jo Shahan Interim CFO, January 2019 038.00 002.00 X 122787 0 0 MarJean Kennedy Director of Marketing, December 2019 038.00 002.00 X 5766 0 599 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 3679176 423001 45 false true false United Anesthesia Inc 3211 Dudley Avenue Parkersburg WV 26101 Anesthesia Services 3397697 Health Carousel LLC 3805 Edwards Road Suite 700 Cincinnati OH 45209 Healthcare Staffing Services 2373636 Restorix Health Inc 455 Hamilton Ave Suite 800 White Plains NY 106011829 Wound Care Services 976640 Mayo Collaborative Services Inc 200 SW 1st Street Rochester MN 559050001 Laboratory Services 857602 Parkersburg Cardiology Assoc Inc 600 18th Street Suite 512 Parkersburg WV 261013236 Healthcare Staffing Services 749340 30 82000 82000 Patient Service Revenue, Net 621110 307518124 306927491 590633 Pharmacy Sales - Patients 621110 5990862 5961958 28904 Health and Wellness Center 621990 812345 812345 Ambulance Services 621110 46739 46739 314368070 208962 -29314 238276 86 86 1638761 30719 1608042 1608042 1608042 1200 1200 1200 1200 Cafeteria Income 624200 1197386 1197386 WV Treasury Refund 900099 1082210 1082210 Rebate Revenue 900099 855194 855194 534303 534303 3669093 319937453 315138030 590223 4127200 X 52980 52980 0 0 0 3271352 723334 2548018 0 72304764 64296229 8008535 4209473 3673950 535523 14750854 12831533 1919321 6493004 5586054 906950 0 449239 500 448739 0 24139 24139 0 28878502 25460476 3418026 723847 3795 720052 8124549 5086001 3038548 23779 250 23529 0 3671158 3043214 627944 282751 173752 108999 0 41033 38826 2207 9891394 8199492 1691902 54507320 23356065 31151255 15595867 12953692 2642175 15261 -88145 103406 Medical Supplies Patient Chargables 55836898 55836898 Provision for Bad Debts 14614753 14614753 Taxes, Licenses Fees 11404478 9318416 2086062 Dues, Education Training Recruiting 1111101 673139 437962 804282 61505 742777 307082778 245896709 61186069 0 281663 1275475 15291013 7275691 26679516 37305451 5086928 5852592 3713946 3812938 363630577 215120620 140460535 148509957 17715187 23217177 730073 3907726 7427545 5601733 217386406 236758740 18151411 24791341 199521276 190162202 19550138 26627113 28343497 39001620 265566322 280582276 X -48179916 -43823536 -48179916 -43823536 217386406 236758740 X 12854675 -399769 -8098526 X false true X true false X 0.00000 0.00000 0.00000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 24139 24139 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 24,139, was related to lobbying activities of the AHA and WVHA. false 2107095 2107095 162289713 72643763 89645950 175235709 136805150 38430559 23998060 5671707 18326353 148509957 Financial derivatives and other financial products Closely-held equity interests Federal income taxes Accrued wages, benefits and payroll taxes 13242792 Malpractice Liability 1183644 Accrued bond interest 581024 Due to third party payors 451000 Interest rate swaps 13383027 Self insurance liability 3273356 Debt Issuance Costs -997414 Deferred Compensation 165500 Minimum Pension Liability Adjustment 4237523 Finance Lease Liability - Long Term -387345 Long Term Lease Liability 3868513 39001620 X 307678773 2412928 -14620327 -12207399 319886172 51281 51281 319937453 292493170 30719 30719 292462451 14620327 14620327 307082778 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, WVUIS and GHC are organizations subject to federal and/or state income taxes. The System does not have any material uncertain tax positions as of December 31, 2019 and 2018. XI 2d This amount includes 14,614,753 provision for bad debts and a scholarship payment of 5,574 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 30,719 that was reported in Part VIII line 6b as an offset to revenue revenue as well as and contribution revenue of 82,000. XII 4b This amount includes provision for bad debts of 14,614,753 and a scholarship payment of 5,574 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 30,719 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 1802369 1802369 0.00620 68304370 41993089 26311281 0.09000 371354 371354 70478093 42364443 28113650 0.09620 262156 41529 220627 0.00080 2183731 1187602 996129 0.00340 199381 199381 0.00070 2645268 1229131 1416137 0.00490 73123361 43593574 29529787 0.10110 92858 92858 0.00030 92858 92858 0.00030 true 4432655 228005 120641907 162365931 -41724024 X true true Ohio Valley Ambulatory Surgery Center LLC Ambulatory Services 0.62500 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 true X X X X X X X X 17 true false false true X wvumedicine.org/camden-clark/patients-and-visitors/about-us/community-health-needs-assessment/ X true 18 true wvumedicine.org/camden-clark/patients-and-visitors/about-us/community-health-needs-assessment/ 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/bill-pay/financial-assistance/ 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/camden-clark/wp-content/uploads/sites/6/2018/10/CCMC-CHNA-Report-August-2018-Revision.pdf and the Implementation Plan can be found here https//wvumedicine.org/camden-clark/patients-and-visitors/about-us/community-health-needs-assessment/ 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 are 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. 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 2018 Community Benefits which can be found online http//wvumedicine.org/about/community-benefit/. Part I Line 7 Total community benefit expense for 2019 is 73,123,361 and is 25.00 of total net expenses. To calculate net expense, bad debt of 14,614,753 was deducted from total expenses of 307,082,778 as shown in Part IX line 25 of the core Form 990, for a net expense of 292,468,025. 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 14,614,753 by our cost to charge ratio of 30.33 derived from Worksheet 2 in the IRS Schedule H instructions for a toal of 4,432,655. 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 751,747 which we then multipled by our cost to charge ratio of 30.33 for a total of 228,005. 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, 2019 from patients and third-party payors is as follows Medicare - 27, Medicaid - 17, Blue Cross - 24, Commercial, managed care and other - 26, Patients - 6, 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 6 162,365,931 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, 41,724,024 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/camden-clark/wp-content/uploads/sites/6/2018/10/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 In the 2017 CHNA, 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 and includes them in overall consideration of populations served by CCMC. CCMC, located in Parkersburg, WV is a part of Wood County. According to estimates, Wood County has a population of 84,496, median household income of 66,592 and approximately 15 of the Countys residents are below the poverty level. The defined 10 county service area has a total estimated population of 249,000 and a median household income of 41,609. 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, and Community Health Association, doing business as, Jackson General Hospital in Ripley, WV. Part VI Line 6 The System also includes the 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, a behavioral health center located in Clarksburg, WV. In addition to these practices, the System also includes WVUH-East, Inc. and Camden-Clark Health Services which operate as management companies for their respective hospitals. The System also includes University Healthcare Foundation in Martinsburg, WV, United Health Foundation in Bridgeport, WV, Camden-Clark Foundation in Parkersburg, WV, St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Foundation in Glen Dale, WV which perform various fundraising activities for their respective hospitals. true American Heart Association 7272 Greenville Avenue Dallas TX 75231 135613797 501c3 10000 FMV Support West Virginia University Foundation One Waterfront Place 7th Floor Morgantown WV 26507 556017181 501c3 7750 FMV Sponsorship Marietta Area Chamber of Commerce 100 Front Street No 200 Marietta OH 45750 314242580 501c6 5536 FMV Support American Red Cross Blood SVC PO Box 33093 Newark NJ 071880093 530196605 501c3 5100 FMV Support Community Health Association PO Box 720 Ripley WV 25271 550462730 501c3 5000 FMV Support Belpre Area Multi-Use Trail Project 713 Park Drive Belpre OH 45714 475105131 501c3 5000 FMV Support Ohio University PO Box 960 Athens OH 45701 316402113 501c3 6303 FMV Scholarships 6 1 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 Thomas Heller Vice President, Human Resources 289763 59882 8538 12234 1144 371561 Todd Kruger General Legal Counsel 330450 45238 7521 12415 25699 421323 Cynthia Kern Vice President, Quality 228050 30745 1597 9508 1271 271171 Christopher Childress Director of Pharmacy 151688 227 6951 14430 173296 Michael Trimble Pharmacist 132098 23054 6061 336 161549 Pamela Mincks Pharmacist 125219 13027 5800 8594 152640 Jennifer Stauch Pharmacy Operations Manager 134772 5489 5825 24740 170826 Sean Smith VP, Operations 182565 39963 3460 25156 25026 276170 Janice Midcap Chief Experience Officer 129114 6469 5903 8738 150224 Douglas Frary Chief Operating Officer 300729 20951 21156 43251 18885 404972 Christine Daniels VP, Nursing 202532 27056 16481 30427 25442 301938 Steve Altmiller President 505717 97125 58087 12600 19420 692949 129452 Gene Sexton Pharmacy Manager 140485 1230 6213 24588 172516 Kyle Pierson VP, Finance 194828 15000 313 29440 12309 251890 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. Part I Line 3 Compensation for the President of CCMC is established by West Virginia United Health System, Inc. WVUHS. WVUHS utilizes compensation consultants, who review 990s of related organizations, review employment contracts for similar positions, and compensation surveys. The results of the mentioned research are provided to the System Compensation Committee for review and approval. Part I Line 4b The following individuals received deferred compensation contributions in 2019 Sean Smith in the amount of 18,894 Kyle Pierson in the amount of 20,800 Douglas Frary in the amount of 30,651 and Christine Daniels in the amount of 21,002. These amounts were properly recorded in deferred compensation on the Form 990 Schedule J. Part II Amounts reported in Column F as reported as deferred compensation in prior years was distributed by a thrid party administrator. They are responsible for tax reporting of those payments. Part I Line 6a Per the WVUHS Incentive Plan incentives are contingent on meeting a net earning target. A West Virginia Hospital Finance Authority 621256910 956622VY7 2013-10-03 47037860 2013 A Series - Refund 2004 A bonds and fund improvements false false false B West Virginia Hospital Finance Authority 621256910 956622L85 2016-06-15 19440924 2016 A - Refunding of 2007 A Bonds false false false C West Virginia Hospital Finance Authority 621256910 956622P40 2018-07-31 56880000 2018C Series - Refund 2004 BC Bonds false false false A 10675000 47037860 6638409 411597 28772226 12146948 2016 false true true true B 1167992 19440924 149889 19287978 122 2016 true true true true C 205000 56880000 422708 56457292 2018 true false true true A false false true true false false false true B false false true true false false false true C false false true true false false false true A false false false true false false true Cantor Fitzgerald true false true B false true false false false false true Cantor Fitzgerald true false true C false true false false true false false false true A true B true C true Part I Line A 2013 A Bond - The total issue price reported on Line 3 varies from the total of Lines 4 through 12 by 931,320, this variance is due to the 2004 Series A bonds that were defeased via the 2013A issuance. These funds were sitting in debt service, interest, and the project fund accounts at the time of the 2013 issuance and were rolled into the 2013 A funds. Part I Line B 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 C - 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 B 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 2013 Series A issuance was prepared for the period October 3, 2013 through November 30, 2019 and found that no rebate is due. The next computation date is the earlier of November 30, 2020 or the date the issue is fully redeemed. Part IV Line 2c Column B - Rebate calculation for the 2016 Series A issuance is not due until 2021. Column C - Rebate calculation for the 2018 Series C issuance is not due until 2023. Part IV Line 5c Column A - The securities for the GIC for the 2013 A Bonds were purchased on October 25, 2013 and the last one matured on May 27, 2016. Column B - The securities for the 2016 A Bonds were purchased on June 15, 2016 and the last one matured on May 31, 2019. Part IV Line 5c Column A - The securities for the GIC for the 2013 A Bonds were purchased on October 25, 2013 and the last one matured on May 27, 2016. Column B - 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 13,897,467, Grants and allocations 0, Revenue 18,090,133 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. Form 990, Part III, Line 4d Program Service Expenses 95,892,399, Grants and allocations 0, Revenue 100,653,637 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 The organization utilizes an excutive compensation consultant to survey data and make recommendations. The compensation of the President is determined by using an independent compensation consultant, as well as a compensation survey or study. It is supported by a written employment contract which is then reviewed and approved by a compensation committee and the WVUHS board of directors. Compensation of other officers and key employees is reviewed and approved by the board of directors. Minutes from meetings of the compensation committee and board of directors are documented and kept on file. 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 10,674,739, Pension Liability Adjustment of 662,370 related to GAAP reclassifications and pension plan valuations of frozen plans, 82,000 contributions from Camden-Clark Foundation, release of temporary restricted net assets of 96, investments posted to net assets of 142,174, premier investment adjustment of 3,177,653 posted to net assets, and 660 of rounding/error suspense amounts all posted to Net Assets. 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, and Collection Agency Fees. Consulting and Professional fees of 1,833,345, 415,143 is considered program service and 1,418,202 is considered management and general expense. Contracted Labor fees of 9,977,169 of which 8,241,269 is considered program service and 1,735,900 is considered management and general. Contract Labor - Patient Care of 5,415,443 of which all is considered program service. Contracted Physician Expense of 11,306,539 which 11,246,976 is considered program service and 59,563 management and general expense. Lastly, Collection Agency Fees of 346,006 of which 141,645 is considered program service and 204,361 is considered management and general expense. Form 990, Part IX, Line 23 Column B - Insurance expense for the year end is presented as a negative due to the year end adjustment of Malpractice/Liability Insurance based on the actuarial report. 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