STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

JEFFERSON MEMORIAL HOSPITAL: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
JEFFERSON MEMORIAL HOSPITAL (EIN 55-0359755)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-12
IRS object ID
201903169349306775
Schema version
2018v3.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-12T09:42:52-00:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550359755EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jefferson Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlJEFFBusinessNameControlTxt
Phone3047281600PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12000 Foundation Way Room 2310AddressLine1Txt
CityMartinsburgCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25401ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonZach KernsPersonNm
Person TitleVP of FinancePersonTitleTxt
Signature2019-11-12SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address157.182.216.2IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-13IPDt
IP Tm01:05:38IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id5D18E0CDD66F5C2C6782695A054BAE6AB9A943F9AtSubmissionCreationDeviceId
At Submission Filing Device Id961A8E11061A341FA9665A68F3B1FFC5AE12E713AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-04-17 16:48:07ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Jefferson Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerZach KernsPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12000 Foundation Way Suite 2310AddressLine1Txt
CityMartinsburgCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25401ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$59,094,217GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttps://wvumedicine.org/jefferson/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1912FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionJefferson Memorial Hospital is a non-profit, critical access hospital serving the residents of the Eastern Panhandle of WV.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee396TotalEmployeeCnt
Total Volunteers30TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$115,890NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$62,343PYContributionsGrantsAmt
CY Contributions Grants$5,000CYContributionsGrantsAmt
PY Program Service Revenue$53,552,726PYProgramServiceRevenueAmt
CY Program Service Revenue$58,243,771CYProgramServiceRevenueAmt
PY Investment Income$1,178,635PYInvestmentIncomeAmt
CY Investment Income$531,233CYInvestmentIncomeAmt
PY Other Revenue$232,725PYOtherRevenueAmt
CY Other Revenue$252,936CYOtherRevenueAmt
PY Total Revenue$55,026,429PYTotalRevenueAmt
CY Total Revenue$59,032,940CYTotalRevenueAmt
PY Grants And Similar Paid$4,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$11,392CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$19,862,125PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$21,601,344CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$33,010,301PYOtherExpensesAmt
CY Other Expenses$34,553,792CYOtherExpensesAmt
PY Total Expenses$52,876,426PYTotalExpensesAmt
CY Total Expenses$56,166,528CYTotalExpensesAmt
PY Revenues Less Expenses$2,150,003PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,866,412CYRevenuesLessExpensesAmt
Total Assets BOY$64,390,074TotalAssetsBOYAmt
Total Assets EOY$64,973,124TotalAssetsEOYAmt
Total Liabilities BOY$23,863,980TotalLiabilitiesBOYAmt
Total Liabilities EOY$21,769,937TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$40,526,094NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$43,203,187NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionJefferson Memorial Hospital is a non-profit critical access hospital serving the residents in the Eastern Panhandle of WV. It operates a 24/7 emergency room. Jefferson Memorial Hospital is organized to provide quality hospital patient care services to the Eastern Panhandle of WV regardless of the patients ability to pay.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$17,095,256ExpenseAmt
Revenue$19,547,178RevenueAmt
DescAs a not for profit critical access hospital, Jefferson Memorial Hospital JMH provides general medical services to the community of Ranson, WV. Such services include but are not limited to family medicine, internal medicine, observation to see if hospital admission is necessary, and outpatient ancillary testing. During 2018, JMH documented 1,078 outpatients in the observation status and 9,523 outpatient ancillary tests were performed.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$12,280,709ExpenseAmt
Revenue$19,840,462RevenueAmt
DescJefferson Memorial Hospital JMH is a critical access hospital and operates a 24 hours per day, 7 days per week emergency department which cares for patients regardless of their ability to pay. During 2018 the Emergency Department documented 23,894 patient visits.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$9,135,280ExpenseAmt
Revenue$10,788,705RevenueAmt
DescJefferson Memorial Hospital JMH provides both general and advanced surgical services to those residents located in Ranson, WV and the surrounding area. Surgical service areas at JMH include gall bladder, breast and colon, orthopaedics and joint replacement, otolaryngology, gynecology, urology, ophthalmology and cosmetic surgery. In addition, many of these surgical procedures performed at JMH utilize cutting edge laparoscopy and endoscopy techniques. The hospital also provides a One Day Surgical Unit that provided care to 2,671 patients during 2018.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$5,497,169TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$8,067,426TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$44,008,414TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstYes (true)ReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document87IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee396EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonZach KernsPersonNm
Phone3042641000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12000 Foundation Way Suite 2310AddressLine1Txt
CityMartinsburgCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25401ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeInd
David DeJarnett
Director/ Vice Chairman000.03Yes (X)Yes (X)$0$0$0
Terry Hess
Director/ Treasurer000.03Yes (X)Yes (X)$0$0$0
Christopher Burg Jr
Director000.03Yes (X)$0$0$0
James E Rogers
Director000.03Yes (X)$0$0$0
Henry Kayes
Director000.03Yes (X)$0$0$0
Emma Eggleston MD
Director/Interim Dean, WVU Eastern Division SoM000.03Yes (X)$0$310,871$18,929039.97
Judie Charlton MD
Director000.03Yes (X)$0$0$0
Timothy Devine
Director / JMH Med Staff President040.00Yes (X)$0$244,710$17,150
Chiquita Howard-Bostic
Director000.03Yes (X)$0$0$0
Dawn Jones MD
Director000.03Yes (X)$0$0$0
Betty Gunnoe
Director / Secretary000.03Yes (X)Yes (X)$0$0$0
Richard Pill
Director / Chairman000.03Yes (X)Yes (X)$0$0$0
Brian Romine
Director000.03Yes (X)$0$0$0
Paul Welch MD
Director/BMC Medical Staff000.03Yes (X)$0$4,000$0
Susan Snowden
Director000.03Yes (X)$0$0$0
Neal McLaughlin
VP Operations040.00Yes (X)$243,581$0$39,023
Charles Keeling
CRNA040.00$241,442$0$20,534Yes (X)
Angela Taylor
CRNA040.00$238,952$0$27,153Yes (X)
Cynthia Howard
CRNA040.00$218,064$0$3,398Yes (X)
Jonathan Kline
Pharmacist040.00$171,792$0$25,265Yes (X)
Frew Negatu
Pharmacist040.00$148,581$0$25,689Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,262,412TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$559,581TotReportableCompRltdOrgAmt
Total Other Compensation$177,141TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K22IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Focusone Solutions LLC
13609 California StOmahaNE681545260Management and Software Services$1,580,993
JMH Emergency Physicians Inc
20010 Century Blvd Suite 200GermantownMD208741118Physician Services$962,830
Alliance Healthcare Services
100 Bayview CircleNewport BeachCA926602983Clinical Care Service Provider$647,190
Mayo Collaborative Services
200 SW 1st StreetRochesterMN559050001Laboratory Services$261,725
Francisco Ontiveros
212 Cool Springs RdWinston SalemNC271071728Interior Construction Services$106,487
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
All Other Contributions$5,000AllOtherContributionsAmt
Total Contributions$5,000TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient Service RevenueDesc
Business621110BusinessCd
Total Revenue Column$58,243,771TotalRevenueColumnAmt
Related Or Exempt Func Income$58,243,771RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$58,243,771TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$592,510TotalRevenueColumnAmt
Exclusion$592,510ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$24,628RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$24,628RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$24,628TotalRevenueColumnAmt
Exclusion$24,628ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$61,277OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$61,277OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$61,277TotalRevenueColumnAmt
Exclusion-$61,277ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
Cafeteria Income900099$124,846$124,846
Rebate Revenue900099$49,853$49,853
Cash Discounts900099$16,935$16,935

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$36,674TotalRevenueColumnAmt
Exclusion$36,674ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$228,308OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$59,032,940TotalRevenueColumnAmt
Related Or Exempt Func Income$58,243,771RelatedOrExemptFuncIncomeAmt
Exclusion$784,169ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$11,392TotalAmt
Program Services$11,392ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$282,604TotalAmt
Management And General$282,604ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$15,706,074TotalAmt
Program Services$14,305,890ProgramServicesAmt
Management And General$1,400,184ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$656,040TotalAmt
Program Services$597,555ProgramServicesAmt
Management And General$58,485ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,350,011TotalAmt
Program Services$3,086,904ProgramServicesAmt
Management And General$263,107ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,606,615TotalAmt
Program Services$1,463,387ProgramServicesAmt
Management And General$143,228ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$63,159TotalAmt
Management And General$63,159ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$660TotalAmt
Program Services$660ProgramServicesAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$7,589TotalAmt
Management And General$7,589ManagementAndGeneralAmt
FieldValueIRS element (for citing)
Fees For Services Prof FundraisingFeesForServicesProfFundraising

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$11,181,319TotalAmt
Program Services$7,955,617ProgramServicesAmt
Management And General$3,225,702ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,441TotalAmt
Program Services$178ProgramServicesAmt
Management And General$2,263ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,487,354TotalAmt
Program Services$1,025,360ProgramServicesAmt
Management And General$461,994ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$511,781TotalAmt
Program Services$273,050ProgramServicesAmt
Management And General$238,731ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$267,764TotalAmt
Program Services$42,535ProgramServicesAmt
Management And General$225,229ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$415,340TotalAmt
Program Services$221,596ProgramServicesAmt
Management And General$193,744ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$8,335,255TotalAmt
Program Services$4,430,477ProgramServicesAmt
Management And General$3,904,778ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,326,415TotalAmt
Program Services$1,241,211ProgramServicesAmt
Management And General$1,085,204ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$449,348TotalAmt
Program Services$257,508ProgramServicesAmt
Management And General$191,840ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Provision for Doubtful Accounts$2,706,413$2,706,413
Medical Supplies$4,886,270$4,886,270
Recruiting$266,718$203,265$63,453
Taxes, Licenses, Fees$1,512,967$1,220,375$292,592

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$132,999TotalAmt
Program Services$78,771ProgramServicesAmt
Management And General$54,228ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$56,166,528TotalAmt
Program Services$44,008,414ProgramServicesAmt
Management And General$12,158,114ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$44,269BOYAmt
EOY$36,803EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$18,746,541BOYAmt
EOY$22,040,492EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,834,734BOYAmt
EOY$7,778,248EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$806,524BOYAmt
EOY$836,249EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$7,540BOYAmt
EOY$19,643EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$40,538,662LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$24,798,604LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$15,597,166BOYAmt
EOY$15,740,058EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$20,616,780BOYAmt
EOY$18,359,985EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$736,520BOYAmt
EOY$161,646EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$64,390,074BOYAmt
EOY$64,973,124EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$13,364,677BOYAmt
EOY$12,870,264EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,201,885BOYAmt
EOY$8,759,865EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,297,418BOYAmt
EOY$139,808EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$23,863,980BOYAmt
EOY$21,769,937EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$34,409,305BOYAmt
EOY$37,622,455EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$331,612BOYAmt
EOY$376,134EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,785,177BOYAmt
EOY$5,204,598EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$40,526,094BOYAmt
EOY$43,203,187EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$64,390,074BOYAmt
EOY$64,973,124EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,866,412ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$818,222NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$628,903OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd
Public Support CY1700.00000PublicSupportCY170Pct
Public Support CY5090.00000PublicSupportCY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$7,589OtherActivitiesAmt
Total Lobbying Expenditures$7,589TotalLobbyingExpendituresAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceII-B 1iFormAndLineReferenceDesc
ExplanationAs a member of the WV Hospital Association and the American Hospital Association, a portion of the dues paid have been identified by the above mentioned organizations as attributable to lobbying activities.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$947,533OtherCostOrOtherBasisAmt
Book Value$947,533BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,766,258OtherCostOrOtherBasisAmt
Depreciation$10,913,855DepreciationAmt
Book Value$9,852,403BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,765OtherCostOrOtherBasisAmt
Depreciation$5,765DepreciationAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,773,037OtherCostOrOtherBasisAmt
Depreciation$13,453,077DepreciationAmt
Book Value$4,319,960BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,046,069OtherCostOrOtherBasisAmt
Depreciation$425,907DepreciationAmt
Book Value$620,162BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,740,058TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDesc
Financial derivatives and other financial products
Closely-held equity interests

Invst Program Related Org InvstProgramRelatedOrgGrp (5 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Beneficial Interests in Perpetual Trusts$5,204,598F
Bond Fund$60,574F
Other Investments$658,105F
Funded Depreciation$12,436,708F
Self Insurance FundF
FieldValueIRS element (for citing)
Total Book Value Program Rltd$18,359,985TotalBookValueProgramRltdAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
Federal income taxes
Capital Leases$35,564
Self Insurance Liabilities
Interest Rate Swaps$157,790
Leases Payable - Current
Debt Issuance Costs-$53,546
FieldValueIRS element (for citing)
Total Liability$139,808TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$55,508,305TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$818,222NetUnrealizedGainsInvstAmt
Other Revenue-$2,706,413OtherRevenueAmt
Revenue Not Reported-$3,524,635RevenueNotReportedAmt
Revenue Subtotal$59,032,940RevenueSubtotalAmt
Total Revenue Per Form990$59,032,940TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$53,460,115TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$53,460,115ExpensesSubtotalAmt
Other Expenses Not Included$2,706,413OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,706,413ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$56,166,528TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
X 2The annual audit and financial statements of Jefferson Medical Center are prepared on a consolidated basis as a member of the WV United Health System. WVUHS, WVUH, PVH, CCHS, CCMC, CCF, CCPC, University Healthcare, BMC, JMC, UHCF, UHC, USC, UHF, UPC SJH, SJF, RMH and RMF 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 accounts for uncertainty in income taxes using a recognition threshold of more-likely-than not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold is met. The System does not have any material uncertain tax positions as of December 31, 2018 and 2017.
XI 2dThe amount shown on line 2d consists of 2,706,413 provision for doubtful accounts reported as an offset to revenue on the financial statements.
XII 4bThe amount shown on line 4b consists of 2,706,413 provision for doubtful accounts reported as an offset to revenue on the financial statements.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$838,385TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$93,223DirectOffsettingRevenueAmt
Net Community Benefit Expns$745,162NetCommunityBenefitExpnsAmt
Total Expense0.01390TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,063,802TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,063,802DirectOffsettingRevenueAmt

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$202,152TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$177,265DirectOffsettingRevenueAmt
Net Community Benefit Expns$24,887NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,104,339TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,334,290DirectOffsettingRevenueAmt
Net Community Benefit Expns$770,049NetCommunityBenefitExpnsAmt
Total Expense0.01440TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$52,300TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,250DirectOffsettingRevenueAmt
Net Community Benefit Expns$51,050NetCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,665,063TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,665,063NetCommunityBenefitExpnsAmt
Total Expense0.03110TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,392TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$11,392NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,728,755TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,250DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,727,505NetCommunityBenefitExpnsAmt
Total Expense0.03230TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,833,094TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,335,540DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,497,554NetCommunityBenefitExpnsAmt
Total Expense0.04670TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$842TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$842NetCommunityBenefitExpnsAmt

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$619TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$619NetCommunityBenefitExpnsAmt

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,253TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,253NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,714TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,714NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$1,155,592BadDebtExpenseAmt
Reimbursed By Medicare$16,450,548ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$20,339,113CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$3,888,565MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jefferson Memorial HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 South Preston StreetAddressLine1Txt
CityRansonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25438ZIPCd
FieldValueIRS element (for citing)
Website Addresshttps//wvumedicine.org/jefferson/WebsiteAddressTxt
State License103StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
Teaching HospitalYes (X)TeachingHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Facility Reporting GroupAFacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ABusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps//wvumedicine.org/east/wp-content/uploads/sites/19/2019/02/CHNA-Report.pdfOwnWebsiteURLTxt
Implementation Strategy AdoptfalseImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttps//wvumedicine.org/east/wp-content/uploads/sites/19/2019/02/CHNA-Report.pdfStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedfalseEligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care0000000200.000000000000FPGFamilyIncmLmtFreeCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps//wvumedicine.org/bill-pay/financial-assistance/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps//wvumedicine.org/bill-pay/financial-assistance/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps//wvumedicine.org/bill-pay/financial-assistance/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesYes (true)GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Group Jefferson Memorial Hospital Line Part V, Section B, Line 5The Community Health Needs Assessment CHNA process involved collecting both primary and secondary data. Primary data was gathered from external and internal stakeholders via interviews, web-based survey instruments, focus groups, formal and informal key informant interviews, and observations of public meetings. The stakeholders represent the broad interests of the communities served by University Healthcare and included public health officials, teachers, school nurses, social service providers, community health center providers, staff, and board members, persons living with chronic health conditions and their families, other community members, and University Healthcare-affiliated executives, clinicians, administrators, and staff. In addition, special outreach efforts were made to be sure that the voices of all persons were heard and included in the development of health priorities and strategies to address those priorities. Dr. Buck partnered with Shepherd University and WVU BSW and MSW students and interns to increase outreach for input from clients of DHHR, Berkeley and Jefferson County Health Departments, Jefferson Community Ministries, Catholic Charities, and other social service agencies and organizations.
Group Jefferson Memorial Hospital Line Part V, Section B, Line 3Four different assessments were completed 1 Community Themes and Strengths Assessment CTSA 2 Health System Assessment HSA 3 Community Health Status Assessment CHSA and 4 Forces of Change Assessment FOC. The CHSA and HSA were conducted using surveys, focus groups, key informant interview research methods, and secondary analysis of hospital data. The CHSA consisted of a secondary analysis of publicly available health data and cancer registry data. A full list of individuals that contributed to the CHNA can be found at the end of the CHNA document http//wvumedicine.org/university-healthcare/wp-content/uploads/sites/19/2017/05/2016-Community-Health-Needs-AssessmentImplementation-Plan-Berkeley-Medical-Jefferson-Medical-Centers.pdf.
Group Jefferson Memorial Hospital Line Part V, Section B, Line 6aThe Community Needs Health Assessment CHNA was undertaken jointly with City Hospital, Inc.
Group Jefferson Memorial Hospital Line Part V, Section B, Line 11City Hospital and Jefferson Memorial Hospital worked collaboratively on strategies and their implementation but priorities for each hospital differed slightly. These differences reflected the unique attributes of the hospitals, services each hospital provides, and the communities they serve. Jefferson County priorities included 1 improved access to high quality care across the continuum and behavioral health services 2 initiatives to improve dietary habits, reduce sedentary behavior/increase activity levels, and reduce illicit drug use and, 3 strategies to address binge drinking and alcohol-related vehicle crash fatalities. Hospital-specific priorities for Jefferson Memorial Hospital were 1 hospital-wide and community diabetes initiatives 2 behavioral health in acute, emergency room, and community-based settings 3 collaborations to improve access to health care among persons with lower and fixed incomes and, 4 strategies to address community-wide trends related to population demographic trends, specifically, growth in aging and racial/ethnic minority populations.
Group Jefferson Memorial Hospital Line Part V, Section B, Line 11Universal problems to be addressed by the CHNA Implementation Teams IT were 1 high prevalence of substance abuse and gaps in care for persons with serious mental illness 2 high incidence of and poor health outcomes among persons with chronic disease such as diabetes, heart disease, and lung disease and, 3 rising rates of lung cancer deaths among women in the region and late stage breast cancer diagnoses. The CHNA identified a fourth priority area focused on maternal/child health disparities. Since community providers and other community groups were already addressing the issue, it was determined that the development of an additional UHC team would be redundant.
Group Jefferson Memorial Hospital Line Part V, Section B, Line 13bJefferson Memorial Hospital JMH offers discounted care only to individuals who qualify for free care. JMH 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 Jefferson Memorial Hospital Line Part V, Section B, Line 24All 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 (26 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I Line 3cJefferson Memorial Hospital JMH uses 200 Federal Poverty Guideline to determine free care eligibility. JMH 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.
Part I Line 6aJefferson Memorial Hospital community benefit numbers are reported in total with the other hospitals within West Virginia United Health System. The 2018 amounts can be found at the following web address http//wvumedicine.org/about/community-benefit/.
Part I Line 7Column f - Total community benefit expense for 2018 is 17,833,094 and is 33.36 of total net expenses. To calculate net expense, bad debt of 2,706,413 was deducted from total expenses of 56,166,528 as shown in Part IX line 25 of the core Form 990.
Part I Line 7Worksheet 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 IIPhysical Improvements and Housing - Jefferson Memorial Hospital employees volunteered one full day at the Boys Girls Club in Charles Town as part of the United Way of the Eastern Panhandles annual Day of Caring.
Part IIEconomic Development - A representative from JMH Home Health Services serves on the Jefferson County Chamber of Commerce Board of Directors.
Part IICommunity Support - We sponsor and have a team participate in the annual March of Dimes Walk Jefferson County, American Cancer Society Relay for Life in Jefferson County and various other fundraising events for local, health related, non-profit organizations. Many WVUH-East employees serve as volunteer board directors on community non-profit organizations such as Hospice of the Panhandle, Boys Girls Club of the Eastern Panhandle, and the United Way of the Eastern Panhandle as well as participate in other non-profit organizations such as the Jefferson County Council of Aging Senior Center, FLOC, provide children the opportunity for hands on learning through programs and youth developement, and various community support activities with Jefferson County Community Ministries.
Part IIEnvironmental Improvements - 2018 marked the third full year for Jefferson Memorial Hospital as a tobacco free campus.
Part IILeadership Development and Training - One manager participated in the Chamber of Commerces Leadership Jefferson program in 2018. Several managers participated in leadership development trainings and have sent several staff to inservices to enrich their skills.
Part IICoalition building - JMH staff participates in the Health Human Services Collaborative and workgroups such as the Health Work Group and Behavioral Health Workgroup. These activities focus on improving community access to health care, human services in general, and determine ways to encourage healthy lifestyles. JMH also sponsored health wellness events and participate in wellness events with the local schools, Jefferson County Parks Recreation, the City of Ranson, Ranson Parks and Recreation, the City of Charles Town and employer wellness fairs such as American Public University.
Part IICommunity health improvement advocacy - In 2018, Jefferson Memorial Hospital continued with Cycle 2 community health needs assessment and implementation plans to address four key issues --perinatal and maternal/infant health, chronic illness prevention and care, cancer prevention and care breast, lung and colon, and behavioral health. JMH staff participate on wellness committees for the Jefferson County School board and for the individual schools. JMH staff also participate in, and sponsored a food program at the Jefferson County Community Ministries, another local non-profit agency. JMH staff also promote health eating and teaching healthier cooking and conducted blood pressure screenings once a month.
Part IIWorkforce Development - WVUH-East is also a major sponsor of the Womens Network which is an organization established by the Berkeley and Jefferson County Chambers. This group sponsors womens professional activities, social networking and professional development seminars. Jefferson Memorial Hospital also has agreements with area community colleges and universities to allow students to complete clinical rotations at the hospital. JMH also provides a job shadow program and a summer junior volunteer program to teens to allow them opportunities to shadow professionals to learn about possible careers in the workforce as well as participates in school career fairs in the elementary through high schools in the county.
Part III Line 4Jefferson Memorial 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 receivables 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 in 2018 or the provision for bad debts in 2017. 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 in 2018 and allowances for bad debts in 2017 and such amounts have historically been within managements expectations. The mix of accounts receivable at December 31, 2018 and 2017 from patients and third-party payors is as follows 2018 Medicare 29, Medicaid 18, Blue Cross 24, Commercial/Managed Care/Other 26, Patients 3, Total 100. For 2017, Medicare 29, Medicaid 14, Blue Cross 21, Commercial/Managed Care/Other 32, Patients 4, Total 100.
Part III Line 4For 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 8The amount reported in Part III Line 6 20,339,113 was calculated using the total Medicare allowable cost from the Medicare cost report.
Part III Line 8Jefferson Memorial Hospitals 3,888,565 shortfall 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 9bJMH 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 2Jefferson Memorial Hospital is a critical care hospital within the health care system of West Virginia University Hospitals - East WVUH-East. The marketing department considers several components in assessing how the organization determines the need of the communities it serves. Through outside consultants, to collaborating with various departments, a needs assessment takes into account several factors including physician to population ratios, physician availability in the entire service area, and general health risks for our community. The Primary Service Area PSA for WVUH-East includes Berkeley County, WV and Jefferson County, WV with Morgan County, WV being a secondary service area. This data is then analyzed to provide general estimates to where WVUH-East could better care for residents of West Virginias Eastern Panhandle.
Part VI Line 2Sources utilized to help gather this information come from a variety of areas. Physician distribution and population data come from the American Medical Association and the U.S. Census Bureau and the general health risk for our community come from clinical diagnosis information gathered by the West Virginia Health Care Authority and Thomson Reuters Market Planner Plus. We also conduct market research to ask consumers how they perceive the health system and where they go for health care services. Once all the data is gathered to determine where residents of West Virginia are going for care and what types of services they are receiving, a needs assessment can then begin based on physician distribution and population estimates. Note that WVUH-East is working with other local organizations in a project known as MAPP Mobilizing for Action through Planning and Partnerships to create and implement a community health improvement plan.
Part VI Line 3JMH employs 2 financial analysts to meet with patients to discuss financial eligibility for our charity care program. JMH has applications for charity and the qualification requirements for receiving charity available at all registration areas for both facilities. Patients who do not qualify for state or federal funded programs can apply for the charity care program at WVUH-EAST.
Part VI Line 4Jefferson Memorial Hospital is a non-profit critical access hospital located in Jefferson County, WV population 56, 811 in the city of Ranson with a total population of 5,182 residents. Jefferson Memorial Hospital along with City Hospital located in Martinsburg makes up the Eastern Division of WVU Medicine which is a part of the West Virginia United Health System. WVU Medicine provides a majority of inpatient services for the population in our Primary Service Area PSA. The PSA for the Eastern Division of WVU Medicine includes Berkeley County, WV, and Jefferson County, WV. The 2017 market share for Jefferson Memorials Primary Service Area is 8.0, with 25.4 of those patients covered by Medicaid and 1.0 of the patients uninsured. City Hospital, Inc., a non-profit acute care hospital under common management, is within the Primary Service Area and War Memorial Hospital, a non-profit critical access hospital, operated by Valley Health System, is in the extended service area. Jefferson Countys population is 56,811, with a median household income of 72,526 and an unemployment rate of 3.3 Currently, 10.4 of Jefferson County residents live below the poverty line according to the US Census Bureau Quick Facts 2018. Berkeley County has a population of 117,123, a median household income of 59,480 and an unemployment rate of 4.1. Currently 11.8 of Berkeley County residents live below the poverty line. In WVU Medicines Eastern Division extended service area, Morgan County, WV has a population of 17,787, with a median household income of 46,348 and unemployment of 4.5. Currently, 13.0 of Morgan County residents live below the poverty line.
Part VI Line 5In 2009, WVUH-East started offering discounted screening in response to a struggling economy. Recognizing that individuals were putting off scheduling routine, preventive testing such as mammograms and blood work, WVUH-East offered Discounted Mammogram Clinics in May and October 2018 cash, no insurance. The clinics were successful in serving over 50 patients at Jefferson Memorial Hospital.
Part VI Line 5Our Mini-Medical School Program, which is held 9 times a year in Berkeley County, is a community health education program featuring local physicians and topics that address health needs in our communities. The program is jointly sponsored by WVUH-East and the WVU Robert C. Byrd Health Sciences Center Eastern Division. It is offered free to the community with an average attendance of 40 - 50.
Part VI Line 6JMH 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 6System 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, and Reynolds Memorial Hospital, in Glen Dale, WV, which joined the System in October 2016.
Part VI Line 6The 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 Clarksburg, 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.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Jefferson County Chamber of CommerceBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1201 E Washington StreetAddressLine1Txt
CityCharles TownCityNm
State AbbreviationWVStateAbbreviationCd
ZIP254141073ZIPCd
FieldValueIRS element (for citing)
Recipient EIN550440146RecipientEIN
IRC Section501c6IRCSectionDesc
Cash Grant$5,500CashGrantAmt
Valuation Method UsedFMVValuationMethodUsedDesc
Purpose Of GrantSupportPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total Other Org1TotalOtherOrgCnt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd
Rebuttable Presumption ProcfalseRebuttablePresumptionProcInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmount
Emma Eggleston MD
Director/Interim Dean, WVU Eastern Division SoM$263,307$46,612$953$15,798$3,130$329,800
Timothy Devine
Director / JMH Med Staff President$205,614$37,043$2,052$15,250$1,901$261,860
Charles Keeling
CRNA$239,115$2,327$3,670$16,864$261,976
Angela Taylor
CRNA$238,349$603$3,682$23,471$266,105
Cynthia Howard
CRNA$203,359$14,704$2,986$413$221,462
Jonathan Kline
Pharmacist$167,992$236$2,570$22,695$197,057$3,564
Neal McLaughlin
VP Operations$190,999$5,544$22,355$16,668$282,604$47,038
Frew Negatu
Pharmacist$144,905$841$2,295$23,394$174,270$2,835

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I Line 3Salaries of all officers are subject to the approval of a compensation committee designated by the WV University Healthcare Board of Directors. This committee uses the work of an independent salary and benefit consultant to determine the compensation packages to be made available to officers to ensure the compensation does not exceed fair market value of comparable positions at similar organizations. All data is retained and all decisions are appropriately documented pertaining to the compensation setting practices. This review occurs annually and was last completed in 2017 for 2018 compensation amounts.
Part I Line 4bDuring 2018, certain individuals reported in Part VII participated in a nonqualified retirement plan. The following is a list of those individuals, plan types and amounts. Neil McLaughlin - deferred contributions to the Cash Contributions Account of 19,442.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 4dProgram Service Expenses 5,497,169, Grants and allocations 0, Revenue 8,067,426 Jefferson Memorial Hospital JMH is a not-for-profit, critical access hospital that operates twenty-four 24 hours a day, seven 7 days a week. The hospital offers a variety of services which include the following but not limited to birthing, cardiopulmonary, emergency, home health, infectious disease, laboratory, pediatric, pharmacy, radiology, care management, special care, surgery, transitional care, vascular therapy and womens imaging. It serves as part of a regional health system, West Virginia University Hospitals-East, Inc. WV University Healthcare which serves Berkeley, Jefferson and Morgan Counties in West Virginia.
Form 990, Part IV, Line 24aBond issuances allocated to Jefferson Memorial Hospital are being reported on Schedule K of West Virginia University Hospitals, Inc. EIN 55-0643304. West Virginia University Hospitals, Inc. is a 501c3 and is the parent hospital of Jefferson Memorial Hospital.
Form 990, Part V, Line 2aJefferson Memorial Hospitals JMH serves as paymaster for certain employees of West Virginia Univeristy Hospitals, East d/b/a University Healthcare WVUH-East. As paymaster JMH withholds and remits all appropriate taxes and associated returns/filings. JMH bills WVUH-East for compesnation and benefits attributable to the shared employees. Employees that perform duties for WVUH-East are reported as employees of that entity and their compensation and benefits are reported as expense on that 990.
Form 990, Part VI, Section B, Line 12cEach board member is required to disclose, annually, any relationships which may give rise to a potential conflict of interest. These responses are processed and maintained by the WVUH-East Compliance Committee. All board members are to be willing to identify conflicts of interest and abstain from voting when appropriate.
Form 990, Part VI, Section B, Line 15bExecutive compensation is based upon the work of an independent salary consulting firm, which compiles data from comparable facilities in comparable geographic regions. The information is then used by the board of directors and compensation committee to set salaries. This work is documented and retained.
Form 990, Part VI, Section C, Line 19All financial and governing documents, including the conflict of interest policy are maintained on site and made available to the public upon written request.
Form 990, Part IX, Line 11gThis total consists of Consulting Professional fees of 3,150,780 of which 9,250 is considered program service and 3,141,530 is considered management and general expenses Contracted Labor fees of 1,343,550 of which 1,270,211 are considered program service expenses and 73,339 management and general expenses Lab Fees of 1,325,174 of which all is considered program service expenses Contract Labor- Patient Care fees of 1,821,887 of which all is considered program service expenses Consulting Professional - Med Staff fees of 2,097 of which all is considered program service fees Consulting and Professional - Med Staff Director fees of 258,761 of which 247,928 is considered program service expense and 10,833 management and general expense Contracted Physician Expense of 3,143,956 all of which is considered program service expense and Collection Agency Fees of 135,114 all considered program service expense.
Form 990, Part XI, Line 9Other changes in net assets or fund balance includes 960 of Amortization of FMV of derivatives, 1,164,000 adjustment to malpractice insurance liability, 44,522 Change in Temporarily Restricted Net Assets, and 580,579 Change in Permanently Restricted Net Assets. The malpractice insurance adjustment was a related party transfer of medical malpractice liability from the local hospital JMC to the System as part of moving to a self-insured captive insurance plan across the System with these hospitals only paying a premium for coverage under the plan and the medical malpractice liability residing at the System level under the captive insurance entity, Augusta LLC.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
WVU Hospitals - East Inc
2000 Foundation Way Suite 2310MartinsburgWV25401202337985Health SystemWV501C312aWest Virginia University Hospitals Incfalse
WVU Hospitals Inc
PO Box 8034MorgantownWV26506550643304Patient CareWV501C33WV United Health Systemfalse
WV United Health System Inc
3040 University AvenueMorgantownWV26505550754713Health SystemWV501C312afalseN/A
City Hospital Inc
2000 Foundation Way Suite 2310MartinsburgWV25401550383321Patient CareWV501C33WVUH-East Incfalse
University Healthcare Foundation
2000 Foundation Way Suite 2310MartinsburgWV25401311118075Hospital SupportWV501C312afalseN/A
United Summit Center
6 Hospital PlazaClarksburgWV26301550752788Behavioral HealthWV501C33falseN/A
United Hospital Center Inc
327 Medical Park DriveBridgeportWV26330550525724Patient CareWV501C33WV United Health Systemfalse
United Physicians Care Inc
686 South Pike StreetShinnstonWV26431550638563Patient CareWV501C33falseN/A
United Health Foundation
327 Medical Park DriveBridgeportWV26330550621706Hospital SupportWV501C312afalseN/A
WVU Healthcare Co-Op
PO Box 8059MorgantownWV26506550650441SupportWV501C312aWV United Health Systemfalse
Camden-Clark Health Services
800 Garfield AveParkersburgWV26101550769602Healthcare AccessWV501C312a, IWV United Health Systemfalse
Camden-Clark Foundation
604 Ann StreetParkersburgWV26101550667789SupportWV501C312aCamden-Clark Health Servicesfalse
Camden-Clark Memorial Hospital
800 Garfield AveParkersburgWV26101311524546Patient CareWV501C33Camden-Clark Health Servicesfalse
Camden-Clark Physician Corp
604 Ann StreetParkersburgWV26101264058719Patient CareWV501C312a, ICamden-Clark Health Servicesfalse
University Healthcare Physicians
2500 Foundation WayMartinsburgWV25401900893455Patient CareWV501C33falseN/A
Potomac Valley Hospital
100 Pin Oak LaneKeyserWV26726550420956Patient CareWV501C33WVU Hospitals Incfalse
St Joseph's Hospital of Buckhannon Inc
1 Amalia DriveBuckhannonWV26201550356996Patient CareWV501C33WV United Health Systemfalse
St Joseph's Foundation of Buckhannon Inc
1 Amalia DriveBuckhannonWV26201550727650SupportWV501C312b, IIfalseN/A
Reynolds Memorial Hospital Inc
800 Wheeling AveGlen DaleWV26038550357045Patient CareWV501C33West Virginia University Hospitals Incfalse
Reynolds Memorial Foundation
800 Wheeling AveGlen DaleWV26038550710402SupportWV501C33falseN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Allied Health Services Inc
PO Box 782MorgantownWV26507550652017Medical LabWVN/AC Corpfalse
West Virginia United Insurance Services Inc
3040 University Avenue Suite 3200MorgantownWV26505550756055Provider NetworkWVN/AC Corpfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd