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        <ExplanationTxt>The 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.</ExplanationTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Jefferson Memorial Hospital Line Part V, Section B, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The 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.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Jefferson Memorial Hospital Line Part V, Section B, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Four 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.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Jefferson Memorial Hospital Line Part V, Section B, Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>The Community Needs Health Assessment CHNA was undertaken jointly with City Hospital, Inc.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Jefferson Memorial Hospital Line Part V, Section B, Line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>City 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.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Jefferson Memorial Hospital Line Part V, Section B, Line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>Universal 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.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Jefferson Memorial Hospital Line Part V, Section B, Line 13b</FormAndLineReferenceDesc>
        <ExplanationTxt>Jefferson 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.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Jefferson Memorial Hospital Line Part V, Section B, Line 24</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 3c</FormAndLineReferenceDesc>
        <ExplanationTxt>Jefferson 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>Jefferson 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/.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Column 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>Physical 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>Economic Development - A representative from JMH Home Health Services serves on the Jefferson County Chamber of Commerce Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>Community 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>Environmental Improvements - 2018 marked the third full year for Jefferson Memorial Hospital as a tobacco free campus.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>Leadership 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>Coalition 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>Community 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>Workforce 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Jefferson 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount reported in Part III Line 6 20,339,113 was calculated using the total Medicare allowable cost from the Medicare cost report.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>Jefferson 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 9b</FormAndLineReferenceDesc>
        <ExplanationTxt>JMH 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Jefferson 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Sources 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>JMH 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Jefferson 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>In 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>Our 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>JMH 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.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>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, and Reynolds Memorial Hospital, in Glen Dale, WV, which joined the System in October 2016.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>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 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.</ExplanationTxt>
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        <PersonNm>Timothy Devine</PersonNm>
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        <PersonNm>Charles Keeling</PersonNm>
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        <PersonNm>Angela Taylor</PersonNm>
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        <PersonNm>Cynthia Howard</PersonNm>
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        <PersonNm>Jonathan Kline</PersonNm>
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        <PersonNm>Neal McLaughlin</PersonNm>
        <TitleTxt>VP Operations</TitleTxt>
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        <PersonNm>Frew Negatu</PersonNm>
        <TitleTxt>Pharmacist</TitleTxt>
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        <FormAndLineReferenceDesc>Part I Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Salaries 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.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>During 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.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d</FormAndLineReferenceDesc>
        <ExplanationTxt>Program 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IV, Line 24a</FormAndLineReferenceDesc>
        <ExplanationTxt>Bond 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part V, Line 2a</FormAndLineReferenceDesc>
        <ExplanationTxt>Jefferson 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Each 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>Executive 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>All financial and governing documents, including the conflict of interest policy are maintained on site and made available to the public upon written request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>This 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Other 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.</ExplanationTxt>
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          <CityNm>Shinnston</CityNm>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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          <CityNm>Parkersburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26101</ZIPCd>
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        <EIN>311524546</EIN>
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        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Physician Corp</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>604 Ann Street</AddressLine1Txt>
          <CityNm>Parkersburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26101</ZIPCd>
        </USAddress>
        <EIN>264058719</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12a, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>University Healthcare Physicians</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2500 Foundation Way</AddressLine1Txt>
          <CityNm>Martinsburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25401</ZIPCd>
        </USAddress>
        <EIN>900893455</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Potomac Valley Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>100 Pin Oak Lane</AddressLine1Txt>
          <CityNm>Keyser</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26726</ZIPCd>
        </USAddress>
        <EIN>550420956</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WVU Hospitals Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>St Joseph's Hospital of Buckhannon Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Amalia Drive</AddressLine1Txt>
          <CityNm>Buckhannon</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26201</ZIPCd>
        </USAddress>
        <EIN>550356996</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>St Joseph's Foundation of Buckhannon Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>1 Amalia Drive</AddressLine1Txt>
          <CityNm>Buckhannon</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <EIN>550727650</EIN>
        <PrimaryActivitiesTxt>Support</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12b, II</PublicCharityStatusTxt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26038</ZIPCd>
        </USAddress>
        <EIN>550357045</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>West Virginia University Hospitals Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Reynolds Memorial Foundation</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>800 Wheeling Ave</AddressLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26038</ZIPCd>
        </USAddress>
        <EIN>550710402</EIN>
        <PrimaryActivitiesTxt>Support</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Allied Health Services Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 782</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26507</ZIPCd>
        </USAddress>
        <EIN>550652017</EIN>
        <PrimaryActivitiesTxt>Medical Lab</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>West Virginia United Insurance Services Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>3040 University Avenue Suite 3200</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26505</ZIPCd>
        </USAddress>
        <EIN>550756055</EIN>
        <PrimaryActivitiesTxt>Provider Network</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>