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CAMDEN-CLARK PHYSICIAN CORPORATION: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
CAMDEN-CLARK PHYSICIAN CORPORATION (EIN 26-4058719)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-14
IRS object ID
201933189349304323
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)
Return2019-11-14T12:04:30-00:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN264058719EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Camden-Clark Physician CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCAMDBusinessNameControlTxt
Phone3044242817PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1604 Ann StreetAddressLine1Txt
CityParkersburgCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26101ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKyle PiersonPersonNm
Person TitleCFOPersonTitleTxt
Signature2019-11-14SignatureDt
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)
IP2019-11-14IPDt
IP Tm16:54:08IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id5D18E0CDD66F5C2C6782695A054BAE6AB9A943F9AtSubmissionCreationDeviceId
At Submission Filing Device Id961A8E11061A341FA9665A68F3B1FFC5AE12E713AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSteve AltmillerPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 Garfield AvenueAddressLine1Txt
CityParkersburgCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26101ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$45,259,542GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2008FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionTo support, manage, and furnish facilities, personnel, and medical services to individuals in need.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee266TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$10,000PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$38,617,448PYProgramServiceRevenueAmt
CY Program Service Revenue$44,798,677CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$136,405PYOtherRevenueAmt
CY Other Revenue$460,865CYOtherRevenueAmt
PY Total Revenue$38,763,853PYTotalRevenueAmt
CY Total Revenue$45,259,542CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$25,457,962PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$29,536,633CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$13,305,891PYOtherExpensesAmt
CY Other Expenses$15,722,907CYOtherExpensesAmt
PY Total Expenses$38,763,853PYTotalExpensesAmt
CY Total Expenses$45,259,540CYTotalExpensesAmt
CY Revenues Less Expenses$2CYRevenuesLessExpensesAmt
Total Assets BOY$2,731,805TotalAssetsBOYAmt
Total Assets EOY$4,903,721TotalAssetsEOYAmt
Total Liabilities BOY$2,507,306TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,169,240TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$224,499NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,734,481NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe general purposes of the corporation are as follows to establish, support, manage, and furnish facilities, personnel, and services to provide diagnostic, therapeautic, wellness, health promotion, surgical, and other professional medical services to sick, injured, or disabled personsMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$8,088,197ExpenseAmt
Revenue$12,177,234RevenueAmt
DescCamden Clark Physician Corporation offers Cardiac Services through Parkersburg Cardiology. This specialization works with top of the line heart care. In 2018, Cardiac Services reported 77,183 work relative value units wRVUs.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$8,510,687ExpenseAmt
Revenue$12,110,341RevenueAmt
DescCamden Clark Physician Corporation offers 7 Primary Care clinics across Parkersburg, WV and into Belpre, OH. These clinics work with the general public to provide patient well being. In 2018, Primary Care reported 90,215 work relative value units wRVUs.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$6,659,144ExpenseAmt
Revenue$8,353,283RevenueAmt
DescCamden Clark Physician Corporation offers Hospitalist coverage through a team of employed physicians and in collaboration with Camden Clark Medical Center. In 2018, Hospitalists reported 71,297 work relative value units wRVUs.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$20,967,267TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$12,601,244TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$44,225,295TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
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 InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
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
IRP Document21IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee266EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
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 Members5GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
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
States Where Copy Of Return Is FldWVStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMary F RussellPersonNm
Phone3044242817PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 Garfield AvenueAddressLine1Txt
CityParkersburgCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26101ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Kathy G Eddy
Board Member, Chairman001.00001.00Yes (X)Yes (X)$0$0$0
Terry Capel MD
Board Member, Vice Chairman001.00001.00Yes (X)Yes (X)$0$0$0
Joe Campbell
Board Member001.00001.00Yes (X)$0$0$0
Daniel J McGraw MD
Board Member, Medical Director040.00Yes (X)$882,038$0$35,031
Steve Altmiller
Board Member, Ex-Officio, CCMC CEO001.00039.00Yes (X)Yes (X)$0$524,426$95,638
Lisa Casalenuovo - Smeltzer DO
Physician040.00$355,158$0$33,705Yes (X)
Nik Shah MD
Physician040.00$775,167$0$35,513Yes (X)
Anil Singh MD
Physician040.00$810,711$0$34,979Yes (X)
Patrick Dugan MD
Physician040.00$637,276$0$34,872Yes (X)
Bairava Kuppuswamy MD
Physician040.00$640,111$0$35,024Yes (X)
Scott Naum DO
Physician040.00$641,917$0$34,499Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,742,378TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$524,426TotReportableCompRltdOrgAmt
Total Other Compensation$339,261TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K58IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Parkersburg Cardiology Associates Inc
600 18th St Suite 512ParkersburgWV261013236Physician Services$7,771,460
Weatherby Locums Inc
PO Box 972633DallasTX753972633Physician Staffing Services$1,423,954
All Star Recruiting Locums LLC
800 Fairway Dr Suite 300Deerfield BeachFL334411824Healthcare Staffing Services$106,984
Medpower Staffing
22422 Dolomite Hills DrAshburnVA201487168Healthcare Staffing Services$103,853
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue621110$28,046,803$28,046,803
Hospital Support Revenue621110$16,751,874$16,751,874
FieldValueIRS element (for citing)
Total Program Service Revenue$44,798,677TotalProgramServiceRevenueAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$17,232RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$17,232RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,232TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Other Miscellaneous Revenue900099$443,425$443,425
Cash Discounts900099$208$208
FieldValueIRS element (for citing)
Other Revenue Total$443,633OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$45,259,542TotalRevenueColumnAmt
Related Or Exempt Func Income$45,242,102RelatedOrExemptFuncIncomeAmt
Exclusion$208ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

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$1,305,932TotalAmt
Program Services$1,305,932ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$24,684,580TotalAmt
Program Services$24,053,262ProgramServicesAmt
Management And General$631,318ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$539,809TotalAmt
Program Services$526,003ProgramServicesAmt
Management And General$13,806ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,164,721TotalAmt
Program Services$2,107,599ProgramServicesAmt
Management And General$57,122ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$841,591TotalAmt
Program Services$820,067ProgramServicesAmt
Management And General$21,524ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
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$11,096,833TotalAmt
Program Services$11,025,112ProgramServicesAmt
Management And General$71,721ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,612TotalAmt
Program Services$1,583ProgramServicesAmt
Management And General$29ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$385,589TotalAmt
Program Services$370,606ProgramServicesAmt
Management And General$14,983ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$13,713TotalAmt
Program Services$13,713ProgramServicesAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,058,413TotalAmt
Program Services$982,300ProgramServicesAmt
Management And General$76,113ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$59,376TotalAmt
Program Services$57,916ProgramServicesAmt
Management And General$1,460ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$50,369TotalAmt
Program Services$50,369ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$139,992TotalAmt
Program Services$90,067ProgramServicesAmt
Management And General$49,925ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$618,242TotalAmt
Program Services$618,242ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$1,180,553$1,180,553
Provision for Doubtful Accounts$760,002$760,002
Recruiting$106,114$106,114
Taxes, Licenses Fees$104,984$25,881$79,103

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$147,115TotalAmt
Program Services$129,974ProgramServicesAmt
Management And General$17,141ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$45,259,540TotalAmt
Program Services$44,225,295ProgramServicesAmt
Management And General$1,034,245ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$110,176BOYAmt
EOY$264,742EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$462,876BOYAmt
EOY$672,291EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,691,536BOYAmt
EOY$3,604,132EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$15,375BOYAmt
EOY$1,500EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$224,861BOYAmt
EOY$181,394EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,518,382LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,332,661LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$226,981BOYAmt
EOY$185,721EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
EOY-$6,059EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,731,805BOYAmt
EOY$4,903,721EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$544,131BOYAmt
EOY$1,418,841EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,963,175BOYAmt
EOY$1,750,399EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,507,306BOYAmt
EOY$3,169,240EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$224,499BOYAmt
EOY$1,734,481EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$224,499BOYAmt
EOY$1,734,481EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,731,805BOYAmt
EOY$4,903,721EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$1,509,980OtherChangesInNetAssetsAmt
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
Facts And Circumstances TestPart I Section A Line 3 Although the organization qualifies as a hospital under IRC Section 170B1AIII as shown on Schedule A, Part I, Line III, the organization is not a licensed hospital in the state of West Virginia, and therefore, it is not required to complete Form 990, Schedule H.FactsAndCircumstancesTestTxt

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,518,382OtherCostOrOtherBasisAmt
Depreciation$1,332,661DepreciationAmt
Book Value$185,721BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$185,721TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

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

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Federal income taxes
Accrued wages, benefits, and payroll taxes$1,648,219
Accrued pension benefits$88,892
State income taxes$13,288
FieldValueIRS element (for citing)
Total Liability$1,750,399TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$44,499,540TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$760,002OtherRevenueAmt
Revenue Not Reported-$760,002RevenueNotReportedAmt
Revenue Subtotal$45,259,542RevenueSubtotalAmt
Total Revenue Per Form990$45,259,542TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$44,499,538TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$44,499,538ExpensesSubtotalAmt
Other Expenses Not Included$760,002OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$760,002ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$45,259,540TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
X 2WVUHS, 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 does not have any material uncertain tax positions as of December 31, 2018 and 2017.
X 2The 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. Management determined there were no tax uncertainties that met the recognition threshold in 2018 and 2017. The Systems policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in operating expenses.
XI 2dThe amount shown on line 2d consists of 760,002 provision for doubtful accounts reported as an offset to revenue on the financial statements but is reported as an expense on Form 990.
XII 4bThe amount shown on line 4b consists of 760,002, provision for doubtful accounts reported as an offset to revenue on the financial statements but is reported as an expense on Form 990.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredfalseSubstantiationRequiredInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (true)CompBasedOnRevenueOfFlngOrgInd
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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmount
Daniel J McGraw MD
Board Member, Medical Director$879,716$2,322$8,250$26,781$917,069
Steve Altmiller
Board Member, Ex-Officio, CCMC CEO$453,023$71,403$80,208$15,430$620,064
Lisa Casalenuovo - Smeltzer DO
Physician$353,989$1,169$7,083$26,622$388,863
Nik Shah MD
Physician$768,309$6,858$8,250$27,263$810,680
Anil Singh MD
Physician$639,418$2,322$8,250$26,729$845,690$168,971
Patrick Dugan MD
Physician$602,561$810$8,250$26,623$672,148$33,904
Bairava Kuppuswamy MD
Physician$424,643$1,332$8,250$26,775$675,135$214,135
Scott Naum DO
Physician$639,684$2,233$8,250$26,249$676,416

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I Line 3CCHS has no compensated employees. Compensation for Camden-Clark Memorial Hospital Corporation CEO is established by West Virginia United Health System WVUHS. WVUHS utilizes compensation consultants, who review 990s of related organizations, review employment contracts for similar positions and compensation surveys. The results of the mentioned research above are provided to the System Compensation Committee for review and approval.
Part I Line 4bDuring 2018, certain individuals reported in Part VII participated in a nonqualified retirement plan. Steve Altmiller, Board Member and CCMC CEO, had deferred CAA contributions of 80,208.
Part I Line 5Some but not all physicians have a productivity bonus in their contract. This bonus is based on producing over a set relative value unit RVU during the year. Physician compensation is capped at the 90 MGMA or at an alternative amount as determined by an independent third party valuation firm.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 4dProgram Service Expenses 20,967,267, Grants and allocations 0, Revenue 12,601,244 CCPC strives to offer a comprehensive range of inpatient, outpatient and outreach clinic services, including prevention, guidance, diagnosis, treatment, restoration, rehabilitation and other efforts as may be required to meet the health care needs of the community in which it serves. In addition to the Cardiac, Primary Care and Hospitalists program services described above, the organization employs physicians who specialize in surgery, diabetes and nutritional management, behavioral health. CCPC has started to grow a network of employed primary care physicians throughout the community in an effort to address what is believed to be a significant shortage of available primary care for the residents of the mid-ohio valley. Although reimbursement for services rendered is critica to the operation and stability of the organization, it is recognized that not all individuals possess the ability to purchase essential medical services. Our mission, in conjunction with Camden Clark Medical Hospital, is to serve the community by providing health care services and health care education.
Form 990, Part III, Line 1Without regard to race, creed, color, sex, national origin, or financial status, and to otherwise promote the quality, accessibility, and affordability of such professional medical services.
Form 990, Part VI, Section A, Line 6Camden-Clark Health Services, Inc. As of March 1, 2011, affiliated with West Virginia United Health System, a non-profit, tax-exempt corporation is the sole member of the organization.
Form 990, Part VI, Section A, Line 7aCamden-Clark Health Services Inc., the organizations sole member, nominates all board members of the organization. Board members are elected by West Virginia Health System, WVUHS from the CCHS nominations.
Form 990, Part VI, Section A, Line 7bCamden-Clark Health Services, Inc., the organizations sole member, approves certain reserved items regarding Camden-Clark Physician Corporation.
Form 990, Part VI, Section B, Line 11bThe chief financial officer, director of finance and the board of directors review the completed Form 990 prior to filing.
Form 990, Part VI, Section B, Line 12cTo identify and monitor any conflicts, a signed conflict of interest statement is required from board members of the organization and key individuals that are in a position to make or influence decisions. If an actual or possible conflict of interest is observed or disclosed, the organization invokes the procedures set out in the policy/bylaws for addressing the conflict of interest. For key individuals employees, a specific conflict of interest standard in the organizations code of ethics and business conduct also exists.
Form 990, Part VI, Section B, Line 15aThe systems CEO and top management officials are employed by Camden-Clark Memorial Hospital CCMH and have roles throughout Camden-Clark Health Services CCHS which is also affiliated with West Virginia United Health System WVUHS. This organization does not have a CEO. The top management officials pay is reviewed and approved by the CCMH/CCHS board of directors.
Form 990, Part VI, Section B, Line 15bFor the physicians, their contracts are based on individual fair market evaluations utilizing medical group management association standards and other data.
Form 990, Part VI, Section C, Line 19The organizations governing documents, conflict of interest policy, and financial statements are made available upon request. The organizations financial statements are also available on the WV Healthcare Authoritys website.
Form 990, Part VI, Section A, Line 1Dr. Daniel McGraw and Steve Altmiller are not independent and are voting board members. Dr. McGraw was compensated by CCPC. Steve Altmiller was compensated for holding the position of CEO at Camden Clark Memorial Hospital. These individuals are compensated for their work for their respective organizations, not for serving on the board of directors.
Form 990, Part IX, Line 11gExpenses reported on line 11g consist of the following items Consulting and Professional Fees of 8,968 of which 979 is considered program service expense and 7,989 is considered management and general expense Contracted Labor of 4,392,813 of which 4,329,081 is considered program service expense and 63,732 is considered management and general expense Contracted Labor - Patient Care of 106,984 all of which is considered program service expense Physician Practice Support of 301 all of which is considered program service expense Contracted and Professional Med Staff of 63,213 all of which is considered program service expense Contracted Physician Expense of 6,509,111 all of which is considered program service expense and Collection Agency Fees of 15,443 all of which is considered program service expense.
Form 990, Part XI, Line 9Other changes in net assets includes 1,509,980 of related organization capitalization.

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
Camden-Clark Health Services Inc
800 Garfield AvenueParkersburgWV26101550769602Aids, strengthens, and supports Camden-Clark Memorial Hospital.WV501c3Line 12A, IWest Virginia United Health Systemfalse
Camden-Clark Memorial Hospital Corporation
800 Garfield AvenueParkersburgWV26101311524546Operates an acute care and emergency hospital facility.WV501c3Line 3falseN/A
Auxiliary of Camden-Clark Memorial Hospital
800 Garfield AvenueParkersburgWV26101550386283Promotes advancement and welfare of Camden-Clark Memorial Hospital.WV501c3Line 12AfalseN/A
Camden-Clark Foundation Inc
800 Garfield AvenueParkersburgWV26101550667789Raise and manage funds for Camden-Clark Memorial Hospital.WV501c3Line 12AfalseN/A
WV United Health System
3040 University AvenueMorgantownWV26505550175471Healthcare AccessWV501c3Line 12AfalseN/A
West Virginia University Hospitals Inc
PO Box 8034MorgantownWV26506550643304Patient CareWV501c3Line 3West Virginia United Health Systemfalse
West Virginia University Hospitals East
2000 Foundation WayMartinsburgWV25401202337985Healthcare AccessWV501c3Line 12AWest Virginia University Hospitals Incfalse
City Hospital Inc
2000 Foundation WayMartinsburgWV25401550383321Patient CareWV501c3Line 3West Virginia University Hospitals Eastfalse
Jefferson Memorial Hospital
2000 Foundation WayMartinsburgWV25401550359755Patient CareWV501c3Line 3West Virginia University Hospitals Eastfalse
University Healthcare Foundation
2000 Foundation WayMartinsburgWV25401311118075Hospital SupportWV501c3Line 12AfalseN/A
United Hospital Center Inc
327 Medical Park DriveBridgeportWV26330550525724Patient CareWV501c3Line 3West Virginia United Health Systemfalse
United Physicians Care Inc
686 South Pike StreetShinnstonWV26431550638563Patient CareWV501c3Line 3falseN/A
United Hospital Foundation
327 Medical Park DriveBridgeportWV26330550621706Hospital SupportWV501c3Line 12AfalseN/A
WV Healthcare Co-Op
PO Box 8059MorgantownWV26506550650441SupportWV501c3Line 12AWest Virginia United Health Systemfalse
United Summit Center
6 Hospital PlazaClarksburgWV26301550752788Behavioral HealthWV501c3Line 3falseN/A
Potomac Valley Hospital of WVa Inc
100 Pin Oak LaneKeyserWV26726550420956Patient CareWV501c3Line 3West Virginia University Hospitals Incfalse
St Joseph's Hospital of Buckhannon Inc
1 Amalia DriveBuckhannonWV26201550356996Patient CareWV501c3Line 3West Virginia United Health Systemfalse
Reynolds Memorial Hospital Inc
800 Wheeling AveGlen DaleWV26038550357045Patient CareWV501c3Line 3West Virginia University Hospitals Incfalse
Reynolds Memorial Foundation
800 Wheeling AveGlen DaleWV26038550710402Hospital SupportWV501c3Line 12AfalseN/A
St Josephs Foundation of Buckhannon
1 Amalia DriveBuckhannonWV26201550727650Hospital SupportWV501c3Line 12b IIfalseN/A

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
Ohio Valley Ambulatory
608 Washington BlvdBelpreOH45714208671724Outpatient Surgical ServicesWVNAfalsefalse
Gateway Home Care LLC
1353 Edwin Miller BlvdMartinsburgWV254043703541965474Durable Medical EquipmentWVCity Hospital Incfalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Allied Health Services Inc
PO Box 782MorgantownWV26507550652017Medical LabWVNAC Corpfalse
West Virginia United Insurance Services
3040 University Avenue Suite 3040MorgantownWV26505550756055Provider NetworkWVNAC 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 ExchangeYes (true)AssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd