2019-08-15T15:28:45-05:00 2018-09-30 550486667 Arnett Carbis Toothman LLP P O Box 2629 Charleston WV 25329 990 2017-10-01 550404900 Herbert J Thomas Memorial Hospital Association HERB 3047663528 4605 MacCorkle Avenue SW South Charleston WV 25309 Timothy Skeldon Sr. Vice President, CFO 3047663528 2019-08-15 1 Dolores Rose P01286262 3043460441 216.12.119.47 2019-08-15 12:33:12 ED P CCB4B172F6B20DCDE3AC5A6CD979E579473977C6 A995AF694121DE0697350269C2DD630E7BAA3A7A 2017 2019-02-21 02:37:17Z Thomas Memorial Hospital Daniel Lauffer 4605 MacCorkle Avenue SW South Charleston WV 25309 191540170 0 X www.thomaswv.org X 1946 WV To provide health care services to residents of South Charleston, WV and surrounding communities. 9 8 1438 108 187221 -139588 94585 47661 187405422 186701316 1800733 1064253 3309717 3726940 192610457 191540170 63209 91154 0 0 63670100 74015839 0 0 0 132857993 114330862 196591302 188437855 -3980845 3102315 196441960 189958295 177937345 167840770 18504615 22117525 To provide health care services to residents of South Charleston, WV and surrounding communities. 0 0 182986788 91154 189658350 Services provided by the hospital include 38,508 inpatient days and 176,400 outpatient visits which includes 27,615 in ER visits. The hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Charges forgone for charity amounted to $1,171,221. The hospital provided community education activities and sponsors free health screening and wellness programs. 182986788 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 149 0 1438 1 1 1 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Timothy Skeldon Sr Vice President CFO 3047663428 4605 MacCorkle Ave SW South Charleston WV 25309 Larry Bissett Chairman 1.00 1.00 X X 0 0 0 Donna Panucci DDS Secretary 1.00 X X 0 0 0 Brian Ulery Sr. Vice President/COO 24.00 16.00 X X 321196 0 26896 Bassam Shamma MD Trustee 1.00 X 0 0 0 Carla Campbell Trustee 1.00 X 0 0 0 John Neville MD Trustee 1.00 X 0 0 0 Dennis Sutton Trustee 1.00 1.00 X 0 0 0 Darren Harris MD Trustee 1.00 X 0 0 0 Laurie Harper MD Trustee 1.00 X 0 0 0 Daniel J Lauffer President & CEO 24.00 16.00 X 0 488777 26888 Renee Cross VP of Finance (termed 7/14/17) 24.00 16.00 X 0 305467 20526 Timothy K Skeldon Sr. VP Finance (as of 7/24/17) 24.00 16.00 X 151461 0 3283 Aaron Alexander VP General Counsel 40.00 X 229442 0 29223 Tarek Anderson MD Director Neonatologist 40.00 X 314835 0 35172 Alaina N Crislip Associate General Counsel 24.00 16.00 X 196772 0 21605 Matthew B Upton MD CMO & CMIO 24.00 16.00 X 310089 0 26896 William Priddy Pharmacy Manager 40.00 X 180023 0 9386 Stephen Dexter TMH Retired CEO President TMH Services 0.00 X 469175 0 3454 2172993 794244 203329 51 1 1 0 Hospitalist Medicine Physicians of WV PO Box 742936 Los Angeles CA 90074 ER and Hospitalist Services 2996912 Fastaff LLC PO Box 911452 Denver CO 80291 Contract Nursing 2117150 Professional Anesthesia Services 110 Roane Street Charleston WV 25302 Anesthesia Services 1793810 Advanced Technical Solutions LLC PO Box 149 Scott Depot WV 25560 Information Systems 629212 Jackson Kelly PLLC PO Box 45705 Baltimore MD 21297 Legal Services 491548 28 47661 47661 Patient services 622110 177171788 177171788 340B Program Revenue 900099 6268402 6268402 Family Pharmacy 446110 3261126 2935013 326113 186701316 612471 612471 1034467 0 1034467 1034467 1034467 451782 0 451782 451782 451782 Laboratory-Other 900099 973114 973114 Cafeteria & vending 722212 930324 930324 Miscellaneous Revenue 900099 402863 541755 -138892 386172 386172 2692473 191540170 189658350 187221 1646938 X 91154 91154 842689 816903 25786 60134978 58294847 1840131 600022 581661 18361 9483436 9193243 290193 2954714 2864300 90414 1114528 1114528 208970 208970 26426 26426 25199402 24428300 771102 10067039 9758988 308051 676949 656234 20715 36262 36262 4432730 4297088 135642 71352 69169 2183 5914926 5733929 180997 7819579 7580300 239279 585199 567292 17907 Medical supplies 37400593 37400593 Bad debts 11698406 11698406 Healthcare provider tax 5022244 5022244 Sales and use tax 2229883 2161649 68234 1826374 1770488 55886 188437855 182986788 5451067 0 1428153 862654 5477732 5191452 20456878 16759673 4629337 5248434 1121105 1259210 294878391 189479931 111274086 105398460 45978145 44520440 2009287 4426938 4067237 6291034 196441960 189958295 31120261 27982742 66341 35638 96706060 93576198 50044683 46246192 177937345 167840770 X 18504615 22117525 18504615 22117525 196441960 189958295 X 3102315 1372816 -862221 X 0 1 X 1 0 X 0 0 0 0 0 1 26426 0 0 0 26426 0 Part II-B, Line 1: Line 1f: A portion of dues paid by the hospital to the American Hospital Association and the West Virginia Hospital Association is attributable to lobbying. 11964611 11964611 152567626 80615535 71952091 117928002 102963661 14964341 12418152 5900735 6517417 105398460 Estimated malpractice liability 15532766 Accrued pension liabilities 21143356 Capital lease obligations 1116216 Accrued interest payable 4569479 Accrued payroll & payroll taxes 3884375 46246192 X Part X, Line 2: The System, Thomas Memorial, the Foundation, Saint Francis and THS Physician Partners are recognized as exempt from Federal and state income taxes under Section 501(c)(3) of the Internal Revenue Code and similar state statutes relating to not-for-profit organizations. Under applicable provisions of the Internal Revenue Code and state statutes, TMH Services, which is a for-profit entity and subject to Federal and state income taxes, elected to be treated as a C-corporation for income tax purposes. Accounting principles generally accepted in the United States of America require the management of the System to evaluate tax positions taken by the System. Management has evaluated the Systems tax positions and concluded that the System had maintained its tax exempt status and had taken no uncertain tax positions that require recognition or disclosure in the financial statements. Therefore, no provision or liability for income taxes has been included in the consolidated financial statements. The System is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The management of the System believes it is no longer subject to income tax examinations for years prior to the fiscal year ended September 30, 2015. 1 1 X 1 X 0 1 1 0 0 335528 335528 0.00190 38953332 30777267 8176065 0.04630 39288860 30777267 8511593 0.04820 20653 20653 0.00010 91154 91154 0.00050 111807 111807 0.00060 39400667 30777267 8623400 0.04880 1 11698406 37047761 37732564 -684803 X 1 1 1 Thomas Valuecare Inc Company reserved for future use 1.00000 2 Stonerise Home Health LLC Home Health 0.30000 1 1 Thomas Memorial Hospital 4605 MacCorkle Avenue SW South Charleston WV 25309 X X X Psychiatric Herbert J Thomas Memorial Hospital 1 0 0 1 X X X X X X X X 16 1 1 1 1 X http://www.thomashealth.org/communityhealth X http://www.healthykanawha.org/Final_2017_Assessment_Report.pdf X 1 17 1 http://www.thomashealth.org/communityhealth 0 1 X 200.000000000000 X X X X 1 1 X X X X 1 X www.thomashealth.org/financial X www.thomashealth.org/financial X www.thomashealth.org/financial X X X X 1 X 0 X X X X 1 X 0 0 Herbert J. Thomas Memorial Hospital Part V, Section B, Line 5: The Coalition conducted a randomized home telephone survey, conducted interviews with professional representatives of key sectors of the community, conducted focus groups with under-represented populations, and held a health issues forum. Herbert J. Thomas Memorial Hospital Part V, Section B, Line 6a: St. Francis Hospital, Charleston Area Medical Center, Highland Hospital, Women & Children's Hospital Herbert J. Thomas Memorial Hospital Part V, Section B, Line 6b: Kanawha Coalition for Community Health Improvement Herbert J. Thomas Memorial Hospital Part V, Section B, Line 11: By conducting a CHNA, Thomas Memorial identified the areas with significant need in which it would focus its health improvement activity to be: 1) alcohol and drug abuse; 2) obesity and diabetes; and 3) access to affordable counseling and mental health services. Although Thomas identified other health needs, they were not as significant as the 3 identified above. The other needs identified within widely case CHNA's are being addressed by provider withint he community that have more expertise in those areas. Cost containment, resource constraints, and a relatively low priority assigned to the health need are additonal reasons why only the most significant health needs could be addressed by Thomas Memorial. Part I, Line 7: The cost of charity care and unreimbursed Medicaid was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions.The amount of cash and in-kind contributions to community groups was obtained from the hospital's accounting records. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 11,698,406. Part III, Line 2: Bad debt expense as reported on audited financial statements. Part III, Line 4: Bad debt expense is described in the consolidated financial statements as follows: Patient accounts receivable are carried at the original charge less an estimate made for doubtful or uncollectible accounts. The allowance is based upon a review of the outstanding balances aged by financial class. Management uses collection percentages based upon historical collection experience to determine collectability. Management also reviews troubled, aged accounts to determine collection potential. Patient accounts receivable are written off when deemed uncollectible. Recoveries of accounts previously written off are recorded as a reduction to bad debt expense when received. Part III, Line 8: Medicare allowable reimbursements and cost were obtained from the hospital's Medicare cost report. Part III, Line 9b: The organization's collection policies do not apply to patients that are known to qualify for financial assistance. Additionally, the organization has a separate Financial Assistance policy; patients who qualify for assistance under the policy do not receive a bill. Part VI, Line 2: The hospital is a member of the Kanawha Coalition for Community Health Improvement. The Coalition conducts a survey every three years to assess health care needs of the community. Results of the survey are presented in a meeting of community leaders and other interested persons, and are conveyed to the general public by local media. Results of the most recent survey were released March, 2017. Part VI, Line 3: The hospital informs and educates patients about their eligibility for assistance by: (1) providing a copy of the policy, or a summary thereof, and financial assistance contact information to patients as part of the intake process; (2) including the policy, or a summary thereof, along with financial assistance contact information, in patient bills; and (3) discussing with the patient the availability of various government benefits, such as Medicaid or state programs, and assisting the patient with qualification for such programs, where applicable. For those patients who come into our office after they receive a bill, we explain this same process to them. We also employ an outside agency, Advanced Patient Advocacy (APA), to speak with patients regarding Medicaid and other state and federal funding options. APA may speak with the patient during a stay or visit or after discharge. Hospital also has a DHHR employee on campus to help with getting the employees enrolled into Medicaid. Part VI, Line 4: The organization's geographic service area includes approximately 476,000 persons in a 12 county area of south-central West Virginia. Heart disease, cancer and pulmonary disease are the leading causes of death in the service area. Patients in the service area are typical of West Virginia as a whole. The population served is 48% male, 52% female. Approximately 20% of residents in the area have no healthcare insurance coverage and no family doctor or other healthcare provider. Except for the area within the Charleston, WV city limits, all of the counties in the organization's geographic service area are federally-designated Medically Underserved and Health Manpower Shortage Areas. Part VI, Line 5: All members of the hospital's Board of Directors reside in the local community. The hospital extends medical staff privileges to all qualified physicians in the community who meet specific credentialing criteria. The hospital's 24 hour emergency room is available to all persons, regardless of ability to pay. The hospital prepares its budget to ensure adequate funding for capital improvements that are made on an on-going basis. Part VI, Line 6: The hospital, along with St. Francis Hospital, is part of Thomas Health System, Inc. The health system was formed to forge a partnership based on the strength of the two established hospitals. Bringing the two hospitals under the umbrella of the Thomas Health System allows them to provide innovative and cost-effective health care services to the Kanawha Valley and surrounding areas. Economies of scale have allowed for cost reductions in numerous areas, while providing advanced technology to a larger community, with access to the highest quality of physicians, nurses and support staff in our service area. The system provides a wide range of services that serves the entire community. 1 CAMC Health Education and Research Institute PO Box 1547 Charleston WV 25326 550753754 501(c)(3) 69544 Operating costs for the Kanawha Coalition for Community Health Improvement for FY 16 & 17 The Foundation for Thomas Health 4605 MacCorkle Avenue SW Charleston WV 25309 550694220 501(c)(3) 10000 Nursing scholarships 2 Part I, Line 2: The Organization does not consider monitoring the use of grant proceeds a necessity as the organizations receiving the grants all receive audited financial statements. X X X X 0 1 0 0 0 0 0 0 0 Brian Ulery Sr. Vice President/COO 321196 0 0 0 0 0 14439 0 12457 0 348092 0 0 0 Daniel J Lauffer President & CEO 0 438331 0 25833 0 24613 0 13500 0 13388 0 515665 0 0 Renee Cross VP of Finance (termed 7/14/17) 0 208097 0 0 0 97370 0 20526 0 0 0 325993 0 0 Timothy K Skeldon Sr. VP Finance (as of 7/24/17) 116345 0 17500 0 17616 0 0 0 3283 0 154744 0 0 0 Aaron Alexander VP General Counsel 229142 0 300 0 0 0 12000 0 17223 0 258665 0 0 0 Tarek Anderson MD Director Neonatologist 314835 0 0 0 0 0 15611 0 19561 0 350007 0 0 0 Alaina N Crislip Associate General Counsel 196472 0 300 0 0 0 10250 0 11355 0 218377 0 0 0 Matthew B Upton MD CMO & CMIO 310089 0 0 0 0 0 14439 0 12457 0 336985 0 0 0 William Priddy Pharmacy Manager 179691 0 100 0 232 0 8985 0 401 0 189409 0 0 0 Stephen Dexter TMH Retired CEO President TMH Services 36703 0 0 0 432472 0 1949 0 1505 0 472629 0 0 0 Part I, Line 4b Renee Cross received a payment from the Hospital's 457(b) plan in the amount of $97,370 Stephen Dexter received a payment from the Hospital's 457(b) in the amount of $432,472 A West Virginia Hospital Finance Authority 621256910 956622XRO 2008-06-30 94030170 Capital expenditures and equipment purchases 0 0 0 A 5906878 92695993 7223714 10534952 1489249 73448078 2010 1 0 1 1 A 0 1 1 1 0 0.03000 0.03000 0 0 0 A 0 0 1 0 0 0 1 Trinity Plus Funding 1 0 0 A 0 Larry Bissett Chair of Thomas Memorial Hospital Board 113489 Compensation received by son, who is the Director of Physical Therapy at Saint Frances Hospital 0 Form 990, Part VI, Section A, line 6 Thomas Health System, Inc., a nonprofit corporation organized under the laws of the State of West Virginia, is the sole member of the organization. Form 990, Part VI, Section A, line 7a The organization's board of directors is elected by its sole member, Thomas Health System, Inc. Form 990, Part VI, Section B, line 11b Thomas Health System, Inc. (the System) is the sole member of the organization. The System's finance committee is responsible for financial management of the organization. The 990 is reviewed by the organization's CFO and the chairman of the finance committee. The 990 is then discussed with the System's finance committee and a copy is provided to all board members before it is filed with the IRS. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with our written conflict of interest policy by asking annually that all Trustees, officers and employees (managers) who have decision making/purchasing authority disclose any potential conflicts of interest. Disclosure forms are signed annually then logged onto a spread sheet that identifies any potential conflicts. Form 990, Part VI, Section B, line 15 The Executive Compensation Committee, comprised of members who are free of any conflicts of interest, adheres to a disciplined process for reviewing compensation for senior executives to ensure that the compensation is reasonable. The Committee has retained an independent consulting and advisory firm, Yaffe & Company, to provide appropriate market data as to comparability. The Committee reviews comparability data and other relevant evidence and approves the compensation of senior executives; provided, however, that in the case of the CEO, the Board, after review of the comparability data and other relevant evidence, including a recommendation from the Committee, has the final approval with regard to the CEO's compensation. Only those Board members who are free of conflicts of interest vote on the CEO's compensation. All compensation decisions, including the comparability data reviewed and any other relevant information considered, are contemporaneously documented in meeting minutes. Form 990, Part VI, Section C, line 19 The Hospital makes its governing documents, conflict of interest policy and financial statements available to the public upon request. These documents are maintained in the administrative offices of the hospital and are provided via copy upon request. The documents also can be reviewed on site at the hospital upon advance notice. Form 990, Part IX, line 11g Hospitalist: Program service expenses 1,932,678. Management and general expenses 61,007. Fundraising expenses 0. Total expenses 1,993,685. Lab Services: Program service expenses 1,208,288. Management and general expenses 38,141. Fundraising expenses 0. Total expenses 1,246,429. Administrative Services: Program service expenses 4,564,347. Management and general expenses 144,078. Fundraising expenses 0. Total expenses 4,708,425. Medical Services: Program service expenses 9,212,202. Management and general expenses 290,792. Fundraising expenses 0. Total expenses 9,502,994. Other Purchased Services: Program service expenses 7,360,677. Management and general expenses 232,346. Fundraising expenses 0. Total expenses 7,593,023. Billing: Program service expenses 150,108. Management and general expenses 4,738. Fundraising expenses 0. Total expenses 154,846. Form 990, Part XI, line 9: Defined benefit pension plan adjustment 6,079,629. Equity transfer to related exempt organization -6,941,850. Schedule K On June 30, 2008, the West Virginia Hospital Finance Authority issued $148,920,000 Hospital Improvement Revenue Bonds Series 2008 on behalf of Thomas Health System, Inc. Thomas Health System, Inc. is the sole member of Herbert J. Thomas Memorial Hospital Association (Thomas Memorial Hospital) and Charleston Hospital, Inc. dba St. Francis Hospital. Bond proceeds, and related liability, were allocated between the two hospitals. Total proceeds of the issue reported in Part II, line 3 are net of bond discount in the amount of $1,333,842. Thomas Health System Inc 4605 MacCorkle Avenue SW South Charleston WV 25309 260440674 Corporate office WV 501(c)(3) Line 3 N/A 0 St Francis Hospital 333 Laidley St Charleston WV 25301 611272692 Hospital WV 501(c)(3) Line 3 Thomas Health System Inc 0 THS Physician Partners Inc 4605 MacCorkle Avenue SW South Charleston WV 25309 454395947 Medical services WV 501(c)(3) Line 3 Thomas Health System Inc 0 TMH Services Inc 437 Division Street Ste 311 South Charleston WV 25309 550676607 Equipment sales, rental and related services, vending sales WV Thomas Memorial Hospital C 1.00000 1 0 1 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 1 0 TMH Services Inc K 296344 FMV - Cash THS Physician Partners Inc B 6941850 FMV - Cash