ST JOSEPHS HOSPITAL OF BUCKHANNON INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- ST JOSEPHS HOSPITAL OF BUCKHANNON INC (EIN 55-0356996)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-14
- IRS object ID
- 201813189349308921
- Schema version
- 2017v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-14T04:09:30-00:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550356996 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Joseph's Hospital of Buckhannon Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STJO | BusinessNameControlTxt |
| Phone | 3044732000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Amalia Drive | AddressLine1Txt |
| City | Buckhannon | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26201 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Ivar Gjolberg | PersonNm |
| Person Title | Administrator | PersonTitleTxt |
| Signature | 2018-11-14 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 157.182.216.2 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-14 | IPDt |
| IP Tm | 14:48:05 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 714A1ACB7E7DEE539613438CC2220F9E5560AD5B | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 714A1ACB7E7DEE539613438CC2220F9E5560AD5B | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Ivar Gjolberg | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Amalia Drive | AddressLine1Txt |
| City | Buckhannon | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $49,300,518 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://wvumedicine.org/st-josephs-hospital/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | We are inspired by the love of Christ to provide our community with quality health care in ways that respect the God-given dignity of each person and the sacredness of human life. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 482 | TotalEmployeeCnt |
| Total Volunteers | 26 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $25,844 | PYContributionsGrantsAmt |
| CY Contributions Grants | $48,614 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $44,588,363 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $47,618,550 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$210,919 | PYInvestmentIncomeAmt |
| CY Investment Income | $188,506 | CYInvestmentIncomeAmt |
| PY Other Revenue | $778,734 | PYOtherRevenueAmt |
| CY Other Revenue | $1,339,152 | CYOtherRevenueAmt |
| PY Total Revenue | $45,182,022 | PYTotalRevenueAmt |
| CY Total Revenue | $49,194,822 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $24,914,211 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,713,036 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,230,598 | PYOtherExpensesAmt |
| CY Other Expenses | $22,591,652 | CYOtherExpensesAmt |
| PY Total Expenses | $45,144,809 | PYTotalExpensesAmt |
| CY Total Expenses | $47,304,688 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $37,213 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,890,134 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $40,939,815 | TotalAssetsBOYAmt |
| Total Assets EOY | $41,298,519 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $32,133,732 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,898,383 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,806,083 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,400,136 | NetAssetsOrFundBalancesEOYAmt |
| Mission | We are inspired by the love of Christ to provide our community with quality health care in ways that respect the God-given dignity of each person and the sacredness of human life. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $39,343,022 | ExpenseAmt |
| Revenue | $48,939,050 | RevenueAmt |
| Desc | The hospital provides impartial access to treatment or accommodation for care that is available or medically indicated regardless of race, creed, sex, national orgin or source of payment. In order to enable our patients to lead healthy, productive lives, the hospital strives to supply a comprehensive range of acute inpatient, long-term and outpatient care, outreach clinics, home care and emergency room services including prevention, guidance, diagnosis, treatment, restoration, rehabilitation, and other efforts as may be required, to meet the health care needs of the community as the hospital resources will permit. Although payment for services rendered is essential to the operation and stability of the hospital, it is recognized that not all individuals possess the financial means to purchase essential medical services. Our mission is to serve the community with respect to providing health care services and health care education. In keeping with this commitment, the hospital will serve all members of its community regardless of means or source of payment. | Desc |
| Total Program Service Expenses | $39,343,022 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 71 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 482 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | false | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Russell Plywaczynski | PersonNm |
| Phone | 3044732185 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Amalia Drive | AddressLine1Txt |
| City | Buckhannon | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26201 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Dennis Xander | ||||||||
| Chairperson | 001.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Sr Mary Grace Barile | ||||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | |||
| Shawn Hanifan | ||||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | |||
| Bartley Brown DO | ||||||||
| Director | 040.00 | Yes (X) | $251,395 | $0 | $20,455 | |||
| Rob Kimble | ||||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | |||
| Sr Francesca Lowis | ||||||||
| Director | 040.00 | Yes (X) | $35,510 | $0 | $89 | |||
| Don Nestor | ||||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | |||
| Sam Nolte | ||||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | |||
| Michael C Tillman | ||||||||
| Director | 001.00 | Yes (X) | $0 | $601,464 | $38,126 | 039.00 | ||
| Katherine Wagner | ||||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | |||
| Renee Hofer | ||||||||
| Chief Financial Officer | 040.00 | Yes (X) | $110,869 | $0 | $16,948 | |||
| Eric Rice | ||||||||
| VP - Ancillary Services | 040.00 | Yes (X) | $117,605 | $0 | $16,680 | |||
| Ivar Gjolberg | ||||||||
| Administrator | 040.00 | Yes (X) | $297,285 | $0 | $52,911 | |||
| Anissa Hite-Davis | ||||||||
| VP Human Resources | 040.00 | Yes (X) | $97,931 | $0 | $15,746 | |||
| Brenda Bauer | ||||||||
| VP of Quality | 040.00 | Yes (X) | $107,018 | $0 | $1,354 | |||
| Annamarie Chidester | ||||||||
| VP Patient Services | 040.00 | Yes (X) | $119,461 | $0 | $16,004 | |||
| Susan Long | ||||||||
| Physician | 040.00 | $647,939 | $0 | $17,754 | Yes (X) | |||
| Salvatore Lanasa | ||||||||
| Physician | 040.00 | $359,710 | $0 | $456 | Yes (X) | |||
| Sara Chua | ||||||||
| Physician | 040.00 | $272,019 | $0 | $19,292 | Yes (X) | |||
| Yaser Kalash | ||||||||
| Physician | 040.00 | $453,702 | $0 | $18,795 | Yes (X) | |||
| Amy Pearson | ||||||||
| Physician | 040.00 | $445,314 | $0 | $10,164 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,315,758 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $601,464 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $244,774 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 24 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Clinical Colleagues Inc | |||||
| 1121 North Bethlehem Pike | Spring House | PA | 19477 | Hospitalist Management Services | $752,951 |
| Quest Diagnostics Nichols Institute | |||||
| 14225 Newbrook Dr | Chantilly | VA | 201512228 | Diagnostic Services | $231,323 |
| Alliance Healthcare Services | |||||
| 100 Bayview Circle | Newport Beach | CA | 92660 | Clinical Care Services | $205,500 |
| Prometheus Laboratories Inc | |||||
| 9410 Carroll Park Dr | San Diego | CA | 921215201 | Laboratory Services | $110,132 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $48,614 | RelatedOrganizationsAmt |
| Total Contributions | $48,614 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Service Revenue | Desc |
| Total Revenue Column | $47,618,550 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $47,618,550 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $47,618,550 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $188,506 | TotalRevenueColumnAmt |
| Exclusion | $188,506 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $124,348 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $105,696 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $18,652 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,652 | TotalRevenueColumnAmt |
| Exclusion | $18,652 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Pharmacy Income | 446110 | $636,217 | $636,217 |
| Cafeteria Income | 624200 | $219,741 | $219,741 |
| Clinical Lab | 900099 | $96,071 | $96,071 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $368,471 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $368,471 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,320,500 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,194,822 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $48,939,050 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $207,158 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,005,412 | TotalAmt |
| Management And General | $1,005,412 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,449,140 | TotalAmt |
| Program Services | $17,808,654 | ProgramServicesAmt |
| Management And General | $640,486 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $676,146 | TotalAmt |
| Program Services | $652,673 | ProgramServicesAmt |
| Management And General | $23,473 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,158,272 | TotalAmt |
| Program Services | $3,158,272 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,424,066 | TotalAmt |
| Program Services | $1,374,628 | ProgramServicesAmt |
| Management And General | $49,438 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,674 | TotalAmt |
| Management And General | $48,674 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,063 | TotalAmt |
| Management And General | $9,063 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,142 | TotalAmt |
| Management And General | $7,142 | ManagementAndGeneralAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees For Services Prof Fundraising | FeesForServicesProfFundraising |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,796,985 | TotalAmt |
| Program Services | $3,037,954 | ProgramServicesAmt |
| Management And General | $759,031 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,669 | TotalAmt |
| Program Services | $9,014 | ProgramServicesAmt |
| Management And General | $156,655 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,067,464 | TotalAmt |
| Program Services | $1,648,767 | ProgramServicesAmt |
| Management And General | $418,697 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $764,299 | TotalAmt |
| Program Services | $389,174 | ProgramServicesAmt |
| Management And General | $375,125 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,409 | TotalAmt |
| Program Services | $17,582 | ProgramServicesAmt |
| Management And General | $22,827 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,466 | TotalAmt |
| Program Services | $30,466 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $257,502 | TotalAmt |
| Program Services | $137,084 | ProgramServicesAmt |
| Management And General | $120,418 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,415,793 | TotalAmt |
| Program Services | $1,261,192 | ProgramServicesAmt |
| Management And General | $2,154,601 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,368,864 | TotalAmt |
| Program Services | $697,012 | ProgramServicesAmt |
| Management And General | $671,852 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,029,800 | TotalAmt |
| Program Services | $241,245 | ProgramServicesAmt |
| Management And General | $788,555 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Provision of Bad Debt | $2,958,818 | $2,958,818 | |
| Medical Supplies | $4,688,398 | $4,688,398 | |
| Taxes, Licenses Fees | $1,274,524 | $1,025,862 | $248,662 |
| Recruiting | $210,580 | $5,567 | $205,013 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $457,202 | TotalAmt |
| Program Services | $200,660 | ProgramServicesAmt |
| Management And General | $256,542 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,304,688 | TotalAmt |
| Program Services | $39,343,022 | ProgramServicesAmt |
| Management And General | $7,961,666 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,427 | BOYAmt |
| EOY | $313,860 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,389,563 | BOYAmt |
| EOY | $2,161,496 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,480,917 | BOYAmt |
| EOY | $6,256,014 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,891 | BOYAmt |
| EOY | $14,035 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $718,838 | BOYAmt |
| EOY | $815,810 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $881,523 | BOYAmt |
| EOY | $228,246 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $18,153,541 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,905,736 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,790,856 | BOYAmt |
| EOY | $15,247,805 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $855,435 | BOYAmt |
| EOY | $855,435 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,824,210 | BOYAmt |
| EOY | $4,482,055 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,937,155 | BOYAmt |
| EOY | $10,923,763 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,939,815 | BOYAmt |
| EOY | $41,298,519 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,325,852 | BOYAmt |
| EOY | $6,363,421 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,860,000 | BOYAmt |
| EOY | $7,860,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,384,563 | BOYAmt |
| EOY | $6,107,338 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,563,317 | BOYAmt |
| EOY | $11,567,624 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,133,732 | BOYAmt |
| EOY | $31,898,383 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,747,751 | BOYAmt |
| EOY | $10,997,571 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,332 | BOYAmt |
| EOY | -$1,597,435 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,000 | BOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,806,083 | BOYAmt |
| EOY | $9,400,136 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,939,815 | BOYAmt |
| EOY | $41,298,519 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,890,134 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $301,354 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$1,597,435 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
| Public Support CY170 | 0.00000 | PublicSupportCY170Pct |
| Public Support CY509 | 0.00000 | PublicSupportCY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $7,142 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,142 | TotalLobbyingExpendituresAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | II-B 1i | FormAndLineReferenceDesc |
| Explanation | As a member of the WV Hospital Association and the American Hospital Association, a portion of the dues paid have been identified by the above mentioned organizations as attributable to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,340,839 | OtherCostOrOtherBasisAmt |
| Book Value | $1,340,839 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,831,398 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,503,209 | DepreciationAmt |
| Book Value | $10,328,189 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $129,832 | OtherCostOrOtherBasisAmt |
| Depreciation | $32,204 | DepreciationAmt |
| Book Value | $97,628 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,384,664 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,362,030 | DepreciationAmt |
| Book Value | $3,022,634 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $466,808 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,293 | DepreciationAmt |
| Book Value | $458,515 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,247,805 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (4 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Financial derivatives and other financial products | ||
| Closely-held equity interests | ||
| Other Investments | $246,760 | F |
| Current Investments | $4,235,295 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $4,482,055 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Unamortized Borrowing Costs | $371,619 |
| Goodwill Other Intangibles | $10,552,144 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $10,923,763 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| Federal income taxes | |
| Estimated Malpractice Costs - Current | $331,569 |
| Due to Third Party Payors | $3,384,153 |
| Other Current Liabilities | $86,011 |
| Pension Obligation | $9,155,133 |
| Miniumum Pension Liability | -$1,389,242 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,567,624 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $46,293,086 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$2,958,818 | OtherRevenueAmt |
| Revenue Not Reported | -$2,958,818 | RevenueNotReportedAmt |
| Revenue Subtotal | $49,251,904 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$57,082 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$57,082 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $49,194,822 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $44,451,565 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $44,451,565 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,853,123 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,853,123 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $47,304,688 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| X 2 | The annual audit and financial statements of SJH are prepared on a consolidated basis as a member of the West Virginia United Health System WVUHS. WVUHS 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. There were no tax uncertainties for SJH that met the recognition threshold in 2017 or 2016. |
| XI 2d | This amount shown on line 2d consists of 2,958,818 provision for doubtful accounts reported as an offset to revenue on the financial statements but is reported as an expense on the Form 990. |
| XI 4b | The amount shown on line 4b consists of 105,696 of expenses associated with the properties for which rental income is received and 48,614 of contributions from St. Josephs Foundation posted in Net Assets. |
| XII 4b | The amount shown on line 4b consists of 2,958,818 provision for doubtful accounts reported as an offset to revenue on the financial statements but is reported as an expense on the Form 990 and 105,696 of expenses associated with the properties for which rental income is received reported in Part VIII Line 6b and 1 rounding. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $169,012 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $169,012 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,048,172 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,048,172 | DirectOffsettingRevenueAmt |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $42,701 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $42,701 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,259,885 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,090,873 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $169,012 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,718 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,718 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,718 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,718 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,272,603 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,090,873 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $181,730 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00410 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,388,869 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $7,625 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $17,392,255 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $14,465,881 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $2,926,374 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Joseph's Hospital of Buckhannon | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Amalia Drive | AddressLine1Txt |
| City | Buckhannon | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https//wvumedicine.org/st-josephs-hospital/ | WebsiteAddressTxt |
| State License | 87 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Skilled Nursing Facility, Outpatient | OtherDesc |
| Facility Reporting Group | a | FacilityReportingGroupCd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | a | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https//wvumedicine.org/st-josephs-hospital/wp-content/uploads/sites/15/2016/12/SJHCHNA2016Final.pdf | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https//wvumedicine.org/st-josephs-hospital/wp-content/uploads/sites/15/2016/12/SJHCHNA2016Final.pdf | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 0000000200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https//wvumedicine.org/bill-pay/financial-assistance/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http//wvumedicine.org/wp-content/uploads/2018/06/Financial-Assistance-Application-and-checklist-6152 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https//wvumedicine.org/wp-content/uploads/2015/11/Plain-Language-Summary-102015.pdf | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | Yes (true) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Group St. Josephs Hospital of Buckhannon Line Part V, Section B, Line 5 | Input for the completion of the initial Community Health Needs Assessment CHNA was obtained from public health officials, local health department and agencies, publicly elected officials, religious officials, long-term care executives, and representatives of or members of chronic disease groups and organizations. In early 2016 St. Josephs Hospital SJH conducted a CHNA centered around community engagement and input. For the 2016 CHNA update SJH contracted with the WVU School of Public Health to help with the process. The resulting report and implementation plan can be found online at https//wvumedicine.org/st-josephs-hospital/wp-content/uploads/sites/15/2016/12/SJHCHNA2016Final.pdf |
| Group St. Josephs Hospital of Buckhannon Line Part V, Section B, Line 11 | Based on the CHNA results, the leadership team chose two priority areas which they felt SJH could adequately target and address through an implementation plan. These areas were 1. Access to Wellness Opportunities and 2. Obesity/Diabetes. Additionally, it was a goal of the SJH Leadership Team to incorporate sensitivity to issues of limited transportation and poverty, especially children in poverty, into the overall CHNA. Complete details of the prioritization process and findings are available within the CHNA report athttps//wvumedicine.org/st-josephs-hospital/wp-content/uploads/sites/15/2016/12/SJHCHIP2016Final.pdf |
| Group St. Josephs Hospital of Buckhannon | Patients with no insurance coverage are considered self-pay patients. Those patients are automatically given a 50 uninsured discount from gross charges, based on commercial insurance average. |
| Group St. Josephs Hospital of Buckhannon | As of 10/01/2015, St. Josephs Hospital SJH transferred sponsorship from Pallottine Health Systems, Inc. to United Hospital Center, a founding member of West Virginia United Health System, Inc.. With this transfer, SJH changed from a fiscal year-end to a calendar year-end. The previous CHNA was completed during the 2013 calendar year. With the sponsorship transfer and new year-end, SJH completed its most recent CHNA in March 2016. |
| Group St. Josephs Hospital of Buckhannon Line Part V, Section B, Line 11 | During the 2012-2013 CHNA the top five priorities identified through public input were 1. Drug abuse by adults, 2. Drug abuse by youths, 3. Obesity, 4. Diabetes, and 5. Cancer. These issues were grouped together as 1. Drug abuse, 2. Obesity/Diabetes, and 3. Cancer. Leadership Teams were divided into two groups for additional discussion. It was decided that St. Josephs would focus on Access to Wellness Opportunities and Obestiy/Diabetes. Leadership Team members felt that the health issues of diabetes and obesity were intertwined and could very likely be addressed using complementary interventions. |
| Group St. Josephs Hospital of Buckhannon Line Part V, Section B, Line 24 | Access to wellness opportunities was identified as a highly ranked issue that leadership team members felt they had the capacity to address through the implementation planning process. Substance abuse was recognized to be a top community health priority by all three data prioritization activities. At the same time, there were limited secondary data to describe or further investigate the issue in a county wide fashion. The Leadership Team felt St. Josephs may have minimal control over the issue and thus would not choose to prioritize it for purposes of this report. |
| Group St. Josephs Hospital of Buckhannon Line Part V, Section B, Line 24 | All patients are charged an amount equal to gross charges regardless of payment method. Once FAP eligibility is confirmed, charge amounts are moved to Charity Care and no longer charged to the patient. |
Supplemental Information Detail SupplementalInformationDetail (29 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I Line 3c | Uncompensated Care Procedure 1 Anyone applying for uncompensated care will be required to fill out an uncompensated care application. This can be done in the following manner a the credit/collection department can take the application when doing financial assessment, b the application can be taken any time during the billing cycle, or c the application can be mailed to the patient. |
| Part I Line 3c | 2 Anyone applying for uncompensated care will be required to provide the hospital with proof of income. The proof of income can be as listed a tax return from most recent year of filing, check stubs from the last three months or a check stub showing year-to-date earnings b a statement of earnings from the employer or source of income c medicaid denial letter or verification through WVDHHR screening website. The associate will insure that Medicaid eligibility is solicited. If appropriate documentation is not attached, application will be denied or d listing of all assets, ATVs, boats, campers, property, stocks, bonds, CDs, etc.. The most current months bank statement is required. |
| Part I Line 3c | 3 The Business Office Manager or his/her designee will make all determinations a the monthly income is listed and multiplied by 12 b the chart is referenced to determine uncompensated eligibility c if eligible, this is noted and signed by the associate d if not eligible, expense information is analyzed. Non-discretionary expenses are considered necessities of life or job shelter, food, utilities, car loan, etc. e comparison of expenses to income determines disposable income for payment of a hospital debt f total expenses are then totaled, with the same expense to income comparison g accounts will be required to have asset information verified with the county assessors office. If cash convertible asset information is exactly twice the amount of the patient portion of the St. Josephs Hospital bill or more, applicant is not eligible for assistance. If substantial hard assets exist, they will be considered. |
| Part I Line 3c | 4 A patient will be notified if uncompensated care is denied or a percentage is granted. |
| Part I Line 3c | 5 Accounts approved for uncompensated care will be written off using the appropriate forms and codes. |
| Part I Line 3c | 6 Medicare accounts that are written off to uncompensated care must be listed on the medicare bad debt compliance checklist. |
| Part I Line 3c | 7 Determination for uncompensated care will be based on annual income guidelines see attachment. |
| Part I Line 3c | 8 St. Josephs Hospital will make medically necessary services available on an inpatient or outpatient basis to individuals who cannot afford to pay for such services. |
| Part I Line 3c | 9 Accounts that have been referred to a collection agency will not be eligible for consideration. |
| Part I Line 6a | St. Josephs community benefit numbers are reported in total with the other hospitals within West Virginia United Health System. The 2017 amounts can be found at the following web address https//wvumedicine.org/about/community-benefit/. |
| Part I Line 7 | Charity care at cost and unreimbursed medicaid are computed using the cost to charge ratio method on worksheet 2 of the Schedule H instructions. |
| Part I Line 7 | The bad debt expense included on Form 990, Part IX, Line 24a, but subtracted for purposes of calculating the percentage in this column is 2,958,818. |
| Part II | St. Josephs has no Community Building activities to report for 2017. |
| Part III Line 2 | Patient receivables are reported at net realizable value. Accounts are written off when they are determined to be noncollectable based upon managements assessment of individual accounts. The allowance for doubtful collections is estimated based upon a periodic review of the accounts receivable aging, payer classifications, and application of historical write-off percentages. The estimated cost of services provided that ultimately result in bad debt expense are estimated utilizing the cost-to-charge ratio as determined by the filed cost report for the corresponding tax year related to this Form 990. |
| Part III Line 2 | Bad Debt Expense at cost was calculated by multiplying bad debt expense of 2,958,818 by our cost-to-charge ratio of 46.94 derived from Worksheet 2 in the IRS Schedule H instructions for a total of 1,388,869. |
| Part III Line 3 | Estimated bad debt attributable to patients eligible for charity care was calculated by running a report within our patient revenue software of all bad debt account balances greater than 15,000. The total of that report was 16,245 which we then multiplied by our cost to charge ratio of 46,94 for a total of 7,625. |
| Part III Line 3 | The estimated bad debt attributable to patients eligible for charity care of 9,625 should be considered community benefit due to the fact that anyone with outstanding balances of 15,000 or greater usually qualifies as catastrophic if the patient completes the application process. |
| Part III Line 3 | In our charity care policy, we define catastrophic care as any illness or injury that will likely require continuous or frequent treatment for more than one year. Regardless, that bad debt should be considered community benefit as we provide services to those in need regardless of their ability to pay. |
| Part III Line 4 | St. Josephs Hospitals financial statements are prepared on a consolidated basis as a member of the WV United Health System. The footnote for Account Receivable is as follows Patient accounts receivable are reported at net realizable value. Accounts are written off when they are determined to be uncollectible based upon mangements assessment of individual accounts. In evaluating the collectability of patient accounts receivable, the System analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. For receivables associated with services provided to patients who have third-party coverage, the System analyzes contractual amounts due and provides an allowance for doubtful accounts and a provision for bad debts, if necessary. 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 amount actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Systems allowance for doubtful accounts for self-pay patients increased to 60 of self-pay accounts receivable at December 31, 2017, from 57 of self-pay accounts receivable at December 31, 2016. In addition, the Systems self-pay write-offs net of recoveries increased to approximately 61,142,000 in 2017, from approximately 51,775,000 in 2016, which is the result of a slightly higher payor mix percentage of individuals without insurance and a slightly higher exposure to self-pay balances from high deductible third-party insurance plans. The System does not maintain a material allowance for doubtful accounts from third-party payors, nor does it have a history of significant write-offs from third-party payors. 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 maintains allowances for potential credit losses and such losses have historically been within managements expectations. The mix of receivables at December 31, 2017 and 2016 from patients and third-party payors is as follows. For 2017, Medicare 29, Medicaid 14, Blue Cross 21, Commercial/HMO/Other 32, Patients 4, Total 100. For 2016, Medicare 31, Medicaid 14, Blue Cross 21, Commercial/HMO/Other 30, Patients 4, Total 100. |
| Part III Line 8 | The medicare allowable costs and revenues were derived from the medicare cost report. |
| Part III Line 9b | Prior to an account going to collections, especially if it is a self-pay patient, the organization checks medicaid and charity eligibility. St. Josephs Hospital requires all self-pay patients to talk to a financial counselor to determine qualification for charity care and medicaid programs. Self-pay patients are required to show proof that they have been denied by medicaid. After it is determined that self-pay patients do not qualify for assistance, and if they are still unable to pay their bills, they are set up on a payment plan suited to their income level. Only when a self-pay patient falls behind on his/her payments and it is certain he or she does not qualify for assistance are they sent to a collection agency. |
| Part VI Line 2 | St. Josephs Hospital has contracted with the West Virginia University School of Public Health to perform the community wide needs assessment survey and has translated this information into the Community Health Needs Assessment Report which outlines actions taken. In addition, an outside company performs post admission surveys for all inpatients. This survey includes questions regarding whether the patients needs were met during the stay, and the hospital reviews this HCAHPS data to determine what services may need to be added based on that data. |
| Part VI Line 3 | St. Josephs Hospital of Buckhannon will advise patients and their families of financial assistance through the following means direct patient contact, in person or over the phone notice of availability of financial assistance will be posted in each registration area and emergency department and other waiting areas notice of availability of financial assistance will be printed with each patient initial bill availability of financial assistance will be printed on applicable letters and statements notice of availability will be posted on the hospitals website published in additional languages if needed by more than 10 of the population outreach to community most likely to utilize the FAP to include outreach to public agencies and other non-for-profit agencies and availability of financial assistance will be posted annually in local paper. |
| Part VI Line 4 | St. Josephs Hospital is located in a small town in a rural, moutainous region of West Virginia. The hospital serves its home county with a population of approximately 24,465 residents, as well as parts of five surrounding counties. The population served is an aging population with nearly 30 of the population in the 45 to 65 year old age group and will be reaching retirement age over the next 20 years, resulting in a major impact on health care in the area. In St. Josephs Hospitals home county, 20.2 of the population is below the poverty level and 8.1 of the population is uninsured, with 4 of the children in the county having no insurance. The teen pregnancy rate is 31.23. The following hospitals provide a full range of acute care, ancillary and case mangement services and many also provide long-term care. The hospitals are located in the immediate service area or the contiguous service area Stonewall Jackson Memorial Hospital, United Hospital Center, Davis Memorial Hospital, Louis A. Johnson VA Medical Center, and Broaddus Hospital. In addition, William J. Sharpe Hospital in Weston, West Virginia provides comprehensive psychiatric services for patients that have been involuntarily committed to the facility. |
| Part VI Line 5 | St. Josephs hospital promotes the health of the community by maintaining an open medical staff, using community members on its board of directors, providing support of community health activities blood screenings, health fair, flu shot clinics, etc.. The hospital has also been actively recruiting both primary care providers and specialists to meet the healthcare needs of our service area. |
| Part VI Line 6 | St. Josephs Hospital of Buckhannon, Inc. is a not-for-profit health care facility wholly owned and sponsored by United Hospital Center, Inc. UHC. United Hospital Center is a subsidiary of the West Virginia United Health System which includes the following hospitals and their subsidiaries United Hospital Center, Camden Clark Memorial, and West Virginia University Hospital. St. Josephs Hospital is committed to the core values of compassion, hospitality, reverence, interdependence, stewardship, and trust. |
| Part VI Line 6 | St. Josephs is a part of the WV United Health System WVUHS. WVUHS is a not-for-profit corporation formed to serve as part of an integrated health science and healthcare delivery team. WVUHS serves as the parent corporation to an affiliated group of healthcare providing entities. The strategic plan of the System states intent to build a regional health care delivery system in its services area, while offering a variety of options for providers who want to participate. The System maintains a demonstrated commitment to assist rural communities in preserving and improving the health care available to the patients it serves. |
| Part VI Line 6 | System management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems service areas. Other hospitals in the System include United Hospital Center in Bridgeport, WV, West Virginia University Hospital in Morgatnown, WV, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, Camden-Clark Medical Center located in Parkersburg, WV, Potomac Valley Hospital located in Keyser, WV, and Reynolds Memorial Hospital in Glen Dale, WV. |
| Part VI Line 6 | The System also includes the phsyician 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. In addition to these practices, the System includes WVUH-East, Inc. and Camden-Clark Health Services which operate as management companies for their respective hospitals. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Susan Long | ||||||||||||
| Physician | $501,386 | $146,553 | $2,600 | $15,154 | $665,693 | |||||||
| Salvatore Lanasa | ||||||||||||
| Physician | $271,379 | $456 | $360,166 | $88,331 | ||||||||
| Sara Chua | ||||||||||||
| Physician | $264,806 | $7,213 | $1,900 | $17,392 | $291,311 | |||||||
| Yaser Kalash | ||||||||||||
| Physician | $453,702 | $2,600 | $16,195 | $472,497 | ||||||||
| Amy Pearson | ||||||||||||
| Physician | $445,314 | $2,437 | $7,727 | $455,478 | ||||||||
| Bartley Brown DO | ||||||||||||
| Director | $251,395 | $2,249 | $18,206 | $271,850 | ||||||||
| Michael C Tillman | ||||||||||||
| Director | $409,371 | $120,328 | $71,765 | $17,550 | $20,576 | $639,590 | ||||||
| Ivar Gjolberg | ||||||||||||
| Administrator | $251,545 | $45,602 | $7,425 | $45,486 | $350,196 | $138 | ||||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I Line 3 | FormAndLineReferenceDesc |
| Explanation | The CEOs compensation is paid by United Hospital Center, Inc. UHC. United Hospital Center uses the following methods to establish the compensation of the CEO compensation committee, independent compensation consultant, Form 990 of other non-profit organizations, compensation survey or study, and approval by the board of directors or compensation committee. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, Line 11 | The Form 990 is prepared by the West Virginia United Health System, Inc. tax team and then reviewed by the Director of Finance at St. Josephs Hospital of Buckhannon. After gaining approval from the Director of Finance, it is then presented to the board members for a final review. Upon board review, it is signed and submitted to the IRS. |
| Form 990, Part VI, Section B, Line 12c | Upon employment and annually thereafter, each key employee and officer of the organization is required to complete a conflict of interest and disclosure form, providing sufficient information about his/her personal interests and relationships so the organization can 1 determine whether any potential or actual conflicts of interest may exist, and 2 monitor work or service assignments to avoid placing the key employee, officer, or director in a position where there may be an appearance potential or actual of a conflict of interest or a question of objectivity. The completed conflict of interest and disclosure forms for directors are returned to the organization. These members are monitored and not assigned any projects that would create any potential conflict of interest. Any board member with a potential conflict recuses himself or herself from all discussions regarding the conflict. |
| Form 990, Part VI, Section B, Line 15 | The compensation of the CEO is determined by the West Virginia United Health System Compensation Committee based upon a salary and benefit survey prepared by an independent company using data of comparable facilities. This information is provided to the compensation committee which is made up of independent board members who are then responsible for setting the compensation packages offered to each executive, ensuring that the compensation package does not exceed fair market value based on the data from the consultant group. The minutes of the compensation committee are contemporaneously documented and retained. A full compensation survey was completed in 2016 for 2017 compensation amounts. |
| Form 990, Part VI, Section C, Line 19 | The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request at its office at 1 Amalia Drive, Buckhannon, WV 26201. A nominal fee is charged if copies are requested. |
| Form 990, Part XI, Line 9 | Other changes in net assets / fund balance consist of related organization capitalization of 1,597,435. |
| Form 990, Part VI, Section A, Line 6 | The organization is a membership not a stock corporation under West Virginia State law. The Organizations sole corporate member is United Hospital Center, Inc., a related not-for-profit organization. |
| Form 990, Part VI, Section A, Line 7a | In accordance with the terms and requirements of its governing documents i.e. bylaws, on an annual basis, the organizations current board members recommend the list of candidates for membership to the governing body for the subsequent term to the St. Josephs hospital board of directors. The United Hospital Center, Inc. board of directors will approve and elect these candidates to serve as the organizations board of directors. |
| Form 990, Part VI, Section A, Line 7b | United Hospital Center, Inc., as the sole corporate member, also has the right to approve or ratify significant decisions of the organizations governing body including the amendment of bylaws and charters, removal of members of the governing body, and the decision to dissolve the organization. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (19 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| West Virginia United Health System Inc | |||||||||||
| PO Box 8034 | Morgantown | WV | 26506 | 550754713 | Healthcare Access | WV | 501C3 | 12a | N/A | false | |
| West Virginia University Hospitals | |||||||||||
| PO Box 8034 | Morgantown | WV | 26506 | 550643304 | Patient Care | WV | 501C3 | 3 | false | West Virginia United Health System Inc | |
| West Virginia University Hospitals - East Inc | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 202337985 | Patient Access | WV | 501C3 | 12a | false | West Virginia University Hospitals | |
| Jefferson Memorial Hospital Inc | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 550359755 | Patient Care | WV | 501C3 | 3 | false | West Virginia University Hospitals - East Inc | |
| University Healthcare Foundation | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 311118075 | Hospital Support | WV | 501C3 | 12a | N/A | false | |
| United Health Foundation | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550621706 | Hospital Support | WV | 501C3 | 12a | false | United Hospital Center Inc | |
| United Hospital Center Inc | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550525724 | Patient Care | WV | 501C3 | 3 | false | West Virginia United Health System Inc | |
| United Physicians Care Inc | |||||||||||
| 686 South Pike Street | Shinnston | WV | 26431 | 550638563 | Patient Care | WV | 501C3 | 3 | N/A | false | |
| United Summit Center Inc | |||||||||||
| 6 Hospital Plaza | Clarksburg | WV | 26301 | 550752788 | Behavioral Health | WV | 501C3 | 3 | N/A | false | |
| West Virginia Health Care Co-Op | |||||||||||
| PO Box 8059 | Morgantown | WV | 26506 | 550650441 | Support | WV | 501C3 | 12a | false | West Virginia United Health System | |
| Camden-Clark Memorial Hospital | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26102 | 311524546 | Patient Care | WV | 501C3 | 3 | false | Camden-Clark Health Services | |
| Camden-Clark Health Services | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26102 | 550769602 | Healthcare Access | WV | 501C3 | 12a, I | false | West Virginia United Health System Inc | |
| Camden-Clark Foundation | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26102 | 550667789 | Support | WV | 501C3 | 12a | false | Camden-Clark Health Services | |
| Camden-Clark Physician Corp | |||||||||||
| 604 Ann Street | Parkersburg | WV | 26101 | 264058719 | Patient Care | WV | 501C3 | 12a, I | false | Camden-Clark Health Services | |
| Potomac Valley Hospital of W Va Inc | |||||||||||
| 100 Pin Oak Lane | Keyser | WV | 26726 | 550420956 | Patient Care | WV | 501C3 | 3 | false | West Virginia University Hospitals | |
| Reynolds Memorial Hospital | |||||||||||
| 800 Wheeling Ave | Glen Dale | WV | 26038 | 550357045 | Patient Care | WV | 501C3 | 3 | false | West Virginia University Hospitals | |
| Reynolds Memorial Foundation | |||||||||||
| 800 Wheeling Ave | Glen Dale | WV | 26038 | 550710402 | Support | WV | 501C3 | 12a | N/A | false | |
| St Joseph's Foundation of Buckhannon Inc | |||||||||||
| 1 Amalia Drive | Buckhannon | WV | 26201 | 550727650 | Support | WV | 501C3 | 12a | N/A | false | |
| City Hospital Inc | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 550383321 | Patient Care | WV | 501C3 | 3 | false | West Virginia University Hospitals - East Inc | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gateway Home Care LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1353 Edwin Miller Blvd | AddressLine1Txt |
| City | Martinsburg | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 254043703 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541965474 | EIN |
| Primary Activities | Durable Medical Equipment | PrimaryActivitiesTxt |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | Related | PredominantIncomeTypeTxt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Allied Health Services Inc | |||||||||
| PO Box 782 | Morgantown | WV | 26507 | 550652017 | Medical Lab | WV | N/A | C Corp | false |
| West Virginia United Insurance Services Inc | |||||||||
| 3040 University Avenue Suite 3200 | Morgantown | WV | 26505 | 550756055 | Provider Network | WV | N/A | C Corp | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |