CAMDEN-CLARK MEMORIAL HOSPITAL CORPORATION: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- CAMDEN-CLARK MEMORIAL HOSPITAL CORPORATION (EIN 31-1524546)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-12
- IRS object ID
- 201823169349305567
- 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 I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-12T06:11:54-00:00 | 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 | 311524546 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Camden-Clark Memorial Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CAMD | BusinessNameControlTxt |
| Phone | 3044242202 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Garfield Avenue | AddressLine1Txt |
| City | Parkersburg | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26101 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary Jo Shahan | PersonNm |
| Person Title | Interim CFO | PersonTitleTxt |
| Signature | 2018-11-12 | 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 | 2018-11-12 | IPDt |
| IP Tm | 23:02:53 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 0A63003A2DC7132982EF3DF1E37B1510D6F938D3 | 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
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Camden Clark Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | David K McClure | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Garfield Avenue | AddressLine1Txt |
| City | Parkersburg | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $261,582,579 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://wvumedicine.org/camden-clark/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | To operate an acute care and emergency hospital facility. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 2164 | TotalEmployeeCnt |
| Total Volunteers | 224 | TotalVolunteersCnt |
| Total Gross UBI | $1,755,606 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $158,890 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $111,375 | PYContributionsGrantsAmt |
| CY Contributions Grants | $34,698 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $239,975,989 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $254,696,486 | CYProgramServiceRevenueAmt |
| PY Investment Income | $696,448 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,925,974 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,269,414 | PYOtherRevenueAmt |
| CY Other Revenue | $3,865,121 | CYOtherRevenueAmt |
| PY Total Revenue | $247,053,226 | PYTotalRevenueAmt |
| CY Total Revenue | $261,522,279 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $11,010 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $20,750 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $86,568,577 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $94,258,427 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $145,121,663 | PYOtherExpensesAmt |
| CY Other Expenses | $172,417,385 | CYOtherExpensesAmt |
| PY Total Expenses | $231,701,250 | PYTotalExpensesAmt |
| CY Total Expenses | $266,696,562 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $15,351,976 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$5,174,283 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $254,136,216 | TotalAssetsBOYAmt |
| Total Assets EOY | $239,473,063 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $275,993,931 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $272,370,648 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$21,857,715 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$32,897,585 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of Camden-Clark Memorial Hospital is to meet the health care needs of our community for a lifetime. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $8,575,971 | ExpenseAmt |
| Revenue | $46,295,634 | RevenueAmt |
| Desc | Camden Clark Memorial Hospital offers emergency room services as part of the hospitals mission of meeting the healthcare needs of the community for a lifetime. Due to the community that it serves, the majority of patients visiting the ER are either underinsured or uninsured. For the reporting period, there were approximately 49,331 ER visits, of this total, 9,951 were ultimately admitted to the hospital. This represents 56.15 of the total hospital admissions for 2017. Therefore, a significant portion of the hospitals inpatient volume comes directly from the ER. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,814,920 | ExpenseAmt |
| Revenue | $13,618,378 | RevenueAmt |
| Desc | Camden-Clark Memorial Hospital is a leader in cancer care for the mid-ohio valley, providing cancer care to patients in a 45 mile radius from the hospital. In addition to a wide range of treatment options provided, the hospital offers a number of related services to its patients. Through the hospitals collaboration with the American Cancer Society, the development of the organizations cancer resource center, a hair restoration salon, a patient navigator and an oncology social, the hospital has enhanced the education, navigation and social support of its cancer patients and families. The hospitals community and social services provide a holistic healing environment which includes support groups for patients/families and aesthetic services to enhance the patients physical and emotional well-being. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,005,744 | ExpenseAmt |
| Revenue | $16,767,047 | RevenueAmt |
| Desc | Camden-Clark Memorial Hospital offers heart and vascular services for its immediate service area directly through the hospital. In addition, services are provided to underserved counties throughout the area via physicians that are employed by Camden Clark Physician Corporation, a related entity. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $165,746,690 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $20,750 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $178,010,902 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $182,143,325 | 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 | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | 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 | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | 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 |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 221 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 2164 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| 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 |
| 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary Jo Shahan | PersonNm |
| Phone | 3044242202 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Garfield Avenue | AddressLine1Txt |
| City | Parkersburg | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26102 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Terry Capel MD | |||||||||
| Board Member- Chairman | 001.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Joseph Campbell | |||||||||
| Board Member | 001.00 | Yes (X) | $0 | $0 | $0 | ||||
| Randall E Snider | |||||||||
| Board Member- Secretary as of 7/1/2017 | 001.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Michael Morehead MD | |||||||||
| Board Member | 001.00 | Yes (X) | $0 | $0 | $0 | ||||
| Orton Armstrong MD | |||||||||
| Board Member | 001.00 | Yes (X) | $0 | $0 | $0 | ||||
| Kathy G Eddy | |||||||||
| Board Member- Vice Chairman | 001.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Lynford Lovell | |||||||||
| Board Member | 001.00 | Yes (X) | $0 | $0 | $0 | ||||
| Gregory Gore | |||||||||
| Board Member- Secretary through 6/30/017 | 001.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| David McClure | |||||||||
| President / CEO | 038.00 | Yes (X) | $600,708 | $0 | $20,202 | 002.00 | |||
| Thomas Heller | |||||||||
| Vice President, Human Resources | 030.00 | Yes (X) | $344,039 | $0 | $16,190 | 010.00 | |||
| Cynthia Kern | |||||||||
| Vice President, Quality | 040.00 | Yes (X) | $265,418 | $0 | $7,509 | ||||
| Carolyn Allen | |||||||||
| Vice President, Finance | 033.00 | Yes (X) | $365,594 | $0 | $16,164 | 007.00 | |||
| Tommy Mars | |||||||||
| Chief Nursing Officer | 040.00 | Yes (X) | $288,135 | $0 | $22,035 | ||||
| Sean Smith | |||||||||
| VP, Operations | 040.00 | Yes (X) | $157,350 | $0 | $23,725 | ||||
| Janice Midcap | |||||||||
| Chief Experience Officer | 040.00 | Yes (X) | $116,047 | $0 | $12,986 | ||||
| David Gnegy MD | |||||||||
| VP, Medical Affairs | 040.00 | Yes (X) | $85,500 | $0 | $0 | ||||
| Todd Kruger | |||||||||
| General Legal Counsel | 040.00 | $409,580 | $0 | $25,476 | Yes (X) | ||||
| Gene Allen Sexton | |||||||||
| Pharmacist | 040.00 | $140,636 | $0 | $22,897 | Yes (X) | ||||
| Joshua Woods | |||||||||
| Chief Information Officer | 040.00 | $141,425 | $0 | $6,204 | Yes (X) | ||||
| Shaun Carter | |||||||||
| Pharmacy Systems Analyst | 040.00 | $139,275 | $0 | $2,629 | Yes (X) | ||||
| Pamela Mincks | |||||||||
| Pharmacist | 040.00 | $128,414 | $0 | $12,837 | Yes (X) | ||||
| Tracey Hood | |||||||||
| OVASC Administrator | 040.00 | $131,225 | $0 | $13,339 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,313,346 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $202,193 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 28 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Specialty Laboratories Inc | |||||
| 27027 Tourney Rd | Valencia | CA | 91355 | Laboratory Services | $723,984 |
| Jackson Nurse Professionals LLC | |||||
| 3452 Lake Lynda Dr Suite 200 | Orlando | FL | 328171481 | Nursing Services | $639,723 |
| C & A Industries | |||||
| 13609 California St | Omaha | NE | 681545233 | Staffing and Recruitment Services | $614,180 |
| Jackson Kelly | |||||
| PO BOX 45705 | Baltimore | MD | 212975705 | Legal Services | $475,466 |
| Mills Group LLC | |||||
| 63 Wharf St Suite 300 | Morgantown | WV | 26501 | Architecture Services | $370,259 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 26 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $34,548 | RelatedOrganizationsAmt |
| All Other Contributions | $150 | AllOtherContributionsAmt |
| Total Contributions | $34,698 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Patient Service Revenue, Net | 621110 | $253,394,906 | $251,650,944 | $1,743,962 |
| Pass-through income - OVASC, HH, Premier | 621110 | $702,086 | $690,442 | $11,644 |
| Pharmacy Sales - Patients | 621110 | $317,127 | $317,127 | |
| Ambulance Services | 621910 | $282,367 | $282,367 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $254,696,486 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,440,895 | TotalRevenueColumnAmt |
| Exclusion | $2,440,895 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,756 | TotalRevenueColumnAmt |
| Exclusion | $40,756 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,015,633 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $60,300 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $955,333 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $955,333 | TotalRevenueColumnAmt |
| Exclusion | $955,333 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $444,323 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $444,323 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $444,323 | TotalRevenueColumnAmt |
| Exclusion | $444,323 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Cafeteria Income | 624200 | $1,158,707 | $1,158,707 | |
| Health and Wellness Center | 621990 | $770,982 | $770,982 | |
| Employee Benefit - Expense Reimbursements | 900099 | $145,448 | $145,448 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $834,651 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $834,651 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,909,788 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $261,522,279 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $254,691,961 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,755,606 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,040,014 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,750 | TotalAmt |
| Program Services | $20,750 | ProgramServicesAmt |
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 | $2,776,660 | TotalAmt |
| Program Services | $797,631 | ProgramServicesAmt |
| Management And General | $1,979,029 | 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 | $68,262,910 | TotalAmt |
| Program Services | $56,527,119 | ProgramServicesAmt |
| Management And General | $11,735,791 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,917,693 | TotalAmt |
| Program Services | -$60,037 | ProgramServicesAmt |
| Management And General | $1,977,730 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,036,996 | TotalAmt |
| Program Services | $13,982 | ProgramServicesAmt |
| Management And General | $14,023,014 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,264,168 | TotalAmt |
| Management And General | $7,264,168 | 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 | $110,302 | TotalAmt |
| Program Services | $17,080 | ProgramServicesAmt |
| Management And General | $93,222 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,309 | TotalAmt |
| Management And General | $3,309 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,799 | TotalAmt |
| Management And General | $23,799 | 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 | $27,449,110 | TotalAmt |
| Program Services | $23,956,230 | ProgramServicesAmt |
| Management And General | $3,492,880 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $709,958 | TotalAmt |
| Program Services | $133 | ProgramServicesAmt |
| Management And General | $709,825 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,612,444 | TotalAmt |
| Program Services | $5,857,234 | ProgramServicesAmt |
| Management And General | $2,755,210 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,694 | TotalAmt |
| Management And General | $51,694 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,789,683 | TotalAmt |
| Program Services | $3,175,525 | ProgramServicesAmt |
| Management And General | $614,158 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $210,760 | TotalAmt |
| Program Services | $116,464 | ProgramServicesAmt |
| Management And General | $94,296 | 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 | $47,576 | TotalAmt |
| Program Services | $7,659 | ProgramServicesAmt |
| Management And General | $39,917 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,538,682 | TotalAmt |
| Program Services | $7,154,898 | ProgramServicesAmt |
| Management And General | $1,383,784 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,959,865 | TotalAmt |
| Program Services | $16,081,962 | ProgramServicesAmt |
| Management And General | $20,877,903 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,108,898 | TotalAmt |
| Program Services | $12,710,868 | ProgramServicesAmt |
| Management And General | $2,398,030 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,129,914 | TotalAmt |
| Management And General | $4,129,914 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Provision for Doubtful Accounts | $10,414,523 | $10,414,523 | |
| Medical Supplies Patient Chargables | $44,375,247 | $44,375,247 | |
| Taxes, Licenses Fees | $9,816,197 | $55,513 | $9,760,684 |
| Dues, Education Training Recruiting | $1,693,812 | $913,527 | $780,285 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,612 | TotalAmt |
| Program Services | $7,017 | ProgramServicesAmt |
| Management And General | $364,595 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,696,562 | TotalAmt |
| Program Services | $182,143,325 | ProgramServicesAmt |
| Management And General | $84,553,237 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $761,629 | BOYAmt |
| EOY | $185,921 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,723,579 | BOYAmt |
| EOY | $2,320,215 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,152,818 | BOYAmt |
| EOY | $44,116,479 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $260,436 | BOYAmt |
| EOY | $54,564 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,188,274 | BOYAmt |
| EOY | $5,068,013 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,837,174 | BOYAmt |
| EOY | $1,492,373 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $323,527,581 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $184,232,631 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,353,252 | BOYAmt |
| EOY | $139,294,950 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,740,329 | BOYAmt |
| EOY | $37,960,841 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,020,027 | BOYAmt |
| EOY | $730,083 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,098,698 | BOYAmt |
| EOY | $8,249,624 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $254,136,216 | BOYAmt |
| EOY | $239,473,063 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,730,614 | BOYAmt |
| EOY | $27,913,470 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,350,316 | BOYAmt |
| EOY | $121,884,392 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,418,538 | BOYAmt |
| EOY | $89,428,524 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,494,463 | BOYAmt |
| EOY | $33,144,262 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $275,993,931 | BOYAmt |
| EOY | $272,370,648 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$21,857,715 | BOYAmt |
| EOY | -$32,897,585 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$21,857,715 | BOYAmt |
| EOY | -$32,897,585 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $254,136,216 | BOYAmt |
| EOY | $239,473,063 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$5,174,283 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $4,479,221 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$10,344,808 | 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 | $23,799 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $23,799 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | II-B 1 | FormAndLineReferenceDesc |
| Explanation | The organization paid dues to the American Hospital Association AHA as well as the West Virginia Hospital Association WVHA. A portion of these dues, specifically 23,799, was related to lobbying activities of the AHA and WVHA. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,107,095 | OtherCostOrOtherBasisAmt |
| Book Value | $2,107,095 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $148,640,206 | OtherCostOrOtherBasisAmt |
| Depreciation | $60,246,731 | DepreciationAmt |
| Book Value | $88,393,475 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $166,383,001 | OtherCostOrOtherBasisAmt |
| Depreciation | $119,503,867 | DepreciationAmt |
| Book Value | $46,879,134 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,397,279 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,482,033 | DepreciationAmt |
| Book Value | $1,915,246 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $139,294,950 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc |
|---|
| Financial derivatives and other financial products |
| Closely-held equity interests |
Other Liabilities Org OtherLiabilitiesOrgGrp (11 entries)
| DescDesc | AmtAmt |
|---|---|
| Federal income taxes | |
| Accrued wages, benefits and payroll taxes | $9,769,730 |
| Malpractice Liability | $2,997,000 |
| Accrued pension benefits | -$2,007,609 |
| Accrued bond interest | -$1,342,930 |
| Due to third party payors | $1,693,926 |
| Interest rate swaps | $13,706,697 |
| Self insurance liability | $5,969,000 |
| Debt Issuance Costs | -$132,854 |
| Deferred Compensation | $1,126,211 |
| Minimum Pension Liability Adjustment | $1,365,091 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $33,144,262 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $253,173,064 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $2,741,642 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$10,414,523 | OtherRevenueAmt |
| Revenue Not Reported | -$7,672,881 | RevenueNotReportedAmt |
| Revenue Subtotal | $260,845,945 | RevenueSubtotalAmt |
| Other Revenues Not Included | $676,334 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $676,334 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $261,522,279 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $256,342,189 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $256,342,189 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $10,354,373 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $10,354,373 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $266,696,562 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| X 2 | The System accounts for uncertainty in income taxes using a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold is met. Management determined there were no tax uncertainties that met the recognition threshold in 2017 and 2016. The Systems policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in operating expenses. |
| XI 2d | Line 2d includes 10,414,523 Provision for Bad Debts that were reported as an offset to revenue on the audited financial statements but are reported as an expense on the Form 990. |
| XI 4b | Expense associated with rental property of 60,300 that was reported in Part VIII Line 6b as an offset to rental revenue, Pass Through Income from OVASC HH of 702,086 and Contribution Revenue of 34,548. |
| XII 4b | Provision for Bad Debts of 10,414,523 reported as an offset to revenue on the audited financial statements but are reported as an expense on the Form 990, Contribution Revenue of 150 and Rental Expenses of 60,300. |
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 | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| 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 | $1,607,469 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,607,469 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00630 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $64,720,813 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $48,596,607 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,124,206 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06290 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $278,484 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $277,468 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,016 | NetCommunityBenefitExpnsAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $66,606,766 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $48,874,075 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $17,732,691 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06920 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $335,758 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $335,758 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,250,525 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $985,699 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $264,826 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,750 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,750 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,607,033 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $985,699 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $621,334 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $68,213,799 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $49,859,774 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,354,025 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07160 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,755,477 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $359,882 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $101,189,050 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $136,477,927 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$35,288,877 | 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 |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ohio Valley Ambulatory Surgery Center LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | Ambulatory Services | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.62500 | OrgProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Camden-Clark Memorial Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Garfield Avenue | AddressLine1Txt |
| City | Parkersburg | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | http//wvumedicine.org/camden-clark/ | WebsiteAddressTxt |
| State License | 102 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Disproportionate Share Hospital | 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 | 15 | 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 | http//wvumedicine.org/camden-clark/wp-content/uploads/sites/6/2016/04/Community-Health-Needs-Assessm | 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 | http//wvumedicine.org/camden-clark/wp-content/uploads/sites/6/2016/04/Community-Health-Needs-Assessm | StrategyWebsiteURLTxt |
| 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 |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| 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 | http//wvumedicine.org/camden-clark/wp-content/uploads/sites/6/2016/02/FINA | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http//wvumedicine.org/camden-clark/wp-content/uploads/sites/6/2016/02/FINA | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http//wvumedicine.org/wp-content/uploads/2015/11/plain-language-summary-10 | 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 (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Group Camden-Clark Memorial Hospital Line Part V, Section B, Line 5 | To prepare the 2015 CHNA the organization collected a vast amount of demographic data on the community served, met with United Way agencies and the Health Department, and used information garnered from studies performed by the Sisters of St. Joseph. In 2017 WV United Health System entered into a contract with the WVU School of Public Health to organize CHNAs for all System hospitals. In July 2017 CCMC leadership began meeting with WVU School of Public Health faculty and staff to begin the process of preparing the next CHNA for CCMC which is due in 2018. |
| Group Camden-Clark Memorial Hospital Line Part V, Section B, Line 11 | The 2015 CHNA results identified 4 prevalent community risk factors that include Obesity/childhood obesity, high smoking and oral tobacco use, sedentary lifestyles with little regular exercise, and high cholesterol, lipids or triglyceride levels. CCMC leadership chose two priority areas which they felt CCMC could adequately target and address through the implementation plan. These areas were 1. Access to Wellness Opportunities and 2. Obesity/Diabetes. CCMC believes that utilizing the Diabetes Education, Cancer Services, Preventive Screenings, Community Education, Dinner with a Doc - lecture series, and Drug Abuse Education, Prevention, and Treatment programs they can make significant strides towards addressing the above mentioned priority areas. CCMC is working with area organizations to work toward addressing needs not being addressed by the most recent implementation plan. Updated information on the progress made using the 2015 implementation plan will be provided in the 2018 CHNA or 2019 implementation plan. |
| Group Camden-Clark Memorial Hospital Line Part V, Section B, Line 15e | A state medicaid representative was on site to help determine eligibility and help patients through the eligibility process. |
| Group Camden-Clark Memorial Hospital 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Patriot Point Diagnostic | ||||
| 2838 Pike Street | Parkersburg | WV | 26101 | Radiology/Lab |
| Garfield Diagnositc | ||||
| 2012 Garfield Ave Bdng 2 Ste 1 | Parkersburg | WV | 26101 | Radiology/Lab |
| Sleep Lab | ||||
| 19th Street Campus | Parkersburg | WV | 26101 | Diagnostic |
Supplemental Information Detail SupplementalInformationDetail (21 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I Line 3c | Camden-Clark Medical Center CCMC uses 200 Federal Poverty Guideline FPG to determine free care eligibility. However, CCMC does not offer discounted care to individuals who fail the 200 FPG test. |
| Part I Line 6a | WVU Medicine prepared a System wide summary report of 2017 Community Benefits which can be found online http//wvumedicine.org/about/community-benefit/. |
| Part I Line 7 | Total community benefit expense for 2017 is 68,213,353 and is 26.62 of total net expenses. To calculate net expense, bad debt of 10,414,523 was deducted from total expenses of 266,692,562 as shown in Part IX line 25 of the core Form 990, for a net expense of 256,282,039. |
| Part I Line 7 | Worksheet 2 from the IRS Schedule H instructions was used to derive the Cost-to-Charge ratio, which was used to calculate Charity Care, Unreimbursed Medicaid and other means-tested government programs at cost. |
| Part III Line 2 | Bad Debt Expense at cost was calculated by multiplying bad debt expense of 10,414,523 by our cost to charge ratio of 36.06 derived from Worksheet 2 in the IRS Schedule H instructions for a total of 3,755,477. |
| 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 25,000. The total of that report was 998,008 which we then multiplied by our cost to charge ratio of 36.06 for a total of 359,882. |
| Part III Line 3 | The estimated bad debt attributable to patients eligible for charity care of 359,882 should be considered community benefit due to the fact that anyone with outstanding balances of 25,000 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 | WVUHS consolidated footnote for Accounts Receivable Patients states Patient accounts receivable are reported at net realizable value. Accounts are written off when they are determined to be uncollectable based upon managements 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 amounts 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 2017 Medicare 29, Medicaid 14, Blue Cross 21, Commercial/HMO/Other 32, Patients 4 , Total 100. 2016 as follows Medicare 31, Medicaid 14, Blue Cross 21, Commercial/HMO/Other 30, Patients 4, Total 100. |
| Part III Line 4 | For receivables associated with self-pay patients, which includes both patients without insurance and insured patients with deductible and copayment balances, the System records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the billed rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. |
| Part III Line 8 | The amount reported in Part III Line 6 136,477,927 was calculated using the total Medicare allowable cost from the Medicare cost report, less Medicare reimbursement of direct GME. |
| Part III Line 8 | CCMCs shortfall, 35,288,877 of Medicare program reimbursement should be considered a community benefit because we are relieving a government burden by providing care in excess of our costs to these patients. |
| Part III Line 9b | CCMC does have a debt collection policy. When a patient has been approved for financial assistance under our charity care policy, they will not be sent to bad debt. Additionally, if a patient is being evaluated for charity, the patient will not be sent to a bad debt agency pending charity guarantor status until the pending status has been finalized approved/denied. All other patients with outstanding balances will be processed through billing and collections pursuant to our Financial Policy. |
| Part VI Line 2 | CCMC is part of the Mid-Ohio Valley Rural Health Alliance. The Alliance members jointly assess the needs of the region and work with a consultant to ensure needs are addressed. CCMC conducted a Community Health Needs Assessment CHNA in 2015 that was adopted by the Board of Directors on May 2016. The 2015 CHNA was used to develop an Implementation Plan that was approved by the CCMC Board of Directors in May 2017, that plan can be found online http//wvumedicine.org/camden-clark/wp-content/uploads/sites/6/2016/04/Community-Health-Needs-Assessment-2015.pdf |
| Part VI Line 3 | CCMC provides, in writing, all options for possible financial assistance. This information is also available on CCMCs website. CCMC also has representatives that are available to discuss options with inpatients and outpatients on a daily basis. WV State Medicaid workers are onsite to help determine patient eligibility and to assist patients through the eligibility process. |
| Part VI Line 4 | CCMC, located in Parkersburg, WV, serves the Mid-Ohio Valley region of Western West Virginia and Southeastern Ohio which consists of 11 counties with an estimated population over 250,000 and per capita income of 38,500. CCMC serves an aging population and there is a declining corporate presence in the area which negatively impacts the unemployment rate. In addition, the community includes several federally designated medically underserved areas or populations. There is one other hospital in the primary service area, located in Marietta, OH. |
| Part VI Line 5 | A majority of the organizations governing body is comprised of persons who reside in the primary service area and who are neither employees nor independent contractors of the hospital, not family members thereof. The organization extends medical staff privileges to all qualified physicians in the community to many of its departments. |
| Part VI Line 5 | Any surplus of funds is used primarily to enhance patient care. While no research is done in this facility, a residency program was started in 2009. |
| Part VI Line 6 | CCMC 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. As a university medical center and the largest hospital of the System, WVUH plays a significant role in improving the general health care of the community. |
| 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 West Virginia University Hospitals, Inc. in Morgantown, WV, United Hospital Center in Bridgeport, WV, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, Potomac Valley Hospital located in Keyser, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Hospital, in Glen Dale, WV, which joined the System in October 2016. |
| Part VI Line 6 | The System also includes the physician practices of United Physicians Care, Inc. and Camden-Clark Physician Corp that operate in conjunction with the System hospitals along with United Summit Center, a behavioral health center located in Clarksburg, WV. In addition to these practices, the System also includes WVUH-East, Inc. and Camden-Clark Health Services which operate as management companies for their respective hospitals. The System also includes University Healthcare Foundation in Martinsburg, WV, United Health Foundation in Clarksburg, WV, Camden-Clark Foundation in Parkersburg, WV, St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Foundation in Glen Dale, WV which perform various fundraising activities for their respective hospitals. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| American Red Cross | |||||||
| 220 8th Street | Parkersburg | WV | 26101 | 530196605 | 501c3 | $5,000 | Operations |
| Wood County Development | |||||||
| PO Box 1683 | Parkersburg | WV | 26101 | 310965347 | 501c4 | $11,000 | Operations |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I Line 2 | FormAndLineReferenceDesc |
| Explanation | Contributions are discretionary and decisions on which organizations Camden-Clark Memorial Hospital supports are made by the CEO in conjunction with the Director of Marketing. Typically, local organizations are supported throughout the year and the donations are typically not specifically restricted, so there is no follow up process for monitoring the use of the funds. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| 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 | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|
| David McClure | ||||||
| President / CEO | $484,348 | $110,088 | $6,272 | $8,100 | $12,102 | $620,910 |
| Thomas Heller | ||||||
| Vice President, Human Resources | $283,310 | $58,894 | $1,835 | $7,801 | $8,389 | $360,229 |
| Todd Kruger | ||||||
| General Legal Counsel | $317,857 | $90,978 | $745 | $8,100 | $17,376 | $435,056 |
| Cynthia Kern | ||||||
| Vice President, Quality | $212,447 | $52,536 | $435 | $6,058 | $1,451 | $272,927 |
| Carolyn Allen | ||||||
| Vice President, Finance | $303,290 | $61,004 | $1,300 | $8,100 | $8,064 | $381,758 |
| Tommy Mars | ||||||
| Chief Nursing Officer | $193,370 | $38,127 | $56,638 | $7,911 | $14,124 | $310,170 |
| Gene Allen Sexton | ||||||
| Pharmacist | $120,319 | $400 | $19,917 | $4,222 | $18,675 | $163,533 |
| Sean Smith | ||||||
| VP, Operations | $156,452 | $800 | $98 | $4,818 | $18,907 | $181,075 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I Line 1a | Memberships at the health and wellness center are offered to each member of the senior leadership team. These are covered in the applicable employment contracts. |
| Part I Line 3 | Compensation for the CEO of CCMC is established by West Virginia Health System WVUHS. WVUHS utilizes compensation consultants, who review 990s of related organizations, review employment contracts for similar positions, compensation surveys. The results of the before mentioned research are provided to the System Compensation Committee for reivew and approval. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| West Virginia Hospital Finance Authority | ||||||||
| A | 621256910 | 956622VY7 | 2004-06-30 | $19,350,000 | 2004 B Series - Refund prior issuance and fund improvements | false | false | false |
| West Virginia Hospital Finance Authority | ||||||||
| B | 621256910 | 956622VY7 | 2004-06-30 | $57,900,000 | 2004 C Series - Refund prior issuance | false | false | false |
| West Virginia Hospital Finance Authority | ||||||||
| C | 621256910 | 956622VY7 | 2013-10-03 | $47,037,860 | 2013 A Series - Refund 2004 A bonds and fund improvements | false | false | false |
| West Virginia Hospital Finance Authority | ||||||||
| D | 621256910 | 956622L85 | 2016-06-15 | $19,440,924 | 2016 A - Refunding of 2007 A Bonds | false | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Refunding EscrowRefundingEscrowAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $7,850,000 | $19,350,000 | $1,618,092 | $1,167,255 | $95,902 | $11,468,751 | $5,000,000 | 2008 | Yes (true) | false | Yes (true) | Yes (true) | |
| B | $6,350,000 | $57,900,000 | $4,854,274 | $3,343,149 | $286,963 | $32,615,614 | $16,800,000 | 2008 | Yes (true) | false | Yes (true) | Yes (true) | |
| C | $6,630,000 | $47,037,860 | $5,335,549 | $411,600 | $30,075,086 | $12,146,948 | Yes (true) | false | false | Yes (true) | |||
| D | $400,099 | $19,440,924 | $149,889 | $19,290,973 | 2016 | Yes (true) | Yes (true) | Yes (true) | Yes (true) | $62 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|
| A | false | false | Yes (true) | Yes (true) | false | false | false | Yes (true) |
| B | false | false | Yes (true) | Yes (true) | false | false | false | Yes (true) |
| C | false | false | Yes (true) | Yes (true) | false | false | false | Yes (true) |
| D | false | false | Yes (true) | Yes (true) | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Term Of GICTermOfGICPct | Regulatory Safe Harbor StsfdRegulatorySafeHarborStsfdInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lehman Brothers Spec | ||||||||||||||
| A | false | false | Yes (true) | false | Yes (true) | false | Yes (true) | 0000000028.600000000000 | Yes (true) | Yes (true) | Yes (true) | |||
| Raymond James Financial Products | ||||||||||||||
| B | false | false | Yes (true) | false | Yes (true) | Yes (true) | Yes (true) | 0000000028.600000000000 | Yes (true) | Yes (true) | Yes (true) | 0000000028.600000000000 | false | false |
| Cantor Fitzgerald | ||||||||||||||
| C | false | Yes (true) | false | false | false | false | Yes (true) | Yes (true) | false | Yes (true) | ||||
| Raymond James Financial Products | ||||||||||||||
| D | false | Yes (true) | false | false | false | Yes (true) | Yes (true) | 0000000001.670000000000 | Yes (true) | false | Yes (true) | 0000000025.420000000000 | false | false |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
| C | Yes (true) |
| D | Yes (true) |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I Line AB | The 2004 Bonds were issued in a series with the 2004 A bonds which were refunded through the 2013 A Series refunding reported in Line C. |
| Part I Line C | 2013 A Bond - The total issue price reported on Line 3 varies from the total of Lines 4 through 12 by 931,322, this variance is due to the 2004 Series A bonds that were defeased via the 2013A issuance. These funds were sitting in debt service, interest, and the project fund accounts at the time of the 2013 issuance and were rolled into the 2013 A funds. |
| Part I Line D | 2016 A Bond - The 2016 A Bonds were issued on behalf of the West Virginia United Health System Obligated Group with an issue price of 288,869,596 per Form 8038. The 2016 A Bonds were issued to refund certain outstanding bonds. Per internal allocations based on the balance of the refunded bonds in the general ledger CCMC received 19,440,924 in proceeds to refund the 2007A bond issuance as an advanced refunding. The remaining amounts allocated from this issuance are reported on Form 990 for WVUH and UHC. |
| Part I | Schedule K - For purposes of reporting bond issuance allocations on Schedule K to the Internal Revenue Service, West Virginia University Hospitals, Inc. WVUH as parent company to City Hospital, Inc. CHI, The Charles Town General Hospital dba Jefferson Medical Center JMC, University Healthcare Foundation, Inc. UHF, and Potomac Valley Hospital is reporting bond issuances allocated to WVUH and its subsidiaries on a consolidated basis on Schedule K attached to their tax return. United Hospital Center, Inc. UHC EIN 55-0525724 and Camden-Clark Memorial Hospital Corporation CCMH EIN 31-1524546 are reporting bond allocations issued to them on the return filed by such taxpayer. |
| Part I | Several bond issuances were issued in multiple series and each series is reported in this tax return separately. For each series identified in Schedule K, Part I, the taxpayer will reconcile the series amount reported in this tax return and the tax return filed by UHC and CCMC to the applicable 8038 filed with the IRS for each bond issuance. Each bond series is reported on the appropriate Form 990, Schedule K, only once in this manner. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dr Michael Morehead | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Board Member | RelationshipDescriptionTxt |
| Transaction | $110,590 | TransactionAmt |
| Transaction | Payments for services to Parkersburg Neurological | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part III Line 1 | FormAndLineReferenceDesc |
| Explanation | Dr. Morehead is a 50 owner of Parkersburg Neurological. Parkersburg Neurological received 110,590 reported on Form 1099-MISC from CCMC for services rendered in 2017. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4d | Program Service Expenses 165,746,690, Grants and allocations 20,750, Revenue 178,010,902 The hospital strives to supply a comprehensive range of inpatient, outpatient, outreach clinics and emergency room services, including prevention, guidance, diagnosis, treatment, restoration, rehabilitation and other efforts as may be required to meet the health care need of the community and as the hospitals resources will permit. Although reimbursement for services rendered is critical to the operation and stability of the hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. Our mission is to serve the community by providing health care services and health care education. Therefore, in keeping with this commitment to service all members of the community, Camden-Clark Memorial Hospital will provide the following where the individuals need and/or an inability to pay coexist free care and/or subsidized care, and care provided to persons covered by governmental programs at or below cost. |
| Form 990, Part IV, Line 20b | The organization must attach a copy of its most recent audited financial statements. Attached are the consolidated financial statements of West Virginia United Health System, Inc. WVUHS and controlled entities. WVUHS became the sole member of Camden Clark Health Services, Inc., the parent corporation of Camden-Clark Memorial Hospital on March 1, 2011. The financial position, results of operations, and cash flows of Camden-Clark Memorial Hospital are included in the aforementioned consolidated audited financial statements. |
| Form 990, Part VI, Section A, Line 6 | Camden-Clark Health Services, Inc., a non-profit, tax-exempt corporation, is the sole member of the organization. |
| Form 990, Part VI, Section A, Line 7a | Camden-Clark Health Services Inc., the organizations sole member, nominates all board members of the organization. Board members are elected by West Virginia United Health System, WVUHS from the CCHS nominations. WVUHS elects all CCHS, CCMC, CCPC and CCF Board members from a slate of Director Nominees submitted to them by CCHS. CCHS will consider the underlying nominations of CCMC,CCPC and CCF before they submit their nominations. |
| Form 990, Part VI, Section A, Line 7b | As the sole member of Camden Clark Health Services, Inc., WVUHS through its affiliation agreement, holds power to approve certain decisions such as annual budget, capital expenditures over 1 million, new debt over 1 million, new programs, and extraordinary filings. |
| Form 990, Part VI, Section B, Line 11 | The Form 990 is prepared by the WVUHS Tax Team and is provided for review to the CFO, VP General Counsel, and Accounting Manager. It is also reviewed by the non-profit tax manager of our independent auditing firm. It is then reviewed by the Finance Committee. After being presented to the committee, it is provided to all board members for comments prior to filing with the IRS. |
| Form 990, Part VI, Section B, Line 12c | To identify and monitor any conflicts, a signed conflict of interest statement is required from board members of the organization and key individuals that are in a position to make or influence decisions. If an actual or possible conflict of interest is observed or disclosed, the organization invokes the procedures set out in the policy, bylaws for addressing the conflict of interest. For key individuals employees, a specific conflict of interest standard in the organizations code of ethics and business conduct also exists. |
| Form 990, Part VI, Section B, Line 15 | The organization utilizes an executive compensation consultant to survey data and make recommendations. The compensation of the CEO is determined by using an independent compensation consultant, as well as a compensation survey or study. It is supported by a written employment contract which is then reviewed and approved by a compensation committee and the WVUHS board of directors. Compensation of other officers and key employees is reviewed and approved by the board of directors. Minutes from meetings of the compensation committee and board of directors are documented and kept on file. |
| Form 990, Part VI, Section C, Line 19 | The organizations financial statements are made available on request and are also available on the West Virginia Healthcare Authority website. The organizations governing documents and conflict of interest policy are made available upon request. |
| Form 990, Part XI, Line 9 | Changes in Net AssetsTransfers to related organizations 9,068,223, Pass-Through Income from OVASC HH 702,086, Prior Year Pension Liability Adjustment of 539,944, 34,548 contributions from Camden-Clark Foundation, and 7 rounding adjustment. |
| Form 990, Part IX, Line 11g | Other service expenses consist of the following items consulting and professional, contracted labor, contracted labor patient care, contracted physicians expense, consulting and professional med staff and collection agency fees. Consulting and professional totaled 501,687, 249,397 of which was classified as program service expense and 252,290 as management and general expense. Contracted labor totaled 12,466,804, 9,229,969 of which was classified as program service expense and 3,236,835 as management and general expense. Contracted labor patient care totaled 4,532,429, 4,535,837 of which was classified as program service expense and 3,408 as management and general expense. Contracted physician expense totaled 9,782,304, 9,737,679 of which was classified as program service expense and 44,625 as management and general expense. Consulting and professional med staff totaled 88,985, all of which was management and general expense. Collection agency fees totaled 254,871, 203,347 of which was classified as program service expense and 51,524 as management and general expense. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Camden-Clark Health Services Inc | |||||||||||
| 800 Garfield Avenue | Parkersburg | WV | 26102 | 550769602 | Healthcare Access | WV | 501c3 | Line 12A, I | West Virginia United Health System | false | |
| Camden-Clark Foundation | |||||||||||
| 800 Garfield Avenue | Parkersburg | WV | 26102 | 550667789 | Hospital Support | WV | 501c3 | Line 12A | Camden-Clark Health Services | false | |
| Auxiliary of Camden-Clark Memorial Hospital | |||||||||||
| 800 Garfield Avenue | Parkersburg | WV | 26102 | 550386283 | Patient Care | WV | 501c3 | Line 3 | false | N/A | |
| Camden-Clark Physician Corporation | |||||||||||
| 604 Ann Street | Parkersburg | WV | 26101 | 264058719 | Patient Care | WV | 501c3 | Line 12A, I | Camden-Clark Health Services | false | |
| West Virginia United Health System | |||||||||||
| 3040 University Avenue | Morgantown | WV | 26505 | 550175471 | Healthcare Access | WV | 501c3 | Line 12A | false | N/A | |
| West Virginia University Hospitals Inc | |||||||||||
| PO Box 8034 | Morgantown | WV | 26506 | 550643304 | Patient Care | WV | 501c3 | Line 3 | West Virginia United Health System | false | |
| West Virginia University Hospitals East | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 202337985 | Healthcare Access | WV | 501c3 | Line 12A | West Virginia University Hospitals Inc | false | |
| City Hospital Inc | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 550383321 | Patient Care | WV | 501c3 | Line 3 | West Virginia University Hospitals East | false | |
| Jefferson Memorial Hospital | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 550359755 | Patient Care | WV | 501c3 | Line 3 | West Virginia University Hospitals East | false | |
| University Healthcare Foundation | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 311118075 | Hospital Support | WV | 501c3 | Line 12A | false | N/A | |
| United Hospital Center Inc | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550525724 | Patient Care | WV | 501c3 | Line 3 | West Virginia United Health System | false | |
| United Physicians Care Inc | |||||||||||
| 686 South Pike Street | Shinnston | WV | 26431 | 550638563 | Patient Care | WV | 501c3 | Line 3 | false | N/A | |
| United Hospital Foundation | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550621706 | Hospital Support | WV | 501c3 | Line 12A | false | N/A | |
| WV Healthcare Co-Op | |||||||||||
| PO Box 8059 | Morgantown | WV | 26506 | 550650441 | Support | WV | 501c3 | Line 12A | West Virginia United Health System | false | |
| United Summit Center | |||||||||||
| 6 Hospital Plaza | Clarksburg | WV | 26301 | 550752788 | Behavioral Health | WV | 501c3 | Line 3 | false | N/A | |
| Potomac Valley Hospital Inc | |||||||||||
| 100 Pin Oak Lane | Keyser | WV | 26726 | 550420956 | Patient Care | WV | 501c3 | Line 3 | West Virginia University Hospitals Inc | false | |
| St Joseph's Hospital of Buckhannon Inc | |||||||||||
| 1 Amalia Drive | Buckhannon | WV | 26201 | 550356996 | Patient Care | WV | 501c3 | Line 3 | West Virginia United Health System | false | |
| Reynolds Memorial Hospital Inc | |||||||||||
| 800 Wheeling Ave | Glen Dale | WV | 26038 | 550357045 | Patient Care | WV | 501c3 | Line 3 | West Virginia University Hospitals Inc | false | |
| Reynolds Memorial Foundation | |||||||||||
| 800 Wheeling Ave | Glen Dale | WV | 26038 | 550710402 | Hospital Support | WV | 501c3 | Line 12A | false | N/A | |
| St Joseph's Foundation of Buckhannon Inc | |||||||||||
| 1 Amalia Drive | Buckhannon | WV | 26201 | 550727650 | Hospital Support | WV | 501c3 | Line 12b, II | St Joseph's Hospital of Buckhannon | false | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ohio Valley Ambulatory Surgery Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 608 Washington Blvd | AddressLine1Txt |
| City | Belpre | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45714 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208671724 | EIN |
| Primary Activities | Outpatient Surgical Services | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Camden-Clark Memorial Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | Related | PredominantIncomeTypeTxt |
| Share Of Total Income | $696,076 | ShareOfTotalIncomeAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (true) | GeneralOrManagingPartnerInd |
| Ownership | 0.62500 | OwnershipPct |
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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Allied Health Services Inc | |||||||||
| PO Box 782 | Morgantown | WV | 26507 | 550652017 | Medical Lab | WV | WV United Health System | C Corp | false |
| West Virginia United Insurance Services | |||||||||
| 3040 University Avenue Suite 3200 | Morgantown | WV | 26505 | 550756055 | Provider Network | WV | WV United Health System | C Corp | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | 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 | Yes (true) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |