2018-08-15T15:47:00-05:00 2017-09-30 550486667 Arnett Carbis Toothman LLP P O Box 2629 Charleston WV 25329 990 2016-10-01 550392395 Highland Hospital Association HIGH 3049261600 300 56th Street Charleston WV 25304 Chris Miller CFO 3049261600 2018-08-15 1 Dolores Rose P01286262 3043460441 2016 2022-09-23 18:48:47Z X Cynthia Persily 300 56th Street Charleston WV 25304 26392116 0 X www.highlandhosp.com X 1955 WV To provide psychiatric care to adults and children. X 0 0 484 0 0 0 11421 269477 21947138 24757913 3352 672679 1003033 692047 22964944 26392116 3297 15929 0 0 13887180 15414286 0 0 0 8797775 9832491 22688252 25262706 276692 1129410 9932702 0 10191697 0 -258995 0 X To provide psychiatric care to adults and children. 0 1 21620963 15929 26120102 The hospital provided 24,532 inpatient days of psychiatric care, including 7,012 inpatient routine service days, 17,457 sub-provider service days, and 63 sub-acute service days. 21620963 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 22 0 484 1 0 0 0 0 0 0 0 0 0 0 X 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X Chris Miller 3049261600 1418A MacCorkle Avenue SW Charleston WV 25303 Allan McVey Chairman 1.00 2.00 X X 0 0 0 Erica Mani Vice-Chairman/Treasurer 1.00 1.00 X X 0 0 0 Kiran S Devaraj MD Secretary 40.00 9.00 X X 367559 0 19090 Cynthia Persily PhD President/CEO 15.00 30.00 X X 196603 0 2090 Byard Matt Coleman Trustee 1.00 6.00 X 0 0 0 Michelle Easton PharmD Trustee 1.00 2.00 X 0 0 0 Brenda Isaac RN Trustee 1.00 1.00 X 0 0 0 David Molgaard Trustee 1.00 1.00 X 0 0 0 R Gregory Pennington Trustee 1.00 1.00 X 0 0 0 R Terrance Rodgers Trustee 1.00 6.00 X 0 0 0 Chris Miller CFO as of 10/26/2015 40.00 X 100948 0 7753 Jennifer Thacker Pharmacist 40.00 X 111441 0 11570 Catherine Plumley Physician 40.00 X 115050 0 1594 Daniel G Walker Pharmacist 40.00 X 140290 0 1691 1031891 0 43788 6 0 1 0 Netsmart Technologies 4950 College Boulevard Overland Park KS 66211 Electronic Medical Records Vendor 216747 Security America PO Box 4525 Charleston WV 25364 Contracted Security Services 214324 Xtend Healthcare 500 W Main Street Suite 14 Hendersonville TN 37075 Contracted Billing Services 178000 Spilman Thomas and Battle PO Box 273 Charleston WV 25321 Law Services 155344 Arnett Carbis Toothman LLP PO Box 25329 Charleston WV 25329 Accounting and Auditing Services 149383 13 15000 254477 269477 Inpatient Services 622110 24757913 24757913 24757913 2537 2537 670142 0 670142 670142 670142 Management Services 541610 384700 384700 Pharmacy Service Revenue 446110 188307 188307 Intercompany Services 900099 119040 119040 692047 26392116 26120102 0 2537 15929 15929 791183 668708 122475 11415714 9648562 1767152 775923 655810 120113 1479974 1250874 229100 951492 804201 147291 55736 55736 138799 138799 1191148 1006759 184389 177098 149683 27415 552555 467020 85535 3544648 2995937 548711 28217 23849 4368 7434 6283 1151 5145 4349 796 236250 199678 36572 272339 230181 42158 Bad debts 1613486 1613486 Repairs & Maintenance 610920 516350 94570 Medical supplies 604797 604797 Healthcare Provider Tax 559702 559702 234217 198805 35412 25262706 21620963 3641743 0 438235 0 8012 0 0 5451624 0 0 0 0 190793 0 293590 0 0 1584469 0 24473 0 0 0 0 1941506 0 9932702 0 2972939 172509 7046249 0 10191697 0 X -258995 0 -258995 0 9932702 0 X 1129410 -87942 -782473 X X 1 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 X 1 X 1 X 1 1 0 0 0 10320808 10320808 10320808 10320808 0 0.00000 458280 458280 0.01940 15929 15929 0.00070 474209 474209 0.02010 10795017 10320808 474209 0.02010 0 1613486 1290789 904938 904938 X 1 1 1 1 Highland Hospital Association 300 56th Street SE Charleston WV 25304 X Psych hospital Highland Hospital Association 1 0 0 1 X X X X X X X X 15 1 0 0 1 X http://highlandhosp.com/about-highland/ X 1 15 1 http://highlandhosp.com/about-highland/ 0 1 X 100.000000000000 200.000000000000 X X X X 1 1 X X X 1 X X X X 1 X 0 X 0 X 0 0 Highland Hospital Association Part V, Section B, Line 5: For this needs assessment, Highland Hospital included feedback from the community and experts in the public health, mental health, and clinical care field. The assessment also took into account the health needs of vulnerable populations, including minorities, those with chronic illness, low-income and medically underserved. Highland Hospital Association Part V, Section B, Line 11: Cost limitations prevent the Hospital from addressing every need identified in the CHNA. Part I, Line 7: The amount of cash and in-kind contributions to community groups was obtained from the hospital's accounting records. Part I, Ln 7 Col(f): Patient accounts receivable are reported at estimated net realizable amounts from patients and responsible third-party payors. Amounts owed to the Association are reported net of allowances for uncollectible accounts. Specific patient balances are written off at the time they are determined to be uncollectible. The process for estimating the ultimate collection of receivables involves significant assumptions and judgments. In this regard, the Association has implemented a standardized approach to estimate and review the collectability of its receivables based on patient accounts receivable aging trends. Historical collection and payor reimbursement experience is an integral part of the estimation process related to determining an allowance for contractual and uncollectible accounts. In addition, the Association assesses the current state of its billing functions in order to identify any known collection or reimbursement issues to determine the impact, if any on its reserve estimates, which involve judgment. Revisions in reserve estimates are recorded as an adjustment to net patient service revenue or the provision for uncollectible accounts. The Association believes that its collection and reserve process, along with the monitoring of its billing processes, help to reduce the risk associated with material revisions to reserve estimates resulting from adverse changes in collection, reimbursement experience and billing functions. Part III, Line 2: Bad debt expense as reported on the financial statements. Part III, Line 3: Approximately 80% of those who are eligible do not provide proof of income or don't apply for charity care. Line 3 equals 80% of bad debt expense on Line 2. Part III, Line 4: Financial footnote that describes bad debt expense as of 9/30/16: Patient accounts receivable are reported at estimated net realizable amounts from patients and responsible third-party payors. Amounts owed to the Association are reported net of allowances for uncollectible accounts. Specific patient balances are written off at the time they are determined to be uncollectible. The process for estimating the ultimate collection of receivables involves significant assumptions and judgments. In this regard, the Association has implemented a standardized approach to estimate and review the collectability of its receivables based on patient accounts receivable aging trends. Historical collection and payor reimbursement experience is an integral part of the estimation process related to determining an allowance for contractual and uncollectible accounts. In addition, the Association assesses the current state of its billing functions in order to identify any known collection or reimbursement issues to determine the impact, if any on its reserve estimates, which involve judgment. Revisions in reserve estimates are recorded as an adjustment to net patient service revenue or the provision for uncollectible accounts. The Association believes that its collection and reserve process, along with the monitoring of its billing processes, help to reduce the risk associated with material revisions to reserve estimates resulting from adverse changes in collection, reimbursement experience and billing functions. Part III, Line 8: Medicare costs were obtained from the hospital's Medicare cost report. Part III, Line 9b: Patients and former patients with delinquent private pay accounts will be notified and given the option of paying in full or participating in a predefined monthly payment plan. Patients will be notified of their financial obligation for services rendered by receiving monthly billing statements. The Hospital offers a charity application and sliding-scale discount application to each patient at time of admission. If the patient does not qualify for charity, does not return the application, or returns it and does not qualify for charity assistance, the patient is contacted to make payment arrangements. Then, the hospital sends out four invoices and three collection notices over a period of time, after which the patient is turned over to a collection agency. In essence, the patient has 120 days to either apply for charity care or make payment. Part VI, Line 2: This CHNA focuses on the primary service area of Kanawha County, West Virginia. The study considered services offered by hospitals in the area, population trends, socio-economic demographics and the region's overall sufficiency of healthcare providers in the community. The study included data obtained from numerous health organizations as well as interviews with community leaders, hospital staff and the Hospital's Board of Directors. This information is being used to determine the community's future health needs. Part VI, Line 3: Uninsured patients are notified of the charity care and sliding fee scale discount policies at admission and again during the collection process if they have not already taken advantage of the available programs. Part VI, Line 4: Our primary service area is defined as the geographic area within which the majority of our patients reside. After reviewing our 2015 Summary of Discharges by County, we determined our Primary Service Area to be Kanawha County, WV with 47% of our total discharges living in Kanawha County. Our secondary service area based on our 2015 Summary of Discharges by County is a 10-county area that includes: Putnam, Boone, Cabell, Wood, Jackson, Mercer, Logan, Fayette, Raleigh, and Lincoln with 33% of patients residing within these 10 counties in West Virginia.According to the United States 2010 census, Kanawha County, West Virginia has a population of 193,063 living in 92,618 housing units and has a population density of 214.1 persons per square mile. In Kanawha County 89.1% of persons self-identified as white and 7.3% self-identified as black. High school graduates comprise 85.9% of the population over 25 and 23.4% have a college degree. An estimated 13.7% of persons live below the poverty level in the county. The population is aging, with 45% of the population over the age of 45.We are a small rural state with pockets of some urbanization. We provide treatment to patients from all 55 counties of the state. The population of West Virginia is 1,852,994 according to the US Census report from 2010. This is up 2.5% from 2000. The 2009 average income in WV was $32,219, while the US average income was $39,130. The 2010 percentage of residents below the poverty level in WV was 17% while the percentage in the entire US is 13.2%. The percentage of Medicaid patients for 2010 was 36%. There are 2 other community psychiatric hospitals in our state and 2 state-operated inpatient facilities. Part VI, Line 5: 1) All of Highland's board members reside in our service area. 2) Highland extends medical staff privileges to all qualified physicians in our one department. 3) Highland reinvests all of our surplus back into our daily budget. We keep up with current trends on facility improvements and provide medical staff development opportunities to staff by encouraging and supporting participation in conferences and other related seminars. 4) Highland offers behavioral health treatment to children and adolescents, a service that is not offered elsewhere in the Charleston area. 5) The Highland Hospital Foundation raises money throughout the year through events, mail appeals, Neighborhood Investment Programs and donations. 6) Highland has a web site that discusses our community involvement. Part VI, Line 6: Highland's mission is to identify and respond to mental health needs, and promote physical, social, emotional and intellectual well-being. Our vision is to be a valued leader in psychiatric healthcare, recognized for providing innovative and patient-centered programming in a technologically advanced, financially secure and user-friendly environment. Our values include a genuine commitment to learning, continuous evaluation and improvement, data-based decision-making, and respecting and supporting the individual needs and differences of patients, staff and our community. 0 Highland Hospital Foundation 300 56th Street Charleston WV 25304 550705451 501(c)3 15000 FMV To further the mission of the Foundation 1 X X 0 0 0 0 0 0 0 0 0 Kiran S Devaraj MD Secretary 367559 0 0 0 0 0 0 0 19090 0 386649 0 0 0 Cynthia Persily PhD President/CEO 196603 0 0 0 0 0 0 0 2090 0 198693 0 0 0 Cash and temporary investments 2017-09-26 190970 Fair market value 822364266 Meridian Behavioral Health Systems LLC (MBH Highland LLC) PO Box 851 Brentwood TN 37024 Limited Liability Partnership Accounts receivable and prepaid expenses 2017-09-26 3868880 Book value 822364266 Meridian Behavioral Health Systems LLC (MBH Highland LLC) PO Box 851 Brentwood TN 37024 Limited Liability Partnership Buildings, equipment and land 2017-09-26 1632903 Book value 822364266 Meridian Behavioral Health Systems LLC (MBH Highland LLC) PO Box 851 Brentwood TN 37024 Limited Liability Partnership Inventories 2017-09-26 222560 Cost 822364266 Meridian Behavioral Health Systems LLC (MBH Highland LLC) PO Box 851 Brentwood TN 37024 Limited Liability Partnership Related party receivables 2017-09-26 1663150 Book value 822364266 Meridian Behavioral Health Systems LLC (MBH Highland LLC) PO Box 851 Brentwood TN 37024 Limited Liability Partnership 0 1 0 0 1 1 1 1 0 Part I, Line 2e: Person(s) Involved: Cynthia PersilyChris MillerKiran Devaraj Part I, Line 2e: Explanation of Involvement: Cynthia Persily was the CEO and President of the organization and will continue as the CEO of the successor organization.Chris Miller was the CFO of the organization and will continue as the CFO of the successor organization.Kiran Devaraj will continue as the medical director of the successor organization. Part I, Line 3: All liabilities due were paid and the The Articles of Dissolution were filed and authorized by the West Virginia Secretary of State as of September 26, 2017. Form 990, Part III, line 3 The board of directors of HHA, Inc. (Corporation) the parent company and sole member of Highland Hospital Association and other Highland companies adopted a resolution to sell substantially all of the assets of the Corporation, Highland Hospital Association, Highland Behavioral Health Services (dba Process Strategies) and Highland Health Center to MBH Health Center LLC, and MBH Process Strategies LLC. Upon the sale of substantially all of the assets of the Corporation the purpose for which the Corporation was formed will no longer exist. The Board determined it is in the best interest of the Corporation and the community to dissolve the Corporation and sell the operations and assets to the Meridian Behavioral Health Systems of Brentwood Tennessee. As the successor, Meridian will enhance and ensure the continuity of the community's behavioral health services provided by Highland and provide the best means and resources to meet the original and continued mission of the organization. Form 990, Part VI, Section B, line 11b The 990 is received from the accounting firm and reviewed by the CEO and CFO to make sure nothing is omitted. The CFO then signs the return and mails it to all regulatory and tax authorities. Form 990, Part VI, Section B, line 12c The Quality Management Director keeps a copy of the policy on file and secures the signatures of the board members every year. If situations arise, board members will excuse themselves from any vote in which they may have a conflict of interest. The conflict of interest policy is reviewed annually by the Risk Manager in a meeting with board members to ensure there are no conflicts at voting times. Form 990, Part VI, Section B, line 15 The organization reviews compensation levels on a comparative basis. The CEO must approve all salary increases whether by job type, or individually. The CEO's salary is negotiated with and approved by the Board of Directors. The Data Blue Market Watch Survey is used to compare and provide guidance in compensation decisions. Form 990, Part VI, Section C, line 19 The 990 is available through direct inquiry of the fiscal office of the organization. Form 990, Part XI, line 9: Sale of assets and dissolution of organization -782,473. Form 990, Part XII, Line 2C Highland Hospital Association has a separate finance committee which oversees the audits of all of the members of Highland Health System. The Finance Committee reviews and makes a recommendation to the Board of Directors as to whether to accept the audit and point out any areas of discussion or concern with Board members. The process has not changed. Highland Behavioral Health Services Inc 300 56th St Charleston WV 25304 550777789 Psychiatric Treatment WV 501(c)(3) 9 HHA Inc 0 HHA Inc 300 56th St Charleston WV 25304 550705453 Parent Company WV 501(c)(3) 11, Type I N/A 0 Highland Health Center Inc 300 56th St Charleston WV 25304 205948175 Patient Treatment WV 501(c)(3) 3 HHA Inc 0 Highland Hospital Foundation Inc 300 56th St Charleston WV 25304 550705451 Foundation WV 501(c)(3) 11, Type I HHA Inc 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0