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STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY (EIN 55-0422958)
Tax period
2016-10-01 to 2017-09-30
Filed
2018-08-15
IRS object ID
201842279349301569
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-08-15T10:20:38-05:00ReturnTs
Tax Period End2017-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN550486667PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Arnett Carbis Toothman LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1P O Box 2629AddressLine1Txt
CityCharlestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25329ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550422958EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STONEWALL JACKSON MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSTONBusinessNameControlTxt
Phone3042698059PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1230 Hospital PlazaAddressLine1Txt
CityWESTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26452ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAvah L StalnakerPersonNm
Person TitleCEOPersonTitleTxt
Phone3042698059PhoneNum
Signature2018-08-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDolores RosePreparerPersonNm
PTINP01286262PTIN
Phone3043460441PhoneNum
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerAvah L StalnakerPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1230 Hospital PlazaAddressLine1Txt
CityWESTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26452ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$78,226,545GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.stonewallhospital.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1959FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionIt is the mission of Stonewall Jackson Memorial Hospital to provide excellent care to all we serve.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee558TotalEmployeeCnt
Total Volunteers30TotalVolunteersCnt
Total Gross UBI-$1,400TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$1,400NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$84,296PYContributionsGrantsAmt
CY Contributions Grants$30,452CYContributionsGrantsAmt
PY Program Service Revenue$48,261,302PYProgramServiceRevenueAmt
CY Program Service Revenue$45,509,999CYProgramServiceRevenueAmt
PY Investment Income$581,470PYInvestmentIncomeAmt
CY Investment Income$3,064,459CYInvestmentIncomeAmt
PY Other Revenue$1,143,763PYOtherRevenueAmt
CY Other Revenue$464,448CYOtherRevenueAmt
PY Total Revenue$50,070,831PYTotalRevenueAmt
CY Total Revenue$49,069,358CYTotalRevenueAmt
PY Grants And Similar Paid$34,349PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$35,176CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$27,786,962PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$26,761,523CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$21,795,229PYOtherExpensesAmt
CY Other Expenses$29,310,875CYOtherExpensesAmt
PY Total Expenses$49,616,540PYTotalExpensesAmt
CY Total Expenses$56,107,574CYTotalExpensesAmt
PY Revenues Less Expenses$454,291PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$7,038,216CYRevenuesLessExpensesAmt
Total Assets BOY$71,934,756TotalAssetsBOYAmt
Total Assets EOY$71,970,220TotalAssetsEOYAmt
Total Liabilities BOY$8,072,985TotalLiabilitiesBOYAmt
Total Liabilities EOY$12,575,586TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$63,861,771NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$59,394,634NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionIt is the mission of Stonewall Jackson Memorial Hospital to provide excellent care to all we serve.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$42,099,235ExpenseAmt
Revenue$45,955,771RevenueAmt
DescStonewall Jackson Memorial Hospital provides acute medical and outpatient services to residents of Weston, West Virginia and surrounding communities which covers 10 different counties. Services included 5,721 days of inpatient care, 73,021 outpatient visits, 13,390 emergency room visits, 1,288 ambulatory surgery visits, 5,491 Home Health visits and 53,513 Physician Clinic visits. The Hospital had 192 deliveries during the year in which approximately 70% were Medicaid patients. Many of these babies had significant substance abuse problems. Due to the drug addiction problems of the Mothers, very few of these women have received prenatal care. During the tax year, the Hospital lost physicians so that the Hospital retains a locum tenens physician to continue this service. The cost of this coverage was approximately $230,000.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$12,376ExpenseAmt
Grant$10,376GrantAmt
DescAnnual Blood Screening: Stonewall Jackson Memorial Hospital provides all supplies and staff to operate the program. A portion of the excess revenue is forwarded to the local Rotary Club to promote charitable services. Other programs include: scoliosis screening at county elementary and middle schools, health fairs at the local senior citizens center, free sports physicals to middle and high school students, Children's Safety Day to promote healthy choices to children under 12 years of age, events for free osteoporosis screenings, events for free Dermascans to screen for skin cancer, Weston Walk-run to promote exercise as a way to improve cardiac health, free women's health screening for breast and cervical cancer, free vein screenings and free hearing screenings. Revenue and expenses are included in Line 4a above.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$28,830ExpenseAmt
Grant$24,800GrantAmt
Revenue$22,433RevenueAmt
DescWilliam Adler Scholarship Fund - Stonewall Jackson Memorial Hospital sponsored program to provide scholarships to local graduating high school seniors who are pursuing a career in the health care field. It is hoped that this program will encourage more students to seek health care professions and lesson the health care staffing shortage.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$42,140,441TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document14IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee558EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWVStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Joe A Barnes CPABusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3042698050PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1230 Hospital PlazaAddressLine1Txt
CityWestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP264528558ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
John Law CPA
President1.00Yes (X)Yes (X)$0$0$0
Joseph Snead MD
Vice-President22.50Yes (X)Yes (X)$193,678$0$125,851
R Gerald Wood RPH
Secretary1.00Yes (X)Yes (X)$0$0$0
Denver Turner
Treasurer1.00Yes (X)Yes (X)$0$0$0
C Gregory Cunningham
Director1.00Yes (X)$0$0$0
Robin Poling
Director1.00Yes (X)$0$0$0
John W Wyllie III MD
Director37.50Yes (X)$422,153$0$48,894
David Gallien
Director1.00Yes (X)$0$0$0
Michael Hager
Director1.00Yes (X)$0$0$0
Avah Stalnaker
CEO37.50Yes (X)$295,062$0$45,668
Delphia Arbogast
CFO (termed 5/31/16)37.50Yes (X)$53,433$0$17,730
Joe Barnes
CFO CFO as of 5/18/1737.50Yes (X)$0$0$0
Kevin Stalnaker
Assistant CEO37.50$194,897$0$54,319Yes (X)
Ronald Pearson MD
Physician37.50$397,400$0$13,250Yes (X)
Doyle Sickles MD
Physician37.50$520,001$0$63,336Yes (X)
Michael Gregory DO
Physician37.50$355,905$0$40,562Yes (X)
Freddie Persinger DO
Physician37.50$561,648$0$26,285Yes (X)
Mustafa Kurdi MD
Physician37.50$348,826$0$39,446Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,343,003TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$475,341TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K28IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Sodexo Inc & Affiliates
PO Box 536922AtlantaGA503536922Maintenance/Dietary$598,408
Atlanticon
PO Box 621FairbornOH45324Consulting$594,560
K&R Medical
682 US Highway 68 EastBentonKY42025Rental of MRI Equipment$247,000
Laboratory Corporation
PO Box 12140BurlingtonNC272162140Laboratory Services$240,082
Mountain State Textile
417 Fairmont AvenueFairmontWV26554Laundry$199,400
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K14CntrctRcvdGreaterThan100KCnt
Fundraising$12,543FundraisingAmt
All Other Contributions$17,909AllOtherContributionsAmt
Total Contributions$30,452TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient ServicesDesc
Business622110BusinessCd
Total Revenue Column$45,509,999TotalRevenueColumnAmt
Related Or Exempt Func Income$45,509,999RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$45,509,999TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$864,331TotalRevenueColumnAmt
Exclusion$864,331ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$48,093RealAmt
Personal$11,117PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$56,310RealAmt
Personal$12,517PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$8,217RealAmt
Personal-$1,400PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$9,617TotalRevenueColumnAmt
Unrelated Business Revenue-$1,400UnrelatedBusinessRevenueAmt
Exclusion-$8,217ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$31,284,458SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$29,084,330SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,200,128SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,200,128TotalRevenueColumnAmt
Exclusion$2,200,128ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$9,890FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$12,543ContriRptFundraisingEventAmt
Fundraising Direct Expenses$4,030FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,860TotalRevenueColumnAmt
Exclusion$5,860ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Cafeteria/Vending sales722310$133,395$133,395
Vending Machine Sales722310$42,469$42,469
Medical records fees900099$15,609$15,609

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$276,732TotalRevenueColumnAmt
Related Or Exempt Func Income$276,732RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$468,205OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$49,069,358TotalRevenueColumnAmt
Related Or Exempt Func Income$45,978,204RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue-$1,400UnrelatedBusinessRevenueAmt
Exclusion$3,062,102ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$10,376TotalAmt
Program Services$10,376ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$24,800TotalAmt
Program Services$24,800ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,185,930TotalAmt
Program Services$807,737ProgramServicesAmt
Management And General$378,193ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$21,708,693TotalAmt
Program Services$14,785,791ProgramServicesAmt
Management And General$6,922,902ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$691,487TotalAmt
Program Services$470,972ProgramServicesAmt
Management And General$220,515ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,756,560TotalAmt
Program Services$1,196,393ProgramServicesAmt
Management And General$560,167ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,418,853TotalAmt
Program Services$966,381ProgramServicesAmt
Management And General$452,472ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$327,565TotalAmt
Management And General$327,565ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$301,303TotalAmt
Management And General$301,303ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,754,467TotalAmt
Program Services$2,557,167ProgramServicesAmt
Management And General$1,197,300ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$254,992TotalAmt
Program Services$173,675ProgramServicesAmt
Management And General$81,317ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,744,608TotalAmt
Program Services$1,869,353ProgramServicesAmt
Management And General$875,255ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$840,384TotalAmt
Program Services$572,386ProgramServicesAmt
Management And General$267,998ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,048,699TotalAmt
Program Services$714,269ProgramServicesAmt
Management And General$334,430ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$104,270TotalAmt
Program Services$71,018ProgramServicesAmt
Management And General$33,252ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,202TotalAmt
Program Services$4,224ProgramServicesAmt
Management And General$1,978ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,229,042TotalAmt
Program Services$2,199,301ProgramServicesAmt
Management And General$1,029,741ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$782,462TotalAmt
Program Services$532,935ProgramServicesAmt
Management And General$249,527ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical supplies$8,494,064$8,494,064
Bad debts$3,939,329$3,939,329
Repairs and maintenance$1,617,630$1,101,768$515,862
Charity Care Expenses$782,863$782,863

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,082,995TotalAmt
Program Services$865,639ProgramServicesAmt
Management And General$217,356ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$56,107,574TotalAmt
Program Services$42,140,441ProgramServicesAmt
Management And General$13,967,133ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$392,366BOYAmt
EOY$1,424,214EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$9,284,479BOYAmt
EOY$4,752,133EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,775,594BOYAmt
EOY$6,852,768EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,275,263BOYAmt
EOY$1,394,117EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$410,827BOYAmt
EOY$170,003EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$50,355,085LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$32,222,314LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$12,520,331BOYAmt
EOY$18,132,771EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$37,682,640BOYAmt
EOY$37,085,621EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$67,668BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,525,588BOYAmt
EOY$2,158,593EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$71,934,756BOYAmt
EOY$71,970,220EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,142,672BOYAmt
EOY$10,068,225EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$38,881BOYAmt
EOY$52,418EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$891,432BOYAmt
EOY$2,454,943EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,072,985BOYAmt
EOY$12,575,586EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$63,861,771BOYAmt
EOY$59,394,634EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$63,861,771BOYAmt
EOY$59,394,634EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$71,934,756BOYAmt
EOY$71,970,220EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$7,038,216ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,571,079NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$5,000GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$5,000TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationA portion of dues paid by the hospital to the American Hospital Assocation and the West Virginia Hospital Association is attributable to lobbying.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,519,778OtherCostOrOtherBasisAmt
Book Value$6,519,778BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,386,631OtherCostOrOtherBasisAmt
Depreciation$10,964,501DepreciationAmt
Book Value$2,422,130BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$30,320,619OtherCostOrOtherBasisAmt
Depreciation$21,257,813DepreciationAmt
Book Value$9,062,806BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$128,057OtherCostOrOtherBasisAmt
Book Value$128,057BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$18,132,771TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$44,051,752TotalRevEtcAuditedFinclStmtAmt
Other Revenue$22,124OtherRevenueAmt
Revenue Not Reported$22,124RevenueNotReportedAmt
Revenue Subtotal$44,029,628RevenueSubtotalAmt
Other Revenues Not Included$5,039,730OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$5,039,730RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$49,069,358TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$51,080,361TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$12,517OtherExpensesIncludedAmt
Expenses Not Reported$12,517ExpensesNotReportedAmt
Expenses Subtotal$51,067,844ExpensesSubtotalAmt
Other Expenses Not Included$5,039,730OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$5,039,730ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$56,107,574TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:The Hospital follows the guidance for accounting for uncertainty in income taxes recognized in a company's financial statements that prescribes 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 has been met. The guidance also addresses derecognition, classification, interest and penalties, accounting in interim periods, and disclosures. Management has determined that this guidance had no material effect on the financial statements. The Hospital's policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in management and general expenses. There were no interest or penalties recognized on the statements of operations and changes in net assets as a result of this guidance. Generally, tax returns for years ended September 30, 2014, and thereafter remain subject to examination by federal and state tax authorities.
Part XI, Line 2d - Other Adjustments:Net rental income netted with rental expense on 990 9,607. Net rental expenses netted with rental expense on 990 12,517.
Part XI, Line 4b - Other Adjustments:Investment expenses netted with revenue on the financial statements 301,303. Bad debt and Charity expense netted with revenue on the financial statements 4,722,192. Net fundraising revenue netted with expenses on financial statements 5,859. Expense offsetting income on financial statements 10,376.
Part XII, Line 2d - Other Adjustments:Net rental expenses netted with rental expense on 990 12,517.
Part XII, Line 4b - Other Adjustments:Investment expenses netted with revenue on the financial statements 301,303. Bad debt expense netted with revenue on the financial statements 4,722,192. Net fundraising revenue netted with expenses on financial statements 5,859. Expense offsetting income on financial statements 10,376.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Charity Golf TournamentEvent1Nm
Gross Receipts Event1$22,433GrossReceiptsEvent1Amt
Charitable Contri Event1$12,543CharitableContriEvent1Amt
Gross Revenue Event1$9,890GrossRevenueEvent1Amt
Cash Prizes Event1$900CashPrizesEvent1Amt
Rent Facility Costs Event1$3,110RentFacilityCostsEvent1Amt
Other Direct Expenses Event1$20OtherDirectExpensesEvent1Amt
Gross Receipts Total$22,433GrossReceiptsTotalAmt
Charitable Contributions Tot$12,543CharitableContributionsTotAmt
Gross Revenue Total Events$9,890GrossRevenueTotalEventsAmt
Cash Prizes Total Events$900CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$3,110RentFcltyCostsTotalEventsAmt
Oth Direct Expnss Total Events$20OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$4,030DirectExpenseSummaryEventsAmt
Net Income Summary$5,860NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other162.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$386,023TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$386,023NetCommunityBenefitExpnsAmt
Total Expense0.00740TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,936,331TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,149,559DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,786,772NetCommunityBenefitExpnsAmt
Total Expense0.09180TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,322,354TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,149,559DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,172,795NetCommunityBenefitExpnsAmt
Total Expense0.09920TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,129,131TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,157,224DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,971,907NetCommunityBenefitExpnsAmt
Total Expense0.05700TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,129,131TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,157,224DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,971,907NetCommunityBenefitExpnsAmt
Total Expense0.05700TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,451,485TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,306,783DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,144,702NetCommunityBenefitExpnsAmt
Total Expense0.15620TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,939,329BadDebtExpenseAmt
Bad Debt Expense Attributable$1,642,700BadDebtExpenseAttributableAmt
Reimbursed By Medicare$14,224,934ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$21,178,527CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$6,953,593MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Stonewall Jackson Memorial HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1230 Hospital PlazaAddressLine1Txt
CityWestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26452ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Stonewall Jackson Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLwww.stonewalljacksonhospital.com/getpage.php?name=mission&sub=About+UsOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLwww.stonewalljacksonhospital.com/getpage.php?name=mission&sub=About+UsStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care162.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://www.stonewalljacksonhospital.com/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttp://www.stonewalljacksonhospital.com/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp://www.stonewalljacksonhospital.com/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Stonewall Jackson Memorial HospitalPart V, Section B, Line 5: The Hospital took into account input from representatives from health department, schools, local businesses and town Mayor.
Stonewall Jackson Memorial HospitalPart V, Section B, Line 6b: Lewis County Health Department
Stonewall Jackson Memorial HospitalPart V, Section B, Line 11: Drug abuse was the number one health concern. To combat this, SJMH's emergency department has adopted the WV hospital association guidelines for prescribing opiates. All nursing staff at SJMH is required to complete continuing education on "drug diversion education on opiates". All SJMH pharmacists complete continuing education on drug diversion education on opiates, and all SJMH physicians are registered with the WV board of pharmacies. The second concern for the community was obesity. To combat this, SJMH has an adult fitness program, we received a grant to fund a walking program in the fall of 2012, we provide annual physicals for athletes in the area for free, we sponsor the Weston 5K run and wellness walk, we created a walking path in the parking lot, we established a wellness committee for our employees. We also coordinate with the City of Weston to refurbish playgrounds in the area. Even though the Hospital operates for 24/365 at a loss, it provides a much needed service. For example, to the West of the Hospital, it is over 1 hour from the closest hospital, Stonewall Jackson.
Stonewall Jackson Memorial HospitalPart V, Section B, Line 13h: Patients whose family income exceeds 162% of the FPL may be eligible to receive discounted rates on a case-by-case basis based on their specific circumstances, such as catastrophic illness or medical indigence, at the discretion of SJMH; however the discounted rates shall not be greater than the amounts generally billed to (received by the hospital for) commercially insured or Medicare patients.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - Stonewall Jackson Home CareBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1456 Suite B Market Place MallAddressLine1Txt
CityWestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26452ZIPCd
FieldValueIRS element (for citing)
FacilityHome Health CareFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:The Health Resources and Services Administration eligibility guidelines are used. We also evaluate the patient's assets and the amount of medical debt. We have signs posted at Registration, around and in the Emergency Department and in all physician clinics. We send letters to patients who are not paying their bills and give the application to private pay inpatients. We also tell the patients during telephone conversations if the patient indicates he/she is not able to pay the bill or pay all of the bill.
Part I, Line 7:The cost of charity care was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions.The unreimbursed cost of Medicaid was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions.
Part I, Line 7, Column (f):The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 3,939,329.
Part III, Line 2:Bad debt expense as reported on audited financial statements.
Part III, Line 3:Based on historical information, we estimate 41.7% of the bad debt expense represents amounts from patients eligible under the hospital financial assistance policy.
Part III, Line 4:Patient accounts receivable are carried at the original charge less an estimate made for doubtful or uncollectible accounts. The allowance is based upon a review of the outstanding balances aged by financial class. Management uses collection percentages based upon historical collection experience to determine collectability. Management also reviews troubled, aged accounts to determine collection potential. Patient accounts receivable are written off when deemed uncollectible. Recoveries of accounts previously written off are recorded as a reduction to bad debt expense when received. Interest is not charged on patient accounts receivable.
Part III, Line 8:The Medicare cost report was used to determine revenue allowable costs associated with the revenue.
Part III, Line 9b:Our collections policy applies to all patients regardless of financial class or any other classification. During our collections process, if the patient indicates they do not have the ability to pay their bill, the credit staff offers exoneration.
Part VI, Line 2:The assessment was conducted in three phases: The first phase was attaining background information on the healthcare problems of the local area and state. The second phase was a survey conducted online and by paper. The last phase was a focus group conducted by an experienced mediator.
Part VI, Line 3:We have signs posted at Registration, around and in the Emergency Department and in all physician clinics. We send letters to patients who are not paying their bills. We give the application to Private Pay inpatients. We tell the patients when during telephone conversations if the patient indicates he/she is not able to pay the bill or pay all of the bill.
Part VI, Line 4:Stonewall Jackson Memorial Hospital serves a relatively large rural population of about 65,000 people with an average household income of $32,000. 30% of the population is disabled. Approximately 30% are Medicaid Eligible or are uninsured. We are the largest hospital in our service area, which includes two other hospitals, one being a Critical Access Hospital. We are located in a federally-designated medically underserved area.
Part VI, Line 5:Stonewall Jackson Memorial Hospital (SJMH) is a 70 bed rural acute hospital located in Lewis county West Virginia. SJMH is the only hospital located in the county as such it is solely responsible for the healthcare of this rural community. SJMH provides 24 hours Emergency Room and Obstetrics services and provides care regardless of the patient's ability to pay. The majority of the governing body is comprised of community members. Medical privileges are offered to all qualified physicians in the community and SJMH has worked diligently to provide other physician services by expanding the services they provide.SJMH continues to make capital improvement to the facility and expand patient care services to meet the needs of the community.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Rotary Club of WestonBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 222AddressLine1Txt
CityWestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26452ZIPCd
FieldValueIRS element (for citing)
Recipient EIN550371556RecipientEIN
IRC Section501(c)4IRCSectionDesc
Cash Grant$10,376CashGrantAmt
Purpose Of GrantTo help the Rotary support various children's programs in Lewis County.PurposeOfGrantTxt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeHealthcare scholarships for recent high school graduates.GrantTypeTxt
Recipient22RecipientCnt
Non Cash Assistance$24,800NonCashAssistanceAmt
Valuation Method UsedFMV - CashValuationMethodUsedDesc

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Joseph Snead MD
Vice-President$160,693$0$31,972$0$1,013$0$121,700$0$4,151$0$319,529$0$0$0
John W Wyllie III MD
Director$398,693$0$21,606$0$1,854$0$37,500$0$11,394$0$471,047$0$0$0
Avah Stalnaker
CEO$288,028$0$0$0$7,034$0$34,039$0$11,629$0$340,730$0$0$0
Kevin Stalnaker
Assistant CEO$194,627$0$0$0$270$0$28,000$0$26,319$0$249,216$0$0$0
Ronald Pearson MD
Physician$397,400$0$0$0$0$0$13,250$0$0$0$410,650$0$0$0
Doyle Sickles MD
Physician$518,417$0$0$0$1,584$0$37,250$0$26,086$0$583,337$0$0$0
Michael Gregory DO
Physician$289,061$0$66,568$0$276$0$13,250$0$27,312$0$396,467$0$0$0
Freddie Persinger DO
Physician$504,052$0$57,500$0$96$0$0$0$26,285$0$587,933$0$0$0
Mustafa Kurdi MD
Physician$348,466$0$0$0$360$0$13,250$0$26,196$0$388,272$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 3Management duties customarily are performed under the direct supervision of officers, directors, trustees or key employees, but the Hospital has contracted out the management duties of the Maintenance department. The manager of the Maintenance department (also considered a department head) is employed by the Maintenance company. All other Maintenance staff are employees of the Hospital. The Hospital contracts out the management duties of the Pharmacy department. The manager of the Pharmacy department (also considered a department head) is employed by the Pharmacy company. All other Pharmacy staff are employees of the Hospital. The Hospital contracts out the management duties of the Dietary department. The manager of the Dietary department (also considered a department head) is employed by the Dietary company. The certified Dietary Manager and the Dietitian are also the employees of the Dietary company. All other Dietary staff are employees of the Hospital.
Form 990, Part VI, Section B, line 11bThe CFO reviewed the 990 prior to filing with the IRS. A copy will be provided to the board members at the next scheduled board meeting.
Form 990, Part VI, Section B, line 12cAll board members disclose possible conflicts of interest prior to appointment and periodically throughout their terms as trustees.
Form 990, Part VI, Section B, line 15The Hospital obtains salary survey data. Performance evaluations are done on each of these personnel & financial conditions are considered.
Form 990, Part VI, Section C, line 19The Hospital places a publication in the local newspaper stating the governing documents, conflicts of interest policy and financial statements are available upon request.

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Stonewall Home Oxygen Therapy IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 Market Place Mall Suite 8AddressLine1Txt
CityWestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26452ZIPCd
FieldValueIRS element (for citing)
EIN550754278EIN
Primary ActivitiesOxygen Therapy ServicesPrimaryActivitiesTxt
Legal Domicile StateWVLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Stonewall Jackson Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income-$113,898ShareOfTotalIncomeAmt
Share Of EOY Assets$355,632ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Stonewall Home Oxygen Therapy IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeATransactionTypeTxt
Involved$11,117InvolvedAmt
Method Of Amount DeterminationFMV - CashMethodOfAmountDeterminationTxt