2018-11-15T14:32:35-06:00 2017-12-31 861065772 Deloitte Tax LLP 111 S Wacker Drive Chicago IL 60606 990 2017-01-01 550526150 Charleston Area Medical Center Inc CHAR 3043887603 PO Box 1547 Charleston WV 253261547 Jeff Sandene Executive VP and CFO 3043887603 2018-11-15 1 Rachel Henderson-Pennington P01499421 3124861000 107.77.226.82 2018-11-15 10:11:45 ES P 8121CA463AABFA4EFE5158FD2073B628CA1C8F6D 2B300E1FC09CCA321063079848B1E489E0A7BF4B 2017 2019-02-21 02:37:17Z CAMC Jeff Sandene 501 Morris Street Charleston WV 25301 1160406528 0 X www.camc.org X 1971 WV Striving to provide the best healthcare to every patient, every day.CAMC owns and operates four separately-licensed hospitals as a tertiary-care academic medical center designed to provide care for community residents through every stage of life. CAMC patients depend on CAMC to provide convenient and compassionate care delivered regardless of a patient's ability to pay. 17 13 8736 304 10070058 1013323 3193134 2809964 1035128087 1095188793 4345593 4612561 1889185 1816522 1044555999 1104427840 1813274 1714748 0 0 499722499 546521430 0 0 0 560504597 574434785 1062040370 1122670963 -17484371 -18243123 974092647 972952668 599234552 592753399 374858095 380199269 X Charleston Area Medical Center, Inc.'s ("CAMC") primary charitable exempt purpose is to provide hospital care, without distinction, for all the inhabitants of the City of Charleston, State of West Virginia and elsewhere, to promote legitimate methods for the prevention of disease and positive promotion of health (both personal and public), and to foster and conduct education in medicine in all its branches and adjunct arts and sciences, such as nursing and technical occupations, which contribute to the diagnosis, treatment and prevention of disease. 0 0 745959899 528352 1096467174 CAMC is one of West Virginia's largest medical center with over 8,736 employees and 651 medical staff. CAMC is licensed for 956 beds at four campuses and our health care services delivery focuses on providing a full range of inpatient and outpatient services as a tertiary regional referral center, teaching and safety net hospital. As a regional referral center, CAMC has one of only two state Level 1 Trauma Centers, a Level III Neonatal ICU, a Pediatric ICU, a DNV-Certified Primary Stroke Center, and a Bariatric Center of Excellence. CAMC is the primary medical safety net provider of women and children's and trauma services in central and southern West Virginia and provides 20% of the charity care in the state. There were inpatient days of 206,907, outpatient visits of 584,538, emergency department visits of 101,137 and deliveries of 2,628 in 2017. CAMC gives back to the community because we understand the impact that high quality medical care, charity care, education, corporate contributions and community partnerships have on the lives of real people. 39490150 1030371 CAMC has established medical and allied health education excellence as a core competency. Provision and support for education include training for interns and residents, nurses, anesthetists and other personnel. 105 WVU/WVSOM medical students trained at CAMC hospitals and 171 medical residents were employed by CAMC. CAMC provided faculty support to the University of Charleston and BridgeValley Community andTechnical College helping educate pharmacy students, nursing students and physician assistance program. CAMC assisted 27 employees through student loan forgiveness, and provided educational assistance to 395 individuals who intend to pursue a career in healthcare. 89137429 156025 736864 CAMC does much more than just provide health care, being involved in nearly every aspect of the health and well being of the community. CAMC offered 78 outreach programs which served an estimated 62,020 people. CAMC provided acute inpatient and outpatient hospital services including unreimbursed charity care at cost of $18,316,638. Creative, state-of-the-art programs and services are provided to our community to serve our community - particularly the needs of the low income, elderly and other vulnerable persons. Community benefits are programs or activities that provide treatment or promote health and healing as a response to identified community needs and meet at least one of the following community benefit criteria: 1) Improves access to health care services; 2) Enhances health of the community; 3) Advances medical or health care knowledge; 4) Relieves or reduces the burden of government or other community efforts. 874587478 1 1 0 1 0 0 0 0 1 1 1 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 628 0 1 8736 1 1 1 0 0 0 0 0 0 0 0 0 X 17 13 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 WV X Jeff Sandene 3043887603 501 Morris Street Charleston WV 25301 David L Ramsey President, CEO & Trustee 50.00 6.50 X X 4679220 0 261043 John R Hoblitzell Esq Chairman 2.50 5.00 X X 0 0 0 William Rice Jr Vice Chairman 3.00 3.50 X X 0 0 0 Gina R Busch MD Trustee 2.50 2.50 X 0 0 0 Charles L Capito Jr Trustee 2.50 2.50 X 0 0 0 Mark A Chandler Trustee 2.50 2.50 X 0 0 0 Fonda Elliot Trustee 2.50 2.50 X 0 0 0 John L Goad MD Trustee 50.00 2.50 X 697541 0 30987 James P Griffith MD Trustee 2.50 2.50 X 0 0 0 Wanda Hightower Trustee (start 4/17) 2.50 2.50 X 0 0 0 Melvin Jones Trustee 2.50 2.50 X 0 0 0 Brenda J Powell Trustee (end 4/17) 2.50 2.50 X 0 0 0 Linda J Powers Trustee 2.50 2.50 X 0 0 0 Karen S Price Trustee 2.50 2.50 X 0 0 0 Eric D Shouldis MD Trustee (start 1/17) 50.00 3.00 X 409913 0 45234 Steven L Smith Trustee 2.50 2.50 X 0 0 0 Kenneth L Tackett Trustee 2.50 2.50 X 0 0 0 Edwin H Welch Ph D Trustee 2.50 3.50 X 0 0 0 Robert D Whitler VP Gov't & Comm Affairs 50.00 1.00 X 255192 0 34649 Ronald E Moore VP Prof Prac & CNO (end 10/17) 50.00 1.00 X 338454 0 216787 Kristi Snyder VP Human Resources 50.00 6.00 X 350817 0 200299 Angela Fenton Hill Secretary & Gen Counsel 50.00 6.00 X 322020 0 197041 Dale R Wood VP System Improv & CQO (until 8/17) 50.00 0.00 X 303231 0 163056 Thomas P McIlwain MD VP Med Affairs and CMO 50.00 5.00 X 556962 0 56071 Jeffrey L Oskin VP Administrator 50.00 0.00 X 463381 0 177302 Jeffrey H Goode VP Ambulatory Services 50.00 0.00 X 410677 0 229814 S Andrew Weber VP Administrator 50.00 0.00 X 341118 0 186454 Eileen Clark VP Info Svc & CIO 50.00 5.00 X 370208 0 127842 Stephen Z Bell VP Finance 50.00 0.00 X 326839 0 110965 Robert B Danielson VP Corporate Compliance 50.00 5.00 X 241489 0 108679 Glenn Crotty Jr MD Executive VP & COO 50.00 6.00 X 797373 0 46105 Michael D Williams VP Administrator 50.00 0.00 X 407343 0 322630 Randall H Hodges VP Administrator 50.00 0.00 X 331203 0 38126 Jeff Sandene Executive VP & CFO 50.00 10.00 X 494230 0 180188 Heidi Edwards VP Prof Prac & CNO (start 12/17) 50.00 1.00 X 196803 0 27826 Lillian Morris Interim CNO (end 12/17) 50.00 0.00 X 193671 0 9550 Robert B Shin MD Physician 40.00 0.00 X 1052205 0 11791 Samuel C Rossi MD Physician 40.00 0.00 X 914650 0 32646 John Deel MD Physician 40.00 0.00 X 904315 0 42171 Nathan Kister MD Physician 40.00 0.00 X 848934 0 39268 Christopher Adams MD Physician 40.00 0.00 X 846876 0 32631 Larry C Hudson Executive VP & CFO 0.00 0.00 X 117905 0 1288 Rocky Blake Former Interim VP Info Services 0.00 0.00 X 243669 0 35476 17416239 0 2965919 543 1 1 0 WVU Physicians of Charleston 3110 MacCorkle Ave SE Charleston WV 25304 GME/Physician Services 20800012 Charleston Area Radiation Therapy Center 100 Bayview Circle Newport Beach CA 92660 Radiation Therapy 10486925 MedAssets Supply Chain Systems PO Box 742081 Atlanta GA 303742081 Nursing Services 8685522 Jackson Nurse Professionals PO Box 404118 Atlanta GA 30384 Nursing Services 5568435 Universal Physician Services 1414 Lancaster Drive Marietta OH 45750 Physician Services 5279785 128 2054635 755329 755329 2809964 Net Patient Revenue 621990 1029404022 1029404022 Pharmacy 446110 23563629 1668589 21895040 Lab Services 621500 10011794 10011794 Cafeteria/Vending 721000 7041301 7041301 Rental (Non Residentia 531120 5738510 1794377 3944133 19429537 4069545 58264 15301728 1095188793 4344065 198723 4145342 472150 472150 55775034 55978688 -203654 -203654 -203654 Laundry 812300 1113954 1113954 Management Fees 541610 373173 373173 Medical Center Inn 721110 306879 306879 22516 22516 1816522 1104427840 1038951778 10070058 52596040 1242377 1242377 472371 472371 14370147 14370147 1808025 1275479 532546 409682770 348576513 61106257 12097011 10000810 2096201 80474813 66529930 13944883 28088664 22921389 5167275 15062218 11736023 3326195 5072540 5072540 625903 625903 172484 172484 994808 994808 98761165 79513423 19247742 1525385 157624 1367761 8219425 5188104 3031321 19241044 553188 18687856 19953954 12195457 7758497 3563108 1340086 2223022 87923 11989 75934 15884694 15884694 6332701 6332701 43754233 20118778 23635455 17462891 203889 17259002 Medical Supplies 225829378 225061803 767575 Provider Tax 30134630 30134630 Provision for Uncollect 27042353 25924161 1118192 Sales & Use Tax 11462738 11462738 23251210 5096753 18154457 1122670963 874587478 248083485 0 40125 40220 106404470 96191021 228012778 248297908 3179 680627 24057570 19438245 2889713 4753299 1077867164 705808802 381179656 372058362 21309119 8948379 90869961 97873873 35523541 34422709 83802535 90248025 974092647 972952668 152416242 153620119 13425150 13240028 288956234 279670233 12742 59885 84178831 82075544 7522653 5836194 52722700 58251396 599234552 592753399 X 333815832 332464151 28638365 34505258 12403898 13229860 374858095 380199269 974092647 972952668 X -18243123 17367564 -11 6216744 X 0 1 X 1 0 X 0 1 0 1 5654 0 0 1 162884 0 1 69425 237963 0 Part II-B, Line 1: Occasionally, individuals are asked by legislators at both the state and national levels for opinions on certain issues and the process of health-related legislation. At such time, CAMC representatives may hold discussions with legislative officials to present their information and perspectives regarding various health care issues. Such interactions do not typically involve CAMC expressing whether or not they support a particular bill, but rather consist of general discussions related to the pertinent health issues. CAMC is a member of the West Virginia Hospital Association, Association of American Medical Colleges, and 340B Health for Pharmaceutical Access. A percentage of the membership dues paid are related to lobbying activities. 0 1 X 41042263 1557388 5953945 818479 47735117 37936483 664817 3046608 605645 41042263 36907460 15881552 -1263368 12972453 616708 37936483 36316561 817450 1272837 1496226 3162 36907460 31115133 747434 5250714 793950 2770 36316561 0.28000 0.72000 0 1 1 28605461 28605461 504738541 258677391 246061150 11543284 8962998 2580286 509229274 428111635 81117639 23750604 10056778 13693826 372058362 Malpractice Fund 50138417 F Malpractice Fund 1347830 C Recruitment/Student Loan 2270984 C Workers Comp Self Insured Fund 360515 F Investments Other 6980961 C 2013 Note Project Fund 36775166 F 97873873 Interest in Net Assets - CAMC Foundation 47735117 Bond Debt Reserve Fund 12638148 Bond Collateral 16660000 Trustee Funds 7195615 Affiliate Receivable- CAMC Foundation 548038 Affiliate Receivable- CHERI 400568 Derivative Asset Value 5070539 90248025 Estimated Malpractice Claims 29893474 Estimated Workers Compensation Claims 1686715 Affiliate Payable- CAMC Foundation 49361 Affiliate Payable- CHERI 1288506 Settlements due to 3rd Parties 11862561 Estimated Retiree Health 1960383 Umbrella Trust & SERP 11510396 58251396 X Part IV, Line 2b: CAMC operates HealthCare Financial Services, which provides collections services to outside clients. Payments that are not recovered by the collection department include both the commission portion and the amount due to the outside client. The amount listing in Part X Line 21 reflects the amount CAMC needs transmitted to the client. Part V, Line 4: To further the mission of the organization. Part X, Line 2: CAMC's financial statements are audited as part of the financial statements of CAMC Health System, Inc. and Subsidiaries (collectively, the "System"). Language regarding ASC 740 (FIN 48) included in the consolidated footnotes is as follows: "The IRS has determined that CAMC, the Foundation, and the Institute are exempt from income taxes under Section 501 (c)(3) of the Code and applicable state statutes. The System does not have any material uncertain tax positions as of December 31, 2017." 1 1 X 1 X 1 X 1 1 0 1 1 18316638 18316638 0.01670 271139201 182411000 88728201 0.08080 2350704 1370637 980067 0.00090 291806543 183781637 108024906 0.09840 1542994 327524 1215470 0.00110 44550839 6833548 37717291 0.03430 1000394 634467 365927 0.00030 341073 341073 0.00030 47435300 7795539 39639761 0.03600 339241843 191577176 147664667 0.13440 200 200 0.00000 187077 187077 0.00020 8960 8960 0.00000 39981 39981 0.00000 144548 39711 104837 0.00010 380766 39711 341055 0.00030 0 24053321 0 299616033 449213712 -149597679 1 1 1 General Division Medical Office Building LLC Medical Office Space Rental 0.79930 0.20070 2 Charleston Area Radiation Therapy Centers LLC Radiation Therapy 0.20000 0.30000 4 1 CAMC Memorial Hospital 3200 MacCorkle Avenue Charleston WV 25304 www.camc.org 20 X X X X A 2 CAMC General Hospital 501 Morris Street Charleston WV 25301 www.camc.org 20 X X X X A 3 CAMC Women and Children's Hospital 800 Pennsylvania Avenue Charleston WV 253025302 www.camc.org 20 X X X X A 4 CAMC Teays Valley Hospital 1400 Hospital Drive Hurricane WV 25526 www.camc.org 20 X X X X B Facility Reporting Group - A 0 0 1 X X X X X X X X X 17 1 1 1 1 X See Part V, Section C. X www.healthykanawha.org X 1 17 1 See Part V, Section C. 0 1 X 200.000000000000 300.000000000000 X X 1 1 X X X 1 X http://www.camc.org/charity-uninsured-plan X http://www.camc.org/charity-uninsured-plan X http://www.camc.org/charity-uninsured-plan X X X X X X 1 X 0 X X X X 1 X 0 0 Facility Reporting Group - B 0 0 1 X X X X X X X X X 15 1 0 1 1 X See Part V, Section C. X 1 15 1 See Part V, Section C. 0 1 X 200.000000000000 300.000000000000 X X 1 1 X X X 1 X http://www.camc.org/charity-uninsured-plan X http://www.camc.org/charity-uninsured-plan X http://www.camc.org/charity-uninsured-plan X X X X X X 1 X 0 X X X X 1 X 0 0 Schedule H, Part V, Section B. Facility Reporting Group B Part V, Section B, line 7a: http://www.camc.org/documents/Community/2015-CAMC-Teays-Community-Benefit%20Needs-Assessment-and-Implementation-Strategies.pdfSchedule H, Part V, Section B. Facility Reporting Group BPart V, Section B, line 10a: http://www.camc.org/documents/Community/2015-CAMC-Teays-Community-Benefit%20Needs-Assessment-and-Implementation-Strategies.pdf Schedule H, Part V, Section B. Facility Reporting Group A Part V, Section B, line 7a: https://www.camc.org/documents/Community/2017-2019%20Community%20Health%20Needs%20Assessment%20and%202017%20-%202019%20Implementation%20Strategy.pdfSchedule H, Part V, Section B. Facility Reporting Group APart V, Section B, Line 10a:https://www.camc.org/documents/Community/2017-2019%20Community%20Health%20Needs%20Assessment%20and%202017%20-%202019%20Implementation%20Strategy.pdf Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: CAMC Memorial Hospital, - Facility 2: CAMC General Hospital, - Facility 3: CAMC Women and Children's Hospital Facility Reporting Group - A Part V, Section B, line 5: Household Telephone Survey:The household surveys were conducted using appropriate quality controlswhich included involving research experts in the design of the survey instrument, thorough and consistent training of interviewers, and the useof reputable survey-analysis software. The principal investigatorprovided oversight to the surveying process including data collection andentry. Data was collected and entered using a web-based survey. Thisreport was compiled and verified for accuracy by members of the KanawhaCoalition for Community Health Improvement. This survey sample sizeresults in a statistically significant 95% confidence interval with anerror margin of plus or minus 5.73%. Not all respondents answered everyquestion; therefore the margin of error was adjusted and reported for eachquestion, based on the number of respondents. Numbers too small to bestatistically significant were noted as such. An independent samplingfirm randomly selected landline telephone numbers for Kanawha Countyhouseholds. The random landline sample consisted of 8,600 numbers whichwas screened for disconnects and businesses, resulting in a list of 4,568numbers. A total of 26 nursing students received training andadministered the phone survey. After learning that the number of Americanhomes with only wireless telephones continues to grow and 47.4% ofAmerican homes had only wireless telephones (January - June 2015 NationalCenter for Health Statistics Survey), the Kanawha Coalition attempted toincrease the number of responses among younger residents and lower incomeresidents, by doubling the acquired address based sample of householdswith only wireless phones. The wireless sample of 5,600 householdsreceived postcards in the mail directing them to the online survey or tocall the Kanawha Coalition to arrange a convenient time to take the surveyby telephone. The Kanawha Coalition process works to ensure that thesurvey sample size is valid, and that the sample is randomly selected. Italso ensured that the fourth-year nursing students with the University of Charleston's School of Nursing were adequately trained in how toadminister the phone survey. As with any telephone survey, there arecertain limitations. The result of the survey depends on the accuracy ofthe responses given by the persons interviewed. Self-reported behaviormust be interpreted with caution. To assure proper sampling distribution,the demographics of the survey respondents were compared to countydemographics based on 2010-2015 U.S. Census Quickfacts data. Thiscomparison reveals an over-representation of respondents who were female,over 55 years of age, widowed, had no children in the home and wereCaucasian. There was an under-representation of African Americans, peoplewith lower-educational attainment (high school or less), those withchildren in the home, and those who had never been married.Focus Groups:To understand community needs, focus groups were held throughout KanawhaCounty in November 2016. As one component of the Coalition's five-partassessment, focus groups offer insight into the needs, concerns andexperiences of people whose voice is not often heard. Typically, focusgroups are comprised of a small group of individuals, usually a vulnerableor target population. In this case focus groups were organized incommunities located in different geographical locations in the county. Itis important to note that the results reflect the perceptions of somecommunity members, but may not necessarily represent all community membersin Kanawha County. A series of six focus groups were convened.Participants received gift cards for their completion of the focus group.The purpose of the discussion was to obtain input on issues that couldimpact the health of the residents of their communities. A total of 51 community members participated in focus groups in the followingcommunities: Cross Lanes, Elkview, Kanawha City, Marmet, Miami andLondon, WV. The Kanawha Coalition provided training to fourth-yearUniversity of Charleston-School of Health Science's nursing students to enable them to facilitate the groups. The students also compiled the results and prepared reports of the findings for the Kanawha Coalition.Steering Committee:Steering Committee Members are from the CAMC, Thomas Health System, Highland Hospital, Charleston Area Alliance, Kanawha County Schools, WV Bureau for Public Health, Partnership of African American Churches and the Kanawha Coalition for Community Health Improvement and they serve in an advisory capacity for the Coalition. The Steering Committee follows a set of Guiding Principles as it promotes and safeguards the integrity of the collaborative process as each assumes the role of an equal partner in the process. They make tangible commitments of resources to the Coalition and believe that the process is the product and serves as the vehicle to put people together to explore and address challenges and opportunities to improve the health of the people of Kanawha County. The Steering Committee is committed to including all members of the community in the community health needs assessment process as it cultivates a community-wide sense of ownership, not organizational ownership. It provides encouragement and support to keep Coalition volunteers engaged and motivated while remaining flexible in its approach to meeting community needs. It believes in continuous quality improvement and supports an ongoing process to evaluate and improve outcomes and it celebrates successes along the way. Members of the Kanawha Coalition Steering Committee actively participate in the survey planning process to provide public health insight and ensure data integrity. Additionally, epidemiologists from the West Virginia Department of Health and Human Services work with the Coalition for question design for consistency with other surveys to allow benchmarks and comparisons. In addition, Key Informant Interviews provide in-depth information on the community. The Steering Committee also provides contact information for key informants in the community.Key Informant Interviews:The 87 key informants representing 20 different sectors or areas of expertise in the community were given both standardized questions and open ended questions designed to elicit a full range of responses. They were asked to identify the top three populations in Kanawha County with unmet needs and to share their biggest concerns in terms of health risk behaviors, clinical care, social and economic factors and the physical environment. They were also asked to share the challenges and barriers they believed exist and how best to overcome them. Finally, they were asked to identify the top three overall issues in Kanawha County and what they believed to be the top three health related strengths and assets for the community. Facility Reporting Group - A Part V, Section B, line 6a: Thomas Health System (Thomas Memorial Hospital and St. Francis Hospital); Highland Hospital Facility Reporting Group - A Part V, Section B, line 6b: United Way of Central West Virginia; FamilyCare Health Center; Kanawha-Charleston Health Department; Kanawha County Schools; Spilman Thomas & Battle, PLLC; Kanawha Coalition for Community Health Improvement; Charleston Area Alliance; Partnership of African American Churches; WV Department of Health and Human Services. Facility Reporting Group - A Part V, Section B, line 11: The following community health need issues were identified as community priorities and funded as part of operational planning by the CAMC Board of Trustees: Drugs, Diabetes, Obesity, Heart Disease/Hypertension/Heart Attack/Stroke, Limited Access to Healthy Foods, Tobacco Use, Lack of Access to Mental Health and Addiction Services, and Cancer.Results for each of our Community Benefit Implementation Strategies and additional programs additional programs are described in detail in our 2017 Community Benefit Report and Report on 2017-2019 Implementation Strategies at www.camc.org. Some of the ways CAMC Memorial, General, and Women and Children's Hospitals addressed the significant needs identified in its most recently conducted CHNA are included below:1.) One of the community need issues identified is Drugs (all types, does not include alcohol). We addressed this community need issue through the CAMC Ryan White Program. In 2017, there were 368 participants (an 11.8% increase) and we provided $61,622 in unreimbursed care. We also developed a satellite Ryan White Program Clinic in Beckley, Raleigh County when the provider serving those residents left the area. The new clinic is located in the Beckley-Raleigh County Health Department and services are provided via a combination of providers and telemedicine equipment. We also addressed this issue with the Drug Addicted Mother Baby Program. In 2017, 672 mothers were identified and participated in the program at CAMC Women and Children's Hospital. This was a 22% increase over the previous year.2.) Another community need issue identified is Diabetes. We addressed this community need issue with our Outpatient Diabetes Education Program and information available through our Health Information Center. We also provided community screenings via our annual Healthfest and Teddy Bear Fair health fairs. 3.) Obesity was addressed via our continued provision of Play Patch, a 940square feet children's play area that includes fruit and vegetable themedplay equipment along with a family restroom at the local shopping mall.It was also addressed via a financial donation to create a walking trailin the community of Pinch. 4.) Heart Disease/Hypertension/Heart Attack/Stroke wasaddressed via community education provided via the CAMC Mall Walkers, BLSTraining for the Community, CAMC Healthfest and the Physician Guest Lecture Programs. Health Screenings for heart disease were also providedat the CAMC Healthfest. In all, over 2,000 residents of the communitywere impacted by CAMC's outreach efforts.5.) Limited Access to Healthy Foods is addressed through our Local WealthCreation "Value Chain program and our continued efforts to work with TheGreater Kanawha Valley Foundation to create and sustain a wealth creationvalue chain. This approach bridges conventional approaches to communityand economic development by using a systems framework, working with wealthcreation value chains. CAMC's 5 county primary service area is comprisedof 356,000 people with small increases in the size of the workingpopulation since 1990. 18% of people and 25% of children live in povertywith little improvement over of the past 10 years. The health connectionis that improvements in health care are associated with higherproductivity in the workforce and for the economy overall. The value chainpremises are that we need to be intentionally inclusive of local peopleand places as economic contributors to have a positive impact on wealth inour communities. This program's focus is on working with local growersto develop their capability to sell their produce to CAMC at a guaranteedquantity and price and once the process is established to roll it out toother "buyers". In 2017, we worked with over 100 individuals tocoordinate the number of growers providing fresh produce purchased by CAMCand to maintain and expand GAP certification.6.) Tobacco Use was addressed through "Tobacco Free for Baby and Me" cessation program for the 200 women who were identified as tobacco users in the CAMC Women's Medicine Center in 2017. The program had an 18.9% quit rate with quit validation (CO levels at non-smoker) at 72.5%. The program's quit rate continues to be above the National Quit Rate of 13%- 18%. A Certified Tobacco Treatment Specialist provides individual counseling four hours per week. The program Intake Form has been revised to compliment a research study on the usage of e-cigs in pregnant women. 7.) Lack of Access to Mental Health and Addiction Services was addressedthrough the Outpatient Mental Health Program offered through the CAMCFamily Resource Center. The program is for low income residents andserved 115 individuals in 2017.8.) Cancer was addressed through Breast Cancer Awareness Activities,Community Cancer Screenings, and our Healthy Steps Program, Look Good/Feel Better Program and participation in various community events such asRelay for Life and Run for Your Life. Facility Reporting Group - A Part V, Section B, line 13h: Other criteria considered for financial assistance eligibility: A financial assistance estimation tool that utilizes public records; and whether or not a patient receives assistance from certain state agencies. Part V, Section B Facility Reporting Group B Facility Reporting Group B consists of: - Facility 4: CAMC Teays Valley Hospital Facility Reporting Group - B Part V, Section B, line 5: United Way of Central WV completed a community survey in July 2015 to identify top health, education, income/economic and safety net issues for Putnam County. Survey Monkey web based tool was utilized. 105 responses were collected from Putnam County comprised of 75% female and 25% male. 2015 Putnam County Fair Survey on substance abuse with 91 adults and 120 youth completing the survey. In April 2015, 41 law enforcement officers responded to the question: What is the most concerning emerging trends with local youth substance abuse? Putnam Wellness Coalition completed Key Leader interviews with 10 participants on various issues. EnAct Community Action Agency conducted a needs assessment in Boone, Clay, Fayette, Kanawha and Putnam Counties. The project included surveying residents, interviewing community stakeholders, conducting secondary data research, facilitating an analysis retreat, and providing a summary report with key findings and recommendations. There were 131 responses from individuals who indicated residency in Putnam County. To further identify primary and chronic disease needs and other health issues of uninsured, low-income persons, and minority groups, the Advisory Committee reviewed Putnam County beneficiary utilization of United Way services. Dr. Michael Brumage, Executive Director/Health Officer of the Kanawha-Charleston Health Department, was consulted on the health needs of Putnam County. The Kanawha-Charleston Health Department assumed responsibility for the Putnam Country Health Department after the 2012 Putnam County Needs assessment was completed. A large percentage of Putnam County residents work and seek health care in Kanawha County, including at the Kanawha-Charleston Health Department. One of Dr. Brumage's staff now serves as administrator for both Kanawha-Charleston and Putnam County Health Departments. Although new to his job, Dr. Brumage is already active and vital participant of the Kanawha Coalition for Community Health Improvement and is committed to working with the United Way Putnam County Advisory Committee and CAMC Teays Valley Hospital to identify and address identified health issues. In addition, Dr. Brumage identified partnership opportunities that were incorporated into the Implementation Strategies for CAMC Teays Valley Hospital. Facility Reporting Group - B Part V, Section B, line 6a: The hospital facility's CHNA was not conducted with one or more other hospital facilities.Part V, Sec tion B, line 6b: AEP, United Way of Central WV, Cummins Crosspoint, Putnam County Wellness Coalition, Teays Valley Church of the Nazarene, Putnam County Manager, Putnam County Schools Facility Reporting Group - B Part V, Section B, line 11: The following health issues are identified as community priorities in 2015 for 2015-2017: Physical Inactivity; Afterschool Hunger (children); Unhealthy Diet; Drugs (heroin, prescription drugs); Alcohol Use; Tobacco Use; Parental Oversight (overall and particularly after school); Melanoma; Lack of Food (associated with poverty); Lack of Affordable Child Care. Implementation strategies for 2015-2017 with 2017 progress updatesinclude:1.) Providing physical activity opportunities for the at-risk cardiacpopulation. In 2015, an exercise program was established for patientsfollowing the completion of cardiac rehab and in 2017 the program hadnumerous participants, with 9,800 total visits.2.) Provide access to primary and specialty health care for the servicearea through medical staff recruitment. In 2017, new physicianrecruitment included Orthopedics (1) and Primary Care (2).3.) Divert non-violent youth who abuse alcohol and drugs to a drug andalcohol free future. In 2017, the Putnam County Juvenile Drug Courtprogram graduated 12 students with a continued very high success rate.4.) Provide food to low income children during the summer through thebackpack buddy program. In 2017, CAMC Teays worked with United Way andother community providers to provide this program over the summer thoughfunding and packing boxes for mailing.5.) CAMC Teays also addresses the physical activity priority health need through the CARDIAC Project, Camp Kno Koma, providing sports physicals to high school athletes, providing orthopedic coverage for area school sports and placing AEDs in all schools. Poverty is addressed through enrollment assistance for patients and families for health coverage and through charity care. 6.) Melanoma was addressed by having an oncology office located at Teays Valley hospital which allows easier access for individuals to get treatment.2017 results for each of CAMC Teays Valley Hospital Implementation Strategies and additional programs are described in detail in the CAMC Teays Valley Hospital Community Needs Assessment and Implementation Strategies 2015 - 2017 report found at www.camc.org. The following needs are not addressed by CAMC Teays Valley Hospital: Unhealthy Diet. This need is addressed by the CAMC Weight Loss Center. Alcohol Use is addressed by Alcoholics Anonymous. Lack of Affordable Child Care is not addressed because CAMC Teays does not have the capacity or funding to address this issue. Facility Reporting Group - B Part V, Section B, line 13h: Other criteria considered for financial assistance eligibility: A financial assistance estimation tool that utilizes public records; and whether or not a patient receives assistance from certain state agencies 15 1 - CAMC Imaging Center 60 RHL Boulevard South Charleston WV 25309 Outpatient Imaging Center 2 - CAMC Urgent Care Center 314 Goff Mountain Road Suite 3 Cross Lanes WV 25313 Urgent Care Facility 3 - CAMC Physical Therapy and Sports Med Ce 200 Tracy Way Charleston WV 253111258 Rehabilitation Facility 4 - CAMC Solutions 2568 Pennsylvania Avenue Charleston WV 253024907 Pharmacy Compounding Center 5 - CAMC Pharmacy (closed 817) 314 Goff Mountain Road Cross Lanes WV 25313 Pharmacy 6 - St Mary's Laboratory Services 2900 First Ave Suite 607 Huntington WV 25702 Laboratory Services 7 - CAMC Weight Loss Center 600 Tracy Way Suite 2 Charleston WV 25311 Weight Loss Center 8 - CAMC Primary Care-Nitro 4111 First Avenue 3 Nitro WV 25143 Family Practice 9 - CAMC Primary Care-Winfield 3456 Winfield Road Winfield WV 25526 Family Practice 10 - Plastic Surgery Center 210 Brooks Street Suite 200 Charleston WV 25301 Plastic Surgery 11 - Teays Valley Orthopedics 3703 Teays Valley Road Hurricane WV 25526 Orthopedic Center 12 - Urologic Surgical Center 11 Courtney Drive Charleston WV 25304 Urological Center 13 - Cardiology-South Charleston 4610 Kanawha Ave SW South Charleston WV 25309 Cardiology 14 - Cardiology-Summersville 400 Fairview Heights Road Summersville WV 26651 Cardiology 15 - Orthopedics- Madison 467 Main Street Suite 1 Madison WV 25310 Orthopedic Center Part I, Line 7: Utilized worksheet 2 to determine cost-to-charge ratio. Part I, Ln 7 Col(f): The Bad Debt expense included on Form 990, Part IX, Line 25(A),but subtracted for purposes of calculating the percentage inthis column, is $ 24,053,321. Part I, Line 3c CAMC may screen private pay balances for pre-qualified eligibility by using financial assistance estimation tools that access public records. Using a proprietary algorithm (looking at tax records, bankruptcies, etc), the tool returns whether the patient is likely to qualify for the Financial Assistance Policy. In cases where pre-qualified eligibility does not qualify a patient for financial assistance, the patient may complete a financial assistance application where application material is evaluated to determine if the patient can qualify based on income and assets. If the patient meets income criteria for eligibility an inventory of available assets is evaluated. If the patients available assets fall below $50,000 excluding the patients primary residence and primary vehicle, the patient will qualify for financial assistance. If a patient is found to be receiving certain State agency assistance (i.e. WIC, SNAP, etc), such patient will be presumed eligible for CAMC financial assistance, and an application for assistance needed to determine income and asset eligibility criteria will be unnecessary. Part II, Community Building Activities: CAMC Memorial, General and Women and Children's HospitalsCommunity building activities improve the community's health and safety by addressing the root causes of health problems. CAMC is a member of the Partners in Health Network, Inc. ("Partners"), which is comprised of a network of mostly small and rural hospitals, clinics and health departments who work together to address quality and educational needs for improving care management, assistance with NCQA accreditation for patient centered medical homes and improved quality through addressing sepsis and other health issues. Access to health care for 5,000 working uninsured individuals in central and southern West Virginia is provided through Partners' Community Access Program. Additionally, CAMC provides students enrolled in post-secondary education with related on-the-job training that is required for their graduation. Health Fairs for the community focusing on adults and children provide screening and health information to identify and address health issues. CAMC also partners with the Greater Kanawha Valley Foundation to create a value chain food system to support wealth creation for local growers.CAMC Teays Valley HospitalCommunity building activities improve the community's health and safety by addressing the root causes of health problems. CAMC Teays supports Medical Explorers, a program designed to introduce youth in Putnam County who have designated health care as their health cluster to the health care environment. This helps to addresses lack of parental oversight. Teays also supports the Putnam County Career Fair, Health Services Career Conference, and Portfolio Expositions where area high school students and adults are provided information on the educational requirements for health care careers. Hospital staff participate in the review of the student's school portfolio, resumes and conduct mock interviews with each student. CAMC Teays also supports health fairs to provide health information, bloodwork, and bicycle helmets. Part III, Line 2: This is the bad debt expense from the audited financial statements. Bad Debt is the net of discounts, payments and recoveries. Part III, Line 3: There is no amount of charity included in the bad debt expense due to all patients being run through a financial assistance estimator. Part III, Line 4: The footnote for Allowance for Uncollectible Accounts is on page 9 of CAMC Health System's audited financial statements. In summary, private pay accounts and amounts for deductibles and co-insurance that are deemed uncollectible that do not appear to meet the charity care guidelines are written off as bad debt expense and appear as a deduction from patient service revenue in the audited financial statements. Part III, Line 8: CAMC treats any government reimbursement that is insufficient to cover allocated costs as being a community benefit. CAMC chooses to serve the community by participating in the Medicare program and accepting Medicare reimbursement. Part III, Line 8: Cost to charge ratio from the Medicare costs report is used. Part III, Line 9b: CAMC's collection policy makes provisions for patients who qualify for financial assistance. Patients who receive financial assistance must have income at 300% or less of Federal Poverty Guidelines, insufficient assets to pay for the care, and may not be eligible for any public programs. Patients who qualify for financial assistance with income under 200% FPG are given a 100% discount. Patients who qualify for financial assistance with income between 201-300% FPG receive a 50% discount. All patient responsibility debt not approved for financial assistance is reviewed with a financial assistance estimator. This financial assistance estimator process is only used to approve assistance. It is not used to deny assistance. Accounts are only reviewed for Financial Assistance at the 100% discount category. This process is performed before extraordinary collection efforts. Patients without third-party coverage who do not qualify for charity are given a 50% discount from charges (which is greater than any commercial discount). In addition to charity and uninsured discounts, CAMC provides assistance with payment plans, government programs, and an Employee Assistance Program. Part VI, Line 2: CAMC supports and strengthens its key communities through a systematic approach that begins with our mission, vision and values. Annually during our strategic planning process we review the community health needs assessment findings and priorities to develop our community strategy. This strategy is based on issues identified through the needs assessment process and supplemented with findings from our internal Environmental Analysis. Communities are identified, strategies are identified and plans are funded, implemented, tracked and measured. Our Board approves the plan and reviews plan progress annually. Because of the size and scope of our services, the approach we use to identify our key communities is based on the strategy, key stakeholders needs, and our capacity. Our community for the KCCHI work groups is Kanawha County as determined by the KCCHI mission. For our CAMC community strategy, community is based on the need identified and population to be addressed. We develop Health Indicator Data Sheets for each of our service area counties and identify key issues to address for all or part of our service area. For example, our Perinatal Telemedicine Project includes 14 rural counties and our Child Advocacy Center and HIV program serve our entire service area. Each strategy is deployed through a planning process that addresses key stakeholder needs and is evaluated based on predetermined criteria for outcomes expected. Cycles of learning have ensured the Civic Affairs Council monetary contributions support community organizations in the service area that are clearly aligned with our community strategy. In addition to addressing community needs and contributing financially, our leadership team serves in key leadership roles for community activities, programs and organizations as well as supports the workforce in participating in many community benefit activities such as Day of Caring and HealthFest. CAMC Teays Valley Hospital supports and strengthens the Putnam County community through its annual planning process where the needs assessmentfindings and priorities are reviewed to develop its community strategy and the community(ies) within Putnam County that are impacted. This strategy is based on issues identified through the needs assessment process and supplemented with findings from review of internal data. Strategies are identified and plans are funded, implemented, tracked and measured. The CAMC Board Planning and Public Policy Committee and the CAMC Board of Trustees approve the plan and review plan progress annually. In addition to addressing community needs and contributing financially, CAMC Teays' Vice President and Associate Administrator serve in key leadership roles for community activities, programs and organizations as well as support the workforce in participating in many community benefit activities. As part of the strategic planning process, CAMC Teays determines if there are additional areas of support that can be provided to address the identified community health needs assessment issues. Part VI, Line 3: CAMC informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under CAMC's Financial Assistance Policy during the registration process. Information is available through signage and a plain language summary of the policy is given to each patient. In addition, Financial Assistance applications are available at each registration location. CAMC Financial Counselors are located in each Emergency Department and Admitting area. During registration, if a patient is uninsured, they may be referred to a Financial Counselor who provides education about Charity Care, Medicaid Eligibility and Federal Disability. WV State employees are also on site at each hospital to accept and process Medicaid applications and notify patients if they qualify. Part VI, Line 4: CAMC's community area of focus includes include our Primary and Secondary Service area. Our primary service area ("PSA") includes: Kanawha, Putnam, Fayette, Boone and Logan Counties. Our secondary service area ("SSA") is Jackson, Roane, Clay, Nicholas, Raleigh and Mercer Counties. Kanawha County constitutes a population of 185,662 with a median age of 43.2 and a household median income of $46,809. The PSA/SSA population is 573,706, with a median age of 43.2 and median income of $43,539. Teays' community and primary area of focus is Putnam County. Putnam County has a population of 52,674 with a median age of 42.5 and a household median income of $60,690. Demographic, health and socioeconomic information is provided in detail in the 2017 Community Benefit Reports found on www.camc.org. Part VI, Line 5: CAMC's governing board is its Board of Trustees, a 17 member volunteer community board that meets WV State law requirements for nonprofit board membership including community representation. Admission to the medical staff is open to all qualified physicians in the area, consistent with the size and nature of the facility. Each CAMC hospital operates a full-time emergency room open to everyone, regardless of ability to pay. CAMC serves a broad cross-section of the community through research and charity care. CAMC applies any surplus funds toward improving facilities, equipment, patient care, medical training, research and education. CAMC's Community Health Improvement Services, Health Professions Education, Financial and In-kind Contributions, Community and Building Activities are detailed in the Community Benefit Report on our website at www.camc.org. Part VI, Line 6: CAMC Health Education and Research Institute serves as the education and research arm of the CAMC Health System. The Institute promotes the health of the community by sponsoring health professional training programs training the region's health professionals in the community, region and state sponsoring management and leadership development programs, sponsoring community health education and prevention education programs for the community, conducting clinical and health services research targeted to improve health and health services delivery of our patients and community, pursuing special program funding and grants to support education and research programs, promoting economic development through its employment of approximately 80 full-time education, research and support staff and through its extramural and externally funded sponsored programs, promoting telehealth opportunities that link providers for health consultation and that improves access to health services to patients, creating linkages to education affiliates allowing approximately 800 learners to receive clinical training experiences at CAMC, sponsoring simulation training experiences for regional education affiliates, and promoting and sustaining networks and partnerships that improve access to clinical trials and research funding opportunities. The CAMC Foundations' mission is to support and promote CAMC's delivery of excellent and compassionate health services and CAMC's contribution to the quality of life and economic vitality of the region. This is accomplished through support of many services to CAMC patients and employees. Each year, the Foundation supports the Prevention First Program at CAMC Women and Children's Hospital. The Prevention First Program seeks to reduce medical costs, facilitate all aspects of health care, including support of the medical plan established by the primary care physician, while meeting the special needs of low-income children and families in the home environment. Specifically, the Prevention First Program promotes healthy outcomes that will decrease pre-term labor, infant mortality, unplanned C-Section rate, NICU/PICU length of stay and increase infant birth weight while promoting well-child care and immunizations. The Foundation also helps keep physicians and allied health care employees up-to-date by providing funding for many continuing education programs.Integrated Health Care Providers was an affiliated company of the CAMC Health System existing to support the mission of CAMC in striving to provide the best healthcare to every patient every day. IHCPI ceased operations as of December 31, 2017 and received Certificate of Dissolution on 3/20/2018; however, during the year when the CAMC Health System identified an essential patient need, an access issue for patients, or when the existing provider community cannot provide an essential service, IHCPI through its affiliation with the CAMC Health System works to fill the gaps. IHCPI operated sub-specialty physician practices primarily operated to support the tertiary care mission of CAMC. IHCPI practices see a disproportionate share of the underinsured in their physician practices. Part VI, Line 7, Reports Filed With States WV Part VI: The following disclosure is in accordance with Rev. Proc 2015-21 Section 7 in regards to Schedule H, Part V, Section B, Line 13:During the tax year, CAMC's financial assistance policy did not reflect a complete list of the providers delivering emergency or other medically necessary care in the hospital facilities. CAMC's financial assistance policy did include a provider list, however the provider list had not been updated since January 2016. This was discovered in April 2018 as CAMC worked with tax consultants on Schedule H for the 2017 Form 990. CAMC updated the provider list on June 29, 2018 and posted the updated provider list on the CAMC website. CAMC has also implemented procedures to ensure compliance with this requirement in the future. Going forward, CAMC will utilize a 501(r) compliance checklist to ensure compliance with the provider list requirement. CAMC plans to update the provider list and post the updated list to the CAMC website annually. Part VI: The following disclosure is in accordance with Rev. Proc 2015-21 Section 7 in regards to Schedule H, Part V, Section B, Line 22:During the tax year, CAMC did not timely update the calculation of Amounts Generally Billed ("AGB"). CAMC's financial assistance policy describes that CAMC intended to calculate AGB using the look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period. However, CAMC did not correctly calculate AGB using the method described in their financial assistance policy ("FAP"). CAMC did complete an analysis in which they believed they were complying with the 501(r) regulations and asserted at that time that no individual that qualified for financial assistance under the FAP was charged more than AGB. CAMC also did not list the percentage for AGB or provide a link to where the AGB percentage can be found on its website. This was discovered in April 2018 as CAMC worked with tax consultants on Schedule H for the 2017 Form 990. In April of 2018 CAMC calculated what the AGB would have been based on calendar year 2015 and 2016 data. CAMC believes that this fortunately did not cause any patients who qualify for financial assistance to be charged greater than AGB. This was evaluated by determining the AGB for claims allowed in calendar year 2015 and 2016 and comparing that to the discounts offered to patients who qualify for financial assistance under the financial assistance policy (either 50% or 100% discount, depending on patient eligibility). In April of 2018 CAMC also calculated the AGB percentage based on calendar year 2017 data and implemented the new AGB% and discount offered for those who qualify for financial assistance in their systems within the 120-day period allotted in the regulations. CAMC updated the financial assistance policy for the new AGB % and made the FAP widely available on its website and in paper format in September 2018. CAMC has also implemented procedures to ensure compliance with this requirement in the future. Going forward CAMC will utilize a 501(r) compliance checklist to ensure compliance with the AGB requirement. CAMC plans to complete the AGB calculation and update the FAP as required annually by April 15th. 1 University of Charleston 2300 MacCorkle Ave SE Charleston WV 253041099 550357039 501(c)(3) 285000 Nursing, Pharmacy and General Program Support BridgeValley Community and Technical College 619 2nd Avenue Montgomery WV 25136 465109796 273000 Nursing and General Support Braxton County Memorial Hospital 100 Hoylman Drive Gassaway WV 26624 550611919 501(c)(3) 200000 General Program Support WV Health Right Inc 1520 Washington Street Charleston WV 25311 311066881 501(c)(3) 140883 General Program Support Ronald McDonald House Charities of Southern West Virginia Inc 910 Pennsylvania Avenue Charleston WV 25302 550631080 501(c)(3) 17642 General Program Support Putnam County Chamber of Commerce PO Box 553 Teays Valley WV 25569 310951886 501(c)(3) 7500 General Program Support 5 1 Nursing Scholarships 112 162925 Allied Health Scholarships 52 57150 Medical Scholarships 49 107225 Employee Dependent Scholarships 38 47500 Employee Scholarships 144 97571 Part I, Line 2: CAMC provides nursing, allied health and medical student scholarships funded by the Foundation. An application portfolio is submitted by the candidate and reviewed and scored anonymously by the Foundation's Nursing Allied Health and Medical Student Scholarship committee co-chairs for subsequent scholarship award by the committee. CAMC provides employee and employee dependent scholarships. Candidates submit an application and required materials and a committee reviews applications based on scholarship guidelines and criteria and awards scholarships. Scholarship payments are submitted directly to the college or university on behalf of the recipient. CAMC provides support to the University of Charleston ("UC") nursing program and pharmacy school program. UC is a nonprofit, tax exempt organization. UC provided CAMC with an acknowledgement letter along with a giving history report. CAMC provides assistance to various community programs which are reviewed by the Civic Affairs Council for award or at the discretion of the Chief Executive Officer. X 0 1 1 1 0 0 0 0 0 1 0 David L Ramsey President, CEO & Trustee 810969 0 225000 0 3643251 0 227590 0 33453 0 4940263 0 3579630 0 John L Goad MD Trustee 697436 0 0 0 105 0 10800 0 20187 0 728528 0 0 0 Eric D Shouldis MD Trustee (start 1/17) 396088 0 13587 0 238 0 10800 0 34434 0 455147 0 0 0 Robert D Whitler VP Gov't & Comm Affairs 189945 0 36232 0 29015 0 9353 0 25296 0 289841 0 0 0 Ronald E Moore VP Prof Prac & CNO (end 10/17) 173576 0 52673 0 112205 0 192382 0 24405 0 555241 0 19386 0 Kristi Snyder VP Human Resources 259092 0 56660 0 35065 0 188995 0 11304 0 551116 0 23491 0 Angela Fenton Hill Secretary & Gen Counsel 271663 0 37490 0 12867 0 168798 0 28243 0 519061 0 0 0 Dale R Wood VP System Improv & CQO (until 8/17) 183948 0 60732 0 58551 0 152320 0 10736 0 466287 0 32885 0 Thomas P McIlwain MD VP Med Affairs and CMO 389966 0 86827 0 80169 0 30800 0 25271 0 613033 0 0 0 Jeffrey L Oskin VP Administrator 348992 0 67752 0 46637 0 158764 0 18538 0 640683 0 34174 0 Jeffrey H Goode VP Ambulatory Services 298012 0 61391 0 51274 0 190572 0 39242 0 640491 0 31519 0 S Andrew Weber VP Administrator 241708 0 56907 0 42503 0 149780 0 36674 0 527572 0 31471 0 Eileen Clark VP Info Svc & CIO 299970 0 55912 0 14326 0 106011 0 21831 0 498050 0 0 0 Stephen Z Bell VP Finance 208174 0 51579 0 67086 0 96813 0 14152 0 437804 0 35806 0 Robert B Danielson VP Corporate Compliance 179397 0 30621 0 31471 0 83596 0 25083 0 350168 0 21315 0 Glenn Crotty Jr MD Executive VP & COO 509168 0 155860 0 132345 0 10800 0 35305 0 843478 0 50880 0 Michael D Williams VP Administrator 301617 0 60108 0 45618 0 289236 0 33394 0 729973 0 30846 0 Randall H Hodges VP Administrator 213941 0 52850 0 64412 0 10800 0 27326 0 369329 0 0 0 Jeff Sandene Executive VP & CFO 415461 0 20000 0 58769 0 155955 0 24233 0 674418 0 0 0 Heidi Edwards VP Prof Prac & CNO (start 12/17) 141283 0 24421 0 31099 0 6034 0 21792 0 224629 0 0 0 Lillian Morris Interim CNO (end 12/17) 154117 0 18945 0 20609 0 7023 0 2527 0 203221 0 0 0 Robert B Shin MD Physician 1052205 0 0 0 0 0 10800 0 991 0 1063996 0 0 0 Samuel C Rossi MD Physician 914650 0 0 0 0 0 10800 0 21846 0 947296 0 0 0 John Deel MD Physician 904180 0 0 0 135 0 10800 0 31371 0 946486 0 0 0 Nathan Kister MD Physician 808761 0 0 0 40173 0 10800 0 28468 0 888202 0 0 0 Christopher Adams MD Physician 798225 0 0 0 48651 0 10800 0 21831 0 879507 0 0 0 Larry C Hudson Executive VP & CFO 17148 0 99759 0 998 0 1263 0 25 0 119193 0 0 0 Rocky Blake Former Interim VP Info Services 197555 0 25622 0 20492 0 9233 0 26243 0 279145 0 0 0 Part I, Line 1a CAMC provided temporary housing to Jeff Sandene as part of his move to Charleston during 2017. CAMC paid for part of the housing directly and treated that portion as taxable compensation. CAMC also reimbursed him for a small portion of his housing expenses. Part I, Line 1b CAMC does not have a policy specifically related to housing allowances. However, CAMC followed the organization's standard procedures for expense reimbursement. The allowed expenses for housing allowance were determined based on terms in the listed person's employment contract. CAMC followed IRS guidelines for determining taxability of such expenses. Part I, Line 3 The CAMCHSI Board of Directors Compensation Committee selects and supervises an independent consultant who advises the Committee on compensation arrangements and transactions between CAMC Health System, Inc. subsidiaries (including CAMC) and executives (including CAMC's CEO). The Committee uses the data to determine the total compensation of CAMC's CEO and other executive officers. This data is reviewed every two years or when a new person comes into an executive role. Part I, Lines 4a-b Ronald Moore received $61,895 severance in 2017. Ronald Moore is a participant in the CAMC Health System, Inc. Executive Severance Plan. Mr. Moore's separation from employment was deemed "Involuntary Termination of Employment Not For Cause and as such he is eligible to receive his regular salary and continuation of medical benefits for up to twelve months. Participation is subject to a confidentiality clause. Part I, Lines 4b: Supplemental Executive Retirement Plan ("SERP"). Participants are key officers of CAMCHSI and subsidiaries. Participant David Ramsey in 2017 was paid $3,208,522. Terms and Conditions of SERP plan: Defined Benefit. Vest at age 60, or later, if one time postponement is made prior to age 59. Deferred vesting date cannot be earlier than age 65 or later than age 68. Benefit at age 60 with 30 years of service is computed as the difference between 55% of Final Average Total compensation and sum of retirement benefits paid from: CAMC Health System, Inc. Qualified Retirement Plan, Non-Qualified Retirement Restoration Plan and 50% of projected age 62 Primary Social Security Benefit. Eligible to receive SERP benefits upon earliest of: normal retirement or date elected, if extended; death; disability; involuntary termination without cause. Early retirement at age 55 with at least 5 years of service reduced 1.83% for each year of service less 30 and 0.5% reduction for each month prior to Normal Retirement Date (age 60). Taxes due upon distribution. Subject to the Substantial Risk of Forfeiture. CEO Supplemental Executive Retirement Plan ("SERP"): Participant-CEO Terms and Conditions of CEO SERP Plan: Defined Contribution. Vest at age 65. Benefit at age 65 projected as the difference between 60% of Final 5 Year Average Total compensation and sum of retirement benefits paid from: CAMC Health System, Inc. Qualified Retirement Plan and 50% of projected age 65 Primary Social Security Benefit. Actual benefits will depend upon simulated investment results based on investment options selected by participant. Eligible to receive SERP benefits upon earliest of: deferred vesting date; death; disability; involuntary termination without cause. Taxes due upon vesting. Subject to the Substantial Risk of Forfeiture. Under the Execu-Flex Benefit Plan (409A), executives receive 11% of their salary in flex allowance. This flex allowance is used to elect executive benefits. Any remaining flex allowance is credited to a tax-deferred Capital Accumulation Account. The minimum vesting period is two years, maximum age is 68. A two year non-compete agreement (Substantial Risk of Forfeiture Agreement) applies if termination of employment occurs prior to the vesting date. Certain participants had amounts vested and included as reportable compensation this year, as detailed below: David L. Ramsey - $91,164 Dale R. Wood - $32,894 Glenn Crotty Jr., M.D. - $104,671 Thomas P. McIlwain, M.D. - $52,668 Jeffrey L. Oskin - $34,183 Michael D. Williams - $30,854 Ronald E. Moore - $19,391 Jeffrey H. Goode - $31,527 Kristi Snyder-$23,497 Randall H. Hodges - $26,157 S. Andrew Weber - $31,479 Stephen Z. Bell - $35,816 Robert D. Whitler - $15,937 Robert D. Danielson - $21,321 Part I, Line 7 The organization provides incentive payments to certain employees after operating and performance goals are achieved. Incentive payment plans are reviewed and approved by the CAMC Health System, Inc. Board of Directors Compensation Committee. A West Virginia Hospital Finance Authority 621256910 956624AQ3 2008-06-19 127355000 See Part VI 0 0 0 B West Virginia Hospital Finance Authority 621256910 956622ZV9 2009-09-10 177519271 See Part VI 0 0 0 C West Virginia Hospital Finance Authority 621256910 956622F74 2014-07-24 50641160 See Part VI 0 0 0 D West Virginia Hospital Finance Authority 621256910 000000000 2008-09-30 26000000 See Part VI 0 0 0 A 8565000 130398907 2071347 773024 94470515 33084021 2015 1 0 1 1 B 82145000 178397571 9032725 842090 2455533 17301803 2926790 146196700 2013 1 0 1 1 C 50641160 3605423 640714 50000446 1 0 1 1 D 8349959 26105219 146457 4214557 21744205 2013 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 1 Merrill Lynch Capital 29.200000000000 0 0 0 1 1 B 0 0 0 1 0 0 1 Wachovia 23.000000000000 1 1 1 C 0 1 0 0 0 0 1 Wachovia 23.000000000000 1 0 1 D 0 0 0 1 1 0 0 1 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: West Virginia Hospital Finance Authority Date the Rebate Computation was Performed: 06/30/2013 Issuer Name: West Virginia Hospital Finance Authority Date the Rebate Computation was Performed: 06/30/2014 Issuer Name: West Virginia Hospital Finance Authority Date the Rebate Computation was Performed: 06/30/2013 Schedule K Supplental Information Part I, Line A (F) Description of purpose: The proceeds for the 2008A Bonds were used to (i) currently refund the Series 1995A Bonds originally issued on 9/26/95, (ii) pay the costs of certain capital expenditures made, or to be made, by CAMC, refinance a bank loan, and (iii) pay the costs of issuing the Series 2008A Bonds, including certain fees of the bank. Part I Line B (F) Description of purpose: The proceeds for the 2009A Bonds were used to (i) currently refund the outstanding principal amount of the 2002 Series A and B Bonds originally issued on 9/24/02, (ii) pay a portion of a termination payment as a result of termination of hedge agreement in connection with the 2002 Bonds (an extraordinary working capital expenditure), (iii) fund a debt service reserve fund, and (iv) pay the costs of issuing the 2009 Bonds. Part I Line C (F) Description of purpose: The proceeds for the 2014A Bonds were used to (i) currently refund and extinguish a portion of the Series 2009A Bonds issued 9/10/2009 and (ii) pay the costs of issuing the 2014A Bonds. Part I Line D (F) Description of purpose: The proceeds of the 2008A Bonds were to refund a portion of a $30,000,000 temporary note used to finance the acquisition, construction and improvement of facility and to finance a project acquisition fund. Differences between the issue price (Part I) and total proceeds (Part II, line 3) are due to investment earnings. Working capital expenditures reported in Part II, Line 9, Column B consist of a swap termination payment. Part II, line 11, column B: Form 8038 reported that $148,894,025 of proceeds was to be used to retire the prior debt. The actual amount required for that purpose was $146,196,700. The remainder was deposited to a project fund and spent on capital expenditures eligible for tax-exempt financing. Part III has been completed for the column B bonds only with respect to the new money portion of the issue, as the refunding portion refunded pre-2003 debt. Part III has been completed for the column C bonds exactly the same as for the column B bonds, since the column C bonds current refunded a portion of the column B bonds. Part IV, Line 6, column A, B, and D: Such amounts were appropriately yield restricted. Rick Crotty Family Member of Glenn Crotty Jr., MD, Officer 63869 Employed by organization 0 Barbara Covelli Family member of Glenn Crotty Jr., MD, Officer 107511 Employed by organization 0 Donna Bell Family member of Stephen Z. Bell, Officer 171089 Employed by organization 0 Matthew Griffith Family member of James P. Griffith, MD, Trustee 24901 Employed by organization 0 John Snyder Family member of Kristi Snyder, Officer 84711 Employed by organization 0 Christine Oskin Family member of Jeffrey L. Oskin, Officer 128351 Employed by organization 0 Erik Reeder Family member of Glenn Crotty Jr., MD, Officer 45479 Employed by organization 0 Kim Goode Family member of Jeffrey H. Goode, Officer 40172 Employed by organization 0 Alexis McCormick Family member of Robert D. Whitler, Officer 45986 Employed by organization 0 Kellie Teel Family member of S. Andrew Weber, Officer 31497 Employed by organization 0 Janet Morris Family member of Lillian Morris, Officer 67240 Employed by organization 0 X Med. Analyzer 7 691225 FMV 0 0 0 0 Part I, Column (b): Column (b) refers to the number of items contributed. Form 990, Part VI, Section A, line 4 CAMC Bylaws amended January 25, 2017 to eliminate term limits for trustees 5.4 Term and Tenure Form 990, Part VI, Section A, line 6 CAMC Health System, Inc. ("CAMCHSI") is CAMC's sole voting member. Form 990, Part VI, Section A, line 7a CAMC Health System, Inc. ("CAMCHSI") is CAMC's sole voting member and has authority to elect all voting trustees of CAMC other than ex-officio trustees names in CAMC's governing documents. The sole voting member has the sole authority to amend CAMC's governing documents. Form 990, Part VI, Section A, line 7b CAMCHSI is CAMC's sole voting member and has reserved powers under CAMC's governing documents, which provide that decisions of CAMC's governing body, such as election of officers, approval of annual budgets and borrowings, are subject to approval by the sole voting member. The sole voting member also has all approval powers provided to members of West Virginia nonprofit corporations under state law. Form 990, Part VI, Section B, line 11b CAMC compiles necessary information for Form 990 through the efforts of various officers and trustees of the organization and its affiliates. The return is then prepared and reviewed by an external consultant firm. This firm then reviews the completed Form 990 with the CAMC Board of Trustees and its Audit Committee. Form 990, Part VI, Section B, line 12c Corporate officers, including the President and Secretary, develop the agendas for board meetings and identify and resolve potential conflict of interest issues relative to action items. Annual disclosure procedures are implemented and the board chair and Nominating Committee periodically review conflict situations. The organization's conflict of interest policy requires all disclosed conflicts to be reported by the Chief Compliance Officer to the CAMC Health System Management Compliance Committee. The Compliance Officer will inform the Board of Trustees Audit Committee at their next scheduled meeting of all such activities approved by the CAMC Health System Management Compliance Committee. The Manager (the direct supervisor of a company representative) may concur with the Compliance Officer's decision or may ask that CAMC Health System Management Compliance Committee review the Conflict of Interest Form in question. The CAMC Health System Management Compliance Committee will then review the conflict of interest in question at the next meeting and their decision is final. Form 990, Part VI, Section B, line 15 The CAMCHSI Board of Directors Compensation Committee selects and supervises an independent consultant who advises the Committee on compensation arrangements and transactions between CAMC Health System, Inc. subsidiaries (including CAMC) and executives. The Committee uses the data to determine the total compensation of CAMC's CEO and the other executives. The data is reviewed every two years or when a new person comes into an executive role. Form 990, Part VI, Section C, line 19 The organization's audit is part of a consolidated financial audit for CAMC Health System, Inc. and Subsidiaries. Consolidated audited financial statements are available on-line at CAMC.org. They are also filed with the WV Health Care Authority where they are available online and in person. There is no formal method of making the organization's Bylaws and Conflict of Interest Policy publicly available, but they are available upon request. The organization's Articles of Incorporation are on file at and publicly available through the West Virginia Secretary of State's Office. Form 990, Part XI, line 9: Increase/Decrease in beneficial interest in CAMC Foundation 6,692,855. Change in Affiliate Receivable 898,352. Affiliate Transfers: CAMC Health System, Inc. and Subsidiaries -657,753. Change in Retirement Obligation 1,660,962. Changes in Non-Controlling Interest 18,104. IHCPI Balance Transfer -2,395,776. CAMC Health System Inc PO Box 1547 Charleston WV 253261547 550664138 Parent Company WV 501(c)(3) Line 12c, III-FI N/A 0 CAMC Health Education and Research Institute Inc PO Box 1547 Charleston WV 253261547 550753754 Medical Educational Research WV 501(c)(3) Line 12b, II CAMC Health System Inc 1 CAMC Foundation Inc PO Box 1547 Charleston WV 253261547 310887133 Fundraising WV 501(c)(3) Line 7 CAMC Health System Inc 1 Women and Children's Medical Office Building LLC PO Box 1547 Charleston WV 253261547 550669065 Medical Office Building WV Charleston Area Medical Center Inc Related 275860 3226666 0 1 0.90440 General Division Medical Office Building LLC PO Box 1547 Charleston WV 253261547 550623949 Medical Office Building WV Charleston Area Medical Center Inc Related 507988 728760 0 1 0.79930 Integrated Health Care Providers Inc PO Box 1547 Charleston WV 253261547 550751010 Specialty Physician Practices WV N/A C 1 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 1 1 0 CAMC Foundation Inc C 2010235 Fair Market Value Women and Children's Medical Office Building LLC C 271327 Fair Market Value General Division Medical Office Building LLC C 479588 Fair Market Value CAMC Health Education and Research Institute Inc J 266161 Contract CAMC Foundation Inc K 591447 Contact Women and Children's Medical Office Building LLC K 1172074 Contract General Division Medical Office Building LLC K 1003936 Contract CAMC Health System Inc L 173796 Fair Market Value CAMC Health Education and Research Institute Inc L 437781 Fair Market Value CAMC Foundation Inc L 247221 Fair Market Value Women and Children's Medical Office Building LLC L 256108 Fair Market Value General Division Medical Office Building LLC L 194654 Fair Market Value CAMC Health Education and Research Institute Inc M 17767102 Contract CAMC Health Education and Research Institute Inc P 513535 Fair Market Value CAMC Health Education and Research Institute Inc Q 3289428 Fair Market Value CAMC Foundation Inc Q 319552 Fair Market Value Women and Children's Medical Office Building LLC Q 211382 Fair Market Value General Division Medical Office Building LLC Q 149371 Fair Market Value CAMC Health System Inc R 757809 Fair Market Value CAMC Health Education and Research Institute Inc R 6497101 Fair Market Value Integrated Health Care Providers Inc C 264456 Contract Integrated Health Care Providers Inc L 1509712 Contract Integrated Health Care Providers Inc P 394734 Fair Market Value Integrated Health Care Providers Inc Q 5064766 Fair Market Value CAMC Health Education and Research Institute Inc C 44400 Fair Market Value