2017-11-15T03:22:58-06:00 2016-12-31 861065772 Deloitte Tax LLP 111 S Wacker Drive Chicago IL 60606 990 2016-01-01 550526150 Charleston Area Medical Center Inc CHAR 3043885432 PO Box 1547 Charleston WV 253261547 Jeff Sandene Executive VP and CFO 3043885432 2017-11-14 1 Rachel Henderson-Pennington P01499421 3124861000 67.184.180.201 2017-11-14 23:20:37 CS P AE0B06613614058A5B8C3A2626B833A408B7625B AA00B1F84F9C7B153FAC1002728AC755A3241D24 2016 2021-01-29 14:40:06Z CAMC Jeff Sandene 501 Morris Street Charleston WV 25301 1450749976 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 8738 345 8212816 943056 6804457 3193134 974303527 1035128087 11182787 4345593 2105824 1889185 994396595 1044555999 1254437 1813274 0 0 420076656 499722499 0 0 0 556169032 560504597 977500125 1062040370 16896470 -17484371 984239646 974092647 605291610 599234552 378948036 374858095 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 699682077 648391 1036575965 CAMC is West Virginia's largest medical center with over 7,042 employees and 553 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 180,371, outpatient visits of 675,036, emergency department visits of 101,530 and deliveries of 2,701 in 2016. 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. 37811649 1011942 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. 132 WVU/WVSOM medical students trained at CAMC hospitals and 172 medical residents were employed by CAMC. CAMC provided faculty support to the University of Charleston and Bridgeview Community and Technical College helping educate pharmacy students, nursing students and physician assistance program. CAMC assisted 49 employees through student loan forgiveness, and distributed 374 scholarships. 94492408 152941 665157 CAMC does much more than just provide health care, being involved in nearly every aspect of the lives and well being of the community. CAMC offered 95 programs which served an estimated 102,165 people. CAMC provided acute inpatient and outpatient hospital services including unreimbursed charity care at cost of $18,895,221. 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. 831986134 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 1 663 0 1 8738 1 1 1 0 0 0 0 0 0 0 0 0 X 17 13 0 0 0 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 1145249 0 458285 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 3.00 X 727697 0 29766 James P Griffith MD Trustee 2.50 2.50 X 0 0 0 Samuel Shawn Groves MD Trustee 50.00 2.50 X 523014 0 40421 Melvin Jones Trustee 2.50 2.50 X 0 0 0 Brenda J Powell Trustee 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 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 242905 0 33046 Ronald E Moore VP Prof Prac & CNO 50.00 1.00 X 2124147 0 41518 Kristi Snyder VP Human Resources 50.00 6.00 X 323432 0 167182 Angela Fenton Hill Secretary & Gen Counsel (start 7/16) 50.00 6.00 X 278753 0 33144 Dale R Wood VP System Improv & CQO 50.00 0.00 X 827770 0 147368 Larry C Hudson Executive VP & CFO 50.00 10.00 X 664729 0 21508 Thomas P McIlwain MD VP Med Affairs and CMO 50.00 5.00 X 591858 0 69890 Jeffrey L Oskin VP Administrator 50.00 0.00 X 426102 0 146243 Jeffrey H Goode VP Ambulatory Services 50.00 0.00 X 378180 0 190169 S Andrew Weber VP Administrator 50.00 0.00 X 312089 0 157183 Eileen Clark VP Info Svc & CIO (start 2/16) 50.00 5.00 X 299823 0 49335 Stephen Z Bell VP Finance 50.00 0.00 X 308290 0 57704 Robert B Danielson VP Compliance 50.00 5.00 X 228927 0 91904 Glenn Crotty Jr MD Executive VP & COO 50.00 6.00 X 720974 0 59263 Marshall A McMullen Jr Secretary & Gen Counsel (end 7/16) 51.00 5.00 X 503397 0 48201 Michael D Williams VP Administrator 50.00 0.00 X 385151 0 271787 Randall H Hodges VP Administrator 50.00 0.00 X 313976 0 34563 Rocky Blake Interim VP Info Svc & CIO (end 2/16) 50.00 5.00 X 255855 0 33062 John Deel MD Physician 40.00 0.00 X 1173823 0 41021 Robert B Shin MD Physician 40.00 0.00 X 1108027 0 11567 Nathan Kister MD Physician 40.00 0.00 X 1067002 0 47284 Samuel C Rossi MD Physician 40.00 0.00 X 945269 0 31404 James Cox MD Physician 40.00 0.00 X 913434 0 41307 Gregory M Veltri Former VP Info Svc & CIO 0.00 0.00 X 285600 0 20203 17075473 0 2374328 535 1 1 0 WVU Physicians of Charleston 3110 MacCorkle Ave SE Charleston WV 25304 GME/Physician Services 21122103 Cerner Corporation PO Box 959156 Saint Louis MO 631959156 IT Service and Support 13254643 BBL Carlton LLC 600 Kanawha Blvd Suite 200 Charleston WV 25301 Contractor Services 10755667 Jackson Nurse Professionals PO Box 404118 Atlanta GA 30384 Nursing Services 9854611 Charleston Area Radiation Therapy 100 Bayview Circle Newport Beach CA 92660 Radiation Therapy 9568025 72 2524660 76860 591614 591614 3193134 Net Patient Revenue 621990 986725410 986725410 Pharmacy 446110 18896305 237526 18658779 Lab Services 621500 7996770 66133 7930637 Cafeteria/Vending 721000 7251544 7251544 Rental (Non Residentia 531120 5689019 954266 4734753 8569039 6519987 44653 2004399 1035128087 5012345 223850 4788495 -319681 -319681 405846906 406193977 -347071 -347071 -347071 Laundry 812300 1088602 1088602 Medical Center Inn 721110 362395 362395 Management fees 541610 345843 345843 92345 92345 1889185 1044555999 996378831 8212816 36771218 1359332 1359332 453942 453942 13607453 13607453 721139 338098 383041 383466971 330894038 52572933 12952646 10811384 2141262 62235093 52118974 10116119 26739197 21755198 4983999 18688725 12851520 5837205 2757852 2757852 606232 606232 97217 97217 1231504 1231504 99208661 71005195 28203466 1846962 407700 1439262 9528819 5775039 3753780 12046965 1261416 10785549 19972191 13158336 6813855 5002753 1508073 3494680 64289 22666 41623 15157767 15157767 9894097 9894097 39644985 22368493 17276492 11808535 1062405 10746130 Medical Supplies 212329157 211982589 346568 Provision for Uncollect 30419825 30419825 Provider tax 25821415 25821415 Sales & Use Tax 10541089 10541089 33835557 6716399 27119158 1062040370 831986134 230054236 0 42926 40125 214137333 106404470 148851462 228012778 4166 3179 20651924 24057570 3641809 2889713 1051523299 670343643 379377274 381179656 29383029 21309119 88840745 90869961 8559296 35523541 90749682 83802535 984239646 974092647 140545421 152416242 11291758 13425150 301173311 288956234 15856 12742 87482112 84178831 8952183 7522653 55830969 52722700 605291610 599234552 X 341011553 333815832 25826606 28638365 12109877 12403898 378948036 374858095 984239646 974092647 X -17484371 11636094 1758336 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 4411 0 0 1 101523 0 1 62920 168854 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 Safety Net Hospitals for Pharmaceutical Access. A percentage of the membership dues paid are related to lobbying activities. 0 1 X 37936483 664817 3046608 605645 41042263 36907460 15881552 -1263368 12972453 616708 37936483 36316561 817450 1272837 1496226 3162 36907460 31115133 747434 5250714 793950 2770 36316561 27674365 751017 3451658 758744 3163 31115133 0.30000 0.70000 0 1 1 28573062 28573062 478966161 243373582 235592579 11543284 8392182 3151102 496630611 409504311 87126300 35810181 9073568 26736613 381179656 Malpractice Fund 42384527 F Malpractice Fund 2747830 C Recruitment/Student Loan 2529942 C Workers Comp Self Insured Fund 192106 F Investments Other 6603166 C 2013 Note Project Fund 36412390 F 90869961 Interest in Net Assets-CAMC Foundation 41042263 Bond Debt Reserve Fund 12493282 Bond Collateral 13480000 Other Investments 446276 Affiliate Receivable-Foundation 1786682 Affiliate Receivable-CHERI 384581 Affiliate Receivable-Integrated 976447 Derivative Asset Value 4304565 Trustee Funds 8888439 83802535 Estimated Malpractice Claims 22692680 Estimated Workers Compensation Claims 1670700 Affiliate Payable-Foundation 49332 Affiliate Payable-CHERI 1494917 Affiliate Payable-IHCPI 194683 Settlements Due to 3rd Parties 10275784 Estimated Retiree Health 2236913 Umbrella Trust and SERP 14107691 52722700 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, 2016." 1 1 X 1 X 1 X 1 1 1 0 1 1 18895221 18895221 0.01830 247597763 142072000 105525763 0.10230 1372427 721387 651040 0.00060 267865411 142793387 125072024 0.12120 2550427 196459 2353968 0.00230 42471918 7188547 35283371 0.03420 746717 693927 52790 0.00010 454038 454038 0.00040 46223100 8078933 38144167 0.03700 314088511 150872320 163216191 0.15820 1100 1100 0.00000 165922 165922 0.00020 7360 7360 0.00000 42427 42427 0.00000 122204 49869 72335 0.00010 339013 49869 289144 0.00030 0 30595748 0 273181668 416967944 -143786276 1 1 1 General Division Medical Office Bldg Partnership Medical Office Space Rental 0.81930 0.18070 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 14 1 1 1 1 X www.camc.org/documents/community/2014/CBRG-Plan-2014-2016.pdf X www.healthykanawha.org X 1 14 1 www.camc.org/documents/community/2014/CBRG-Plan-2014-2016 0 1 X 200.000000000000 300.000000000000 X X 1 1 X X X 1 X http://www.camc.org/charity-uninsured-plan X www.camc.org/charity-uninsured-plan X 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 www.camc.org/charity-uninsured-plan X www.camc.org/charity-uninsured-plan X 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 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 controls which included involving research experts in the design of the survey instrument, thorough and consistent training of interviewers, and the use of reputable survey-analysis software. The principal investigator provided oversight to the surveying process including data collection and entry. Data was collected and entered using a web-based survey. This report was compiled and verified for accuracy by members of the Kanawha Coalition for Community Health Improvement. This survey sample size results in a statistically significant 95% confidence interval with an error margin of plus or minus 5.63%. Not all respondents answered every question; therefore the margin of error was adjusted and reported for each question, based on the number of respondents. An independent sampling firm randomly selected landline telephone numbers for Kanawha County households. The random landline sample consisted of 4,000 numbers which was screened for disconnects and businesses, resulting in a list of 2,000 numbers. A total of 16 individuals received training and administered the phone survey. After learning that the number of American homes with only wireless telephones continues to grow and the 39.4% of American homes had only wireless telephones (January - June 2013 National Health Interview Survey), the Kanawha Coalition acquired a random address sample of 5,000 additional Kanawha County residents which included wireless and some unlisted numbers. The wireless sample received postcards in the mail directing them to the online survey or to call the Kanawha Coalition to arrange a convenient time to take the survey by telephone. The Kanawha Coalition process works to ensure that the survey sample size is valid, and that the sample is randomly selected. It also ensured that the fourth-year nursing students with the University of Charleston's School of Nursing were adequately trained in how to administer the phone survey. As with any telephone survey, there are certain limitations. The result of the survey depends on the accuracy of the responses given by the persons interviewed. Self-reported behavior must be interpreted with caution. To assure proper sampling distribution, the demographics of the survey respondents were compared to county demographics based on 2010 U.S. Census data. This comparison reveals an over-representation of respondents who were female, over 55 years of age, had no children in the home and were Caucasian. There was an under-representation of African Americans, people with lower-educational attainment (high school or less), those with children in the home, and those who had never been married. The Kanawha Coalition conducted focus groups among individuals from these underrepresented populations. Focus group findings are intentionally reported independently from those of the scientific random survey to maintain fidelity. Focus Groups:Six focus groups were held in 2013. A total of 15 senior citizens, 14 single-parents, and 10 African Americans participated. Host sites for the focus groups included the Kanawha Institute for Social Research and Action (KISRA), Shiloh Baptist Church, the United Way of Central West Virginia (Retired Senior Volunteer Program), and the Martin Luther King Community Center (after school program). Focus group participants were asked to share their opinions about barriers and challenges facing their particular population regarding access to health services, social and economic factor (e.g. employment, education, assess to technology, and community attitudes surrounding discrimination, racism), the physical "built" environment (e.g. housing, access to healthy foods, air and water quality) and any other top health issues and pressing concerns. Facility Reporting Group - A Part V, Section B, line 6a: Thomas Health System (Thomas Memorial Hospital and St. Francis Hospital); Highland HospitalPart V, Section B, line 6b: United Way of Central West Virginia; FamilyCare Health Center; Kanawha-Charleston Health Department; Kanawha County Schools; Wellness Council of West Virginia; Spilman Thomas & Battle, PLLC; Kanawha Coalition for Community Health Improvement; Charleston Area Alliance. Facility Reporting Group - A Part V, Section B, line 11: The following health issues are identified as community priorities and funded as part of operational planning by the CAMC Board of Trustees: Obesity, Drugs/Prescription and Illicit, Lack of Physical Activity, Heart Disease/High Blood Pressure, Tobacco Use/Second Hand Smoke Exposure, Unemployment Jobs/Poverty, Cancer, Lung Disease/Asthma. Results for each of our Community Benefit Implementation Strategies and additional programs are described in detail in our 2016 Community Benefit Report and Report on 2014-2016 Implementation Strategies at www.camc.org. Some of CAMC Memorial, General and Women and Children's Hospital's 2016 outcomes for implementation strategies are included below:1.) Physician Drug Diversion training addressed the community need of Drugs/Prescription and Illicit. In 2014, there were 2,365 physician and mid-level providers who participated with an evaluation of 4.5 and 80% with a post-test passing score. In 2015, 1,458 participants had an evaluation of 4.4 with an 80% pass rate. There were 151 total participants in 2016 including physicians and mid-level providers. This was a three year program that ran between July 3, 2013 and July 31, 2016. Participant evaluation average was 4.4 on a 1-5 Likert Scale and there was an 80% pass rate.2.) We addressed the community need of Cancer, Lung Cancer through continued growth in 2015 of our nurse navigator and survivorship program. The navigators had over 7,600 encounters in 2015 with overall satisfaction of 94%. The survivorship program provided care plans for 30 patients and saw 15-20 patients/week. In 2016, the Breast Navigator saw 1,102 patients. The navigator position has been instrumental in assisting the physicians with the OncotypeDX testing to expedite the time to treatment process and to assist with the Breast Multi-disciplinary clinic. The Breast Cancer Support Group meets every Thursday, with attendance of up to 23 survivors. This group will be participating in the filming of a video to be presented at Mountains of Hope Cancer Coalition, the CAMC website and YouTube, as well as an upcoming communication workshop in Spring 2017.Lung/Head and Neck Navigator saw 1,120 patients in 2016. The navigator has screened 344 patients with 30 LRad 4s and assists LRad 4 patients through a multi- disciplinary team that meets monthly to review all cases and offer their expertise. All navigators are active participants in the Mountains of Hope Cancer Coalition and multiple cancer education/screening and outreach opportunities. They are assisting in the first upcoming fashion show for patients and family members with the various cranial prosthetics, mastectomy/prosthetic garments, compression garments and ostomy cover ups. Navigators supported the first Cancer Screening & Prevention Day held at the CAMC Cancer Center in March 2016 to provide cancer screenings and education on the prevention of cancers. Other community events included: Run for Your Life Run/Walk, ALA Bike Trek, ALA Lung Expo, Housing Development screenings, Health Fest and other community health fairs as invited. The Colon/GI Navigator saw 948 patients in 2016. The Colon/GI Navigator monitors and trains staff on the importance of proper distress screening in oncology patients and represented CAMC Cancer Center at the American Psychosocial Oncology Society (APOS) Conference poster presentation on Distress Screening practices in March 2016. They also represented CAMC Cancer Center at the Academy of Oncology Nurse & Patient Navigators (AONN) Conference in November 2016, where work on Distress Screening was submitted as an abstract for Best Practice. The Colon/GI Navigator has achieved national certification testing. Financial Navigators had 1,157 patient encounters. Survivorship Care - Our goal for 2016 was 25% of all patients diagnosed and/or treated with a curative intent have a survivorship visit. Achieved 26%. 75 total care plans given in 2016. 189 appointments scheduled. 3.) Our Healthy Kids Program addresses the community need of Obesity and began 12 years ago offering group visits only one evening a week. In 2013, clinical time was increased to 3 clinics per week and 1 evening group. The new patient volume has nearly doubled with 33, 61 and 74 new patients in years 2014 to 2016, respectively. Group session occurs each Tuesday evening with group nutrition education and group exercise. The kid's gym has been expanded to include more age appropriate portable physical activity equipment and a new A-frame Iron Range Training system. Services were increased to our patients and families including guest speakers, grocery store tours, menu planning and monthly cooking classes which contributed to their success. The access has also improved with decreasing 3rd appointment time out for a new patient from 39 days in 2013 to 14 days in 2016. We no longer have a waiting list and can schedule patients when they call. Total patient visits volumes have also increased from 227 encounters to 320 encounters which does not include the evening group visits. The 3rd appointment out for existing patients is 9 days. Healthy Kids celebrated with outstanding clinical outcomes in 2014 with 96% of patients lowering their BMI from their first to last documented office visit. A retrospective study was completed in 2016 looked at initial success and long-term weight management. Results showed 91% of patients decreased their BMI z-score (a standard deviation score to directly compare BMI's). At an average of 8 years later, 69.2% of these patients kept their weight off successfully. This research study won first place in original research in April, 2017 at the CAMC Research Day. Increasing exposure for Healthy Kids services for all children was facilitated by a new website and brochure and hosting displays at various conferences. 4.) Obesity is also addressed through our KEYS 4 Healthy Kids program. In 2016, KEYS 4 Healthy Kids increased reach in the public school setting with youth gardens, and childcare center nutrition and physical activity improvements. From 2014-2016, KEYS worked with 61 child care centers in 24 counties across the state. In 2016, KEYS worked with 9 schools impacting 4,837 WV students. KEYS also worked with the WV Bureau for Public Health and the Harvard Prevention Research Center to complete a return on investment cost analysis for Key 2 a Healthy Start as a primary obesity prevention initiative. As a result, it was estimated that 752 cases of obesity would be prevented. 5.) Tobacco Use was addressed through "Tobacco Free for Baby and Me" cessation program for the 326 women who were identified as tobacco users in the CAMC Women's Medicine Center in 2015. The program had a 20% quit rate compared to the national quit rate of 13%. In addition, quit validation is 79%. The "Tobacco Free For Baby and Me" cessation program reported an average 23% quit rate in 2016. The program's quit rate continues to be above the National Quit Rate of 13%- 18%. Quit Validation is reported at 87%. The program provides a Certified Tobacco Treatment Specialist for 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.6.) Cancer was addressed through our work to provide Medical Homes/Neighborhood and the increase in preventive screenings. In 2016 the Family Medicine Center achieved NCQA PCMH Level 2 Recognition and will apply for renewal in 2019. The following preventive health screenings were achieved: Breast Cancer Screenings - 46% July 2015 to 75% May 2017 Colorectal Cancer Screenings - 31% July 2015 to 94% Cervical Cancer Screenings - 49% July 2015 to 85%Flu Vaccines - 81% of FMC patients received flu vaccine 7.) Unemployment Jobs/Poverty is addressed through building the base of local growers providing vegetables to CAMC. As of 2016, West Virginia now has 14 GAP certified growers. Local efforts include working with State Department of Agriculture to increase the number of training classes and timeliness of the certification process. Met with growers and interest has increased and growers were supported in developing their Farm Safety Plans. One grower provided CSA boxes to 100 CAMC employees and medical staff for the 2016 season. For the 2016 growing season (6/15/16 - 10/31/16), West Virginia, Ohio and Kentucky sourced product was $42,477 which is 20.2% of net purchases. This includes 2,346 of the 10,752 pieces or 21.8% of total pieces were local. The following community health priority was not addressed by CAMC: High School Dropout. This issue continues to be addressed by United Way of Central WV, Kanawha County Schools and State Department of Education with improving results. 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 2016 progress updates include: 1.) Providing physical activity opportunities for the at-risk cardiac population. In 2015, an exercise program was established for patients following the completion of cardiac rehab and in 2016 the program had 117 participants.2.) Provide access to primary and specialty health care for the service area through medical staff recruitment. In 2016, new physician recruitment included Pulmonology (1) and Anesthesiology (2).3.) Divert non-violent youth who abuse alcohol and drugs to a drug and alcohol free future. In 2016, the Putnam County Juvenile Drug Court program graduated 15-20 students with a continued very high success rate. 4.) Provide medical supplies for each Putnam County Library for use in emergency situations. As of 2016, each classroom in Putnam County, all libraries and police were provided with emergency kits. 5.) Provide food to low income children during the summer through the backpack buddy program. In 2016, CAMC Teays worked with United Way and other community providers to provide this program over the summer though funding and packing boxes for mailing. 6.) Melanoma was addressed through participation in the Woman Up Conference with information and education on melanoma.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.2016 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. 12 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 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 Part I, Line 7: Utilized worksheet 2 to determine cost-to-charge ratio. 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 $ 30,595,748. 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. One of the root causes CAMC addresses is lack of jobs. As a result, CAMC partners with the Greater Kanawha Valley Foundation, the WV Department of Agriculture and Cory Brothers Food Distributors to create a value chain food system to support wealth creation for local growers.CAMC is also a member of the Partners in Health Network 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. The focus is on strengthening local providers to improve access to care. 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 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 are no longer any 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 measure. 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 Kanawha Coalition Community Health Improvement ("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 assessment findings 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 PSA includes: Kanawha, Putnam, Fayette, Boone and Logan Counties. Our SSA is Jackson, Roane, Clay, Nicholas, Raleigh and Mercer Counties. Kanawha County constitutes a population of 190,359 with a median age of 43.7 and a household median income of $43,309. The PSA/SSA population is 594,570, with a median age of 43.3 and median income of $42,432. Teays' community and primary area of focus is Putnam County. Putnam County has a population of 53,553 with a median age of 43.4 and a household median income of $52,703. Demographic, health and socioeconomic information is provided in detail in the 2016 Community Benefit Reports and the Community Health Needs Assessment 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 Foundation's 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 (IHCPI) is 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. When the CAMC Health System identifies 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. Currently, IHCPI operates a host of sub-specialty physician practices primarily operated to support the Level I trauma and 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 1 WV Health Right Inc 1520 Washington Street Charleston WV 25311 311066881 501(c)(3) 145940 General Program Support Ronald McDonald House Charities of Southern West Virginia Inc 910 Pennsylvania Avenue Charleston WV 25302 550631080 501(c)(3) 312001 General Program Support Braxton County Memorial Hospital 100 Hoylman Drive Gassaway WV 26624 550611919 501(c)(3) 200000 General Program Support American Heart Association 162 Court Street Charleston WV 25301 135613797 501(c)(3) 8000 General Program Support American Red Cross 113 Lakeview Drive Charleston WV 25313 530196605 501(c)(3) 25000 General Program Support Fund for the Arts 803 Quarrier Street 100 Charleston WV 25301 550614854 501(c)(3) 7500 General Program Support Hospice Care 1606 Kanawha Blvd W Charleston WV 253872536 341337316 501(c)(3) 23000 General Program Support West Virginia Chamber of Commerce PO Box 2789 Charleston WV 25330 550306990 501(c)(6) 12000 General Program Support YMCA of Kanawha Valley 100 YMCA Drive Charleston WV 25311 550357058 501(c)(3) 6000 General Program Support 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 9 2 Nursing Scholarships 114 158200 Allied Health Scholarships 51 58000 Medical Scholarships 40 106225 Employee Dependent Scholarships 34 42500 Employee Scholarships 135 89017 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. 1 1 0 0 0 0 0 1 0 David L Ramsey President, CEO & Trustee 785590 0 225000 0 134659 0 435062 0 23223 0 1603534 0 81011 0 John L Goad MD Trustee 686465 0 0 0 41232 0 10600 0 19166 0 757463 0 0 0 Samuel Shawn Groves MD Trustee 473679 0 0 0 49335 0 10600 0 29821 0 563435 0 0 0 Robert D Whitler VP Gov't & Comm Affairs 183989 0 31836 0 27080 0 8937 0 24109 0 275951 0 0 0 Ronald E Moore VP Prof Prac & CNO 224332 0 41129 0 1858686 0 29710 0 11808 0 2165665 0 1294367 0 Kristi Snyder VP Human Resources 246628 0 46369 0 30435 0 163283 0 3899 0 490614 0 19117 0 Angela Fenton Hill Secretary & Gen Counsel (start 7/16) 244062 0 16711 0 17980 0 10276 0 22868 0 311897 0 0 0 Dale R Wood VP System Improv & CQO 267855 0 48450 0 511465 0 137228 0 10140 0 975138 0 200480 0 Larry C Hudson Executive VP & CFO 443147 0 102650 0 118932 0 10600 0 10908 0 686237 0 0 0 Thomas P McIlwain MD VP Med Affairs and CMO 381829 0 61844 0 148185 0 45727 0 24163 0 661748 0 62265 0 Jeffrey L Oskin VP Administrator 332287 0 48321 0 45494 0 135395 0 10848 0 572345 0 32851 0 Jeffrey H Goode VP Ambulatory Services 286294 0 49545 0 42341 0 159348 0 30821 0 568349 0 24158 0 S Andrew Weber VP Administrator 232331 0 44482 0 35276 0 125362 0 31821 0 469272 0 24340 0 Eileen Clark VP Info Svc & CIO (start 2/16) 261224 0 20000 0 18599 0 30087 0 19248 0 349158 0 0 0 Stephen Z Bell VP Finance 203675 0 40311 0 64304 0 46364 0 11340 0 365994 0 33029 0 Robert B Danielson VP Compliance 175770 0 24717 0 28440 0 70701 0 21203 0 320831 0 18437 0 Glenn Crotty Jr MD Executive VP & COO 499035 0 121897 0 100042 0 36040 0 23223 0 780237 0 46071 0 Marshall A McMullen Jr Secretary & Gen Counsel (end 7/16) 182124 0 39664 0 281609 0 35622 0 12579 0 551598 0 51732 0 Michael D Williams VP Administrator 290651 0 44251 0 50249 0 247628 0 24159 0 656938 0 27415 0 Randall H Hodges VP Administrator 209248 0 42762 0 61966 0 10600 0 23963 0 348539 0 0 0 Rocky Blake Interim VP Info Svc & CIO (end 2/16) 205153 0 33902 0 16800 0 9866 0 23196 0 288917 0 0 0 John Deel MD Physician 1173823 0 0 0 0 0 10600 0 30421 0 1214844 0 0 0 Robert B Shin MD Physician 1108027 0 0 0 0 0 10600 0 967 0 1119594 0 0 0 Nathan Kister MD Physician 1026829 0 0 0 40173 0 10600 0 36684 0 1114286 0 0 0 Samuel C Rossi MD Physician 945269 0 0 0 0 0 10600 0 20804 0 976673 0 0 0 James Cox MD Physician 913434 0 0 0 0 0 10600 0 30707 0 954741 0 0 0 Gregory M Veltri Former VP Info Svc & CIO 0 0 0 0 285600 0 0 0 20203 0 305803 0 0 0 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 Gregory Veltri received $285,344 severance in 2016. CAMC has a Mutual Severance Agreement with Mr. Veltri which states "Although Veltri will no longer be performing duties or exercising any responsibilities, CAMCHSI will continue to pay Veltri his bi-weekly pay check through December 2016." Part I, Lines 4a-b Supplemental Executive Retirement Plan ("SERP"). Participants are key officers of CAMCHSI and subsidiaries. Participant Ronald Moore in 2016 was paid $1,805,731. 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 - $82,157 Dale R. Wood - $31,135 Larry C. Hudson - $73,618 Glen Crotty Jr., MD - $72,240 Thomas P. McIlwain, M.D. - $120,635 Jeffrey L. Oskin - $32,856 Michael D. Williams - $27,419 Ronald E. Moore - $20,291 Jeffrey H. Goode - $24,162 Kristi Snyder-$19,120 Randall H. Hodges - $24,064 S. Andrew Weber - $24,344 Stephen Z. Bell - $33,034 Robert D. Whitler - $13,707 Robert D. Danielson - $18,440 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 6915000 130398907 2071347 773024 94470515 33084021 2015 1 0 1 1 B 75720000 178397572 8929186 842090 2455533 17301803 2926790 146196700 2013 1 0 1 1 C 50641160 3564096 640714 50000446 1 0 1 1 D 7231460 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 2009 A Bonds issued 9/10/2009 and (ii) pay the costs of issuing the 2014 A 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, columns A, B, and D: Such amounts were appropriately yield restricted. Rick Crotty Family member of Glenn Crotty Jr., MD, Officer 63050 Employed by organization 0 Barbara Covelli Family member of Glenn Crotty Jr., MD, Officer 105484 Employed by organization 0 Donna Bell Family member of Stephen Z. Bell, Officer 169663 Employed by organization 0 Matthew Griffith Family member of James P. Griffith, MD, Trustee 24836 Employed by organization 0 Gloria Jean Morgan Family member of Kristi Snyder, Officer 14471 Employed by organization 0 John Snyder Family member of Kristi Snyder, Officer 88163 Employed by organization 0 Christine Oskin Family member of Jeffrey L. Oskin, Officer 123422 Employed by organization 0 Erik Reeder Family member of Glenn Crotty Jr., MD, Officer 44658 Employed by organization 0 Kim Goode Family Member of Jeffrey H. Goode, Officer 47734 Employed by organization 0 James Williams Family Member of Gregory Veltri, Former Officer 35964 Employed by organization 0 Alexis McCormick Family Member of Robert D. Whitler, Officer 39959 Employed by organization 0 Kellie Teel Family Member of S. Andrew Weber, Officer 45178 Employed by organization 0 X Med. Analyzers 3 591614 FMV 0 0 1 0 Part I, Column (b): Column (b) refers to the number of contributors. 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 the 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 online 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 3,105,780. Change in Affiliate Receivable Balance 853,522. Affiliate Transfers: CAMC Health System, Inc. and Subsidiaries -1,506,462. Change in Retirement Obligation -603,114. Changes in Non-Controlling Interest -91,390. 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 Partnership PO Box 1547 Charleston WV 253261547 550669065 Medical Office Building WV Charleston Area Medical Center Inc Related 77377 3222133 0 1 0.90440 General Division Medical Office Building Partnership PO Box 1547 Charleston WV 253261547 550623949 Medical Office Building WV Charleston Area Medical Center Inc Related 331003 700360 0 1 0.81930 Integrated Health Care Providers Inc PO Box 1547 Charleston WV 253261547 550751010 Specialty Physician Practices WV N/A C 1 0 1 1 0 0 0 0 0 0 1 1 1 1 0 0 1 1 1 0 CAMC Health System Inc L 118859 Fair Market Value CAMC Health System Inc R 763987 Fair Market Value CAMC Health Education and Research Institute Inc J 264857 Contract CAMC Health Education and Research Institute Inc M 17361977 Contract CAMC Health Education and Research Institute Inc L 418836 Fair Market Value CAMC Health Education and Research Institute Inc P 448480 Fair Market Value CAMC Health Education and Research Institute Inc Q 3331828 Fair Market Value CAMC Health Education and Research Institute Inc R 6120047 Fair Market Value CAMC Foundation Inc C 2524660 Fair Market Value CAMC Foundation Inc K 591447 Contract CAMC Foundation Inc L 240156 Fair Market Value CAMC Foundation Inc Q 455386 Fair Market Value Integrated Health Care Providers Inc B 3622807 Contract Integrated Health Care Providers Inc K 253083 Contract Integrated Health Care Providers Inc L 3599202 Contract Integrated Health Care Providers Inc P 1460834 Fair Market Value Integrated Health Care Providers Inc Q 7780504 Fair Market Value Integrated Health Care Providers Inc R 893717 Fair Market Value Women and Children's Medical Office Building Partnership C 180885 Fair Market Value General Division Medical Office Building Partnership C 327725 Fair Market Value Women and Children's Medical Office Building Partnership K 1147038 Contract General Division Medical Office Building Partnership K 959631 Contract Women and Children's Medical Office Building Partnership L 256108 Contract General Division Medical Office Building Partnership L 194795 Contract Women and Children's Medical Office Building Partnership Q 204320 Fair Market Value General Division Medical Office Building Partnership Q 164863 Fair Market Value