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SUMMERSVILLE REGIONAL MEDICAL CENTER: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
SUMMERSVILLE REGIONAL MEDICAL CENTER (EIN 55-0491651)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-14
IRS object ID
201643199349308099
Schema version
2015v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-11-14T16:00:31-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN550486667PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1P O Box 2629AddressLine1Txt
CityCharlestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25329ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550491651EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Summersville Regional Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSUMMBusinessNameControlTxt
Phone3048722891PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 Fairview Heights RoadAddressLine1Txt
CitySummersvilleCityNm
State AbbreviationWVStateAbbreviationCd
ZIP266519308ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJoe A BarnesPersonNm
Person TitleCFOPersonTitleTxt
Phone3048722891PhoneNum
Signature2016-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTessa W CarrPreparerPersonNm
PTINP01291277PTIN
Phone3043460441PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDaniel AyresPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 Fairview Heights RoadAddressLine1Txt
CitySummersvilleCityNm
State AbbreviationWVStateAbbreviationCd
ZIP266519308ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$57,818,449GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.summersvilleregional.orgWebsiteAddressTxt
Type Of Organization OtherYes (X)TypeOfOrganizationOtherInd
Other Organization DscMunicipal Public WorkOtherOrganizationDsc
Formation1968FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionSummersville Regional Medical Center provides acute care services through 53 licensed beds including Intensive Care Unit, Medical/Surgery, OB and Swing Bed. In addition there are 52 extended care beds providing Long Term Care services to the residents. Summersville Regional Medical Center operates an Emergency Room taking all patients regardless of insurance in conjunction with a regional medical center approach, connecting patients to tertiary care facilities as necessary for services. Ancillary diagnostic services are also provided including Lab, X-ray, CT, MRI, Ultrasound, PT/OT, Nuclear medicine, Surgery, and Emergency Room. Physician clinics include Rural Health Clinics, Surgery practice, Women's health practice and Orthopedics practice.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee636TotalEmployeeCnt
Total Volunteers30TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$7,660PYContributionsGrantsAmt
CY Contributions Grants$80,426CYContributionsGrantsAmt
PY Program Service Revenue$44,644,258PYProgramServiceRevenueAmt
CY Program Service Revenue$54,178,542CYProgramServiceRevenueAmt
PY Investment Income$94,270PYInvestmentIncomeAmt
CY Investment Income$58,866CYInvestmentIncomeAmt
PY Other Revenue$2,350,122PYOtherRevenueAmt
CY Other Revenue$2,262,647CYOtherRevenueAmt
PY Total Revenue$47,096,310PYTotalRevenueAmt
CY Total Revenue$56,580,481CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,500CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$30,181,725PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$30,778,113CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$19,538,408PYOtherExpensesAmt
CY Other Expenses$27,937,977CYOtherExpensesAmt
PY Total Expenses$49,720,133PYTotalExpensesAmt
CY Total Expenses$58,718,590CYTotalExpensesAmt
PY Revenues Less Expenses-$2,623,823PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,138,109CYRevenuesLessExpensesAmt
Total Assets BOY$25,556,926TotalAssetsBOYAmt
Total Assets EOY$23,974,128TotalAssetsEOYAmt
Total Liabilities BOY$17,641,231TotalLiabilitiesBOYAmt
Total Liabilities EOY$18,224,590TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,915,695NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,749,538NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAbove all else, Summersville Regional Medical Center is committed to the care and improvement of human life. In recognition of this commitment, we will strive to deliver quality, cost effective healthcare to the communities we serve.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$50,497,988ExpenseAmt
Grant$2,500GrantAmt
Revenue$56,256,345RevenueAmt
DescThe Hospital provided 26,024 inpatient days of care as follows: 6,689 acute intensive care, 1,842 swing bed and 17,313 long-term care. Other services provided include 61,486 outpatient procedures, 23,122 emergency room visits and 24,693 rural health clinic visits. The Hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Charges foregone for charity during the year amounted to $212,147 for hospital services. The level of financial assistance provided by the Hospital has decreased over the last couple of years due to the fact that the State of West Virginia expanded Medicaid. With the Medicaid expansion, individuals with income at 138% of the poverty guidelines are now eligible for Medicaid. Prior to the Medicaid expansion, the level of income to qualify for Medicaid was much lower.Desc
Total Program Service Expenses$50,497,988TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document28IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee636EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Joe A Barnes CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3048722891PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 Fairview Heights RoadAddressLine1Txt
CitySummersvilleCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26651ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Brian Johnson
Chairman1.00Yes (X)Yes (X)$0$0$0
Bruce Tallamy
Vice Chairman1.00Yes (X)Yes (X)$0$0$0
Robert Shafer
Trustee4.00Yes (X)$0$31,812$050.00
Mike Steadham
Trustee1.00Yes (X)$0$0$01.00
Kenny Baker
Trustee1.00Yes (X)$0$0$0
Valarie Phillips
Trustee1.00Yes (X)$0$0$0
Saundra Kinser
Trustee1.00Yes (X)$0$0$0
James Marsh
Trustee1.00Yes (X)$0$0$0
James Epling
Trustee1.00Yes (X)$0$0$01.00
Gary Withee
Trustee1.00Yes (X)$0$0$0
Judy Sentz
Trustee1.00Yes (X)$0$0$0
Kevin Brown DDS
Trustee1.00Yes (X)$0$0$0
Stephen Boone RPh
Trustee1.00Yes (X)$0$0$0
Mark Shifflett
Trustee1.00Yes (X)$0$0$0
Bandy Mullins MD
Trustee/Chief of Staff40.00Yes (X)$573,735$0$20,127
Daniel Ayres
CEO40.00Yes (X)$223,648$0$4,726
Mark Lovell
CFO 1/1/15-4/1/1640.00Yes (X)$165,763$0$0
Yancy S Short
Physician40.00$453,313$0$20,127Yes (X)
Stanley Morris
Physician53.00$513,887$0$20,127Yes (X)
Lukasz Rostocki
Physician40.00$406,550$0$20,008Yes (X)
Tracy Lester
Physician44.00$383,990$0$12,676Yes (X)
Michael Taylor
Physician40.00$385,916$0$16,323Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,106,802TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$31,812TotReportableCompRltdOrgAmt
Total Other Compensation$114,114TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K33IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Rehab One
1834 Park AvenueBelleWV25215Physical Therapy$1,006,372
Weatherby Locums Inc
PO Box 972633DallasTX75397Locum Physicians$491,078
QHR
105 Continental PlaceBrentwoodTN37027Consulting$372,369
Flaherty Sensabaugh & Bonasso
PO Box 3843CharlestonWV25338Legal Services$142,458
Arnett Carbis Toothman
PO Box 2629CharlestonWV25329Accounting Services$127,808
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Fundraising$47,800FundraisingAmt
All Other Contributions$32,626AllOtherContributionsAmt
Total Contributions$80,426TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient service revenueDesc
Business622110BusinessCd
Total Revenue Column$54,178,542TotalRevenueColumnAmt
Related Or Exempt Func Income$54,178,542RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$54,178,542TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,707TotalRevenueColumnAmt
Exclusion$6,707ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$200,547RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$3,741RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$196,806RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$196,806TotalRevenueColumnAmt
Exclusion$196,806ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,262,314SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,210,155SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$52,159SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$52,159TotalRevenueColumnAmt
Exclusion$52,159ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$12,110FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$47,800ContriRptFundraisingEventAmt
Fundraising Direct Expenses$24,072FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$11,962TotalRevenueColumnAmt
Exclusion-$11,962ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Pharmacy446110$1,748,874$1,748,874
Cafeteria Sales722210$122,941$122,941
Refunds and Rebates900099$112,592$112,592

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$93,396TotalRevenueColumnAmt
Related Or Exempt Func Income$93,396RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,077,803OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$56,580,481TotalRevenueColumnAmt
Related Or Exempt Func Income$56,256,345RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$243,710ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,500TotalAmt
Program Services$2,500ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$990,996TotalAmt
Program Services$817,175ProgramServicesAmt
Management And General$173,821ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$24,308,213TotalAmt
Program Services$20,044,552ProgramServicesAmt
Management And General$4,263,661ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$486,766TotalAmt
Program Services$401,387ProgramServicesAmt
Management And General$85,379ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,395,725TotalAmt
Program Services$2,800,115ProgramServicesAmt
Management And General$595,610ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,596,413TotalAmt
Program Services$1,316,402ProgramServicesAmt
Management And General$280,011ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$172,162TotalAmt
Management And General$172,162ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$129,384TotalAmt
Management And General$129,384ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$5,587TotalAmt
Management And General$5,587ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,075,861TotalAmt
Program Services$3,360,955ProgramServicesAmt
Management And General$714,906ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$62,306TotalAmt
Program Services$51,378ProgramServicesAmt
Management And General$10,928ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,456,135TotalAmt
Program Services$1,200,729ProgramServicesAmt
Management And General$255,406ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$946,778TotalAmt
Program Services$780,713ProgramServicesAmt
Management And General$166,065ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$86,573TotalAmt
Program Services$71,388ProgramServicesAmt
Management And General$15,185ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$608,576TotalAmt
Management And General$608,576ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,773,237TotalAmt
Program Services$1,462,211ProgramServicesAmt
Management And General$311,026ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$958,818TotalAmt
Program Services$790,641ProgramServicesAmt
Management And General$168,177ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Bad Debt Expense$8,037,612$8,037,612
Medical supplies$6,847,722$6,847,722
Repairs and maintenance$1,340,195$1,105,125$235,070
Provider tax$895,930$895,930

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$541,101TotalAmt
Program Services$511,453ProgramServicesAmt
Management And General$29,648ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$58,718,590TotalAmt
Program Services$50,497,988ProgramServicesAmt
Management And General$8,220,602ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,045BOYAmt
EOY$2,048EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,638,619BOYAmt
EOY$711,399EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,607,787BOYAmt
EOY$6,201,257EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,444,844BOYAmt
EOY$1,433,454EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$511,341BOYAmt
EOY$361,897EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$45,664,526LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$30,631,872LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$16,168,765BOYAmt
EOY$15,032,654EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$183,525BOYAmt
EOY$231,419EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$25,556,926BOYAmt
EOY$23,974,128EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,932,153BOYAmt
EOY$7,507,055EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,343,839BOYAmt
EOY$10,025,844EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,365,239BOYAmt
EOY$691,691EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,641,231BOYAmt
EOY$18,224,590EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,907,227BOYAmt
EOY$5,740,971EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,468BOYAmt
EOY$8,567EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,915,695BOYAmt
EOY$5,749,538EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,556,926BOYAmt
EOY$23,974,128EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$2,138,109ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$28,048NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$5,502OtherActivitiesAmt
Total Lobbying Expenditures$5,502TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationThe organization pays membership fees to the American Hospital Association and WV American Hospital Association, which participates in lobbying activities. The amount reported above represents the portion of the dues allocated for lobbying by the Associations.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$288,184OtherCostOrOtherBasisAmt
Book Value$288,184BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,164,207OtherCostOrOtherBasisAmt
Depreciation$11,598,312DepreciationAmt
Book Value$10,565,895BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,287,936OtherCostOrOtherBasisAmt
Depreciation$18,284,315DepreciationAmt
Book Value$3,003,621BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,924,199OtherCostOrOtherBasisAmt
Depreciation$749,245DepreciationAmt
Book Value$1,174,954BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,032,654TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescCapital leasesDesc
Amt$691,691Amt
FieldValueIRS element (for citing)
Total Liability$691,691TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$48,305,661TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$28,048NetUnrealizedGainsInvstAmt
Other Revenue$3,741OtherRevenueAmt
Revenue Not Reported-$24,307RevenueNotReportedAmt
Revenue Subtotal$48,329,968RevenueSubtotalAmt
Other Revenues Not Included$8,250,513OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$8,250,513RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$56,580,481TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$50,471,818TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$3,741OtherExpensesIncludedAmt
Expenses Not Reported$3,741ExpensesNotReportedAmt
Expenses Subtotal$50,468,077ExpensesSubtotalAmt
Other Expenses Not Included$8,250,513OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$8,250,513ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$58,718,590TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part XI, Line 2d - Other Adjustments:Rental expenses netted with income on form 990 3,741.
Part XI, Line 4b - Other Adjustments:Bad debt and charity expense netted with income on fin. stmts. 8,249,759. Investment mgmt fees netted with income on fin. stmts. 754.
Part XII, Line 2d - Other Adjustments:Rental expenses netted with income on form 990 3,741.
Part XII, Line 4b - Other Adjustments:Bad debt and charity expense netted with income on fin. stmts. 8,249,759. Investment mgmt fees netted with income on fin. stmts. 754.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GalaEvent1Nm
Gross Receipts Event1$28,612GrossReceiptsEvent1Amt
Charitable Contri Event1$19,862CharitableContriEvent1Amt
Gross Revenue Event1$8,750GrossRevenueEvent1Amt
Rent Facility Costs Event1$9,339RentFacilityCostsEvent1Amt
Entertainment Event1$2,950EntertainmentEvent1Amt
Other Direct Expenses Event1$400OtherDirectExpensesEvent1Amt
Event2Golf TournamentEvent2Nm
Gross Receipts Event2$31,298GrossReceiptsEvent2Amt
Charitable Contri Event2$27,938CharitableContriEvent2Amt
Gross Revenue Event2$3,360GrossRevenueEvent2Amt
Rent Facility Costs Event2$10,995RentFacilityCostsEvent2Amt
Other Direct Expenses Event2$388OtherDirectExpensesEvent2Amt
Gross Receipts Total$59,910GrossReceiptsTotalAmt
Charitable Contributions Tot$47,800CharitableContributionsTotAmt
Gross Revenue Total Events$12,110GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$20,334RentFcltyCostsTotalEventsAmt
Entertainment Total Events$2,950EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$788OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$24,072DirectExpenseSummaryEventsAmt
Net Income Summary-$11,962NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
Most Hospitals PolicyYes (X)MostHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other225.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$95,119TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$95,119DirectOffsettingRevenueAmt

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,345,921TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,267,247DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,078,674NetCommunityBenefitExpnsAmt
Total Expense0.02130TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,441,040TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,362,366DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,078,674NetCommunityBenefitExpnsAmt
Total Expense0.02130TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,230,339TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,230,339DirectOffsettingRevenueAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,500NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,232,839TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,230,339DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,500NetCommunityBenefitExpnsAmt

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,673,879TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,592,705DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,081,174NetCommunityBenefitExpnsAmt
Total Expense0.02130TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$3,603,790BadDebtExpenseAmt
Reimbursed By Medicare$11,726,280ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$12,857,312CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,131,032MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Summersville Regional Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 Fairview Heights RoadAddressLine1Txt
CitySummersvilleCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26651ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherLong-term nursing careOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Summersville Regional Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://www.summersvilleregional.org/newsite/wp-content/uploads/2015/12/ComOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttps://www.summersvilleregional.org/newsite/wp-content/uploads/2015/12/ComStrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care225.000000000000FPGFamilyIncmLmtDscntCarePct
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.summersvilleregional.org/newsite/wp-content/uploads/2016/07/SRMFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.summersvilleregional.org/newsite/wp-content/uploads/2015/12/FinFAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Summersville Regional Medical CenterPart V, Section B, Line 5: Input for completion of the CHNA was obtained from public health officials;local health departments and agencies; publically elected officials; religious officials; long-term care and work shelter executives; and representatives of or members of chronic disease groups or organizations.
Summersville Regional Medical CenterPart V, Section B, Line 11: Financial constraints prevent the Hospital from addressing all needs.

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7:Charity care at cost and unreimbursed Medicaid are computed using the cost to charge ratio method in Worksheet 2 of the Schedule H instructions.
Part I, Line 7, Column (f):The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 8,037,612.
Part I, Line 6aThe organization makes its community benefit report available to the public through public meetings.
Part III, Line 2:The cost of bad debts was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions.
Part III, Line 4:Patient accounts receivable are carried at the original charge less an estimate made for doubtful or uncollectible accounts. The allowance is based upon a review of the outstanding balances aged by financial class. Management uses collection percentages based upon historical collection experience to determine collectability. Management also reviews troubled, aged accounts to determine collection potential. Patient accounts receivable are written off when deemed uncollectible. Recoveries of accounts previously written off are recorded as a reduction to bad debt expense when received. Interest is not charged on patient accounts receivable.
Part III, Line 8:The organization used the Medicare cost report information for revenues and expenses. The organization does not consider this to be a community benefit expense due to fluctuations in reimbursements related to Medicare audits.
Part VI, Line 2:To assess the health care needs of the community served, the hospital conducts a Community Health Needs Assessment every 3 years. The data obtained from the research is then utilized to implement a strategy to provide additional services and/or improve current services to better serve the needs of the community.
Part VI, Line 3:To educate patients regarding the financial assistance available, the hospital provides a copy of the financial assistance application and policy on their website.
Part VI, Line 4:We are a small rural hospital which is surrounded by Critical Access hospitals and also the only remaining hospital in Nicholas County as the other hospital closed in bankruptcy in 2008. We have a group of volunteers who are able to gain charitable support in order to encourage charitable donations by providing activities throughout our facility and through the State of West Virginia NIPS program that were not previously available to our community. As of 2015, the population of Nicholas county is estimated to be 25,979. The estimated median household income in 2015 is $41,753 versus a median of $43,153 for the whole state of West Virginia. An estimated 19.2% of residents lived below the poverty level in 2009 while 7.7% were estimated to live below 50% of the poverty level.
Part VI, Line 5:The Hospital operates three primary care clinics, two of which are located in Richwood, West Virginia and Ansted, West Virginia. Both Richwood and Ansted are located in very rural areas with very small populations. During 2015, both of these clinics lost a total of approximately $750,000.The Hospital also provides obstetrical and gynecology services to patients of Summersville, West Virginia and the surrounding areas. The vast majority of the patients qualify for Medicaid {70%), and a large percentage of the babies born in the unit have health problems such as drug addiction. During 2015, the Hospital lost approximately $1.0 million operating this program. As you can tell, these are very high risks pregnancies with women with very low income and limited ability to travel to larger cities to receive these services.The Hospital provides 24/7 emergency room services to the patients residing in the Hospital's service area. Due to the low number of patients being served, and the payor mix of the patients the Hospital does treat, the Hospital has to provide a subsidy to the physician group who staffs the emergency room. During FY 2015, the Hospital's emergency room physician cost was approximately $1,350,000. Even though the Affordable Care Act was supposed to encourage Medicaid patients to primary care clinics, this has not been as successful as the industry had hoped. Consequently, the Emergency Room still treats a large number of Medicaid patients.Our Board of Directors all reside in our primary care area of Nicholas County, West Virginia. The Board is comprised of small business, union, low income, members at large, medical staff director, and mayor of the City of Summersville. Board members are not employees, contractors of the organization nor family members. We extend medical staff privileges to all qualified physicians in our community or providers who have a visiting clinic in our community. Any surplus funds are reinvested back into the organization through capital expenditure projects, or payment on existing debt, which has been secured on a tax-free basis. Our emergency room is available to all clients regardless of ability to pay.
Part VI, Line 6:The organization is not part of a health care system.

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Bandy Mullins MD
Trustee/Chief of Staff$407,994$0$165,741$0$0$0$7,950$0$13,675$0$595,360$0$0$0
Daniel Ayres
CEO$223,648$0$0$0$0$0$0$0$6,224$0$229,872$0$0$0
Mark Lovell
CFO 1/1/15-4/1/16$165,763$0$0$0$0$0$0$0$0$0$165,763$0$0$0
Yancy S Short
Physician$395,541$0$57,772$0$0$0$7,950$0$13,675$0$474,938$0$0$0
Stanley Morris
Physician$467,249$0$46,638$0$0$0$7,950$0$13,675$0$535,512$0$0$0
Lukasz Rostocki
Physician$406,550$0$0$0$0$0$7,950$0$13,557$0$428,057$0$0$0
Tracy Lester
Physician$326,178$0$57,812$0$0$0$7,950$0$6,224$0$398,164$0$0$0
Michael Taylor
Physician$211,770$0$174,146$0$0$0$7,950$0$9,695$0$403,561$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
City of Summersville Building Commission
A5507169402006-09-29$7,750,000Debt refunding and hospital improvements000
City of Summersville Building Commission
B5507169402008-03-03$5,000,000Hospital facilities000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$1,928,216$7,750,000$3,843,860$3,906,14020070Yes (1)Yes (1)Yes (1)
B$795,940$5,000,000$5,000,000200900Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0000000
B0000000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000000000
B000000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11The board reviews and approves the 990 form before it is filed with the IRS. If this cannot be accomplished at a regularly scheduled meeting, a special meeting will be held to uphold this board action.
Form 990, Part VI, Section B, line 12cConflict of interest statements require a board member with a conflict to excuse themselves from the discussion and boardroom if a matter of discussion and voting would be a conflict of interest with them individually. Statements completed by other board members are reviewed by the Chairman. The vice-chairman reviews the chairman's conflict of interest statement.
Form 990, Part VI, Section B, line 15Compensation for the CEO is reviewed by a CEO compensation committee. They are responsible to help set goals, review achievement of goals and make a recommendation to the board for the incentive compensation. At a separate time, they review the CEO compensation contract and make recommendations to the board based on comparative CEO compensation using Yaffee, WVHA Compensation Survey and other applicable and available compensation tools. The CFO's compensation is reviewed and benchmarked against other compensation tools and is set by the CEO on an annual basis.
Form 990, Part VI, Section C, line 19Governing documents, conflict of interest policy and financial statements are available upon request by persons. They are not posted on the website at the present time. This has been discussed in public session of the board meetings.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Summersville Building CommissionBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 Fairview Heights RoadAddressLine1Txt
CitySummersvilleCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26651ZIPCd
FieldValueIRS element (for citing)
EIN550716940EIN
Primary ActivitiesBuilding CommissionPrimaryActivitiesTxt
Legal Domicile StateWVLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLine 6PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd