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DAVIS MEMORIAL HOSPITAL: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
DAVIS MEMORIAL HOSPITAL (EIN 55-0375433)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-11-17
IRS object ID
202523219349324117
Schema version
2024v5.2
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)
Return2025-11-17T17:55:14-06:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 4200AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550375433EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DAVIS MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDAVIBusinessNameControlTxt
Phone3046363300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1484AddressLine1Txt
CityELKINSCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26241ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJEFF SANDENEPersonNm
Person TitleEVP AND CFOPersonTitleTxt
Phone3046373196PhoneNum
Signature2025-11-17SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANGELA M MOOREPreparerPersonNm
PTINP00244342PTIN
Phone3174648600PhoneNum
Preparation2025-11-14PreparationDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRON ANDROPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1484AddressLine1Txt
CityELKINSCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26241ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$115,132,247GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.DAVISHEALTHSYSTEM.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1903FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionTO PROVIDE QUALITY HEALTH CARE TO RESIDENTS OF ELKINS, WEST VIRGINIA AND SURROUNDING COMMUNITIES.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee1051TotalEmployeeCnt
Total Volunteers65TotalVolunteersCnt
Total Gross UBI$88,949TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$25,199NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$39,490PYContributionsGrantsAmt
CY Contributions Grants$244,397CYContributionsGrantsAmt
PY Program Service Revenue$104,381,650PYProgramServiceRevenueAmt
CY Program Service Revenue$113,420,026CYProgramServiceRevenueAmt
PY Investment Income$369,577PYInvestmentIncomeAmt
CY Investment Income$57,288CYInvestmentIncomeAmt
PY Other Revenue$2,673,491PYOtherRevenueAmt
CY Other Revenue$1,409,164CYOtherRevenueAmt
PY Total Revenue$107,464,208PYTotalRevenueAmt
CY Total Revenue$115,130,875CYTotalRevenueAmt
PY Grants And Similar Paid$32,619PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$66,961,917PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$70,310,683CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$69,101,645PYOtherExpensesAmt
CY Other Expenses$67,407,981CYOtherExpensesAmt
PY Total Expenses$136,096,181PYTotalExpensesAmt
CY Total Expenses$137,718,664CYTotalExpensesAmt
PY Revenues Less Expenses-$28,631,973PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$22,587,789CYRevenuesLessExpensesAmt
Total Assets BOY$50,342,111TotalAssetsBOYAmt
Total Assets EOY$74,271,161TotalAssetsEOYAmt
Total Liabilities BOY$84,306,469TotalLiabilitiesBOYAmt
Total Liabilities EOY$123,554,069TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$33,964,358NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$49,282,908NetAssetsOrFundBalancesEOYAmt
MissionWE CARE FOR LIFE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$114,564,621ExpenseAmt
Revenue$113,569,578RevenueAmt
DescTHE ORGANIZATION OPERATED AN 80 BED ACUTE CARE HOSPITAL IN ELKINS, WEST VIRGINIA.Desc
Total Program Service Expenses$114,564,621TotalProgramServiceExpensesAmt
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
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
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 Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document91IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1051EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
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 PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWVStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RICK SCHERICHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3046373196PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1812 GORMAN AVEAddressLine1Txt
CityELKINSCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26241ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
DAVID GOLDBERG
DIRECTOR1.0057.00Yes (X)Yes (X)$0$996,584$51,139
VANCE JACKSON
DHS CEO (END 6/24)35.005.00Yes (X)Yes (X)$0$393,822$226,509
AMANDA PENNINGTON MD
DIRECTOR40.000.00Yes (X)$402,022$0$43,206
MISHA PHILLIPS-LEE
DIRECTOR40.002.00Yes (X)$242,415$0$30,075
WILLIAM KOCH
VP FINANCE AND CFO25.0015.00Yes (X)Yes (X)$0$155,808$24,191
DREW PINGLEY
VICE CHAIR40.000.00Yes (X)Yes (X)$112,771$0$29,611
MARK DOAK
DIRECTOR/INTERIM CEO35.006.00Yes (X)Yes (X)$56,250$0$0
RONALD ANDRO
DHS SVP ADMINISTRATIVE OFFICER35.007.00Yes (X)Yes (X)$0$37,284$87
DANNY FRANKE
DIRECTOR14.002.00Yes (X)$23,642$0$175
JAMES TRIPLETT
CHAIRMAN1.001.00Yes (X)Yes (X)$0$0$0
CHAD SHOEMAKER
DIRECTOR1.000.00Yes (X)$0$0$0
CONNIE TENNEY
DIRECTOR1.000.00Yes (X)$0$0$0
DENISE CAMPBELL
DIRECTOR1.000.00Yes (X)$0$0$0
TOM FELTON
DIRECTOR1.000.00Yes (X)$0$0$0
MOHAMED FAHIM
ANESTHESIOLOGIST40.000.00$643,464$0$65,062Yes (X)
MICHAEL GALLOWAY
PHYSICIAN40.000.00$603,259$0$40,486Yes (X)
ARTHUR FINE
PHYSICIAN40.000.00$588,364$0$39,049Yes (X)
GARRETT BUTLER
PHYSICIAN40.001.00$508,227$0$37,836Yes (X)
EMAD KOWATLI
PHYSICIAN40.000.00$481,471$0$36,991Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,661,885TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,583,498TotReportableCompRltdOrgAmt
Total Other Compensation$624,417TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K92IndivRcvdGreaterThan100KCnt
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
QUALIVIS LLC
PO BOX 674913DALLASTX753974913AGENCY SERVICES$2,958,508
RIVERSIDE ANESTHESIA PSC
425 LEWIS HARGETT CIRCLELEXINGTONKY40503ANESTHESIA SERVICES$2,404,594
COMMONWEALTH ANESTHESIA PSC
425 LEWIS HARGETT CIRCLELEXINGTONKY40503ANESTHESIA SERVICES$1,306,441
CPS SOLUTIONS LLC
PO BOX 7410634CHICAGOIL606740634IT CONSULTING$1,130,192
LUCAS J PAVLOVICH
1502 HARRISON AVENUEELKINSWV26241ORTHOPEDIC SERVICES$1,122,572
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K23CntrctRcvdGreaterThan100KCnt
Related Organizations$244,397RelatedOrganizationsAmt
Total Contributions$244,397TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICES622110$112,110,748$112,110,748
PHARMACY REVENUE456110$1,309,278$1,309,278
FieldValueIRS element (for citing)
Total Program Service Revenue$113,420,026TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$58,660TotalRevenueColumnAmt
Unrelated Business Revenue$34,787UnrelatedBusinessRevenueAmt
Exclusion$23,873ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$82,644RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$82,644RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$82,644TotalRevenueColumnAmt
Unrelated Business Revenue$12,492UnrelatedBusinessRevenueAmt
Exclusion$70,152ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,372SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$1,372SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,372TotalRevenueColumnAmt
Exclusion-$1,372ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
CAFETERIA722514$1,135,298$1,135,298
MANAGEMENT FEES561000$41,670$41,670

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$149,552TotalRevenueColumnAmt
Related Or Exempt Func Income$149,552RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,326,520OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$115,130,875TotalRevenueColumnAmt
Related Or Exempt Func Income$113,569,578RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$88,949UnrelatedBusinessRevenueAmt
Exclusion$1,227,951ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$883,917TotalAmt
Management And General$883,917ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$111,715TotalAmt
Program Services$111,715ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$49,977,899TotalAmt
Program Services$42,950,077ProgramServicesAmt
Management And General$7,027,822ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,360,871TotalAmt
Program Services$1,170,349ProgramServicesAmt
Management And General$190,522ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$14,681,247TotalAmt
Program Services$12,402,531ProgramServicesAmt
Management And General$2,278,716ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,295,034TotalAmt
Program Services$2,636,027ProgramServicesAmt
Management And General$659,007ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$657,085TotalAmt
Management And General$657,085ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$198,207TotalAmt
Management And General$198,207ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$323,039TotalAmt
Management And General$323,039ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$66,678TotalAmt
Management And General$66,678ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$21,097,179TotalAmt
Program Services$19,023,512ProgramServicesAmt
Management And General$2,073,667ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$241,501TotalAmt
Program Services$241,501ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,820,124TotalAmt
Program Services$3,871,006ProgramServicesAmt
Management And General$949,118ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$819,425TotalAmt
Program Services$655,540ProgramServicesAmt
Management And General$163,885ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,656,606TotalAmt
Program Services$3,612,452ProgramServicesAmt
Management And General$1,044,154ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$174,007TotalAmt
Program Services$139,810ProgramServicesAmt
Management And General$34,197ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$16,066TotalAmt
Program Services$12,853ProgramServicesAmt
Management And General$3,213ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$4,493,148TotalAmt
Management And General$4,493,148ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$42,000TotalAmt
Program Services$42,000ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,782,705TotalAmt
Program Services$3,026,164ProgramServicesAmt
Management And General$756,541ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$433,573TotalAmt
Program Services$433,573ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$17,867,879$17,867,879
PROVIDER TAX$3,455,941$3,455,941
REPAIRS AND MAINTENANCE$2,116,003$1,692,802$423,201
LICENSE/FEES$1,028,906$822,001$206,905

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,117,909TotalAmt
Program Services$396,888ProgramServicesAmt
Management And General$721,021ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$137,718,664TotalAmt
Program Services$114,564,621ProgramServicesAmt
Management And General$23,154,043ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$5,639,442BOYAmt
EOY$5,443,515EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$26,831BOYAmt
EOY$1,998,246EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$17,177,198BOYAmt
EOY$25,538,764EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,436,856BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,733,259BOYAmt
EOY$1,413,856EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$791,198BOYAmt
EOY$364,343EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$24,347,951LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,271,387LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,831,503BOYAmt
EOY$21,076,564EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,188,349BOYAmt
EOY$295,536EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY-$1,381,207BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$20,898,682BOYAmt
EOY$18,140,337EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$50,342,111BOYAmt
EOY$74,271,161EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$23,126,209BOYAmt
EOY$34,255,688EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$56,303,320BOYAmt
EOY$56,721,419EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,876,940BOYAmt
EOY$32,576,962EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$84,306,469BOYAmt
EOY$123,554,069EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$33,964,358BOYAmt
EOY-$49,282,908EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$33,964,358BOYAmt
EOY-$49,282,908EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$50,342,111BOYAmt
EOY$74,271,161EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$22,587,789ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$130,158NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments$7,139,081PriorPeriodAdjustmentsAmt
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)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
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$5,308OtherActivitiesAmt
Total Lobbying Expenditures$5,308TotalLobbyingExpendituresAmt
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, WHICH PARTICIPATES IN LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$805,609OtherCostOrOtherBasisAmt
Book Value$805,609BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,058,635OtherCostOrOtherBasisAmt
Depreciation$610,415DepreciationAmt
Book Value$13,448,220BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,520,273OtherCostOrOtherBasisAmt
Depreciation$1,893,698DepreciationAmt
Book Value$3,626,575BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,963,434OtherCostOrOtherBasisAmt
Depreciation$767,274DepreciationAmt
Book Value$3,196,160BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$21,076,564TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
RIGHT OF USE ASSETS$9,802
DUE FROM SUBSIDIARIES$18,130,535
FieldValueIRS element (for citing)
Total Book Value Other Assets$18,140,337TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO AFFILATES$32,238,498
POST RETIREMENT BENEFIT OBLIGATION$338,464
FieldValueIRS element (for citing)
Total Liability$32,576,962TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE IRS HAS DETERMINED THAT THE SYSTEM ENTITIES ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE CODE AND APPLICABLE STATE STATUTES, EXCEPT FOR MHC, FHE, CMC, AND HFI, WHICH ARE CORPORATIONS SUBJECT TO INCOME TAX. THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2024 AND 2023. TAX RETURNS FOR THE YEAR ENDED JUNE 30, 2020, ARE OPEN FOR THE MHS ENTITIES AND TAX RETURNS FOR THE YEAR ENDED DECEMBER 31, 2021, ARE OPEN FOR CAMC ENTITIES.ExplanationTxt

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other120.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
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$3,384,221TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,384,221NetCommunityBenefitExpnsAmt
Total Expense0.02490TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$31,061,704TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,936,592DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,125,112NetCommunityBenefitExpnsAmt
Total Expense0.06710TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$34,445,925TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,936,592DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,509,333NetCommunityBenefitExpnsAmt
Total Expense0.09200TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$34,445,925TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,936,592DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,509,333NetCommunityBenefitExpnsAmt
Total Expense0.09200TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense-$1,731,406BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$13,848,736ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$18,601,157CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,752,421MedicareSurplusOrShortfallAmt

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 Line1DAVIS MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1484AddressLine1Txt
CityELKINSCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26241ZIPCd
FieldValueIRS element (for citing)
Website AddressHTTPS://WWW.DAVISHEALTHSYSTEM.ORG/LOCAWebsiteAddressTxt
State License141StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1DAVIS MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
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
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted22CHNAConductedYr
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 URLSEE PART V, PAGE 8OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, PAGE 8StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care120.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
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
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, PAGE 8FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, PAGE 8FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, PAGE 8FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
DAVIS MEMORIAL HOSPITALPART V, SECTION B, LINE 5: INPUT WAS SOLICITED FROM THOSE REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY IN AUGUST 2022. DISCUSSIONS INCLUDED THE HEALTH NEEDS OF THE COMMUNITY, BARRIERS TO HEALTH CARE ACCESS, OPPORTUNITIES FOR IMPROVEMENT, PERCEPTION OF DAVIS MEDICAL CENTER AND FEEDBACK ON THE HOSPITAL'S INITIATIVES. KEY STAKEHOLDERS APPROACHED FOR INPUT INCLUDED COMMUNITY HEALTH CENTERS, COLLEGES, NON-PROFIT ORGANIZATIONS, EMERGENCY MEDICAL SERVICES, HEALTH DEPARTMENTS, DEVELOPMENT AUTHORITIES, CHAMBER OF COMMERCE, STATE AND LOCAL GOVERNMENT AGENCIES, ETC., AS WELL AS PUBLIC OFFICIALS AND CHURCH LEADERS.
DAVIS MEMORIAL HOSPITALPART V, SECTION B, LINE 11: THE PRIMARY HEALTH CONCERN IS SUBSTANCE ABUSE FOLLOWED BY MENTAL HEALTH ISSUES. OTHER HEALTH CONCERNS INCLUDE:1. SUBSTANCE ABUSE2. MENTAL HEALTH3. CHRONIC DISEASE MANAGEMENT (COPD)4. FOOD INSECURITY5. TRANSPORTATION INSECURITYTHE HOSPITAL HAS MANY COMMUNTIY OUTREACH PROGRAMS SUCH AS: 100 MILES IN 100 DAYS; MULTIPHASIC BLOOD TESTS, BIKE RODEO, HEALTH FAIRS, ETC. LAUREL PLACE PROVIDES GERIATRIC INPATIENT PSYCHIATRY. THE HOSPITAL WILL CONTINUE TO COLLABORATE WITH EXTERNAL PARTNERS ON STRATEGIES AND POLICIES THAT WILL POSITIVELY IMPACT THE LOCAL DRUG EPIDEMIC.THE HOSPITAL WILL CONTINUE TO BUILD ON THE DAVIS MEDICAL CENTER NUTRITION/POPULATION HEALTH COLLABORATION FOR DIABETES PREVENTION PROGRAM AND INCREASE THE NUMBER OF PARTICIPANTS YEAR OVER YEAR.
DAVIS MEMORIAL HOSPITALPART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY IS POSTED IN ALL PATIENT REGISTRATION AREAS INCLUDING ER, ADMISSIONS AND OP TESTING. THE PROCEDURE IS ALSO EXPLAINED IN FINANCIAL COUNSELING BROCHURES AVAILABLE THROUGHOUT THE HEALTH SYSTEM AND IN PHYSICIAN OFFICES. ALL EMPLOYEES ARE ALSO NOTIFIED VIA THE INTERNAL WEBSITE WHERE IT IS POSTED. WE ALSO EMPLOY TWO FINANCIAL COUNSELORS WHO WORK WITH AND SCREEN THE UNINSURED AND UNDERINSURED POPULATIONS. WE ALSO HAVE A FINANCIAL ADVOCATE FROM HEALTH AND HUMAN SERVICES.
DAVIS MEMORIAL HOSPITALPART V, SECTION B, LINE 20E: THE HOSPITAL ALSO SCREENS PATIENTS THROUGH A THIRD PARTY DATABASE THROUGH THE ADVISORY BOARD PRIOR TO PLACEMENT WITH A COLLECTION AGENCY. THIS SCRUB PROVIDES US WITH THE LIKELIHOOD THE PATIENT WILL QUALIFY FOR MEDICAID AS WELL AS SCREENS THE PATIENTS FOR OUR INTERNAL ASSISTANCE POLICY. THE PRESUMPTIVE CHARITY ADJUSTMENTS ARE DONE AS BUDGETARY CONSTRAINTS ALLOW TO BETTER IDENTIFY THE MEDICALLY INDIGENT AND PATIENTS WHO HAVE A NEED FOR ASSISTANCE TO PREVENT DEROGATORY COLLECTION ACTIVITY.
PART V, SECTION B, LINE 7AHTTPS://WWW.DAVISHEALTHSYSTEM.ORG/CONTENT/UPLOADS/DAVISHEALTHSYSTEM.ORG/FILES/2023_DMC_CHNA.PDF
PART V, SECTION B, LINE 10AHTTPS://WWW.DAVISHEALTHSYSTEM.ORG/CONTENT/UPLOADS/DAVISHEALTHSYSTEM.ORG/FILES/2023_DMC_CHNA.PDF
PART V, SECTION B, LINE 16AHTTPS://WWW.DAVISHEALTHSYSTEM.ORG/PATIENTS-VISITORS/FINANCIAL-COUNSELING
PART V, SECTION B, LINE 16BHTTPS://WWW.DAVISHEALTHSYSTEM.ORG/PATIENTS-VISITORS/FINANCIAL-COUNSELING
PART V, SECTION B, LINE 16CHTTPS://WWW.DAVISHEALTHSYSTEM.ORG/PATIENTS-VISITORS/FINANCIAL-COUNSELING
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - DIRECT CARE OF ELKINS
720 BEVERLY PIKEELKINSWV26241MEDICAL CLINIC
2 - BUCKHANNON MEDICAL CENTER
11 NORTH LOCUST STREETBUCKHANNONWV26201MEDICAL CLINIC

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 $ 1,731,406.
PART III, LINE 2:BAD DEBT EXPENSE AS REPORTED ON AUDITED FINANCIAL STATEMENTS.
PART III, LINE 4:AUDITED FINANCIAL STATEMENT FOOTNOTE RELATING TO BAD DEBT EXPENSE: WHEN WE HAVE AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME, THE RIGHT IS TREATED AS A RECEIVABLE. PATIENT RECEIVABLES, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH WE HAVE THE UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD PARTY PAYORS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF OUR RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. THE ESTIMATED UNCOLLECTIBLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT ACCOUNTS RECEIVABLE. FOR CHANGES IN CREDIT ISSUES NOT ASSESSED AT THE DATE OF SERVICE, THE SYSTEM WILL PROSPECTIVELY RECOGNIZE THOSE AMOUNTS IN NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS. THE PROVISION FOR DOUBTFUL ACCOUNTS WAS IMMATERIAL AS OF DECEMBER 31, 2024 AND 2023.
PART III, LINE 8:MEDICARE ALLOWABLE COSTS AND REVENUES ARE FROM THE MEDICARE COST REPORT.
PART III, LINE 9B:PATIENTS WHO INDICATE THEY HAVE AN INABILITY TO PAY FOR THEIR MEDICAL CARE ARE REFERRED TO THE FINANCIAL COUNSELOR AND/OR A MEDICAID ELIGIBILITY SPECIALIST. PATIENTS WHO DO MEET FINANCIAL ASSISTANCE GUIDELINES BUT DEMONSTRATE AN INABILITY TO MEET OUR MINIMUM PAYMENT GUIDELINES ARE GIVEN A REDUCED PAYMENT PLAN. COLLECTION PROCEDURES REGARDING REDUCED PAYMENT PLANS FOLLOW THE HOSPITAL'S NORMAL PROCEDURES. PATIENTS WITH CATASTROPHIC ILLNESSES ARE REFERRED TO THE WV CATASTROPHIC ILLNESS FUND. PATIENTS WHOSE CARE IS A RESULT OF A CRIME WILL BE REFERRED TO THE WV CRIME VICTIMS FUND.
PART VI, LINE 2:DAVIS HEALTH SYSTEM RELIES HEAVILY ON DATA PROVIDED BY THE BUREAU FOR PUBLIC HEALTH; NAMELY, THE COUNTY HEALTH PROFILES THAT OUTLINE RISK FACTORS FOR CHRONIC DISEASES. IN ADDITION, THE COMMUNITY HEALTH PROMOTION DIRECTOR GLEANS INFORMATION AND STATISTICS FROM HEALTH SCREENINGS THAT ARE HELD FOR THE PUBLIC, AS WELL AS OUR EMPLOYEES. THIS INFORMATION HELPS IN PLANNING FUTURE EDUCATIONAL EVENTS AND SCREENINGS.
PART VI, LINE 3:THE INFORMATION IS POSTED IN PUBLIC AREAS WITHIN THE HOSPITAL. THE FINANCIAL POLICY BROCHURE IS PUBLICLY DISPLAYED AND POSTED ON THE INTERNAL NETWORK AND THE HEALTH SYSTEM WEBSITE. A PATIENT ADVOCATE CONTACTS WORK LISTS OF MEDICALLY INDIGENT PATIENTS TO HELP SECURE AND PROVIDE EDUCATION TO AFFILIATE AND NON-AFFILIATE PHYSICIAN OFFICES REFERRING TO DAVIS MEMORIAL HOSPITAL.
PART VI, LINE 4:THE HOSPITAL SERVES SEVERAL RURAL COUNTIES IN EASTERN WEST VIRGINIA. RANDOLPH COUNTY HAS A POPULATION OF 27,932 WITH 15.7% HAVING A BACHELOR'S DEGREE OR HIGHER AND AVERAGE HOUSEHOLD INCOME OF $45,206. UPSHUR COUNTY HAS A POPULATION OF 23,816 WITH 16.2% HAVING A BACHELOR'S DEGREE OR HIGHER, AVERAGE HOUSEHOLD INCOME OF $40,802. BARBOUR COUNTY HAS A POPULATION OF 15,465 WITH 13.9% HAVING A BACHELOR'S DEGREE OR HIGHER, AVERAGE HOUSEHOLD INCOME OF $38,906. POCAHONTAS COUNTY HAS A POPULATION OF 7,869 WITH 13.6% HAVING A BACHELOR'S DEGREE OR HIGHER, AVERAGE HOUSEHOLD INCOME OF $37,642. TUCKER COUNTY HAS A POPULATION OF 6,762 WITH 19.5% HAVING A BACHELOR'S DEGREE OR HIGHER, AVERAGE HOUSEHOLD INCOME OF $47,527. ADDITIONALLY, 16.8% OF ALL WEST VIRGINIANS LIVE BELOW THE POVERTY LEVEL. DAVIS MEMORIAL IS THE ONLY HOSPITAL IN RANDOLPH COUNTY. THERE IS ONE CRITICAL ACCESS HOSPITAL IN BARBOUR COUNTY, ONE CRITICAL ACCESS HOSPITAL IN POCAHONTAS COUNTY AND ONE GENERAL SERVICE HOSPITAL IN UPSHUR COUNTY.
PART VI, LINE 5:THE ORGANIZATION'S HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE IN THE FOLLOWING WAYS. THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. THE CORPORATE BY LAWS PROVIDE FOR BOARD REPRESENTATION FROM THE COUNTIES SURROUNDING DAVIS MEMORIAL HOSPITAL. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. THE ORGANIZATION OPERATES AN EMERGENCY ROOM AVAILABLE TO ALL, REGARDLESS OF ABILITY TO PAY. SPECIALIZED SERVICES OFFERED BY THE ORGANIZATION THAT ARE NOT AVAILABLE ELSEWHERE INCLUDE NEUROLOGY, PAIN MANAGEMENT, OTOLARYNGOLOGY, PULMONOLOGY, LITHOTRIPSY, SLEEP STUDIES, PET, DIGITAL MAMMOGRAPHY, CRITICAL CARE MEDICINE, GENERAL SURGERY, INTERNAL MEDICINE, OBSTETRICS AND GYNECOLOGY, RADIATION ONCOLOGY, MEDICAL ONCOLOGY AND HEMATOLOGY. AN ADVANCED TELEMEDICINE INITIATIVE AT DAVIS HEALTH SYSTEM PROVIDES ADDITIONAL SPECIALIZED SERVICES IN PARTNERSHIP WITH OTHER HEALTH CARE PROVIDERS, NURSING HOMES AND LARGER MEDICAL INSTITUTIONS - PROVIDING GREATER MEDICAL ACCESS TO PATIENTS IN MORE RURAL AREAS OF THE STATE. THE ORGANIZATION SERVES AS A VEHICLE FOR ATTRACTING CHARITABLE SUPPORT, AS WELL AS A SOURCE OF COMMUNITY VOLUNTEER ACTIVITIES. STUDENT VOLUNTEERS, YOUTH VOLUNTEERS AND AN ACTIVE ADULT VOLUNTEER PROGRAM SUPPORT THE MISSION OF THE HEALTH SYSTEM BY ENHANCING PATIENT CARE AND PROGRAMS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
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 (10 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
DAVID GOLDBERG
DIRECTOR$0$736,828$0$241,048$0$18,708$0$13,800$0$37,339$0$1,047,723$0$0
MOHAMED FAHIM
ANESTHESIOLOGIST$639,144$0$0$0$4,320$0$38,365$0$26,697$0$708,526$0$0$0
MICHAEL GALLOWAY
PHYSICIAN$582,426$0$0$0$20,833$0$11,721$0$28,765$0$643,745$0$0$0
ARTHUR FINE
PHYSICIAN$567,851$0$0$0$20,513$0$11,430$0$27,619$0$627,413$0$0$0
VANCE JACKSON
DHS CEO (END 6/24)$0$166,596$0$150$0$227,076$0$190,581$0$35,928$0$620,331$0$0
GARRETT BUTLER
PHYSICIAN$496,446$0$11,285$0$496$0$10,001$0$27,835$0$546,063$0$0$0
EMAD KOWATLI
PHYSICIAN$461,462$0$0$0$20,009$0$9,275$0$27,716$0$518,462$0$0$0
AMANDA PENNINGTON MD
DIRECTOR$401,648$0$0$0$374$0$16,211$0$26,995$0$445,228$0$0$0
MISHA PHILLIPS-LEE
DIRECTOR$242,415$0$0$0$0$0$7,484$0$22,591$0$272,490$0$0$0
WILLIAM KOCH
VP FINANCE AND CFO$0$155,658$0$150$0$0$0$6,331$0$17,860$0$179,999$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ATHE HOSPITAL WILL REIMBURSE FOR ALL OF THE REASONABLE TRAVEL, LODGING AND MEAL EXPENSES INCURRED BY THE CEO'S SPOUSE FOR TWO BUSINESS-RELATED MEETINGS OR CONFERENCES PER YEAR.
PART I, LINES 4A-BVANCE JACKSON RECEIVED $227,026 OF SEVERANCE PAYMENTS DURING TY24. 457(F) INELIGIBLE DEFERRED COMPENSATION PLAN - A 457 F PLAN IS OFFERED TO CERTAIN MANAGEMENT AND/OR HIGHLY COMPENSATED EMPLOYEES TO OFFER THOSE EMPLOYEES A DEFERRED COMPENSATION OPPORTUNITY. THE PLAN IS INTENDED TO BE A "TOP-HAT PLAN", OR UNFUNDED DEFERRED COMPENSATION PLAN MAINTAINED FOR A SELECT GROUP OF EMPLOYEES. PARTICIPANTS MAY BECOME VESTED IN AMOUNTS CREDITED ON JANUARY 1 ELECTED BY THE PARTICIPANT AT THE TIME THE INITIAL DEFERRAL WAS ELECTED. A PARTICIPANT SHALL BECOME FULLY VESTED UPON DEATH, DISABILITY, ATTAINMENT OF AGE 60, OR SEPARATION OF SERVICE, AS DEFINED BY THE PLAN. ANY UNVESTED CONTRIBUTIONS SHALL BE FORFEITED TO THE PLAN OR EMPLOYER. FOR 2024 NO DISTRIBUTIONS / PAYMENTS WERE MADE FROM THE PLAN; DAVID GOLDBERG WAS THE ONLY PARTICIPANT.
PART I, LINE 3:THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE OVERSIGHT OF THE COMPENSATION FOR THE SENIOR STAFF. A CONSULTANT (YAFFE & COMPANY) IS ENGAGED WHO FACILITATES THE ANNUAL EVALUATION PROCESS FOR DETERMINING COMPENSATION FOR EXECUTIVES. THE CONSULTANT COORDINATES A SERIES OF MEETINGS, LEADS DISCUSSIONS ON THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE EVALUATION, PRESENTS MARKET ANALYSIS INFORMATION FOR KEY POSITIONS AND PROVIDES RECOMMENDATIONS FOR SALARY LEVELS BASED ON THAT INFORMATION. THE COMMITTEE MAKES THEIR DECISION USING THE GUIDANCE OF THE CONSULTANT.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
RICHARD CAMPBELL
FAMILY MEMBER OF DENISE CAMPBELL$30,892EMPLOYMENT0
CHRISTIE SHOEMAKER
FAMILY MEMBER OF CHAD SHOEMAKER$80,823EMPLOYMENT0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6DAVIS MEMORIAL HOSPITAL'S SOLE MEMBER IS DAVIS HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7ADAVIS MEMORIAL HOSPITAL'S BOARD MEMBERS ARE ELECTED OR APPOINTED BY DAVIS HEALTH SYSTEM, INC.
FORM 990, PART VI, SECTION A, LINE 7BDAVIS HEALTH SYSTEM, INC. IS DAVIS MEMORIAL HOSPITAL'S SOLE MEMBER AND HAS RESERVED POWERS UNDER DAVIS MEMORIAL HOSPITAL'S GOVERNING DOCUMENTS, WHICH PROVIDE THAT DECISIONS OF DAVIS MEMORIAL HOSPITAL'S GOVERNING BODY, SUCH AS ELECTION OF OFFICERS, APPROVAL OF ANNUAL BUDGETS AND BORROWINGS, ARE SUBJECT TO APPROVAL BY THE SOLE MEMBER. THE SOLE MEMBER ALSO HAS ALL APPROVAL POWERS PROVIDED TO MEMBERS OF WEST VIRGINIA NONPROFIT CORPORATIONS UNDER STATE LAW.
FORM 990, PART VI, SECTION B, LINE 11BTHE 990 WILL BE DISTRIBUTED TO ALL BOARD MEMBERS. IT WILL BE PRESENTED AND DISCUSSED AT A BOARD OF TRUSTEES MEETING OR A FINANCE COMMITTEE MEETING, WHICHEVER OCCURS FIRST AFTER THE COMPLETION OF FORM 990. IF THE FINANCE COMMITTEE MEETING IS THE FIRST TO OCCUR, ALL MEMBERS OF THE BOARD OF TRUSTEES WILL BE ENCOURAGED TO ATTEND THE FINANCE COMMITTEE WHERE THE FORM IS TO BE DISCUSSED.
FORM 990, PART VI, SECTION B, LINE 12CTHE DAVIS HEALTH SYSTEM CONFLICT OF INTEREST POLICY REQUIRES THAT EACH DIRECTOR, OFFICER, AND COMMITTEE MEMBER WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THE PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY AND READS AND UNDERSTANDS THE POLICY. BOARD MEMBERS COMPLETE THE STATEMENT IN JANUARY OF EACH YEAR. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE EXECUTIVE COMMITTEE. IN ADDITION TO BOARD MEMBERS, SENIOR STAFF ARE REQUIRED TO ANNUALLY PREPARE A CONFLICT OF INTEREST STATEMENT.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE OVERSIGHT OF THE COMPENSATION FOR THE SENIOR STAFF. A CONSULTANT (YAFFE & COMPANY) IS ENGAGED WHO FACILITATES THE ANNUAL EVALUATION PROCESS FOR DETERMINING COMPENSATION FOR EXECUTIVES. THE CONSULTANT COORDINATES A SERIES OF MEETINGS, LEADS DISCUSSIONS ON THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE EVALUATION, PRESENTS MARKET ANALYSIS INFORMATION FOR KEY POSITIONS AND PROVIDES RECOMMENDATIONS FOR SALARY LEVELS BASED ON THAT INFORMATION. THE COMMITTEE MAKES THEIR DECISION USING THE GUIDANCE OF THE CONSULTANT.
FORM 990, PART VI, SECTION C, LINE 19THE BOARD OF TRUSTEES ADOPTED A RECORD KEEPING AND DISCLOSURE POLICY IN JANUARY OF 2003. THE POLICY PROVIDES FOR DISCLOSURE OF CORPORATE AND FINANCIAL RECORDS NOT COVERED BY GOVERNMENTAL OR CONTRACTUAL AGREEMENTS. ANY REQUEST FOR FINANCIAL OR OTHER CORPORATE DOCUMENTS ARE SUBMITTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES AND DECISIONS ARE MADE ON A CASE BY CASE BASIS. THE COMPLIANCE CODE OF CONDUCT POLICY INCLUDES STANDARDS RELATING TO CONFLICTS OF INTEREST WITHIN THE ORGANIZATION. THIS INFORMATION IS SHARED WITH THE PUBLIC, BEING POSTED ON THE WEBSITE IN ADDITION TO BEING DISTRIBUTED TO ALL PATIENTS ADMITTED TO THE HOSPITAL.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES: PROGRAM SERVICE EXPENSES 19,023,512. MANAGEMENT AND GENERAL EXPENSES 2,073,667. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,097,179.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
VANDALIA HEALTH INC
PO BOX 1547CHARLESTONWV253261547550664138PARENT COMPANYWV501(C)(3)12C, III-FIN/A0
CAMC FOUNDATION INC
PO BOX 1547CHARLESTONWV253261547310887133FUNDRAISINGWV501(C)(3)12A, IYes (1)CHARLESTON AREA MEDICAL CENTER INC
CHARLESTON AREA MEDICAL CENTER INC
PO BOX 1547CHARLESTONWV253261547550526150HOSPITALWV501(C)(3)30VANDALIA HEALTH INC
MONONGALIA HEALTH SYSTEM INC
1200 JD ANDERSON DRIVEMORGANTOWNWV26505550621551PARENT COMPANYWV501(C)(3)12C, III-FI0VANDALIA HEALTH INC
MONONGALIA COUNTY GENERAL HOSPITAL COMPANY
1200 JD ANDERSON DRIVEMORGANTOWNWV26505237441353HOSPITALWV501(C)(3)3Yes (1)MONONGALIA HEALTH SYSTEM INC
MON ELDER SERVICES INC
1200 JD ANDERSON DRIVEMORGANTOWNWV26505311520863CONTINUING CARE RETIREMENT CENTERWV501(C)(3)10Yes (1)MONONGALIA HEALTH SYSTEM INC
THE FOUNDATION OF MONONGALIA GENERAL HOSPITAL
1200 JD ANDERSON DRIVEMORGANTOWNWV26505550570338RAISE FUNDS FOR MONONGALIA GENERAL HOSPITALWV501(C)(3)7Yes (1)MONONGALIA COUNTY GENERAL HOSPITAL CO
PRESTON MEMORIAL HOSPITAL
150 MEMORIAL DRIVEKINGWOODWV26537311097818HOSPITALWV501(C)(3)3Yes (1)MONONGALIA HEALTH SYSTEM INC
PRESTON MEMORIAL MEDICAL GROUP
300 SOUTH PRICE STREETKINGWOODWV26537550717988PRIMARY AND URGENT CAREWV501(C)(3)3Yes (1)PRESTON MEMORIAL HOSPITAL CORPORATION
PRESTON MEMORIAL HOSPITAL FOUNDATION
300 SOUTH PRICE STREETKINGWOODWV26537550740121RAISE FUNDS FOR PRESTON HOSPITALWV501(C)(3)12B, IIYes (1)PRESTON MEMORIAL HOSPITAL CORPORATION
LIABILITY INSURANCE TRUST FOR MONONGALIA HEALTH SYSTEM
1200 JD ANDERSON DRIVEMORGANTOWNWV26505550689535LIABILITY INSURANCE TRUSTWV501(C)(3)12A, IYes (1)MONONGALIA HEALTH SYSTEM INC
STONEWALL JACKSON MEMORIAL HOSPITAL
230 HOSPITAL PLAZAWESTONWV26452550422958HOSPITALWV501(C)(3)3Yes (1)MONONGALIA HEALTH SYSTEM INC
MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC
140 MIDDLETOWN LOOPWHITEHALLWV26554853994078HOSPITALWV501(C)(3)3Yes (1)MONONGALIA HEALTH SYSTEM INC
CAMC GREENBRIER VALLEY MEDICAL CENTER INC
1320 MAPLEWOOD AVENUERONCEVERTEWV24970884128022HOSPITALWV501(C)(3)3Yes (1)CHARLESTON AREA MEDICAL CENTER INC
CAMC PLATEAU MEDICAL CENTER INC
430 MAIN STREETOAK HILLWV25901921715117HOSPITALWV501(C)(3)3Yes (1)CHARLESTON AREA MEDICAL CENTER INC
CAMC HEALTH EDUCATION AND RESEARCH INSTITUTE INC
PO BOX 1547CHARLESTONWV253261547550753754MEDICAL EDUCATIONAL RESEARCHWV501(C)(3)12A, IYes (1)CHARLESTON AREA MEDICAL CENTER INC
DAVIS HEALTH SYSTEM INC
PO BOX 1484ELKINSWV26241550737655HEALTH SYSTEMWV501(C)(3)12B, II0MONONGALIA HEALTH SYSTEM INC
BROADDUS HOSPITAL ASSOCIATION INC
PO BOX 930PHILLIPIWV26416550379108HOSPITALWV501(C)(3)3Yes (1)DAVIS HEALTH SYSTEM INC
DAVIS HEALTH SYSTEM FOUNDATION INC
PO BOX 1188ELKINSWV26241320185772PROVIDES SUPPORT TO DAVIS HEALTH SYSTEM ENTITIESWV501(C)(3)10Yes (1)DAVIS HEALTH SYSTEM INC
WEBSTER MEMORIAL HOSPITAL
812 GORMAN AVENUEELKINSWV26241871759588HOSPITALWV501(C)(3)3Yes (1)DAVIS HEALTH SYSTEM INC

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
GENERAL DIVISION MEDICAL OFFICE BUILDING LLC
PO BOX 1547CHARLESTONWV253261547550623949MEDICAL OFFICE BUILDINGWVN/A00
DASCO-CAMC HOME MEDICAL EQUIPMENT LLC
501 MORRIS STREETCHARLESTONWV25301844487189HOME MEDICAL EQUIPMENTWVN/A00
MGH SURGERY LLC
2000 MON HEALTH MEDICAL PARK DRIVEMORGANTOWNWV26505472736896SURGERY CENTERWVN/A00
MON HEALTH-DASCO HOME MEDICAL EQUIPMENT LLC
375 N WEST STWESTERVILLEOH43082871577276HOME MEDICAL EQUIPMENTOHN/A00
CHARLESTON SURGICAL HOSPITAL LLC
1306 KANAWHA BLVD ECHARLESTONWV25301550526191SURGERY CENTERWVN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
VANDALIA INSURANCE COMPANY
76 ST PAUL STREET STE 500BURLINGTONVT05401030308754INSURANCEVTN/ACYes (1)
MON HEALTH CARE INC
1200 JD ANDERSON DRIVEMORGANTOWNWV26505550654973MEDICAL EQUIPMENTWVN/ACYes (1)
STONEWALL HOME OXYGEN THERAPY INC
100 MARKET PLACE MALL SUITE 8WESTONWV26452550754278OXYGEN THERAPY SERVICESWVN/ACYes (1)
HEALTH FACILITIES INC
909 GORMAN AVENUEELKINSWV26241550516937HEALTH CAREWVN/ACYes (1)
CENTRAL WV MEDCORP INC
PO BOX 2630ELKINSWV26241550739314PHYSICIAN SERVICESWVN/ACYes (1)
DAVIS REGIONAL HEALTH PARTNERS INC
PO BOX 2632ELKINSWV26241550746206CONTRACT NEGOTIATIONSWVN/ACYes (1)
XERCOR RE SEGREGATED PORTFOLIO #2 DAVIS
CAPTIVE INSURANCEN/ACYes (1)18 FORUM LANE 2ND FLOORGRAND CAYMANCAYMAN ISLANDSCJKY1-1102CJ
FAIRMONT HOME EQUIPMENT AND SUPPLY
1200 JD ANDERSON DRIVEMORGANTOWNWV26505550763259EQUIPMENT RENT & SVCWVN/ACYes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
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 OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (9 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
HEALTH FACILITIES INC
K$141,529FAIR MARKET VALUE
MONONGALIA COUNTY GENERAL HOSPITAL COMPANY
P$16,898,001FAIR MARKET VALUE
BROADDUS HOSPITAL ASSOCIATION INC
P$3,168,294FAIR MARKET VALUE
WEBSTER MEMORIAL HOSPITAL
P$1,597,924FAIR MARKET VALUE
HEALTH FACILITIES INC
P$121,128FAIR MARKET VALUE
BROADDUS HOSPITAL ASSOCIATION INC
Q$2,035,013FAIR MARKET VALUE
WEBSTER MEMORIAL HOSPITAL
Q$4,775,493FAIR MARKET VALUE
HEALTH FACILITIES INC
Q$9,627,789FAIR MARKET VALUE
DAVIS HEALTH SYSTEM FOUNDATION INC
C$214,221FAIR MARKET VALUE