CAMC PLATEAU MEDICAL CENTER INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- CAMC PLATEAU MEDICAL CENTER INC (EIN 92-1715117)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-11-17
- IRS object ID
- 202523219349323157
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-11-17T17:13:05-06:00 | ReturnTs |
| Tax Period End | 2024-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 4200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 921715117 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAMC PLATEAU MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CAMC | BusinessNameControlTxt |
| Phone | 3043887603 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 MORRIS ST | AddressLine1Txt |
| City | CHARLESTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFF SANDENE | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 3043887603 | PhoneNum |
| Signature | 2025-11-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANGELA M MOORE | PreparerPersonNm |
| PTIN | P00244342 | PTIN |
| Phone | 3174648600 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JEFF SANDENE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 MORRIS ST | AddressLine1Txt |
| City | CHARLESTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $54,592,722 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CAMC.ORG/PLATEAU-MEDICAL-CENTER | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2022 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | CAMC PLATEAU MEDICAL CENTER, INC. (CAMC PMC) OWNS AND OPERATES A CRITICAL CARE ACCESS HOSPITAL DESIGNED TO PROVIDE CARE FOR COMMUNITY RESIDENTS THROUGH EVERY STAGE OF LIFE. CAMC PMC PATIENTS DEPEND ON CAMC PMC TO PROVIDE CONVENIENT AND COMPASSIONATE CARE DELIVERED REGARDLESS OF A PATIENT'S ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $32,858,680 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $54,534,611 | CYProgramServiceRevenueAmt |
| PY Investment Income | $160,334 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,380 | CYInvestmentIncomeAmt |
| PY Other Revenue | $59,427 | PYOtherRevenueAmt |
| CY Other Revenue | $56,731 | CYOtherRevenueAmt |
| PY Total Revenue | $33,078,441 | PYTotalRevenueAmt |
| CY Total Revenue | $54,592,722 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,029,215 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $19,783,148 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $21,713,911 | PYOtherExpensesAmt |
| CY Other Expenses | $28,746,256 | CYOtherExpensesAmt |
| PY Total Expenses | $33,743,126 | PYTotalExpensesAmt |
| CY Total Expenses | $48,529,404 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$664,685 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,063,318 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $102,148,038 | TotalAssetsBOYAmt |
| Total Assets EOY | $112,661,322 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $102,812,723 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $107,262,689 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$664,685 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,398,633 | NetAssetsOrFundBalancesEOYAmt |
| Mission | STRIVING TO PROVIDE THE BEST HEALTHCARE TO EVERY PATIENT, EVERY DAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $29,703,176 | ExpenseAmt |
| Revenue | $54,534,614 | RevenueAmt |
| Desc | CAMC PLATEAU MEDICAL CENTER, INC. (CAMC PMC) IS A CRITICAL ACCESS HOSPITAL LOCATED IN OAK HILL, WEST VIRGINIA. IT HAS 25 LICENSED BEDS AND OFFERS THE FOLLOWING SPECIALTY SERVICES: CARDIOLOGY, EMERGENCY MEDICINE, FAMILY MEDICINE, GENERAL SURGERY, INTERNAL MEDICINE, ORTHOPEDICS, PATHOLOGY, PODIATRY AND MEDICAL IMAGING. IT HAS 17 EMPLOYED PHYSICIANS AND 9 EMPLOYED NON-PHYSICIAN PROVIDERS. THERE WERE 3,581 INPATIENT DAYS, 24,039 OUTPATIENT VISITS, 42,200 CLINIC VISITS AND 13,146 ER VISITS IN 2024. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,074,174 | ExpenseAmt |
| Desc | CAMC PLATEAU MEDICAL CENTER, INC. (CAMC PMC) DOES MUCH MORE THAN JUST PROVIDE HEALTH CARE, BEING INVOLVED IN NEARLY EVERY ASPECT OF THE HEALTH AND WELL BEING OF THE COMMUNITY. CAMC PMC PROVIDED ACUTE INPATIENT AND OUTPATIENT HOSPITAL SERVICES INCLUDING UNREIMBURSED CHARITY CARE AT COST OF $1,695,719. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $35,777,350 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 49 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFF SANDENE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3043887603 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 MORRIS STREET | AddressLine1Txt |
| City | CHARLESTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25301 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| DAVID L RAMSEY | ||||||||||
| PRESIDENT /CHAIR | 5.00 | 62.00 | Yes (X) | Yes (X) | $0 | $1,926,954 | $131,607 | |||
| GLENN CROTTY JR MD | ||||||||||
| TRUSTEE | 1.00 | 57.50 | Yes (X) | $0 | $1,156,127 | $58,825 | ||||
| JEFF SANDENE | ||||||||||
| TRUSTEE | 1.00 | 66.00 | Yes (X) | $0 | $960,798 | $250,403 | ||||
| CHRISTOPHER R KILIANY | ||||||||||
| TRUSTEE | 1.00 | 40.00 | Yes (X) | $0 | $261,862 | $66,465 | ||||
| VINCENT L NICOLAU | ||||||||||
| TRUSTEE | 1.00 | 40.00 | Yes (X) | $0 | $252,764 | $32,022 | ||||
| CHAD HOVIS | ||||||||||
| TREASURER | 5.00 | 58.00 | Yes (X) | $0 | $360,988 | $130,760 | ||||
| REBECCA STEVENSON | ||||||||||
| SECRETARY | 5.00 | 59.00 | Yes (X) | $0 | $191,854 | $66,073 | ||||
| JUSTUS SMITH | ||||||||||
| VP AND CHIEF NURSING OFFICER | 50.00 | 0.00 | $0 | $291,443 | $96,807 | Yes (X) | ||||
| TODD LARES | ||||||||||
| EMERGENCY MEDICINE PHYSICIAN | 40.00 | 0.00 | $0 | $518,648 | $14,831 | Yes (X) | ||||
| HOWARD NEWMARK | ||||||||||
| EMERGENCY MEDICINE PHYSICIAN | 40.00 | 0.00 | $0 | $409,063 | $1,871 | Yes (X) | ||||
| RAJESH NANDA | ||||||||||
| EMERGENCY MEDICINE PHYSICIAN | 40.00 | 0.00 | $0 | $297,581 | $13,175 | Yes (X) | ||||
| HEATHER HYLTON | ||||||||||
| VP FINANCE | 40.00 | 0.00 | $0 | $259,046 | $13,158 | Yes (X) | ||||
| BRENT GLOVER | ||||||||||
| EMERGENCY MEDICINE PHYSICIAN | 40.00 | 0.00 | $0 | $252,919 | $0 | Yes (X) | ||||
| ANGELA HILL | ||||||||||
| FORMER SECRETARY | 0.00 | 55.00 | $0 | $1,000,360 | $307,203 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,140,407 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,183,200 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDSTREAM ANESTHESIA PLLC | |||||
| PO BOX 63467 | CHARLOTTE | NC | 282633467 | HEALTHCARE SERVICES | $1,691,056 |
| CHSPSC LLC | |||||
| 4000 MERIDIAN BLVD | FRANKLIN | TN | 37068 | CONSULTING SERVICES | $749,450 |
| PEACHTREE INPATIENT CONSULTING | |||||
| 324 LESLIE COURT | BRISTOL | TN | 376205596 | CONSULTING SERVICES | $549,000 |
| PSYCHIATRIC MEDICAL CARE LLC | |||||
| PO BOX 734606 | DALLAS | TX | 753734606 | HEALTHCARE SERVICES | $515,028 |
| PREMIER HEALTHCARE SOLUTION | |||||
| 5882 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | HEALTHCARE SERVICES | $446,465 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $54,534,611 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $54,534,611 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $54,534,611 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,380 | TotalRevenueColumnAmt |
| Exclusion | $1,380 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA/VENDING | 722514 | $56,728 | $56,728 | |
| FEE HEALTH INFO REQSTS | 900099 | $3 | $3 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $56,731 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,592,722 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $54,534,614 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $58,108 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $356,490 | TotalAmt |
| Management And General | $356,490 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,289,157 | TotalAmt |
| Program Services | $11,662,636 | ProgramServicesAmt |
| Management And General | $2,626,521 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $513,168 | TotalAmt |
| Program Services | $430,047 | ProgramServicesAmt |
| Management And General | $83,121 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,540,752 | TotalAmt |
| Program Services | $2,826,125 | ProgramServicesAmt |
| Management And General | $714,627 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,083,581 | TotalAmt |
| Program Services | $866,865 | ProgramServicesAmt |
| Management And General | $216,716 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $753,077 | TotalAmt |
| Management And General | $753,077 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $300,359 | TotalAmt |
| Management And General | $300,359 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,152,100 | TotalAmt |
| Program Services | $6,443,002 | ProgramServicesAmt |
| Management And General | $709,098 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,382 | TotalAmt |
| Program Services | $15,382 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,908,029 | TotalAmt |
| Program Services | $1,532,177 | ProgramServicesAmt |
| Management And General | $375,852 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,025,044 | TotalAmt |
| Program Services | $764,721 | ProgramServicesAmt |
| Management And General | $260,323 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,264 | TotalAmt |
| Program Services | $71,991 | ProgramServicesAmt |
| Management And General | $7,273 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,688,557 | TotalAmt |
| Management And General | $5,688,557 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,103,239 | TotalAmt |
| Program Services | $1,682,591 | ProgramServicesAmt |
| Management And General | $420,648 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $727,066 | TotalAmt |
| Program Services | $727,066 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $6,549,098 | $6,513,173 | $35,925 |
| PROVIDER TAX | $1,466,765 | $1,466,765 | |
| REPAIRS & MAINTENANCE | $926,012 | $740,810 | $185,202 |
| ALL OTHER EXPENSES | $52,264 | $33,999 | $18,265 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,529,404 | TotalAmt |
| Program Services | $35,777,350 | ProgramServicesAmt |
| Management And General | $12,752,054 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $525 | BOYAmt |
| EOY | $525 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,397,782 | BOYAmt |
| EOY | $11,439,017 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,026,555 | BOYAmt |
| EOY | $1,380,263 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $278,924 | BOYAmt |
| EOY | $290,267 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $62,920,181 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,744,762 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,764,255 | BOYAmt |
| EOY | $57,175,419 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,269,757 | BOYAmt |
| EOY | $32,302,992 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,410,240 | BOYAmt |
| EOY | $10,072,839 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,148,038 | BOYAmt |
| EOY | $112,661,322 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,438,366 | BOYAmt |
| EOY | $3,080,919 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $318,731 | BOYAmt |
| EOY | $31,875 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,055,626 | BOYAmt |
| EOY | $104,149,895 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,812,723 | BOYAmt |
| EOY | $107,262,689 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$664,685 | BOYAmt |
| EOY | $5,398,633 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$664,685 | BOYAmt |
| EOY | $5,398,633 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,148,038 | BOYAmt |
| EOY | $112,661,322 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $6,063,318 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $300,000 | OtherCostOrOtherBasisAmt |
| Book Value | $300,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $54,996,888 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,395,423 | DepreciationAmt |
| Book Value | $52,601,465 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,661,825 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,153,378 | DepreciationAmt |
| Book Value | $3,508,447 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,961,468 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,195,961 | DepreciationAmt |
| Book Value | $765,507 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $57,175,419 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| AFFILIATE RECEIVABLE - CHARLESTON AREA MEDICAL CENTER, INC. | $9,835,240 |
| AFFILIATE RECEIVABLE - CAMC GREENBRIER VALLEY MEDICAL CENTER, INC. | $11,352 |
| AFFILIATE RECEIVABLE - VANDALIA, INC. | $226,247 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $10,072,839 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| AP - MEDICARE | $72,100 |
| AFFILIATE PAYABLE - CAMC, INC. | $100,568,968 |
| AFFILIATE PAYABLE - CHERI, INC. | $1,632 |
| AFFILIATE PAYABLE - CAMC GVMC, INC. | $14,349 |
| AP-MEDICAID | $6,325 |
| AFFILIATE PAYABLE- VANDALIA, INC. | $3,486,521 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $104,149,895 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | CAMC PLATEAU MEDICAL CENTER'S FINANCIAL STATEMENTS ARE AUDITED AS PART OF THE FINANCIAL STATEMENTS OF VANDALIA HEALTH, INC. AND SUBSIDIARIES (COLLECTIVELY, THE "SYSTEM"). LANGUAGE REGARDING ASC 740 (FIN 48) INCLUDED IN THE CONSOLIDATED FOOTNOTES IS AS FOLLOWS: "THE IRS HAS DETERMINED THAT 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. 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,695,719 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,695,719 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03460 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,497,902 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,080,217 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,417,685 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09000 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $160,640 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $111,668 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $48,972 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,354,261 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,191,885 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,162,376 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12560 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,354,261 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,191,885 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,162,376 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12560 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | -$534,744 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $17,094,409 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $21,797,807 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,703,398 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAMC PLATEAU MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 430 MAIN STREET W | AddressLine1Txt |
| City | OAK HILL | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 259013414 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CAMC.ORG | WebsiteAddressTxt |
| State License | 176 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAMC PLATEAU MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | Yes (1) | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 24 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.CAMC.ORG/ABOUT-CAMC/COMMUNITY-BENEFIT-REPORTS | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 24 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.CAMC.ORG/ABOUT-CAMC/COMMUNITY-BENEFIT-REPORTS | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.CAMC.ORG/CHARITY-UNINSURED-PLAN | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.CAMC.ORG/CHARITY-UNINSURED-PLAN | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.CAMC.ORG/CHARITY-UNINSURED-PLAN | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CAMC PLATEAU MEDICAL CENTER, INC. | PART V, SECTION B, LINE 2: ON DECEMBER 22, 2022, CHARLESTON AREA MEDICAL CENTER, INC. (CAMC) FORMED A NEW SUBSIDIARY, CAMC PLATEAU MEDICAL CENTER, INC. (PMC), TO ACQUIRE SUBSTANTIALLY ALL OF THE ASSETS OF PLATEAU MEDICAL CENTER IN OAK HILL, WEST VIRGINIA. THIS ACQUISITION CLOSED ON APRIL 1, 2023. |
| CAMC PLATEAU MEDICAL CENTER, INC. | PART V, SECTION B, LINE 5: KEY LEADERS, FROM ORGANIZATIONS LISTED BELOW, IN FAYETTE COUNTY IDENTIFIED AND PRIORITIZED COMMUNITY HEALTH NEEDS. THROUGH CAMC PLATEAU MEDICAL CENTER'S STRATEGIC PLANNING PROCESS, THE COMMUNITY HEALTH NEEDS ASSESSMENT AND PRIORITIZED COMMUNITY HEALTH NEEDS ARE USED TO SET COMMUNITY HEALTH IMPLEMENTATION STRATEGIES FOR CAMC PLATEAU CENTER. INPUT WAS GOTTEN FROM THE FOLLOWING ORGANIZATIONS: FAYETTE COUNTY HEALTH DEPARTMENT; CAMC PLATEAU MEDICAL CENTER; ENACT COMMUNITY ACTION; UNITED FOR ALICE RESEARCH CENTER; OAK HILL COMMUNITY ENGAGEMENT TEAM; HOUSED-UP, INC.; FAYETTE COUNTY OFFICE OF EMERGENCY SERVICES; FAYETTE COUNTY HOMELAND SECURITY; AND WV DEPARTMENT OF NATURAL RESOURCES |
| CAMC PLATEAU MEDICAL CENTER, INC. | PART V, SECTION B, LINE 6B: -FAYETTE COUNTY HEALTH DEPARTMENT-ENACT COMMUNITY ACTION-UNITED FOR ALICE RESEARCH CENTER-OAK HILL COMMUNITY ENGAGEMENT TEAM-HOUSED-UP, INC.-FAYETTE COUNTY OFFICE OF EMERGENCY SERVICES-FAYETTE COUNTY HOMELAND SECURITY-WV DEPARTMENT OF NATURAL RESOURCES |
| CAMC PLATEAU MEDICAL CENTER, INC. | PART V, SECTION B, LINE 11: THE FOLLOWING COMMUNITY HEALTH STRATEGIES HAVE BEEN FUNDED AND ARE BEING IMPLEMENTED. THE CAMC PLATEAU MEDICAL CENTER BOARD OF TRUSTEES APPROVED THE IMPLEMENTATION STRATEGIES AND REVIEWS PLAN PROGRESS ANNUALLY.1.) PROVIDE ACCESS TO PRIMARY AND SPECIALTY HEALTH CARE FOR THE SERVICE AREA THROUGH MEDICAL STAFF RECRUITMENT AND ESTABLISHMENT OF A PRIMARY SITE FOR ALL SPECIALISTS BY-RECRUIT MEDICAL STAFF FOR HIGH PRIORITY COMMUNITY NEEDS-INCREASED PRIMARY CARE SERVICES BY PLACING ADDITIONAL PRIMARY CARE LOCATIONS IN RALEIGH, FAYETTE AND NICHOLAS COUNTIES-IMPROVE ACCESS BY PROVIDING AN ADDITIONAL LOCATION THAT WILL HOUSE SPECIALISTS IN ONE LOCATION.2.) PROVIDE PHYSICAL ACTIVITY OPPORTUNITIES FOR THE AT RISK CARDIAC POPULATION AND ACCESS TO CARDIOLOGY SPECIALTY SERVICES BY - RECRUIT CARDIOLOGIST-PROVIDE A CARDIAC REHAB PROGRAM- PROVIDE EXERCISE PROGRAM FOR PATIENTS AFTER THEY COMPLETE PRESCRIBED CARDIAC REHAB PROGRAM- INCREASE CAPACITY FOR CARDIAC RELATED SERVICES3.) PROVIDE AFFORDABLE MEDICATION TO OUR COMMUNITY SERVED BY-EXPAND OUTPATIENT INFUSION SERVICES-OPEN INHOUSE OUTPATIENT PHARMACY-CREATE "MEDS TO BEDS" SERVICE-POTENTIAL OFFSITE OUTPATIENT PHARMACY LOCATION (S)4.) INCREASE IDENTIFICATION AND AWARENESS OF CARDIOVASCULAR DISEASE; INCREASE PHYSICAL ACTIVITY FOR THE AT RISK POPULATION BY-PROVIDE COMMUNITY-WIDE AND OFFICE-BASED INFORMATION ON MODIFYING CARDIOVASCULAR DISEASE RISK-WORK WITH COMMUNITY PARTNERS TO FOCUS ON MODIFIABLE RISK FACTORS (TOBACCO, OBESITY, DIET, EXERCISE).-EXPANSION OF STRESS TEST HOURS5.) PROVIDE FOOD TO LOW INCOME CHILDREN DURING THE SUMMER THROUGH THE BACKPACK PROGRAM BY-SUPPORT LOCAL CHURCH WITH THE BACKPACK PROGRAMTHE FOLLOWING COMMUNITY NEEDS ARE NOT ADDRESSED BY CAMC PLATEAU MEDICAL CENTER AND THE RATIONALE IS PROVIDED FOR EACH. - SUFFICIENT, SAFE AND AFFORDABLE HOUSING / HOMELESSNESS. THIS ISSUE IS ADDRESSED BY OTHER ORGANIZATIONS IN OUR COMMUNITY.- LOW INCOME / POVERTY GOOD PAYING JOBS FOR ADULTS & YOUTH - OPPORTUNITIES TO OPEN BUSINESSES IN THE COMMUNITY. CAMC PLATEAU MEDICAL CENTER DOES NOT HAVE THE CAPABILITY OR FUNDING TO ADDRESS THIS ISSUE.- QUALITY OF PUBLIC SCHOOL EDUCATION & ACCESS TO COLLEGE PROGRAMS. CAMC PLATEAU MEDICAL CENTER DOES NOT HAVE THE CAPABILITY OR FUNDING TO ADDRESS THIS ISSUE.- LACK OF BROADBAND / COMPUTER & TECHNOLOGY SKILLS. CAMC PLATEAU MEDICAL CENTER DOES NOT HAVE THE CAPABILITY OR FUNDING TO ADDRESS THIS ISSUE.- PUBLIC SAFETY. CAMC PLATEAU MEDICAL CENTER DOES NOT HAVE THE CAPABILITY OR FUNDING TO ADDRESS THIS ISSUE. |
| CAMC PLATEAU MEDICAL CENTER, INC. | PART V, SECTION B, LINE 13H: OTHER CRITERIA CONSIDERED FOR FINANCIAL ASSISTANCE ELIGIBILITY: A FINANCIAL ASSISTANCE ESTIMATION TOOL THAT UTILIZES PUBLIC RECORDS; AND WHETHER OR NOT A PATIENT RECEIVES ASSISTANCE FROM CERTAIN STATE AGENCIES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - PMC PHYSICAL THERAPY | ||||
| 501 MAIN ST | OAK HILL | WV | 25901 | PHYSICAL THERAPY |
| 2 - PMC GERIATRIC INTENSE DAY THERAPY | ||||
| 201 JONES AVE | OAK HILL | WV | 25901 | PSYCHIATRIC SERVICES |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | CAMC PLATEAU MEDICAL CENTER MAY SCREEN PRIVATE PAY BALANCES FOR PRE-QUALIFIED ELIGIBILITY BY USING FINANCIAL ASSISTANCE ESTIMATION TOOLS THAT ACCESS PUBLIC RECORDS. USING A PROPRIETARY ALGORITHM (LOOKING AT TAX RECORDS, BANKRUPTCIES, ETC), THE TOOL RETURNS WHETHER THE PATIENT IS LIKELY TO QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. IN CASES WHERE PRE-QUALIFIED ELIGIBILITY DOES NOT QUALIFY A PATIENT FOR FINANCIAL ASSISTANCE, THE PATIENT MAY COMPLETE A FINANCIAL ASSISTANCE APPLICATION WHERE APPLICATION MATERIAL IS EVALUATED TO DETERMINE IF THE PATIENT CAN QUALIFY BASED ON INCOME AND ASSETS. IF THE PATIENT MEETS INCOME CRITERIA FOR ELIGIBILITY AN INVENTORY OF AVAILABLE ASSETS IS EVALUATED. IF THE PATIENTS AVAILABLE ASSETS FALL BELOW $50,000 EXCLUDING THE PATIENTS PRIMARY RESIDENCE AND PRIMARY VEHICLE, THE PATIENT WILL QUALIFY FOR FINANCIAL ASSISTANCE. IF A PATIENT IS FOUND TO BE RECEIVING CERTAIN STATE AGENCY ASSISTANCE (I.E. WIC, SNAP, ETC.), SUCH PATIENT WILL BE PRESUMED ELIGIBLE FOR CAMC PLATEAU MEDICAL CENTER FINANCIAL ASSISTANCE, AND THEY WILL BE ASKED TO SUBMIT AN ABBREVIATED APPLICATION CONTAINING ONLY THE INFORMATION REGARDING THEIR STATE AGENCY ASSISTANCE. |
| PART I, LINE 7: | UTILIZED WORKSHEET 2 TO DETERMINE COST TO CHARGE RATIO |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ -534,744. |
| PART III, LINE 2: | THIS IS THE BAD DEBT EXPENSE FROM THE AUDITED FINANCIAL STATEMENTS. BAD DEBT IS THE NET OF DISCOUNTS, PAYMENTS AND RECOVERIES. |
| PART III, LINE 4: | THE FOOTNOTE FOR ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ON PAGE 14 OF VANDALIA HEALTH'S AUDITED FINANCIAL STATEMENTS. PATIENT RECEIVABLES, INCLUDING BILLED ACCOUNTS AND UNBILLEDACCOUNTS FOR WHICH WE HAVE THE UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROMTHIRD-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. |
| PART III, LINE 8: | CAMC PMC TREATS ANY GOVERNMENT REIMBURSEMENT THAT IS INSUFFICIENT TO COVER ALLOCATED COSTS AS BEING A COMMUNITY BENEFIT. CAMC PMC CHOOSES TO SERVE THE COMMUNITY BY PARTICIPATING IN THE MEDICARE PROGRAM AND ACCEPTING MEDICARE REIMBURSEMENT. COST TO CHARGE RATIO FROM THE MEDICARE COSTS REPORT IS USED. |
| PART III, LINE 9B: | CAMC PMC'S COLLECTION POLICY MAKES PROVISIONS FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. PATIENTS WHO RECEIVE FINANCIAL ASSISTANCE MUST HAVE INCOME AT 300% OR LESS OF FEDERAL POVERTY GUIDELINES, INSUFFICIENT ASSETS TO PAY FOR THE CARE, AND MAY NOT BE ELIGIBLE FOR ANY PUBLIC PROGRAMS. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE WITH INCOME UNDER 200% FPG ARE GIVEN A 100% DISCOUNT. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE WITH INCOME BETWEEN 201-300% FPG RECEIVE A 53% DISCOUNT. ALL PATIENT RESPONSIBILITY DEBT NOT APPROVED FOR FINANCIAL ASSISTANCE IS REVIEWED WITH A FINANCIAL ASSISTANCE ESTIMATOR. THIS FINANCIAL ASSISTANCE ESTIMATOR PROCESS IS ONLY USED TO APPROVE ASSISTANCE. IT IS NOT USED TO DENY ASSISTANCE. ACCOUNTS ARE ONLY REVIEWED FOR FINANCIAL ASSISTANCE AT THE 100% DISCOUNT CATEGORY. THIS PROCESS IS PERFORMED BEFORE EXTRAORDINARY COLLECTION EFFORTS. PATIENTS WITHOUT THIRD-PARTY COVERAGE WHO DO NOT QUALIFY FOR CHARITY ARE GIVEN A 53% DISCOUNT FROM CHARGES (WHICH IS GREATER THAN ANY COMMERCIAL DISCOUNT). IN ADDITION TO CHARITY AND UNINSURED DISCOUNTS, CAMC PMC PROVIDES ASSISTANCE WITH PAYMENT PLANS, GOVERNMENT PROGRAMS, AND AN EMPLOYEE ASSISTANCE PROGRAM. |
| PART VI, LINE 2: | CAMC PLATEAU MEDICAL CENTER SUPPORTS AND STRENGTHENS THE FAYETTE COUNTY COMMUNITY THROUGH OUR ANNUAL PLANNING PROCESS WHERE WE REVIEW THE NEEDS ASSESSMENT FINDINGS AND PRIORITIES TO DEVELOP OUR COMMUNITY STRATEGY AND THE COMMUNITY(IES) WITHIN FAYETTE COUNTY THAT ARE IMPACTED. THIS STRATEGY IS BASED ON ISSUES IDENTIFIED THROUGH THE NEEDS ASSESSMENT PROCESS AND SUPPLEMENTED WITH FINDINGS FROM REVIEW OF OUR INTERNAL DATA. STRATEGIES ARE IDENTIFIED AND PLANS ARE FUNDED, IMPLEMENTED, TRACKED AND MEASURED. THE CAMC PLATEAU MEDICAL CENTER BOARD OF TRUSTEES APPROVE THE PLAN AND REVIEWS PLAN PROGRESS ANNUALLY. IN ADDITION TO ADDRESSING COMMUNITY NEEDS AND CONTRIBUTING FINANCIALLY, PLATEAU MEDICAL CENTER'S VICE PRESIDENT AND ASSOCIATE ADMINISTRATOR SERVE IN KEY LEADERSHIP ROLES FOR COMMUNITY ACTIVITIES, PROGRAMS AND ORGANIZATIONS AS WELL AS SUPPORT THE WORKFORCE IN PARTICIPATING IN MANY COMMUNITY BENEFIT ACTIVITIES. AS PART OF THE STRATEGIC PLANNING PROCESS, CAMC PLATEAU MEDICAL CENTER DETERMINES IF THERE ARE ADDITIONAL AREAS OF SUPPORT THAT CAN BE PROVIDED TO ADDRESS THE IDENTIFIED COMMUNITY HEALTH NEEDS ASSESSMENT ISSUES. THE FOLLOWING TABLE LISTS PROGRAMS AND SUPPORT ALREADY IN PLACE PROVIDED BY CAMC PLATEAU MEDICAL CENTER THAT ADDRESS THESE COMMUNITY PRIORITIES, AND ARE IDENTIFIED AND FUNDED AS PART OF OPERATIONAL AND COMMUNITY BENEFIT PLANNING BY THE CAMC PLATEAU MEDICAL CENTER BOARD OF TRUSTEES. |
| PART VI, LINE 3: | CAMC PMC INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER CAMC PMC'S FINANCIAL ASSISTANCE POLICY DURING THE REGISTRATION PROCESS. INFORMATION IS AVAILABLE THROUGH SIGNAGE AND A PLAIN LANGUAGE SUMMARY OF THE POLICY IS GIVEN TO EACH PATIENT. IN ADDITION, FINANCIAL ASSISTANCE APPLICATIONS ARE AVAILABLE AT EACH REGISTRATION LOCATION. CAMC PMC FINANCIAL COUNSELORS ARE LOCATED IN EACH ADMITTING AREA. DURING REGISTRATION, IF A PATIENT IS UNINSURED, THEY MAY BE REFERRED TO A FINANCIAL COUNSELOR WHO PROVIDES EDUCATION ABOUT CHARITY CARE, MEDICAID ELIGIBILITY AND FEDERAL DISABILITY. WV STATE EMPLOYEES FROM DEPARTMENT OF HEALTH AND HUMAN RESOURCES ARE ALSO ON SITE AT EACH HOSPITAL TO ACCEPT AND PROCESS MEDICAID APPLICATIONS AND NOTIFY PATIENTS IF THEY QUALIFY. |
| PART VI, LINE 4: | CAMC PLATEAU MEDICAL CENTER'S SERVES FAYETTE COUNTY, WEST VIRGINIA IN ITS ROLE AS A CRITICAL ACCESS HOSPITAL. FAYETTE COUNTY HAS A TOTAL POPULATION OF 40,545 AND A MEDIAN AGE OF 45 AND MEDIAN INCOME OF $50,090, |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WV |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID L RAMSEY | ||||||||||||||
| PRESIDENT /CHAIR | $0 | $1,051,150 | $0 | $619,074 | $0 | $256,730 | $0 | $79,545 | $0 | $52,062 | $0 | $2,058,561 | $0 | $106,038 |
| ANGELA HILL | ||||||||||||||
| FORMER SECRETARY | $0 | $441,508 | $0 | $88,839 | $0 | $470,013 | $0 | $268,155 | $0 | $39,048 | $0 | $1,307,563 | $0 | $449,309 |
| GLENN CROTTY JR MD | ||||||||||||||
| TRUSTEE | $0 | $779,502 | $0 | $262,109 | $0 | $114,516 | $0 | $13,800 | $0 | $45,025 | $0 | $1,214,952 | $0 | $0 |
| JEFF SANDENE | ||||||||||||||
| TRUSTEE | $0 | $621,095 | $0 | $217,144 | $0 | $122,559 | $0 | $240,058 | $0 | $10,345 | $0 | $1,211,201 | $0 | $57,462 |
| TODD LARES | ||||||||||||||
| EMERGENCY MEDICINE PHYSICIAN | $0 | $518,648 | $0 | $0 | $0 | $0 | $0 | $13,800 | $0 | $1,031 | $0 | $533,479 | $0 | $0 |
| CHAD HOVIS | ||||||||||||||
| TREASURER | $0 | $266,813 | $0 | $52,797 | $0 | $41,378 | $0 | $68,629 | $0 | $62,131 | $0 | $491,748 | $0 | $25,838 |
| HOWARD NEWMARK | ||||||||||||||
| EMERGENCY MEDICINE PHYSICIAN | $0 | $409,063 | $0 | $0 | $0 | $0 | $0 | $854 | $0 | $1,017 | $0 | $410,934 | $0 | $0 |
| JUSTUS SMITH | ||||||||||||||
| VP AND CHIEF NURSING OFFICER | $0 | $225,158 | $0 | $51,891 | $0 | $14,394 | $0 | $60,109 | $0 | $36,698 | $0 | $388,250 | $0 | $0 |
| CHRISTOPHER R KILIANY | ||||||||||||||
| TRUSTEE | $0 | $256,576 | $0 | $300 | $0 | $4,986 | $0 | $10,590 | $0 | $55,875 | $0 | $328,327 | $0 | $0 |
| RAJESH NANDA | ||||||||||||||
| EMERGENCY MEDICINE PHYSICIAN | $0 | $297,581 | $0 | $0 | $0 | $0 | $0 | $11,913 | $0 | $1,262 | $0 | $310,756 | $0 | $0 |
| VINCENT L NICOLAU | ||||||||||||||
| TRUSTEE | $0 | $247,478 | $0 | $300 | $0 | $4,986 | $0 | $10,128 | $0 | $21,894 | $0 | $284,786 | $0 | $0 |
| HEATHER HYLTON | ||||||||||||||
| VP FINANCE | $0 | $223,344 | $0 | $35,702 | $0 | $0 | $0 | $10,388 | $0 | $2,770 | $0 | $272,204 | $0 | $0 |
| REBECCA STEVENSON | ||||||||||||||
| SECRETARY | $0 | $172,346 | $0 | $15,547 | $0 | $3,961 | $0 | $7,921 | $0 | $58,152 | $0 | $257,927 | $0 | $0 |
| BRENT GLOVER | ||||||||||||||
| EMERGENCY MEDICINE PHYSICIAN | $0 | $252,919 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $252,919 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE VANDALIA BOARD OF DIRECTORS COMPENSATION COMMITTEE SELECTS AND SUPERVISES AN INDEPENDENT CONSULTANT WHO ADVISES THE COMMITTEE ON COMPENSATION ARRANGEMENTS AND TRANSACTIONS BETWEEN VANDALIA HEALTH , INC. SUBSIDIARIES (INCLUDING CAMC PLATEAU MEDICAL CENTER) AND EXECUTIVES (INCLUDING CAMC PLATEAU MEDICAL CENTER'S PRESIDENT). THE COMMITTEE USES THE DATA TO DETERMINE THE TOTAL COMPENSATION OF CAMC PLATEAU MEDICAL CENTER'S PRESIDENT AND OTHER EXECUTIVE OFFICERS. THIS DATA IS REVIEWED EVERY TWO YEARS OR WHEN A NEW PERSON COMES INTO AN EXECUTIVE ROLE. |
| PART I, LINE 4B | TARGET BENEFIT SERP - A TARGET BENEFIT SERP IS OFFERED TO THREE EXECUTIVES, WITH AN ANNUAL EMPLOYER CONTRIBUTION THAT TARGETS PROVIDING 55% OF FINAL AVERAGE COMPENSATION AT AGE 60 FOR 30 YEARS OF SERVICE. THE TARGET BENEFIT IS OFFSET BY THE FROZEN DEFINED BENEFIT SERP ACCRUED BENEFIT, THE FROZEN RESTORATION PLAN BALANCE, EMPLOYER-PROVIDED QUALIFIED RETIREMENT BENEFITS, EMPLOYER-PROVIDED 457(B) PLAN BENEFITS, AND 50% OF AGE 62 SOCIAL SECURITY. EACH ANNUAL FUNDING CONTRIBUTION VESTS THE EARLIER OF 5 YEARS OR AGE 60. TAXES ARE ADVANCED FROM VESTED ACCOUNTS, WITH THE REMAINING BALANCE HELD UNTIL TERMINATION. ALL CONTRIBUTIONS ARE VESTED IN THE EVENT OF DEATH, DISABILITY, INVOLUNTARY TERMINATION WITHOUT CAUSE, OR VOLUNTARY TERMINATION FOR GOOD REASON FOLLOWING CHANGE OF CONTROL. UNVESTED CONTRIBUTIONS ARE FORFEITED FOR VOLUNTARY TERMINATION OR TERMINATION FOR CAUSE. DEFINED CONTRIBUTION SERP - A DEFINED CONTRIBUTION SERP IS OFFERED TO SELECT EXECUTIVES, WITH AN ANNUAL 10% OF SALARY CONTRIBUTION. EACH ANNUAL CONTRIBUTION VESTS THE EARLIER OF 5 YEARS OR AGE 65. TAXES ARE ADVANCED FROM VESTED ACCOUNTS, WITH THE REMAINING BALANCE HELD UNTIL TERMINATION. ALL CONTRIBUTIONS ARE VESTED IN THE EVENT OF DEATH, DISABILITY, INVOLUNTARY TERMINATION WITHOUT CAUSE, OR VOLUNTARY TERMINATION FOR GOOD REASON FOLLOWING CHANGE OF CONTROL. UNVESTED CONTRIBUTIONS ARE FORFEITED FOR VOLUNTARY TERMINATION OR TERMINATION FOR CAUSE. UNDER THE EXECU-FLEX BENEFIT PLAN (409A), EXECUTIVES RECEIVE 11% OF THEIR SALARY IN FLEX ALLOWANCE. THIS FLEX ALLOWANCE IS USED TO ELECT EXECUTIVE BENEFITS. ANY REMAINING FLEX ALLOWANCE IS CREDITED TO A TAX-DEFERRED CAPITAL ACCUMULATION ACCOUNT. THE MINIMUM VESTING PERIOD IS TWO YEARS, MAXIMUM AGE IS 68. A TWO YEAR NON-COMPETE AGREEMENT (SUBSTANTIAL RISK OF FORFEITURE AGREEMENT) APPLIES IF TERMINATION OF EMPLOYMENT OCCURS PRIOR TO THE VESTING DATE. CERTAIN PARTICIPANTS HAD AMOUNTS VESTED AND INCLUDED AS REPORTABLE COMPENSATION THIS YEAR, AS DETAILED BELOW: GLENN CROTTY, JR. M.D. - $80,919 ANGELA F. HILL - $452,281 DAVID L. RAMSEY - $154,224 JEFF SANDENE - $72,258 CHAD HOVIS - $29,414 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | DAVID RAMSEY, GLENN CROTTY JR., MD, JEFFREY SANDENE, REBECCA STEVENSON AND CHAD HOVIS HAVE A BUSINESS RELATIONSHIP DUE TO EMPLOYMENT BY A RELATED COMPANY WITHIN THE HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 6 | CHARLESTON AREA MEDICAL CENTER, INC. (CAMC) IS CAMC PLATEAU MEDICAL CENTER'S SOLE VOTING MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | CHARLESTON AREA MEDICAL CENTER, INC. (CAMC), IS CAMC PLATEAU MEDICAL CENTER'S (CAMC PMC) SOLE VOTING MEMBER AND HAS AUTHORITY TO ELECT ALL VOTING TRUSTEES OF CAMC PMC OTHER THAN EX-OFFICIO DIRECTORS NAMED IN CAMC PMC'S GOVERNING DOCUMENTS. THE SOLE VOTING MEMBER HAS THE SOLE AUTHORITY TO AMEND CAMC PMC'S GOVERNING DOCUMENTS. |
| FORM 990, PART VI, SECTION A, LINE 7B | CAMC IS CAMC PMC'S SOLE VOTING MEMBER AND HAS RESERVED POWERS UNDER CAMC PMC'S GOVERNING DOCUMENTS, WHICH PROVIDE THAT DECISIONS OF CAMC PMC'S GOVERNING BODY SUCH AS ELECTION OF OFFICERS, APPROVAL OF ANNUAL BUDGETS AND BORROWINGS ARE SUBJECT TO APPROVAL BY THE SOLE VOTING MEMBER. THE SOLE VOTING MEMBER ALSO HAS ALL APPROVAL POWERS PROVIDED TO MEMBERS OF WEST VIRGINIA NONPROFIT CORPORATIONS UNDER STATE LAW. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION COMPILES NECESSARY INFORMATION FOR FORM 990 WITH VARIOUS OFFICERS AND DIRECTORS OF THE ORGANIZATION AND ITS AFFILIATES. THE RETURN IS THEN PREPARED AND REVIEWED BY AN EXTERNAL CONSULTANT FIRM. THE VANDALIA HEALTH INC. CHIEF FINANCIAL OFFICER REVIEWS THE COMPLETED FORM 990 WITH THE CAMC PLATEAU MEDICAL CENTER, INC. BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION B, LINE 12C | CORPORATE OFFICERS, INCLUDING THE PRESIDENT AND SECRETARY, DEVELOP THE AGENDAS FOR BOARD MEETINGS AND IDENTIFY AND RESOLVE POTENTIAL CONFLICT OF INTEREST ISSUES RELATIVE TO ACTION ITEMS. ANNUAL DISCLOSURE PROCEDURES ARE IMPLEMENTED AND THE PRESIDENT AND THE VANDALIA HEALTH, INC. BOARD OF DIRECTORS GOVERNANCE COMMITTEE PERIODICALLY REVIEW CONFLICT SITUATIONS. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY REQUIRES ALL DISCLOSED CONFLICTS TO BE REPORTED BY THE CHIEF COMPLIANCE OFFICER TO THE VANDALIA HEALTH'S MANAGEMENT COMPLIANCE COMMITTEE. THE COMPLIANCE OFFICER WILL INFORM THE BOARD OF DIRECTORS AUDIT COMMITTEE AT THEIR NEXT SCHEDULED MEETING OF ALL SUCH ACTIVITIES APPROVED BY THE VANDALIA HEALTH MANAGEMENT COMPLIANCE COMMITTEE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE VANDALIA HEALTH, INC. BOARD OF DIRECTORS COMPENSATION COMMITTEE SELECTS AND SUPERVISES AN INDEPENDENT CONSULTANT WHO ADVISES THE COMMITTEE ON COMPENSATION ARRANGEMENTS AND TRANSACTIONS BETWEEN VANDALIA HEALTH COMPANIES AND EXECUTIVES. THE COMMITTEE USES THE DATA TO DETERMINE THE TOTAL COMPENSATION OF PRESIDENT. THE DATA IS REVIEWED EVERY TWO YEARS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S AUDIT IS PART OF A CONSOLIDATED FINANCIAL AUDIT FOR VANDALIA HEALTH, INC. AND SUBSIDIARIES. CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ONLINE AT CAMC.ORG. THEY ARE ALSO FILED WITH THE WV HEALTH CARE AUTHORITY WHERE THEY ARE AVAILABLE ONLINE AND IN PERSON. THERE IS NO FORMAL METHOD OF MAKING THE ORGANIZATION'S BYLAWS AND CONFLICT OF INTEREST POLICY PUBLICLY AVAILABLE, BUT THEY ARE AVAILABLE UPON REQUEST. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE ON FILE AT AND PUBLICLY AVAILABLE THROUGH THE WEST VIRGINIA SECRETARY OF STATE'S OFFICE. |
| FORM 990, PART IX, LINE 11G | HEALTHCARE CONTRACTORS: PROGRAM SERVICE EXPENSES 6,443,002. MANAGEMENT AND GENERAL EXPENSES 709,098. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,152,100. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (21 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| VANDALIA HEALTH INC | |||||||||||
| PO BOX 1547 | CHARLESTON | WV | 253261547 | 550664138 | PARENT COMPANY | WV | 501(C)(3) | 12C, III-FI | N/A | 0 | |
| CAMC FOUNDATION INC | |||||||||||
| PO BOX 1547 | CHARLESTON | WV | 253261547 | 310887133 | FUNDRAISING | WV | 501(C)(3) | 12A, I | Yes (1) | CHARLESTON AREA MEDICAL CENTER INC | |
| CHARLESTON AREA MEDICAL CENTER INC | |||||||||||
| PO BOX 1547 | CHARLESTON | WV | 253261547 | 550526150 | HOSPITAL | WV | 501(C)(3) | 3 | 0 | VANDALIA HEALTH INC | |
| MONONGALIA HEALTH SYSTEM INC | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550621551 | PARENT COMPANY | WV | 501(C)(3) | 12C, III-FI | 0 | VANDALIA HEALTH INC | |
| MONONGALIA COUNTY GENERAL HOSPITAL COMPANY | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 237441353 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| MON ELDER SERVICES INC | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 311520863 | CONTINUING CARE RETIREMENT CENTER | WV | 501(C)(3) | 10 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| THE FOUNDATION OF MONONGALIA GENERAL HOSPITAL | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550570338 | RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL | WV | 501(C)(3) | 7 | Yes (1) | MONONGALIA COUNTY GENERAL HOSPITAL CO | |
| PRESTON MEMORIAL HOSPITAL | |||||||||||
| 150 MEMORIAL DRIVE | KINGWOOD | WV | 26537 | 311097818 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| PRESTON MEMORIAL MEDICAL GROUP | |||||||||||
| 300 SOUTH PRICE STREET | KINGWOOD | WV | 26537 | 550717988 | PRIMARY AND URGENT CARE | WV | 501(C)(3) | 3 | Yes (1) | PRESTON MEMORIAL HOSPITAL CORPORATION | |
| PRESTON MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 300 SOUTH PRICE STREET | KINGWOOD | WV | 26537 | 550740121 | RAISE FUNDS FOR PRESTON HOSPITAL | WV | 501(C)(3) | 12B, II | Yes (1) | PRESTON MEMORIAL HOSPITAL CORPORATION | |
| AUXILIARY OF MONONGALIA GENERAL HOSPITAL INC | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550362965 | RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL | WV | 501(C)(3) | 12A, I | Yes (1) | MONONGALIA COUNTY GENERAL HOSPITAL CO | |
| LIABILITY INSURANCE TRUST FOR MONONGALIA HEALTH SYSTEM | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550689535 | LIABILITY INSURANCE TRUST | WV | 501(C)(3) | 12A, I | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| STONEWALL JACKSON MEMORIAL HOSPITAL | |||||||||||
| 230 HOSPITAL PLAZA | WESTON | WV | 26452 | 550422958 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC | |||||||||||
| 140 MIDDLETOWN LOOP | WHITEHALL | WV | 26554 | 853994078 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| CAMC GREENBRIER VALLEY MEDICAL CENTER INC | |||||||||||
| 1320 MAPLEWOOD AVENUE | RONCEVERTE | WV | 24970 | 884128022 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | CHARLESTON AREA MEDICAL CENTER INC | |
| CAMC HEALTH EDUCATION AND RESEARCH INSTITUTE INC | |||||||||||
| PO BOX 1547 | CHARLESTON | WV | 253261547 | 550753754 | MEDICAL EDUCATIONAL RESEARCH | WV | 501(C)(3) | 12A, I | Yes (1) | CHARLESTON AREA MEDICAL CENTER INC | |
| DAVIS HEALTH SYSTEM INC | |||||||||||
| PO BOX 1484 | ELKINS | WV | 26241 | 550737655 | HEALTH SYSTEM | WV | 501(C)(3) | 12B, II | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| DAVIS MEMORIAL HOSPITAL INC | |||||||||||
| PO BOX 1484 | ELKINS | WV | 26241 | 550375433 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | DAVIS HEALTH SYSTEM INC | |
| BROADDUS HOSPITAL ASSOCIATION INC | |||||||||||
| PO BOX 930 | PHILLIPI | WV | 26416 | 550379108 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | DAVIS HEALTH SYSTEM INC | |
| DAVIS HEALTH SYSTEM FOUNDATION INC | |||||||||||
| PO BOX 1188 | ELKINS | WV | 26241 | 320185772 | PROVIDES SUPPORT TO DAVIS HEALTH SYSTEM ENTITIES | WV | 501(C)(3) | 10 | Yes (1) | DAVIS HEALTH SYSTEM INC | |
| WEBSTER MEMORIAL HOSPITAL | |||||||||||
| 812 GORMAN AVENUE | ELKINS | WV | 26241 | 871759588 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | DAVIS HEALTH SYSTEM INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| GENERAL DIVISION MEDICAL OFFICE BUILDING LLC | |||||||||
| PO BOX 1547 | CHARLESTON | WV | 253261547 | 550623949 | MEDICAL OFFICE BUILDING | WV | N/A | 0 | 0 |
| DASCO-CAMC HOME MEDICAL EQUIPMENT LLC | |||||||||
| 501 MORRIS STREET | CHARLESTON | WV | 25301 | 844487189 | HOME MEDICAL EQUIPMENT | WV | N/A | 0 | 0 |
| MGH SURGERY LLC | |||||||||
| 2000 MON HEALTH MEDICAL PARK DRIVE | MORGANTOWN | WV | 26505 | 472736896 | SURGERY CENTER | WV | N/A | 0 | 0 |
| MON HEALTH-DASCO HOME MEDICAL EQUIPMENT LLC | |||||||||
| 375 N WEST ST | WESTERVILLE | OH | 43082 | 871577276 | HOME MEDICAL EQUIPMENT | OH | N/A | 0 | 0 |
| CHARLESTON SURGICAL HOSPITAL LLC | |||||||||
| 1306 KANAWHA BLVD E | CHARLESTON | WV | 25301 | 550526191 | SURGERY CENTER | WV | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VANDALIA INSURANCE COMPANY | |||||||||||||||
| 76 ST PAUL STREET STE 500 | BURLINGTON | VT | 05401 | 030308754 | INSURANCE | VT | N/A | C | Yes (1) | ||||||
| MON HEALTH CARE INC | |||||||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550654973 | MEDICAL EQUIPMENT | WV | N/A | C | Yes (1) | ||||||
| STONEWALL HOME OXYGEN THERAPY INC | |||||||||||||||
| 100 MARKET PLACE MALL SUITE 8 | WESTON | WV | 26452 | 550754278 | OXYGEN THERAPY SERVICES | WV | N/A | C | Yes (1) | ||||||
| HEALTH FACILITIES INC | |||||||||||||||
| 909 GORMAN AVENUE | ELKINS | WV | 26241 | 550516937 | HEALTH CARE | WV | N/A | C | Yes (1) | ||||||
| CENTRAL WV MEDCORP INC | |||||||||||||||
| PO BOX 2630 | ELKINS | WV | 26241 | 550739314 | PHYSICIAN SERVICES | WV | N/A | C | Yes (1) | ||||||
| DAVIS REGIONAL HEALTH PARTNERS INC | |||||||||||||||
| PO BOX 2632 | ELKINS | WV | 26241 | 550746206 | CONTRACT NEGOTIATIONS | WV | N/A | C | Yes (1) | ||||||
| XERCOR RE SEGREGATED PORTFOLIO #2 DAVIS | |||||||||||||||
| CAPTIVE INSURANCE | N/A | C | Yes (1) | 18 FORUM LANE 2ND FLOOR | GRAND CAYMAN | CAYMAN ISLANDS | CJ | KY1-1102 | CJ | ||||||
| FAIRMONT HOME EQUIPMENT AND SUPPLY | |||||||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550763259 | EQUIPMENT RENT & SVC | WV | N/A | C | Yes (1) | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CAMC GREENBRIER VALLEY MEDICAL CENTER INC | ||
| P | $179,046 | FAIR MARKET VALUE |
| CAMC GREENBRIER VALLEY MEDICAL CENTER INC | ||
| Q | $171,350 | FAIR MARKET VALUE |