STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

ST JOSEPHS HOSPITAL OF BUCKHANNON INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
ST JOSEPHS HOSPITAL OF BUCKHANNON INC (EIN 55-0356996)
Tax period
2013-10-01 to 2014-09-30
Filed
2015-08-17
IRS object ID
201502299349302655
Schema version
2013v4.0
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)
Return2015-08-17T11:43:30-05:00ReturnTs
Tax Period End2014-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN550486667PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Arnett Carbis Toothman LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1P O Box 2629AddressLine1
CityCharlestonCity
StateWVState
ZIP Code25329ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550356996EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1St Joseph's Hospital of Buckhannon IncBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlSTJOBusinessNameControlTxt
Phone3044732000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 Amalia DriveAddressLine1
CityBuckhannonCity
StateWVState
ZIP Code26201ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSue Johnson-PhillippePersonNm
Person TitlePresident & CEOPersonTitleTxt
Phone3044732000PhoneNum
Signature2015-08-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonHarry C HarlessPreparerPersonNm
PTINP01042847PTIN
Phone3043460441PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSue Johnson-PhillippePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 Amalia DriveAddressLine1
CityBuckhannonCity
StateWVState
ZIP Code26201ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$46,235,666GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttp://www.stj.net/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1989FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionWe are inspired by the love of Christ to provide our community with quality health care in ways that respect the God-given dignity of each person and the sacredness of human life.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee519TotalEmployeeCnt
Total Volunteers30TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$274,452PYContributionsGrantsAmt
CY Contributions Grants$124,420CYContributionsGrantsAmt
PY Program Service Revenue$42,531,164PYProgramServiceRevenueAmt
CY Program Service Revenue$44,863,105CYProgramServiceRevenueAmt
PY Investment Income$639,541PYInvestmentIncomeAmt
CY Investment Income$598,571CYInvestmentIncomeAmt
PY Other Revenue$436,841PYOtherRevenueAmt
CY Other Revenue$602,166CYOtherRevenueAmt
PY Total Revenue$43,881,998PYTotalRevenueAmt
CY Total Revenue$46,188,262CYTotalRevenueAmt
PY Grants And Similar Paid$6,990PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$25,881,281PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$24,573,448CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$22,260,991PYOtherExpensesAmt
CY Other Expenses$20,224,316CYOtherExpensesAmt
PY Total Expenses$48,149,262PYTotalExpensesAmt
CY Total Expenses$44,797,764CYTotalExpensesAmt
PY Revenues Less Expenses-$4,267,264PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,390,498CYRevenuesLessExpensesAmt
Total Assets BOY$25,229,230TotalAssetsBOYAmt
Total Assets EOY$28,090,287TotalAssetsEOYAmt
Total Liabilities BOY$31,310,243TotalLiabilitiesBOYAmt
Total Liabilities EOY$33,532,206TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$6,081,013NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$5,441,919NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWe are inspired by the love of Christ to provide our community with quality health care in ways that respect the God-given dignity of each person and the sacredness of human life.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$37,114,943ExpenseAmt
Revenue$44,863,105RevenueAmt
DescThe Hospital provides impartial access to treatment or accommodation for care that is available or medically indicated regardless of race, creed, sex, national origin or source of payment. In order to enable our patients to lead healthy, productive lives, the hospital strives to supply a comprehensive range of acute inpatient, long-term and outpatient care, outreach clinics, home care and emergency room services including prevention, guidance, diagnosis, treatment, restoration, rehabilitation, and other efforts as may be required, to meet the health care needs of the community as the hospital resources will permit. Although payment for services rendered is essential to the operation and stability of the hospital, it is recognized that not all individuals possess the financial means to purchase essential medical services. Our mission is to serve the community with respect to providing health care services and health care education. In keeping with this commitment, the hospital will serve all members of its community regardless of means or source of payment. The hospital also operates physician clinics and durable medical equipment services centers.Desc
Total Program Service Expenses$37,114,943TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl 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 OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document40IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee519EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
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 Body0Form990ProvidedToGvrnBodyInd
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
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Renee HoferBusinessNameLine1
FieldValueIRS element (for citing)
Phone3044732185PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 Amalia DriveAddressLine1
CityBuckhannonCity
StateWVState
ZIP Code26201ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Sue Johnson-Phillippe
President & CEO40.00Yes (X)Yes (X)$0$261,496$0
Sr Diane Bushee
Member1.00Yes (X)$0$0$0
Sr Marian Ruth Creamer
Member1.00Yes (X)$0$0$0
Steve Foster
Treasurer1.00Yes (X)$0$0$0
Sr Mary Grace Barile
Member1.00Yes (X)$0$0$0
Sr Francesca Lowis
Vice-Chair/Secretary1.00Yes (X)$0$0$0
Michael G Sellards
President & CEO - SMMC/PHS1.00Yes (X)Yes (X)$0$951,880$24,05340.00
Terry Cronin
Chair1.00Yes (X)$0$0$0
Bob Skinner
Member1.00Yes (X)$0$0$0
Robert Blake MD
Member1.00Yes (X)$0$0$0
Dennis Xander
Member1.00Yes (X)$0$0$0
Sr Gail Borgmeyer
Member1.00Yes (X)$0$0$0
Tom Moore
CFO40.00Yes (X)$174,615$0$6,853
Renee Hofer
Controller40.00Yes (X)$115,003$0$6,853
John Rollins
Chief of Staff40.00$238,407$0$6,853Yes (X)
Susan Long
General Surgeon40.00$539,363$0$6,853Yes (X)
James Kim
Orthopedic Surgeon40.00$330,703$0$6,853Yes (X)
Yaser Kalash
Cardiologist40.00$450,405$0$6,853Yes (X)
Salvatore Lanasa
General Surgeon40.00$455,405$0$6,853Yes (X)
Ilan Bornstein
Physician40.00$309,546$0$6,853Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,613,447TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,213,376TotReportableCompRltdOrgAmt
Total Other Compensation$78,877TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K30IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
WVU Medical Corporation
PO Box 740MorgantownWV26507ER Physician Coverage$1,074,212
Employee Benefit Service
PO Box 890144CharlotteNC28289Third Party Administrator$679,622
Nelson Mullins Riley & Scarborough LLP
949 3rd Ave Ste 200HuntingtonWV25701Legal Services$474,976
Quest Diagnostics
12436 Collection CenChicagoIL60693Laboratory Services$251,822
Alliance Healthcare SVCS
PO Box 96485ChicagoIL60693MRI Services Contract$214,200
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K14CntrctRcvdGreaterThan100KCnt
Related Organizations$100,558RelatedOrganizationsAmt
All Other Contributions$23,862AllOtherContributionsAmt
Noncash Contributions$62,174NoncashContributionsAmt
Total Contributions$124,420TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient service revenue622110$43,859,006$43,859,006
Medicare incentive payments622110$1,004,099$1,004,099
FieldValueIRS element (for citing)
Total Program Service Revenue$44,863,105TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$135,429TotalRevenueColumnAmt
Exclusion$135,429ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$318TotalRevenueColumnAmt
Exclusion$318ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$63,144RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$5,982RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$57,162RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$57,162TotalRevenueColumnAmt
Exclusion$57,162ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$504,564OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$41,422OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$463,142OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$463,142TotalRevenueColumnAmt
Exclusion$463,142ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
Pharmacy income446110$304,577$304,577
Cafeteria and vending722212$216,557$216,557
Medical records revenue900099$9,863$9,863

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,689TotalRevenueColumnAmt
Exclusion$13,689ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$544,686OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$46,188,262TotalRevenueColumnAmt
Related Or Exempt Func Income$44,863,105RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,200,737ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$428,639TotalAmt
Program Services$348,655ProgramServicesAmt
Management And General$79,984ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$18,744,197TotalAmt
Program Services$15,246,530ProgramServicesAmt
Management And General$3,497,667ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$538,823TotalAmt
Program Services$438,279ProgramServicesAmt
Management And General$100,544ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,612,979TotalAmt
Program Services$2,938,797ProgramServicesAmt
Management And General$674,182ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,248,810TotalAmt
Program Services$1,015,782ProgramServicesAmt
Management And General$233,028ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$399,361TotalAmt
Management And General$399,361ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$201,655TotalAmt
Management And General$201,655ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$61,169TotalAmt
Management And General$61,169ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,838,841TotalAmt
Program Services$2,309,113ProgramServicesAmt
Management And General$529,728ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$148,272TotalAmt
Management And General$148,272ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,680,943TotalAmt
Program Services$2,994,079ProgramServicesAmt
Management And General$686,864ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$479,486TotalAmt
Program Services$390,014ProgramServicesAmt
Management And General$89,472ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$858,828TotalAmt
Program Services$698,571ProgramServicesAmt
Management And General$160,257ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$24,806TotalAmt
Program Services$20,177ProgramServicesAmt
Management And General$4,629ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$156,260TotalAmt
Program Services$127,102ProgramServicesAmt
Management And General$29,158ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,524,271TotalAmt
Program Services$1,239,842ProgramServicesAmt
Management And General$284,429ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$943,673TotalAmt
Program Services$767,584ProgramServicesAmt
Management And General$176,089ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Bad debt$4,692,645$4,692,645
Medical supplies$1,695,662$1,695,662
Provider tax$769,109$769,109
Dues and subscriptions$186,459$151,666$34,793

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,562,876TotalAmt
Program Services$1,271,336ProgramServicesAmt
Management And General$291,540ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$44,797,764TotalAmt
Program Services$37,114,943ProgramServicesAmt
Management And General$7,682,821ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$423,570BOYAmt
EOY$1,736,524EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,121,954BOYAmt
EOY$2,435,198EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,425,217BOYAmt
EOY$7,832,638EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$12,490BOYAmt
EOY$8,690EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,003,064BOYAmt
EOY$968,038EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$965,865BOYAmt
EOY$1,461,605EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$38,214,138LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$24,792,688LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$14,601,806BOYAmt
EOY$13,421,450EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$18,399BOYAmt
EOY$17,171EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$472,350BOYAmt
EOY$87,033EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$184,515BOYAmt
EOY$121,940EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$25,229,230BOYAmt
EOY$28,090,287EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,241,740BOYAmt
EOY$12,872,958EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$22,293BOYAmt
EOY$8,768EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$172,948BOYAmt
EOY$130,274EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$380,556BOYAmt
EOY$237,396EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$19,492,706BOYAmt
EOY$20,282,810EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$31,310,243BOYAmt
EOY$33,532,206EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$6,146,854BOYAmt
EOY-$5,489,284EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$40,841BOYAmt
EOY$22,365EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$25,000BOYAmt
EOY$25,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$6,081,013BOYAmt
EOY-$5,441,919EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,229,230BOYAmt
EOY$28,090,287EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,390,498ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$16,453NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$734,951OtherChangesInNetAssetsAmt
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 D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$468,833OtherCostOrOtherBasisAmt
Book Value$468,833BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$25,213,395OtherCostOrOtherBasisAmt
Depreciation$15,207,832DepreciationAmt
Book Value$10,005,563BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,367,500OtherCostOrOtherBasisAmt
Depreciation$8,666,692DepreciationAmt
Book Value$2,700,808BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,164,410OtherCostOrOtherBasisAmt
Depreciation$918,164DepreciationAmt
Book Value$246,246BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,421,450TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
Accrued pension costs$8,358,077
Notes payable - related parties$2,664,761
Bonds reported on parent's return$8,038,815
Lease payable$99,323
Accrued malpractice liability$515,929
LT Debt 2003 series$605,905
FieldValueIRS element (for citing)
Total Liability$20,282,810TotalLiabilityAmt

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 Other125.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$221,285TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$221,285NetCommunityBenefitExpnsAmt
Total Expense0.00550TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,130,607TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,160,250DirectOffsettingRevenueAmt
Net Community Benefit Expns$970,357NetCommunityBenefitExpnsAmt
Total Expense0.02420TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$169,885TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$108,501DirectOffsettingRevenueAmt
Net Community Benefit Expns$61,384NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,521,777TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,268,751DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,253,026NetCommunityBenefitExpnsAmt
Total Expense0.03120TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,521,777TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,268,751DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,253,026NetCommunityBenefitExpnsAmt
Total Expense0.03120TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$54,298TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$54,298NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$54,298TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$54,298NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,908,499BadDebtExpenseAmt
Reimbursed By Medicare$4,209,670ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$4,195,733CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$13,937MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn0FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1St Joseph's Hosptial of BuckhannonBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 Amalia DriveAddressLine1
CityBuckhannonCity
StateWVState
ZIP Code26201ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherSkilled Nursing Facility, Outpatient Physician ClinicOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1St Joseph's Hospital of Buckhannon IncBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://www.stj.netOwnWebsiteURLTxt
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Develop Community Wide PlanYes (X)DevelopCommunityWidePlanInd
Exec Community Wide PlanYes (X)ExecCommunityWidePlanInd
Include Operational PlanYes (X)IncludeOperationalPlanInd
Adopt BudgetYes (X)AdoptBudgetInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
All Needs AddressedYes (1)AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care125.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Asset LevelYes (X)AssetLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
Insurance StatusYes (X)InsuranceStatusInd
Uninsured DiscountYes (X)UninsuredDiscountInd
Medicaid MedicareYes (X)MedicaidMedicareInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
St. Joseph's Hospital of Buckhannon, IncPart V, Section B, Line 12i: Debt to income ratio
St. Joseph's Hospital of Buckhannon, IncPart V, Section B, Line 20d: Patients with no insurance coverage are considered self-pay patients. Those patients are automatically given a 15% uninsured discount from gross charges, based on commercial insurance average.
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
St Joseph's Hospital
1 Amalia DriveBuckhannonWV26201Skilled nursing facility
St Joseph's Hospital
1 Amalia DriveBuckhannonWV26201Physician Clinics
St Joseph's Hospital
1 Amalia DriveBuckhannonWV26201DME Services

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:Uncompensated Care Procedure: 1) Anyone applying for uncompensated care will be required to fill out an Uncompensated Care Application. This can be done in the following manner: a) The admissions clerk can take the application at the time of the admission. b) The Credit/Collection department can take the application when doing financial assessment. c) The application can be taken any time during the billing cycle. d) The application can be mailed to the patient. 2) Anyone applying for uncompensated care will be required to provide the hospital with proof of income. The proof of income can be as listed: a) Tax return from most recent year of filing, check stubs from the last three months or a check stub showing year-to-date earnings. b) A statement of earnings from the employer or source of income. c) Medicaid denial letter or verification through WVDHHR screening website. The associate will insure that Medicaid eligibility is solicited. If appropriate documentation is not attached, application will be denied. d) Listing of all assets, ATV's, Boats, Campers, Property, Stocks, Bonds, CD's etc. The most current months bank statement is required. 3) The Business Office Manager or his/her designee will make all determinations: a) The Monthly income is listed and multiplied by 12. b) The chart is referenced to determine uncompensated eligibility. c) If eligible, this is noted and signed by the associate. d) If not eligible, expense information is analyzed. Non-discretionary expenses are considered necessities of life or job (shelter, food, utilities, car loan, etc.). e) Comparison of expenses to income determines disposable income for payment of a hospital debt. f) Total expenses are then totaled, with the same expense to income comparison. g) Accounts will be required to have asset information verified with the county assessor's office. If cash convertible asset information is exactly twice the amount of the patient portion of the St. Joseph's Hospital bill or more, applicant is not eligible for assistance. If substantial hard assets exist, they will be considered.4) A patient will be notified if Uncompensated Care is denied or a percentage is granted. 5) Accounts approved for uncompensated care will be written off using the appropriate forms and codes.6) Medicare accounts that are written off to Uncompensated Care must be listed on the Medicare bad Debt Compliance Checklist. Medicare accounts will be required to have asset information verified with the county assessors office.7) Determination for Uncompensated Care will be based on annual income guidelines (see attachment). Determination will be made at the end of each month.8) St. Joseph's Hospital will make medically necessary services available on an inpatient or outpatient basis to individuals who cannot afford to pay for such services.9) Accounts that have been referred to a collection agency will not be eligible for consideration.
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 $ 4,692,645.
Part II, Community Building Activities:The recruitment of physicians to this community is vital for the health of the community.
Part III, Line 2:The cost of bad debts was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instrucdtions.
Part III, Line 4:Patient accounts receivable: Patient accounts receivable are carried at the net realizable value less an estimate for doubtful or uncollectible accounts. The allowance is based upon a review of the outstanding balances, aged by financial class. Management uses collection percentages, based upon historical collection experience, to determine collectability. Management also reviews troubled, aged accounts to determine collection potential. Patient accounts receivable are written off when deemed uncollectible. Recoveries of accounts previously written off are recorded as a reduction to bad debt expense when received. Interest is not charged on patient accounts receivable.Upshur County WV is the primary service area for St. Joseph's Hospital. The 2010 census showed that 19.3% of the population in Upshur county to be below poverty level. Thus, 19.3% of the bad debt cost was used to calculate the estimated amount of the Organization's bad debt expense attributable to patients under the Organization's financial assistance policy.The cost of bad debt expense was determined using the cost to charge ratio.The amount of bad debt expense attributable to patients under the financial assistance policy is estimated to be 25% of bad debt expense using patient accounting department's personal experience.
Part III, Line 9b:Prior to an account going to collections, especially if it is a self-pay patient, the Organization checks Medicaid and charity eligibility. St. Joseph's hospital requires all self-pay patients to talk to a financial counselor to determine qualification for charity care and Medicaid programs. Self-pay patients are required to show proof that they have been denied by Medicaid. After it is determined that self-pay patients do not qualify for assistance, and if they are still unable to pay their bills, they are set up on a payment plan suited to their income level. Only when a self-pay patient falls behind on his/her payments and it is certain he or she does not qualify for assistance are they sent to a collection agency.
Part VI, Line 2:St. Joseph's Hospital has contracted with an outside company to perform the community wide needs assessment survey and has translated this information into the Community Health Needs Assessment Report which outlines actions taken. In addition, an outside company performs post admission surveys for all inpatients. This survey includes questions regarding whether the patient's needs were met during the stay, and the hospital reviews this HCAHPS data to determine what services may need to be added based on that data.
Part VI, Line 4:St. Joseph's Hospital is located in a small town in a rural, mountainous region of West Virginia. The hospital serves its home county (with a population of approximately 24,477 residents), as well as parts of five surrounding counties. The population served is an aging population with nearly 30% of the population in the 45 to 65 year old age group and will be reaching retirement age over the next 20 years, resulting in a major impact on health care in the area. In St. Joseph's Hospital's home county, 18.8% of the population is below the poverty level and nineteen percent (19%) of the population is uninsured, with 4.6% of the children in the county having no insurance. The teen pregnancy rate is 31.2%. The following hospitals provide a full range of acute care, ancillary and case management services and many also provide long-term care. The hospitals are located in the immediate service area or the contiguous service area: Stonewall Jackson Memorial Hospital, United Hospital Center, Davis Memorial Hospital, Louis A. Johnson VA Medical Center, and Broaddus Hospital. In addition, William J. Sharpe Hospital in Weston, West Virginia provides comprehensive psychiatric services for patients that have been involuntarily committed to the facility.
Part VI, Line 5:St. Joseph's hospital promotes the health of the community by maintaining an open medical staff, using community members on its board of directors, providing support of community health activities (blood screenings, health fair, flu shot clinics, etc.). The Hospital has also been actively recruiting both primary care providers and specialists to meet the health care needs of our service area.
Part VI, Line 6:St. Joseph's Hospital of Buckhannon, Inc. is a not-for-profit health care facility wholly sponsored by Pallottine Health Services, Inc. (PHS). Pallottine Health Services is a ministry of the Pallottine Missionary Sisters and includes both St. Joseph Hospital of Buckhannon, West Virginia and St. Mary's Medical Center of Huntington, West Virginia. Both of these hospitals are committed to the core values of compassion, hospitality, reverence, interdependence, stewardship, and trust. PHS files a community benefit report every three years in West Virginia. St. Joseph's Hospital is included in this community benefit report.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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
Sue Johnson-Phillippe
President & CEO$0$250,980$0$0$0$10,516$0$0$0$0$0$261,496$0$0
Michael G Sellards
President & CEO - SMMC/PHS$0$637,500$0$137,324$0$177,056$0$7,650$0$16,403$0$975,933$0$0
Tom Moore
CFO$174,615$0$0$0$0$0$0$0$7,155$0$181,770$0$0$0
John Rollins
Chief of Staff$238,407$0$0$0$0$0$0$0$7,309$0$245,716$0$0$0
Susan Long
General Surgeon$539,363$0$0$0$0$0$0$0$7,309$0$546,672$0$0$0
James Kim
Orthopedic Surgeon$330,703$0$0$0$0$0$0$0$7,081$0$337,784$0$0$0
Yaser Kalash
Cardiologist$450,405$0$0$0$0$0$0$0$7,309$0$457,714$0$0$0
Salvatore Lanasa
General Surgeon$455,405$0$0$0$0$0$0$0$7,309$0$462,714$0$0$0
Ilan Bornstein
Physician$309,546$0$0$0$0$0$0$0$7,309$0$316,855$0$0$0

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

FieldValueIRS element (for citing)
PersonJoseph Reed MDPersonNm
Relationship With OrgFormer board memberRelationshipWithOrgTxt
Loan PurposePurchase of a buildingLoanPurposeTxt
Loan To OrganizationYes (X)LoanToOrganizationInd
Original Principal$220,500OriginalPrincipalAmt
Balance Due$130,274BalanceDueAmt
Default0DefaultInd
Board Or Committee ApprovalYes (1)BoardOrCommitteeApprovalInd
Written AgreementYes (1)WrittenAgreementInd
FieldValueIRS element (for citing)
Total Balance Due$130,274TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ComforTech Heating & CoolingBusinessNameLine1
FieldValueIRS element (for citing)
Relationship Descriptionentity owned 49% by director Terry CroninRelationshipDescriptionTxt
Transaction$27,950TransactionAmt
TransactionContracted maintenance and purchase of equipment.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescMedical EquipDesc
Contribution1ContributionCnt
Noncash Contributions Rpt F990$62,174NoncashContributionsRptF990Amt
Method Of Determining RevenuesReplacement costMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6The Organization is a membership (not a stock) corporation under West Virginia State law. The Organization's sole corporate member is Pallottine Health Services, a related not-for-profit organization.
Form 990, Part VI, Section A, line 7aIn accordance with the terms and requirements of its governing documents (i.e. bylaws), on an annual basis, the Organization's current board members recommend the list of candidates for membership to the governing body for the subsequent term to the St. Joseph's Hospital board of directors. The Pallottine Health Services board of directors will approve and elect these candidates to serve as the organization's board of directors.
Form 990, Part VI, Section A, line 7bPallottine Health Services, as the sole corporate member, also has the right to approve or ratify significant decisions of the Organization's governing body including the amendment of bylaws and charters, removal of members of the governing body, and the decision to dissolve the organization.
Form 990, Part VI, Section B, line 11The Form 990 is reviewed by the organization's management (A team comprised of representatives of the finance and administration departments) in consultation with an accounting firm (Arnett Carbis Toothman). The financial review is based on the organization's audited financial statements for the relevant time period. Before the Form 990 is filed with the IRS, the finance committee of the organization's board of directors reviews the Form 990. Relevant portions of the form 990 are transmitted to the board before the return is filed.
Form 990, Part VI, Section B, line 12cUpon employment and annually thereafter, each key employee and officer of the organization is required to complete a conflict of interest and disclosure form, providing sufficient information about his/her personal interests and relationships so the organization can (1) determine whether any potential or actual conflicts of interest may exist, and (2) monitor work or service assignments to avoid placing the key employee, officer or director in a position where there may be an appearance (potential or actual) of a conflict of interest or a question of objectivity. The completed conflict of interest and disclosure forms for directors are returned to the organization. These members are monitored and not assigned any projects that would create any potential conflict of interest. The determination of conflict of interest would be made at the PHS board level. Any board member with a potential conflict recuses himself or herself from all discussions regarding the conflict.
Form 990, Part VI, Section B, line 15Pallottine Health Services (PHS), the organization's single member, regularly provides documentation to PHS's compensation committee with respect to the compensation of the Organization's officers and key employees for review and approval. Such information includes comparable data from similar size tax-exempt organizations in Buckhannon, West Virginia and surrounding communities as well as compensation for these positions (as disclosed on Form 990) with other organizations in the health care industry that are of similar size, demographics, and geography. Review and approval of the compensation arrangement by the officers/executive committee is documented.
Form 990, Part VI, Section C, line 19The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request at its office at 1 Amalia Drive, Buckhannon, WV 26201. A nominal fee is charged if copies are requested.
Form 990, Part XI, line 9:Change in pension plan funded status -716,475. Additional revenue adjusted through net assets on financial statements -18,476.
Form 990, Part IV, Question 24ASt. Joseph's Hospital is part of the obligated group for tax-exempt bonds held by Pallottine Health Services. All bonds are reported on the Pallottine Health Services Form 990 for the year ended 9/30/13.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Pallottine Health Services
2900 First AvenueHuntingtonWV25702550688201Parent - managementWV501(C)(3)11aN/A0
Pallottine Missionary Sisters
1 Amalia DriveBuckhannonWV26201431783315ChurchMO501(C)(3)1N/A0
St Mary's Medical Center
2900 First AvenueHuntingtonWV25702550357050HospitalWV501(C)(3)30Pallottine Health Services
St Mary's Medical Center Foundation
2900 First AvenueHuntingtonWV25702141887211FoundationWV501(C)(3)11b0St Mary's Medical Center
St Joseph's Foundation of Buckhannon
1 Amalia DriveBuckhannonWV26201550727650FoundationWV501(C)(3)11cYes (1)St Joseph's Hospital of Buckhannon

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
St Mary's Occupational Health and Medical Services
2900 First AvenueHuntingtonWV25702542136110Medical ServicesWVN/A
Tri-State MRI
2900 First AvenueHuntingtonWV25702550669726Medical ServicesWVN/A
Claire-Frances Health Services
200 Mall Road Suite 3AshlandKY41101311517507Medical ServicesWVN/A
Huntington Area MRI
2900 First AvenueHuntingtonWV25702261877332Medical ServicesWVN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Entity TypeEntityTypeTxtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Upshur Medical Management Services
1 Amalia DriveBuckhannonWV26201550727649InactiveWVSaint Joseph's HospitalC1.00000Yes (1)
Vanguard Financial Services
2900 First AvenueHuntingtonWV25702450496141Collection AgencyWVC0N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
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 OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1St Joseph's Foundation of Buckhannon IncBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeCTransactionTypeTxt
Involved$100,558InvolvedAmt
Method Of Amount DeterminationInternal accounting recordsMethodOfAmountDeterminationTxt