STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

PLEASANT VALLEY HOSPITAL INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
PLEASANT VALLEY HOSPITAL INC (EIN 55-0440086)
Tax period
2013-10-01 to 2014-09-30
Filed
2015-08-14
IRS object ID
201542269349301884
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)
Return2015-08-14T11:02:49-05:00ReturnTs
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)
EIN550440086EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Pleasant Valley HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlPLEABusinessNameControlTxt
Phone3046754340PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12520 Valley DriveAddressLine1
CityPt PleasantCity
StateWVState
ZIP Code25550ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRichard HoganPersonNm
Person TitleCFOPersonTitleTxt
Phone3046754340PhoneNum
Signature2015-08-14SignatureDt
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 TS2016-04-25 22:37:26ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerGlen WashingtonPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12520 Valley DriveAddressLine1
CityPt PleasantCity
StateWVState
ZIP Code25550ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$70,153,147GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.pvalley.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1955FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionProvide quality inpatient and outpatient healthcare to the community regardless of ability to pay. Provide a wellness center to promote community health through fitness programs.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee858TotalEmployeeCnt
Total Volunteers100TotalVolunteersCnt
Total Gross UBI-$1,196TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$1,446NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$50,198PYContributionsGrantsAmt
CY Contributions Grants$77,668CYContributionsGrantsAmt
PY Program Service Revenue$69,367,500PYProgramServiceRevenueAmt
CY Program Service Revenue$68,652,995CYProgramServiceRevenueAmt
PY Investment Income$244,120PYInvestmentIncomeAmt
CY Investment Income$288,538CYInvestmentIncomeAmt
PY Other Revenue$896,245PYOtherRevenueAmt
CY Other Revenue$1,104,339CYOtherRevenueAmt
PY Total Revenue$70,558,063PYTotalRevenueAmt
CY Total Revenue$70,123,540CYTotalRevenueAmt
PY Grants And Similar Paid$80,728PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$49,383CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$40,403,175PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$39,881,479CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$32,276,133PYOtherExpensesAmt
CY Other Expenses$30,678,722CYOtherExpensesAmt
PY Total Expenses$72,760,036PYTotalExpensesAmt
CY Total Expenses$70,609,584CYTotalExpensesAmt
PY Revenues Less Expenses-$2,201,973PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$486,044CYRevenuesLessExpensesAmt
Total Assets BOY$36,272,220TotalAssetsBOYAmt
Total Assets EOY$35,112,016TotalAssetsEOYAmt
Total Liabilities BOY$15,855,451TotalLiabilitiesBOYAmt
Total Liabilities EOY$15,181,291TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$20,416,769NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$19,930,725NetAssetsOrFundBalancesEOYAmt
MissionTo operate an acute care hospital facility for the citizens of Point Pleasant, West Virginia and the surrounding communities and counties.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$59,192,631ExpenseAmt
Grant$49,383GrantAmt
Revenue$68,510,264RevenueAmt
DescThe hospital provided 39,620 acute, nursery, and skilled nursing days; 122,478 outpatient visits; 15,541 emergency room visits; 2,261 ambulatory surgeries; 1,152 observation visits; 19,284 home health visits; 1,228 hospice visits; and 41,740 physician office visits.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$119,419ExpenseAmt
Revenue$142,731RevenueAmt
DescThe hospital operates a wellness center which provides community health education and fitness programs that are available to hospital employees and all residents of the surrounding communities.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$59,312,050TotalProgramServiceExpensesAmt
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 AssetsYes (1)ReportOtherAssetsInd
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 OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document45IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee858EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention 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 Line1Richard Hogan CFOBusinessNameLine1
FieldValueIRS element (for citing)
Phone3046754340PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12520 Valley DriveAddressLine1
CityPoint PleasantCity
StateWVState
ZIP Code25550ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Mario Liberatore
Trustee3.000.50Yes (X)$0$0$0
Peter Allinder
Chairman3.000.30Yes (X)$0$0$0
Annette Boyles
Vice Chairman3.000.50Yes (X)$0$0$0
Charles Lanham
Treasurer3.000.50Yes (X)$0$0$0
Michael Lieving
Trustee3.000.50Yes (X)$0$0$0
Scott Barnitz
Trustee3.000.30Yes (X)$0$0$0
Jack Buxton OD
Trustee3.000.30Yes (X)$0$0$0
Clayton Faber
Trustee3.000.30Yes (X)$0$0$0
Randall Hawkins MD
Trustee40.000.30Yes (X)$308,859$0$27,714
William Tatterson
Trustee3.000.30Yes (X)$0$0$0
Thomas Willoughby
Trustee3.000.30Yes (X)$0$0$0
C Dallas Kayser
Trustee3.000.30Yes (X)$0$0$0
Dorsel Keefer
Trustee3.000.30Yes (X)$0$0$0
James Lockhart DDS
Trustee3.000.30Yes (X)$0$0$0
William Knight
Trustee3.000.30Yes (X)$0$0$0
James Rossi
Trustee3.000.30Yes (X)$0$0$0
Lannes Williamson
Secretary3.000.30Yes (X)$0$0$0
Amanda Clark
Trustee3.000.30Yes (X)$0$0$0
Thomas E Schauer
President/CEO40.00$231,774$0$19,510Yes (X)
Larry Unroe
President/CEO40.00$101,778$0$0Yes (X)
Richard Hogan
CFO40.00$173,639$0$17,792Yes (X)
Robert Tayengco MD
Physician40.00$383,371$0$27,714Yes (X)
James Toothman MD
Physician40.00$790,421$0$27,714Yes (X)
Ori Tzuk MD
Physician40.00$566,940$0$27,131Yes (X)
Clifford Roberson MD
Physician40.00$552,330$0$17,604Yes (X)
Stephen Rerych MD
Physician40.00$425,870$0$27,714Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,534,982TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$192,893TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K9IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
NAPS Incorporated
714 1/2 Lee StreetCharlestonWV25301Anesthesia Services$492,979
Quest Diagnostics
PO Box 740709AtlantaGA30374Laboratory Services$416,147
Crest Services
735 Plaza Blvd 210CoppeilTX75019Biomedical Services$308,190
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Government Grants$2,496GovernmentGrantsAmt
All Other Contributions$75,172AllOtherContributionsAmt
Total Contributions$77,668TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Services622110$66,922,264$66,922,264
Electronic health records incenti900099$1,588,000$1,588,000
Wellness Center621111$142,731$142,731
FieldValueIRS element (for citing)
Total Program Service Revenue$68,652,995TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$288,538TotalRevenueColumnAmt
Unrelated Business Revenue-$1,196UnrelatedBusinessRevenueAmt
Exclusion$289,734ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$416,526RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$29,607RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$386,919RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$386,919TotalRevenueColumnAmt
Exclusion$386,919ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
Cafeteria & vending722212$201,993$201,993
Purchase discounts900099$102,303$102,303
Gift shop453220$38,950$38,950

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$374,174TotalRevenueColumnAmt
Exclusion$374,174ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$717,420OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$70,123,540TotalRevenueColumnAmt
Related Or Exempt Func Income$68,652,995RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue-$1,196UnrelatedBusinessRevenueAmt
Exclusion$1,394,073ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$49,383TotalAmt
Program Services$49,383ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$812,935TotalAmt
Program Services$649,616ProgramServicesAmt
Management And General$163,319ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$26,278,072TotalAmt
Program Services$20,998,807ProgramServicesAmt
Management And General$5,279,265ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$695,531TotalAmt
Program Services$555,799ProgramServicesAmt
Management And General$139,732ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$10,265,267TotalAmt
Program Services$8,202,975ProgramServicesAmt
Management And General$2,062,292ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,829,674TotalAmt
Program Services$1,462,092ProgramServicesAmt
Management And General$367,582ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$50,177TotalAmt
Management And General$50,177ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$54,628TotalAmt
Management And General$54,628ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,858,563TotalAmt
Program Services$4,681,578ProgramServicesAmt
Management And General$1,176,985ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$346,609TotalAmt
Program Services$276,975ProgramServicesAmt
Management And General$69,634ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,092,603TotalAmt
Program Services$1,661,835ProgramServicesAmt
Management And General$430,768ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$7,812TotalAmt
Program Services$6,243ProgramServicesAmt
Management And General$1,569ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$986,276TotalAmt
Program Services$788,133ProgramServicesAmt
Management And General$198,143ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$486,512TotalAmt
Program Services$388,772ProgramServicesAmt
Management And General$97,740ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$372,135TotalAmt
Program Services$297,373ProgramServicesAmt
Management And General$74,762ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,676,804TotalAmt
Program Services$2,139,034ProgramServicesAmt
Management And General$537,770ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$580,775TotalAmt
Program Services$464,097ProgramServicesAmt
Management And General$116,678ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Bad debts$7,770,407$7,770,407
Medical supplies$5,420,809$5,420,809
Repairs & maintenance$1,646,491$1,315,711$330,780
Medicaid provider tax$1,251,207$1,251,207

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,076,914TotalAmt
Program Services$931,204ProgramServicesAmt
Management And General$145,710ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$70,609,584TotalAmt
Program Services$59,312,050ProgramServicesAmt
Management And General$11,297,534ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$88,306EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,366,936BOYAmt
EOY$4,675,198EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,360,126BOYAmt
EOY$10,930,441EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$227,546BOYAmt
EOY$185,048EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,263,211BOYAmt
EOY$1,210,736EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$453,905BOYAmt
EOY$320,461EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$76,350,782LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$61,764,970LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$16,718,566BOYAmt
EOY$14,585,812EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$35,817BOYAmt
EOY$284,646EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,846,113BOYAmt
EOY$2,831,368EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$36,272,220BOYAmt
EOY$35,112,016EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,861,438BOYAmt
EOY$7,549,600EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,360,000BOYAmt
EOY$5,785,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,634,013BOYAmt
EOY$1,846,691EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,855,451BOYAmt
EOY$15,181,291EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,416,769BOYAmt
EOY$19,930,725EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,416,769BOYAmt
EOY$19,930,725EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$36,272,220BOYAmt
EOY$35,112,016EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$486,044ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,254,831OtherCostOrOtherBasisAmt
Book Value$1,254,831BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$320,643InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$24,556,628OtherCostOrOtherBasisAmt
Depreciation$17,338,017DepreciationAmt
Book Value$7,539,254BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$233,667OtherCostOrOtherBasisAmt
Depreciation$233,667DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$47,744,298OtherCostOrOtherBasisAmt
Depreciation$42,257,310DepreciationAmt
Book Value$5,486,988BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,240,715OtherCostOrOtherBasisAmt
Depreciation$1,935,976DepreciationAmt
Book Value$304,739BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$14,585,812TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
Due from related parties$128,107
Other receivables$2,304,351
Accrued interest$2,551
Estimated third party receivables$396,359
FieldValueIRS element (for citing)
Total Book Value Other Assets$2,831,368TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Capital lease agreements$1,116,217
Estimated third party payor settlements$683,208
Bond issue liabilities$47,266
FieldValueIRS element (for citing)
Total Liability$1,846,691TotalLiabilityAmt

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
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other100.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$250,325TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$250,325NetCommunityBenefitExpnsAmt
Total Expense0.00400TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,060,304TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,422,159DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,638,145NetCommunityBenefitExpnsAmt
Total Expense0.04200TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,310,629TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,422,159DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,888,470NetCommunityBenefitExpnsAmt
Total Expense0.04600TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$163,803TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$30,553DirectOffsettingRevenueAmt
Net Community Benefit Expns$133,250NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,113,372TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,113,372NetCommunityBenefitExpnsAmt
Total Expense0.01770TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$47,735TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$47,735NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,324,910TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$30,553DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,294,357NetCommunityBenefitExpnsAmt
Total Expense0.02060TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,635,539TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,452,712DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,182,827NetCommunityBenefitExpnsAmt
Total Expense0.06660TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$754TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$754NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,582TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$6,582NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,315TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,315NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$351,624TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$351,624NetCommunityBenefitExpnsAmt
Total Expense0.00560TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,646TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$6,646NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$366,921TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$366,921NetCommunityBenefitExpnsAmt
Total Expense0.00580TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,753,832BadDebtExpenseAmt
Reimbursed By Medicare$9,342,221ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,046,508CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$295,713MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Pleasant Valley HospitalBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line12520 Valley DriveAddressLine1
CityPt PleasantCity
StateWVState
ZIP Code25550ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherSkilled nursing facilityOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Pleasant Valley HospitalBusinessNameLine1
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
Own Website URLwww.pvalley.orgOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
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 Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care100.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Asset LevelYes (X)AssetLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Provided On AdmissionYes (X)ProvidedOnAdmissionInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
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 (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pleasant Valley HospitalPart V, Section B, Line 3: First account perspectives were obtained from key community representatives through three different modes. These are: surveys, personal interviews and a focus group. The focus group was conducted on March 14, 2013 at the hospital. The focus group represented nine different community organizations plus various community representatives. The individuals who participated in the focus group are as follows: 1. City Dept. of Point Pleasant, WV / Mayor - Point Pleasant, 2. City Department of Point Pleasant, WV / City Clerk, 3. Early Education Station / Director, 4. Family Resource Network / Executive Director, 5. Mason County Health Department / Representative, 6. Mason County Schools / Director, 7. Mason County Commission / Commissioner, 8. Mason County Healthy Families / Supervisor, 9. Pleasant Valley Hospital / Director of Marketing, 10. Pleasant Valley Hospital / Radiologist, and 11. Prestera Ctr. / Clinical Psychologist.
Pleasant Valley HospitalPart V, Section B, Line 14g: The policy is discussed with patients before they are discharged. Copy of the policy is provided to patients prior to discharge.
Pleasant Valley HospitalPart V, Section B, Line 20d: Charges to bill patients are based on income level, asset level, and medical indigency. These were for patients who qualified for financial assistance. The Hospital also gave self-pay patients prompt pay discounts of of gross charges. Pateints were not denied financial assistance because the applications were incomplete. The applications were put on hold until the missing information was obtained.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Pleasant Valley Hospital Nursing & RehabBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1640 Sand Hill RoadAddressLine1
CityPoint PleasantCity
StateWVState
ZIP Code25550ZIPCode
FieldValueIRS element (for citing)
FacilitySkilled nursing facilityFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7:The cost of charity care and unreimbursed Medicaid were estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H Instructions.The cost of (1) community health improvement services and community bnefit operations, (2) health professions education, and (3) cash and in-kind contributions was obtained from the hospital's accounting records.
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 $ 7,770,407.
Part II, Community Building Activities:Our weight loss challenge gives the community the ability to use our wellness services. Our wellness services includes cardio and weight lifting machines and certified exercise physiologists. Blood pressure, weight, body fat were monitored before the challenge and after the challenge. This promotes a healthly lifestyle in the community. Mason County is a medically underserved area and the hospital spends money for recruitment for this area. The amount shown for workforce development is the amount paid to recruit new physicians to the area.
Part II - Community Building ActivitiesRepresentation on boards of coalitions that build community capacity and share ideas.
Part III, Line 4:Patient accounts receivable are carried at the original charge less an estimate made for doubtful or uncollectible accounts. The allowance is based upon a review of the outstanding balances aged by financial class. Management uses collection percentages based upon historical collection experience to determine collectibility. 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.Cost of bad debts was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions.
Part III, Line 8:Medicare allowable costs were estimated using Worksheet B of the Schedule H instructions.
Part III, Line 9b:Pleasant Valley Hospital has a charity care policy and a Collection and Bad Debt policy that discusses qualifying and eligibility for charity care, collection practices and handling of bad debt accounts. It is a practice to handle all patient accounts in the same manner/precedent. Patients are sent monthly statements - even while applying and pending financial assistance and will continue to receive statements until determination is made. Once determination is made the account balance or the % portion of the account balance is adjusted to "Financial Assistance".
Part VI, Line 2:The Hospital participates in the State of West Virginia Abeyance program. We prepare reports for this probran identifying our community benefit programs. This information is reported to the West Virginia Healthcare Authority which makes its records available to the publice.
Part VI, Line 3:The process in place offers the uninsured and underinsured patient the ability to apply for charity care through a formal application process established by reviewing both income and expense to make a final determination of eligibility. It requires proper verification of income through a pay stub, tax return, etc. It is also verified that the patient is not eligible for a state assisted program via a denial letter from the program or verification through the state caseworker. The patient will either be contacted by the Business Office or will contact the Business Office during the collection and statement process to discuss financial arrangements regarding their patient account. All options of payments will be discussed and charity care offered as an alternative option after screening the patient's financial ability to make payment.
Part VI, Line 4:Pleasant Valley Hospital is a rural hospital in Point Pleasant, WV. Pleasant Valley Hospital serves mainly the people of Mason and Jackson County, WV and Meigs and Gallia County, OH. We are a federally designated medically underserved area. Mason County has 27,016 residents, the median household income is $38,411, and 19% are below poverty levels. Jackson County has 29,126 residents, the median household income is $40,376, and 19% are below poverty levels. Gallia county has 30,397 residents, the median household income is $39,226 and 17.7% is below poverty levels. Meigs County has 23,331 residents, the median household income is $35,469 and 21.9% is below poverty levels. Medicaid patients made up 24.8% of our total discharges and 18.5% of our total outpatient visits in FY2014. Uninsured patients made up of 3.3% of our total discharges and 2.4% of our total outpatient vists in FY2014. There is one other not-for-profit hospital within 15 miles of PVH. They serve many of the same areas that PVH does.
Part VI, Line 5:The majority of the organization's governing body is comprised of persons who reside in the organization's primary service area, who are neither employees or contractors of the organization, nor family members thereof. The hospital extends medical staff privileges to all qualified physicians in its community. The hospital provides a 24 hour emergency room and is available to all regardless of the ability to pay. All the services provided by the hospital are provided regardless of the ability to pay. The hospital has an auxiliary that helps our patients and visitors if they need a wheelchair when they arrive or if they need dirctions on where to go within the Hospital. The hospital provides Breast Cancer Screenings/Mammograms free to patients who cannot pay for the service. The hospital has a fitness center for the community and it also conducts many health fairs throughout the year. The hospital provides many health screenings throughout the year in addition to a nutritional program. Our SNF provides transportation for its residents to health facilities. The hospital has support groups for members of the community. The hospital donates money to the community for various projects.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
Mason County Board of Education
1200 Main StreetPoint PleasantWV25550556000353501(c)(3)$10,000High school athletic program support and Kids Expo
Mason County Fair Inc
PO Box 334Point PleasantWV25550550628521501(c)(3)$21,305Support of fair activities.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Randall Hawkins MD
Trustee$200,984$0$107,875$0$0$0$11,889$0$16,607$0$337,355$0$0$0
Thomas E Schauer
President/CEO$139,274$0$0$0$92,500$0$7,796$0$12,337$0$251,907$0$0$0
Richard Hogan
CFO$173,538$0$101$0$0$0$0$0$18,576$0$192,215$0$0$0
Robert Tayengco MD
Physician$383,269$0$102$0$0$0$11,889$0$16,669$0$411,929$0$0$0
James Toothman MD
Physician$790,319$0$102$0$0$0$11,889$0$16,701$0$819,011$0$0$0
Ori Tzuk MD
Physician$525,138$0$41,802$0$0$0$11,889$0$16,339$0$595,168$0$0$0
Clifford Roberson MD
Physician$526,228$0$26,102$0$0$0$11,889$0$6,811$0$571,030$0$0$0
Stephen Rerych MD
Physician$425,768$0$102$0$0$0$11,889$0$16,835$0$454,594$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 4aFormAndLineReferenceDesc
ExplanationThomas Schauer $92,500ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
The County Commission of Mason County WV
A556000352575194BM62003-06-17$7,805,000To refund Series 1993 bonds000
The County Commission of Mason County WV
B556000352575194CH62006-10-12$3,895,000Capital improvements & equipment acquisition000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndCapital ExpendituresCapitalExpendituresAmt
A$2,800,000$7,805,000$7,021,907$156,100$626,993200300Yes (1)Yes (1)
B$2,365,000$3,895,000$389,500$77,900200800Yes (1)Yes (1)$3,427,600

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

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

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

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

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (11 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Lee Anne Kayser
Family member of C. Dallas Kayser, Hospital Trustee$24,787Wages0
Heather Lloyd
Family member of James Lockhart, Hospital Trustee$12,998Fees for service-independent contractor0
Jane Zirkle
Family member of Mike Lieving, Hospital Trustee$23,029Wages0
Wes Lieving DO
Family member of Mike Lieving, Hospital Trustee$237,333Wages0
Peoples Bank
James Lockhart, Hospital Trustee, is a board member of the bank$271Interest bearing checking accounts0
Peoples Bank
Dorsal Keefer, Hospital Truste, is a board member of the bank$271Interest bearing checking accounts0
Ohio Valley Bank
Charles Lanham, Hospital Trustee, is an officer of the bank`$31,112Interest on certificates of deposit0
Ohio Valley Bank
Mario Liberatore, Hospital Trustee, is an officer of the bank$31,112Interest on certificates of deposit0
Ohio Valley Bank
Lannes Williamson, Hospital Trustee, is a board member of the bank$31,112Interest on certificates of deposit0
Farmers Bank
Michael Lieving, Hospital Trustee, is an officer of the bank$8,432Interest on certificates of deposit0
David Faber MD
Family member of Clayton Faber, Hospital Trustee$175,583Wages0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2Dallas Kayser, Charles Lanham, and Michael Shaw have a business relationship. Mario Liberatore and Lannes Williamson have a business relationship. Dallas Kayers's spouse and James Rossi have a business relationship.
Form 990, Part VI, Section B, line 11The 990 is prepared by the Hospital's independent accountants. It is then reviewed by the CFO and CEO and a copy is provided to the governing board before it is filed with the IRS.
Form 990, Part VI, Section B, line 12cEach board member fills out a questionnaire at the end of the fiscal year. The questionnaire has questions on it that determine independence status and other relationships between board members and between the board member and the hospital. This helps in determining possible conflicts that may arise. In addition, the board members must sign a conflict of interest policy that requires them with due diligence to state that they have a conflict of interest when that conflict arises. The board member must leave the board meeting during discussions and voting.
Form 990, Part VI, Section B, line 15The compensation committee is made up of independent board members. These members are appointed by the board. The compensation committee decides the compensation of the CEO and VPs. The compensation committee consults with an independent consultant to determine a fair compensation for the CEO and VPs based on peer data. The Compensation committee has used this study to determine base salary for the CEO and VPs. The CEO contract is taken back to the board for final approval.
Form 990, Part VI, Section C, line 19These documents are available upon request for inspection at the hospital or by mailing a copy upon request.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
Pleasant Valley Hospital Foundation Inc
2420 Valley DrPt PleasantWV25550200120079FundraisingWV501(c)(3)Line 9N/A0
Pleasant Valley Hospital Health Foundation Inc
2420 Valley DrPt PleasantWV25550550649849Scholarships/HealthcareWV501(c)(3)Line 11b, IIN/A0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Pleasant Valley Home Medical EquipmentBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1Viand StAddressLine1
CityPt PleasantCity
StateWVState
ZIP Code25550ZIPCode
FieldValueIRS element (for citing)
EIN550653315EIN
Primary ActivitiesRetail - Medical equipment sales & rentalPrimaryActivitiesTxt
Legal Domicile StateWVLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Pleasant Valley HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income-$276,964ShareOfTotalIncomeAmt
Share Of EOY Assets$1,480,788ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd