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PALLOTTINE HEALTH SERVICES: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
PALLOTTINE HEALTH SERVICES (EIN 55-0688201)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-15
IRS object ID
201412279349303356
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-15T12:09:58-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN550486667EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Arnett Foster Toothman PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1P O Box 2629AddressLine1
CityCharlestonCity
StateWVState
ZIP Code25329ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN550688201EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Pallottine Health Services IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPALLNameControl
Phone3045261224Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12900 First AvenueAddressLine1
CityHuntingtonCity
StateWVState
ZIP Code25702ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMichael G SellardsName
TitleCEOTitle
Phone3045261224Phone
Date Signed2014-08-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameHarry C HarlessName
PTINP01042847PTIN
Phone3043460441Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMichael G SellardsNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12900 First AvenueAddressLine1
CityHuntingtonCity
StateWVState
ZIP Code25702ZIPCode
FieldValueIRS element (for citing)
Gross Receipts7934632GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileWVStateLegalDomicile
Activity Or Mission DescriptionThe organization provides management services, advice and consultation to West Virginia affiliates sponsored by the religious community of the Missionary Sisters of the Catholic Apostolate (Pallottine).ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees7TotalNbrEmployees
Total Nbr Volunteers3TotalNbrVolunteers
Total Gross UBI32040TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1871890ProgramServiceRevenuePriorYear
Program Service Revenue CY2129400ProgramServiceRevenueCY
Investment Income Prior Year830569InvestmentIncomePriorYear
Investment Income Current Year1102077InvestmentIncomeCurrentYear
Other Revenue Prior Year932128OtherRevenuePriorYear
Other Revenue Current Year43350OtherRevenueCurrentYear
Total Revenue Prior Year3634587TotalRevenuePriorYear
Total Revenue Current Year3274827TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year40750GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY40000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1932663SalariesEtcPriorYear
Salaries Etc Current Year2494463SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year861858OtherExpensePriorYear
Other Expenses Current Year1148737OtherExpensesCurrentYear
Total Expenses Prior Year2835271TotalExpensesPriorYear
Total Expenses Current Year3683200TotalExpensesCurrentYear
Revenues Less Expenses Prior Year799316RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-408373RevenuesLessExpensesCY
Total Assets BOY19067440TotalAssetsBOY
Total Assets EOY22786633TotalAssetsEOY
Total Liabilities BOY11655371TotalLiabilitiesBOY
Total Liabilities EOY15501412TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY7412069NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7285221NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe mission of Pallottine Health Services, Inc. is to sponsor Health Care institutions that promote and demonstrate the human\religious, professional and economic values of the Pallottine Sisters, which are consistent with the teachings of the Roman Catholic Church and the ethical and religious directives for Catholic health care services. Adherence to these values will ensure that services provided in Pallottine health facilities respect the dignity of the human person and the sacredness of human life; are carried out in a spirit of ecumenisn and equality in an atmosphere of Christian community; and respond, within the limits of available resources, to the health need of the communities they serve with special concern for the poor.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense3144740Expense
Grants40000Grants
Revenue2129400Revenue
DescriptionManagement services, advice and consultation provided to the West Virginia Affiliates sponsored by the religious community of Missionary Sisters of the Catholic Apostolate (Pallottine) - St. Joseph's Hospital of Buckhannon, Inc. and St. Mary's Medical Center, Inc.Description
Total Program Service Expense3144740TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10962NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees7NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Angela SwearingenBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3045261224TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12900 First AvenueAddressLine1
CityHuntingtonCity
StateWVState
ZIP Code25702ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedKey EmployeeKeyEmployeeFormerFormer
Sr Gail Borgmeyer SAC
President40.00XX000
Sr M Diane Bushee SAC
Secretary/Treasurer2.00XX00038.00
Sr M Francesca Lowis SAC
Vice-President2.00XX00038.00
Sr Mary Grace Barile SAC
Trustee2.00X00038.00
Sr Marian Ruth Creamer SAC
Trustee2.00X000
Barbara Stevens
Trustee2.00X000
Robert Yost
Trustee2.00X000
David Alkire
Trustee2.00X000
Michael G Sellards
President & CEO - SMMC2.00X84310603271238.00
Sue Johnson-Phillippe
CEO, St. Joseph's Hospital2.002579560038.00X
Angela Swearingen
CFO2.0028891602997038.00X
Todd Campbell
COO - SMMC2.0040955803230538.00X
S David Creech
Former CEO, Pallottine Health Services0.00125084000.00X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1924620TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation94987TotalOtherCompensation
Number Individuals GT100 K4NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionManagement feesDescription
Business Code561000BusinessCode
Total Revenue Column2129400TotalRevenueColumn
Related Or Exempt Function Income2129400RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue2129400TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column918304TotalRevenueColumn
Exclusion$918,304ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4843578Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities4659805Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities183773Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column183773TotalRevenueColumn
Exclusion$183,773ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Premier Purchasing, LLC9000033204032040
Other Income90009911310$11,310
FieldValueIRS element (for citing)
Total Other Revenue43350TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3274827TotalRevenueColumn
Related Or Exempt Function Income2129400RelatedOrExemptFunctionIncome
Unrelated Business Revenue32040UnrelatedBusinessRevenue
Exclusion$1,113,387ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total40000Total
Program Services40000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2109541Total
Program Services2039601ProgramServices
Management And General69940ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total256235Total
Program Services244252ProgramServices
Management And General11983ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total19457Total
Program Services19138ProgramServices
Management And General319ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total39290Total
Program Services38820ProgramServices
Management And General470ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total69940Total
Program Services69457ProgramServices
Management And General483ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total38160Total
Program Services38160ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total433214Total
Management And General433214ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total555443Total
Program Services555443ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total438Total
Program Services438ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6350Total
Program Services6350ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total18990Total
Program Services18990ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6499Total
Program Services6499ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total22051Total
Management And General22051ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Dues & subscriptions6390763907
Other expenses36853685

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3683200Total
Program Services3144740ProgramServices
Management And General538460ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY822614BOY
EOY944554EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1013037BOY
EOY808796EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7994473BOY
EOY10384552EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY11305BOY
EOY11305EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY10858BOY
EOY46513EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis85436LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec61606LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY30329BOY
EOY23830EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6939052BOY
EOY7510065EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2245772BOY
EOY3057018EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY19067440BOY
EOY22786633EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10465159BOY
EOY14678597EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY146750BOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1043462BOY
EOY822815EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY11655371BOY
EOY15501412EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY7412069BOY
EOY7285221EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7412069BOY
EOY7285221EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY19067440BOY
EOY22786633EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-408373ReconcilationRevenueExpenses
Reconciliation Unrealized Invest281525ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (4 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
St Joseph's of Buckhannon Inc
5503569963111$0
St Mary's Medical Center Inc
5503570503111$0
St Joseph's Foundation of Buckhannon Inc
5507276503011$3,250
St Mary's Medical Center Foundation
1418872113011$2,750
FieldValueIRS element (for citing)
Total Number Of Supported Orgs4TotalNumberOfSupportedOrgs
Sum Of Amounts6000SumOfAmounts

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis85436OtherCostOrOtherBasis
Depreciation61606Depreciation
Book Value23830BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings23830TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
Premier Purchasing Partners681887
Chart Services2375131
FieldValueIRS element (for citing)
Total Book Value Other Assets3057018TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Separation Liability$14,019
Retirement Funds Payable$808,796
FieldValueIRS element (for citing)
Total Of Amounts822815TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Michael G Sellards
President & CEO - SMMC583185012161601383050163090262930885708000
Sue Johnson-Phillippe
CEO, St. Joseph's Hospital2395560100000840000000257956000
Angela Swearingen
CFO2412230475430150072370227330318886000
Todd Campbell
COO - SMMC320055040717048786096020227030441863000
S David Creech
Former CEO, Pallottine Health Servic000012508400000125084000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 1aReturnReference
ExplanationMichael Sellards, the CEO, is entitled to reimbursement for reasonable travel expense for his spouse to accompany him to three educational meetings per year; one of which being the West Virginia Hospital Association annual meeting.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
West Virginia Hospital Finance Authority
A621256910956624AL42003-12-1861000000See Part VI.000
West Virginia Hospital Finance Authority
B621256910956624AM22006-04-2635000000See Part VI.000
West Virginia Hospital Finance Authority
C621256910NoneAvail2009-06-2317500000See Part VI.000

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A29150006322266232576615463753887227520061011
B10450000372127624626323695774720130001
C175433561200001743251020100011

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersTotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A001100.005000.00500000
B0000000
C0000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqsTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied
(no name)
A000010000
Morgan Stanley
B1111112.000000000000000
(no name)
C000010000

Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A0
B0
C0

Form990 Schedule K Part VI Form990ScheduleKPartVI (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Schedule K, Part I, Line A, Column (F)Description of purposeConstructing/renovating and equipping healthcare facilities. Refunded bonds issued November 24, 1987.
Schedule K, Part VClarification of 'no' responseAdoption of written procedures to prevent violations of federal tax requirements is in process. Although a written policy is currently not in place, an annual review of tax-ecempt issues is performed by management.
schedule K, Part I, Line B, Column (F)Constructing/renovating and equipping healthcare facilities.
Schedule K, Part I, Line C, Column (F)Constructing/renovating and equipping healthcare facilities.
Schedule K, Part I, Line A, Column (F)Description of purposeThe tax-exempt bonds are reported in the accounting records of St. Joseph's Hospital of Buchannon, Inc. and St. Mary's Medical Center. Since the bond proceeds are issued on behalf of Pallottine Health Services, Inc., we have reported them on our Form 990.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
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 sponsor is Pallottine Missionary Sisters(PMS), 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. The Board of Directors of its sponsor, PMS, approve these candidates to serve as the organization's Board of Directors.
Form 990, Part VI, Section A, line 7bPallottine Missionary Sisters, 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 in consultation with an independent accounting firm. The financial review is based on the organization's audited financial statements for the relevant time period. The Board of Directors will receive the final version of Form 990 at its September 17, 2014 board meeting for review.
Form 990, Part VI, Section B, line 12cUpon employment or appointment and annually thereafter each key employee, board member and officer of the organization is required to complete a conflict of interest and disclosure form, providing sufficient information abount 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 conflicts of interest and disclosure forms for key employees, officers and directors are returned to the organization. In the event that any board member is deemed to lack independence or a conflict of interest exists, he/she is required to leave the room and cannot be part of the discussion or vote.
Form 990, Part VI, Section B, line 15On a regular basis, the organization provides documentation to the compensation committee of the board 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 the Huntington, West Virginia community 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 2900 First Avenue, Huntington, WV 25702. A nominal fee is charged if copies are requested.
Form 990, Part IX, line 11gPurchased services: Program service expenses 555,443. Management and general expenses 0. Fundraising expenses 0. Total expenses 555,443.Other Fees

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
St Mary's Medical Center
2900 First AvenueHuntingtonWV25702550357050HospitalWV501(c)(3)Line 3Pallottine Health Services1
Pallottine Missionary Sisters
15270 Old Halls Ferry RoadFlorissantMO63034431783315ChurchMO501(c)(3)Line 10N/A
St Joseph's Hospital of Buckhannon
2900 First AvenueHuntingtonWV25702550356996HospitalWV501(c)(3)Line 3Pallottine Health Services1
St Joseph's Foundation of Buckhannon
1 Amalia DriveBuckhannonWV26201550727650FoundationWV501(c)(3)Line 11b, IISt Joseph Hospital of Buckhannon0
St Mary's Medical Center Foundation
2900 First AvenueHuntingtonWV25702141887211FoundationWV501(c)(3)Line 11b, IISt Mary's Medical Center0

Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
St Mary's Occupational Health Services
2900 First AvenueHuntingtonWV25702542136110Medical ServicesWVN/A
Tri State MRI
PO Box 3108HuntingtonWV25702550669726Medical ServicesWVN/A
Claire Frances Health Services PLLC
200 Mall Road Suite 3AshlandKY41101311517507Medical ServicesWVN/A
Huntington Area MRI Services LLC
2900 First AvenueHuntingtonWV25702261877332Medical ServicesWVN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrg
Vanguard Financial Services
2900 First AvenueHuntingtonWV25702450496141Collection AGWVN/AC0
Upshur Medical Management Services
1 Amalia DriveBuckhannonWV26201550727649Medical ServicesWVN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
St Mary's Medical Center
E3799462Internal accounting records
St Mary's Medical Center
L1761000Internal accounting records
St Joseph's Hospital of Buckhannon
D1182730Internal accounting records
St Joseph's Hospital of Buckhannon
L368400Internal accounting records