2014-03-20T11:08:58-07:00 2013-09-30 990 2012-10-01 550357045 REYNOLDS MEMORIAL HOSPITAL INC REYN 3048453211 800 Wheeling Avenue Glen Dale WV 260381697 Jay Prager 3048433230 2014-03-20 2012 2015-11-30 17:44:51Z BERNARD P TWIGG 800 WHEELING AVENUE GLEN DALE WV 260381697 35020730 0 X reynoldsmemorial.com X 1899 WV To provide quality care to patients and the community at a reasonable cost. 21 21 491 112 0 0 987722 1004995 33423327 31850632 1105658 620668 2662119 1544435 38178826 35020730 0 0 0 0 19679821 21002850 0 0 0 16764689 15799581 36444510 36802431 1734316 -1781701 25154706 25138577 9187959 10843514 15966747 14295063 To provide quality care to patients and the community at a reasonable cost. 0 0 31480818 72386 31850632 During 2012-2013, the hospital continuously provided high quality inpatient, outpatient, skilled nursing, and home health services to a community of around 33,000 people. All services were provided regardless of a patient's ability to pay. Under the hospital's established charity policy, any patient whose income is less than 200% of Federal Income Poverty Guidelines automatically qualifies for free care. The hospital provided approximately $4.9 million of health care at free or reduced rates during the 2012-2013 period. The hospital also sponsored many health care screening and education services to the community at free or reduced cost during this period. 0 0 0 31480818 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 53 0 1 491 1 0 0 0 0 0 0 X 21 21 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X William R Hunt CFO 3048453211 800 Wheeling Avenue Glen Dale WV 26038 E Marc Abraham 2 X X 0 0 0 Fr Bruce Bevans 2 X 0 0 0 Patricia Dunlap 2 X X 0 0 0 Michael McCoy 2 X X 0 0 0 Sidney E Grisell 2 X 0 0 0 Wayne Harvey 2 X 0 0 0 David Hess MD 2 X 10000 0 0 Jesus Ho MD 40 X 196193 0 5886 Keith A Hughes 2 X 0 0 0 Gilbert King 2 X 0 0 0 David Nally MD 40 X 170067 0 0 William Neal 2 X 0 0 0 Douglas Paisley 2 X 0 0 0 Jon Saffell 2 X 0 0 0 George Sidiropolis 2 X 0 0 0 Rev J Thomas Steele 2 X 0 0 0 Bernard Twigg 2 X X 0 0 0 Phillip D Wallace 2 X 0 0 0 Tammy Ullom 151 X 1585 0 0 Rudy Zatezalo 2 X 0 0 0 Amy V Dobkin 2 X 0 0 0 Jay Prager 40 X 198875 0 36236 William R Hunt 40 X 131215 0 10983 Kevin Britt 40 X 121312 0 18909 Jesus Maysonet MD 40 X 530773 0 22920 Robert Shalowitz MD 40 X 275001 0 22920 Joshua Lucas DO 40 X 324848 0 22920 William Martin 40 X 263293 0 22920 Hany Tadros MD 40 X 320002 0 22920 John Sicurella 2 2 X 104425 0 18403 2647589 0 205017 22 1 1 0 Cardinal Health 71 Mil Acres Drive Wheeling WV 26003 pharmacy supplies 1450903 Owens & Minor One Stuart Plaza Greensburg PA 15601 medical supplies 783652 WV Dept of Tax and Revenue PO Box 773 Charleston WV 25323 Medicaid provider tax 903320 AMERICAN ELECTRIC POWER PO BOX 751 WHEELING WV 26003 UTILITY 574849 IPFS CORP PO BOX 9045 NEW YORK NY 100879045 malpractice insurance 569971 31 0 32439 0 0 72386 900170 0 1004995 INPATIENT OUTPATIENT MEDICAL SERVICES 622000 31850632 31850632 0 0 0 0 0 0 31850632 620668 620668 0 0 0 0 0 0 0 0 0 0 159185 0 0 0 159185 0 159185 159185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 VISITOR MEALS 622000 132176 132176 0 0 TUITION 622000 57935 57935 0 0 MEDICAL RECORDS 622000 15057 15057 0 0 1180082 1180082 0 0 1385250 35020730 34015735 0 0 0 0 0 0 0 0 0 0 451402 0 451402 0 0 0 0 0 17843417 16170173 1673244 0 482941 404202 78739 0 964049 813742 150307 0 1261041 1098506 162535 0 0 0 0 0 141808 0 141808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77679 77679 0 0 6200440 5298238 902202 0 0 0 0 0 0 0 0 0 985885 985885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282646 0 282646 0 0 0 0 0 1950228 1950228 0 0 658123 0 658123 0 Professional Expense 3253748 3253748 0 0 Medicaid provider tax 820607 0 820607 0 Equipment maintenance,repairs,rentals 1428417 1428417 0 0 36802431 31480818 5321613 0 0 0 2450746 1294764 0 0 6872322 7347573 0 0 0 0 0 0 544081 820220 232906 652713 51540583 45660024 6773192 5880559 1291783 1372338 0 0 0 0 0 0 6989676 7770410 25154706 25138577 4624984 6104540 0 0 0 0 0 0 0 0 0 0 4241496 4372309 0 0 321479 366665 9187959 10843514 X 14483839 12702138 0 0 1482908 1592925 15966747 14295063 25154706 25138577 -1781701 110017 0 0 0 0 X 0 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 316135 316135 0 26448206 23349008 3099198 0 222855 215039 7816 0 24553387 22095977 2457410 0 0 0 0 5880559 INTEREST IN RMH FOUNDATION 6236146 BENEFICIAL INTEREST IN HAMILIN FOUNDATION 1398200 MISCELLANEOUS RECEIVABLES AND ASSETS 136064 7770410 0 SELF INSURANCE 200000 MISCELLANEOUS LIABILITIES 166665 366665 35020730 0 0 0 0 0 35020730 0 0 0 35020730 36802431 0 0 0 0 0 36802431 0 0 0 36802431 1 1 1 X 0 1 1 0 1 1 0 0 612371 0 612371 0.0166 0 0 5559716 2847748 2711968 0.0737 0 0 0 0 0 0 0 0 6172087 2847748 3324339 0.0903 0 0 58594 4888 53706 0.0015 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58594 4888 53706 0.0015 0 0 6230681 2852636 3378045 0.0918 1 1634023 817012 11388597 11426457 -37860 X 1 0 1 1 REYNOLDS MEMORIAL HOSPITAL

800 WHEELING AVENUE GLEN DALE WV 26038

X X X REYNOLDS MEMORIAL HOSPITAL 1 1 X X X X X X X X X 11 1 0 1 X X X X X 0 0 1 1 200 0 1 X X X 1 1 X X X 1 X X X 1 X X X X X 1 X 0 1 SchH_P01_S00_L03c Schedule H, Part I, Line 3c Discounted services, for those over the 200% of the FPG, are determined by evaluating income, assets, and liabilities on a case by case basis. The hospital also offers discounts to self-pay patients for prompt payment, and also accepts payment plans over time without charging interest. SchH_P01_S00_L07 Schedule H, Part I, Line 7 Per IRS worksheets for schedule H. SchH_P03_S0A_L04 Schedule H, Part III, Section A, Line 4 Footnote to financials statements - "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. Costing methodology to determine amounts on lines 2 and 3 - The supplemental worksheets provided with the form 990 were used. Rationale for including bad debt as a community benefit - management estimates that at least 50% of bad debt accounts would qualify for charity care, if the patients would respond to the hospital's request for financial information. Many patients decline to respond to requests for financial information. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 Based on the filed Medicare Cost Report for FYE 9/30/13. We are uncertain if the unrecovered cost of treating Medicare beneficiaries qualifies as a community benefit. SchH_P03_S0C_L09b Schedule H, Part III, Section C, Line 9b Collection efforts are no made on patients who qualify for charity care. SchH_P05_S0B_L07 Schedule H, Part V, Section B, Line 7 Due to budget constraints, only the most important health issues were considered. SchH_P05_S0B_L20 Schedule H, Part V, Section B, Line 20 The hospital used the lowest level of charges for services. SchH_P05_S0B_L22 Schedule H, Part V, Section B, Line 22 Those patients who are determined not medically indigent and able to pay. SchH_P06_S00_L02 Schedule H, Part VI, Line 2 The hospital periodically updates its long range strategic plan. During this process, it considers changes to its service complement based on community surveys, a review of internal data, and public health information available from the state. SchH_P06_S00_L03 Schedule H, Part VI, Line 3 The hospital employs a resource finding clerk to assist patients in obtaining benefits from Medicare, Medicaid, Vocational Rehab, and other federal and state sources. SchH_P06_S00_L04 Schedule H, Part VI, Line 4 Marshall County, WV is a community of 33,000 people with high rates of obesity and significant number of smokers. There is not much diversity in the population. The population has high levels of heart disease, diabetes, cancer, and lung disease. X X X X X 0 0 0 0 0 0 0 0 0 Jesus Ho MD 196193 0 0 0 0 0 5886 0 0 0 202079 0 0 0 David Nally MD 170067 0 0 0 0 0 0 0 0 0 170067 0 0 0 Jay Prager 198875 0 0 0 0 0 20966 0 15270 0 235111 0 0 0 Jesus Maysonet MD 530773 0 0 0 0 0 7650 0 15270 0 553693 0 0 0 Joshua Lucas DO 324848 0 0 0 0 0 7650 0 15270 0 347768 0 0 0 William Martin 263293 0 0 0 0 0 7650 0 15270 0 286213 0 0 0 Robert Shalowitz MD 275001 0 0 0 0 0 7650 0 15270 0 297921 0 0 0 Hany Tadros MD 320002 0 0 0 0 0 7650 0 15270 0 342922 0 0 0 SchJ_P01_S00_L03 Schedule J, Part I, Line 3 The compensation committee, which is comprised of the four officers of the Board of Directors, annually evaluates the CEO's job performance and compensation. A Marshall County Building Commission 2008-06-25 1500000 acquire equipment, retire existing debt 0 0 0 A 0 0 0 0 0 0 0 0 0 1500000 0 0 2008 0 0 1 1 A 0 0 0 0 0 0 0 1 0 1 A 0 0 0 0 1 0 0 0 1 A 1 LORI ABRAHAM FAMILY MEMBER OF TRUSTEE 75607 EMPLOYMENT 0 PATTI KIMPEL FAMILY MEMBER OF TRUSTEE 57255 EMPLOYMENT 0 DIANE NALLY FAMILY MEMBER OF TRUSTEE 76332 EMPLOYMENT 0 ROBERT ULLOM FAMILY MEMBER OF TRUSTEE 98684 INDEPENDENT CONTRACTOR 0 BETTY SUHODOLSKI FAMILY MEMBER OF OFFICER 17692 EMPLOYMENT 0 LEANNE GODDARD FAMILY MEMBER OF TRUSTEE 21959 EMPLOYMENT 0 F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a Reynolds Memorial Healthcare System (parent organization) is the sole member of the hospital. F990_P06_S0A_L07b Form 990, Part VI, Section A, Line 7b Decisions of the hospital are subject to the approval of Reynolds Memorial Healthcare System (parent corporation). F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The IRS Form 990 is reviewed by the Executive Committee prior to filing. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c Each trustee and key employee must annually attest to any potential conflicts of interest. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 The hospital has a compensation committee which evaluates compensation of key employees based on independent data. It reviews this data annually. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 A schedule of the meetings of the Board of Directors is published at the hospital, and the public is welcome. Financial statements, conflict of interest policies, and other documents are available upon request. Reynolds Memorial Foundation 800 Wheeling Avenue Glen Dale WV 26038 550710402 foundation to support hospital WV 501(c)3 3 N/A Reynolds Memorial Healthcare System 800 Wheeling Avenue Glen Dale WV 26038 550710401 non-profit healthcare system WV 509(a)3 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0