Webster County Memorial Hospital: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: Webster County Memorial Hospital (EIN 55-6005561)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-08
IRS object ID: 201431289349300003
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule J
Schedule M
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-08T07:48:15-05:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	550486667	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Arnett Foster Toothman PLLC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	P O Box 2629	AddressLine1
City	Charleston	City
State	WV	State
ZIP Code	25329	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	556005561	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Webster County Memorial Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	WEBS	NameControl
Phone	3048475682	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	324 Miller Mountain Drive	AddressLine1
City	Webster Springs	City
State	WV	State
ZIP Code	26288	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Annette Keenan	Name
Title	CEO	Title
Phone	3048475682	Phone
Date Signed	2014-05-02	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Dale Carpenter	Name
PTIN	P00189642	PTIN
Phone	3043460441	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Annette Keenan	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	324 Miller Mountain Drive	AddressLine1
City	Webster Springs	City
State	WV	State
ZIP Code	26288	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	15457296	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.webstercountymemorialhospital.net	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1951	YearFormation
State Legal Domicile	WV	StateLegalDomicile
Activity Or Mission Description	To provide acute short-term care to residents of Webster and surrounding counties of West Virginia.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	7	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	185	TotalNbrEmployees
Total Nbr Volunteers	4	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	203454	ContributionsGrantsPriorYear
Contributions Grants Current Year	87856	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	13640686	ProgramServiceRevenuePriorYear
Program Service Revenue CY	14245606	ProgramServiceRevenueCY
Investment Income Prior Year	9605	InvestmentIncomePriorYear
Investment Income Current Year	51508	InvestmentIncomeCurrentYear
Other Revenue Prior Year	467762	OtherRevenuePriorYear
Other Revenue Current Year	1072326	OtherRevenueCurrentYear
Total Revenue Prior Year	14321507	TotalRevenuePriorYear
Total Revenue Current Year	15457296	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	7364977	SalariesEtcPriorYear
Salaries Etc Current Year	8295465	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	5467151	OtherExpensePriorYear
Other Expenses Current Year	6663393	OtherExpensesCurrentYear
Total Expenses Prior Year	12832128	TotalExpensesPriorYear
Total Expenses Current Year	14958858	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	1489379	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	498438	RevenuesLessExpensesCY
Total Assets BOY	3927524	TotalAssetsBOY
Total Assets EOY	4462430	TotalAssetsEOY
Total Liabilities BOY	1935086	TotalLiabilitiesBOY
Total Liabilities EOY	1971554	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	1992438	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	2490876	NetAssetsOrFundBalancesEOY
Mission Description	The mission of Webster County Memorial Hospital is to provide excellent, high quality care in a compassionate and cost-effective manner.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	11730255	Expense
Revenue	14245606	Revenue
Description	Critical Access Hospital services provided included 612 inpatient days, 28,457 outpatient visits, and 14,205 RHC visits. Charges forgone for charity amounted to $248,179.	Description
Total Program Service Expense	11730255	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	0	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	1	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	0	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	10	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	185	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	7	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	Julie Clutter	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	3048475682	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	324 Miller Mountain Drive	AddressLine1
City	Webster Springs	City
State	WV	State
ZIP Code	26288	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
Elsworth Sonny Helmick
Chairman	2.00	X	0	0	0
Larry Lynch
Trustee	2.00	X	0	0	0
John Leslie
Trustee	2.00	X	0	0	0
Betsy Morris
Trustee	2.00	X	0	0	0
Cathy Morton McSwain
Trustee	2.00	X	0	0	0
Carol Cogar
Trustee	2.00	X	0	0	0
Mary Anne Carpenter
Trustee	2.00	X	0	0	0
Annette Keenan
CEO	40.00		134336	0	1816	X
John Blake
PA-C	40.00		217271	0	2774		X
Luke McElwain
Physician	40.00		243008	0	1554		X
Todd Lares
Physician	40.00		230010	0	1674		X
Robert Mace
Physician	40.00		291296	0	2274		X
Steven Craft
Physician	40.00		183497	0	734		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1299418	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	10826	TotalOtherCompensation
Number Individuals GT100 K	12	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K
Government Grants	24300	GovernmentGrants
All Other Contributions	63556	AllOtherContributions
Noncash Contributions	63556	NoncashContributions
Total Contributions	87856	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	Patient Service Revenue	Description
Business Code	624100	BusinessCode
Total Revenue Column	14245606	TotalRevenueColumn
Related Or Exempt Function Income	14245606	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	14245606	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	51508	TotalRevenueColumn
Exclusion	$51,508	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	5061	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	0	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	5061	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	5061	TotalRevenueColumn
Exclusion	$5,061	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
Pharmacy	446110	892193	$892,193
Cafeteria	722210	16165	$16,165

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	158907	TotalRevenueColumn
Exclusion	$158,907	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	1067265	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	15457296	TotalRevenueColumn
Related Or Exempt Function Income	14245606	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$1,123,834	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	139198	Total
Program Services	103758	ProgramServices
Management And General	35440	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	6167271	Total
Program Services	4597083	ProgramServices
Management And General	1570188	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	25030	Total
Program Services	18657	ProgramServices
Management And General	6373	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1481040	Total
Program Services	1103968	ProgramServices
Management And General	377072	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	482926	Total
Program Services	359973	ProgramServices
Management And General	122953	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	107979	Total
Management And General	107979	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	942213	Total
Program Services	702326	ProgramServices
Management And General	239887	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	15214	Total
Management And General	15214	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	1116017	Total
Program Services	831879	ProgramServices
Management And General	284138	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	136903	Total
Program Services	102047	ProgramServices
Management And General	34856	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	151875	Total
Program Services	113208	ProgramServices
Management And General	38667	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	27928	Total
Program Services	20818	ProgramServices
Management And General	7110	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	37373	Total
Program Services	27858	ProgramServices
Management And General	9515	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	391810	Total
Program Services	292055	ProgramServices
Management And General	99755	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	161664	Total
Program Services	120504	ProgramServices
Management And General	41160	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
Bad debt expense	2217301	2217301	0
Medical supplies	638154	475680	162474
Charity care expenses	248179	248179	0
Provider tax	170683	170683

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	300100	Total
Program Services	224278	ProgramServices
Management And General	75822	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	14958858	Total
Program Services	11730255	ProgramServices
Management And General	3228603	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	290707	BOY
EOY	293673	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	1853514	BOY
EOY	1950147	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	258621	BOY
EOY	338032	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	78717	BOY
EOY	91831	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	6048132	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	4660572	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	1274658	BOY
EOY	1387560	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	110271	BOY
EOY	157440	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	61036	BOY
EOY	243747	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	3927524	BOY
EOY	4462430	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	1395556	BOY
EOY	1554386	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	539530	BOY
EOY	417168	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	1935086	BOY
EOY	1971554	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1978633	BOY
EOY	2485532	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	13805	BOY
EOY	5344	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1992438	BOY
EOY	2490876	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	3927524	BOY
EOY	4462430	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	498438	ReconcilationRevenueExpenses
Reconcilation Other Changes	0	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	32757	OtherCostOrOtherBasis
Book Value	32757	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1776692	OtherCostOrOtherBasis
Depreciation	1620830	Depreciation
Book Value	155862	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4072377	OtherCostOrOtherBasis
Depreciation	3001953	Depreciation
Book Value	1070424	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	166306	OtherCostOrOtherBasis
Depreciation	37789	Depreciation
Book Value	128517	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	1387560	TotalOfBookValueLandBuildings

Other Assets OtherAssets

Field	Value	IRS element (for citing)
Description	Third party settlements	Description
Book Value	243747	BookValue

Field	Value	IRS element (for citing)
Total Book Value Other Assets	243747	TotalBookValueOtherAssets
Tot Revenue Etc Audited Fincl Stmt	13044194	TotRevenueEtcAuditedFinclStmt
Other Revenues	52378	OtherRevenues
Revenue Not Rptd F990	52378	RevenueNotRptdF990
Revenue Subtotal	12991816	RevenueSubtotal
Other Revenues Not Included	2465480	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	2465480	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	15457296	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	12545756	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	52378	OtherExpensesIncluded
Expenses Not Rptd F990	52378	ExpensesNotRptdF990
Expenses Subtotal	12493378	ExpensesSubtotal
Other Expenses Not Included	2465480	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	2465480	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	14958858	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifier	ExplanationExplanation
Part XI, Line 2d - Other Adjustments:	Expenses netted against income on financial statements 52,378.
Part XI, Line 4b - Other Adjustments:	Bad debts netted against income on financial statements 2,217,301. Charity care netted against income on financial statements 248,179.
Part XII, Line 2d - Other Adjustments:	Expenses netted against income on financial statements 52,378.
Part XII, Line 4b - Other Adjustments:	Bad debts netted against income on financial statements 2,217,301. Charity care netted against income on financial statements 248,179.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent150	X	Pcent150
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	150.000000000000	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	0	ExpensesExceededBudget
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	134265	TotalCommunityBenefitExpense
Net Community Benefit Expense	134265	NetCommunityBenefitExpense
Percent Of Total Expense	0.01050	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	645667	TotalCommunityBenefitExpense
Direct Offsetting Revenue	537062	DirectOffsettingRevenue
Net Community Benefit Expense	108605	NetCommunityBenefitExpense
Percent Of Total Expense	0.00850	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	779932	TotalCommunityBenefitExpense
Direct Offsetting Revenue	537062	DirectOffsettingRevenue
Net Community Benefit Expense	242870	NetCommunityBenefitExpense
Percent Of Total Expense	0.01900	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	28823	TotalCommunityBenefitExpense
Net Community Benefit Expense	28823	NetCommunityBenefitExpense
Percent Of Total Expense	0.00230	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	28823	TotalCommunityBenefitExpense
Net Community Benefit Expense	28823	NetCommunityBenefitExpense
Percent Of Total Expense	0.00230	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	808755	TotalCommunityBenefitExpense
Direct Offsetting Revenue	537062	DirectOffsettingRevenue
Net Community Benefit Expense	271693	NetCommunityBenefitExpense
Percent Of Total Expense	0.02130	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$1,199,560	BadDebtExpenseAmount
Amount Reimbursed By Medicare	3423127	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	3423127	CostOfCareReimbursedByMedicare

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Webster County Memorial Hospital	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	PO Box 312	AddressLine1
City	Webster Springs	City
State	WV	State
ZIP Code	26288	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours
Other	Rural Health Clinic	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Webster County Memorial Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Needs Assessment Conducted	11	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	0	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
On Request	X	OnRequest
Other Method	X	OtherMethod
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	0	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	150.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	150.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Provided On Admission	X	ProvidedOnAdmission
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
Part I, Line 3c: The patient's income is considered and reviewed to determine the amount of discount they receive, if not free care. The patient's assets are also reviewed. They can only have one vehicle and one house. If the patient has more than one vehicle, the total of the vehicles cannot be more than $2,000. If they total more than $2,000, the patient will automatically be reduced to a percentage less than 100%.
Part I, Line 7: The cost to charge ratio as calculated from worksheet 2 was used to determine community benefit expenses for all subsidized health services.
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 $ 2217301.
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.The cost to charge ratio as calculated from worksheet 2 was used to determine bad debt expense.
Part III, Line 8: Medicare cost report was used to report Medicare revenue and expenses.Any shortfall should be treated as a community benefit.
Part III, Line 9b: Patient's are informed about the finanical assistance program when they call to ask about their medical bills. The billers offer the patient information about the program over the phone or if the patient is seen by the biller in person, they are shown the application and the documents that are needed.
Part V, Section B, Line 3: We consulted all available community members willing to fill out our questionnaire. Then we took all that information and reviewed it and made changes as we could, such as hiring two more providers and changing our advertising. We also offered a couple of more services.	Webster County Memorial Hospital
Part V, Section B, Line 5c: We took needs assessments to areas in community where multiple people are at such as lodges, heath fairs and senior centers. We also had report available in hospital for patients.	Webster County Memorial Hospital
Part V, Section B, Line 7: We reviewed all of the input given to us and changed what we could, such as communication, waiting times, recruited and added two more ER doctors, and lined parking lot. Patients wanted things like more parking, surgeons and OB which we cannot do due to limited space. We did consult regarding telemedicine to get services we do not offer available here. Other issues we had were patients not aware of financial assistance and updated equipment and those things were going to be addressed in advertising.	Webster County Memorial Hospital
Part V, Section B, Line 12h: All patients are charged the same price for all services in our charge master, for all noninsured and insured patients. Once the Business Office receives the financial assistance application, we look at the patient's total income and assets for the household. We then go by the FPG times 150% and determine the patient's eligibility.	Webster County Memorial Hospital
Part V, Section B, Line 14g: Patient's were given applications during our county's health fair.	Webster County Memorial Hospital
Part V, Section B, Line 18e: The patient is sent the 5 statements and if they don't make a payment or contact the billing office, the billing department of Webster County Memorial Hospital will review their accounts manually and determine if the patient received the 5 statements or made any payments. Then the account will be sent to collections.	Webster County Memorial Hospital
Part VI, Line 2: Director of Clinical Operations & Quality continuously reviews referral logs made by secretaries to see if there is any services we can provide here. Then we find out cost and reimbursement issues and present to CEO.
Part VI, Line 3: If the patient presents to the registration desk and is private pay, they are told by the registration staff of the program. They are then offered an application and told that they need to provide the documentation on the application to the billing department. If the patient is private pay and is admitted to the hospital as IP or OBS, the Social Worker meets with the patient and provides them an application and goes over the information needed to apply.
Part VI, Line 4: Our geographical service area is rural. Population of our county is 9,043. Residents have an average income of $25,990 with 24.3% being below the Federal Poverty Guidelines. We are the only hospital serving the community and the next nearest facility is 40 miles away.
Part VI, Line 5: 1) Governing body is comprised of members of all areas who are not employees of organization. 2) We extend privileges to all qualified staff working for facility. 3) We apply surplus funds into providing new services for patients. 4) Emergency Room is available to all patients whether they have ability to pay or not 5) We offer MRI, Cardiac and Pulmonary Rehab and Nuclear medicine that is not available at any other location in county. 6) We offer charitable care which has increased this year due to patient education, serve the communtiy and have volunteers that help.
WV	List of States receiving Community Benefit Report	Part VI, Line 7

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Substantiation Required	1	SubstantiationRequired
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
John Blake
PA-C	217271	0	0	0	0	0	500	0	3290	0	221061	0	0	0
Luke McElwain
Physician	243008	0	0	0	0	0	1554	0	1230	0	245792	0	0	0
Todd Lares
Physician	230010	0	0	0	0	0	0	0	2970	0	232980	0	0	0
Robert Mace
Physician	291296	0	0	0	0	0	0	0	3369	0	294665	0	0	0
Steven Craft
Physician	183497	0	0	0	0	0	0	0	1994	0	185491	0	0	0

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Number Of Contributions	1	NumberOfContributions
Noncash Contribs Rptd F990	63556	NoncashContribsRptdF990
Method Of Determining Revenues	Cost of donated property	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	0	ReviewProcessUnusualNCGifts
Third Parties Used	0	ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReference	ExplanationExplanation
Form 990, Part VI, Section B, line 11	During a regularly scheduled board meeting, each board member receives a copy of the completed Form 990. The board will vote and approve the completed form before filing.
Form 990, Part VI, Section B, line 12c	Officers and Directors are required to complete an annual conflict of interest questionnaire. This questionnaire is then reviewed by the Board of Trustees, annually, for any interests that could give rise to conflicts. If a conflict should arise, the individual would have to disclose this conflict to the Board of Trustees. The board member would not be permitted to vote on the issue, if applicable.
Form 990, Part VI, Section B, line 15	To determine compensation of the Organization's CEO, the organization compares Forms 990 of other organizations, reviews written employment contracts and performs compensation surveys of similar facilities. A review of compensation is conducted internally by the Board of Trustees.
Form 990, Part VI, Section C, line 19	The Organization's governing documents, conflict of interest policy and financial statements are made available upon request.