STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY (EIN 55-0422958)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-04-08
- IRS object ID
- 201300989349300400
- Schema version
- 2011v1.5
- 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 G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-04-08T07:03:01-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | 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 | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550422958 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STON | NameControl |
| Phone | 3042698059 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 Hospital Plaza | AddressLine1 |
| City | WESTON | City |
| State | WV | State |
| ZIP Code | 26452 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dodie Arbogast | Name |
| Title | CFO | Title |
| Phone | 3042698059 | Phone |
| Date Signed | 2013-03-26 | 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 | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Avah L Stalnaker | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 Hospital Plaza | AddressLine1 |
| City | WESTON | City |
| State | WV | State |
| ZIP Code | 26452 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 50907993 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.stonewallhospital.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1959 | YearFormation |
| State Legal Domicile | WV | StateLegalDomicile |
| Activity Or Mission Description | The mission is to provide quality medical care to the citizens of Lewis and surrounding counties regardless of the patient's ability to pay. To enable the citizens of our service area to receive quality care close to home. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 611 | TotalNbrEmployees |
| Total Nbr Volunteers | 44 | TotalNbrVolunteers |
| Total Gross UBI | 1349 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 349 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 79133 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 82859 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 42984578 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 44112962 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1336593 | InvestmentIncomePriorYear |
| Investment Income Current Year | -438688 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 224496 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2105522 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 44624800 | TotalRevenuePriorYear |
| Total Revenue Current Year | 45862655 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 33430 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 31886 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 23888959 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 25017884 | 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 | 17403206 | OtherExpensePriorYear |
| Other Expenses Current Year | 20032437 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 41325595 | TotalExpensesPriorYear |
| Total Expenses Current Year | 45082207 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3299205 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 780448 | RevenuesLessExpensesCY |
| Total Assets BOY | 58409902 | TotalAssetsBOY |
| Total Assets EOY | 64514533 | TotalAssetsEOY |
| Total Liabilities BOY | 7588125 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7412873 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 50821777 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 57101660 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | It is the mission of Stonewall Jackson Memorial Hospital to provide the best possible combination of primary care in a safe, efficient, and compassionate manner. It is, and always shall be, our duty to assess the quality of care provided and to continue to seek methods of improving both our evaluation of and delivery of patient care. It is our unswerving faith in this mission that assures our role as a vital community hospital and as an economic resource for our community. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 35470597 | Expense |
| Revenue | 44056199 | Revenue |
| Description | Stonewall Jackson Memorial Hospital provides Acute medical and outpatient services to residents of Weston, West Virginia and surrounding communities which covers 10 different counties. Services included 9,673 days of inpatient care, 78,735 outpatient visits, 15,826 emergency room visits, 1,504 ambulatory surgery visits, 5,254 Home Health visits and 49,383 Physician Clinic visits. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 44000 | Expense |
| Grants | 9520 | Grants |
| Revenue | 28000 | Revenue |
| Description | Annual blood screening: Stonewall Jackson Memorial Hospital provides all supplies and staff to operate the program. Excess revenue is forwarded to the local Rotary Club to promote charitable services. Other programs include: Glucose & blood pressure screenings at local Senior Center, Scoliosis screening at county elementary and middle schools, free sports physicals to middle school and high school students, October fest program to promote healthy choices to childrenunder 12 years old, events for free Osteoporosis screenings, events for free Dermascans to screen for skin cancer, and Weston Walk-run to promote exercise as a way to improve cardiac health; free women's health screening for breast and cervical cancer, free hearing screenings. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 28866 | Expense |
| Grants | 22250 | Grants |
| Revenue | 28763 | Revenue |
| Description | William Adler Scholarship Fund - Stonewall Jackson Memorial Hospital sponsored program to provide scholarships to local graduating high school seniors who are pursuing career in the health care field through an accredited program. It is hoped that this program will encourage more students to seek health care professions and lessen the health care staffing shortage. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Relay for Life sponsor | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 35543463 | 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 | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | 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 | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | 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 | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 124 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 611 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| 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 | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | 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 | Dodie Arbogast | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3042698050 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 Hospital Plaza | AddressLine1 |
| City | Weston | City |
| State | WV | State |
| ZIP Code | 264528558 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 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 |
|---|---|---|---|---|---|---|---|
| John Law | |||||||
| President | 1.00 | X | 0 | 0 | 0 | ||
| Joseph Snead | |||||||
| Vice-President | 37.50 | X | 234061 | 0 | 27505 | ||
| R Gerald Wood | |||||||
| Secretary | 1.00 | X | 0 | 0 | 0 | ||
| Denver Turner | |||||||
| Treasurer | 1.00 | X | 0 | 0 | 0 | ||
| Jean Bennett | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| R G Lockard | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Robin Poling | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| John W Wyllie | |||||||
| Director | 37.50 | X | 400508 | 0 | 18271 | ||
| David Gallien | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Avah Stalnaker | |||||||
| CEO | 37.50 | 157112 | 0 | 15282 | X | ||
| Delphia Arbogast | |||||||
| CFO | 37.50 | 91329 | 0 | 21417 | X | ||
| Shafic Sraj | |||||||
| Physician | 37.50 | 400032 | 0 | 28889 | X | ||
| Antoine Naim | |||||||
| Physician | 37.50 | 298432 | 0 | 18876 | X | ||
| Peter Edgerton | |||||||
| Physician | 37.50 | 425264 | 0 | 18876 | X | ||
| Doyle Sickles | |||||||
| Physician | 37.50 | 432838 | 0 | 28889 | X | ||
| Ronald Pearson | |||||||
| Physician | 34.50 | 358800 | 0 | 12500 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2798376 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 190505 | TotalOtherCompensation |
| Number Individuals GT100 K | 31 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Mountain State Radiology | |||||
| 21 W Third Street | Washington | MO | 63090 | Radiology Interpretation | 408100 |
| Lab Corp | |||||
| PO Box 12140 | Burlington | NC | 27216 | Laboratory Services | 254199 |
| CPS | |||||
| PO Box 1000 | Memphis | TN | 38148 | Pharmacy Consulting | 225007 |
| Reliable Builders | |||||
| PO Box 122 | Buckhannon | WV | 26201 | Construction | 202234 |
| Sodexo | |||||
| PO Box 936522 | Atlanta | GA | 503536922 | Maintenance Consulting | 186155 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| Fundraising Events | 31770 | FundraisingEvents |
| All Other Contributions | 51089 | AllOtherContributions |
| Total Contributions | 82859 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient Services | Description |
| Business Code | 622110 | BusinessCode |
| Total Revenue Column | 44112962 | TotalRevenueColumn |
| Related Or Exempt Function Income | 44112962 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 44112962 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1443232 | TotalRevenueColumn |
| Exclusion | $1,443,232 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 42056 | Real |
| Personal | 7200 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 63647 | Real |
| Personal | 5851 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -21591 | Real |
| Personal | 1349 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -20242 | TotalRevenueColumn |
| Unrelated Business Revenue | 1349 | UnrelatedBusinessRevenue |
| Exclusion | -$21,591 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3040803 | Securities |
| Other | 21350 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4944073 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -1903270 | Securities |
| Other | 21350 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1881920 | TotalRevenueColumn |
| Exclusion | -$1,881,920 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 31663 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 31770 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 31767 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -104 | TotalRevenueColumn |
| Exclusion | -$104 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Electronic health reco | 900099 | 1918914 | $1,918,914 |
| Cafeteria sales | 722310 | 136396 | $136,396 |
| Vending Machines | 454210 | 70558 | $70,558 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2125868 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 45862655 | TotalRevenueColumn |
| Related Or Exempt Function Income | 44112962 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1349 | UnrelatedBusinessRevenue |
| Exclusion | $1,665,485 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9520 | Total |
| Program Services | 9520 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22366 | Total |
| Program Services | 22366 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1140567 | Total |
| Program Services | 825200 | ProgramServices |
| Management And General | 315367 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20523861 | Total |
| Program Services | 14849013 | ProgramServices |
| Management And General | 5674848 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 693155 | Total |
| Program Services | 501498 | ProgramServices |
| Management And General | 191657 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1299525 | Total |
| Program Services | 940206 | ProgramServices |
| Management And General | 359319 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1360776 | Total |
| Program Services | 984521 | ProgramServices |
| Management And General | 376255 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113320 | Total |
| Management And General | 113320 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 103930 | Total |
| Management And General | 103930 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 154605 | Total |
| Management And General | 154605 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1417417 | Total |
| Program Services | 1025501 | ProgramServices |
| Management And General | 391916 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 180223 | Total |
| Program Services | 130391 | ProgramServices |
| Management And General | 49832 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1520409 | Total |
| Program Services | 1101475 | ProgramServices |
| Management And General | 418934 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 127639 | Total |
| Program Services | 92347 | ProgramServices |
| Management And General | 35292 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 897238 | Total |
| Program Services | 649152 | ProgramServices |
| Management And General | 248086 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78567 | Total |
| Program Services | 56843 | ProgramServices |
| Management And General | 21724 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 79434 | Total |
| Program Services | 57470 | ProgramServices |
| Management And General | 21964 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1923006 | Total |
| Program Services | 1391295 | ProgramServices |
| Management And General | 531711 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 214064 | Total |
| Program Services | 154875 | ProgramServices |
| Management And General | 59189 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Medical supplies | 6648833 | 6648833 | 0 |
| Bad debts | 4357001 | 4357001 | 0 |
| Repairs and maintenance | 1103524 | 798400 | 305124 |
| Medicaid provider tax | 388065 | 388065 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 725162 | Total |
| Program Services | 559491 | ProgramServices |
| Management And General | 165671 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45082207 | Total |
| Program Services | 35543463 | ProgramServices |
| Management And General | 9538744 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 249191 | BOY |
| EOY | 149289 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 663502 | BOY |
| EOY | 1606486 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7871244 | BOY |
| EOY | 7261430 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1047805 | BOY |
| EOY | 1051146 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 354012 | BOY |
| EOY | 301932 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 35507251 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 24717540 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9351604 | BOY |
| EOY | 10789711 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37347792 | BOY |
| EOY | 41517511 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75402 | BOY |
| EOY | 195934 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1449350 | BOY |
| EOY | 1641094 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58409902 | BOY |
| EOY | 64514533 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6007407 | BOY |
| EOY | 5778236 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 191227 | BOY |
| EOY | 92210 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1389491 | BOY |
| EOY | 1199213 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 343214 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7588125 | BOY |
| EOY | 7412873 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50821777 | BOY |
| EOY | 57101660 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50821777 | BOY |
| EOY | 57101660 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58409902 | BOY |
| EOY | 64514533 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 780448 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 5499435 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| 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 | 646015 | OtherCostOrOtherBasis |
| Book Value | 646015 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12164316 | OtherCostOrOtherBasis |
| Depreciation | 9320944 | Depreciation |
| Book Value | 2843372 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21640013 | OtherCostOrOtherBasis |
| Depreciation | 15396596 | Depreciation |
| Book Value | 6243417 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1056907 | OtherCostOrOtherBasis |
| Book Value | 1056907 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 10789711 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Estimated third party payor settlements | Description |
| Amount | $343,214 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 343214 | TotalOfAmounts |
| Total Revenue | 45862655 | TotalRevenue |
| Total Expenses | 45082207 | TotalExpenses |
| Excess Or Deficit For Year | 780448 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 5499319 | NetUnrealizedGLOnInvestments |
| Other | $116 | OtherAmount |
| Total Adjustments | 5499435 | TotalAdjustments |
| Excess Or Deficit Per FS | 6279883 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 41380761 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 37618 | OtherRevenues |
| Revenue Not Rptd F990 | 37618 | RevenueNotRptdF990 |
| Revenue Subtotal | 41343143 | RevenueSubtotal |
| Other Revenues Not Included | 4519512 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 4519512 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 45862655 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 40600197 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 37618 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 37618 | ExpensesNotRptdF990 |
| Expenses Subtotal | 40562579 | ExpensesSubtotal |
| Other Expenses Not Included | 4519628 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 4519628 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 45082207 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | The organization had no uncertain tax positions under Fin 48 as reported in the financial statements. |
| Part XI, Line 8 - Other Adjustments: | Grant expenses netted with grant revenue on the financial statements 116. | |
| Part XII, Line 2d - Other Adjustments: | Van rent expenses included in expenses on the financial statements 5,851. Fundraising expenses included in expenses on the financial statements 31,767. | |
| Part XII, Line 4b - Other Adjustments: | Expenses netted with revenue on the financial statements 7,906. Bad debt expense netted with revenue on the financial statements 4,357,001. Investment fees included in nonoperating income in financial statements 154,605. | |
| Part XIII, Line 2d - Other Adjustments: | Van rent expenses included in expenses on the financial statements 5,851. Fundraising expenses included in expenses on the financial statements 31,767. | |
| Part XIII, Line 4b - Other Adjustments: | Expenses netted with revenue on the financial statements 7,906. Investment fees included in nonoperating income in financial statements 154,605. Bad debt expense netted with revenue on the financial statements 4,357,001. Grant expenses netted with grant revenue on the financial statements 116. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Charity Golf Tournament | NameOfEvent1 |
| Gross Receipts Event1 | 28763 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 22250 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 6513 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 850 | CashPrizesEvent1 |
| Rent Facility Costs Event1 | 5767 | RentFacilityCostsEvent1 |
| Name Of Event2 | Rotary Blood Screening | NameOfEvent2 |
| Gross Receipts Event2 | 34670 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 9520 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 25150 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 25150 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 63433 | GrossReceiptsTotal |
| Charitable Contributions Total | 31770 | CharitableContributionsTotal |
| Gross Revenue Total Events | 31663 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 850 | CashPrizesTotalEvents |
| Rent Facility Costs Total Events | 5767 | RentFacilityCostsTotalEvents |
| Other Direct Expenses Total Events | 25150 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 31767 | DirectExpenseSummaryEvents |
| Net Income Summary | -104 | NetIncomeSummary |
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 | 0 | FPGReferenceFreeCare |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 645473 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 645473 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01580 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8738890 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5692813 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3046077 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07480 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9384363 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5692813 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3691550 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09060 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 10 | NumberOfActivitiesOrPrograms |
| Persons Served | 2800 | PersonsServed |
| Total Community Benefit Expense | 10430 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 10430 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 22 | PersonsServed |
| Total Community Benefit Expense | 28866 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 28866 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5789 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5789 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 11 | NumberOfActivitiesOrPrograms |
| Persons Served | 2822 | PersonsServed |
| Total Community Benefit Expense | 45085 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 45085 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 11 | NumberOfActivitiesOrPrograms |
| Persons Served | 2822 | PersonsServed |
| Total Community Benefit Expense | 9429448 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5692813 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3736635 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09170 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 125991 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 125991 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00310 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 125991 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 125991 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00310 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,921,002 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 7974245 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 7847407 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 126838 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | 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 | Stonewall Jackson Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 Hospital Plaza | AddressLine1 |
| City | Weston | City |
| State | WV | State |
| ZIP Code | 26452 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stonewall Jackson Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 0 | UsesFPGFree |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| 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 |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| 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 | 1 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| Part I, Line 3c: WV food stamp eligibility guidelines are used. We also evaluate the patient's assets and the amount of medical debt. We have signs posted at Registration, around and in the Emergency Department and in all physician clinics. We send letters to patients who are not paying their bills and give the application to private pay inpatients. We also tell the patients during telephone conversations if the patient indicates he/she is not able to pay the bill or pay all of the bill. | |
| Part I, Line 7: The cost of charity care was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions.The unreimbursed cost of Medicaid was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions. | |
| 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 $ 4357001. | |
| Part II: We recruit physicians to this area based entirely on what services the patients need. Our goal is to be able to provide physicians who can address these needs in the community. | |
| 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 | |
| Part III, Line 9b: Our collections policy applies to all patients regardless of financial class or any other classification. During our collections process, if the patient indicates they do not have the ability to pay their bill, the credit staff offers exoneration. | |
| Part V, Section B, Line 21: Charges are the same for all payers and private pay but private pay patients are given a 20% discount off of charges if the bill is paid within 30 days of the statement date. | Stonewall Jackson Memorial Hospital |
| Part VI, Line 3: We have signs posted at Registration, around and in the Emergency Department and in all physician clinics. We send letters to patients who are not paying their bills. We give the application to Private Pay inpatients. We tell the patients when during telephone converations if the patient indicates he/she is not able to pay the bill or pay all of the bill. | |
| Part VI, Line 4: Stonewall Jackson Memorial Hospital serves a relatively large rural population of about 65,000 people with an average household income of $32,000. 30% of the population is disabled. Approximately 30% are Medicaid Eligible or are uninsured. We are the largest hospital in our service area, which includes two other hospitals, one being a Critical Access Hospital. We are located in a federally-designated medically underserved area. | |
| Part VI, Line 5: Stonewall Jackson Memorial Hospital (SJMH) is a 70 bed rural acute hospital located in Lewis county West Virginia. SJMH is the only hospital located in the county as such it is solely responsible for the healthcare of this rural community. SJMH provides 24 hours Emergency Room and Obstetrics services and provides care regardless of the patient's ability to pay. The majority of the governing body is comprised of community members. Medical privileges are offered to all qualified physicians in the community and SJMH has worked diligently to provide other physician services by expanding the services they provide.SJMH continues to make capital improvement to the facility and expand patient care services to meet the needs of the community. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rotary Club of Weston | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 222 | AddressLine1 |
| City | Weston | City |
| State | WV | State |
| ZIP Code | 26452 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 550371556 | EINOfRecipient |
| IRC Section | 501(c) (4) | IRCSection |
| Amount Of Cash Grant | 9520 | AmountOfCashGrant |
| Purpose Of Grant | To help the Rotary raise money for various children's programs in Lewis County. | PurposeOfGrant |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | Nursing School Scholarships for recent high school graduates. | TypeOfGrant |
| Number Of Recipients | 22 | NumberOfRecipients |
| Amount Of Cash Grant | 22250 | AmountOfCashGrant |
| Method Of Valuation | FMV - Cash | MethodOfValuation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| 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 (8 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Joseph Snead | |||||||||||||
| 233666 | 0 | 0 | 0 | 395 | 0 | 11887 | 0 | 17548 | 0 | 263496 | 0 | 0 | 0 |
| John W Wyllie | |||||||||||||
| 400254 | 0 | 0 | 0 | 254 | 0 | 11895 | 0 | 8711 | 0 | 421114 | 0 | 0 | 0 |
| Avah Stalnaker | |||||||||||||
| 157057 | 0 | 0 | 0 | 55 | 0 | 8880 | 0 | 7945 | 0 | 173937 | 0 | 0 | 0 |
| Shafic Sraj | |||||||||||||
| 400016 | 0 | 0 | 0 | 16 | 0 | 12500 | 0 | 18724 | 0 | 431256 | 0 | 0 | 0 |
| Antoine Naim | |||||||||||||
| 298384 | 0 | 0 | 0 | 48 | 0 | 12500 | 0 | 8711 | 0 | 319643 | 0 | 0 | 0 |
| Peter Edgerton | |||||||||||||
| 425132 | 0 | 0 | 0 | 132 | 0 | 12500 | 0 | 8711 | 0 | 446475 | 0 | 0 | 0 |
| Doyle Sickles | |||||||||||||
| 432765 | 0 | 0 | 0 | 73 | 0 | 12500 | 0 | 18724 | 0 | 464062 | 0 | 0 | 0 |
| Ronald Pearson | |||||||||||||
| 358800 | 0 | 0 | 0 | 0 | 0 | 12500 | 0 | 0 | 0 | 371300 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 3 | Management duties customarily are performed under the direct supervision of officers, directors, trustees or key employees, but the Hospital has contracted out the management duties of the Maintenance department. The manager of the Maintenance department (also considered a department head) is employed by the Maintenance company. All other Maintenance staff are employees of the Hospital. The Hospital contracts out the management duties of the Pharmacy department. The manager of the Pharmacy department (also considered a department head) is employed by the Pharmacy company. All other Pharmacy staff are employees of the Hospital. | |
| Form 990, Part VI, Section B, line 11 | The process the Hospital uses to review their 990 before filing with the IRS is the CFO is responsible for reviewing the form 990 for completeness and accuracy. A completed copy is provided for the board. It is then signed and submitted to the IRS. | |
| Form 990, Part VI, Section B, line 12c | All board members disclose possible conflicts of interest prior to appointment and periodically throughout their terms as trustees. | |
| Form 990, Part VI, Section B, line 15 | The Hospital obtains salary survey data. Performance evaluations are done on each of these personnel & financial conditions are considered. | |
| Form 990, Part VI, Section C, line 19 | The Hospital places a publication in the local newspaper stating the governing documents, conflicts of interest policy and financial statements are available upon request. The policies and procedures are on the Stonewall Jackson website. | |
| Form 990, Part XI, line 5: | Net unrealized gains on investments: 5,499,319. Grant expenses netted with grant revenue on the financial statements 116. Total to Form 990, Part XI, Line 5: 5,499,435. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stonewall Home Oxygen Therapy Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 Market Place Mall Suite 8 | AddressLine1 |
| City | Weston | City |
| State | WV | State |
| ZIP Code | 26452 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550754278 | EIN |
| Primary Activity | Oxygen Therapy Services | PrimaryActivity |
| Legal Domicile State | WV | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 61709 | ShareOfTotalIncome |
| Share Of EOY Assets | 524507 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Stonewall Home Oxygen Therapy Inc | ||
| A | 53888 | FMV - Cash |
| Stonewall Home Oxygen Therapy Inc | ||
| P | 173395 | FMV - Cash |
| Stonewall Home Oxygen Therapy Inc | ||
| Q | 29112 | FMV - Cash |