2013-04-18T15:18:11-07:00 2012-09-30 990 2011-10-01 550357045 REYNOLDS MEMORIAL HOSPITAL INC REYN 3048453211 800 Wheeling Avenue Glen Dale WV 260381697 Jay Prager 3048433230 2013-04-18 2011 2016-03-07 17:11:31Z BERNARD P TWIGG 800 WHEELING AVENUE GLEN DALE WV 260381697 38178826 0 X reynoldsmemorial.com X 1899 WV To provide quality care to patients and the community at a reasonable cost. 21 21 505 70 0 0 984439 987722 36330117 33423327 797284 1105658 855486 2662119 38967326 38178826 0 0 0 0 19833627 19679821 0 0 0 19267719 16764689 39101346 36444510 -134020 1734316 23640864 25154706 9584768 9187959 14056096 15966747 To provide quality care to patients and the community at a reasonable cost. 0 0 31174634 69865 33423327 During 2011-2012, the hospital continuously provided high quality inpatient,outpatient,skilled nursing, and home health services to a community of around 33,000 people. All services were provided regardless of a patient's ability to pay. Under the hospital's established charity care plan, any patient whose income is less than 200% of Federal Income Poverty Guidelines automatically qualifies for free care. The hospital provided approximately $5.3 million of health care at free or reduced rates during 2011-2012. In addition, the hospital sponsored many health screening and health education services to the community at free or reduced cost during the same period. 0 0 0 31174634 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 1 51 0 1 505 1 0 0 0 0 0 0 X 21 21 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X William R Hunt CFO 3048453211 800 Wheeling Avenue Glen Dale WV 26038 E Marc Abraham 2 X X 0 0 0 Fr Bruce Bevans 2 X 0 0 0 Patricia Dunlap 2 X X 0 0 0 Michael McCoy 2 X X 0 0 0 Sidney E Grisell 2 X 0 0 0 Wayne Harvey 2 X 0 0 0 David Hess MD 2 X 10000 0 0 Jesus Ho MD 40 X 50600 0 1941 Keith A Hughes 2 X 0 0 0 Gilbert King 2 X 0 0 0 David Nally MD 40.00 X 172400 0 0 William Neal 2 X 0 0 0 Douglas Paisley 2 X 0 0 0 Jon Saffell 2 X 0 0 0 George Sidiropolis 2 X 0 0 0 Rev J Thomas Steele 2 X 0 0 0 Bernard Twigg 2 X X 0 0 0 Phillip D Wallace 2 X 0 0 0 Louise Norman 2 X 0 0 0 Rudy Zatezalo 2 X 0 0 0 Amy V Dobkin 2 X 0 0 0 Jay Prager 40 X 174721 0 33220 William R Hunt 40 X 109651 0 9414 Jesus Maysonet MD 40 X 527835 0 20478 Robert Shalowitz MD 40 X 286540 0 20478 Joshua Lucas DO 40 X 324489 0 20478 Bill Apostolon DO 40 X 259954 0 20478 Hany Tadros MD 40 X 332310 0 20478 John Sicurella 10 X 132086 0 16941 2380586 0 163906 20 1 1 0 Cardinal Health 71 Mil Acres Drive Wheeling WV 26003 pharmacy supplies 1553617 Marshall County Imaging 1338 National Road Wheeling WV 26003 radiology services 825500 Owens & Minor One Stuart Plaza Greensburg PA 15601 medical supplies 799832 WV Dept of Tax and Revenue PO Box 773 Charleston WV 25323 Medicaid provider tax 810790 AMERICAN ELECTRIC POWER PO BOX 751 WHEELING WV 26003 UTILITY 560444 38 0 31986 0 0 69865 885871 0 987722 INPATIENT OUTPATIENT MEDICAL SERVICES 622000 33423327 33423327 0 0 0 0 0 0 33423327 1105658 1105658 0 0 0 0 0 0 0 0 0 0 160124 0 0 0 160124 0 160124 160124 0 0 0 0 0 VISITOR MEALS 622000 132656 132656 0 0 TUITION 622000 59026 59026 0 0 MEDICAL RECORDS 622000 11065 11065 0 0 2299248 2299248 0 0 2501995 38178826 37191104 0 0 0 0 0 0 0 0 0 0 285009 0 285009 0 0 0 0 0 17162742 15404709 1758033 0 454752 400182 54570 0 640517 563655 76862 0 1136801 1000385 136416 0 0 0 0 0 137982 0 137982 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69653 69653 0 0 5521607 4745569 776038 0 0 0 0 0 0 0 0 0 905612 905612 0 0 76993 76993 0 0 0 0 0 0 0 0 0 0 306676 0 306676 0 0 0 0 0 1960827 1960827 0 0 820673 0 820673 0 professional fees 3637518 3637518 0 0 medicaid provider tax 917617 0 917617 0 equipment maintenance,repairs,rentals 1365772 1365772 0 0 1043759 1043759 0 0 36444510 31174634 5269876 0 0 0 697932 2450746 0 0 6913598 6872322 0 0 0 0 0 0 564578 544081 817284 232906 50879920 44106728 7782210 6773192 539884 1291783 0 0 0 0 0 0 6325378 6989676 23640864 25154706 4755103 4624984 0 0 0 0 0 0 0 0 0 0 4490637 4241496 0 0 339028 321479 9584768 9187959 X 12749523 14483839 0 0 1306573 1482908 14056096 15966747 23640864 25154706 X 1734316 176335 X 0 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 316135 316135 0 26358044 22961674 3396370 0 0 0 0 0 24186475 21145054 3041421 0 19266 0 19266 6773192 INTEREST IN RMH FOUNDATION 5628457 BENEFICIAL INTEREST IN HAMLIN FOUNDATION 1316992 MISCELLANEOUS RECEIVABLES AND ASSETS 44227 6989676 0 SELF INSURANCE 200000 MISCELLANEOUS LIABILITIES 121479 321479 38178826 36444510 1734316 176335 0 0 0 0 176335 1910651 38178826 0 0 0 0 0 38178826 0 0 0 38178826 36444510 0 0 0 0 0 36444510 0 0 0 36444510 1 1 1 X 0 1 1 0 1 1 0 0 680566 0 680566 0.0187 0 0 5548739 3601235 1947504 0.0534 0 0 0 0 0 0 0 0 6229305 3601235 2628070 0.0721 0 0 76193 9557 66636 0.0018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76193 9557 66636 0.0018 0 0 6305498 3610792 2694706 0.0739 1 1676229 838000 10337978 10975104 -637126 X 1 0 1 1 REYNOLDS MEMORIAL HOSPITAL

800 WHEELING AVENUE GLEN DALE WV 26038

X X X REYNOLDS MEMORIAL HOSPITAL 1 1 1 200 0 1 X X X 1 1 X X X 1 X X X 1 X X X X X 1 X 0 1 SchH_P01_S00_L03c Schedule H, Part I, Line 3c Discounted services, for those over 200% of the FPG, are determined by evaluating income,assets,and liabilities on a case by case basis. The hospital also offers discounts to self-pay patients for prompt payment, and it also accepts payment plans over time without charging interest. SchH_P01_S00_L07 Schedule H, Part I, Line 7 Per IRS worksheets for scheduel H. SchH_P03_S0A_L04 Schedule H, Part III, Section A, Line 4 Footnote to financial statements-"Manangement also reviews troubled, aged accounts to determine collection potential. Patient accounts receivable are written off when deemed uncollectible. Recoveries of accounts previously written off are recorded as a reduction to bad debt expense when received." Costing methodology to determine amounts on lines 2 and 3 - The supplemental worksheets provided with the form 990 were used. Rationale for including bad debt as a community benefit - manangement estimates that at least 50% of bad debt accounts would qualify for charity care, if the patients would respond to the hospital's request for finanacial information. Many patients decline to respond to requests for financial information. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 Based on the filed Medicare Cost Report for FYE 9/30/12. We are uncertain if the unrecovered cost of treating Medicare beneficiaries qualifies as a community benefit. SchH_P03_S0C_L09b Schedule H, Part III, Section C, Line 9b No collection effort is made on patients who qualify for charity care. SchH_P05_S0B_L19 Schedule H, Part V, Section B, Line 19 The hospital used the lowest available charge for services. SchH_P05_S0B_L21 Schedule H, Part V, Section B, Line 21 Those patients who are determined not medically indigent and able to pay. SchH_P06_S00_L02 Schedule H, Part VI, Line 2 The hospital periodically updates its long range strategic plan. During this process it considers changes to its service complement based on community surveys, a review of its internal data, and public health information available from the state. SchH_P06_S00_L03 Schedule H, Part VI, Line 3 The hospital employs a resource finding clerk to assist patients in obtaining benefits from medicare, medicaid, vocational rehab, and other federal and state sources. SchH_P06_S00_L04 Schedule H, Part VI, Line 4 Marshall County, WV is a community of 33,000 people with high rates of obesity and a significant number of smokers. There is not much diversity in the population. The population has high levels of heart disease, diabetes, cancer, and lung disease. X X X X X 0 0 0 0 0 0 0 0 0 Jay Prager 174721 0 0 0 0 0 20242 0 12978 0 207941 0 210608 0 Jesus Maysonet MD 527835 0 0 0 0 0 7500 0 12978 0 548313 0 493740 0 Hany Tadros MD 332310 0 0 0 0 0 7500 0 12978 0 352788 0 0 0 Joshua Lucas DO 324489 0 0 0 0 0 7500 0 12978 0 344967 0 326468 0 Robert Shalowitz MD 286540 0 0 0 0 0 7500 0 12978 0 307018 0 270329 0 Bill Apostolon DO 259954 0 0 0 0 0 7500 0 12978 0 280432 0 0 0 David Nally MD 172400 0 0 0 0 0 0 0 0 0 172400 0 0 0 SchJ_P01_S00_L03 Schedule J, Part I, Line 3 The compensation committee, which is comprised of the four officers of the Board of Directors, annually evaluates the CEO's job performance and compensation. Marshall County Building Commission 2008-06-25 1500000 acquire equipment, retire existing debt 0 0 0 0 0 0 0 0 0 0 0 0 1500000 0 0 2008 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 LORI ABRAHAM FAMILY MEMBER OF TRUSTEE 68558 EMPLOYMENT 0 PATTI KIMPEL FAMILY MEMBER OF TRUSTEE 56075 EMPLOYMENT 0 DIANE NALLY FAMILY MEMBER OF TRUSTEE 65709 EMPLOYMENT 0 DONNA SIDIROPOLIS FAMILY MEMBER OF TRUSTEE 25696 EMPLOYMENT 0 BETTY SUHODOLSKI FAMILY MEMBER OF OFFICER 24484 EMPLOYMENT 0 LEANNE GODDARD FAMILY MEMBER OF TRUSTEE 19155 EMPLOYMENT 0 BETSY SICURELLA FAMILY MEMBER OF FORMER OFFICER 11641 EMPLOYMENT 0 F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a Reynolds Memorial Healthcare System(parent organization) is the sole member of the hospital. F990_P06_S0A_L07b Form 990, Part VI, Section A, Line 7b Decisions of the hospital are subject to the approval of Reynolds Memorial Healthcare System(parent corporation). F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The IRS Form 990 is reviewed by the Executive Committe prior to filing. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c Each trustee and key employee must annually attest to any potential conflicts of interest. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 The hospital has a compensation committee which evaluates compensation of key employees based on independent data. It reviews this data annually. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 A schedule of the meetings of the Board of Directors is published at the hospital, and the public is welcome. Financial statements, conflict of interest policies, and other documents are available upon request. F990_P11_S00_L05 Form 990, Part XI, Line 5 The net realized and unrealized gains on permanently restricted net assets for year ended 9/30/12. Reynolds Memorial Foundation 800 Wheeling Avenue Glen Dale WV 26038 550710402 foundation to support hospital WV 501(c)3 3 N/A Reynolds Memorial Healthcare System 800 Wheeling Avenue Glen Dale WV 26038 550710401 non-profit healthcare system WV 509(a)3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0