PLEASANT VALLEY HOSPITAL INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- PLEASANT VALLEY HOSPITAL INC (EIN 55-0440086)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-07
- IRS object ID
- 201302199349300520
- 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 H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-07T09:04:06-05:00 | 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 | 550440086 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pleasant Valley Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PLEA | NameControl |
| Phone | 3046754340 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2520 Valley Drive | AddressLine1 |
| City | Pt Pleasant | City |
| State | WV | State |
| ZIP Code | 25550 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Richard Hogan | Name |
| Title | CFO | Title |
| Phone | 3046754340 | Phone |
| Date Signed | 2013-08-05 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Harry C Harless | Name |
| PTIN | P01042847 | PTIN |
| Phone | 3043460441 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Thomas Schauer | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2520 Valley Drive | AddressLine1 |
| City | Pt Pleasant | City |
| State | WV | State |
| ZIP Code | 25550 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 71783453 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.pvalley.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1955 | YearFormation |
| State Legal Domicile | WV | StateLegalDomicile |
| Activity Or Mission Description | Provide quality inpatient and outpatient healthcare to the community regardless of ability to pay. Provide a wellness center to promote community health through fitness programs. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 940 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 1300 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 193897 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 53248 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 69702851 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 70786499 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 96525 | InvestmentIncomePriorYear |
| Investment Income Current Year | 34913 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 953340 | OtherRevenuePriorYear |
| Other Revenue Current Year | 870872 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 70946613 | TotalRevenuePriorYear |
| Total Revenue Current Year | 71745532 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 17997 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 15637 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 40775854 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 39867268 | 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 | 32513865 | OtherExpensePriorYear |
| Other Expenses Current Year | 33177217 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 73307716 | TotalExpensesPriorYear |
| Total Expenses Current Year | 73060122 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -2361103 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1314590 | RevenuesLessExpensesCY |
| Total Assets BOY | 41613039 | TotalAssetsBOY |
| Total Assets EOY | 40584241 | TotalAssetsEOY |
| Total Liabilities BOY | 17709086 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 17965499 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 23903953 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 22618742 | NetAssetsOrFundBalancesEOY |
| Mission Description | To operate an acute care hospital facility for the citizens of Point Pleasant, West Virginia and the surrounding communities and counties. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 61251085 | Expense |
| Grants | 15637 | Grants |
| Revenue | 70485060 | Revenue |
| Description | The hospital provided 42,598 acute, nursery, and skilled nursing days; 120,817 outpatient visits; 17,359 emergency room visits; 2,178 ambulatory surgeries; 1,446 observation visits; 13,954 home health visits; 1,447 hospice visits; and 56,270 physician office visits. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 119417 | Expense |
| Revenue | 222222 | Revenue |
| Description | The hospital operates a wellness center which provides community health education and fitness programs that are available to hospital employees and all residents of the surrounding communities. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 61370502 | 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 | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | 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 | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 48 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 940 | 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 | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | 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 | Richard Hogan CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3046754340 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2520 Valley Drive | AddressLine1 |
| City | Point Pleasant | City |
| State | WV | State |
| ZIP Code | 25550 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 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 |
|---|---|---|---|---|---|---|---|
| Mario Liberatore | |||||||
| Chairman | 3.00 | X | 0 | 0 | 0 | ||
| Peter Allinder | |||||||
| Vice Chairman | 3.00 | X | 0 | 0 | 0 | ||
| Annette Boyles | |||||||
| Secretary | 3.00 | X | 0 | 0 | 0 | ||
| Charles Lanham | |||||||
| Treasurer | 3.00 | X | 0 | 0 | 0 | ||
| Michael Lieving | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| Scott Barnitz | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| Mike Bartrum | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| Jack Buxton OD | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| Clayton Faber | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| Randall Hawkins MD | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| William Tatterson | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| Thomas Willoughby | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| C Dallas Kayser | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| Dorsel Keefer | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| James Lockhart DDS | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| William Knight | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| James Rossi | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| R Michael Shaw | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| Lanes Williamson | |||||||
| Trustee | 3.00 | X | 0 | 0 | 0 | ||
| Thomas Schauer | |||||||
| President/CEO | 40.00 | 181400 | 0 | 33309 | X | ||
| Hugh Collins | |||||||
| President/CEO | 40.00 | 165977 | 0 | 27272 | X | ||
| William A Barker Jr | |||||||
| Vice President | 40.00 | 161646 | 0 | 24886 | X | ||
| Robert Lewis MD | |||||||
| Physician | 40.00 | 649027 | 0 | 39507 | X | ||
| James Toothman MD | |||||||
| Physician | 40.00 | 641052 | 0 | 39517 | X | ||
| Ori Tzuk MD | |||||||
| Physician | 40.00 | 607439 | 0 | 39517 | X | ||
| Clifford Roberson MD | |||||||
| Physician | 40.00 | 558355 | 0 | 27902 | X | ||
| Stephen Rerych MD | |||||||
| Physician | 40.00 | 425879 | 0 | 39517 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3390775 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 271427 | TotalOtherCompensation |
| Number Individuals GT100 K | 28 | 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 |
|---|---|---|---|---|---|
| NAPS Inc | |||||
| 714 1/2 Lee St | Charleston | WV | 25301 | Anesthesia | 550506 |
| Quest Diagnostics | |||||
| PO Box 740709 | Atlanta | GA | 30374 | Laboratory | 542846 |
| Crest Services | |||||
| 735 Plaza Blvd 210 | Coppell | TX | 75019 | Biomedical | 321598 |
| Comphealth Inc | |||||
| PO Box 972651 | Dallas | TX | 75019 | Healthcare provider staffing | 222900 |
| Ohio Valley Sleep Diagnostice | |||||
| Rt 1 Box 55 Claylick Rd | Ripley | WV | 25271 | Sleep lab | 165800 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
| Government Grants | 4196 | GovernmentGrants |
| All Other Contributions | 49052 | AllOtherContributions |
| Total Contributions | 53248 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Patient Services | 622110 | 70388546 | 70388546 | ||
| Wellness Center | 621111 | 222222 | 222222 | ||
| From K-1: Premier Pur | 900099 | 97814 | 96514 | 1300 | |
| Electronic health reco | 900099 | 77917 | $77,917 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 70786499 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 34913 | TotalRevenueColumn |
| Exclusion | $34,913 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 429410 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 37921 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 391489 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 391489 | TotalRevenueColumn |
| Exclusion | $391,489 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Cafeteria & vending | 722212 | 355155 | $355,155 |
| Gift shop | 453220 | 50755 | $50,755 |
| Purchase discounts | 900099 | 17304 | $17,304 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 56169 | TotalRevenueColumn |
| Exclusion | $56,169 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 479383 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 71745532 | TotalRevenueColumn |
| Related Or Exempt Function Income | 70707282 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1300 | UnrelatedBusinessRevenue |
| Exclusion | $983,702 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15637 | Total |
| Program Services | 15637 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 415180 | Total |
| Program Services | 333057 | ProgramServices |
| Management And General | 82123 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27937690 | Total |
| Program Services | 22411615 | ProgramServices |
| Management And General | 5526075 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 741334 | Total |
| Program Services | 594698 | ProgramServices |
| Management And General | 146636 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8854729 | Total |
| Program Services | 7103264 | ProgramServices |
| Management And General | 1751465 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1918335 | Total |
| Program Services | 1538888 | ProgramServices |
| Management And General | 379447 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 98836 | Total |
| Management And General | 98836 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35837 | Total |
| Management And General | 35837 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4400373 | Total |
| Program Services | 3529979 | ProgramServices |
| Management And General | 870394 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 337754 | Total |
| Program Services | 270946 | ProgramServices |
| Management And General | 66808 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4869232 | Total |
| Program Services | 3901059 | ProgramServices |
| Management And General | 968173 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 699283 | Total |
| Program Services | 560965 | ProgramServices |
| Management And General | 138318 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1009279 | Total |
| Program Services | 809644 | ProgramServices |
| Management And General | 199635 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 423362 | Total |
| Program Services | 339621 | ProgramServices |
| Management And General | 83741 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 480824 | Total |
| Program Services | 385717 | ProgramServices |
| Management And General | 95107 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2858025 | Total |
| Program Services | 2292708 | ProgramServices |
| Management And General | 565317 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1677859 | Total |
| Program Services | 1345978 | ProgramServices |
| Management And General | 331881 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad debts | 9055497 | 9055497 | |
| Medical supplies | 3513356 | 3513356 | |
| Medicaid provider tax | 1774109 | 1774109 | |
| Repairs & maintenance | 1452525 | 1165216 | 287309 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 491066 | Total |
| Program Services | 428548 | ProgramServices |
| Management And General | 62518 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73060122 | Total |
| Program Services | 61370502 | ProgramServices |
| Management And General | 11689620 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 916195 | BOY |
| EOY | 578367 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7017663 | BOY |
| EOY | 8628887 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11499660 | BOY |
| EOY | 9426373 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 123040 | BOY |
| EOY | 202913 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1182891 | BOY |
| EOY | 1276175 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 551306 | BOY |
| EOY | 662721 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 73895356 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 56425222 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18787759 | BOY |
| EOY | 17470134 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 224441 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 162927 | BOY |
| EOY | 138290 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1147157 | BOY |
| EOY | 2200381 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41613039 | BOY |
| EOY | 40584241 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5378062 | BOY |
| EOY | 6435935 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7830000 | BOY |
| EOY | 7110000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4501024 | BOY |
| EOY | 4419564 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17709086 | BOY |
| EOY | 17965499 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23903953 | BOY |
| EOY | 22618742 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23903953 | BOY |
| EOY | 22618742 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41613039 | BOY |
| EOY | 40584241 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1314590 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 29379 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| 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 | 1254831 | OtherCostOrOtherBasis |
| Book Value | 1254831 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 320643 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 24103788 | OtherCostOrOtherBasis |
| Depreciation | 15623686 | Depreciation |
| Book Value | 8800745 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 233667 | OtherCostOrOtherBasis |
| Depreciation | 232812 | Depreciation |
| Book Value | 855 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 44619887 | OtherCostOrOtherBasis |
| Depreciation | 38724408 | Depreciation |
| Book Value | 5895479 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3362540 | OtherCostOrOtherBasis |
| Depreciation | 1844316 | Depreciation |
| Book Value | 1518224 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 17470134 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Bond issue costs | 15706 |
| Due from related parties | 302199 |
| Other receivables | 1839184 |
| Accrued interest | 43292 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2200381 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Capital lease agreements | $1,887,232 |
| Estimated third party payor settlements | $2,532,332 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4419564 | TotalOfAmounts |
| Total Revenue | 71745532 | TotalRevenue |
| Total Expenses | 73060122 | TotalExpenses |
| Excess Or Deficit For Year | -1314590 | ExcessOrDeficitForYear |
| Other | $29,379 | OtherAmount |
| Total Adjustments | 29379 | TotalAdjustments |
| Excess Or Deficit Per FS | -1285211 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 71787148 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 139430 | OtherRevenues |
| Revenue Not Rptd F990 | 139430 | RevenueNotRptdF990 |
| Revenue Subtotal | 71647718 | RevenueSubtotal |
| Other Revenues Not Included | 97814 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 97814 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 71745532 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 73072359 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 12237 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 12237 | ExpensesNotRptdF990 |
| Expenses Subtotal | 73060122 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 73060122 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part XI, Line 8 - Other Adjustments: | Income per K-1: Premier Purchasing Partners -97,814. Distribution: Premier Purchasing Partners 127,193. Total to Schedule D, Part XI, Line 8: 29,379. |
| Part XII, Line 2d - Other Adjustments: | Distributions from Premier Purchasing Partners 127,193. Depreciation included in rental expenses on 990 12,237. |
| Part XII, Line 4b - Other Adjustments: | From K-1: Premier Purchasing Partners 97,814. |
| Part XIII, Line 2d - Other Adjustments: | Depreciation included in rental expenses on 990 12,237. |
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 |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 100.000000000000 | 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 | 346196 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 346196 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00540 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14719691 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13316122 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1403569 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02190 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15065887 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13316122 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1749765 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02730 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 56883 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6359 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 50524 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1131256 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1131256 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01770 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 50116 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 50116 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1238255 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6359 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1231896 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01930 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16304142 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13322481 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2981661 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04660 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 13994 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 13994 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1107 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1107 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2955 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2955 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 154212 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 154212 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 10112 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 10112 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 182380 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 182380 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00280 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $3,667,476 | BadDebtExpenseAmount |
| Amount Attributable To | 794571 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 11358499 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 10236850 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 1121649 | MedicareSurplusOrShortfall |
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 | Pleasant Valley Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2520 Valley Drive | AddressLine1 |
| City | Pt Pleasant | City |
| State | WV | State |
| ZIP Code | 25550 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | Skilled nursing facility | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pleasant Valley Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 100.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| 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 |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pleasant Valley Hospital Nursing & Rehab | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 640 Sand Hill Road | AddressLine1 |
| City | Point Pleasant | City |
| State | WV | State |
| ZIP Code | 25550 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | Skilled nursing facility | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 7: The cost of charity care and unreimbursed Medicaid were estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H Instructions.The cost of (1) community health improvement services and community bnefit operations, (2) health professions education, and (3) cash and in-kind contributions was obtained from the hospital's accounting records. | ||
| 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 $ 9055497. | ||
| Part II: Our weight loss challenge gives the community the ability to use our wellness services. Our wellness services includes cardio and weight lifting machines and certified exercise physiologists. Blood pressure, weight, body fat were monitored before the challenge and after the challenge. This promotes a healthly lifestyle in the community. Mason County is a medically underserved area and the hospital spends money for recruitment for this area. The amount shown for workforce development is the amount paid to recruit new physicians to the area. | ||
| Representation on boards of coalitions that build community capacity and share ideas. | How these activities promote the health of the communities served | Part II - Community Building Activities |
| 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.Cost of bad debts was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions. | ||
| Part III, Line 8: Medicare allowable costs were estimated using Worksheet B of the Schedule H instructions. | ||
| Part III, Line 9b: Pleasant Valley Hospital has a charity care policy and a Collection and Bad Debt policy that discusses qualifying and eligibility for charity care, collection practices and handling of bad debt accounts. It is a practice to handle all patient accounts in the same manner/precedent. Patients are sent monthly statements - even while applying and pending financial assistance and will continue to receive statements until determination is made. Once determination is made the account balance or the % portion of the account balance is adjusted to "Financial Assistance". | ||
| Part V, Section B, Line 13g: The policy is discussed with patients before they are discharged. Copy of the policy is provided to patients prior to discharge. | Pleasant Valley Hospital | |
| Part V, Section B, Line 19d: Charges to bill patients are based on income level, asset level, and medical indigency. These were for patients who qualified for financial assistance. The Hospital also gave self-pay patients prompt pay discounts of of gross charges. Pateints were not denied financial assistance because the applications were incomplete. The applications were put on hold until the missing information was obtained. | Pleasant Valley Hospital | |
| Part VI, Line 2: The Hospital participates in the State of West Virginia Abeyance program. We prepare reports for this probran identifying our community benefit programs. This information is reported to the West Virginia Healthcare Authority which makes its records available to the publice. | ||
| Part VI, Line 3: The process in place offers the uninsured and underinsured patient the ability to apply for charity care through a formal application process established by reviewing both income and expense to make a final determination of eligibility. It requires proper verification of income through a pay stub, tax return, etc. It is also verified that the patient is not eligible for a state assisted program via a denial letter from the program or verification through the state caseworker. The patient will either be contacted by the Business Office or will contact the Business Office during the collection and statement process to discuss financial arrangements regarding their patient account. All options of payments will be discussed and charity care offered as an alternative option after screening the patient's financial ability to make payment. | ||
| Part VI, Line 4: Pleasant Valley Hospital is a rural hospital in Point Pleasant, WV. Pleasant Valley Hospital serves mainly the people of Mason and Jackson County, WV and Meigs and Gallia County, OH. We are a federally designated medically underserved area. Mason County has 27,179 residents, the median household income is $36,468, and 17.8% are below poverty levels. Jackson County has 29,234 residents, the median household income is $43,191, and 16.7% are below poverty levels. Meigs County has 23,593 residents, the median household income is $33,708, and 21.3% are below poverty levels. Gallia County has 30,708 residents, the median household income is $36,918 and 20% are below poverty levels. Medicaid patients made up 23.8% of our total discharges and 16.3% of our total outpatient visits in FY 2012. Uninsured patients made up 4.6% of our total discharges and 4.3% of our total outpatient visits in FY 2012. There is one other not-for-profit hospital within 15 miles of PVH. They serve many of the same areas that we do. | ||
| Part VI, Line 5: The majority of the organization's governing body is comprised of persons who reside in the organization's primary service area, who are neither employees or contractors of the organization, nor family members thereof. The hospital extends medical staff privileges to all qualified physicians in its community. The hospital provides a 24 hour emergency room and is available to all regardless of the ability to pay. All the services provided by the hospital are provided regardless of the ability to pay. The hospital has an auxiliary that helps our patients and visitors if they need a wheelchair when they arrive or if they need dirctions on where to go within the Hospital. The hospital provides Breast Cancer Screenings/Mammograms free to patients who cannot pay for the service. The hospital has a fitness center for the community and it also conducts many health fairs throughout the year. The hospital provides many health screenings throughout the year in addition to a nutritional program. Our SNF provides transportation for its residents to health facilities. The hospital has support groups for members of the community. The hospital donates money to the community for various projects. |
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 | Mason County Board of Education | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 Main Street | AddressLine1 |
| City | Point Pleasant | City |
| State | WV | State |
| ZIP Code | 25550 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 556000353 | EINOfRecipient |
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Cash Grant | 10000 | AmountOfCashGrant |
| Purpose Of Grant | High school athletic program support | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Thomas Schauer | |||||||||||||
| 180903 | 0 | 101 | 0 | 396 | 0 | 15088 | 0 | 19019 | 0 | 215507 | 0 | 0 | 0 |
| Hugh Collins | |||||||||||||
| 40979 | 0 | 0 | 0 | 124998 | 0 | 15125 | 0 | 12512 | 0 | 193614 | 0 | 0 | 0 |
| William A Barker Jr | |||||||||||||
| 161149 | 0 | 101 | 0 | 396 | 0 | 6665 | 0 | 19019 | 0 | 187330 | 0 | 0 | 0 |
| Robert Lewis MD | |||||||||||||
| 435911 | 0 | 213062 | 0 | 54 | 0 | 21296 | 0 | 19501 | 0 | 689824 | 0 | 0 | 0 |
| James Toothman MD | |||||||||||||
| 157198 | 0 | 483794 | 0 | 60 | 0 | 21296 | 0 | 19187 | 0 | 681535 | 0 | 0 | 0 |
| Ori Tzuk MD | |||||||||||||
| 525000 | 0 | 82301 | 0 | 138 | 0 | 21296 | 0 | 20359 | 0 | 649094 | 0 | 0 | 0 |
| Clifford Roberson MD | |||||||||||||
| 524992 | 0 | 32601 | 0 | 762 | 0 | 21296 | 0 | 8743 | 0 | 588394 | 0 | 0 | 0 |
| Stephen Rerych MD | |||||||||||||
| 425016 | 0 | 101 | 0 | 762 | 0 | 21296 | 0 | 19878 | 0 | 467053 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| The County Commission of Mason County WV | |||||||
| 556000352 | 575194BM6 | 2003-06-17 | 7805000 | To refund Series 1993 bonds | 0 | 0 | 0 |
| The County Commission of Mason County WV | |||||||
| 556000352 | 575194CH6 | 2006-10-12 | 3895000 | Capital improvements & equipment acquisition | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Capital ExpendituresCapitalExpenditures |
|---|---|---|---|---|---|---|---|---|---|---|
| 2630000 | 7805000 | 7021907 | 156100 | 626993 | 2003 | 0 | 0 | 1 | 1 | |
| 1960000 | 3895000 | 389500 | 77900 | 2008 | 0 | 0 | 1 | 1 | 3427600 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (12 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Lee Anne Kayser | |||
| Family member of C. Dallas Kayser, Hospital Trustee | 50245 | Wages | 0 |
| Carrie Dillard MD | |||
| Family member of James Lockhart, Hospital trustee | 150111 | Wages | 0 |
| Heather Lloyd | |||
| Family member of James Lockhart, Hospital Trustee | 34892 | Fees for service-independent contractor | 0 |
| Jane Zirkle | |||
| Family member of Mike Lieving, Hospital Trustee | 23103 | Wages | 0 |
| Wes Lieving DO | |||
| Family member of Mike Lieving, Hospital Trustee | 229027 | Wages | 0 |
| Peoples Bank | |||
| James Lockhart, Hospital Trustee, is a board member of the bank | 832 | Interest bearing checking accounts | 0 |
| Peoples Bank | |||
| Dorsal Keefer, Hospital Truste, is a board member of the bank | 832 | Interest bearing checking accounts | 0 |
| Peoples Bank | |||
| R. Michael Shaw, Hospital Trustee, is a board member of the bank | 832 | Interest bearing checking accounts | 0 |
| Ohio Valley Bank | |||
| Mario Liberatore, Hospital Trustee, is an officer of the bank | 30629 | Interest on certificates of deposit | 0 |
| Ohio Valley Bank | |||
| Lannes Williamson, Hospital Trustee, is a board member of the bank | 30629 | Interest on certificates of deposit | 0 |
| Farmers Bank | |||
| Michael Lieving, Hospital Trustee, is an officer of the bank | 3034 | Interest on certificates of deposit | 0 |
| Carrie Dillard MD | |||
| Family member of James Lockhart, Hospital Trustee | 10000 | Matching grant funds received to pay student loans. The hospital is in a federally designated medically underserved area. To aid in physician recruitment, the hospital received grant funds. The grant funds were paid directly to the educatinal institution. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Dallas Kayser, Charles Lanham, and Michael Shaw have a business relationship. Mario Liberatore and Lannes Williamson have a business relationship. Dallas Kayers's spouse and James Rossi have a business relationship. | |
| Form 990, Part VI, Section B, line 11 | The 990 is prepared by the Hospital's independent accountants. It is then reviewed by the CFO and CEO and a copy is provided to the governing board before it is filed with the IRS. | |
| Form 990, Part VI, Section B, line 12c | Each board member fills out a questionnaire at the end of the fiscal year. The questionnaire has questions on it that determine independence status and other relationships between board members and between the board member and the hospital. This helps in determining possible conflicts that may arise. In addition, the board members must sign a conflict of interest policy that requires them with due diligence to state that they have a conflict of interest when that conflict arises. The board member must leave the board meeting during discussions and voting. | |
| Form 990, Part VI, Section B, line 15 | The compensation committee is made up of independent board members. These members are appointed by the board. The compensation committee decides the compensation of the CEO and VPs. The compensation committee consults with an independent consultant to determine a fair compensation for the CEO and VPs based on peer data. The Compensation committee has used this study to determine base salary for the CEO and VPs. The CEO contract is taken back to the board for final approval. | |
| Form 990, Part VI, Section C, line 19 | These documents are available upon request for inspection at the hospital or by mailing a copy upon request. | |
| Form 990, Part XI, line 5: | Income per K-1: Premier Purchasing Partners -97,814. Distribution: Premier Purchasing Partners 127,193. Total to Form 990, Part XI, Line 5: 29,379. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Pleasant Valley Hospital Foundation Inc | ||||||||||
| 2420 Valley Dr | Pt Pleasant | WV | 25550 | 200120079 | Fundraising | WV | 501(c)(3) | Line 9 | N/A | 0 |
| Pleasant Valley Hospital Health Foundation Inc | ||||||||||
| 2420 Valley Dr | Pt Pleasant | WV | 25550 | 550649849 | Scholarships/Healthcare | WV | 501(c)(3) | Line 11b, II | N/A | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pleasant Valley Home Medical Equipment | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Viand St | AddressLine1 |
| City | Pt Pleasant | City |
| State | WV | State |
| ZIP Code | 25550 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550653315 | EIN |
| Primary Activity | Retail - Medical equipment sales & rental | PrimaryActivity |
| Legal Domicile State | WV | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 328688 | ShareOfTotalIncome |
| Share Of EOY Assets | 1636801 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | 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 | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |