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CAMC Teays Valley Hospital Inc: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CAMC Teays Valley Hospital Inc (EIN 55-0752636)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201313199349309506
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T15:50:15-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 S Wacker DriveAddressLine1
CityChicagoCity
StateILState
ZIP Code60606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN550752636EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CAMC Teays Valley Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCAMCNameControl
Phone3047571700Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1547AddressLine1
CityCharlestonCity
StateWVState
ZIP Code25301ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRandy HodgesName
TitlePresidentTitle
Phone3043886247Phone
Date Signed2013-11-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLaura GillespieName
PTINP00855604PTIN
Phone3124861000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Teays Valley HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonRandy HodgesNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11400 Hospital DriveAddressLine1
CityHurricaneCity
StateWVState
ZIP Code25526ZIPCode
FieldValueIRS element (for citing)
Gross Receipts74961044GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.camc.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileWVStateLegalDomicile
Activity Or Mission DescriptionCAMC Teays Valley Hospital, Inc.'s ("Teays") primary exempt purpose is to provide hospital services for the people residing in the geographical area of Putnam County, the State of West Virginia and elsewhere. These services promote legitimate methods for the prevention of disease and the positive promotion of personal and public health. Teays fosters and conducts education within the nursing and technical occupations, which contribute to the diagnosis, treatment and prevention of disease.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers31TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year67701027ProgramServiceRevenuePriorYear
Program Service Revenue CY74585211ProgramServiceRevenueCY
Investment Income Prior Year39941InvestmentIncomePriorYear
Investment Income Current Year57239InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year236889OtherRevenueCurrentYear
Total Revenue Prior Year67740968TotalRevenuePriorYear
Total Revenue Current Year74879339TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year21914597SalariesEtcPriorYear
Salaries Etc Current Year22734136SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year43639764OtherExpensePriorYear
Other Expenses Current Year45630650OtherExpensesCurrentYear
Total Expenses Prior Year65554361TotalExpensesPriorYear
Total Expenses Current Year68364786TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2186607RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6514553RevenuesLessExpensesCY
Total Assets BOY36162773TotalAssetsBOY
Total Assets EOY40686388TotalAssetsEOY
Total Liabilities BOY38607829TotalLiabilitiesBOY
Total Liabilities EOY35972424TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-2445056NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY4713964NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionStriving to provide the best healthcare to every patient, every day.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense40124870Expense
Revenue74585211Revenue
DescriptionTeays Valley Hospital is licensed for 70 beds, and our health care services focuses on providing a full range of inpatient and outpatient services. Inpatient days of 15,051, outpatient visits of 65,028, and emergency department visits of 18,118. We support our community because we understand the impact that medical care, charity care, education, corporate contributions and community partnerships have on the lives the population we serve.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense13391174Expense
DescriptionTeays Valley Hospital provided un-reimbursed charity care at cost of $4,114,006 and bad debts at cost of $9,277,168 to the community in 2012. Teays Valley Hospital does much more than just provide health care, being involved in nearly every aspect of the lives and well being of the community. Programs and services are available to our community to serve our community-particularly the needs of the low income, elderly, youth, and other vulnerable persons. Community benefits are programs or activities that provide treatment or promote health and healing as a response to identified community needs and meet at least one of the following community benefit criteria:1) Improves access to health care services.2) Enhances health of the community.3) Advances medical or health care knowledge.4) Relieves or reduces the burden of government or other community efforts. Teays benefit activities offered 32 programs which affected an estimated 12,000 people.Description
FieldValueIRS element (for citing)
Total Program Service Expense53516044TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109639NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWVStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Larry C HudsonBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3043887603TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1501 Morris StreetAddressLine1
CityCharlestonCity
StateWVState
ZIP Code25301ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
James A Akins MD
Trustee3.00X000
David W Bunger
Trustee3.00X000
Leonard A Fichter DO
Medical Staff Past President3.00X000
David L Ramsey Sch O
Trustee3.00X0137896750453156.50
E Michael Robie DO
Medical Staff President3.00X000
Richard L Slater
Trustee3.00X000
Nancy R Smith
Trustee3.00X000
Diane E Duttine Sanders
Trustee3.00X000
Oshel B Craigo
Vice Chairman of the Brd3.00X000
Steven L Smith
Chairman of the Board3.00X000X
Randall H Hodges
President45.000276581266529X
Larry C Hudson
Vice President/Treasurer3.0006882448908657.00X
Francis C Gall Jr
Secretary3.0002224683439155.00X
Thomas Rittinger DO
Hospitalist40.00040217738296X
Mary B Mullins
Associate Adminstrator40.0001801977800X
Lance T Carney
Pharmacy Manager40.00014686335546X
Harry Fletcher
Patient Flow Coordinator40.0001235758643X
Roy Messick
Clinical Nurse II40.0001171944350X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3536266TotalReportableCompFrmRltdOrgs
Total Other Compensation989172TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Siemens Medical Solutions
Dept AT 40065AtlantaGA311920065Information Technology Services1180353
Alliance Healthcare Services
PO Box 96485ChicagoIL60693Diagnostic Imaging Services859369
Capital Medical Nursing
PO Box 998PocaWV25159Nursing Services363945
NAPS Inc
2215 Smith RoadCharlestonWV25339CRNA Nursing Services286600
University Physicians and Surgeons
1249 15th St Ste 2000HuntingtonWV25701Physician Pulmonary Services197833
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient Revenue6221107426440474264404
Clinical Services Sold621990247139247139
Rental (Non-Res)5311206916869168

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column4500TotalRevenueColumn
Related Or Exempt Function Income4500RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue74585211TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column49827TotalRevenueColumn
Exclusion$49,827ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other89117Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other81705Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other7412Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column7412TotalRevenueColumn
Exclusion$7,412ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
Cafeteria/Vending722212232788$232,788
Medical Records Fee8129004101$4,101
FieldValueIRS element (for citing)
Total Other Revenue236889TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column74879339TotalRevenueColumn
Related Or Exempt Function Income74585211RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$294,128ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total543110Total
Management And General543110ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total17259875Total
Program Services16327018ProgramServices
Management And General932857ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total445581Total
Program Services100119ProgramServices
Management And General345462ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4485570Total
Program Services1163893ProgramServices
Management And General3321677ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2054471Total
Program Services189340ProgramServices
Management And General1865131ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total6060Total
Management And General6060ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total41065Total
Management And General41065ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total8651Total
Management And General8651ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4335968Total
Program Services3371336ProgramServices
Management And General964632ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total47573Total
Program Services1285ProgramServices
Management And General46288ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4006312Total
Program Services2145783ProgramServices
Management And General1860529ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total147319Total
Management And General147319ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total673527Total
Program Services37352ProgramServices
Management And General636175ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1074Total
Program Services540ProgramServices
Management And General534ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total8537Total
Management And General8537ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1075216Total
Management And General1075216ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total1271564Total
Management And General1271564ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1647980Total
Program Services1285028ProgramServices
Management And General362952ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total988074Total
Management And General988074ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies106401871059119748990
Bad Debts96510879277168373919
Charity72222857222285
Provider Tax18037001803700

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total68364786Total
Program Services53516044ProgramServices
Management And General14848742ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY15434BOY
EOY2200EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7419833BOY
EOY9014146EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1041303BOY
EOY1279154EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY176436BOY
EOY173820EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis31055569LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec12116238LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY19741914BOY
EOY18939331EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2015391BOY
EOY2012483EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY5752462BOY
EOY9265254EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY36162773BOY
EOY40686388EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6056064BOY
EOY4216674EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY23935104BOY
EOY23242535EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY6089998BOY
EOY5804712EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2526663BOY
EOY2708503EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY38607829BOY
EOY35972424EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-2445056BOY
EOY4713964EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-2445056BOY
EOY4713964EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY36162773BOY
EOY40686388EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses6514553ReconcilationRevenueExpenses
Reconcilation Other Changes644467ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4902037OtherCostOrOtherBasis
Book Value4902037BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11923051OtherCostOrOtherBasis
Depreciation2192089Depreciation
Book Value9730962BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis13928926OtherCostOrOtherBasis
Depreciation9894776Depreciation
Book Value4034150BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis301555OtherCostOrOtherBasis
Depreciation29373Depreciation
Book Value272182BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings18939331TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
Affiliate: Integrated Health Care Providers, Inc.3343
Affiliate: Charleston Area Medical Center, Inc.8389375
Long-term Receivable - Physicians & Student Loans854565
Deferred Bond Costs17971
FieldValueIRS element (for citing)
Total Book Value Other Assets9265254TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Affiliate: Charleston Area Medical Center, Inc.$2,530,173
Affiliate: Integrated Health Care Providers, Inc.$178,330
FieldValueIRS element (for citing)
Total Of Amounts2708503TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X, Line 2:ReturnReference
ExplanationTeays' financial statements are audited as part of the audit of the financial statements of CAMC Health System, Inc. and Subsidiaries (collectively, the "System"). Language regarding ASC 740 (FIN 48) included in the Consolidated footnotes is as follows: "CAMC, the Foundation, the Institute and CAMC Teays, are exempt from income taxes under Section 501 (c)(3) of the Internal Revenue Code (the "Code") and applicable state statutes, but are subject to unrelated business income tax. The System does not have any material uncertain tax positions at December 31, 2012."Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4114006TotalCommunityBenefitExpense
Net Community Benefit Expense4114006NetCommunityBenefitExpense
Percent Of Total Expense0.07010PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense7686438TotalCommunityBenefitExpense
Direct Offsetting Revenue4702358DirectOffsettingRevenue
Net Community Benefit Expense2984080NetCommunityBenefitExpense
Percent Of Total Expense0.05080PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense762693TotalCommunityBenefitExpense
Direct Offsetting Revenue117065DirectOffsettingRevenue
Net Community Benefit Expense645628NetCommunityBenefitExpense
Percent Of Total Expense0.01100PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense12563137TotalCommunityBenefitExpense
Direct Offsetting Revenue4819423DirectOffsettingRevenue
Net Community Benefit Expense7743714NetCommunityBenefitExpense
Percent Of Total Expense0.13190PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense234613TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense234613NetCommunityBenefitExpense
Percent Of Total Expense0.00400PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense250TotalCommunityBenefitExpense
Net Community Benefit Expense250NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense11939TotalCommunityBenefitExpense
Net Community Benefit Expense11939NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense246802TotalCommunityBenefitExpense
Net Community Benefit Expense246802NetCommunityBenefitExpense
Percent Of Total Expense0.00420PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense12809939TotalCommunityBenefitExpense
Direct Offsetting Revenue4819423DirectOffsettingRevenue
Net Community Benefit Expense7990516NetCommunityBenefitExpense
Percent Of Total Expense0.13610PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense8275TotalCommunityBuildingExpense
Net Community Building Expense8275NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense3580TotalCommunityBuildingExpense
Net Community Building Expense3580NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense11000TotalCommunityBuildingExpense
Net Community Building Expense11000NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense22855TotalCommunityBuildingExpense
Net Community Building Expense22855NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$9,277,168BadDebtExpenseAmount
Amount Attributable To5232323AmountAttributableTo
Amount Reimbursed By Medicare16938771AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare22883799CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5945028MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number11FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1CAMC Teays Valley Hospital IncBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1PO Box 1547AddressLine1
CityCharlestonCity
StateWVState
ZIP Code25301ZIPCode
FieldValueIRS element (for citing)
Website Addresswww.camc.orgWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CAMC Teays Valley Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 7: Utilized Worksheet 2 provided in the instructions of Schedule H to determine cost-to-charge ratio.
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 $ 9651087.
Part II: Teays community building activities promote the health of our community through community support, offering programs such as the cardiac project which assesses elementary school age children for potential heart problems and diabetes; the Putnam County Drug Endangered Children Task Force to help eliminate drugs in the community; and offering a Putnam County Breast Cancer Support Group for emotional and resource support for breast cancer patients in the community.
Part III, Line 4: There is no footnote describing bad debt, however, private pay accounts and amounts for deductibles and co-insurance that are deemed uncollectable that do not appear to meet the charity care guidelines, are written off as bad debt expense and appear as an operating expense in the statement of operations. In determining the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy, one month of actual bad debt write-off's was reviewed. From this one month, the amount of bad debt for uninsured patients was determined to be 60%. Then a sample of 100 of these uninsured patients was taken and run through a credit worthy calculator that determined 94% of the patients met the income eligibility guidelines under the organization's charity care policy.
Part III, Line 8: The organization considers any government reimbursement that is insufficient to cover allocated costs as being a community benefit. We chose to serve the community by participating in the Medicare program and accepting Medicare reimbursement.
Part III, Line 9b: Teays's collection policy makes provisions for patients who qualify for charity care or financial assistance. Patients who receive charity assistance must meet the following requirements: income at 200% or less of Federal poverty income and resource guidelines, insufficient assets to pay for the care, and not eligible for any public programs. Patients without third-party coverage who do not qualify for charity are given a 35% discount from charges (which is greater than any commercial discount). In addition to charity and uninsured discounts, Teays provides assistance with payment plans, government programs, and an Employee Assistance Program.
Part V, Section B, Line 14g: A summary of the policy is provided to patients on admission and posted in areas of service.CAMC Teays Valley Hospital, Inc.
Part V, Section B, Line 20d: Patients who qualify for charity care are given a 100% discount. If a patient does not qualify for charity care but is uninsured, a 35% discount from billed charges is given, which is greater than the highest negotiated commercial insurance discount.CAMC Teays Valley Hospital, Inc.
Part VI, Line 2: Teays board of trustees is comprised primarily of community leaders. These individuals are aware of the needs of the community and thus can most effectively help determine the direction Teays will take to address those needs. Representatives of Teays also meet with civic groups, such as the Putnam County Chamber of Commerce and local ministerial groups, to gain insight on what is needed in the local area in terms of programs offered.
Part VI, Line 3: Teays informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under Teays charity care policy during the registration process. Brochures are available at each registration point with contact information and phone numbers for our financial counselors. WV state employees are also on site to accept and process medicaid applications and notify patients if they qualify.
Part VI, Line 4: Teays community and primary area of focus is defined as our primary and secondary service areas and includes Putnam County in West Virginia. Putnam County constitutes a population of 55,617, with a median age of 37.7 and household median income of $52,809. We provide, alone and in collaboration with, a wide-ranging array of community benefit services designed to improve community health and the health of individuals, and to increase access to health care. This includes providing free and discounted services to people who are uninsured and underinsured.
Part VI, Line 5: Teays has a board of trustees comprised primarily of prominent civic and business leaders. Thirty percent of the members are hospital administrators, physicians or others professionally connected to the hospital. Admission to the hospital's medical staff is open to all qualified physicians in the area, consistent with the size and nature of the facility. Teays operates a full-time emergency room open to everyone, regardless of ability to pay. Teays serves a broad cross-section of the community through charity care. Teays applies any surplus funds toward improving facilities, equipment, patient care, medical training, and education. Integrated Health Care Providers, Inc., a sister company to Teays, is called upon to open a practice when determined that an essential physician need or access issues for patients is present.
Part VI, Line 6: Teays is part of the CAMC Health System. A sister company to CAMC, CAMC Health Education and Research Institute, Inc. ("CHERI"), is actively engaged in clinical trials and has active research protocols in oncology, cardiology/cardiovascular medicine, medicine and medicine subspecialties, behavioral health community medicine, pediatrics, nursing research and trauma/pain. A majority of this research is conducted at CAMC hospitals. CHERI serves as the education and research arm of the CAMC Health System, Inc. Charleston Area Medical Center Foundation, Inc.'s ("The Foundation") mission is to support and promote CAMC's delivery of excellent and compassionate health services, and its contribution to the quality of life and economic vitality of the region. The Foundation is a sister company and support organization to CAMC. Integrated Health Care Providers, Inc., a sister company to CAMC, is called upon to open a practice when determined that an essential physician need or access issues for patients is present. Teays board of directors is comprised of prominent civic leaders, rather than exclusively members who are hospital administrators, physicians or others professionally connected to the hospital. Admission to the hospital's medical staff is open to all qualified physicians in the area, consistent with the size and nature of the facility. The hospital operates a full-time emergency room open to everyone, regardless of ability to pay. The hospital serves a broad cross-section of the community through research or charity care. The hospital applies any surplus funds toward improving facilities, equipment, patient care, medical training, research and education.
WVReports Filed With StatesPart VI, Line 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
David L Ramsey Sch O
Trustee063267202797620466533046067804385301883498065766
Randall H Hodges
President01989700610400165710247170019359054311000
Larry C Hudson
Vice President/Treasurer0353370016666001682140702270188590777330053078
Francis C Gall Jr
Secretary018997902762304866012192022199025685900
Thomas Rittinger DO
Hospitalist040212700050010000028296044047300
Mary B Mullins
Associate Adminstrator01388780233190180000480003000018799700
Lance T Carney
Pharmacy Manager01291650118770582105910029636018240900

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 3The CAMC Health System, Inc. Board of Directors Compensation Committee selects and supervises an independent consultant who advises the Committee on compensation arrangements and transactions between CAMCHSI companies and executives. The Committee uses the data to determine the total compensation of the Teays CEO. The data is reviewed every two years or when a new person comes into an executive role.
Part I, Line 4bSupplemental Executive Retirement Plan ("SERP"). Participants are members of the Executive group. Terms & Conditions of SERP Plan: Defined Benefit. Vest at age 60, or later,if one time postponement is made prior to age 59. Deferred vesting date cannot be earlier than age 65 or later than age 68. Benefit at age 60 with 30 years of service is computed as the difference between 55% of Final Average Total compensation and sum of retirement benefits paid from: CAMC Teays Valley Hospital, Inc. Qualified Retirement Plan, Non-Qualified Retirement Benefit Restoration Plan and 50% of projected age 62 Primary Social Security Benefit. Eligible to receive SERP benefits upon earliest of: normal retirement or date elected, if extended; death; disability; involuntary termination without cause. Early retirement at age 55 with at least 5 years of service reduced 1.83% for each year of service less than 30 and .5% reduction for each month prior to Normal Retirement Date (age 60). Taxes due upon distribution. Subject to the Substantial Risk of Forfeiture. CEO Supplemental Executive Retirement Plan ("SERP"): Participant-CEO Terms and Conditions of CEO SERP Plan: Defined Contribution. Vest at age 65. Benefit at age 65 projected as the difference between 60% of Final 5 Year Average Total compensation and sum of retirement benefits paid from: CAMC Teays Valley Hospital, Inc. Qualified Retirement Plan and 50% of projected age 65 Primary Social Security Benefit. Actual benefits will depend upon simulated investment results based on investment options selected by participant. Eligible to receive SERP benefits upon earliest of: deferred vesting date; death; disability; involuntary termination without cause. Taxes due upon vesting. Subject to the Substantial Risk of Forfeiture. Neither contributions to nor distributions from the supplemental nonqualified plan were made in the current year.
Part I, Line 7CAMC provides incentive payments to certain employees after operating and performance goals are achieved. Incentive payment plans are reviewed and approved by the CAMC Health System, Inc. (CAMC's parent company) Board of Directors Compensation Committee.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1West Virginia Hospital Finance AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN621256910IssuerEIN
Date Issued2008-09-30DateIssued
Issue Price26000000IssuePrice
Description Of PurposeSee Part VIDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired2757464AmountRetired
Total Proceeds26105219TotalProceeds
Issuance Costs From Proceeds146457IssuanceCostsFromProceeds
Capital Expenditures2202074CapitalExpenditures
Other Spent Proceeds21744205OtherSpentProceeds
Amount Unspent2012483AmountUnspent
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made0FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty1MngmentCntrctBondFinancdPrprty
Engage Bond Counsel Contracts1EngageBondCounselContracts
Any Research Agreements0AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs1NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet1RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due0NoRebateDue
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested1GrossProceedsInvested
Written Proc To Monitor Reqs1WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action1ProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Schedule K, part IDescription of Purpose:To refund a portion of a $30,000,000 temporary note used to finance the acquisition, construction, and improvement of facility and to finance a project acquisition fund. Differences between the issue price (Part I) and total proceeds (Part II, line 3) are due to investment earnings.
Part IV, Line 5, Column ASuch amounts were appropriately yield restricted.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Doing Business AsForm 990, Part I, Item CDBA: Teays Valley Hospital
Form 990, Part VI, Section A, line 2David Ramsey, Larry Hudson, and Francis Gall have a business relationship due to joint employment by a common health system entity.
Form 990, Part VI, Section A, line 4Bylaws were amended to make immediate past president a voting member of the Board of Directors.
Form 990, Part VI, Section A, line 6CAMC Health System, Inc. ("CAMCHSI") is Teays' sole voting member.
Form 990, Part VI, Section A, line 7aCAMC Health System, Inc. ("CAMCHSI") is Teays' sole voting member and has authority to elect all voting trustees of Teays other than ex- officio trustees named in Teays governing documents. The sole voting member has the sole authority to amend Teays' governing documents.
Form 990, Part VI, Section A, line 7bCAMCHSI is Teays' sole voting member and has reserved powers under Teays' governing documents, which provide that decisions of Teays' governing body such as election of officers, approval of annual budgets and borrowings are subject to approval by the sole voting member. The sole voting member also has all approval powers provided to members of West Virginia nonprofit corporations under state law.
Form 990, Part VI, Section B, line 11Teays' compiles necessary information for the Form 990 through efforts of various officers and directors of the organization. The return is then prepared and reviewed by an external consultant firm. The completed Form 990 is reviewed with the CAMC Health System Board of Directors.
Form 990, Part VI, Section B, line 12cCorporate officers including the President and Secretary develop the agendas for board meetings and identify potential conflict of interest issues relative to action items and assist the board chairs with resolution of same. Annual disclosure procedures are implemented and the board chair and CAMC Health System, Inc. Nominating Committee periodically review conflict situations.
Form 990, Part VI, Section B, line 15The CAMCHSI Board of Directors Compensation Committee selects and supervises an independent consultant who advises the Committee on compensation arrangements and transactions between CAMC Health System, Inc. (including Teays) and executives (including CEO). The Committee uses the data to determine the total compensation of Teays' CEO and other executive officers. This data is reviewed every two years or when a new person comes into an executive role.
Form 990, Part VI, Section C, line 19Teays is part of a consolidated financial audit for CAMC Health System, Inc. and Subsidiaries. Consolidated audited financial statements are available on-line at CAMC.org. They are also filed with the WV Health Care Authority where they are available on-line and in person. There is no formal method of making the Bylaws and Conflict of Interest Policy publicly available, but they are available upon request. The Articles of Incorporation are publicly available at the WV Secretary of State's Office.
Explanation of compensation paid to David L. Ramsey:Form 990, Part VII, Section A:The compensation paid to David L. Ramsey reflects payment for his services as President and CEO of Charleston Area Medical Center, Inc., a related organization, not remuneration for his participation on the Board of Trustees of Teays.
Changes in Net Assets or Fund Balances:Form 990, Part XI, line 9:Gain on SWAP transactions from 2008 Bonds 644,467.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CAMC Health System Inc
PO Box 1547CharlestonWV253261547550664138Parent CompanyWV501(c)(3)Line 11, Type III-FIN/A0
Charleston Area Medical Center Inc
PO Box 1547CharlestonWV253261547550526150HospitalWV501(c)(3)Line 31CAMC Health System Inc
CAMC Health Education and Research Institute Inc
PO Box 1547CharlestonWV253261547550753754Medical Educational ResearchWV501(c)(3)Line 11, Type II-FI1CAMC Health System Inc
Charleston Area Medical Center Foundation Inc
PO Box 1547CharlestonWV253261547310887133FoundationWV501(c)(3)Line 11, Type II-FI1CAMC Health System Inc

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
Women & Children's Medical Office Building Partnership
PO Box 1547CharlestonWV253261547550669065Medical Office BuildingWVN/A
General Division Medical Staff Office Building Partnership
PO Box 1547CharlestonWV253261547550623949Medical Office BuildingWVN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Integrated Health Care Providers IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 1547AddressLine1
CityCharlestonCity
StateWVState
ZIP Code253261547ZIPCode
FieldValueIRS element (for citing)
EIN550751010EIN
Primary ActivitySpecialty Physician PracticesPrimaryActivity
Legal Domicile StateWVLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Integrated Health Care Providers Inc
R1271564Contract
Charleston Area Medical Center Inc
M1865131Contract
Charleston Area Medical Center Inc
P23669766FMV
Charleston Area Medical Center Inc
Q1563406FMV
Charleston Area Medical Center Inc
S945034FMV